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Moneke I, Ögütür E, Chatterjee S, Haberecker M, Jang JH, Fähndrich S, Senbaklavaci Ö, Faccioli E, Opitz I, Passlick B, Diederichs S, Jungraithmayr W. CD26-inhibition correlates with the absence of chronic lung allograft dysfunction and decreases fibroblast activity in vitro. Br J Surg 2022. [DOI: 10.1093/bjs/znac176.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Chronic lung allograft dysfunction (CLAD) limits the survival after lung transplantation (Tx). CLAD is characterized by progressive fibrosis of small airways and lung parenchyma. No effective therapy is available that reverses or prevents CLAD. CD26 is a molecule with enzymatic activity also playing a key role in the progression of fibrotic diseases. Here, we analyzed the inhibitory effect of CD26 on fibroblast activity in vitro and the role of CD26-inhibition on allograft rejection in lung transplant patients.
Methods
Profibrogenic mRNA and protein levels were analyzed in vitro on the CD26-expressing fibroblast cell line Wi-38 using RT-qPCR and Western blot. CD26 was inhibited by Vildagliptin. Migration and proliferation activity of activated fibroblasts were analyzed by Incucyte® and Celltiter-Glo®. Characteristics of patients undergoing lung Tx between 2004 and 2021 were reviewed. Lung biopsies were analyzed by immunohistochemistry (IHC) for CD26.
Results
In vitro, the expression of profibrogenic genes (αSMA, FAPα, IGFBP7, Collagen 3 and Fibronectin) was significantly reduced in activated lung fibroblasts by Vildagliptin treatment. Also, migration and proliferation activity were attenuated by Vildagliptin. In 221 patients analyzed, CLAD was absent in 34 patients treated with the CD26-inhibitor Sitagliptin vs. an incidence of 18% in patients without Sitagliptin intake (p=0.02). Five-year survival in patients on Sitagliptin was significantly improved vs. patients without CD26-inhibitor intake (80% vs. 58%, p=0.006). Likewise, the incidence of acute cellular rejection (ACR) was significantly reduced in patients on Sitagliptin (7% vs. 35%, p=0.01). IHC of patient lung biopsies showed expression of CD26 in perifibrotic areas of CLAD lesions. Additional clinical data from University Hospital Zurich and from University Hospital Padua confirmed the finding that Sitagliptin intake correlated with the absence of acute and chronic allograft rejection.
Conclusion
CD26-inhibition attenuates key pro-fibrotic mediators and fibroblast activity in vitro. Impressively, patients on CD26-inhibitor did not show any CLAD. Moreover, ACR was significantly reduced. Gliptins which are in routine clinical use for the treatment of type II diabetes therefore seem to have great potential to be repurposed for a novel clinical application against lung allograft rejection.
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Affiliation(s)
- I Moneke
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - E Ögütür
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - S Chatterjee
- Institute for Environmental Medicine, Perelmann School of Medicine, University of Pennsylvania , Philadelphia, USA
| | - M Haberecker
- Institute of Pathology, University Hospital Zurich , Zurich, Switzerland
| | - J H Jang
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - S Fähndrich
- Department of Pneumology, University Medical Center Freiburg , Freiburg, Switzerland
| | - Ö Senbaklavaci
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - E Faccioli
- Department of Thoracic Surgery, University Hospital of Padua , Padua, Italy
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - I Opitz
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - B Passlick
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - S Diederichs
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
- German Cancer Research Center RNA Biology & Cancer, , Heidelberg, Germany
| | - W Jungraithmayr
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
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Frodl A, Eberbach H, Senbaklavaci Ö, Schmal H, Jaeger M. Fracture dislocation of the humerus with intrathoracic humeral head fragment - A case report and review of the literature. Trauma Case Rep 2022; 37:100592. [PMID: 35005168 PMCID: PMC8718900 DOI: 10.1016/j.tcr.2021.100592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2021] [Indexed: 11/30/2022] Open
Abstract
We present a rare case of humeral fracture dislocation with intrathoracic humeral head fragment. A 74-year old female was transferred to a major trauma facility after falling on her arm while gardening. An intrathoracic humeral head fragment was diagnosed after initial imaging. In correspondence with the department of thoracic surgery, the decision was made to remove the intrathoracic fragment thoracoscopically and succeed with a reverse total shoulder arthroplasty.
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Affiliation(s)
- A Frodl
- Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany
| | - H Eberbach
- Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany
| | - Ö Senbaklavaci
- Department of Thoracic Surgery, Freiburg University Hospital, Freiburg, Germany
| | - H Schmal
- Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany.,University Hospital Odense, Dep. Of Orthopedic Surgery, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - M Jaeger
- Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany
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Hartert M, Senbaklavaci Ö, Schuon R, Taspinar H, Ergün S, Mann W, Vahl CF. Successful relocation of an infected tracheostomy at the level of the inferior manubrium sterni: No mission impossible. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hartert M, Senbaklavaci Ö, Kreitner KF, Vahl CF. From partial anomalous pulmonary venous drainage to chronic thromboembolic pulmonary hypertension: successful surgical correction of a 14 year misinterpreted clinical feature. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abugameh A, Peivandi A, Conzelmann L, Senbaklavaci Ö, Mehlhorn U, Vahl CF. Redo-operations for aortic-, mitral- and simultaneous double valve prosthesis endocarditis: Early and mid-term survival. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abugameh A, Peivandi A, Senbaklavaci Ö, Vahl CF. Off pump coronary artery bypass via T-shaped ministernotomy in an anomalous origin of the right coronary artery. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Senbaklavaci Ö, Wisser W, Özpeker C, Kritzinger M, Schlick W, Wolner E, Klepetko W. Lung volume reduction surgery in patients with emphysema. Eur Surg 1999. [DOI: 10.1007/bf02619930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Senbaklavaci Ö, Wisser W, Gruber E, Wanke T, Hartl S, Wolner E, Klepetko W. Erfahrungen und Ergebnisse mit der volumsreduzierenden Operation beim fortgeschrittenen Lungenemphysem. Z Herz-, Thorax-, Gefäßchir 1997. [DOI: 10.1007/bf03042144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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