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Pryymachuk G, El-Awaad E, Piekarek N, Drebber U, Maul AC, Hescheler J, Wodarz A, Pfitzer G, Neiss WF, Pietsch M, Schroeter MM. Angiotensin II type 1 receptor localizes at the blood-bile barrier in humans and pigs. Histochem Cell Biol 2022; 157:513-524. [PMID: 35229169 PMCID: PMC9114028 DOI: 10.1007/s00418-022-02087-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 12/24/2022]
Abstract
Animal models and clinical studies suggest an influence of angiotensin II (AngII) on the pathogenesis of liver diseases via the renin–angiotensin system. AngII application increases portal blood pressure, reduces bile flow, and increases permeability of liver tight junctions. Establishing the subcellular localization of angiotensin II receptor type 1 (AT1R), the main AngII receptor, helps to understand the effects of AngII on the liver. We localized AT1R in situ in human and porcine liver and porcine gallbladder by immunohistochemistry. In order to do so, we characterized commercial anti-AT1R antibodies regarding their capability to recognize heterologous human AT1R in immunocytochemistry and on western blots, and to detect AT1R using overlap studies and AT1R-specific blocking peptides. In hepatocytes and canals of Hering, AT1R displayed a tram-track-like distribution, while in cholangiocytes AT1R appeared in a honeycomb-like pattern; i.e., in liver epithelia, AT1R showed an equivalent distribution to that in the apical junctional network, which seals bile canaliculi and bile ducts along the blood–bile barrier. In intrahepatic blood vessels, AT1R was most prominent in the tunica media. We confirmed AT1R localization in situ to the plasma membrane domain, particularly between tight and adherens junctions in both human and porcine hepatocytes, cholangiocytes, and gallbladder epithelial cells using different anti-AT1R antibodies. Localization of AT1R at the junctional complex could explain previously reported AngII effects and predestines AT1R as a transmitter of tight junction permeability.
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Affiliation(s)
- Galyna Pryymachuk
- Department of Anatomy I, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Ehab El-Awaad
- Institute II of Pharmacology, Center of Pharmacology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 24, 50931, Cologne, Germany
- Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt
| | - Nadin Piekarek
- Department of Anatomy I, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Uta Drebber
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Alexandra C Maul
- Experimental Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Juergen Hescheler
- Institute for Neurophysiology, Center for Physiology and Pathophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch-Str. 39, 50931, Cologne, Germany
| | - Andreas Wodarz
- Department of Anatomy I, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- Cologne Excellence Cluster Cellular Stress Response in Aging-Associated Diseases (CECAD), University of Cologne, Joseph-Stelzmann-Str. 26, 50931, Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, Robert-Koch-Str. 21, 50931, Cologne, Germany
| | - Gabriele Pfitzer
- Institute of Vegetative Physiology, Center for Physiology and Pathophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch-Str. 39, 50931, Cologne, Germany
| | - Wolfram F Neiss
- Department of Anatomy I, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Markus Pietsch
- Institute II of Pharmacology, Center of Pharmacology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 24, 50931, Cologne, Germany
| | - Mechthild M Schroeter
- Institute for Neurophysiology, Center for Physiology and Pathophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch-Str. 39, 50931, Cologne, Germany
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Schorn L, Fienitz T, De Donno F, Sterner-Kock A, Maul AC, Holtmann H, Lommen J, Rothamel D. Critical-size Defect Augmentation Using Sintered and Non-Sintered Bovine Bone Matrix - An Experimental Controlled Study in Minipigs. J Oral Maxillofac Surg 2021; 79:1866-1873. [PMID: 34051155 DOI: 10.1016/j.joms.2021.03.025] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/11/2021] [Accepted: 03/23/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE Xenogeneic bone substitute materials are often used for augmentation of larger bone defects. Purification methods for these materials vary, mainly in terms of temperature. The aim of this study was to determine in vivo how sintering affects quantitative and qualitative bone regeneration of 2 bovine augmentation materials. METHODS A total of 56 critical size defects were set at the frontal bone of 14 domestic pigs (4 each) and filled randomly with either bovine, sintered hydroxyapatite (BO), bovine, non-sintered hydroxyapatite (BOS), local autologous bone (AB) or left empty. All defects were additionally covered with a collagen membrane. Specimens were harvested after 4 and 8 weeks and were evaluated histologically and histomorphometrically. RESULTS Histologically new bone could be seen in every group. Significantly highest new bone formation was found in AB. No significant difference could be detected between BO and BOS. CONCLUSIONS According to the results of this study, sintered bone substitute material remains histologically distinguishable but does not affect quantitative and qualitative bone regeneration.
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Affiliation(s)
- Lara Schorn
- Resident, Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf Düsseldorf, DE
| | - Tim Fienitz
- Resident, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach, DE; Head of Department, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach, Germany and Professor, , University Hospital Düsseldorf, Düsseldorf,DE.
| | - Francesco De Donno
- Resident, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach, DE
| | - Anja Sterner-Kock
- Professor, Head of Department, Center for Experimental Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, DE
| | - Alexandra C Maul
- Head of Department, Center for Experimental Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, DE
| | - Henrik Holtmann
- Consultant, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach,DE
| | - Julian Lommen
- Resident, Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf Düsseldorf,DE
| | - Daniel Rothamel
- Head of Department, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach, Germany and Professor, , University Hospital Düsseldorf, Düsseldorf,DE
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Schorn L, Fienitz T, Gerstenberg MF, Sterner-Kock A, Maul AC, Lommen J, Holtmann H, Rothamel D. Influence of different carrier materials on biphasic calcium phosphate induced bone regeneration. Clin Oral Investig 2021; 25:3729-3737. [PMID: 33433653 DOI: 10.1007/s00784-020-03700-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/23/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Biphasic calcium phosphate (BCP) is a bioceramic material successfully used in alloplastic bone augmentation. Despite many advantages, a disadvantage of BCP seems to be a difficult application and position instability. The aim of this study was to determine how different carrier materials influence BCP-induced quantitative and qualitative bone regeneration. MATERIALS AND METHODS A total of 70 critical size defects were set in the frontal bone of 14 domestic pigs (5 each) and filled randomly with either BCP alone (BCP), BCP in combination with nano-hydroxyapatite (BCP + NHA), BCP embedded in native porcine type I/III collagen blocks (BCP + C), autologous bone (AB), or were left empty (ED). Specimens were harvested after 4 and 8 weeks and were evaluated histologically as well as histomorphometrically. RESULTS Significantly lowest rate of new bone formation was found in ED (p = < 0.001) and BCP + NHA groups (p = 0.05). After 8 weeks, the highest percentage of new bone formation was observed in the BCP + C group. Fibrous matrix was detected highest in BCP alone. The lowest residual bone substitute material was found in BCP + C after 8 weeks. CONCLUSIONS BCP-induced bone regeneration is indeed affected by different carrier types. Surface morphology and bioactive characteristics influence osseointegration and new bone formation in vivo. The combination of type I/III collagen seems most suitable for qualitative and quantitative bone regeneration. CLINICAL RELEVANCE Stabilization of granular bone substitutes using type I/III collagen might be an alternative to granulates alone, indicating excellent volume stability, satisfactory plasticity, and easy application.
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Affiliation(s)
- Lara Schorn
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, Düsseldorf, Germany
| | - Tim Fienitz
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Ludwig-Weber-Straße 15, 41061, Mönchengladbach, Germany.
| | - Maximilian F Gerstenberg
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital of Cologne, Kerpener Str. 64, 50937, Cologne, Germany
| | - Anja Sterner-Kock
- Center for Experimental Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 64, 50937, Cologne, Germany
| | - Alexandra C Maul
- Center for Experimental Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 64, 50937, Cologne, Germany
| | - Julian Lommen
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, Düsseldorf, Germany
| | - Henrik Holtmann
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Ludwig-Weber-Straße 15, 41061, Mönchengladbach, Germany
| | - Daniel Rothamel
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, Düsseldorf, Germany.,Department of Oral-, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Ludwig-Weber-Straße 15, 41061, Mönchengladbach, Germany
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Neumann T, Finke SR, Henninger M, Lemke S, Hoepfner B, Steven D, Maul AC, Schroeder DC, Annecke T. First-time evaluation of ascending compared to rectangular transthoracic defibrillation waveforms in modelled out-of-hospital cardiac arrest. Resusc Plus 2020; 1-2:100006. [PMID: 34223293 PMCID: PMC8244241 DOI: 10.1016/j.resplu.2020.100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 11/04/2022] Open
Abstract
Aim of the study Prognosis in out-of-hospital cardiac arrest (OHCA) depends on cardiopulmonary resuscitation (CPR) duration. Therefore, the optimal biphasic defibrillation waveform shows high conversion rates besides low energy. Matthew Fishler theoretically predicted it to be truncated ascending exponential. We realised a prototypic defibrillator and compared ascending with conventional rectangular waveforms in modelled OHCA and CPR. Methods Approved by the authorities, 57 healthy swine (Landrace × Piétrain) were randomised to ASCDefib (n 26) or CONVDefib (n 26). Five swine served as sham control. We induced ventricular fibrillation (VF) electrically in anaesthetised swine randomised to ASCDefib or CONVDefib and discontinued mechanical ventilation. After 5 min of untreated cardiac arrest, we started CPR with mechanical chest compressions and ventilation. We performed transthoracic biphasic defibrillations after 2, 4, 6 and 8 min CPR targeting 4 J/kg in either group. Depending on the randomised group, the defibrillation protocol was either three ascending followed by one rectangular waveform (ASCDefib) or three rectangular followed by one ascending waveform (CONVDefib). Results Under our model-specific conditions, VF was initially terminated by 13/80 ascending waveforms and 13/79 rectangular waveforms and persistent return of spontaneous circulation was achieved in 8/26 (ASCDefib) vs. 10/26 (CONVDefib) animals. Mean current rather than waveform design was predictive for defibrillation success in a generalised linear model. Conclusion Contrary to theoretical assumptions, transthoracic biphasic defibrillation with ascending waveforms is not superior to rectangular waveforms in modelled OHCA. We advocate defibrillation dosage to be guided by current, that has proven its predictive value again. Institutional protocol number 84–02.04.2017.A176.
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Affiliation(s)
- Tobias Neumann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Research Group "Clinical Research and Teaching", Kerpener Str. 62, 50937 Cologne, Germany
| | - Simon-Richard Finke
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Research Group "Clinical Research and Teaching", Kerpener Str. 62, 50937 Cologne, Germany
| | - Maja Henninger
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Research Group "Clinical Research and Teaching", Kerpener Str. 62, 50937 Cologne, Germany
| | - Sebastian Lemke
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Research Group "Clinical Research and Teaching", Kerpener Str. 62, 50937 Cologne, Germany
| | - Ben Hoepfner
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Research Group "Clinical Research and Teaching", Kerpener Str. 62, 50937 Cologne, Germany
| | - Daniel Steven
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Electrophysiology, Kerpener Str. 62, 50937 Cologne, Germany
| | - Alexandra C Maul
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Experimental Medicine, Kerpener Str. 62, 50937 Cologne, Germany
| | - Daniel C Schroeder
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Research Group "Clinical Research and Teaching", Kerpener Str. 62, 50937 Cologne, Germany
| | - Thorsten Annecke
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Research Group "Clinical Research and Teaching", Kerpener Str. 62, 50937 Cologne, Germany
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Schroeder DC, Maul AC, Guschlbauer M, Finke SR, de la Puente Bethencourt D, Becker I, Padosch SA, Hohn A, Annecke T, Böttiger BW, Sterner-Kock A, Herff H. Intravascular Cooling Device Versus Esophageal Heat Exchanger for Mild Therapeutic Hypothermia in an Experimental Setting. Anesth Analg 2020; 129:1224-1231. [PMID: 30418241 DOI: 10.1213/ane.0000000000003922] [Citation(s) in RCA: 2] [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: 12/19/2022]
Abstract
BACKGROUND Targeted temperature management is a standard therapy for unconscious survivors of cardiac arrest. To date, multiple cooling methods are available including invasive intravascular cooling devices (IVDs), which are widely used in the clinical setting. Recently, esophageal heat exchangers (EHEs) have been developed providing cooling via the esophagus that is located close to the aorta and inferior vena cava. The objective was to compare mean cooling rates, as well as differences, to target temperature during maintenance and the rewarming period of IVD and EHE. METHODS The study was conducted in 16 female domestic pigs. After randomization to either IVD or EHE (n = 8/group), core body temperature was reduced to 33°C. After 24 hours of maintenance (33°C), animals were rewarmed using a target rate of 0.25°C/h for 10 hours. All cooling phases were steered by a closed-loop feedback system between the internal jugular vein and the chiller. After euthanasia, laryngeal and esophageal tissue was harvested for histopathological examination. RESULTS Mean cooling rates (4.0°C/h ± 0.4°C/h for IVD and 2.4°C/h ± 0.3°C/h for EHE; P < .0008) and time to target temperature (85.1 ± 9.2 minutes for IVD and 142.0 ± 21.2 minutes for EHE; P = .0008) were different. Mean difference to target temperature during maintenance (0.07°C ± 0.05°C for IVD and 0.08°C ± 0.10°C for EHE; P = .496) and mean rewarming rates (0.2°C/h ± 0.1°C/h for IVD and 0.3°C/h ± 0.2°C/h for EHE; P = .226) were similar. Relevant laryngeal or esophageal tissue damage could not be detected. There were no significant differences in undesired side effects (eg, bradycardia or tachycardia, hypokalemia or hyperkalemia, hypoglycemia or hyperglycemia, hypotension, overcooling, or shivering). CONCLUSIONS After insertion, target temperatures could be reached faster by IVD compared to EHE. Cooling performance of IVD and EHE did not significantly differ in maintaining target temperature during a targeted temperature management process and in active rewarming protocols according to intensive care unit guidelines in this experimental setting.
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Affiliation(s)
- Daniel C Schroeder
- From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Alexandra C Maul
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany
| | - Maria Guschlbauer
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany.,Decentral Animal Facility, University Hospital of Cologne, Cologne, Germany
| | - Simon-Richard Finke
- From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | | | - Ingrid Becker
- Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Cologne, Germany
| | - Stephan A Padosch
- From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Andreas Hohn
- From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Thorsten Annecke
- From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Bernd W Böttiger
- From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Anja Sterner-Kock
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany
| | - Holger Herff
- From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
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Eickhoff R, Guschlbauer M, Maul AC, Klink CD, Neumann UP, Engel M, Hellmich M, Sterner-Kock A, Krieglstein CF. A new device to prevent fascial retraction in the open abdomen - proof of concept in vivo. BMC Surg 2019; 19:82. [PMID: 31286901 PMCID: PMC6615246 DOI: 10.1186/s12893-019-0543-3] [Citation(s) in RCA: 7] [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] [Received: 09/07/2018] [Accepted: 06/24/2019] [Indexed: 12/11/2022] Open
Abstract
Background An open abdomen is often necessary for survival of patients after peritonitis, compartment syndrome, or in damage control surgery. However, abdominal wall retraction relieves delays and complicates abdominal wall closure. The principle of the newly fascia preserving device (FPD) is the application of anteriorly directed traction on both fascial edges over an external support through a longitudinal beam to relieve increased abdominal pressure and prevent fascial retraction. Methods Twelve pigs were randomly divided into two groups. Both groups underwent midline laparotomy under general anesthesia. Group one was treated with the new device, group two served as controls. The tension for closing the abdominal fascia was measured immediately after laparotomy as well as at 24 and 48 h. Vital parameters and ventilation pressure were recorded. Post mortem, all fascial tissues were histologically examined. Results All pigs demonstrated increases in abdominal circumference. In both groups, forces for closing the abdomen increased over the observation period. Concerning the central closing force after 24 h we saw a significant lower force in the FPD group (14.4 ± 3 N) vs. control group (21.6 ± 5.7 N, p < 0.001). By testing the main effects using an ANOVA analysis we found a significant group related effect concerning closing force and abdominal circumference of the FDP-group vs. control group (p < 0.001; p < 0.001). The placement of the device on chest and pelvis did not influence vital parameters and ventilation pressure. Histologic exam detected no tissue damage. Conclusions This trial shows the feasibility to prevent fascial retraction during the open abdomen by using the new device. Thus, it is expected that an earlier closure of the abdominal wall will be possible, and a higher rate of primary closure will be attained.
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Affiliation(s)
- Roman Eickhoff
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Maria Guschlbauer
- Center for Experimental Medicine, University of Cologne, Robert-Koch-Str. 10 Building No. 51A, 50931, Cologne, Germany.,Decentral Animal Facility, University Hospital of Cologne, Gleueler Str. 24, 50931, Cologne, Germany
| | - Alexandra C Maul
- Center for Experimental Medicine, University of Cologne, Robert-Koch-Str. 10 Building No. 51A, 50931, Cologne, Germany
| | - Christian D Klink
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ulf P Neumann
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Michael Engel
- Department of Surgery, Marienhospital Brühl GmbH, Mühlenstraße, 21-25 50321, Brühl, Germany
| | - Martin Hellmich
- IMSB, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Anja Sterner-Kock
- Center for Experimental Medicine, University of Cologne, Robert-Koch-Str. 10 Building No. 51A, 50931, Cologne, Germany
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Schroeder DC, Maul AC, Guschlbauer M, Finke SR, de la Puente Bethencourt D, Neumann T, Padosch SA, Annecke T, Böttiger BW, Sterner-Kock A, Herff H. Esophageal Heat Exchanger Versus Water-Circulating Cooling Blanket for Targeted Temperature Management. Ther Hypothermia Temp Manag 2019; 9:251-257. [PMID: 30893023 DOI: 10.1089/ther.2018.0054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
To date, the optimal cooling device for targeted temperature management (TTM) remains unclear. Water-circulating cooling blankets are broadly available and quickly applied but reveal inaccuracy during maintenance and rewarming period. Recently, esophageal heat exchangers (EHEs) have been shown to be easily inserted, revealed effective cooling rates (0.26-1.12°C/h), acceptable deviations from target core temperature (<0.5°C), and rewarming rates between 0.2 and 0.4°C/h. The aim of this study was to compare cooling rates, accuracy during maintenance, and rewarming period as well as side effects of EHEs with water-circulating cooling blankets in a porcine TTM model. Mean core temperature of domestic pigs (n = 16) weighing 83.2 ± 3.6 kg was decreased to a target core temperature of 33°C by either using EHEs or water-circulating cooling blankets. After 8 hours of maintenance, rewarming was started at a goal rate of 0.25°C/h. Mean cooling rates were 1.3 ± 0.1°C/h (EHE) and 3.2 ± 0.5°C/h (blanket, p < 0.0002). Mean difference to target core temperature during maintenance ranged between ±1°C. Mean rewarming rates were 0.21 ± 0.01°C/h (EHE) and 0.22 ± 0.02°C/h (blanket, n.s.). There were no differences with regard to side effects such as brady- or tachycardia, hypo- or hyperkalemia, hypo- or hyperglycemia, hypotension, shivering, or esophageal tissue damage. Target temperature can be achieved faster by water-circulating cooling blankets. EHEs and water-circulating cooling blankets were demonstrated to be reliable and safe cooling devices in a prolonged porcine TTM model with more variability in EHE group.
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Affiliation(s)
- Daniel C Schroeder
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Alexandra C Maul
- Department of Experimental Medicine, University Hospital of Cologne, Cologne, Germany
| | - Maria Guschlbauer
- Department of Experimental Medicine, University Hospital of Cologne, Cologne, Germany.,Decentral Animal Facility, University Hospital of Cologne, Cologne, Germany
| | - Simon-Richard Finke
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | | | - Tobias Neumann
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Stephan A Padosch
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Thorsten Annecke
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Bernd W Böttiger
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Anja Sterner-Kock
- Department of Experimental Medicine, University Hospital of Cologne, Cologne, Germany
| | - Holger Herff
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
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Neumann T, Finke SR, Maul AC, Henninger M, Höpfner B, Lemke S, Annecke T, Schroeder DC. Accuracy and precision of the non-invasive zero-heat-flux thermometry in conditions of cardiac arrest. Resuscitation 2018. [DOI: 10.1016/j.resuscitation.2018.07.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Schroeder DC, Maul AC, Mahabir E, Koxholt I, Yan X, Padosch SA, Herff H, Bultmann-Mellin I, Sterner-Kock A, Annecke T, Hucho T, Böttiger BW, Guschlbauer M. Evaluation of small intestinal damage in a rat model of 6 Minutes cardiac arrest. BMC Anesthesiol 2018; 18:61. [PMID: 29866034 PMCID: PMC5993127 DOI: 10.1186/s12871-018-0530-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 05/25/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Contribution of the small intestine to systemic inflammation after cardiac arrest (CA) is poorly understood. The objective was to evaluate whether an in vivo rat model of 6 min CA is suitable to initiate intestinal ischaemia-reperfusion-injury and to evaluate histomorphological changes and inflammatory processes in the small intestinal mucosa resp. in sera. METHODS Adult male Wistar rats were subjected to CA followed by cardio-pulmonary resuscitation. Proximal jejunum and serum was collected at 6 h, 24 h, 72 h and 7 d post return of spontaneous circulation (ROSC) and from a control group. The small intestine was evaluated histomorphologically. Cytokine concentrations were measured in jejunum lysates and sera. RESULTS Histomorphological evaluation revealed a significant increase in mucosal damage in the jejunum at all timepoints compared to controls (p < 0.0001). In jejunal tissues, concentrations of IL-1α, IL-1β, IL-10, and TNF-α showed significant peaks at 24 h and were 1.5- to 5.7-fold higher than concentrations at 6 h and in the controls (p < 0.05). In serum, a significant higher amount of cytokine was detected only for IL-1β at 24 h post-ROSC compared to controls (15.78 vs. 9.76 pg/ml). CONCLUSION CA resulted in mild small intestinal tissue damage but not in systemic inflammation. A rat model of 6 min CA is not capable to comprehensively mimic a post cardiac arrest syndrome (PCAS). Whether there is a vital influence of the intestine on the PCAS still remains unclear.
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Affiliation(s)
- Daniel C. Schroeder
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany
| | - Alexandra C. Maul
- Experimental Medicine, University Hospital of Cologne, Robert-Koch-Str.10, Cologne, Germany
| | - Esther Mahabir
- Comparative Medicine, Center for Molecular Medicine Cologne, University of Cologne, Robert-Koch-Str.21, Cologne, Germany
| | - Isabell Koxholt
- Comparative Medicine, Center for Molecular Medicine Cologne, University of Cologne, Robert-Koch-Str.21, Cologne, Germany
| | - Xiaowei Yan
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany
| | - Stephan A. Padosch
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany
| | - Holger Herff
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany
| | - Insa Bultmann-Mellin
- Experimental Medicine, University Hospital of Cologne, Robert-Koch-Str.10, Cologne, Germany
| | - Anja Sterner-Kock
- Experimental Medicine, University Hospital of Cologne, Robert-Koch-Str.10, Cologne, Germany
| | - Thorsten Annecke
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany
| | - Tim Hucho
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany
| | - Bernd W. Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany
| | - Maria Guschlbauer
- Experimental Medicine, University Hospital of Cologne, Robert-Koch-Str.10, Cologne, Germany
- Decentral Animal Facility, University Hospital of Cologne, Robert-Koch-Str.10, Cologne, Germany
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10
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Schnapper A, Christmann A, Knudsen L, Rahmanian P, Choi YH, Zeriouh M, Karavidic S, Neef K, Sterner-Kock A, Guschlbauer M, Hofmaier F, Maul AC, Wittwer T, Wahlers T, Mühlfeld C, Ochs M. Stereological assessment of the blood-air barrier and the surfactant system after mesenchymal stem cell pretreatment in a porcine non-heart-beating donor model for lung transplantation. J Anat 2017; 232:283-295. [PMID: 29193065 DOI: 10.1111/joa.12747] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 01/09/2023] Open
Abstract
More frequent utilization of non-heart-beating donor (NHBD) organs for lung transplantation has the potential to relieve the shortage of donor organs. In particular with respect to uncontrolled NHBD, concerns exist regarding the risk of ischaemia/reperfusion (IR) injury-related graft damage or dysfunction. Due to their immunomodulating and tissue-remodelling properties, bone-marrow-derived mesenchymal stem cells (MSCs) have been suspected of playing a beneficial role regarding short- and long-term survival and function of the allograft. Thus, MSC administration might represent a promising pretreatment strategy for NHBD organs. To study the initial effects of warm ischaemia and MSC application, a large animal lung transplantation model was generated, and the structural organ composition of the transplanted lungs was analysed stereologically with particular respect to the blood-gas barrier and the surfactant system. In this study, porcine lungs (n = 5/group) were analysed. Group 1 was the sham-operated control group. In pigs of groups 2-4, cardiac arrest was induced, followed by a period of 3 h of ventilated ischaemia at room temperature. In groups 3 and 4, 50 × 106 MSCs were administered intravascularly via the pulmonary artery and endobronchially, respectively, during the last 10 min of ischaemia. The left lungs were transplanted, followed by a reperfusion period of 4 h. Then, lungs were perfusion-fixed and processed for light and electron microscopy. Samples were analysed stereologically for IR injury-related structural parameters, including volume densities and absolute volumes of parenchyma components, alveolar septum components, intra-alveolar oedema, and the intracellular and intra-alveolar surfactant pool. Additionally, the volume-weighted mean volume of lamellar bodies (lbs) and their profile size distribution were determined. Three hours of ventilated warm ischaemia was tolerated without eliciting histological or ultrastructural signs of IR injury, as revealed by qualitative and quantitative assessment. However, warm ischaemia influenced the surfactant system. The volume-weighted mean volume of lbs was reduced significantly (P = 0.024) in groups subjected to ischaemia (group medians of groups 2-4: 0.180-0.373 μm³) compared with the sham control group (median 0.814 μm³). This was due to a lower number of large lb profiles (size classes 5-15). In contrast, the intra-alveolar surfactant system was not altered significantly. No significant differences were encountered comparing ischaemia alone (group 2) or ischaemia plus application of MSCs (groups 3 and 4) in this short-term model.
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Affiliation(s)
- Anke Schnapper
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,REBIRTH (From Regenerative Biology to Reconstructive Therapy), Cluster of Excellence, Hannover, Germany
| | - Astrid Christmann
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,REBIRTH (From Regenerative Biology to Reconstructive Therapy), Cluster of Excellence, Hannover, Germany
| | - Lars Knudsen
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,REBIRTH (From Regenerative Biology to Reconstructive Therapy), Cluster of Excellence, Hannover, Germany
| | - Parwis Rahmanian
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany
| | - Yeong-Hoon Choi
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany.,Center of Molecular Medicine, University of Cologne, Cologne, Germany
| | - Mohamed Zeriouh
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany
| | - Samira Karavidic
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany
| | - Klaus Neef
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany.,Center of Molecular Medicine, University of Cologne, Cologne, Germany
| | - Anja Sterner-Kock
- Center for Experimental Medicine, University of Cologne, Cologne, Germany
| | - Maria Guschlbauer
- Center for Experimental Medicine, University of Cologne, Cologne, Germany.,Decentral Animal Facility, University of Cologne, Cologne, Germany
| | - Florian Hofmaier
- Center for Experimental Medicine, University of Cologne, Cologne, Germany
| | - Alexandra C Maul
- Center for Experimental Medicine, University of Cologne, Cologne, Germany
| | - Thorsten Wittwer
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany.,Center of Molecular Medicine, University of Cologne, Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany.,Center of Molecular Medicine, University of Cologne, Cologne, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,REBIRTH (From Regenerative Biology to Reconstructive Therapy), Cluster of Excellence, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Matthias Ochs
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.,REBIRTH (From Regenerative Biology to Reconstructive Therapy), Cluster of Excellence, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
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11
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Guschlbauer M, Maul AC, Yan X, Herff H, Annecke T, Sterner-Kock A, Böttiger BW, Schroeder DC. Zero-Heat-Flux Thermometry for Non-Invasive Measurement of Core Body Temperature in Pigs. PLoS One 2016; 11:e0150759. [PMID: 26938613 PMCID: PMC4777531 DOI: 10.1371/journal.pone.0150759] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/18/2016] [Indexed: 11/29/2022] Open
Abstract
Hypothermia is a severe, unpleasant side effect during general anesthesia. Thus, temperature surveillance is a prerequisite in general anesthesia settings during experimental surgeries. The gold standard to measure the core body temperature (Tcore) is placement of a Swan-Ganz catheter in the pulmonary artery, which is a highly invasive procedure. Therefore, Tcore is commonly examined in the urine bladder and rectum. However, these procedures are known for their inaccuracy and delayed record of temperatures. Zero-heat-flux (ZHF) thermometry is an alternative, non-invasive method quantifying Tcore in human patients by applying a thermosensoric patch to the lateral forehead. Since the porcine cranial anatomy is different to the human’s, the optimal location of the patch remains unclear to date. The aim was to compare three different patch locations of ZHF thermometry in a porcine hypothermia model. Hypothermia (33.0°C Tcore) was conducted in 11 anesthetized female pigs (26-30kg). Tcore was measured continuously by an invasive Swan-Ganz catheter in the pulmonary artery (Tpulm). A ZHF thermometry device was mounted on three different defined locations. The smallest average difference between Tpulm and TZHF during stable temperatures was 0.21 ± 0.16°C at location A, where the patch was placed directly behind the eye. Also during rapidly changing temperatures location A showed the smallest bias with 0.48 ± 0.29°C. Location A provided the most reliable data for Tcore. Therefore, the ZHF thermometry patch should be placed directly behind the left temporal corner of the eye to provide a non-invasive method for accurate measurement of Tcore in pigs.
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Affiliation(s)
- Maria Guschlbauer
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany
| | - Alexandra C. Maul
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany
- * E-mail:
| | - Xiaowei Yan
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Holger Herff
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Thorsten Annecke
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Anja Sterner-Kock
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany
| | - Bernd W. Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Daniel C. Schroeder
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
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12
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Wittwer T, Rahmanian P, Choi YH, Zeriouh M, Karavidic S, Neef K, Christmann A, Piatkowski T, Schnapper A, Ochs M, Mühlfeld C, Sterner-Kock A, Guschlbauer M, Hofmaier F, Maul AC, Wahlers T. Erratum: Mesenchymal stem cell pretreatment of non-heart-beating-donors in experimental lung transplantation. J Cardiothorac Surg 2015; 10:75. [PMID: 26016796 PMCID: PMC4446806 DOI: 10.1186/s13019-014-0198-1] [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: 11/10/2022] Open
Affiliation(s)
- Thorsten Wittwer
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Kerpener Strasse 61, 50924, Cologne, Germany. .,Center of Molecular Medicine, University of Cologne, Cologne, Germany.
| | - Parwis Rahmanian
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Kerpener Strasse 61, 50924, Cologne, Germany.
| | - Yeong-Hoon Choi
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Kerpener Strasse 61, 50924, Cologne, Germany. .,Center of Molecular Medicine, University of Cologne, Cologne, Germany.
| | - Mohamed Zeriouh
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Kerpener Strasse 61, 50924, Cologne, Germany.
| | - Samira Karavidic
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Kerpener Strasse 61, 50924, Cologne, Germany.
| | - Klaus Neef
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Kerpener Strasse 61, 50924, Cologne, Germany. .,Center of Molecular Medicine, University of Cologne, Cologne, Germany.
| | - Astrid Christmann
- Institute of Functional and Applied Anatomy, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.
| | - Tanja Piatkowski
- Institute of Functional and Applied Anatomy, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.
| | - Anke Schnapper
- Institute of Functional and Applied Anatomy, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.
| | - Matthias Ochs
- Institute of Functional and Applied Anatomy, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany. .,Cluster of Excellence Rebirth (From Regenerative Biology to Reconstructive Therapy), Hannover, Germany.
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany. .,Cluster of Excellence Rebirth (From Regenerative Biology to Reconstructive Therapy), Hannover, Germany.
| | - Anja Sterner-Kock
- Center for Experimental Medicine, University of Cologne, Cologne, Germany.
| | - Maria Guschlbauer
- Center for Experimental Medicine, University of Cologne, Cologne, Germany.
| | - Florian Hofmaier
- Center for Experimental Medicine, University of Cologne, Cologne, Germany.
| | - Alexandra C Maul
- Center for Experimental Medicine, University of Cologne, Cologne, Germany.
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Kerpener Strasse 61, 50924, Cologne, Germany. .,Center of Molecular Medicine, University of Cologne, Cologne, Germany.
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13
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Bultmann-Mellin I, Conradi A, Maul AC, Dinger K, Wempe F, Wohl AP, Imhof T, Wunderlich FT, Bunck AC, Nakamura T, Koli K, Bloch W, Ghanem A, Heinz A, von Melchner H, Sengle G, Sterner-Kock A. Modeling autosomal recessive cutis laxa type 1C in mice reveals distinct functions for Ltbp-4 isoforms. Dis Model Mech 2015; 8:403-15. [PMID: 25713297 PMCID: PMC4381339 DOI: 10.1242/dmm.018960] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 02/16/2015] [Indexed: 01/03/2023] Open
Abstract
Recent studies have revealed an important role for LTBP-4 in elastogenesis. Its mutational inactivation in humans causes autosomal recessive cutis laxa type 1C (ARCL1C), which is a severe disorder caused by defects of the elastic fiber network. Although the human gene involved in ARCL1C has been discovered based on similar elastic fiber abnormalities exhibited by mice lacking the short Ltbp-4 isoform (Ltbp4S(-/-)), the murine phenotype does not replicate ARCL1C. We therefore inactivated both Ltbp-4 isoforms in the mouse germline to model ARCL1C. Comparative analysis of Ltbp4S(-/-) and Ltbp4-null (Ltbp4(-/-)) mice identified Ltbp-4L as an important factor for elastogenesis and postnatal survival, and showed that it has distinct tissue expression patterns and specific molecular functions. We identified fibulin-4 as a previously unknown interaction partner of both Ltbp-4 isoforms and demonstrated that at least Ltbp-4L expression is essential for incorporation of fibulin-4 into the extracellular matrix (ECM). Overall, our results contribute to the current understanding of elastogenesis and provide an animal model of ARCL1C.
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Affiliation(s)
- Insa Bultmann-Mellin
- Center for Experimental Medicine, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Anne Conradi
- Center for Experimental Medicine, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Alexandra C Maul
- Center for Experimental Medicine, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Katharina Dinger
- Center for Experimental Medicine, Medical Faculty, University of Cologne, 50931 Cologne, Germany. Department of Pediatrics and Adolescent Medicine, Medical Faculty, University of Cologne, 50937 Cologne, Germany
| | - Frank Wempe
- Department of Molecular Hematology, University of Frankfurt Medical School, 60590 Frankfurt am Main, Germany
| | - Alexander P Wohl
- Center for Biochemistry, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Thomas Imhof
- Center for Biochemistry, Medical Faculty, University of Cologne, 50931 Cologne, Germany. Institute for Dental Research and Oral Musculoskeletal Biology, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - F Thomas Wunderlich
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931 Cologne, Germany. Max Planck Institute for Metabolism Research, 50931 Cologne, Germany. Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
| | - Alexander C Bunck
- Department of Radiology, Medical Faculty, University of Cologne, 50937 Cologne, Germany
| | - Tomoyuki Nakamura
- Department of Pharmacology, Kansai Medical University, Osaka 570-8506, Japan
| | - Katri Koli
- Research Programs Unit and Transplantation Laboratory, Haartman Institute, University of Helsinki, 00014 Helsinki, Finland
| | - Wilhelm Bloch
- Institute of Cardiology and Sports Medicine, German Sport University Cologne, 50933 Cologne, Germany
| | - Alexander Ghanem
- Department of Medicine/Cardiology, University of Bonn, 53127 Bonn, Germany
| | - Andrea Heinz
- Institute of Pharmacy, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Harald von Melchner
- Department of Molecular Hematology, University of Frankfurt Medical School, 60590 Frankfurt am Main, Germany
| | - Gerhard Sengle
- Center for Biochemistry, Medical Faculty, University of Cologne, 50931 Cologne, Germany. Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931 Cologne, Germany
| | - Anja Sterner-Kock
- Center for Experimental Medicine, Medical Faculty, University of Cologne, 50931 Cologne, Germany.
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