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Woelfel S, Dütschler J, König M, Dulovic A, Graf N, Junker D, Oikonomou V, Krieger C, Truniger S, Franke A, Eckhold A, Forsch K, Koller S, Wyss J, Krupka N, Oberholzer M, Frei N, Geissler N, Schaub P, Albrich WC, Friedrich M, Schneiderhan-Marra N, Misselwitz B, Korte W, Bürgi JJ, Brand S. STAR SIGN study: Evaluation of COVID-19 vaccine efficacy against the SARS-CoV-2 variants BQ.1.1 and XBB.1.5 in patients with inflammatory bowel disease. Aliment Pharmacol Ther 2023; 58:678-691. [PMID: 37571863 DOI: 10.1111/apt.17661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/06/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Vaccine-elicited immune responses are impaired in patients with inflammatory bowel disease (IBD) treated with anti-TNF biologics. AIMS To assess vaccination efficacy against the novel omicron sublineages BQ.1.1 and XBB.1.5 in immunosuppressed patients with IBD. METHODS This prospective multicentre case-control study included 98 biologic-treated patients with IBD and 48 healthy controls. Anti-spike IgG concentrations and surrogate neutralisation against SARS-CoV-2 wild-type, BA.1, BA.5, BQ.1.1, and XBB.1.5 were measured at two different time points (2-16 weeks and 22-40 weeks) following third dose vaccination. Surrogate neutralisation was based on antibody-mediated blockage of ACE2-spike protein-protein interaction. Primary outcome was surrogate neutralisation against tested SARS-CoV-2 sublineages. Secondary outcomes were proportions of participants with insufficient surrogate neutralisation, impact of breakthrough infection, and correlation of surrogate neutralisation with anti-spike IgG concentration. RESULTS Surrogate neutralisation against all tested sublineages was reduced in patients with IBD who were treated with anti-TNF biologics compared to patients treated with non-anti-TNF biologics and healthy controls (each p ≤ 0.001) at visit 1. Anti-TNF therapy (odds ratio 0.29 [95% CI 0.19-0.46]) and time since vaccination (0.85 [0.72-1.00]) were associated with low, and mRNA-1273 vaccination (1.86 [1.12-3.08]) with high wild-type surrogate neutralisation in a β-regression model. Accordingly, higher proportions of patients treated with anti-TNF biologics had insufficient surrogate neutralisation against omicron sublineages at visit 1 compared to patients treated with non-anti-TNF biologics and healthy controls (each p ≤ 0.015). Surrogate neutralisation against all tested sublineages decreased over time but was increased by breakthrough infection. Anti-spike IgG concentrations correlated with surrogate neutralisation. CONCLUSIONS Patients with IBD who are treated with anti-TNF biologics show impaired neutralisation against novel omicron sublineages BQ.1.1 and XBB.1.5 and may benefit from prioritisation for future variant-adapted vaccines.
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Affiliation(s)
- Simon Woelfel
- Max von Pettenkofer Institute of Hygiene and Medical Microbiology, Faculty of Medicine, Ludwig Maximilian University of Munich (LMU Munich), Munich, Germany
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Joel Dütschler
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Outpatient Clinic, Ambulatory Services Rorschach, Rorschach, Switzerland
| | - Marius König
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Alex Dulovic
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Nicole Graf
- Clinical Trials Unit, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Vasileios Oikonomou
- Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia Krieger
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Samuel Truniger
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Outpatient Clinic, Ambulatory Services Rorschach, Rorschach, Switzerland
| | - Annett Franke
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Outpatient Clinic, Ambulatory Services Rorschach, Rorschach, Switzerland
| | - Annika Eckhold
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Kristina Forsch
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Seraina Koller
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Jacqueline Wyss
- Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Niklas Krupka
- Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Nicola Frei
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Nora Geissler
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Peter Schaub
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Werner C Albrich
- Division of Infectious Diseases & Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Matthias Friedrich
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Benjamin Misselwitz
- Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | | | | | - Stephan Brand
- Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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Häring J, Michel T, Becker M, Junker D, Tchitchagua T, Leschnik O, Lange B, Castell S, Krause G, Strengert M, Dulovic A, Schneiderhan-Marra N. Simultaneous Detection of Different Antibody Classes in a Multiplexed Serological Test. J Vis Exp 2023. [PMID: 37522730 DOI: 10.3791/65323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
To monitor the progression of infectious diseases, it is useful to assess immunoreactivity against various antigenic determinants, and measure different antibody isotypes because they appear at different stages of the host immune response. With Lyme borreliosis, the pathogenic agent can be one of the multiple members of the Borrelia species. Therefore, correct sample classification requires evaluating the immunoreactivity against different antigens of different Borrelia species. Additionally, anti-pathogen IgG and IgM responses can have different elicitation time courses during disease progression. Here we demonstrate the development of a two-reporter multiplex immunoassay that has utility in identifying Borrelia-specific immune response in human serum samples by simultaneously evaluating both IgG and IgM immunoreactivity against different bacterial antigens in the same reaction well. This dual-reporter approach retains the analytical performance of single-reporter methods while conserving time and resources and reducing sample size requirements. This assay allows essentially double the serological information to be generated from a blood sample in half the time.
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Affiliation(s)
- Julia Häring
- NMI Natural and Medical Sciences Institute, University of Tübingen
| | - Tanja Michel
- NMI Natural and Medical Sciences Institute, University of Tübingen
| | - Matthias Becker
- NMI Natural and Medical Sciences Institute, University of Tübingen
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute, University of Tübingen
| | | | - Olaf Leschnik
- Department of Neurology, Sächsisches Krankenhaus Rodewisch
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research; German Centre for Infection Research (DZIF)
| | - Stefanie Castell
- Department of Epidemiology, Helmholtz Centre for Infection Research; German Centre for Infection Research (DZIF)
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research; German Centre for Infection Research (DZIF)
| | - Monika Strengert
- Department of Epidemiology, Helmholtz Centre for Infection Research
| | - Alex Dulovic
- NMI Natural and Medical Sciences Institute, University of Tübingen
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Uzun G, Müller R, Althaus K, Becker M, Marsall P, Junker D, Nowak-Harnau S, Schneiderhan-Marra N, Klüter H, Schrezenmeier H, Bugert P, Bakchoul T. Correlation between Clinical Characteristics and Antibody Levels in COVID-19 Convalescent Plasma Donor Candidates. Viruses 2023; 15:1357. [PMID: 37376656 DOI: 10.3390/v15061357] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
COVID-19 convalescent plasma (CCP) with high neutralizing antibodies has been suggested in preventing disease progression in COVID-19. In this study, we investigated the relationship between clinical donor characteristics and neutralizing anti-SARS-CoV-2 antibodies in CCP donors. COVID-19 convalescent plasma donors were included into the study. Clinical parameters were recorded and anti-SARS-CoV-2 antibody levels (Spike Trimer, Receptor Binding Domain (RBD), S1, S2 and nucleocapsid protein) as well as ACE2 binding inhibition were measured. An ACE2 binding inhibition < 20% was defined as an inadequate neutralization capacity. Univariate and multivariable logistic regression analysis was used to detect the predictors of inadequate neutralization capacity. Ninety-one CCP donors (56 female; 61%) were analyzed. A robust correlation between all SARS-CoV-2 IgG antibodies and ACE2 binding inhibition, as well as a positive correlation between donor age, body mass index, and a negative correlation between time since symptom onset and antibody levels were found. We identified time since symptom onset, normal body mass index (BMI), and the absence of high fever as independent predictors of inadequate neutralization capacity. Gender, duration of symptoms, and number of symptoms were not associated with SARS-CoV-2 IgG antibody levels or neutralization. Neutralizing capacity was correlated with SARS-CoV-2 IgG antibodies and associated with time since symptom onset, BMI, and fever. These clinical parameters can be easily incorporated into the preselection of CCP donors.
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Affiliation(s)
- Günalp Uzun
- Centre for Clinical Transfusion Medicine, University Hospital of Tuebingen, 72072 Tuebingen, Germany
- Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72072 Tuebingen, Germany
| | - Rebecca Müller
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, 68167 Mannheim, Germany
| | - Karina Althaus
- Centre for Clinical Transfusion Medicine, University Hospital of Tuebingen, 72072 Tuebingen, Germany
- Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72072 Tuebingen, Germany
| | - Matthias Becker
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, 72770 Reutlingen, Germany
| | - Patrick Marsall
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, 72770 Reutlingen, Germany
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, 72770 Reutlingen, Germany
| | - Stefanie Nowak-Harnau
- Centre for Clinical Transfusion Medicine, University Hospital of Tuebingen, 72072 Tuebingen, Germany
| | - Nicole Schneiderhan-Marra
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, 72770 Reutlingen, Germany
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, 68167 Mannheim, Germany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, 89081 Ulm, Germany
- Institute for Transfusion Medicine and University Hospital Ulm, University of Ulm, 89081 Ulm, Germany
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, 68167 Mannheim, Germany
| | - Tamam Bakchoul
- Centre for Clinical Transfusion Medicine, University Hospital of Tuebingen, 72072 Tuebingen, Germany
- Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72072 Tuebingen, Germany
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Jacobsen H, Strengert M, Maaß H, Ynga Durand MA, Katzmarzyk M, Kessel B, Harries M, Rand U, Abassi L, Kim Y, Lüddecke T, Metzdorf K, Hernandez P, Ortmann J, Heise JK, Castell S, Gornyk D, Glöckner S, Melhorn V, Kemmling Y, Lange B, Dulovic A, Marsall P, Häring J, Junker D, Schneiderhan-Marra N, Hoffmann M, Pöhlmann S, Krause G, Cicin-Sain L. Diminished neutralization responses towards SARS-CoV-2 Omicron VoC after mRNA or vector-based COVID-19 vaccinations. Sci Rep 2022; 12:19858. [PMID: 36400804 PMCID: PMC9673895 DOI: 10.1038/s41598-022-22552-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 10/17/2022] [Indexed: 11/19/2022] Open
Abstract
SARS-CoV-2 variants accumulating immune escape mutations provide a significant risk to vaccine-induced protection against infection. The novel variant of concern (VoC) Omicron BA.1 and its sub-lineages have the largest number of amino acid alterations in its Spike protein to date. Thus, they may efficiently escape recognition by neutralizing antibodies, allowing breakthrough infections in convalescent and vaccinated individuals in particular in those who have only received a primary immunization scheme. We analyzed neutralization activity of sera from individuals after vaccination with all mRNA-, vector- or heterologous immunization schemes currently available in Europe by in vitro neutralization assay at peak response towards SARS-CoV-2 B.1, Omicron sub-lineages BA.1, BA.2, BA.2.12.1, BA.3, BA.4/5, Beta and Delta pseudotypes and also provide longitudinal follow-up data from BNT162b2 vaccinees. All vaccines apart from Ad26.CoV2.S showed high levels of responder rates (96-100%) towards the SARS-CoV-2 B.1 isolate, and minor to moderate reductions in neutralizing Beta and Delta VoC pseudotypes. The novel Omicron variant and its sub-lineages had the biggest impact, both in terms of response rates and neutralization titers. Only mRNA-1273 showed a 100% response rate to Omicron BA.1 and induced the highest level of neutralizing antibody titers, followed by heterologous prime-boost approaches. Homologous BNT162b2 vaccination, vector-based AZD1222 and Ad26.CoV2.S performed less well with peak responder rates of 48%, 56% and 9%, respectively. However, Omicron responder rates in BNT162b2 recipients were maintained in our six month longitudinal follow-up indicating that individuals with cross-protection against Omicron maintain it over time. Overall, our data strongly argue for booster doses in individuals who were previously vaccinated with BNT162b2, or a vector-based primary immunization scheme.
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Affiliation(s)
- Henning Jacobsen
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Monika Strengert
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- TWINCORE, Centre for Experimental and Clinical Infection Research, Joint Venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Henrike Maaß
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Maeva Katzmarzyk
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Barbora Kessel
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Ulfert Rand
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Leila Abassi
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Yeonsu Kim
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Tatjana Lüddecke
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Kristin Metzdorf
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Pilar Hernandez
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Julia Ortmann
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Jana-Kristin Heise
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Stefanie Castell
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Daniela Gornyk
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Stephan Glöckner
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Vanessa Melhorn
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Yvonne Kemmling
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Alex Dulovic
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Patrick Marsall
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Julia Häring
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | | | - Markus Hoffmann
- Deutsches Primatenzentrum, Leibniz-Institut Für Primatenforschung, Göttingen, Germany
- Faculty of Biology and Psychology, Georg-August-University, Göttingen, Germany
| | - Stefan Pöhlmann
- Deutsches Primatenzentrum, Leibniz-Institut Für Primatenforschung, Göttingen, Germany
- Faculty of Biology and Psychology, Georg-August-University, Göttingen, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- TWINCORE, Centre for Experimental and Clinical Infection Research, Joint Venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany.
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany.
| | - Luka Cicin-Sain
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany.
- Centre for Individualized Infection Medicine (CIIM), Joint Venture of Helmholtz Centre for Infection Research and Medical School Hannover, Inhoffenstraße 7, 38124, Braunschweig, Germany.
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Häring J, Hassenstein MJ, Becker M, Ortmann J, Junker D, Karch A, Berger K, Tchitchagua T, Leschnik O, Harries M, Gornyk D, Hernández P, Lange B, Castell S, Krause G, Dulovic A, Strengert M, Schneiderhan-Marra N. Borrelia multiplex: a bead-based multiplex assay for the simultaneous detection of Borrelia specific IgG/IgM class antibodies. BMC Infect Dis 2022; 22:859. [PMID: 36396985 PMCID: PMC9670078 DOI: 10.1186/s12879-022-07863-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background Lyme borreliosis (LB) is the most common tick-borne infectious disease in the northern hemisphere. The diagnosis of LB is usually made by clinical symptoms and subsequently supported by serology. In Europe, a two-step testing consisting of an enzyme-linked immunosorbent assay (ELISA) and an immunoblot is recommended. However, due to the low sensitivity of the currently available tests, antibody detection is sometimes inaccurate, especially in the early phase of infection, leading to underdiagnoses. Methods To improve upon Borrelia diagnostics, we developed a multiplex Borrelia immunoassay (Borrelia multiplex), which utilizes the new INTELLIFLEX platform, enabling the simultaneous dual detection of IgG and IgM antibodies, saving further time and reducing the biosample material requirement. In order to enable correct classification, the Borrelia multiplex contains eight antigens from the five human pathogenic Borrelia species known in Europe. Six antigens are known to mainly induce an IgG response and two antigens are predominant for an IgM response. Results To validate the assay, we compared the Borrelia multiplex to a commercial bead-based immunoassay resulting in an overall assay sensitivity of 93.7% (95% CI 84.8–97.5%) and a specificity of 96.5% (95%CI 93.5–98.1%). To confirm the calculated sensitivity and specificity, a comparison with a conventional 2-step diagnostics was performed. With this comparison, we obtained a sensitivity of 95.2% (95% CI 84.2–99.2%) and a specificity of 93.0% (95% CI 90.6–94.7%). Conclusion Borrelia multiplex is a highly reproducible cost- and time-effective assay that enables the profiling of antibodies against several individual antigens simultaneously. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07863-9.
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Becker M, Cossmann A, Lürken K, Junker D, Gruber J, Juengling J, Ramos GM, Beigel A, Wrenger E, Lonnemann G, Stankov MV, Dopfer-Jablonka A, Kaiser PD, Traenkle B, Rothbauer U, Krause G, Schneiderhan-Marra N, Strengert M, Dulovic A, Behrens GMN. Longitudinal cellular and humoral immune responses after triple BNT162b2 and fourth full-dose mRNA-1273 vaccination in haemodialysis patients. Front Immunol 2022; 13:1004045. [PMID: 36275672 PMCID: PMC9582343 DOI: 10.3389/fimmu.2022.1004045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/26/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
Haemodialysis patients respond poorly to vaccination and continue to be at-risk for severe COVID-19. Therefore, dialysis patients were among the first for which a fourth COVID-19 vaccination was recommended. However, targeted information on how to best maintain immune protection after SARS-CoV-2 vaccinations in at-risk groups for severe COVID-19 remains limited. We provide, to the best of our knowledge, for the first time longitudinal vaccination response data in dialysis patients and controls after a triple BNT162b2 vaccination and in the latter after a subsequent fourth full-dose of mRNA-1273. We analysed systemic and mucosal humoral IgG responses against the receptor-binding domain (RBD) and ACE2-binding inhibition towards variants of concern including Omicron and Delta with multiplex-based immunoassays. In addition, we assessed Spike S1-specific T-cell responses by interferon γ release assay. After triple BNT162b2 vaccination, anti-RBD B.1 IgG and ACE2 binding inhibition reached peak levels in dialysis patients, but remained inferior compared to controls. Whilst we detected B.1-specific ACE2 binding inhibition in 84% of dialysis patients after three BNT162b2 doses, binding inhibition towards the Omicron variant was only detectable in 38% of samples and declining to 16% before the fourth vaccination. By using mRNA-1273 as fourth dose, humoral immunity against all SARS-CoV-2 variants tested was strongly augmented with 80% of dialysis patients having Omicron-specific ACE2 binding inhibition. Modest declines in T-cell responses in dialysis patients and controls after the second vaccination were restored by the third BNT162b2 dose and significantly increased by the fourth vaccination. Our data support current advice for a four-dose COVID-19 immunisation scheme for at-risk individuals such as haemodialysis patients. We conclude that administration of a fourth full-dose of mRNA-1273 as part of a mixed mRNA vaccination scheme to boost immunity and to prevent severe COVID-19 could also be beneficial in other immune impaired individuals. Additionally, strategic application of such mixed vaccine regimens may be an immediate response against SARS-CoV-2 variants with increased immune evasion potential.
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Affiliation(s)
- Matthias Becker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Anne Cossmann
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Karsten Lürken
- Department of Internal Medicine and Nephrology, Dialysis Centre Eickenhof, Langenhagen, Germany
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Jens Gruber
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Jennifer Juengling
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Gema Morillas Ramos
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Andrea Beigel
- Department of Internal Medicine and Nephrology, Dialysis Centre Eickenhof, Langenhagen, Germany
| | - Eike Wrenger
- Department of Internal Medicine and Nephrology, Dialysis Centre Eickenhof, Langenhagen, Germany
| | - Gerhard Lonnemann
- Department of Internal Medicine and Nephrology, Dialysis Centre Eickenhof, Langenhagen, Germany
| | - Metodi V. Stankov
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Alexandra Dopfer-Jablonka
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig, Hannover, Germany
| | - Philipp D. Kaiser
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Bjoern Traenkle
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Ulrich Rothbauer
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Pharmaceutical Biotechnology, University of Tübingen, Tübingen, Germany
| | - Gérard Krause
- German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig, Hannover, Germany
- Department Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- TWINCORE GmbH, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | | | - Monika Strengert
- Department Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- TWINCORE GmbH, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
- *Correspondence: Monika Strengert, ; Alex Dulovic, ; Georg M. N. Behrens,
| | - Alex Dulovic
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- *Correspondence: Monika Strengert, ; Alex Dulovic, ; Georg M. N. Behrens,
| | - Georg M. N. Behrens
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig, Hannover, Germany
- CiiM - Centre for Individualized Infection Medicine, Hannover, Germany
- *Correspondence: Monika Strengert, ; Alex Dulovic, ; Georg M. N. Behrens,
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Junker D, Becker M, Wagner TR, Kaiser PD, Maier S, Grimm TM, Griesbaum J, Marsall P, Gruber J, Traenkle B, Heinzel C, Pinilla YT, Held J, Fendel R, Kreidenweiss A, Nelde A, Maringer Y, Schroeder S, Walz JS, Althaus K, Uzun G, Mikus M, Bakchoul T, Schenke-Layland K, Bunk S, Haeberle H, Göpel S, Bitzer M, Renk H, Remppis J, Engel C, Franz AR, Harries M, Kessel B, Lange B, Strengert M, Krause G, Zeck A, Rothbauer U, Dulovic A, Schneiderhan-Marra N. Antibody Binding and Angiotensin-Converting Enzyme 2 Binding Inhibition Is Significantly Reduced for Both the BA.1 and BA.2 Omicron Variants. Clin Infect Dis 2022; 76:e240-e249. [PMID: 35717657 PMCID: PMC9384292 DOI: 10.1093/cid/ciac498] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 01/11/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The rapid emergence of the Omicron variant and its large number of mutations led to its classification as a variant of concern (VOC) by the World Health Organization. Subsequently, Omicron evolved into distinct sublineages (eg, BA.1 and BA.2), which currently represent the majority of global infections. Initial studies of the neutralizing response toward BA.1 in convalescent and vaccinated individuals showed a substantial reduction. METHODS We assessed antibody (immunoglobulin G [IgG]) binding, ACE2 (angiotensin-converting enzyme 2) binding inhibition, and IgG binding dynamics for the Omicron BA.1 and BA.2 variants compared to a panel of VOCs/variants of interest, in a large cohort (N = 352) of convalescent, vaccinated, and infected and subsequently vaccinated individuals. RESULTS While Omicron was capable of efficiently binding to ACE2, antibodies elicited by infection or immunization showed reduced binding capacities and ACE2 binding inhibition compared to wild type. Whereas BA.1 exhibited less IgG binding compared to BA.2, BA.2 showed reduced inhibition of ACE2 binding. Among vaccinated samples, antibody binding to Omicron only improved after administration of a third dose. CONCLUSIONS Omicron BA.1 and BA.2 can still efficiently bind to ACE2, while vaccine/infection-derived antibodies can bind to Omicron. The extent of the mutations within both variants prevents a strong inhibitory binding response. As a result, both Omicron variants are able to evade control by preexisting antibodies.
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Affiliation(s)
| | | | | | - Philipp D Kaiser
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Sandra Maier
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Tanja M Grimm
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Johanna Griesbaum
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Patrick Marsall
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Jens Gruber
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Bjoern Traenkle
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Constanze Heinzel
- Institute of Tropical Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Yudi T Pinilla
- Institute of Tropical Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Jana Held
- Institute of Tropical Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Rolf Fendel
- Institute of Tropical Medicine, University Hospital Tuebingen, Tuebingen, Germany,German Center for Infection Research, partner site Tuebingen, Tuebingen, Germany,Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Andrea Kreidenweiss
- Institute of Tropical Medicine, University Hospital Tuebingen, Tuebingen, Germany,German Center for Infection Research, partner site Tuebingen, Tuebingen, Germany,Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Annika Nelde
- Department of Peptide-Based Immunotherapy, University of Tuebingen and University Hospital Tuebingen, Tuebingen, Germany,Department of Internal Medicine, Clinical Collaboration Unit Translational Immunology, German Cancer Consortium, University Hospital Tuebingen, Tuebingen, Germany,Department of Immunology, Institute for Cell Biology, University of Tuebingen, Tuebingen, Germany,Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies,” University of Tuebingen, Tuebingen, Germany
| | - Yacine Maringer
- Department of Peptide-Based Immunotherapy, University of Tuebingen and University Hospital Tuebingen, Tuebingen, Germany,Department of Internal Medicine, Clinical Collaboration Unit Translational Immunology, German Cancer Consortium, University Hospital Tuebingen, Tuebingen, Germany,Department of Immunology, Institute for Cell Biology, University of Tuebingen, Tuebingen, Germany,Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies,” University of Tuebingen, Tuebingen, Germany
| | - Sarah Schroeder
- Department of Peptide-Based Immunotherapy, University of Tuebingen and University Hospital Tuebingen, Tuebingen, Germany,Department of Immunology, Institute for Cell Biology, University of Tuebingen, Tuebingen, Germany,Department of Otorhinolaryngology, Head and Neck Surgery, University of Tuebingen, Tuebingen, Germany
| | - Juliane S Walz
- Department of Peptide-Based Immunotherapy, University of Tuebingen and University Hospital Tuebingen, Tuebingen, Germany,Department of Internal Medicine, Clinical Collaboration Unit Translational Immunology, German Cancer Consortium, University Hospital Tuebingen, Tuebingen, Germany,Department of Immunology, Institute for Cell Biology, University of Tuebingen, Tuebingen, Germany,Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies,” University of Tuebingen, Tuebingen, Germany
| | - Karina Althaus
- Center for Clinical Transfusion Medicine, Tuebingen, Germany,Institute of Clinical and Experimental Transfusion Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Gunalp Uzun
- Center for Clinical Transfusion Medicine, Tuebingen, Germany
| | - Marco Mikus
- Center for Clinical Transfusion Medicine, Tuebingen, Germany
| | - Tamam Bakchoul
- Center for Clinical Transfusion Medicine, Tuebingen, Germany,Institute of Clinical and Experimental Transfusion Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Katja Schenke-Layland
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany,Department of Immunology, Institute for Cell Biology, University of Tuebingen, Tuebingen, Germany,Department for Medical Technologies and Regenerative Medicine, Institute of Biomedical Engineering, University of Tuebingen, Tuebingen, Germany,Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Stefanie Bunk
- Infectious Diseases, Department of Internal Medicine I, University Hospital Tuebingen, Tuebingen, Germany
| | - Helene Haeberle
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Siri Göpel
- German Center for Infection Research, partner site Tuebingen, Tuebingen, Germany,Infectious Diseases, Department of Internal Medicine I, University Hospital Tuebingen, Tuebingen, Germany
| | - Michael Bitzer
- Infectious Diseases, Department of Internal Medicine I, University Hospital Tuebingen, Tuebingen, Germany,Center for Personalized Medicine, University of Tuebingen, Tuebingen, Germany
| | - Hanna Renk
- University Children’s Hospital, Tuebingen, Germany
| | | | - Corinna Engel
- University Children’s Hospital, Tuebingen, Germany,Center for Pediatric Clinical Studies, University Hospital Tuebingen, Tuebingen, Germany
| | - Axel R Franz
- University Children’s Hospital, Tuebingen, Germany,Center for Pediatric Clinical Studies, University Hospital Tuebingen, Tuebingen, Germany
| | - Manuela Harries
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Barbora Kessel
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Berit Lange
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Monika Strengert
- Helmholtz Centre for Infection Research, Braunschweig, Germany,TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture of Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Gerard Krause
- Helmholtz Centre for Infection Research, Braunschweig, Germany,TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture of Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Anne Zeck
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Ulrich Rothbauer
- NMI Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany,Pharmaceutical Biotechnology, University of Tuebingen, Tuebingen, Germany
| | - Alex Dulovic
- Correspondence: A. Dulovic, Natural and Medical Sciences Institute at the University of Tuebingen, Markwiesenstrasse 55, Reutlingen, 72770 Germany ()
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8
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Junker D, Dulovic A, Becker M, Wagner TR, Kaiser PD, Traenkle B, Kienzle K, Bunk S, Struemper C, Haeberle H, Schmauder K, Ruetalo N, Malek N, Althaus K, Koeppen M, Rothbauer U, Walz JS, Schindler M, Bitzer M, Göpel S, Schneiderhan-Marra N. COVID-19 patient serum less potently inhibits ACE2-RBD binding for various SARS-CoV-2 RBD mutants. Sci Rep 2022; 12:7168. [PMID: 35505068 PMCID: PMC9062870 DOI: 10.1038/s41598-022-10987-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 12/06/2021] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
As global vaccination campaigns against SARS-CoV-2 proceed, there is particular interest in the longevity of immune protection, especially with regard to increasingly infectious virus variants. Neutralizing antibodies (Nabs) targeting the receptor binding domain (RBD) of SARS-CoV-2 are promising correlates of protective immunity and have been successfully used for prevention and therapy. As SARS-CoV-2 variants of concern (VOCs) are known to affect binding to the ACE2 receptor and by extension neutralizing activity, we developed a bead-based multiplex ACE2-RBD inhibition assay (RBDCoV-ACE2) as a highly scalable, time-, cost-, and material-saving alternative to infectious live-virus neutralization tests. By mimicking the interaction between ACE2 and the RBD, this serological multiplex assay allows the simultaneous analysis of ACE2 binding inhibition to the RBDs of all SARS-CoV-2 VOCs and variants of interest (VOIs) in a single well. Following validation against a classical virus neutralization test and comparison of performance against a commercially available assay, we analyzed 266 serum samples from 168 COVID-19 patients of varying severity. ACE2 binding inhibition was reduced for ten out of eleven variants examined compared to wild-type, especially for those displaying the E484K mutation such as VOCs beta and gamma. ACE2 binding inhibition, while highly individualistic, positively correlated with IgG levels. ACE2 binding inhibition also correlated with disease severity up to WHO grade 7, after which it reduced.
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Affiliation(s)
- Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstrasse 55, 72770, Reutlingen, Germany
| | - Alex Dulovic
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstrasse 55, 72770, Reutlingen, Germany
| | - Matthias Becker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstrasse 55, 72770, Reutlingen, Germany
| | - Teresa R Wagner
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstrasse 55, 72770, Reutlingen, Germany.,Pharmaceutical Biotechnology, Eberhard Karls University, Tübingen, Germany
| | - Philipp D Kaiser
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstrasse 55, 72770, Reutlingen, Germany
| | - Bjoern Traenkle
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstrasse 55, 72770, Reutlingen, Germany
| | - Katharina Kienzle
- Department Internal Medicine I, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076, Tübingen, Germany
| | - Stefanie Bunk
- Department Internal Medicine I, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076, Tübingen, Germany
| | - Carlotta Struemper
- Department Internal Medicine I, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076, Tübingen, Germany
| | - Helene Haeberle
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Kristina Schmauder
- Institute for Medical Microbiology and Hygiene, University Hospital Tübingen, Tübingen, Germany.,German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Natalia Ruetalo
- Institute for Medical Virology and Epidemiology, University Hospital Tübingen, Tübingen, Germany
| | - Nisar Malek
- Department Internal Medicine I, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076, Tübingen, Germany.,Center for Personalized Medicine, Eberhard Karls University, Tübingen, Germany
| | - Karina Althaus
- Institute for Clinical and Experimental Transfusion Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Michael Koeppen
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Ulrich Rothbauer
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstrasse 55, 72770, Reutlingen, Germany.,Pharmaceutical Biotechnology, Eberhard Karls University, Tübingen, Germany
| | - Juliane S Walz
- Department of Internal Medicine, Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), University Hospital Tübingen, Tübingen, Germany.,Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Tübingen, Germany.,Dr. Margarete Fischer-Bosch-Institute for Clinical Pharmacology, Robert Bosch Center for Tumor Diseases (RBCT), Stuttgart, Germany
| | - Michael Schindler
- Institute for Medical Virology and Epidemiology, University Hospital Tübingen, Tübingen, Germany
| | - Michael Bitzer
- Department Internal Medicine I, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076, Tübingen, Germany.,Center for Personalized Medicine, Eberhard Karls University, Tübingen, Germany
| | - Siri Göpel
- Department Internal Medicine I, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076, Tübingen, Germany. .,German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany.
| | - Nicole Schneiderhan-Marra
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstrasse 55, 72770, Reutlingen, Germany.
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9
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Dulovic A, Strengert M, Ramos GM, Becker M, Griesbaum J, Junker D, Lürken K, Beigel A, Wrenger E, Lonnemann G, Cossmann A, Stankov MV, Dopfer-Jablonka A, Kaiser PD, Traenkle B, Rothbauer U, Krause G, Schneiderhan-Marra N, Behrens GM. Diminishing Immune Responses against Variants of Concern in Dialysis Patients 4 Months after SARS-CoV-2 mRNA Vaccination. Emerg Infect Dis 2022; 28:743-750. [PMID: 35203113 PMCID: PMC8962909 DOI: 10.3201/eid2804.211907] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Patients undergoing chronic hemodialysis were among the first to receive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations because of their increased risk for severe coronavirus disease and high case-fatality rates. By using a previously reported cohort from Germany of at-risk hemodialysis patients and healthy donors, where antibody responses were examined 3 weeks after the second vaccination, we assessed systemic cellular and humoral immune responses in serum and saliva 4 months after vaccination with the Pfizer-BioNTech BNT162b2 vaccine using an interferon-γ release assay and multiplex-based IgG measurements. We further compared neutralization capacity of vaccination-induced IgG against 4 SARS-CoV-2 variants of concern (Alpha, Beta, Gamma, and Delta) by angiotensin-converting enzyme 2 receptor-binding domain competition assay. Sixteen weeks after second vaccination, compared with 3 weeks after, cellular and humoral responses against the original SARS-CoV-2 isolate and variants of concern were substantially reduced. Some dialysis patients even had no detectable B- or T-cell responses.
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10
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Dulovic A, Kessel B, Harries M, Becker M, Ortmann J, Griesbaum J, Jüngling J, Junker D, Hernandez P, Gornyk D, Glöckner S, Melhorn V, Castell S, Heise JK, Kemmling Y, Tonn T, Frank K, Illig T, Klopp N, Warikoo N, Rath A, Suckel C, Marzian AU, Grupe N, Kaiser PD, Traenkle B, Rothbauer U, Kerrinnes T, Krause G, Lange B, Schneiderhan-Marra N, Strengert M. Comparative Magnitude and Persistence of Humoral SARS-CoV-2 Vaccination Responses in the Adult Population in Germany. Front Immunol 2022; 13:828053. [PMID: 35251012 PMCID: PMC8888837 DOI: 10.3389/fimmu.2022.828053] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/17/2022] [Indexed: 12/01/2022] Open
Abstract
Recent increases in SARS-CoV-2 infections have led to questions about duration and quality of vaccine-induced immune protection. While numerous studies have been published on immune responses triggered by vaccination, these often focus on studying the impact of one or two immunisation schemes within subpopulations such as immunocompromised individuals or healthcare workers. To provide information on the duration and quality of vaccine-induced immune responses against SARS-CoV-2, we analyzed antibody titres against various SARS-CoV-2 antigens and ACE2 binding inhibition against SARS-CoV-2 wild-type and variants of concern in samples from a large German population-based seroprevalence study (MuSPAD) who had received all currently available immunisation schemes. We found that homologous mRNA-based or heterologous prime-boost vaccination produced significantly higher antibody responses than vector-based homologous vaccination. Ad26.CoV2S.2 performance was particularly concerning with reduced titres and 91.7% of samples classified as non-responsive for ACE2 binding inhibition, suggesting that recipients require a booster mRNA vaccination. While mRNA vaccination induced a higher ratio of RBD- and S1-targeting antibodies, vector-based vaccines resulted in an increased proportion of S2-targeting antibodies. Given the role of RBD- and S1-specific antibodies in neutralizing SARS-CoV-2, their relative over-representation after mRNA vaccination may explain why these vaccines have increased efficacy compared to vector-based formulations. Previously infected individuals had a robust immune response once vaccinated, regardless of which vaccine they received, which could aid future dose allocation should shortages arise for certain manufacturers. Overall, both titres and ACE2 binding inhibition peaked approximately 28 days post-second vaccination and then decreased.
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Affiliation(s)
- Alex Dulovic
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Barbora Kessel
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Matthias Becker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Julia Ortmann
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Johanna Griesbaum
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Jennifer Jüngling
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Pilar Hernandez
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Daniela Gornyk
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Stephan Glöckner
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Vanessa Melhorn
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Stefanie Castell
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Jana-Kristin Heise
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Yvonne Kemmling
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Torsten Tonn
- German Red Cross Blood Donation Service North East, Dresden, Germany
| | - Kerstin Frank
- German Red Cross Blood Donation Service North East, Dresden, Germany
| | - Thomas Illig
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Norman Klopp
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Neha Warikoo
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Angelika Rath
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Christina Suckel
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Anne Ulrike Marzian
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Nicole Grupe
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Philipp D. Kaiser
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Bjoern Traenkle
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Ulrich Rothbauer
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Pharmaceutical Biotechnology, Department of Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany
| | - Tobias Kerrinnes
- Department of RNA-Biology of Bacterial Infections, Helmholtz Institute for RNA-Based Infection Research, Würzburg, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- TWINCORE, Centre for Experimental and Clinical Infection Research, a Joint Venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | | | - Monika Strengert
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- TWINCORE, Centre for Experimental and Clinical Infection Research, a Joint Venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
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11
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Renk H, Dulovic A, Seidel A, Becker M, Fabricius D, Zernickel M, Junker D, Groß R, Müller J, Hilger A, Bode SFN, Fritsch L, Frieh P, Haddad A, Görne T, Remppis J, Ganzemueller T, Dietz A, Huzly D, Hengel H, Kaier K, Weber S, Jacobsen EM, Kaiser PD, Traenkle B, Rothbauer U, Stich M, Tönshoff B, Hoffmann GF, Müller B, Ludwig C, Jahrsdörfer B, Schrezenmeier H, Peter A, Hörber S, Iftner T, Münch J, Stamminger T, Groß HJ, Wolkewitz M, Engel C, Liu W, Rizzi M, Hahn BH, Henneke P, Franz AR, Debatin KM, Schneiderhan-Marra N, Janda A, Elling R. Robust and durable serological response following pediatric SARS-CoV-2 infection. Nat Commun 2022; 13:128. [PMID: 35013206 PMCID: PMC8748910 DOI: 10.1038/s41467-021-27595-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [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: 08/26/2021] [Accepted: 11/22/2021] [Indexed: 02/07/2023] Open
Abstract
The quality and persistence of children's humoral immune response following SARS-CoV-2 infection remains largely unknown but will be crucial to guide pediatric SARS-CoV-2 vaccination programs. Here, we examine 548 children and 717 adults within 328 households with at least one member with a previous laboratory-confirmed SARS-CoV-2 infection. We assess serological response at 3-4 months and 11-12 months after infection using a bead-based multiplex immunoassay for 23 human coronavirus antigens including SARS-CoV-2 and its Variants of Concern (VOC) and endemic human coronaviruses (HCoVs), and additionally by three commercial SARS-CoV-2 antibody assays. Neutralization against wild type SARS-CoV-2 and the Delta VOC are analysed in a pseudotyped virus assay. Children, compared to adults, are five times more likely to be asymptomatic, and have higher specific antibody levels which persist longer (96.2% versus 82.9% still seropositive 11-12 months post infection). Of note, symptomatic and asymptomatic infections induce similar humoral responses in all age groups. SARS-CoV-2 infection occurs independent of HCoV serostatus. Neutralization responses of children and adults are similar, although neutralization is reduced for both against the Delta VOC. Overall, the long-term humoral immune response to SARS-CoV-2 infection in children is of longer duration than in adults even after asymptomatic infection.
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Affiliation(s)
- Hanna Renk
- University Children's Hospital Tübingen, Tübingen, Germany
| | - Alex Dulovic
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Alina Seidel
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Matthias Becker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Dorit Fabricius
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Maria Zernickel
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Rüdiger Groß
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Janis Müller
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Alexander Hilger
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian F N Bode
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Linus Fritsch
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Pauline Frieh
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anneke Haddad
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tessa Görne
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Tina Ganzemueller
- Institute for Medical Virology and Epidemiology of Viral Diseases, University Hospital Tübingen, Tübingen, Germany
| | - Andrea Dietz
- Institute of Virology, Ulm University Medical Center, Ulm, Germany
| | - Daniela Huzly
- Institute of Virology, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hartmut Hengel
- Institute of Virology, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Susanne Weber
- Institute of Medical Biometry and Statistics, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eva-Maria Jacobsen
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Philipp D Kaiser
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Bjoern Traenkle
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Ulrich Rothbauer
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Maximilian Stich
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Georg F Hoffmann
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Barbara Müller
- Department of Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany
| | - Carolin Ludwig
- Institute of Transfusion Medicine, Ulm University, Ulm, Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany
- German Red Cross Blood Transfusion Service, Baden-Württemberg-Hessen, Germany
| | - Bernd Jahrsdörfer
- Institute of Transfusion Medicine, Ulm University, Ulm, Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany
- German Red Cross Blood Transfusion Service, Baden-Württemberg-Hessen, Germany
| | - Hubert Schrezenmeier
- Institute of Transfusion Medicine, Ulm University, Ulm, Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany
- German Red Cross Blood Transfusion Service, Baden-Württemberg-Hessen, Germany
| | - Andreas Peter
- Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Tübingen, Germany
| | - Sebastian Hörber
- Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Tübingen, Germany
| | - Thomas Iftner
- Institute for Medical Virology and Epidemiology of Viral Diseases, University Hospital Tübingen, Tübingen, Germany
| | - Jan Münch
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | | | | | - Martin Wolkewitz
- Institute of Medical Biometry and Statistics, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Corinna Engel
- University Children's Hospital Tübingen, Tübingen, Germany
- Center for Pediatric Clinical Studies, University Hospital Tübingen, Tübingen, Germany
| | - Weimin Liu
- Department of Microbiology and Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Marta Rizzi
- Department of Rheumatology and Clinical Immunology, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Beatrice H Hahn
- Department of Microbiology and Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Philipp Henneke
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Institute for Immunodeficiency, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Axel R Franz
- University Children's Hospital Tübingen, Tübingen, Germany
- Center for Pediatric Clinical Studies, University Hospital Tübingen, Tübingen, Germany
| | - Klaus-Michael Debatin
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | | | - Ales Janda
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Roland Elling
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Institute for Immunodeficiency, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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12
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Wratil PR, Schmacke NA, Karakoc B, Dulovic A, Junker D, Becker M, Rothbauer U, Osterman A, Spaeth PM, Ruhle A, Gapp M, Schneider S, Muenchhoff M, Hellmuth JC, Scherer C, Mayerle J, Reincke M, Behr J, Kääb S, Zwissler B, von Bergwelt-Baildon M, Eberle J, Kaderali L, Schneiderhan-Marra N, Hornung V, Keppler OT. Evidence for increased SARS-CoV-2 susceptibility and COVID-19 severity related to pre-existing immunity to seasonal coronaviruses. Cell Rep 2021; 37:110169. [PMID: 34932974 PMCID: PMC8648802 DOI: 10.1016/j.celrep.2021.110169] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 05/14/2021] [Revised: 10/27/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022] Open
Abstract
The importance of pre-existing immune responses to seasonal endemic coronaviruses (HCoVs) for the susceptibility to SARS-CoV-2 infection and the course of COVID-19 is the subject of an ongoing scientific debate. Recent studies postulate that immune responses to previous HCoV infections can either have a slightly protective or no effect on SARS-CoV-2 pathogenesis and, consequently, be neglected for COVID-19 risk stratification. Challenging this notion, we provide evidence that pre-existing, anti-nucleocapsid antibodies against endemic α-coronaviruses and S2 domain-specific anti-spike antibodies against β-coronavirus HCoV-OC43 are elevated in patients with COVID-19 compared to pre-pandemic donors. This finding is particularly pronounced in males and in critically ill patients. Longitudinal evaluation reveals that antibody cross-reactivity or polyclonal stimulation by SARS-CoV-2 infection are unlikely to be confounders. Thus, specific pre-existing immunity to seasonal coronaviruses may increase susceptibility to SARS-CoV-2 and predispose individuals to an adverse COVID-19 outcome, guiding risk management and supporting the development of universal coronavirus vaccines.
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Affiliation(s)
- Paul R Wratil
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany; German Center for Infection Research (DZIF), partner site Munich, 80802 Munich, Bavaria, Germany
| | - Niklas A Schmacke
- Department of Biochemistry and Gene Center, LMU München, 81377 Munich, Bavaria, Germany
| | - Burak Karakoc
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany
| | - Alex Dulovic
- Natural and Medical Sciences Institute at the University of Tübingen, 72770 Reutlingen, Baden-Württemberg, Germany
| | - Daniel Junker
- Natural and Medical Sciences Institute at the University of Tübingen, 72770 Reutlingen, Baden-Württemberg, Germany
| | - Matthias Becker
- Natural and Medical Sciences Institute at the University of Tübingen, 72770 Reutlingen, Baden-Württemberg, Germany
| | - Ulrich Rothbauer
- Natural and Medical Sciences Institute at the University of Tübingen, 72770 Reutlingen, Baden-Württemberg, Germany; Pharmaceutical Biotechnology, University of Tübingen, 72770 Reutlingen, Baden-Württemberg, Germany
| | - Andreas Osterman
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany
| | - Patricia M Spaeth
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany
| | - Adrian Ruhle
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany
| | - Madeleine Gapp
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany
| | - Stephanie Schneider
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany
| | - Maximilian Muenchhoff
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany; German Center for Infection Research (DZIF), partner site Munich, 80802 Munich, Bavaria, Germany; COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany
| | - Johannes C Hellmuth
- COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; Department of Medicine III, Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; German Cancer Consortium (DKTK), 81377 Munich, Bavaria, Germany
| | - Clemens Scherer
- COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; Medizinische Klinik und Poliklinik I, Klinikum der Universität München, LMU München, 80336 Munich, Bavaria, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, 85764 Neuherberg, Bavaria, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, 81377 Munich, Bavaria, Germany
| | - Julia Mayerle
- COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; Department of Medicine II, Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany
| | - Martin Reincke
- COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, 80336 Munich, Bavaria, Germany
| | - Juergen Behr
- COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, 85764 Neuherberg, Bavaria, Germany; Department of Medicine V, Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany
| | - Stefan Kääb
- COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; Medizinische Klinik und Poliklinik I, Klinikum der Universität München, LMU München, 80336 Munich, Bavaria, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, 81377 Munich, Bavaria, Germany
| | - Bernhard Zwissler
- COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, 85764 Neuherberg, Bavaria, Germany; Department of Anaesthesiology, Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany
| | - Michael von Bergwelt-Baildon
- COVID-19 Registry of the LMU Munich (CORKUM), Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; Department of Medicine III, Klinikum der Universität München, LMU München, 81377 Munich, Bavaria, Germany; German Cancer Consortium (DKTK), 81377 Munich, Bavaria, Germany
| | - Josef Eberle
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany
| | - Lars Kaderali
- Institute of Bioinformatics, University Medicine Greifswald, 17475 Greifswald, Mecklenburg-Vorpommern, Germany
| | - Nicole Schneiderhan-Marra
- Natural and Medical Sciences Institute at the University of Tübingen, 72770 Reutlingen, Baden-Württemberg, Germany
| | - Veit Hornung
- Department of Biochemistry and Gene Center, LMU München, 81377 Munich, Bavaria, Germany
| | - Oliver T Keppler
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Pettenkoferstr. 9a, 80336 Munich, Bavaria, Germany; German Center for Infection Research (DZIF), partner site Munich, 80802 Munich, Bavaria, Germany.
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13
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Wagner TR, Schnepf D, Beer J, Ruetalo N, Klingel K, Kaiser PD, Junker D, Sauter M, Traenkle B, Frecot DI, Becker M, Schneiderhan‐Marra N, Ohnemus A, Schwemmle M, Schindler M, Rothbauer U. Biparatopic nanobodies protect mice from lethal challenge with SARS‐CoV‐2 variants of concern. EMBO Rep 2021; 23:e53865. [PMID: 34927793 PMCID: PMC8811630 DOI: 10.15252/embr.202153865] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 10/13/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 11/09/2022] Open
Abstract
The ongoing COVID‐19 pandemic and the emergence of new SARS‐CoV‐2 variants of concern (VOCs) requires continued development of effective therapeutics. Recently, we identified high‐affinity neutralizing nanobodies (Nbs) specific for the receptor‐binding domain (RBD) of SARS‐CoV‐2. Taking advantage of detailed epitope mapping, we generate two biparatopic Nbs (bipNbs) targeting a conserved epitope outside and two different epitopes inside the RBD:ACE2 interface. Both bipNbs bind all currently circulating VOCs with high affinities and are capable to neutralize cellular infection with VOC B.1.351 (Beta) and B.1.617.2 (Delta) in vitro. To assess if the bipNbs NM1267 and NM1268 confer protection against SARS‐CoV‐2 infection in vivo, human ACE2 transgenic mice are treated intranasally before infection with a lethal dose of SARS‐CoV‐2 B.1, B.1.351 (Beta) or B.1.617.2 (Delta). Nb‐treated mice show significantly reduced disease progression and increased survival rates. Histopathological analyses further reveal a drastically reduced viral load and inflammatory response in lungs. These data suggest that both bipNbs are broadly active against a variety of emerging SARS‐CoV‐2 VOCs and represent easily applicable drug candidates.
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Affiliation(s)
- Teresa R Wagner
- Pharmaceutical Biotechnology Eberhard Karls University Tübingen Germany
- NMI Natural and Medical Sciences Institute at the University of Tübingen Reutlingen Germany
| | - Daniel Schnepf
- Institute of Virology Medical Center University Freiburg Freiburg Germany
| | - Julius Beer
- Institute of Virology Medical Center University Freiburg Freiburg Germany
| | - Natalia Ruetalo
- Institute for Medical Virology and Epidemiology of Viral Diseases University Hospital Tübingen Tübingen Germany
| | - Karin Klingel
- Institute for Pathology and Neuropathology University Hospital Tübingen Tübingen Germany
| | - Philipp D Kaiser
- NMI Natural and Medical Sciences Institute at the University of Tübingen Reutlingen Germany
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tübingen Reutlingen Germany
| | - Martina Sauter
- Institute for Pathology and Neuropathology University Hospital Tübingen Tübingen Germany
| | - Bjoern Traenkle
- NMI Natural and Medical Sciences Institute at the University of Tübingen Reutlingen Germany
| | - Desiree I Frecot
- Pharmaceutical Biotechnology Eberhard Karls University Tübingen Germany
- NMI Natural and Medical Sciences Institute at the University of Tübingen Reutlingen Germany
| | - Matthias Becker
- NMI Natural and Medical Sciences Institute at the University of Tübingen Reutlingen Germany
| | | | - Annette Ohnemus
- Institute of Virology Medical Center University Freiburg Freiburg Germany
| | - Martin Schwemmle
- Institute of Virology Medical Center University Freiburg Freiburg Germany
- Faculty of Medicine University of Freiburg Freiburg Germany
| | - Michael Schindler
- Institute for Medical Virology and Epidemiology of Viral Diseases University Hospital Tübingen Tübingen Germany
| | - Ulrich Rothbauer
- Pharmaceutical Biotechnology Eberhard Karls University Tübingen Germany
- NMI Natural and Medical Sciences Institute at the University of Tübingen Reutlingen Germany
- Cluster of Excellence iFIT (EXC2180) “Image‐Guided and Functionally Instructed Tumor Therapies” Eberhard Karls University Tübingen Germany
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14
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Fink S, Ruoff F, Stahl A, Becker M, Kaiser P, Traenkle B, Junker D, Weise F, Ruetalo N, Hörber S, Peter A, Nelde A, Walz J, Krause G, Baillot A, Schenke-Layland K, Joos TO, Rothbauer U, Schneiderhan-Marra N, Schindler M, Templin MF. Multiplexed Serum Antibody Screening Platform Using Virus Extracts from Endemic Coronaviridae and SARS-CoV-2. ACS Infect Dis 2021; 7:1596-1606. [PMID: 33724771 PMCID: PMC8101008 DOI: 10.1021/acsinfecdis.0c00725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Indexed: 02/04/2023]
Abstract
The presence of antibodies against endemic coronaviruses has been linked to disease severity after SARS-CoV-2 infection. Assays capable of concomitantly detecting antibodies against endemic coronaviridae such as OC43, 229E, NL63, and SARS-CoV-2 may help to elucidate this question. We developed a serum screening platform using a bead-based Western blot system called DigiWest, capable of running hundreds of assays using microgram amounts of protein prepared directly from different viruses. Characterization of the immunoassay for detection of SARS-CoV-2 specific antibodies revealed a sensitivity of 90.3% and a diagnostic specificity of 98.1%. Concordance analysis with the SARS-CoV-2 immunoassays available by Roche, Siemens, and Euroimmun indicates comparable assay performances (Cohen's κ ranging from 0.8874 to 0.9508). Analogous assays for OC43, 229E, and NL63 were established and combined into one multiplex with the SARS-CoV-2 assay. Seroreactivity for different coronaviruses was detected with high incidence, and the multiplex assay was adapted for serum screening.
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Affiliation(s)
- Simon Fink
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
| | - Felix Ruoff
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
| | - Aaron Stahl
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
| | - Matthias Becker
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
| | - Philipp Kaiser
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
| | - Bjoern Traenkle
- Pharmaceutical Biotechnology,
Eberhard-Karls-University, 72076
Tübingen, Germany
| | - Daniel Junker
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
| | - Frank Weise
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
| | - Natalia Ruetalo
- Institute for Medical Virology and
Epidemiology of Viral Diseases, University Hospital
Tübingen, 72076 Tübingen,
Germany
| | - Sebastian Hörber
- Central Laboratory, Institute for
Clinical Chemistry and Pathobiochemistry, University
Hospital Tübingen, Tübingen 72076,
Germany
- Institute for Diabetes
Research and Metabolic Diseases of the Helmholtz Center Munich
at the University of Tübingen, 72076
Tübingen, Germany
- German Center for Diabetes
Research (DZD), München-Neuherberg 85764,
Germany
| | - Andreas Peter
- Central Laboratory, Institute for
Clinical Chemistry and Pathobiochemistry, University
Hospital Tübingen, Tübingen 72076,
Germany
- Institute for Diabetes
Research and Metabolic Diseases of the Helmholtz Center Munich
at the University of Tübingen, 72076
Tübingen, Germany
- German Center for Diabetes
Research (DZD), München-Neuherberg 85764,
Germany
| | - Annika Nelde
- Clinical Collaboration Unit
Translational Immunology, German Cancer Consortium (DKTK), Department
of Internal Medicine, University Hospital
Tübingen, 72076 Tübingen,
Germany
- Department of Immunology, Institute
for Cell Biology, University of
Tübingen, 72076 Tübingen,
Germany
- Cluster of Excellence iFIT (EXC2180)
“Image-Guided and Functionally Instructed Tumor
Therapies”, University of
Tübingen, 72076 Tübingen,
Germany
| | - Juliane Walz
- Clinical Collaboration Unit
Translational Immunology, German Cancer Consortium (DKTK), Department
of Internal Medicine, University Hospital
Tübingen, 72076 Tübingen,
Germany
- Department of Immunology, Institute
for Cell Biology, University of
Tübingen, 72076 Tübingen,
Germany
- Cluster of Excellence iFIT (EXC2180)
“Image-Guided and Functionally Instructed Tumor
Therapies”, University of
Tübingen, 72076 Tübingen,
Germany
- Department of Hematology, Oncology,
Clinical Immunology and Rheumatology, University Hospital
Tübingen, 72076 Tübingen,
Germany
| | - Gérard Krause
- Department of Epidemiology,
Helmholtz Centre for Infection
Research, 38124 Braunschweig,
Germany
- TWINCORE GmbH, Centre
for Experimental and Clinical Infection Research, a joint
venture of the Hannover Medical School and the Helmholtz Centre
for Infection Research, 30625 Hannover,
Germany
| | - Armin Baillot
- Department of Virology/Serology,
Niedersächsisches
Landesgesundheitsamt, 30449 Hannover,
Germany
| | - Katja Schenke-Layland
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
- Cluster of Excellence iFIT (EXC2180)
“Image-Guided and Functionally Instructed Tumor
Therapies”, University of
Tübingen, 72076 Tübingen,
Germany
- Department of Women’s Health,
Research Institute for Women’s Health,
Eberhard-Karls-University, 72076
Tübingen, Germany
- Department of Medicine/Cardiology,
Cardiovascular Research Laboratories, David Geffen School
of Medicine at UCLA, Los Angeles, California
90095, United States
| | - Thomas O. Joos
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
| | - Ulrich Rothbauer
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
- Pharmaceutical Biotechnology,
Eberhard-Karls-University, 72076
Tübingen, Germany
| | | | - Michael Schindler
- Institute for Medical Virology and
Epidemiology of Viral Diseases, University Hospital
Tübingen, 72076 Tübingen,
Germany
| | - Markus F. Templin
- NMI Natural and Medical
Sciences Institute at the University of
Tübingen, 72770 Reutlingen,
Germany
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15
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Becker M, Dulovic A, Junker D, Ruetalo N, Kaiser PD, Pinilla YT, Heinzel C, Haering J, Traenkle B, Wagner TR, Layer M, Mehrlaender M, Mirakaj V, Held J, Planatscher H, Schenke-Layland K, Krause G, Strengert M, Bakchoul T, Althaus K, Fendel R, Kreidenweiss A, Koeppen M, Rothbauer U, Schindler M, Schneiderhan-Marra N. Immune response to SARS-CoV-2 variants of concern in vaccinated individuals. Nat Commun 2021; 12:3109. [PMID: 34035301 PMCID: PMC8149389 DOI: 10.1038/s41467-021-23473-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [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: 03/08/2021] [Accepted: 04/28/2021] [Indexed: 12/20/2022] Open
Abstract
SARS-CoV-2 is evolving with mutations in the receptor binding domain (RBD) being of particular concern. It is important to know how much cross-protection is offered between strains following vaccination or infection. Here, we obtain serum and saliva samples from groups of vaccinated (Pfizer BNT-162b2), infected and uninfected individuals and characterize the antibody response to RBD mutant strains. Vaccinated individuals have a robust humoral response after the second dose and have high IgG antibody titers in the saliva. Antibody responses however show considerable differences in binding to RBD mutants of emerging variants of concern and substantial reduction in RBD binding and neutralization is observed against a patient-isolated South African variant. Taken together our data reinforce the importance of the second dose of Pfizer BNT-162b2 to acquire high levels of neutralizing antibodies and high antibody titers in saliva suggest that vaccinated individuals may have reduced transmission potential. Substantially reduced neutralization for the South African variant further highlights the importance of surveillance strategies to detect new variants and targeting these in future vaccines.
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Affiliation(s)
- Matthias Becker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Alex Dulovic
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Daniel Junker
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Natalia Ruetalo
- Institute for Medical Virology and Epidemiology, University Hospital Tübingen, Tübingen, Germany
| | - Philipp D Kaiser
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Yudi T Pinilla
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Constanze Heinzel
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Julia Haering
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Bjoern Traenkle
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Teresa R Wagner
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Pharmaceutical Biotechnology, University of Tübingen, Tübingen, Germany
| | - Mirjam Layer
- Institute for Medical Virology and Epidemiology, University Hospital Tübingen, Tübingen, Germany
| | - Martin Mehrlaender
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Valbona Mirakaj
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Jana Held
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | | | - Katja Schenke-Layland
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Cluster of Excellence iFIT (EXC2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Tübingen, Germany
- Department of Women's Health, Research Institute for Women's Health, University of Tübingen, Tübingen, Germany
- Department of Medicine/Cardiology, Cardiovascular Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Gérard Krause
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- TWINCORE GmbH, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Monika Strengert
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- TWINCORE GmbH, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Tamam Bakchoul
- Institute for Clinical and Experimental Transfusion Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Karina Althaus
- Institute for Clinical and Experimental Transfusion Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Rolf Fendel
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Andrea Kreidenweiss
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Michael Koeppen
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Ulrich Rothbauer
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany.
- Pharmaceutical Biotechnology, University of Tübingen, Tübingen, Germany.
| | - Michael Schindler
- Institute for Medical Virology and Epidemiology, University Hospital Tübingen, Tübingen, Germany.
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16
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Wagner TR, Ostertag E, Kaiser PD, Gramlich M, Ruetalo N, Junker D, Haering J, Traenkle B, Becker M, Dulovic A, Schweizer H, Nueske S, Scholz A, Zeck A, Schenke‐Layland K, Nelde A, Strengert M, Walz JS, Zocher G, Stehle T, Schindler M, Schneiderhan‐Marra N, Rothbauer U. NeutrobodyPlex-monitoring SARS-CoV-2 neutralizing immune responses using nanobodies. EMBO Rep 2021; 22:e52325. [PMID: 33904225 PMCID: PMC8097376 DOI: 10.15252/embr.202052325] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 12/21/2020] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 12/23/2022] Open
Abstract
In light of the COVID-19 pandemic, there is an ongoing need for diagnostic tools to monitor the immune status of large patient cohorts and the effectiveness of vaccination campaigns. Here, we present 11 unique nanobodies (Nbs) specific for the SARS-CoV-2 spike receptor-binding domain (RBD), of which 8 Nbs potently inhibit the interaction of RBD with angiotensin-converting enzyme 2 (ACE2) as the major viral docking site. Following detailed epitope mapping and structural analysis, we select two inhibitory Nbs, one of which binds an epitope inside and one of which binds an epitope outside the RBD:ACE2 interface. Based on these, we generate a biparatopic nanobody (bipNb) with viral neutralization efficacy in the picomolar range. Using bipNb as a surrogate, we establish a competitive multiplex binding assay ("NeutrobodyPlex") for detailed analysis of the presence and performance of neutralizing RBD-binding antibodies in serum of convalescent or vaccinated patients. We demonstrate that NeutrobodyPlex enables high-throughput screening and detailed analysis of neutralizing immune responses in infected or vaccinated individuals, to monitor immune status or to guide vaccine design.
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Affiliation(s)
- Teresa R Wagner
- Pharmaceutical BiotechnologyEberhard Karls UniversityTuebingenGermany
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Elena Ostertag
- Interfaculty Institute of BiochemistryEberhard Karls UniversityTuebingenGermany
| | - Philipp D Kaiser
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Marius Gramlich
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Natalia Ruetalo
- Institute for Medical Virology and Epidemiology of Viral DiseasesUniversity Hospital TuebingenTuebingenGermany
| | - Daniel Junker
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Julia Haering
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Bjoern Traenkle
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Matthias Becker
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Alex Dulovic
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Helen Schweizer
- Livestock Center of the Faculty of Veterinary MedicineLudwig Maximilians UniversityOberschleissheimGermany
| | - Stefan Nueske
- Livestock Center of the Faculty of Veterinary MedicineLudwig Maximilians UniversityOberschleissheimGermany
| | - Armin Scholz
- Livestock Center of the Faculty of Veterinary MedicineLudwig Maximilians UniversityOberschleissheimGermany
| | - Anne Zeck
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
| | - Katja Schenke‐Layland
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
- Cluster of Excellence iFIT (EXC2180) “Image‐Guided and Functionally Instructed Tumor Therapies”Eberhard Karls UniversityTuebingenGermany
- Department of Women’s HealthResearch Institute for Women’s HealthEberhard Karls UniversityTuebingenGermany
- Department of Medicine/CardiologyCardiovascular Research LaboratoriesDavid Geffen School of Medicine at UCLALos AngelesCAUSA
| | - Annika Nelde
- Cluster of Excellence iFIT (EXC2180) “Image‐Guided and Functionally Instructed Tumor Therapies”Eberhard Karls UniversityTuebingenGermany
- Clinical Collaboration Unit Translational ImmunologyGerman Cancer Consortium (DKTK)Department of Internal MedicineUniversity Hospital TuebingenTuebingenGermany
- Institute for Cell BiologyDepartment of ImmunologyEberhard Karls UniversityTuebingenGermany
| | - Monika Strengert
- Department of EpidemiologyHelmholtz Centre for Infection ResearchBraunschweigGermany
- TWINCORE GmbHCentre for Experimental and Clinical Infection ResearchA Joint venture of the Hannover Medical School and the Helmholtz Centre for Infection ResearchHannoverGermany
| | - Juliane S Walz
- Cluster of Excellence iFIT (EXC2180) “Image‐Guided and Functionally Instructed Tumor Therapies”Eberhard Karls UniversityTuebingenGermany
- Clinical Collaboration Unit Translational ImmunologyGerman Cancer Consortium (DKTK)Department of Internal MedicineUniversity Hospital TuebingenTuebingenGermany
- Institute for Cell BiologyDepartment of ImmunologyEberhard Karls UniversityTuebingenGermany
- Dr. Margarete Fischer‐Bosch Institute of Clinical Pharmacology and Robert Bosch Center for Tumor DiseaseRBCTStuttgartGermany
| | - Georg Zocher
- Interfaculty Institute of BiochemistryEberhard Karls UniversityTuebingenGermany
| | - Thilo Stehle
- Interfaculty Institute of BiochemistryEberhard Karls UniversityTuebingenGermany
- Vanderbilt University School of MedicineNashvilleTNUSA
| | - Michael Schindler
- Institute for Medical Virology and Epidemiology of Viral DiseasesUniversity Hospital TuebingenTuebingenGermany
| | | | - Ulrich Rothbauer
- Pharmaceutical BiotechnologyEberhard Karls UniversityTuebingenGermany
- Natural and Medical Sciences InstituteUniversity of TuebingenReutlingenGermany
- Cluster of Excellence iFIT (EXC2180) “Image‐Guided and Functionally Instructed Tumor Therapies”Eberhard Karls UniversityTuebingenGermany
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17
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Nelde A, Bilich T, Heitmann JS, Maringer Y, Salih HR, Roerden M, Lübke M, Bauer J, Rieth J, Wacker M, Peter A, Hörber S, Traenkle B, Kaiser PD, Rothbauer U, Becker M, Junker D, Krause G, Strengert M, Schneiderhan-Marra N, Templin MF, Joos TO, Kowalewski DJ, Stos-Zweifel V, Fehr M, Rabsteyn A, Mirakaj V, Karbach J, Jäger E, Graf M, Gruber LC, Rachfalski D, Preuß B, Hagelstein I, Märklin M, Bakchoul T, Gouttefangeas C, Kohlbacher O, Klein R, Stevanović S, Rammensee HG, Walz JS. SARS-CoV-2-derived peptides define heterologous and COVID-19-induced T cell recognition. Nat Immunol 2020; 22:74-85. [PMID: 32999467 DOI: 10.1038/s41590-020-00808-x] [Citation(s) in RCA: 383] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/11/2020] [Indexed: 12/14/2022]
Abstract
T cell immunity is central for the control of viral infections. To characterize T cell immunity, but also for the development of vaccines, identification of exact viral T cell epitopes is fundamental. Here we identify and characterize multiple dominant and subdominant SARS-CoV-2 HLA class I and HLA-DR peptides as potential T cell epitopes in COVID-19 convalescent and unexposed individuals. SARS-CoV-2-specific peptides enabled detection of post-infectious T cell immunity, even in seronegative convalescent individuals. Cross-reactive SARS-CoV-2 peptides revealed pre-existing T cell responses in 81% of unexposed individuals and validated similarity with common cold coronaviruses, providing a functional basis for heterologous immunity in SARS-CoV-2 infection. Diversity of SARS-CoV-2 T cell responses was associated with mild symptoms of COVID-19, providing evidence that immunity requires recognition of multiple epitopes. Together, the proposed SARS-CoV-2 T cell epitopes enable identification of heterologous and post-infectious T cell immunity and facilitate development of diagnostic, preventive and therapeutic measures for COVID-19.
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Affiliation(s)
- Annika Nelde
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany
| | - Tatjana Bilich
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany
| | - Jonas S Heitmann
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany
| | - Yacine Maringer
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany
| | - Helmut R Salih
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany
| | - Malte Roerden
- Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany.,Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany
| | - Maren Lübke
- Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Jens Bauer
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Jonas Rieth
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Marcel Wacker
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Andreas Peter
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Sebastian Hörber
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Bjoern Traenkle
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Philipp D Kaiser
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Ulrich Rothbauer
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany.,Pharmaceutical Biotechnology, University of Tübingen, Tübingen, Germany
| | - Matthias Becker
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Daniel Junker
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.,TWINCORE GmbH, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany.,German Center for Infection Research, Braunschweig, Germany
| | - Monika Strengert
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.,TWINCORE GmbH, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | | | - Markus F Templin
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Thomas O Joos
- NMI, Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | | | | | - Michael Fehr
- Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany
| | - Armin Rabsteyn
- Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany.,Department of General Pediatrics, Oncology/Hematology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Valbona Mirakaj
- Department of Anesthesia and Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Julia Karbach
- Department of Oncology and Hematology, Krankenhaus Nordwest, Frankfurt, Germany
| | - Elke Jäger
- Department of Oncology and Hematology, Krankenhaus Nordwest, Frankfurt, Germany
| | - Michael Graf
- Applied Bioinformatics, Center for Bioinformatics and Department of Computer Science, University of Tübingen, Tübingen, Germany
| | - Lena-Christin Gruber
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany
| | - David Rachfalski
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Beate Preuß
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany
| | - Ilona Hagelstein
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany
| | - Melanie Märklin
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany
| | - Tamam Bakchoul
- Institute for Clinical and Experimental Transfusion Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Cécile Gouttefangeas
- Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany
| | - Oliver Kohlbacher
- Applied Bioinformatics, Center for Bioinformatics and Department of Computer Science, University of Tübingen, Tübingen, Germany.,Institute for Bioinformatics and Medical Informatics, University of Tübingen, Tübingen, Germany.,Biomolecular Interactions, Max-Planck-Institute for Developmental Biology, Tübingen, Germany.,Institute for Translational Bioinformatics, University Hospital Tübingen, Tübingen, Germany
| | - Reinhild Klein
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany
| | - Stefan Stevanović
- Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany
| | - Hans-Georg Rammensee
- Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany
| | - Juliane S Walz
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany. .,Institute for Cell Biology, Department of Immunology, University of Tübingen, Tübingen, Germany. .,Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany.
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18
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Tokas T, Junker D, Nagele U. One-stop biparametric MRI and MRI/ultrasound fusion-guided biopsy: can we include the histopathology result and our treatment recommendations in our diagnostic pathway? World J Urol 2019; 38:2067-2068. [PMID: 31529245 DOI: 10.1007/s00345-019-02940-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/28/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Theodoros Tokas
- Department of Urology and Andrology, General Hospital Hall in Tirol, Milser Str. 10, 6060, Hall in Tirol, Austria.
| | - Daniel Junker
- Department of Radiology, General Hospital Hall in Tirol, Hall in Tirol, Austria
| | - Udo Nagele
- Department of Urology and Andrology, General Hospital Hall in Tirol, Milser Str. 10, 6060, Hall in Tirol, Austria
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19
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Junker D, Stöggl T. The Training Effects of Foam Rolling on Core Strength Endurance, Balance, Muscle Performance and Range of Motion: A Randomized Controlled Trial. J Sports Sci Med 2019; 18:229-238. [PMID: 31191092 PMCID: PMC6543984] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/15/2019] [Indexed: 06/09/2023]
Abstract
Self myofascial therapy via foam roller is a common technique used by many athletes and patients to aid recovery, improve range of motion (ROM) and prevent injury. Further, it is suggested that foam rolling improves core stability. However, research about the training effects of foam rolling on measures of core "strength endurance", muscle performance, balance and flexibility is limited. Forty recreationally active females and males (age: 18-48 yrs) were randomly assigned to a foam roll (FOAM, n = 14), a core stabilization (CORE; n = 12) and a control group (CG, n = 12). FOAM massaged their lower leg muscles (5 exercises) with the foam roll 2 times per week for 8 weeks while CORE was assigned to core stability training including 5 exercises. CG underwent no intervention. Applied tests for outcome measurements were the Bourban trunk muscle strength test (TMS), standing long jump (SLJ), single leg triple hop for distance (SLTH) test, Y-Balance test and stand and reach test. There was an interaction effect (time x treatment) for the dorsal TMS (p = 0.043), demonstrating greater improvements in CORE compared with FOAM and CG with no difference between FOAM and CG. For the stand and reach test a main effect for time (p < 0.001) and time x treatment interaction (p = 0.005) were found, indicating an increase in ROM in FOAM compared with CORE and CG with no difference between the latter. No significant effects were found for balance and muscle performance. An 8-week training with the foam roll is effective in increasing ROM in the stand and reach test without concomitant decreases in core "strength endurance", muscle performance and balance parameters. The core stabilization training was sufficient to improve performance in dorsal TMS test.
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Affiliation(s)
- Daniel Junker
- Department of Sport and Exercise Science, University of Salzburg, Austria
- Therapie und Training, Telfs, Austria
| | - Thomas Stöggl
- Department of Sport and Exercise Science, University of Salzburg, Austria
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20
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Auer T, Heidegger I, DE Zordo T, Junker D, Jaschke W, Steinkohl F, Aigner F. Fusion Imaging of Contrast-enhanced Ultrasound With CT or MRI for Kidney Lesions. In Vivo 2019; 33:203-208. [PMID: 30587624 DOI: 10.21873/invivo.11460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 09/12/2018] [Revised: 10/10/2018] [Accepted: 10/18/2018] [Indexed: 01/04/2023]
Abstract
AIM To evaluate the feasibility of ultrasound (US) computed tomography (CT) or magnetic resonance imaging (MRI) fusion imaging (FI) for localization and assessment of kidney lesions. MATERIALS AND METHODS Twenty-eight patients with kidney lesions previously detected on CT or MRI were included in this retrospective study. All 28 patients with kidney lesions, which were indefinable (42.9%) or hard to localize (57.1%) on gray-scale US alone, underwent FI of US with CT/MRI datasets. In 23 (82%) patients with indeterminate kidney lesions, FI including contrast-enhanced US was conducted. RESULTS FI was successfully performed in 25 out of 28 (89.3%) patients. FI with contrast-enhanced US was able to clarify the previously detected kidney lesions in 21 out of 23 patients (91.3%). CONCLUSION FI is a feasible technique for localizing kidney lesions that are hard to define by grayscale US alone and the additional application of contrast-enhanced US is useful in clarifying indeterminate CT or MRI findings.
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Affiliation(s)
- Thomas Auer
- Department of Radiology, Landeskrankenhaus Hall, Hall in Tirol, Austria.,Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Isabel Heidegger
- Department of Urology, Medical University Innsbruck, Innsbruck, Austria
| | - Tobias DE Zordo
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.,Department of Radiology, Brixana Private Clinic, Brixen, Italy
| | - Daniel Junker
- Department of Radiology, Landeskrankenhaus Hall, Hall in Tirol, Austria.,Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Werner Jaschke
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Fabian Steinkohl
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Friedrich Aigner
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
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21
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Abstract
Magnetic resonance imaging (MRI) of the prostate has become the gold standard for visualization of prostate cancer. Prostate MRI is usually performed as multiparametric MRI (mpMRI). Since mpMRI has several drawbacks, a biparametric MRI (bpMRI) of the prostate has been proposed. Many studies have been published on mpMRI and bpMRI in recent years. This short review offers an overview of the latest developments in this rapidly evolving field of research.
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Affiliation(s)
- Fabian Steinkohl
- 1Department für Radiologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Renate Pichler
- 2Universitätsklinik für Urologie, Medizinische Universität Innsbruck, Anichstr. 35, Innsbruck, 6020 Austria
| | - Daniel Junker
- Diagnostische und Interventionelle Radiologie, Landeskrankenhaus Hall in Tirol, Milser Str. 10, Hall in Tirol, 6060 Austria
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22
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Junker D, Steinkohl F, Fritz V, Bektic J, Tokas T, Aigner F, Herrmann TRW, Rieger M, Nagele U. Comparison of multiparametric and biparametric MRI of the prostate: are gadolinium-based contrast agents needed for routine examinations? World J Urol 2018; 37:691-699. [PMID: 30078170 DOI: 10.1007/s00345-018-2428-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/31/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To investigate, if and how omitting gadolinium-based contrast agents (GBCA) and dynamic contrast-enhanced imaging (DCE) influences diagnostic accuracy and tumor detection rates of prostate MRI. METHODS In this retrospective study, 236 patients were included. The results of biparametric (bpMRI) and multiparametric magnetic resonance imaging (mpMRI) were compared using the PI-RADS version 2 scoring system. The distribution of lesions to PIRADS score levels, tumor detection rates, diagnostic accuracy and RoC analysis were calculated and compared to the results of histopathological analysis or 5-year follow-up for benign findings. RESULTS Omitting DCE changed PI-RADS scores in 9.75% of patients, increasing the number of PI-RADS 3 scores by 8.89% when compared to mpMRI. No change of more than one score level was observed. BpMRI did not show significant differences in diagnostic accuracy or tumor detection rates. (AuC of 0.914 vs 0.917 in ROC analysis). Of 135 prostate carcinomas (PCa), 94.07% were scored identically, and 5.93% were downgraded only from PI-RADS 4 to PI-RADS 3 by bpMRI. All of them were low-grade PCa with Gleason Score 6 or 7a. No changes were observed for PCa ≥ 7b. CONCLUSION Omitting DCE did not lead to significant differences in diagnostic accuracy or tumor detection rates when using the PI-RADS 2 scoring system. According to these data, it seems reasonable to use a biparametric approach for initial routine prostate MRI. This could decrease examination time and reduce costs without significantly lowering the diagnostic accuracy.
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Affiliation(s)
- Daniel Junker
- Department of Radiology, Community Hospital Hall in Tirol, Milser Straße 10, 6060, Hall in Tirol, Austria. .,Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
| | - Fabian Steinkohl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Veronika Fritz
- Department of Urology, Community Hospital Hall in Tirol, Hall in Tirol, Austria
| | - Jasmin Bektic
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Theodoros Tokas
- Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.,Department of Urology, Community Hospital Hall in Tirol, Hall in Tirol, Austria
| | - Friedrich Aigner
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas R W Herrmann
- Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.,Department of Urology, Klinik für Urologie, Spital Thurgau AG, Frauenfeld, Switzerland
| | - Michael Rieger
- Department of Radiology, Community Hospital Hall in Tirol, Milser Straße 10, 6060, Hall in Tirol, Austria
| | - Udo Nagele
- Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.,Department of Urology, Community Hospital Hall in Tirol, Hall in Tirol, Austria
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Steinkohl F, Gruber L, Bektic J, Nagele U, Aigner F, Herrmann TRW, Rieger M, Junker D. Retrospective analysis of the development of PIRADS 3 lesions over time: when is a follow-up MRI reasonable? World J Urol 2017; 36:367-373. [PMID: 29243110 DOI: 10.1007/s00345-017-2135-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/16/2017] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Often PIRADS 3 findings are usually followed up with further MRIs of the prostate. Current guidelines do not state an optimal interval between the initial MRI and the follow-up MRI. The aim of this study was to find out if PIRADS 3 lesions evolve over time and to determine how long the optimal interval between initial MRI and follow-ups should be. METHODS In this retrospective study, 141 consecutive patients were included who underwent at least one follow-up MRI after an initial PIRADS 3 finding. Changes in PIRADS score and the interval between the first and the follow-up MRI were recorded. An optimal duration was calculated. RESULTS Of all patients, 76.6% had a change from PIRADS 3 to either 2 or 4 in the first follow-up MRI. Reclassifications to PIRADS 4 happened earlier than reclassifications to PIRADS 2 (after 366.5 ± 217.9 days and after 534.2 ± 253.0 days, respectively). An optimal point of time for a follow-up to distinguish between changes to PIRADS 2 versus PIRADS 4 turned out to be 379 days (12.4 months, AUC 0.734, p = 0.0001). Of all patients with a PIRADS 3 lesion 14.8% harboured a prostate carcinoma. CONCLUSION Performing follow-up mpMRI rather than immediate biopsy may be beneficial for patients with PIRADS 3, as most lesions can be reclassified after a manageable period of time. Upgrades to PIRADS 4 seem to happen earlier and within fewer follow-ups than downgrades to PIRADS 2. The optimal interval for follow-up MRIs seems to be 12.4 months.
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Affiliation(s)
- Fabian Steinkohl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Leonhard Gruber
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Jasmin Bektic
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Udo Nagele
- Department of Urology, Landeskrankenhaus Hall in Tirol, Hall in Tirol, Austria.,Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria
| | - Friedrich Aigner
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas R W Herrmann
- Department of Urology, Hannover Medical School, Hannover, Germany.,Department of Urology, Kantonspital Thurgau, Frauenfeld, Switzerland.,Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria
| | - Michael Rieger
- Department of Radiology, Landeskrankenhaus Hall in Tirol, Milser Straße 10, 6060, Hall in Tirol, Austria
| | - Daniel Junker
- Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria. .,Department of Radiology, Landeskrankenhaus Hall in Tirol, Milser Straße 10, 6060, Hall in Tirol, Austria.
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Loizides A, Glodny B, Zoller H, Zelger BG, Junker D, Henninger B, Putzer D, Gruber H. Contrast enhanced ultrasound of a rare case of Peliosis hepatis. Med Ultrason 2017; 19:114-116. [PMID: 28180205 DOI: 10.11152/mu-940] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Peliosis hepatis is a rare benign disorder of the liver, histologically characterized by blood-filled cystic cavities of various sizes and irregular shapes, communicating with the hepatic sinusoids. Only a few cases of peliosis hepatis have been described using contrast enhanced ultrasound showing admittedly various dynamic enhancement patterns. We present a case of peliosis hepatis with a typical target-sign enhancement depicted by means of contrast enhanced ultrasound.
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Affiliation(s)
- Alexander Loizides
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
| | - Bernhard Glodny
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Heinz Zoller
- Department of Internal Medicine II, Gastroenterology & Hepatology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Daniel Junker
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Benjamin Henninger
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Daniel Putzer
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Hannes Gruber
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
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25
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Auer T, Edlinger M, Bektic J, Nagele U, Herrmann T, Schäfer G, Aigner F, Junker D. Performance of PI-RADS version 1 versus version 2 regarding the relation with histopathological results. World J Urol 2016; 35:687-693. [PMID: 27510762 DOI: 10.1007/s00345-016-1920-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [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: 04/28/2016] [Accepted: 08/04/2016] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Aim of this study was to compare the diagnostic performance of PI-RADS version 1 (v1) and version 2 (v2) in the detection of prostate cancer (PCa). METHODS Multiparametric MRIs (mpMRI) of 50 consecutive patients with biopsy proven PCa, which had originally been evaluated according to PIRADS v1, were now retrospectively re-evaluated, comparing PI-RADS v1 and v2. MpMRI data were evaluated in comparison with histopathological whole-mount step-section slides. MRI examinations included T2-weighted, diffusion-weighted, and dynamic contrast-enhanced MRI. RESULTS Overall PI-RADS v1 showed a significantly larger discriminative ability of tumor detection: PI-RADS v1 AUC 0.96 (95 % CI 0.94-0.98) and v2 AUC 0.90 (95 % CI 0.86-0.94). For peripheral zone lesions, PI-RADS v1 showed a significantly larger ability of PCa discrimination: v1 AUC 0.97 (95 % CI 0.95-0.99) and v2 AUC 0.92 (95 % CI 0.88-0.96). For transition zone lesions, PI-RADS v1 showed more discrimination: v1 AUC 0.96 (95 % CI 0.92-1.00) and v2 0.90 (95 % CI 0.83-0.97), but the difference was not significant. PI-RADS v2 resulted in significantly more false negative results (3 % in v1, 14 % in v2) and a comparable number of true positive results (82 % in v1, 80 % in v2). CONCLUSION PI-RADS v2 uses a simplified approach, but shows a lower diagnostic accuracy. This could lead to a higher rate of false negative results with the risk of missing tumors within low PI-RADS score levels. Therefore, its use cannot be recommended unconditionally, and further improvement should be considered.
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Affiliation(s)
- Thomas Auer
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Michael Edlinger
- Department of Medical Statistics, Informatics, and Health Economics, Medical University of Innsbruck, Schöpfstraße 41/1, 6020, Innsbruck, Austria
| | - Jasmin Bektic
- Department of Urology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Udo Nagele
- Landeskrankenhaus Hall, Abteilung für Urologie und Andrologie, Milser Straße 10, 6060, Hall in Tirol, Austria
| | - Thomas Herrmann
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Georg Schäfer
- Department of Pathology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Friedrich Aigner
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Daniel Junker
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
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Merklein M, Junker D, Schaub A, Neubauer F. Hybrid Additive Manufacturing Technologies – An Analysis Regarding Potentials and Applications. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.phpro.2016.08.057] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [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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Daniaux M, Auer T, De Zordo T, Junker D, Santner W, Hubalek M, Jaschke W, Aigner F. Strain Elastography of Breast and Prostata Cancer: Similarities and Differences. ROFO-FORTSCHR RONTG 2015; 188:253-8. [PMID: 26529265 DOI: 10.1055/s-0041-106540] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
UNLABELLED Typically both breast and prostate cancer present as tissue with decreased elasticity. Palpation is the oldest technique of tumor detection in both organs and is based on this principle. Thus an operator can grade a palpable mass as suspicious for cancer. Strain elastography as modern ultrasound technique allows the visualization of tissue elasticity in a color coded elastogram and can be understood as technical finger. The following article shows similarities and differences of ultrasound strain elastography in the diagnosis of breast and prostate cancer. KEY POINTS • In prostata cancer elastography, in breast cancer B-mode is the primary sonographic search modality. • The diagnostic value of the search modalities change with increasing age.• A cut-off value for a strain ratio is hard to obtain in the elastography of the prostata, because there is no stabile reference tissue in the prostata.
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Affiliation(s)
- M Daniaux
- Radiology, Medical University Innsbruck, Austria
| | - T Auer
- Radiology, Medical University Innsbruck, Austria
| | - T De Zordo
- Radiology, Medical University Innsbruck, Austria
| | - D Junker
- Radiology, Medical University Innsbruck, Austria
| | - W Santner
- Radiology, Hirslanden, Clinic Aarau, Switzerland
| | - M Hubalek
- Gynecology, Medical University Innsbruck, Austria
| | - W Jaschke
- Radiology, Medical University Innsbruck, Austria
| | - F Aigner
- Radiology, Medical University Innsbruck, Austria
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Junker D, Herrmann TRW, Bader M, Bektic J, Henkel G, Kruck S, Sandbichler M, Schilling D, Schäfer G, Nagele U. Evaluation of the 'Prostate Interdisciplinary Communication and Mapping Algorithm for Biopsy and Pathology' (PIC-MABP). World J Urol 2015; 34:245-52. [PMID: 26129626 DOI: 10.1007/s00345-015-1627-z] [Citation(s) in RCA: 2] [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] [Received: 04/20/2015] [Accepted: 06/20/2015] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Experience from interdisciplinary cooperation revealed the need for a prostate mapping scheme to communicate multiparametric MRI (mpMRI) findings between radiologists, urologists, and pathologists, which should be detailed, yet easy to memorize. For this purpose, the 'Prostate interdisciplinary communication and mapping algorithm for biopsy and pathology' (PIC-MABP) was developed. This study evaluated the accuracy of the PIC-MABP system. METHODS PIC-MABP was tested and validated in findings of 10 randomly selected patients from routine clinical practise with 18 histologically proven cancer lesions. Patients received an mpMRI of the prostate prior to prostatectomy. After surgery the prostates were prepared as whole-mount step sections. Cancer lesions, which were found suspicious on mpMRI, were assigned to the according PIC-MABP sectors by a radiologist. MpMRI slides were masked and sent to seven urologists from different centres, providing only the PIC-MABP location of each lesion. Urologists marked the accordant regions. Then mpMRI slides were unmasked, and the correctness of each mark was evaluated. RESULTS One hundred and seventeen of the 126 marks (93%) were correctly assigned. Detection rates differed for lesions >0.5 cc compared with lesions <0.5 cc (p < 0.005): 3/7 (43%) marks were correctly assigned in lesions <0.3 cc, 16/21 (76%) in lesions with 0.3-0.5 cc, and 98/98 (100%) in lesions >0.5 cc. Interobserver agreement was good for lesions >0.5 cc and poor for lesions <0.3 cc (Fleiss Kappa 1 vs. 0.0175). CONCLUSION PIC-MABP seems to be a reliable system to communicate the location of mpMRI findings >0.5 cc between different disciplines and can be a useful guidance for cognitive mpMRI/TRUS fusion biopsy.
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Affiliation(s)
- Daniel Junker
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Thomas R W Herrmann
- Department of Urology and Urooncology, Hanover Medical School [MHH], Carl Neuberg Str. 1, 30625, Hannover, Germany.
| | - Markus Bader
- UroClinic München Giesing, Tegernseer Landstraße 44a, 81541, Munich, Germany.
| | - Jasmin Bektic
- Department of Urology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Gregor Henkel
- Urologic Practice Dr. Gregor Henkel, Prof. Sinwel Weg 4/2, 6330, Kufstein, Austria.
| | - Stephan Kruck
- University Hospital for Urology Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - Markus Sandbichler
- Urologic Practice Dr. Sandbichler, Speckbacherstraße 20, 6380, St. Johann in Tirol, Austria.
| | - David Schilling
- University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
| | - Georg Schäfer
- Department of Pathology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Udo Nagele
- Landeskrankenhaus Hall, Abteilung für Urologie und Andrologie, Milser Straße 10, 6060, Hall in Tirol, Austria.
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Nagele U, Junker D. Prostate interdisciplinary communication and mapping algorithm for biopsy and pathology (PIC-MABP) of multiparametric MRI findings. World J Urol 2015; 33:1057-9. [PMID: 25673241 DOI: 10.1007/s00345-015-1491-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 01/11/2015] [Indexed: 12/19/2022] Open
Affiliation(s)
- Udo Nagele
- Landeskrankenhaus Hall, Abteilung für Urologie und Andrologie, Milser Straße 10, 6060, Hall in Tirol, Austria,
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Abstract
Technical fusion is defined as the ultrasound-guided navigation through a previously generated 3 D imaging dataset such as a computed tomography (CT) or magnetic resonance imaging (MRI). This technique allows for moving the fused CT/MRI datasets synchroneously with the real-time ultrasound in the same plane. Established and furthermore not yet described applications, the technical principles and the limitations of this promising technique will be introduced.
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Affiliation(s)
- F Aigner
- Radiology, Medical University Innsbruck, Austria
| | - T De Zordo
- Radiology, Medical University Innsbruck, Austria
| | | | - D Junker
- Radiology, Medical University Innsbruck, Austria
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Junker D, Schäfer G, Heidegger I, Bektic J, Ladurner M, Jaschke W, Aigner F. Multiparametric Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Targeted Biopsy of the Prostate: Preliminary Results of a Prospective Single-Centre Study. Urol Int 2015; 94:313-8. [DOI: 10.1159/000365489] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 06/24/2014] [Indexed: 11/19/2022]
Abstract
Purpose: To evaluate multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion targeted biopsy (TB) of the prostate for prostate cancer (PCa) diagnosis. Patients and Methods: From April 2013 to January 2014, 53 men were included in this prospective single-centre study. The degree of PCa suspicion from mpMRI findings was classified according to the PI-RADS scoring system. Of these, 50 patients underwent both an mpMRI/TRUS fusion TB and a 10-core systematic biopsy (SB) of the prostate and were eligible for analysis. Results: 225 targeted and 500 systematic cores were included in this study. PCa was histologically confirmed in 52.0% of patients (26/50), whereas TB revealed PCa in 46.0% (23/50) and SB in 36.0% (18/50). TB identified PCa in 16.0% of all patients (8/50) that were missed by SB. All told, the targeted core was 2.8 times more likely to be PCa-positive than the systematic core (29.3 vs. 10.4%). Conclusions: mpMRI/TRUS fusion TB of the prostate is safe, practicable and may improve PCa diagnosis using fewer biopsy cores compared to SB.
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Neubauer V, Junker D, Griesmaier E, Schocke M, Kiechl-Kohlendorfer U. Bronchopulmonary dysplasia is associated with delayed structural brain maturation in preterm infants. Neonatology 2015; 107:179-84. [PMID: 25632975 DOI: 10.1159/000369199] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/16/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND In recent years, cerebral magnetic resonance imaging (MRI) has been increasingly used to depict the wide spectrum of preterm brain injury. Furthermore, it has already been demonstrated by MRI at term-equivalent age (TEA) that preterm infants show delayed brain maturation as compared to term infants, and this delay has been related to neurobehavioral outcome. OBJECTIVES The aim of the current study was to investigate the influence of prevalent neonatal risk factors for adverse outcome on structural brain maturation in very preterm infants at TEA. METHODS One hundred and thirty very preterm infants born at a mean gestational age of 29.7 weeks were included. MRI was performed at TEA and given a validated 'total maturation score'. Brain maturation scores were compared with neonatal data. RESULTS In univariate analysis, bronchopulmonary dysplasia (BPD), late-onset sepsis and retinopathy of prematurity were significantly associated with delayed brain maturation. Furthermore, infants with delayed maturation had been ventilated significantly longer and more often suffered from severe arterial hypotension. In multivariate analysis, BPD remained significant as predictor of delayed brain maturation. CONCLUSIONS This study is the first to show that delayed structural brain maturation as evaluated by MRI at TEA is preceded by BPD, which is known to be a predictor of adverse outcome in preterm infants. This finding adds further evidence to show that adverse outcome in preterm infants may have additional neural correlates that exceed common brain injury.
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Affiliation(s)
- Vera Neubauer
- Neonatology, Department of Paediatrics II, Innsbruck Medical University, Innsbruck, Austria
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Junker D, Quentin M, Nagele U, Edlinger M, Richenberg J, Schaefer G, Ladurner M, Jaschke W, Horninger W, Aigner F. Evaluation of the PI-RADS scoring system for mpMRI of the prostate: a whole-mount step-section analysis. World J Urol 2014; 33:1023-30. [PMID: 25081011 DOI: 10.1007/s00345-014-1370-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 07/22/2014] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Evaluation of the Prostate Imaging Reporting and Data System (PI-RADS) scoring system for classifying multi-parametric magnetic resonance imaging findings of the prostate using whole-mount step-section slides as reference standard. MATERIALS AND METHODS Prospective inclusion of 50 consecutive patients with biopsy-proven prostate cancer (PCa). All patients received a multi-parametric MRI of the prostate, consisting of T2-weighted, diffusion-weighted, and dynamic contrast-enhanced MRI. After prostatectomy, all prostates were prepared as whole-mount step-section slides. For each patient, six lesions were predefined on whole-mount step-sections according to a distinct scheme and the corresponding regions were identified on MRI. Each lesion then was scored on MRI according to PI-RADS by an experienced blinded uro-radiologist and compared with histopathological findings. RESULTS PCa received significant (p < 0.01) higher overall PI-RADS scores (4.10 ± 0.75) compared with benign changes (2.00 ± 0.74). In the peripheral zone, each single modality score showed good diagnostic accuracy for PCa detection (area under the curve [AUC] > 0.90). When combining all single modality scores, an even higher discriminative ability of PCa detection (AUC = 0.97, 95 % CI 0.95-0.99) could be achieved. In contrast, in the transitional zone, dynamic contrast-enhanced MRI (DCE) showed very low diagnostic accuracy (AUC = 0.60). Regarding tumor malignancy, no high-grade PCa (Gleason >7a) was present at PI-RADS scores <4 and no Gleason 6 PCa at a PI-RADS score of 5. CONCLUSION The PI-RADS scoring system showed good diagnostic accuracy: Only PI-RADS 4 and 5 showed high-grade PCa. However, it seems necessary to revise the PI-RADS scoring system concerning DCE in the transitional zone.
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Affiliation(s)
- Daniel Junker
- Department of Radiology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria,
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Abstract
Neuropsychiatric systemic lupus erythematosus (NPSLE) is defined by involvement of the central nervous system in systemic lupus erythematosus (SLE), with a wide range of both neurological and psychiatric manifestations. Although its aetiopathogenesis is not fully elucidated, NPSLE seems to be a consequence of cerebral vascular pathology including thromboembolism, small-vessel vasculopathy and, in rare cases, true vasculitis. Cerebral vasculitis is rare, and cerebral large-vessel vasculitis in SLE is even more unusual. We report the case of a female patient with the diagnosis of SLE. She presented with stroke-like symptoms, headache and vertigo, and palpable purpura on her legs. Further investigations revealed that she suffered from both vasculitis of the cerebral large vessels and coexisting cutaneous small-vessel vasculitis.
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Affiliation(s)
- B C Böckle
- Department of Dermatology, Innsbruck Medical University, Austria
| | - D Jara
- Barbara Bommer Foundation for Clinical Immunodermatology, Department of Dermatology, Innsbruck Medical University, Austria
| | - K Aichhorn
- Department of Dermatology, Innsbruck Medical University, Austria
| | - D Junker
- Department of Radiology, Innsbruck Medical University, Austria
| | - T Berger
- Clinical Department of Neurology, Innsbruck Medical University, Austria
| | - G Ratzinger
- Department of Dermatology, Innsbruck Medical University, Austria
| | - N T Sepp
- Department of Dermatology, Innsbruck Medical University, Austria Barbara Bommer Foundation for Clinical Immunodermatology, Department of Dermatology, Innsbruck Medical University, Austria
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Junker D, Schäfer G, Aigner F, Schullian P, Pallwein-Prettner L, Bektic J, Horninger W, Halpern EJ, Frauscher F. Potentials and limitations of real-time elastography for prostate cancer detection: a whole-mount step section analysis. ScientificWorldJournal 2012; 2012:193213. [PMID: 23346015 PMCID: PMC3549343 DOI: 10.1100/2012/193213] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [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: 09/26/2012] [Accepted: 12/17/2012] [Indexed: 11/24/2022] Open
Abstract
Objectives. To evaluate prostate cancer (PCa) detection rates of real-time elastography (RTE) in dependence of tumor size, tumor volume, localization and histological type. Materials and Methods. Thirdy-nine patients with biopsy proven PCa underwent RTE before radical prostatectomy (RPE) to assess prostate tissue elasticity, and hard lesions were considered suspicious for PCa. After RPE, the prostates were prepared as whole-mount step sections and were compared with imaging findings for analyzing PCa detection rates. Results. RTE detected 6/62 cancer lesions with a maximum diameter of 0–5 mm (9.7%), 10/37 with a maximum diameter of 6–10 mm (27%), 24/34 with a maximum diameter of 11–20 20 mm (70.6%), 14/14 with a maximum diameter of >20 mm (100%) and 40/48 with a volume ≥0.2 cm3 (83.3%). Regarding cancer lesions with a volume ≥ 0.2 cm³ there was a significant difference in PCa detection rates between Gleason scores with predominant Gleason pattern 3 compared to those with predominant Gleason pattern 4 or 5 (75% versus 100%; P = 0.028). Conclusions. RTE is able to detect PCa of significant tumor volume and of predominant Gleason pattern 4 or 5 with high confidence, but is of limited value in the detection of small cancer lesions.
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Affiliation(s)
- Daniel Junker
- Department of Radiology, Medical University of Innsbruck, Anichstraß 35, 6020 Innsbruck, Austria
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De Zordo T, Aigner F, Dejaco C, Pallwein-Prettner L, Junker D, Jaschke W, Frauscher F. Echtzeit-Sonoelastografie der Prostata: Wie hilfreich ist die Berechnung einer Elastizitäts-Ratio in der Detektion des Prostatakarzinoms? ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1324421] [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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Aigner F, De Zordo T, Pallwein-Prettner L, Junker D, Schäfer G, Pichler R, Leonhartsberger N, Pinggera G, Dogra VS, Frauscher F. Real-time sonoelastography for the evaluation of testicular lesions. Radiology 2012; 263:584-9. [PMID: 22396607 DOI: 10.1148/radiol.12111732] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate the feasibility of using real-time sonoelastography (RTE) for the differentiation and characterization of testicular lesions. MATERIALS AND METHODS Institutional review board approval was obtained for this retrospective study, and the requirement to obtain informed consent was waived. Fifty patients (mean age, 42 years; age range, 18-81 years) with testicular lesions detected with gray-scale ultrasonography (US) and color and/or power Doppler US were evaluated with RTE between December 2004 and August 2010 to assess tissue elasticity of the testes. Stiff or "hard" lesions were suspected of being malignant. Testicular lesions with normal or decreased tissue stiffness ("soft" lesions) were considered benign. Findings from surgery and histopathologic examination were used as the reference standard in 34 cases, and findings from clinical and US follow-up were used as the reference standard in 16 cases. Sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic accuracy were calculated. RESULTS Thirty-four of the 50 lesions (68%) were testicular tumors and 16 (32%) were of nontumorous origin. RTE showed the presence of hard lesions in all cases of testicular tumors and three cases of nontumorous lesions. Four lesions with an uncertain diagnosis when tested with gray-scale US and color and/or power Doppler US alone were soft at RTE and showed nontumorous character at follow-up. RTE showed a sensitivity of 100%, a specificity of 81%, a negative predictive value of 100%, a positive predictive value of 92%, and an accuracy of 94% in the diagnosis of testicular tumors. CONCLUSION RTE demonstrated all testicular tumors as lesions with increased tissue stiffness. Because of its higher specificity, RTE can provide additional information in cases with indeterminate US findings.
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Affiliation(s)
- Friedrich Aigner
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
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Aigner F, Pallwein L, Schocke M, Lebovici A, Junker D, Schäfer G, Mikuz G, Pedross F, Horninger W, Jaschke W, Halpern EJ, Frauscher F. Comparison of real-time sonoelastography with T2-weighted endorectal magnetic resonance imaging for prostate cancer detection. J Ultrasound Med 2011; 30:643-9. [PMID: 21527612 DOI: 10.7863/jum.2011.30.5.643] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVES The purpose of this study was to compare the value of real-time sonoelastography with T2-weighted endorectal magnetic resonance imaging (MRI) for prostate cancer detection. METHODS Thirty-three patients with an elevated prostate-specific antigen level were investigated with real-time sonoelastography and T2-weighted endorectal MRI for prostate cancer diagnosis before systematic prostate biopsy. Real-time sonoelastography was performed to assess prostate tissue elasticity, and hard areas were considered suspicious for prostate cancer. Low-signal intensity nodules on T2-weighted endorectal MRI were considered suspicious for prostate cancer. Imaging findings were assigned to 6 areas of the peripheral zone (sextants), and their cancer detection rates were compared. RESULTS Overall, prostate cancer was detected in 13 of 33 patients (39.4%). Both real-time sonoelastography and T2-weighted endorectal MRI detected 11 cancer-positive patients (84.6%). Real-time sonoelastography showed 27 suspicious lesions in 198 sextants, and 15 (55.6%) were cancer positive. T2-weighted endorectal MRI showed 31 suspicious lesions in 198 sextants, and 13 (40.6%) were cancer positive. These findings resulted in sensitivity rates and negative predictive values per patient of 84.6% and 86.7%, respectively, for sonoelastography and 84.6% and 83.3% for MRI. The per-sextant analysis showed sensitivity rates and negative predictive values of 57.7% and 93.6% for sonoelastography and 50.0% and 92.2% for MRI. CONCLUSIONS Real-time sonoelastography showed comparable results as T2-weighted endorectal MRI for prostate cancer detection.
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Affiliation(s)
- Friedrich Aigner
- Department of Radiology II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
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Aigner F, Pallwein L, Junker D, Schäfer G, Mikuz G, Pedross F, Mitterberger MJ, Jaschke W, Halpern EJ, Frauscher F. Value of real-time elastography targeted biopsy for prostate cancer detection in men with prostate specific antigen 1.25 ng/ml or greater and 4.00 ng/ml or less. J Urol 2010; 184:913-7. [PMID: 20643432 DOI: 10.1016/j.juro.2010.05.026] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE We assessed the prostate cancer detection rate of real-time elastography targeted biopsy in men with total prostate specific antigen 1.25 ng/ml or greater and 4.00 ng/ml or less. MATERIALS AND METHODS Real-time elastography using an EUB 8500 Hitachi ultrasound system (Hitachi Medical, Tokyo, Japan) was done in 94 men with a mean age of 57.4 years (range 35 to 77) with increased prostate specific antigen between 1.25 ng/ml or greater and 4.00 ng/ml or less (mean 3.20, range 1.30 to 4.00) and a free-to-total prostate specific antigen ratio of less than 18%. Real-time elastography was done to evaluate peripheral zone tissue elasticity and hard areas were defined as suspicious. Targeted biopsies with a maximum of 5 cores were done in suspicious areas, followed by 10-core systematic biopsy. We analyzed the cancer detection rate of real-time elastography and systematic biopsy. RESULTS Cancer was found in 27 of 94 patients (28.7%). Real-time elastography detected cancer in 20 patients (21.3%) and systematic biopsy detected it in 18 (19.1%). Positive cancer cores were found in real-time elastography targeted cores in 38 of 158 cases (24%) and in systematic cores in 38 of 752 (5.1%) (chi-square test p <0.0001). The cancer detection rate per core was 4.7-fold greater for targeted than for systematic biopsy. CONCLUSIONS Real-time elastography targeted biopsy allows prostate cancer detection in men with prostate specific antigen 1.25 ng/ml or greater and 4 ng/ml or less with a decreased number of cores compared with that of systematic biopsy.
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Affiliation(s)
- Friedrich Aigner
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
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Aigner F, Mitterberger M, Rehder P, Pallwein L, Junker D, Horninger W, Frauscher F. Status of transrectal ultrasound imaging of the prostate. J Endourol 2010; 24:685-91. [PMID: 20433367 DOI: 10.1089/end.2009.0640] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To describe the current and new developments in transrectal ultrasound (US) imaging of the prostate. PATIENTS AND METHODS Grayscale imaging of the prostate is the standard method for diagnostic evaluation and biopsy guidance. Color Doppler (CD) imaging, including CD and power Doppler US, allows for detection of macrovascularity and may therefore be helpful for assessment of prostatic blood flow. The use of US microbubbles for CD imaging and new contrast-specific techniques enable assessment of prostate microvascularity associated with prostate cancer (PCa). Recently, real-time elastography has been introduced to improve detection of cancer based upon changes in tissue stiffness. RESULTS Contrast-enhanced CD imaging has shown to enable PCa detection by performing targeted biopsies into suspicious areas. Comparisons between systematic and contrast-enhanced targeted biopsies have shown that the targeted approach detects more cancers and cancers with higher Gleason scores with a reduced number of biopsy cores. New microbubble-specific US techniques can improve sensitivity and specificity of US imaging for PCa detection. Real-time elastography has been demonstrated to be useful for the detection of PCa, and may further improve PCa staging. CONCLUSIONS The new US techniques seem to have the potential to improve PCa detection, and also PCa grading and staging. As these diagnostic methods improve, the ultimate hope is to eliminate biopsy in patients without cancer.
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Affiliation(s)
- Friedrich Aigner
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
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Feuchtner GM, Dichtl W, DeFrance T, Stühlinger M, Klauser A, Berger T, Junker D, Spuller K, Pachinger O, zur Nedden D, Hintringer F. Fusion of multislice computed tomography and electroanatomical mapping data for 3D navigation of left and right atrial catheter ablation. Eur J Radiol 2008; 68:456-64. [PMID: 17913424 DOI: 10.1016/j.ejrad.2007.08.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Revised: 08/28/2007] [Accepted: 08/28/2007] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess whether fusion of multislice computed tomography (CT) images with electroanatomical (EA)-mapping data using a new image integration module (CartoMerge) is feasible and accurate to navigate ablation catheters in right and left atrial catheter ablation. MATERIAL AND METHODS Twenty-four patients were examined with ECG-gated cardiac multislice CT (64 mm x 0.6mm, 0.33 s) 1 day before left atrial (LA) (15 patients) radiofrequency or right atrial cavotricuspid isthmus ablation (9 patients). CT data were fused with the non-fluoroscopic EA-mapping data by using dedicated software (CartoMerge) and the value of CT was analysed. RESULTS In 23/24 (96%) patients, CT images could be fused with the EA-map. The alignment error was 2.16+/-0.35 mm. In 15/15 (100%) patients, CT added relevant anatomical information regarding the course of the esophagus or the pulmonary veins before LA-ablation. CT added useful information in only 3/8 (37.5%) of patients undergoing right atrial cavotricuspid isthmus ablation. CONCLUSION 3D-navigation of RF-ablation catheters in the atria assisted by image fusion of multislice CT with EA-mapping data is feasible and accurate. CT added relevant anatomical information about the left atrium and the pulmonary veins before LA-ablation, CT also provided information about the course of the esophagus which might help to avoid thermal injury. CT image fusion might be of minor value before right atrial cavotricuspid isthmus catheter ablation.
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Affiliation(s)
- Gudrun M Feuchtner
- Department of Radiology II, Innsbruck Medical University, Anichstr. 35, Innsbruck A-6020, Austria.
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Feuchtner G, Junker D, Bonatti J, Friedrich G. Right coronary artery fistula into left ventricle: dynamic compression shown by multislice computed tomography. Eur J Cardiothorac Surg 2007; 32:933. [PMID: 17904377 DOI: 10.1016/j.ejcts.2007.08.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Revised: 08/23/2007] [Accepted: 08/24/2007] [Indexed: 11/30/2022] Open
Affiliation(s)
- Gudrun Feuchtner
- Department of Radiology II, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck, Austria.
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Feuchtner G, Schachner T, Junker D, Bonaros N, Ohlinger A, Friedrich G, Cooper J, Laufer G, Bonatti J. Multislice Computed Tomography for Preoperative and Postoperative Assessment in Totally Endoscopic Coronary Artery Bypass Grafting. Heart Surg Forum 2007; 10:E243-7. [PMID: 17599901 DOI: 10.1532/hsf98.20070705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article reviews the clinical value of noninvasive multi-slice computed tomography (MSCT) angiography before and after totally endoscopic coronary artery bypass surgery. The use of coronary and aorto-iliaco-femoral MSCT angiography in the preoperative assessment is addressed and the use of bypass MSCT angiography for postoperative control of bypass graft patency is discussed.
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Affiliation(s)
- Gudrun Feuchtner
- Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck, Austria.
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Solano-Aguilar GI, Zarlenga D, Beshah E, Vengroski K, Gasbarre L, Junker D, Cochran M, Weston C, Valencia D, Chiang C, Dawson H, Urban JF, Lunney JK. Limited effect of recombinant porcine interleukin-12 on porcine lymphocytes due to a low level of IL-12 beta2 receptor. Vet Immunol Immunopathol 2002; 89:133-48. [PMID: 12383645 DOI: 10.1016/s0165-2427(02)00205-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The cytokine interleukin-12 (IL-12) is a key molecule in the regulation of CD4 + T cell development and specifically potentiates T helper 1 responses in mouse and man. However, biological effects mediated by IL-12 have not been well defined in pigs. Herein, recombinant porcine IL-12 (rPoIL-12) was expressed in a swine poxvirus system as a biologically active heterodimer and used to stimulate bovine or swine lymphoblast cells. After 3 days of incubation, only bovine blasts were responsive to the rPoIL-12 treatment as monitored by cell proliferation in several independent trials. Similarly, i.m. administration of rPoIL-12 in the hind leg of 3-week-old pigs indicated a reduction in the number of interferon-gamma (IFN-gamma) producing lymphocytes isolated from inguinal lymph nodes. The porcine IL-12R beta2 (IL-12Rbeta2) sequence was cloned and results generated by reverse transcriptase polymerase chain reaction (RT-PCR) demonstrated that the expression of IL-12R on porcine blasts as measured by the relative levels of IL-12Rbeta2 mRNA was less than that in bovine blasts and are in agreement with the reduced proliferation response of swine blast cells to rPoIL-12 treatment. Real time PCR analysis demonstrated that after PBMC stimulation, bovine blasts had an 11-fold increase in IL-12Rbeta2 mRNA levels while porcine blasts had almost no change. These data support a mechanism for IL-12 stimulation in swine inconsistent with that observed in conventional models.
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Affiliation(s)
- G I Solano-Aguilar
- Nutrient Requirement and Functions Laboratory, BHNRC-ARS-USDA, 10300 Baltimore Avenue, Building 307, Room 228, Beltsville, MD 20705, USA.
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Rautenschlein S, Sharma JM, Winslow BJ, McMillen J, Junker D, Cochran M. Embryo vaccination of turkeys against Newcastle disease infection with recombinant fowlpox virus constructs containing interferons as adjuvants. Vaccine 1999; 18:426-33. [PMID: 10519931 DOI: 10.1016/s0264-410x(99)00254-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Recombinant fowlpox viruses (rFPV) expressing the fusion and hemagglutinin-neuraminidase glycoproteins of Newcastle disease virus (NDV) as well as chicken type I interferon (IFN) or type II IFN were used to vaccinate specific pathogen-free (SPF) turkeys in ovo. No significant changes in the hatchability, survival rate, performance and weight gain were observed after vaccination with the rFPV vaccines in comparison to diluent-inoculated embryos. The rFPV-NDV-IFN-II construct induced the onset of anti-NDV antibody production in SPF birds at one week post hatch, one week earlier than other vaccine constructs. Three to five weeks post hatch, the turkeys were challenged with the neurotropic velogenic NDV strain Texas GB (NDV-GB-Tx). The rFPV-NDV-IFN-II construct was the most protective vaccine against NDV. rFPV vaccines significantly (p<0.05) suppressed the mitogenic response of peripheral blood leukocytes in vaccinated turkeys in comparison to placebo inoculated controls at 25 days post vaccination. Birds vaccinated with rFPV-NDV-IFN-I construct did not have an inhibition in the mitogenic response.
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Affiliation(s)
- S Rautenschlein
- Department of Veterinary PathoBiology, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA
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Geginat G, Kretschmar M, Walter S, Junker D, Hof H, Nichterlein T. Suppression of acquired immunity against Listeria monocytogenes by amphotericin B-mediated inhibition of CD8 T cell function. J Infect Dis 1999; 180:1186-94. [PMID: 10479147 DOI: 10.1086/315007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Amphotericin B is frequently used for the treatment of fungal infections of immunocompromised individuals. Whereas immunomodulatory side effects of this agent are known, the influence of amphotericin B was studied in the model of murine Listeria monocytogenes infection. Treatment of L. monocytogenes-immune mice with a nontoxic dose of amphotericin B (0.75 mg/kg) reduced antilisterial protection by 4-5 orders of magnitude, while it had no significant effect on natural immunity against L. monocytogenes in naive mice. Treatment of mice with amphotericin B also abolished the protection mediated by transfer of an L. monocytogenes-specific CD8 T cell line. Furthermore, in vitro analysis showed that amphotericin B impaired target cell lysis and interferon-gamma production by peptide-specific CD8 T cell lines and antigen presentation by L. monocytogenes-infected macrophagelike cells. These data indicate that amphotericin B has a strong suppressive effect on the function of CD8 T cells in vitro and in vivo.
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Affiliation(s)
- G Geginat
- Institut für Medizinische Mikrobiologie und Hygiene, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg, 68167 Mannheim, Germany
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Honecker W, Dohmen C, Haan H, Junker D, Otter G, Starlinger M, Wintz P, Hofmann J, Bertl W, Egger J, Krause B, Eggli S, Engfer R, Findeisen C, Hermes EA, Kozlowski T, Niebuhr CB, Pruys HS. Improved limit on the branching ratio of micro-->e conversion on lead. Phys Rev Lett 1996; 76:200-203. [PMID: 10061041 DOI: 10.1103/physrevlett.76.200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Abstract
The large number of phenotypically distinct strains of infectious bronchitis virus (IBV) provide a broad genetic background for examining naturally occurring coronavirus variation. Comparisons of the published nucleotide sequence of S1 genes of strains isolated in Europe, Japan and the USA and four additional American strains described in this report identified 4 genetically distinct groups. The Dutch group was the most divergent sharing only about 60% identity with the American, Mass and European groups which were about 80% homologous with each other. Whereas the strains within the Mass, European and Dutch strains were at least 95% homologous, the strains within the American group were most variable, sharing about 80% identity. The hypervariable region (HVR) which tended to correlate with serotype extended from amino acid residue 53 to 148. In addition to the previously described putative recombination events in the S1 gene of PP14 and SE17, we have now described similar shifts in homology in the corresponding gene of the Gray, Holte, 6/82 (European strain), and Iowa strains. Although minor cross-over sites were identified in the more conserved 3' end at approximately nt 1000 and 1400, a frequently used hot-spot for recombination extended from nt 25 to a region immediately upstream of, but not including, the hypervariable region (HVR). In addition to point mutations, deletions, and insertions, recombination often involving Mass-like and Ark-like sequences, is a commonly used mechanism responsible for the evolution of IBV.
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Affiliation(s)
- L Wang
- Department of Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station 77843
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Hewer W, Junker D, Dressing H, Olbrich R. [Psychoses in encephalitis of uncertain etiology. Atypical course of multiple sclerosis?]. Nervenarzt 1994; 65:163-8. [PMID: 8177356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We report on 6 patients (4 female, 2 male, age 17-40 yrs.), admitted to hospital because of psychotic illness. In 2 patients paranoid-hallucinatory symptomatology was prominent, while a manic, a schizo-affective, a catatonic and a mixed organic brain syndrome were found in one case each. Neurological signs could be detected in 4 and EEG-abnormalities in 5 patients. On the basis of CSF findings typical of chronic encephalitis, together with evidence of demyelinating lesions on MRT we confirmed the presence of inflammatory brain disease in all six patients. As a specific etiology could not be established in any of the cases, we suggest the encephalitic variant of multiple sclerosis as the probable diagnosis. In view of our clinical observations, we assume that by using modern investigational techniques--especially sophisticated CSF analysis and MRT--an encephalitic etiology of schizophrenic and affective syndromes may be proven in higher frequency than in the past.
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Affiliation(s)
- W Hewer
- Psychiatrische Klinik am Zentralinstitut für Seelische Gesundheit, Mannheim
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Abstract
During an outbreak of severe respiratory disease, a field strain of infectious bronchitis virus (IBV), PP14, was isolated from a bird in a Texas flock that had been previously vaccinated with an attenuated Mass serotype virus. After cloning and sequencing the S1 gene from several IBV strains, it was found that the 5' end of the cDNA was 96% identical to the published sequences of Mass41 and 77% identical with Ark99. The following 402 bases which included the hypervariable regions (HVR) of the S1 gene were 94% homologous with Ark99 and only 69% with Mass41. In addition, the HVR in the 3' noncoding region of the genome, which is totally absent in Mass41, was 99% homologous with the Ark99 strain. This abrupt shift in identity of PP14 in the S1 strongly indicated that a recombination event had occurred about 98 bases from the beginning of the S1 gene between an Ark-like and a Mass-like virus. Downstream, 33 bases from the PP14 recombination junction, a second putative "cross-over" site was identified in the S1 of the SE17 strain where the 5'131 bases of the S1 gene of the Ark99 and SE17 were found to be 95% identical and the following 368 base sequence was only 78% homologous. In addition, a second shift in homology in the S1 of SE17 was identified between nucleotide 1112 and 1460 which shared 95% identity with Mass41. The putative recombination junctions which were downstream of the signal sequence and upstream of the S1 HVR may represent a "hot spot," but not an exclusive region, for exchanging genetic material between IBV strains. Genetic shifts are apparently not only common mechanisms for variation in nature, but vaccine strains may actually play a critical role in these events in the evolution of virulent strains of IBV.
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Affiliation(s)
- L Wang
- Department of Veterinary Pathobiology, Texas A&M University, College Station 77843
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