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von Samson-Himmelstjerna FA, Kakavand N, Gleske C, Schraml F, Basta AA, Braunisch MC, Bräsen JH, Schmitz J, Kraus D, Weinmann-Menke J, Zacharias HU, Vaulet T, Naesens M, Krautter M, Schwenger V, Esser G, Kolbrink B, Amann K, Holzmann-Littig C, Echterdiek F, Kunzendorf U, Renders L, Schulte K, Heemann U. Potential and Uncertainties of RejectClass in Acute Kidney Graft Dysfunction: An Independent Validation Study. Transplantation 2024; 108:1228-1238. [PMID: 38196094 DOI: 10.1097/tp.0000000000004906] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Kidney graft rejections are classified based on the Banff classification. The RejectClass algorithm, initially derived from a cohort comprising mostly protocol biopsies, identifies data-driven phenotypes of acute rejection and chronic pathology using Banff lesion scores. It also provides composite scores for inflammation activity and chronicity. This study independently evaluates the performance of RejectClass in a cohort consisting entirely of indication biopsies. METHODS We retrospectively applied RejectClass to 441 patients from the German TRABIO (TRAnsplant BIOpsies) cohort who had received indication biopsies. The primary endpoint was death-censored graft failure during 2 y of follow-up. RESULTS The application of RejectClass to our cohort demonstrated moderately comparable phenotypic features with the derivation cohort, and most clusters indicated an elevated risk of graft loss. However, the reproduction of all phenotypes and the associated risks of graft failure, as depicted in the original studies, was not fully accomplished. In contrast, adjusted Cox proportional hazards analyses substantiated that both the inflammation score and the chronicity score are independently associated with graft loss, exhibiting hazard ratios of 1.7 (95% confidence interval, 1.2-2.3; P = 0.002) and 2.2 (95% confidence interval, 1.8-2.6; P < 0.001), respectively, per 0.25-point increment (scale: 0.0-1.0). CONCLUSIONS The composite inflammation and chronicity scores may already have direct utility in quantitatively assessing the disease stage. Further refinement and validation of RejectClass clusters are necessary to achieve more reliable and accurate phenotyping of rejection.
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Affiliation(s)
| | - Nassim Kakavand
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Charlotte Gleske
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian Schraml
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Agathe A Basta
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias C Braunisch
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jan H Bräsen
- Nephropathology Unit, Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Daniel Kraus
- Department of Nephrology, Department of Internal Medicine 1, University Medical Center Mainz, Mainz, Germany
| | - Julia Weinmann-Menke
- Department of Nephrology, Department of Internal Medicine 1, University Medical Center Mainz, Mainz, Germany
| | - Helena U Zacharias
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Thibaut Vaulet
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Maarten Naesens
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Markus Krautter
- Department of Nephrology, Transplant Center, Klinikum Stuttgart, Stuttgart, Germany
| | - Vedat Schwenger
- Department of Nephrology, Transplant Center, Klinikum Stuttgart, Stuttgart, Germany
| | - Grit Esser
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Benedikt Kolbrink
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Kerstin Amann
- Department of Nephropathology, University Hospital Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Christopher Holzmann-Littig
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Fabian Echterdiek
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Ulrich Kunzendorf
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Lutz Renders
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kevin Schulte
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Uwe Heemann
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Schmitz J, Kracht J, Evert K, Wenzel JJ, Schemmerer M, Lehmann U, Panning M, Pape L, Pohl M, Bräsen JH. Hepatitis E virus infection of transplanted kidneys. Am J Transplant 2024; 24:491-497. [PMID: 38072120 DOI: 10.1016/j.ajt.2023.11.016] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/02/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
Immunocompromised patients are at risk of chronic hepatitis E (HEV) infection. Recurrent T cell and borderline rejections in a pediatric patient with high HEV copy numbers led us to study HEV infection within renal transplants. To investigate the frequency of renal HEV infection in transplanted patients, 15 samples from patients with contemporaneous diagnoses of HEV infection were identified at our center. Ten samples had sufficient residual paraffin tissue for immunofluorescence (IF) and RNA-fluorescence-in-situ-hybridization (RNA-FISH). The biopsy of the pediatric index patient was additionally sufficient for tissue polymerase chain reaction and electron microscopy. HEV RNA was detected in paraffin tissue of the index patient by tissue polymerase chain reaction. Subsequently, HEV infection was localized in tubular epithelial cells by IF, RNA-FISH, and electron microscopy. One additional biopsy from an adult was positive for HEV by RNA-FISH and IF. Focal IF positivity for HEV peptide was observed in 7 additional allografts. Ribavirin therapy was not successful in the pediatric index patient; after relapse, ribavirin is still administered. In the second patient, successful elimination of HEV was achieved after short-course ribavirin therapy. HEV infection is an important differential diagnosis for T cell rejection within transplanted kidneys. Immunostaining of HEV peptide does not necessarily prove acute infection. RNA-FISH seems to be a reliable method to localize HEV.
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Affiliation(s)
- Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Julia Kracht
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Katja Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Jürgen J Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Mathias Schemmerer
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Ulrich Lehmann
- Molecular Pathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Marcus Panning
- Institute of Virology, University Clinics Freiburg, Freiburg, Germany
| | - Lars Pape
- Department of Pediatrics II, University Hospital of Essen, Essen, Germany
| | - Martin Pohl
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany.
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3
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Liebold F, Adler W, Jansen S, Klussmann JP, Meyer M, Nehrlich L, Schmitz J, Vingerhoets A, Heindl LM, Hinkelbein J. Evaluation of colour vision impairment during acute hypobaric hypoxia in aviation medicine: a randomized controlled trial. J Physiol Sci 2024; 74:6. [PMID: 38311742 PMCID: PMC10840265 DOI: 10.1186/s12576-024-00898-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 01/18/2024] [Indexed: 02/06/2024]
Abstract
The digitization of aircraft cockpits places high demands on the colour vision of pilots. The present study investigates colour vision changes upon acute exposure to hypobaric hypoxia. The digital Waggoner Computerized Color Vision Test and the Waggoner D-15 were performed by 54 healthy volunteers in a decompression chamber. Respective altitude levels were sea level, 10,000 or 15,000 ft for exposure periods of 15 and 60 min, respectively. As for 60 min of exposure a significant decrease in colour perception was found between subjects at 15,000 ft as compared to the control group as well as between subjects at 15,000 ft as compared to subjects at 10,000 ft. No significant difference was found in the comparison within the 15,000 ft groups across time points pre-, peri-, and post-exposure. Thus, pilots appear to experience only minor colour vision impairment up to an exposure altitude of 15,000 ft over 60 min of exposure.
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Affiliation(s)
- F Liebold
- Department of Anaesthesiology und Intensive Care Medicine, University Hospital and Faculty of Medicine Cologne, Cologne, Germany.
- Department of Anaesthesiology und Intensive Care Medicine, University Hospital and Faculty of Medicine Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
| | - W Adler
- Institute for Medical Informatics, Biometry and Epidemiology (IMBE), Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - S Jansen
- Department of Otorhinolaryngology, University Hospital and Faculty of Medicine Cologne, Cologne, Germany
| | - J P Klussmann
- Department of Otorhinolaryngology, University Hospital and Faculty of Medicine Cologne, Cologne, Germany
| | - M Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - L Nehrlich
- Department of Anaesthesiology und Intensive Care Medicine, University Hospital and Faculty of Medicine Cologne, Cologne, Germany
| | - J Schmitz
- Department of Anaesthesiology und Intensive Care Medicine, University Hospital and Faculty of Medicine Cologne, Cologne, Germany
- Department of Sleep and Human Factor, German Aerospace Centre, Linder Höhe, 51147, Cologne, Germany
| | - A Vingerhoets
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - L M Heindl
- Department of Ophthalmology, University Hospital and Faculty of Medicine Cologne, Cologne, Germany
| | - J Hinkelbein
- Johannes Wesling Klinikum Minden, University Hospital, Ruhr University Bochum, Bochum, Germany
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4
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Ghallab A, González D, Strängberg E, Hofmann U, Myllys M, Hassan R, Hobloss Z, Brackhagen L, Begher-Tibbe B, Duda JC, Drenda C, Kappenberg F, Reinders J, Friebel A, Vucur M, Turajski M, Seddek AL, Abbas T, Abdelmageed N, Morad SAF, Morad W, Hamdy A, Albrecht W, Kittana N, Assali M, Vartak N, van Thriel C, Sous A, Nell P, Villar-Fernandez M, Cadenas C, Genc E, Marchan R, Luedde T, Åkerblad P, Mattsson J, Marschall HU, Hoehme S, Stirnimann G, Schwab M, Boor P, Amann K, Schmitz J, Bräsen JH, Rahnenführer J, Edlund K, Karpen SJ, Simbrunner B, Reiberger T, Mandorfer M, Trauner M, Dawson PA, Lindström E, Hengstler JG. Inhibition of the renal apical sodium dependent bile acid transporter prevents cholemic nephropathy in mice with obstructive cholestasis. J Hepatol 2024; 80:268-281. [PMID: 37939855 PMCID: PMC10849134 DOI: 10.1016/j.jhep.2023.10.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND & AIMS Cholemic nephropathy (CN) is a severe complication of cholestatic liver diseases for which there is no specific treatment. We revisited its pathophysiology with the aim of identifying novel therapeutic strategies. METHODS Cholestasis was induced by bile duct ligation (BDL) in mice. Bile flux in kidneys and livers was visualized by intravital imaging, supported by MALDI mass spectrometry imaging and liquid chromatography-tandem mass spectrometry. The effect of AS0369, a systemically bioavailable apical sodium-dependent bile acid transporter (ASBT) inhibitor, was evaluated by intravital imaging, RNA-sequencing, histological, blood, and urine analyses. Translational relevance was assessed in kidney biopsies from patients with CN, mice with a humanized bile acid (BA) spectrum, and via analysis of serum BAs and KIM-1 (kidney injury molecule 1) in patients with liver disease and hyperbilirubinemia. RESULTS Proximal tubular epithelial cells (TECs) reabsorbed and enriched BAs, leading to oxidative stress and death of proximal TECs, casts in distal tubules and collecting ducts, peritubular capillary leakiness, and glomerular cysts. Renal ASBT inhibition by AS0369 blocked BA uptake into TECs and prevented kidney injury up to 6 weeks after BDL. Similar results were obtained in mice with humanized BA composition. In patients with advanced liver disease, serum BAs were the main determinant of KIM-1 levels. ASBT expression in TECs was preserved in biopsies from patients with CN, further highlighting the translational potential of targeting ASBT to treat CN. CONCLUSIONS BA enrichment in proximal TECs followed by oxidative stress and cell death is a key early event in CN. Inhibiting renal ASBT and consequently BA enrichment in TECs prevents CN and systemically decreases BA concentrations. IMPACT AND IMPLICATIONS Cholemic nephropathy (CN) is a severe complication of cholestasis and an unmet clinical need. We demonstrate that CN is triggered by the renal accumulation of bile acids (BAs) that are considerably increased in the systemic blood. Specifically, the proximal tubular epithelial cells of the kidney take up BAs via the apical sodium-dependent bile acid transporter (ASBT). We developed a therapeutic compound that blocks ASBT in the kidneys, prevents BA overload in tubular epithelial cells, and almost completely abolished all disease hallmarks in a CN mouse model. Renal ASBT inhibition represents a potential therapeutic strategy for patients with CN.
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Affiliation(s)
- Ahmed Ghallab
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany; Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt.
| | - Daniela González
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | | | - Ute Hofmann
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tübingen, Auerbachstr. 112, 70376 Stuttgart, Germany
| | - Maiju Myllys
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Reham Hassan
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany; Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt
| | - Zaynab Hobloss
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Lisa Brackhagen
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Brigitte Begher-Tibbe
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Julia C Duda
- Department of Statistics, TU Dortmund University, 44227 Dortmund, Germany
| | - Carolin Drenda
- Department of Statistics, TU Dortmund University, 44227 Dortmund, Germany
| | | | - Joerg Reinders
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Adrian Friebel
- Institute of Computer Science & Saxonian Incubator for Clinical Research (SIKT), University of Leipzig, Haertelstraße 16-18, 04107 Leipzig, Germany
| | - Mihael Vucur
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty at Heinrich-Heine-University, 40225 Dusseldorf, Germany
| | - Monika Turajski
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Abdel-Latief Seddek
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt
| | - Tahany Abbas
- Histology Department, Faculty of Medicine, South Valley University, 83523 Qena, Egypt
| | - Noha Abdelmageed
- Department of Pharmacology, Faculty of Veterinary Medicine, Sohag University, 82524 Sohag, Egypt
| | - Samy A F Morad
- Department of Pharmacology, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt
| | - Walaa Morad
- Histology Department, Faculty of Medicine, South Valley University, 83523 Qena, Egypt
| | - Amira Hamdy
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt
| | - Wiebke Albrecht
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Naim Kittana
- Department of Biomedical Sciences, An-Najah National University, P.O. Box 7 Nablus, Palestine, Israel
| | - Mohyeddin Assali
- Department of Pharmacy, An-Najah National University, P.O. Box 7 Nablus, Palestine, Israel
| | - Nachiket Vartak
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Christoph van Thriel
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Ansam Sous
- Department of Pharmacy, An-Najah National University, P.O. Box 7 Nablus, Palestine, Israel
| | - Patrick Nell
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Maria Villar-Fernandez
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Cristina Cadenas
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Erhan Genc
- MRI Unit, Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, Technical University Dortmund, 44139 Dortmund, Germany
| | - Rosemarie Marchan
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Tom Luedde
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty at Heinrich-Heine-University, 40225 Dusseldorf, Germany
| | | | | | - Hanns-Ulrich Marschall
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden
| | - Stefan Hoehme
- Institute of Computer Science & Saxonian Incubator for Clinical Research (SIKT), University of Leipzig, Haertelstraße 16-18, 04107 Leipzig, Germany
| | - Guido Stirnimann
- University Clinic for Visceral Surgery and Medicine, Inselspital University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Matthias Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tübingen, Auerbachstr. 112, 70376 Stuttgart, Germany; Departments of Clinical Pharmacology, and of Biochemistry and Pharmacy, University Tuebingen, 72076 Tuebingen, Germany; Cluster of Excellence iFIT (EXC2180), Image-Guided and Functionally Instructed Tumor Therapies, University of Tuebingen, 69120 Tuebingen, Germany
| | - Peter Boor
- Institute of Pathology and Department of Nephrology, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Kerstin Amann
- Department of Nephropathology, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Jessica Schmitz
- Institute of Pathology, Nephropathology Unit, Hannover Medical School, 30625 Hannover, Germany
| | - Jan H Bräsen
- Institute of Pathology, Nephropathology Unit, Hannover Medical School, 30625 Hannover, Germany
| | - Jörg Rahnenführer
- Department of Statistics, TU Dortmund University, 44227 Dortmund, Germany
| | - Karolina Edlund
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany
| | - Saul J Karpen
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Emory University, Atlanta, GA 30322, United States
| | - Benedikt Simbrunner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria; Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Thomas Reiberger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria; Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Mattias Mandorfer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria; Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria; Hans Popper Laboratory of Molecular Hepatology, Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Paul A Dawson
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Emory University, Atlanta, GA 30322, United States
| | | | - Jan G Hengstler
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Ardeystr. 67, 44139 Dortmund, Germany.
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5
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Sadlonova M, Hansen N, Esselmann H, Celano CM, Derad C, Asendorf T, Chebbok M, Heinemann S, Wiesent A, Schmitz J, Bauer FE, Ehrentraut J, Kutschka I, Wiltfang J, Baraki H, von Arnim CAF. Preoperative Delirium Risk Screening in Patients Undergoing a Cardiac Surgery: Results from the Prospective Observational FINDERI Study. Am J Geriatr Psychiatry 2023:S1064-7481(23)00523-7. [PMID: 38228452 DOI: 10.1016/j.jagp.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Postoperative delirium (POD) is a common complication of cardiac surgery that is associated with higher morbidity, longer hospital stay, cognitive decline, and mortality. Preoperative assessments may help to identify patients´ POD risk. However, a standardized screening assessment for POD risk has not been established. DESIGN Prospective observational FINd DElirium RIsk factors (FINDERI) study. PARTICIPANTS Patients aged ≥50 years undergoing cardiac surgery. MEASUREMENTS The primary aim was to analyze the predictive value of the Delirium Risk Screening Questionnaire (DRSQ) prior to cardiac surgery. Secondary aims are to investigate cognitive, frailty, and geriatric assessments, and to use data-driven machine learning (ML) in predicting POD. Predictive properties were assessed using receiver operating characteristics analysis and multivariate approaches (regularized LASSO regression and decision trees). RESULTS We analyzed a data set of 504 patients (68.3 ± 8.2 years, 21.4% women) who underwent cardiac surgery. The incidence of POD was 21%. The preoperatively administered DRSQ showed an area under the curve (AUC) of 0.68 (95% CI 0.62, 0.73), and the predictive OR was 1.25 (95% CI 1.15, 1.35, p <0.001). Using a ML approach, a three-rule decision tree prediction model including DRSQ (score>7), Trail Making Test B (time>118), and Montreal Cognitive Assessment (score ≤ 22) was identified. The AUC of the three-rule decision tree on the training set was 0.69 (95% CI 0.63, 0.75) and 0.62 (95% CI 0.51, 0.73) on the validation set. CONCLUSION Both the DRSQ and the three-rule decision tree might be helpful in predicting POD risk before cardiac surgery.
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Affiliation(s)
- Monika Sadlonova
- Department of Cardiovascular and Thoracic Surgery (MS, IK, HB), University of Göttingen Medical Center, Göttingen, Germany; Department of Geriatrics (MS, MC, SH, AW, JS, FEB, JE, CAFA), University of Göttingen Medical Center, Göttingen, Germany; Department of Psychosomatic Medicine and Psychotherapy (MS,), University of Göttingen Medical Center, Göttingen, Germany; DZHK (German Center for Cardiovascular Research) (MS, IK, HB, CAFA), Göttingen, Germany; Department of Psychiatry (MS, CMC), Massachusetts General Hospital, Boston, MA.
| | - Niels Hansen
- Department of Psychiatry and Psychotherapy (NH, HE, JW), University of Göttingen Medical Center, Göttingen, Germany
| | - Hermann Esselmann
- Department of Psychiatry and Psychotherapy (NH, HE, JW), University of Göttingen Medical Center, Göttingen, Germany
| | - Christopher M Celano
- Department of Psychiatry (MS, CMC), Massachusetts General Hospital, Boston, MA; Department of Psychiatry (CMC), Harvard Medical Schol, Boston, MA
| | - Carlotta Derad
- Department of Medical Statistics (CD, TA), University of Göttingen Medical Center, Göttingen, Germany
| | - Thomas Asendorf
- Department of Medical Statistics (CD, TA), University of Göttingen Medical Center, Göttingen, Germany
| | - Mohammed Chebbok
- Department of Geriatrics (MS, MC, SH, AW, JS, FEB, JE, CAFA), University of Göttingen Medical Center, Göttingen, Germany; Department of Cardiology and Pneumology (MC), University of Göttingen Medical Center, Göttingen, Germany
| | - Stephanie Heinemann
- Department of Geriatrics (MS, MC, SH, AW, JS, FEB, JE, CAFA), University of Göttingen Medical Center, Göttingen, Germany
| | - Adriana Wiesent
- Department of Geriatrics (MS, MC, SH, AW, JS, FEB, JE, CAFA), University of Göttingen Medical Center, Göttingen, Germany
| | - Jessica Schmitz
- Department of Geriatrics (MS, MC, SH, AW, JS, FEB, JE, CAFA), University of Göttingen Medical Center, Göttingen, Germany
| | - Frederike E Bauer
- Department of Geriatrics (MS, MC, SH, AW, JS, FEB, JE, CAFA), University of Göttingen Medical Center, Göttingen, Germany
| | - Julia Ehrentraut
- Department of Geriatrics (MS, MC, SH, AW, JS, FEB, JE, CAFA), University of Göttingen Medical Center, Göttingen, Germany
| | - Ingo Kutschka
- Department of Cardiovascular and Thoracic Surgery (MS, IK, HB), University of Göttingen Medical Center, Göttingen, Germany; DZHK (German Center for Cardiovascular Research) (MS, IK, HB, CAFA), Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy (NH, HE, JW), University of Göttingen Medical Center, Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE) (JW), Göttingen, Germany; Neurosciences and Signaling Group (JW), Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Hassina Baraki
- Department of Cardiovascular and Thoracic Surgery (MS, IK, HB), University of Göttingen Medical Center, Göttingen, Germany; DZHK (German Center for Cardiovascular Research) (MS, IK, HB, CAFA), Göttingen, Germany
| | - Christine A F von Arnim
- Department of Geriatrics (MS, MC, SH, AW, JS, FEB, JE, CAFA), University of Göttingen Medical Center, Göttingen, Germany; DZHK (German Center for Cardiovascular Research) (MS, IK, HB, CAFA), Göttingen, Germany
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6
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Esders SL, Hülskötter K, Schreiner T, Wohlsein P, Schmitz J, Bräsen JH, Distl O. Single Nucleotide Polymorphisms Associated with AA-Amyloidosis in Siamese and Oriental Shorthair Cats. Genes (Basel) 2023; 14:2126. [PMID: 38136948 PMCID: PMC10742459 DOI: 10.3390/genes14122126] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
AA-amyloidosis in Siamese and Oriental shorthair cats is a lethal condition in which amyloid deposits accumulate systemically, especially in the liver and the thyroid gland. The age at death of affected cats varies between one and seven years. A previous study indicated a complex mode of inheritance involving a major locus. In the present study, we performed a multi-locus genome-wide association study (GWAS) using five methods (mrMLM, FASTmrMLM, FASTmrEMMA, pLARmEB and ISIS EM-BLASSO) to identify variants associated with AA-amyloidosis in Siamese/Oriental cats. We genotyped 20 affected mixed Siamese/Oriental cats from a cattery and 48 healthy controls from the same breeds using the Illumina Infinium Feline 63 K iSelect DNA array. The multi-locus GWAS revealed eight significantly associated single nucleotide polymorphisms (SNPs) on FCA A1, D1, D2 and D3. The genomic regions harboring these SNPs contain 55 genes, of which 3 are associated with amyloidosis in humans or mice. One of these genes is SAA1, which encodes for a member of the Serum Amyloid A family, the precursor protein of Amyloid A, and a mutation in the promotor of this gene causes hereditary AA-amyloidosis in humans. These results provide novel knowledge regarding the complex genetic background of hereditary AA-amyloidosis in Siamese/Oriental cats and, therefore, contribute to future genomic studies of this disease in cats.
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Affiliation(s)
- Stella L. Esders
- Institute for Animal Breeding and Genetics, University of Veterinary Medicine Hannover (Foundation), 30559 Hannover, Germany;
| | - Kirsten Hülskötter
- Department of Pathology, University of Veterinary Medicine Hannover (Foundation), 30559 Hannover, Germany; (K.H.); (T.S.); (P.W.)
| | - Tom Schreiner
- Department of Pathology, University of Veterinary Medicine Hannover (Foundation), 30559 Hannover, Germany; (K.H.); (T.S.); (P.W.)
| | - Peter Wohlsein
- Department of Pathology, University of Veterinary Medicine Hannover (Foundation), 30559 Hannover, Germany; (K.H.); (T.S.); (P.W.)
| | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany; (J.S.); (J.H.B.)
| | - Jan H. Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany; (J.S.); (J.H.B.)
| | - Ottmar Distl
- Institute for Animal Breeding and Genetics, University of Veterinary Medicine Hannover (Foundation), 30559 Hannover, Germany;
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7
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Wahida A, Schmaderer C, Büttner-Herold M, Branca C, Donakonda S, Haberfellner F, Torrez C, Schmitz J, Schulze T, Seibt T, Öllinger R, Engleitner T, Haller B, Steiger K, Günthner R, Lorenz G, Yabal M, Bachmann Q, Braunisch MC, Moog P, Matevossian E, Aßfalg V, Thorban S, Renders L, Späth MR, Müller RU, Stippel DL, Weichert W, Slotta-Huspenina J, von Vietinghoff S, Viklicky O, Green DR, Rad R, Amann K, Linkermann A, Bräsen JH, Heemann U, Kemmner S. High RIPK3 expression is associated with a higher risk of early kidney transplant failure. iScience 2023; 26:107879. [PMID: 37868627 PMCID: PMC10585402 DOI: 10.1016/j.isci.2023.107879] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/05/2022] [Accepted: 09/07/2023] [Indexed: 10/24/2023] Open
Abstract
Renal ischemia-reperfusion injury (IRI) is associated with reduced allograft survival, and each additional hour of cold ischemia time increases the risk of graft failure and mortality following renal transplantation. Receptor-interacting protein kinase 3 (RIPK3) is a key effector of necroptosis, a regulated form of cell death. Here, we evaluate the first-in-human RIPK3 expression dataset following IRI in kidney transplantation. The primary analysis included 374 baseline biopsy samples obtained from renal allografts 10 minutes after onset of reperfusion. RIPK3 was primarily detected in proximal tubular cells and distal tubular cells, both of which are affected by IRI. Time-to-event analysis revealed that high RIPK3 expression is associated with a significantly higher risk of one-year transplant failure and prognostic for one-year (death-censored) transplant failure independent of donor and recipient associated risk factors in multivariable analyses. The RIPK3 score also correlated with deceased donation, cold ischemia time and the extent of tubular injury.
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Affiliation(s)
- Adam Wahida
- Medical Department III of Hematology and Oncology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Christoph Schmaderer
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Maike Büttner-Herold
- Department of Nephropathology, Friedrich-Alexander University (FAU) Erlangen-Nurnberg, Erlangen, Germany
| | - Caterina Branca
- Medical Department III of Hematology and Oncology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Sainitin Donakonda
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Flora Haberfellner
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Carlos Torrez
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Tobias Schulze
- Medical Department III of Hematology and Oncology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Tobias Seibt
- Transplant Center, University Hospital Munich, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Rupert Öllinger
- Institute of Molecular Oncology and Functional Genomics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Thomas Engleitner
- Institute of Molecular Oncology and Functional Genomics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Katja Steiger
- Institute of Pathology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Roman Günthner
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Georg Lorenz
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Monica Yabal
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Quirin Bachmann
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias C. Braunisch
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Philipp Moog
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Edouard Matevossian
- Clinic of General, Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital Munich, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Volker Aßfalg
- Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stefan Thorban
- Institute of Molecular Immunology and Experimental Oncology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Lutz Renders
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Martin R. Späth
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Dirk L. Stippel
- Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany
| | - Wilko Weichert
- Institute of Pathology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Julia Slotta-Huspenina
- Institute of Pathology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Sibylle von Vietinghoff
- Nephrology Section, Medical Clinic 1, University Hospital Bonn, Rheinische Friedrich Wilhelm University of Bonn, Bonn, Germany
| | - Ondrej Viklicky
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Douglas R. Green
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Roland Rad
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Kerstin Amann
- Department of Nephropathology, Friedrich-Alexander University (FAU) Erlangen-Nurnberg, Erlangen, Germany
| | - Andreas Linkermann
- Division of Nephrology, Clinic of Internal Medicine 3, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
- Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Uwe Heemann
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Stephan Kemmner
- Department of Nephrology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany
- Transplant Center, University Hospital Munich, Ludwig-Maximilians-University (LMU), Munich, Germany
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8
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Ester O, Hörst F, Seibold C, Keyl J, Ting S, Vasileiadis N, Schmitz J, Ivanyi P, Grünwald V, Bräsen JH, Egger J, Kleesiek J. Valuing vicinity: Memory attention framework for context-based semantic segmentation in histopathology. Comput Med Imaging Graph 2023; 107:102238. [PMID: 37207396 DOI: 10.1016/j.compmedimag.2023.102238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/21/2023]
Abstract
The segmentation of histopathological whole slide images into tumourous and non-tumourous types of tissue is a challenging task that requires the consideration of both local and global spatial contexts to classify tumourous regions precisely. The identification of subtypes of tumour tissue complicates the issue as the sharpness of separation decreases and the pathologist's reasoning is even more guided by spatial context. However, the identification of detailed tissue types is crucial for providing personalized cancer therapies. Due to the high resolution of whole slide images, existing semantic segmentation methods, restricted to isolated image sections, are incapable of processing context information beyond. To take a step towards better context comprehension, we propose a patch neighbour attention mechanism to query the neighbouring tissue context from a patch embedding memory bank and infuse context embeddings into bottleneck hidden feature maps. Our memory attention framework (MAF) mimics a pathologist's annotation procedure - zooming out and considering surrounding tissue context. The framework can be integrated into any encoder-decoder segmentation method. We evaluate the MAF on two public breast cancer and liver cancer data sets and an internal kidney cancer data set using famous segmentation models (U-Net, DeeplabV3) and demonstrate the superiority over other context-integrating algorithms - achieving a substantial improvement of up to 17% on Dice score. The code is publicly available at https://github.com/tio-ikim/valuing-vicinity.
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Affiliation(s)
- Oliver Ester
- Institute for AI in Medicine (IKIM), University Hospital Essen (AöR), Essen, Germany; Cancer Research Center Cologne Essen (CCCE), West German Cancer Center Essen, University Hospital Essen (AöR), Essen, Germany
| | - Fabian Hörst
- Institute for AI in Medicine (IKIM), University Hospital Essen (AöR), Essen, Germany; Cancer Research Center Cologne Essen (CCCE), West German Cancer Center Essen, University Hospital Essen (AöR), Essen, Germany.
| | - Constantin Seibold
- Institute of Anthropomatics and Robotics, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Julius Keyl
- Institute for AI in Medicine (IKIM), University Hospital Essen (AöR), Essen, Germany; Institute of Pathology, University Hospital Essen (AöR), University of Duisburg-Essen, Essen, Germany
| | - Saskia Ting
- Institute of Pathology, University Hospital Essen (AöR), University of Duisburg-Essen, Essen, Germany; Institute of Pathology Nordhessen, Kassel, Germany
| | - Nikolaos Vasileiadis
- Nephropathology Unit, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Philipp Ivanyi
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Viktor Grünwald
- Cancer Research Center Cologne Essen (CCCE), West German Cancer Center Essen, University Hospital Essen (AöR), Essen, Germany; Clinic for Medical Oncology, Clinic for Urology, West German Cancer Center, University Hospital Essen (AöR), Essen, Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Jan Egger
- Institute for AI in Medicine (IKIM), University Hospital Essen (AöR), Essen, Germany; Cancer Research Center Cologne Essen (CCCE), West German Cancer Center Essen, University Hospital Essen (AöR), Essen, Germany
| | - Jens Kleesiek
- Institute for AI in Medicine (IKIM), University Hospital Essen (AöR), Essen, Germany; Cancer Research Center Cologne Essen (CCCE), West German Cancer Center Essen, University Hospital Essen (AöR), Essen, Germany; German Cancer Consortium (DKTK), Partner Site Essen, Germany
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9
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Goldspink A, Schmitz J, Babyak O, Brauns N, Milleck J, Breloh AM, Fleig SV, Jobin K, Schwarz L, Haller H, Wagenlehner F, Bräsen JH, Kurts C, von Vietinghoff S. Kidney medullary sodium chloride concentrations induce neutrophil and monocyte extracellular DNA traps that defend against pyelonephritis in vivo. Kidney Int 2023:S0085-2538(23)00265-X. [PMID: 37098380 DOI: 10.1016/j.kint.2023.03.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/25/2022] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 04/27/2023]
Abstract
Urinary tract infections are common. Here, we delineate a role of extracellular DNA trap (ET) formation in kidney antibacterial defense and determine mechanisms of their formation in the hyperosmotic environment of the kidney medulla. ET of granulocytic and monocytic origin were present in the kidneys of patients with pyelonephritis along with systemically elevated citrullinated histone levels. Inhibition of the transcription coregulatory, peptidylarginine deaminase 4 (PAD4), required for ET formation, prevented kidney ET formation and promoted pyelonephritis in mice. ETs predominantly accumulated in the kidney medulla. The role of medullary sodium chloride and urea concentrations in ET formation was then investigated. Medullary-range sodium chloride, but not urea, dose-, time- and PAD4-dependently induced ET formation even in the absence of other stimuli. Moderately elevated sodium chloride promoted myeloid cell apoptosis. Sodium gluconate also promoted cell death, proposing a role for sodium ions in this process. Sodium chloride induced myeloid cell calcium influx. Calcium ion-free media or -chelation reduced sodium chloride-induced apoptosis and ET formation while bacterial lipopolysaccharide amplified it. Autologous serum improved bacterial killing in the presence of sodium chloride-induced ET. Depletion of the kidney sodium chloride gradient by loop diuretic therapy diminished kidney medullary ET formation and increased pyelonephritis severity. Thus, our data demonstrate that ETs may protect the kidney against ascending uropathogenic E. coli and delineate kidney medullary range sodium chloride concentrations as novel inducers of programmed myeloid cell death.
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Affiliation(s)
| | | | - Olena Babyak
- Institute of Experimental Immunology, University Clinic and Rheinische Friedrich-Wilhelms Universität Bonn, Bonn
| | - Nicolas Brauns
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover
| | | | - Anne M Breloh
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover
| | - Susanne V Fleig
- Nephrology Section, First Medical Clinic; Department of Geriatrics, University Hospital RWTH Aachen, Aachen
| | - Katarzyna Jobin
- Institute of Experimental Immunology, University Clinic and Rheinische Friedrich-Wilhelms Universität Bonn, Bonn; Würzburg Institute of Systems Immunology, Max Planck Research Group at the Julius-Maximilians-Universität, Würzburg
| | - Lisa Schwarz
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany
| | - Hermann Haller
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover
| | - Florian Wagenlehner
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany
| | | | - Christian Kurts
- Institute of Experimental Immunology, University Clinic and Rheinische Friedrich-Wilhelms Universität Bonn, Bonn
| | - Sibylle von Vietinghoff
- Nephrology Section, First Medical Clinic; Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover.
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10
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Balparda M, Schmitz J, Duemmel M, Wuthenow IC, Schmidt M, Alseekh S, Fernie AR, Lercher MJ, Maurino VG. Viridiplantae-specific GLXI and GLXII isoforms co-evolved and detoxify glucosone in planta. Plant Physiol 2023; 191:1214-1233. [PMID: 36423222 PMCID: PMC9922399 DOI: 10.1093/plphys/kiac526] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Reactive carbonyl species (RCS) such as methylglyoxal (MGO) and glyoxal (GO) are highly reactive, unwanted side-products of cellular metabolism maintained at harmless intracellular levels by specific scavenging mechanisms.MGO and GO are metabolized through the glyoxalase (GLX) system, which consists of two enzymes acting in sequence, GLXI and GLXII. While plant genomes encode a number of different GLX isoforms, their specific functions and how they arose during evolution are unclear. Here, we used Arabidopsis (Arabidopsis thaliana) as a model species to investigate the evolutionary history of GLXI and GLXII in plants and whether the GLX system can protect plant cells from the toxicity of RCS other than MGO and GO. We show that plants possess two GLX systems of different evolutionary origins and with distinct structural and functional properties. The first system is shared by all eukaryotes, scavenges MGO and GO, especially during seedling establishment, and features Zn2+-type GLXI proteins with a metal cofactor preference that were present in the last eukaryotic common ancestor. GLXI and GLXII of the second system, featuring Ni2+-type GLXI, were acquired by the last common ancestor of Viridiplantae through horizontal gene transfer from proteobacteria and can together metabolize keto-D-glucose (KDG, glucosone), a glucose-derived RCS, to D-gluconate. When plants displaying loss-of-function of a Viridiplantae-specific GLXI were grown in KDG, D-gluconate levels were reduced to 10%-15% of those in the wild type, while KDG levels showed an increase of 48%-67%. In contrast to bacterial GLXI homologs, which are active as dimers, plant Ni2+-type GLXI proteins contain a domain duplication, are active as monomers, and have a modified second active site. The acquisition and neofunctionalization of a structurally, biochemically, and functionally distinct GLX system indicates that Viridiplantae are under strong selection to detoxify diverse RCS.
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Affiliation(s)
- Manuel Balparda
- Molekulare Pflanzenphysiologie, Institut für Zelluläre und Molekulare Botanik, Rheinische Friedrich-Wilhelms-Universität Bonn, Kirschallee 1, 53115 Bonn, Germany
| | - Jessica Schmitz
- Plant Molecular Physiology and Biotechnology, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - Martin Duemmel
- Plant Molecular Physiology and Biotechnology, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - Isabell C Wuthenow
- Plant Molecular Physiology and Biotechnology, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - Marc Schmidt
- Plant Molecular Physiology and Biotechnology, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - Saleh Alseekh
- Max-Planck-Institute of Molecular Plant Physiology, Am Mühlenberg 1, 14476 Potsdam-Golm, Germany
- Center for Plant Systems Biology and Biotechnology, 4000 Plovdiv, Bulgaria
| | - Alisdair R Fernie
- Max-Planck-Institute of Molecular Plant Physiology, Am Mühlenberg 1, 14476 Potsdam-Golm, Germany
- Center for Plant Systems Biology and Biotechnology, 4000 Plovdiv, Bulgaria
| | - Martin J Lercher
- Institute for Computer Science and Department of Biology, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - Veronica G Maurino
- Molekulare Pflanzenphysiologie, Institut für Zelluläre und Molekulare Botanik, Rheinische Friedrich-Wilhelms-Universität Bonn, Kirschallee 1, 53115 Bonn, Germany
- Plant Molecular Physiology and Biotechnology, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, 40225 Düsseldorf, Germany
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11
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Pfenning MB, Schmitz J, Scheffner I, Schulte K, Khalifa A, Tezval H, Weidemann A, Kulschewski A, Kunzendorf U, Dietrich S, Haller H, Kielstein JT, Gwinner W, Bräsen JH. High Macrophage Densities in Native Kidney Biopsies Correlate With Renal Dysfunction and Promote ESRD. Kidney Int Rep 2022; 8:341-356. [PMID: 36815108 PMCID: PMC9939427 DOI: 10.1016/j.ekir.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Macrophages and monocytes are main players in innate immunity. The relevance of mononuclear phagocyte infiltrates on clinical outcomes remains to be determined in native kidney diseases. Methods Our cross-sectional study included 324 patients with diagnostic renal biopsies comprising 17 disease entities and normal renal tissues for comparison. All samples were stained for CD68+ macrophages. Selected groups were further subtyped for CD14+ monocytes and CD163+ alternatively activated macrophages. Using precise pixel-based digital measurements, we quantified cell densities as positively stained areas in renal cortex and medulla as well as whole renal tissue. Laboratory and clinical data of all cases at the time of biopsy and additional follow-up data in 158 cases were accessible. Results Biopsies with renal disease consistently revealed higher CD68+-macrophage densities and CD163+-macrophage densities in cortex and medulla compared to controls. High macrophage densities correlated with impaired renal function at biopsy and at follow-up in all diseases and in diseases analyzed separately. High cortical CD68+-macrophage densities preceded shorter renal survival, defined as requirement of permanent dialysis. CD14+ monocyte densities showed no difference compared to controls and did not correlate with renal function. Conclusion Precise quantification of macrophage densities in renal biopsies may contribute to risk stratification to identify patients with high risk for end-stage renal disease (ESRD) and might be a promising therapeutic target in renal disease.
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Affiliation(s)
- Maren B. Pfenning
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Lower Saxony, Germany,Medical Department I, Gastroenterology, Hepatology and Nephrology, Clinics Passau, Passau, Bavaria, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Lower Saxony, Germany
| | - Irina Scheffner
- Clinic for Kidney and Hypertension Diseases, Hannover Medical School, Hannover, Lower Saxony, Germany
| | - Kevin Schulte
- Clinic for Nephrology and Hypertension, Christian-Albrechts-University, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany
| | - Abedalrazag Khalifa
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Lower Saxony, Germany
| | - Hossein Tezval
- Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Lower Saxony, Germany
| | - Alexander Weidemann
- Medical Clinic III – Nephrology and Dialysis, St. Vinzenz Hospital, Paderborn, North Rhine-Westphalia, Germany
| | - Anke Kulschewski
- Clinic for Nephrology and Hypertension, University Hospital Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Ulrich Kunzendorf
- Clinic for Nephrology and Hypertension, Christian-Albrechts-University, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany
| | - Sebastian Dietrich
- Clinic for Nephrology and Hypertension, Christian-Albrechts-University, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany
| | - Hermann Haller
- Clinic for Kidney and Hypertension Diseases, Hannover Medical School, Hannover, Lower Saxony, Germany
| | - Jan T. Kielstein
- Medical Clinic V, Nephrology, Rheumatology and Blood Purification, Academic Teaching Hospital Braunschweig, Braunschweig, Lower Saxony, Germany
| | - Wilfried Gwinner
- Clinic for Kidney and Hypertension Diseases, Hannover Medical School, Hannover, Lower Saxony, Germany
| | - Jan H. Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Lower Saxony, Germany,Correspondence: Jan Hinrich Bräsen, Nephropathology Unit, Institute of Pathology, Hannover Medical School, OE 5110, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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Akgun Y, Tao L, Maris A, Humphries R, Schmitz J. Unusual Combination of Gastrointestinal Pathogens Detected by Multiplex PCR. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Infectious gastroenteritis (IGE) is a common but complex entity which is a major cause of global morbidity and mortality. IGE is caused by a wide range of etiologic agents such as viruses, bacteria, and parasites. In the United States there are approximately 373 million of IGE cases per year. Most cases of IGE resolve without identification of a specific pathogen. Multiplex molecular assays allow identification of multiple possible pathogens with rapid turnaround time and increased sensitivity, facilitating to formulate an effective treatment plan and control measures.
Methods/Case Report
We present a case of a pediatric patient with no significant past medical history who has been having runny stools that have progressively worsened in the last 3 months and 2 days history of bloody stools with mucus before emergency room presentation. She had no fever, vomiting, joint pain, oral ulcer, and rash. Physical exam showed that the patient appeared well, nontoxic, and vital signs were within normal limit. Copious rhinorrhea was noted. She was at 50th percentile for age on the growth chart. Family denied any recent travel or sick contacts however stated that all the family members have been on well water. Complete blood count was obtained and showed a platelet count of 669 x 10(3)/mcL and WBC of 16.6 x 10(3)/mcL with differential showing absolute lymphocytosis, absolute monocytosis and absolute eosinophilia. Biofire FilmArray gastrointestinal panel performed on the stool detected Giardia lamblia, Campylobacter, Shiga-like toxin producing E. coli and Adenovirus F 40/41. Repeat of the panel per protocol detected the same four pathogens.
Results (if a Case Study enter NA)
N/A.
Conclusion
This case report highlights the significance of detecting multiple causative pathogens. While long term watery diarrhea may guide clinicians to malabsorptive process and the use of well water to Giardia, a sensitive and specific multiplex assay can detect all the pathogens involved in the disease process and greatly simplify the treatment plan for patients. This unusual combination of pathogens can explain the unique symptomology of the patient including long term watery diarrhea, recent bloody diarrhea as well as copious rhinorrhea and failure to thrive.
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Affiliation(s)
- Y Akgun
- Pathology, Microbiology and Immunology, Vanderbilt University Medical Center , Nashville, Tennessee , United States
| | - L Tao
- Pathology, Microbiology and Immunology, Vanderbilt University Medical Center , Nashville, Tennessee , United States
| | - A Maris
- Pathology, Microbiology and Immunology, Vanderbilt University Medical Center , Nashville, Tennessee , United States
| | - R Humphries
- Pathology, Microbiology and Immunology, Vanderbilt University Medical Center , Nashville, Tennessee , United States
| | - J Schmitz
- Pathology, Microbiology and Immunology, Vanderbilt University Medical Center , Nashville, Tennessee , United States
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13
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Glaser M, von Levetzow C, Michels S, Nogova L, Katzenmeier M, Wömpner C, Schmitz J, Bitter E, Terjung I, Passmann E, Schaufler D, Eisert A, Fischer R, Riedel R, Hahne S, Merkelbach-Bruse S, Büttner R, Wolf J, Scheffler M. 9P Small-scale ROS1 aberrations: Functional impact and therapeutic potential. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.010] [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: 11/27/2022] Open
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14
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Glaser M, von Levetzow C, Michels S, Nogova L, Katzenmeier M, Wömpner C, Schmitz J, Bitter E, Terjung I, Passmann E, Schaufler D, Eisert A, Fischer R, Riedel R, Weber JP, Hahne S, Merkelbach-Bruse S, Büttner R, Wolf J, Scheffler M. EP08.02-114 Comprehensive Analysis of ROS1 Aberrations without Rearrangements in Non-small cell Lung Cancer Patients. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.797] [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: 11/28/2022]
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15
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Grether NB, Napravnik F, Imhof T, Linke RP, Bräsen JH, Schmitz J, Dohrn M, Schneider C, Svačina MKR, Stetefeld J, Koch M, Lehmann HC. Amyloidogenicity assessment of transthyretin gene variants. Ann Clin Transl Neurol 2022; 9:1252-1263. [PMID: 35903975 PMCID: PMC9380149 DOI: 10.1002/acn3.51626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Hereditary transthyretin‐mediated amyloidosis is a treatable condition caused by amyloidogenic variants in the transthyretin‐gene resulting in severe peripheral neuropathy or cardiomyopathy. Only about a third of over 130 known variants are clearly pathogenic, most are classified as variants of uncertain significance. A clear delineation of these into pathogenic or non‐pathogenic is highly desirable but hampered by low frequency and penetrance. We thus sought to characterize their amylogenic potential by an unbiased in vitro approach. Methods Thioflavin T and turbidity assays were used to compare the potential of mammalian cell expressed wt‐transthyretin and 12 variant proteins (either variants of uncertain significance, benign, pathogenic) to aggregate and produce amyloid fibrils in vitro. As proof of principle, the assays were applied to transthyretin‐Ala65Val, a variant that was newly detected in a family with peripheral neuropathy and amyloid deposits in biopsies. In silico analysis was performed to compare the position of the benign and pathogenic variants. Results Transthyretin‐Ala65Val showed a significantly higher amyloidogenic potential than wt‐transthyretin, in both turbidity‐ and Thioflavin T‐assays, comparable to known pathogenic variants. The other eight tested variants did not show an increased amyloidogenic potential. In silico structural analysis further confirmed differences between pathogenic and benign variants in position and interactions. Interpretation We propose a biochemical approach to assess amyloidogenic potential of transthyretin variants. As exemplified by transthyretin‐Ala65Val, data of three assays together with histopathology clearly demonstrates its amyloidogenicity.
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Affiliation(s)
- Nicolai B Grether
- Department of Neurology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Felix Napravnik
- Department of Neurology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thomas Imhof
- Institute for Dental Research and Oral Musculoskeletal Biology and Center for Biochemistry, University of Cologne, Cologne, Germany
| | | | - Jan H Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Maike Dohrn
- Department of Neurology, Medical Faculty of the RWTH Aachen University Aachen, Germany.,Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Christian Schneider
- Department of Neurology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Martin K R Svačina
- Department of Neurology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Jörg Stetefeld
- Department of Chemistry, University of Manitoba, Winnipeg, Canada
| | - Manuel Koch
- Institute for Dental Research and Oral Musculoskeletal Biology and Center for Biochemistry, University of Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Helmar C Lehmann
- Department of Neurology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
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16
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Richter B, Kapanadze T, Weingärtner N, Walter S, Vogt I, Grund A, Schmitz J, Bräsen JH, Limbourg FP, Haffner D, Leifheit-Nestler M. High phosphate-induced progressive proximal tubular injury is associated with the activation of Stat3/Kim-1 signaling pathway and macrophage recruitment. FASEB J 2022; 36:e22407. [PMID: 35713543 DOI: 10.1096/fj.202200167rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/24/2022] [Accepted: 05/28/2022] [Indexed: 12/11/2022]
Abstract
Dietary phosphate intake in the Western population greatly exceeds the recommended dietary allowance and is linked to enhanced cardiovascular and all-cause mortality. It is unclear whether a chronic high phosphate diet (HPD) causes kidney injury in healthy individuals. Here, we show that feeding a 2% HPD in C57BL/6N mice for one up to six months resulted in hyperphosphatemia, hyperphosphaturia, increased plasma levels of fibroblast growth factor (FGF) 23, and parathyroid hormone (PTH) compared to mice on a 0.8% phosphate diet. Kidney injury was already noted after two months of HPD characterized by loss of proximal tubular (PT) cell polarity, flattened epithelia, disruption of brush border membranes, vacuolization, increased PT cell proliferation, marked interstitial mononuclear infiltration, and progressive accumulation of collagen fibers. HPD increased Stat3 activation and Kim-1 expression in PT epithelial cells and enhanced renal synthesis of chemokines recruiting monocytes and macrophages as well as macrophage related factors. Enhanced recruitment of F4/80+ macrophages around injured PT lesions was timely associated with increased Kim-1 synthesis, tubular MCP-1 expression, and degree of PT injury score. Likewise, tubulointerstitial fibrosis was associated with activation of Stat3/Kim-1 signaling pathway. The stimulation of human proximal tubular cells with high phosphate activated Stat3 signaling and induced HAVCR1 and CCL2 expression. We conclude that high phosphate results in progressive proximal tubular injury, indicating that high dietary phosphate intake may affect kidney health and therefore represents an underestimated health problem for the general population.
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Affiliation(s)
- Beatrice Richter
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Tamar Kapanadze
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.,Vascular Medicine Research, Hannover Medical School, Hannover, Germany
| | - Nina Weingärtner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Stefanie Walter
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Isabel Vogt
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Andrea Grund
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Jessica Schmitz
- Institute of Pathology, Nephropathology Unit, Hannover Medical School, Hannover, Germany
| | - Jan Hinrich Bräsen
- Institute of Pathology, Nephropathology Unit, Hannover Medical School, Hannover, Germany
| | - Florian P Limbourg
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.,Vascular Medicine Research, Hannover Medical School, Hannover, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Maren Leifheit-Nestler
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
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17
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Kolbrink B, von Samson-Himmelstjerna FA, Messtorff ML, Riebeling T, Nische R, Schmitz J, Bräsen JH, Kunzendorf U, Krautwald S. Vitamin K1 inhibits ferroptosis and counteracts a detrimental effect of phenprocoumon in experimental acute kidney injury. Cell Mol Life Sci 2022; 79:387. [PMID: 35763128 PMCID: PMC9239973 DOI: 10.1007/s00018-022-04416-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 02/07/2023]
Abstract
Ferroptosis, a type of iron-dependent programmed cell death distinct from apoptosis, necroptosis, and other types of cell death, is characterized by lipid peroxidation, reactive oxygen species production, and mitochondrial dysfunction. Accumulating evidence has highlighted vital roles for ferroptosis in multiple diseases, including acute kidney injury. Therefore, ferroptosis has become a major focus for translational research. However, despite its involvement in pathological conditions, there are no pharmacologic inhibitors of ferroptosis in clinical use. In the context of drug repurposing, a strategy for identifying new uses for approved drugs outside the original medical application, we discovered that vitamin K1 is an efficient inhibitor of ferroptosis. Our findings are strengthened by the fact that the vitamin K antagonist phenprocoumon significantly exacerbated ferroptotic cell death in vitro and also massively worsened the course of acute kidney injury in vivo, which is of utmost clinical importance. We therefore assign vitamin K1 a novel role in preventing ferroptotic cell death in acute tubular necrosis during acute kidney injury. Since the safety, tolerability, pharmacokinetics, and pharmacodynamics of vitamin K1 formulations are well documented, this drug is primed for clinical application, and provides a new strategy for pharmacological control of ferroptosis and diseases associated with this mode of cell death.
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Affiliation(s)
- Benedikt Kolbrink
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, Campus Kiel, Fleckenstr. 4, 24105, Kiel, Germany
| | | | - Maja Lucia Messtorff
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, Campus Kiel, Fleckenstr. 4, 24105, Kiel, Germany
| | - Theresa Riebeling
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, Campus Kiel, Fleckenstr. 4, 24105, Kiel, Germany
| | - Raphael Nische
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, Campus Kiel, Fleckenstr. 4, 24105, Kiel, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, University of Hannover, 30625, Hannover, Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, University of Hannover, 30625, Hannover, Germany
| | - Ulrich Kunzendorf
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, Campus Kiel, Fleckenstr. 4, 24105, Kiel, Germany
| | - Stefan Krautwald
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, Campus Kiel, Fleckenstr. 4, 24105, Kiel, Germany.
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18
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Schmitz J, Brauns N, Hüsing AM, Flechsig M, Glomb T, Bräsen JH, Haller H, von Vietinghoff S. Renal medullary osmolytes NaCl and urea differentially modulate human tubular cell cytokine expression and monocyte recruitment. Eur J Immunol 2022; 52:1258-1272. [DOI: 10.1002/eji.202149723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/20/2022] [Accepted: 05/06/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Jessica Schmitz
- Nephropathology Unit Institute for Pathology University Clinic and Rheinische Friedrich‐Wilhelms Universität Bonn Bonn Germany
| | - Nicolas Brauns
- Department of Internal Medicine Division of Nephrology and Hypertension University Clinic and Rheinische Friedrich‐Wilhelms Universität Bonn Bonn Germany
| | - Anne M. Hüsing
- Department of Internal Medicine Division of Nephrology and Hypertension University Clinic and Rheinische Friedrich‐Wilhelms Universität Bonn Bonn Germany
| | - Martina Flechsig
- Department of Internal Medicine Division of Nephrology and Hypertension University Clinic and Rheinische Friedrich‐Wilhelms Universität Bonn Bonn Germany
| | - Thorsten Glomb
- Core Facility Transcriptomics Hannover Medical School Hannover Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit Institute for Pathology University Clinic and Rheinische Friedrich‐Wilhelms Universität Bonn Bonn Germany
| | - Hermann Haller
- Department of Internal Medicine Division of Nephrology and Hypertension University Clinic and Rheinische Friedrich‐Wilhelms Universität Bonn Bonn Germany
| | - Sibylle von Vietinghoff
- Department of Internal Medicine Division of Nephrology and Hypertension University Clinic and Rheinische Friedrich‐Wilhelms Universität Bonn Bonn Germany
- Nephrology Section First Medical Clinic University Clinic and Rheinische Friedrich‐Wilhelms Universität Bonn Bonn Germany
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19
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Schmitz J, Christensen D, Müller L, Neugebohren L, Zachrau T, Philine Brandt H, Größler F, Johannes T, Gwinner W, Hinrich Bräsen J. MO055: Multi-Class Segmentation of Kidney Tissues using Convolutional Neuronal Networks (CNNS). Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac063.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Routine pathological diagnostics in kidneys are mainly based on semi-quantitative eyeballing. In own former studies, we showed predictive value of precise immune cell quantification in allografts using digital semi-automated techniques. We now aim to achieve fully automated segmentation workflow with CNNs.
METHOD
Standard routine stains (immuno/histochemistry, immunofluorescence) were digitized (20×) with Metafer, a commercial scanning/imaging platform. Diagnostically relevant anatomical compartments (cortex, medulla, glomeruli, tubuli [proximal/distal/collecting duct], glomerular/peritubular capillaries and nuclei) were manually annotated by use of immunomarkers to generate large data sets on human renal biopsies and nephrectomies. Data were used to train multi-class semantic segmentation CNNs with broad data augmentation to achieve a robustness against staining variances.
RESULTS
Using Jones-HE stains for multi-class segmentation, a cortex-medulla-extrarenal CNN revealed pixel based hit rates above 97.9%, detection of glomeruli had a pixel based hit rate above 99%, a multi-class CNN for tubules, tubular membranes and peritubular capillaries resulted in a hit rate of 91.5%, and nuclear-based cell detection shows pixel based hit rates above 98%. Identification of cell location in interstitium, tubuli, glomeruli, peritubular and glomerular capillaries reached very high hit rates: Glomerular endothelial cells actually result in 83% true positives, 13% false negatives and 4% false positives. Additionally, a tubulus classifier (proximal tubulus, distal tubulus, collecting duct and atrophic tubulus) with an accuracy >90% was developed.
CONCLUSION
Automated structure segmentation by CNNs can complement and specify classical nephropathological diagnostics, especially for spatial risk marker evaluation in early transplant biopsies.
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Affiliation(s)
- Jessica Schmitz
- Institute of Pathology, Hannover Medical School (MHH), Hanover, Germany
| | | | - Lena Müller
- Institute of Pathology, Hannover Medical School (MHH), Hanover, Germany
| | - Lina Neugebohren
- Institute of Pathology, Hannover Medical School (MHH), Hanover, Germany
| | - Tim Zachrau
- Institute of Pathology, Hannover Medical School (MHH), Hanover, Germany
| | | | - Frederik Größler
- Institute of Pathology, Hannover Medical School (MHH), Hanover, Germany
| | | | - Wilfried Gwinner
- Department of Nephrology and Hypertension, Hannover Medical School (MHH), Hanover, Germany
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20
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Richter B, Kapanadze T, Weingärtner N, Walter S, Vogt I, Grund A, Schmitz J, Hinrich Bräsen J, Limbourg F, Haffner D, Leifheit-Nestler M. MO448: Progressive Tubular Injury Caused by High Phosphate Intake is Associated With Activation of STAT3/KIM-1 Signalling and Macrophage Recruitment in Mice. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac070.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Dietary phosphate intake greatly exceeds the recommended daily allowance in the Western population. Elevated phosphate levels are linked to increased cardiovascular and all-cause mortality, impaired bone health and premature ageing. The renal effects of chronic high dietary phosphate intake for healthy individuals are still not clear.
METHOD
Male C57BL/6 mice received a 2% high phosphate diet (HPD) or a 0.8% normal phosphate diet (NPD) for 1 to 6 months. We collected blood, urine and kidneys to investigate phosphate metabolism and progression of kidney injury. In vitro analysis for the toxic effects of phosphate or the phosphaturic hormones parathyroid hormone (PTH) and fibroblast growth factor (FGF) 23 was done in HK-2 humane proximal tubule (PT) cells.
RESULTS
HPD in mice caused hyperphosphataemia despite increased phosphaturia. Both intact FGF23 and PTH plasma levels were significantly increased in mice on HPD at 1 month onward. Mice on HPD showed significantly increased creatinine levels and albuminuria. Histopathological analysis of the kidneys revealed increased PT injury in mice receiving HPD compared to NPD controls from 2 months onward followed by a rapid progression of organ damage from month 5 to 6. Picrosirius red staining of kidney sections showed a progressively increased accumulation of collagen fibers in renal cortex of mice on HPD, which was significant from 4 months onward and accompanied by enhanced expression of transforming growth factor-β1, collagen 1 and fibronectin. The significant induction of the tubular injury marker Havcr1, encodes for Kim-1, started already after 1 month of feeding HPD, progressed over time and was strongest after 6 months. Immunofluorescence staining revealed Kim-1 localization to damaged PT, which was most prominent after 3 and 6 months of HPD. Renal Kim-1 protein levels were positively associated with tubular injury score and tubulointerstitial fibrosis. Histological staining and quantification revealed significantly increased number of pStat3+ cells in PTs of HPD-fed mice at months 1, 2, 5 and 6, indicating activated Stat3 signaling. The number of pStat3+ cells was positively associated with Kim-1 synthesis. Inflammation cytokine array with kidney tissue lysates showed, among others, enhanced expression of monocyte chemoattractant protein (MCP)-1 and macrophage colony-stimulating factor (MCSF) in HPD-fed mice. The mRNA expression of Csf1 (encodes for MCSF) was upregulated in HPD-fed mice and most pronounced after 6 months. Ccl2 mRNA expression (encodes for MCP-1) was significantly enhanced after 3, 5 and 6 months of HPD compared to NPD. Immunofluorescence staining showed a strong and specific induction of MCP-1 in PT epithelial cells due to HPD. The HPD-induced Ccl2 expression was positively associated with Kim-1 expression indicating an interaction between pStat3/Kim-1 signalling pathway and MCP-1. Immunohistochemical staining and flow cytometry analysis revealed a significantly increased recruitment of F4/80+ macrophages in renal tissue of HPD-fed mice after 3 and 6 months. The enhanced renal macrophage recruitment in the entire HPD cohort was associated with increased MCP-1 protein synthesis and increased tubular injury score. In vitro experiments using HK-2 cells showed that stimulation with FGF23 or high phosphate, but not PTH, induced the phosphorylation of STAT3. Interestingly, only treatment with high phosphate significantly upregulated HAVCR1 and CCL2 expression.
CONCLUSION
Chronic oral phosphate load in mice induced progressive inflammatory kidney injury dominated by macrophages. The direct toxic effects of phosphate are mediated by Stat3/Kim-1 signalling activation in PT cells. Our data support the hypothesis that kidney injury induced by widespread high dietary phosphate intake may cause a global health problem and underline the urgent need for clinical studies on this issue.
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Affiliation(s)
- Beatrice Richter
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Tamar Kapanadze
- Hannover Medical School, Department of Nephrology and Hypertension, Hannover, Germany
- Hannover Medical School, Vascular Medicine Research, Hannover, Germany
| | - Nina Weingärtner
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Stefanie Walter
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Isabel Vogt
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Andrea Grund
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Jessica Schmitz
- Hannover Medical School, Institute of Pathology, Nephropathology Unit, Hannover, Germany
| | - Jan Hinrich Bräsen
- Hannover Medical School, Institute of Pathology, Nephropathology Unit, Hannover, Germany
| | - Florian Limbourg
- Hannover Medical School, Department of Nephrology and Hypertension, Hannover, Germany
- Hannover Medical School, Vascular Medicine Research, Hannover, Germany
| | - Dieter Haffner
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Maren Leifheit-Nestler
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
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Hoff U, Markmann D, Thurn-Valassina D, Nieminen-Kelhä M, Erlangga Z, Schmitz J, Bräsen JH, Budde K, Melk A, Hegner B. The mTOR inhibitor Rapamycin protects from premature cellular senescence early after experimental kidney transplantation. PLoS One 2022; 17:e0266319. [PMID: 35446876 PMCID: PMC9022825 DOI: 10.1371/journal.pone.0266319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 03/18/2022] [Indexed: 01/07/2023] Open
Abstract
Interstitial fibrosis and tubular atrophy, a major cause of kidney allograft dysfunction, has been linked to premature cellular senescence. The mTOR inhibitor Rapamycin protects from senescence in experimental models, but its antiproliferative properties have raised concern early after transplantation particularly at higher doses. Its effect on senescence has not been studied in kidney transplantation, yet. Rapamycin was applied to a rat kidney transplantation model (3 mg/kg bodyweight loading dose, 1.5 mg/kg bodyweight daily dose) for 7 days. Low Rapamycin trough levels (2.1-6.8 ng/mL) prevented the accumulation of p16INK4a positive cells in tubules, interstitium, and glomerula. Expression of the cytokines MCP-1, IL-1β, and TNF-α, defining the proinflammatory senescence-associated secretory phenotype, was abrogated. Infiltration with monocytes/macrophages and CD8+ T-lymphocytes was reduced and tubular function was preserved by Rapamycin. Inhibition of mTOR was not associated with impaired structural recovery, higher glucose levels, or weight loss. mTOR inhibition with low-dose Rapamycin in the immediate posttransplant period protected from premature cellular senescence without negative effects on structural and functional recovery from preservation/reperfusion damage, glucose homeostasis, and growth in a rat kidney transplantation model. Reduced senescence might maintain the renal regenerative capacity rendering resilience to future injuries resulting in protection from interstitial fibrosis and tubular atrophy.
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Affiliation(s)
- Uwe Hoff
- Department of Nephrology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Denise Markmann
- Nieren- und Dialysezentrum Schöneberg-Tempelhof, Berlin, Germany
| | | | - Melina Nieminen-Kelhä
- Departement of Neurosurgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | | | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Klemens Budde
- Department of Nephrology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Anette Melk
- Childrens’ Hospital, Hannover Medical School, Hannover, Germany
| | - Björn Hegner
- Department of Nephrology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Vitanas Hospital for Geriatric Medicine, Berlin, Germany
- * E-mail:
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Meumann N, Schmithals C, Elenschneider L, Hansen T, Balakrishnan A, Hu Q, Hook S, Schmitz J, Bräsen JH, Franke AC, Olarewaju O, Brandenberger C, Talbot SR, Fangmann J, Hacker UT, Odenthal M, Ott M, Piiper A, Büning H. Hepatocellular Carcinoma Is a Natural Target for Adeno-Associated Virus (AAV) 2 Vectors. Cancers (Basel) 2022; 14:cancers14020427. [PMID: 35053588 PMCID: PMC8774135 DOI: 10.3390/cancers14020427] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/21/2021] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Gene therapy is a novel approach to treat diseases by introducing corrective genetic information into target cells. Adeno-associated virus vectors are the most frequently applied gene delivery tools for in vivo gene therapy and are also studied as part of innovative anticancer strategies. Here, we report on the natural preference of AAV2 vectors for hepatocellular carcinoma (HCC) compared to nonmalignant liver cells in mice and human tissue. This preference in transduction is due to the improved intracellular processing of AAV2 vectors in HCC, resulting in significantly more vector genomes serving as templates for transcription in the cell nucleus. Based on this natural tropism for HCC, novel therapeutic strategies can be designed or existing therapeutic approaches can be strengthened as they currently result in only a minor improvement of the poor prognosis for most liver cancer patients. Abstract Although therapeutic options are gradually improving, the overall prognosis for patients with hepatocellular carcinoma (HCC) is still poor. Gene therapy-based strategies are developed to complement the therapeutic armamentarium, both in early and late-stage disease. For efficient delivery of transgenes with antitumor activity, vectors demonstrating preferred tumor tropism are required. Here, we report on the natural tropism of adeno-associated virus (AAV) serotype 2 vectors for HCC. When applied intravenously in transgenic HCC mouse models, similar amounts of vectors were detected in the liver and liver tumor tissue. In contrast, transduction efficiency, as indicated by the level of transgene product, was moderate in the liver but was elevated up to 19-fold in mouse tumor tissue. Preferred transduction of HCC compared to hepatocytes was confirmed in precision-cut liver slices from human patient samples. Our mechanistic studies revealed that this preference is due to the improved intracellular processing of AAV2 vectors in HCC, resulting, for example, in nearly 4-fold more AAV vector episomes that serve as templates for gene transcription. Given this background, AAV2 vectors ought to be considered to strengthen current—or develop novel—strategies for treating HCC.
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Affiliation(s)
- Nadja Meumann
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany; (N.M.); (A.-C.F.); (O.O.); (U.T.H.)
- REBIRTH Research Center for Translational Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany
- Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany;
| | - Christian Schmithals
- Department of Medicine 1, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany; (C.S.); (A.P.)
| | - Leroy Elenschneider
- Fraunhofer Institute for Toxicology and Experimental Medicine Preclinical Pharmacology and In-Vitro Toxicology, 30625 Hannover, Germany; (L.E.); (T.H.)
| | - Tanja Hansen
- Fraunhofer Institute for Toxicology and Experimental Medicine Preclinical Pharmacology and In-Vitro Toxicology, 30625 Hannover, Germany; (L.E.); (T.H.)
| | - Asha Balakrishnan
- Clinic for Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, 30625 Hannover, Germany; (A.B.); (Q.H.); (S.H.); (M.O.)
- Twincore Centre for Experimental and Clinical Infection Research, 30625 Hannover, Germany
| | - Qingluan Hu
- Clinic for Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, 30625 Hannover, Germany; (A.B.); (Q.H.); (S.H.); (M.O.)
- Twincore Centre for Experimental and Clinical Infection Research, 30625 Hannover, Germany
| | - Sebastian Hook
- Clinic for Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, 30625 Hannover, Germany; (A.B.); (Q.H.); (S.H.); (M.O.)
- Twincore Centre for Experimental and Clinical Infection Research, 30625 Hannover, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany; (J.S.); (J.H.B.)
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany; (J.S.); (J.H.B.)
| | - Ann-Christin Franke
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany; (N.M.); (A.-C.F.); (O.O.); (U.T.H.)
| | - Olaniyi Olarewaju
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany; (N.M.); (A.-C.F.); (O.O.); (U.T.H.)
- REBIRTH Research Center for Translational Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Christina Brandenberger
- Institute of Functional and Applied Anatomy, Hannover Medical School, 30625 Hannover, Germany;
- Biomedical Research in Endstage and Obstructive Lung Research (BREATH), German Center for Lung Research (DZL), 30625 Hannover, Germany
| | - Steven R. Talbot
- Institute for Laboratory Animal Science, Hannover Medical School, 30625 Hannover, Germany;
| | - Josef Fangmann
- KRH Klinikum Siloah, Liver Center Hannover (LCH), 30459 Hannover, Germany;
| | - Ulrich T. Hacker
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany; (N.M.); (A.-C.F.); (O.O.); (U.T.H.)
- Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, 04103 Leipzig, Germany
| | - Margarete Odenthal
- Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany;
- Institute of Pathology, University Hospital Cologne, 50931 Cologne, Germany
| | - Michael Ott
- Clinic for Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, 30625 Hannover, Germany; (A.B.); (Q.H.); (S.H.); (M.O.)
- Twincore Centre for Experimental and Clinical Infection Research, 30625 Hannover, Germany
| | - Albrecht Piiper
- Department of Medicine 1, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany; (C.S.); (A.P.)
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Hildegard Büning
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany; (N.M.); (A.-C.F.); (O.O.); (U.T.H.)
- REBIRTH Research Center for Translational Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany
- Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany;
- German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, 38124 Braunschweig, Germany
- Correspondence: ; Tel.: +49-511-532-5106
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Klein A, Radespiel U, Felmy F, Brezina T, Ciurkiewicz M, Schmitz J, Bräsen JH, Linke RP, Reinartz S, Distl O, Beineke A. AA-amyloidosis in captive northern tree shrews ( Tupaia belangeri). Vet Pathol 2021; 59:340-347. [PMID: 34931557 DOI: 10.1177/03009858211066847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A high prevalence of AA-amyloidosis was identified in a breeding colony of northern tree shrews (Tupaia belangeri) in a retrospective analysis, with amyloid deposits in different organs being found in 26/36 individuals (72%). Amyloid deposits, confirmed by Congo red staining, were detected in kidneys, intestines, skin, and lymph nodes, characteristic of systemic amyloidosis. Immunohistochemically, the deposited amyloid was intensely positive with anti-AA-antibody (clone mc4), suggesting AA-amyloidosis. The kidneys were predominantly affected (80%), where amyloid deposits ranged from mild to severe and was predominantly located in the renal medulla. In addition, many kidneys contained numerous cysts with atrophy of the renal parenchyma. There was no significant association between concurrent neoplastic or inflammatory processes and amyloidosis. The lack of distinctive predisposing factors suggests a general susceptibility of captive T. belangeri to develop amyloidosis. Clinical and laboratory findings of a female individual with pronounced kidney alterations were indicative of renal failure. The observed tissue tropism with pronounced kidney alterations, corresponding renal dysfunction, and an overall high prevalence suggests amyloidosis as an important disease in captive tree shrews.
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Affiliation(s)
- Annette Klein
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Ute Radespiel
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Felix Felmy
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Tina Brezina
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | | | | | | | - Reinhold Paul Linke
- Reference Center of Amyloid Diseases, Munich, Germany.,domatec GmbH, Mühldorf a. Inn, Germany
| | - Sina Reinartz
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Ottmar Distl
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Andreas Beineke
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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24
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Merveille O, Lampert T, Schmitz J, Forestier G, Feuerhake F, Wemmert C. An automatic framework for fusing information from differently stained consecutive digital whole slide images: A case study in renal histology. Comput Methods Programs Biomed 2021; 208:106157. [PMID: 34091100 DOI: 10.1016/j.cmpb.2021.106157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This article presents an automatic image processing framework to extract quantitative high-level information describing the micro-environment of glomeruli in consecutive whole slide images (WSIs) processed with different staining modalities of patients with chronic kidney rejection after kidney transplantation. METHODS This four-step framework consists of: 1) approximate rigid registration, 2) cell and anatomical structure segmentation 3) fusion of information from different stainings using a newly developed registration algorithm 4) feature extraction. RESULTS Each step of the framework is validated independently both quantitatively and qualitatively by pathologists. An illustration of the different types of features that can be extracted is presented. CONCLUSION The proposed generic framework allows for the analysis of the micro-environment surrounding large structures that can be segmented (either manually or automatically). It is independent of the segmentation approach and is therefore applicable to a variety of biomedical research questions. SIGNIFICANCE Chronic tissue remodelling processes after kidney transplantation can result in interstitial fibrosis and tubular atrophy (IFTA) and glomerulosclerosis. This pipeline provides tools to quantitatively analyse, in the same spatial context, information from different consecutive WSIs and help researchers understand the complex underlying mechanisms leading to IFTA and glomerulosclerosis.
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Affiliation(s)
- Odyssee Merveille
- ICube, University of Strasbourg, CNRS (UMR 7357), Strasbourg, France; Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, F-69100, LYON, France.
| | - Thomas Lampert
- ICube, University of Strasbourg, CNRS (UMR 7357), Strasbourg, France
| | | | | | - Friedrich Feuerhake
- Institute of Pathology, Hannover Medical School, Germany; University Clinic, Freiburg, Germany
| | - Cédric Wemmert
- ICube, University of Strasbourg, CNRS (UMR 7357), Strasbourg, France
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25
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Tuschen K, Bräsen JH, Schmitz J, Vischedyk M, Weidemann A. Relapse of class V lupus nephritis after vaccination with COVID-19 mRNA vaccine. Kidney Int 2021; 100:941-944. [PMID: 34352310 PMCID: PMC8328524 DOI: 10.1016/j.kint.2021.07.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 10/31/2022]
Affiliation(s)
- Katharina Tuschen
- Medical Clinic III - Nephrology and Dialysis, St. Vincenz Hospital Paderborn, Paderborn, Germany
| | - Jan Hinrich Bräsen
- Nephropathology, Institute of Pathology, Medical School Hannover, Hannover, Germany
| | - Jessica Schmitz
- Nephropathology, Institute of Pathology, Medical School Hannover, Hannover, Germany
| | | | - Alexander Weidemann
- Medical Clinic III - Nephrology and Dialysis, St. Vincenz Hospital Paderborn, Paderborn, Germany.
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26
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Hermsen M, Volk V, Bräsen JH, Geijs DJ, Gwinner W, Kers J, Linmans J, Schaadt NS, Schmitz J, Steenbergen EJ, Swiderska-Chadaj Z, Smeets B, Hilbrands LB, Feuerhake F, van der Laak JAWM. Quantitative assessment of inflammatory infiltrates in kidney transplant biopsies using multiplex tyramide signal amplification and deep learning. J Transl Med 2021; 101:970-982. [PMID: 34006891 PMCID: PMC8292146 DOI: 10.1038/s41374-021-00601-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 01/26/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/20/2022] Open
Abstract
Delayed graft function (DGF) is a strong risk factor for development of interstitial fibrosis and tubular atrophy (IFTA) in kidney transplants. Quantitative assessment of inflammatory infiltrates in kidney biopsies of DGF patients can reveal predictive markers for IFTA development. In this study, we combined multiplex tyramide signal amplification (mTSA) and convolutional neural networks (CNNs) to assess the inflammatory microenvironment in kidney biopsies of DGF patients (n = 22) taken at 6 weeks post-transplantation. Patients were stratified for IFTA development (<10% versus ≥10%) from 6 weeks to 6 months post-transplantation, based on histopathological assessment by three kidney pathologists. One mTSA panel was developed for visualization of capillaries, T- and B-lymphocytes and macrophages and a second mTSA panel for T-helper cell and macrophage subsets. The slides were multi spectrally imaged and custom-made python scripts enabled conversion to artificial brightfield whole-slide images (WSI). We used an existing CNN for the detection of lymphocytes with cytoplasmatic staining patterns in immunohistochemistry and developed two new CNNs for the detection of macrophages and nuclear-stained lymphocytes. F1-scores were 0.77 (nuclear-stained lymphocytes), 0.81 (cytoplasmatic-stained lymphocytes), and 0.82 (macrophages) on a test set of artificial brightfield WSI. The CNNs were used to detect inflammatory cells, after which we assessed the peritubular capillary extent, cell density, cell ratios, and cell distance in the two patient groups. In this cohort, distance of macrophages to other immune cells and peritubular capillary extent did not vary significantly at 6 weeks post-transplantation between patient groups. CD163+ cell density was higher in patients with ≥10% IFTA development 6 months post-transplantation (p < 0.05). CD3+CD8-/CD3+CD8+ ratios were higher in patients with <10% IFTA development (p < 0.05). We observed a high correlation between CD163+ and CD4+GATA3+ cell density (R = 0.74, p < 0.001). Our study demonstrates that CNNs can be used to leverage reliable, quantitative results from mTSA-stained, multi spectrally imaged slides of kidney transplant biopsies.
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Affiliation(s)
- Meyke Hermsen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Valery Volk
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | | | - Daan J Geijs
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wilfried Gwinner
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Jesper Kers
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Center for Analytical Sciences Amsterdam (CASA), Van 't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, Amsterdam, The Netherlands
| | - Jasper Linmans
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nadine S Schaadt
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Jessica Schmitz
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Eric J Steenbergen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Zaneta Swiderska-Chadaj
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
- Faculty of Electrical Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Bart Smeets
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Friedrich Feuerhake
- Institute for Pathology, Hannover Medical School, Hannover, Germany
- Institute for Neuropathology, University Clinic Freiburg, Freiburg, Germany
| | - Jeroen A W M van der Laak
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
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27
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Fleig SV, Konen FF, Schröder C, Schmitz J, Gingele S, Bräsen JH, Lovric S, Schmidt BMW, Haller H, Skripuletz T, von Vietinghoff S. Long-term B cell depletion associates with regeneration of kidney function. Immun Inflamm Dis 2021; 9:1479-1488. [PMID: 34324242 PMCID: PMC8589377 DOI: 10.1002/iid3.499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/22/2022]
Abstract
Background Chronic kidney disease (CKD) is a common condition that increases mortality and the risk of cardiovascular and other morbidities regardless of underlying renal condition. Chronic inflammation promotes renal fibrosis. Recently, renal B cell infiltrates were described in chronic kidney disease of various etiologies beyond autoimmunity. Methods We here investigated B cells and indicators of tertiary lymphoid structure formation in human renal biopsies. Renal function was studied during long‐term B cell depletion in human patients with membranous nephropathy and with CKD of unknown origin. Results Cytokine profiles of tertiary lymphoid structure formation were detected in human renal interstitium in a range of kidney diseases. Complex B cell structures consistent with tertiary lymphoid organ formation were evident in human membranous nephropathy. Here, B cell density did not significantly associate with proteinuria severity, but with worse excretory renal function. Proteinuria responses mostly occurred within the first 6 months of B cell depletion. In contrast, recovery of excretory kidney function was observed only after 18 months of continuous therapy, consistent with a structural process. Renal tertiary lymphatic structures were also detected in the absence of autoimmune kidney disease. To start to address whether B cell depletion may affect CKD in a broader population, we assessed kidney function in neurologic patients with CKD of unknown origin. In this cohort, eGFR significantly increased within 24 months of B cell depletion. Conclusion Long‐term B cell depletion associated with significant improvement of excretory kidney function in human CKD. Kinetics and mechanisms of renal B cell aggregation should be investigated further to stratify the impact of B cells and their aggregates as therapeutic targets.
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Affiliation(s)
- Susanne V Fleig
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover.,Nephrology Section, Medical Clinic 1, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Franz F Konen
- Department of Neurology, Hannover Medical School, Hannover.,Interdisciplinary Day Clinic, Hannover Medical School, Hannover
| | - Christoph Schröder
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover.,Interdisciplinary Day Clinic, Hannover Medical School, Hannover
| | - Jessica Schmitz
- Nephropathology unit, Institute for Pathology, Hannover Medical School, Hannover
| | - Stefan Gingele
- Department of Neurology, Hannover Medical School, Hannover.,Interdisciplinary Day Clinic, Hannover Medical School, Hannover
| | - Jan H Bräsen
- Nephropathology unit, Institute for Pathology, Hannover Medical School, Hannover
| | - Svjetlana Lovric
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover.,Interdisciplinary Day Clinic, Hannover Medical School, Hannover
| | - Bernhard M W Schmidt
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover
| | - Hermann Haller
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover
| | - Thomas Skripuletz
- Department of Neurology, Hannover Medical School, Hannover.,Interdisciplinary Day Clinic, Hannover Medical School, Hannover
| | - Sibylle von Vietinghoff
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover.,Nephrology Section, Medical Clinic 1, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany.,Interdisciplinary Day Clinic, Hannover Medical School, Hannover
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Pfenning MB, Schmitz J, Schulte K, Hafer C, Khalifa AA, Kulschewski A, Feldkamp T, Kielstein JT, Gwinner W, Kunzendorf U, Dietrich S, Bräsen JH. MO444MACROPHAGE DENSITIES CORRELATE WITH LONG-TERM FUNCTION IN PAUCI-IMMUNE AND MEMBRANOUS GLOMERULONEPHRITIS AS WELL AS IN HYPERTENSIVE NEPHROPATHY. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab090.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Macrophages and monocytes are main players in innate immunity. In renal diseases, their role is poorly understood. Our multicentric cross-sectional study aimed to study the prevalence of macrophages and monocytes in various human native kidney diseases. For this, we used precise pixel-based digital quantification of their densities in renal biopsies and correlated our findings with clinical data.
Method
We included 324 patients, who underwent a diagnostic renal biopsy. Additional normal kidney samples from 16 tumour nephrectomies were used as controls. According to the diagnosed diseases, we established 17 patient groups. Biopsies were stained for CD68+-macrophages using automated immunohistochemistry (Ventana Ultra) and selected groups were further subtyped for CD14+-monocytes and CD163+-M2-macrophages (67 cases, pauci-immune glomerulonephritis (PIGN), IgA-nephropathy (IgAN) and control samples). Digitized sections (Leica) were analysed using the open-source software QuPath to quantify cell densities (positively stained areas displayed as percentages of ROI) in renal cortex, medulla and extrarenal tissue, respectively. Detailed clinical and laboratory data at timepoint of biopsy were available for all patients. Additional data for follow-up were achievable in 158 cases.
Results
Renal disease samples presented higher mean macrophage densities compared to control cases (CD68: cortex 1.2 vs. 0.2%, p<0.001, medulla 0.8 vs. 0.04%, p<0.001; CD163: cortex 3.2 vs. 0.5%, p<0.001, medulla 2.3 vs. 0.6%, p<0.05), but CD14+-density did not differ between patients and control samples. The highest cortical CD68+-density occurred in PIGN (1.98%) and in medulla in ascending infections (1.86%). The lowest cortical CD68+-densities were measured in thin basal membrane syndrome / Alport-syndrome (0.56%) and in medulla in immunotactoid and fibrillary glomerulopathy (0.26%). Chronic kidney disease displayed lower percentages of CD68+-densities (cortex: 1.15%; medulla: 0.49%) compared to acute kidney injury (cortex: 1.84%, p<0.001; medulla: 1.08%, p<0.001) and acute on chronic kidney injury (cortex: 1.81%, p<0.001; medulla: 1.43%, p<0.001). We detected a correlation of CD68+- and CD163+-infiltration with kidney function (eGFR) in cortex and medulla at the time of biopsy (CD68: r=-0.51 for cortex, r=-0.60 for medulla; CD163: r=-0.71 for cortex, r=-0.73 for medulla; p<0.001) and follow up (CD68: r=-0.41 for cortex, r=-0.34 for medulla, p<0.001; CD163: r=-0.46 for cortex, r=-0.50 for medulla, p<0.05). Older patients (>64 years) showed a higher medullary M2-infiltration (1.81% vs. 4.34%, p<0.005). The eGFR at the time of biopsy inversely correlated (p<0.05) with cortical CD68+-density in IgAN (r=-0.39), PIGN (r=-0.53), membranous glomerulonephritis (MGN; r=-0.70), focal segmental glomerulonephritis (r=-0.63), and hypertensive nephropathy (HNP; r=-0.44). At follow-up, this correlation (p<0.05) was still present in PIGN (r=-0.43), MGN (r=-0.58), and HNP (r=-0.77). In PIGN, cortical CD163+-density and eGFR were associated (p<0.001) at timepoint of biopsy (r=-0.51) and follow-up (r=-0.51). Particularly, cANCA-vasculitis showed a strong correlation between eGFR and cortical CD68+- as well as CD163+-densities at time of biopsy (CD68: r=-0.78; CD163: r=-0.75, p<0.001) and also for follow-up (CD68: r=-0.48; CD163: r=-0.68, p<0.05).
Conclusion
Macrophages may promote progression of human renal diseases, whereas monocytes do not correlate with eGFR-decline. Especially, in cANCA- vasculitis CD163+- infiltration is associated with renal outcome. Additional studies are needed to investigate, whether macrophages can serve as predictive markers or therapeutical targets in native renal diseases.
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Affiliation(s)
- Maren Bettina Pfenning
- Hannover Medical School (MHH), Nephropathology Unit, Institute of Pathology, Hannover, Germany
| | - Jessica Schmitz
- Hannover Medical School (MHH), Nephropathology Unit, Institute of Pathology, Hannover, Germany
| | - Kevin Schulte
- University Hospital Schleswig-Holstein, Christian-Albrechts-University, Department of Nephrology and Hypertension, Kiel, Germany
| | - Carsten Hafer
- Academic Teaching Hospital Braunschweig, Medical Clinic V, Nephrology, Rheumatology and Blood Purification, Braunschweig, Germany
| | | | - Anke Kulschewski
- University Hospital Oldenburg, Clinic for Nephrology and Hypertension, Oldenburg, Germany
| | - Thorsten Feldkamp
- Nephological Center of Lower Saxony, Klinikum Hann. Münden, Department of Internal Medicine and Nephrology, Kidney Transplant Center, Hann. Münden
| | - Jan T Kielstein
- Academic Teaching Hospital Braunschweig, Medical Clinic V, Nephrology, Rheumatology and Blood Purification, Braunschweig, Germany
| | - Wilfried Gwinner
- Hannover Medical School (MHH), Department of Nephrology, Hannover, Germany
| | - Ulrich Kunzendorf
- University Hospital Schleswig-Holstein, Christian-Albrechts-University, Department of Nephrology and Hypertension, Kiel, Germany
| | - Sebastian Dietrich
- University Hospital Schleswig-Holstein, Christian-Albrechts-University, Department of Nephrology and Hypertension, Kiel, Germany
| | - Jan Hinrich Bräsen
- Hannover Medical School (MHH), Nephropathology Unit, Institute of Pathology, Hannover, Germany
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Roy-Chowdhury E, Brauns N, Helmke A, Nordlohne J, Bräsen JH, Schmitz J, Volkmann J, Fleig SV, Kusche-Vihrog K, Haller H, von Vietinghoff S. Human CD16+ monocytes promote a pro-atherosclerotic endothelial cell phenotype via CX3CR1-CX3CL1 interaction. Cardiovasc Res 2021; 117:1510-1522. [PMID: 32717023 DOI: 10.1093/cvr/cvaa234] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/17/2020] [Accepted: 07/22/2020] [Indexed: 12/31/2022] Open
Abstract
AIMS Monocytes are central for atherosclerotic vascular inflammation. The human non-classical, patrolling subtype, which expresses high levels of CD16 and fractalkine receptor CX3CR1, strongly associates with cardiovascular events. This is most marked in renal failure, a condition with excess atherosclerosis morbidity. The underlying mechanism is not understood. This study investigated how human CD16+ monocytes modulate endothelial cell function. METHODS AND RESULTS In patients with kidney failure, CD16+ monocyte counts were elevated and dynamically decreased within a year after transplantation, chiefly due to a drop in CD14+CD16+ cells. The CX3CR1 ligand CX3CL1 was similarly elevated in the circulation of humans and mice with renal impairment. CX3CL1 up-regulation was also observed close to macrophage rich human coronary artery plaques. To investigate a mechanistic basis of this association, CD16+CX3CR1HIGH monocytes were co-incubated with primary human endothelium in vitro. Compared to classical CD14+ monocytes or transwell cocultures, CD16+ monocytes enhanced endothelial STAT1 and NF-κB p65 phosphorylation, up-regulated expression of CX3CL1 and interleukin-1β, numerous CCL and CXCL chemokines and molecules promoting leucocyte patrolling and adhesion such as ICAM1 and VCAM1. Genes required for vasodilatation including endothelial nitric oxide synthase decreased while endothelial collagen production increased. Uraemic patients' monocytes enhanced endothelial CX3CL1 even more markedly. Their receptor CX3CR1 was required for enhanced aortic endothelial stiffness in murine atherosclerosis with renal impairment. CX3CR1 dose-dependently modulated monocyte-contact-dependent gene expression in human endothelium. CONCLUSION By demonstrating endothelial proatherosclerotic gene regulation in direct contact with CD16+ monocytes, in part via cellular CX3CR1-CX3CL1 interaction, our data delineate a mechanism how this celltype can increase cardiovascular risk.
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Affiliation(s)
- Eva Roy-Chowdhury
- Division of Nephrology and Hypertension, Department of Internal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
| | - Nicolas Brauns
- Division of Nephrology and Hypertension, Department of Internal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
| | - Alexandra Helmke
- Division of Nephrology and Hypertension, Department of Internal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
| | - Johannes Nordlohne
- Division of Nephrology and Hypertension, Department of Internal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
| | | | - Jessica Schmitz
- Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Julia Volkmann
- Division of Nephrology and Hypertension, Department of Internal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
| | - Susanne V Fleig
- Division of Nephrology and Hypertension, Department of Internal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
| | | | - Hermann Haller
- Division of Nephrology and Hypertension, Department of Internal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
| | - Sibylle von Vietinghoff
- Division of Nephrology and Hypertension, Department of Internal Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
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Viereck J, Bührke A, Foinquinos A, Chatterjee S, Kleeberger JA, Xiao K, Janssen-Peters H, Batkai S, Ramanujam D, Kraft T, Cebotari S, Gueler F, Beyer AM, Schmitz J, Bräsen JH, Schmitto JD, Gyöngyösi M, Löser A, Hirt MN, Eschenhagen T, Engelhardt S, Bär C, Thum T. Targeting muscle-enriched long non-coding RNA H19 reverses pathological cardiac hypertrophy. Eur Heart J 2021; 41:3462-3474. [PMID: 32657324 PMCID: PMC8482849 DOI: 10.1093/eurheartj/ehaa519] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 12/06/2019] [Accepted: 06/03/2020] [Indexed: 12/19/2022] Open
Abstract
AIMS Pathological cardiac remodelling and subsequent heart failure represents an unmet clinical need. Long non-coding RNAs (lncRNAs) are emerging as crucial molecular orchestrators of disease processes, including that of heart diseases. Here, we report on the powerful therapeutic potential of the conserved lncRNA H19 in the treatment of pathological cardiac hypertrophy. METHOD AND RESULTS Pressure overload-induced left ventricular cardiac remodelling revealed an up-regulation of H19 in the early phase but strong sustained repression upon reaching the decompensated phase of heart failure. The translational potential of H19 is highlighted by its repression in a large animal (pig) model of left ventricular hypertrophy, in diseased human heart samples, in human stem cell-derived cardiomyocytes and in human engineered heart tissue in response to afterload enhancement. Pressure overload-induced cardiac hypertrophy in H19 knock-out mice was aggravated compared to wild-type mice. In contrast, vector-based, cardiomyocyte-directed gene therapy using murine and human H19 strongly attenuated heart failure even when cardiac hypertrophy was already established. Mechanistically, using microarray, gene set enrichment analyses and Chromatin ImmunoPrecipitation DNA-Sequencing, we identified a link between H19 and pro-hypertrophic nuclear factor of activated T cells (NFAT) signalling. H19 physically interacts with the polycomb repressive complex 2 to suppress H3K27 tri-methylation of the anti-hypertrophic Tescalcin locus which in turn leads to reduced NFAT expression and activity. CONCLUSION H19 is highly conserved and down-regulated in failing hearts from mice, pigs and humans. H19 gene therapy prevents and reverses experimental pressure-overload-induced heart failure. H19 acts as an anti-hypertrophic lncRNA and represents a promising therapeutic target to combat pathological cardiac remodelling.
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Affiliation(s)
- Janika Viereck
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.,Cardior Pharmaceuticals GmbH, Hannover Medical School Campus, Feodor-Lynen-Str. 15, Hannover 30625, Germany
| | - Anne Bührke
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Ariana Foinquinos
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Shambhabi Chatterjee
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Jan A Kleeberger
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Ke Xiao
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Heike Janssen-Peters
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Sandor Batkai
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.,Cardior Pharmaceuticals GmbH, Hannover Medical School Campus, Feodor-Lynen-Str. 15, Hannover 30625, Germany
| | - Deepak Ramanujam
- Institute of Pharmacology and Toxicology, Technische Universität München, Biedersteiner Str. 29, Munich 80802, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Biedersteiner Str. 29, Munich 80802, Germany
| | - Theresia Kraft
- Institute for Molecular and Cell Physiology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Serghei Cebotari
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Faikah Gueler
- Department of Nephrology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Andreas M Beyer
- Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.,Cardiovascular Center, Medical College of Wisconsin, Milwaukee, USA.,Department of Physiology, Medical College of Wisconsin, Milwaukee, USA
| | - Jessica Schmitz
- Institute for Pathology, Nephropathology Unit, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Jan H Bräsen
- Institute for Pathology, Nephropathology Unit, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Jan D Schmitto
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | | | - Alexandra Löser
- Department of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Deutschland, Hamburg/Kiel/Lübeck
| | - Marc N Hirt
- Department of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Deutschland, Hamburg/Kiel/Lübeck
| | - Thomas Eschenhagen
- Department of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Deutschland, Hamburg/Kiel/Lübeck
| | - Stefan Engelhardt
- Institute of Pharmacology and Toxicology, Technische Universität München, Biedersteiner Str. 29, Munich 80802, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Biedersteiner Str. 29, Munich 80802, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.,Cardior Pharmaceuticals GmbH, Hannover Medical School Campus, Feodor-Lynen-Str. 15, Hannover 30625, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Germany
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Schmitz J, Hüdig M, Meier D, Linka N, Maurino VG. The genome of Ricinus communis encodes a single glycolate oxidase with different functions in photosynthetic and heterotrophic organs. Planta 2020; 252:100. [PMID: 33170407 PMCID: PMC7655567 DOI: 10.1007/s00425-020-03504-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 10/23/2020] [Indexed: 06/11/2023]
Abstract
The biochemical characterization of glycolate oxidase in Ricinus communis hints to different physiological functions of the enzyme depending on the organ in which it is active. Enzymatic activities of the photorespiratory pathway are not restricted to green tissues but are present also in heterotrophic organs. High glycolate oxidase (GOX) activity was detected in the endosperm of Ricinus communis. Phylogenetic analysis of the Ricinus L-2-hydroxy acid oxidase (Rc(L)-2-HAOX) family indicated that Rc(L)-2-HAOX1 to Rc(L)-2-HAOX3 cluster with the group containing streptophyte long-chain 2-hydroxy acid oxidases, whereas Rc(L)-2-HAOX4 clusters with the group containing streptophyte GOX. Rc(L)-2-HAOX4 is the closest relative to the photorespiratory GOX genes of Arabidopsis. We obtained Rc(L)-2-HAOX4 as a recombinant protein and analyze its kinetic properties in comparison to the Arabidopsis photorespiratory GOX. We also analyzed the expression of all Rc(L)-2-HAOXs and conducted metabolite profiling of different Ricinus organs. Phylogenetic analysis indicates that Rc(L)-2-HAOX4 is the only GOX encoded in the Ricinus genome (RcGOX). RcGOX has properties resembling those of the photorespiratory GOX of Arabidopsis. We found that glycolate, the substrate of GOX, is highly abundant in non-green tissues, such as roots, embryo of germinating seeds and dry seeds. We propose that RcGOX fulfills different physiological functions depending on the organ in which it is active. In autotrophic organs it oxidizes glycolate into glyoxylate as part of the photorespiratory pathway. In fast growing heterotrophic organs, it is most probably involved in the production of serine to feed the folate pathway for special demands of those tissues.
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Affiliation(s)
- Jessica Schmitz
- Plant Molecular Physiology and Biotechnology Division, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, and Cluster of Excellence on Plant Sciences (CEPLAS), Düsseldorf, Germany
| | - Meike Hüdig
- Plant Molecular Physiology and Biotechnology Division, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, and Cluster of Excellence on Plant Sciences (CEPLAS), Düsseldorf, Germany
- Molecular Plant Physiology Division, Institute of Molecular Physiology and Biotechnology of Plants, University of Bonn, Kirschallee 1, 53115, Bonn, Germany
| | - Dieter Meier
- Plant Molecular Physiology and Biotechnology Division, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, and Cluster of Excellence on Plant Sciences (CEPLAS), Düsseldorf, Germany
| | - Nicole Linka
- Institute for Plant Biochemistry, Heinrich Heine University, and Cluster of Excellence on Plant Sciences (CEPLAS), Düsseldorf, Germany
| | - Veronica G Maurino
- Plant Molecular Physiology and Biotechnology Division, Institute of Developmental and Molecular Biology of Plants, Heinrich Heine University, and Cluster of Excellence on Plant Sciences (CEPLAS), Düsseldorf, Germany.
- Molecular Plant Physiology Division, Institute of Molecular Physiology and Biotechnology of Plants, University of Bonn, Kirschallee 1, 53115, Bonn, Germany.
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Maris A, Jacobs J, Van Horn G, Stratton CW, Schmitz J. Microbiologic Proof-Of-Concept: A Novel Device Combining UV Light And Ozone For Human Skin Antisepsis. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Hand hygiene (HH) decreases healthcare-associated infections (HAI). Available products include alcohol-based gels, foams, wipes, and “gold-standard” hand-washing with soap and water. We tested an investigational device (HyLuxO3; GMI, LLC, patent pending) for antimicrobial effect (AME). HyLuxO3 was engineered to deliver UV-C light energy and high velocity O3 airflow to safely achieve human skin antisepsis within OSHA and EPA regulatory limits. Combined UV and O3 has yet to be evaluated for HH and may demonstrate synergistic AME.
Methods
HyLuxO3 was tested on LB agar to titrate device variables to ascertain intensities for optimal AME; later testing was performed on VITRO-SKIN (Florida Suncare Testing, Bunnell, FL), a human skin surrogate. ATCC strains of MRSA, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Candida albicans were used to test AME vs. vegetative microbes; Bacillus atrophaeus spores were used as a surrogate for C. difficile. Tested variables included time under device, [O3], airflow velocity, 222 and/or 254 nm UV light, sample distance from UV lamp, and UV beam width. Positive controls were used to calculate log-kill curves for AME.
Results
Similar results were seen on LB agar and VITRO-SKIN. >7 log-kill and >5 log-kill were acheived vs. vegetative microbes (<30 sec) and spores (60 sec), respectively, under optimized variables. Presence of UV light and sample distance from and time under the device were the most important variables. 254 nm UV had a significantly better AME than 222 nm; combining both UV lamps had a significant synergistic AME. The narrowest UV beam (2 mm) yielded the greatest AME (total energy input kept constant). Adding O3 to UV had a modest but significant synergistic effect; optimal [O3] was 0.3-0.8 ppm. Changing airflow velocity had no significant effect on AME.
Conclusion
HyLuxO3 is a novel device that achieves >7 log-kill vs. common pathogenic vegetative microbes and >5 log-kill vs. spores using combined UV light and [O3] safe for human skin antisepsis (and surface/fomite decontamination)- and- yields such impressive AME on faster timescales than those required by bleach/other chemical products unsuitable for human skin. Future studies on human hands (using many other microbes) will determine if HyLuxO3 meets regulatory and efficacy requirements for use in and beyond healthcare settings, especially with the specter of emerging respiratory viruses.
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Affiliation(s)
- A Maris
- Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, UNITED STATES
| | - J Jacobs
- Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, UNITED STATES
| | - G Van Horn
- Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, UNITED STATES
| | - C W Stratton
- Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, UNITED STATES
| | - J Schmitz
- Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, UNITED STATES
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Struck AK, Klotz D, Hülskötter K, Wohlsein P, Schmitz J, Bräsen JH, Distl O. Complex segregation analysis of familial amyloidosis in Oriental shorthair cats. Vet J 2020; 265:105552. [PMID: 33129552 DOI: 10.1016/j.tvjl.2020.105552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/13/2020] [Revised: 09/19/2020] [Accepted: 09/24/2020] [Indexed: 11/29/2022]
Abstract
Amyloidosis in Siamese/Oriental cats is a lethal condition with variable age of clinical onset. There is no sex predisposition and clinical signs of disease usually become apparent by 1-7 years of age. In the terminal stages, the liver is enlarged and pale, and contains parenchymal hemorrhages. In the present study, pedigree data from 17 cats with clinical signs consistent with amyloidosis underwent genetic analysis. Necropsy and histopathological data were available for 10 of the 17 cats. Necropsy findings included pale, fragile and enlarged livers with capsular ruptures and parenchymal hemorrhages, and sanguineous effusions in the abdominal cavity. Congo red staining with birefringence confirmed systemic amyloidosis mostly involving the liver and thyroid gland. In four of the 10 cases, protein deposits were classified as amyloid A protein (AA-amyloid) by immunostaining. Pedigree data for all 17 affected cats indicated a familial trait. Animal threshold model analysis demonstrated that the heritability for amyloidosis was 0.56 ± 0.09 (standard error). Complex segregation analysis was used for statistical comparisons among models to determine environmental or sex dependent effects, and Mendelian, polygenic, or mixed Mendelian and polygenic inheritance patterns. A mixed model with a Mendelian and polygenic component provided the best fit to the data and thus was most likely. All other models of inheritance were rejected due to their insufficient ability to explain segregation of amyloidosis. In conclusion, we found evidence for a complex genetic basis for amyloidosis in Oriental shorthair cats.
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Affiliation(s)
- A K Struck
- Institute for Animal Breeding and Genetics, University of Veterinary Medicine Hannover, Bünteweg 17p, D-30559 Hannover, Germany
| | - D Klotz
- Department of Pathology, University of Veterinary Medicine Hannover, Bünteweg 17, D-30559 Hannover, Germany
| | - K Hülskötter
- Department of Pathology, University of Veterinary Medicine Hannover, Bünteweg 17, D-30559 Hannover, Germany
| | - P Wohlsein
- Department of Pathology, University of Veterinary Medicine Hannover, Bünteweg 17, D-30559 Hannover, Germany
| | - J Schmitz
- Institute of Pathology, Nephropathology Unit, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625 Hannover, Germany
| | - J H Bräsen
- Institute of Pathology, Nephropathology Unit, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625 Hannover, Germany
| | - O Distl
- Institute for Animal Breeding and Genetics, University of Veterinary Medicine Hannover, Bünteweg 17p, D-30559 Hannover, Germany.
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35
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Noé G, Wendt E, Schmitz J, Spüntrup C. Wo beginnt die Cervix uteri? – Die Diskrepanz zwischen der makroskopisch und mikroskopisch definierten Cervix uteri. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- G Noé
- KKH Dormagen, Gynäkologie und Geburtshilfe
| | | | | | - C Spüntrup
- KKH Dormagen, Gynäkologie
- Pelvic School Saarbrücken, Gynäkologie
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36
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Snyder AD, Zuniga E, Ma L, Steinberg JL, Woisard K, Narayana PA, Lane S, Schmitz J, Moeller FG. Examination of preliminary behavioral and effective connectivity findings from treatment response to citalopram in cocaine use disorder: A dynamic causal modeling study. Psychiatry Res Neuroimaging 2020; 303:111127. [PMID: 32593950 PMCID: PMC8948471 DOI: 10.1016/j.pscychresns.2020.111127] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 10/24/2022]
Abstract
We sought effective (directional) connectivity parameters associated with response to citalopram in cocaine use disorder (CUD) by conducting a functional magnetic resonance imaging (fMRI) experiment with participants diagnosed with CUD (n = 13) and matched healthy controls (HC; n = 17). CUD participants showed a positive correlation between bilateral DLPFC-to-putamen effective connectivity and treatment effectiveness score. These preliminary results support further investigation of prefrontal-striatal interactions in response to treatment in CUD.
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Affiliation(s)
- A D Snyder
- Institute for Drug and Alcohol Studies; Department of Psychiatry.
| | - E Zuniga
- Institute for Drug and Alcohol Studies
| | - L Ma
- Institute for Drug and Alcohol Studies; Department of Radiology
| | - J L Steinberg
- Institute for Drug and Alcohol Studies; Department of Psychiatry
| | - K Woisard
- Institute for Drug and Alcohol Studies; Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - P A Narayana
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - S Lane
- Program in Neuroscience, Graduate School of Biomedical Sciences, University of Texas Health Science Center at Houston, Houston, Texas, United States
| | - J Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, United States
| | - F G Moeller
- Institute for Drug and Alcohol Studies; Department of Psychiatry; Department of Pharmacology and Toxicology; Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States.
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Leyh-Bannurah SR, Wolffgang U, Schmitz J, Ouellet V, Azzi F, Tian Z, Helmke B, Graefen M, Budäus L, Karakiewicz P, Trudel D, Saad F. State-of-the-art weakly supervised automated classification of prostate cancer tissue microarrays via deep learning: Can sufficient accuracy be achieved without manual patch level annotation? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33954-9] [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: 11/26/2022] Open
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Schmitz J, Battenberg T, Drinhaus H, Eifinger F, Ries C, Hinkelbein J. Auswirkung der Implementierung eines Schockraumkoordinators auf Prozessparameter der Polytraumaversorgung im Schockraum eines Maximalversorgers. Anaesthesist 2020; 69:497-505. [DOI: 10.1007/s00101-020-00776-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/04/2020] [Accepted: 03/18/2020] [Indexed: 12/01/2022]
Abstract
Zusammenfassung
Hintergrund
In der Altersgruppe bis 40 Jahre stellt das schwere Trauma die häufigste Todesursache in Deutschland dar. Entsprechend der S3-Leitlinie „Polytrauma/Schwerverletztenbehandlung“ ist seit 2011 die Anwesenheit eines Schockraumkoordinators in Erwägung zu ziehen, der durch optimierte Versorgungs- und Behandlungsabläufe das Überleben der Patienten verbessern kann. Ziel der vorliegenden Untersuchung war die Analyse unterschiedlicher Prozessparameter zur Schockraumversorgung polytraumatisierter Patienten vor und nach Implementierung eines Schockraumkoordinators für die Polytraumaversorgung.
Material und Methoden
Um einen ausreichenden zeitlichen Abstand zum Zeitpunkt der Neueinführungen (2011) einzuhalten, wurden die Jahre 2009 und 2012 zum Vergleich herangezogen: Alle eingescannten Schockraumprotokolle der Jahre 2009 (01.01.2009–31.12.2009) und 2012 (01.01.2012–31.12.2012) wurden gesichtet und ausgewertet.
Ergebnisse
Aus dem Jahr 2009 wurden 213 und aus dem Jahr 2012 wurden 420 Schockraumeinsätze in die Auswertung einbezogen. Die durchschnittliche Schockraumanzahl lag im Jahr 2009 bei 17,8/Monat und im Jahr 2012 bei 35/Monat. Die mittlere Anzahl der Schockraumeinsätze hat sich nahezu verdoppelt (p < 0,001). Die mittlere Schockraumdauer lag im Jahr 2012 im Durchschnitt 5,8 min unter der im Jahr 2009 (p = 0,56).
Schlussfolgerungen
Die Patientenversorgung war in Anwesenheit eines Schockraumkoordinators bzw. nach Implementierung der SOP weder statistisch signifikant noch klinisch relevant verkürzt.
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Nwabuobi C, Gowda N, Schmitz J, Wood N, Pargas A, Bagiardi L, Odibo L, Camisasca-Lopina H, Kuznicki M, Sinkey R, Odibo A. Risk factors for Cesarean delivery in pregnancy with small-for-gestational-age fetus undergoing induction of labor. Ultrasound Obstet Gynecol 2020; 55:799-805. [PMID: 31441151 DOI: 10.1002/uog.20850] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To identify risk factors for Cesarean delivery and non-reassuring fetal heart tracing (NRFHT) in pregnancies with a small-for-gestational-age (SGA) fetus undergoing induction of labor and to design and validate a prediction model, combining antenatal and intrapartum variables known at the time of labor induction, to identify pregnancies at increased risk of Cesarean delivery. METHODS This was a retrospective cohort study of non-anomalous, singleton gestations with a SGA fetus that underwent induction of labor, delivered in a single tertiary referral center between January 2011 and December 2016. SGA was defined as estimated fetal weight (EFW) < 10th percentile. The primary outcome was to identify risk factors associated with Cesarean delivery. The secondary outcome was to identify risk factors associated with NRFHT. Univariate and multivariate analyses were used to determine which clinical characteristics, available at the time of admission, had the strongest association with Cesarean delivery and NRFHT during labor induction. The predictive value of the final models was assessed by the area under the receiver-operating-characteristics curve (AUC). Sensitivity and specificity of the models were also assessed. Internal validation of the models was performed using 10 000 bootstrap replicates of the original cohort. The adequacy of the models was evaluated using the Hosmer-Lemeshow goodness-of-fit test. RESULTS A total of 594 pregnancies were included. Cesarean delivery was performed in 243 (40.9%) pregnancies. Significant risk factors associated with Cesarean delivery, and included in the final model, were maternal age, gestational age at delivery and initial method of labor induction. The bootstrap estimate of the AUC of the final prediction model for Cesarean delivery was 0.82 (95% CI, 0.78-0.86). The model had sensitivity of 64.2%, specificity of 86.9%, positive likelihood ratio (LR) of 4.9 and negative LR of 0.41. The model had good fit (P = 0.617). NRFHT complicated 117 (19.7%) pregnancies. Significant risk factors for NRFHT included EFW < 5th percentile, abnormal umbilical artery Doppler studies (pulsatility index > 95th percentile or absent/reversed end-diastolic flow) and gestational age at delivery. The final prediction model for NRFHT had an AUC of 0.69 (95% CI, 0.63-0.75) and specificity of 97.0%. CONCLUSION We identified several significant risk factors for Cesarean delivery and NRFHT among SGA pregnancies undergoing induction of labor. Clinicians may use these risk factors to guide patient counseling and to help anticipate the potential need for operative delivery. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- C Nwabuobi
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - N Gowda
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - J Schmitz
- Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - N Wood
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - A Pargas
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - L Bagiardi
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - L Odibo
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - H Camisasca-Lopina
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - M Kuznicki
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - R Sinkey
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - A Odibo
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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Vogt I, Walter S, Veenstra AC, Kapanadze T, Schmitz J, Bräsen JH, Schmitt R, Limbourg F, Haffner D, Leifheit-Nestler M. MO044HIGH DIETARY PHOSPHATE INTAKE ENHANCES INTACT FGF23 AND CAUSES ACUTE TUBULAR INJURY WITH SEVERE INFLAMMATION AND FIBROSIS IN UNTREATED MICE. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa140.mo044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
In early stages of chronic kidney disease (CKD) rising levels of the phosphaturic hormone fibroblast growth factor (FGF) 23 maintain the phosphate homeostasis, whereas in end-stage kidney disease hyperphosphatemia manifests. Both elevated FGF23 and phosphate levels contribute to CKD progression and are associated with an increased mortality in CKD patients. So far, it is unknown whether high inorganic phosphate uptake causes renal injury as well in the absence of CKD. Therefore, we analyzed the effects of a long-term high phosphate diet (HPD) on the renal function in healthy mice.
Method
We studied the effects of a 2% HPD compared to a 0.8% normal phosphate diet (NPD) fed to healthy male C57BL/6 mice. After six month, blood pressure and metabolic serum and urine parameters were measured. The renal function was characterized by histology, flow cytometry and gene expression analysis. Additionally, we investigate the effects of elevated FGF23 and phosphate on mouse proximal tubular cells (mPT) in vitro.
Results
Feeding of a HPD for 6 months significantly increased systolic blood pressure (95 vs 79 mmHg; p=0.003), plasma creatinine (0.33±0.01 vs 0.29±0.02 mg/dL; p=0.004), C-term FGF23 (1991±394 vs 309±56 pg/mL; p<0.0001), intact FGF23 (1701±429 vs 191±30 pg/mL; p<0.0001) and urinary phosphate excretion (1732±968 vs 520±123 mg/dL; p=0.0005) compared to NPD controls, whereas serum phosphate (14.3±5.3 vs 13.4±2.9 mg/dL; p=0.68) and parathyroid hormone levels (417±104 vs 544±187 pg/mL; p=0.51) remained unchanged. The HPD caused acute tubular injury in the renal cortex with loss of polarity of proximal tubular epithelial cells and enhanced renal fibrosis and inflammation demonstrated by PAS and Picrosirius red staining. These histological pathologies were associated with a 100-fold increase of KIM-1 and a 7-fold increase of NGAL mRNA expression in the kidneys of HPD mice compared to the NPD group. In HPD mice, flow cytometry analysis showed a reduced storage of Ly6Chi monocytes in the spleen, whereas Ly6Chi monocytes, granulocytes, macrophages, B-cells, and CD4+ T-cells (each p<0.05) were significantly induced in the kidney compared to NPD-fed mice. Histological staining’s displayed an accumulation of B- and T-cells in regions of tubular injury in HPD mice. Furthermore, the HPD significantly enhanced the mRNA expression of the chemotactic markers for monocytes Il34 and Ccl2 and inflammatory cytokines Tnfα and Il1β. Whether enhanced phosphaturia directly or HPD-mediated increase of intact FGF23 cause the renal toxicity is currently investigated in mPTs.
Conclusion
Chronic high phosphate load induces kidney injury in the proximal tubules with severe inflammation and fibrosis in healthy mice. Our results suggest that a controlled dietary intake of inorganic phosphate is not only important for CKD patients but also for the general population.
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Affiliation(s)
- Isabel Vogt
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Stefanie Walter
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Anna Catharina Veenstra
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Tamar Kapanadze
- Hannover Medical School, Department of Nephrology and Hypertension, Hannover, Germany
| | - Jessica Schmitz
- Hannover Medical School, Institute of Pathology, Nephropathology Unit, Hannover, Germany
| | - Jan Hinrich Bräsen
- Hannover Medical School, Institute of Pathology, Nephropathology Unit, Hannover, Germany
| | - Roland Schmitt
- Hannover Medical School, Department of Nephrology and Hypertension, Hannover, Germany
| | - Florian Limbourg
- Hannover Medical School, Department of Nephrology and Hypertension, Hannover, Germany
| | - Dieter Haffner
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
| | - Maren Leifheit-Nestler
- Hannover Medical School, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover, Germany
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41
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Schmidt A, Mächtel R, Ammon A, Engelsdorf T, Schmitz J, Maurino VG, Voll LM. Reactive oxygen species dosage in Arabidopsis chloroplasts can improve resistance towards Colletotrichum higginsianum by the induction of WRKY33. New Phytol 2020; 226:189-204. [PMID: 31749193 DOI: 10.1111/nph.16332] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/12/2019] [Indexed: 05/06/2023]
Abstract
Arabidopsis plants overexpressing glycolate oxidase in chloroplasts (GO5) and loss-of-function mutants of the major peroxisomal catalase isoform, cat2-2, produce increased hydrogen peroxide (H2 O2 ) amounts from the respective organelles when subjected to photorespiratory conditions like increased light intensity. Here, we have investigated if and how the signaling processes triggered by H2 O2 production in response to shifts in environmental conditions and the concomitant induction of indole phytoalexin biosynthesis in GO5 affect susceptibility towards the hemibiotrophic fungus Colletotrichum higginsianum. Combining histological, biochemical, and molecular assays, we found that the accumulation of the phytoalexin camalexin was comparable between GO genotypes and cat2-2 in the absence of pathogen. Compared with wild-type, GO5 showed improved resistance after light-shift-mediated production of H2 O2 , whereas cat2-2 became more susceptible and allowed significantly more pathogen entry. Unlike GO5, cat2-2 suffered from severe oxidative stress after light shifts, as indicated by glutathione pool size and oxidation state. We discuss a connection between elevated oxidative stress and dampened induction of salicylic acid mediated defense in cat2-2. Genetic analyses demonstrated that induced resistance of GO5 is dependent on WRKY33, but not on camalexin production. We propose that indole carbonyl nitriles might play a role in defense against C. higginsianum.
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Affiliation(s)
- Andree Schmidt
- Division of Biochemistry, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Staudtstraße 5, 91058, Erlangen, Germany
| | - Rebecca Mächtel
- Division of Biochemistry, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Staudtstraße 5, 91058, Erlangen, Germany
| | - Alexandra Ammon
- Division of Biochemistry, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Staudtstraße 5, 91058, Erlangen, Germany
| | - Timo Engelsdorf
- Molecular Plant Physiology, Department of Biology, Philipps-University Marburg, Karl-von-Frisch Straße 8, 35043, Marburg, Germany
| | - Jessica Schmitz
- Institute of Developmental and Molecular Biology of Plants, Heinrich-Heine-University Düsseldorf and Cluster of Excellence on Plant Sciences (CEPLAS), Universitätsstraße 1, 40225, Düsseldorf, Germany
| | - Veronica G Maurino
- Institute of Developmental and Molecular Biology of Plants, Heinrich-Heine-University Düsseldorf and Cluster of Excellence on Plant Sciences (CEPLAS), Universitätsstraße 1, 40225, Düsseldorf, Germany
| | - Lars M Voll
- Division of Biochemistry, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Staudtstraße 5, 91058, Erlangen, Germany
- Molecular Plant Physiology, Department of Biology, Philipps-University Marburg, Karl-von-Frisch Straße 8, 35043, Marburg, Germany
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42
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Yuzefovych Y, Valdivia E, Rong S, Hack F, Rother T, Schmitz J, Bräsen JH, Wedekind D, Moers C, Wenzel N, Gueler F, Blasczyk R, Figueiredo C. Genetic Engineering of the Kidney to Permanently Silence MHC Transcripts During ex vivo Organ Perfusion. Front Immunol 2020; 11:265. [PMID: 32140158 PMCID: PMC7042208 DOI: 10.3389/fimmu.2020.00265] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 09/20/2019] [Accepted: 01/31/2020] [Indexed: 12/29/2022] Open
Abstract
Organ gene therapy represents a promising tool to correct diseases or improve graft survival after transplantation. Polymorphic variation of the major histocompatibility complex (MHC) antigens remains a major obstacle to long-term graft survival after transplantation. Previously, we demonstrated that MHC-silenced cells are protected against allogeneic immune responses. We also showed the feasibility to silence MHC in the lung. Here, we aimed at the genetic engineering of the kidney toward permanent silencing of MHC antigens in a rat model. We constructed a sub-normothermic ex vivo perfusion system to deliver lentiviral vectors encoding shRNAs targeting β2-microglobulin and the class II transactivator to the kidney. In addition, the vector contained the sequence for a secreted nanoluciferase. After kidney transplantation (ktx), we detected bioluminescence in the plasma and urine of recipients of an engineered kidney during the 6 weeks of post-transplant monitoring, indicating a stable transgene expression. Remarkably, transcript levels of β2-microglobulin and the class II transactivator were decreased by 70% in kidneys expressing specific shRNAs. Kidney genetic modification did not cause additional cell death compared to control kidneys after machine perfusion. Nevertheless, cytokine secretion signatures were altered during perfusion with lentiviral vectors as revealed by an increase in the secretion of IL-10, MIP-1α, MIP-2, IP-10, and EGF and a decrease in the levels of IL-12, IL-17, MCP-1, and IFN-γ. Biodistribution assays indicate that the localization of the vector was restricted to the graft. This study shows the potential to generate immunologically invisible kidneys showing great promise to support graft survival after transplantation and may contribute to reduce the burden of immunosuppression.
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Affiliation(s)
- Yuliia Yuzefovych
- Hannover Medical School, Institute of Transfusion Medicine and Transplant Engineering, Hanover, Germany
| | - Emilio Valdivia
- Hannover Medical School, Institute of Transfusion Medicine and Transplant Engineering, Hanover, Germany
| | - Song Rong
- Department of Nephrology, Hannover Medical School, Hanover, Germany
| | - Franziska Hack
- Hannover Medical School, Institute of Transfusion Medicine and Transplant Engineering, Hanover, Germany
| | - Tamina Rother
- Hannover Medical School, Institute of Transfusion Medicine and Transplant Engineering, Hanover, Germany
| | - Jessica Schmitz
- Hannover Medical School, Institute for Pathology, Hanover, Germany
| | | | - Dirk Wedekind
- Hannover Medical School, Institute for Laboratory Animal Science, Hanover, Germany
| | - Cyril Moers
- Department of Surgery-Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Nadine Wenzel
- Hannover Medical School, Institute of Transfusion Medicine and Transplant Engineering, Hanover, Germany
| | - Faikah Gueler
- Department of Nephrology, Hannover Medical School, Hanover, Germany
| | - Rainer Blasczyk
- Hannover Medical School, Institute of Transfusion Medicine and Transplant Engineering, Hanover, Germany
| | - Constanca Figueiredo
- Hannover Medical School, Institute of Transfusion Medicine and Transplant Engineering, Hanover, Germany
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43
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Schimmel K, Jung M, Foinquinos A, José GS, Beaumont J, Bock K, Grote-Levi L, Xiao K, Bär C, Pfanne A, Just A, Zimmer K, Ngoy S, López B, Ravassa S, Samolovac S, Janssen-Peters H, Remke J, Scherf K, Dangwal S, Piccoli MT, Kleemiss F, Kreutzer FP, Kenneweg F, Leonardy J, Hobuß L, Santer L, Do QT, Geffers R, Braesen JH, Schmitz J, Brandenberger C, Müller DN, Wilck N, Kaever V, Bähre H, Batkai S, Fiedler J, Alexander KM, Wertheim BM, Fisch S, Liao R, Diez J, González A, Thum T. Natural Compound Library Screening Identifies New Molecules for the Treatment of Cardiac Fibrosis and Diastolic Dysfunction. Circulation 2020; 141:751-767. [PMID: 31948273 PMCID: PMC7050799 DOI: 10.1161/circulationaha.119.042559] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Myocardial fibrosis is a hallmark of cardiac remodeling and functionally involved in heart failure development, a leading cause of deaths worldwide. Clinically, no therapeutic strategy is available that specifically attenuates maladaptive responses of cardiac fibroblasts, the effector cells of fibrosis in the heart. Therefore, our aim was to develop novel antifibrotic therapeutics based on naturally derived substance library screens for the treatment of cardiac fibrosis. METHODS Antifibrotic drug candidates were identified by functional screening of 480 chemically diverse natural compounds in primary human cardiac fibroblasts, subsequent validation, and mechanistic in vitro and in vivo studies. Hits were analyzed for dose-dependent inhibition of proliferation of human cardiac fibroblasts, modulation of apoptosis, and extracellular matrix expression. In vitro findings were confirmed in vivo with an angiotensin II-mediated murine model of cardiac fibrosis in both preventive and therapeutic settings, as well as in the Dahl salt-sensitive rat model. To investigate the mechanism underlying the antifibrotic potential of the lead compounds, treatment-dependent changes in the noncoding RNAome in primary human cardiac fibroblasts were analyzed by RNA deep sequencing. RESULTS High-throughput natural compound library screening identified 15 substances with antiproliferative effects in human cardiac fibroblasts. Using multiple in vitro fibrosis assays and stringent selection algorithms, we identified the steroid bufalin (from Chinese toad venom) and the alkaloid lycorine (from Amaryllidaceae species) to be effective antifibrotic molecules both in vitro and in vivo, leading to improvement in diastolic function in 2 hypertension-dependent rodent models of cardiac fibrosis. Administration at effective doses did not change plasma damage markers or the morphology of kidney and liver, providing the first toxicological safety data. Using next-generation sequencing, we identified the conserved microRNA 671-5p and downstream the antifibrotic selenoprotein P1 as common effectors of the antifibrotic compounds. CONCLUSIONS We identified the molecules bufalin and lycorine as drug candidates for therapeutic applications in cardiac fibrosis and diastolic dysfunction.
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Affiliation(s)
- Katharina Schimmel
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Mira Jung
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Ariana Foinquinos
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Gorka San José
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Javier Beaumont
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Katharina Bock
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Lea Grote-Levi
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Ke Xiao
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Angelika Pfanne
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Annette Just
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Karina Zimmer
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Soeun Ngoy
- Department of Medicine, Divisions of Genetics and Cardiology (S.N., S.F., R.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Susana Ravassa
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Sabine Samolovac
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Heike Janssen-Peters
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Janet Remke
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Kristian Scherf
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany.,Cardiovascular Institute, Stanford University School of Medicine, CA (K.S., S.D., K.M.A., R.L.)
| | - Seema Dangwal
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany.,Cardiovascular Institute, Stanford University School of Medicine, CA (K.S., S.D., K.M.A., R.L.)
| | - Maria-Teresa Piccoli
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Felix Kleemiss
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Fabian Philipp Kreutzer
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Franziska Kenneweg
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Julia Leonardy
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Lisa Hobuß
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Laura Santer
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Quoc-Tuan Do
- Greenpharma SAS, Department of Chemoinformatics, Orléans, France (Q.-T.D.)
| | - Robert Geffers
- Helmholtz Centre for Infection Research, Research Group Genome Analytics, Braunschweig, Germany (R.G.)
| | - Jan Hinrich Braesen
- Institute for Pathology, Nephropathology Unit (J.H.B., J.S.), Hannover Medical School, Germany
| | - Jessica Schmitz
- Institute for Pathology, Nephropathology Unit (J.H.B., J.S.), Hannover Medical School, Germany
| | - Christina Brandenberger
- Institute of Functional and Applied Anatomy (C. Brandenberger), Hannover Medical School, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center, a cooperation of Charité-Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Germany (D.N.M., N.W.)
| | - Nicola Wilck
- Experimental and Clinical Research Center, a cooperation of Charité-Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Germany (D.N.M., N.W.).,Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Germany (N.W.)
| | - Volkhard Kaever
- Research Core Unit Metabolomics, Institute of Pharmacology (V.K., H.B.), Hannover Medical School, Germany
| | - Heike Bähre
- Research Core Unit Metabolomics, Institute of Pharmacology (V.K., H.B.), Hannover Medical School, Germany
| | - Sandor Batkai
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Jan Fiedler
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Kevin M Alexander
- Cardiovascular Institute, Stanford University School of Medicine, CA (K.S., S.D., K.M.A., R.L.)
| | - Bradley M Wertheim
- Department of Medicine, Division of Pulmonary and Critical Care Medicine (B.M.W.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sudeshna Fisch
- Department of Medicine, Divisions of Genetics and Cardiology (S.N., S.F., R.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Ronglih Liao
- Cardiovascular Institute, Stanford University School of Medicine, CA (K.S., S.D., K.M.A., R.L.).,Department of Medicine, Divisions of Genetics and Cardiology (S.N., S.F., R.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Javier Diez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,Department of Cardiology and Cardiac Surgery and Department of Nephrology, Clínica Universidad de Navarra, Pamplona, Spain (J.D.)
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany.,REBIRTH Center of Translational Regenerative Medicine (T.T.), Hannover Medical School, Germany
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Abstract
BACKGROUND To date, there is insufficient knowledge about crescentic glomerulonephritis (cGN), the most frequent immunologic cause of acute kidney injury in children. METHODS Over a period of 16 years, we retrospectively analyzed kidney biopsy results, the clinical course, and laboratory data in 60 pediatric patients diagnosed with cGN. RESULTS The underlying diseases were immune complex GN (n = 45/60, 75%), including IgA nephropathy (n = 19/45, 42%), lupus nephritis (n = 10/45, 22%), Henoch-Schoenlein purpura nephritis (n = 7/45, 16%) and post-infectious GN (n = 7/45, 16%), ANCA-associated pauci-immune GN (n = 10/60, 17%), and anti-glomerular basement-membrane GN (n = 1/60, 2%). Patient CKD stages at time of diagnosis and at a median of 362 days (range 237-425) were CKD I: n = 13/n = 29, CKD II: n = 15/n = 9, CKD III: n = 16/n = 7, CKD IV: n = 3/n = 3, CKD V: n = 13/n = 5. Course of cGN was different according to class of cGN, duration of disease from first clinical signs to diagnosis of cGN by biopsy, percentage of crescentic glomeruli, amount of tubular atrophy/interstitial fibrosis and necrosis on renal biopsy, gender, age, nephrotic syndrome, arterial hypertension, dialysis at presentation, and relapse. Forty-eight/60 children were treated with ≥ 5 (methyl-) prednisolone pulses and 53 patients received oral prednis(ol)one in combination with mycophenolate mofetil (n = 20), cyclosporine A (n = 20), and/or cyclophosphamide (n = 6), rituximab (n = 5), azathioprine (n = 2), tacrolimus (n = 1), and plasmapheresis/immunoadsorption (n = 5). CONCLUSIONS The treatment success of cGN is dependent on early diagnosis and aggressive therapy, as well as on the percentage of crescentic glomeruli on renal biopsy and on the underlying type of cGN. CsA and MMF seem to be effective alternatives to cyclophosphamide.
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Affiliation(s)
- Ulrike Mayer
- grid.10423.340000 0000 9529 9877Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Jessica Schmitz
- grid.10423.340000 0000 9529 9877Department of Pathology, Nephropathology Unit, Hannover Medical School, Hannover, Germany
| | - Jan Hinrich Bräsen
- grid.10423.340000 0000 9529 9877Department of Pathology, Nephropathology Unit, Hannover Medical School, Hannover, Germany
| | - Lars Pape
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
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45
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Miller KD, Milne P, Baker S, Barr D, Haghani A, Loo B, Matteini P, Monson KD, Perez R, Rawn T, Rosi F, Schmitz J, Summer S, Yadlapalli S. Determination of Low-Level Pesticide Residues in Soft Drinks and Sports Drinks by Liquid Chromatography with Tandem Mass Spectrometry: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/91.1.181] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A collaborative study was conducted on a method for the measurement of 11 low-level pesticide residues in soft drinks and sports drinks by liquid chromatography with tandem mass spectrometry. The pesticide residues determined in this study were alachlor, atrazine, butachlor, isoproturon, malaoxon, monocrotophos, methyl paraoxon, phorate, phorate sulfone, phorate sulfoxide, and 2,4-dichlorophenoxyacetic acid (2,4-D). Blind fortification solutions containing 3 different levels of pesticide residues were provided to 9 collaborating laboratories to create test samples at concentrations of 0, 0.1, and 0.5 g/L with a 10-fold concentration for phorate in a total of 6 matrixes (2 colas, 1 diet cola, 1 clear lemon-lime soft drink, 1 orange soft drink, and 1 sports drink). Good qualitative performance of the method was demonstrated for all pesticide residues. Reproducibility relative standard deviation (RSDR) ranged from 7 to 151 for alachlor, atrazine, butachlor, isoproturon, malaoxon, monocrotophos, methyl paraoxon, phorate, phorate sulfone, phorate sulfoxide, and 2,4-D at the 0.1 g/L level (1.0 g/L for phorate). At 0.5 g/L (5.0 g/L for phorate), RSDR ranged from 9 to 57 for alachlor, atrazine, butachlor isoproturon, malaoxon, monocrotophos, methyl paraoxon, phorate, phorate sulfone, phorate sulfoxide, and 2,4-D in all matrixes. Repeatability relative standard deviation (RSDr), applicable to the diet cola and sports drink, ranged from 0 to 124 for the 11 pesticide residues at the 0.1 g/L level (1.0 g/L for phorate). At 0.5 g/L (5.0 g/L for phorate), RSDr ranged from 4 to 26. Recoveries for the 11 pesticide residues in all matrixes ranged from 84 to 300 at the 0.1 g/L level (1.0 g/L for phorate) and from 66 to 127 at the 0.5 g/L (5.0 g/L for phorate) level. Coefficients of determination (r2) of the matrix-matched calibration curves were 0.95. It is recommended that the method be accepted by AOAC as Official First Action with a limit of quantification of 0.5 g/L for alachlor, atrazine, butachlor, isoproturon, malaoxon, methyl paraoxon, monocrotophos, phorate sulfone, phorate sulfoxide, and 2,4-D and 5.0 g/L for phorate.
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Affiliation(s)
| | - Paul Milne
- PepsiCo Inc, 100 Stevens Ave, Valhalla, NY 10595
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46
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Egelkamp J, Chichelnitskiy E, Kühne JF, Wandrer F, Daemen K, Keil J, Bräsen JH, Schmitz J, Bellmàs-Sanz R, Iordanidis S, Katsirntaki K, Hake K, Akhdar A, Neudörfl C, Haller H, Blume C, Falk CS. Back signaling of HLA class I molecules and T/NK cell receptor ligands in epithelial cells reflects the rejection-specific microenvironment in renal allograft biopsies. Am J Transplant 2019; 19:2692-2704. [PMID: 31062482 DOI: 10.1111/ajt.15417] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 10/25/2018] [Revised: 03/29/2019] [Accepted: 04/18/2019] [Indexed: 01/25/2023]
Abstract
The role of endothelial cells in the pathophysiology of antibody-mediated rejection after renal transplantation has been widely investigated. We expand this scenario to the impact of epithelial cells on the microenvironment during rejection. Primary proximal tubular epithelial cells were stimulated via HLA class I, CD155 and CD166 based on their potential signal-transducing capacity to mediate back signaling after encounter with either T/NK cells or donor-specific antibodies. Upon crosslinking of these ligands with mAbs, PTEC secreted IL-6, CXCL1,8,10, CCL2, and sICAM-1. These proteins were also released by PTEC as consequence of a direct interaction with T/NK cells. Downmodulation of the receptor CD226 on effector cells confirmed the involvement of this receptor/ligand pair in back signaling. In vivo, CD155 and CD166 expression was detectable in proximal and distal tubuli of renal transplant biopsies, respectively. The composition of the protein microenvironment in these biopsies showed a substantial overlap with the PTEC response. Cluster and principal component analyses of the microenvironment separated unsuspicious from rejection biopsies and, furthermore, ABMR, TCMR, and borderline rejection. In conclusion, our results provide evidence that epithelial cells may contribute to the rejection process and pave the way to a better understanding of the pathomechanisms of kidney allograft rejection.
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Affiliation(s)
- Johanna Egelkamp
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | | | - Jenny F Kühne
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Franziska Wandrer
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Kerstin Daemen
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Jana Keil
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Ramon Bellmàs-Sanz
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Susanne Iordanidis
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | | | - Kevin Hake
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Ali Akhdar
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Christine Neudörfl
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Hermann Haller
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Cornelia Blume
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.,Institute of Technical Chemistry, Leibniz University Hannover, Hannover, Germany
| | - Christine S Falk
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany.,DZIF, German Center for Infection Research, TTU-IICH, Hannover/Braunschweig, Germany
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47
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Volkmann J, Schmitz J, Nordlohne J, Dong L, Helmke A, Sen P, Immenschuh S, Bernhardt WM, Gwinner W, Bräsen JH, Schmitt R, Haller H, von Vietinghoff S. Kidney injury enhances renal G-CSF expression and modulates granulopoiesis and human neutrophil CD177 in vivo. Clin Exp Immunol 2019; 199:97-108. [PMID: 31509227 PMCID: PMC6904607 DOI: 10.1111/cei.13372] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2019] [Indexed: 12/25/2022] Open
Abstract
Kidney injury significantly increases overall mortality. Neutrophilic granulocytes (neutrophils) are the most abundant human blood leukocytes. They are characterized by a high turnover rate, chiefly controlled by granulocyte colony stimulating factor (G‐CSF). The role of kidney injury and uremia in regulation of granulopoiesis has not been reported. Kidney transplantation, which inherently causes ischemia–reperfusion injury of the graft, elevated human neutrophil expression of the surface glycoprotein CD177. CD177 is among the most G‐CSF‐responsive neutrophil genes and reversibly increased on neutrophils of healthy donors who received recombinant G‐CSF. In kidney graft recipients, a transient rise in neutrophil CD177 correlated with renal tubular epithelial G‐CSF expression. In contrast, CD177 was unaltered in patients with chronic renal impairment and independent of renal replacement therapy. Under controlled conditions of experimental ischemia–reperfusion and unilateral ureteral obstruction injuries in mice, renal G‐CSF mRNA and protein expression significantly increased and systemic neutrophilia developed. Human renal tubular epithelial cell G‐CSF expression was promoted by hypoxia and proinflammatory cytokine interleukin 17A in vitro. Clinically, recipients of ABO blood group‐incompatible kidney grafts developed a larger rise in neutrophil CD177. Their grafts are characterized by complement C4d deposition on the renal endothelium, even in the absence of rejection. Indeed, complement activation, but not hypoxia, induced primary human endothelial cell G‐CSF expression. Our data demonstrate that kidney injury induces renal G‐CSF expression and modulates granulopoiesis. They delineate differential G‐CSF regulation in renal epithelium and endothelium. Altered granulopoiesis may contribute to the systemic impact of kidney injury.
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Affiliation(s)
- J Volkmann
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - J Schmitz
- Department of Pathology, Hannover Medical School, Hannover, Germany
| | - J Nordlohne
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - L Dong
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - A Helmke
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - P Sen
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - S Immenschuh
- Department of Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - W M Bernhardt
- Clinic for Hypertension, Kidney- and Metabolic Diseases Hannover, Hannover, Germany
| | - W Gwinner
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - J H Bräsen
- Department of Pathology, Hannover Medical School, Hannover, Germany
| | - R Schmitt
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - H Haller
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - S von Vietinghoff
- Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
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48
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Moerke C, Jaco I, Dewitz C, Müller T, Jacobsen AV, Gautheron J, Fritsch J, Schmitz J, Bräsen JH, Günther C, Murphy JM, Kunzendorf U, Meier P, Krautwald S. The anticonvulsive Phenhydan ® suppresses extrinsic cell death. Cell Death Differ 2019; 26:1631-1645. [PMID: 30442947 PMCID: PMC6748113 DOI: 10.1038/s41418-018-0232-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/30/2018] [Accepted: 10/30/2018] [Indexed: 12/27/2022] Open
Abstract
Different forms of regulated cell death-like apoptosis and necroptosis contribute to the pathophysiology of clinical conditions including ischemia-reperfusion injury, myocardial infarction, sepsis, and multiple sclerosis. In particular, the kinase activity of the receptor-interacting serine/threonine protein kinase 1 (RIPK1) is crucial for cell fate in inflammation and cell death. However, despite its involvement in pathological conditions, no pharmacologic inhibitor of RIPK1-mediated cell death is currently in clinical use. Herein, we screened a collection of clinical compounds to assess their ability to modulate RIPK1-mediated cell death. Our small-scale screen identified the anti-epilepsy drug Phenhydan® as a potent inhibitor of death receptor-induced necroptosis and apoptosis. Accordingly, Phenhydan® blocked activation of necrosome formation/activation as well as death receptor-induced NF-κB signaling by influencing the membrane function of cells, such as lipid raft formation, thus exerting an inhibitory effect on pathophysiologic cell death processes. By targeting death receptor signaling, the already FDA-approved Phenhydan® may provide new therapeutic strategies for inflammation-driven diseases caused by aberrant cell death.
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Affiliation(s)
- Caroline Moerke
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, 24105, Kiel, Germany
| | - Isabel Jaco
- Toby Robins Research Centre, Institute of Cancer Research, London, SW3 6JB, UK
| | - Christin Dewitz
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, 24105, Kiel, Germany
| | - Tammo Müller
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, 24105, Kiel, Germany
| | - Annette V Jacobsen
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Jérémie Gautheron
- Université Pierre et Marie Curie, UMR_S 938, Inserm, 75012, Paris, France
| | - Jürgen Fritsch
- Institute for Clinical Microbiology and Hygiene, University of Regensburg, 93053, Regensburg, Germany
| | - Jessica Schmitz
- Department of Pathology, University of Hannover, 30625, Hannover, Germany
| | - Jan Hinrich Bräsen
- Department of Pathology, University of Hannover, 30625, Hannover, Germany
| | - Claudia Günther
- Department of Medicine 1, Friedrich-Alexander-University, 91052, Erlangen, Germany
| | - James M Murphy
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Ulrich Kunzendorf
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, 24105, Kiel, Germany
| | - Pascal Meier
- Toby Robins Research Centre, Institute of Cancer Research, London, SW3 6JB, UK
| | - Stefan Krautwald
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, 24105, Kiel, Germany.
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49
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Schmitz J, Stepan H, Schrey-Petersen S, Hoffmann J. [Does Lower Uterine Segment Thickness Measurement Improve Birth Planning After Previous Cesarean Section?]. Z Geburtshilfe Neonatol 2019; 223:350-358. [PMID: 31163458 DOI: 10.1055/a-0828-8774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Lower uterine segment (LUS) thickness measurement is frequently used to select patients for trial of labor after a previous cesarean section (TOLAC). To date no significant benefit of LUS measurement has ever been proven, and no standard protocol or clear cut-off value exists. The aim of this study was to evaluate the benefit of LUS measurement in a daily routine setting. MATERIAL AND METHODS In this retrospective study, we evaluated 631 pregnancies after previous cesarean section (CS). Ultrasound measurements of myometrial (mLUS) and/or full LUS (fLUS) thickness were performed in 399 (63%) patients. The incidence, time, and mode of detection of uterine defects were studied. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were calculated for different cut-off values of LUS thickness. RESULTS Uterine defects were diagnosed in 28 (4.4%) patients. Detection rate of ultrasound was low (13.6%), with better sensitivity, specificity, PPV, and NPV at lower (2 mm (fLUS) / 1 mm (mLUS): 75/96/48.3/98.7%) than at higher cut-off values (3 mm (fLUS) / 2 mm (mLUS): 15.8/93.2/10.4/68.7%). DISCUSSION The benefit of LUS thickness measurement appears overestimated. As a large number of methodological factors trigger inaccuracy, a consistent protocol including both a transabdominal and a transvaginal scan performed by a trained examiner might improve accuracy. Exclusion of uterine defects might be more useful for prenatal selection after CS.
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Affiliation(s)
- Jessica Schmitz
- Zentrum für Kinder- und Jugendmedizin, Helios Universitätsklinikum Wuppertal - Universität Witten/Herdecke, Wuppertal
| | - Holger Stepan
- Abteilung für Geburtsmedizin, Universitätsfrauenklinik Leipzig, Leipzig
| | | | - Janine Hoffmann
- Abteilung für Geburtsmedizin, Universitätsfrauenklinik Leipzig, Leipzig
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50
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Person F, Rinschen MM, Brix SR, Wulf S, Noriega MDLM, Fehrle W, Schmitz J, Schwarz A, Ivanyi P, Steinmetz OM, Reinhard L, Hoxha E, Zipfel PF, Bräsen JH, Wiech T. Bevacizumab-associated glomerular microangiopathy. Mod Pathol 2019; 32:684-700. [PMID: 30552416 DOI: 10.1038/s41379-018-0186-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 11/09/2022]
Abstract
Bevacizumab is a humanized monoclonal IgG1 antibody, which neutralizes vascular endothelial growth factor and is used for treating multiple cancer types. As a known and frequent adverse event, this therapy can lead to renal damage including proteinuria and nephrotic syndrome. In a retrospective approach, we analyzed 17 renal biopsies from patients receiving bevacizumab treatment. We observed a distinctive histopathological pseudothrombotic pattern different from the previously reported thrombotic microangiopathy. Since this pattern includes some features similar to acute and chronic thrombotic microangiopathy, focal segmental glomerulosclerosis and cryoglobulinemic membranoproliferative glomerulonephritis, biopsies with these diagnoses were included for comparison. Clinical, laboratory, light microscopic, immunohistochemical (including a proximity ligation assay), proteomic and electron microscopic features were assessed. Nephrotic syndrome was present in 15 of the 17 bevacizumab-treated patients. All 17 displayed a patchy pattern of variably PAS-positive hyaline pseudothrombi occluding markedly dilated glomerular capillaries in their biopsies. Mass spectrometry-based proteome analysis revealed a special protein pattern demonstrating some features of thrombotic microangiopathy and some of cryoglobulinemic glomerulonephritis, including a strong accumulation of IgG in the pseudothrombi. Proximity ligation assay did not show interaction of IgG with C1q, arguing for accumulation without classic pathway complement activation. In contrast to thrombi in thrombotic microangiopathy cases, the hyaline pseudothrombi did not contain clusters of CD61-positive platelets. Electron microscopy of bevacizumab cases did not show fibrin polymers or extensive loss of podocyte foot processes. Even though cases of bevacizumab-associated microangiopathy share some features with thrombotic microangiopathy, its overall histopathological pattern is quite different from acute or chronic thrombotic microangiopathy cases. We conclude that bevacizumab therapy can lead to a unique hyaline occlusive glomerular microangiopathy, likely arising from endothelial leakage followed by subendothelial accumulation of serum proteins. It can be diagnosed by light microscopy and is an important differential diagnosis in cancer patients with nephrotic syndrome.
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Affiliation(s)
- Fermin Person
- Institute of Pathology and Nephropathology Section, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Markus M Rinschen
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Silke R Brix
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sonia Wulf
- Institute of Pathology and Nephropathology Section, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | | | - Wilfried Fehrle
- Institute of Pathology and Nephropathology Section, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Anke Schwarz
- Clinic for Nephrology, Hannover Medical School, Hannover, Germany
| | - Philipp Ivanyi
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Oliver M Steinmetz
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Linda Reinhard
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elion Hoxha
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter F Zipfel
- Leibniz Institute for Natural Product Research and Infection Biology, Jena, Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Thorsten Wiech
- Institute of Pathology and Nephropathology Section, University Hospital Hamburg Eppendorf, Hamburg, Germany.
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