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Ütkür K, Mayer K, Liu S, Brinkmann U, Schaffrath R. Functional Integrity of Radical SAM Enzyme Dph1•Dph2 Requires Non-Canonical Cofactor Motifs with Tandem Cysteines. Biomolecules 2024; 14:470. [PMID: 38672486 DOI: 10.3390/biom14040470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The Dph1•Dph2 heterodimer from yeast is a radical SAM (RS) enzyme that generates the 3-amino-3-carboxy-propyl (ACP) precursor for diphthamide, a clinically relevant modification on eukaryotic elongation factor 2 (eEF2). ACP formation requires SAM cleavage and atypical Cys-bound Fe-S clusters in each Dph1 and Dph2 subunit. Intriguingly, the first Cys residue in each motif is found next to another ill-defined cysteine that we show is conserved across eukaryotes. As judged from structural modeling, the orientation of these tandem cysteine motifs (TCMs) suggests a candidate Fe-S cluster ligand role. Hence, we generated, by site-directed DPH1 and DPH2 mutagenesis, Dph1•Dph2 variants with cysteines from each TCM replaced individually or in combination by serines. Assays diagnostic for diphthamide formation in vivo reveal that while single substitutions in the TCM of Dph2 cause mild defects, double mutations almost entirely inactivate the RS enzyme. Based on enhanced Dph1 and Dph2 subunit instability in response to cycloheximide chases, the variants with Cys substitutions in their cofactor motifs are particularly prone to protein degradation. In sum, we identify a fourth functionally cooperative Cys residue within the Fe-S motif of Dph2 and show that the Cys-based cofactor binding motifs in Dph1 and Dph2 are critical for the structural integrity of the dimeric RS enzyme in vivo.
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Affiliation(s)
- Koray Ütkür
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany
| | - Klaus Mayer
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, 82377 Penzberg, Germany
| | - Shihui Liu
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, 82377 Penzberg, Germany
| | - Raffael Schaffrath
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany
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Wessels U, Neff F, Fakhiri J, Mayer K, Brinkmann U, Stubenrauch K. Novel assay format for total anti-adeno-associated virus antibody detection with low capsid consumption and built-in specificity control. Bioanalysis 2024. [PMID: 38497775 DOI: 10.4155/bio-2023-0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Aim: To develop an assay format for detection of total anti-adeno-associated virus 2 (AAV2) antibodies with low capsid material consumption. Methods: An immune complex (IC) assay format was developed. The format is based on the formation of ICs in solution and their subsequent detection using an anti-AAV2 antibody for capture and an antibody against the study species IgG for detection. Results: The feasibility of the IC assay for detection of preexisting and treatment-emergent anti-AAV2 antibodies was demonstrated in cynomolgus monkey and human serum samples, including samples from a preclinical study with AAV2-based therapies. Conclusion: The presented IC assay is an easy-to-perform total anti-AAV2 antibody assay that requires a small amount of unlabeled capsid material and provides an intrinsic specificity control.
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Affiliation(s)
- Uwe Wessels
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center, Munich, Germany
- Roche Diagnostics GmbH, Nonnenwald 2, Penzberg, 82377, Germany
| | - Florian Neff
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center, Munich, Germany
| | - Julia Fakhiri
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center, Munich, Germany
| | - Klaus Mayer
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center, Munich, Germany
| | - Ulrich Brinkmann
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center, Munich, Germany
| | - Kay Stubenrauch
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center, Munich, Germany
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3
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Ütkür K, Schmidt S, Mayer K, Klassen R, Brinkmann U, Schaffrath R. DPH1 Gene Mutations Identify a Candidate SAM Pocket in Radical Enzyme Dph1•Dph2 for Diphthamide Synthesis on EF2. Biomolecules 2023; 13:1655. [PMID: 38002337 PMCID: PMC10669111 DOI: 10.3390/biom13111655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
In eukaryotes, the Dph1•Dph2 dimer is a non-canonical radical SAM enzyme. Using iron-sulfur (FeS) clusters, it cleaves the cosubstrate S-adenosyl-methionine (SAM) to form a 3-amino-3-carboxy-propyl (ACP) radical for the synthesis of diphthamide. The latter decorates a histidine residue on elongation factor 2 (EF2) conserved from archaea to yeast and humans and is important for accurate mRNA translation and protein synthesis. Guided by evidence from archaeal orthologues, we searched for a putative SAM-binding pocket in Dph1•Dph2 from Saccharomyces cerevisiae. We predict an SAM-binding pocket near the FeS cluster domain that is conserved across eukaryotes in Dph1 but not Dph2. Site-directed DPH1 mutagenesis and functional characterization through assay diagnostics for the loss of diphthamide reveal that the SAM pocket is essential for synthesis of the décor on EF2 in vivo. Further evidence from structural modeling suggests particularly critical residues close to the methionine moiety of SAM. Presumably, they facilitate a geometry specific for SAM cleavage and ACP radical formation that distinguishes Dph1•Dph2 from classical radical SAM enzymes, which generate canonical 5'-deoxyadenosyl (dAdo) radicals.
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Affiliation(s)
- Koray Ütkür
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany; (K.Ü.); (S.S.); (R.K.)
| | - Sarina Schmidt
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany; (K.Ü.); (S.S.); (R.K.)
| | - Klaus Mayer
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, 82377 Penzberg, Germany; (K.M.); (U.B.)
| | - Roland Klassen
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany; (K.Ü.); (S.S.); (R.K.)
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, 82377 Penzberg, Germany; (K.M.); (U.B.)
| | - Raffael Schaffrath
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, 82377 Penzberg, Germany; (K.M.); (U.B.)
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4
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Vasylyeva H, Mironyuk I, Strilchuk M, Mayer K, Dallas L, Tryshyn V, Maliuk I, Hryhorenko M, Zhukov O, Savka K. Age dating of liquid 90Sr- 90Y sources. Appl Radiat Isot 2023; 200:110906. [PMID: 37451148 DOI: 10.1016/j.apradiso.2023.110906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/07/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
In the context of age dating of 90Sr, the selective adsorption of zirconium ions from the mixture with strontium and yttrium by adsorbents based on TiO2 with a chemically modified surface was investigated. The general features of the separation process of strontium, yttrium, and zirconium in batch conditions were determined. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was used to analyze the initial and residual concentrations of the studied cations. Separation of 90Zr and 90Sr from a liquid source containing 90Sr-90Y using adsorbents based on TiO2 was performed for the first time. The ratio of 90Zr/90Sr was measured, and the age of liquid 90Sr-90Y sources was determined. In addition, we studied the age dating of 90Sr-90Y sources using a combination of liquid-scintillation counting of 90Sr and ICP-MS measurement. The results of both methods - the method of age-dating with the chemical separation of isotopes and the combination of LSC and ICP-MS analysis - agree very well and thus serve for cross-validation. Moreover, the combination of the two methods increases the confidence in the age-dating results of 90Sr-90Y sources.
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Affiliation(s)
| | - Ivan Mironyuk
- Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Mykola Strilchuk
- Institute for Nuclear Research, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Klaus Mayer
- Joint Research Centre, European Commission, Karlsruhe, Germany
| | | | - Volodymyr Tryshyn
- Institute for Nuclear Research, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Igor Maliuk
- Institute for Nuclear Research, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Maryna Hryhorenko
- Institute for Nuclear Research, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Oleksandr Zhukov
- Institute for Nuclear Research, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Khrystyna Savka
- Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
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Arend M, Ütkür K, Hawer H, Mayer K, Ranjan N, Adrian L, Brinkmann U, Schaffrath R. Yeast gene KTI13 (alias DPH8) operates in the initiation step of diphthamide synthesis on elongation factor 2. Microb Cell 2023; 10:195-203. [PMID: 37662670 PMCID: PMC10468694 DOI: 10.15698/mic2023.09.804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023]
Abstract
In yeast, Elongator-dependent tRNA modifications are regulated by the Kti11•Kti13 dimer and hijacked for cell killing by zymocin, a tRNase ribotoxin. Kti11 (alias Dph3) also controls modification of elongation factor 2 (EF2) with diphthamide, the target for lethal ADP-ribosylation by diphtheria toxin (DT). Diphthamide formation on EF2 involves four biosynthetic steps encoded by the DPH1-DPH7 network and an ill-defined KTI13 function. On further examining the latter gene in yeast, we found that kti13Δ null-mutants maintain unmodified EF2 able to escape ADP-ribosylation by DT and to survive EF2 inhibition by sordarin, a diphthamide-dependent antifungal. Consistently, mass spectrometry shows kti13Δ cells are blocked in proper formation of amino-carboxyl-propyl-EF2, the first diphthamide pathway intermediate. Thus, apart from their common function in tRNA modification, both Kti11/Dph3 and Kti13 share roles in the initiation step of EF2 modification. We suggest an alias KTI13/DPH8 nomenclature indicating dual-functionality analogous to KTI11/DPH3.
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Affiliation(s)
- Meike Arend
- Institute of Biology, Division of Microbiology, University of Kassel, Heinrich-Plett-Str. 40, 34132 Kassel, Germany
| | - Koray Ütkür
- Institute of Biology, Division of Microbiology, University of Kassel, Heinrich-Plett-Str. 40, 34132 Kassel, Germany
| | - Harmen Hawer
- Institute of Biology, Division of Microbiology, University of Kassel, Heinrich-Plett-Str. 40, 34132 Kassel, Germany
| | - Klaus Mayer
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center München, Nonnenwald 2, 82377 Penzberg, Germany
| | - Namit Ranjan
- Max-Planck-Institute for Biophysical Chemistry, Am Fassberg 11, 37077 Göttingen, Germany
| | - Lorenz Adrian
- Environmental Biotechnology, Helmholtz Centre for Environmental Research - UFZ, 04318 Leipzig, Germany
| | - Ulrich Brinkmann
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center München, Nonnenwald 2, 82377 Penzberg, Germany
| | - Raffael Schaffrath
- Institute of Biology, Division of Microbiology, University of Kassel, Heinrich-Plett-Str. 40, 34132 Kassel, Germany
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6
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Ütkür K, Mayer K, Khan M, Manivannan T, Schaffrath R, Brinkmann U. DPH1 and DPH2 variants that confer susceptibility to diphthamide deficiency syndrome in human cells and yeast models. Dis Model Mech 2023; 16:dmm050207. [PMID: 37675463 PMCID: PMC10538292 DOI: 10.1242/dmm.050207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
The autosomal-recessive diphthamide deficiency syndrome presents as intellectual disability with developmental abnormalities, seizures, craniofacial and additional morphological phenotypes. It is caused by reduced activity of proteins that synthesize diphthamide on human translation elongation factor 2. Diphthamide synthesis requires seven proteins (DPH1-DPH7), with clinical deficiency described for DPH1, DPH2 and DPH5. A limited set of variant alleles from syndromic patients has been functionally analyzed, but databases (gnomAD) list additional so far uncharacterized variants in human DPH1 and DPH2. Because DPH enzymes are conserved among eukaryotes, their functionality can be assessed in yeast and mammalian cells. Our experimental assessment of known and uncharacterized DPH1 and DPH2 missense alleles showed that six variants are tolerated despite inter-species conservation. Ten additional human DPH1 (G113R, A114T, H132P, H132R, S136R, C137F, L138P, Y152C, S221P, H240R) and two DPH2 (H105P, C341Y) variants showed reduced functionality and hence are deficiency-susceptibility alleles. Some variants locate close to the active enzyme center and may affect catalysis, while others may impact on enzyme activation. In sum, our study has identified functionally compromised alleles of DPH1 and DPH2 genes that likely cause diphthamide deficiency syndrome.
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Affiliation(s)
- Koray Ütkür
- Institut für Biologie,Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany
| | - Klaus Mayer
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, 82377 Penzberg, Germany
| | - Maliha Khan
- Institut für Biologie,Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany
| | - Thirishika Manivannan
- Institut für Biologie,Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany
| | - Raffael Schaffrath
- Institut für Biologie,Fachgebiet Mikrobiologie, Universität Kassel, 34132 Kassel, Germany
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, 82377 Penzberg, Germany
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Hu B, Liu Z, Haensch R, Mithöfer A, Peters FS, Vornam B, Messerer M, Mayer K, von Wirén N, Rennenberg H. Diplodia sapinea infection reprograms foliar traits of its pine (Pinus sylvestris L.) host to death. Tree Physiol 2023; 43:611-629. [PMID: 36503935 DOI: 10.1093/treephys/tpac137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 11/25/2022] [Accepted: 12/04/2022] [Indexed: 05/03/2023]
Abstract
Infection with the necrotrophic fungus Diplodia sapinea (Fr.) Fuckel is among the economically and ecologically most devastating diseases of conifers in the northern hemisphere and is accelerated by global climate change. This study aims to characterize the changes mediated by D. sapinea infection on its pine host (Pinus sylvestris L.) that lead to the death of its needles. For this purpose, we performed an indoor infection experiment and inoculated shoot tips of pine seedlings with virulent D. sapinea. The consequences for foliar traits, including the phytohormone profile, were characterized at both the metabolite and transcriptome level. Our results showed that D. sapinea infection strongly affected foliar levels of most phytohormones and impaired a multitude of other metabolic and structural foliar traits, such as reactive oxygen species scavenging. Transcriptome analysis revealed that these changes are partially mediated via modified gene expression by fungal exposure. Diplodia sapinea appears to overcome the defense reactions of its pine host by reprogramming gene expression and post-transcriptional controls that determine essential foliar metabolic traits such as the phytohormone profile, cell wall composition and antioxidative system.
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Affiliation(s)
- Bin Hu
- Center of Molecular Ecophysiology (CMEP), College of Resources and Environment, Southwest University No. 2, Tiansheng Road, Beibei District, 400715 Chongqing, P.R. China
- Institute of Forest Sciences, Chair of Tree Physiology, Albert-Ludwigs-Universität Freiburg, Georges-Koehler-Allee 53/54, D-79110 Freiburg, Germany
| | - Zhenshan Liu
- Center of Molecular Ecophysiology (CMEP), College of Resources and Environment, Southwest University No. 2, Tiansheng Road, Beibei District, 400715 Chongqing, P.R. China
| | - Robert Haensch
- Center of Molecular Ecophysiology (CMEP), College of Resources and Environment, Southwest University No. 2, Tiansheng Road, Beibei District, 400715 Chongqing, P.R. China
- Institute for Plant Biology, Technische Universität Braunschweig, Humboldtstraße 1, D-38106 Braunschweig, Germany
| | - Axel Mithöfer
- Research Group Plant Defense Physiology, Max Planck Institute for Chemical Ecology, Hans-Knöll-Straße 8, D-07745 Jena, Germany
| | - Franziska S Peters
- Department of Forest Protection, FVA Forest Research Institute of Baden-Württemberg (FVA-BW), Wonnhalde Straße 04, D-79100 Freiburg, Germany
| | - Barbara Vornam
- Buesgen Institute Forest Genetics and Forest Tree Breeding, Faculty for Forest Sciences and Forest Ecology, University of Goettingen, Buesgenweg 2, 37077 Goettingen, Germany
| | - Maxim Messerer
- Plant Genome and Systems Biology, Helmholtz Center Munich-German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Klaus Mayer
- Plant Genome and Systems Biology, Helmholtz Center Munich-German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Nicolaus von Wirén
- Molecular Plant Nutrition, Leibniz-Institute for Plant Genetics and Crop Plant Research (IPK), D-06466 Gatersleben, Germany
| | - Heinz Rennenberg
- Center of Molecular Ecophysiology (CMEP), College of Resources and Environment, Southwest University No. 2, Tiansheng Road, Beibei District, 400715 Chongqing, P.R. China
- Institute of Forest Sciences, Chair of Tree Physiology, Albert-Ludwigs-Universität Freiburg, Georges-Koehler-Allee 53/54, D-79110 Freiburg, Germany
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8
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Pagliano E, Keegan E, Varga Z, Nadeau K, Meija J, Wong H, Vardanega C, Wallenius M, Mayer K, Cochrane C, El-Jaby A, Mester Z. Determination of inorganic anions in uranium ore concentrate reference materials. J Radioanal Nucl Chem 2023. [DOI: 10.1007/s10967-023-08837-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
AbstractThe determination of inorganic anions in uranium ore concentrates (UOCs) is useful to nuclear forensics for establishing the provenance of sample materials. In this collaborative study, quantitation of inorganic anions was carried out on three UOC reference materials from the National Research Council Canada: UCLO-1 (https://doi.org/10.4224/crm.2020.uclo-1), UCHI-1 (https://doi.org/10.4224/crm.2020.uchi-1), and UPER-1 (https://doi.org/10.4224/crm.2020.uper-1). The analytes were extracted into water and characterized by ion chromatography with combined standard uncertainties (uc) between 1.6 and 11%. The highest contributor to uc was homogeneity. Sulfate was the most abundant anion (2000–12,000 mg/kg SO42−). Other anions were in the 15–500 mg/kg range.
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9
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Varga Z, Nicholl A, Wallenius M, Mayer K, Mock T. Propagation and variation of material characteristics during the uranium ore concentrate production at Dolní Rožinka, Czech Republic. J Radioanal Nucl Chem 2023. [DOI: 10.1007/s10967-023-08781-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
AbstractIn the framework of the European Commission Support Programme to the International Atomic Energy Agency (EC SP task A1753) 20 samples were obtained from the Dolní Rožínka (DIAMO, Czech Republic) uranium milling facility. The sampling procedure followed stepwise the uranium production and purification from the U ore to uranium ore concentrate (yellow cake) end-product. Elemental concentrations, rare-earth elemental pattern, anion concentrations, morphology and isotope abundance ratios of S, Sr, Pb and U were measured at each sampling stage. The purpose of the measurements was to investigate the applicability of various material characteristics for authentication, propagation and variation of these parameters, and to identify the relevant signatures for nuclear forensics and safeguards during the uranium production.
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Vasic V, Buldun C, Ritz M, Dickopf S, Georges GJ, Spick C, Peuker A, Meier T, Mayer K, Brinkmann U. Targeted chain-exchange-mediated reconstitution of a split type-I cytokine for conditional immunotherapy. MAbs 2023; 15:2245111. [PMID: 37608616 PMCID: PMC10448976 DOI: 10.1080/19420862.2023.2245111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/17/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023] Open
Abstract
Antibody-cytokine fusions targeted against tumor-associated antigens (TAAs) are promising cancer immunotherapy agents, with many such molecules currently undergoing clinical trials. However, due to the limited number of tumor-specific targets, on-target off-tumor effects can lead to systemic toxicity. Additionally, targeted cytokines can be scavenged by cytokine receptors on peripheral cells, decreasing tumor penetration. This study aims at overcoming these issues by engineering a platform for targeted conditionally active type I cytokines. Building on our previously reported PACE (Prodrug-Activating Chain Exchange) platform, we split the type I cytokine interleukin-4 (IL-4) to create two inactive IL-4 prodrugs, and fused these split IL-4 counterparts to the C-termini of antibody-like molecules that undergo proximity-induced chain exchange. In doing so, we developed IL-4 prodrugs that preferentially reconstitute into active IL-4 on target cells. We demonstrate that pre-assembled split IL-4 (without additional inactivation) retains activity and present two different strategies of splitting and inactivating IL-4. Using an IL-4 responsive cell-line, we show that IL-4 prodrugs are targeted to TAAs on target cells and regain activity upon chain exchange, primarily in a cis-activation setting. Furthermore, we demonstrate that split IL-4 complementation is also possible in a trans-activation setting, which opens up the possibility for activation of immune cells in the tumor vicinity. We demonstrate that targeted on-cell prodrug conversion is more efficient than nonspecific activation in-solution. Due to the structural similarity between IL-4 and other type I cytokines relevant in cancer immunotherapy such as IL-2, IL-15, and IL-21, cytokine-PACE may be expanded to develop a variety of targeted conditionally active cytokines for cancer immunotherapy.
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Affiliation(s)
- Vedran Vasic
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Can Buldun
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
- Bellevue Asset Management, Küsnacht, Switzerland
| | - Manfred Ritz
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
- Department of Chemistry, Technical University of Munich, Garching, Germany
| | - Steffen Dickopf
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
- Discovery Biology, Morphosys AG, Planegg, Germany
| | - Guy J. Georges
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Christian Spick
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Alessa Peuker
- Reagent Research and Design, Roche Diagnostics GmbH, Penzberg, Germany
| | - Thomas Meier
- Reagent Research and Design, Roche Diagnostics GmbH, Penzberg, Germany
| | - Klaus Mayer
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
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Rauca V, Iuliano C, Mayer K, Kaesler S, Biedermann T. 487 Mast cells alter the invasive properties of melanoma cells in vitro. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.501] [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: 11/19/2022]
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12
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Lahu S, Presch A, Ndrepepa G, Bernlochner I, Joner M, Xhepa E, Kufner S, Sager HB, Mayer K, Kessler T, Laugwitz KL, Schunkert H, Neumann FJ, Kastrati A, Cassese S. Ticagrelor or prasugrel in patients with acute coronary syndrome and high bleeding risk. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1384] [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
The relative efficacy and safety of more potent P2Y12 inhibitors in patients with acute coronary syndrome (ACS) and high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI) remains unclear.
Purpose
To study the treatment effect of ticagrelor and prasugrel in PCI patients presenting with ACS and HBR.
Methods
This post-hoc analysis of the ISAR-REACT 5 trial included patients with ACS undergoing PCI, randomized to ticagrelor or prasugrel, in whom HBR was defined as per Academic Research Consortium criteria. The primary (efficacy) endpoint was the composite of all-cause death, myocardial infarction, or stroke. The secondary (safety) endpoint was Bleeding Academic Research Consortium (BARC) type 3 to 5 bleeding. Outcomes were assessed 12 months after randomisation.
Results
Out of the 3,239 patients included in this analysis, 486 fulfilled the criteria for ARC-HBR definition (HBR group; ticagrelor, n=230 and prasugrel, n=256), whilst 2,753 did not (non-HBR group; ticagrelor, n=1,375 and prasugrel, n=1,378). Compared to the non-HBR group, the HBR group had a higher risk for the primary (hazard ratio [HR]=3.57, 95% confidence interval [CI], 2.79–4.57, p<0.001), and secondary endpoint (HR=2.94 [2.17–3.99], p<0.001). In the HBR group, the primary (HR=1.09; [0.73–1.62]) and secondary (HR=1.18 [0.67–2.08]) endpoints were not statistically different between patients assigned to ticagrelor and prasugrel. In the non-HBR group, the primary endpoint (HR=1.62 [1.19–2.20]) occurred more frequently in patients assigned to ticagrelor as compared to patients assigned to prasugrel, without difference in safety (HR=1.08 [0.74–1.58]). There was no treatment allocation-by-HBR status interaction with respect to the primary (p for interaction = 0.123), or secondary (p for interaction = 0.803) endpoints.
Conclusions
In patients with ACS undergoing PCI, HBR status increased both ischemic and bleeding risks without significant impact on the relative efficacy or safety of ticagrelor versus prasugrel. These results warrant confirmation in larger cohorts.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Center for Cardiovascular Research (DZHK)Deutsches Herzzentrum München
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Affiliation(s)
- S Lahu
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - A Presch
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - G Ndrepepa
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - I Bernlochner
- Klinikum rechts der Isar, Medizinische Klinik und Poliklinik Innere Medizin I , Munich , Germany
| | - M Joner
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - E Xhepa
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - S Kufner
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - H B Sager
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - K Mayer
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - T Kessler
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - K L Laugwitz
- Klinikum rechts der Isar, Medizinische Klinik und Poliklinik Innere Medizin I , Munich , Germany
| | - H Schunkert
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - F J Neumann
- University Heart Center Freiburg-Bad Krozingen, Department of Cardiology and Angiology II , Bad Krozingen , Germany
| | - A Kastrati
- German Heart Center Munich, Technical University of Munich , Munich , Germany
| | - S Cassese
- German Heart Center Munich, Technical University of Munich , Munich , Germany
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Scalamogna M, Lahu S, Ndrepepa G, Mayer K, Gewalt S, Menichelli M, Bernlochner I, Joner M, Xhepa E, Kufner S, Laugwitz KL, Neumann FJ, Schunkert H, Kastrati A, Cassese S. Ticagrelor or prasugrel in patients with acute coronary syndrome and prior myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1400] [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
Objectives
To investigate the efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndrome (ACS) and prior myocardial infarction (MI).
Background
The efficacy and safety of ticagrelor versus prasugrel in ACS patients with prior MI remains unstudied.
Methods
Patients with ACS scheduled for an invasive strategy and randomized to ticagrelor or prasugrel in the ISAR-REACT 5 trial with available information concerning prior MI were included in the present analysis. The primary endpoint was the composite of all-cause death, myocardial infarction, or stroke; the secondary endpoint was Bleeding Academic Research Consortium (BARC) type 3 to 5 bleeding. Endpoints were assessed 12 months after randomization.
Results
A total of 4,015 patients were included in this analysis (prior MI= 631 patients; no prior MI = 3,384 patients). As compared to patients without prior MI, the primary endpoint occurred more frequently in patients with prior MI (12.6% vs. 7.2%; hazard ratio [HR] = 1.78, 95% confidence interval [CI] 1.38–2.29; p= <0.001) without significant difference in terms of secondary endpoint between groups (5.8% vs. 5.7%; HR=1.02 [0.71–1.45]; p=0.921). Patients with prior MI randomized to ticagrelor versus prasugrel displayed higher risk for primary (HR=1.62 [1.03–2.55]) but not secondary endpoint (HR=1.28 [0.56–2.91]). Patients without prior MI randomized to ticagrelor or prasugrel displayed no significant difference in terms of primary (HR=1.28 [0.99–1.65]) or secondary endpoints (HR=1.13 [0.82–1.55]). There was no treatment assignment-by-prior MI status interaction with respect to the primary (p for interaction = 0.373) and the secondary (p for interaction= 0.786) endpoints.
Conclusions
Patients with ACS and prior MI are at higher risk for recurrent ischemic but not bleeding events. The history of MI does not affect the relative efficacy and safety of ticagrelor versus prasugrel in patients with ACS.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Center for Cardiovascular Research (DZHK)Deutsches Herzzentrum München
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Affiliation(s)
- M Scalamogna
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - S Lahu
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - G Ndrepepa
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - K Mayer
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - S Gewalt
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | | | - I Bernlochner
- Hospital right the Isar, Medizinische Klinik und Poliklinik I , Munich , Germany
| | - M Joner
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - E Xhepa
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - S Kufner
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - K L Laugwitz
- Hospital right the Isar, Medizinische Klinik und Poliklinik I , Munich , Germany
| | - F J Neumann
- University Heart Center Freiburg-Bad Krozingen , Bad Krozingen , Germany
| | - H Schunkert
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - A Kastrati
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
| | - S Cassese
- German Heart Center Muenchen Technical University of Munich , Munich , Germany
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Shankar SP, Grimsrud K, Lanoue L, Egense A, Willis B, Hörberg J, AlAbdi L, Mayer K, Ütkür K, Monaghan KG, Krier J, Stoler J, Alnemer M, Shankar PR, Schaffrath R, Alkuraya FS, Brinkmann U, Eriksson LA, Lloyd K, Rauen KA. A novel DPH5-related diphthamide-deficiency syndrome causing embryonic lethality or profound neurodevelopmental disorder. Genet Med 2022; 24:2207. [PMID: 36205747 PMCID: PMC9598985 DOI: 10.1016/j.gim.2022.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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15
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LeBlanc KL, Nadeau K, Meija J, Yang L, Babay PA, Bavio MA, Boome C, Chipley D, Cristaldo Leguizamón RS, Denton J, Drew DL, Fernández MA, Fugaru V, Genetti VD, Gonzalez F, Inglis JD, Jovanovic S, Keegan E, Kell T, Kimura Y, Kinman W, Kiser S, Lindvall RE, Loi E, Mayer K, Mercier JF, Millar R, Nicholl A, Orlovskaya L, Ramella JL, Serban A, Sharp MA, Shi Y, Tóbi C, Valenzuela L, Varga Z, Vesterlund A, Virgolici M, Yamazaki H, Zubillaga EN, El-Jaby A, Mester Z. Collaborative Study for Certification of Trace Elements in Uranium Ore Concentrate CRMs UCLO-1, UCHI-1, and UPER-1. J Radioanal Nucl Chem 2022. [DOI: 10.1007/s10967-022-08446-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractTrace impurity patterns are important nuclear forensic signatures in uranium ore concentrates (UOCs) and Certified Reference Materials (CRMs) are used to validate the analysis methods employed by end users. Herein, we discuss the certification campaign for three new UOC CRMs from the National Research Council Canada: UCLO-1 (https://doi.org/10.4224/crm.2020.uclo-1), UCHI-1 (https://doi.org/10.4224/crm.2020.uchi-1), and UPER-1 (https://doi.org/10.4224/crm.2020.uper-1). This study involved 15 laboratories from 10 countries, using sector-field and (triple) quadrupole inductively-coupled plasma mass spectrometry to analyze 64 trace element impurities. We discuss the importance of the acids used for sample digestion, difficulties analyzing in a high uranium matrix, and data combination and uncertainty evaluation for this large dataset.
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Zhang H, Quintana J, Ütkür K, Adrian L, Hawer H, Mayer K, Gong X, Castanedo L, Schulten A, Janina N, Peters M, Wirtz M, Brinkmann U, Schaffrath R, Krämer U. Translational fidelity and growth of Arabidopsis require stress-sensitive diphthamide biosynthesis. Nat Commun 2022; 13:4009. [PMID: 35817801 PMCID: PMC9273596 DOI: 10.1038/s41467-022-31712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/30/2022] [Indexed: 11/09/2022] Open
Abstract
Diphthamide, a post-translationally modified histidine residue of eukaryotic TRANSLATION ELONGATION FACTOR2 (eEF2), is the human host cell-sensitizing target of diphtheria toxin. Diphthamide biosynthesis depends on the 4Fe-4S-cluster protein Dph1 catalyzing the first committed step, as well as Dph2 to Dph7, in yeast and mammals. Here we show that diphthamide modification of eEF2 is conserved in Arabidopsis thaliana and requires AtDPH1. Ribosomal -1 frameshifting-error rates are increased in Arabidopsis dph1 mutants, similar to yeast and mice. Compared to the wild type, shorter roots and smaller rosettes of dph1 mutants result from fewer formed cells. TARGET OF RAPAMYCIN (TOR) kinase activity is attenuated, and autophagy is activated, in dph1 mutants. Under abiotic stress diphthamide-unmodified eEF2 accumulates in wild-type seedlings, most strongly upon heavy metal excess, which is conserved in human cells. In summary, our results suggest that diphthamide contributes to the functionality of the translational machinery monitored by plants to regulate growth.
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Affiliation(s)
- Hongliang Zhang
- Molecular Genetics and Physiology of Plants, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitaetsstrasse 150, Box 44 ND3/30, 44801, Bochum, Germany
| | - Julia Quintana
- Molecular Genetics and Physiology of Plants, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitaetsstrasse 150, Box 44 ND3/30, 44801, Bochum, Germany
| | - Koray Ütkür
- Microbiology, Institute for Biology, University of Kassel, 34132, Kassel, Germany
| | - Lorenz Adrian
- Environmental Biotechnology, Helmholtz Centre for Environmental Research-UFZ, 04318, Leipzig, Germany.,Chair of Geobiotechnology, Technische Universität Berlin, 13355, Berlin, Germany
| | - Harmen Hawer
- Microbiology, Institute for Biology, University of Kassel, 34132, Kassel, Germany
| | - Klaus Mayer
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, 82377, Penzberg, Germany
| | - Xiaodi Gong
- Centre for Organismal Studies (COS), University of Heidelberg, 69120, Heidelberg, Germany
| | - Leonardo Castanedo
- Molecular Genetics and Physiology of Plants, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitaetsstrasse 150, Box 44 ND3/30, 44801, Bochum, Germany
| | - Anna Schulten
- Molecular Genetics and Physiology of Plants, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitaetsstrasse 150, Box 44 ND3/30, 44801, Bochum, Germany
| | - Nadežda Janina
- Molecular Genetics and Physiology of Plants, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitaetsstrasse 150, Box 44 ND3/30, 44801, Bochum, Germany
| | - Marcus Peters
- Molecular Immunology, Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany
| | - Markus Wirtz
- Centre for Organismal Studies (COS), University of Heidelberg, 69120, Heidelberg, Germany
| | - Ulrich Brinkmann
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, 82377, Penzberg, Germany
| | - Raffael Schaffrath
- Microbiology, Institute for Biology, University of Kassel, 34132, Kassel, Germany
| | - Ute Krämer
- Molecular Genetics and Physiology of Plants, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitaetsstrasse 150, Box 44 ND3/30, 44801, Bochum, Germany.
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17
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Shankar SP, Grimsrud K, Lanoue L, Egense A, Willis B, Hörberg J, AlAbdi L, Mayer K, Ütkür K, Monaghan KG, Krier J, Stoler J, Alnemer M, Shankar PR, Schaffrath R, Alkuraya FS, Brinkmann U, Eriksson LA, Lloyd K, Rauen KA. A novel DPH5-related diphthamide-deficiency syndrome causing embryonic lethality or profound neurodevelopmental disorder. Genet Med 2022; 24:1567-1582. [PMID: 35482014 DOI: 10.1016/j.gim.2022.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Diphthamide is a post-translationally modified histidine essential for messenger RNA translation and ribosomal protein synthesis. We present evidence for DPH5 as a novel cause of embryonic lethality and profound neurodevelopmental delays (NDDs). METHODS Molecular testing was performed using exome or genome sequencing. A targeted Dph5 knockin mouse (C57BL/6Ncrl-Dph5em1Mbp/Mmucd) was created for a DPH5 p.His260Arg homozygous variant identified in 1 family. Adenosine diphosphate-ribosylation assays in DPH5-knockout human and yeast cells and in silico modeling were performed for the identified DPH5 potential pathogenic variants. RESULTS DPH5 variants p.His260Arg (homozygous), p.Asn110Ser and p.Arg207Ter (heterozygous), and p.Asn174LysfsTer10 (homozygous) were identified in 3 unrelated families with distinct overlapping craniofacial features, profound NDDs, multisystem abnormalities, and miscarriages. Dph5 p.His260Arg homozygous knockin was embryonically lethal with only 1 subviable mouse exhibiting impaired growth, craniofacial dysmorphology, and multisystem dysfunction recapitulating the human phenotype. Adenosine diphosphate-ribosylation assays showed absent to decreased function in DPH5-knockout human and yeast cells. In silico modeling of the variants showed altered DPH5 structure and disruption of its interaction with eEF2. CONCLUSION We provide strong clinical, biochemical, and functional evidence for DPH5 as a novel cause of embryonic lethality or profound NDDs with multisystem involvement and expand diphthamide-deficiency syndromes and ribosomopathies.
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Affiliation(s)
- Suma P Shankar
- Division of Genomic Medicine, UC Davis Health MIND Institute, Department of Pediatrics, UC Davis Health, University of California, Davis, Sacramento, CA; Department of Ophthalmology and Vision Science, UC Davis Health, University of California, Davis, Sacramento, CA.
| | - Kristin Grimsrud
- Department of Pathology and Laboratory Medicine, UC Davis Health, University of California, Davis, Sacramento, CA; UC Davis Mouse Biology Program, University of California, Davis, Davis, CA
| | - Louise Lanoue
- UC Davis Mouse Biology Program, University of California, Davis, Davis, CA
| | - Alena Egense
- Division of Genomic Medicine, UC Davis Health MIND Institute, Department of Pediatrics, UC Davis Health, University of California, Davis, Sacramento, CA
| | - Brandon Willis
- UC Davis Mouse Biology Program, University of California, Davis, Davis, CA
| | - Johanna Hörberg
- Department of Chemistry and Molecular Biology, University of Gothenburg, Gothenburg, Sweden
| | - Lama AlAbdi
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia; Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Klaus Mayer
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich (RICM), Penzberg, Germany
| | - Koray Ütkür
- Division of Microbiology, Institute of Biology, University of Kassel, Kassel, Germany
| | | | - Joel Krier
- Division of Genetics, Brigham and Women's Hospital, Boston, MA; Undiagnosed Diseases Network
| | - Joan Stoler
- Undiagnosed Diseases Network; Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA
| | - Maha Alnemer
- Department of Obstetrics & Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Prabhu R Shankar
- Division of Health Informatics, Department of Public Health Sciences, School of Medicine, University of California, Davis, Sacramento, CA
| | - Raffael Schaffrath
- Division of Microbiology, Institute of Biology, University of Kassel, Kassel, Germany
| | - Fowzan S Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich (RICM), Penzberg, Germany
| | - Leif A Eriksson
- Department of Chemistry and Molecular Biology, University of Gothenburg, Gothenburg, Sweden
| | - Kent Lloyd
- UC Davis Mouse Biology Program, University of California, Davis, Davis, CA; Department of Surgery, UC Davis Health, University of California, Davis, Sacramento, CA
| | - Katherine A Rauen
- Division of Genomic Medicine, UC Davis Health MIND Institute, Department of Pediatrics, UC Davis Health, University of California, Davis, Sacramento, CA
| | -
- Undiagnosed Diseases Network
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18
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Dickopf S, Buldun C, Vasic V, Georges G, Hage C, Mayer K, Forster M, Wessels U, Stubenrauch KG, Benz J, Ehler A, Lauer ME, Ringler P, Kobold S, Endres S, Klein C, Brinkmann U. Prodrug-Activating Chain Exchange (PACE) converts targeted prodrug derivatives to functional bi- or multispecific antibodies. Biol Chem 2022; 403:495-508. [PMID: 35073465 PMCID: PMC9125802 DOI: 10.1515/hsz-2021-0401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/23/2021] [Indexed: 12/26/2022]
Abstract
Driven by the potential to broaden the target space of conventional monospecific antibodies, the field of multi-specific antibody derivatives is growing rapidly. The production and screening of these artificial proteins entails a high combinatorial complexity. Antibody-domain exchange was previously shown to be a versatile strategy to produce bispecific antibodies in a robust and efficient manner. Here, we show that the domain exchange reaction to generate hybrid antibodies also functions under physiological conditions. Accordingly, we modified the exchange partners for use in therapeutic applications, in which two inactive prodrugs convert into a product with additional functionalities. We exemplarily show the feasibility for generating active T cell bispecific antibodies from two inactive prodrugs, which per se do not activate T cells alone. The two complementary prodrugs harbor antigen-targeting Fabs and non-functional anti-CD3 Fvs fused to IgG-CH3 domains engineered to drive chain-exchange reactions between them. Importantly, Prodrug-Activating Chain Exchange (PACE) could be an attractive option to conditionally activate therapeutics at the target site. Several examples are provided that demonstrate the efficacy of PACE as a new principle of cancer immunotherapy in vitro and in a human xenograft model.
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Affiliation(s)
- Steffen Dickopf
- Large Molecule Research (LMR), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Can Buldun
- Large Molecule Research (LMR), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Vedran Vasic
- Large Molecule Research (LMR), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Guy Georges
- Large Molecule Research (LMR), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Carina Hage
- Discovery Oncology, Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Klaus Mayer
- Large Molecule Research (LMR), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Matthias Forster
- Large Molecule Research (LMR), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Uwe Wessels
- Pharmaceutical Sciences (PS), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Kay-Gunnar Stubenrauch
- Pharmaceutical Sciences (PS), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
| | - Jörg Benz
- Small Molecule Research, Roche Innovation Center Basel , Roche Pharma Research and Early Development (pRED) , Basel , Switzerland
| | - Andreas Ehler
- Small Molecule Research, Roche Innovation Center Basel , Roche Pharma Research and Early Development (pRED) , Basel , Switzerland
| | - Matthias E. Lauer
- Chemical Biology, Roche Innovation Center Basel , Roche Pharma Research and Early Development (pRED) , Basel , Switzerland
| | - Philippe Ringler
- Center for Cellular Imaging and Nano Analytics , Biozentrum University of Basel , Basel , Switzerland
| | - Sebastian Kobold
- Center of Integrated Protein Science Munich (CIPS-M) and Division of Clinical Pharmacology, Department of Medicine IV , University Hospital, Ludwig Maximilians University of Munich, German Center for Lung Research (DZL) , Munich , Germany
- German Center for Translational Cancer Research (DKTK) , Partner Site Munich , Munich , Germany
| | - Stefan Endres
- Center of Integrated Protein Science Munich (CIPS-M) and Division of Clinical Pharmacology, Department of Medicine IV , University Hospital, Ludwig Maximilians University of Munich, German Center for Lung Research (DZL) , Munich , Germany
- German Center for Translational Cancer Research (DKTK) , Partner Site Munich , Munich , Germany
| | - Christian Klein
- Discovery Oncology, Roche Innovation Center Zurich , Roche Pharma Research and Early Development (pRED) , Schlieren , Switzerland
| | - Ulrich Brinkmann
- Large Molecule Research (LMR), Roche Innovation Center Munich , Roche Pharma Research and Early Development (pRED) , Penzberg , Germany
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19
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Varga Z, Wallenius M, Krachler M, Rauff-Nisthar N, Fongaro L, Knott A, Nicholl A, Mayer K. Trends and perspectives in Nuclear Forensic Science. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2021.116503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Fredericksen RJ, Whitney BM, Trejo E, Nance RM, Fitzsimmons E, Altice FL, Carrico AW, Cleland CM, Del Rio C, Duerr A, El-Sadr WM, Kahana S, Kuo I, Mayer K, Mehta S, Ouellet LJ, Quan VM, Rich J, Seal DW, Springer S, Taxman F, Wechsberg W, Crane HM, Delaney JAC. Individual and poly-substance use and condomless sex among HIV-uninfected adults reporting heterosexual sex in a multi-site cohort. BMC Public Health 2021; 21:2002. [PMID: 34736425 PMCID: PMC8567631 DOI: 10.1186/s12889-021-12026-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/15/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We analyzed the association between substance use (SU) and condomless sex (CS) among HIV-negative adults reporting heterosexual sex in the Seek, Test, Treat, and Retain (STTR) consortium. We describe the impact of SU as well as person/partner and context-related factors on CS, identifying combinations of factors that indicate the highest likelihood of CS. METHODS We analyzed data from four US-based STTR studies to examine the effect of SU on CS using two SU exposures: 1) recent SU (within 3 months) and 2) SU before/during sex. Behavioral data were collected via 1:1 or self-administered computerized interviews. Adjusted individual-study, multivariable relative risk regression was used to examine the relationship between CS and SU. We also examined interactions with type of sex and partner HIV status. Pooled effect estimates were calculated using traditional fixed-effects meta-analysis. We analyzed data for recent SU (n = 6781; 82% men, median age = 33 years) and SU before/during sex (n = 2915; 69% men, median age = 40 years). RESULTS For both exposure classifications, any SU other than cannabis increased the likelihood of CS relative to non-SU (8-16%, p-values< 0.001). In the recent SU group, however, polysubstance use did not increase the likelihood of CS compared to single-substance use. Cannabis use did not increase the likelihood of CS, regardless of frequency of use. Type of sex was associated with CS; those reporting vaginal and anal sex had a higher likelihood of CS compared to vaginal sex only for both exposure classifications (18-21%, p < 0.001). Recent SU increased likelihood of CS among those reporting vaginal sex only (9-10%, p < 0.001); results were similar for those reporting vaginal and anal sex (5-8%, p < 0.01). SU before/during sex increased the likelihood of CS among those reporting vaginal sex only (20%; p < 0.001) and among those reporting vaginal and anal sex (7%; p = 0.002). Single- and poly-SU before/during sex increased the likelihood of CS for those with exclusively HIV-negative partners (7-8%, p ≤ 0.02), and for those reporting HIV-negative and HIV-status unknown partners (9-13%, p ≤ 0.03). CONCLUSION Except for cannabis, any SU increased the likelihood of CS. CS was associated with having perceived HIV-negative partners and with having had both anal/vaginal sex.
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Affiliation(s)
- R. J. Fredericksen
- UW Center for AIDS Research, Harborview Medical Center, 325 Ninth Avenue, Box 359931, Seattle, WA 98104-2499 USA
| | - B. M. Whitney
- UW Center for AIDS Research, Harborview Medical Center, 325 Ninth Avenue, Box 359931, Seattle, WA 98104-2499 USA
| | - E. Trejo
- UW Center for AIDS Research, Harborview Medical Center, 325 Ninth Avenue, Box 359931, Seattle, WA 98104-2499 USA
| | - R. M. Nance
- UW Center for AIDS Research, Harborview Medical Center, 325 Ninth Avenue, Box 359931, Seattle, WA 98104-2499 USA
| | - E. Fitzsimmons
- UW Center for AIDS Research, Harborview Medical Center, 325 Ninth Avenue, Box 359931, Seattle, WA 98104-2499 USA
| | - F. L. Altice
- Yale University AIDS Program, 135 College Street, Suite 323, New Haven, CT 06510-2283 USA
| | - A. W. Carrico
- Division of Prevention Science and Community Health, University of Miami, 1120 NW 14th St, Miami, FL 33136 USA
| | - C. M. Cleland
- Center for Drug Use and HIV Research, NYU School of Global Public Health, 665 Broadway, 11th Floor, New York, NY 10012 USA
| | - C. Del Rio
- Rollins School of Public Health, Emory University, 1518 Clifton Road, NE Room 7011, Atlanta, GA 30322 USA
| | - A. Duerr
- Fred Hutchinson Cancer Research Center, HIV Vaccine Trials Network, Box 358080 (LE 500), Seattle, WA 98109 USA
| | - W. M. El-Sadr
- Mailman School of Public Health, Columbia University, 722 West 168th Street, 13th floor, New York, NY 10032 USA
| | - S. Kahana
- National Institute on Drug Abuse, 6001 Executive Blvd, Rockville, Maryland 20852 USA
| | - I. Kuo
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC 20052 USA
| | - K. Mayer
- The Fenway Institute, 1340 Boylston Street, Boston, MA 02215 USA
| | - S. Mehta
- Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, Maryland 21205 USA
| | - L. J. Ouellet
- School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St, Chicago, IL USA
| | - V. M. Quan
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, Maryland 21205 USA
| | - J. Rich
- Center for Prisoner Health and Human Rights, Immunology Center, The Miriam Hospital, Warren Alpert Medical School, Brown University, 1125 North Main St, Providence, RI 02904 USA
| | - D. W. Seal
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, Suite 2200, New Orleans, LA 70112 USA
| | - S. Springer
- Department of Internal Medicine, School of Medicine, Yale University, 135 College Street, New Haven, CT 06510 USA
| | - F. Taxman
- Center for Advancing Correctional Excellence, Institute of Biohealth Innovation, George Mason University, 4461 Rockfish Creek Lane, Fairfax, VA 22030 USA
| | - W. Wechsberg
- Department of Health Policy and Management, Gillings School of Public Health, University of North Carolina Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599 USA
| | - H. M. Crane
- UW Center for AIDS Research, Harborview Medical Center, 325 Ninth Avenue, Box 359931, Seattle, WA 98104-2499 USA
| | - J. A. C. Delaney
- College of Pharmacy, University of Manitoba, Apotex Centre, 750 McDermot Avenue, Winnipeg, Manitoba R3E 0T5 Canada
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21
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Lahu S, Ndrepepa G, Gewalt S, Schuepke S, Bernlochner I, Aytekin A, Neumann FJ, Menichelli M, Richardt G, Laugwitz KL, Schunkert H, Kastrati A, Mayer K. Efficacy and safety of ticagrelor versus prasugrel in smokers and nonsmokers with acute coronary syndromes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1432] [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
The efficacy and safety of ticagrelor versus prasugrel according to smoking status in patients with acute coronary syndromes (ACS) are not known.
Purpose
The aim of this study was to assess the efficacy and safety of ticagrelor versus prasugrel according to smoking status in patients with ACS undergoing invasive evaluation.
Methods
This pre-specified analysis of the ISAR-REACT 5 trial included 1349 smokers and 2652 nonsmokers randomised to receive ticagrelor or prasugrel. The primary endpoint was the incidence of death, myocardial infarction, or stroke; the secondary endpoint was the incidence of Bleeding Academic Research Consortium (BARC) type 3 to 5 bleeding. Both endpoints were assessed at 12 months after randomisation.
Results
There was no significant treatment arm-by-smoking status interaction regarding the efficacy outcome. The primary endpoint occurred in 47 patients (7.0%) in the ticagrelor group and 41 patients (6.2%) in the prasugrel group in smokers (hazard ratio [HR]=1.15; 95% confidence interval [CI] 0.76–1.75; P=0.510) and in 133 patients (10.2%) in the ticagrelor group and 94 patients (7.2%) in the prasugrel group in nonsmokers (HR=1.44 [1.10–1.87], P=0.007; Pint=0.378). The secondary endpoint occurred in 27 patients (4.6%) in the ticagrelor group and 33 patients (5.6%) in the prasugrel group in smokers (HR=0.81 [0.49–1.35]; P=0.412) and in 66 patients (6.0%) in the ticagrelor group and 46 patients (4.4%) in the prasugrel group in nonsmokers (HR=1.38 [0.94–2.01]; P=0.097).
Conlusions
Although there was no significant interaction between smoking and treatment effect, the present findings suggest a greater advantage of prasugrel over ticagrelor in nonsmoker vs. smoker patients with ACS.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Centre for Cardiovascular Research;Deutsches Herzzentrum München, Germany
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Affiliation(s)
- S Lahu
- German Heart Centre Munich, Munich, Germany
| | - G Ndrepepa
- German Heart Centre Munich, Munich, Germany
| | - S Gewalt
- German Heart Centre Munich, Munich, Germany
| | - S Schuepke
- German Heart Centre Munich, Munich, Germany
| | - I Bernlochner
- Klinikum rechts der Isar, Medizinische Klinik und Poliklinik Innere Medizin I, Munich, Germany
| | - A Aytekin
- German Heart Centre Munich, Munich, Germany
| | - F J Neumann
- University Heart Center Freiburg-Bad Krozingen, Department of Cardiology and Angiology II, Bad Krozingen, Germany
| | - M Menichelli
- Hospital Fabrizio Spaziani, Cardiology, Frosinone, Italy
| | - G Richardt
- Heart Center Bad Segeberg, Bad Segeberg, Germany
| | - K L Laugwitz
- Klinikum rechts der Isar, Medizinische Klinik und Poliklinik Innere Medizin I, Munich, Germany
| | | | - A Kastrati
- German Heart Centre Munich, Munich, Germany
| | - K Mayer
- German Heart Centre Munich, Munich, Germany
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22
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Wohrle J, Seeger J, Lahr S, Mayer K, Bernlochner I, Gewalt S, Hochholzer W, Hemetsberger R, Hapfelmeier A, Sager H, Joner M, Richardt G, Neumann FJ, Schunkert H, Kastrati A. Ticagrelor or prasugrel in patients with acute coronary syndrome in relation to glomerular filtration rate. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1421] [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
Objectives
The aim of this study was to assess the safety and efficacy of ticagrelor versus prasugrel for patients with acute coronary syndrome (ACS) according to their glomerular filtration rate (GFR).
Background
The outcomes of ticagrelor versus prasugrel in patients with ACS according to GFR have not been defined.
Methods
Patients (n=3985) with GFR available were categorized in three groups according to the tertiles of GFR. The primary endpoint was a composite of all-cause death, myocardial infarction and stroke at 1 year.
Results
The primary endpoint occurred significantly more often in patients with low GFR compared to high GFR as well as in patients with low GFR compared to intermediate GFR (picture 1). Patients in the lowest GFR group had significantly higher ischemic and bleeding risks than patients in the intermediate (hazard ratio [HR] 1.93 and 1.68) or high GFR groups (HR 3.52 and 2.96). In the group with low GFR, the primary endpoint occurred in 103 of 677 ticagrelor patients (15.4%) and in 72 of 652 prasugrel patients (11.2%; (HR=1.45, [1.07–1.96], p=.016, picture 2). In addition, each single component of the primary endpoint and stent thrombosis were numerically lower with prasugrel compared with ticagrelor. Occurrence of myocardial infarction was 3.7% with prasugrel compared to 6.6% with ticagrelor (p=0.019). BARC 3–5 bleeding events were similar with ticagrelor and prasugrel (8.8% versus 7.1%, p=0.278). In the intermediate and high GFR group the primary endpoint and bleeding events were similar between prasugrel and ticagrelor.
Conclusions
The incidence of a composite endpoint (all-cause death, myocardial infarction or stroke) occurred less frequently in patients who received prasugrel compared to patients who received ticagrelor in the low GFR population, whereas rate of bleeding events was similar.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Supported by a grant (FKZ 81X1600501) from the German Center for Cardiovascular Research and the Deutsches Herzzentrum München, Germany. Primary endpoint according to GFRLow GFR: Prasugrel versus Ticagrelor
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Affiliation(s)
- J Wohrle
- Medical Campus Lake Constance, Friedrichshafen, Germany
| | - J Seeger
- Medical Campus Lake Constance, Friedrichshafen, Germany
| | - S Lahr
- German Heart Centre Munich, Munich, Germany
| | - K Mayer
- German Heart Centre Munich, Munich, Germany
| | | | - S Gewalt
- German Heart Centre Munich, Munich, Germany
| | - W Hochholzer
- University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | | | | | - H Sager
- German Heart Centre Munich, Munich, Germany
| | - M Joner
- German Heart Centre Munich, Munich, Germany
| | - G Richardt
- Heart Center Bad Segeberg, Bad Segeberg, Germany
| | - F J Neumann
- University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | | | - A Kastrati
- German Heart Centre Munich, Munich, Germany
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23
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Lahu S, Behnes M, Ndrepepa G, Neumann FJ, Sibbing D, Bernlochner I, Menichelli M, Mayer K, Richardt G, Angiolillo DJ, Laugwitz KL, Schunkert H, Schuepke S, Kastrati A, Akin I. Body mass index and efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndromes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1431] [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
The efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndromes (ACS) according to body mass index (BMI) remain unknown.
Purpose
To assess the efficacy and safety of ticagrelor versus prasugrel in patients with ACS according to BMI.
Methods
This post-hoc analysis of the ISAR-REACT 5 trial included 3987 patients with BMI data available. BMI was grouped in 3 categories: low (BMI<25 kg/m2, n=1084), intermediate (BMI ≥25 to <30 kg/m2, n=1890) and high (BMI≥30 kg/m2, n=1013). The primary endpoint was the 12-month incidence of all-cause death, myocardial infarction, or stroke. The secondary endpoint was the 12-month incidence of Bleeding Academic Research Consortium (BARC) type 3 to 5 bleeding.
Results
There was no significant treatment arm-by-BMI interaction regarding the primary endpoint (Pint=0.578). However, the primary endpoint occurred in 63 patients assigned to ticagrelor and 39 patients assigned to prasugrel in the low BMI group (11.7% vs. 7.5%; hazard ratio [HR]=1.62; 95% confidence interval [CI], 1.09–2.42; P=0.018), 78 patients assigned to ticagrelor and 58 patients assigned to prasugrel in the intermediate BMI group (8.3% vs. 6.2%; HR=1.36 [0.97–1.91]; P=0.076), and 43 patients assigned to ticagrelor and 37 patients assigned to prasugrel in the high BMI group (8.6% vs. 7.3%; HR=1.18 [0.76–1.84]; P=0.451). BARC type 3 to 5 bleeding events did not differ between ticagrelor and prasugrel in patients with low (6.5% vs. 6.6%), intermediate (5.6% vs. 5.0%), or high (4.4% vs. 2.8%) BMI.
Conclusions
BMI of patients with ACS did not impact significantly on the treatment effect of ticagrelor vs. prasugrel in terms of both efficacy and safety.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Center for Cardiovascular Research;Deutsches Herzzentrum München, Germany
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Affiliation(s)
- S Lahu
- German Heart Centre Munich, Munich, Germany
| | - M Behnes
- University Medical Centre of Mannheim, First Department of Medicine, Mannheim, Germany
| | - G Ndrepepa
- German Heart Centre Munich, Munich, Germany
| | - F J Neumann
- University Heart Center Freiburg-Bad Krozingen, Department of Cardiology and Angiology II, Bad Krozingen, Germany
| | - D Sibbing
- Ludwig Maximilians University Hospital, Munich, Germany
| | - I Bernlochner
- Klinikum rechts der Isar, Medizinische Klinik und Poliklinik Innere Medizin I, Munich, Germany
| | - M Menichelli
- Hospital Fabrizio Spaziani, Cardiology, Frosinone, Italy
| | - K Mayer
- German Heart Centre Munich, Munich, Germany
| | - G Richardt
- Heart Center Bad Segeberg, Bad Segeberg, Germany
| | - D J Angiolillo
- University of Florida College of Medicine, Jacksonville, United States of America
| | - K L Laugwitz
- Klinikum rechts der Isar, Medizinische Klinik und Poliklinik Innere Medizin I, Munich, Germany
| | | | - S Schuepke
- German Heart Centre Munich, Munich, Germany
| | - A Kastrati
- German Heart Centre Munich, Munich, Germany
| | - I Akin
- University Medical Centre of Mannheim, First Department of Medicine, Mannheim, Germany
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24
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Kovacs B, Burri H, Reek S, Sticherling C, Linka A, Ammann P, Mueller A, Kobza R, Haegeli L, Mayer K, Eriksson U, Reichlin T, Steffel J, Saguner A, Duru F. High incidence of inappropriate alarms in patients with wearable cardioverter-defibrillators: findings from the swiss WCD registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0668] [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
Introduction
The wearable cardioverter defibrillator (WCD) uses surface electrodes built into the vest to detect underlying arrhythmia before initiating a treatment sequence. However, it is also prone to inappropriate detection due to artefacts.
Purpose
The aim of this study was to assess the alarm burden in patients and its possible impact on clinical outcomes.
Methods
The Swiss WCD Registry is a nationwide, retrospective, observational registry. Patients were included from December 2011 until February 2018. Clinical characteristics and data from the WCDs, including alarm burden were analysed. Recordings ≥30 seconds of length were analysed and categorized as VT/VF, atrial fibrillation (AF), supraventricular tachycardia or artefact.
Results
A total of 10'653 device alarms were documented in 324 of 456 patients (71.1%) over a mean WCD wear-time of 2.0±1.6 months. Among these, the episode duration was 30 seconds or more in 2996 (28.2%). One hundred and eleven (3.7%) were VT/VF episodes. The remaining recordings were inappropriate arrhythmia detections (2736 (91%) due to artefacts; 117 (3.7%) AF; 48 (1.6%) supraventricular tachycardia). Two-hundred and seven patients (45.0%) had 3 or more alarms per month, whereas 49 patients (10.7%) had 1 or more alarms per day. Body mass index (BMI) was significantly higher in patients with 3 or more alarms per month (p=0.002, 25.6 vs. 27.3 kg/m2) High alarm burden was not associated with a lower average daily wear time (20.8 hours vs 20.7 hours, p=0.785) or a decreased implantable cardioverter defibrillator implantation rate after stopping WCD use (48% vs 47.3%, p=0.156).
Conclusions
In patients using WCDs, alarms emitted by the device and impending inappropriate shocks were frequent and most commonly caused by artefacts. A high alarm burden did not lead to a decreased adherence, as determined by average daily wear-times. Obesity was significantly associated with a higher alarm burden.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B Kovacs
- University Hospital Zurich, Cardiology, Zurich, Switzerland
| | - H Burri
- University Hospital of Geneva, Cardiology, Geneva, Switzerland
| | - S Reek
- Hirslanden Medical Center, Cardiology, Aarau, Switzerland
| | - C Sticherling
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - A Linka
- Cantonal Hospital Winterthur, Cardiology, Winterthur, Switzerland
| | - P Ammann
- Cantonal Hospital St. Gallen, Cardiology, St. Gallen, Switzerland
| | - A.S Mueller
- Triemli Hospital, Cardiology, Zurich, Switzerland
| | - R Kobza
- Lucerne Cantonal Hospital, Cardiology, Lucerne, Switzerland
| | - L Haegeli
- Cantonal Hospital Aarau, Cardiology, Aarau, Switzerland
| | - K Mayer
- Cantonal Hospital Grison, Cardiology, Chur, Switzerland
| | - U Eriksson
- GZO Zurich Regional Health Center, Cardiology, Wetzikon, Switzerland
| | - T Reichlin
- Bern University Hospital, Inselspital, Cardiology, Bern, Switzerland
| | - J Steffel
- University Hospital Zurich, Cardiology, Zurich, Switzerland
| | - A.M Saguner
- University Hospital Zurich, Cardiology, Zurich, Switzerland
| | - F Duru
- University Hospital Zurich, Cardiology, Zurich, Switzerland
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John S, Riessen R, Karagiannidis C, Janssens U, Busch HJ, Kochanek M, Michels G, Hermes C, Buerke M, Kluge S, Baumgärtel M, Braune S, Erbguth F, Fuhrmann V, Lebiedz P, Mayer K, Müller-Werdan U, Oppert M, Sayk F, Sedding D, Willam C, Werdan K. [Core curriculum Medical intensive care medicine of the German Society of Medical Intensive Care and Emergency Medicine (DGIIN)]. Med Klin Intensivmed Notfmed 2021; 116:1-45. [PMID: 33427907 PMCID: PMC7799161 DOI: 10.1007/s00063-020-00765-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2020] [Indexed: 11/25/2022]
Abstract
Medical intensive care medicine treats patients with severe, potentially life-threatening diseases covering the complete spectrum of internal medicine. The qualification in medical intensive care medicine requires a broad spectrum of knowledge and skills in medical intensive care medicine, but also in the general field of internal medicine. Both sides of the coin must be taken into account, the treatment with life-sustaining strategies of the acute illness of the patient and also the treatment of patient's underlying chronic diseases. The indispensable foundation of medical intensive care medicine as described in this curriculum includes basic knowledge and skills (level of competence I-III) as well as of behavior and attitudes. This curriculum is primarily dedicated to the internist in advanced training in medical intensive care medicine. However, this curriculum also intends to reach trainers in intensive care medicine and also the German physician chambers with their examiners, showing them which knowledge, skills as well as behavior and attitudes should be taught to trainees according to the education criteria of the German Society of Medical Intensive Care and Emergency Medicine (DGIIN).
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Affiliation(s)
- S John
- Klinikum Nürnberg-Süd, Medizinische Klinik 8, Abteilung für Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - R Riessen
- Dept. für Innere Medizin, Internistische Intensivstation, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - C Karagiannidis
- ARDS und ECMO Zentrum Köln-Merheim, Professur für extrakorporale Lungenersatzverfahren der Universität Witten-Herdecke, Abteilung Pneumologie, Intensiv- und Beatmungsmedizin, Kliniken der Stadt Köln gGmbH, Köln, Deutschland
| | - U Janssens
- Klinik für Innere Medizin und Internistische Intensivmedizin, St.-Antonius-Hospital gGmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Eschweiler, Deutschland
| | - H-J Busch
- Universitäts-Notfallzentrum Freiburg, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - M Kochanek
- Klinik I für Innere Medizin (Hämatologie und Onkologie), Schwerpunkt Internistische Intensivmedizin, Universitätsklinikum Köln, Köln, Deutschland
| | - G Michels
- Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital gGmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Eschweiler, Deutschland
| | | | - M Buerke
- Medizinische Klinik II, St. Marien-Krankenhaus Siegen, Siegen, Deutschland
| | - S Kluge
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - M Baumgärtel
- Klinikum Nürnberg-Nord, Intensivstation 10/II, Klinik für Innere Medizin 3, Schwerpunkt Pneumologie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - S Braune
- IV. Med. Klinik - Internistische Intensivmedizin und Notaufnahme, Franziskus-Hospital Münster, Münster, Deutschland
| | - F Erbguth
- Klinikum Nürnberg, Universitätsklinik für Neurologie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - V Fuhrmann
- Klinik für Innere Medizin I, Evangelisches Klinikum Niederrhein, Duisburg, Deutschland
| | - P Lebiedz
- Klinik für Innere Medizin und Internistische Intensivmedizin, Ev. Krankenhaus Oldenburg, Steinweg 13-17, Oldenburg, Deutschland
| | - K Mayer
- Medizinische Klinik 4, Pneumologie und Schlafmedizin, ViDia Kliniken, Karlsruhe, Deutschland
| | - U Müller-Werdan
- Klinik für Geriatrie und Altersmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
- Evangelisches Geriatriezentrum Berlin (EGZB), Berlin, Deutschland
| | - M Oppert
- Klinik für Notfall- und Intensivmedizin, Klinikum Ernst von Bergmann, Potsdam, Deutschland
| | - F Sayk
- Campus Lübeck, Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
| | - D Sedding
- Universitätsklinikum Halle (Saale), Klinik und Poliklinik für Innere Medizin III, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland
| | - C Willam
- Universitätsklinikum Erlangen, Medizinische Klinik 4, Nephrologie und Hypertensiologie, Friedrich-Alexander-Universität Erlangen, Erlangen, Deutschland
| | - K Werdan
- Universitätsklinikum Halle (Saale), Klinik und Poliklinik für Innere Medizin III, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland.
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26
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Michel S, Wagner C, Nosenko T, Steiner B, Samad-Zamini M, Buerstmayr M, Mayer K, Buerstmayr H. Merging Genomics and Transcriptomics for Predicting Fusarium Head Blight Resistance in Wheat. Genes (Basel) 2021; 12:114. [PMID: 33477759 PMCID: PMC7832326 DOI: 10.3390/genes12010114] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 01/13/2023] Open
Abstract
Genomic selection with genome-wide distributed molecular markers has evolved into a well-implemented tool in many breeding programs during the last decade. The resistance against Fusarium head blight (FHB) in wheat is probably one of the most thoroughly studied systems within this framework. Aside from the genome, other biological strata like the transcriptome have likewise shown some potential in predictive breeding strategies but have not yet been investigated for the FHB-wheat pathosystem. The aims of this study were thus to compare the potential of genomic with transcriptomic prediction, and to assess the merit of blending incomplete transcriptomic with complete genomic data by the single-step method. A substantial advantage of gene expression data over molecular markers has been observed for the prediction of FHB resistance in the studied diversity panel of breeding lines and released cultivars. An increase in prediction ability was likewise found for the single-step predictions, although this can mostly be attributed to an increased accuracy among the RNA-sequenced genotypes. The usage of transcriptomics can thus be seen as a complement to already established predictive breeding pipelines with pedigree and genomic data, particularly when more cost-efficient multiplexing techniques for RNA-sequencing will become more accessible in the future.
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Affiliation(s)
- Sebastian Michel
- Institute of Biotechnology in Plant Production (IFA-Tulln), University of Natural Resources and Life Sciences Vienna, 3430 Tulln, Austria; (C.W.); (B.S.); (M.S.-Z.); (M.B.); (H.B.)
| | - Christian Wagner
- Institute of Biotechnology in Plant Production (IFA-Tulln), University of Natural Resources and Life Sciences Vienna, 3430 Tulln, Austria; (C.W.); (B.S.); (M.S.-Z.); (M.B.); (H.B.)
| | - Tetyana Nosenko
- PGSB Plant Genome and Systems Biology, Helmholtz Center Munich, German Research Center for Environmental Health, 85764 Neuherberg, Germany; (T.N.); (K.M.)
- Research Unit Environmental Simulation (EUS) at the Institute of Biochemical Plant Pathology (BIOP), Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Barbara Steiner
- Institute of Biotechnology in Plant Production (IFA-Tulln), University of Natural Resources and Life Sciences Vienna, 3430 Tulln, Austria; (C.W.); (B.S.); (M.S.-Z.); (M.B.); (H.B.)
| | - Mina Samad-Zamini
- Institute of Biotechnology in Plant Production (IFA-Tulln), University of Natural Resources and Life Sciences Vienna, 3430 Tulln, Austria; (C.W.); (B.S.); (M.S.-Z.); (M.B.); (H.B.)
- Saatzucht Edelhof GmbH, 3910 Zwettl, Austria
| | - Maria Buerstmayr
- Institute of Biotechnology in Plant Production (IFA-Tulln), University of Natural Resources and Life Sciences Vienna, 3430 Tulln, Austria; (C.W.); (B.S.); (M.S.-Z.); (M.B.); (H.B.)
| | - Klaus Mayer
- PGSB Plant Genome and Systems Biology, Helmholtz Center Munich, German Research Center for Environmental Health, 85764 Neuherberg, Germany; (T.N.); (K.M.)
| | - Hermann Buerstmayr
- Institute of Biotechnology in Plant Production (IFA-Tulln), University of Natural Resources and Life Sciences Vienna, 3430 Tulln, Austria; (C.W.); (B.S.); (M.S.-Z.); (M.B.); (H.B.)
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27
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David S, Mayer K, Gray T, Patel D, Velasquez J, Kirby N. Conjugation of Polymer-Coated Gold Nanoparticles with Anti-EGFR Antibodies for Enhanced Radiation Therapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1596] [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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Bongiovanni D, Mayer K, Schreiner N, Karschin V, Wustrow I, Gosetti R, Schuepke S, Schunkert H, Laugwitz K, Kastrati A, Bernlochner I. ADP-induced platelet aggregation in patients with acute coronary syndrome treated with prasugrel or ticagrelor. Results of the ISAR REACT 5 platelet aggregation substudy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1721] [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
The recently published randomized multicenter open label ISAR REACT 5 trial showed that prasugrel was superior to ticagrelor with respect to the composite primary end point of death, myocardial infarction, or stroke at one year after randomization in patients with acute coronary syndrome with planned invasive evaluation. The reasons for this finding are speculative.
Purpose
The aim of this prespecified platelet aggregation substudy was to assess platelet aggregation induced by adenosine-diphosphate (ADP) in patients who received prasugrel or ticagrelor treatment and underwent PCI.
Methods
We assessed all patients who underwent PCI and who had valid ADP-induced platelet aggregation values at hospital admission and at 2–24 hours after administration of prasugrel or ticagrelor loading dose followed by maintenance dose. ADP-induced platelet aggregation values were measured using the Mulitplate Analyzer®. Patients were recruited in the German Heart Center, Munich, Germany or in Klinikum rechts der Isar, Munich, Germany, Technical University of Munich.
Results
A total of 608 patients were analyzed. Patients in the prasugrel group were slightly but significantly older than patients in the ticagrelor group (66,5 years versus 64,6 years, P=0,048). The remaining baseline characteristics did not significantly differ between the two treatment groups. ADP-induced platelet aggregation (median [IQR]) at baseline did not differ between prasgurel- and ticagrelor treated patients (809 [556; 1057] AU x min versus 797 [534–1095] AU x min. At 2–24 hours after study drug administration ADP-induced platelet aggregation was significantly lower in patients who had received prasugrel in comparison to ticagrelor (105 [57–176] AU x min versus 138 [77–207] AU x min (Figure 1).
Conclusion
ADP-induced platelet aggregation was significantly lower in patients who received prasugrel in comparison to patients who received ticagrelor, which could have influenced patients' outcome in the ISAR-REACT 5 trial.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- D Bongiovanni
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - K Mayer
- Deutsches Herzzentrum Muenchen Technical University of Munich, Cardiology, Munich, Germany
| | - N Schreiner
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - V Karschin
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - I Wustrow
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - R Gosetti
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - S Schuepke
- Deutsches Herzzentrum Muenchen Technical University of Munich, Cardiology, Munich, Germany
| | - H Schunkert
- Deutsches Herzzentrum Muenchen Technical University of Munich, Cardiology, Munich, Germany
| | - K.L Laugwitz
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - A Kastrati
- Deutsches Herzzentrum Muenchen Technical University of Munich, Cardiology, Munich, Germany
| | - I Bernlochner
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
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Bongiovanni D, Mayer K, Schreiner N, Karschin V, Wustrow I, Gosetti R, Schunkert H, Laugwitz K, Schuepke S, Kastrati A, Bernlochner I. Immature platelet fraction is a strong predictor of adverse cardiovascular events in patients with acute coronary syndrome. Results of the ISAR-REACT 5 reticulated platelet substudy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1668] [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
Reticulated or immature Platelets are pro-thrombotic RNA-rich young platelets, which have been reported to correlate with adverse events in several pathological settings including coronary artery disease. However, the predictive value of this subgroup of platelets in patients with acute coronary syndrome treated with the potent novel P2Y12 inhibitors prasugrel or ticagrelor has not been investigated yet. Moreover, their role as predictors of major bleeding is unclear.
Purpose
The primary aim of this prespecified reticulated platelet ISAR-REACT-5 substudy was to evaluate the immature platelet fraction (IPF%) in peripheral blood as a predictor of the composite primary endpoint consisting of death, myocardial infarction, or stroke at one year after randomization in patients with acute coronary syndrome.
Methods
IPF was assessed in the first 24h after randomization using a fully automated system and correlated to the incidence of the primary endpoint. All patients with available IPF values were included. The Sysmex system uses two fluorescent dyes to stain platelet RNA and a computer algorithm (Sysmex IPF Master) discriminates immature from mature platelets by the intensity of forward scattered light and fluorescence. The immature platelet fraction is displayed as percentage of the total optical platelet count (IPF%).
Results
IPF values within the first 24h after randomization were available in a total of 506 randomized patients. Baseline characteristics and IPF (median [IQR]) values did not differ between the 2 study groups (IPF: prasugrel 3.9% [2.7–5.8] ticagrelor 3.4% [2.5–5.6] p=0.56). Significantly higher IPF values were observed in patients reaching the primary endpoint (n=55 of 506) independent from the study group (p for interaction= 0.28). ROC-curve analysis revealed a cut-of value of IPF 3.6% for the prediction of death, myocardial infarction or stroke with a Hazard ratio (HR) according to cox-regression analysis of 1.98 (95% CI, 1.15–3.44), P=0.01 (Figure 1A). Interestingly, we also detected a trend for higher major bleedings (BARC 3–5) in patients with elevated IPF values above IPF>4.8% according to ROC-curve analysis (Figure 1B).
Conclusion
IPF was significantly associated with the primary endpoint in the ISAR-REACT 5 substudy independent from the treatment group and therefore is a promising novel biomarker for the prediction of adverse cardiovascular events in patients with acute coronary syndrome.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- D Bongiovanni
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - K Mayer
- Deutsches Herzzentrum Muenchen Technical University of Munich, Cardiology, Munich, Germany
| | - N Schreiner
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - V Karschin
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - I Wustrow
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - R Gosetti
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - H Schunkert
- Deutsches Herzzentrum Muenchen Technical University of Munich, Cardiology, Munich, Germany
| | - K.L Laugwitz
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - S Schuepke
- Deutsches Herzzentrum Muenchen Technical University of Munich, Cardiology, Munich, Germany
| | - A Kastrati
- Deutsches Herzzentrum Muenchen Technical University of Munich, Cardiology, Munich, Germany
| | - I Bernlochner
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
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Hawer H, Mendelsohn BA, Mayer K, Kung A, Malhotra A, Tuupanen S, Schleit J, Brinkmann U, Schaffrath R. Diphthamide-deficiency syndrome: a novel human developmental disorder and ribosomopathy. Eur J Hum Genet 2020; 28:1497-1508. [PMID: 32576952 PMCID: PMC7575589 DOI: 10.1038/s41431-020-0668-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/06/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
We describe a novel type of ribosomopathy that is defined by deficiency in diphthamidylation of translation elongation factor 2. The ribosomopathy was identified by correlating phenotypes and biochemical properties of previously described patients with diphthamide biosynthesis gene 1 (DPH1) deficiencies with a new patient that carried inactivating mutations in both alleles of the human diphthamide biosynthesis gene 2 (DPH2). The human DPH1 syndrome is an autosomal recessive disorder associated with developmental delay, abnormal head circumference (microcephaly or macrocephaly), short stature, and congenital heart disease. It is defined by variants with reduced functionality of the DPH1 gene observed so far predominantly in consanguineous homozygous patients carrying identical mutant alleles of DPH1. Here we report a child with a very similar phenotype carrying biallelic variants of the human DPH2. The gene products DPH1 and DPH2 are components of a heterodimeric enzyme complex that mediates the first step of the posttranslational diphthamide modification on the nonredundant eukaryotic translation elongation factor 2 (eEF2). Diphthamide deficiency was shown to reduce the accuracy of ribosomal protein biosynthesis. Both DPH2 variants described here severely impair diphthamide biosynthesis as demonstrated in human and yeast cells. This is the first report of a patient carrying compound heterozygous DPH2 loss-of-function variants with a DPH1 syndrome-like phenotype and implicates diphthamide deficiency as the root cause of this patient's clinical phenotype as well as of DPH1-syndrome. These findings define "diphthamide-deficiency syndrome" as a special ribosomopathy due to reduced functionality of components of the cellular machinery for eEF2-diphthamide synthesis.
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Affiliation(s)
- Harmen Hawer
- Fachgebiet Mikrobiologie, Institut für Biologie, Universität Kassel, D-34132, Kassel, Hessen, Germany
| | | | - Klaus Mayer
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, D-82377, Penzberg, Bavaria, Germany
| | - Ann Kung
- Kaiser Permanente Oakland Medical Center, Oakland, CA, 94611, USA
| | - Amit Malhotra
- Kaiser Permanente Oakland Medical Center, Oakland, CA, 94611, USA
| | - Sari Tuupanen
- Blueprint Genetics Oy, Keilaranta 16 A-B, 02150, Espoo, Finland
| | | | - Ulrich Brinkmann
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, D-82377, Penzberg, Bavaria, Germany.
| | - Raffael Schaffrath
- Fachgebiet Mikrobiologie, Institut für Biologie, Universität Kassel, D-34132, Kassel, Hessen, Germany
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Dengl S, Mayer K, Bormann F, Duerr H, Hoffmann E, Nussbaum B, Tischler M, Wagner M, Kuglstatter A, Leibrock L, Buldun C, Georges G, Brinkmann U. Format chain exchange (FORCE) for high-throughput generation of bispecific antibodies in combinatorial binder-format matrices. Nat Commun 2020; 11:4974. [PMID: 33009381 PMCID: PMC7532213 DOI: 10.1038/s41467-020-18477-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/20/2020] [Indexed: 12/17/2022] Open
Abstract
Generation of bispecific antibodies (bsAbs) requires a combination of compatible binders in formats that support desired functionalities. Here, we report that bsAb-matrices can be generated by Format Chain Exchange (FORCE), enabling screening of combinatorial binder/format spaces. Input molecules for generation of bi/multi-valent bsAbs are monospecific entities similar to knob-into-hole half-antibodies, yet with complementary CH3-interface-modulated and affinity-tagged dummy-chains. These contain mutations that lead to limited interface repulsions without compromising expression or biophysical properties of educts. Mild reduction of combinations of educts triggers spontaneous chain-exchange reactions driven by partially flawed CH3-educt interfaces resolving to perfect complementarity. This generates large bsAb matrices harboring different binders in multiple formats. Benign biophysical properties and good expression yields of educts, combined with simplicity of purification enables process automation. Examples that demonstrate the relevance of screening binder/format combinations are provided as a matrix of bsAbs that simultaneously bind Her1/Her2 and DR5 without encountering binder or format-inflicted interferences. Bispecific antibodies have been generated in many different formats and it is becoming clear that rational design alone cannot create optimal functionalities. Here the authors introduce the high throughput methodology, Format Chain Exchange (FORCE), to enable combinatorial generation of bispecific antibodies.
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Affiliation(s)
- Stefan Dengl
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Klaus Mayer
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Felix Bormann
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Harald Duerr
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Eike Hoffmann
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Bianca Nussbaum
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Michael Tischler
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Martina Wagner
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Andreas Kuglstatter
- Roche Pharma Research and Early Development (pRED), Structural Biology, Roche Innovation Center Basel, Basel, Switzerland
| | - Lea Leibrock
- Roche Pharma Research and Early Development (pRED), Structural Biology, Roche Innovation Center Basel, Basel, Switzerland
| | - Can Buldun
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Guy Georges
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development (pRED), Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany.
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Brunkhorst FM, Weigand MA, Pletz M, Gastmeier P, Lemmen SW, Meier-Hellmann A, Ragaller M, Weyland A, Marx G, Bucher M, Gerlach H, Salzberger B, Grabein B, Welte T, Werdan K, Kluge S, Bone HG, Putensen C, Rossaint R, Quintel M, Spies C, Weiß B, John S, Oppert M, Jörres A, Brenner T, Elke G, Gründling M, Mayer K, Weimann A, Felbinger TW, Axer H, Heller T, Gagelmann N. [S3 guideline sepsis-prevention, diagnosis, treatment, and aftercare : Summary of the strong recommendations]. Med Klin Intensivmed Notfmed 2020; 115:178-188. [PMID: 32185422 DOI: 10.1007/s00063-020-00671-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- F M Brunkhorst
- Zentrum für Klinische Studien, Integriertes Forschungs- und Behandlungszentrum (IFB) Sepsis und Sepsisfolgen, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Salvador-Allende-Platz 27, 07747, Jena, Deutschland.
| | - M A Weigand
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M Pletz
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - P Gastmeier
- Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - S W Lemmen
- Zentralbereich für Krankenhaushygiene und Infektiologie, Universitätsklinikum Aachen, Aachen, Deutschland
| | - A Meier-Hellmann
- Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, Helios-Klinikum Erfurt GmbH, Erfurt, Deutschland
| | - M Ragaller
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - A Weyland
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie, Klinikum Oldenburg gGmbH, Oldenburg, Deutschland
| | - G Marx
- Klinik für Operative Intensivmedizin und Intermediate Care, Universitätsklinikum Aachen, Aachen, Deutschland
| | - M Bucher
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Halle, Halle, Deutschland
| | - H Gerlach
- Klinik für Anästhesie, operative Intensivmedizin und Schmerztherapie, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | - B Salzberger
- Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - B Grabein
- Stabsstelle Klinische Mikrobiologie und Krankenhaushygiene, Klinikum der Universität München, München, Deutschland
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - K Werdan
- Universitätsklinik und Poliklinik für Innere Medizin III, Klinikum der MLU Halle-Wittenberg, Halle, Deutschland
| | - S Kluge
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - H G Bone
- Zentrum für Anästhesiologie, Intensivmedizin und Schmerztherapie, Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Deutschland
| | - C Putensen
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Bonn, Deutschland
| | - R Rossaint
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, Aachen, Deutschland
| | - M Quintel
- Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - C Spies
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - B Weiß
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - S John
- Klinik für Innere Medizin 8, Schwerpunkt Kardiologie, Klinikum Nürnberg, Nürnberg, Deutschland
| | - M Oppert
- Klinik für Notfall- und Internistische Intensivmedizin, Klinikum Ernst von Bergmann Potsdam, Potsdam, Deutschland
| | - A Jörres
- Medizinische Klinik I, Klinik für Nephrologie, Transplantationsmedizin und internistische Intensivmedizin, Krankenhaus Merheim, Klinikum der Universität Witten/Herdecke, Köln, Deutschland
| | - T Brenner
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - G Elke
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Kiel, Kiel, Deutschland
| | - M Gründling
- Klinik für Anästhesiologie - Anästhesie, Intensiv‑, Notfall- und Schmerzmedizin, Universitätsklinikum Greifswald, Greifswald, Deutschland
| | - K Mayer
- Medizinische Klinik und Poliklinik II, Klinikum der Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - A Weimann
- Klinik für Allgemein‑, Viszeral- und Onkologische Chirurgie, Klinikum "St. Georg" Leipzig gGmbH, Leipzig, Deutschland
| | - T W Felbinger
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Städtisches Klinikum München, München, Deutschland
| | - H Axer
- Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
| | - T Heller
- Universitätsklinikum Jena, Jena, Deutschland
| | - N Gagelmann
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Tutschek B, Mayer K, Rauch A. Fetal tuberous sclerosis and diagnosis of paternal gonadal mosaicism. Ultrasound Obstet Gynecol 2020; 55:691-692. [PMID: 31587404 DOI: 10.1002/uog.21880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 09/15/2019] [Indexed: 06/10/2023]
Affiliation(s)
- B Tutschek
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - K Mayer
- Center of Human Genetics and Laboratory Diagnostics, Martinsried, Germany
| | - A Rauch
- Institute of Medical Genetics, University of Zurich, Schlieren-Zürich, Switzerland
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Wallach C, Mayer K, Henneberger T, Klein W, Fässler TF. Intermediates and products of the reaction of Zn(ii) organyls with tetrel element Zintl ions: cluster extension versus complexation. Dalton Trans 2020; 49:6191-6198. [DOI: 10.1039/d0dt01096k] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Upon reactions of Zintl ions with Zn(ii) organyls various Zn-Zintl clusters as well as Zn-amide intermediates were isolated.
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Affiliation(s)
- C. Wallach
- Department Chemie
- Technische Universität München
- 85747 Garching b. München
- Germany
| | - K. Mayer
- Department Chemie
- Technische Universität München
- 85747 Garching b. München
- Germany
| | - T. Henneberger
- Department Chemie
- Technische Universität München
- 85747 Garching b. München
- Germany
| | - W. Klein
- Department Chemie
- Technische Universität München
- 85747 Garching b. München
- Germany
| | - T. F. Fässler
- Department Chemie
- Technische Universität München
- 85747 Garching b. München
- Germany
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Marchetti M, Mayer K, Wallenius M, Bulgheroni A, Wiss T, Lützenkirchen K, Fongaro L. Image texture analysis and colorimetry for the classification of uranium ore concentrate powders. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202022507003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In the context of nuclear security, uranium ore concentrates (UOCs) play an important role: they are traded in large quantities and this makes their use “out of regulatory control” a possible scenario.
Once an incident of illicit trafficking o f n uclear m aterial is detected, an understanding of its origin and production process is required; this implies the necessity to use analytical techniques able to measure characteristic parameters (e.g. physical, chemical, isotopic characteristics of the nuclear materials) which are referred to, in the field o f t he n uclear f orensics, a s signatures.
The present study investigates the potential of image texture analysis (i.e. the angle measure technique), combined with the spectrophotometric determination of colours for the evaluation of the origin of several UOCs. The use of different multivariate statistical techniques allows the categorization of about 80 different samples into a few groups of UOCs powders, which makes this approach a promising method complementing the already established methods in nuclear forensics.
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36
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Mehmet S, Rohrbach S, Oswald I, Denke M, Weiss B, Uhlich H, Mayer K, Böning A, Niemann B. Influence of Nutrition on the Short- and Long-Term Outcome after ECLS and ECMO Therapy. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705491] [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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Krachler M, Wallenius M, Nicholl A, Mayer K. Spatially-resolved uranium isotopic analysis of contaminated scrap metal using laser ablation multi-collector ICP-MS. RSC Adv 2020; 10:16629-16636. [PMID: 35498871 PMCID: PMC9053028 DOI: 10.1039/d0ra02899a] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/16/2020] [Indexed: 11/21/2022] Open
Abstract
LA-MC-ICP-MS is a fast and quasi non-destructive technique to reveal possible U isotopic inhomogeneity in scrap metal samples, filling the gap between bulk isotopic analysis and particle analysis.
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Affiliation(s)
- Michael Krachler
- European Commission
- Joint Research Centre (JRC)
- Directorate for Nuclear Safety and Security
- D-76125 Karlsruhe
- Germany
| | - Maria Wallenius
- European Commission
- Joint Research Centre (JRC)
- Directorate for Nuclear Safety and Security
- D-76125 Karlsruhe
- Germany
| | - Adrian Nicholl
- European Commission
- Joint Research Centre (JRC)
- Directorate for Nuclear Safety and Security
- D-76125 Karlsruhe
- Germany
| | - Klaus Mayer
- European Commission
- Joint Research Centre (JRC)
- Directorate for Nuclear Safety and Security
- D-76125 Karlsruhe
- Germany
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Johnson J, Anderson D, Li J, Santos Tino A, Politch J, Lipscomb J, Defelice J, Gelman M, Mayer K. HIV particles expressed in semen under INSTI-based suppressive therapy are largely myeloid cell-derived and exhibit widely diverse genotypes. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30172-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rieger CT, Liss B, Mellinghoff S, Buchheidt D, Cornely OA, Egerer G, Heinz WJ, Hentrich M, Maschmeyer G, Mayer K, Sandherr M, Silling G, Ullmann A, Vehreschild MJGT, von Lilienfeld-Toal M, Wolf HH, Lehners N. Anti-infective vaccination strategies in patients with hematologic malignancies or solid tumors-Guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). Ann Oncol 2019; 29:1354-1365. [PMID: 29688266 PMCID: PMC6005139 DOI: 10.1093/annonc/mdy117] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Infectious complications are a significant cause of morbidity and mortality in patients with malignancies specifically when receiving anticancer treatments. Prevention of infection through vaccines is an important aspect of clinical care of cancer patients. Immunocompromising effects of the underlying disease as well as of antineoplastic therapies need to be considered when devising vaccination strategies. This guideline provides clinical recommendations on vaccine use in cancer patients including autologous stem cell transplant recipients, while allogeneic stem cell transplantation is subject of a separate guideline. The document was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) by reviewing currently available data and applying evidence-based medicine criteria.
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Affiliation(s)
- C T Rieger
- Hematology and Oncology Germering, Lehrpraxis der Ludwig-Maximilians-Universität, University of Munich, Munich.
| | - B Liss
- Department of Internal Medicine, Helios University Hospital Wuppertal, Wuppertal
| | - S Mellinghoff
- Department I of Internal Medicine, University Hospital Cologne, Cologne; CECAD Cluster of Excellence, University of Cologne, Cologne
| | - D Buchheidt
- Department of Internal Medicine - Hematology and Oncology, Mannheim University Hospital, University of Heidelberg, Heidelberg
| | - O A Cornely
- Department I of Internal Medicine, University Hospital Cologne, Cologne; CECAD Cluster of Excellence, University of Cologne, Cologne; Clinical Trials Center Cologne, ZKS Köln, University Hospital of Cologne, Cologne
| | - G Egerer
- Department of Hematology, University Hospital Heidelberg, Heidelberg
| | - W J Heinz
- Department of Internal Medicine II - Hematology and Oncology, University of Würzburg, Würzburg
| | - M Hentrich
- Department of Hematology and Oncology, Rotkreuzklinikum München, Munich
| | - G Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam
| | - K Mayer
- Department of Hematology and Oncology, University Hospital Bonn, Bonn
| | | | - G Silling
- Department of Hematology and Oncology, University of Aachen, Aachen
| | - A Ullmann
- Department of Internal Medicine II - Hematology and Oncology, University of Würzburg, Würzburg
| | - M J G T Vehreschild
- Department of Internal Medicine, Helios University Hospital Wuppertal, Wuppertal
| | - M von Lilienfeld-Toal
- Department of Hematology and Oncology, Internal Medicine II, University Hospital Jena, Jena
| | - H H Wolf
- Department of Hematology and Oncology, University Hospital Halle, Halle
| | - N Lehners
- Department of Hematology, University Hospital Heidelberg, Heidelberg; Max-Eder-Group Experimental Therapies for Hematologic Malignancies, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Pradelli L, Mayer K, Klek S, Omar Alsaleh A, Rosenthal M, Heller A, Muscaritoli M. SUN-LB640: Omega-3 Fatty-Acid Enriched Parenteral Nutrition Regimens in Hospitalized Patients in EU5 Countries: A Pharmacoeconomic Analysis. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32606-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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41
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Varga Z, Wallenius M, Nicholl A, Mayer K, Balan I, Benea V. Measurement of production date (age) of nanogram amount of uranium. J Radioanal Nucl Chem 2019. [DOI: 10.1007/s10967-019-06705-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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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Mathew K, Kayzar-Boggs T, Varga Z, Gaffney A, Denton J, Fulwyler J, Garduno K, Gaunt A, Inglis J, Keller R, Kinman W, Labotka D, Lujan E, Maassen J, Mastren T, May I, Mayer K, Nicholl A, Ottenfeld C, Parsons-Davis T, Porterfield D, Rim J, Rolison J, Stanley F, Steiner R, Tandon L, Thomas M, Torres R, Treinen K, Wallenius M, Wende A, Williams R, Wimpenny J. Intercomparison of the Radio-Chronometric Ages of Plutonium-Certified Reference Materials with Distinct Isotopic Compositions. Anal Chem 2019; 91:11643-11652. [DOI: 10.1021/acs.analchem.9b02156] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kattathu Mathew
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Theresa Kayzar-Boggs
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Zsolt Varga
- European Commission, Joint Research Centre (JRC), Directorate for Nuclear Safety and Security, P.O. Box 2340, 76125 Karlsruhe, Germany
| | - Amy Gaffney
- Lawrence Livermore National Laboratory, Nuclear and Chemical Sciences Division, 7000 East Avenue, L-231, Livermore, California 94550, United States
| | - Joanna Denton
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - James Fulwyler
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Katherine Garduno
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Andrew Gaunt
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Jeremy Inglis
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Russ Keller
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - William Kinman
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Dana Labotka
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Elmer Lujan
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Joel Maassen
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Tara Mastren
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Iain May
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Klaus Mayer
- European Commission, Joint Research Centre (JRC), Directorate for Nuclear Safety and Security, P.O. Box 2340, 76125 Karlsruhe, Germany
| | - Adrian Nicholl
- European Commission, Joint Research Centre (JRC), Directorate for Nuclear Safety and Security, P.O. Box 2340, 76125 Karlsruhe, Germany
| | - Chelsea Ottenfeld
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Tashi Parsons-Davis
- Lawrence Livermore National Laboratory, Nuclear and Chemical Sciences Division, 7000 East Avenue, L-231, Livermore, California 94550, United States
| | - Donivan Porterfield
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Jung Rim
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - John Rolison
- Lawrence Livermore National Laboratory, Nuclear and Chemical Sciences Division, 7000 East Avenue, L-231, Livermore, California 94550, United States
| | - Floyd Stanley
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Rob Steiner
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Lav Tandon
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Mariam Thomas
- Actinide Analytical Chemistry, Los Alamos National Laboratory, MS G740, Los Alamos, New Mexico 87545, United States
| | - Richard Torres
- Lawrence Livermore National Laboratory, Material Sciences Division, 7000 East Avenue, L-231, Livermore, California 94550, United States
| | - Kerri Treinen
- Lawrence Livermore National Laboratory, Nuclear and Chemical Sciences Division, 7000 East Avenue, L-231, Livermore, California 94550, United States
| | - Maria Wallenius
- European Commission, Joint Research Centre (JRC), Directorate for Nuclear Safety and Security, P.O. Box 2340, 76125 Karlsruhe, Germany
| | - Allison Wende
- Nuclear and Radiochemistry, Los Alamos National Laboratory, MS J514, Los Alamos, New Mexico 87545, United States
| | - Ross Williams
- Lawrence Livermore National Laboratory, Nuclear and Chemical Sciences Division, 7000 East Avenue, L-231, Livermore, California 94550, United States
| | - Josh Wimpenny
- Lawrence Livermore National Laboratory, Nuclear and Chemical Sciences Division, 7000 East Avenue, L-231, Livermore, California 94550, United States
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Schmid D, Buntz A, Hanh Phan TN, Mayer K, Hoffmann E, Thorey I, Niewöhner J, Vasters K, Sircar R, Mundigl O, Kontermann RE, Brinkmann U. Transcytosis of payloads that are non-covalently complexed to bispecific antibodies across the hCMEC/D3 blood-brain barrier model. Biol Chem 2019; 399:711-721. [PMID: 29466231 DOI: 10.1515/hsz-2017-0311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/08/2018] [Indexed: 01/23/2023]
Abstract
A transcellular shuttle system was generated for the delivery of non-covalently linked payloads across blood-brain barrier (BBB) endothelial cells. Transcytosis-enabling shuttles are composed of bispecific antibodies (bsAbs) that simultaneously bind transferrin receptor (TfR) and haptens such as digoxigenin or biocytinamide. Haptenylated payloads are attached to these vehicles via non-covalent hapten-antibody complexation. This enables targeting to and internalization into human BBB-derived microvascular endothelial hCMEC/D3 cells. In contrast to other shuttles, this system does not require special affinities or formats of their TfR-binding moieties for transcytosis and subsequent release. Non-covalent payload complexation to bsAb is flexible and robust, works for a multitude of payloads and enables separation of payloads from shuttles during transcytosis. Released payloads can enter the brain without connected bsAb entities, minimizing potential interference with distribution or functionality. Intracellular separation of shuttle and payload and recycling to cell surfaces may also enable recharging of the cell-bound BBB shuttle with payload for subsequent (merry-go-round) transport cycles.
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Affiliation(s)
- Daniela Schmid
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Annette Buntz
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Thi Ngoc Hanh Phan
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Klaus Mayer
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Eike Hoffmann
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Irmgard Thorey
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Jens Niewöhner
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Katrin Vasters
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Ranjan Sircar
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Olaf Mundigl
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
| | - Roland E Kontermann
- Institute of Cell Biology and Immunology, University of Stuttgart, Allmandring 31, D-70569 Stuttgart, Germany
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development (pRED), Therapeutic Modalities - Large Molecule Research, Roche Innovation Center Munich, D-82377 Penzberg, Germany
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Mateus-Seidl R, Stahl S, Dengl S, Birzele F, Herrmuth H, Mayer K, Niederfellner G, Liu XF, Pastan I, Brinkmann U. Interplay between reversible phosphorylation and irreversible ADP-ribosylation of eukaryotic translation elongation factor 2. Biol Chem 2019; 400:501-512. [PMID: 30218597 DOI: 10.1515/hsz-2018-0280] [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: 06/07/2018] [Accepted: 09/11/2018] [Indexed: 11/15/2022]
Abstract
The functionality of eukaryotic translation elongation factor 2 (eEF2) is modulated by phosphorylation, eEF2 is simultaneously the molecular target of ADP-ribosylating toxins. We analyzed the interplay between phosphorylation and diphthamide-dependent ADP-ribosylation. Phosphorylation does not require diphthamide, eEF2 without it still becomes phosphorylated. ADP-ribosylation not only modifies the H715 diphthamide but also inhibits phosphorylation of S595 located in proximity to H715, and stimulates phosphorylation of T56. S595 can be phosphorylated by CDK2 and CDK1 which affects EEF2K-mediated T56-phosphorylation. Thus, ADP-ribosylation and S595-phosphorylation by kinases occur within the same vicinity and both trigger T56-phosphorylation. Diphthamide is surface-accessible permitting access to ADP-ribosylating enzymes, the adjacent S595 side chain extends into the interior. This orientation is incompatible with phosphorylation, neither allowing kinase access nor phosphate attachment. S595 phosphorylation must therefore be accompanied by structural alterations affecting the interface to ADP-ribosylating toxins. In agreement with that, replacement of S595 with Ala, Glu or Asp prevents ADP-ribosylation. Phosphorylation (starvation) as well as ADP-ribosylation (toxins) inhibit protein synthesis, both affect the S595/H715 region of eEF2, both trigger T57-phosphorylation eliciting similar transcriptional responses. Phosphorylation is short lived while ADP-ribosylation is stable. Thus, phosphorylation of the S595/H715 'modifier region' triggers transient interruption of translation while ADP-ribosylation arrests irreversibly.
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Affiliation(s)
- Rita Mateus-Seidl
- Roche Pharma Research and Early Development, Discovery Oncology, Roche Innovation Center Munich, Nonnenwald 2, D-82377 Penzberg, FRG, Germany
| | - Sebastian Stahl
- Roche Pharma Research and Early Development, Large Molecule Research, Roche Innovation Center Munich, Nonnenwald 2, D-82377 Penzberg, FRG, Germany
| | - Stefan Dengl
- Roche Pharma Research and Early Development, Large Molecule Research, Roche Innovation Center Munich, Nonnenwald 2, D-82377 Penzberg, FRG, Germany
| | - Fabian Birzele
- Roche Pharma Research and Early Development, Pharmaceutical Sciences- Bioinformatics, Roche Innovation Center Basel, Grenzacherstr. 124, CH-4070 Basel, Germany
| | - Hedda Herrmuth
- Roche Pharma Research and Early Development, Discovery Oncology, Roche Innovation Center Munich, Nonnenwald 2, D-82377 Penzberg, FRG, Germany
| | - Klaus Mayer
- Roche Pharma Research and Early Development, Large Molecule Research, Roche Innovation Center Munich, Nonnenwald 2, D-82377 Penzberg, FRG, Germany
| | - Gerhard Niederfellner
- Roche Pharma Research and Early Development, Discovery Oncology, Roche Innovation Center Munich, Nonnenwald 2, D-82377 Penzberg, FRG, Germany
| | - Xiu-Fen Liu
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 37 Convent Dr, Bethesda, MD 20814, USA
| | - Ira Pastan
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 37 Convent Dr, Bethesda, MD 20814, USA
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development, Large Molecule Research, Roche Innovation Center Munich, Nonnenwald 2, D-82377 Penzberg, FRG, Germany
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Urreizti R, Mayer K, Evrony GD, Said E, Castilla-Vallmanya L, Cody NAL, Plasencia G, Gelb BD, Grinberg D, Brinkmann U, Webb BD, Balcells S. DPH1 syndrome: two novel variants and structural and functional analyses of seven missense variants identified in syndromic patients. Eur J Hum Genet 2019; 28:64-75. [PMID: 30877278 DOI: 10.1038/s41431-019-0374-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/21/2019] [Accepted: 03/01/2019] [Indexed: 11/09/2022] Open
Abstract
DPH1 variants have been associated with an ultra-rare and severe neurodevelopmental disorder, mainly characterized by variable developmental delay, short stature, dysmorphic features, and sparse hair. We have identified four new patients (from two different families) carrying novel variants in DPH1, enriching the clinical delineation of the DPH1 syndrome. Using a diphtheria toxin ADP-ribosylation assay, we have analyzed the activity of seven identified variants and demonstrated compromised function for five of them [p.(Leu234Pro); p.(Ala411Argfs*91); p.(Leu164Pro); p.(Leu125Pro); and p.(Tyr112Cys)]. We have built a homology model of the human DPH1-DPH2 heterodimer and have performed molecular dynamics simulations to study the effect of these variants on the catalytic sites as well as on the interactions between subunits of the heterodimer. The results show correlation between loss of activity, reduced size of the opening to the catalytic site, and changes in the size of the catalytic site with clinical severity. This is the first report of functional tests of DPH1 variants associated with the DPH1 syndrome. We demonstrate that the in vitro assay for DPH1 protein activity, together with structural modeling, are useful tools for assessing the effect of the variants on DPH1 function and may be used for predicting patient outcomes and prognoses.
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Affiliation(s)
- Roser Urreizti
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, IRSJD, CIBERER, Barcelona, Spain.
| | - Klaus Mayer
- Roche Pharma Research and Early Development. Large Molecule Research, Roche Innovation Center, Munich, Nonnenwald 2, 82377, Penzberg, Germany
| | - Gilad D Evrony
- Center for Human Genetics & Genomics, New York University Langone Health, New York, NY, USA
| | - Edith Said
- Section of Medical Genetics, Mater dei Hospital, Msida, Malta.,Department of Anatomy and Cell Biology, University of Malta, Msida, Malta
| | - Laura Castilla-Vallmanya
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, IRSJD, CIBERER, Barcelona, Spain
| | - Neal A L Cody
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Sema4, Stamford, CT, USA
| | | | - Bruce D Gelb
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel Grinberg
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, IRSJD, CIBERER, Barcelona, Spain
| | - Ulrich Brinkmann
- Roche Pharma Research and Early Development. Large Molecule Research, Roche Innovation Center, Munich, Nonnenwald 2, 82377, Penzberg, Germany
| | - Bryn D Webb
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Susanna Balcells
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, IBUB, IRSJD, CIBERER, Barcelona, Spain
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Abstract
Abstract
Nuclear forensic analysis of uranium oxide fuel pellets and the respective data interpretation have proven to be important elements of the investigative process when such material is found out of regulatory control. Uranium oxide fuel pellets are produced at industrial scale and have to meet tight technical specifications. Variations in the production process of different manufacturers or fuel fabrication facilities offer an additional source of information. The compilation of such information in a nuclear materials database has proven to be a highly valuable resource. In consequence, measureable material properties (referred to as “signatures”) such as the isotopic composition, the physical dimensions, the chemical impurities, the products of the radioactive decay of uranium and the microstructure allow establishing the processing history of the material. To this end, dedicated analytical methods have to be developed and suitable methods for data evaluation and interpretation need to be utilised. The successful application of these nuclear forensic tools is illustrated with two case studies on real incidents of illicit nuclear trafficking of uranium oxide fuel pellets.
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Affiliation(s)
- Klaus Lützenkirchen
- European Commission, Joint Research Centre (JRC) , 76125 Karlsruhe , Germany
| | - Maria Wallenius
- European Commission, Joint Research Centre (JRC) , 76125 Karlsruhe , Germany
| | - Zsolt Varga
- European Commission, Joint Research Centre (JRC) , 76125 Karlsruhe , Germany
| | - Thierry Wiss
- European Commission, Joint Research Centre (JRC) , 76125 Karlsruhe , Germany
| | - Alexander Knott
- European Commission, Joint Research Centre (JRC) , 76125 Karlsruhe , Germany
| | - Adrian Nicholl
- European Commission, Joint Research Centre (JRC) , 76125 Karlsruhe , Germany
| | - Klaus Mayer
- European Commission, Joint Research Centre (JRC) , 76125 Karlsruhe , Germany
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Mayer K, Mundigl O, Kettenberger H, Birzele F, Stahl S, Pastan I, Brinkmann U. Diphthamide affects selenoprotein expression: Diphthamide deficiency reduces selenocysteine incorporation, decreases selenite sensitivity and pre-disposes to oxidative stress. Redox Biol 2019; 20:146-156. [PMID: 30312900 PMCID: PMC6180344 DOI: 10.1016/j.redox.2018.09.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 12/31/2022] Open
Abstract
The diphthamide modification of translation elongation factor 2 is highly conserved in eukaryotes and archaebacteria. Nevertheless, cells lacking diphthamide can carry out protein synthesis and are viable. We have analyzed the phenotypes of diphthamide deficient cells and found that diphthamide deficiency reduces selenocysteine incorporation into selenoproteins. Additional phenotypes resulting from diphthamide deficiency include altered tRNA-synthetase and selenoprotein transcript levels, hypersensitivity to oxidative stress and increased selenite tolerance. Diphthamide-eEF2 occupies the aminoacyl-tRNA translocation site at which UGA either stalls translation or decodes selenocysteine. Its position is in close proximity and mutually exclusive to the ribosomal binding site of release/recycling factor ABCE1, which harbors a redox-sensitive Fe-S cluster and, like diphthamide, is present in eukaryotes and archaea but not in eubacteria. Involvement of diphthamide in UGA-SECIS decoding may explain deregulated selenoprotein expression and as a consequence oxidative stress, NFkB activation and selenite tolerance in diphthamide deficient cells.
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Affiliation(s)
- Klaus Mayer
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Olaf Mundigl
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Hubert Kettenberger
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Fabian Birzele
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, Basel, Switzerland
| | - Sebastian Stahl
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany
| | - Ira Pastan
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ulrich Brinkmann
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center Munich, Penzberg, Germany.
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48
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Hawer H, Ütkür K, Arend M, Mayer K, Adrian L, Brinkmann U, Schaffrath R. Importance of diphthamide modified EF2 for translational accuracy and competitive cell growth in yeast. PLoS One 2018; 13:e0205870. [PMID: 30335802 PMCID: PMC6193676 DOI: 10.1371/journal.pone.0205870] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/02/2018] [Indexed: 01/23/2023] Open
Abstract
In eukaryotes, the modification of an invariant histidine (His-699 in yeast) residue in translation elongation factor 2 (EF2) with diphthamide involves a conserved pathway encoded by the DPH1-DPH7 gene network. Diphthamide is the target for diphtheria toxin and related lethal ADP ribosylases, which collectively kill cells by inactivating the essential translocase function of EF2 during mRNA translation and protein biosynthesis. Although this notion emphasizes the pathological importance of diphthamide, precisely why cells including our own require EF2 to carry it, is unclear. Mining the synthetic genetic array (SGA) landscape from the budding yeast Saccharomyces cerevisiae has revealed negative interactions between EF2 (EFT1-EFT2) and diphthamide (DPH1-DPH7) gene deletions. In line with these correlations, we confirm in here that loss of diphthamide modification (dphΔ) on EF2 combined with EF2 undersupply (eft2Δ) causes synthetic growth phenotypes in the composite mutant (dphΔ eft2Δ). These reflect negative interference with cell performance under standard as well as thermal and/or chemical stress conditions, cell growth rates and doubling times, competitive fitness, cell viability in the presence of TOR inhibitors (rapamycin, caffeine) and translation indicator drugs (hygromycin, anisomycin). Together with significantly suppressed tolerance towards EF2 inhibition by cytotoxic DPH5 overexpression and increased ribosomal -1 frame-shift errors in mutants lacking modifiable pools of EF2 (dphΔ, dphΔ eft2Δ), our data indicate that diphthamide is important for the fidelity of the EF2 translocation function during mRNA translation.
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Affiliation(s)
- Harmen Hawer
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, Kassel, Germany
| | - Koray Ütkür
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, Kassel, Germany
| | - Meike Arend
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, Kassel, Germany
| | - Klaus Mayer
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center München, Penzberg, Germany
| | - Lorenz Adrian
- AG Geobiochemie, Department Isotopenbiogeochemie, Helmholtz-Zentrum für Umweltforschung GmbH–UFZ, Leipzig, Germany
- Fachgebiet Geobiotechnologie, Technische Universität Berlin, Berlin, Germany
| | - Ulrich Brinkmann
- Roche Pharma Research & Early Development, Large Molecule Research, Roche Innovation Center München, Penzberg, Germany
| | - Raffael Schaffrath
- Institut für Biologie, Fachgebiet Mikrobiologie, Universität Kassel, Kassel, Germany
- * E-mail:
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49
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Richter DC, Heininger A, Brenner T, Hochreiter M, Bernhard M, Briegel J, Dubler S, Grabein B, Hecker A, Krüger WA, Mayer K, Pletz MW, Störzinger D, Pinder N, Hoppe-Tichy T, Weiterer S, Zimmermann S, Brinkmann A, Weigand MA, Lichtenstern C. [Bacterial sepsis : Diagnostics and calculated antibiotic therapy]. Anaesthesist 2018; 66:737-761. [PMID: 28980026 DOI: 10.1007/s00101-017-0363-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The mortality of patients with sepsis and septic shock is still unacceptably high. An effective antibiotic treatment within 1 h of recognition of sepsis is an important target of sepsis treatment. Delays lead to an increase in mortality; therefore, structured treatment concepts form a rational foundation, taking relevant diagnostic and treatment steps into consideration. In addition to the assumed focus and individual risks of each patient, local resistance patterns and specific problem pathogens must be taken into account for selection of anti-infection treatment. Many pathophysiological alterations influence the pharmacokinetics of antibiotics during sepsis. The principle of standard dosing should be abandoned and replaced by an individual treatment approach with stronger weighting of the pharmacokinetics/pharmacodynamics (PK/PD) index of the substance groups. Although this is not yet the clinical standard, prolonged (or continuous) infusion of beta-lactam antibiotics and therapeutic drug monitoring (TDM) can help to achieve defined PK targets. Prolonged infusion is sufficient without TDM but for continuous infusion TDM is basically necessary. A further argument for individual PK/PD-oriented antibiotic approaches is the increasing number of infections due to multidrug resistant pathogens (MDR) in the intensive care unit. For effective treatment antibiotic stewardship teams (ABS team) are becoming more established. Interdisciplinary cooperation of the ABS team with infectiologists, microbiologists and clinical pharmacists leads not only to a rational administration of antibiotics but also has a positive influence on the outcome. The gold standards for pathogen detection are still culture-based detection and microbiological resistance testing for the various antibiotic groups. Despite the rapid investigation time, novel polymerase chain reaction (PCR)-based procedures for pathogen identification and resistance determination, are currently only an adjunct to routine sepsis diagnostics due to the limited number of studies, high costs and limited availability. In complicated septic courses with multiple anti-infective treatment or recurrent sepsis, PCR-based procedures can be used in addition to therapy monitoring and diagnostics. Novel antibiotics represent potent alternatives in the treatment of MDR infections. Due to the often defined spectrum of pathogens and the practically absent resistance, they are suitable for targeted treatment of severe MDR infections (therapy escalation).
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Affiliation(s)
- D C Richter
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
| | - A Heininger
- Zentrum für Infektiologie, Sektion für Krankenhaus- und Umwelthygiene, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - T Brenner
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - M Hochreiter
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - M Bernhard
- Zentrale Notaufnahme, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - J Briegel
- Klinik für Anästhesiologie, Klinikum der Universität München, München, Deutschland
| | - S Dubler
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - B Grabein
- Stabsstelle "Klinische Mikrobiologie und Krankenhaushygiene", Klinikum der Universität München, München, Deutschland
| | - A Hecker
- Klinik für Allgemein‑, Viszeral‑, Thorax‑, Transplantations- und Kinderchirurgie, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen, Deutschland
| | - W A Krüger
- Klinik für Anästhesiologie und operative Intensivmedizin, Gesundheitsverbund Landkreis Konstanz, Klinikum Konstanz, Konstanz, Deutschland
| | - K Mayer
- Apotheke des Universitätsklinikums Heidelberg, Heidelberg, Deutschland
| | - M W Pletz
- Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - D Störzinger
- Apotheke des Universitätsklinikums Heidelberg, Heidelberg, Deutschland
| | - N Pinder
- Apotheke des Universitätsklinikums Heidelberg, Heidelberg, Deutschland
| | - T Hoppe-Tichy
- Zentrum für Infektiologie, Sektion für Krankenhaus- und Umwelthygiene, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - S Weiterer
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - S Zimmermann
- Zentrum für Infektiologie, Sektion für Krankenhaus- und Umwelthygiene, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - A Brinkmann
- Klinik für Anästhesie, operative Intensivmedizin und spezielle Schmerztherapie, Klinikum Heidenheim, Heidenheim, Deutschland
| | - M A Weigand
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - Christoph Lichtenstern
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
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50
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Reppe K, Müller-Plathe M, Krause PM, Wienhold SM, Dietert K, Gurtner C, Gutbier B, Nouailles G, Müller-Redetzky HC, Gruber A, Hocke A, Mayer K, Witzenrath M. Einfluss von Resolvin E1 auf die pulmonale Entzündungsreaktion in verschiedenen Pneumoniemodellen. Pneumologie 2018. [DOI: 10.1055/s-0038-1660919] [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]
Affiliation(s)
- K Reppe
- Med. Klinik mit SP Infektiologie & Pneumologie, Arbeitsbereich Pulmonale Inflammation, Charité-Universitätsmedizin Berlin
| | - M Müller-Plathe
- Med. Klinik mit SP Infektiologie & Pneumologie, Arbeitsbereich Pulmonale Inflammation, Charité-Universitätsmedizin Berlin
| | - PM Krause
- Med. Klinik mit SP Infektiologie & Pneumologie, Arbeitsbereich Pulmonale Inflammation, Charité-Universitätsmedizin Berlin
| | - SM Wienhold
- Med. Klinik mit SP Infektiologie & Pneumologie, Arbeitsbereich Pulmonale Inflammation, Charité-Universitätsmedizin Berlin
| | - K Dietert
- Institut für Tierpathologie, FU Berlin
| | - C Gurtner
- Institut für Tierpathologie, FU Berlin
| | - B Gutbier
- Med. Klinik mit SP Infektiologie & Pneumologie, Arbeitsbereich Pulmonale Inflammation, Charité-Universitätsmedizin Berlin
| | - G Nouailles
- Med. Klinik mit SP Infektiologie & Pneumologie, Arbeitsbereich Pulmonale Inflammation, Charité-Universitätsmedizin Berlin
| | | | - A Gruber
- Institut für Tierpathologie, FU Berlin
| | - A Hocke
- Med. Klinik mit SP Infektiologie & Pneumologie, Arbeitsbereich Pulmonale Inflammation, Charité-Universitätsmedizin Berlin
| | - K Mayer
- Zentrum für Innere Medizin, Medizinische Klinik II, Universitätsklinikum Gießen und Marburg, University of Gießen and Marburg Lung Center (UGMLC), Gießen
| | - M Witzenrath
- Med. Klinik mit SP Infektiologie & Pneumologie, Arbeitsbereich Pulmonale Inflammation, Charité-Universitätsmedizin Berlin
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