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Dohmen M, Petermann-Meyer A, Blei D, Bremen R, Brock-Midding E, Brüne M, Geiser F, Haastert B, Halbach SM, Heuser C, Holsteg S, Heier L, Icks A, Karger A, Montalbo J, Nakata H, Panse J, Rottmann TP, Sättler K, Viehmann A, Vomhof M, Ernstmann N, Brümmendorf TH. Comprehensive support for families with parental cancer (Family-SCOUT), evaluation of a complex intervention: study protocol for a non-randomized controlled trial. Trials 2021; 22:622. [PMID: 34526078 PMCID: PMC8442380 DOI: 10.1186/s13063-021-05577-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/27/2021] [Indexed: 11/11/2022] Open
Abstract
Background Families with minor children affected by parental cancer are at risk of considerable emotional and organizational stress that can severely burden all family members. So far, there has been a lack of comprehensive support services for affected families. The aim of this project is to implement and evaluate a complex psychosocial intervention for these families by providing advice, information, and care on an emotional, psycho-social, and communicative level during and after the cancer experience and across healthcare sectors. Methods Family-SCOUT is a project supported by the German Innovation Fund (https://innovationsfonds.g-ba.de/). The evaluation is based on a mixed-methods quasi-experimental design with the intervention and control groups. A standardized postal survey at three measurement points (T0: study enrollment; T1: 3 months of follow-up; T2: 9 months of follow-up), secondary data from the participating health insurance funds, and semi-structured qualitative interviews are used for summative and formative evaluation. The study aim is to include n=560 families. Data will be analyzed according to the intention-to-treat principle. The primary analysis is the comparison of the Hospital Anxiety and Depression Scale (HADS) response rates (minimal important difference (MID) ≥ 1.6 in at least one of the two parents) at T2 between the intervention and control group using Fisher’s exact test. The conduct of the study as well as the development and implementation of the intervention will be accompanied by comprehensive study monitoring following the principles of an effectiveness-implementation hybrid study. Discussion The results will allow to test the effectiveness and efficiency of the intervention for the target group. The first experience with the implementation of the intervention in model regions will be available. The evaluation results will serve as the basis to assess the need of including the intervention in the catalog of services of the statutory health insurance funds in Germany. Trial registration ClinicalTrials.gov, NCT04186923. Retrospectively registered on 4 December 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05577-y.
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Affiliation(s)
- Marc Dohmen
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
| | - Andrea Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany. .,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.
| | - Daniel Blei
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Rebecca Bremen
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
| | - Evamarie Brock-Midding
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Manuela Brüne
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Franziska Geiser
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Burkhard Haastert
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany.,mediStatistica, Neuenrade, Germany
| | - Sarah Maria Halbach
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Christian Heuser
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Steffen Holsteg
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Lina Heier
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Institute for Patient Safety (IfPS), University Hospital Bonn, Bonn, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Andre Karger
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Joseph Montalbo
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Hannah Nakata
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Jens Panse
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
| | - Till-Philip Rottmann
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kristina Sättler
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Anja Viehmann
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Markus Vomhof
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Nicole Ernstmann
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Institute for Patient Safety (IfPS), University Hospital Bonn, Bonn, Germany
| | - Tim H Brümmendorf
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
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Peeva V, Blei D, Trombly G, Corsi S, Szukszto MJ, Rebelo-Guiomar P, Gammage PA, Kudin AP, Becker C, Altmüller J, Minczuk M, Zsurka G, Kunz WS. Linear mitochondrial DNA is rapidly degraded by components of the replication machinery. Nat Commun 2018; 9:1727. [PMID: 29712893 PMCID: PMC5928156 DOI: 10.1038/s41467-018-04131-w] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [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: 09/25/2017] [Accepted: 04/04/2018] [Indexed: 02/02/2023] Open
Abstract
Emerging gene therapy approaches that aim to eliminate pathogenic mutations of mitochondrial DNA (mtDNA) rely on efficient degradation of linearized mtDNA, but the enzymatic machinery performing this task is presently unknown. Here, we show that, in cellular models of restriction endonuclease-induced mtDNA double-strand breaks, linear mtDNA is eliminated within hours by exonucleolytic activities. Inactivation of the mitochondrial 5'-3'exonuclease MGME1, elimination of the 3'-5'exonuclease activity of the mitochondrial DNA polymerase POLG by introducing the p.D274A mutation, or knockdown of the mitochondrial DNA helicase TWNK leads to severe impediment of mtDNA degradation. We do not observe similar effects when inactivating other known mitochondrial nucleases (EXOG, APEX2, ENDOG, FEN1, DNA2, MRE11, or RBBP8). Our data suggest that rapid degradation of linearized mtDNA is performed by the same machinery that is responsible for mtDNA replication, thus proposing novel roles for the participating enzymes POLG, TWNK, and MGME1.
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Affiliation(s)
- Viktoriya Peeva
- 0000 0001 2240 3300grid.10388.32Institute of Experimental Epileptology and Cognition Research, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
| | - Daniel Blei
- 0000 0001 2240 3300grid.10388.32Institute of Experimental Epileptology and Cognition Research, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
| | - Genevieve Trombly
- 0000 0001 2240 3300grid.10388.32Institute of Experimental Epileptology and Cognition Research, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
| | - Sarah Corsi
- 0000 0001 2240 3300grid.10388.32Institute of Experimental Epileptology and Cognition Research, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany ,0000 0001 0462 7212grid.1006.7Present Address: Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
| | - Maciej J. Szukszto
- 0000000121885934grid.5335.0MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, CB2 0XY UK
| | - Pedro Rebelo-Guiomar
- 0000000121885934grid.5335.0MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, CB2 0XY UK ,0000 0001 1503 7226grid.5808.5Graduate Program in Areas of Basic and Applied Biology (GABBA), University of Porto, Porto, 4200-135 Portugal
| | - Payam A. Gammage
- 0000000121885934grid.5335.0MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, CB2 0XY UK
| | - Alexei P. Kudin
- 0000 0001 2240 3300grid.10388.32Institute of Experimental Epileptology and Cognition Research, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
| | - Christian Becker
- 0000 0000 8580 3777grid.6190.eCologne Center for Genomics, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Weyertal 115b, Cologne, D-50931 Germany
| | - Janine Altmüller
- 0000 0000 8580 3777grid.6190.eCologne Center for Genomics, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Weyertal 115b, Cologne, D-50931 Germany ,0000 0000 8580 3777grid.6190.eInstitute of Human Genetics, University of Cologne, Kerpener Str. 34, Cologne, D-50931 Germany
| | - Michal Minczuk
- 0000000121885934grid.5335.0MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, CB2 0XY UK
| | - Gábor Zsurka
- 0000 0001 2240 3300grid.10388.32Institute of Experimental Epileptology and Cognition Research, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany ,0000 0001 2240 3300grid.10388.32Department of Epileptology and Life & Brain Center, University of Bonn, Sigmund-Freud-Str. 25, Bonn, D-53105 Germany
| | - Wolfram S. Kunz
- 0000 0001 2240 3300grid.10388.32Institute of Experimental Epileptology and Cognition Research, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany ,0000 0001 2240 3300grid.10388.32Department of Epileptology and Life & Brain Center, University of Bonn, Sigmund-Freud-Str. 25, Bonn, D-53105 Germany
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