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Rajendran R, Rajendran V, Böttiger G, Stadelmann C, Shirvanchi K, von Au L, Bhushan S, Wallendszus N, Schunin D, Westbrock V, Liebisch G, Ergün S, Karnati S, Berghoff M. The small molecule fibroblast growth factor receptor inhibitor infigratinib exerts anti-inflammatory effects and remyelination in a model of multiple sclerosis. Br J Pharmacol 2023; 180:2989-3007. [PMID: 37400950 DOI: 10.1111/bph.16186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/07/2023] [Accepted: 05/15/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Fibroblast growth factors and receptors (FGFR) have been shown to modulate inflammation and neurodegeneration in multiple sclerosis (MS). The selective FGFR inhibitor infigratinib has been shown to be effective in cancer models. Here, we investigate the effects of infigratinib on prevention and suppression of first clinical episodes of myelin oligodendrocyte glycoprotein (MOG)35-55 -induced experimental autoimmune encephalomyelitis (EAE) in mice. EXPERIMENTAL APPROACH The FGFR inhibitor infigratinib was given over 10 days from the time of experimental autoimmune encephalomyelitis induction or the onset of symptoms. The effects of infigratinib on proliferation, cytotoxicity and FGFR signalling proteins were studied in lymphocyte cell lines and microglial cells. KEY RESULTS Administration of infigratinib prevented by 40% and inhibited by 65% first clinical episodes of the induced experimental autoimmune encephalomyelitis. In the spinal cord, infiltration of lymphocytes and macrophages/microglia, destruction of myelin and axons were reduced by infigratinib. Infigratinib enhanced the maturation of oligodendrocytes and increased remyelination. In addition, infigratinib resulted in an increase of myelin proteins and a decrease in remyelination inhibitors. Further, lipids associated with neurodegeneration such as lysophosphatidylcholine and ceramide were decreased as were proliferation of T cells and microglial cells. CONCLUSION AND IMPLICATIONS This proof of concept study demonstrates the therapeutic potential of targeting FGFRs in a disease model of multiple sclerosis. Application of oral infigratinib resulted in anti-inflammatory and remyelinating effects. Thus, infigratinib may have the potential to slow disease progression or even to improve the disabling symptoms of multiple sclerosis.
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Affiliation(s)
- Ranjithkumar Rajendran
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Vinothkumar Rajendran
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Gregor Böttiger
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Christine Stadelmann
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - Kian Shirvanchi
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Laureen von Au
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Sudhanshu Bhushan
- Institute for Anatomy and Cell Biology, University of Giessen, Giessen, Germany
| | - Natascha Wallendszus
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Darja Schunin
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Victor Westbrock
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
| | - Gerhard Liebisch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - Süleyman Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Srikanth Karnati
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | - Martin Berghoff
- Experimental Neurology Group, Department of Neurology, University of Giessen, Giessen, Germany
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Wagner B, Härig CL, Walter B, Sommer J, Sammer G, Berghoff M. Is There Reduced Hemodynamic Brain Activation in Multiple Sclerosis Even with Undisturbed Cognition? Int J Mol Sci 2022; 24:ijms24010112. [PMID: 36613551 PMCID: PMC9820283 DOI: 10.3390/ijms24010112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Cognitive impairments related to changes in deep gray matter and other brain regions occur in up to 70% of people with multiple sclerosis. But do such brain changes also occur in patients without significant cognitive impairment? Eighteen participants with relapsing-remitting multiple sclerosis (RRMS) and fifteen healthy controls participated in this study. Cognitive status, depression, and fatigue were assessed using the Multiple Sclerosis Inventory of Cognition (MUSIC), Beck's Depression Inventory (BDI-II), and the Fatigue Severity Scale (FSS). fMRI was recorded while a participant performed the modified attention network test (ANT). The effects of ANT executive attention network on hemodynamic activation of a priori defined regions of interest, including the hippocampus, anterior cingulate cortex (ACC), thalamus, caudate nucleus, pallidum, and putamen were studied. The individual lesion load was estimated. For fMRI data analysis a general linear model with randomization statistics including threshold-free cluster enhancement as implemented in the FSL software was used. Participants with RRMS showed reduced activation of the executive attention network in the hippocampus, pallidum, and ACC. The thalamus was involved in both group activations but did not differ between groups. In summary, functional changes in the brain can also be demonstrated in RRMS patients without cognitive deficits. The affected brain regions can best be assigned to the attention network for executive control. This association could likely serve as a biological indicator of susceptibility to imminent cognitive impairment in MS.
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Affiliation(s)
- Bianca Wagner
- Department of Neurology, Justus-Liebig-University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Clara L. Härig
- Department of Neurology, Justus-Liebig-University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Bertram Walter
- Bender Institute of Neuroimaging, Justus-Liebig-University of Giessen, Otto-Behaghel-Strasse 10H, 35394 Giessen, Germany
| | - Jens Sommer
- Department of Psychiatry, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany
| | - Gebhard Sammer
- Cognitive Neuro Science at the Centre of Psychiatry, Justus-Liebig-University of Giessen, Klinikstrasse 36, 35392 Giessen, Germany
- Department of Psychology, Justus-Liebig-University of Giessen, Otto-Behaghel-Strasse 10F, 35394 Giessen, Germany
- Correspondence: (G.S.); (M.B.); Tel.: +49-641-45835 (G.S.); +49-641-98544306 (M.B.); Fax: +49-641-99-45789 (G.S.); +49-641-98545329 (M.B.)
| | - Martin Berghoff
- Department of Neurology, Justus-Liebig-University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
- Correspondence: (G.S.); (M.B.); Tel.: +49-641-45835 (G.S.); +49-641-98544306 (M.B.); Fax: +49-641-99-45789 (G.S.); +49-641-98545329 (M.B.)
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3
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Rajendran R, Rajendran V, Gupta L, Shirvanchi K, Schunin D, Karnati S, Giraldo-Velásquez M, Berghoff M. Interferon Beta-1a versus Combined Interferon Beta-1a and Oligodendrocyte-Specific FGFR1 Deletion in Experimental Autoimmune Encephalomyelitis. Int J Mol Sci 2022; 23:ijms232012183. [PMID: 36293040 PMCID: PMC9603153 DOI: 10.3390/ijms232012183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/30/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022] Open
Abstract
Recombinant beta interferons-1 (IFNβ-1) are used as first line therapies in patients with relapsing multiple sclerosis (MS), a chronic inflammatory and neurodegenerative disease of the CNS. IFNβ-1a/b has moderate effects on the prevention of relapses and slowing of disease progression. Fibroblast growth factors (FGFs) and FGF receptors (FGFRs) are known to play a key role in the pathology of MS and its model EAE. To investigate the effects of short-term treatment with s.c. IFNβ-1a versus the combined application of s.c. IFNβ-1a and oligodendrocyte-specific deletion of FGFR1 (Fgfr1ind−/− mice) in MOG35-55-induced EAE. IFNβ-1a (30 mg/kg) was applied s.c. from days 0–7 p.i. of EAE in controls and Fgfr1ind−/− mice. FGFR signaling proteins associated with inflammation/degeneration in MS/EAE were analyzed by western blot in the spinal cord. Further, FGFR1 in Oli-neu oligodendrocytes were inhibited by PD166866 and treated with IFNβ-1a (400 ng/mL). Application of IFNβ-1a over 8 days resulted in less symptoms only at the peak of disease (days 9–11) compared to controls. Application of IFNβ-1a in Fgfr1ind−/− mice resulted in less symptoms primarily in the chronic phase of EAE. Fgfr1ind−/− mice treated with IFNβ-1a showed increased expression of pERK and BDNF. In Oli-neu oligodendrocytes, treatment with PD166866 and IFNβ-1a also showed an increased expression of pERK and BDNF/TrkB. These data suggest that the beneficial effects in the chronic phase of EAE and on signaling molecules associated with ERK and BDNF expression are caused by the modulation of FGFR1 and not by interferon beta-1a. FGFR may be a potential target for therapy in MS.
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Affiliation(s)
- Ranjithkumar Rajendran
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Vinothkumar Rajendran
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Liza Gupta
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Kian Shirvanchi
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Darja Schunin
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
| | - Srikanth Karnati
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstrasse 6, 97080 Würzburg, Germany
| | | | - Martin Berghoff
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany
- Correspondence: ; Tel.: +49-641-98544306; Fax: +49-641-98545329
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Wiendl H, Gold R, Berger T, Derfuss T, Linker R, Mäurer M, Aktas O, Baum K, Berghoff M, Bittner S, Chan A, Czaplinski A, Deisenhammer F, Di Pauli F, Du Pasquier R, Enzinger C, Fertl E, Gass A, Gehring K, Gobbi C, Goebels N, Guger M, Haghikia A, Hartung HP, Heidenreich F, Hoffmann O, Kallmann B, Kleinschnitz C, Klotz L, Leussink VI, Leutmezer F, Limmroth V, Lünemann JD, Lutterotti A, Meuth SG, Meyding-Lamadé U, Platten M, Rieckmann P, Schmidt S, Tumani H, Weber F, Weber MS, Zettl UK, Ziemssen T, Zipp F. Multiple Sclerosis Therapy Consensus Group (MSTCG): position statement on disease-modifying therapies for multiple sclerosis (white paper). Ther Adv Neurol Disord 2021; 14:17562864211039648. [PMID: 34422112 PMCID: PMC8377320 DOI: 10.1177/17562864211039648] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/28/2021] [Indexed: 12/20/2022] Open
Abstract
Multiple sclerosis is a complex, autoimmune-mediated disease of the central nervous system characterized by inflammatory demyelination and axonal/neuronal damage. The approval of various disease-modifying therapies and our increased understanding of disease mechanisms and evolution in recent years have significantly changed the prognosis and course of the disease. This update of the Multiple Sclerosis Therapy Consensus Group treatment recommendation focuses on the most important recommendations for disease-modifying therapies of multiple sclerosis in 2021. Our recommendations are based on current scientific evidence and apply to those medications approved in wide parts of Europe, particularly German-speaking countries (Germany, Austria, and Switzerland).
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Affiliation(s)
- Heinz Wiendl
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster
| | - Ralf Gold
- Neurologie, St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum, Gudrunstraße 56, 44791 Bochum, Germany
| | - Thomas Berger
- Universitätsklinik für Neurologie, Medizinische Universität Wien, Wien, Austria
| | - Tobias Derfuss
- Neurologische Klinik und Poliklinik, Universitätsspital Basel, Basel, Switzerland
| | - Ralf Linker
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Mathias Mäurer
- Neurologie und Neurologische Frührehabilitation, Klinikum Würzburg Mitte gGmbH, Standort Juliusspital, Würzburg, Germany
| | - Orhan Aktas
- Neurologische Klinik, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Karl Baum
- Neurologie, Klinik Hennigsdorf, Hennigsdorf, Germany
| | | | - Stefan Bittner
- Klinik für Neurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Andrew Chan
- Neurologie, Inselspital, Universitätsspital Bern, Bern, Switzerland
| | | | | | | | | | - Christian Enzinger
- Universitätsklinik für Neurologie, Medizinische Universität Graz, Graz, Austria
| | - Elisabeth Fertl
- Wiener Gesundheitsverbund, Neurologische Abteilung, Wien, Austria
| | - Achim Gass
- Neurologische Klinik, Universitätsmedizin Mannheim/Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Klaus Gehring
- Berufsverband Deutscher Nervenärzte (BVDN), Neurozentrum am Klosterforst, Itzehoe, Germany
| | | | - Norbert Goebels
- Klinik für Neurologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Michael Guger
- Klinik für Neurologie 2, Kepler Universitätsklinikum, Linz, Austria
| | | | - Hans-Peter Hartung
- Klinik für Neurologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany; Klinik für Neurologie, Medizinische Universität Wien, Wien, Austria
| | - Fedor Heidenreich
- Diakovere Krankenhaus, Henriettenstift, Klinik für Neurologie und klinische Neurophysiologie, Hannover, Germany
| | - Olaf Hoffmann
- Klinik für Neurologie, Alexianer St. Josefs-Krankenhaus Potsdam, Potsdam, Germany; NeuroCure, Charité-Universitätsmedizin Berlin, Berlin, Germany; Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
| | - Boris Kallmann
- Kallmann Neurologie, Multiple Sklerose Zentrum Bamberg, Bamberg, Germany
| | | | - Luisa Klotz
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Münster, Germany
| | | | - Fritz Leutmezer
- Neurologie, Universitäts-Klinik für Neurologie Wien, Wien, Austria
| | - Volker Limmroth
- Klinik für Neurologie, Krankenhaus Köln-Merheim, Köln, Germany
| | - Jan D Lünemann
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Münster, Germany
| | | | - Sven G Meuth
- Neurologische Klinik, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | | | - Michael Platten
- Neurologische Klinik, Universitätsmedizin Mannheim/Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Peter Rieckmann
- Medical Park, Fachklinik für Neurologie, Zentrum für Klinische Neuroplastizität, Bischofswiesen, Germany
| | - Stephan Schmidt
- Neurologie, Gesundheitszentrum St. Johannes Hospital, Bonn, Germany
| | - Hayrettin Tumani
- Fachklinik für Neurologie Dietenbronn, Akademisches Krankenhaus der Universität Ulm, Ulm, Germany
| | - Frank Weber
- Neurologie, Sana Kliniken, Cham, Switzerland
| | - Martin S Weber
- Institut für Neuropathologie, Neurologische Klinik, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Uwe K Zettl
- Klinik und Poliklinik für Neurologie, Zentrum für Nervenheilkunde, Universitätsmedizin Rostock, Rostock, Germany
| | - Tjalf Ziemssen
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Frauke Zipp
- Klinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
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5
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Wiendl H, Gold R, Berger T, Derfuss T, Linker R, Mäurer M, Stangel M, Aktas O, Baum K, Berghoff M, Bittner S, Chan A, Czaplinski A, Deisenhammer F, Di Pauli F, Du Pasquier R, Enzinger C, Fertl E, Gass A, Gehring K, Gobbi C, Goebels N, Guger M, Haghikia A, Hartung HP, Heidenreich F, Hoffmann O, Hunter ZR, Kallmann B, Kleinschnitz C, Klotz L, Leussink V, Leutmezer F, Limmroth V, Lünemann JD, Lutterotti A, Meuth SG, Meyding-Lamadé U, Platten M, Rieckmann P, Schmidt S, Tumani H, Weber MS, Weber F, Zettl UK, Ziemssen T, Zipp F. [Multiple sclerosis treatment consensus group (MSTCG): position paper on disease-modifying treatment of multiple sclerosis 2021 (white paper)]. Nervenarzt 2021; 92:773-801. [PMID: 34297142 PMCID: PMC8300076 DOI: 10.1007/s00115-021-01157-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/07/2021] [Indexed: 12/16/2022]
Abstract
Die Multiple Sklerose ist eine komplexe, autoimmun vermittelte Erkrankung des zentralen Nervensystems, charakterisiert durch inflammatorische Demyelinisierung sowie axonalen/neuronalen Schaden. Die Zulassung verschiedener verlaufsmodifizierender Therapien und unser verbessertes Verständnis der Krankheitsmechanismen und -entwicklung in den letzten Jahren haben die Prognose und den Verlauf der Erkrankung deutlich verändert. Diese Aktualisierung der Behandlungsempfehlung der Multiple Sklerose Therapie Konsensus Gruppe konzentriert sich auf die wichtigsten Empfehlungen für verlaufsmodifizierende Therapien der Multiplen Sklerose im Jahr 2021. Unsere Empfehlungen basieren auf aktuellen wissenschaftlichen Erkenntnissen und gelten für diejenigen Medikamente, die in weiten Teilen Europas, insbesondere in den deutschsprachigen Ländern (Deutschland, Österreich, Schweiz), zugelassen sind.
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Affiliation(s)
- Heinz Wiendl
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland. .,Steuerungsgruppe der MSTKG, Münster, Deutschland. .,Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland.
| | - Ralf Gold
- Steuerungsgruppe der MSTKG, Münster, Deutschland. .,Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland. .,Neurologie, St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum, Gudrunstraße 56, 44791, Bochum, Deutschland.
| | - Thomas Berger
- Steuerungsgruppe der MSTKG, Münster, Deutschland.,Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland.,Universitätsklinik für Neurologie, Medizinische Universität Wien, Wien, Österreich
| | - Tobias Derfuss
- Steuerungsgruppe der MSTKG, Münster, Deutschland.,Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland.,Neurologische Klinik und Poliklinik, Universitätsspital Basel, Basel, Schweiz
| | - Ralf Linker
- Steuerungsgruppe der MSTKG, Münster, Deutschland.,Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland.,Klinik und Poliklinik für Neurologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Mathias Mäurer
- Steuerungsgruppe der MSTKG, Münster, Deutschland.,Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland.,Neurologie und Neurologische Frührehabilitation, Klinikum Würzburg Mitte gGmbH, Standort Juliusspital, Würzburg, Deutschland
| | - Martin Stangel
- Steuerungsgruppe der MSTKG, Münster, Deutschland.,Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland.,Klinische Neuroimmunologie und Neurochemie, Klinik für Neurologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Orhan Aktas
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Karl Baum
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Martin Berghoff
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Stefan Bittner
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Andrew Chan
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Adam Czaplinski
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | | | - Franziska Di Pauli
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Renaud Du Pasquier
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Christian Enzinger
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Elisabeth Fertl
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Achim Gass
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Klaus Gehring
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Claudio Gobbi
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Norbert Goebels
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Michael Guger
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Aiden Haghikia
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Hans-Peter Hartung
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Fedor Heidenreich
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Olaf Hoffmann
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Zoë R Hunter
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Münster, Deutschland
| | - Boris Kallmann
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | | | - Luisa Klotz
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Verena Leussink
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Fritz Leutmezer
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Volker Limmroth
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Jan D Lünemann
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Andreas Lutterotti
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Sven G Meuth
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Uta Meyding-Lamadé
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Michael Platten
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Peter Rieckmann
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Stephan Schmidt
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Hayrettin Tumani
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Martin S Weber
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Frank Weber
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Uwe K Zettl
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Tjalf Ziemssen
- Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland
| | - Frauke Zipp
- Steuerungsgruppe der MSTKG, Münster, Deutschland.,Multiple Sklerose Therapie Konsensus Gruppe (MSTKG), Münster, Deutschland.,Klinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland
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6
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Höpfinger A, Berghoff M, Karrasch T, Schmid A, Schäffler A. Systematic Quantification of Neurotrophic Adipokines RBP4, PEDF, and Clusterin in Human Cerebrospinal Fluid and Serum. J Clin Endocrinol Metab 2021; 106:e2239-e2250. [PMID: 33484131 DOI: 10.1210/clinem/dgaa983] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT Data on the presence/quantification of the neurotrophic adipokines retinol-binding protein-4 (RBP4), clusterin, and pigment epithelium-derived factor (PEDF) in human cerebrospinal fluid (CSF) are scarce and migration of these adipokines across of the blood-brain barrier (BBB) is uncertain. OBJECTIVE This work aimed to quantify RBP4, PEDF, and clusterin in paired serum and CSF samples of patients undergoing neurological evaluation. METHODS A total of 268 patients (109 male, 159 female) were included. Adipokine serum and CSF concentrations were measured by enzyme-linked immunosorbent assay in duplicate. RESULTS RBP4 was abundant in serum (mean, 31.9 ± 24.2 μg/mL). The serum concentrations were approximately 145 times higher than in CSF (CSF to serum RBP4 ratio, 8.2 ± 4.3 × 10-3). PEDF was detectable in serum (mean, 30.2 ± 11.7 μg/mL) and concentrations were approximately 25 times higher than in CSF (CSF to serum PEDF ratio, 42.3 ± 15.6 × 10-3). Clusterin serum concentrations were abundant with mean levels of 346.0 ± 114.6 μg/mL, which were approximately 40 times higher than CSF levels (CSF to serum clusterin ratio, 29.6 ± 23.4 × 10-3). RBP4 and PEDF serum levels correlated positively with CSF levels, which were increased in overweight/obese patients and in type 2 diabetic patients. The CSF concentrations of all 3 adipokines increased with BBB dysfunction. RBP4 in CSF correlated positively with inflammatory parameters. In detail, only RBP4 showed the kinetics and associations that are mandatory for a putative mediator of the fat-brain axis. CONCLUSION RBP4, PEDF, and clusterin are permeable to the BBB and increase with the measure of BBB dysfunction. RBP4 represents an inflammatory neurotrophic adipokine and is a promising mediator of the fat-brain axis.
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Affiliation(s)
- Alexandra Höpfinger
- Department of Internal Medicine III, Giessen University Hospital, Gießen, Germany
| | - Martin Berghoff
- Department of Neurology, Giessen University Hospital, Gießen, Germany
| | - Thomas Karrasch
- Department of Internal Medicine III, Giessen University Hospital, Gießen, Germany
| | - Andreas Schmid
- Department of Internal Medicine III, Giessen University Hospital, Gießen, Germany
| | - Andreas Schäffler
- Department of Internal Medicine III, Giessen University Hospital, Gießen, Germany
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7
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Rajendran R, Böttiger G, Stadelmann C, Karnati S, Berghoff M. FGF/FGFR Pathways in Multiple Sclerosis and in Its Disease Models. Cells 2021; 10:884. [PMID: 33924474 PMCID: PMC8068804 DOI: 10.3390/cells10040884] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/01/2021] [Accepted: 04/10/2021] [Indexed: 12/19/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system (CNS) affecting more than two million people worldwide. In MS, oligodendrocytes and myelin sheaths are destroyed by autoimmune-mediated inflammation, while remyelination is impaired. Recent investigations of post-mortem tissue suggest that Fibroblast growth factor (FGF) signaling may regulate inflammation and myelination in MS. FGF2 expression seems to correlate positively with macrophages/microglia and negatively with myelination; FGF1 was suggested to promote remyelination. In myelin oligodendrocyte glycoprotein (MOG)35-55-induced experimental autoimmune encephalomyelitis (EAE), systemic deletion of FGF2 suggested that FGF2 may promote remyelination. Specific deletion of FGF receptors (FGFRs) in oligodendrocytes in this EAE model resulted in a decrease of lymphocyte and macrophage/microglia infiltration as well as myelin and axon degeneration. These effects were mediated by ERK/Akt phosphorylation, a brain-derived neurotrophic factor, and downregulation of inhibitors of remyelination. In the first part of this review, the most important pharmacotherapeutic principles for MS will be illustrated, and then we will review recent advances made on FGF signaling in MS. Thus, we will suggest application of FGFR inhibitors, which are currently used in Phase II and III cancer trials, as a therapeutic option to reduce inflammation and induce remyelination in EAE and eventually MS.
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MESH Headings
- Animals
- Brain-Derived Neurotrophic Factor/genetics
- Brain-Derived Neurotrophic Factor/immunology
- Disease Models, Animal
- Encephalomyelitis, Autoimmune, Experimental/chemically induced
- Encephalomyelitis, Autoimmune, Experimental/drug therapy
- Encephalomyelitis, Autoimmune, Experimental/genetics
- Encephalomyelitis, Autoimmune, Experimental/immunology
- Fibroblast Growth Factor 2/deficiency
- Fibroblast Growth Factor 2/genetics
- Gene Expression Regulation
- Humans
- Immunologic Factors/therapeutic use
- Mice, Knockout
- Microglia/drug effects
- Microglia/immunology
- Microglia/pathology
- Multiple Sclerosis/drug therapy
- Multiple Sclerosis/genetics
- Multiple Sclerosis/immunology
- Multiple Sclerosis/pathology
- Myelin Sheath/drug effects
- Myelin Sheath/immunology
- Myelin Sheath/pathology
- Myelin-Oligodendrocyte Glycoprotein/administration & dosage
- Oligodendroglia/drug effects
- Oligodendroglia/immunology
- Oligodendroglia/pathology
- Peptide Fragments/administration & dosage
- Proto-Oncogene Proteins c-akt/genetics
- Proto-Oncogene Proteins c-akt/immunology
- Receptor, Fibroblast Growth Factor, Type 2/antagonists & inhibitors
- Receptor, Fibroblast Growth Factor, Type 2/genetics
- Receptor, Fibroblast Growth Factor, Type 2/immunology
- Remyelination/drug effects
- Remyelination/genetics
- Remyelination/immunology
- Signal Transduction
- Mice
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Affiliation(s)
- Ranjithkumar Rajendran
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany; (R.R.); (G.B.)
| | - Gregor Böttiger
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany; (R.R.); (G.B.)
| | - Christine Stadelmann
- Institute of Neuropathology, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany;
| | - Srikanth Karnati
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstrasse 6, 97080 Würzburg, Germany;
| | - Martin Berghoff
- Experimental Neurology, Department of Neurology, University of Giessen, Klinikstrasse 33, 35385 Giessen, Germany; (R.R.); (G.B.)
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8
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Kamali S, Rajendran R, Stadelmann C, Karnati S, Rajendran V, Giraldo-Velasquez M, Berghoff M. Oligodendrocyte-specific deletion of FGFR2 ameliorates MOG 35-55 -induced EAE through ERK and Akt signalling. Brain Pathol 2021; 31:297-311. [PMID: 33103299 PMCID: PMC8018040 DOI: 10.1111/bpa.12916] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022] Open
Abstract
Fibroblast growth factors (FGFs) and their receptors (FGFRs) are involved in demyelinating pathologies including multiple sclerosis (MS). In our recent study, oligodendrocyte‐specific deletion of FGFR1 resulted in a milder disease course, less inflammation, reduced myelin and axon damage in EAE. The objective of this study was to elucidate the role of oligodendroglial FGFR2 in MOG35‐55‐induced EAE. Oligodendrocyte‐specific knockout of FGFR2 (Fgfr2ind−/−) was achieved by application of tamoxifen; EAE was induced using the MOG35‐55 peptide. EAE symptoms were monitored over 62 days. Spinal cord tissue was analysed by histology, immunohistochemistry and western blot. Fgfr2ind−/− mice revealed a milder disease course, less myelin damage and enhanced axonal density. The number of oligodendrocytes was not affected in demyelinated areas. However, protein expression of FGFR2, FGF2 and FGF9 was downregulated in Fgfr2ind−/− mice. FGF/FGFR dependent signalling proteins were differentially regulated; pAkt was upregulated and pERK was downregulated in Fgfr2ind−/− mice. The number of CD3(+) T cells, Mac3(+) cells and B220(+) B cells was less in demyelinated lesions of Fgfr2ind−/− mice. Furthermore, expression of IL‐1β, TNF‐α and CD200 was less in Fgfr2ind−/− mice than controls. Fgfr2ind−/− mice showed an upregulation of PLP and downregulation of the remyelination inhibitors SEMA3A and TGF‐β expression. These data suggest that cell‐specific deletion of FGFR2 in oligodendrocytes has anti‐inflammatory and neuroprotective effects accompanied by changes in FGF/FGFR dependent signalling, inflammatory cytokines and expression of remyelination inhibitors. Thus, FGFRs in oligodendrocytes may represent potential targets for the treatment of inflammatory and demyelinating diseases including MS.
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Affiliation(s)
- Salar Kamali
- Department of Neurology, University of Giessen, Giessen, Germany
| | | | - Christine Stadelmann
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - Srikanth Karnati
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
| | | | | | - Martin Berghoff
- Department of Neurology, University of Giessen, Giessen, Germany
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9
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Leal A, Bogantes-Ledezma S, Ekici AB, Uebe S, Thiel CT, Sticht H, Berghoff M, Berghoff C, Morera B, Meisterernst M, Reis A. The polynucleotide kinase 3'-phosphatase gene (PNKP) is involved in Charcot-Marie-Tooth disease (CMT2B2) previously related to MED25. Neurogenetics 2018; 19:215-225. [PMID: 30039206 PMCID: PMC6280876 DOI: 10.1007/s10048-018-0555-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/02/2018] [Accepted: 07/05/2018] [Indexed: 11/26/2022]
Abstract
Charcot-Marie-Tooth disease (CMT) represents a heterogeneous group of hereditary peripheral neuropathies. We previously reported a CMT locus on chromosome 19q13.3 segregating with the disease in a large Costa Rican family with axonal neuropathy and autosomal recessive pattern of inheritance (CMT2B2). We proposed a homozygous missense variant in the Mediator complex 25 (MED25) gene as causative of the disease. Nevertheless, the fact that no other CMT individuals with MED25 variants were reported to date led us to reevaluate the original family. Using exome sequencing, we now identified a homozygous nonsense variant (p.Gln517ter) in the last exon of an adjacent gene, the polynucleotide kinase 3'-phosphatase (PNKP) gene. It encodes a DNA repair protein recently associated with recessive ataxia with oculomotor apraxia type 4 (AOA4) and microcephaly, seizures, and developmental delay (MCSZ). Subsequently, five unrelated Costa Rican CMT2 subjects initially identified as being heterozygous for the same MED25 variant were found to be also compound heterozygote for PNKP. All were heterozygous for the same variant found homozygous in the large family and a second one previously associated with ataxia (p.Thr408del). Detailed clinical reassessment of the initial family and the new individuals revealed in all an adult-onset slowly progressive CMT2 associated with signs of cerebellar dysfunction such as slurred speech and oculomotor involvement, but neither microcephaly, seizures, nor developmental delay. We propose that PKNP variants are the major causative variant for the CMT2 phenotype in these individuals and that the milder clinical manifestation is due to an allelic effect.
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Affiliation(s)
- Alejandro Leal
- Section of Genetics and Biotechnology, School of Biology, Universidad de Costa Rica, Sede Montes de Oca, San José, 2060, Costa Rica.
- Neuroscience Research Center, Universidad de Costa Rica, San José, Costa Rica.
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | | | - Arif B Ekici
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Steffen Uebe
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christian T Thiel
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Sticht
- Institute of Biochemistry, Friedrich-Alexander-Universtät Erlangen-Nürnberg, Erlangen, Germany
| | | | | | - Bernal Morera
- School of Biological Sciences, Universidad Nacional, Heredia, Costa Rica
| | | | - André Reis
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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10
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Heesen C, Haase R, Melzig S, Poettgen J, Berghoff M, Paul F, Zettl U, Marziniak M, Angstwurm K, Kern R, Ziemssen T, Stellmann JP. Perceptions on the value of bodily functions in multiple sclerosis. Acta Neurol Scand 2018; 137:356-362. [PMID: 29205262 DOI: 10.1111/ane.12881] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND In neurological diseases presenting with a plethora of symptoms, the value of bodily functions for a given patient might be a guide for clinical management. Multiple sclerosis (MS) is paradigmatic in this respect, and little is known about the value of different bodily functions of patients and their physicians' perceptions. METHODS In a multicenter study, 171 patients with relapsing-remitting multiple sclerosis (RRMS), 61% with a clinically active disease within the last 2 years were followed over up to 3 years and yearly patients and their study physician rated on the perceived value of 13 bodily functions via a priority list. Differences between patients and physicians as well as modulating disease demographic factors were analyzed. RESULTS Patients with RRMS rated visual function followed by thinking and memory and walking highest while physicians stressed mobility, followed by thinking and memory and alertness most. Ratings were independent from disease duration or disability. Strongest value judgment differences were seen in swallowing regarded more relevant by patients and hand function regarded more relevant by physicians. In general, patients' and physicians' ratings through time were quite stable. Collapsing physical items into a physical functioning scale and mental items in a mental function scale, both dimensions were regarded equally important by patients while physicians underscored physical functioning (P = .016). CONCLUSION There are differences between patients and physicians in value statements of bodily functions in MS. In particular, visual functioning is under-recognized by physicians.
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Affiliation(s)
- C. Heesen
- Institut für Neuroimmunologie und Multiple Sklerose; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
- Klinik und Poliklinik für Neurologie; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
| | - R. Haase
- Zentrum für klinische Neurowissenschaften; Klinik und Poliklinik für Neurologie; Universitätsklinikum Carlk Gustav Carus; Dresden Germany
| | - S. Melzig
- Zentrum für klinische Neurowissenschaften; Klinik und Poliklinik für Neurologie; Universitätsklinikum Carlk Gustav Carus; Dresden Germany
| | - J. Poettgen
- Institut für Neuroimmunologie und Multiple Sklerose; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
- Klinik und Poliklinik für Neurologie; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
| | - M. Berghoff
- Department of Neurology; Justus-Liebig University Giessen; Giessen Germany
| | - F. Paul
- NeuroCure Clinical Research Center and Experimental and Clinical Research Center; Clinical and Experimental Multiple Sclerosis Research Center; Department of Neurology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - U. Zettl
- Zentrum für Nervenheilkunde; Klinik und Poliklinik für Neurologie; Universitätsmedizin Rostock; Rostock Germany
| | - M. Marziniak
- Neurologie; kbo-Isar-Amper-Klinikum; Haar Germany
| | - K. Angstwurm
- Klinik und Poliklinik für Neurologie der Universität Regensburg am Bezirksklinikum Regensburg; Regensburg Germany
| | - R. Kern
- Zentrum für klinische Neurowissenschaften; Klinik und Poliklinik für Neurologie; Universitätsklinikum Carlk Gustav Carus; Dresden Germany
| | - T. Ziemssen
- Zentrum für klinische Neurowissenschaften; Klinik und Poliklinik für Neurologie; Universitätsklinikum Carlk Gustav Carus; Dresden Germany
| | - J. P. Stellmann
- Institut für Neuroimmunologie und Multiple Sklerose; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
- Klinik und Poliklinik für Neurologie; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
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11
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Schmid A, Berghoff M, Hochberg A, Schäffler A, Karrasch T. CTRP-3 is permeable to the blood-brain barrier and is not regulated by glucose or lipids in vivo. Eur J Clin Invest 2017; 47:203-212. [PMID: 27930815 DOI: 10.1111/eci.12709] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 11/30/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND C1q/TNF-related protein-3 (CTRP-3) represents a novel anti-inflammatory and antidiabetic adipokine secreted by adipose tissue. The physiological and postprandial regulation of CTRP-3 remains obscure and it is not known whether CTRP-3 is permeable to the brain. The postprandial regulation of CTRP-3 during an oral glucose tolerance test (n = 100) and an oral lipid tolerance test (n = 100) in humans was investigated. Moreover, CTRP-3 concentrations were measured in paired serum and cerebrospinal fluid (CSF) samples of patients (n = 270) undergoing neurological evaluation. The expression of CTRP-3 mRNA was investigated in adipocytes upon stimulation with glucose, sex hormones and a broad panel of fatty acids. MATERIALS AND METHODS Serum and CSF CTRP-3 concentrations were measured by ELISA. 3T3-L1 adipocytes were used for stimulation experiments. CTRP-3 mRNA expression was quantified by using real-time PCR analysis. RESULTS CTRP-3 is present in human cerebrospinal fluid with a mean CSF/serum ratio of 110 ± 64 × 10-3 . CTRP-3 is not regulated postprandially by carbohydrates or lipids in the healthy state. Females have slightly higher levels of CTRP-3 when compared to males. A significant and positive correlation of CTRP-3 to LDL cholesterol serum levels is reproducible in several cohorts and deserves further mechanistic investigation. Whereas glucose concentrations do not influence CTRP-3 mRNA expression in 3T3-L1 adipocytes in vitro, fatty acids differentially modulate CTRP-3 expression. CONCLUSIONS The novel adipokine CTRP-3 is detectable in human cerebrospinal fluid (proof of principle). Due to its blood-brain barrier permeability, CTRP-3 represents a novel putative candidate for a physiological regulator molecule affecting central nervous functions.
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Affiliation(s)
- Andreas Schmid
- Department of Internal Medicine III, University Hospital Giessen, Giessen, Germany
| | - Martin Berghoff
- Department of Neurology, University Hospital Giessen, Giessen, Germany
| | - Alexandra Hochberg
- Department of Internal Medicine III, University Hospital Giessen, Giessen, Germany
| | - Andreas Schäffler
- Department of Internal Medicine III, University Hospital Giessen, Giessen, Germany
| | - Thomas Karrasch
- Department of Internal Medicine III, University Hospital Giessen, Giessen, Germany
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12
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Rajendran R, Giraldo-Velásquez M, Stadelmann C, Berghoff M. Oligodendroglial fibroblast growth factor receptor 1 gene targeting protects mice from experimental autoimmune encephalomyelitis through ERK/AKT phosphorylation. Brain Pathol 2017; 28:212-224. [PMID: 28117910 DOI: 10.1111/bpa.12487] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/18/2017] [Indexed: 01/17/2023] Open
Abstract
Fibroblast growth factors (FGFs) exert diverse biological effects by binding and activation of specific fibroblast growth factor receptors (FGFRs). FGFs and FGFRs have been implicated in demyelinating pathologies including multiple sclerosis. In vitro activation of the FGF2/FGFR1 pathway results in downregulation of myelin proteins. FGF1, 2 and 9 have been shown to be involved in the pathology of multiple sclerosis. Recent studies on the function of oligodendroglial FGFR1 in a model of toxic demyelination showed that deletion of FGFR1 led to increased remyelination and preservation of axonal density and an increased number of mature oligodendrocytes. In the present study the in vivo function of oligodendroglial FGFR1 was characterized using an oligodendrocyte-specific genetic approach in the most frequently used model of multiple sclerosis the MOG35-55 -induced EAE. Oligodendroglial FGFR1 deficient mice (referred to as Fgfr1ind-/- ) showed a significantly ameliorated disease course in MOG35-55 -induced EAE. Less myelin and axonal loss, and reduced lymphocyte and macrophage/microglia infiltration were found in Fgfr1ind-/- mice. The reduction in disease severity in Fgfr1ind-/- mice was accompanied by ERK/AKT phosphorylation, and increased expression of BDNF and TrkB. Reduced proinflammatory cytokine and chemokine expression was seen in Fgfr1ind-/- mice compared with control mice. Considering that FGFR inhibitors are used in cancer trials, the oligodendroglial FGFR1 pathway may provide a new target for therapy in multiple sclerosis.
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Affiliation(s)
- Ranjithkumar Rajendran
- Department of Neurology, University of Giessen, Klinikstrasse 33, Giessen, 35385, Germany
| | | | - Christine Stadelmann
- Institute of Neuropathology, University of Göttingen, Robert-Koch-Strasse 40, Göttingen, 37099, Germany
| | - Martin Berghoff
- Department of Neurology, University of Giessen, Klinikstrasse 33, Giessen, 35385, Germany
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13
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Grams AE, Rehwald R, Schmittnägel C, Schmidt T, Tanislav C, Berghoff M, Krombach GA, Moritz R, Obert M, Gizewski ER, Glodny B. Factors influencing intracranial vessel densities on unenhanced computed tomography: differences between hemispheres. Clin Imaging 2016; 40:1081-1085. [DOI: 10.1016/j.clinimag.2016.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 06/18/2016] [Accepted: 06/21/2016] [Indexed: 01/17/2023]
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14
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Schmid A, Hochberg A, Berghoff M, Schlegel J, Karrasch T, Kaps M, Schäffler A. Quantification and regulation of adipsin in human cerebrospinal fluid (CSF). Clin Endocrinol (Oxf) 2016; 84:194-202. [PMID: 26186410 DOI: 10.1111/cen.12856] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/03/2015] [Accepted: 07/10/2015] [Indexed: 02/01/2023]
Abstract
CONTEXT Data on quantification and regulation of adipsin in human cerebrospinal fluid (CSF) are sparse, and the physiological role of adipsin as an adipokine crossing the blood-brain barrier (BBB) is uncertain. OBJECTIVES This study quantified adipsin concentrations in paired serum and CSF samples of patients undergoing neurological evaluation and spinal puncture. DESIGN A total of 270 consecutive patients with specified neurological diagnosis were included in this study without prior selection. MAIN OUTCOME MEASURES Adipsin serum and CSF concentrations were measured by ELISA. A variety of serum and CSF routine parameters were measured by standard procedures. Anthropometric data, medication and patient history were available. RESULTS Adipsin concentrations ranged between 467 and 5148 ng/ml in serum and between 4·2 and 133·5 ng/ml in CSF. Serum adipsin concentrations were correlated positively with respective CSF concentrations and were approximately 40-fold higher when compared to CSF. The mean CSF/serum ratio for adipsin was 27 ± 22 × 10-3 . Serum and CSF adipsin levels were independent of gender and significantly higher in overweight/obese individuals. Serum and CSF adipsin levels correlated significantly with age and were higher in patients suffering from diabetes mellitus or hypertension. CSF adipsin concentrations showed a significant correlation with markers of inflammation in CSF, but not with CSF total cell count or the presence of oligoclonal bands. Patients suffering from infectious diseases had higher CSF levels of adipsin than multiple sclerosis patients. CONCLUSIONS Adipsin is present in human CSF under pathophysiological conditions. The positive correlation between serum and CSF concentrations, the positive correlation between the CSF/serum ratios for adipsin and total protein and the lack of association with CSF cell count argue against an autochthonous production in the central nervous system. In contrast, the present data argue for a significant BBB permeability to adipsin.
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Affiliation(s)
- Andreas Schmid
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Alexandra Hochberg
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Martin Berghoff
- Department of Neurology, Giessen University Hospital, Giessen, Germany
| | - Jutta Schlegel
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Thomas Karrasch
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Manfred Kaps
- Department of Neurology, Giessen University Hospital, Giessen, Germany
| | - Andreas Schäffler
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
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15
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Berghoff M, Hochberg A, Schmid A, Schlegel J, Karrasch T, Kaps M, Schäffler A. Quantification and regulation of the adipokines resistin and progranulin in human cerebrospinal fluid. Eur J Clin Invest 2016; 46:15-26. [PMID: 26509463 DOI: 10.1111/eci.12558] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/24/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Adipokines bearing the potential to cross the blood-brain barrier (BBB) are promising candidates for the endocrine regulation of central nervous processes and of a postulated fat-brain axis. Resistin and progranulin concentrations in paired serum and cerebrospinal fluid (CSF) samples of patients undergoing neurological evaluation and spinal puncture were investigated. MATERIALS AND METHODS Samples of n = 270 consecutive patients with various neurological diseases were collected without prior selection. Adipokine serum and CSF concentrations were measured by enzyme-linked immunosorbent assay and serum and CSF routine parameters by standard procedures. Anthropometric data, medication and patient history were available. RESULTS Serum levels of resistin and progranulin were positively correlated among each other, with respective CSF levels, low-density lipoprotein cholesterol levels and markers of systemic inflammation. CSF resistin concentrations were generally low. Progranulin CSF concentrations and CSF/serum progranulin ratio were significantly higher in patients with infectious diseases, with disturbed BBB function and with elevated CSF cell count and presence of oligoclonal bands. Both adipokines are able to cross the BBB depending on a differing patency that increases with increasing grade of barrier dysfunction. Whereas resistin represents a systemic marker of inflammation, CSF progranulin levels strongly depend on the underlying disease and dysfunction of blood-CSF barrier. CONCLUSIONS Resistin and progranulin represent novel and putative regulators of the fat-brain axis by their ability to cross the BBB under physiological and pathophysiological conditions. The presented data provide insight into the characteristics of BBB function regarding progranulin and resistin and the basis for future establishment of normal values for CSF concentrations and CSF/serum ratios.
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Affiliation(s)
- Martin Berghoff
- Department of Neurology, Giessen University Hospital, Giessen, Germany
| | - Alexandra Hochberg
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Andreas Schmid
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Jutta Schlegel
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Thomas Karrasch
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Manfred Kaps
- Department of Neurology, Giessen University Hospital, Giessen, Germany
| | - Andreas Schäffler
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
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16
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Leal A, Berghoff C, Berghoff M, Rojas-Araya M, Carolina O, Heuss D, Del Valle G, Rautenstrauss B. A Costa Rican family affected with Charcot-Marie-Tooth disease due to the myelin protein zero (MPZ) p.Thr124Met mutation shares the Belgian haplotype. REV BIOL TROP 2015; 62:1285-93. [PMID: 25720167 DOI: 10.15517/rbt.v62i4.13473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The p.Thr124Met mutation in the myelin protein zero (MPZ) causes the Charcot-Marie-Tooth disease type 2J, a peripheral neuropathy with additional symptoms as pupillary alterations and deafness. It was observed in several families around the world originating e. g. from Germany, Belgium, Japan, Italy and North America. Here we report Central American patients originating from a family in Costa Rica carrying this mutation. Clinical, electrophysiological and molecular analysis of patients and controls were performed, including gene and linked markers' sequencing. Carriers share almost the entire haplotype with two non related Belgian CMT patients. As a result of the haplotype analysis, based on ten markers (seven SNPs, two microsatellites and an intronic polyA stretch), the founder effect hypothesis for this allele migration is suggestive.
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17
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Hochberg AM, Berghoff M, Schlegel J, Schmid A, Karrasch T, Kaps M, Schäffler A. Concentrations and regulation of adipokines resistin and progranulin in human cerebrospinal fluid. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547721] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Tietz SM, Hofmann R, Thomas T, Tackenberg B, Gaestel M, Berghoff M. MK2 and Fas receptor contribute to the severity of CNS demyelination. PLoS One 2014; 9:e100363. [PMID: 24964076 PMCID: PMC4070940 DOI: 10.1371/journal.pone.0100363] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 05/27/2014] [Indexed: 11/18/2022] Open
Abstract
Models of inflammatory or degenerative diseases demonstrated that the protein-kinase MK2 is a key player in inflammation. In this study we examined the role of MK2 in MOG35-55-induced experimental autoimmune encephalomyelitis (EAE), the animal model for multiple sclerosis. In MK2-deficient (MK2-/-) mice we found a delayed onset of the disease and MK2-/- mice did not recover until day 24 after EAE induction. At this day a higher number of leukocytes in the CNS of MK2-/- mice was found. TNFα was not detectable in serum of MK2-/- mice in any stage of EAE, while high TNFα levels were found at day 16 in wild-type mice. Further investigation revealed an increased expression of FasR mRNA in leukocytes isolated from CNS of wild-type mice but not in MK2-/- mice, however in vitro stimulation of MK2-/- splenocytes with rmTNFα induced the expression of FasR. In addition, immunocomplexes between the apoptosis inhibitor cFlip and the FasR adapter molecule FADD were only detected in splenocytes of MK2-/- mice at day 24 after EAE induction. Moreover, the investigation of blood samples from relapsing-remitting multiple sclerosis patients revealed reduced FasR mRNA expression compared to healthy controls. Taken together, our data suggest that MK2 is a key regulatory inflammatory cytokines in EAE and multiple sclerosis. MK2-/- mice showed a lack of TNFα and thus might not undergo TNFα-induced up-regulation of FasR. This may prevent autoreactive leukocytes from apoptosis and may led to prolonged disease activity. The findings indicate a key role of MK2 and FasR in the regulation and limitation of the immune response in the CNS.
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Affiliation(s)
- Silvia M. Tietz
- Department of Neurology, Justus-Liebig-University Giessen, Giessen, Germany
- Theodor-Kocher-Institute, Universtiy of Bern, Bern, Switzerland
| | - Regina Hofmann
- Department of Child Neurology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Tobias Thomas
- Department of Neurology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Björn Tackenberg
- Department of Neurology, Clinical Neuroimmunology Group, Philipps-University, Marburg, Germany
| | - Matthias Gaestel
- Institute of Biochemistry, Hannover Medical School, Hannover, Germany
| | - Martin Berghoff
- Department of Neurology, Justus-Liebig-University Giessen, Giessen, Germany
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19
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Köpke S, Kern S, Ziemssen T, Berghoff M, Kleiter I, Marziniak M, Paul F, Vettorazzi E, Pöttgen J, Fischer K, Kasper J, Heesen C. Evidence-based patient information programme in early multiple sclerosis: a randomised controlled trial. J Neurol Neurosurg Psychiatry 2014; 85:411-8. [PMID: 24104856 DOI: 10.1136/jnnp-2013-306441] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the efficacy of an evidence-based patient information programme aiming to increase informed choice in patients with early multiple sclerosis (MS). BACKGROUND Patients with early MS face a number of uncertainties concerning diagnosis, prognosis and effectiveness of immunotherapy. Prior studies suggest that evidence-based patient information combined with group education can promote informed choice in MS patients. METHODS A 12-month, six-centre, double-blind randomised controlled clinical trial with 192 patients with a diagnosis of confirmed relapsing-remitting MS or clinical isolated syndrome in Germany. A 4-h interactive evidence-based educational programme was compared with a 4-h MS-specific stress management programme. The primary endpoint was informed choice after 6 months comprising risk knowledge and congruency between attitude towards immunotherapy and actual immunotherapy uptake. Secondary endpoints included autonomy preference, decision autonomy, decisional conflict and satisfaction, anxiety and depression, and number of immunotherapies. RESULTS For the primary endpoint, a significant difference was shown with 50 of 85 (59%) participants in the intervention group achieving informed choice after 6 months compared with 18 of 89 (20%) in the control group (OR 0.2 (95% CI 0.1 to 0.4), p<0.001). Four weeks after the intervention, more participants in the intervention group showed good risk knowledge (difference between groups 39% (95% CI 26% to 53%), p<0.001). There were no significant differences between groups for attitude towards immunotherapy and for immunotherapy uptake. There were trends towards increased autonomy preference after the intervention and increased adherence to immunotherapies in the intervention group. CONCLUSIONS The intervention significantly increased informed choice and relevant risk knowledge without negative side effects.
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Affiliation(s)
- Sascha Köpke
- Institute of Social Medicine, University of Lübeck, , Lübeck, Germany
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20
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Berghoff M, Dassinger B, Iwinska-Zelder J, Giraldo M, Bilgin S, Kaps M, Gizewski ER. A case of natalizumab-associated progressive multifocal leukoencephalopathy-role for advanced MRI? Clin Neuroradiol 2013; 24:173-6. [PMID: 23532437 DOI: 10.1007/s00062-013-0216-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/05/2013] [Indexed: 10/27/2022]
Affiliation(s)
- M Berghoff
- Department of Neurology, University of Giessen, Klinikstrasse 33, 35385, Giessen, Germany,
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21
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Berghoff M, Schänzer A, Hildebrandt GC, Dassinger B, Klappstein G, Kaps M, Gizewski ER, Acker T, Grams A. Development of progressive multifocal leukoencephalopathy in a patient with non-Hodgkin lymphoma 13 years after treatment with cladribine. Leuk Lymphoma 2012; 54:1340-2. [PMID: 23098217 DOI: 10.3109/10428194.2012.740669] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Abstract
Genetic modifications used to answer biological questions in cultured cells are widely used in basic research. Common transfection methods are based on viral components causing cell activation or chemical modifications of small interfering RNA and cytotoxic reagents. Here, we report a rapid and efficient approach to transfect hard-to-transfect human U937 cells via the HVJ Envelope vector system, independent from special transfection media or immobilization of cells. This protocol provides a convenient means of knocking down MAPK-activated kinase 2 in hard-to-transfect cells to study inflammation, cell adhesion, and migration characteristics.
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Affiliation(s)
- S M Tietz
- Department of Neurology, Justus-Liebig-University Giessen, Giessen, Germany.
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23
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Oettel M, Dorosz S, Berghoff M, Nestler B, Schilling T. Description of hard-sphere crystals and crystal-fluid interfaces: a comparison between density functional approaches and a phase-field crystal model. Phys Rev E Stat Nonlin Soft Matter Phys 2012; 86:021404. [PMID: 23005760 DOI: 10.1103/physreve.86.021404] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Indexed: 06/01/2023]
Abstract
In materials science the phase-field crystal approach has become popular to model crystallization processes. Phase-field crystal models are in essence Landau-Ginzburg-type models, which should be derivable from the underlying microscopic description of the system in question. We present a study on classical density functional theory in three stages of approximation leading to a specific phase-field crystal model, and we discuss the limits of applicability of the models that result from these approximations. As a test system we have chosen the three-dimensional suspension of monodisperse hard spheres. The levels of density functional theory that we discuss are fundamental measure theory, a second-order Taylor expansion thereof, and a minimal phase-field crystal model. We have computed coexistence densities, vacancy concentrations in the crystalline phase, interfacial tensions, and interfacial order parameter profiles, and we compare these quantities to simulation results. We also suggest a procedure to fit the free parameters of the phase-field crystal model. Thereby it turns out that the order parameter of the phase-field crystal model is more consistent with a smeared density field (shifted and rescaled) than with the shifted and rescaled density itself. In brief, we conclude that fundamental measure theory is very accurate and can serve as a benchmark for the other theories. Taylor expansion strongly affects free energies, surface tensions, and vacancy concentrations. Furthermore it is phenomenologically misleading to interpret the phase-field crystal model as stemming directly from Taylor-expanded density functional theory.
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Affiliation(s)
- M Oettel
- Johannes Gutenberg-Universität Mainz, Institut für Physik, WA 331, D-55099 Mainz, Germany
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24
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Berghoff M, Schlamann MU, Maderwald S, Grams AE, Kaps M, Ladd ME, Gizewski ER. 7 Tesla MRI demonstrates vascular pathology in Baló’s concentric sclerosis. Mult Scler 2012; 19:120-2. [DOI: 10.1177/1352458512445302] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Baló’s concentric sclerosis (BCS) is an inflammatory demyelinating disease related to multiple sclerosis; its underlying pathology remains unclear. At 7 T MRI in a 19-year-old female BCS patient, microhaemorrhages and ectatic veins were found in T2 hyperintense regions, features which have not been previously reported in conjunction with BCS, and these findings may support the view that vascular pathology plays a role in BCS. MRS data suggest that neuron loss and lipid turnover still took place months after a remission. Plasma exchange was effective in treating a relapse with severe motor deficits, and the off-label use of natalizumab was successful in maintaining remission in this patient.
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Affiliation(s)
- M Berghoff
- Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany
| | - MU Schlamann
- Department of Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - S Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - AE Grams
- Department of Neuroradiology, University Hospital Giessen and Marburg, Giessen, Germany
| | - M Kaps
- Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany
| | - ME Ladd
- Department of Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - ER Gizewski
- Department of Neuroradiology, University Hospital Giessen and Marburg, Giessen, Germany
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25
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Tietz S, Viard M, Thomas T, Gaestel M, Berghoff M. MK2-Deficiency Fails To Protect Mice from Experimental Autoimmune Encephalomyelitis (P05.114). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.114] [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] Open
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26
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Bäuerle J, Gizewski ER, Stockhausen KV, Rosengarten B, Berghoff M, Grams AE, Kaps M, Nedelmann M. Sonographic assessment of the optic nerve sheath and transorbital monitoring of treatment effects in a patient with spontaneous intracranial hypotension: case report. J Neuroimaging 2011; 23:237-9. [PMID: 21883624 DOI: 10.1111/j.1552-6569.2011.00640.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To investigate the potential of the ultrasound-based evaluation of the optic nerve sheath in a patient with spontaneous intracranial hypotension due to cervical cerebrospinal fluid (CSF) leakage. METHODS Repeated measurements of the optic nerve sheath diameter (ONSD) using B-mode sonography were performed before treatment initiation, during medical treatment, and during a course of repeated placement of epidural blood patches. RESULTS On admission, transorbital sonography revealed a decreased ONSD of 4.1 mm on the right and 4.3 mm on the left side. After 8 months of treatment with caffeine and computed tomography-guided epidural blood patches a gradual distension of the ONSD into the normal range was bilaterally observed (right: 5.2 mm; left: 5.3 mm). CONCLUSIONS The ultrasound-based evaluation of the optic nerve sheath may be helpful in detecting CSF hypovolemia and for determination of treatment effects. This report should be seen as a basis for future investigations on the sonographic assessment of the optic nerve sheath in diagnosis and treatment of intracranial hypotension.
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Affiliation(s)
- Jochen Bäuerle
- Department of Neurology, Justus-Liebig-University, Giessen, Germany.
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27
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Oberländer M, Berghoff M. Effects of the CC chemokine receptor 2 in mice deficient for the myelin protein zero (P0). Mol Cell Neurosci 2010; 45:59-65. [PMID: 20553884 DOI: 10.1016/j.mcn.2010.05.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 04/26/2010] [Accepted: 05/19/2010] [Indexed: 12/24/2022] Open
Abstract
In myelin protein zero (P0)-deficient mice immune cells are critically involved in the pathogenesis of a primary genetic disease. Previously it has been shown that the chemokine CCL2 affects the functional properties of endoneurial macrophages in heterozygous P0 mice. The aim of the present study was to characterize the role of the CCL2-receptor CCR2 in the pathogenesis of the neuropathy in P0 deficient mice. In demyelinating nerves of heterozygous P0 mice (P0+/-) CCR2-deficiency did not affect the number of endoneurial macrophages; there was a trend towards a higher number of activated macrophages. CCR2-deficiency resulted in an increased nerve demyelination. In dysmyelinating nerves of homozygous P0 mice (P0-/-), CCR2-deficiency led to a significant decrease of endoneurial macrophages but did not affect axonal degeneration. There was no effect of CCR2 on T-lymphocytes in both disease models. Our data confirm a functional role of the CCR2 receptor in the examined models of hereditary neuropathies. In P0+/- mutants CCR2 decreases macrophage activation and is protective against demyelination, whereas in P0-/- mice it increases the accumulation of endoneurial macrophages.
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Affiliation(s)
- Martina Oberländer
- Department of Neurology, University of Münster, Albert-Schweitzer-Str. 33, 48149 Münster, Germany.
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28
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Berghoff C, Berghoff M, Leal A, Morera B, Contreras C, Barrantes R, Rautenstrauss B, Del Valle G, Heuss D. Late onset autosomal dominant Charcot-Marie-Tooth 2 neuropathy in a Costa Rican family. Neurol Res 2008; 31:283-8. [PMID: 18826755 DOI: 10.1179/174313208x346080] [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: 10/31/2022]
Abstract
OBJECTIVE To describe the clinical, electrophysiologic and morphologic features of a Costa Rican family with an autosomal dominant inherited Charcot-Marie-Tooth (CMT) neuropathy. METHODS The field study took place in Costa Rica, Central America. Seven patients underwent neurological examinations and standard electrodiagnostic tests, and a sural nerve biopsy was taken from one patient. Fifteen family members were screened for gene defects associated with CMT disease. RESULTS Characteristic features of this family were a late age of onset (35-56 years), positive sensory symptoms and muscle cramps. Based on electrodiagnostic and morphologic data, the patients were classified as having a CMT2 neuropathy. The CMT1A duplication/HNPP deletion and point mutations in genes PMP22, MPZ, Cx32 and EGR2 implicated in the most common types of CMT disease were excluded. Subsequently, almost all known CMT loci were excluded by linkage analysis. DISCUSSION Features of this family were a late age of onset and positive sensory symptoms. This new autosomal dominant CMT neuropathy is associated with an unknown gene defect.
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29
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Oberländer M, Fischer S, Martini R, Berghoff M, Müller M. Bedeutung des Chemokinrezeptors CCR2 in Tiermodellen hereditärer Neuropathien. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086575] [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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30
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Müller M, Berghoff M, Kobsar I, Kiefer R, Martini R. Macrophage colony stimulating factor is a crucial factor for the intrinsic macrophage response in mice heterozygously deficient for the myelin protein P0. Exp Neurol 2007; 203:55-62. [PMID: 16962581 DOI: 10.1016/j.expneurol.2006.07.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Revised: 07/11/2006] [Accepted: 07/21/2006] [Indexed: 12/12/2022]
Abstract
Mouse mutants heterozygously deficient for the myelin protein P0 (P0+/-) resemble certain forms of human hereditary neuropathies. Endoneurial macrophages of intrinsic origin are intimately involved in the pathogenesis of the demyelinating neuropathy in these mutants. We have previously shown that deficiency for macrophage colony stimulating factor (M-CSF) prevents an increase of the number of endoneurial macrophages and alleviates the mutants' demyelinating phenotype. The aim of this study was to investigate which population of endoneurial macrophages - long-term resident macrophages or recently infiltrated macrophages - is affected by M-CSF deficiency. For this purpose, we generated bone marrow chimeric mice by transplanting GFP+ bone marrow into P0 mutants (P0+/-) and P0 mutants that lack M-CSF (P0+/- mcsf-op). This enabled us to discriminate recently infiltrated short-term resident GFP+ macrophages from long-term resident GFP- macrophages. Three months after bone marrow transplantation, P0+/- mice expressing M-CSF showed a substantial upregulation and activation of both GFP- and GFP+ macrophages in femoral nerves when compared to P0+/+ mice. In contrast, in P0+/- mcsf-op mutants, both GFP- and GFP+ macrophages did not substantially increase. Only small numbers of GFP+ but no GFP- macrophages were activated and phagocytosed myelin in chimeric P0+/- mcsf-op mutants, possibly reflecting recent activation outside the endoneurium before entering the nerve. Our findings demonstrate that M-CSF is crucial for the activation, in situ increase and myelin phagocytosis of both long-term and short-term resident endoneurial macrophages in P0+/- myelin mutants. M-CSF is, therefore, considered as a target candidate for therapeutic strategies to treat human demyelinating neuropathies.
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Affiliation(s)
- Marcus Müller
- Department of Neurology, University of Münster, Albert-Schweitzer-Str. 33, D-48129 Münster, Germany
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31
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Görtler J, Berghoff M, Kayser G, Kayser K. Grid technology in tissue-based diagnosis: fundamentals and potential developments. Diagn Pathol 2006; 1:23. [PMID: 16930477 PMCID: PMC1564417 DOI: 10.1186/1746-1596-1-23] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [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: 08/09/2006] [Accepted: 08/24/2006] [Indexed: 11/10/2022] Open
Abstract
Tissue-based diagnosis still remains the most reliable and specific diagnostic medical procedure. It is involved in all technological developments in medicine and biology and incorporates tools of quite different applications. These range from molecular genetics to image acquisition and recognition algorithms (for image analysis), or from tissue culture to electronic communication services. Grid technology seems to possess all features to efficiently target specific constellations of an individual patient in order to obtain a detailed and accurate diagnosis in providing all relevant information and references. Grid technology can be briefly explained by so-called nodes that are linked together and share certain communication rules in using open standards. The number of nodes can vary as well as their functionality, depending on the needs of a specific user at a given point in time. In the beginning of grid technology, the nodes were used as supercomputers in combining and enhancing the computation power. At present, at least five different Grid functions can be distinguished, that comprise 1) computation services, 2) data services, 3) application services, 4) information services, and 5) knowledge services. The general structures and functions of a Grid are described, and their potential implementation into virtual tissue-based diagnosis is analyzed. As a result Grid technology offers a new dimension to access distributed information and knowledge and to improving the quality in tissue-based diagnosis and therefore improving the medical quality.
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Affiliation(s)
| | - Martin Berghoff
- Department of Neurology, University Münster, Münster, Germany
| | - Gian Kayser
- Institute of Pathology, University Freiburg, Freiburg, Germany
| | - Klaus Kayser
- UICC-TPCC, Institute of Pathology, Charite, Berlin, Germany
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32
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Berghoff M, Kilo S, Hilz MJ, Freeman R. Differential impairment of the sudomotor and nociceptor axon-reflex in diabetic peripheral neuropathy. Muscle Nerve 2006; 33:494-9. [PMID: 16411196 DOI: 10.1002/mus.20497] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
It is not known whether C-fiber functional subclasses are differentially affected by diabetes mellitus or whether the patterns of C-fiber dysfunction are different between type 1 and type 2 diabetes. We therefore examined efferent sympathetic sudomotor and primary afferent nociceptor C-fiber function in diabetic patients. Acetylcholine (10%) was used to evoke C-fiber (axon-reflex)-mediated responses. The nociceptor (flare) response was measured using a laser Doppler device. The sudomotor response was quantified with silastic imprints. The nociceptor C-fiber-mediated flare response was reduced in type 2 diabetic patients (P < 0.008) but was similar to controls in type 1 diabetic patients. The sympathetic C-fiber-mediated responses, including sweat volume (P < 0.05) and the number of activated sweat glands (P = 0.003), were increased in patients with type 1 diabetes. There also was a trend toward a larger axon-reflex sweat area in patients with type 1 diabetes (P = 0.09). No differences in these sweat responses were found in patients with type 2 diabetes compared to controls. These findings suggest that the functional abnormalities in diabetic peripheral neuropathy are not homogeneous and that C-fiber subclasses are differentially affected in type 1 and 2 diabetes mellitus.
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Affiliation(s)
- Martin Berghoff
- Department of Neurology, University of Münster, Münster, Germany
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33
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Wang Ip C, Kroner A, Fischer S, Berghoff M, Kobsar I, Mäurer M, Martini R. Role of immune cells in animal models for inherited peripheral neuropathies. Neuromolecular Med 2006; 8:175-90. [PMID: 16775375 DOI: 10.1385/nmm:8:1-2:175] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2005] [Revised: 11/10/2005] [Accepted: 11/15/2005] [Indexed: 12/20/2022]
Abstract
Mice expressing half of the normal dose of protein zero (P0+/- mice) or completely deficient gap-junction protein connexin 32 -/- mice mimic demyelinating forms of inherited neuropathies, such as Charcot-Marie-Tooth (CMT) neuropathies type 1B and CMT type 1X, respectively. In both models, an almost normal myelin formation is observed during the first months of life, followed by a slowly progressing demyelinating neuropathy. In both models, there is a substantial increase of CD8+ T-lymphocytes and macrophages within the demyelinating nerves. Recently, this has also been observed in mice mildly overexpressing human peripheral myelin protein 22 kD mimicking the most common form of CMT, CMT type 1A. In all demyelinating models, the macrophages show close contacts with intact myelin sheaths or demyelinated axons, suggesting an active role of these cells in myelin degeneration. Additionally, fibroblast-like cells contact macrophages, suggesting a functional role of fibroblast-like cells in macrophage activation. By cross-breeding P0+/- and gap-junction protein connexin 32-/- mice with immunodeficient recombination activating gene-1-deficient mutants, a substantial alleviation of the demyelinating phenotype was observed. Similarly, cross-breeding of P0+/- mice with mutants with a defect in macrophage activation led to an alleviated phenotype as well. These findings demonstrate that the immune system is involved in the pathogenesis of demyelinating neuropathies. In contrast, in P0-/- mice, which display a compromised myelin compaction and axonal loss from onset, immune cells appear to have a neuroprotective effect because cross-breeding with recombination activating gene-1 mutants leads to an aggravation of axonopathic changes. In the present review, we discuss the influence of the immune system on inherited de- and dysmyelination regarding disease mechanisms and possible clinical implications.
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Affiliation(s)
- Chi Wang Ip
- Department of Neurology, Developmental Neurobiology, University of Wuerzburg, Josef-Schneider-Str. 11, D-97080 Wuerzburg, Germany
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34
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Berghoff M, Samsam M, Müller M, Kobsar I, Toyka KV, Kiefer R, Mäurer M, Martini R. Neuroprotective effect of the immune system in a mouse model of severe dysmyelinating hereditary neuropathy: enhanced axonal degeneration following disruption of the RAG-1 gene. Mol Cell Neurosci 2005; 28:118-27. [PMID: 15607947 DOI: 10.1016/j.mcn.2004.09.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2004] [Revised: 09/03/2004] [Accepted: 09/08/2004] [Indexed: 12/30/2022] Open
Abstract
In mouse models of later onset forms of human hereditary demyelinating neuropathies, the immune system plays a crucial pathogenic role. Here, we investigated the influence of immune cells on early onset dysmyelination in mice homozygously deficient of the myelin component P0. In peripheral nerves of P0(-/-) mice, CD8+ T-lymphocytes increased with age. Macrophages peaked at 3 months followed by a substantial decline. They were mainly of hematogenous origin. To evaluate the functional role of immune cells, we cross-bred P0(-/-) mutants with RAG-1-deficient mice. At 3 months, the number of endoneurial macrophages did not differ from the macrophage number of immunocompetent myelin mutants, but the later decline of macrophages was not observed. Quantitative electron microscopy revealed that in plantar nerves of 6-month-old double mutants, significantly more axons had degenerated than in immunocompetent littermates. These data suggest a neuroprotective net effect of T-lymphocytes on axon survival in inherited, early onset dysmyelination.
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Affiliation(s)
- Martin Berghoff
- Section of Developmental Neurobiology, Department of Neurology, University of Würzburg, 97080 Würzburg, Germany
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Berghoff C, Berghoff M, Leal A, Morera B, Barrantes R, Reis A, Neundörfer B, Rautenstrauss B, Del Valle G, Heuss D. Clinical and electrophysiological characteristics of autosomal recessive axonal Charcot-Marie-Tooth disease (ARCMT2B) that maps to chromosome 19q13.3. Neuromuscul Disord 2004; 14:301-6. [PMID: 15099588 DOI: 10.1016/j.nmd.2004.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2003] [Revised: 01/28/2004] [Accepted: 02/12/2004] [Indexed: 11/16/2022]
Abstract
Charcot-Marie-Tooth disease (CMT) comprises a heterogeneous group of hereditary motor and sensory peripheral neuropathies. The autosomal recessive axonal form of CMT (ARCMT2) is rare. Eight patients of a large consanguineous family of Spanish ancestry in Costa Rica were diagnosed with ARCMT2B; previous genetic studies of this family revealed linkage to chromosome 19q13.3. The clinical and electrophysiological features of these patients are reported. All patients presented with a symmetric motor and sensory neuropathy, which was more pronounced in the lower limbs. Further, distal muscle wasting and impaired deep tendon reflexes were found. Age at onset was between 26 and 42 years, and the disease duration ranged from 2 to 19 years. Electrophysiological studies revealed a primary axonal degenerative process. The clinical characteristics of this family differed in several aspects from previously reported families with ARCMT2.
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Affiliation(s)
- Corinna Berghoff
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
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Leal A, Berghoff C, Berghoff M, Del Valle G, Contreras C, Montoya O, Hernández E, Barrantes R, Schlötzer-Schrehardt U, Neundörfer B, Reis A, Rautenstrauss B, Heuss D. Charcot-Marie-Tooth disease: a novel Tyr145Ser mutation in the myelin protein zero (MPZ, P0) gene causes different phenotypes in homozygous and heterozygous carriers within one family. Neurogenetics 2003; 4:191-7. [PMID: 12845552 DOI: 10.1007/s10048-003-0153-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2002] [Accepted: 04/29/2003] [Indexed: 10/26/2022]
Abstract
Charcot-Marie-Tooth disease type 1B (CMT 1B) is caused by mutations in the gene coding for peripheral myelin protein zero (MPZ, P0) that plays a fundamental role in adhesion and compaction of peripheral myelin. Here we report a Costa Rican family with a hereditary peripheral neuropathy due to a novel Tyr145Ser MPZ mutation. Four family members were heterozygously affected; two siblings of two heterozygous carriers were homozygous for this mutation. On neurological examination the heterozygous parents and their homozygous children both showed distal sensory deficits. The mother and the siblings displayed impaired deep tendon reflexes and mild sensory ataxia. The homozygous individuals were more severely affected with an earlier age of onset, distal motor weakness, and pupillary abnormalities. Electrophysiological studies revealed both signs of demyelination and axonal nerve degeneration. The sural nerve biopsy of one sibling showed thinly myelinated nerve fibers, onion bulb formation, and clusters of regenerating fibers. On electron microscopy axonal degeneration and decompaction of inner myelin layers were found. This Costa Rican family shows phenotypic variability depending on the homozygous or heterozygous state of the Tyr145Ser mutation carriers.
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Affiliation(s)
- Alejandro Leal
- Institute of Health Research (INISA) and School of Biology, University of Costa Rica, San José, Costa Rica
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Abstract
Primary (AL; immunoglobulin light-chain associated) amyloidosis is characterized by the deposition of pathological proteins in the extracellular matrix of tissues and organs. Autonomic and sensory peripheral neuropathy is a common feature of this disorder. The pathogenesis of the neuropathy is poorly defined. The aims of this study were to investigate vascular and neural function in the cutaneous microcirculation of AL amyloidosis patients. Seven patients with AL amyloidosis and controls were studied. Acetylcholine and sodium nitroprusside were iontophoresed into the forearm skin. Endothelial, smooth muscle, and C-fiber-mediated cutaneous blood flow (CuBF) were recorded by laser Doppler flowmetry. Endothelial vasodilation in the forearm skin was attenuated in AL amyloidosis patients (p = 0.007). Maximum endothelium-mediated CuBF in the patient group was reduced (p = 0.047). No group differences could be detected in the C-fiber response or smooth muscle vasodilation (p value not significant). Maximum C-fiber and endothelium-independent CuBF did not differ between the two groups (p value not significant). Early in the disease, AL amyloidosis patients present with impaired endothelial function. At this stage, C-fiber and smooth muscle function are still preserved. These data suggest that endothelial abnormalities precede and may contribute to the pathogenesis of the neuropathy associated with AL amyloidosis.
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Affiliation(s)
- Martin Berghoff
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Kobsar I, Berghoff M, Samsam M, Wessig C, Mäurer M, Toyka KV, Martini R. Preserved myelin integrity and reduced axonopathy in connexin32-deficient mice lacking the recombination activating gene-1. Brain 2003; 126:804-13. [PMID: 12615640 DOI: 10.1093/brain/awg072] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Mice heterozygously deficient for myelin protein zero (P0) mimicking human Charcot-Marie-Tooth (CMT) disease 1B show T-lymphocyte and macrophage upregulation in peripheral nerves, which aggravates and modulates the genetically mediated demyelinating neuropathy. In connexin32 (cx32)-deficient (cx32(def)) mice, which mimic the X-linked dominant form of CMT (CMTX), T-lymphocyte and macrophage numbers are also significantly elevated in peripheral nerves. To test the hypothesis that immune cells are indeed pathogenic in this model, we cross-bred cx32(def) mice with recombination activating gene-1 (RAG-1)-deficient mice, which lack mature T- and B-lymphocytes. In these immunoincompetent double mutants, the number of endoneurial macrophages was reduced. Furthermore, features indicative of myelin degeneration and axonopathic changes were mitigated in the RAG-1-deficient double mutants, whereas enlarged periaxonal Schwann cell collars, a hallmark specific for cx32-mutants, were not reduced. Since both cx32- and P0 deficiency lead to similar immunopathogenic processes, we conclude that immune-mediated demyelination may be a feature common to many CMT-like neuropathies independent of the genetic origin.
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Affiliation(s)
- I Kobsar
- Department of Neurology, University of Würzburg, Würzburg, Germany
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Mäurer M, Kobsar I, Berghoff M, Schmid CD, Carenini S, Martini R. Role of immune cells in animal models for inherited neuropathies: facts and visions. J Anat 2002; 200:405-14. [PMID: 12090406 PMCID: PMC1570697 DOI: 10.1046/j.1469-7580.2002.00045.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2002] [Indexed: 12/20/2022] Open
Abstract
Mice heterozygously deficient in the peripheral myelin adhesion molecule P0 (P0+/- mice) are models for some forms of Charcot-Marie-Tooth (CMT) neuropathies. In addition to the characteristic hallmarks of demyelination, elevated numbers of CD8-positive T-lymphocytes and F4/80-positive macrophages are striking features in the nerves of these mice. These immune cells increase in number with age and progress of demyelination, suggesting that they might be functionally related to myelin damage. In order to investigate the pathogenetic role of lymphocytes, the myelin mutants were cross-bred with recombination activating gene 1 (RAG-1)-deficient mice, which lack mature T- and B-lymphocytes. The immunodeficient myelin mutants showed a less severe myelin degeneration. The beneficial effect of lymphocyte-deficiency was reversible, since demyelination worsened in immunodeficient myelin-mutants when reconstituted with bone marrow from wild-type mice. Ultrastructural analysis revealed macrophages in close apposition to myelin and demyelinated axons. We therefore cross-bred the P0+/- mice with spontaneous osteopetrotic (op) mutants deficient in the macrophage colony-stimulating factor (M-CSF), hence displaying impaired macrophage activation. In the corresponding double mutants the numbers of macrophages were not elevated in the peripheral nerves, and the demyelinating phenotype was less severe than in the genuine P0+/- mice, demonstrating that macrophages are also functionally involved in the pathogenesis of genetically mediated demyelination. We also examined other models for inherited neuropathies for a possible involvement of immune cells. We chose mice deficient in the gap junction component connexin 32, a model for the X-linked form of CMT. Similar to P0-deficient mice, T-lymphocytes and macrophages were elevated and macrophages showed a close apposition to degenerating myelin. We conclude that the involvement of T-lymphocytes and macrophages is a common pathogenetic feature in various forms of slowly progressive inherited neuropathies.
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Affiliation(s)
- Mathias Mäurer
- Department of Neurology, University of Würzburg, Germany
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Berghoff M, Kathpal M, Kilo S, Hilz MJ, Freeman R. Vascular and neural mechanisms of ACh-mediated vasodilation in the forearm cutaneous microcirculation. J Appl Physiol (1985) 2002; 92:780-8. [PMID: 11796692 DOI: 10.1152/japplphysiol.01167.2000] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.1] [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: 02/02/2023] Open
Abstract
The relative contribution of endothelial vasodilating factors to acetylcholine (ACh)-mediated vasodilation in the forearm cutaneous microcirculation is unclear. The aims of this study were to investigate the contributions of prostanoids and cutaneous C fibers to basal cutaneous blood flow (CuBF) and ACh-mediated vasodilation. ACh was iontophoresed into the forearm, and cutaneous perfusion was measured by laser-Doppler flowmetry. To inhibit the production of prostanoids, four doses of acetylsalicylic acid (ASA; 81, 648, 972, and 1,944 mg) were administered orally. Cutaneous nerve fibers were blocked with topical anesthesia. Cyclooxygenase inhibition did not change basal CuBF or endothelium-mediated vasodilation to ACh. In contrast, ASA (972 and 1,944 mg) significantly reduced the C-fiber-mediated axon reflex in a dose-dependent fashion. Blockade of C-fiber function significantly reduced axon reflex-mediated vasodilation but did not affect basal CuBF or endothelium-dependent vasodilation. The findings suggest that prostanoids do not contribute significantly to basal CuBF or endothelium-dependent vasodilation in the forearm microcirculation. In contrast, prostanoids are mediators of the ACh-provoked axon reflex.
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Affiliation(s)
- Martin Berghoff
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA
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Leal A, Morera B, Del Valle G, Heuss D, Kayser C, Berghoff M, Villegas R, Hernández E, Méndez M, Hennies HC, Neundörfer B, Barrantes R, Reis A, Rautenstrauss B. A second locus for an axonal form of autosomal recessive Charcot-Marie-Tooth disease maps to chromosome 19q13.3. Am J Hum Genet 2001; 68:269-74. [PMID: 11112660 PMCID: PMC1234926 DOI: 10.1086/316934] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2000] [Accepted: 11/06/2000] [Indexed: 01/30/2023] Open
Abstract
Autosomal recessive Charcot-Marie-Tooth disease (CMT) represents a heterogeneous group of disorders affecting the peripheral nervous system. The axonal form of the disease is designated as "CMT type 2" (CMT2), and one locus (1q21.2-q21.3) has been reported for the autosomal recessive form. Here we report the results of a genomewide search in an inbred Costa Rican family (CR-1) affected with autosomal recessive CMT2. By analyzing three branches of the family we detected linkage to the 19q13.3 region, and subsequent homozygosity mapping defined shared haplotypes between markers D19S902 and D19S907 in a 5.5-cM range. A maximum two-point LOD score of 9.08 was obtained for marker D19S867, at a recombination fraction of.00, which strongly supports linkage to this locus. The epithelial membrane protein 3 gene, encoding a PMP22 homologous protein and located on 19q13.3, was ruled out as being responsible for this form of CMT. The age at onset of chronic symmetric sensory-motor polyneuropathy was 28-42 years (mean 33.8 years); the electrophysiological data clearly reflect an axonal degenerative process. The phenotype and locus are different from those of demyelinating CMT4F, recently mapped to 19q13.1-13.3; hence, the disease affecting the Costa Rican family constitutes an axonal, autosomal recessive CMT subtype (ARCMT2B).
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Affiliation(s)
- Alejandro Leal
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Bernal Morera
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Gerardo Del Valle
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Dieter Heuss
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Corinna Kayser
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Martin Berghoff
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Ramón Villegas
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Erick Hernández
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - María Méndez
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Hans Christian Hennies
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Bernhard Neundörfer
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Ramiro Barrantes
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - André Reis
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
| | - Bernd Rautenstrauss
- Institute of Human Genetics and Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Institute of Health Research (INISA) and School of Biology, University of Costa Rica, Department of Neurology, San Juan de Dios Hospital, Caja Costarricense del Seguro Social, and Asociación de Genealogía e Historia de Costa Rica, San José, Costa Rica; Gene Mapping Centre, Max-Delbrueck-Centre, Berlin; and Unitat de Biologia Evolutiva, Universitat Pompeu Fabra, Barcelona
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Hilz MJ, Hecht MJ, Berghoff M, Singer W, Neundoerfer B. Abnormal vasoreaction to arousal stimuli--an early sign of diabetic sympathetic neuropathy demonstrated by laser Doppler flowmetry. J Clin Neurophysiol 2000; 17:419-25. [PMID: 11012045 DOI: 10.1097/00004691-200007000-00008] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Early diagnosis of diabetic autonomic neuropathy contributes to the prevention of serious complications and improves the prognosis of patients with diabetes. Common tests of peripheral autonomic function are the quantitative sudomotor axon reflex test or the sympathetic skin response (SSR). Quantitative sudomotor axon reflex test is quantifiable but technically demanding. Sympathetic skin response cannot be quantified easily. To study whether measurement of skin vasomotion is suited to assess early sympathetic peripheral neuropathy, we monitored skin blood flow at the index finger pulp using laser Doppler flowmetry before and after electrical stimulation. We assured that the stimulus was sufficient to elicit an efferent sympathetic response by monitoring palmar SSR ipsilateral to the flow measurement. In 21 diabetic patients with at least stage one polyneuropathy and 21 age-matched controls, SSR was recorded from one palm and sole following electrical stimulation at the contralateral wrist. Sympathetic skin response was present at the palms in all patients and controls and absent at the sole of two patients only. Eight patients (38.9%) had abnormal SSR, with absent plantar responses in two patients, prolonged plantar latencies in six patients, and prolonged volar SSR latencies in two patients. Skin blood flow responses were more often abnormal (46.1%) than SSR (P < 0.05), responses were delayed in two patients and absent in another 8 patients. Skin blood flow retest reliability was high with a repeatability coefficient of 10.64% in controls and 12.34 % in patients. Skin blood flow monitoring after sympathetic stimulation provides a reproducible parameter of sympathetic vasomotor control and complements the diagnostic value of SSR testing.
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Affiliation(s)
- M J Hilz
- Department of Neurology, University of Erlangen-Nuremberg, Germany
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Abstract
OBJECTIVE To examine the role played by endothelium-dependent and endothelium-independent vasodilation of the cutaneous microcirculation and their relationship to neural microcirculatory control in type 1 and type 2 diabetic patients. METHODS Acetylcholine and sodium nitroprusside were iontophoresed using a dose-response technique. Endothelium-dependent, endothelium-independent, and C-fiber-mediated vasodilation were measured with a laser Doppler device. RESULTS Endothelium-dependent vasodilation of the forearm cutaneous microcirculation was attenuated in diabetic subjects. The response was less in type 2 diabetic subjects than in controls (p < 0.005). In contrast, there was no significant difference between type 1 diabetic subjects and controls. There was no significant abnormality in endothelium-independent vasodilation in either diabetic group. The C-fiber-mediated axon reflex in the forearm was impaired in both type 1 and type 2 diabetics, which is consistent with a small-fiber neuropathy (p < 0.005). The duration of diabetes in type 2 diabetics was a significant predictor of the maximum endothelium-mediated vasodilation. CONCLUSION Changes in cutaneous blood flow are seen relatively early in the course of diabetic peripheral neuropathy and are characterized by endothelial and neural but not smooth muscle dysfunction. The presence of significant C-fiber impairment in both diabetic groups, together with significantly greater dysfunction in endothelium-dependent vasodilation in type 2 diabetics, suggests that the endothelial function and nitric oxide may play a greater role in the pathogenesis of diabetic peripheral neuropathy in type 2 diabetic patients.
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Affiliation(s)
- S Kilo
- Department of Neurology, Beth Israel Deaconess Medical Center and the Harvard Medical School, Boston, MA 02215, USA
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Abstract
OBJECTIVES Due to its low solubility and negligible metabolism, desflurane is assumed to be especially suitable for application by low-flow anaesthetic techniques. The aim of this clinical investigation was the development of a standardised dosing scheme for low-flow and minimal-flow desflurane anaesthesia. METHODS One hundred six ASA status I-II patient were assigned to six groups according to the duration of the initial high-flow phase, fresh gas flow, and fresh-gas desflurane concentration. The median age, height, body weight, and constitution of the groups was comparable. After an initial high-flow phase using 4.4 l/min, the fresh gas flow was reduced to 0.5 l/min (minimal-flow anaesthesia) or 1.0 1/min (low-flow anaesthesia). Inspired nitrous oxide concentrations were maintained at 60% to 70%. Using different standardised schemes of vaporizer settings, inspired desflurane concentrations were applied in the range from 3.4% to 8.7%, i.e., between 1 and 1.5 MAC. Inspired and expired desflurane concentrations were measured continuously by the side-stream technique and recorded on-line. Venous blood samples were taken immediately prior to induction and 45 min after flow reduction for measurement of carboxyhaemoglobin (COHb) concentration). RESULTS In the 10- to 15-min initial phase during which a high fresh gas flow of 4.4 l/min was used, the inspired desflurane concentration reached values in the range of 90%-95% of the fresh gas concentration. In low-flow anaesthesia this concentration could be maintained without any alteration of the vaporizer setting, whereas in minimal-flow anaesthesia with flow reduction the fresh gas concentration had to be increased by 1% to 2%: The quotient calculated by division of the inspired desflurane concentration by its fresh gas concentration (Q = CI/CF) ranges between 0.65 and 0.75 in animal-flow and between 0.80 and 0.85 in low-flow anaesthesia. If use was made of the wide output range of the desflurane vaporizer, the inspired concentration could be increased rapidly by about 5% in 8 min, although the flow was kept constant at 0.5 l/min. Compared with its value prior to induction (2.13 +/- 1.05%), the COHb concentration decreased statistically significantly by about 0.7% during the 1st hour of minimal-flow anaesthesia (1.42 +/- 1.01%). In no case was a COHb concentration observed that exceeded threatening or even toxic values, although the soda lime was changed routinely only once a week. CONCLUSIONS The pharmacokinetic properties of desflurane, resulting in especially low individual uptake, and the wide output range of the vaporizer facilitate the use of low-flow anesthetic techniques in routine clinical practice. Even in minimal-flow anesthesia, the duration of the initial high-flow phase can be shortened to min. If the flow is reduced to 1 l/min, the inspired desflurane concentration achieved in the initial high-flow phase can be maintained without any alteration of the vaporizer setting. In minimal-flow anesthesia, however, with flow reduction to 0.5 l/min, the fresh gas concentration has to be increased to a value 1%-2% higher than the inspired nominal value. Due to the wide dialing range of the desflurane vaporizer, the amount of vapour delivered into the breathing system can be increased to about 110 ml/min even at a flow of 0.5 l/min. The large amount of agent that can be delivered into the system even under low-flow conditions, together with the very low individual uptake, results in a time-constant that is sufficient short for the clinically required rapid increase in inspired desflurane concentrations. The short time-constant of low-flow desflurane anaesthesia improves the control of the anaesthetic concentration. If all measures are taken to safely avoid inadvertent drying out of the soda lime, there is no evidence that low-flow anaesthesia with desflurane is liable to increase the risk of accidental carbon monoxide poisoning. (ABSTRACT TRUNCATED)
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Affiliation(s)
- J Baum
- Abteilung für Anästhesie und Intensivmedizin, Krankenhaus St. Elisabeth-Stift, Damme
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