2
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Kolibabka M, Dannehl M, Oezer K, Murillo K, Huang H, Riemann S, Hoffmann S, Gretz N, Schlotterer A, Feng Y, Hammes HP. Differences in junction-associated gene expression changes in three rat models of diabetic retinopathy with similar neurovascular phenotype. Neurobiol Dis 2023; 176:105961. [PMID: 36526091 DOI: 10.1016/j.nbd.2022.105961] [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: 10/18/2022] [Revised: 11/24/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Diabetic retinopathy, also defined as microvascular complication of diabetes mellitus, affects the entire neurovascular unit with specific aberrations in every compartment. Neurodegeneration, glial activation and vasoregression are observed consistently in models of diabetic retinopathy. However, the order and the severity of these aberrations varies in different models, which is also true in patients. In this study, we analysed rat models of diabetic retinopathy with similar phenotypes to identify key differences in the pathogenesis. For this, we focussed on intercellular junction-associated gene expression, which are important for the communication and homeostasis within the neurovascular unit. Streptozotocin-injected diabetic Wistar rats, methylglyoxal supplemented Wistar rats and polycystin-2 transgenic (PKD) rats were analysed for neuroretinal function, vasoregression and retinal expression of junction-associated proteins. In all three models, neuroretinal impairment and vasoregression were observed, but gene expression profiling of junction-associated proteins demonstrated nearly no overlap between the three models. However, the differently expressed genes were from the main classes of claudins, connexins and integrins in all models. Changes in Rcor1 expression in diabetic rats and Egr1 expression in PKD rats confirmed the differences in upstream transcription factor level between the models. In PKD rats, a possible role for miRNA regulation was observed, indicated by an upregulation of miR-26b-5p, miR-122-5p and miR-300-3p, which was not observed in the other models. In silico allocation of connexins revealed not only differences in regulated subtypes, but also in affected retinal cell types, as well as connexin specific upstream regulators Sox7 and miR-92a-3p. In this study, we demonstrate that, despite their similar phenotype, models for diabetic retinopathy exhibit significant differences in their pathogenic pathways and primarily affected cell types. These results underline the importance for more sensitive diagnostic tools to identify pathogenic clusters in patients as the next step towards a desperately needed personalized therapy.
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Affiliation(s)
- Matthias Kolibabka
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; European Center for Angioscience, Ludolf-Krehl-Strasse 13 - 17, 68167 Mannheim, Germany.
| | - Marcus Dannehl
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; European Center for Angioscience, Ludolf-Krehl-Strasse 13 - 17, 68167 Mannheim, Germany
| | - Kübra Oezer
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Katharina Murillo
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; European Center for Angioscience, Ludolf-Krehl-Strasse 13 - 17, 68167 Mannheim, Germany
| | - Hongpeng Huang
- Experimental Pharmacology, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 13 - 17, 68167 Manheim, Germany
| | - Sarah Riemann
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; European Center for Angioscience, Ludolf-Krehl-Strasse 13 - 17, 68167 Mannheim, Germany
| | - Sigrid Hoffmann
- Medical Research Center, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Norbert Gretz
- Medical Research Center, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Andrea Schlotterer
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; European Center for Angioscience, Ludolf-Krehl-Strasse 13 - 17, 68167 Mannheim, Germany
| | - Yuxi Feng
- Experimental Pharmacology, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 13 - 17, 68167 Manheim, Germany
| | - Hans-Peter Hammes
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; European Center for Angioscience, Ludolf-Krehl-Strasse 13 - 17, 68167 Mannheim, Germany
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5
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Schütte T, Kedziora SM, Haase N, Herse F, Busjahn A, Birukov A, Alenina N, Müller DN, Bader M, Schupp M, Dechend R, Kräker K, Golic M. Intrauterine Exposure to Diabetic Milieu Does Not Induce Diabetes and Obesity in Male Adulthood in a Novel Rat Model. Hypertension 2020; 77:202-215. [PMID: 33249866 DOI: 10.1161/hypertensionaha.120.16360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Several studies show an association of maternal diabetes during pregnancy with adverse offspring metabolic health. Other studies, however, suggest that this effect might be biased by obesity, which is independently associated with offspring metabolic disease and often coexistent to maternal diabetes. We performed a prospective study in a rat model to test the hypothesis that the burden of a diabetic pregnancy without obesity deteriorates metabolic health in male offspring. We generated maternal type 2 diabetes before conception that persisted during pregnancy by knockdown of the insulin receptor in small hairpin RNA-expressing transgenic rats. Male WT (wild type) offspring were followed up until adulthood and metabolically challenged by high-fat diet. Blood glucose was measured continuously via a telemetry device. Glucose and insulin tolerance tests were performed, and body composition was analyzed. Weight gain and glucose levels during adolescence and adulthood were similar in male offspring of diabetic and control pregnancies. Body weight and fat mass after high-fat diet, as well as glucose and insulin tolerance tests, were unaltered between male adult offspring of both groups. Glycemic control consisting of up to 49 000 individual glucose measures was comparable between both groups. Intrauterine exposure to maternal hyperglycemia and hyperinsulinemia without obesity had no impact on male offspring metabolic health in our model. We conclude that the intrauterine exposure itself does not represent a mechanism for fetal programming of diabetes and obesity in our model. Other maternal metabolic parameters during pregnancy, such as obesity, might impact long-term offspring metabolic health.
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Affiliation(s)
- Till Schütte
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Institute of Pharmacology, Berlin, Germany (T.S., M.S.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.)
| | - Sarah M Kedziora
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Nadine Haase
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Florian Herse
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | | | - Anna Birukov
- German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.).,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (A. Birukov).,German Center for Diabetes Research, München-Neuherberg, Germany (A. Birukov)
| | - Natalia Alenina
- Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.)
| | - Dominik N Müller
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Michael Bader
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Institute for Biology, University of Lübeck, Germany (M.B.)
| | - Michael Schupp
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Institute of Pharmacology, Berlin, Germany (T.S., M.S.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.)
| | - Ralf Dechend
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.).,HELIOS Klinikum, Department of Cardiology and Nephrology, Berlin, Germany (R.D.)
| | - Kristin Kräker
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Michaela Golic
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
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9
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Golic M, Stojanovska V, Bendix I, Wehner A, Herse F, Haase N, Kräker K, Fischer C, Alenina N, Bader M, Schütte T, Schuchardt M, van der Giet M, Henrich W, Muller DN, Felderhoff-Müser U, Scherjon S, Plösch T, Dechend R. Diabetes Mellitus in Pregnancy Leads to Growth Restriction and Epigenetic Modification of the
Srebf2
Gene in Rat Fetuses. Hypertension 2018; 71:911-920. [DOI: 10.1161/hypertensionaha.117.10782] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/08/2018] [Accepted: 02/06/2018] [Indexed: 11/16/2022]
Abstract
Diabetic pregnancy is correlated with increased risk of metabolic and neurological disorders in the offspring putatively mediated epigenetically. Little is known about epigenetic changes already present in fetuses of diabetic pregnancies. We aimed at characterizing the perinatal environment after preexisting maternal diabetes mellitus and at identifying relevant epigenetic changes in the fetus. We focused on the transcription factor
Srebf2
(sterol regulatory element binding transcription factor 2), a master gene in regulation of cholesterol metabolism. We tested whether diabetic pregnancy induces epigenetic changes in the
Srebf2
promoter and if they become manifest in altered
Srebf2
gene expression. We worked with a transgenic rat model of type 2 diabetes mellitus (Tet29) in which the insulin receptor is knocked down by doxycycline-induced RNA interference. Doxycycline was administered preconceptionally to Tet29 and wild-type control rats. Only Tet29 doxycycline dams were hyperglycemic, hyperinsulinemic, and hyperlipidemic. Gene expression was analyzed with quantitative real-time reverse transcriptase polymerase chain reaction and CpG promoter methylation with pyrosequencing. Immunohistochemistry was performed on fetal brains. Fetuses from diabetic Tet29 dams were hyperglycemic and growth restricted at the end of pregnancy. They further displayed decreased liver and brain weight with concomitant decreased microglial activation in the hippocampus in comparison to fetuses of normoglycemic mothers. Importantly, diabetic pregnancy induced CpG hypermethylation of the
Srebf2
promoter in the fetal liver and brain, which was associated with decreased
Srebf2
gene expression. In conclusion, diabetic and hyperlipidemic pregnancy induces neurological, metabolic, and epigenetic alterations in the rat fetus.
Srebf2
is a potential candidate mediating intrauterine environment-driven epigenetic changes and later diabetic offspring health.
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Affiliation(s)
- Michaela Golic
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Violeta Stojanovska
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Ivo Bendix
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Anika Wehner
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Florian Herse
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Nadine Haase
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Kristin Kräker
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Caroline Fischer
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Natalia Alenina
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Michael Bader
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Till Schütte
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Mirjam Schuchardt
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Markus van der Giet
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Wolfgang Henrich
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Dominik N. Muller
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Ursula Felderhoff-Müser
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Sicco Scherjon
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Torsten Plösch
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
| | - Ralf Dechend
- From the Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Obstetrics, Germany (M.G., W.H.); Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology with Breast Center, Campus Charité Mitte, Germany (M.G.); Experimental and Clinical Research Center, a cooperation between the
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