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Weiler SME, Bissinger M, Rose F, von Bubnoff F, Lutz T, Ori A, Schirmacher P, Breuhahn K. SEPTIN10-mediated crosstalk between cytoskeletal networks controls mechanotransduction and oncogenic YAP/TAZ signaling. Cancer Lett 2024; 584:216637. [PMID: 38242197 DOI: 10.1016/j.canlet.2024.216637] [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: 09/12/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024]
Abstract
The transcriptional co-activators of the Hippo pathway, YAP and TAZ, are regulated by mechanotransduction, which depends on dynamic actin cytoskeleton remodeling. Here, we identified SEPTIN10 as a novel cytoskeletal protein, which is transcriptionally regulated by YAP/TAZ and whose overexpression correlates with poor survival and vascular invasion in hepatocellular carcinoma (HCC) patients. Functional characterization demonstrated that SEPTIN10 promotes YAP/TAZ-dependent cell viability, migration and invasion of liver cancer cells. Mechanistically, SEPTIN10 interacts with actin and microtubule filaments supporting actin stress fiber formation and intracellular tension through binding to CAPZA2 while concurrently inhibiting microtubule polymerization through the blockage of MAP4 function. This functional antagonism is important for cytoskeleton-dependent feedback activation of YAP/TAZ, as microtubule depolymerization induces actin stress fiber formation and subsequently YAP/TAZ activity. Importantly, the crosstalk between microfilaments and microtubules is mediated by SEPTIN10 as its loss abrogates actin stress fiber formation after microtubule disruption. Together, the YAP/TAZ target gene SEPTIN10 controls the dynamic interplay between actin and microtubule filaments, which feeds back on Hippo pathway activity in HCC cells and thus acts as molecular switch with impact on oncogenic signaling and cancer cell biology.
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Affiliation(s)
- Sofia M E Weiler
- Institute of Pathology, University Hospital Heidelberg, 69120, Heidelberg, Germany.
| | - Michaela Bissinger
- Institute of Pathology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Fabian Rose
- Institute of Pathology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Fabian von Bubnoff
- Institute of Pathology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Teresa Lutz
- Institute of Pathology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Alessandro Ori
- Leibniz Institute on Aging - Fritz Lipmann Institute (FLI), 07745, Jena, Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Kai Breuhahn
- Institute of Pathology, University Hospital Heidelberg, 69120, Heidelberg, Germany.
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Helmstaedter C, Lutz T, Wolf V, Witt JA. Prevalence of dementia in a level 4 university epilepsy center: how big is the problem? Front Neurol 2023; 14:1217594. [PMID: 37928163 PMCID: PMC10623304 DOI: 10.3389/fneur.2023.1217594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/27/2023] [Indexed: 11/07/2023] Open
Abstract
Background The relationship between epilepsy and dementia is currently a topic of great interest. Our study aimed to determine the prevalence of dementia diagnoses among patients of a large level 4 university epilepsy center. Methods In this retrospective monocentric study conducted at the Department of Epileptology of the University Hospital Bonn, we searched for dementia-related terms in a total of 145,501 medical letters from 40,360 adult patients who were seen between 2003 and 2021. Files with at least one hit were selected and analyzed with regard to diagnoses, age, age at epilepsy onset, and the question as to whether epilepsy preceded or followed the dementia diagnosis. Results Among the medical letters of 513 patients, dementia-related terms were found. The letters of 12.7% of these patients stated a dementia diagnosis, 6.6% were suspected of having dementia, 4.9% had mild cognitive impairment, and 6.6% had other neurodegenerative diseases without dementia. Taking all 40,360 patients into account, the prevalence of diagnosed or suspected dementia was 0.25%. An older age (≥60 years) and late-onset epilepsy (≥60 years), but not a longer epilepsy duration, increased the odds of dementia by 6.1 (CI 3.5-10.7) and 2.9 (CI 1.7-4.7), respectively. Additionally, vascular, metabolic, inflammatory, and behavioral mood-related comorbidities were commonly observed. Epilepsy tended to precede (23.2%) rather than follow (8.1%) the dementia diagnosis. Conclusion Despite the clear limitations of a selection bias and the potential underdiagnosis of dementia and underestimation of its prevalence when relying on the medical letters from a specialized center which rather focuses on epilepsy-related issues, the findings of this study offer valuable insights from the perspective of an epilepsy center. In this setting, the prevalence of dementia in epilepsy is rather low. However, physicians should be aware that the risk of dementia is higher in the elderly, in late-onset epilepsies, and when comorbid risk factors exist. Seizures can also be an early sign of a neurodegenerative disease. Future research should explicitly screen for dementia in patients with epilepsy and stratify them according to their underlying pathologies and comorbidities.
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Langer MM, Bauschen A, Guckenbiehl S, Klauss S, Lutz T, Denk G, Zwanziger D, Moeller LC, Lange CM. Evolution of non-thyroidal illness syndrome in acute decompensation of liver cirrhosis and acute-on-chronic liver failure. Front Endocrinol (Lausanne) 2023; 14:1104388. [PMID: 36755907 PMCID: PMC9899974 DOI: 10.3389/fendo.2023.1104388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/06/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND AND AIMS Non-thyroidal illness syndrome (NTIS) is frequent in critically ill patients and associated with adverse outcomes. We aimed to characterize the evolution of NTIS in patients with acute decompensation (AD) of cirrhosis and acute-on-chronic liver failure (ACLF), since NTIS is not well described in these newly defined syndromes. METHODS Thyroid hormones (TH) were quantified at baseline in consecutive patients with cirrhosis. In addition, 76 inflammatory mediators were quantified by proximity extension analysis assay in a subgroup of patients. Associations between TH, cirrhosis stage, mortality and inflammation were assessed. RESULTS Overall, 437 patients were included, of whom 165 (37.8%), 211 (48.3%), and 61 (14%) had compensated cirrhosis (CC), AD, and ACLF. FT3 concentrations were lower in AD versus CC, and further decreased in ACLF. Importantly, NTIS was present in 83 (39.3%) patients with AD and in 44 (72.1%) patients with ACLF (P<0.001). Yet, TSH and TSH-based indexes (TSH/FT3-ratio, thyroid index) showed an U-shaped evolution during progression of cirrhosis, suggesting a partially preserved responsiveness of the hypothalamus and pituitary in AD. Infections were associated with lower FT3 concentrations in AD, but not in ACLF. Low FT3 concentrations correlated significantly with 90-day mortality. Both, AD/ACLF and NTIS, were associated with signatures of inflammatory mediators, which were partially non-overlapping. CONCLUSION NTIS is frequent already in AD and therefore precedes critically illness in a subgroup of patients with decompensated cirrhosis. This might constitute a new paradigm of TH signaling in cirrhosis, offering opportunities to explore preventive effects of TH in AD.
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Affiliation(s)
- Mona-May Langer
- Department for Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Department of Internal Medicine II, Ludwig-Maximilians University (LMU) University Hospital Munich, Munich, Germany
| | - Alina Bauschen
- Department for Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sabrina Guckenbiehl
- Department for Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sarah Klauss
- Department of Internal Medicine II, Ludwig-Maximilians University (LMU) University Hospital Munich, Munich, Germany
| | - Teresa Lutz
- Department of Internal Medicine II, Ludwig-Maximilians University (LMU) University Hospital Munich, Munich, Germany
| | - Gerald Denk
- Department of Internal Medicine II, Ludwig-Maximilians University (LMU) University Hospital Munich, Munich, Germany
| | - Denise Zwanziger
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Lars C. Moeller
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Christian M. Lange
- Department for Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Department of Internal Medicine II, Ludwig-Maximilians University (LMU) University Hospital Munich, Munich, Germany
- *Correspondence: Christian M. Lange,
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Ben Khaled N, Allgeier J, Lutz T, Weber S, Lange CM. Medikamentöse Therapie bei Patienten mit Leberzirrhose. Gastroenterologie 2022. [PMCID: PMC9247913 DOI: 10.1007/s11377-022-00635-6] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Die Leberzirrhose ist das Endstadium chronischer Lebererkrankungen und insbesondere im fortgeschrittenen Stadium mit einer hohen Morbidität und Mortalität verbunden. Patienten mit Leberfunktionseinschränkung sind permanent von einer Vielzahl schwerwiegender Komplikationen bedroht. Ein optimales pharmakologisches Management bei Patienten mit Leberinsuffizienz kann die Progression der Grunderkrankung verlangsamen, Hospitalisationen verhindern sowie Lebensqualität und Überleben verbessern. Dieser Artikel gibt einen Überblick über den aktuellen Stand und neue Entwicklungen der Pharmakotherapie bei Patienten mit Leberzirrhose.
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Affiliation(s)
- Najib Ben Khaled
- Medizinische Klinik und Poliklinik II, LMU Klinikum, Marchioninistr. 15, 81377 München, Bayern Deutschland
| | - Julian Allgeier
- Medizinische Klinik und Poliklinik II, LMU Klinikum, Marchioninistr. 15, 81377 München, Bayern Deutschland
| | - Teresa Lutz
- Medizinische Klinik und Poliklinik II, LMU Klinikum, Marchioninistr. 15, 81377 München, Bayern Deutschland
| | - Sabine Weber
- Medizinische Klinik und Poliklinik II, LMU Klinikum, Marchioninistr. 15, 81377 München, Bayern Deutschland
| | - Christian M. Lange
- Medizinische Klinik und Poliklinik II, LMU Klinikum, Marchioninistr. 15, 81377 München, Bayern Deutschland
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Hehlmann MI, Schwartz B, Lutz T, Gómez Penedo JM, Rubel JA, Lutz W. The Use of Digitally Assessed Stress Levels to Model Change Processes in CBT - A Feasibility Study on Seven Case Examples. Front Psychiatry 2021; 12:613085. [PMID: 33767638 PMCID: PMC7985334 DOI: 10.3389/fpsyt.2021.613085] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/15/2021] [Indexed: 01/05/2023] Open
Abstract
In psychotherapy research, the measurement of treatment processes and outcome are predominantly based on self-reports. However, given new technological developments, other potential sources can be considered to improve measurements. In a feasibility study, we examined whether Ecological Momentary Assessments (EMA) using digital phenotyping (stress level) can be a valuable tool to investigate change processes during cognitive behavioral therapy (CBT). Seven outpatients undergoing psychological treatment were assessed using EMA. Continuous stress levels (heart rate variability) were assessed via fitness trackers (Garmin) every 3 min over a 2-week time period (6,720 measurements per patient). Time-varying change point autoregressive (TVCP-AR) models were employed to detect both gradual and abrupt changes in stress levels. Results for seven case examples indicate differential patterns of change processes in stress. More precisely, inertia of stress level changed gradually over time in one of the participants, whereas the other participants showed both gradual and abrupt changes. This feasibility study demonstrates that intensive longitudinal assessments enriched by digitally assessed stress levels have the potential to investigate intra- and interindividual differences in treatment change processes and their relations to treatment outcome. Further, implementation issues and implications for future research and developments using digital phenotyping are discussed.
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Affiliation(s)
| | - Brian Schwartz
- Department of Psychology, University of Trier, Trier, Germany
| | - Teresa Lutz
- Department of Psychology, University of Trier, Trier, Germany
| | - Juan Martín Gómez Penedo
- Department of Psychology, University of Buenos Aires (Consejo Nacional de Investigaciones Científicas y Técnicas), Buenos Aires, Argentina
| | - Julian A Rubel
- Department of Psychology, Justus-Liebig-University, Giessen, Germany
| | - Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany
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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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Marquard S, Thomann S, Weiler SME, Bissinger M, Lutz T, Sticht C, Tóth M, de la Torre C, Gretz N, Straub BK, Marquardt J, Schirmacher P, Breuhahn K. Yes-associated protein (YAP) induces a secretome phenotype and transcriptionally regulates plasminogen activator Inhibitor-1 (PAI-1) expression in hepatocarcinogenesis. Cell Commun Signal 2020; 18:166. [PMID: 33097058 PMCID: PMC7583285 DOI: 10.1186/s12964-020-00634-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 03/10/2020] [Accepted: 07/31/2020] [Indexed: 12/12/2022] Open
Abstract
Background Overexpression and nuclear enrichment of the oncogene yes-associated protein (YAP) cause tumor initiation and support tumor progression in human hepatocellular carcinoma (HCC) via cell autonomous mechanisms. However, how YAP expression in tumor cells affects intercellular communication within the tumor microenvironment is not well understood. Methods To investigate how tumor cell-derived YAP is changing the paracrine communication network between tumor cells and non-neoplastic cells in hepatocarcinogenesis, the expression and secretion of cytokines, growth factors and chemokines were analyzed in transgenic mice with liver-specific and inducible expression of constitutively active YAP (YAPS127A). Transcriptomic and proteomic analyses were performed using primary isolated hepatocytes and blood plasma. In vitro, RNAinterference (RNAi), expression profiling, functional analyses and chromatin immunoprecipitation (ChIP) analyses of YAP and the transcription factor TEA domain transcription factor 4 (TEAD4) were performed using immortalized cell lines. Findings were confirmed in cohorts of HCC patients at the transcript and protein levels. Results YAP overexpression induced the expression and secretion of many paracrine-acting factors with potential impact on tumorous or non-neoplastic cells (e.g. plasminogen activator inhibitor-1 (PAI-1), C-X-C motif chemokine ligand 13 (CXCL13), CXCL16). Expression analyses of human HCC patients showed an overexpression of PAI-1 in human HCC tissues and a correlation with poor overall survival as well as early cancer recurrence. PAI-1 statistically correlated with genes typically induced by YAP, such as connective tissue growth factor (CTGF) and cysteine rich angiogenic inducer 61 (CYR61) or YAP-dependent gene signatures (CIN4/25). In vitro, YAP inhibition diminished the expression and secretion of PAI-1 in murine and human liver cancer cell lines. PAI-1 affected the expression of genes involved in cellular senescence and oncogene-induced senescence was confirmed in YAPS127A transgenic mice. Silencing of TEAD4 as well as treatment with the YAP/TEAD interfering substance Verteporfin reduced PAI-1 expression. ChIP analyses confirmed the binding of YAP and TEAD4 to the gene promoter of PAI-1 (SERPINE1). Conclusions These results demonstrate that the oncogene YAP changes the secretome response of hepatocytes and hepatocyte-derived tumor cells. In this context, the secreted protein PAI-1 is transcriptionally regulated by YAP in hepatocarcinogenesis. Perturbation of these YAP-dependent communication hubs including PAI-1 may represent a promising pharmacological approach in tumors with YAP overexpression. Video abstract
Supplementary information Supplementary information accompanies this paper at 10.1186/s12964-020-00634-6.
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Affiliation(s)
- Simone Marquard
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Thomann
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Sofia M E Weiler
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Michaela Bissinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Teresa Lutz
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Present address: Department of Medicine II, LMU Munich, Munich, Germany
| | - Carsten Sticht
- Medical Faculty Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Marcell Tóth
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Carolina de la Torre
- Medical Faculty Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Norbert Gretz
- Medical Faculty Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Beate K Straub
- Institute of Pathology, Johannes Gutenberg University, Mainz, Germany
| | - Jens Marquardt
- Department of Medicine I, Johannes Gutenberg University, Mainz, Germany.,Present address: Department of Medicine I, University Hospital Lübeck, Lübeck, Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Kai Breuhahn
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
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8
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Jomard A, Chavez-Talavera O, Doytcheva P, Tailleux A, Wolfrum C, Lutz T, Ruschitzka F, von Eckardstein A, Staels B, Osto E. Best Poster Award - Second Prize: Bile Acids as Novel Vascular Signalling Molecules and Therapeutic Target. Eur Cardiol 2020; 15:e25. [PMID: 32612685 PMCID: PMC7312619 DOI: 10.15420/ecr.2020.15.1.po2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | - E Osto
- Schlieren-Zurich, Switzerland
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9
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Braun U, Wiest A, Lutz T, Riond B, Hilbe M, Baumgartner M, Binz T. Hair cortisol concentration in clinically healthy slaughter calves with and -without chronic bronchopneumonic -lesions. SCHWEIZ ARCH TIERH 2020; 161:639-647. [PMID: 31586926 DOI: 10.17236/sat00226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The hypothesis of this study was that healthy calves undergo less stress and thus have lower hair cortisol concentrations than calves with chronic bronchopneumonic lesions. Fifty healthy calves (group 1) and 50 calves with chronic bronchopneumonic lesions (group 2) were used immediately after slaughter, at which time hair samples and both adrenal glands were collected. The hair samples and the left adrenal gland were used for cortisol measurement and the right adrenal gland was used for histological and morphometrical examinations. The median hair cortisol concentrations of calves in groups 1 and 2 were 1.6 and 1.9 pg/mg hair, respectively, and did not differ significantly. The same was true for the mean cortisol concentration of the adrenal gland (1.1 and 1.4 µg/g tissue) and for the adrenal cortisol content (3.7 and 4.6 µg). The weights of the cortex (3.3, mean, and 3.5 g, median) and medulla (1.7 and 1.8 g, both median) did not differ significantly between the groups. This study did not detect differences in hair and adrenal cortisol concentrations between clinically healthy slaughter calves with and without chronic bronchopneumonic lesions. In further studies, calves with clinical signs should be taken into account.
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Affiliation(s)
- U Braun
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
| | - A Wiest
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
| | - T Lutz
- Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zurich
| | - B Riond
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich
| | - M Hilbe
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich
| | - M Baumgartner
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich
| | - T Binz
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich
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10
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Nateqi J, Lin S, Krobath H, Gruarin S, Lutz T, Dvorak T, Gruschina A, Ortner R. [From symptom to diagnosis-symptom checkers re-evaluated : Are symptom checkers finally sufficient and accurate to use? An update from the ENT perspective]. HNO 2019; 67:334-342. [PMID: 30993374 DOI: 10.1007/s00106-019-0666-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Every seventh diagnosis is a misdiagnosis. Each year, 1.5 million lives could be saved worldwide with the correct diagnosis. Physicians have to consider over 20,000 diseases. A study from Harvard University published in 2015 tested 19 symptom checkers and found them to be insufficient, with only 29-71% accuracy in diagnosis. OBJECTIVE The current study investigates the diagnostic accuracy of new symptom checkers from an ENT perspective. MATERIALS AND METHODS The authors update the abovenamed diagnostic accuracy comparison by (1) including the five new symptom checkers Symptoma, Ada, FindZebra, Mediktor, and Babylon; and (2) normalizing results of the previously tested symptom checkers as to reflect each diagnostic accuracy based on the same set of patient vignettes. The winner is then compared to the two symptom checkers with the most scientific evidence, namely Isabel and FindZebra, on the basis of an ENT-specific test with patient vignettes sourced from the British Medical Journal. RESULTS Most of the new symptom checkers demonstrated diagnostic accuracy rates within the previously established range, with the exception of Symptoma, which scored the right diagnosis in 82.2% of cases at the top of the list (+38% points), and in 100% of cases in the top 3 (+29% points) and the top 10 (+16% points), thus raising the bar in this field. The cross-validation with ENT cases resulted in a diagnostic accuracy of 64.3 vs. 21.4 vs. 26.2% (top 1), 92.9 vs. 40.5 vs. 42.9% (top 3), and 100 vs. 61.9 vs. 54.8% (top 10) for Symptoma vs. Isabel vs. FindZebra, respectively. CONCLUSIONS Symptoma is the first and only viable solution in this market. Large-scale studies should be conducted to further validate these results as well as to assess the actual practical performance of the symptom checkers and their ability to diagnose rare diseases.
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Affiliation(s)
- J Nateqi
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich.
| | - S Lin
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - H Krobath
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - S Gruarin
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - T Lutz
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - T Dvorak
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - A Gruschina
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - R Ortner
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
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11
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Wei T, Weiler SME, Tóth M, Sticht C, Lutz T, Thomann S, De La Torre C, Straub B, Merker S, Ruppert T, Marquardt J, Singer S, Gretz N, Schirmacher P, Breuhahn K. YAP-dependent induction of UHMK1 supports nuclear enrichment of the oncogene MYBL2 and proliferation in liver cancer cells. Oncogene 2019; 38:5541-5550. [PMID: 30936457 DOI: 10.1038/s41388-019-0801-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/01/2019] [Accepted: 03/16/2019] [Indexed: 02/03/2023]
Abstract
The oncogene yes-associated protein (YAP) is a key modifier of liver homeostasis and regulates mitosis in hepatocytes as well as in malignantly transformed cells. However, the question of how YAP supports cell proliferation in hepatocellular carcinoma (HCC) is not well understood. Here we identified U2AF momology motif kinase 1 (UHMK1) as a direct transcriptional target of YAP and the transcription factor forkhead box M1 (FOXM1), which supports HCC cell proliferation but not migration. Indeed, UHMK1 stimulates the expression of genes that are specific for cell cycle regulation and which are known downstream effectors of YAP. By using BioID labeling and mass spectrometry, the dimerization partner, RB-like, E2F and multi-vulval class B (DREAM) complex constituent MYB proto-oncogene like 2 (MYBL2, B-MYB) was identified as a direct UHMK1 interaction partner. Like YAP, UHMK1 stimulates nuclear enrichment of MYBL2, which is associated HCC cell proliferation and the expression of the cell cycle regulators CCNB1, CCNB2, KIF20A, and MAD2L1. The association between YAP, UHMK1, MYBL2, and proliferation was confirmed in YAPS127A-transgenic mice and human HCC tissues. In summary, we provide a model by which YAP supports cell proliferation through the induction of important cell cycle regulators in a UHMK1- and MYBL2-dependent manner.
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Affiliation(s)
- Teng Wei
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Marcell Tóth
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Carsten Sticht
- Medical Faculty Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Teresa Lutz
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Thomann
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Carolina De La Torre
- Medical Faculty Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Beate Straub
- Institute of Pathology, Johannes Gutenberg University, Mainz, Germany
| | - Sabine Merker
- Zentrum für Molekulare Biologie der Universität Heidelberg (ZMBH), DKFZ-ZMBH Alliance, Heidelberg, Germany
| | - Thomas Ruppert
- Zentrum für Molekulare Biologie der Universität Heidelberg (ZMBH), DKFZ-ZMBH Alliance, Heidelberg, Germany
| | - Jens Marquardt
- Department of Medicine I, Johannes Gutenberg University, Mainz, Germany
| | - Stephan Singer
- Institute of Pathology, University Medicine Greifswald, Greifswald, Germany
| | - Norbert Gretz
- Medical Faculty Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Kai Breuhahn
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
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12
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Heiligenhaus A, Minden K, Tappeiner C, Baus H, Bertram B, Deuter C, Foeldvari I, Föll D, Frosch M, Ganser G, Gaubitz M, Günther A, Heinz C, Horneff G, Huemer C, Kopp I, Lommatzsch C, Lutz T, Michels H, Neß T, Neudorf U, Pleyer U, Schneider M, Schulze-Koops H, Thurau S, Zierhut M, Lehmann HW. Update of the evidence based, interdisciplinary guideline for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis. Semin Arthritis Rheum 2018; 49:43-55. [PMID: 30595409 DOI: 10.1016/j.semarthrit.2018.11.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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: 08/20/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Uveitis in juvenile idiopathic arthritis (JIAU) is frequently associated with the development of complications and visual loss. Topical corticosteroids are the first line therapy, and disease modifying anti-rheumatic drugs (DMARDs) are commonly used. However, treatment has not been standardized. METHODS Interdisciplinary guideline were developed with representatives from the German Ophthalmological Society, Society for Paediatric Rheumatology, Professional Association of Ophthalmologists, German Society for Rheumatology, parents' group, moderated by the Association of the Scientific Medical Societies in Germany. A systematic literature analysis in MEDLINE was performed, evidence and recommendations were graded, an algorithm for anti-inflammatory treatment and final statements were discussed in a consensus meeting (Nominal Group Technique), a preliminary draft was fine-tuned and discussed thereafter by all participants (Delphi procedure). RESULTS Consensus was reached on recommendations, including a standardized treatment strategy according to uveitis severity in the individual patient. Thus, methotrexate shall be introduced for uveitis not responding to low-dose (≤ 2 applications/day) topical corticosteroids, and a TNFalpha antibody (preferably adalimumab) used, if uveitis inactivity is not achieved. In very severe active uveitis with uveitis-related deterioration of vision, systemic corticosteroids should be considered for bridging until DMARDs take effect. If TNFalpha antibodies fail to take effect or lose effect, another biological should be selected (tocilizumab, abatacept or rituximab). De-escalation of DMARDs should be preceded by a period of ≥ 2 years of uveitis inactivity. CONCLUSIONS An interdisciplinary, evidence-based treatment guideline for JIAU is presented.
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Affiliation(s)
- A Heiligenhaus
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany.
| | - K Minden
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - C Tappeiner
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - H Baus
- The Participation of the Following Bodies: Parents' Group for Children with Uveitis and their Families, Germany
| | - B Bertram
- Professional Association of Ophthalmologists (BVA), Germany
| | - C Deuter
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - I Foeldvari
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - D Föll
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - M Frosch
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - G Ganser
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - M Gaubitz
- German Society of Rheumatology (DGRh), Germany
| | - A Günther
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - C Heinz
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - G Horneff
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - C Huemer
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - I Kopp
- Association of the Scientific Medical Societies in Germany (AWMF), Germany
| | - C Lommatzsch
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - T Lutz
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - H Michels
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - T Neß
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - U Neudorf
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - U Pleyer
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - M Schneider
- German Society of Rheumatology (DGRh), Germany
| | | | - S Thurau
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - M Zierhut
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - H W Lehmann
- The Society for Paediatric Rheumatology (GKJR), Germany
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13
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Lutz T. Amylin and the area postrema, but not only there. Appetite 2018. [DOI: 10.1016/j.appet.2018.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Massella L, Mekahli D, Paripović D, Prikhodina L, Godefroid N, Niemirska A, Ağbaş A, Kalicka K, Jankauskiene A, Mizerska-Wasiak M, Afonso AC, Salomon R, Deschênes G, Ariceta G, Özçakar ZB, Teixeira A, Duzova A, Harambat J, Seeman T, Hrčková G, Lungu AC, Papizh S, Peco-Antic A, De Rechter S, Giordano U, Kirchner M, Lutz T, Schaefer F, Devuyst O, Wühl E, Emma F. Prevalence of Hypertension in Children with Early-Stage ADPKD. Clin J Am Soc Nephrol 2018; 13:874-883. [PMID: 29674338 PMCID: PMC5989684 DOI: 10.2215/cjn.11401017] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [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: 10/11/2017] [Accepted: 02/27/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Autosomal dominant polycystic kidney disease is the most common inheritable kidney disease, frequently thought to become symptomatic in adulthood. However, patients with autosomal dominant polycystic kidney disease may develop signs or symptoms during childhood, in particular hypertension. Although ambulatory BP monitoring is the preferred method to diagnose hypertension in pediatrics, data in children with autosomal dominant polycystic kidney disease are limited. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Our retrospective multicenter study was conducted to collect ambulatory BP monitoring recordings from patients with autosomal dominant polycystic kidney disease age <18 years old. Basic anthropometric parameters as well as data on kidney function, BP treatment, and kidney ultrasound were also collected. RESULTS Data from 310 children with autosomal dominant polycystic kidney disease with a mean age of 11.5±4.1 years old were collected at 22 European centers. At the time when ambulatory BP monitoring was performed, 95% of children had normal kidney function. Reference data for ambulatory BP monitoring were available for 292 patients. The prevalence rates of children with hypertension and/or those who were treated with antihypertensive drugs were 31%, 42%, and 35% during daytime, nighttime, or the entire 24-hour cycle, respectively. In addition, 52% of participants lacked a physiologic nocturnal BP dipping, and 18% had isolated nocturnal hypertension. Logistic regression analysis showed a significant association between a categorical cyst score that was calculated on the basis of the number of cysts >1 cm per kidney and daytime hypertension (odds ratio, 1.70; 95% confidence interval, 1.21 to 2.4; P=0.002), nighttime hypertension (odds ratio, 1.31; 95% confidence interval, 1.05 to 1.63; P=0.02), or 24-hour hypertension (odds ratio, 1.39; 95% confidence interval, 1.08 to 1.81; P=0.01). Kidney length, expressed as SD score, was also significantly associated with nighttime hypertension (odds ratio, 1.23; 95% confidence interval, 1.06 to 1.42; P=0.10). CONCLUSIONS These data indicate high prevalence of hypertension in children with autosomal dominant polycystic kidney disease starting at young ages.
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Affiliation(s)
- Laura Massella
- Division of Nephrology, Department of Pediatric Subspecialties, and
| | - Djalila Mekahli
- Polycystic Kidney Disease Research Group, Laboratory of Pediatrics, Department of Development and Regeneration, Gynaecology Pediatrics and Urology (G-PURE), Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Dušan Paripović
- Nephrology Department, University Children’s Hospital, Belgrade, Serbia
| | - Larisa Prikhodina
- Department of Inherited and Acquired Kidney Diseases, Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Nathalie Godefroid
- Department of Pediatrics, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Anna Niemirska
- Department of Nephrology, Kidney Transplantation and Arterial Hypertension, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Ayşe Ağbaş
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Karolina Kalicka
- Department of Pediatric Nephrology, Medical University in Lublin, Lublin, Poland
| | | | | | - Alberto Caldas Afonso
- Centro Materno Infantil do Norte, Centro Hospitalar do Porto, Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal
| | - Rémi Salomon
- Department of Pediatric Nephrology, Assistance Publique Hôpitaux de Paris, Necker Enfant Malades, Descartes University, Paris, France
- Reference Centre of Hereditary Renal Diseases of the Child and Adult, Assistance Publique Hôpitaux de Paris, Necker Enfants Malades, Paris, France
| | - Georges Deschênes
- Division of Pediatric Nephrology, Assistance Publique Hôpitaux de Paris, Robert Debré, Sorbonne University, Paris, France
| | - Gema Ariceta
- Pediatric Nephrology Service, University Hospital Vall d’Hebrón, Universidad Autonoma de Barcelona, Barcelona, Spain
| | - Z. Birsin Özçakar
- Division of Pediatric Nephrology and Rheumatology, Department of Pediatrics, Ankara University Medical School, Ankara, Turkey
| | - Ana Teixeira
- Pediatric Nephrology Unit, Centro Hospitalar São João, Porto, Portugal
| | - Ali Duzova
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Jérôme Harambat
- Pediatric Nephrology Unit, Bordeaux University Hospital, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1219, Bordeaux, France
| | - Tomáš Seeman
- Department of Pediatrics, 2nd Medical Faculty, University Hospital Motol, Charles University Prague, Prague, Czech Republic
| | - Gabriela Hrčková
- Department of Pediatrics of the Faculty of Medicine, Comenius University in Bratislava and the University Children’s Hospital Bratislava, Bratislava, Slovakia
| | | | - Svetlana Papizh
- Department of Inherited and Acquired Kidney Diseases, Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Amira Peco-Antic
- Nephrology Department, University Children's Hospital and School of Medicine, University of Belgrade, Serbia
| | - Stéphanie De Rechter
- Polycystic Kidney Disease Research Group, Laboratory of Pediatrics, Department of Development and Regeneration, Gynaecology Pediatrics and Urology (G-PURE), Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Ugo Giordano
- Arterial Hypertension Unit, Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Marietta Kirchner
- Department of Medical Biometry, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Teresa Lutz
- Pediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Franz Schaefer
- Pediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Olivier Devuyst
- Institute of Physiology, University of Zurich, Zurich, Switzerland; and
- Division of Nephrology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Elke Wühl
- Pediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Francesco Emma
- Division of Nephrology, Department of Pediatric Subspecialties, and
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15
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von Felden J, Vermehren J, Ingiliz P, Mauss S, Lutz T, Simon KG, Busch HW, Baumgarten A, Schewe K, Hueppe D, Boesecke C, Rockstroh JK, Daeumer M, Luebke N, Timm J, Schulze Zur Wiesch J, Sarrazin C, Christensen S. High efficacy of sofosbuvir/velpatasvir and impact of baseline resistance-associated substitutions in hepatitis C genotype 3 infection. Aliment Pharmacol Ther 2018. [PMID: 29536554 DOI: 10.1111/apt.14592] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Twelve weeks of the pangenotypic direct-acting antiviral (DAA) combination sofosbuvir/velpatasvir (SOF/VEL) was highly efficient in patients with hepatitis C virus (HCV) genotype 3 (GT3) infection in the ASTRAL-3 approval study. However, presence of resistance-associated substitutions (RASs) in the HCV nonstructural protein 5A (NS5A) was associated with lower treatment response. AIM To assess the efficacy and safety of SOF/VEL ± ribavirin (RBV) and the impact of NS5A RASs and RBV use on treatment outcome in HCV GT3 infection in a real-world setting. METHODS In this multicentre cohort study, GT3 patients from ten treatment centres across Germany were included. Sustained virological response was assessed 12 weeks after end-of-treatment (SVR12) in modified intention-to-treat (mITT) and per-protocol analysis (PP). NS5A RASs were tested by population-based sequencing. RESULTS A total of 293 GT3 patients were included. The median age was 48 years, 70% were male, 25.3% were cirrhotic, 9.2% were HCV/HIV co-infected and 21.8% were treatment-experienced, including 4.1% with DAA experience. Baseline NS5A RASs (Y93H, A30K, L31M) were detected in 11.2%. RBV was added in 5% of noncirrhotic and 58.9% of cirrhotic patients, respectively. SVR12 rates for SOF/VEL±RBV were 95.9% (mITT) and 99.5% (PP), respectively. Only 1 virological relapse occurred in a cirrhotic patient previously treated with SOF/RBV. No treatment-related major adverse events occurred. CONCLUSION Twelve weeks of SOL/VEL±RBV was safe and highly efficient in HCV GT3 across a diverse patient population. Baseline NS5A RASs were rarely observed and presence did not seem to impact SVR, regardless of the use of RBV.
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16
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Bielak M, Husmann E, Weyandt N, Haas JP, Hügle B, Horneff G, Neudorf U, Lutz T, Lilienthal E, Kallinich T, Tenbrock K, Berendes R, Niehues T, Wittkowski H, Weißbarth-Riedel E, Heubner G, Oommen P, Klotsche J, Foell D, Lainka E. IL-6 blockade in systemic juvenile idiopathic arthritis - achievement of inactive disease and remission (data from the German AID-registry). Pediatr Rheumatol Online J 2018; 16:22. [PMID: 29622022 PMCID: PMC5887199 DOI: 10.1186/s12969-018-0236-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/09/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Systemic juvenile idiopathic arthritis (sJIA) is a complex disease with an autoinflammatory component of unknown etiology related to the innate immune system. A major role in the pathogenesis has been ascribed to proinflammatory cytokines like interleukin-6 (IL-6), and effective drugs inhibiting their signaling are being developed. This study evaluates sJIA patients treated with the IL-6 inhibitor tocilizumab (TCZ) concerning clinical response rate, disease course and adverse effects in a real-life clinical setting. METHODS In 2009 a clinical and research consortium was established, including an online registry for autoinflammatory diseases (AID) ( https://aid-register.de ). Data for this retrospective TCZ study were documented by 13 centers. RESULTS From 7/2009 to 4/2014, 200 patients with sJIA were recorded in the AID-registry. Out of these, 46 (19 m, 27 f, age 1-18 years) received therapy with TCZ. Long term treatment (median 23 months) has been documented in 24/46 patients who were evaluated according to Wallace criteria (active disease 6/24, inactive disease 5/24, remission 13/24 cases). Under observation co-medication were used in 40/46 cases. Adverse events were reported in 11/46 patients. The clinical response rate (no clinical manifestation, no increased inflammation parameters) within the first 12 weeks of treatment was calculated to be 35%. CONCLUSION Out of 200 sJIA children reported in the German AID-registry, 46 were treated with TCZ, showing a clinical response rate of 35% during the first 12 weeks, and inactive disease and/or remission under medication in 75% after one year. Adverse events were seen in 24% and severe adverse events in 4%. TRIAL REGISTRATION The AID-Registry is funded by the BMBF (01GM08104, 01GM1112D, 01GM1512D).
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Affiliation(s)
- M. Bielak
- Department of Pediatric Rheumatology, University Children’s Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - E. Husmann
- Department of Pediatric Rheumatology, University Children’s Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - N. Weyandt
- Department of Pediatric Rheumatology, University Children’s Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - J.-P. Haas
- German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - B. Hügle
- German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - G. Horneff
- Department of Pediatrics, Asklepios Clinic Sankt Augustin, Centre for Pediatric Rheumatology, Sankt Augustin, Germany ,0000 0000 8852 305Xgrid.411097.aDepartment of Pediatric and Adolescents medicine, Medical faculty, University Hospital of Cologne, Cologne, Germany
| | - U. Neudorf
- Department of Pediatric Rheumatology, University Children’s Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - T. Lutz
- 0000 0001 0328 4908grid.5253.1Center for Pediatric and Adolescent Medicine/Pediatric Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - E. Lilienthal
- 0000 0004 0490 981Xgrid.5570.7Department of Pediatrics, Ruhr-University Bochum, Bochum, Germany
| | - T. Kallinich
- 0000 0001 2218 4662grid.6363.0Department of Pediatric Pneumology and Immunology and Center for Chronically Sick Children of the Charité, Charité University Medicine Berlin, Berlin, Germany
| | - K. Tenbrock
- 0000 0001 0728 696Xgrid.1957.aDepartment of Pediatric Pneumology, Allergology and Immunology, RWTH Aachen University, Aachen, Germany
| | - R. Berendes
- Department of Pediatric Rheumatology, St. Marien’s Children’s Hospital Landshut, Landshut, Germany
| | - T. Niehues
- HELIOS Children’s Hospital Krefeld, Pediatric Immunology and Rheumatology, Krefeld, Germany
| | - H. Wittkowski
- 0000 0001 2172 9288grid.5949.1Department of Pediatric Rheumatology and Immunology, University of Münster, Münster, Germany
| | - E. Weißbarth-Riedel
- 0000 0001 2180 3484grid.13648.38Department of Pediatric Rheumatology, University Children’s Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - G. Heubner
- Children’s Hospital Dresden-Neustadt, Dresden, Germany
| | - P. Oommen
- 0000 0001 2176 9917grid.411327.2Department of Pediatric Oncology, Hematology and Clinical Immunology, Center for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - J. Klotsche
- 0000 0000 9323 8675grid.418217.9German Rheumatism Research Centre Berlin, Berlin, Germany
| | - Dirk Foell
- 0000 0001 2172 9288grid.5949.1Department of Pediatric Rheumatology and Immunology, University of Münster, Münster, Germany
| | - E. Lainka
- Department of Pediatric Rheumatology, University Children’s Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
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Jomard A, Doytcheva P, Deuel J, Luscher T, Wolfrum C, Lutz T, Osto E. P533The functional relevance of HDL structure and composition in the improvement of cholesterol efflux capacity after Roux-en-Y gastric bypass. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.389] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Jomard
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Laboratory of Translational Nutrition Biology, Zurich, Switzerland
| | - P Doytcheva
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - J Deuel
- University Hospital Zurich, Internal medicine, Zurich, Switzerland
| | - T Luscher
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - C Wolfrum
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Laboratory of Translational Nutrition Biology, Zurich, Switzerland
| | - T Lutz
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - E Osto
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
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18
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Bischoff J, Mauss S, Cordes C, Lutz T, Scholten S, Moll A, Jäger H, Cornberg M, Manns MP, Baumgarten A, Rockstroh JK. Rates of sustained virological response 12 weeks after the scheduled end of direct-acting antiviral (DAA)-based hepatitis C virus (HCV) therapy from the National German HCV registry: does HIV coinfection impair the response to DAA combination therapy? HIV Med 2018; 19:299-307. [PMID: 29368456 DOI: 10.1111/hiv.12579] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The European Association for the Study of the Liver (EASL) treatment recommendations for hepatitis C no longer discriminate between HIV/hepatitis C virus (HCV)-coinfected and HCV-monoinfected patients. However, recent data from Spain are questioning these recommendations on the basis of the findings of higher relapse rates and lower cure rates in HIV/HCV-infected subjects. The aim of our study was to compare HCV cure rates in monoinfected and coinfected patients from Germany. METHODS Data acquired from the Deutsches Hepatitis C-Registry were analysed. A total of 5657 HCV-monoinfected subjects and 488 HIV/HCV-coinfected patients were included in the study. Rates of sustained virological response 12 weeks after the scheduled end of therapy (SVR12) were collected in both subgroups and in cirrhotic and noncirrhotic patients. RESULTS HIV/HCV-coinfected patients were more frequently male (84.6% vs. 56.4%, respectively; P < 0.001) and younger than HCV-monoinfected subjects (46.5 ± 9 vs. 53.8 ± 12.5 years, respectively; P < 0.001). The CD4 blood cell count was > 350 cells/μL in 63.1% of HIV-positive subjects and 88.7% were on antiretroviral therapy. SVR12 rates were 90.3% (5111 of 5657) in our HCV-monoinfected cohort and 91.2% (445 of 488) in our coinfected patients. Liver cirrhosis was confirmed in 1667 of 5657 (29.5%) monoinfected patients and 84 of 488 (17.2%; P < 0.001) coinfected patients. SVR12 rates did not differ between HCV-monoinfected and HIV/HCV-coinfected patients with liver cirrhosis (87.8% vs. 89.3%, respectively; P = 0.864). A treatment duration of 8 weeks did not reduce the percentage of patients with SVR12 in either subgroup (93.7% in both groups). CONCLUSIONS We found high SVR12 rates in monoinfected as well as coinfected individuals. No differences were detected between the two subgroups regardless of whether there was accompanying liver cirrhosis or a shortened treatment duration.
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Affiliation(s)
- J Bischoff
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - S Mauss
- Center for HIV and Hepatogastroenterology, Duesseldorf, Germany
| | - C Cordes
- Praxis Dr. Cordes, Berlin, Germany
| | - T Lutz
- Infektiologikum, Frankfurt, Germany
| | - S Scholten
- Dr. Scholten und Schneeweiß GbR, Köln, Germany
| | - A Moll
- Praxiszentrum Kaiserdamm, Berlin, Germany
| | - H Jäger
- MVZ Karlsplatz, Munich, Germany
| | - M Cornberg
- Hannover Medical School, Hannover, Germany
| | - M P Manns
- Hannover Medical School, Hannover, Germany
| | - A Baumgarten
- Center for Infectious Diseases, Berlin, Prenzlauer Berg, Germany
| | - J K Rockstroh
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
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19
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Welzel TM, Hinrichsen H, Sarrazin C, Buggisch P, Baumgarten A, Christensen S, Berg T, Mauss S, Teuber G, Stein K, Deterding K, van Bömmel F, Heyne R, John C, Zimmermann T, Lutz T, Schott E, Hettinger J, Kleine H, König B, Hüppe D, Wedemeyer H. Real-world experience with the all-oral, interferon-free regimen of ombitasvir/paritaprevir/ritonavir and dasabuvir for the treatment of chronic hepatitis C virus infection in the German Hepatitis C Registry. J Viral Hepat 2017; 24:840-849. [PMID: 28342229 DOI: 10.1111/jvh.12708] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 02/16/2017] [Indexed: 12/13/2022]
Abstract
Real-world studies are relevant to complement clinical trials on novel antiviral therapies against chronic hepatitis C; however, clinical practice data are currently limited. This study investigated effectiveness and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r)±dasabuvir (DSV)±ribavirin (RBV) for treatment of HCV genotype (GT) 1 and GT4 infection in a large real-world cohort. The German Hepatitis C Registry is an observational cohort study prospectively collecting clinical practice data on direct-acting antiviral therapies. Patients with GT1/4 infection treated with OBV/PTV/r±DSV±RBV were analysed. Effectiveness was assessed by sustained virologic response in 558 patients who reached post-treatment week 12 (SVR12). Safety is reported in 1017 patients who initiated treatment. Of the patients, 892 (88%) had GT1 and 125 (12%) had GT4 infection. Prior treatment experience and cirrhosis were reported in 598 (59%) and 228 (22%) patients, respectively. Overall, SVR12 (mITT) was 96% (486/505) in GT1- and 100% (53/53) in GT4 patients. SVR12 rates were high across subgroups including patients with cirrhosis (95%, 123/129), patients with moderate to severe renal impairment (100%, 34/34), and subgroups excluded from registrational trials like patients ≥70 years (96%, 64/67) and failures to prior protease inhibitor treatment (96%, 46/48). Adverse events (AEs) and serious AEs were reported in 52% (525/1017) and 2% (21/1017) of patients, respectively, and led to treatment discontinuation in 1.5% (15/1017) of patients. OBV/PTV/r±DSV±RBV was effective and generally well tolerated for treatment of HCV infection in clinical practice.
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Affiliation(s)
- T M Welzel
- Department of Medicine 1, University Hospital, J.W. Goethe University, Frankfurt am Main, Germany
| | - H Hinrichsen
- Gastroenterology-Hepatology Center Kiel, Kiel, Germany
| | - C Sarrazin
- Department of Medicine 1, University Hospital, J.W. Goethe University, Frankfurt am Main, Germany.,Medical Department II, Gastroenterology, Hepatology, Infectiology, St. Josefs-Hospital, Wiesbaden, Germany
| | - P Buggisch
- Liver Unit, Asklepios Clinic St. Georg, IFI-Institute, Hamburg, Germany
| | | | - S Christensen
- Center for Interdisciplinary Medicine (CIM), Münster, Germany
| | - T Berg
- Section of Hepatology, Clinic for Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - S Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - G Teuber
- Private Practice, Frankfurt am Main, Germany
| | - K Stein
- Hepatologie - Magdeburg, Magdeburg, Germany
| | - K Deterding
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - F van Bömmel
- Section of Hepatology, Clinic for Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - R Heyne
- Leberzentrum am Checkpoint Berlin, Berlin, Germany
| | - C John
- Private Practice for Internal Medicine, Berlin, Germany
| | - T Zimmermann
- Department of Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - T Lutz
- Infektiologikum, Frankfurt am Main, Germany
| | - E Schott
- Department of Hepatology and Gastroenterology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J Hettinger
- AbbVie Deutschland GmbH & Co KG, Wiesbaden, Germany
| | - H Kleine
- AbbVie Deutschland GmbH & Co KG, Wiesbaden, Germany
| | - B König
- AbbVie Deutschland GmbH & Co KG, Wiesbaden, Germany
| | - D Hüppe
- Center for Gastroenterology and Hepatology, Herne
| | - H Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
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20
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Marzolla V, Taheri A, Caprio M, Wolfrum C, Lutz T, Luscher T, Osto E. P3477Role of glucagon-like peptides and glucagon in the control of vascular function. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3477] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Weiler SME, Pinna F, Wolf T, Lutz T, Geldiyev A, Sticht C, Knaub M, Thomann S, Bissinger M, Wan S, Rössler S, Becker D, Gretz N, Lang H, Bergmann F, Ustiyan V, Kalin TV, Singer S, Lee JS, Marquardt JU, Schirmacher P, Kalinichenko VV, Breuhahn K. Induction of Chromosome Instability by Activation of Yes-Associated Protein and Forkhead Box M1 in Liver Cancer. Gastroenterology 2017; 152:2037-2051.e22. [PMID: 28249813 DOI: 10.1053/j.gastro.2017.02.018] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/07/2017] [Accepted: 02/19/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Many different types of cancer cells have chromosome instability. The hippo pathway leads to phosphorylation of the transcriptional activator yes-associated protein 1 (YAP1, YAP), which regulates proliferation and has been associated with the development of liver cancer. We investigated the effects of hippo signaling via YAP on chromosome stability and hepatocarcinogenesis in humans and mice. METHODS We analyzed transcriptome data from 242 patients with hepatocellular carcinoma (HCC) to search for gene signatures associated with chromosomal instability (CIN); we investigated associations with overall survival time and cancer recurrence using Kaplan-Meier curves. We analyzed changes in expression of these signature genes, at mRNA and protein levels, after small interfering RNA-mediated silencing of YAP in Sk-Hep1, SNU182, HepG2, or pancreatic cancer cells, as well as incubation with thiostrepton (an inhibitor of forkhead box M1 [FOXM1]) or verteporfin (inhibitor of the interaction between YAP and TEA domain transcription factor 4 [TEAD4]). We performed co-immunoprecipitation and chromatin immunoprecipitation experiments. We collected liver tissues from mice that express a constitutively active form of YAP (YAPS127A) and analyzed gene expression signatures and histomorphologic parameters associated with chromosomal instability. Mice were given injections of thiostrepton and livers were collected and analyzed by immunoblotting, immunohistochemistry, histology, and real-time polymerase chain reaction. We performed immunohistochemical analyses on tissue microarrays of 105 HCCs and 7 nontumor liver tissues. RESULTS Gene expression patterns associated with chromosome instability, called CIN25 and CIN70, were detected in HCCs from patients with shorter survival time or early cancer recurrence. TEAD4 and YAP were required for CIN25 and CIN70 signature expression via induction and binding of FOXM1. Disrupting the interaction between YAP and TEAD4 with verteporfin, or inhibiting FOXM1 with thiostrepton, reduced the chromosome instability gene expression patterns. Hyperplastic livers and tumors from YAPS127A mice had increased CIN25 and CIN70 gene expression patterns, aneuploidy, and defects in mitosis. Injection of YAPS127A mice with thiostrepton reduced liver overgrowth and signs of chromosomal instability. In human HCC tissues, high levels of nuclear YAP correlated with increased chromosome instability gene expression patterns and aneuploidy. CONCLUSIONS By analyzing cell lines, genetically modified mice, and HCC tissues, we found that YAP cooperates with FOXM1 to contribute to chromosome instability. Agents that disrupt this pathway might be developed as treatments for liver cancer. Transcriptome data are available in the Gene Expression Omnibus public database (accession numbers: GSE32597 and GSE73396).
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Affiliation(s)
- Sofia M E Weiler
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Federico Pinna
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Wolf
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Teresa Lutz
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Aman Geldiyev
- International Educational-Scientific Center, Ashgabat City, Turkmenistan
| | - Carsten Sticht
- Medical Faculty Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Maria Knaub
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Thomann
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Michaela Bissinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Shan Wan
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephanie Rössler
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Diana Becker
- Department of Medicine I, Johannes Gutenberg University, Mainz, Germany
| | - Norbert Gretz
- Medical Faculty Mannheim, Medical Research Center, University of Heidelberg, Mannheim, Germany
| | - Hauke Lang
- Department of Medicine I, Johannes Gutenberg University, Mainz, Germany
| | - Frank Bergmann
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Vladimir Ustiyan
- Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Tatiana V Kalin
- Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stephan Singer
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ju-Seog Lee
- Department of Systems Biology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jens U Marquardt
- Department of Medicine I, Johannes Gutenberg University, Mainz, Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Vladimir V Kalinichenko
- Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kai Breuhahn
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
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Naumann U, Moll A, Schleehauf D, Lutz T, Schmidt W, Jaeger H, Funke B, Witte V. Similar efficacy and tolerability of raltegravir-based antiretroviral therapy in HIV-infected patients, irrespective of age group, burden of comorbidities and concomitant medication: Real-life analysis of the German 'WIP' cohort. Int J STD AIDS 2016; 28:893-901. [PMID: 28385065 PMCID: PMC5513442 DOI: 10.1177/0956462416679550] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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] [Indexed: 11/18/2022]
Abstract
Only limited efficacy and tolerability data on raltegravir (RAL) use are currently available. Study objectives were to describe the efficacy and tolerability profile of RAL-based antiretroviral therapy (ART) in routine clinical practice in Germany. The WIP study (WIP = “Wirksamkeit von Isentress unter Praxisbedingungen”, Efficacy of Isentress under routine clinical conditions) was a prospective, multi-centre cohort study in Germany. Human immunodeficiency virus (HIV)-infected patients aged ≥ 18 years in whom combinational ART with RAL 400 mg BID was indicated were enrolled. The primary endpoint was virologic response (HIV-RNA <50 copies/mL; non-completion equals failure) after 48 weeks. Of 451 patients, 85.1% (n = 384) were still receiving RAL at week 48. At baseline (BL), the prevalence of concomitant diseases was higher in patients of the age group ≥50 years (94.2% vs. 75.7%) as well as concomitant medications (74.8 % vs. 55.4%). Virologic response at week 48 was 74.7% (overall), 75.0% (naïve at BL), 81.5% (suppressed at BL), 47.1% (interrupted previous treatment at BL) and 64.9% (failing at BL), without significant differences by age group. A significant correlation of achievement of HIV-RNA <50 copies/mL was seen with treatment status at BL (p = 0.004). In addition, 77.3 % of the patients with a CD4 cell count >200 cells/µL at BL achieved HIV-RNA <50 copies/mL (p = 0.029). RAL was well tolerated with 80 adverse events (AEs) in 49 patients (10.9%) and 8 serious AEs (SAEs) in 6 patients (1.3%) reported to be drug related. A total of 22 patients (4.9%) discontinued treatment due to AEs. The WIP study shows that the previously reported efficacy and safety profile of RAL can be achieved in a population with multiple comorbidities and comedications, with no major difference observed in ageing patients (≥50 years) vs. younger patients. RAL is therefore an attractive treatment option in routine medical care in Germany.
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Affiliation(s)
- U Naumann
- 1 Praxiszentrum Kaiserdamm, Berlin, Germany
| | - A Moll
- 1 Praxiszentrum Kaiserdamm, Berlin, Germany
| | | | - T Lutz
- 2 Infektiologikum Frankfurt, Frankfurt, Germany
| | - W Schmidt
- 3 MVZ Ärzteforum Seestrasse, Berlin, Germany
| | - H Jaeger
- 4 MVZ Karlsplatz, HIV Research and Clinical Care Centre, Munich, Germany
| | - B Funke
- 5 MSD Sharp & Dohme GmbH, Haar, Germany
| | - V Witte
- 5 MSD Sharp & Dohme GmbH, Haar, Germany
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Wan S, Meyer AS, Weiler S, Lutz T, Roessler S, Schirmacher P, Pinna F, Breuhahn K. Abstract 1130: Subcellular localization of the cell polarity protein Scribble defines its oncogenic activity in hepatocellular carcinoma. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-1130] [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: 11/16/2022]
Abstract
Abstract
Background:
Disturbance of hepatocyte polarity is frequently observed in liver cancer tissues; however, it is still controversially discussed if this phenotype represents the cause or the result of tumorigenesis. Due to their multi-functional properties, hepatocytes are characterized by distinct luminal, lateral and basal domains that are defined by specific protein complex. These cell protein complexes such as the apical Crumbs- (CRB3, Pals1, Patj), the lateral Par- (Par3, Par6, aPKC) and the basolateral Scribble-complex (Scrib, Dlg, Lgl) are essential for the formation of hepatocellular polarity. So far, it is unknown if and which protein complex constituents are involved in liver tumor development and how these factors induce possible downstream effector mechanisms.
Methods:
To identify complex proteins that affect hepatocellular polarity, a siRNA screen targeting all relevant polarity factors was performed in HCC cells that form bile canaliculi in vitro (HepG2). Localization of Scribble in HCC cell lines and human HCC tissues was analyzed by western immunoblotting and immunofluorescence. Expression vectors containing wildtype Scribble and an isoform lacking polarity complex binding capacity were cloned (Scrib-wt, Scrib-P305L) and stably transfected in HCC cells. The impact of these isoforms on PI3K/AKT signaling pathway activity and cell viability were analyzed. In addition, the interaction of Scrib-wt, Scrib-P305L with phosphatases regulating the PI3K/AKT pathway was tested by Co-IP analysis.
Results:
The siRNA screen revealed that Scribble strongly affects hepatocellular polarity. Scribble located near the membrane in polarized cells (e.g., HepG2, HuH-1) but in the cytoplasm in non-polarized cells (HLE, HLF). Scribble overexpression and cytoplasmic accumulation correlates with poor overall survival of HCC patients. In vitro, the inhibition of Scribble reduced and overexpression of cytoplasmic Scribble (Scrib-P305L) induced AKT phosphorylation. In addition, Scrib-P305L supported HCC cell viability in an AKT-dependent manner. Immunofluorescence revealed co-localization of Scribble with the AKT phosphatases PTEN and PHLPP1. Co-IP studies revealed a physical interaction between PHLPP1 and both Scribbles isoforms (wildtype and P305L mutant).
Conclusion/Outlook:
Our data demonstrate that the cytoplasmic accumulation of Scribble in HCC cells promotes tumor cell growth in an AKT-dependent manner probably through the interaction with AKT phosphatases. These results indicate that the disturbance of cell polarity (e.g. by Scribble overexpression) can foster oncogenic effects and therefore must be regarded as initiating event in hepatocarcinogenesis.
Citation Format: Shan Wan, Anne-Sophie Meyer, Sofia Weiler, Teresa Lutz, Stephanie Roessler, Peter Schirmacher, Federico Pinna, Kai Breuhahn. Subcellular localization of the cell polarity protein Scribble defines its oncogenic activity in hepatocellular carcinoma. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1130.
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Affiliation(s)
- Shan Wan
- 1Univ. Hospital Inst. of Pathology, Heidelberg, Germany
| | | | - Sofia Weiler
- 1Univ. Hospital Inst. of Pathology, Heidelberg, Germany
| | - Teresa Lutz
- 1Univ. Hospital Inst. of Pathology, Heidelberg, Germany
| | | | | | - Federico Pinna
- 2Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Kai Breuhahn
- 1Univ. Hospital Inst. of Pathology, Heidelberg, Germany
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Osto E, Planavila A, Huisamen B, Doytcheva P, Baechler T, Tarasco E, Pellegrini G, Matter C, Lutz T, Luescher T, Ruperez C, Lerin C, Mas-Stachurska A, Sitges M, Giralt M, Villarroya F, Van Vuuren M, Espach Y, Marais E, Lochner A. Obesity and Cardiac Microvascular Function496Roux-en-y gastric bypass surgery reverses obesity-induced vascular dysfunction by blunting jnk2-endothelial activation497Involvement of the Fgf21 system in obesity-associated cardiomyopathy498Is low ATM protein responsible for myocardial insulin resistance associated with obesity? Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw147] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bielak M, Husmann E, Weyandt N, Haas JP, Horneff G, Lutz T, Lilienthal E, Kallinich T, Tenbrock K, Berendes R, Dückers G, Wittkowski H, Weißbarth-Riedel E, Heubner G, Oommen PT, Klotsche J, Neudorf U, Föll D, Niehues T, Lainka E. Interleukin (IL)- 6 inhibition - Follow-up data of the German AID-registry1. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599838 DOI: 10.1186/1546-0096-13-s1-p63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Weiler S, Wolf T, Pinna F, Roessler S, Lutz T, Wan S, Marquardt J, Lang H, Schirmacher P, Breuhahn K. Abstract 4269: A gene signature defines chromosomal instability (CIN) and poor survival in liver cancer patients. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-4269] [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: 11/16/2022]
Abstract
Abstract
Background
The molecular stratification of cancer patients into different subgroups becomes more and more important for clinical treatment. For human hepatocellular carcinoma (HCC), which is the third most common cause of cancer related deaths, molecular classification can be useful to discriminate between patient subgroups with different biological and clinical features. Especially chromosomal instability (CIN) represents one determinant for poor overall survival of HCC patients; however, a respective molecular signature has not been defined so far. In order to stratify HCC patients into groups with CIN we utilized a gene expression signature (termed CIN25 signature) that has been shown to correlate with CIN in other tumor entities such as glioma and breast cancer (Carter et al. 2006). In this study we examined the presence of the CIN25 signature in HCC patients and its correlation with overall survival. Moreover, the most important genes for patient classification were determined.
Methods
Gene expression data from 242 HCC patients (Roessler et al., 2010) was quantile discretized into ten bins and the patients were clustered into 3 groups using the k-means algorithm. The differential expression between these groups was visualized as a heatmap, while cluster specific changes in overall survival were shown using Kaplan-Meier curves. Statistical significance of survival was assessed using the log-rank-test and cox proportional hazard models. The Boruta method, which makes use of Random Forest classification models, was used to determine the most important genes for patient subgroup clustering. Results for CIN25 gene expression were confirmed in an independent cohort (n = 20) using quantitative real-time PCR.
Results
Gene expression analysis of HCC patients revealed the presence of the CIN25 signature. Patients could be clustered into three different groups with low (32%), moderate (35%) and high (33%) expression levels of the CIN signature genes. Survival data analysis showed that patients with high expression levels had a significantly worse overall survival in comparison to patients with low expression levels (p = 0.01). Moreover, the elevated expression of 19 out of the 25 CIN genes was significantly correlated to poor survival. The Boruta method identified MAD2L1, TTK, TPX2 and MCM2 as possible risk stratification markers of HCC patients. In an independent cohort the expression levels of selected CIN genes (n = 9) were measured and revealed significant upregulation in 57-82% of HCC patients.
Conclusion
These data demonstrate that the presence of the CIN25 signature correlates with poor prognosis in HCC patients and could be used to predict overall survival. The determination of genes that classify patients into different subgroups may lead to the establishment of new biomarkers for HCC in the clinics.
References
Carter SL, et al., Nat Genet. 2006 Sep;38(9):1043-8.
Roessler S, et al., Cancer Res. 2010 Dec 15;70(24):10202-12.
Citation Format: Sofia Weiler, Thomas Wolf, Federico Pinna, Stephanie Roessler, Teresa Lutz, Shan Wan, Jens Marquardt, Hauke Lang, Peter Schirmacher, Kai Breuhahn. A gene signature defines chromosomal instability (CIN) and poor survival in liver cancer patients. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4269. doi:10.1158/1538-7445.AM2015-4269
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Affiliation(s)
- Sofia Weiler
- 1University Hospital of Heidelberg, Heidelberg, Germany
| | - Thomas Wolf
- 1University Hospital of Heidelberg, Heidelberg, Germany
| | | | | | - Teresa Lutz
- 1University Hospital of Heidelberg, Heidelberg, Germany
| | - Shan Wan
- 1University Hospital of Heidelberg, Heidelberg, Germany
| | | | - Hauke Lang
- 2University Hospital of Mainz, Mainz, Germany
| | | | - Kai Breuhahn
- 1University Hospital of Heidelberg, Heidelberg, Germany
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Lutz T, Grulich-Henn J, Schneiderbauer R, Hadaschik E. AB1026 A Rare Case of Infantile Systemic Lupus Erythematosus in the First Year of Life and Successful Treatment with Hydroxychloroquine. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4482] [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: 11/03/2022]
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Kuhlmann A, Mittendorf T, Hower M, Heiken H, Gerschmann S, Klauke S, Lutz T, Bogner J, Degen O, van Lunzen J, Bachmann C, Stellbrink HJ, Schmidt W, Leistner I, Mahlich J, Ranneberg B, Stoll M. [Cost of Illness of HIV Patients under Anteretroviral Therapy in Germany - Results of the 48-Week Interim Analysis of the Prospective Multicentre Observational Study 'CORSAR']. Gesundheitswesen 2014; 77:e133-42. [PMID: 25247761 DOI: 10.1055/s-0034-1381993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND With the introduction of highly active combined antiretroviral therapy (c-ART) mortality and morbidity of HIV patients declined substantially. Earlier studies reported that c-ART was able to save health-care costs due to a reduction of other direct medical costs, particularly for inpatient treatments and concomitant medication. To date, analyses of costs and health-related quality of life (HRQOL) of patients under c-ART are lacking in Germany. Hence, this study aims to estimate the current cost of illness and HRQOL of HIV-patients under c-ART in different treatment lines. METHODS A multicenter, prospective observational study was carried out in 12 specialised German centres for infectious diseases: 8 private practices/outpatient centres and 4 specialised hospitals offering both inpatient and outpatient services. Demographic, clinical and medication data were derived from patient records. Resource utilisation, information on productivity, out of pocket costs and HRQOL (EQ-5D) were collected every 12 weeks via a patient questionnaire. All costs were calculated based on price information from publicly accessible databases. RESULTS N=1,154 patients were included in the analysis. Mean direct disease-related costs of -patients under c-ART amounted to 22,563 Euro/year. Patients beyond the 3(rd) line of treatment -incurred considerably higher costs 24,654 Euro/year. In the 1(st) treatment line, c-ART accounted for 83.2% of the total direct costs, in the 2(nd)/3(rd) line for 80.8% and in >3(rd) line for 83.4%, respectively. Indirect costs due to impaired productivity were higher in the 2(nd)/3(rd) treatment line (2,843 Euro) compared to the 1(st) (1,604 Euro) and >3(rd) (1,752 Euro) treatment lines, respectively. The average HRQOL (EQ-5D) varied between 0.77 (self-assessment via visual analogue scale) and 0.91 (utility score based on the German time trade-off tariff). CONCLUSIONS Over the last decade, cost of illness of HIV patients under c-ART decreased slightly with average costs per year still being substantial. Main cost driver of overall costs is c-ART. There have been, however, noticeable shifts between different cost domains.
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Affiliation(s)
- A Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Leibniz -Universität Hannover, Hannover
| | - T Mittendorf
- Health Economic Research & Consulting, Herescon GmbH, Hannover
| | - M Hower
- ID-Ambulanz der Medizinischen Klinik Nord, Klinikum Dortmund, Dortmund
| | - H Heiken
- Innere Medizin, Praxis Georgstraße, Hannover
| | - S Gerschmann
- Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover
| | - S Klauke
- Infektiologie, Infektiologikum, Frankfurt
| | - T Lutz
- Infektiologie, Infektiologikum, Frankfurt
| | - J Bogner
- Infektionskrankheiten und klinische Immunologie, Ludwig-Maximilians-Universität München, München
| | - O Degen
- Infektiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - J van Lunzen
- Infektiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - C Bachmann
- ID-Ambulanz der Medizinischen Klinik Nord, Klinikum Dortmund, Dortmund
| | - H J Stellbrink
- ICH Grindel, Infektionsmedizinisches Centrum Hamburg, Hamburg
| | - W Schmidt
- Innere Medizin, Ärzteforum Seestraße, Berlin
| | - I Leistner
- Innere Medizin, Ärzteforum Seestraße, Berlin
| | - J Mahlich
- Health Economics & Pricing, Janssen-Cilag GmbH, Neuss
| | - B Ranneberg
- Health Economics & Pricing, Janssen-Cilag GmbH, Neuss
| | - M Stoll
- Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover
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Ingiliz P, Krznaric I, Stellbrink HJ, Knecht G, Lutz T, Noah C, Stocker H, Obermeier M, Dupke S, Boesecke C, Rockstroh JK, Baumgarten A, Hoffmann C. Multiple hepatitis C virus (HCV) reinfections in HIV-positive men who have sex with men: no influence of HCV genotype switch or interleukin-28B genotype on spontaneous clearance. HIV Med 2014; 15:355-61. [PMID: 24580777 DOI: 10.1111/hiv.12127] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [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: 01/03/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The incidence of sexually transmitted hepatitis C virus (HCV) reinfection is on the rise in HIV-infected men who have sex with men (MSM). Data on natural history of acute hepatitis C and possible factors associated with spontaneous clearance are limited. The aim of this study was to analyse the outcome of HCV reinfections in HIV-positive MSM. METHODS A retrospective analysis was carried out on patients with more than one sexually acquired HCV infection who were diagnosed at four major German HIV and hepatitis care centres. Reinfection was defined by genotype or phylogenetic clade switch, detectable HCV RNA after a sustained virological response (SVR) or after spontaneous clearance (SC). RESULTS In total, 48 HIV-positive MSM were identified with HCV reinfection, among them 11 with a third episode and one patient with four episodes. At the first episode, 43 and five patients had an SVR and SC, respectively. The second episode was accompanied by a genotype switch in 29 patients (60%). Whereas 30 and nine patients showed an SVR and SC, respectively, eight patients developed chronic hepatitis. Neither HCV genotype switch nor interleukin-28B genotype was associated with SC. However, SC rates at the second episode were higher for patients with SC at the first episode compared with patients without SC (60 vs. 14%, respectively; P = 0.03). Two patients with SC at the first episode were reinfected with the same genotype. CONCLUSIONS Multiple reinfections in HIV-infected MSM do occur, with or without genotype switch, and with prior SC of previous episodes. In this large case series, except for SC at the first episode, no factor was of value in clinical decision-making for early therapeutic intervention in acute HCV reinfection.
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Affiliation(s)
- P Ingiliz
- Medical Center for Infectious Diseases, Berlin, Germany
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Pfeil J, Grulich-Henn J, Wenning D, Breil T, Gunther P, Lutz T. Multiple upper gastrointestinal perforations in a 15-year-old patient treated with tocilizumab. Rheumatology (Oxford) 2014; 53:1713-4. [DOI: 10.1093/rheumatology/keu032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bickel M, Khaykin P, Stephan C, Schmidt K, Buettner M, Amann K, Lutz T, Gute P, Haberl A, Geiger H, Brodt HR, Jung O. Acute kidney injury caused by tenofovir disoproxil fumarate and diclofenac co-administration. HIV Med 2013; 14:633-8. [PMID: 23980564 DOI: 10.1111/hiv.12072] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The renal elimination of tenofovir (TFV) may be subject to renal drug-drug interactions that may increase the risk of kidney injury. Case reports indicated that diclofenac might increase TFV-associated nephrotoxicity via a drug-drug interaction, leading to an increased intracellular TFV concentration in proximal tubular cells. METHODS A retrospective analysis of data for all patients from the Frankfurt HIV Cohort (FHC) who had diclofenac prescriptions between January 2008 and June 2012 was carried out. RESULTS Among 89 patients with diclofenac use, 61 patients (68.5%) were treated with tenofovir disoproxil fumarate (TDF) and 28 patients (31.5%) were treated with TDF-sparing combination antiretroviral therapy (cART). Thirteen patients (14.6%) developed acute kidney injury (AKI) shortly after initiating diclofenac treatment. AKI occurred exclusively in TDF-treated patients, although all had previously stable renal function. All cases were accompanied by new onset of at least two parameters indicating proximal tubular damage, such as normoglycaemic-glucosuria and hypophosphataemia. TFV-associated nephrotoxicity was demonstrated by renal biopsy in four cases. Additionally, 11.5% of patients on TDF treatment developed new-onset proximal tubular damage, while having a preserved glomerular filtration rate. In contrast, diclofenac did not affect renal function in patients with TDF-sparing cART, as only one case of isolated hypophataemia was observed in these patients. In univariate analysis, risk factors for AKI were TDF-containing cART (P = 0.0076) and pre-existing hypophosphataemia (P = 0.0086). CONCLUSIONS Drug-drug interaction caused by diclofenac could exacerbate TFV-associated nephrotoxicity. Diclofenac should be used with caution in patients on TDF therapy, especially in those with hypophosphataemia. Our findings need to be confirmed in larger studies.
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Affiliation(s)
- M Bickel
- Department of Infectious Disease, Goethe University, Frankfurt/Main, Germany
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Hueppe D, Mauss S, Lutz T, Schober A, Boeker KHW, Stoehr A, Link R, Moog G, Baumgarten A, Heyne R, John C, Eisenbach C, Schiffelholz W, Schott E, Teuber G, Schmidt W, Alshuth U, Zehnter E. Prädiktive Baseline Faktoren bei Patienten mit Zirrhose für den Therapieerfolg einer dualen Therapie mit Peginterferon alfa-2a (PEG) plus Ribavirin (RBV), was zählt? Z Gastroenterol 2013. [DOI: 10.1055/s-0033-1352633] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Osto E, Doytcheva P, Corteville C, Spliethoff K, Bueter M, Rohrer L, Landmesser U, Matter C, Lutz T, Luscher T. Increased plasma Glucagon Like Peptide-1 improves endothelial dysfunction immediately after Roux-en-Y gastric bypass prior to body weight loss inhibiting the c-Jun N-terminal Protein Kinase Signaling. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p617] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Knechten H, Stephan C, Mosthaf FA, Jaeger H, Carganico A, Lutz T, Schewe K, Mayr C, Wolf E, Wellmann E, Tappe A. The rainbow cohort: 96 week follow-up of saquinavir-containing regimens in previously antiretroviral therapy (ART)-naive and pre-treated but protease inhibitor (PI)-naive HIV-infected patients. Eur J Med Res 2011; 16:93-100. [PMID: 21486721 PMCID: PMC3352211 DOI: 10.1186/2047-783x-16-3-93] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective We have previously reported data from the German cohort of the multinational observational prospective RAINBOW survey which assessed the tolerability and efficacy of ritonavir-boosted saquinavir (SQV/r)-containing regimens over 48 weeks in routine clinical practice. This analysis presents data from antiretroviral (ART)-naïve and pretreated but protease inhibitor (PI)-naïve patients treated in a long-term one line (96 weeks) follow-up of the initial study. Methods All ART-and PI-naïve patients from the initial RAINBOW cohort who had recorded data to one line 96 weeks of treatment were eligible for inclusion in the current analysis. Efficacy assessments included the proportion of patients with HIV-1 RNA < 50 and < 400 copies/mL and changes in CD4 cell count from baseline to week 96. Tolerability assessments included changes in liver enzymes and lipid levels from baseline to week 96. For evaluation of efficacy, intent-to-treat analysis, in which missing values were recorded as failure (ITT), and last-observation-carried-forward (LOCF) analysis were used. Metabolic parameters were assessed using LOCF analysis. Results The analysis included 175 ART-naïve and 109 pretreated but PI-naïve patients. After 96 weeks, a similar proportion of patients in the ART-naïve and in the pretreated but Pi-naïve group had HIV-1 RNA levels < 400 copies/mL (68.0% and 70.6% [ITT], respectively; 96.6% and 90.8% [LOCF], respectively). The proportion of patients with HIV RNA < 50 copies/mL was higher in the ART-naïve group compared with the pretreated but PI-naïve group (61.1% and 56.9% [ITT], respectively; 84.0% and 75.2% [LOCF], respectively). Median change in CD4 cell count from baseline to week 96 was'+263 cells/mm3 (IQR 170; 384. LOCF; p < 0.0001) in the ART-naïve group, and one line +181 cells/mm3 (IQR 60; 309. LOCF; p < 0.0001) in the pretreated but PI-naïve group. Treatment was well tolerated, with only 2.5% of patients withdrawing from treatment due to side effects. There were no clinically relevant changes in liver enzyme levels. Overall total cholesterol, triglyceride, and low-and high-density lipoprotein levels increased to week 96, although levels remained within normal ranges in the majority of ART-naïve and pretreated patients. Conclusions This follow-up analysis confirms the long term efficacy and tolerability of SQV/r in ART-naïve and pretreated but PI-naïve patients in the real-life clinical setting.
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Affiliation(s)
- H Knechten
- Praxenzentrum Blondelstrasse (PZB), Blondelstr. 9, 52062 Aachen, Germany.
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van Lunzen J, Fätkenheuer G, Lutz T, Klauke S, Mauss S, Knechten H, Braun P, Gallo L, Goldbach J. Efficacy and safety of TDF/FTC-containing, first-line HAART in clinical practice: 3-year data from the German outpatient cohort. J Int AIDS Soc 2010. [PMCID: PMC3112894 DOI: 10.1186/1758-2652-13-s4-p12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Stephan C, Jaeger H, Carganico A, Knecht G, Lutz T, Mayr C, Mosthaf FA, Koeppe S, Mueller M, Wolf E, Tappe A, Wellmann E, Knechten H. Safety and efficacy after switch to a saquinavir-containing antiretroviral regimen in protease inhibitor pretreated HIV-positive patients. Eur J Med Res 2010; 15:369-76. [PMID: 20952345 PMCID: PMC3351903 DOI: 10.1186/2047-783x-15-9-369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective The RAINBOW survey is a multinational observational study assessing the tolerability and efficacy of ritonavir-boosted saquinavir (SQV/r), using the 500 mg film-coated SQV formulation, in routine clinical practice. This analysis presents data from the German subgroup of protease inhibitor (PI)-pretreated, but SQV-naïve patients. Methods Multicenter, prospective, open-label, 48 week cohort study. Efficacy assessments included the proportion of patients with HIV-1 RNA < 50 and < 400 copies/mL and changes in CD4 cell count from baseline to week 48. Tolerability assessments included changes in liver enzymes and lipid levels from baseline to week 48. Results A total of 426 patients were included in the analysis. The proportion of patients with HIV RNA levels < 50 copies/mL at week 48 was 60.3% (compared with 31.7% at switch to SQV/r) (intent-to-treat, last observation carried forward analysis). After 48 weeks, median CD4 count increased by +61 cells/mm3 from baseline (p < 0.01) and 60.3% of patients achieved HIV-1 RNA < 50 copies/mL. Median changes in fasting triglyceride levels (stratified according to baseline level) at week 48 were: +14 mg/dL (IQR -8; 57) for patients with baseline triglyceride < 200 mg/dL; -50 mg/dL (IQR -139; 0) for baseline triglyceride 200-750 mg/dL, and -656 mg/dL (IQR 1024; 0) for baseline triglyceride > 750 mg/dL (p < 0.01 for all). Median changes in fasting total cholesterol (TC) levels (stratified according to baseline) were +16 mg/dL (IQR -3; 43) for patients with baseline TC < 200 mg/dL (p < 0.01), -3 mg/dL (IQR -25; 25) for baseline TC 200-300 mg/dL (p = 0.4), and -47 mg/dL (IQR -87; -4) for baseline TC > 300 mg/dL (p < 0.01). No significant changes in liver enzymes or bilirubin were observed. SQV treatment was discontinued in 22% of patients, 6% due to side effects. Conclusions These data confirm the efficacy and tolerability of SQV/r in PI-experienced, SQV-naïve patients treated in a real-life clinical setting. Of particular relevance are the improvements in triglycerides and TC levels observed in patients with baseline grade III-IV elevations.
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Affiliation(s)
- C Stephan
- Klinikum der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
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Franchini M, Monnais E, Seboek D, Radimerski T, Zini E, Kaufmann K, Lutz T, Reusch C, Ackermann M, Muller B, Linscheid P. Insulin resistance and increased lipolysis in bone marrow derived adipocytes stimulated with agonists of Toll-like receptors. Horm Metab Res 2010; 42:703-9. [PMID: 20603780 DOI: 10.1055/s-0030-1261872] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Our objectives were to identify Toll-like receptors (TLRs) in human bone marrow derived adipocytes, to test specific TLR agonists for their ability to induce a proinflammatory response, and to investigate possible metabolic effects after TLR activation, in particular, those associated with insulin resistance and lipolysis. Mesenchymal stem cells were isolated from human bone marrow and differentiated into adipocytes. Total RNA before or after stimulation with agonists specific for TLR was extracted for analysis of expression of TLRs proinflammatory signals and molecules involved in glucose metabolism (IRS-1 and GLUT4). Furthermore, cytokine protein expression was measured from cell lysates. Finally, insulin induced glucose uptake and lipolysis were measured. Human bone marrow-derived adipocytes express TLR1-10. They react to stimulation with specific ligands with expression of inflammatory markers (IL-1beta, IL-6, TNFalpha, IL-8, MCP-1) at the RNA and protein levels. IRS-1 and GLUT4 expression was downregulated after stimulation with the TLR4 and TLR3 specific ligands LPS and poly (I:C), respectively. Insulin-induced glucose uptake was decreased and lipolysis increased. We conclude that adipocytes express TLR 1-10 and react to agonists specific for TLR 1-6. As a consequence proinflammatory cytokine are induced, in particular, IL-6, IL-8, and MCP-1. Since stimulation is followed by decreased insulin-induced glucose uptake and increased lipolysis we conclude that TLRs may be important linking molecules in the generation of insulin resistance in fat tissue.
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Affiliation(s)
- M Franchini
- Institute of Virology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.
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Vogel M, Ahlenstiel G, Hintsche B, Fenske S, Trein A, Lutz T, Schürmann D, Stephan C, Khaykin P, Bickel M, Mayr C, Baumgarten A, Buggisch P, Klinker H, John C, Gölz J, Staszewski S, Rockstroh JK. The influence of HAART on the efficacy and safety of pegylated interferon and ribavirin therapy for the treatment of chronic HCV infection in HIV-positive Individuals. Eur J Med Res 2010; 15:102-11. [PMID: 20452894 PMCID: PMC3352215 DOI: 10.1186/2047-783x-15-3-102] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective This study was performed to investigate the impact of HAART versus no HAART and nucleoside free versus nucleoside containing HAART on the efficacy and safety of pegylated interferon and ribavirin therapy for the treatment of chronic HCV infection in HIV/HCV co-infected patients. In addition a control group of HCV mono-infected patients undergoing anti-HCV therapy was evaluated. Methods Multicenter, partially randomized, controlled clinical trial. HIV-negative and -positive patients with chronic HCV infection were treated with pegylated interferon alfa-2a and ribavirin (800 - 1200 mg/day) for 24 - 48 weeks in one of four treatment arms: HIV-negative (A), HIV-positive without HAART (B) and HIV-positive on HAART (C). Patients within arm C were randomized to receive open label either a nucleoside containing (C1) or a nucleoside free HAART (C2). Results 168 patients were available for analysis. By intent-to-treat analysis similar sustained virological response rates (SVR, negative HCV-RNA 24 weeks after the end of therapy) were observed comparing HIV-negative and -positive patients (54% vs. 54%, p = 1.000). Among HIV-positive patients SVR rates were similar between patients off and on HAART (57% vs. 52%, p = 0.708). Higher SVR rates were observed in patients on a nucleoside free HAART compared to patients on a nucleoside containing HAART, though confounding could not be ruled out and in the intent-to-treat analysis the difference was not statistically significant (64% vs. 46%, p = 0.209). Conclusions Similar response rates for HCV therapy can be achieved in HIV-positive and -negative patients. Patients on nucleoside free HAART reached at least equal rates of sustained virological response compared to patients on standard HAART.
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Affiliation(s)
- M Vogel
- Department of Internal Medicine I, Rheinische friedrich-Wilhelms-University, Germany
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Knechten H, Stephan C, Mosthaf FA, Jaeger H, Lutz T, Cargnico A, Stoehr A, Koeppe S, Mayr C, Schewe K, Wolf E, Wellmann E, Tappe A. Safety and efficacy of a saquinavir-containing antiretroviral regimen in previously ART-naïve or pretreated but protease inhibitor-naïve HIV-positive patients. Infection 2010; 38:108-16. [PMID: 20352287 DOI: 10.1007/s15010-009-9249-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Accepted: 12/17/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND The RAINBOW survey is a multinational observational study assessing the tolerability and efficacy of ritonavir-boosted saquinavir (SQV/r), using the 500-mg film-coated SQV formulation, in routine clinical practice. This analysis presents data from the German subgroup of antiretroviral therapy (ART)-naïve and pretreated but protease inhibitor (PI)-naïve patients. METHODS This was a multicenter, prospective, open-label, 48-week observational cohort study. Tolerability assessments included changes in liver enzymes and lipid levels from baseline to week 48. Efficacy assessments included changes in the proportion of patients with HIV-1 RNA <50 and <400 copies/ml, and changes in CD4 cell count from baseline to week 48. RESULTS The analysis included 275 ART-naïve and 179 pretreated but PI-naïve patients. The proportion of ART-naïve patients achieving <50 copies/ml by 48 weeks was 53.1% by intent-to-treat (ITT) analysis and 67.3% using last observation carried forward (LOCF) analysis. In pretreated but PI-naïve patients, the proportions achieving <50 copies/ml by 48 weeks were 53.1% (ITT) and 70.4% (LOCF). The median increase in CD4 count at week 48 was +174 cells/mm3 (interquartile range [IQR] 86, 265) in the ART-naïve group and +100 cells/mm3 (IQR 0, 209) in the pretreated but PI-naïve group (p < 0.01 for both; LOCF). Drug-related adverse events were reported in 7.6% of ART-naïve and 2.8% of pretreated but PI-naïve patients. Treatment with SQV/r was stopped in 21.5% of ART-naïve and 17.9% of pretreated but PI-naïve patients (due to side effects in 3.3% and 2.8%, respectively). There were no clinically relevant changes in liver enzyme levels. Overall, the total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein levels increased to week 48, although the levels remained within normal ranges in the majority of patients. CONCLUSIONS The results of this observational cohort study of treatment with the 500-mg tablet formulation of SQV are consistent with high efficacy and tolerability results seen in controlled studies of SQV/r. This analysis confirms that SQV/r is effective and well tolerated in ART-naïve and pretreated but PI-naïve patients in 'real-world' clinical settings.
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Affiliation(s)
- H Knechten
- Practice Center Blondelstrasse (PZB), Blondelstr. 9, 52062 Aachen, Germany.
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Baumgarten A, Lutz T, Kreckel P, Wellmann E, Alshuth U, Mauss S, Rockstroh J. Efficacy and safety of peginterferon alfa-2a + RBV in cHCV/HIV- vs cHCV-infected patients: interim analysis of a multicenter German cohort. J Int AIDS Soc 2010. [PMCID: PMC3112846 DOI: 10.1186/1758-2652-13-s4-o32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bickel M, Bodtländer A, Knecht GK, Stephan C, von Hentig N, Kurowski M, Gute P, Klauke S, Lutz T. Once-daily treatment with saquinavir mesylate (2000 mg) and ritonavir (100 mg) together with a fixed-dose combination of abacavir/lamivudine (600/300 mg) or tenofovir/emtricitabine (245/200 mg) in HIV-1-infected patients. J Antimicrob Chemother 2009; 64:1260-4. [PMID: 19776037 DOI: 10.1093/jac/dkp348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To investigate the feasibility and pharmacokinetics of a once-daily regimen of 2000 mg saquinavir mesylate boosted with 100 mg ritonavir. PATIENTS AND METHODS Patients successfully treated with 1000 mg saquinavir boosted with 100 mg ritonavir twice daily together with two nucleoside or nucleotide reverse transcriptase inhibitors [N(t)RTIs] who were switched to 2000 mg saquinavir with 100 mg ritonavir once daily with unchanged N(t)RTI therapy were analysed. CD4 cells, HIV-RNA PCR and metabolic parameters were compared between baseline and 3, 6, 9 and 12 months after the switch. Saquinavir and ritonavir drug levels were measured before and a median of 3 weeks after switching from twice to once daily at 0, 1, 2, 4, 6, 9, 12 and 24 h after intake of the medication. The area under the serum concentration-time curve from 0 to 24 h (AUC(0-24)) was calculated using the trapezoidal rule. RESULTS Eighteen patients (16 males, median age of 41 years) with a median CD4 cell count of 464 cells/mm(3) were analysed. HIV-RNA PCR remained <500 copies/mL for all patients. After switching from 100 mg twice daily to 100 mg once daily, the AUC(0-24) for ritonavir decreased significantly [21 874 to 10 267 ng.h/mL, geometric mean ratio (GMR) = 0.47; P < 0.001], whereas the AUC(0-24) for saquinavir decreased only marginally from 35 000 to 34 490 ng.h/mL (GMR = 0.99; P = 0.426). The CD4 cell count and the fasting metabolic parameters remained unchanged. CONCLUSIONS Once-daily treatment with ritonavir-boosted saquinavir was well tolerated and resulted in similar saquinavir drug exposure despite much lower ritonavir concentrations when compared with a twice-daily dosing schedule.
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Affiliation(s)
- M Bickel
- HIVCENTER, JW Goethe University Hospital, Theodor Stern Kai 7, Frankfurt, Germany.
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Dissanayake DMNM, Hatton RA, Lutz T, Curry RJ, Silva SRP. The fabrication and analysis of a PbS nanocrystal:C(60) bilayer hybrid photovoltaic system. Nanotechnology 2009; 20:245202. [PMID: 19468169 DOI: 10.1088/0957-4484/20/24/245202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A near-infrared sensitive hybrid photovoltaic system between PbS nanocrystals (PbS-NCs) and C(60) is demonstrated. Up to 0.44% power conversion efficiency is obtained under AM1.5G with a short circuit current density (J(sc)) of 5 mA cm(-2) when the PbS-NC layer is treated in anhydrous methanol. The observed J(sc) is found be approximately one-third of the maximum expected from this hybrid configuration, indicating the potential for further optimization. Crucial for device operation, a smooth film of nanocrystals is seen to form on the hole transporting poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) layer deposited on the transparent electrode, facilitated through an ionic interaction between nanocrystal capping ligands and the PEDOT:PSS. The formation of the open circuit voltage in this system is seen to be influenced by an interfacial dipole formed at the hole-extracting electrode, providing insights for further optimization.
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Affiliation(s)
- D M N M Dissanayake
- Solid State Electronics Laboratory, University of Michigan, Ann Arbor, MI 48109-2122, USA.
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Abstract
Organic-inorganic hybrid heterojunctions have potential as the basis for future photovoltaic devices. Herein, we report the results of investigations exploring the possibility of using pentacene and tetracene as photoelectron donors in conjunction with PbS nanocrystals (PbS-NCs). Photoinduced charge transfer was probed using external quantum efficiency measurements on acene:PbS-NC hybrid photovoltaic devices in conjunction with photoluminescence studies of the corresponding bilayer films. It is shown that photoelectron transfer from pentacene to the PbS-NCs is inefficient as compared to that between tetracene and PbS-NCs. The latter case can be rationalized in terms of the energy level alignment at the heterojunction assuming a common vacuum level. However, in the case of pentacene:PbS-NC junctions an interfacial energy level shift must be considered in order to explain the observations.
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Affiliation(s)
- D M N M Dissanayake
- Solid State Electronics Laboratory, University of Michigan, Ann Arbor, MI 48109-2122, USA.
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Hüppe D, Zehnter E, Mauss S, Böker K, Lutz T, Racky S, Schmidt W, Ullrich J, Sbrijer I, Heyne R, Schober A, John C, Hey KH, Bokemeyer B, Kallinowski B, Möller B, Pape S, Gutmann M, Alshuth U, Niederau C. [Epidemiology of chronic hepatitis C in Germany--an analysis of 10,326 patients in hepatitis centres and outpatient units]. Z Gastroenterol 2008; 46:34-44. [PMID: 18188814 DOI: 10.1055/s-2007-963691] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Little is known about the epidemiology of chronic hepatitis C (CHC) in Germany and especially about the importance of transmission, duration of infection, genotypes, symptoms and quality of life of the patients. The current study prospectively evaluates epidemiological and clinical data of patients infected with the hepatitis C virus (HCV). Using online data entry, various characteristics of 10,326 untreated patients with CHC were documented from March 2003 until May 2006 in 352 centres all over Germany. Mean age of patients was 43.4 years. Patients infected by i.v. drug abuse were considerably younger (36.5 years) than the remaining patients (49.2 years). As indicated by their native language, 64.4% of the patients came from Germany and 19.2% from Russia. 61.7% were infected with genotype 1 and 34.9% with genotype 2 or 3. 45.5% of the patients had been infected by i.v. drug abuse. In at least 5.4% of the patients liver cirrhosis had been proved by biopsy. 63.5% of the patients felt an impairment of quality of life caused by CHC. In many patients infected with hepatitis C socio-economic issues are existent. This is reflected, i.e., in very high rates of unemployment in special subpopulations. Coinfections with hepatitis B and HIV occurred in 1.5% and 4.7%, respectively. Nearly 80% of patients were managed near their homes. The data of the 10 326 patients represent about 2% of all German patients with CHC. This database is up to now the largest of its kind and gives a representative insight into the epidemiological situation of CHC in Germany.
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Affiliation(s)
- D Hüppe
- Gastroenterologische Gemeinschaftspraxis Herne, Herne.
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Bickel M, Eisen J, Stephan C, Crespi CM, Lutz T, Klauke S, Vogl TJ, Jacobi V, Yang OO, Staszewski S, Zangos S. A standardized, comprehensive magnetic resonance imaging protocol for rapid and precise quantification of HIV-1-associated lipodystrophy. HIV Med 2008; 8:413-9. [PMID: 17760732 DOI: 10.1111/j.1468-1293.2007.00487.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Although multiple methods have been proposed, there is no current gold standard for assessing HIV-1-associated lipodystrophy. METHODS HIV-1-infected participants were randomly enrolled and surveyed about changes in the abdomen, thigh, cheek and neck areas. Magnetic resonance imaging (MRI) sequences of these sites were obtained. Participants were grouped according to survey results, and the MRI measurements were compared between groups. RESULTS One hundred participants were included in the study, of whom 79% reported any body fat changes. Persons reporting increased abdominal girth had higher visceral ([mean+/-standard deviation] 142+/-75 vs. 59+/-48 cm2; P<0.0001) and total abdominal adipose tissue than those reporting no change (344+/-119 vs. 201+/-95 cm2; P<0.0001). The amount of localized fat was less for persons reporting sunken cheeks and reduced diameter of the legs compared with those who noted no changes (5.9+/-3.6 vs. 9.3+/-3.8 cm2; P<0.0001, and 35+/-28 vs. 112+/-56 cm2; P<0.0001). Participants reporting increased neck girth had a thicker fat layer in the dorsocervical region compared with those reporting no change (4.0+/-1.8 vs. 2.3+/-1.4 cm; P<0.0002). CONCLUSIONS MRI is a precise method for rapidly surveying body regions affected by HIV-1-associated lipodystrophy. Our proposed protocol provides a rapid, comprehensive survey of these areas, without the need to combine multiple modalities or to expose subjects to radiation.
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Affiliation(s)
- M Bickel
- HIV Medical Treatment and Research Unit, JW Goethe University, Frankfurt, Germany.
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Knechten H, Stephan C, Lutz T, Stoehr A, Carganico A, Knecht G, Schewe K, Jaeger H, Mayr C, Mosthaf FA, Wolf E, Wellmann E, Tappe A. The Rainbow Cohort: saquinavir/r is effective and well tolerated in antiretroviral therapy (ART)-naïve patients – 48-week results from Germany. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p13] [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: 11/10/2022] Open
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van Lunzen J, Fätkenheuer G, Lutz T, Klauke S, Mauss S, Knechten H, Braun P, Gallo L, Ranneberg B. Efficacy and safety of TDF/FTC-containing first-line HAART in clinical practice – 2-year data from the German Outpatient Cohort. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p12] [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: 11/10/2022] Open
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Wendig A, Stephan C, Khaykin P, Bickel M, Lennemann T, Knecht G, Lutz T, von Hentig N, Staszewski S. Lipometabolic side-effects of three ritonavir-boosted double protease inhibitor regimens without reverse transcriptase inhibitors. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p122] [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: 11/10/2022] Open
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Bickel M, Bodtlaender A, Knecht G, Kurowski M, Klauke S, Lutz T. Once-daily saquinavir (SAQ)/ritonavir (RTV) (2000/100 mg) with abacavir/lamivudine (600/300 mg) or tenofovir/emtricitabine (245/300 mg) in naïve patients. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p59] [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: 11/10/2022] Open
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Michel S, Lutz T, Riediger T. Nutrients modulate amylin's effect on c-Fos expression in the area postrema and on food intake. Appetite 2007. [DOI: 10.1016/j.appet.2007.03.138] [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: 11/27/2022]
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