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Ingwersen J, Masanneck L, Pawlitzki M, Samadzadeh S, Weise M, Aktas O, Meuth SG, Albrecht P. Real-world evidence of ocrelizumab-treated relapsing multiple sclerosis cohort shows changes in progression independent of relapse activity mirroring phase 3 trials. Sci Rep 2023; 13:15003. [PMID: 37696848 PMCID: PMC10495413 DOI: 10.1038/s41598-023-40940-w] [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: 05/11/2023] [Accepted: 08/18/2023] [Indexed: 09/13/2023] Open
Abstract
Ocrelizumab is a B cell-depleting drug widely used in relapsing-remitting multiple sclerosis (RRMS) and primary-progressive MS. In RRMS, it is becoming increasingly apparent that accumulation of disability not only manifests as relapse-associated worsening (RAW) but also as progression independent of relapse activity (PIRA) throughout the disease course. This study's objective was to investigate the role of PIRA in RRMS patients treated with ocrelizumab. We performed a single-center, retrospective, cross-sectional study of clinical data acquired at a German tertiary multiple sclerosis referral center from 2018 to 2022. All patients with RRMS treated with ocrelizumab for at least six months and complete datasets were analyzed. Confirmed disability accumulation (CDA) was defined as a ≥ 12-week confirmed increase from the previous expanded disability status scale (EDSS) score of ≥ 1.0 if the previous EDSS was ≤ 5.5 or a ≥ 0.5-point increase if the previous EDSS was > 5.5. PIRA was defined as CDA without relapse since the last EDSS measurement and at least for the preceding 12 weeks. RAW was defined as CDA in an interval of EDSS measurements with ≥ 1 relapses. Cox proportional hazard models were used to analyze the probability of developing PIRA depending on various factors, including disease duration, previous disease-modifying treatments (DMTs), and optical coherence tomography-assessed retinal degeneration parameters. 97 patients were included in the analysis. Mean follow-up time was 29 months (range 6 to 51 months). 23.5% developed CDA under ocrelizumab therapy (n = 23). Of those, the majority developed PIRA (87.0% of CDA, n = 20) rather than RAW (13.0% of CDA, n = 3). An exploratory investigation using Cox proportional hazards ratios revealed two possible factors associated with an increased probability of developing PIRA: a shorter disease duration prior to ocrelizumab (p = 0.02) and a lower number of previous DMTs prior to ocrelizumab (p = 0.04). Our data show that in ocrelizumab-treated RRMS patients, the main driver of disability accumulation is PIRA rather than RAW. Furthermore, these real-world data show remarkable consistency with data from phase 3 randomized controlled trials of ocrelizumab in RRMS, which may increase confidence in translating results from tightly controlled RCTs into the real-world clinical setting.
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Affiliation(s)
- J Ingwersen
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - L Masanneck
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - M Pawlitzki
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - S Samadzadeh
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Regional Health Research and Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Neurology, Slagelse Hospital, Slagelse, Denmark
| | - M Weise
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - O Aktas
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - S G Meuth
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - P Albrecht
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
- Department of Neurology, Maria Hilf Clinics, Moenchengladbach, Germany.
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2
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Weise M, Bux R, Schlienz T, da Silva N, Weller L, Gronemeyer P, Dobberthien P. Fast track production: Accelerated timeline from vial to bioreactor. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255368] [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: 11/07/2022]
Affiliation(s)
- M. Weise
- Boehringer Ingelheim Pharma GmbH & Co. KG Focused Factory Clinical Supply & Transfer Birkendorfer Str. 65 88400 Biberach an der Riß Germany
| | - R. Bux
- Boehringer Ingelheim Pharma GmbH & Co. KG Focused Factory Clinical Supply & Transfer Birkendorfer Str. 65 88400 Biberach an der Riß Germany
| | - T. Schlienz
- Boehringer Ingelheim Pharma GmbH & Co. KG Focused Factory Clinical Supply & Transfer Birkendorfer Str. 65 88400 Biberach an der Riß Germany
| | - N. da Silva
- Boehringer Ingelheim Pharma GmbH & Co. KG Focused Factory Clinical Supply & Transfer Birkendorfer Str. 65 88400 Biberach an der Riß Germany
| | - L. Weller
- Boehringer Ingelheim Pharma GmbH & Co. KG Focused Factory Clinical Supply & Transfer Birkendorfer Str. 65 88400 Biberach an der Riß Germany
| | - P. Gronemeyer
- Boehringer Ingelheim Pharma GmbH & Co. KG Focused Factory Clinical Supply & Transfer Birkendorfer Str. 65 88400 Biberach an der Riß Germany
| | - P. Dobberthien
- Boehringer Ingelheim Pharma GmbH & Co. KG Focused Factory Clinical Supply & Transfer Birkendorfer Str. 65 88400 Biberach an der Riß Germany
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3
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Specker E, Matthes S, Wesolowski R, Schütz A, Grohmann M, Alenina N, Pleimes D, Mallow K, Neuenschwander M, Gogolin A, Weise M, Pfeifer J, Ziebart N, Heinemann U, von Kries JP, Nazaré M, Bader M. Structure-Based Design of Xanthine-Benzimidazole Derivatives as Novel and Potent Tryptophan Hydroxylase Inhibitors. J Med Chem 2022; 65:11126-11149. [PMID: 35921615 DOI: 10.1021/acs.jmedchem.2c00598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tryptophan hydroxylases catalyze the first and rate-limiting step in the synthesis of serotonin. Serotonin is a key neurotransmitter in the central nervous system and, in the periphery, functions as a local hormone with multiple physiological functions. Studies in genetically altered mouse models have shown that dysregulation of peripheral serotonin levels leads to metabolic, inflammatory, and fibrotic diseases. Overproduction of serotonin by tumor cells causes severe symptoms typical for the carcinoid syndrome, and tryptophan hydroxylase inhibitors are already in clinical use for patients suffering from this disease. Here, we describe a novel class of potent tryptophan hydroxylase inhibitors, characterized by spanning all active binding sites important for catalysis, specifically those of the cosubstrate pterin, the substrate tryptophan as well as directly chelating the catalytic iron ion. The inhibitors were designed to efficiently reduce serotonin in the periphery while not passing the blood-brain barrier, thus preserving serotonin levels in the brain.
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Affiliation(s)
- Edgar Specker
- Chemical Biology Platform, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str.10, 13125 Berlin-Buch, Germany
| | - Susann Matthes
- Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Robert-Rössle-Str. 10, 13125 Berlin-Buch, Germany
| | - Radoslaw Wesolowski
- Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Robert-Rössle-Str. 10, 13125 Berlin-Buch, Germany
| | - Anja Schütz
- Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Robert-Rössle-Str. 10, 13125 Berlin-Buch, Germany
| | - Maik Grohmann
- Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Robert-Rössle-Str. 10, 13125 Berlin-Buch, Germany
| | - Natalia Alenina
- Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Robert-Rössle-Str. 10, 13125 Berlin-Buch, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Potsdamer Str. 58, 10785 Berlin, Germany
| | - Dirk Pleimes
- SCINSPIRE Holding & Consulting GmbH, Dunckerstr. 25, 10437 Berlin, Germany
| | - Keven Mallow
- Chemical Biology Platform, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str.10, 13125 Berlin-Buch, Germany
| | - Martin Neuenschwander
- Chemical Biology Platform, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str.10, 13125 Berlin-Buch, Germany
| | - Angelina Gogolin
- Chemical Biology Platform, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str.10, 13125 Berlin-Buch, Germany.,Berliner Hochschule für Technik (BHT), Luxemburger Str. 10, 13353 Berlin, Germany
| | - Marie Weise
- Chemical Biology Platform, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str.10, 13125 Berlin-Buch, Germany.,Berliner Hochschule für Technik (BHT), Luxemburger Str. 10, 13353 Berlin, Germany
| | - Jochen Pfeifer
- Berliner Hochschule für Technik (BHT), Luxemburger Str. 10, 13353 Berlin, Germany
| | - Nandor Ziebart
- Chemical Biology Platform, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str.10, 13125 Berlin-Buch, Germany.,Freie Universität Berlin, Chemistry and Biochemistry Institute, Takustr. 3, 14195 Berlin, Germany
| | - Udo Heinemann
- Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Robert-Rössle-Str. 10, 13125 Berlin-Buch, Germany.,Freie Universität Berlin, Chemistry and Biochemistry Institute, Takustr. 3, 14195 Berlin, Germany
| | - Jens Peter von Kries
- Chemical Biology Platform, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str.10, 13125 Berlin-Buch, Germany
| | - Marc Nazaré
- Chemical Biology Platform, Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str.10, 13125 Berlin-Buch, Germany
| | - Michael Bader
- Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Robert-Rössle-Str. 10, 13125 Berlin-Buch, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Potsdamer Str. 58, 10785 Berlin, Germany.,University of Lübeck, Institute for Biology, Ratzeburger Allee 160, 23562 Lübeck, Germany.,Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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4
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Gazzi T, Brennecke B, Atz K, Korn C, Sykes D, Forn-Cuni G, Pfaff P, Sarott RC, Westphal MV, Mostinski Y, Mach L, Wasinska-Kalwa M, Weise M, Hoare BL, Miljuš T, Mexi M, Roth N, Koers EJ, Guba W, Alker A, Rufer AC, Kusznir EA, Huber S, Raposo C, Zirwes EA, Osterwald A, Pavlovic A, Moes S, Beck J, Nettekoven M, Benito-Cuesta I, Grande T, Drawnel F, Widmer G, Holzer D, van der Wel T, Mandhair H, Honer M, Fingerle J, Scheffel J, Broichhagen J, Gawrisch K, Romero J, Hillard CJ, Varga ZV, van der Stelt M, Pacher P, Gertsch J, Ullmer C, McCormick PJ, Oddi S, Spaink HP, Maccarrone M, Veprintsev DB, Carreira EM, Grether U, Nazaré M. Detection of cannabinoid receptor type 2 in native cells and zebrafish with a highly potent, cell-permeable fluorescent probe. Chem Sci 2022; 13:5539-5545. [PMID: 35694350 PMCID: PMC9116301 DOI: 10.1039/d1sc06659e] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/22/2022] [Indexed: 12/16/2022] Open
Abstract
Despite its essential role in the (patho)physiology of several diseases, CB2R tissue expression profiles and signaling mechanisms are not yet fully understood. We report the development of a highly potent, fluorescent CB2R agonist probe employing structure-based reverse design. It commences with a highly potent, preclinically validated ligand, which is conjugated to a silicon-rhodamine fluorophore, enabling cell permeability. The probe is the first to preserve interspecies affinity and selectivity for both mouse and human CB2R. Extensive cross-validation (FACS, TR-FRET and confocal microscopy) set the stage for CB2R detection in endogenously expressing living cells along with zebrafish larvae. Together, these findings will benefit clinical translatability of CB2R based drugs. Detection and visualization of the cannabinoid receptor type 2 by a cell-permeable high affinity fluorescent probe platform enables tracing receptor trafficking in live cells and in zebrafish.![]()
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Affiliation(s)
- Thais Gazzi
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) Campus Berlin-Buch 13125 Berlin Germany
| | - Benjamin Brennecke
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) Campus Berlin-Buch 13125 Berlin Germany
| | - Kenneth Atz
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Claudia Korn
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - David Sykes
- Faculty of Medicine & Health Sciences, University of Nottingham Nottingham NG7 2UH England UK.,United Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham Midlands England UK
| | | | - Patrick Pfaff
- Laboratorium für Organische Chemie, Eidgenössische Technische Hochschule Zürich Vladimir-Prelog-Weg 3 8093 Zürich Switzerland
| | - Roman C Sarott
- Laboratorium für Organische Chemie, Eidgenössische Technische Hochschule Zürich Vladimir-Prelog-Weg 3 8093 Zürich Switzerland
| | - Matthias V Westphal
- Laboratorium für Organische Chemie, Eidgenössische Technische Hochschule Zürich Vladimir-Prelog-Weg 3 8093 Zürich Switzerland
| | - Yelena Mostinski
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) Campus Berlin-Buch 13125 Berlin Germany
| | - Leonard Mach
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) Campus Berlin-Buch 13125 Berlin Germany
| | - Malgorzata Wasinska-Kalwa
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) Campus Berlin-Buch 13125 Berlin Germany
| | - Marie Weise
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) Campus Berlin-Buch 13125 Berlin Germany
| | - Bradley L Hoare
- Faculty of Medicine & Health Sciences, University of Nottingham Nottingham NG7 2UH England UK.,United Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham Midlands England UK
| | - Tamara Miljuš
- Faculty of Medicine & Health Sciences, University of Nottingham Nottingham NG7 2UH England UK.,United Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham Midlands England UK
| | - Maira Mexi
- Faculty of Medicine & Health Sciences, University of Nottingham Nottingham NG7 2UH England UK.,United Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham Midlands England UK
| | - Nicolas Roth
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London London EC1M 6BQ England UK
| | - Eline J Koers
- Faculty of Medicine & Health Sciences, University of Nottingham Nottingham NG7 2UH England UK.,United Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham Midlands England UK
| | - Wolfgang Guba
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - André Alker
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Arne C Rufer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Eric A Kusznir
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Sylwia Huber
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Catarina Raposo
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Elisabeth A Zirwes
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Anja Osterwald
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Anto Pavlovic
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Svenja Moes
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Jennifer Beck
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Matthias Nettekoven
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Irene Benito-Cuesta
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria Pozuelo de Alarcón 28223 Madrid Spain
| | - Teresa Grande
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria Pozuelo de Alarcón 28223 Madrid Spain
| | - Faye Drawnel
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Gabriella Widmer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Daniela Holzer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Tom van der Wel
- Department of Molecular Physiology, Leiden Institute of Chemistry, Leiden University 2333 CC Leiden the Netherlands
| | - Harpreet Mandhair
- Institute of Biochemistry and Molecular Medicine, University of Bern 3012 Bern Switzerland
| | - Michael Honer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Jürgen Fingerle
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Jörg Scheffel
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin Berlin Germany.,Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP Berlin Germany
| | - Johannes Broichhagen
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) Campus Berlin-Buch 13125 Berlin Germany
| | - Klaus Gawrisch
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health Rockville MD 20852 USA
| | - Julián Romero
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria Pozuelo de Alarcón 28223 Madrid Spain
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Neuroscience Research Center, Medical College of Wisconsin Milwaukee WI 53226 USA
| | - Zoltan V Varga
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health Rockville MD 20852 USA.,HCEMM-SU Cardiometabolic Immunology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University 1085 Budapest Hungary
| | - Mario van der Stelt
- Department of Molecular Physiology, Leiden Institute of Chemistry, Leiden University 2333 CC Leiden the Netherlands
| | - Pal Pacher
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health Rockville MD 20852 USA
| | - Jürg Gertsch
- Institute of Biochemistry and Molecular Medicine, University of Bern 3012 Bern Switzerland
| | - Christoph Ullmer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Peter J McCormick
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London London EC1M 6BQ England UK
| | - Sergio Oddi
- Faculty of Veterinary Medicine, University of Teramo 64100 Teramo European Italy.,European Center for Brain Research (CERC), Santa Lucia Foundation 00179 Rome Italy
| | - Herman P Spaink
- Leiden University Einsteinweg 55 2333 CC Leiden the Netherlands
| | - Mauro Maccarrone
- European Center for Brain Research (CERC), Santa Lucia Foundation 00179 Rome Italy.,Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila 67100 L'Aquila Italy
| | - Dmitry B Veprintsev
- Faculty of Medicine & Health Sciences, University of Nottingham Nottingham NG7 2UH England UK.,United Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham Midlands England UK
| | - Erick M Carreira
- Laboratorium für Organische Chemie, Eidgenössische Technische Hochschule Zürich Vladimir-Prelog-Weg 3 8093 Zürich Switzerland
| | - Uwe Grether
- Roche Pharma Research & Early Development, Roche Innovation Center Basel F. Hoffmann-La Roche Ltd. 4070 Basel Switzerland
| | - Marc Nazaré
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) Campus Berlin-Buch 13125 Berlin Germany
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5
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Wadhwa M, Kang HN, Thorpe R, Knezevic I, Aprea P, Bielsky MC, Ekman N, Heim HK, Joung J, Kurki P, Lacana E, Njue C, Nkansah E, Savkina M, Thorpe R, Yamaguchi T, Wadhwa M, Wang J, Weise M, Wolff-Holz E, Allam M, Bahaa H, Sayed M, Al-Oballi A, Alshahrani A, Baek D, Kim J, Chua H, Gangakhedkar J, Jagtap MP, Lyaskovsky T, Okudaira S, Ondee W, Sotomayor P, Ricra JS, Uviase J, Ahmed F, Rajendran Y, Defendi HT, Cho SO, Qu A, Acha V, Gencoglu M, Ho K, Baldrighi M, Schiestl M, Watson K, Spitzer E, Chong S, Fukushima A, Kang HN, Knezevic I, Pante G, Simao M. WHO informal consultation on revision of guidelines on evaluation of similar biotherapeutic products, virtual meeting, 30 June – 2 July 2021. Biologicals 2022; 76:1-9. [PMID: 35466023 PMCID: PMC9109723 DOI: 10.1016/j.biologicals.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/28/2022] [Accepted: 03/29/2022] [Indexed: 11/26/2022] Open
Abstract
The WHO informal consultation was held to promote the revision of WHO guidelines on evaluation of similar biotherapeutic products (SBPs) adopted by the Expert Committee on Biological Standardization (ECBS) in 2009. It was agreed in the past consultations that the evaluation principles in the guidelines are still valid, but a review was recommended to provide more clarity and case-by-case flexibility. The opportunity was therefore taken to review the experience and identify areas where the current guidance could be more permissive without compromising its basic principles, and where additional explanation could be provided regarding the possibility of reducing the amount of data needed for regulatory approval. The meeting participants applauded the leading role taken by the WHO in providing a much-needed streamlined approach for development and evaluation of SBPs which will provide efficient and cost-effective product development and increase patient access to treatments. It was recognized that the principles as currently described in the draft WHO guidelines are based on sound science and experience gained over the last fifteen years of biosimilar approvals. However, since these guidelines when finalised will constitute the global standard for biosimilar evaluation and assist national regulatory authorities in establishing revised guidance and regulatory practice in this complex area, it was felt that further revision and clarity on certain perspectives in specific areas was necessary to dispel uncertainties arising in the current revised version. This report describes the principles in the draft guidelines, including topics discussed and consensus reached. WHO guidelines serve as a basis for the development of national regulatory framework for biosimilars. Revision of guidelines is to provide more flexibility and clarification on data required for regulatory approval. Revised guidelines would contribute to improving consistency on regulatory decision and patient access to treatments.
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6
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Dhillon R, Weise M, Wrotniak B, Cross K. 56 Factors Predicting Admission in Pediatric and Young Adults With COVID-19. Ann Emerg Med 2021. [PMCID: PMC8335410 DOI: 10.1016/j.annemergmed.2021.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Sarott RC, Westphal MV, Pfaff P, Korn C, Sykes DA, Gazzi T, Brennecke B, Atz K, Weise M, Mostinski Y, Hompluem P, Koers E, Miljuš T, Roth NJ, Asmelash H, Vong MC, Piovesan J, Guba W, Rufer AC, Kusznir EA, Huber S, Raposo C, Zirwes EA, Osterwald A, Pavlovic A, Moes S, Beck J, Benito-Cuesta I, Grande T, Ruiz de Martı N Esteban S, Yeliseev A, Drawnel F, Widmer G, Holzer D, van der Wel T, Mandhair H, Yuan CY, Drobyski WR, Saroz Y, Grimsey N, Honer M, Fingerle J, Gawrisch K, Romero J, Hillard CJ, Varga ZV, van der Stelt M, Pacher P, Gertsch J, McCormick PJ, Ullmer C, Oddi S, Maccarrone M, Veprintsev DB, Nazaré M, Grether U, Carreira EM. Development of High-Specificity Fluorescent Probes to Enable Cannabinoid Type 2 Receptor Studies in Living Cells. J Am Chem Soc 2020; 142:16953-16964. [PMID: 32902974 DOI: 10.1021/jacs.0c05587] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pharmacological modulation of cannabinoid type 2 receptor (CB2R) holds promise for the treatment of numerous conditions, including inflammatory diseases, autoimmune disorders, pain, and cancer. Despite the significance of this receptor, researchers lack reliable tools to address questions concerning the expression and complex mechanism of CB2R signaling, especially in cell-type and tissue-dependent contexts. Herein, we report for the first time a versatile ligand platform for the modular design of a collection of highly specific CB2R fluorescent probes, used successfully across applications, species, and cell types. These include flow cytometry of endogenously expressing cells, real-time confocal microscopy of mouse splenocytes and human macrophages, as well as FRET-based kinetic and equilibrium binding assays. High CB2R specificity was demonstrated by competition experiments in living cells expressing CB2R at native levels. The probes were effectively applied to FACS analysis of microglial cells derived from a mouse model relevant to Alzheimer's disease.
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Affiliation(s)
- Roman C Sarott
- Laboratorium für Organische Chemie, Eidgenössische Technische Hochschule Zürich, Vladimir-Prelog-Weg 3, 8093 Zürich, Switzerland
| | - Matthias V Westphal
- Laboratorium für Organische Chemie, Eidgenössische Technische Hochschule Zürich, Vladimir-Prelog-Weg 3, 8093 Zürich, Switzerland
| | - Patrick Pfaff
- Laboratorium für Organische Chemie, Eidgenössische Technische Hochschule Zürich, Vladimir-Prelog-Weg 3, 8093 Zürich, Switzerland
| | - Claudia Korn
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - David A Sykes
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham NG7 2UH, U.K.,Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham, Midlands B15 2TT, U.K
| | - Thais Gazzi
- Leibniz-Institut für Molekulare Pharmakologie FMP, Campus Berlin-Buch, 13125 Berlin, Germany
| | - Benjamin Brennecke
- Leibniz-Institut für Molekulare Pharmakologie FMP, Campus Berlin-Buch, 13125 Berlin, Germany
| | - Kenneth Atz
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Marie Weise
- Leibniz-Institut für Molekulare Pharmakologie FMP, Campus Berlin-Buch, 13125 Berlin, Germany
| | - Yelena Mostinski
- Leibniz-Institut für Molekulare Pharmakologie FMP, Campus Berlin-Buch, 13125 Berlin, Germany
| | - Pattarin Hompluem
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham NG7 2UH, U.K.,Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham, Midlands B15 2TT, U.K
| | - Eline Koers
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham NG7 2UH, U.K.,Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham, Midlands B15 2TT, U.K
| | - Tamara Miljuš
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham NG7 2UH, U.K.,Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham, Midlands B15 2TT, U.K
| | - Nicolas J Roth
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London EC1M 6BQ, England
| | - Hermon Asmelash
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London EC1M 6BQ, England
| | - Man C Vong
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham NG7 2UH, U.K.,Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham, Midlands B15 2TT, U.K
| | - Jacopo Piovesan
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham NG7 2UH, U.K.,Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham, Midlands B15 2TT, U.K
| | - Wolfgang Guba
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Arne C Rufer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Eric A Kusznir
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Sylwia Huber
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Catarina Raposo
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Elisabeth A Zirwes
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Anja Osterwald
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Anto Pavlovic
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Svenja Moes
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Jennifer Beck
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Irene Benito-Cuesta
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223, Madrid, Spain
| | - Teresa Grande
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223, Madrid, Spain
| | | | - Alexei Yeliseev
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852, United States
| | - Faye Drawnel
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Gabriella Widmer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Daniela Holzer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Tom van der Wel
- Department of Molecular Physiology, Leiden Institute of Chemistry, Leiden University, 2333 CC, Leiden, The Netherlands
| | - Harpreet Mandhair
- Institute of Biochemistry and Molecular Medicine, University of Bern, 3012 Bern, Switzerland
| | - Cheng-Yin Yuan
- Department of Microbiology and Immunology, Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, United States
| | - William R Drobyski
- Department of Medicine, Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, United States
| | - Yurii Saroz
- Department of Pharmacology and Clinical Pharmacology, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, 1142 Auckland, New Zealand
| | - Natasha Grimsey
- Department of Pharmacology and Clinical Pharmacology, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, 1142 Auckland, New Zealand
| | - Michael Honer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Jürgen Fingerle
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Klaus Gawrisch
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852, United States
| | - Julian Romero
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223, Madrid, Spain
| | - Cecilia J Hillard
- Department of Pharmacology and Clinical Pharmacology, Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, United States
| | - Zoltan V Varga
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852, United States.,HCEMM-SU Cardiometabolic Immunology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary
| | - Mario van der Stelt
- Department of Molecular Physiology, Leiden Institute of Chemistry, Leiden University, 2333 CC, Leiden, The Netherlands
| | - Pal Pacher
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852, United States
| | - Jürg Gertsch
- Institute of Biochemistry and Molecular Medicine, University of Bern, 3012 Bern, Switzerland
| | - Peter J McCormick
- William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London EC1M 6BQ, England
| | - Christoph Ullmer
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Sergio Oddi
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.,European Center for Brain Research (CERC)/Santa Lucia Foundation, 00179 Rome, Italy
| | - Mauro Maccarrone
- European Center for Brain Research (CERC)/Santa Lucia Foundation, 00179 Rome, Italy.,Department of Applied Clinical and Biotechnological Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Dmitry B Veprintsev
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham NG7 2UH, U.K.,Centre of Membrane Proteins and Receptors (COMPARE), University of Birmingham and University of Nottingham, Midlands B15 2TT, U.K
| | - Marc Nazaré
- Leibniz-Institut für Molekulare Pharmakologie FMP, Campus Berlin-Buch, 13125 Berlin, Germany
| | - Uwe Grether
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Erick M Carreira
- Laboratorium für Organische Chemie, Eidgenössische Technische Hochschule Zürich, Vladimir-Prelog-Weg 3, 8093 Zürich, Switzerland
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8
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Kirkman SP, Costa DP, Harrison AL, Kotze PGH, Oosthuizen WH, Weise M, Botha JA, Arnould JPY. Dive behaviour and foraging effort of female Cape fur seals Arctocephalus pusillus pusillus. R Soc Open Sci 2019; 6:191369. [PMID: 31824733 PMCID: PMC6837185 DOI: 10.1098/rsos.191369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
While marine top predators can play a critical role in ecosystem structure and dynamics through their effects on prey populations, how the predators function in this role is often not well understood. In the Benguela region of southern Africa, the Cape fur seal (Arctocephalus pusillus pusillus) population constitutes the largest marine top predator biomass, but little is known of its foraging ecology other than its diet and some preliminary dive records. Dive information was obtained from 32 adult females instrumented with dive recorders at the Kleinsee colony (29°34.17' S, 16°59.80' E) in South Africa during 2006-2008. Most dives were in the depth range of epipelagic prey species (less than 50 m deep) and at night, reflecting the reliance of Cape fur seals on small, vertically migrating, schooling prey. However, most females also performed benthic dives, and benthic diving was prevalent in some individuals. Benthic diving was significantly associated with the frequency with which females exceeded their aerobic dive limit. The greater putative costs of benthic diving highlight the potential detrimental effects to Cape fur seals of well-documented changes in the availability of epipelagic prey species in the Benguela.
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Affiliation(s)
- S. P. Kirkman
- Oceans and Coastal Research, Department of the Environment, Forestry and Fisheries, Private Bag X4390, Cape Town 8000, South Africa
- Marine Apex Predator Research Unit (MAPRU), Institute for Coastal and Marine Research, Nelson Mandela University, Port Elizabeth 6031, South Africa
| | - D. P. Costa
- Department of Ecology and Evolutionary Biology, University of California, Santa Cruz, CA 95060, USA
| | - A.-L. Harrison
- Department of Ecology and Evolutionary Biology, University of California, Santa Cruz, CA 95060, USA
- Migratory Bird Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, DC 20008, USA
| | - P. G. H. Kotze
- Oceans and Coastal Research, Department of the Environment, Forestry and Fisheries, Private Bag X4390, Cape Town 8000, South Africa
| | - W. H. Oosthuizen
- Oceans and Coastal Research, Department of the Environment, Forestry and Fisheries, Private Bag X4390, Cape Town 8000, South Africa
| | - M. Weise
- Office of Naval Research—Code 32, 875 North Randolph Street, Arlington, VA 22203-1995, USA
| | - J. A. Botha
- Marine Apex Predator Research Unit (MAPRU), Institute for Coastal and Marine Research, Nelson Mandela University, Port Elizabeth 6031, South Africa
| | - J. P. Y. Arnould
- School of Life and Environmental Sciences, Faculty of Science Engineering and Built Environment, Deakin University, Melbourne, Australia
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9
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Affiliation(s)
- Sebastian Bruckner
- Department of Chemistry, University Bayreuth, Universitaetsstrasse 30, 95440 Bayreuth, Germany
| | - Marie Weise
- Department of Chemistry, University Bayreuth, Universitaetsstrasse 30, 95440 Bayreuth, Germany
| | - Rainer Schobert
- Department of Chemistry, University Bayreuth, Universitaetsstrasse 30, 95440 Bayreuth, Germany
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10
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Seifert H, Körber-Irrgang B, Kresken M, Göbel U, Swidsinski S, Rath PM, Steinmann J, MacKenzie C, Mutters R, Peters G, Becker K, Podbielski A, Weise M, Siegel E, Glöckle B, Kniehl E, Becker A, Wichelhaus TA, Schubert S. In-vitro activity of ceftolozane/tazobactam against Pseudomonas aeruginosa and Enterobacteriaceae isolates recovered from hospitalized patients in Germany. Int J Antimicrob Agents 2018; 51:227-234. [DOI: 10.1016/j.ijantimicag.2017.06.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/11/2017] [Accepted: 06/24/2017] [Indexed: 11/28/2022]
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11
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Braun S, Platzek I, Danowski D, Zöphel K, Weise M, Kolditz M, Katzke S, Strasser R, Höffken G, Halank M. Klinische Bedeutung der CT Pulmonalis-Venografie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598571] [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: 10/20/2022]
Affiliation(s)
- S Braun
- Abteilung für Pneumologie, Medizinische Klinik I, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden
| | - I Platzek
- Institut für Radiologie, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden
| | - D Danowski
- Institut für Radiologie, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden
| | - K Zöphel
- Institut für Nuklearmedizin, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden
| | - M Weise
- Abteilung für Internistische Intensivmedizin, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden
| | - M Kolditz
- Abteilung für Pneumologie, Medizinische Klinik I, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden
| | - S Katzke
- Herzzentrum Dresden, Abteilung für Kardiologie, Universitätsklinik Dresden
| | - R Strasser
- Herzzentrum Dresden, Abteilung für Kardiologie, Universitätsklinik Dresden
| | - G Höffken
- Abteilung für Pneumologie, Medizinische Klinik I, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden
| | - M Halank
- Abteilung für Pneumologie, Medizinische Klinik I, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden
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12
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Weise M, Täubert K, Oberdorfer K. Lungeninfiltration bei Reihenuntersuchung von Flüchtenden – nicht immer ist es TBC. Pneumologie 2017. [DOI: 10.1055/s-0037-1598484] [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: 10/20/2022]
Affiliation(s)
- M Weise
- Diakonissen-Stiftungs-Krankenhaus Speyer
| | - K Täubert
- Diakonissen-Stiftungs-Krankenhaus Speyer
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13
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Anton R, Haas M, Arlett P, Weise M, Balabanov P, Mazzaglia G, Prieto L, Keller-Stanislawski B, Raine J. Drug-induced progressive multifocal leukoencephalopathy in multiple sclerosis: European regulators' perspective. Clin Pharmacol Ther 2017; 102:283-289. [DOI: 10.1002/cpt.604] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/12/2016] [Accepted: 12/13/2016] [Indexed: 01/13/2023]
Affiliation(s)
- R Anton
- European Medicines Agency; London United Kingdom
| | - M Haas
- European Medicines Agency; London United Kingdom
| | - P Arlett
- European Medicines Agency; London United Kingdom
| | - M Weise
- Federal Institute for Drugs and Medical Devices; Bonn Germany
| | - P Balabanov
- European Medicines Agency; London United Kingdom
| | - G Mazzaglia
- European Medicines Agency; London United Kingdom
| | - L Prieto
- European Medicines Agency; London United Kingdom
| | - B Keller-Stanislawski
- Department of Safety of Medicinal Products and Medical Devices; Paul-Ehrlich Institute, Federal Institute for Vaccines and Biomedicines; Langen Germany
| | - J Raine
- Medicines and Healthcare Products Regulatory Agency; London United Kingdom
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14
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Abstract
Although biosimilars approved in the European Union have proved to be safe and efficacious, their licensing requirements continue to be disputed by medical professionals. In particular, extrapolation to indications of the originator without one's own clinical data of the biosimilar is controversial. Conceptually, the development of biosimilars is derived from that of generics. However, due to their complexity and inherent variability, considerably more data are necessary for biosimilars to demonstrate comparability with the originator (the reference product) than for the usually low-molecular generics. Biosimilars increase competition and help contain healthcare, and they improve access for patients to valuable treatments with biologicals. However, biosimilar development is a laborious and lengthy process and requires major biotechnological know-how. The basis is comprehensive, structural, and functional characterization of the biosimilar and reference product as well as their comparison with suitable and sensitive methods. The clinical development programme is reduced and tailored to address remaining uncertainties and to confirm comparable clinical performance. Extrapolation of data to other indications of the reference product is the greatest cost advantage of biosimilar development, but must always be scientifically justified and, if necessary, substantiated by further data. The scientific principles underlying the comparability exercise for a biosimilar are the same as those applied to a change in the manufacturing process of an already licensed biological. In both cases, different versions of a biological substance are compared and the clinical relevance of observed differences is assessed. Competent authorities do have decades of experience in evaluating changes in the manufacturing process, which they can now apply to biosimilars. For approval of a biosimilar and extrapolation of data, the totality of the evidence from the complete comparability exercise is considered, as has been the case for the first biosimilar infliximab.
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Affiliation(s)
- M Weise
- Zulassung 2, Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn, Germany
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Abstract
BACKGROUND Biosimilars are currently a hot topic and there are many unsolved questions, misunderstandings and sometimes considerable uncertainty, especially among clinicians and patients. Regulatory agencies, such as the European Medicines Agency (EMA) issue guidelines for the development and approval of biosimilars, which are based on scientific principles. OBJECTIVE This article addresses some of the frequently noted misunderstandings and misperceptions. For example, why biosimilars are (or can only be) "similar" but not "identical" compared to the original pharmaceutical product, and aspects, such as the pharmaceutical quality of biosimilars, immunogenicity and the approval process for biosimilars are highlighted.
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Affiliation(s)
- C K Schneider
- Abteilung Arzneimittelzulassung und -Zugänglichkeit, Danish Health and Medicines Authority, Axel Heides Gade 1, 2300, Kopenhagen, Dänemark. .,Biosimilar Medicinal Products Working Party (BMWP), Europäische Arzneimittelagentur, London, UK. .,TwincoreZentrum für Experimentelle und Klinische Infektionsforschung, Hannover, Deutschland.
| | - M Weise
- Biosimilar Medicinal Products Working Party (BMWP), Europäische Arzneimittelagentur, London, UK.,Fachgebiets Diabetes mellitus/Kardiovaskuläres System, Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Bonn, Deutschland
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16
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Bretzel RG, Schneider J, Zimmermann I, Küppers B, Weise M, Federlin K. Urinary excretion of alanine aminopeptidase and total proteinuria in experimental diabetes mellitus before and after islet transplantation. Contrib Nephrol 2015; 24:153-64. [PMID: 6112114 DOI: 10.1159/000395240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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17
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Weise M, Prüfer D, Jaques G, Keller M, Mondorf AW. Beta 2-microglobulin and other proteins as parameter for tubular function. Contrib Nephrol 2015; 24:88-98. [PMID: 6164517 DOI: 10.1159/000395233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Urinary excretion of the low molecular weight protein beta 2-microglobulin and tubular enzymes--alanine aminopeptidase (AAP), gamma-glutamyl transpeptidase (gamma-GT) and alkaline phosphatase (AP)--are very sensitive parameters for proximal tubular lesions. In patients with preeclampsia the renal excretion of beta 2-microglobulin allows to differentiate between a primary preeclampsia and a preeclampsia superimposed upon chronic pyelonephritis. In the first group the increase is 3- to 4-fold and in the second group up to 300-fold. In patients with kidney transplantation the urinary excretion of beta 2-microglobulin, AAP, gamma-GT and AP are several times higher than in normals. In case of a rejection episode a further increase of these proteins occur in more than 80% several days before clinical symptoms are present. The application of analgetics (paracetamol, acetylsalicylic acid) in healthy individuals in therapeutical dosages on 3 consecutive days does not show any tubular alteration by the measurement of urinary beta 2-microglobulin. Aminoglycosides (tobramycin, UK 18,892) lead to a cumulative increase of the renal excretion of beta 2-microglobulin and AAP while cephalosporins induce an increase of total proteins in the final urine under the same conditions.
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Abstract
Haemoptysis is a potentially life-threatening condition with the need for prompt diagnosis. In about 10–20% of all cases the bleeding source remains unexplained with the standard diagnostic approach. The aim of this article is to show the necessity of widening the diagnostic approach to haemoptysis with consideration of pulmonary venous stenosis as a possible cause of even severe haemoptysis and haemoptoe. A review of the literature was performed using the Medline/PubMed database with the terms: “pulmonary venous stenosis”, “pulmonary venous infarction” and “haemoptysis”. Further references from the case reports were considered. 58 case reports and case collections about patients with haemoptysis due to pulmonary venous stenosis were detected. This review gives an overview about the case reports and discusses the underlying pathophysiology and the pros and cons of different imaging techniques for the detection of pulmonary venous stenosis. Several conditions predispose to the obstruction of the mediastinal pulmonary veins. Clinical findings are unspecific and may be misleading. Pulmonary venous stenosis can be detected using several imaging techniques, yet three-dimensional magnetic resonance-angiography and three-dimensional contrast-enhanced computed tomography are the most appropriate. Pulmonary venous stenosis should be considered in patients with haemoptysis.
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19
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Ferrari U, Künzel H, Tröndle K, Rottenkolber M, Kohn D, Fugmann M, Banning F, Weise M, Sacco V, Grallert H, Kloiber S, Ising M, Hasbargen U, Parhofer K, Seißler J, Lechner A. Schlafqualität und Glukosemetabolismus. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374917] [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: 10/25/2022]
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20
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Dauber V, Schendell C, Ferrari U, Banning F, Fugmann M, Sacco V, Weise M, Boscheri A, Wolfarth B, Parhofer K, Seißler J, Lechner A. Erniedrigte körperliche Leistungsfähigkeit bei Frauen nach Gestationsdiabetes. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375085] [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: 10/25/2022]
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21
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Eggemann H, Ignatov A, Elling D, Lampe D, Lantzsch T, Weise M, Costa SD. Efficacy and Patient Satisfaction of Breast Conserving Therapy for Central Breast Cancer by the B Technique. Ann Surg Oncol 2013; 20:3438-45. [DOI: 10.1245/s10434-013-3030-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Indexed: 11/18/2022]
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22
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Tröndle K, Ferrari U, Holland L, Schendell C, Fugmann M, Banning F, Weise M, Sacco V, Grallert H, Breier M, Hetterich H, Kammer N, Hunger M, Holle R, Parhofer K, Hrabé de Angelis M, Seißler J, Lechner A. Erste Ergebnisse der PPS-Diab (Prädiktion, Prävention und Subklassifikation von Typ-2-Diabetes mellitus)-Studie: Phänotypische Charakterisierung von Frauen nach Gestationsdiabetes- Ansätze für Prävention? DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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23
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Puff R, Dames P, Weise M, Göke B, Seissler J, Parhofer KG, Lechner A. Reduced proliferation and a high apoptotic frequency of pancreatic beta cells contribute to genetically-determined diabetes susceptibility of db/db BKS mice. Horm Metab Res 2011; 43:306-11. [PMID: 21412687 DOI: 10.1055/s-0031-1271817] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Leptin receptor-deficient db/db mice are a commonly used research model and it is known that the genetic background, on which the mutation is bred, modulates the phenotype. While diabetes-resistant strains sustain near normal glycemia and hyperinsulinemia, susceptible backgrounds develop overt hyperglycemia and islet involution. We hypothesized that genetically-determined differences in the proliferative capacity and the apoptotic frequency of pancreatic beta cells contribute to this phenotypic disparity. We studied C57BLKS/J (BKS; diabetes-susceptible) and C57BL/6 (B6; diabetes-resistant) db/db mice and heterozygous controls from 5 to 12 weeks of age. Body weight, fasting blood glucose, plasma insulin, HOMA-IR, alpha cell mass, beta cell mass, proliferation and apoptosis were measured. Comparable insulin resistance developed in the 2 db/db strains, which was well compensated for on both genetic backgrounds until 7 weeks of age. As expected, the BKS mice became hyperglycemic at 9 weeks. Beta cell proliferation was initially increased in both db/db strains but decreased rapidly in the BKS mice with advancing age. The rate of beta cell apoptosis was already higher in prediabetic BKS mice than in their B6 counterparts. Beta cell mass increased continuously in the B6 strain until 12 weeks of age, but declined from 7 weeks onwards in BKS. An age-dependent decline of beta cell proliferation and an increased rate of beta cell apoptosis already in the prediabetic state probably contribute to the diabetes susceptibility of db/db BKS mice. These factors could also play a role in the genetic predisposition for type 2 diabetes in humans.
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Affiliation(s)
- R Puff
- Ludwig-Maximilians-Universität, Klinikum Grosshadern, Medizinische Klinik, München, Germany
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Menezes L, Brondani I, Restle J, Alves Filho D, Callegaro A, Weise M. Características dos componentes não integrantes da carcaça de novilhos superjovens da raça Devon, terminados em diferentes sistemas de alimentação. ARQ BRAS MED VET ZOO 2011. [DOI: 10.1590/s0102-09352011000200015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O objetivo do estudo foi avaliar as características dos componentes não integrantes da carcaça de novilhos Devon terminados em confinamento (CONF), em pastagem de clima temperado (pastagem de azevém - Lolium multiflorum Lam - PTEM) ou em pastagem de clima tropical (associação de pastagem de milheto - Pennisetum americanum (L.) Leeke - e capim-papuã - Bracharia plantaginea - PTRO). Os novilhos, ao início da terminação, estavam com 320kg e 15 meses de idade. Os animais confinados foram alimentados com relação volumoso:concentrado de 60:40; o volumoso era constituído de silagem de milho, e o concentrado de farelo de trigo, milho e minerais. Os animais foram abatidos com pesos semelhantes de 388,3; 386,7 e 375,8kg no CONF, na PTEM e na PTRO, respectivamente. Os animais da PTRO apresentaram maior (P<0,10) rendimento de carcaça quente (RCQ) relativo a 100kg de peso corporal vazio (RCQPCV) do que os da PTEM, 64,6 versus 62,6%, e os do CONF apresentaram RCQPCV intermediário, 63,7%. Os pesos absolutos do fígado, 5,22; 4,43 e 3,87kg, do conjunto dos órgãos internos, 12,81; 11,37 e 10,83kg, do rúmen-retículo, 7,62; 6,54 e 6,06kg, da gordura do coração, 1,26; 0,65 e 0,30kg, e dos intestinos, 9,97; 7,13 e 7,49kg, foram mais altos (P<0,05) nos animais da PTEM, em relação aos do CONF e da PTRO, respectivamente. A mesma ordem de grandeza ocorreu com os pesos relativos desses órgãos. A PTRO e o CONF originaram animais com maior (P<0,05) peso de conteúdo gastrintestinal em relação à PTEM, respectivamente, 60,27; 55,32 e 41,21kg. O CONF proporcionou animais com pesos absolutos mais elevados (P<0,05) do omaso, 5,17kg, em relação aos da PTEM, 3,70kg, e este peso foi intermediário nos animais da PTRO, 4,77kg. A mesma ordem de grandeza ocorreu com os pesos relativos do omaso, 1,61; 1,12 e 1,54%.
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Braun S, Kolditz M, Halank M, Weise M, Platzek I, Sommer P, Höffken G. [Hemoptysis because of pulmonary vein stenosis and occlusion after pulmonary vein isolation for atrial fibrillation]. Dtsch Med Wochenschr 2011; 136:626-30. [PMID: 21432738 DOI: 10.1055/s-0031-1274552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HISTORY AND ADMISSION FINDINGS A 49-year-old woman was admitted because of hemoptysis for four months. Several bronchoscopies and thoracic computed tomographies at other hospitals had not revealed the cause of the sustained hemoptysis. Eight months before admission she had undergone pulmonary vein ablation (PVA) for paroxysmal atrial fibrillation. After the PVA she had initially received oral anticoagulation, but this had been stopped because of the hemoptysis. Physical examination at admission to our hospital was unremarkable except for moderate obesity and arterial hypertension INVESTIGATIONS Ventilation/perfusion scintigraphy demonstrated combined ventilation and perfusion deficits in the left lower lobe. Transesophageal echocardiography strongly suggested stenoses of the left pulmonary veins. 3-D reconstruction of previously recorded computed tomographic images showed absence of the left inferior pulmonary vein (LIPV) and marked stenosis of the left superior pulmonary vein (LSPV). DIAGNOSIS It was confirmed that the hemoptysis was caused by stenosis of the left pulmonary veins, resulting from the previous PVA. TREATMENT AND COURSE Percutaneous transseptal balloon dilatation of the upper and lower pulmonary veins was successfully performed. The patient was put on oral anticoagulation and discharged home free of symptoms. CONCLUSION Pulmonary vein stenosis must be considered as the most likely cause of hemoptysis and respiratory symptoms after pulmonary vein ablation for atrial fibrillation. Because of ever more frequent interventions to treat atrial fibrillation and other atrial arrhythmias, great clinical vigilance and an interdisciplinary approach is mandatory to assure optimal assessment of patients with acquired pulmonary vein stenosis.
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Affiliation(s)
- S Braun
- Medizinische Klinik I - Pneumologie, Universitätsklinikum Carl Gustav Carus Dresden.
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Eggemann H, Krocker J, Elling D, Lampe D, Lantzsch T, Weise M, Röhl FW, Costa SD. Die B-Plastik – Eine retrospektive Studie zur Wertigkeit und Patientenzufriedenheit einer brusterhaltenden Therapie bei zentralem Sitz des Mammakarzinoms. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269944] [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: 10/18/2022] Open
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Verma S, Green-Golan L, VanRyzin C, Drinkard B, Mehta SP, Weise M, Eisenhofer G, Merke DP. Adrenomedullary function in patients with nonclassic congenital adrenal hyperplasia. Horm Metab Res 2010; 42:607-12. [PMID: 20446239 PMCID: PMC7473418 DOI: 10.1055/s-0030-1253385] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is classified into three types based on disease severity: classic salt-wasting, classic simple virilizing, and nonclassic. Adrenomedullary dysplasia and epinephrine deficiency have been described in classic CAH, resulting in glucose dysregulation. Our objective was to investigate adrenomedullary function in nonclassic CAH and to evaluate adrenomedullary function according to disease severity. Adrenomedullary function was evaluated in response to a standardized cycle ergonometer test in 23 CAH patients (14 females, age 9-38 years; 6 salt-wasting, 7 simple virilizing, 5 nonclassic receiving glucocorticoid treatment, 5 nonclassic not receiving glucocorticoid), and 14 controls (7 females, age 12-38 years). Epinephrine, glucose, and cortisol were measured at baseline and peak exercise. CAH patients and controls were similar in age and anthropometric measures. Patients with nonclassic CAH who were not receiving glucocorticoid and controls experienced the expected stress-induced rise in epinephrine, glucose, and cortisol. Compared to controls, patients with all types of CAH receiving glucocorticoid had impaired exercise-induced changes in epinephrine (salt-wasting: p=0.01;simple virilizing: p=0.01; nonclassic: p=0.03), and cortisol (salt-wasting: p=0.004; simple virilizing: p=0.006; nonclassic: p=0.03). Salt-wasting patients displayed the most significant impairment, including impairment in glucose response relative to controls (p=0.03). Hydrocortisone dose was negatively correlated with epinephrine response (r=-0.58; p=0.007) and glucose response (r=-0.60; p=0.002). The present study demonstrates that untreated patients with nonclassic CAH have normal adrenomedullary function. The degree of epinephrine deficiency in patients with CAH is associated with the severity of adrenocortical dysfunction, as well as glucocorticoid therapy.
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Affiliation(s)
- S Verma
- The Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
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Lechner A, Dames P, Weise M, Parhofer KG, Göke B. Das multifunktionale nukleäre Protein Eny2 reguliert die glukose- und inkretinvermittelte Insulinsekretion. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1255202] [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: 10/19/2022]
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Lechner A, Puff R, Dames P, Weise M, Parhofer KG, Göke B. Mechanisms of genetically-determined diabetes resistance and susceptibility in db/db mice. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1255186] [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: 10/19/2022]
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Bauer W, Weise M. [Persistent cough and bronchiectasis]. Praxis (Bern 1994) 2008; 97:630-634. [PMID: 18592959 DOI: 10.1024/1661-8157.97.11.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A 68 yr. old lady suffered from chronic cough. Bronchiectasis was diagnosed and treated with physiotherapy. Coughing persisted over years, although an asthma disease was controlled by inhalation, a carcinoid tumor was surgically removed, and a coronary artery disease was treated by revasculating surgery. Antibiotics and systemic corticosteroids did not relieve symptoms either. After all, diagnosis and treatment of obstructive sleep apnea led to symptom free life. We assume micro-aspiration during periods of apnea being the cause of the coughing.
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Affiliation(s)
- W Bauer
- Lungen- und Schlafzentrum Bern, Lindenhofspital, Bern
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Dames P, Puff R, Weise M, Parhofer KG, Göke B, Favor J, Graw J, Lechner A. Die beiden DNA-Bindungsdomänen des Transkriptionsfaktors Pax6 haben unterschiedliche Funktionen in der Entwicklung des endokrinen Pankreas. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076149] [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: 10/21/2022]
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Riemay KH, Weise M. Verlauf und Beeinflussung der Autolyse von Hypomyces ochraceus m 359. J Basic Microbiol 2007. [DOI: 10.1002/jobm.19790190406] [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: 11/06/2022]
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Weise M, Linder A, Freitag L. Bronchoskopische Volumenreduktion durch atemsynchrone Aspiration und Einlage von Bronchus-Verschluss-Stents: funktioneller Benefit. Pneumologie 2005. [DOI: 10.1055/s-2005-864553] [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: 10/19/2022]
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Schwenteck T, Draeger J, Ruokonen P, Lechner S, Weise M. Klinische Erprobung neuer Augentonometer auf der Basis des internationalen Standards für Augentonometer ISO 8612. Klin Monbl Augenheilkd 2004; 221:1020-5. [PMID: 15599808 DOI: 10.1055/s-2004-813709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There is a continuous process of development of new tonometer types following different measurement principles. The impedance measurement method, using the elasticity of the eyeball, allows tonometry even through the eyelid. Two new tonometers based on the impedance principle were investigated by clinical comparison measurements according to the international standard for human eye tonometers ( ISO 8612). The tested tonometers determine the intraocular pressure without topical anaesthesia. The different elastic properties of an individual eyelid and also the different elastic properties of the human eye due to a large variation in rigidity cause serious problems for these measurements. Statistical properties of the two investigated tonometers are presented and discussed. Statements and conclusions about the medical application of these measurement devices for ophthalmologists are made.
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Schwenteck T, Weise M, Draeger J, Welsch H. Augeninnendruckänderungen bei Beschleunigungen infolge von Körper-flüssigkeitsverschiebungen, gemessen mit einem neuen Tonometer. Spektrum Augenheilkd 2004. [DOI: 10.1007/bf03163175] [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: 10/20/2022]
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Marx C, Wendt M, Petros S, Engelmann L, Weise M, Höffken G. Crit Care 2003; 7:P004. [DOI: 10.1186/cc1893] [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: 11/10/2022] Open
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Weise M, Westphalen S, Fayyazi A, Emons G, Krauss T. Pseudo-meigs syndrome: uterine leiomyoma with bladder attachment associated with ascites and hydrothorax - a rare case of a rare syndrome. Oncol Res Treat 2002; 25:443-6. [PMID: 12415199 DOI: 10.1159/000067439] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Pseudo-Meigs syndrome is a rare syndrome with pelvic tumors (not ovarian fibromas), which is combined with ascites and hydrothorax. Up to now 23 cases of pseudo-Meigs syndrome associated with uterine leiomyomas are described. We present a further case of a young woman with pseudo-Meigs syndrome combined with bladder attachment and elevated CA-125. CASE REPORT A 27- year-old woman complained about increasing abdominal volume for about 2 months. Clinical results showed a normal sized uterus with a pedunculated leiomyoma, ascites, and a small pleural effusion. CA-125 levels were approximately more than 50 times higher than normal range. An explorative laparotomy revealed a leiomyoma and ascites. The myoma was attached to the posterior wall of the bladder; the rest of the uterus and both adnexae were normal. An organ-preserving operation was performed. Three months afterwards the patient presented normal clinical and sonographical findings and normal CA-125 serum levels. DISCUSSION Uterine leiomyoma is only rarely associated with ascites and hydrothorax. Our case is the 24th in literature. Like other authors we could show elevated CA-125 serum levels. Cases of pseudo-Meigs syndrome with penduculated myomas and tight adhesions of neighbouring structures have been described frequently. In our case the bladder was tightly attached, and the vascularisation seemed to come from the uterus and the bladder. This atypical double supply might be in etiological context with the ascites. Pseudo- Meigs syndrome should be considered as a rare differential diagnosis for ascites and pleural effusions.
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Affiliation(s)
- M Weise
- Department of Gynaecology and Obstetrics, University of Göttingen, Germany
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Brooks E, DelliQuadri T, Meyer D, Preis J, Weise M. Confidentiality and right to privacy issues in mental health managed care. Whittier Law Rev 2002; 19:39-49. [PMID: 12071204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- E Brooks
- San Diego Community College, USA
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Abstract
The report describes a previously healthy 24-year-old women presenting with acute abdominal pain following a hyperextension manoeuvre. The key finding of a continuous bruit with systolic and diastolic components in the epigastric region subsequently led to the diagnosis of an intramural haematoma of the coeliac artery, that caused a subtotal occlusion of the artery. The diagnosis was achieved by both colour-coded duplex sonography and magnetic resonance angiography. The case shows that a conservative management rather than operative reconstruction is justified in an oligo-symptomatic situation with no signs of end-organ damage as in this patient.
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Affiliation(s)
- H J Kruse
- Department of Medicine Carl Gustav Carus, Division of Angiology, Technische Universität Dresden, Germany.
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Abstract
In mammals, release from growth-inhibiting conditions results in catch-up growth. To explain this phenomenon, we proposed the following model: 1) The normal senescent decline in growth plate function depends not on age per se, but on the cumulative number of replications that growth plate chondrocytes have undergone. 2) Conditions that suppress growth plate chondrocyte proliferation therefore slow senescence. 3) After transient growth inhibition, growth plates are thus less senescent and hence show a greater growth rate than expected for age, resulting in catch-up growth. To test this model, we administered dexamethasone to growing rabbits to suppress linear growth. After stopping dexamethasone, catch-up growth occurred. In distal femoral growth plates of untreated controls, we observed a senescent decline in the growth rate and in the heights of the proliferative zone, hypertrophic zone, and total growth plate. During the period of catch-up growth, in the animals previously treated with dexamethasone, the senescent decline in all these variables was delayed. Prior treatment with dexamethasone also delayed epiphyseal fusion. These findings support our model that linear catch-up growth is caused, at least in part, by a delay in growth plate senescence.
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Affiliation(s)
- R I Gafni
- Unit on Growth and Development, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA.
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Abstract
Estrogen is critical for epiphyseal fusion in both young men and women. In this study, we explored the cellular mechanisms by which estrogen causes this phenomenon. Juvenile ovariectomized female rabbits received either 70 microg/kg estradiol cypionate or vehicle i.m. once a week. Growth plates from the proximal tibia, distal tibia, and distal femur were analyzed after 2, 4, 6, or 8 weeks of treatment. In vehicle-treated animals, there was a gradual senescent decline in tibial growth rate, rate of chondrocyte proliferation, growth plate height, number of proliferative chondrocytes, number of hypertrophic chondrocytes, size of terminal hypertrophic chondrocytes, and column density. Estrogen treatment accelerated the senescent decline in all of these parameters. In senescent growth plates, epiphyseal fusion was observed to be an abrupt event in which all remaining chondrocytes were rapidly replaced by bone elements. Fusion occurred when the rate of chondrocyte proliferation approached zero. Estrogen caused this proliferative exhaustion and fusion to occur earlier. Our data suggest that (i) epiphyseal fusion is triggered when the proliferative potential of growth plate chondrocytes is exhausted; and (ii) estrogen does not induce growth plate ossification directly; instead, estrogen accelerates the programmed senescence of the growth plate, thus causing earlier proliferative exhaustion and consequently earlier fusion.
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Affiliation(s)
- M Weise
- Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
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Weise M, Hornberger C, Otten J, Schulze J, Konecny E. ENTWICKLUNG EINER AUSKULTATIONSPUPPE FÜR LEHRZWECKE. BIOMED ENG-BIOMED TE 2001. [DOI: 10.1515/bmte.2001.46.s1.480] [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: 11/15/2022]
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Merke DP, Chrousos GP, Eisenhofer G, Weise M, Keil MF, Rogol AD, Van Wyk JJ, Bornstein SR. Adrenomedullary dysplasia and hypofunction in patients with classic 21-hydroxylase deficiency. N Engl J Med 2000; 343:1362-8. [PMID: 11070100 DOI: 10.1056/nejm200011093431903] [Citation(s) in RCA: 143] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Glucocorticoids are essential for the normal development and functioning of the adrenal medulla. Whether adrenomedullary structure and function are normal in patients with congenital adrenal hyperplasia is not known. METHODS We measured plasma and urinary catecholamines and plasma metanephrines in 38 children with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (25 children with the salt-wasting form and 13 with the simple virilizing form), 39 age-matched normal subjects, and 20 patients who had undergone bilateral adrenalectomy. Adrenal specimens obtained from three other patients with 21-hydroxylase deficiency who had undergone bilateral adrenalectomy and specimens obtained at autopsy from eight other patients were examined histologically. RESULTS Plasma epinephrine and metanephrine concentrations and urinary epinephrine excretion were 40 to 80 percent lower in the patients with congenital adrenal hyperplasia than in the normal subjects (P<0.05), and the values were lowest in the patients with the most severe deficits in cortisol production. Urinary epinephrine excretion and plasma epinephrine concentrations were at or below the limit of detection of the assay in 8 (21 percent) of the patients with congenital adrenal hyperplasia and in 19 (95 percent) of the patients who had undergone adrenalectomy. In the group of patients with congenital adrenal hyperplasia, plasma epinephrine and metanephrine concentrations and urinary epinephrine excretion were approximately 50 percent lower in those who had been hospitalized for adrenal crises than in those who had not. In three patients with congenital adrenal hyperplasia who had undergone bilateral adrenalectomy, the formation of the adrenal medulla was incomplete, and electron-microscopical studies revealed a depletion of secretory vesicles in chromaffin cells. CONCLUSIONS Congenital adrenal hyperplasia compromises both the development and the functioning of the adrenomedullary system.
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Affiliation(s)
- D P Merke
- Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892-1932, USA
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Abstract
Pneumatic external counterpulsation, which is operated by applying electrocardiographic-triggered diastolic pressure via air-filled cuffs to the vascular limbs of lower limbs, is a relatively new therapeutic option for patients with angina pectoris and cerebrovascular diseases like transient ischemic attacks or sudden deafness. In this study, an augmentation in flow volume in the carotid, renal, and hepatic arteries from 20% to 25% and in the coronary arteries from 20% to 40%, as well as an increase in stroke volume by 12% was demonstrated; this shows the therapeutic results in patients with diseases caused by disturbed organ perfusion.
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Affiliation(s)
- D Werner
- Medical Clinic, Friedrich-Alexander-University, Erlangen, Germany
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Weise M, Abad V, Considine RV, Nieman L, Rother KI. Leptin secretion in Cushing's syndrome: preservation of diurnal rhythm and absent response to corticotropin-releasing hormone. J Clin Endocrinol Metab 1999; 84:2075-9. [PMID: 10372713 DOI: 10.1210/jcem.84.6.5773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The normal inverse relationship between leptin and cortisol is lost in chronic hypercortisolism. We studied this apparent dysregulation in patients with Cushing's syndrome to investigate 1) the effect of chronic hypercortisolemia on the circadian rhythm of leptin secretion, 2) the response of leptin after administration of CRH, and 3) the short term effect of curative surgery on leptin. The preoperative morning leptin concentration was 54.2 +/- 8.1 ng/mL, and the nighttime value was 68.6 +/- 9.8 ng/mL, reflecting a mean rise of 32.8 +/- 7.6%, similar to the nocturnal increase observed in normal subjects. By contrast, cortisol's diurnal variation (21.8 +/- 1.7 vs. 16.9 +/- 1.1 mg/dL) was blunted. In women, but not men, body mass index correlated with leptin (P = 0.001). Preoperative ACTH and cortisol (both P < 0.0001), but not leptin levels increased after CRH. Ten days after surgery, basal cortisol values were subnormal (1.1 +/- 0.6 mg/dL), but leptin levels remained unchanged and did not increase after CRH. Body mass index and insulin also remained unchanged. Insulin, but not age, urinary free cortisol, or plasma cortisol correlated with leptin (P < 0.05). In summary, patients with Cushing's syndrome have moderately elevated leptin levels that maintain an intact circadian rhythm but do not respond to acute or subacute alterations of cortisol.
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Affiliation(s)
- M Weise
- Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA
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46
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Werner D, Schellong S, Weise M, Klinghammer L, Nolte C, Daniel WG. [Transesophageal imaging of a coronary fistula in simultaneous endocarditis lenta]. Z Kardiol 1999; 88:229-32. [PMID: 10355074 DOI: 10.1007/s003920050280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 61 year old diabetic patient with bacterial endocarditis probably caused by a congenital coronary fistula is presented. The fistula was already detected by transthoracic echocardiography. Transesophageal color-Doppler echocardiography identified the precise localization and course of the fistula. Additionally, in some parts of the fistula echogenic material could be seen that decreased in size after antibiotic treatment. Therefore, it was considered as corresponding to bacterial vegetations. Coronary angiography disclosed an ectopic aneurysmatic and elongated circumflex coronary artery. Thus, even in rare conditions such as coronary fistulas transesophageal echocardiography may be helpful to allow detection of morphological substrate of associated infective endocarditis.
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Affiliation(s)
- D Werner
- Med. Klinik II Universität Erlangen-Nürnberg, Erlangen
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Abstract
The memory changes associated with age are attributed to the deterioration of the frontal lobes, as well as to the middle temporal structures. Therefore, in addition to a decline in memory for facts and events, as found impaired in amnesics, a memory decline associated with age is predicted for tasks typically found impaired in frontal lobe patients (i.e., temporal order judgment). There are conflicting findings concerning whether indirect measures of memory for facts and events are associated with age. However, there are no studies that address this issue with regard to temporal order judgment. Thirty younger and thirty older adults were tested on a list of words which was repeated five times in fixed or varying order. The number of words recalled, as well as their temporal judgments, were the direct measure of memory. The effect of consistency of order of presentation on the number of words recalled was the indirect measure of memory for temporal order. Results suggest that direct, but not the indirect measures of memory were related to age.
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Affiliation(s)
- E Vakil
- Psychology Department, Bar-Ilan University, Ramat-Gan, Israel
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48
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Weise M, Weise R, Daniel WG. [Imaging methods in acquired heart valve defects]. Internist (Berl) 1994; 35:990-8. [PMID: 7822134] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- M Weise
- Medizinische Klinik II, Technischen Universität Dresden
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Hoffmann P, Klapperstück M, Scholz J, Weise M, Döpfer KP. Protection from reperfusion-induced arrhythmias by polyethylene glycol 600. J Pharm Pharmacol 1993; 45:1093-5. [PMID: 7908982 DOI: 10.1111/j.2042-7158.1993.tb07189.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The effects of polyethylene glycol (PEG) 600 on cardiovascular parameters and reperfusion-induced arrhythmias were investigated using a 5-min period of ligation of the left anterior descending coronary artery followed by reperfusion in an anaesthetized open-chest rat model. PEG 600 was effective in reducing reperfusion arrhythmias, such as ventricular fibrillation and ventricular tachycardia. Mortality was decreased from 29.4% (5/17) in the saline-control to 0% (0/14) in the PEG-treated group (P < 0.05). Biochemical investigations during the ischaemia/reperfusion period revealed that PEG infusion resulted in a reduction of cardiac lactate as well as a striking maintenance of the glutathione content of the heart.
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Affiliation(s)
- P Hoffmann
- Institute of Industrial Toxicology, Martin Luther University, Halle, Germany
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Kitwood SE, Phillips CJ, Weise M. Use of a vaginal mucus impedance meter to detect estrus in the cow. Theriogenology 1993; 40:559-69. [PMID: 16727339 DOI: 10.1016/0093-691x(93)90409-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/1991] [Accepted: 05/28/1993] [Indexed: 11/23/2022]
Abstract
Two experiments were conducted to investigate the efficacy of a vaginal mucus impedance meter for the detection of estrus in the dairy cow. In Experiment 1 the positioning of the probe within the vaginal tract was examined in dairy cows (n=6) by measuring mucus impedance at 5-cm intervals during probe withdrawal and comparing these fixed distance measurements with the depth within the vaginal tract at which the lowest impedance measurement was recorded. Measurements at 15 and 20 cm from the vulva were significantly lower than at other fixed depths, but did not show a reduction during estrus. The lowest recording upon withdrawal of the probe, which usually occurred between 15 and 20 cm from the vulva, was significantly lower than at any fixed depth recordings and was reduced proportionate during estrus to 0.14 of its non-estrus value. In Experiment 2 the accuracy of the probe to confirm estrus in cows exhibiting possible estrus signs was examined. Dairy cows (n=191) were inseminated either on the basis of herdsman observation of behavior alone (Treatment A) or on the basis of herdsman observation with cows exhibiting signs of estrous behaviour, but not standing to be mounted, being tested for vaginal mucus impedance (Treatment B). There were no significant treatment differences in the estrus detection rate, conception rate or other reproductive performance parameters. However, in 12% of cows in Treatment B, measurement of vaginal mucus impedance detected an extra estrous event, giving a theoretical increase in the estrus detection rate from 0.67 to 0.74 detected/predicted estrous events. It was concluded that when using a vaginal probe the lowest value in the vaginal tract should be sought, but that using the probe as an adjunct to herdsman's observation would not greatly increase estrus detection rate.
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Affiliation(s)
- S E Kitwood
- School of Agricultural and Forest Sciences, University of Wales, Bangor, Gwynedd. LL57 2UW, UK
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