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Sutton KA, He M, Ma C, Liu TC, Faubion WA, Hoffmann J, Linneman L, Rodriguez C, Holtz LR. Non-Invasive Markers of Inflammation and Protein Loss Augment Diagnosis of Pediatric Celiac Disease. Clin Transl Gastroenterol 2024:01720094-990000000-00242. [PMID: 38483287 DOI: 10.14309/ctg.0000000000000695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Circulating tissue transglutaminase IgA (TTG IgA) concentration is a sensitive and specific indicator of celiac disease, but discrepancies between serologic and histologic findings occur. We hypothesized that fecal markers of inflammation and protein loss would be greater in patients with untreated celiac disease than in healthy controls. Our study aims to evaluate multiple fecal and plasma markers in celiac disease and correlate these findings with serologic and histologic findings as non-invasive means of evaluating disease activity. METHODS Participants with positive celiac serologies and controls with negative celiac serologies were prospectively enrolled prior to upper endoscopy. Blood, stool and duodenal biopsies were collected. Concentrations of fecal lipocalin-2, calprotectin and alpha-1-antitrypsin and plasma lipocalin-2 were determined. Biopsies underwent modified Marsh scoring. Significance was tested between cases and controls, modified Marsh score and TTG IgA concentration. RESULTS Lipocalin-2 was significantly elevated in the stool (p=0.007) but not the plasma of participants with positive celiac serologies. There was no significant difference in fecal calprotectin or alpha-1 antitrypsin between participants with positive celiac serologies and controls. Fecal alpha-1 antitrypsin >100mg/dL was specific, but not sensitive for biopsy proven celiac disease. CONCLUSIONS Lipocalin-2 is elevated in the stool but not the plasma of patients with celiac disease suggesting a role of local inflammatory response. Calprotectin was not a useful marker in the diagnosis of celiac disease. While random fecal alpha-1 antitrypsin was not significantly elevated in cases compared to controls, an elevation of greater than 100mg/dL was 90% specific for biopsy proven celiac disease.
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Affiliation(s)
- Kimberly A Sutton
- Washington University School of Medicine, Department of Pediatrics, St. Louis, MO
| | - Mai He
- Washington University School of Medicine, Department of Pathology & Immunology, St. Louis, MO
| | - Changqing Ma
- Washington University School of Medicine, Department of Pathology & Immunology, St. Louis, MO
| | - Ta-Chiang Liu
- Washington University School of Medicine, Department of Pathology & Immunology, St. Louis, MO
| | | | - Julie Hoffmann
- Washington University School of Medicine, Department of Pediatrics, St. Louis, MO
| | - Laura Linneman
- Washington University School of Medicine, Department of Pediatrics, St. Louis, MO
| | - Cynthia Rodriguez
- Washington University School of Medicine, Department of Pediatrics, St. Louis, MO
| | - Lori R Holtz
- Washington University School of Medicine, Department of Pediatrics, St. Louis, MO
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Buschert V, Leicher B, Rogl C, Hoffmann J, Blum AL, Scherbaum N, Benninghoff J. [Acceptance of psychosocial bridging measures in dementia : Treatment observation during the COVID-19 pandemic]. Z Gerontol Geriatr 2023; 56:573-579. [PMID: 36205776 PMCID: PMC9540087 DOI: 10.1007/s00391-022-02115-6] [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: 11/09/2021] [Accepted: 08/30/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND In the event of a COVID-19-related absence from an outpatient treatment program, patients suffering from dementia and their caregivers were offered support from a distance. The aim was to examine the extent of the participants' burden as well as how the offer was accepted and evaluated. MATERIAL AND METHODS All participants (n = 63) were offered supportive telephone contact over a period of 8 weeks at varying frequencies (weekly, fortnightly). In addition patients received cognitive and physical tasks by mail every 2 weeks. In order to examine the acceptance of the support, data collected from clinical routine were included in a treatment observation. Additionally, all participants were asked to evaluate the support retrospectively. RESULTS Out of 63 contacted participants, 45 were included in the treatment observation. The telephone support was very well accepted and a tendency towards higher agreement could be ascertained by caregivers. The experience of burden remained stable at a moderate level for all participants; however, caregivers were significantly more burdened. CONCLUSION The present treatment observation shows the acceptance of a location-independent psychosocial treatment program for dementia for future pandemics or treatment failure as well as for the routine care, e.g. for patients with restricted mobility or those living in rural areas without direct hospital connection. In particular, our data strengthen the importance of programs for caregivers in order to alleviate their burden.
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Affiliation(s)
- V Buschert
- Zentrum für Altersmedizin und Entwicklungsstörungen, kbo-Isar-Amper-Klinikum München-Ost, Ringstr. 52, 85540, Haar, Deutschland
| | - B Leicher
- Zentrum für Altersmedizin und Entwicklungsstörungen, kbo-Isar-Amper-Klinikum München-Ost, Ringstr. 52, 85540, Haar, Deutschland
| | - C Rogl
- Zentrum für Altersmedizin und Entwicklungsstörungen, kbo-Isar-Amper-Klinikum München-Ost, Ringstr. 52, 85540, Haar, Deutschland
| | - J Hoffmann
- Zentrum für Altersmedizin und Entwicklungsstörungen, kbo-Isar-Amper-Klinikum München-Ost, Ringstr. 52, 85540, Haar, Deutschland
| | - A-L Blum
- Zentrum für Altersmedizin und Entwicklungsstörungen, kbo-Isar-Amper-Klinikum München-Ost, Ringstr. 52, 85540, Haar, Deutschland
| | - N Scherbaum
- Klinik für Psychiatrie und Psychotherapie, LVR-Klinikum Essen, Kliniken und Institut der Universität Duisburg-Essen, Wickenburgstraße 21, 45147, Essen, Deutschland
| | - J Benninghoff
- Zentrum für Altersmedizin und Entwicklungsstörungen, kbo-Isar-Amper-Klinikum München-Ost, Ringstr. 52, 85540, Haar, Deutschland.
- Klinik für Psychiatrie und Psychotherapie, LVR-Klinikum Essen, Kliniken und Institut der Universität Duisburg-Essen, Wickenburgstraße 21, 45147, Essen, Deutschland.
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Matsumoto M, DePietro D, Shamimi-Noori S, Hoffmann J, Gade T, Reddy S, Nadolski G. Abstract No. 103 Changes in the Match: Results of an IR Applicant and Program Director Survey Regarding Virtual Interviews and Step 1 Pass/Fail. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.152] [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: 02/26/2023] Open
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Matsumoto M, DePietro D, Shamimi-Noori S, Hoffmann J, Gade T, Reddy S, Nadolski G. Abstract No. 109 Integrated IR Residency: Perspectives of Applicants and Program Directors from the 2022 Match. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.158] [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: 02/26/2023] Open
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5
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Hoffmann J, Scholten N, Dresbach T. Factors associated with the closure of German obstetric units and its effects on accessibility. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.424] [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
An increase in regionalization of obstetric services is being observed worldwide. This study investigated factors associated with the closure of obstetric units in hospitals in Germany and aimed to examine the effect of obstetric unit closure on accessibility of obstetric care.
Methods
Secondary data of all German hospital sites with an obstetrics department were analyzed for 2014 and 2019. Multivariate logistic regression was performed to identify factors associated with obstetrics department closure. Subsequently, the driving times to a hospital site with an obstetrics department were mapped, and different scenarios resulting from further regionalization were modelled.
Results
Of 747 hospital sites with an obstetrics department in 2014, 85 obstetrics departments closed down by 2019. Only the annual number of live births was observed to be a factor significantly associated with the closure of obstetrics departments (odds ratio: 0·995; confidence interval: 0.993-0.997). Areas in which driving times to the next hospital site with an obstetrics department exceeded the 30 and 40 min threshold increased from 2014 to 2019. Scenarios in which only hospital sites with a pediatrics department or hospital sites with an annual birth volume of ≥ 600 were considered resulted in large areas in which the driving times would exceed the 30 and 40 min threshold.
Conclusions
The annual number of live births is a factor significantly associated with the closure of obstetrics departments. Despite the closure, good accessibility is maintained for most areas in Germany. Although further regionalization may ensure high-quality care and efficiency, it will have an impact on accessibility.
Key messages
• Despite the closure of many obstetric departments, regional accessibility to obstetric care remains good for most areas in Germany.
• Further regionalization may ensure high-quality care and efficiency but will have an impact on accessibility.
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Affiliation(s)
- J Hoffmann
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science, University of Cologne , Köln, Germany
| | - N Scholten
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science, University of Cologne , Köln, Germany
| | - T Dresbach
- Department of Neonatology and Pediatric Intensive Care Medicine, University Hospital Bonn , Bonn, Germany
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Reimer A, Mause L, Hoffmann J, Hagemeier A, Scholten N. A German study on the impact of stress on interparental relationship strain after preterm birth. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.204] [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
Relationship satisfaction is an important predictor of well-being. Few studies address the effects of stress on interparental relationships of parents with preterm infants. However, the experience of a preterm birth represents an extreme, stressful event and therefore may place a strain on a relationship. Our aim is to examine the impact of postnatal stress on maternal and paternal perceptions of relationship strain.
Methods
As part of the Neo-CamCare project, a retrospective cross-sectional study was conducted targeting parents with infants with a birth weight below 1,500 g. Linear regression was used to analyse the influence of stress on relationship strain.
Results
437 mothers and 301 fathers participated. Data indicate that interparental relationship strain experienced by fathers (M = 2.61, SD = 1.46) is lower than strain experienced by mothers (M = 3.43, SD = 1.7). The stress level due to the infant's behaviour and appearance is lower in fathers (M = 2.53, SD = 0.95) than in mothers (M = 2.98, SD = 1.05). Stress due to parental role change is higher in mothers (M = 3.37, p = 1.04) than in fathers (M = 2.49, SD = 0.99). Regression analyses show that stress due to behaviour and appearance, as well as parental role change, can be associated with relationship strain in mothers. For fathers, only stress experienced due to the behaviour and appearance can be associated with relationship strain, whereas parental role change is not significant.
Conclusions
Our data illustrate that relationship strain can result from stress in mothers and fathers, indicating the need for stress prevention measures for both. Only mothers show relationship strain due to stress in their parental role. Although it is unclear what mechanisms underlie these findings, we assume that the maternal role is still primarily associated with child care. One way to relieve maternal stress could be to increase psychological support and the promotion paternal involvement in the postnatal period.
Key messages
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Affiliation(s)
- A Reimer
- IMVR, University Hospital Cologne , Cologne, Germany
| | - L Mause
- IMVR, University Hospital Cologne , Cologne, Germany
| | - J Hoffmann
- IMVR, University Hospital Cologne , Cologne, Germany
| | - A Hagemeier
- IMSB, University of Cologne , Cologne, Germany
| | - N Scholten
- IMVR, University Hospital Cologne , Cologne, Germany
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Merten M, Rasper T, Cremer S, Schuhmacher B, Tombor L, Zeiher AM, Hoffmann J, Abplanalp WT, Dimmeler S. Human, mouse scRNA-seq and flow cytometry data in ischemic heart failure models predict immune cell activation signatures with altered endothelial cell cross talk. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2965] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Chronic ischemic Heart Failure (HF) with reduced ejection fraction is marked by adverse remodelling and sustained inflammation. The effects of monocytes and T cells in early state immune responses after myocardial infarction are known, to date their role in progression and maintenance of chronic HF remains elusive.
Single cell RNA sequencing of peripheral immune cells from healthy and HF donors revealed a significant increase of the antigen presentation (i.e. HLA-DRB5) and co-stimulatory molecules (i.e. ICAM-1) on monocytes, while the elevation of the T effector memory population in HF patients shows enhanced T cell activation. Subsequent flow cytometry validation in 55 healthy and 110 HF patients confirmed that HF derived monocytes have elevated levels of HLA-DRB5 predicts increased ICAM-1 and TREM-1 (p<0.0001 for both), indicating enhanced T cell activation capacity. In addition, the activated fraction of both CD4+ and CD8+ T cells, including central memory, effector memory and TEMRA cells, is significantly enriched in the HF patients (p<0.0001 for both) with reduction of the naïve T cells. T cell receptor (TCR) sequencing of age matched healthy and HF donors showed an increase in the relative TCR clonality in HF patients, indicating an expansion of the circulating T cells.
ScRNA-seq murine myocardial infarction (MI) time course data (day (d) 0/1/3/7/14/28/48 post-MI), found a progressive increase in Th17 cells and activated CD8+ T cells in the cardiac tissue at d48 (2.8x-, and 2.7x-fold, respectively) relative to d0. The T cell imbalance was marked by loss of immunosuppressive markers such as Lef1 (p=2e-30) in T cell clusters primarily populated by d48 relative to d0.
Mechanistically the downstream effects of the immune cell activation were analysed in the serum of HF patients, where increased levels of sICAM-1, IL-6 and TNFRI levels (1.75x-, 5.30x-, 2.63x-fold, respectively) could be detected. Furthermore, treatment of endothelial cells with the conditioning media from HF-immune cells induced capability to adhere with monocytes in a co-culture system but also decreased the checkpoint inhibitor molecule PD-L1, a known blocker of autoreactive T cells.
These data link HF with enhanced monocyte and T cell activation as well as T cell clonal expansion, along with increased T cell numbers in mouse hearts post-MI. These data suggest HF is may drive impaired resolution of inflammation in cardiac tissue and facilitate adverse remodelling and cardiac damage. Further studies will assess the specific role of chronic monocyte and T cell activation in the progression of heart failure.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): DFG -Deutsche ForschungsgemeinschaftDZHK -Deutsches Zentrum für Herzkreislauferkrankungen
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Affiliation(s)
- M Merten
- Institute of Cardiovascular Regeneration , Frankfurt am Main , Germany
| | - T Rasper
- Institute of Cardiovascular Regeneration , Frankfurt am Main , Germany
| | - S Cremer
- Cardiology, Universitätsklinikum, Goethe University Frankfurt , Frankfurt am Main , Germany
| | - B Schuhmacher
- Institute of Cardiovascular Regeneration , Frankfurt am Main , Germany
| | - L Tombor
- Institute of Cardiovascular Regeneration , Frankfurt am Main , Germany
| | - A M Zeiher
- Cardiology, Universitätsklinikum, Goethe University Frankfurt , Frankfurt am Main , Germany
| | - J Hoffmann
- Cardiology, Universitätsklinikum, Goethe University Frankfurt , Frankfurt am Main , Germany
| | - W T Abplanalp
- Institute of Cardiovascular Regeneration , Frankfurt am Main , Germany
| | - S Dimmeler
- Institute of Cardiovascular Regeneration , Frankfurt am Main , Germany
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8
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Stecklum M, Brzezicha B, Rhein S, Walther W, Hoffmann J. Humanized mouse models for preclinical evaluation of novel immune therapies, checkpoint inhibitors and immune cell engagers. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00833-4] [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: 11/29/2022]
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9
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Brzezicha B, Becker M, Stecklum M, Conrad T, Janz M, Bittner A, Schmitt C, Hoffmann J. New patient derived lymphoma xenograft (PDX) panel for drug development, immuno-oncology and translational research. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00910-8] [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: 11/03/2022]
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10
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Holtz LR, Hoffmann J, Linneman L, He M, Smyrk TC, Liu TC, Shaikh N, Rodriguez C, Dyer RB, Singh RJ, Faubion WA. Rhamnose Is Superior to Mannitol as a Monosaccharide in the Dual Sugar Absorption Test: A Prospective Randomized Study in Children With Treatment-Naïve Celiac Disease. Front Pediatr 2022; 10:874116. [PMID: 35463906 PMCID: PMC9021878 DOI: 10.3389/fped.2022.874116] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIM We sought to correlate two different measures of gut permeability [lactulose:mannitol (L:M) and lactulose:rhamnose (L:R)] to the severity of duodenal histopathology in children with and without elevated antibodies to tissue transglutaminase (tTG). A secondary objective was to correlate gut permeability with celiac disease (CD) serology and indices of inflammation and bacterial product translocation. METHODS We prospectively randomized children undergoing endoscopy with abnormal (n = 54) and normal (n = 10) concentrations of circulating antibodies to tTG, to either L:M or L:R. Biopsies underwent modified Marsh scoring to measure mucosal injury. Circulating anticore Escherichia coli lipopolysaccharide (LPS) IgG, α-1 acid glycoprotein, LPS-binding protein, and C-reactive protein concentrations were measured by enzyme immunoassays. RESULTS Of the 54 cases with positive celiac serology, 31 and 69% had modified Marsh 0/1 scores or ≥3a, respectively. Circulating tTG IgA correlated with the modified Marsh score (p = 0.03). L:R, but not L:M or percent L excreted, differed according to modified Marsh scores (p = 0.01). There was no significant association between any systemic marker of inflammation or gut injury, and modified Marsh scores. Concerningly, most participants had evidence of urinary M before the challenge sugar was administered. CONCLUSIONS L:R, but not L:M, is associated with modified Marsh scores in children undergoing small bowel biopsy for suspected CD. Despite increased intestinal permeability, we see scant evidence of systemic exposure to gut microbes in these children. Gut permeability testing with L:R may predict which patients with abnormal celiac serology will have biopsy evidence for celiac disease and reduce the proportion of such patients undergoing endoscopy whose Marsh scores are ≤1. M should not be used as a monosaccharide for permeability testing in children.
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Affiliation(s)
- Lori R Holtz
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Julie Hoffmann
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Laura Linneman
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Mai He
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Thomas C Smyrk
- Department of Lab Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Ta-Chiang Liu
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Nurmohammad Shaikh
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Cynthia Rodriguez
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Roy B Dyer
- Immunochemical Core Laboratory, Mayo Clinic, Rochester, MN, United States
| | - Ravinder J Singh
- Department of Lab Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.,Immunochemical Core Laboratory, Mayo Clinic, Rochester, MN, United States
| | - William A Faubion
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
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11
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Brokus C, Kattakuzhy S, Gayle B, Narayanan S, Davis A, Cover A, Eyasu R, Ebah E, Ogbumbadiugha-Weekes O, Hoffmann J, Silk R, Stevens J, Mount J, Gannon C, Nussdorf L, Mathur P, Bijole P, Jones M, Kier R, Sternberg D, Greenblatt A, Weintraub E, Masur H, Kottilil S, Rosenthal E. Suboptimal uptake, retention, and adherence of daily oral PrEP among people with OUD receiving HCV treatment. Open Forum Infect Dis 2021; 9:ofab658. [PMID: 35187191 PMCID: PMC8849288 DOI: 10.1093/ofid/ofab658] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background Daily oral preexposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) prevents human immunodeficiency (HIV) among people who inject drugs (PWID). Despite rising HIV incidence and injection drug use (IDU), PrEP use remains low and there is limited research about uptake, adherence, and retention among PWID. Methods The ANCHOR investigation evaluated a community-based care model collocating hepatitis C virus (HCV) treatment, medication for opioid use disorder (OUD), and PrEP in individuals in Washington, DC, and Baltimore, Maryland. PrEP counseling was conducted from HCV treatment day 0 until week 24. Subjects could start any time during this window, were followed for 48 weeks, and were assessed for adherence by self-report and dried blood spot TDF analysis. Results One hundred ninety-eight participants were enrolled, of whom 185 (93%) were HIV negative. Twenty-nine individuals (15.7% of HIV-negative cohort) initiated PrEP. One hundred sixteen participants (62.7%) met 2014 Centers for Disease Control and Prevention (CDC) PrEP criteria due to IDU (82 [44.3%]), sex (9 [4.9%]), or both practices (25 [13.5%]). Providers recommended PrEP to 94 individuals (50.8%), and recommendation was associated with PrEP uptake. Median treatment duration was 104 days (interquartile range, 28–276 days), with 8 participants retained through week 48. Adherence was variable over time by self-report and declined by TDF analysis. No HIV seroconversions occurred. Conclusions This cohort of people with HCV and OUD experienced low uptake of PrEP despite the majority meeting CDC criteria. High rates of disruption and discontinuation, compounded by variable adherence, made TDF/FTC a suboptimal prevention strategy. Emerging modalities like long-acting formulations may address these barriers, but PWID have been excluded from their development to date.
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Affiliation(s)
- C Brokus
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - S Kattakuzhy
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - B Gayle
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - S Narayanan
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - A Davis
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - A Cover
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - R Eyasu
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - E Ebah
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - O Ogbumbadiugha-Weekes
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - J Hoffmann
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - R Silk
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - J Stevens
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - J Mount
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - C Gannon
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - L Nussdorf
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
| | - P Mathur
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - P Bijole
- HIPS, org, Washington, DC, United States
| | - M Jones
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - R Kier
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - D Sternberg
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - A Greenblatt
- Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - E Weintraub
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - H Masur
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - S Kottilil
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - E Rosenthal
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
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12
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Stöcker A, Demirer I, Gunkel S, Hoffmann J, Mause L, Ohnhäuser T, Scholten N. Predictors of perceived pandemic preparedness among general practitioners. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.470] [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
General practitioners (GPs) are essential for providing and maintaining health care during a pandemic. Pandemic preparedness (PP) of GPs can play a vital role in their management of a pandemic situation. This study aimed to examine the association stockpiled personal protective equipment (PPE) and knowledge of pandemic plans on perceived PP among German GPs. This analysis is part of the research project COVID-GAMS (Funding code: 01KI2099).
Methods
Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March-April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age.
Results
508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP across all models; the association of the knowledge of a pandemic plan was significant but considerably smaller. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP.
Conclusions
An adequate stockpile of PPE is essential for perceived pandemic preparedness among GPs. Pandemic plans are considered less important for GPs. General practitioners, health authorities, and policy makers should focus on stockpiling PPE for future pandemic emergencies.
Key messages
Sufficient stockpiled personal protective equipment is the most important factor influencing pandemic preparedness of general practitioners in Germany. Knowledge on a pandemic plan has a subordinate effect on pandemic preparedness of general practitioners; usefulness of a pandemic plan does not have a significant effect.
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Affiliation(s)
- A Stöcker
- Faculty of Human Sciences, IMVR, University of Cologne, Cologne, Germany
- Faculty of Medicine, IMVR, University Hospital Cologne, Cologne, Germany
| | - I Demirer
- Faculty of Human Sciences, IMVR, University of Cologne, Cologne, Germany
- Faculty of Medicine, IMVR, University Hospital Cologne, Cologne, Germany
| | - S Gunkel
- Faculty of Human Sciences, IMVR, University of Cologne, Cologne, Germany
- Faculty of Medicine, IMVR, University Hospital Cologne, Cologne, Germany
| | - J Hoffmann
- Faculty of Human Sciences, IMVR, University of Cologne, Cologne, Germany
- Faculty of Medicine, IMVR, University Hospital Cologne, Cologne, Germany
| | - L Mause
- Faculty of Human Sciences, IMVR, University of Cologne, Cologne, Germany
- Faculty of Medicine, IMVR, University Hospital Cologne, Cologne, Germany
| | - T Ohnhäuser
- Faculty of Human Sciences, IMVR, University of Cologne, Cologne, Germany
- Faculty of Medicine, IMVR, University Hospital Cologne, Cologne, Germany
| | - N Scholten
- Faculty of Human Sciences, IMVR, University of Cologne, Cologne, Germany
- Faculty of Medicine, IMVR, University Hospital Cologne, Cologne, Germany
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13
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Puntmann V, Martin S, Vanchin B, Holm N, Giokoglu E, Hoffmann J, Karyou A, Arendt C, Khodamoradi Y, Vehreschild M, Braner A, Rohde G, Zeiher A, Vogl T, Nagel E. Patterns of cardiac involvement in patients with long COVID syndrome using cardiovascular magnetic resonance. Eur Heart J 2021. [PMCID: PMC8767595 DOI: 10.1093/eurheartj/ehab724.1719] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Long COVID (LC) is an increasingly recognized late complication of COVID-19 infection. Cardiovascular involvement has also been implicated, however, the type and extent of the underlying cardiovascular injury remains unknown. Purpose To evaluate the association between ongoing symptoms and findings with cardiovascular magnetic resonance (CMR) in consecutive patients recently recovered from COVID-19 illness. Methods Prospective observational cohort study of patients recently recovered from COVID-19 illness and no previously known cardiovascular disease were included between April 2020 and April 2021. Demographic characteristics, cardiac blood markers, and CMR imaging a minimum of 4 weeks from the diagnosis were obtained. Results Of the 389 included patients, 192 (49%) were male, the mean (±standard deviation) age was 44 (±13) years and 61 (16%) required hospitalization during the acute illness. The median (IQR) time interval between COVID-19 diagnosis and CMR was 94 (71–165) days. 298 (77%) of patients continued to experience ongoing cardiovascular symptoms (long COVID, LC), including dyspnea, palpitations, atypical chest pain and fatigue at the time of CMR at least 4 weeks after the infection. In most patients, the symptoms were only effort related 137 (46%), whereas in 98 (33%) the symptoms affected the activities of daily life; 10 (3%) had severe and debilitating symptoms at rest. Compared to those with no LC (NLC, n=91), LC patients were more commonly hospitalized, had significantly higher native T1, native T2, and showed pericardial enhancement and effusion (Figure 1). There were no differences in cardiac biomarkers, left ventricular (LV) and right ventricular ejection fraction and mass. Proportionally, men and women were similarly affected (n=144 (73%) vs. n=157 (80%), p=0.18). Previous hospitalization was associated with hypertension and ongoing detectable troponin. LC status was associated with previous hospitalization and CMR findings of raised native T1 and native T2, and in females also pericardial enhancement. Severity of symptoms were associated with increased native T1 and T2 and decreased end-diastolic volume, whereas cardiac function showed no significant difference. Conclusions In this cohort of patients recently recovered from COVID-19 infection, ongoing cardiovascular symptoms were common. The LC status was related to previous hospitalization and CMR imaging findings of myopericardial inflammation. The extent and type of cardiovascular findings was associated with the severity of symptoms. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The German Heart Foundation (Deutsche Herzstiftung) and Bayer AG, Leverkusen, Germany
Figure 1 ![]()
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Affiliation(s)
- V Puntmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Martin
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - B Vanchin
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - N Holm
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - E Giokoglu
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - J Hoffmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A Karyou
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - C Arendt
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Y Khodamoradi
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - M Vehreschild
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A Braner
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - G Rohde
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A Zeiher
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - T Vogl
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - E Nagel
- Wolfgang Goethe University, Frankfurt am Main, Germany
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Merten M, Rasper T, Schuhmacher B, Cremer S, Zeiher A, Hoffmann J, Abplanalp W, Dimmeler S. Chronic ischemic heart failure in humans is associated with changes in expression of antigen processing HLA types and activation of T-cells. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0798] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sustained pathological inflammation is a hallmark of chronic ischemic heart failure (HF). The short term response to myocardial ischemia has found a protective phenotype for T regulatory cells, yet the extent and consequence of prolonged T-cell activation in chronic ischemic heart failure is unclear.
Methods and results
Single cell RNA sequencing of circulating immune cells (n=181,712 cells) from healthy (n=8) and heart failure donors (n=8) revealed a relative increase in the proportion of activated T cells in heart failure patients relative to healthy controls. T cell activation molecules of the HLA-DR series genes on antigen presenting cells were found to be strongly associated with heart failure patients in the sequencing data, with decreases in antigen processing genes (HLA-DM series) in heart failure patients. Validation via flow cytometry in 27 healthy controls and 43 heart failure patients showed relative decreases of greater than 30% for HLA-DM to HLA-DRB molecule ratios in HF patients (p=0.0082), suggesting an aberrant antigen presentation to T cells linked to autoimmunity in heart failure patients. Additionally, costimulatory molecules such as ICAM-1 (p=0.004) and activation markers like TREM-1 (p=0.04) were elevated in circulating monocytes cells, which may potentiate T cell activation. Correspondingly, a significant and striking decrease in CD4+ and CD8+ naïve T cells along with increases in combined effector memory and TEMRA cells could be evidenced in heart failure patients. Levels of the T-cell homing marker CCR5 were elevated in patients with heart failure. To gain additional insights into potential functional consequences in the heart, supernatants from 3h LPS stimulated immune cells (peripheral blood mononuclear cells or T cells) were applied to various vascular cell types (endothelial cells, pericytes) and with cardiac organoids for 48h. Apoptosis was increased more than 3 fold following incubation with media derived from peripheral blood cells of HF patients, suggesting that immune cells from heart failure patients can directly and indirectly impair cardiovascular cells.
Conclusion
Heart failure is marked by sustained increases in relative proportions of effector T cell and TEMRA populations and homing markers suggesting these cells may undergo extravasation to tissues and deteriorate inflamed myocardium - hastening heart failure progression, worsening prognosis. Further research is required to assess how these cells may migrate to myocardial tissues and what interventions could be useful for blocking myocardial damage.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): DZHK, DGK, SFB
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Affiliation(s)
- M Merten
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - T Rasper
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - B Schuhmacher
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Cremer
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A.M Zeiher
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - J Hoffmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - W Abplanalp
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Dimmeler
- Wolfgang Goethe University, Frankfurt am Main, Germany
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15
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Pouymayou B, Hoffmann J, Ludwig R, Guckenberger M, Balermpas P, Unkelbach J. PH-0050 Detailed analysis of lymphatic progression patterns for oropharyngeal squamous cell carcinoma. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07232-7] [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: 11/17/2022]
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16
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Kuehle R, Ewerbeck N, Rückschloß T, Ristow O, El Damaty A, Freudlsperger C, Hoffmann J, Engel M. Photogrammetric evaluation of corrective surgery for trigonocephaly. Int J Oral Maxillofac Surg 2021; 51:70-77. [PMID: 34229921 DOI: 10.1016/j.ijom.2021.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 05/30/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to capture preoperative, postoperative, and follow-up head shapes of male trigonocephaly patients who underwent fronto-orbital remodelling (FOR), using three-dimensional (3D) photography. Fifty-seven male infants with metopic synostosis operated on using standardized FOR during a 5-year period were included. All measurements were compared with those of an age-matched healthy control cohort (n = 253 for early postoperative comparison, n = 43 for the 1-year follow-up comparison) to determine the effect of FOR at 14 days and at 1 year post-surgery. Intracranial volume, frontal angle, nasofrontal angle, interfrontoparietal-interparietal ratio, and inter-orbital distances were measured 1 day preoperatively, 14 days and 1 year postoperatively. Mean age at surgery was 9.7 ± 1.1 months. Prior to surgery, boys with metopic synostosis showed a reduced intracranial volume (-7.0%, P < 0.001), frontal angle (-10.2%, P < 0.001), interfrontoparietal-interparietal ratio (-4.9%, P < 0.01), and orbital distances (-6.5%, P < 0.001) compared to the reference group, but values did not differ significantly from the specific control group after surgery (all P> 0.05). This was consistent by the time of the follow-up examination. Corrective surgery should therefore aim to achieve volume expansion and correction of the deformity. Furthermore, 3D photogrammetry provides a valuable alternative to computed tomography scans in the diagnosis of metopic synostosis, significantly reducing the amount of radiation exposure to the brain.
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Affiliation(s)
- R Kuehle
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany.
| | - N Ewerbeck
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - T Rückschloß
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - O Ristow
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - A El Damaty
- Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - C Freudlsperger
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - J Hoffmann
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - M Engel
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
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Rickman HM, Cohn S, Lala SG, Waja Z, Salazar-Austin N, Hoffmann J, Dooley KE, Hoffmann CJ, Chaisson RE, Martinson NA. Subclinical tuberculosis and adverse infant outcomes in pregnant women with HIV. Int J Tuberc Lung Dis 2021; 24:681-685. [PMID: 32718400 PMCID: PMC10111371 DOI: 10.5588/ijtld.19.0500] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Tuberculosis (TB) in pregnant women with HIV is associated with adverse maternal and infant outcomes. Previous studies have described a substantial prevalence of subclinical TB in this group, but little is known about the impact of subclinical TB on maternal and pediatric outcomes.METHODS: The Tshepiso Study recruited 235 HIV-infected pregnant women with TB (and matched HIV-positive, TB-negative pregnant controls), in Soweto, South Africa, from 2011 to 2014. During enrolment screening, some women initially recruited as controls were subsequently diagnosed with prevalent TB. We therefore assessed the prevalence of subclinical TB, associated participant characteristics and outcomes.RESULTS: Of 162 women initially recruited as TB-negative controls, seven (4.3%) were found to have TB on sputum culture. All seven had negative WHO symptom screens, and six (86%) were smear-negative. Of their seven infants, one was diagnosed with TB, and three (43%) experienced complications compared to zero infants with TB and 11% experiencing complications in the control group of TB-negative mothers (P = 0.045).CONCLUSION: We discovered an appreciable prevalence of subclinical TB in HIV-infected pregnant women in Soweto, which had not been detected by screening algorithms based solely on symptoms. Infants of HIV-infected mothers with subclinical TB appear to have a higher risk of adverse outcomes than those of TB-negative mothers.
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Affiliation(s)
- H M Rickman
- The Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - S Cohn
- The Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - S G Lala
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg
| | - Z Waja
- Perinatal HIV Research Unit (PHRU), South African Medical Research Council Soweto, Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg South Africa
| | - N Salazar-Austin
- The Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - J Hoffmann
- The Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - K E Dooley
- The Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - C J Hoffmann
- The Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - R E Chaisson
- The Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - N A Martinson
- The Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, MD, Perinatal HIV Research Unit (PHRU), South African Medical Research Council Soweto, Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg South Africa
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18
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Hoffmann J, Verdegaal SHM. [A man with groin pain]. Ned Tijdschr Geneeskd 2021; 165:D5733. [PMID: 33651517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 78-year-old man was evaluated at the outpatient orthopaedic clinic with progressive pain in the right groin. X-ray revealed osteoarthritis of the right hip and fibrous dysplasia of the proximal femur. Total hip arthroplasty was performed using a cemented long-stem femoral component spanning the entire lesion.
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Affiliation(s)
- J Hoffmann
- Alrijne Ziekenhuis, afd. Orthopedie, Leiderdorp
- Contact: J. Hoffmann
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19
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Le Quang T, Gungor AC, Vasyukov D, Hoffmann J, Smajic J, Zeier M. Advanced calibration kit for scanning microwave microscope: Design, fabrication, and measurement. Rev Sci Instrum 2021; 92:023705. [PMID: 33648098 DOI: 10.1063/5.0032129] [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] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/31/2021] [Indexed: 06/12/2023]
Abstract
We present in this paper a new design of a capacitive calibration kit for scanning microwave microscopy (SMM). As demonstrated by finite element modelings, the produced devices are highly independent of material parameters due to their lateral configuration. The fabrication of these gold-based structures is realized by using well established clean-room techniques. SMM measurements are performed under different conditions, and all capacitive structures exhibit a strong contrast with respect to the non-capacitive background. The obtained experimental data are employed to calibrate the used SMM tips and to extract the capacitance of produced devices following a method based on the short-open-load calibration algorithm for one-port vector network analyzers. The comparison of experimental capacitance and nominal values provided by our models proves the applicability of the used calibration approach for a wide frequency range.
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Affiliation(s)
- T Le Quang
- RF and Microwave Laboratory of the Federal Institute of Metrology METAS of Switzerland, 3003 Bern-Wabern, Switzerland
| | - A C Gungor
- Institute of Electromagnetic Fields (IEF), ETH Zurich, 8092 Zurich, Switzerland
| | - D Vasyukov
- RF and Microwave Laboratory of the Federal Institute of Metrology METAS of Switzerland, 3003 Bern-Wabern, Switzerland
| | - J Hoffmann
- RF and Microwave Laboratory of the Federal Institute of Metrology METAS of Switzerland, 3003 Bern-Wabern, Switzerland
| | - J Smajic
- Institute of Electromagnetic Fields (IEF), ETH Zurich, 8092 Zurich, Switzerland
| | - M Zeier
- RF and Microwave Laboratory of the Federal Institute of Metrology METAS of Switzerland, 3003 Bern-Wabern, Switzerland
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20
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Idda T, Bonas C, Hoffmann J, Bertram J, Quinete N, Schettgen T, Fietkau K, Esser A, Stope MB, Leijs MM, Baron JM, Kraus T, Voigt A, Ziegler P. Metabolic activation and toxicological evaluation of polychlorinated biphenyls in Drosophila melanogaster. Sci Rep 2020; 10:21587. [PMID: 33299007 PMCID: PMC7726022 DOI: 10.1038/s41598-020-78405-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 11/20/2020] [Indexed: 01/26/2023] Open
Abstract
Degradation of polychlorinated biphenyls (PCBs) is initiated by cytochrome P450 (CYP) enzymes and includes PCB oxidation to OH-metabolites, which often display a higher toxicity than their parental compounds. In search of an animal model reflecting PCB metabolism and toxicity, we tested Drosophila melanogaster, a well-known model system for genetics and human disease. Feeding Drosophila with lower chlorinated (LC) PCB congeners 28, 52 or 101 resulted in the detection of a human-like pattern of respective OH-metabolites in fly lysates. Feeding flies high PCB 28 concentrations caused lethality. Thus we silenced selected CYPs via RNA interference and analyzed the effect on PCB 28-derived metabolite formation by assaying 3-OH-2',4,4'-trichlorobiphenyl (3-OHCB 28) and 3'-OH-4',4,6'-trichlorobiphenyl (3'-OHCB 28) in fly lysates. We identified several drosophila CYPs (dCYPs) whose knockdown reduced PCB 28-derived OH-metabolites and suppressed PCB 28 induced lethality including dCYP1A2. Following in vitro analysis using a liver-like CYP-cocktail, containing human orthologues of dCYP1A2, we confirm human CYP1A2 as a PCB 28 metabolizing enzyme. PCB 28-induced mortality in flies was accompanied by locomotor impairment, a common phenotype of neurodegenerative disorders. Along this line, we show PCB 28-initiated caspase activation in differentiated fly neurons. This suggested the loss of neurons through apoptosis. Our findings in flies are congruent with observation in human exposed to high PCB levels. In plasma samples of PCB exposed humans, levels of the neurofilament light chain increase after LC-PCB exposure, indicating neuronal damage. In summary our findings demonstrate parallels between Drosophila and the human systems with respect to CYP mediated metabolism and PCB mediated neurotoxicity.
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Affiliation(s)
- T Idda
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - C Bonas
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - J Hoffmann
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - J Bertram
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - N Quinete
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
- Department of Chemistry and Biochemistry, Florida International University Florida, Florida, USA
| | - T Schettgen
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - K Fietkau
- Department of Dermatology and Allergology, RWTH Aachen University, 52074, Aachen, Germany
| | - A Esser
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - M B Stope
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, Germany
| | - M M Leijs
- Department of Dermatology and Allergology, RWTH Aachen University, 52074, Aachen, Germany
| | - J M Baron
- Department of Dermatology and Allergology, RWTH Aachen University, 52074, Aachen, Germany
| | - T Kraus
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - A Voigt
- Department of Neurology, University Medical Center, RWTH Aachen University, 52074, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH, RWTH Aachen University, 52074, Aachen, Germany
| | - P Ziegler
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany.
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Hoffmann J, Luxan G, Abplanalp W, Rasper T, Fischer A, Muhly-Reinholz M, Assmus B, Zeiher A, Dimmeler S. Myocardial infarction triggers Inflammatory deterioration of vascular niche by accelerating loss of a specific vessel subtype in bone. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0874] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The interface between heart and bone emerges as a key trigger of post-infarction inflammation and progression of chronic heart failure (CHF). However, our knowledge on the underlying mechanisms of this interaction is incomplete. Bone vasculature, specifically so-called H-type (Endomucinhigh) endothelial cells (EC), plays a crucial role in maintenance of the bone integrity and regulation of hematopoietic stem cells (HSC). While previous studies in mice showed the reduction of H-type vessels by aging, the impact of ischemic heart disease is unclear. Therefore, we aimed to investigate the effects of myocardial infarction (MI) and chronic heart failure on the vascular bone cell composition in mice and humans.
Methods and results
Flow cytometric analysis of harvested bones at the different timepoints after MI induction in mice revealed a gradual loss of H-type endothelial cells in the time-course of developing chronic heart failure (P<0.05 at day 7 and 14 vs. control; P<0.0001 at day 28 vs. control). This results were confirmed in immunostainings of tibia sections showing a significant decrease of H-type vessel length after MI (p<0.05 at day 14 and 28, accordingly). The loss of type-H endothelium was accompanied by a significant expansion of long-term HSC in the bone (P=0.0005 at day 28 post MI vs. control). Importantly, type H ECs were also significantly reduced in the bone of ischemic post-infarct HF patients (n=16) compared with control subjects (n=8; P=0.0003). To gain insights into the mechanisms underlying the changes in the vascular niche, we performed single cells RNA sequencing of human BM ECs. These studies confirmed the decrease in Emcnexpressing ECs in ischemic HF patients, which was accompanied by significantly increased expression of inflammatory genes, including IL1b (P<0.0001). Inflammatory EC phenotypes and IL1b expression in HF could be further confirmed at protein level using cytospin immunostainings. Murine studies further revealed an early induction IL-1b specifically in H-type vessels already at day 1 after MI induction, which preceded the loss of H-type endothelium within the following 4 weeks. By inhibiting IL-1b production using a specific Nlrp3 inflammasome inhibitor (MCC950) we could observe a partial restoration of H-type EC frequencies (P=0.033) and a significant increase in H-type vessel length (p=0.035) at day 28 day after MI.
Conclusions
Our data show for the first time an impact of myocardial infarction and chronic heart failure on the bone marrow vasculature. These changes seem to be strongly associated with inflammatory response in H-type vessels, which precedes its loss after MI. Specifically, the induction of the inflammatory cytokine IL1b may contribute to the disturbed phenotype. This suggest that inhibition of IL1b (e.g. by canakinumab) be used as a novel strategy to prevent or reverse the deterioration of the vascular bone function in ischemic heart disease.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Hoffmann
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - G Luxan
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - W.T Abplanalp
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - T Rasper
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - A.M Fischer
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - M Muhly-Reinholz
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - B Assmus
- Department of Cardiology, University of Giessen, Medical Clinic I, Giessen, Germany
| | - A.M Zeiher
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - S Dimmeler
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
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Abplanalp W, Cremer C, Cremer S, John D, John D, Hoffmann J, Hoffmann J, Rieger M, Rieger M, Vasa-Nicotera M, Vasa-Nicotera M, Zeiher A, Zeiher A, Dimmeler S, Dimmeler S. DNMT3A clonal hematopoiesis-driver mutations are associated with profound changes in monocyte and T cell signatures in humans with heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3626] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Clonal hematopoiesis (CH) driven by mutations of DNA methyltransferase 3a (DNMT3A) is associated with increased incidence of cardiovascular disease and poor prognosis of patients with chronic heart failure (HF) and aortic stenosis. Although experimental studies suggest that DNMT3A CH-driver mutations may enhance inflammation, specific signatures of inflammatory cells in humans are missing. Single-cell RNA-sequencing provides a novel opportunity to define subsets of immune cells mediating inflammation in humans.
Methods
Transcriptomic profiles of peripheral blood mononuclear cells were analysed in N=6 HF patients harboring DNMT3A CH-drived mutations and with HF and N=5 patients with HF and DNMT3A mutations by single-cell RNA-sequencing.
Results
Monocytes of HF patients carrying DNMT3A mutations demonstrated a significantly increased expression of inflammatory genes compared to monocytes derived from patients with HF without DNMT3A mutations. Among the specific up-regulated genes were the prototypic inflammatory interleukins (IL) IL1B, IL6, and IL8, the macrophage inflammatory proteins CCL3 and CCL4 as well as restin, which augments monocyte-endothelial adhesion. The classical monocyte subset of DNMT3A mutation carriers showed increased expression of immunoglobulin superfamily members CD80, CD300LB, and SIGLEC12, as well as the cell adhesion molecule CD58, all of which may be involved in monocyte-T cell interactions. DNMT3A mutation carriers were further characterized by increased expression of T cell receptor chains and Th1, Th17, CD8+ and Treg specific signatures.
Conclusions
This study demonstrates that circulating monocytes and T cells of HF patients harboring CHIP-driver mutations in DNMT3A exhibit a highly inflamed transcriptome, which may contribute to the aggravation of chronic heart failure.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): The German Research Foundation (SFB834, Project B1), and the German Center for Cardiovascular Research (DZHK).
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Affiliation(s)
- W Abplanalp
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - C Cremer
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Cremer
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - D John
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - D John
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - J Hoffmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - J Hoffmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - M.A Rieger
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - M.A Rieger
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | | | | | - A.M Zeiher
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A.M Zeiher
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Dimmeler
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Dimmeler
- Wolfgang Goethe University, Frankfurt am Main, Germany
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Hoffmann J, Tabata N, Mas-Peiro S, Spyridopoulos I, Sinning J, Nickenig G, Dimmeler S, Zeiher A, Vasa-Nicotera M. Long telomere length in circulating leukocytes is associated with monocytosis and poorer survival in patients with transcatheter aortic valve replacement. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1871] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Whiletranscatheter aortic valve replacement (TAVR) has become a standard treatment option in the management of patients with severe aortic stenosis and higher risk for cardiac surgery, occurrence of a systemic inflammatory response after TAVR limits patients' prognosis. Leukocyte telomere length (LTL) is an established marker of cellular senescence and longer telomeres are hallmarks of immune competence and inflammatory responsiveness of leukocyte subsets. In the present study, we assessed LTL and its impact on 2-year survival in patients (pts) following TAVR.
Methods and results
LTL was analyzed using quantitative real-time PCR in 285 consecutive pts (mean age 80.9 years, 49% male) undergoing TAVR and correlated with 2-year all-cause mortality (46 deaths, 16%). Kaplan-Meier survival curves showed that the highest compared to lowest tertile of LTL was associated with an increased rate of all-cause mortality (log rank p=0.03). Multivariate regression model revealed higher EuroSCORE 2 (HR: 1.03, 95% CI: 1.01–1.05; p=0.021) and long LTL (HR: 1.001, 95% CI: 1.001–1.001; p=0.023) to be independent predictors for 2-year mortality, after adjustment for clinical variables such as age, sex, cardiovascular risk factors, LVEF and renal function. When analyzing blood leukocyte subset composition, pts in the highest LTL tertile showed significantly higher levels of circulating neutrophils (p=0.011) and monocytes (p=0.011), whereas there was no significant correlation between LTL and lymphocyte counts (p=0.12).
Conclusion
In elderly patients with severe aortic valve stenosis, long leukocyte telomere length is associated with increased mortality after TAVR. This might be explained by enhanced immune competence and increased pro-inflammatory leukocyte function in these patients as indicated by significant monocytosis, which might drive systemic inflammatory response syndrome or chronic inflammation and limit the prognosis in TAVR patients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Hoffmann
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - N Tabata
- Heartcenter Bonn, University Hospital Bonn, Bonn, Germany
| | - S Mas-Peiro
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - I Spyridopoulos
- Institute of Genetic Medicine, Newcastle-Upon-Tyne, United Kingdom
| | - J.M Sinning
- Heartcenter Bonn, University Hospital Bonn, Bonn, Germany
| | - G Nickenig
- Heartcenter Bonn, University Hospital Bonn, Bonn, Germany
| | - S Dimmeler
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - A.M Zeiher
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - M Vasa-Nicotera
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
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24
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Hoffmann J, Berkowitsch A, Mas-Peiro S, Boeckling F, Rasper T, Dimmeler S, Zeiher A, Vasa-Nicotera M. Preserved Th2 lymphocytes improve prognosis of diabetic patients undergoing TAVR. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1869] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Previous studies have shown that presence of diabetes (DM) worsens outcome of patients after transfemoral aortic valve (TAVR). DM has been associated with pathological T-lymphocyte (T-cell) polarization, marked by decreased anti-inflammatory Th2 cells and increased pro-inflammatory Th1 cells. However, the risk-modulatory impact of T-cell polarization in diabetic patients with severe aortic stenosis has not been shown thus far. In this study we assessed the role of T-cell subsets in diabetic patients undergoing TAVR.
Methods and results
A total of 129 patients (76% male, median age [IQR]: 83 years [79–86]) admitted for TAVR at the University Clinic Frankfurt were enrolled. The patients were evaluated using classical risk scores and the Th1/Th2 T-cell polarization was assessed using flow cytometry. The endpoint of the study was all-cause death. Kaplan-Meier survival, ROC curve analysis and Mann-Whitney-U-Test were used in statistical analysis. The differences were considered significant by error probability p<0.05. Twenty-six patients died within follow up of 274 (188–367) days. The conventional risk parameters were distributed as follows: STS score: 3.45 (2.47–4.97), LVEF: 60% (45–65), CRP: 0.33 mg/dl (0.15–0.79), hsTropT: 24.5 pg/ml (16.5–40.0), IL6: 6.7 pg/ml (4.1–12.2), Hb: 12.3 g/dl (11.00–13,75), Creatinine: 1.15 mg/dl (0.93–1.54), Th1 cells = 79.88 cells/μl (55.69–122.16), Th2 cells: 25.31 cells/μl (19.69–38.33), NT-proBNP: 2033 pg/ml (1076–5531). All these parameters were associated with mortality. Hence, only Hb (AUC=0.761), NT-proBNP (AUC=0.726), Th2 cells (AUC=0.712) and STS score (AUC=0.737) provided AUC>0.7. Diabetes was revealed to be significantly associated with mortality in patients with and without DM (15/48 (31%) vs. 11/81 (14%), respectively, P=0.019). There were no significant differences in the counts of Th-cell subsets between diabetic and non-diabetic patients (Th1 (90.95 (62.41–154.22) vs 76.36 (53.16–100.49), P=0.072); Th2 (29.18 (20.13–43.77) vs 24.74 (20.27- 35.11), p=0.245), for DM and non-DM respectively). However, the survival rate in patients with DM and Th2 cell counts higher than or equal to the calculated optimal cut-off of 24.3 cells/μl was comparable with patients without DM (25/28 (89%) vs. 36/38 (95%), p=0.453). In contrast, diabetic patients with reduced Th2 cells (<24.3 cells/μl) were much more likely to die (10/15 (67%) vs. 8/34 (24%), p=0.003, patients with DM and without, respectively).
Conclusion
Our results show for the first time a risk-modulatory impact of T-cell immunity in diabetic patients with severe degenerative aortic stenosis. Reduced Th2 cells are strongly associated with mortality in patients considered for TAVR and significantly deteriorate prognosis in patients with concomitant diabetes.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Hoffmann
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - A Berkowitsch
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - S Mas-Peiro
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - F Boeckling
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - T Rasper
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - S Dimmeler
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - A.M Zeiher
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - M Vasa-Nicotera
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
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Behrens D, Lawlor R, Heeschen C, Buettner B, Siveke J, Hoffmann J. Correlation of molecular profiles with response to targeted drugs in pancreatic cancer models. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31234-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Kaleta T, Mohrmann S, Krawczyk N, Fehm T, Hoffmann J. Exulzerierendes Hormonrezeptoren-positives Mammakarzinom unter Therapie mit AI und Palbociclib – ein Fallbericht. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714573] [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: 03/22/2023] Open
Affiliation(s)
- T Kaleta
- Universitätsklinikum Düsseldorf, Frauenklinik
| | - S Mohrmann
- Universitätsklinikum Düsseldorf, Frauenklinik
| | - N Krawczyk
- Universitätsklinikum Düsseldorf, Frauenklinik
| | - T Fehm
- Universitätsklinikum Düsseldorf, Frauenklinik
| | - J Hoffmann
- Universitätsklinikum Düsseldorf, Frauenklinik
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27
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Busetto L, Stang C, Hoffmann J, Amiri H, Seker F, Purrucker J, Ringleb PA, Nagel S, Bendszus M, Wick W, Gumbinger C. Patient-centredness in acute stroke care - a qualitative study from the perspectives of patients, relatives and staff. Eur J Neurol 2020; 27:1638-1646. [PMID: 32337811 DOI: 10.1111/ene.14283] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Although patient-centredness is considered a key component of high-quality neurological care, it is unclear to what extent it can or should be implemented during the acute phase. Using acute stroke as an example, the aim was to identify critical junctures for patient-centredness along the acute care pathway from the perspectives of patients, relatives and staff. METHODS A qualitative multi-method study was conducted including 27 non-participant observations and 37 semi-structured interviews with patients, relatives and staff. Junctures were defined as critical when mentioned (as problematic) in two or three information sources (i.e. observations, staff interviews, or patient and relative interviews), as potentially critical when mentioned in one, and as uncritical when not mentioned. RESULTS Post-procedure communication after thrombectomy, patients' stay at the stroke unit and decision-making around transfer, discharge and rehabilitation were identified as critical junctures for patient-centredness. Arrival at the emergency department and the (thrombectomy) treatment itself were identified as uncritical junctures, whilst history-taking and treatment preparation, the treatment decision and patients' stay at the intensive care unit were identified as potentially critical junctures. CONCLUSIONS In acute stroke care, patients, relatives and staff prioritize fast over patient-centred decision-making in the most time-critical phases, especially before and during treatment. This is reversed after the procedure, when difficulties arise implementing a patient-centred approach in clinical practice. To improve patient-centredness where it is most needed, clear guidelines and accessible resources are recommended. Future research should investigate whether insights from acute phases of stroke care are applicable to other neurological conditions as well.
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Affiliation(s)
- L Busetto
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - C Stang
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - J Hoffmann
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - H Amiri
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - F Seker
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - J Purrucker
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - P A Ringleb
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - S Nagel
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - M Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - W Wick
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuro-Oncology, German Cancer Research Center, Heidelberg, Germany
| | - C Gumbinger
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
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28
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Madrahimov N, Alhussini K, Sales V, Radakovic D, Penov K, Benitez Cristaldo R, Hoffmann J, Hassan M, Leyh R, Bening C. First-Ever Built Magnetically Driven Micropump Using 3D Technology for VAD and ECMO Studies in a Mouse Model. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705498] [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: 10/24/2022]
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29
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Madrahimov N, Bening C, Alhussini K, Sales V, Radakovic D, Penov K, Benitez Cristaldo R, Magyar A, Hoffmann J, Leyh R. The Potential Role of Magnetorheological Elastomers as “Smart Materials” in the Future Design of the Artificial Heart and Circulatory Support. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705494] [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: 10/24/2022]
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30
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Moratin J, Metzger K, Kansy K, Ristow O, Engel M, Hoffmann J, Flechtenmacher C, Freier K, Freudlsperger C, Horn D. The prognostic significance of the lymph node ratio in oral cancer differs for anatomical subsites. Int J Oral Maxillofac Surg 2019; 49:558-563. [PMID: 31740138 DOI: 10.1016/j.ijom.2019.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 05/16/2019] [Revised: 09/10/2019] [Accepted: 10/21/2019] [Indexed: 11/15/2022]
Abstract
The aim of this study was to validate the prognostic significance of the lymph node ratio (LNR) in patients suffering from oral squamous cell carcinoma in regard to different anatomical subsites. A cohort of 430 patients was investigated to determine the rates of primary metastasis and local and regional disease recurrence. Correlation analysis of the LNR with relevant clinical and pathological parameters was performed. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the prognostic impact for different subsites. Significantly differing rates of primary metastasis and loco-regional disease recurrence were found for cancer of different anatomical subsites of the head and neck. Furthermore, ROC curve analysis suggested that LNR has prognostic relevance in subsets of cancer (tongue, P< 0.001; alveolar process, P= 0.04; maxilla, P= 0.03; buccal mucosa, P= 0.02). The LNR of cancer located in the soft palate (P= 0.6) and floor of the mouth (P= 0.11) showed little or no association with the clinical outcome. There is the need for a more sensitive consideration of the LNR as a factor in the assessment of risk and the treatment decision, as the anatomical subsite plays a crucial role in its impact on the clinical outcome.
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Affiliation(s)
- J Moratin
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Karl Metzger
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - K Kansy
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - O Ristow
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - M Engel
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - J Hoffmann
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - C Flechtenmacher
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - K Freier
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany; Department of Oral and Craniomaxillofacial Surgery, Saarland University Hospital, Homburg, Germany
| | - C Freudlsperger
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - D Horn
- Department of Oral and Craniomaxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany; Department of Oral and Craniomaxillofacial Surgery, Saarland University Hospital, Homburg, Germany
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31
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Mas-Peiro S, Hoffmann J, Walther T, Zeiher AM, Fichtlscherer S, Vasa-Nicotera M. P1850Usefulness and predictive value of the prognostic nutritional index compared to other commonly-used nutritional indexes as a prognostic nutritional marker for short- and mid-term survival after TAVR. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0601] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Several nutritional indexes predict clinical outcomes after trans-catheter aortic valve replacement (TAVR). The Prognostic Nutritional Index (PNI) is based on serum albumin and lymphocyte count, which makes it a highly practical tool to assess nutritional status. Prognostic value of PNI has been shown in some heart diseases and interventions. Usefulness and predictive value of PNI were investigated in patients with symptomatic aortic stenosis undergoing TAVR. PNI was compared with other commonly-used nutritional indexes that predict survival after TAVR.
Methods
A prospective observational study was carried out in a cohort of 114 patients with aortic stenosis undergoing TAVR in a high-volume centre from 09/2016 to 02/2018. Pre-procedural characteristics and laboratory parameters were measured, and a 1-year follow-up was completed.
PNI was estimated with the formula: (10 × serum albumin [g/dl]) + (0.005 × total lymphocytes [1,000/μl]). Baseline clinical features and 1-year survival were compared in patients with PNI values above vs below median.
A multivariate Cox regression analysis was used to assess the independent predictive value of PNI, for 1-year mortality after TAVR. Kaplan-Meier curves were constructed for patients with PNI above vs below median value. ROC curves were created to assess discrimination ability of PNI, and to compare its AUC values with those for other common nutritional markers, such as Geriatric Nutritional Risk Index (GNRI) and body mass index (BMI).
Results
Mean age was 82.2 years and 59.6% of patients were female. Mean PNI was 46±5. No differences were found in pre-procedural clinical characteristics between patients with PNI values above vs below median.
One-year mortality was significantly higher in patients with PNI values below median (19/23) than in patients with higher PNI values (4/23) (p<0.001). No differences were found in complications according to Valve Academic Research Consortium Criteria-2.
Lower PNI values significantly predicted a lower 1-year survival, even after adjusting for all clinical factors showing significant differences in a univariate analysis (model 1: HR 0.8, 95% CI 0.7–0.9, p<0.0001). Significance persisted also after adjusting for relevant laboratory factors (NT-proBNP, hs-Troponin, CRP, eGFR, cystatin, haemoglobin) (model 2: HR 0.8, 95% CI 0.7–0.9, p<0.05). Kaplan-Meier curves started to diverge soon after the intervention (figure). ROC curves revealed a stronger predictive value for PNI (AUC 0.80) compared to GNRI (0.77) and BMI (0.6) (figure).
Kaplan-Meier curve for PNI and ROC curve
Conclusion
PNI is a useful and practical nutritional marker predicting 1-year survival after TAVR in aortic stenosis. It appears to reflect malnutrition and inflammation prior to the intervention, and to have an impact on prognosis. PNI seems to be a better prognostic marker than BMI or GNRI after TAVR.
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Affiliation(s)
- S Mas-Peiro
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - J Hoffmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - T Walther
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A M Zeiher
- Wolfgang Goethe University, Frankfurt am Main, Germany
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Hoffmann J, Abplanalp W, Rasper T, Fischer A, Assmus B, Wild P, Koeck T, Zeiher AM, Dimmeler S. 6091Chronic heart failure is associated with inflammatory deterioration of the bone marrow vascular niche. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0130] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Inflammation plays a crucial role in many aspects of cardiovascular disease. Particularly, acquired mutations of hematopoietic stem cells (HSC) leading to clonal expansion of inflammatory cells (CHIP) are increased with age and are associated with an enhanced risk of cardiovascular disease. The bone marrow (BM) vascular niche plays a crucial role in maintenance and regulation of HSC functions. Previous studies in mice showed the reduction of a specific Endomucin-high (H-type) endothelial cells (EC) subpopulation by aging. However, the impact of cardiovascular disease is unclear. Therefore, we aimed to investigate the effects of age and heart failure (HF) on the vascular BM cell composition in mice and humans.
Methods and results
Aging mice showed an age-dependent decrease of type H (Emcn-high) BM ECs (p=0.004), whereas the BM frequencies of type L (Emcn-low) ECs did not significantly differ (P=0.18). Importantly, we also observed a marked reduction of type H EC in chronic ischemic mice (P=0.016 vs. sham) indicating that chronic ischemic HF induces similar alterations of the vascular stem cell niche. Importantly, type H ECs were also significantly reduced in ischemic HF patients (n=16) compared with control subjects (n=8; P=0.0003). To gain insights into the mechanisms underlying the changes in the vascular niche, we performed single cells RNA sequencing of human BM ECs. These studies confirmed the decrease in Emcn-expressing ECs in ischemic HF patients, which was accompanied by significantly increased expression of inflammatory genes, including IL1b (P<0.0001 vs. control). Inflammatory EC phenotypes and IL1b expression in HF could be further confirmed at protein level using cytospin immunostainings. Finally, we comprehensively evaluated phenotype-associated differences in the bone marrow plasma proteomes of healthy individuals (n=19) and patients with chronic ischemic (n=22) and non-ischemic (n=19) HF, using proximity extension assays. Here, we identified 182 proteins significantly differentially regulated in CHF versus CTRL. Among the top upregulated proteins the BM environment of patients with CHF showed a striking enrichment of inflammatory and ECM remodeling components.
Conclusions
Our data show for the first time an impact of chronic heart failure on the bone marrow vascular niche in humans. These changes seem to be strongly associated with increased inflammatory response and bone matrix remodeling in CHF. Specifically, the induction of the inflammatory cytokine IL1b may contribute to the disturbed phenotype suggesting that inhibition of IL1b (e.g. by canakinumab) may be used as a novel strategy to prevent or reverse the deterioration of the vascular BM niche.
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Affiliation(s)
- J Hoffmann
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - W Abplanalp
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - T Rasper
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - A Fischer
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - B Assmus
- Department of Cardiology, University of Giessen, Medical Clinic I, Giessen, Germany
| | - P Wild
- Johannes Gutenberg University Mainz (JGU), Preventive Cardiology and Preventive Medicine, Center for Cardiology, Mainz, Germany
| | - T Koeck
- Johannes Gutenberg University Mainz (JGU), Preventive Cardiology and Preventive Medicine, Center for Cardiology, Mainz, Germany
| | - A M Zeiher
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - S Dimmeler
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
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33
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Gatsiou A, Tual-Chalot S, Bonini F, Cesarini V, Ortega-Gomez A, Schook K, Hoffmann J, Kwak S, Selzman CH, Martini M, Dimmeler S, Gallo A, Drakos S, Soehnlein O, Stellos K. 1438MicroRNA editing is integral for interleukin-6 trans-signalling and leukocyte trafficking to ischemic tissues. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0073] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Aim
Adenosine to inosine RNA editing is an essential post-transcriptional RNA modification catalysed by adenosine deaminase acting on RNA-1 and -2 (ADAR1; ADAR2). Endothelial cells (ECs) attract and guide leukocytes to sites of ischemic tissue injury. Here we studied the role of RNA editing in ischemic disease.
Methods
Primary human and murine vascular endothelial cell cultures were used to assess the EC responses to interleukin-6 (IL-6) or ischemia. For the animal studies, the effect of ADAR2 in acute and chronic ischemic disease was evaluated in cremaster muscle microcirculation by intravital microscopy, in peritoneal cavity after sterile peritonitis and in gastrocnemius muscle after hind-limb ischemia by 8-colour flow cytometry and immunohistochemistry (IHC) studies of Adar2−/−/tg as well as of i(nducible)EC-ADAR2 knockout (KO) mice. For the mechanistic studies, deep RNA sequencing, qRT-PCR, western blot, confocal microscopy, target-specific microRNA (miRNA) editing studies, RNA-immunoprecipitation, miRNA/plasmid silencing/overexpression and luciferase reporter assays were used among others. For human studies, ischemic tissues derived from patients with acute or chronic ischemic heart disease were processed.
Results
ADAR2, but not ADAR1, expression is induced by >2-fold in hypoxic ECs and in ischemic vascular ECs in mice and humans. Unbiased gene ontology analysis of the EC transcriptome indicated that ADAR2 controls inflammatory responses and predominantly the expression of interleukin-6-signal transducer (IL6ST), the co-receptor of IL-6. Subsequently, ADAR2 controls IL-6 trans-signalling in ECs as documented by the STAT3 phosphorylation and expression of the downstream leukocyte adhesion molecules, E-selectin and VCAM-1. IL-6-inflamed cremaster muscles showed that rolling and adhesion of leukocyte subsets to vascular wall were severely impaired in Adar2−/−/tg mice. Leukocyte transmigration was also diminished by >2-fold in Adar2−/−/tg and in iEC-ADAR2 KO mice in response to IL-6 or ischemia. Similar results were obtained for leukocyte rolling, adhesion and infiltration after acute (4h) and chronic (3d; 21d) ischemia from iEC-ADAR2 KO mice and human ischemic muscle tissues. Next we studied how ADAR2 controls IL6ST expression. ADAR2-deficient vascular EC miRNAome revealed the upregulation of a conserved group of miRNAs targeting the IL6ST mRNA including miR-199a-5p and miR-335-3p. At a single-nucleotide level, ADAR2-induced RNA editing of the stem loops of the primary miR-199a1/2 and miR-335 directly disrupted Drosha recruitment to both and thus inhibited their maturation process. Accordingly, rescue experiments using miRNA-inhibitors restored IL6ST levels after ADAR2 deficiency.
Conclusion
Taking together, inhibition of the microRNA maturation process by ADAR2-mediated RNA editing is integral for IL-6 trans-signalling in vascular endothelium and subsequent leukocyte trafficking to ischemic tissues in mice and humans.
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Affiliation(s)
- A Gatsiou
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - S Tual-Chalot
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - F Bonini
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - V Cesarini
- Bambino Gesu Children's Hospital, Rome, Italy
| | - A Ortega-Gomez
- Institute for Cardiovascular Prevention (IPEK), Munich, Germany
| | - K Schook
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - J Hoffmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Kwak
- University of Tokyo, Tokyo, Japan
| | - C H Selzman
- University of Utah, Salt Lake City, United States of America
| | - M Martini
- Polyclinic Agostino Gemelli, Rome, Italy
| | - S Dimmeler
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A Gallo
- Bambino Gesu Children's Hospital, Rome, Italy
| | - S Drakos
- University of Utah, Salt Lake City, United States of America
| | - O Soehnlein
- Institute for Cardiovascular Prevention (IPEK), Munich, Germany
| | - K Stellos
- Newcastle University, Newcastle upon Tyne, United Kingdom
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Hoffmann J, Mas-Peiro S, Boeckling F, Rasper T, Berkowitsch A, Fichtlscherer S, Dimmeler S, Zeiher AM, Vasa-Nicotera M. P930Inflammatory leukocyte phenotypes are associated with increased mortality after transfemoral transcatheter aortic valve implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0525] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Systemic inflammatory response syndrome (SIRS) was shown to be a strong predictor of mortality in patients undergoing transcatheter aortic valve implantation (TAVI). However, given the rather non-specific nature of the SIRS criteria and their limited applicability in the modern era of TAVI, including lower periprocedural complication rates and shorter hospitalization periods in experienced competence centers, there is a need for defining novel prognostic inflammatory signatures for improved patient risk stratification. Thus, the objective of the present study was to characterize and assess the prognostic relevance of circulating leukocyte subsets, including phenotypical heterogeneity of monocytes and effector T cells, before and at various times after transfemoral TAVI.
Methods and results
129 consecutive patients (59% male, mean age 82.3±5.6 years) with severe symptomatic aortic stenosis (Pmean 44.2±17mmHg), and high or prohibitive operative risk (mean EuroSCORE II 5.9; STS score 4.1) admitted to our clinic for TAVI were included into the study. Peripheral blood samples were obtained pre-procedurally (baseline, BL), directly after the intervention, and at 24h and 3 days after TAVI, and analyzed for inflammatory and cardiac biomarkers, including hs-CRP, IL-6, hs-TropT, and NT-proBNP. Differential myeloid and T-cell subset (Th1, Th2, Th17, Th1/Th17, Th22, Tregs) distribution and kinetics were analyzed using multiparameter flow cytometry. Neutrophil (P<0.001 vs. BL) as well as classical and intermediate monocyte counts were significantly elevated at 24h (both p<0.0001 vs. BL), whereas non-classical monocytosis developed 3 days after TAVI (P<0.0001 vs. BL). Among CD4+ T-cell subsets, the percentage of Tregs and Th17 significantly increased (both P<0.0001 at 24h vs. BL) after valve implantation. Remarkably, these changes were independent on the valve type (balloon- vs. self-expandable) and no significant effects of predilatation were observed (p>0.05 for all cell subsets). Univariate analysis showed that elevated levels of NT-proBNP (HR: 3.4, 95% CI: 1.7–6.8; P=0.0005), hsCRP (HR: 1.4, 95% CI: 1.2–1.7; P=0.0003), and IL-6 (HR: 1.0, 95% CI: 1.0–1.03; P=0.0007), lower counts of Th2 cells (HR: 0.94, 95% CI: 0.90–0.94; P=0.0045), as well as increased percentages of Th17 cells (HR: 1.2, 95% CI: 1.0–1.4; P=0.023), and of non-classical monocytes (HR=1.019, 95% CI: 1.001–1.039; P=0.049) were independently associated with 12-month all-cause mortality. When included in the regression model with STS score, these inflammatory biomarkers provided higher area under ROC curve and category-free net reclassification improvementof 59% at 1 year (P=0.0001).
ROC curves inflammation markers add STS
Conclusions
Our findings demonstrate for the first time an association of inflammatory leukocyte phenotypes with increased mortality after TAVI. Specific monocytic and T-cell signatures might therefore provide novel additive biomarkers to improve individual risk stratification in patients with severe aortic stenosis.
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Affiliation(s)
- J Hoffmann
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - S Mas-Peiro
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - F Boeckling
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - T Rasper
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - A Berkowitsch
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - S Fichtlscherer
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - S Dimmeler
- JW Goethe University, Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Frankfurt am Main, Germany
| | - A M Zeiher
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - M Vasa-Nicotera
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
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Affiliation(s)
- W Hermann
- Neurologie, SRO AG Langenthal, St. Urbanstraße 67, 4900, Langenthal, Schweiz.
| | - C Hennig
- Mitteldeutscher Praxisverbund Humangenetik, Dresden, Deutschland
| | - J Hoffmann
- Praxis für Humangenetik Tübingen, Tübingen, Deutschland
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Hoffmann J, Wölfle U, Schempp C. Phytotherapie bei entzündlichen Hauterkrankungen. Akt Dermatol 2019. [DOI: 10.1055/a-0881-6976] [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: 10/26/2022]
Abstract
ZusammenfassungIn den letzten Jahren wurden einige neue pflanzliche Arzneimittel, Medizinprodukte und Hautpflegemittel für die topische Behandlung von entzündlichen Hauterkrankungen entwickelt. Besonders gut belegt ist die Wirksamkeit von Inhaltsstoffen aus dem Süßholz bei der atopischen Dermatitis und von Indigoextrakten bei der Psoriasis. Ein neuer vielversprechender Therapieansatz zur äußerlichen Behandlung einer geschädigten Hautbarriere sind Bitterstoffe, die an Bitterstoffrezeptoren der Haut binden und die Keratin- und Lipidsynthese der Keratinozyten anregen. Weitere pflanzliche Wirkstoffe für die Behandlung von Rosazea und Akne vulgaris werden ebenfalls besprochen.
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Affiliation(s)
- J. Hoffmann
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg
| | - U. Wölfle
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg
| | - C. Schempp
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg
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Shavlokhova V, Hoffmann J, Freier K. Automated classification of cancerous tissue of the face and head with confocal microscopy for treatment and diagnosis using deep learning. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Minkin J, Warhadpande S, Kaufman C, Khaja M, Bercu Z, Majdalany B, Martin C, Hoffmann J, Minkin J. Abstract No. 478 Assessing the status of mentorship programs in interventional radiology residency training: results of a 2018 survey. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Niekamp A, Patel P, Hoffmann J, Rochon P. Abstract No. 615 The emerging IR residency: consecutive 2-year medical student IR integrated match survey results from 2017 and 2018. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.720] [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: 11/29/2022] Open
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Kiver VII, Wulf-Goldenberg A, Jurmeister PS, Schweiger C, Gorea O, Hoffmann J, Denkert C, Keilholz U, Liedtke C, Blohmer JU. Abstract P6-03-06: Androgen supplementation in patient derived xenografts in androgen receptor positive breast cancer to increase engraftment and growth rate. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-03-06] [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: 11/16/2022]
Abstract
Abstract
Background:
The European fund for regional development (EFRE) supported Precision Oncology and Personalized Therapy Prediction (POP) Project is establishing preclinical models to further the development of personalized therapy options. In the subgroup breast cancer the current goal is to increase the growth and engraftment rates of breast cancer patient derived xenografts (PDX) models.
Methods:
Breast cancer patients of the Department of Gynecology with Breast Center Charité Universitätsmedizin Berlin, Germany are recruited since May 2017. In total 29 tissue samples were collected and included so far.
Treatment naive and treatment refractory patients, tripple negative breast cancer (TNBC), hormone receptor positive (HR+) and Her2 postivie tumors, primary disease, recurrence or metastasis are sampled. Fresh tumor tissue is extracted via surgery or biopsy. The materials are then implanted into female immunodeficient NOG mice. To establish PDX models for HR+ breast cancer the mice received estrogen supplementation.
To increase engraftment and growth rates androgen receptor (AR) testing and subsequently androgen replacement was started since April 2018.
Up to date, 6 new samples have been collected. One HR+ and two TNBC samples tested also positive for AR. These samples are currently in passage 0 (p0) and are now supplied with androgens to increase engraftment and growth rate. One already established AR+ TNBC PDX is being regrown with androgen supplementation to compare growth rates.
Results:
Out of the initial 23 tissue samples ten (six HR+ and four TNBC) have been able to be engrafted into PDX mice.
The TNBC PDX models are one in p1, one in p2, one in p3 and one is being tested with systemic therapy. Engraftment time in p1 were between 19 and 97 days. Growth time to passagable size between 21 and 112 days.
The HR+ PDX models are four in p1 and two in p2. Engraftment time in p1 was between 26 and 123 days. Growth time to passagable size has been achieved in 2 HR+ PDX within 17 to 48 days.
The engraftment/growth rates and times of the androgen supplemented PDX models will be presented.
Conclusion:
Breast cancer growths in humans slowly and this is also the case in the PDX models. To achieve faster growth and higher engraftment rates androgen supplementation in AR+ breast cancer might be an additional enhancive factor.
Citation Format: Kiver VII, Wulf-Goldenberg A, Jurmeister PS, Schweiger C, Gorea O, Hoffmann J, Denkert C, Keilholz U, Liedtke C, Blohmer J-U. Androgen supplementation in patient derived xenografts in androgen receptor positive breast cancer to increase engraftment and growth rate [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-03-06.
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Affiliation(s)
- VII Kiver
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Wulf-Goldenberg
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - PS Jurmeister
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Schweiger
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - O Gorea
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J Hoffmann
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Denkert
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - U Keilholz
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Liedtke
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J-U Blohmer
- Charite Comprehensive Cancer Center, Berlin, Germany; Charite Institute of Gynecology with Breast Center, Berlin, Germany; Charite Institute for Pathology, Berlin, Germany; Experimental Pharmacology & Oncology Berlin GmbH-Berlin-Buch, Berlin, Germany; German Cancer Consortium (DKTK), Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
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Kansy K, Hoffmann J, Alhalabi O, Mistele N, Freier K, Shavlokhova V, Mertens C, Freudlsperger C, Engel M. Long-term donor site morbidity in head and neck cancer patients and its impact on quality of life: a cross-sectional study. Int J Oral Maxillofac Surg 2019; 48:875-885. [PMID: 30718032 DOI: 10.1016/j.ijom.2019.01.009] [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: 06/22/2018] [Revised: 12/31/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
Modern head and neck reconstructive surgery offers a multitude of different reconstructive options. In such cases, donor site morbidity is an important factor in the affected patient's decision-making. The aim of this study was to perform an objective comparison of donor site morbidity for the five most frequent microvascular donor sites in head and neck reconstructive surgery (radial forearm, anterolateral thigh, fibula, iliac crest, and scapula) using a uniform testing system. In this cross-sectional study, 117 donor sites were analyzed (106 for malignant disease and 11 for non-malignant disease): 73 radial forearm, 14 scapula, 12 anterolateral thigh, 10 fibula, and eight iliac crest. Testing consisted of range of motion, muscle strength, and sensation. The non-affected side served as the control. Quality of life was assessed using the Washington Quality of Life Questionnaire version 4 in its German translation. Range of motion was restricted in 15 cases (12.8%). Muscle strength was decreased in 58 cases (49.6%). Sensation was reduced in 70 cases (60%). Concerning quality of life, 31.2% of patients were limited in their daily activities. The scapula flap showed the highest incidence of overall donor site morbidity. However, correlation between objective and subjective donor site impairment was weak and the majority of patients experienced only minor limitations.
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Affiliation(s)
- K Kansy
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - J Hoffmann
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - O Alhalabi
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - N Mistele
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - K Freier
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - V Shavlokhova
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - C Mertens
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - C Freudlsperger
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - M Engel
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Rippinger N, Heinzler J, Bruckner T, Brucker J, Dinkic C, Hoffmann J, Dornhöfer N, Seitz S, Rom J, Sohn C, Schott TC, Schott S. The impact of a cervical dysplasia diagnosis on individual cancer prevention habits over time: a bicentric case-control study. Arch Gynecol Obstet 2019; 299:847-855. [PMID: 30607592 DOI: 10.1007/s00404-018-5029-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 09/06/2018] [Accepted: 12/14/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Annual cervical cancer screening is recommended in Germany as a part of the statutory preventive care. Abnormal results can provoke psychological distress and anxiety, compromising women's adherence. Little is known about how a cervical dysplasia impacts adherence follow-up visits and prevention habits over time. To optimize care strategies, this study aims to identify women at risk for nonadherence to follow-up visits after a screening event. METHODS Between November 2015 and May 2017, participants with an abnormal Pap smear at the Heidelberg and Leipzig University Hospitals received a four-part questionnaire (sociodemographic data, PHQ-D, self-designed fear and prevention habit questions) at the first consultation (T1) and subsequently after 3 (T2) and 6 (T3) months; healthy controls completed the questionnaire at T1. RESULTS 132 women with an abnormal Pap smear [with conization: S1 (n = 68, 51.5%), without intervention: S2 (n = 64, 48.5%)] and healthy controls (K, n = 101) generally adhered to gynecological checkups, except S1 6 months after the first diagnosis (S1/T3 - 0.47, signed rank p < 0.0005). Knowledge of primary prevention information, i.e., HPV vaccination, was significantly higher among K (K 58%, S1 29%, S2 44%, Chi-squared p = 0.01) as was vaccine uptake (K 39% versus S1/S2 7% and 17%, respectively, Chi-squared p = 0.0004). Fear of upcoming Pap smears rose significantly over time (S1/T1-S1/T2-S1/T3, Wilcoxon signed-rank test p < 0.001) and was higher among those with conization at T2 (Chi-square test, p = 0.01) and partially accompanied by panic disorders at T1 (Chi-square test p = 0.035). Realization of general preventive habits rose significantly among women without an operative procedure (S2) over the study. CONCLUSION This study advances the understanding of non-participation in follow-up visits after a dysplasia diagnosis, identifying post-conization women as a special risk group for decreased adherence.
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Affiliation(s)
- N Rippinger
- Department of Gynaecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - J Heinzler
- Department of Gynaecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - T Bruckner
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Heidelberg, Germany
| | - J Brucker
- Department of Gynaecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - C Dinkic
- Department of Gynaecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - J Hoffmann
- Department of Gynaecology and Obstetrics, Leipzig University Hospital, Leipzig, Germany
| | - N Dornhöfer
- Department of Gynaecology and Obstetrics, Leipzig University Hospital, Leipzig, Germany
| | - S Seitz
- Department of Gynaecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany
| | - J Rom
- Department of Gynaecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - C Sohn
- Department of Gynaecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - T C Schott
- Department of Orthodontics and Orofacial Orthopedics, University Hospital Tubingen, Tubingen, Germany
| | - Sarah Schott
- Department of Gynaecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany. .,German Cancer Consortium (DKTK), Heidelberg and German Cancer Research Centre (DKFZ), Heidelberg, Germany.
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DeMauro SB, Bellamy SL, Fernando M, Hoffmann J, Gratton T, Schmidt B. Patient, Family, and Center-Based Factors Associated with Attrition in Neonatal Clinical Research: A Prospective Study. Neonatology 2019; 115:328-334. [PMID: 30836358 PMCID: PMC6657796 DOI: 10.1159/000494105] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 09/27/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Attrition, or loss to follow-up, presents a significant threat to the integrity and validity of longitudinal clinical research. Little is known about predictors of attrition in neonatal clinical research, and no prior studies have examined how families' experiences participating in research with their infants influences study compliance. OBJECTIVE To identify novel factors that were associated with attrition over 1 year of study follow-up among preterm infants enrolled in the multicenter Prematurity and Respiratory Outcomes Program (PROP) observational study. METHODS At discharge, research coordinators estimated the likelihood of attrition. The parents completed questionnaires about their experience with the study at discharge and at 1 year corrected age. The primary endpoint was completion of 4 PROP interviews during the first year. Logistic models were used to evaluate the associations between infant, family, and center-based characteristics and attrition. RESULTS Among 318 children, 283 (89%) met the primary endpoint. In bivariate analyses, lower maternal education, more people in the household, public insurance, and site were associated with attrition (p < 0.05). Parent survey responses, infant characteristics, and site characteristics were unrelated to attrition. Coordinators' prediction of attrition was associated with completion of early study interviews; this effect waned over time. In multivariable analyses, lower maternal education and more people in the household were the factors most strongly associated with attrition. CONCLUSION Future neonatal research should evaluate novel strategies to decrease the burden associated with study participation and reinforcement of study goals with families who have lower educational levels to facilitate participation and decrease attrition bias.
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Affiliation(s)
- Sara B DeMauro
- Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA, .,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA,
| | - Scarlett L Bellamy
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.,Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Melissa Fernando
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Julie Hoffmann
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Teresa Gratton
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Barbara Schmidt
- Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Schlegel J, Hoffmann J, Röll D, Müller B, Günther S, Zhang W, Janise A, Vössing C, Fühler B, Neidhardt J, Khanna H, Lorenz B, Stieger K. Toward genome editing in X-linked RP-development of a mouse model with specific treatment relevant features. Transl Res 2019; 203:57-72. [PMID: 30213530 PMCID: PMC6294733 DOI: 10.1016/j.trsl.2018.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 01/06/2023]
Abstract
Genome editing represents a powerful tool to treat inherited disorders. Highly specific endonucleases induce a DNA double strand break near the mutant site, which is subsequently repaired by cellular DNA repair mechanisms that involve the presence of a wild type template DNA. In vivo applications of this strategy are still rare, in part due to the absence of appropriate animal models carrying human disease mutations and knowledge of the efficient targeting of endonucleases. Here we report the generation and characterization of a new mouse model for X-linked retinitis pigmentosa (XLRP) carrying a point mutation in the mutational hotspot exon ORF15 of the RPGR gene as well as a recognition site for the homing endonuclease I-SceI. Presence of the genomic modifications was verified at the RNA and protein levels. The mutant protein was observed at low levels. Optical coherence tomography studies revealed a slowly progressive retinal degeneration with photoreceptor loss starting at 9 months of age, paralleling the onset of functional deficits as seen in the electroretinogram. Early changes to the outer retinal bands can be used as biomarker during treatment applications. We further show for the first time efficient targeting using the I-SceI enzyme at the genomic locus in a proof of concept in photoreceptors following adeno-associated virus mediated gene transfer in vivo. Taken together, our studies not only provide a human-XLRP disease model but also act as a platform to design genome editing technology for retinal degenerative diseases using the currently available endonucleases.
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Affiliation(s)
- J Schlegel
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - J Hoffmann
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - D Röll
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - B Müller
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - S Günther
- Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - W Zhang
- Department of Ophthalmology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - A Janise
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - C Vössing
- Human Genetics, Faculty of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany
| | - B Fühler
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - J Neidhardt
- Human Genetics, Faculty of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany; Research Center Neurosensory Science, University Oldenburg, Oldenburg, Germany
| | - H Khanna
- Department of Ophthalmology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - B Lorenz
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - K Stieger
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University Giessen, Giessen, Germany.
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Hoffmann J, Exner M, Bremicker K, Stumpp P, Stepan H. Diagnostik des unteren Uterinsegments bei Status nach Sectio – Erkenntnisse aus einer 3T MRT Studie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671166] [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: 10/28/2022] Open
Affiliation(s)
- J Hoffmann
- Universität Leipzig, Geburtsmedizin, Leipzig, Deutschland
| | - M Exner
- Universität Leipzig, Diagnostische und Interventionelle Radiologie, Leipzig, Deutschland
| | - K Bremicker
- Universität Leipzig, Diagnostische und Interventionelle Radiologie, Leipzig, Deutschland
| | - P Stumpp
- Universität Leipzig, Diagnostische und Interventionelle Radiologie, Leipzig, Deutschland
| | - H Stepan
- Universität Leipzig, Geburtsmedizin, Leipzig, Deutschland
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Zopf D, Tsvetkova Y, Hoffmann J. Identification of effective drug combinations with regorafenib (REG) for the treatment of pediatric rhabdomyosarcomas (RMS). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.041] [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: 11/13/2022] Open
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Kiver V, Gambara G, Jurmeister P, Schweiger C, Fuchs K, Gorea O, Burock S, Liedtke C, Karsten M, Bangemann N, Kußmaul J, Hoffmann J, Regenbrecht C, Denkert C, Keilholz U, Blohmer JU. Erfolgreiche Etablierung von präklinischen Brustkrebsmodellen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671499] [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: 10/28/2022] Open
Affiliation(s)
- V Kiver
- Charité – Universitätsmedizin Berlin, Campus Mitte, Gynäkologie mit Brustzentrum, Berlin, Deutschland
- Charité Comprehensive Cancer Center, Berlin, Deutschland
| | - G Gambara
- Charité Comprehensive Cancer Center, Berlin, Deutschland
- Deutsches Konsortium für translationale Krebsforschung, Berlin, Deutschland
- Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - P Jurmeister
- Charité Comprehensive Cancer Center, Berlin, Deutschland
- Charité – Universitätsmedizin Berlin, Institut für Pathologie, Berlin, Deutschland
| | - C Schweiger
- Charité Comprehensive Cancer Center, Berlin, Deutschland
- Deutsches Konsortium für translationale Krebsforschung, Berlin, Deutschland
- Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - K Fuchs
- Deutsches Konsortium für translationale Krebsforschung, Berlin, Deutschland
- Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - O Gorea
- Charité – Universitätsmedizin Berlin, Campus Mitte, Gynäkologie mit Brustzentrum, Berlin, Deutschland
- Charité Comprehensive Cancer Center, Berlin, Deutschland
| | - S Burock
- Charité Comprehensive Cancer Center, Berlin, Deutschland
| | - C Liedtke
- Charité – Universitätsmedizin Berlin, Campus Mitte, Gynäkologie mit Brustzentrum, Berlin, Deutschland
| | - M Karsten
- Charité – Universitätsmedizin Berlin, Campus Mitte, Gynäkologie mit Brustzentrum, Berlin, Deutschland
| | - N Bangemann
- Charité – Universitätsmedizin Berlin, Campus Mitte, Gynäkologie mit Brustzentrum, Berlin, Deutschland
| | - J Kußmaul
- Charité – Universitätsmedizin Berlin, Campus Mitte, Gynäkologie mit Brustzentrum, Berlin, Deutschland
| | - J Hoffmann
- Experimental Pharmacology &Oncology Berlin GmbH-Buch, Berlin, Deutschland
| | - C Regenbrecht
- cpo – cellular phenomics& oncology Berlin-Buch GmbH, Berlin, Deutschland
| | - C Denkert
- Deutsches Konsortium für translationale Krebsforschung, Berlin, Deutschland
- Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
- Charité – Universitätsmedizin Berlin, Institut für Pathologie, Berlin, Deutschland
| | - U Keilholz
- Charité Comprehensive Cancer Center, Berlin, Deutschland
- Deutsches Konsortium für translationale Krebsforschung, Berlin, Deutschland
- Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - JU Blohmer
- Charité – Universitätsmedizin Berlin, Campus Mitte, Gynäkologie mit Brustzentrum, Berlin, Deutschland
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Andraczek T, Hoffmann J, Stepan H. Die Beziehung zwischen der sFlt-1/PlGF-Ratio und der klinischen Entscheidungsfindung bei Schwangerschaften mit Plazentapathologie – eine „real world“-Analyse. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671456] [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: 10/28/2022] Open
Affiliation(s)
- T Andraczek
- Universitätsklinikum Leipzig, Abteilung Geburtsmedizin, Leipzig, Deutschland
| | - J Hoffmann
- Universitätsklinikum Leipzig, Abteilung Geburtsmedizin, Leipzig, Deutschland
| | - H Stepan
- Universitätsklinikum Leipzig, Abteilung Geburtsmedizin, Leipzig, Deutschland
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Hoonpongsimanont W, Sahota P, Mobayed O, Danishgar L, Ghanem G, Hoffmann J, Saadat S, Lotfipour S. 335 Correlation Between a Direct Alcohol Biomarker, Phosphatidylethanol, and the Alcohol Use Disorders Identification Test. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.340] [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: 11/16/2022]
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Tsvetkova Y, Green C, Schuetz G, Hoffmann J, Zopf D, Lejeune P. Comparative assessment of orthotopic brain tumor growth using bioluminescence and magnetic resonance imaging. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy273.385] [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: 11/13/2022] Open
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