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Goebel H, Koeditz B, Huerta M, Kameri E, Nestler T, Kamphausen T, Friemann J, Hamdorf M, Ohrmann T, Koehler P, Cornely OA, Montesinos-Rongen M, Nicol D, Schorle H, Boor P, Quaas A, Pallasch C, Heidenreich A, von Brandenstein M. COVID-19 Infection Induce miR-371a-3p Upregulation Resulting in Influence on Male Fertility. Biomedicines 2022; 10:biomedicines10040858. [PMID: 35453608 PMCID: PMC9033010 DOI: 10.3390/biomedicines10040858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Received: 01/28/2022] [Revised: 03/19/2022] [Accepted: 03/23/2022] [Indexed: 12/10/2022] Open
Abstract
In December 2019, the first case of COVID-19 was reported and since then several groups have already published that the virus can be present in the testis. To study the influence of SARS-CoV-2 which cause a dysregulation of the androgen receptor (AR) level, thereby leading to fertility problems and inducing germ cell testicular changes in patients after the infection. Formalin-Fixed-Paraffin-Embedded (FFPE) testicular samples from patients who died with or as a result of COVID-19 (n = 32) with controls (n = 6), inflammatory changes (n = 9), seminoma with/without metastasis (n = 11) compared with healthy biopsy samples (n = 3) were analyzed and compared via qRT-PCR for the expression of miR-371a-3p. An immunohistochemical analysis (IHC) and ELISA were performed in order to highlight the miR-371a-3p targeting the AR. Serum samples of patients with mild or severe COVID-19 symptoms (n = 34) were analyzed for miR-371a-3p expression. In 70% of the analyzed postmortem testicular tissue samples, a significant upregulation of the miR-371a-3p was detected, and 75% of the samples showed a reduced spermatogenesis. In serum samples, the upregulation of the miR-371a-3p was also detectable. The upregulation of the miR-371a-3p is responsible for the downregulation of the AR in SARS-CoV-2-positive patients, resulting in decreased spermatogenesis. Since the dysregulation of the AR is associated with infertility, further studies have to confirm if the identified dysregulation is regressive after a declining infection.
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Affiliation(s)
- Heike Goebel
- Institute of Pathology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (H.G.); (A.Q.)
| | - Barbara Koeditz
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (B.K.); (M.H.); (E.K.); (T.N.); (T.O.); (A.H.)
| | - Manuel Huerta
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (B.K.); (M.H.); (E.K.); (T.N.); (T.O.); (A.H.)
| | - Ersen Kameri
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (B.K.); (M.H.); (E.K.); (T.N.); (T.O.); (A.H.)
| | - Tim Nestler
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (B.K.); (M.H.); (E.K.); (T.N.); (T.O.); (A.H.)
| | - Thomas Kamphausen
- Institute of Legal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Melatengürtel 60/62, 50823 Cologne, Germany;
| | - Johannes Friemann
- Klinikum Lüdenscheid, Institute for Pathology, University Hospital Cologne, University of Cologne, Paulmannshöher Straße 14, 58515 Lüdenscheid, Germany;
| | - Matthias Hamdorf
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany;
- Terasaki Institute for Biomedical Innovation (TIBI), 1018 Westwood Blvd, Los Angeles, CA 90024, USA
| | - Timo Ohrmann
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (B.K.); (M.H.); (E.K.); (T.N.); (T.O.); (A.H.)
| | - Philipp Koehler
- Excellence Center for Medical Mycology (ECMM), Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (P.K.); (O.A.C.); (C.P.)
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Chair Translational Research, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Oliver A. Cornely
- Excellence Center for Medical Mycology (ECMM), Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (P.K.); (O.A.C.); (C.P.)
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Chair Translational Research, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
- Clinical Trials Centre Cologne (ZKS Köln), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50935 Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Medical Faculty and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Manuel Montesinos-Rongen
- Department of Neuropathology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany;
| | - David Nicol
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK;
| | - Hubert Schorle
- Department of Developmental Pathology, Institute of Pathology, University Bonn Clinics, University of Bonn, 53113 Bonn, Germany;
| | - Peter Boor
- Department of Pathology, RWTH Aachen University, 52062 Aachen, Germany;
| | - Alexander Quaas
- Institute of Pathology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (H.G.); (A.Q.)
| | - Christian Pallasch
- Excellence Center for Medical Mycology (ECMM), Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (P.K.); (O.A.C.); (C.P.)
| | - Axel Heidenreich
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (B.K.); (M.H.); (E.K.); (T.N.); (T.O.); (A.H.)
- Department of Urology, Medical University Vienna, 1090 Vienna, Austria
| | - Melanie von Brandenstein
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (B.K.); (M.H.); (E.K.); (T.N.); (T.O.); (A.H.)
- Correspondence:
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Nestler T, Kremer L, von Brandenstein M, Koeditz B, Paffenholz P, Hellmich M, Pfister D, Heidenreich A. Viable germ cell tumor and teratoma can be distinguished from necrosis in postchemotherapy retroperitoneal lymph node dissection specimens by a combination of microRNA-371a-3p and 375-5p. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.421] [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: 11/20/2022] Open
Abstract
421 Background: Our objective was to identify a combination of microRNAs (miRNA) to differentiate between viable tumor (V) or teratoma (T) and necrosis/fibrosis (N) in pcRPLND specimens of metastatic nonseminomatous germ cell tumor (NSGCT) patients with residual masses ≥1cm after chemotherapy. Our hypothesis is that a biomarker guided therapy could reduce overtreatment with pcRPLND in patients with only N. Methods: Forty-eight patients were identified, n = 16 each with T/V/N. Representative regions of T/V/N were microdissected, subsequently total RNA was isolated and miRNA expression was analyzed for miR-371a-3p, 375-3p, and 375-5p using qPCR. ROC analysis was performed for each miRNA and for all combinations in order to determine the discriminatory capacity of V and T vs. N. Results: For the group comparisons of V vs. N miR-371a-3p achieved the highest fold change (FC) of 31.1 (p = 0.023) while for T vs. N miR-375-5p performed best (FC 64,2; p < 0.001). Likewise, the most accurate AUC for V was 0.75 using miR-371a-3p, for T 0.80 using miR-375-5p. Combining the best performing miRNAs for V and T resulted in an AUC of 0.94 with a sensitivity of 93.75, specificity of 93.75, PPV of 96.8 and NPV of 83.3. Conclusions: In pcRPLND tissue samples V and T could be distinguished from necrosis/fibrosis by combining miR-371a-3p and miR-375-5p with great accuracy. This combination of miRNAs might serve as new biomarker in the future, in order to spare miRNA-negative patients from pcRPLND. However, further studies analyzing patient’s serum are needed to confirm the clinical impact of these biomarkers.
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Affiliation(s)
- Tim Nestler
- Department of Urology, University Hospital Cologne, Cologne, Germany
| | - Lara Kremer
- Department of Urology and Uro-Oncology, University Hospital of Cologne, Cologne, Germany
| | | | - Barbara Koeditz
- Department of Urology and Uro-Oncology, University Hospital of Cologne, Cologne, Germany
| | - Pia Paffenholz
- Department of Urology and Uro-Oncology, University Hospital of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
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Fischer N, Ellinger J, Koeditz B, Heidenreich A, Hoffmann MA. Predictors for Outcome and Complications Related to Urinary Diversion. Anticancer Res 2021; 41:5585-5591. [PMID: 34732429 DOI: 10.21873/anticanres.15372] [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] [Received: 07/07/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Predictors for complications such as insufficiency of intestinal anastomosis in urinary diversion and other risk factors are not well defined. We aimed to elucidate predictive factors for complications in urinary diversions based on preoperative comorbidities and major complications. A special focus was set on anastomosis insufficiency as a major complication. PATIENTS AND METHODS Preoperative comorbidities, postoperative complications, duration of hospital stay, and follow-up were analyzed in 317 patients with urinary diversion. The impact of preoperative comorbidities on diversion types was described and quantified as defined by the age-adjusted Charlson Comorbidity Index. RESULTS Overall, 14.8% of patients showed anastomosis-related complications, most within the ileal conduit group (15.9% in the cohort). Severe complications (Clavien-Dindo Classification Score >IIIa) were found in smokers (p=0.046), and in patients with vascular diseases (p=0.007), a high American Society of Anaesthesiologists (ASA)-score (p=0.047), a R1- (p=0.009), as well as a pN1 (p=0.007) status. CONCLUSION Several independent predictors for several postoperative complications in urinary diversions were identified, which were independent of the diversion method.
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Affiliation(s)
- Nicolas Fischer
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;
| | - Joerg Ellinger
- Department of Urology, Universitätskliniken Bonn, Bonn, Germany
| | - Barbara Koeditz
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Axel Heidenreich
- Clinic and Polyclinic for Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Kremer L, von Brandenstein M, Wittersheim M, Koeditz B, Paffenholz P, Hellmich M, Pfister D, Heidenreich A, Nestler T. The combination of microRNA-371a-3p and 375-5p can distinguish viable germ cell tumor and teratoma from necrosis in postchemotherapy retroperitoneal lymph node dissection specimens. Transl Androl Urol 2021; 10:1647-1655. [PMID: 33968653 PMCID: PMC8100847 DOI: 10.21037/tau-20-1349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background To identify a combination of microRNAs (miRNA) to differentiate between viable tumor (V) or teratoma (T) and necrosis/fibrosis (N) in pcRPLND specimens of metastatic germ cell tumor (GCT) patients with residual masses ≥1 cm after chemotherapy. Biomarker guided therapy could reduce overtreatment with pcRPLND in patients with only N. Methods We selected 48 metastatic GCT patients who had undergone pcRPLND. V, pure T and N was shown in the resected tissue of 16 patients, respectively. Of these areas total RNA was isolated and miRNA expression was analyzed for miR-371a-3p, 375-3p, and 375-5p using qPCR. ROC analysis was performed for each miRNA and for all combinations in order to determine the discriminatory capacity of V and T vs. N. Results On comparing V vs. N miR-371a-3p achieved the highest fold change (FC) of 31.1 (P=0.023) while for T vs. N miR-375-5p performed best (FC 64.2; P<0.001). Likewise, the most accurate AUC for V was 0.75 using miR-371a-3p, for T 0.80 using miR-375-5p. Combining the best performing miRNAs for V and T resulted in an AUC of 0.94 with a sensitivity of 93.75, specificity of 93.75, PPV of 96.8 and NPV of 83.3. Conclusions By combining miR-371a-3p and miR-375-5p in pcRPLND tissue samples V and T could be distinguished from necrosis/fibrosis with great accuracy. This combination of miRNAs might serve as new biomarker in the future, in order to spare miRNA-negative patients from pcRPLND. However, further studies analyzing patient’s serum are needed to confirm the clinical impact of these biomarkers.
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Affiliation(s)
- Lara Kremer
- Department of Urology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Melanie von Brandenstein
- Department of Urology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Maike Wittersheim
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Barbara Koeditz
- Department of Urology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Pia Paffenholz
- Department of Urology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - David Pfister
- Department of Urology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Axel Heidenreich
- Department of Urology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Tim Nestler
- Department of Urology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz, Germany
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