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Patel RB, Reddy VY, Komtebedde J, Wegerich SW, Sekaric J, Swarup V, Walton A, Laurent G, Chetcuti S, Rademann M, Bergmann M, McKenzie S, Bugger H, Bruno RR, Herrmann HC, Nair A, Gupta DK, Lim S, Kapadia S, Gordon R, Vanderheyden M, Noel T, Bailey S, Gertz ZM, Trochu JN, Cutlip DE, Leon MB, Solomon SD, van Veldhuisen DJ, Auricchio A, Shah SJ. Atrial Fibrillation Burden and Atrial Shunt Therapy in Heart Failure With Preserved Ejection Fraction. JACC Heart Fail 2023; 11:1351-1362. [PMID: 37480877 DOI: 10.1016/j.jchf.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is a common comorbidity in patients with heart failure with preserved ejection fraction (HFpEF) and in heart failure with mildly reduced ejection fraction (HFmrEF). OBJECTIVES This study sought to describe AF burden and its clinical impact among individuals with HFpEF and HFmrEF who participated in a randomized clinical trial of atrial shunt therapy (REDUCE LAP-HF II [A Study to Evaluate the Corvia Medical, Inc IASD System II to Reduce Elevated Left Atrial Pressure in Patients with Heart Failure]) and to evaluate the effect of atrial shunt therapy on AF burden. METHODS Study investigators characterized AF burden among patients in the REDUCE LAP-HF II trial by using ambulatory cardiac patch monitoring at baseline (median patch wear time, 6 days) and over a 12-month follow-up (median patch wear time, 125 days). The investigators determined the association of baseline AF burden with long-term clinical events and examined the effect of atrial shunt therapy on AF burden over time. RESULTS Among 367 patients with cardiac monitoring data at baseline and follow-up, 194 (53%) had a history of AF or atrial flutter (AFL), and median baseline AF burden was 0.012% (IQR: 0%-1.3%). After multivariable adjustment, baseline AF burden ≥0.012% was significantly associated with heart failure (HF) events (HR: 2.00; 95% CI: 1.17-3.44; P = 0.01) both with and without a history of AF or AFL (P for interaction = 0.68). Adjustment for left atrial reservoir strain attenuated the baseline AF burden-HF event association (HR: 1.71; 95% CI: 0.93-3.14; P = 0.08). Of the 367 patients, 141 (38%) had patch-detected AF during follow-up without a history of AF or AFL. Atrial shunt therapy did not change AF incidence or burden during follow-up. CONCLUSIONS In HFpEF and HFmrEF, nearly 40% of patients have subclinical AF by 1 year. Baseline AF burden, even at low levels, is associated with HF events. Atrial shunt therapy does not affect AF incidence or burden. (A Study to Evaluate the Corvia Medical, Inc IASD System II to Reduce Elevated Left Atrial Pressure in Patients with Heart Failure [REDUCE LAP-HF II]; NCT03088033).
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Affiliation(s)
- Ravi B Patel
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Illinois, USA
| | - Vivek Y Reddy
- Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | | | - Gabriel Laurent
- Department of Cardiology, Dijon University Hospital, Dijon, France
| | - Stanley Chetcuti
- Division of Cardiology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Matthias Rademann
- Department of Cardiology, University of Giessen, Bad Nauheim, Germany
| | - Martin Bergmann
- Department of Interventional Cardiology, Cardiologicum, Hamburg, Germany
| | - Scott McKenzie
- School of Medicine, University of Queensland, The Prince Charles Hospital, Brisbane, Australia
| | - Heiko Bugger
- Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Raphael Romano Bruno
- Division of Cardiology, Pulmonology, and Vascular Medicine, Faculty of Medicine, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Howard C Herrmann
- Division of Cardiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ajith Nair
- Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA
| | - Deepak K Gupta
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Scott Lim
- Division of Cardiology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Samir Kapadia
- Division of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Robert Gordon
- Division of Cardiology, NorthShore University Health System, Evanston, Illinois, USA
| | | | - Thomas Noel
- Southern Medical Group, P.A., Tallahassee, Florida, USA
| | - Steven Bailey
- Division of Cardiology, Louisiana State University School of Medicine, Baton Rouge, Louisiana, USA
| | - Zachary M Gertz
- Division of Cardiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jean-Noël Trochu
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
| | - Donald E Cutlip
- Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Martin B Leon
- Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
| | - Scott D Solomon
- Division of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Dirk J van Veldhuisen
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Angelo Auricchio
- Division of Cardiology, Ticino Cardiocentro Institute, Lugano, Switzerland
| | - Sanjiv J Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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2
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Betts TR, Grygier M, Kudsk JEN, Schmitz T, Sandri M, Casu G, Bergmann M, Hildick-Smith D, Christen T, Allocco DJ. Real-world clinical outcomes with a next-generation left atrial appendage closure device: the FLXibility Post-Approval Study. Europace 2023; 25:914-921. [PMID: 36734247 PMCID: PMC10062328 DOI: 10.1093/europace/euac270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/23/2022] [Indexed: 02/04/2023] Open
Abstract
AIMS The FLXibility Post-Approval Study collected data on unselected patients implanted with a WATCHMAN FLX in a commercial clinical setting. METHODS AND RESULTS Patients were implanted with a WATCHMAN FLX per local standard of care, with a subsequent first follow-up visit from 45 to 120 days post-implant and a final follow-up at 1-year post-procedure. A Clinical Event Committee adjudicated all major adverse events and TEE/CT imaging results were adjudicated by a core laboratory. Among 300 patients enrolled at 17 centres in Europe, the mean age was 74.6 ± 8.0 years, mean CHA2DS2-VASc score was 4.3 ± 1.6, and 62.1% were male. The device was successfully implanted in 99.0% (297/300) of patients. The post-implant medication regimen was DAPT for 87.3% (262/300). At first follow-up, core-lab adjudicated complete seal was 88.2% (149/169), 9.5% (16/169) had leak <3 mm, 2.4 (4/169) had leak ≥3 mm to ≤5 mm, and 0% had >5 mm leak. At 1 year, 93.3% (280/300) had final follow-up; 60.5% of patients were on a single antiplatelet medication, 21.4% were on DAPT, 5.6% were on direct oral anticoagulation, and 12.1% were not taking any antiplatelet/anticoagulation medication. Adverse event rates through 1 year were: all-cause death 10.8% (32/295); CV/unexplained death 5.1% (15/295); disabling and non-disabling stroke each 1.0% (3/295, all non-fatal); pericardial effusion requiring surgery or pericardiocentesis 1.0% (3/295); and device-related thrombus 2.4% (7/295). CONCLUSION The WATCHMAN FLX device had excellent procedural success rates, high LAA seal rates, and low rates of thromboembolic events in everyday clinical practice.
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Affiliation(s)
- Tim R Betts
- Department of Cardiology, Oxford University Hospitals NHS Trust, Headley Way, Oxford OX3 9DU UK
| | - Marek Grygier
- Chair and First Department of Cardiology, Poznan University School of Medical Sciences, Długa 1/2, 61-848 Poznan, Poland
| | - Jens Erik Nielsen Kudsk
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 69, 8200 Aarhus N, Denmark
| | - Thomas Schmitz
- Department of Cardiology, Elisabeth-Krankenhaus -Essen GmbH, 45138 Essen, Germany
| | - Marcus Sandri
- Department of Internal Medicine/Cardiology, University of Leipzig, Heart Centre, Strümpellstraße 39, 04289 Leipzig, Germany
| | - Gavino Casu
- Cardiologia Clinica e Interventistica, Azienda Ospedaliero Universitaria di Sassari, Sassari 07100, Italy
| | - Martin Bergmann
- Department of Cardiology, Cardiologicum Hamburg Praxis Wandsbek, Schloßstraße 12, 22041 Hamburg, Germany
| | - David Hildick-Smith
- Sussex Cardiac Centre, Univeristy Hospitals Sussex NHS Trust, Brighton, BN2 3EW, UK
| | - Thomas Christen
- Boston Scientific, 100 Boston Scientific Way, Marlborough, MA 01752, USA
| | - Dominic J Allocco
- Boston Scientific, 100 Boston Scientific Way, Marlborough, MA 01752, USA
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3
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Sievering AW, Wohlmuth P, Geßler N, Gunawardene MA, Herrlinger K, Bein B, Arnold D, Bergmann M, Nowak L, Gloeckner C, Koch I, Bachmann M, Herborn CU, Stang A. Comparison of machine learning methods with logistic regression analysis in creating predictive models for risk of critical in-hospital events in COVID-19 patients on hospital admission. BMC Med Inform Decis Mak 2022; 22:309. [PMID: 36437469 PMCID: PMC9702742 DOI: 10.1186/s12911-022-02057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 11/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Machine learning (ML) algorithms have been trained to early predict critical in-hospital events from COVID-19 using patient data at admission, but little is known on how their performance compares with each other and/or with statistical logistic regression (LR). This prospective multicentre cohort study compares the performance of a LR and five ML models on the contribution of influencing predictors and predictor-to-event relationships on prediction model´s performance. METHODS We used 25 baseline variables of 490 COVID-19 patients admitted to 8 hospitals in Germany (March-November 2020) to develop and validate (75/25 random-split) 3 linear (L1 and L2 penalty, elastic net [EN]) and 2 non-linear (support vector machine [SVM] with radial kernel, random forest [RF]) ML approaches for predicting critical events defined by intensive care unit transfer, invasive ventilation and/or death (composite end-point: 181 patients). Models were compared for performance (area-under-the-receiver-operating characteristic-curve [AUC], Brier score) and predictor importance (performance-loss metrics, partial-dependence profiles). RESULTS Models performed close with a small benefit for LR (utilizing restricted cubic splines for non-linearity) and RF (AUC means: 0.763-0.731 [RF-L1]); Brier scores: 0.184-0.197 [LR-L1]). Top ranked predictor variables (consistently highest importance: C-reactive protein) were largely identical across models, except creatinine, which exhibited marginal (L1, L2, EN, SVM) or high/non-linear effects (LR, RF) on events. CONCLUSIONS Although the LR and ML models analysed showed no strong differences in performance and the most influencing predictors for COVID-19-related event prediction, our results indicate a predictive benefit from taking account for non-linear predictor-to-event relationships and effects. Future efforts should focus on leveraging data-driven ML technologies from static towards dynamic modelling solutions that continuously learn and adapt to changes in data environments during the evolving pandemic. TRIAL REGISTRATION NUMBER NCT04659187.
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Affiliation(s)
| | - Peter Wohlmuth
- Semmelweis University, Asklepios Campus Hamburg, Budapest, Hungary.,Asklepios Proresearch, Research Institute, Hamburg, Germany
| | - Nele Geßler
- Semmelweis University, Asklepios Campus Hamburg, Budapest, Hungary.,Asklepios Proresearch, Research Institute, Hamburg, Germany.,Department of Cardiology and Intensive Care Medicine, Asklepios Hospital St. Georg, Hamburg, Germany
| | - Melanie A Gunawardene
- Department of Cardiology and Intensive Care Medicine, Asklepios Hospital St. Georg, Hamburg, Germany
| | - Klaus Herrlinger
- Department of Internal Medicine, Asklepios Hospital Nord-Heidberg, Hamburg, Germany.,Asklepios Tumorzentrum, Hamburg, Germany
| | - Berthold Bein
- Department of Anesthesiology and Intensive Care Medicine, Asklepios Hospital St. Georg, Hamburg, Germany
| | - Dirk Arnold
- Asklepios Tumorzentrum, Hamburg, Germany.,Department of Hematology, Oncology, Palliative Care and Rheumatology, Asklepios Hospital Altona, Hamburg, Germany
| | - Martin Bergmann
- Department of Internal Medicine, Cardiology, and Pneumology, Asklepios Hospital Wandsbek, Hamburg, Germany
| | - Lorenz Nowak
- Department of Intensive Care and Ventilation Medicine, Asklepios Hospital München-Gauting, Gauting, Germany
| | - Christian Gloeckner
- Department of Internal Medicine, Asklepios Hospital Oberviechtach, Oberviechtach, Germany
| | - Ina Koch
- Biobank for Pulmonary Diseases, Asklepios Hospital München-Gauting, Gauting, Germany
| | - Martin Bachmann
- Department of Intensive Care and Ventilatory Medicine, Asklepios Hospital Harburg, Hamburg, Germany
| | - Christoph U Herborn
- Semmelweis University, Asklepios Campus Hamburg, Budapest, Hungary.,Asklepios Hospitals GmbH & Co. KGaA, Hamburg, Germany
| | - Axel Stang
- Semmelweis University, Asklepios Campus Hamburg, Budapest, Hungary. .,Asklepios Tumorzentrum, Hamburg, Germany. .,Department of Hematology, Oncology and Palliative Care Medicine, Asklepios Hospital Barmbek, Rübenkamp 220, 22291, Hamburg, Germany.
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4
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Lauder L, Bergmann M, Paitazoglou C, Ozdemir R, Iliadis C, Bartunek J, Lauten A, Keller T, Weber S, Sievert H, Anker SD, Mahfoud F. Impact of atrial flow regulator implantation on survival in patients with heart failure with reduced and preserved ejection fraction: a post-hoc analysis of the PRELIEVE study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
This analysis aims to assess the theoretical impact of atrial flow regulator implantation on mortality by comparing the observed survival rate with the median predicted probability for one-year survival.
Methods
The prospective, multicentre, open-label, non-randomised PRELIEVE study assessed the safety and efficacy of the atrial flow regulator in patients with symptomatic HFrEF (left ventricular ejection fraction (LVEF) ≥15% and <40%) or HFpEF (LVEF ≥40% and <70%) and elevated PCWP (≥15mmHg at rest or ≥25mmHg during exercise). In this analysis, after the first 60 patients completed twelve months of follow-up, the theoretical impact of atrial flow regulator implantation on survival was assessed by comparing the observed mortality rate with the median predicted probability for one-year mortality. Each subject's risk of mortality was predicted from individual baseline data using the Meta-Analysis Global Group in Chronic HF (MAGGIC) prognostic model.
Results
A total of 87 patients had undergone successful device implantation for the treatment of HFrEF (53%) and HFpEF (47%). Sixty patients had a complete twelve-month follow-up. The median follow-up was 351 days (interquartile range [IQR] 202–370). A total of six (7%) patients died during follow-up (8.6 deaths per 100 patient-years; 95% confidence interval [CI] 2.7 to 15.5), all of which had HFrEF. The median predicted mortality rate for the overall study population was 12.2 deaths per 100 patient-years (95% CI 10.2 to 14.7). While the observed mortality rate (0 deaths per 100 patient-years) was significantly lower than the median predicted mortality rate (9.3 deaths per 100 patient-years; 95% CI 8.4 to 11.1) in patients with HFpEF (−9.3 deaths per 100 patient-years; 95% CI −11.1 to −8.4), there was no difference in patients with HFrEF (−3.6 deaths per 100 patient-years; 95% CI −9.5 to 3.0) (Figure 1). Four deaths were HF-related deaths (5.7 HF-related deaths per 100 patient-years; 95% CI 1.4 to 11.9; 10.8 HF-related deaths per 100 patient-years; 95% CI 2.5 to 23.1 in the HFrEF subgroup).
Conclusion
In patients with HFpEF, the mortality rate following atrial flow regulator implantation was lower than the predicted mortality rate. These findings need to be confirmed by larger randomised, controlled trials.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Occlutech International AB
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Affiliation(s)
- L Lauder
- University hospital of Saarland (UKS) , Homburg , Germany
| | - M Bergmann
- Cardiologicum Hamburg , Hamburg , Germany
| | - C Paitazoglou
- Schleswig-Holstein University Clinic, Lubeck Campus, University Heart Center Lübeck , Luebeck , Germany
| | - R Ozdemir
- Bezmialem University, Department of Cardiology , Istanbul , Turkey
| | - C Iliadis
- Heart Center at the University of Cologne, Department of Cardiology, Pulmonology, Angiology and Intensive Care Medicine , Cologne , Germany
| | - J Bartunek
- Olv Hospital Aalst, Cardiovascular Center , Aalst , Belgium
| | - A Lauten
- HELIOS Clinic Erfurt, Department of General and Interventional Cardiology , Erfurt , Germany
| | - T Keller
- ACOMED statistik , Leipzig , Germany
| | - S Weber
- ACOMED statistik , Leipzig , Germany
| | - H Sievert
- CardioVascular Center Frankfurt , Frankfurt , Germany
| | - S D Anker
- Berlin Institute of Health Center for Regenerative Therapies , Berlin , Germany
| | - F Mahfoud
- University hospital of Saarland (UKS) , Homburg , Germany
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5
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Paulsen N, Ewertz M, Bergmann T, Holm H, Feddersen S, Fruekilde P, Vojdeman F, Nielsen H, Qvortrup C, Plomgaard P, Bertelsen B, Rossing C, Andersen S, Greibe E, Hoffmann-Lücke E, Ramlov A, Nielsen C, Lolas I, Bøttger P, Bergmann M, Pfeiffer P, Damkier P. SO-29 Dihydropyrimidine dehydrogenase (DPD) genotype and phenotype among Danish cancer patients: Prevalence and correlation between DPYD-genotype mutations and P-uracil concentrations. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.428] [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: 11/01/2022] Open
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6
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Betts TR, Grygier M, Nielsen-Kudsk JE, Schmitz T, Sandri M, Casu G, Bergmann M, Hildick-Smith D, Christen T, Allocco DJ. One-year results from the FLXibility post-approval study: final real-world clinical outcomes with a next-generation left atrial appendage closure device. Europace 2022. [DOI: 10.1093/europace/euac053.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Boston Scientific Corporation, Marlborough, MA, USA
Background
The WATCHMAN FLX left atrial appendage (LAA) closure device received CE-mark and FDA approval based on the results of the PINNACLE FLX IDE study, but evidence of outcomes with this next-generation device in everyday clinical practise is limited.
Purpose
The FLXibility Post-Approval Study collected real-world data on patients implanted with a WATCHMAN FLX in a routine clinical practise.
Methods
Patients were implanted with a WATCHMAN FLX per local standard of care, with a subsequent first follow-up visit from 45-120 days post-implant and a final follow-up at 1 year post procedure. A Clinical Event Committee adjudicated all major adverse events and TEE/CT imaging results were adjudicated by a core laboratory.
Results
Among 300 patients enrolled at 17 centres in Europe, the mean age was 74.6±8.0 years, mean CHA2DS2-VASc score was 4.3±1.6, mean HAS-BLED score was 2.6±1.0, and 62.1% were male. The device was successfully implanted in 99.0% (297/300) of patients; 97.0% (289/298) required only 1 device for an implantation attempt and no patient required >2 devices. TEE was used for 78% of procedures and ICE for 22%. The post-implant medication regimen was DAPT for 87.3% (262/300). At first follow-up, among 170 patients with evaluable imaging, 87.6% (149/170) had no leak, 12.4% (21/170) had leak >0mm to ≤5mm with 16 (9.4%) of these <3mm, and no patient had leak >5mm, per core lab adjudication. At 1 year, 93.3% (280/300) patients had final follow-up or death. At final follow-up, 61% of patients were on a single antiplatelet medication, 21% were on DAPT, 6% were on a direct oral anticoagulation medication, and 12% were not taking any antiplatelet/anticoagulation medication. One-year all-cause mortality was 10.8% (32/295), among which 5.1% (15/295) were cardiovascular or unexplained. Disabling stroke occurred in 1.0% (3/295) of patients and nondisabling stroke also in 1.0% (3/295) of patients; all were nonfatal. No patient experienced a systemic embolism. Device-related thrombus was detected in 2.4% (7/295) patients. Pericardial effusion requiring surgery or pericardiocentesis occurred in 1.0% (3/295), with all of these events occurring in the first 7 days post-procedure. Cumulative BARC-3 or -5 bleeding occurred in 3.7% (11/300) of patients from 0 to 7 days, in 7.3% (22/300) at 6 months, and in 8.1% (24/295) patients at 1 year. One patient (0.3%) had a peri-procedural device embolisation, with no subsequent device embolisations or any device migration reported for any patient through 1 year.
Conclusions
The WATCHMAN FLX device had excellent procedural success rates, with high effective LAA closure rates and low serious adverse event rates in everyday clinical practise.
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Affiliation(s)
- TR Betts
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - M Grygier
- University Hospital of Lords Transfiguration, Poznan, Poland
| | | | - T Schmitz
- Elisabeth Krankenhaus Essen, Essen, Germany
| | - M Sandri
- Herzzentrum Universitat Leipzig, Leipzig, Germany
| | - G Casu
- Sassari University Hospital, Sassari, Italy
| | | | - D Hildick-Smith
- Royal Sussex County Hospital, Brighton, United Kingdom of Great Britain & Northern Ireland
| | - T Christen
- Boston Scientific Corporation, Marlborough, United States of America
| | - DJ Allocco
- Boston Scientific Corporation, Marlborough, United States of America
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7
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Kluge S, Jarczak D, Eberhardt R, Herrlinger K, Janneck M, Borlich O, Weber CF, Schley JV, Emami P, Bergmann M, Addo M, Kerner T. [A survey on the vaccination status of COVID-19 patients in intensive care units in Hamburg]. Dtsch Med Wochenschr 2022; 147:492-494. [PMID: 35405754 DOI: 10.1055/a-1743-1352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Stefan Kluge
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf
| | - Dominik Jarczak
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf
| | - Ralf Eberhardt
- Pneumologie & Internistische Intensivmedizin, Asklepios Klinik Barmbek
| | | | | | | | | | | | | | - Martin Bergmann
- Kardiologie, Pneumologie und internistische Intensivmedizin, Asklepios Klinik Altona
| | - Marylyn Addo
- Sektion Infektiologie, Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf
| | - Thoralf Kerner
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerz- und Palliativmedizin, Asklepios Klinikum Harburg
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8
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Warmbier J, Lüdecke DK, Flitsch J, Buchfelder M, Fahlbusch R, Knappe UJ, Kreutzer J, Buslei R, Bergmann M, Heppner F, Glatzel M, Saeger W. Typing of inflammatory lesions of the pituitary. Pituitary 2022; 25:131-142. [PMID: 34463941 PMCID: PMC8821060 DOI: 10.1007/s11102-021-01180-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/17/2022]
Abstract
Inflammatory pituitary lesions account for 1.8% of all specimens from the German Pituitary Tumor Registry. They occure in 0.5% of the autoptical specimens and in 2.2% of the surgical cases. Women are significantly more often affected than men and are often younger when first diagnosed. In general, primary and secondary inflammation can be distinguished, with secondary types occurring more frequently (75.1%) than idiopathic inflammatory lesions (15.4%). In primary inflammation, the lymphocytic type is more common (88.5%) than the granulomatous type of hypophysitis (11.5%). The most common causes of secondary inflammation are Rathke's cleft cysts (48.6%), followed by tumors (17.4%) such as the craniopharyngioma (9.1%), adenoma (5.5%) or germinoma (2.0%). More causes are tumor-like lesions (7.1%) such as xanthogranuloma (3.5%) or Langerhans histiocytosis (3.5%), abscesses (5.5%), generalized infections (5.1%), spreaded inflammations (4.7%) and previous surgeries (4.0%). In 1.6% of all specimens the reason for the inflammation remains unclear. The described classification of hypophysitis is important for specific treatment planning after surgery.
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Affiliation(s)
- J. Warmbier
- grid.13648.380000 0001 2180 3484Institute of Neuropathology of the University of Hamburg, UKE, 20246 Hamburg, Germany
| | - D. K. Lüdecke
- grid.13648.380000 0001 2180 3484Clinic of Neurosurgery of the University of Hamburg, UKE, 20246 Hamburg, Germany
| | - J. Flitsch
- grid.13648.380000 0001 2180 3484Clinic of Neurosurgery of the University of Hamburg, UKE, 20246 Hamburg, Germany
| | - M. Buchfelder
- grid.5330.50000 0001 2107 3311Clinic of Neurosurgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - R. Fahlbusch
- grid.419379.10000 0000 9724 1951International Neuroscience Institute (INI), Rudolf-Pichelmayr-Str. 4, 30625 Hannover, Germany
| | - U. J. Knappe
- grid.5570.70000 0004 0490 981XDepartment of Neurosurgery, Johannes-Wesling-Klinikum Minden, Ruhr-University Bochum (RUB), 32429 Minden, Germany
| | - J. Kreutzer
- Praxis for Neurosurgery, 90941 Nuremberg, Germany
| | - R. Buslei
- grid.419802.60000 0001 0617 3250Institute of Pathology, SozialStiftung Bamberg, 96049 Bamberg, Germany
| | - M. Bergmann
- grid.419807.30000 0004 0636 7065Institute of Neuropathology, Klinikum Bremen-Mitte, 28205 Bremen, Germany
| | - F. Heppner
- grid.6363.00000 0001 2218 4662Institute of Neuropathology of the Humboldt University of Berlin, Charitè, 10117 Berlin, Germany
| | - M. Glatzel
- grid.13648.380000 0001 2180 3484Institute of Neuropathology of the University of Hamburg, UKE, 20246 Hamburg, Germany
| | - W. Saeger
- grid.13648.380000 0001 2180 3484Institute of Neuropathology of the University of Hamburg, UKE, 20246 Hamburg, Germany
- grid.13648.380000 0001 2180 3484Institutes of Pathology and Neuropathology of the University of Hamburg, UKE, Martinistraße 52, 20246 Hamburg, Germany
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9
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Fink C, Baal N, Wilhelm J, Sarode P, Weigel R, Schumacher V, Nettersheim D, Schorle H, Schröck C, Bergmann M, Kliesch S, Kressin M, Savai R. On the origin of germ cell neoplasia in situ: Dedifferentiation of human adult Sertoli cells in cross talk with seminoma cells in vitro. Neoplasia 2021; 23:731-742. [PMID: 34153645 PMCID: PMC8233172 DOI: 10.1016/j.neo.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022]
Abstract
Germ cell neoplasia in situ (GCNIS) is the noninvasive precursor of testicular germ cell tumors type II, the most common cancer in young men, which originates from embryonic germ cells blocked in their maturation. GCNIS is associated with impaired Sertoli cells (SCs) that express fetal keratin 18 (KRT18) and the pluripotency factor SRY-Box transcription factor 2 (SOX2). According to the current theory concerning the origin of GCNIS, these SCs are prepubertal cells arrested in their maturation due to (epi)genetic anomalies and/or environmental antiandrogens. Thus, they are unable to support the development of germ cells, which leads to their maturational block and further progresses into GCNIS. Alternatively, these SCs are hypothesized to be adult cells dedifferentiating secondarily under the influence of GCNIS. To examine whether tumor cells can dedifferentiate SCs, we established a coculture model of adult human SCs (FS1) and a seminoma cell line similar to GCNIS (TCam-2). After 2 wk of coculture, FS1 cells showed progressive expression of KRT18 and SOX2, mimicking the in vivo changes. TCam-2 cells showed SOX2 expression and upregulation of further pluripotency- and reprogramming-associated genes, suggesting a seminoma to embryonal carcinoma transition. Thus, our FS1/TCam-2 coculture model is a valuable tool for investigating interactions between SCs and seminoma cells. Our immunohistochemical and ultrastructural studies of human testicular biopsies with varying degrees of GCNIS compared to biopsies from fetuses, patients with androgen insensitivity syndrome, and patients showing normal spermatogenesis further suggest that GCNIS-associated SCs represent adult cells undergoing progressive dedifferentiation.
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Affiliation(s)
- Cornelia Fink
- Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University Giessen, Giessen, Germany.
| | - Nelli Baal
- Institute for Clinical Immunology and Transfusion Medicine, Universities of Giessen and Marburg, Giessen, Germany
| | - Jochen Wilhelm
- Department of Internal Medicine, Member of the German Center for Lung Research (DZL), Germany; Institute for Lung Health (ILH), Justus-Liebig-University, Giessen, Germany
| | - Poonam Sarode
- Department of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Member of the DZL, Member of CPI, Bad Nauheim, Germany
| | - Roswitha Weigel
- Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Valérie Schumacher
- Department of Urology and Medicine, Boston Children's Hospital, Department of Surgery and Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Daniel Nettersheim
- Department of Urology, Urological Research Lab, Translational UroOncology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Hubert Schorle
- University Hospital Bonn, Department of Developmental Pathology, Institute of Pathology, Bonn, Germany
| | - Carmen Schröck
- Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Martin Bergmann
- Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Sabine Kliesch
- University of Münster, Centre of Andrology and Reproductive Medicine, Münster, Germany
| | - Monika Kressin
- Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Rajkumar Savai
- Department of Internal Medicine, Member of the German Center for Lung Research (DZL), Germany; Department of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Member of the DZL, Member of CPI, Bad Nauheim, Germany; Institute for Lung Health (ILH), Justus-Liebig-University, Giessen, Germany.
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10
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Bergmann M, Zablotski Y, Rieger A, Speck S, Truyen U, Hartmann K. Comparison of four commercially available point-of-care tests to detect antibodies against canine distemper virus in dogs. Vet J 2021; 273:105693. [PMID: 34148608 DOI: 10.1016/j.tvjl.2021.105693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/06/2021] [Accepted: 05/11/2021] [Indexed: 11/29/2022]
Abstract
Pre-vaccination antibody testing to determine dogs' immunity against canine distemper virus (CDV) is increasingly used. Four point-of-care tests (POC A-D) are available in Europe, but their diagnostic accuracy has not been compared. The study evaluated the diagnostic accuracy and usability of these tests. Sera of client-owned dogs (n = 198; healthy n = 22; unhealthy dogs n = 176) and specific pathogen-free (SPF) dogs (n = 40) were included. Virus neutralisation (VN) was performed as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy (OA) were determined. McNemar's test was used to determine significant differences between specificity and sensitivity of the tests and Cohen's kappa was used to assess agreement. The prevalence of anti-CDV antibodies by VN was 80% in client-owned dogs overall, with 100% prevalence in healthy dogs, and 0% in SPF dogs. POC-C and POC-D were considered easiest to perform. Specificity of all tests was high using sera from SPF dogs (88-100%). In healthy dogs, sensitivity was variable (45-98%). Specificity was low in all four POC tests when using sera from acutely ill dogs (6-53%) and clinically healthy dogs with chronic disease (5-77%). In client-owned dogs, including healthy and unhealthy dogs, agreement was poor between tests. All POC tests had a low specificity when investigating sera from ill client-owned dogs and usefullness of these tests especially in dogs that are acutely ill or have chronic disease is not supported by this study.
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Affiliation(s)
- M Bergmann
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany.
| | - Y Zablotski
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - A Rieger
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - S Speck
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, An den Tierkliniken 1, 04103 Leipzig, Germany
| | - U Truyen
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, An den Tierkliniken 1, 04103 Leipzig, Germany
| | - K Hartmann
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
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11
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Hamm CW, Schneck E, Buerke M, Darius H, Gaede L, Bergmann M, Hoffmeister M, Schneck F, Gräsner JT, Dirkmann D, Sander M. Empfehlungen zur prähospitalen Behandlung des akuten Koronarsyndroms bei Patienten unter Dauertherapie mit neuen oralen Antikoagulanzien (NOAKs). Kardiologe 2021. [DOI: 10.1007/s12181-020-00439-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Lei T, Blois SM, Freitag N, Bergmann M, Bhushan S, Wahle E, Huang ACC, Chen HL, Hartmann MF, Wudy SA, Liu FT, Meinhardt A, Fijak M. Targeted disruption of galectin 3 in mice delays the first wave of spermatogenesis and increases germ cell apoptosis. Cell Mol Life Sci 2021; 78:3621-3635. [PMID: 33507326 DOI: 10.1007/s00018-021-03757-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/22/2020] [Accepted: 01/06/2021] [Indexed: 12/22/2022]
Abstract
Galectin 3 is a multifunctional lectin implicated in cellular proliferation, differentiation, adhesion, and apoptosis. This lectin is broadly expressed in testicular somatic cells and germ cells, and is upregulated during testicular development. Since the role of galectin 3 in testicular function remains elusive, we aimed to characterize the role of galectin 3 in testicular physiology. We found that galectin 3 transgenic mice (Lgals3-/-) exhibited significantly decreased testicular weight in adulthood compared to controls. The transgenic mice also exhibited a delay to the first wave of spermatogenesis, a decrease in the number of germ cells at postnatal day 5 (P5) and P15, and defective Sertoli cell maturation. Mechanistically, we found that Insulin-like-3 (a Leydig cell marker) and enzymes involved in steroid biosynthesis were significantly upregulated in adult Lgals3-/- testes. These observations were accompanied by increased serum testosterone levels. To determine the underlying causes of the testicular atrophy, we monitored cellular apoptosis. Indeed, adult Lgals3-/- testicular cells exhibited an elevated apoptosis rate that is likely driven by downregulated Bcl-2 and upregulated Bax and Bak expression, molecules responsible for live/death cell balance. Moreover, the percentage of testicular macrophages within CD45+ cells was decreased in Lgals3-/- mice. These data suggest that galectin 3 regulates spermatogenesis initiation and Sertoli cell maturation in part, by preventing germ cells from undergoing apoptosis and regulating testosterone biosynthesis. Going forward, understanding the role of galectin 3 in testicular physiology will add important insights into the factors governing the development of germ cells and steroidogenesis and delineate novel biomarkers of testicular function.
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Affiliation(s)
- Tao Lei
- Department of Anatomy and Cell Biology, Justus-Liebig-University of Giessen, Aulweg 123, 35385, Giessen, Germany
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sandra M Blois
- Department of Obstetrics and Fetal Medicine, AG Glycoimmunology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251, Hamburg, Germany
- Experimental and Clinical Research Center, A Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, The Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Nancy Freitag
- Department of Obstetrics and Fetal Medicine, AG Glycoimmunology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251, Hamburg, Germany
- Experimental and Clinical Research Center, A Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, The Charité Universitätsmedizin Berlin, Berlin, Germany
- Division of General Internal and Psychosomatic Medicine, Berlin Institute of Health, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin, Germany
| | - Martin Bergmann
- Institute of Veterinary Anatomy, Histology, and Embryology, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Sudhanshu Bhushan
- Department of Anatomy and Cell Biology, Justus-Liebig-University of Giessen, Aulweg 123, 35385, Giessen, Germany
| | - Eva Wahle
- Department of Anatomy and Cell Biology, Justus-Liebig-University of Giessen, Aulweg 123, 35385, Giessen, Germany
| | | | - Hung-Lin Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Michaela F Hartmann
- Steroid Research and Mass Spectrometry Unit, Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Stefan A Wudy
- Steroid Research and Mass Spectrometry Unit, Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Fu-Tong Liu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Andreas Meinhardt
- Department of Anatomy and Cell Biology, Justus-Liebig-University of Giessen, Aulweg 123, 35385, Giessen, Germany
| | - Monika Fijak
- Department of Anatomy and Cell Biology, Justus-Liebig-University of Giessen, Aulweg 123, 35385, Giessen, Germany.
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13
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Bergmann M, Germann CP, Nordmeyer J, Peters B, Berger F, Schubert S. Short- and Long-term Outcome After Interventional VSD Closure: A Single-Center Experience in Pediatric and Adult Patients. Pediatr Cardiol 2021; 42:78-88. [PMID: 33009919 PMCID: PMC7864847 DOI: 10.1007/s00246-020-02456-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
Interventional closure of congenital ventricular septal defects (VSD) is recording a continuous rise in acceptance. Complete atrioventricular block (cAVB) and residual shunting are major concerns during follow-up, but long-term data for both are still limited. We retrospectively evaluated the outcome of patients with interventional VSD closure and focused on long-term results (> 1 year follow-up). Transcatheter VSD closures were performed between 1993 and 2015, in 149 patients requiring 155 procedures (104 perimembranous, 29 muscular, 19 residual post-surgical VSDs, and 3 with multiple defects). The following devices were used: 65 × Amplatzer™ Membranous VSD Occluder, 33 × Duct Occluder II, 27 × Muscular VSD Occluder, 3 × Duct Occluder I, 24 × PFM-Nit-Occlud®, and 3 × Rashkind-Occluder. The median age at time of implantation was 6.2 (0.01-66.1) years, median height 117 (49-188) cm, and median weight 20.9 (3.2-117) kg. Median follow-up time was 6.2 (1.1-21.3) years and closure rate was 86.2% at last follow-up. Complications resulting in device explantation include one case of cAVB with a Membranous VSD occluder 7 days after implantation and four cases due to residual shunt/malposition. Six (4%) deaths occurred during follow-up with only one procedural related death from a hybrid VSD closure. Overall, our reported results of interventional VSD closure show favorable outcomes with only one (0.7%) episode of cAVB. Interventional closure offers a good alternative to surgical closure and shows improved performance by using softer devices. However, prospective long-term data in the current era with different devices are still mandatory to assess the effectiveness and safety of this procedure.
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Affiliation(s)
- M. Bergmann
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - C. P. Germann
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - J. Nordmeyer
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - B. Peters
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - F. Berger
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Schubert
- grid.418209.60000 0001 0000 0404Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany ,grid.418457.b0000 0001 0723 8327Clinic for Pediatric Cardiology and Congenital Heart Defects, Herz- Und Diabeteszentrum NRW, Ruhr University of Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany
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14
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Ledwoch J, Sievert K, Boersma L, Bergmann M, Ince H, Kische S, Pokushalov E, Schmitz T, Schmidt B, Gori T, Meincke F, Protopopov A, Betts T, Mazzone P, Sievert H. Initial and long-term antithrombotic therapy after left atrial appendage closure with the WATCHMAN. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Evidence regarding post-procedural antithrombotic regimes other than used in randomized trials assessing percutaneous left atrial appendage (LAA) closure is limited.
Purpose
The present work aimed to compare different antithrombotic strategies applied in the real-world EWOLUTION study.
Methods
A total of 998 patients with successful WATCHMAN implantation at 47 centers were available for the present analysis. The composite ischemic endpoint of stroke, TIA, systemic embolism and device thrombus as well as the bleeding endpoint defined as at least major bleeding according to BARC were assessed during an initial period (from implant until first medication change) and long-term period (from first change until up to 2 years).
Results
The antithrombotic medication chosen in the initial phase was dual antiplatelet therapy (DAPT) in 60%, oral anticoagulation (OAC) in 27%, single antiplatelet therapy (SAPT) in 7% and no medication in 6%. In the long-term phase SAPT was used in 65%, DAPT in 23%, no therapy in 8% and OAC in 4%. No significant differences were found between the groups regarding the ischemic endpoint both in the initial period (Kaplan-Meier estimated rate 2.9% for DAPT vs. 4.3% for OAC vs. 3.9% for SAPT or no therapy; p=0.97) and in the second period (4.2% for SAPT vs. 1.8% for DAPT vs. 3.5% for no therapy; p=0.36). With respect to bleeding events the only difference was found in the initial phase with a higher incidence in patients under SAPT or no therapy (1.0% for DAPT vs. 0.8% for OAC vs. 7.4% for SAPT or no therapy; p=0.01). No differences in bleeding complications were observed during the second period (2.6% for SAPT vs. 2.9% for DAPT vs. 2.2% for no therapy; p=0.88).
Conclusions
Tailored antithrombotic treatment using even very reduced strategies such as SAPT or no therapy showed no significant differences regarding ischemic complications after LAA closure.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Boston Scientific
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Affiliation(s)
- J Ledwoch
- Klinikum Neuperlach, Munich, Germany
| | - K Sievert
- CardioVascular Center Frankfurt, Frankfurt, Germany
| | - L Boersma
- St Antonius Hospital, Nieuwegein, Netherlands (The)
| | | | - H Ince
- Vivantes Klinikum Am Urban, Berlin, Germany
| | - S Kische
- Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - E Pokushalov
- State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | | | - B Schmidt
- CardioVascular Center Bethanien (CCB), Frankfurt, Germany
| | - T Gori
- Johannes Gutenberg University Mainz (JGU), Mainz, Germany
| | - F Meincke
- Asklepios Clinic St. Georg, Hamburg, Germany
| | - A Protopopov
- Krasnoyarsk regional hospital, Krasnoyarsk, Russian Federation
| | - T Betts
- John Radcliffe Hospital, Oxford, United Kingdom
| | | | - H Sievert
- CardioVascular Center Frankfurt, Frankfurt, Germany
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15
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Indumathy S, Pueschl D, Klein B, Fietz D, Bergmann M, Schuppe HC, Da Silva N, Loveland BE, Hickey MJ, Hedger MP, Loveland KL. Testicular immune cell populations and macrophage polarisation in adult male mice and the influence of altered activin A levels. J Reprod Immunol 2020; 142:103204. [PMID: 33130539 DOI: 10.1016/j.jri.2020.103204] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/28/2020] [Accepted: 09/02/2020] [Indexed: 12/12/2022]
Abstract
Detailed morphological characterization of testicular leukocytes in the adult CX3CR1 gfp/+ transgenic mouse identified two distinct CX3CR1 + mononuclear phagocyte (macrophage and dendritic cell) populations: stellate/dendriform cells opposed to the seminiferous tubules (peritubular), and polygonal cells associated with Leydig cells (interstitial). Using confocal microscopy combined with stereological enumeration of CX3CR1gfp/+ cells established that there were twice as many interstitial cells (68%) as peritubular cells (32%). Flow cytometric analyses of interstitial cells from mechanically-dissociated testes identified multiple mononuclear phagocyte subsets based on surface marker expression (CX3CR1, F4/80, CD11c). These cells comprised 80% of total intratesticular leukocytes, as identified by CD45 expression. The remaining leukocytes were CD3+ (T lymphocytes) and NK1.1+ (natural killer cells). Functional phenotype assessment using CD206 (an anti-inflammatory/M2 marker) and MHC class II (an activation marker) identified a potentially tolerogenic CD206+MHCII+ sub-population (12% of total CD45+ cells). Rare testicular subsets of CX3CR1 +CD11c+F4/80+ (4.3%) mononuclear phagocytes and CD3+NK1.1+ (3.1%) lymphocytes were also identified for the first time. In order to examine the potential for the immunoregulatory cytokine, activin A to modulate testicular immune cell populations, testes from adult mice with reduced activin A (Inhba+/-) or elevated activin A (Inha+/-) were assessed using flow cytometry. Although the proportion of F4/80+CD11b+ leukocytes (macrophages) was not affected, the frequency of CD206+MHCII+cells was significantly lower and CD206+MHCII- correspondingly higher in Inha+/- testes. This shift in expression of MHCII in CD206+ macrophages indicates that changes in circulating and/or local activin A influence resident macrophage activation and phenotype and, therefore, the immunological environment of the testis.
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Affiliation(s)
- S Indumathy
- Centre for Reproductive Health, Hudson Institute of Medical Research, Victoria, Australia; Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University, Giessen, Germany; Department of Molecular and Translational Sciences, School of Clinical Sciences, Monash University, Victoria, Australia.
| | - D Pueschl
- Centre for Reproductive Health, Hudson Institute of Medical Research, Victoria, Australia; Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University, Giessen, Germany; Department of Molecular and Translational Sciences, School of Clinical Sciences, Monash University, Victoria, Australia
| | - B Klein
- Centre for Reproductive Health, Hudson Institute of Medical Research, Victoria, Australia; Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University, Giessen, Germany
| | - D Fietz
- Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University, Giessen, Germany
| | - M Bergmann
- Department of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University, Giessen, Germany
| | - H-C Schuppe
- Clinic of Urology, Pediatric Urology and Andrology, Justus-Liebig-University, Giessen, Germany
| | - N Da Silva
- Ohana Biosciences, Cambridge, Massachusetts, United States
| | | | - M J Hickey
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, Monash University, Victoria, Australia
| | - M P Hedger
- Centre for Reproductive Health, Hudson Institute of Medical Research, Victoria, Australia; Department of Molecular and Translational Sciences, School of Clinical Sciences, Monash University, Victoria, Australia
| | - K L Loveland
- Centre for Reproductive Health, Hudson Institute of Medical Research, Victoria, Australia; Department of Molecular and Translational Sciences, School of Clinical Sciences, Monash University, Victoria, Australia.
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16
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Atanasova V, Tiefenbacher A, Clement J, Wöran K, Bergmann M, Dolznig H, Egger G. 482P Identification of proteome and secretome signatures in primary colorectal cancer associated fibroblasts. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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17
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Fietz D, Pilatz A, Diemer T, Wagenlehner F, Bergmann M, Schuppe HC. Excessive unilateral proliferation of spermatogonia in a patient with non-obstructive azoospermia - adverse effect of clomiphene citrate pre-treatment? Basic Clin Androl 2020; 30:13. [PMID: 32884817 PMCID: PMC7461256 DOI: 10.1186/s12610-020-00111-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/21/2020] [Accepted: 07/19/2020] [Indexed: 01/14/2023] Open
Abstract
Background Clomiphene citrate has been proposed as pre-treatment for infertile men with non-obstructive, testicular azoospermia (NOA) before surgery for testicular sperm extraction (TESE), especially when serum testosterone is low. Case presentation Here, we report on a 33-year old azoospermic patient with a previous history of repeated "fresh" TESE and clomiphene citrate therapy (50 mg/day over 6 months) before undergoing microscopically assisted, bilateral testicular biopsy. Comprehensive histological and immunohistochemical work-up revealed a heterogeneous spermatogenic arrest at the level of spermatogonia or primary spermatocytes, with focally preserved spermatogenesis up to elongated spermatids in the right testis. In the left testis, the majority of tubules (> 70%) showed no tubular lumen or regular seminiferous epithelium but a great number of spermatogonia-like cells. These cells proved to be normally differentiated spermatogonia (positive for melanoma associated antigen 4 (MAGEA4), negative for placental alkaline phosphatase (PlAP)) with increased proliferative activity (positive for proliferating cell nuclear antigen (PCNA)) and a slightly higher rate of apoptotic cells. When compared to a tissue control with normal spermatogenesis, expression of sex hormone receptors androgen receptor (AR), estrogen receptor (ER) alpha, and G-protein coupled estrogen receptor 1 (GPER1) was not altered in patient samples. Sertoli cells appeared to be mature (positive for vimentin, negative for cytokeratin 18), whereas the expression of zona occludens protein 1 (ZO-1), claudin 11, and connexin 43 was absent or dislocated in the tubules with abundance of spermatogonia. Conclusion This result suggests that formation of the blood-testis barrier is disturbed in affected tubules. To our knowledge this is the first observation of excessive, non-malignant proliferation of spermatogonia in a NOA patient. Although underlying molecular mechanisms remain to be elucidated, we hypothesize that the unusual pathology was triggered by the high-dose clomiphene citrate treatment preceding testicular biopsy.
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Affiliation(s)
- Daniela Fietz
- Institute for Veterinary Anatomy, Histology and Embryology, Justus Liebig University Giessen, Frankfurter Straße 98, 35392 Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany
| | - Adrian Pilatz
- Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany.,Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, 35392 Giessen, Germany
| | - Thorsten Diemer
- Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany.,Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, 35392 Giessen, Germany
| | - Florian Wagenlehner
- Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany.,Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, 35392 Giessen, Germany
| | - Martin Bergmann
- Institute for Veterinary Anatomy, Histology and Embryology, Justus Liebig University Giessen, Frankfurter Straße 98, 35392 Giessen, Germany
| | - Hans-Christian Schuppe
- Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany.,Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, 35392 Giessen, Germany
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Kauerhof AC, Nicolas N, Bhushan S, Wahle E, Loveland KA, Fietz D, Bergmann M, Groome NP, Kliesch S, Schuppe HC, Pilatz A, Meinhardt A, Hedger MP, Fijak M. Investigation of activin A in inflammatory responses of the testis and its role in the development of testicular fibrosis. Hum Reprod 2020; 34:1536-1550. [PMID: 31340036 DOI: 10.1093/humrep/dez109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/27/2019] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does activin A contribute to testicular fibrosis under inflammatory conditions? SUMMARY ANSWER Our results show that activin A and key fibrotic proteins are increased in human testicular biopsies with leukocytic infiltrates and impaired spermatogenesis and in murine experimental autoimmune orchitis (EAO) and that activin A stimulates fibrotic responses in peritubular cells (PTCs) and NIH 3T3 fibroblasts. WHAT IS KNOWN ALREADY Fibrosis is a feature of EAO. Activin A, a regulator of fibrosis, was increased in testes of mice with EAO and its expression correlated with severity of the disease. STUDY DESIGN, SIZE, DURATION This is a cross-sectional and longitudinal study of adult mice immunized with testicular homogenate (TH) in adjuvant to induce EAO, collected at 30 (n = 6), 50 (n = 6) and 80 (n = 5) days after first immunization. Age-matched mice injected with adjuvant alone (n = 14) and untreated mice (n = 15) were included as controls. TH-immunized mice with elevated endogenous follistatin, injected with a non-replicative recombinant adeno-associated viral vector carrying a gene cassette of follistatin (rAAV-FST315; n = 3) or vector with an empty cassette (empty vector controls; n = 2) 30 days prior to the first immunization, as well as appropriate adjuvant (n = 2) and untreated (n = 2) controls, were also examined.Human testicular biopsies showing focal inflammatory lesions associated with impaired spermatogenesis (n = 7) were included. Biopsies showing intact spermatogenesis without inflammation, from obstructive azoospermia patients, served as controls (n = 7).Mouse primary PTC and NIH 3T3 fibroblasts were stimulated with activin A and follistatin 288 (FST288) to investigate the effect of activin A on the expression of fibrotic markers. Production of activin A by mouse primary Sertoli cells (SCs) was also investigated. PARTICIPANTS/MATERIALS, SETTING, METHODS Testicular RNA and protein extracts collected from mice at days 30, 50 and 80 after first immunization were used for analysis of fibrotic marker genes and proteins, respectively. Total collagen was assessed by hydroxyproline assay and fibronectin; collagen I, III and IV, α-smooth muscle actin (α-SMA) expression and phosphorylation of suppressor of mothers against decapentaplegic (SMAD) family member 2 were measured by western blot. Immunofluorescence was used to detect fibronectin. Fibronectin (Fn), αSMA (Acta2), collagen I (Col1a2), III (Col3a1) and IV (Col4a1) mRNA in PTC and NIH 3T3 cells treated with activin A and/or FST288 were measured by quantitative RT-PCR (qRT-PCR). Activin A in SC following tumour necrosis factor (TNF) or FST288 stimulation was measured by ELISA. Human testicular biopsies were analysed by qRT-PCR for PTPRC (CD45) and activin A (INHBA), hydroxyproline assay and immunofluorescence. MAIN RESULTS AND THE ROLE OF CHANCE Production of activin A by SC was stimulated by 25 and 50 ng/ml TNF (P < 0.01, P < 0.001, respectively) as compared to untreated cells. INHBA mRNA was increased in human testicular biopsies with leukocytic infiltrates and impaired spermatogenesis, compared with control biopsies (P < 0.05), accompanied by increased total collagen (P < 0.01) and fibronectin deposition. Total testicular collagen (P < 0.0001) and fibronectin protein expression (P < 0.05) were also increased in EAO, and fibronectin expression was correlated with the severity of the disease (r = 0.9028). In animals pre-treated with rAAV-FST315 prior to immunization with TH, protein expression of fibronectin was comparable to control. Stimulation of PTC and NIH 3T3 cells with activin A increased fibronectin mRNA (P < 0.05) and the production of collagen I (P < 0.001; P < 0.01) and fibronectin (P < 0.05). Moreover, activin A also increased collagen IV mRNA (P < 0.05) in PTC, while αSMA mRNA (P < 0.01) and protein (P < 0.0001) were significantly increased by activin A in NIH 3T3 cells. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION A limited number of human testicular specimens was available for the study. Part of the study was performed in vitro, including NIH 3T3 cells as a surrogate for testicular fibroblasts. WIDER IMPLICATIONS OF THE FINDINGS Resident fibroblasts and PTC may contribute to the progression of testicular fibrosis following inflammation, and activin A is implicated as a key mediator of this process. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Health and Medical Research Council of Australia, the Victorian Government's Operational Infrastructure Support Program and the International Research Training Group between Justus Liebig University (Giessen) and Monash University (Melbourne) (GRK 1871/1-2) on `Molecular pathogenesis on male reproductive disorders' funded by the Deutsche Forschungsgemeinschaft and Monash University. The authors declare no competing financial interests.
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Affiliation(s)
- A Christine Kauerhof
- Department of Anatomy and Cell Biology, Justus Liebig University, Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University, Giessen, Germany.,Department of Molecular and Translational Sciences, Monash University, Clayton, Australia
| | - Nour Nicolas
- Department of Anatomy and Cell Biology, Justus Liebig University, Giessen, Germany.,Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Australia
| | - Sudhanshu Bhushan
- Department of Anatomy and Cell Biology, Justus Liebig University, Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University, Giessen, Germany
| | - Eva Wahle
- Department of Anatomy and Cell Biology, Justus Liebig University, Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University, Giessen, Germany
| | - Kate A Loveland
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Australia.,Department of Molecular and Translational Sciences, Monash University, Clayton, Australia
| | - Daniela Fietz
- Hessian Centre of Reproductive Medicine, Justus Liebig University, Giessen, Germany.,Department of Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Giessen, Germany
| | - Martin Bergmann
- Hessian Centre of Reproductive Medicine, Justus Liebig University, Giessen, Germany.,Department of Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Giessen, Germany
| | - Nigel P Groome
- Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Sabine Kliesch
- Centre of Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University of Münster, Münster, Germany
| | - Hans-Christian Schuppe
- Hessian Centre of Reproductive Medicine, Justus Liebig University, Giessen, Germany.,Department of Urology, Paediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Adrian Pilatz
- Hessian Centre of Reproductive Medicine, Justus Liebig University, Giessen, Germany.,Department of Urology, Paediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Andreas Meinhardt
- Department of Anatomy and Cell Biology, Justus Liebig University, Giessen, Germany.,Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Australia
| | - Mark P Hedger
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Australia.,Department of Molecular and Translational Sciences, Monash University, Clayton, Australia.,Shared last authorship
| | - Monika Fijak
- Department of Anatomy and Cell Biology, Justus Liebig University, Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University, Giessen, Germany.,Shared last authorship
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Barbieri F, Adukauskaite A, Heidbreder A, Brandauer E, Bergmann M, Senoner T, Rubatscher A, Schgoer W, Stuehlinger M, Pfeifer B, Bauer A, Hintringer F, Hoegl B, Dichtl W. P534Central sleep apnea in pacing-induced cardiomyopathy: prevalence, improvement by upgrading to cardiac resynchronisation therapy and impact on structural responder rates and long-term outcome. Europace 2020. [DOI: 10.1093/europace/euaa162.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
ÖNB Jubiläumsfondsprojekt Nr. 15974, ISR grant by Boston Scientific, St. Paul, MN, USA
Background
Central sleep apnea (CSA) in pacing induced cardiomyopathy (PICM) is poorly studied. Specifically, it is unknown whether upgrading from right ventricular pacing (RVP) to cardiac resynchronisation therapy (CRT) improves CSA.
Methods
Fifty-three patients with impaired left ventricular ejection fraction, frequent right ventricular pacing due to high-grade atrioventricular block and heart failure symptoms despite optimal medical therapy underwent upgrading to CRT. Within one month after left ventricular lead implantation (but still not activated), sleep apnea was assessed in all participants by single-night polysomnography (PSG). Nineteen patients with moderate or severe CSA defined by an apnea hypopnea index (AHI) > 15 events per hour were re-scheduled for a follow up PSG 3-5 months after initiation of cardiac resynchronization therapy. Of this cohort, thirteen patients with stable mild heart failure agreed to be randomized to CRT versus RVP in a cross-over design.
Results
CSA (AHI > 5 events per hour) was diagnosed in 26 (49.1%), OSA in 16 (30.2%) patients suffering from PICM . Eleven (20.8%) patients did not have any form of sleep apnea. Moderate to severe CSA (AHI > 15 events per hour) was significantly improved (without specific CPAP therapy) by 102 (96-172) days of CRT: AHI decreased from 39.4 events per hour at baseline to 21.6 by CRT (p < 0.001). Furthermore, CRT led to a substantial decrease in left ventricular endsystolic volumes: baseline 141 ml (103-155), significant improvement under CRT (102 ml, 65-138; p < 0.001), whereas no effect with ongoing RV-pacing (147 ml, 130-161; p = 0.865). Preexistent CSA did not affect the structural response of CRT (56.5% in patients with CSA, 62.5% of patients with obstructive sleep apnea and 54.5% in patients without sleep apnea; p = 0.901) and had no impact on major adverse cardiac events (p = 0.412) and/or survival (p = 0.623) during long-term follow-up.
Conclusions
CSA is highly prevalent in patients with PICM and is significantly improved by upgrading to CRT. Preexistent CSA does not hamper structural improvement and long-term outcome after upgrading to CRT. Thus, CSA seems to occur as a consequence of PICM, rather than as a pathophysiological mediator.
Abstract Figure.
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Affiliation(s)
- F Barbieri
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - A Adukauskaite
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - A Heidbreder
- Muenster University Hospital, Department of Neurology, Division of Sleep Medicine and Neuromuscular Disorders, Muenster, Germany
| | - E Brandauer
- Innsbruck Medical University, Department of Neurology, Sleep Disorders Clinic, Innsbruck, Austria
| | - M Bergmann
- Innsbruck Medical University, Department of Neurology, Sleep Disorders Clinic, Innsbruck, Austria
| | - T Senoner
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - A Rubatscher
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - W Schgoer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - M Stuehlinger
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - B Pfeifer
- University Teaching Hospital Hall in Tirol (UMIT), Institute of Electrical and Biomedical Engineering, Hall in Tyrol, Austria
| | - A Bauer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - F Hintringer
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - B Hoegl
- Innsbruck Medical University, Department of Neurology, Sleep Disorders Clinic, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
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20
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Gaffuri P, Espeli V, Fulciniti F, Paone G, Bergmann M. Immune-related acute and lymphocytic gastritis in a patient with metastatic melanoma treated with pembrolizumab immunotherapy. Pathologica 2020; 111:92-97. [PMID: 31748755 PMCID: PMC8138491 DOI: 10.32074/1591-951x-24-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/22/2019] [Indexed: 01/10/2023] Open
Abstract
Here, we present a case of acute and lymphocytic gastritis related to therapy with pembrolizumab for metastatic melanoma. After an asymptomatic phase with moderate histological inflammation (observed at 9 months of immunotherapy), gastritis became symptomatic and severe on repeated biopsies (13 months after the beginning of pembrolizumab). Symptoms and histological lesions both improved with proton pump inhibitor and steroid therapy, as well as interruption of pembrozulimab. The interest of this case lays in the relative rarity of gastritis over small and large intestinal inflammatory lesions caused by immune checkpoint inhibitors as well as in the features of the inflammatory infiltrate, which may be purely lymphocytic (mainly T-cells, with a prevalence of CD8+ over CD4+ lymphocytes) or mixed lymphocytic and granulocytic, requiring the exclusion of other causes of disease. To our knowledge, only 7 cases of immune-related gastritis have been previously documented in the current literature, of which 4, included the current one, were exclusively associated with pembrozulimab therapy.
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Affiliation(s)
- P Gaffuri
- Repubblica e Cantone Ticino Istituto Cantonale di Patologia, Pathology
| | - V Espeli
- Istituto Oncologico della Svizzera Italiana, Oncology
| | - F Fulciniti
- Repubblica e Cantone Ticino Istituto Cantonale di Patologia, Pathology
| | - G Paone
- Department of Nuclear Medicine and TC-PET, Istituto Oncologico della Svizzera Italiana
| | - M Bergmann
- Repubblica e Cantone Ticino Istituto Cantonale di Patologia, Pathology
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21
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Unger LW, Argeny S, Stift A, Yang Y, Karall A, Freilinger T, Müller C, Bergmann M, Stift J, Riss S. Mesenteric granulomas independently predict long-term risk of surgical recurrence in Crohn's disease. Colorectal Dis 2020; 22:170-177. [PMID: 31393663 PMCID: PMC7028106 DOI: 10.1111/codi.14814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/26/2019] [Indexed: 12/16/2022]
Abstract
AIM The risk factors that predict surgical recurrence in Crohn's disease (CD) remain controversial. Postoperative anti-tumour necrosis factor (anti-TNF) therapy might lower recurrence rates whilst the presence of mesenteric granulomas has been postulated to increase the risk. We hypothesized that mesenteric granulomas indicate disease severity and might predict the risk of surgical recurrence, irrespective of immunosuppressive therapy. METHOD We performed a retrospective review of all consecutive patients undergoing operations for CD between January 2000 and December 2014 at a single tertiary referral centre and assessed the perioperative factors and histological findings at the time of surgery. Surgical recurrence rates and the immunosuppressive regimen were assessed through retrospective chart review and telephone interviews. RESULTS A total of 274 patients were eligible for analysis. Median follow-up was 8.54 (5.48-14.42) years. A total of 63 patients (23.0%) underwent surgery for recurrent CD after a median of 4.75 (2.10-7.96) years. In final histology, 35 (12.8%) patients had mesenteric granulomas. TNF inhibitors were administered postoperatively in 104 (38.0%) and thiopurines in 137 (50.0%) patients. In univariate analysis, only the presence of mesenteric granulomas [hazard ratio (HR) 1.95; 95% CI 1.05-3.62; P = 0.035] significantly increased the risk for recurrent surgery while postoperative anti-TNF (HR 0.85; 95% CI 0.49-1.50; P = 0.581) or thiopurine therapy (HR 1.03; 95% CI 0.61-1.73; P = 0.916) did not. In multivariate analysis, only the presence of mesenteric granulomas significantly influenced the risk of surgical recurrence (HR 1.94, 95% CI 1.04-3.60; P = 0.037). CONCLUSION Intestinal and mesenteric granulomas should be differentiated in pathology reports, because mesenteric, but not intestinal, granulomas may be associated with an increased risk of surgical recurrence.
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Affiliation(s)
- L. W. Unger
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - S. Argeny
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - A. Stift
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - Y. Yang
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - A. Karall
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - T. Freilinger
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - C. Müller
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - M. Bergmann
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - J. Stift
- Clinical Institute of PathologyMedical University of ViennaViennaAustria
| | - S. Riss
- Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
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22
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Germann CP, Bergmann M, Nordmeyer J, Peters B, Berger F, Schmitt K, Schubert S. Long-Term Performance after Interventional VSD Closure—Single Center Experience in Pediatric and Adult Patients. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Waser M, Stefani A, Holzknecht E, Garn H, Kohn B, Hackner H, Brandauer E, Bergmann M, Taupe P, Gall M, Högl B. A new diagnostic approach to identify isolated REM sleep behavior disorder (IRBD): 3D video analysis. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1153] [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: 11/15/2022]
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24
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Bergmann M, Riedinger S, Stefani A, Mitterling T, Holzknecht E, Grassmayr P, Högl B. Effects of singing bowl exposure on Karolinska sleepiness scale and pupillographic sleepiness test. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.093] [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: 10/25/2022]
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25
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Pleuger C, Lehti MS, Cooper M, O'Connor AE, Merriner DJ, Smyth IM, Cottle DL, Fietz D, Bergmann M, O'Bryan MK. CBE1 Is a Manchette- and Mitochondria-Associated Protein With a Potential Role in Somatic Cell Proliferation. Endocrinology 2019; 160:2573-2586. [PMID: 31504408 DOI: 10.1210/en.2019-00468] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 08/28/2019] [Indexed: 11/19/2022]
Abstract
Ciliated bronchial epithelium 1 (CBE1) is a microtubule-associated protein localized to the manchette and developing flagellum during spermiogenesis and is associated with sperm maturation arrest in humans. It was hypothesized that CBE1 functions in microtubule-mediated transport mechanisms and sperm tail formation. To test this hypothesis, we analyzed Cbe1 expression and localization during spermiogenesis, and in mouse inner medullary collecting duct-3 (IMCD3) cells as a model of ciliogenesis. Furthermore, we generated and analyzed the fertility of a Cbe1 mutant mouse line. Mice containing a homozygous deletion in the long forms of Cbe1 were born at a lower frequency than predicted by Mendelian inheritance; however, adult male mice were fertile. An in-depth analysis of the Cbe1 gene revealed alternative transcript variants, which were not affected by the exon 2 mutation. To assess whether short variants compensate for the loss of long variants, exons 2 and 4 (which affect all variants) were individually mutated in IMCD3 cells and the effects on cell proliferation and ciliogenesis were analyzed. In wild-type IMCD3 cells, both variants were upregulated during cilia assembly. CBE1 protein was not a structural component of cilia; rather, CBE1 localized to the mitochondria and the contractile ring of dividing IMCD3 cells. Although IMCD3 cells carrying the mutation in long variants showed no phenotypic alterations, the mutation in exon 4 resulted in a significantly decreased proliferation rate. This study reveals that long isoforms of CBE1 are not essential for male fertility. Data, however, suggest that CBE1 is associated with intramanchette transport and midpiece formation of the sperm tail.
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Affiliation(s)
- Christiane Pleuger
- School of Biological Science, Monash University, Clayton, Victoria, Australia
- Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria Australia
| | - Mari S Lehti
- School of Biological Science, Monash University, Clayton, Victoria, Australia
| | - Madeleine Cooper
- School of Biological Science, Monash University, Clayton, Victoria, Australia
| | - Anne E O'Connor
- School of Biological Science, Monash University, Clayton, Victoria, Australia
| | - D Jo Merriner
- School of Biological Science, Monash University, Clayton, Victoria, Australia
| | - Ian M Smyth
- Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria Australia
| | - Denny L Cottle
- Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria Australia
| | - Daniela Fietz
- Institute for Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Giessen, Germany
| | - Martin Bergmann
- Institute for Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Giessen, Germany
| | - Moira K O'Bryan
- School of Biological Science, Monash University, Clayton, Victoria, Australia
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26
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Kulessa M, Weyer-Menkhoff I, Viergutz L, Kornblum C, Claeys KG, Schneider I, Plöckinger U, Young P, Boentert M, Vielhaber S, Mawrin C, Bergmann M, Weis J, Ziagaki A, Stenzel W, Deschauer M, Nolte D, Hahn A, Schoser B, Schänzer A. An integrative correlation of myopathology, phenotype and genotype in late onset Pompe disease. Neuropathol Appl Neurobiol 2019; 46:359-374. [PMID: 31545528 DOI: 10.1111/nan.12580] [Citation(s) in RCA: 13] [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: 06/21/2019] [Accepted: 08/07/2019] [Indexed: 12/29/2022]
Abstract
AIMS Pompe disease is caused by pathogenic mutations in the alpha 1,4-glucosidase (GAA) gene and in patients with late onset Pome disease (LOPD), genotype-phenotype correlations are unpredictable. Skeletal muscle pathology includes glycogen accumulation and altered autophagy of various degrees. A correlation of the muscle morphology with clinical features and the genetic background in GAA may contribute to the understanding of the phenotypic variability. METHODS Muscle biopsies taken before enzyme replacement therapy were analysed from 53 patients with LOPD. On resin sections, glycogen accumulation, fibrosis, autophagic vacuoles and the degree of muscle damage (morphology-score) were analysed and the results were compared with clinical findings. Additional autophagy markers microtubule-associated protein 1A/1B-light chain 3, p62 and Bcl2-associated athanogene 3 were analysed on cryosections from 22 LOPD biopsies. RESULTS The myopathology showed a high variability with, in most patients, a moderate glycogen accumulation and a low morphology-score. High morphology-scores were associated with increased fibrosis and autophagy highlighting the role of autophagy in severe stages of skeletal muscle damage. The morphology-score did not correlate with the patient's age at biopsy, disease duration, nor with the residual GAA enzyme activity or creatine-kinase levels. In 37 patients with LOPD, genetic analysis identified the most frequent mutation, c.-32-13T>G, in 95%, most commonly in combination with c.525delT (19%). No significant correlation was found between the different GAA genotypes and muscle morphology type. CONCLUSIONS Muscle morphology in LOPD patients shows a high variability with, in most cases, moderate pathology. Increased pathology is associated with more fibrosis and autophagy.
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Affiliation(s)
- M Kulessa
- Institute of Neuropathology, Justus Liebig University, Giessen, Germany
| | - I Weyer-Menkhoff
- Institute of Clinical Pharmacology, Goethe University, Frankfurt/Main, Germany
| | - L Viergutz
- Institute of Neuropathology, Justus Liebig University, Giessen, Germany
| | - C Kornblum
- Department of Neurology, University Hospital Bonn, Bonn, Germany.,Center for Rare Diseases, University Hospital Bonn, Bonn, Germany
| | - K G Claeys
- Department of Neurology, University Hospital Leuven, Leuven, Belgium.,Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - I Schneider
- Department of Neurology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - U Plöckinger
- Interdisciplinary Centre of Metabolism: Endocrinology, Diabetes and Metabolism, Charité-University Medicine Berlin, Berlin, Germany
| | - P Young
- Department of Sleep Medicine and Neuromuscular Disorders, Muenster University Hospital, Münster, Germany.,Medical Park Reithofpark, Bad Feilnbach, Germany
| | - M Boentert
- Department of Sleep Medicine and Neuromuscular Disorders, Muenster University Hospital, Münster, Germany
| | - S Vielhaber
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
| | - C Mawrin
- Institute of Neuropathology, Otto-von-Guericke University, Magdeburg, Germany
| | - M Bergmann
- Institute of Clinical Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany
| | - J Weis
- Institute of Neuropathology, RWTH University Hospital, Aachen, Germany
| | - A Ziagaki
- Interdisciplinary Centre of Metabolism: Endocrinology, Diabetes and Metabolism, Charité-University Medicine Berlin, Berlin, Germany
| | - W Stenzel
- Department of Neuropathology, Charité - Universitätsmedizin, Berlin, Germany
| | - M Deschauer
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - D Nolte
- Institute of Human Genetics, Justus Liebig University Giessen, Giessen, Germany
| | - A Hahn
- Department of Child Neurology, Justus Liebig University Giessen, Giessen, Germany
| | - B Schoser
- Department of Neurology, Friedrich-Baur-Institute, LMU University Munich, Munich, Germany
| | - A Schänzer
- Institute of Neuropathology, Justus Liebig University, Giessen, Germany
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27
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Saw J, Nielsen-Kudsk JE, Bergmann M, Daniels MJ, Tzikas A, Reisman M, Rana BS. Reply. JACC Cardiovasc Interv 2019; 12:1741-1742. [DOI: 10.1016/j.jcin.2019.07.005] [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] [Received: 07/01/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
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Pilatz A, Kilb J, Kaplan H, Fietz D, Hossain H, Schüttler CG, Diemer T, Bergmann M, Domann E, Weidner W, Wagenlehner F, Schuppe HC. High prevalence of urogenital infection/inflammation in patients with azoospermia does not impede surgical sperm retrieval. Andrologia 2019; 51:e13401. [PMID: 31456226 PMCID: PMC7147116 DOI: 10.1111/and.13401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 01/12/2023] Open
Abstract
Considering infection/inflammation to be an important risk factor in male infertility, the aim of this study was to make a comprehensive evaluation of the prevalence of urogenital tract infection/inflammation and its potential impact on sperm retrieval in azoospermic patients. In this prospective study, 71 patients with azoospermia were subjected to an extensive andrological workup including comprehensive microbiological diagnostics (2-glass test, semen, testicular swab and testicular tissue analysis) and testicular biopsy/testicular sperm extraction (TESE). Medical history suggested urogenital tract infection/inflammation in 7% of patients, 11% harboured STIs, 14% showed significant bacteriospermia, 15% had seminal inflammation, 17% fulfilled the MAGI definition, and 27% had relevant pathogens. At the testicular level, 1 patient had a swab positive for bacteria, no viruses were detected, tissue specimens never indicated pathogens, whereas histopathology revealed focal immune cell infiltrates in 23% of samples. Testicular sperm retrieval rate was 100% in obstructive and 46% in nonobstructive azoospermia. None of the infection/inflammation-related variables was associated with the success of sperm retrieval or inflammatory lesions in the testis. The high prevalence of urogenital infection/inflammation among azoospermic men underpins their role as significant aetiologic factors in male infertility. However, this observation does not refer to the chances of sperm retrieval at the time of surgery/TESE.
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Affiliation(s)
- Adrian Pilatz
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Jill Kilb
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany
| | - Huelya Kaplan
- Department of Trauma, Hand and Reconstructive Surgery, Justus Liebig University Giessen, Giessen, Germany
| | - Daniela Fietz
- Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, Giessen, Germany.,Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University Giessen, Giessen, Germany
| | - Hamid Hossain
- Institute for Medical Microbiology, Justus Liebig University Giessen, Giessen, Germany.,Institute for Laboratory Medicine and Microbiology, Klinikum St. Marien Amberg, Amberg, Germany
| | - Christian G Schüttler
- Institute for Medical Virology, National Reference Laboratory (NRZ) for HBV and HDV, Justus Liebig University Giessen, Giessen, Germany
| | - Thorsten Diemer
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Martin Bergmann
- Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, Giessen, Germany.,Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University Giessen, Giessen, Germany
| | - Eugen Domann
- Institute for Medical Microbiology, Justus Liebig University Giessen, Giessen, Germany
| | - Wolfgang Weidner
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany
| | - Florian Wagenlehner
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Hans-Christian Schuppe
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany.,Hessian Centre of Reproductive Medicine, Justus Liebig University Giessen, Giessen, Germany
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Gómez Ruiz M, Alfieri S, Becker T, Bergmann M, Boggi U, Collins J, Figueiredo N, Gögenur I, Matzel K, Miskovic D, Parvaiz A, Pratschke J, Rivera Castellano J, Qureshi T, Svendsen LB, Tekkis P, Vaz C. Expert consensus on a train-the-trainer curriculum for robotic colorectal surgery. Colorectal Dis 2019; 21:903-908. [PMID: 30963654 DOI: 10.1111/codi.14637] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/12/2019] [Indexed: 12/14/2022]
Abstract
AIM Robotic techniques are being increasingly used in colorectal surgery. There is, however, a lack of training opportunities and structured training programmes. Robotic surgery has specific problems and challenges for trainers and trainees. Ergonomics, specific skills and user-machine interfaces are different from those in traditional laparoscopic surgery. The aim of this study was to establish expert consensus on the requirements for a robotic train-the-trainer curriculum amongst robotic surgeons and trainers. METHOD This is a modified Delphi-type study involving 14 experts in robotic surgery teaching. A reiterating 19-item questionnaire was sent out to the same group and agreement levels analysed. A consensus of 0.8 or higher was considered to be high-level agreement. RESULTS Response rates were 93-100% and most items reached high levels of agreement within three rounds. Specific requirements for a robotic faculty development curriculum included maximizing dual-console teaching, theatre team training, nontechnical skills training, patient safety, user-machine interface training and telementoring. CONCLUSION A clear need for the development of a train-the-trainer curriculum has been identified. Further research is needed to assess feasibility, effectiveness and clinical impact of a robotic train-the-trainer curriculum.
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Affiliation(s)
- M Gómez Ruiz
- Unidad de Cirugía Colorrectal, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Marqués de Valdecilla - IDIVAL, Santander, Spain.,IDIVAL, Instituto de Investigación Sanitaria, Santander, Spain
| | - S Alfieri
- Gemelli Robotic Mentoring Center, Catholic University of Sacred Hearth - IRCS Gemelli Foundation, Rome, Italy
| | - T Becker
- General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - M Bergmann
- Department of Visceral Surgery, Surgical Research Laboratories, Vienna, Austria.,Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - U Boggi
- Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - J Collins
- Department of Urology, Karolinska Institutet, Solna, Sweden
| | - N Figueiredo
- Surgery Unit, Fundação Champalimaud, Lisbon, Portugal
| | - I Gögenur
- Department of Surgery, Center for Surgical Science, Zealand University Hospital, Roskilde, Denmark.,Institute for Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - K Matzel
- Leiter Sektion Koloproktologie, Chirurgische Universitätsklinik Erlangen, Erlangen, Germany
| | - D Miskovic
- St Mark's Hospital, Harrow, Middlesex, UK
| | - A Parvaiz
- Poole Hospital NHS Trust, Poole, UK.,School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,Fundação Champalimaud, Lisbon, Portugal
| | - J Pratschke
- Surgery, Charité - Universitätsmedizin Berlin Chirurgische Klinik, Berlin, Germany
| | - J Rivera Castellano
- Unidad de Cirugía Colorrectal, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Marqués de Valdecilla - IDIVAL, Santander, Spain.,IDIVAL, Instituto de Investigación Sanitaria, Santander, Spain
| | | | | | - P Tekkis
- Gastrointestinal Surgery, The Royal Marsden, Fulham Road, London, UK
| | - C Vaz
- Colorectal Cancer Unit, Robotic Surgery Unit, Hospital CUF Infante Santo, Lisbon, Portugal
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Saw J, Nielsen-Kudsk JE, Bergmann M, Daniels MJ, Tzikas A, Reisman M, Rana BS. Antithrombotic Therapy and Device-Related Thrombosis Following Endovascular Left Atrial Appendage Closure. JACC Cardiovasc Interv 2019; 12:1067-1076. [PMID: 31103535 DOI: 10.1016/j.jcin.2018.11.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [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: 09/14/2018] [Revised: 10/29/2018] [Accepted: 11/06/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aim of this study is to review the evidence on the use of antithrombotic therapy and risk of device-related thrombosis after left atrial appendage closure. BACKGROUND Left atrial appendage closure (LAAC) is increasingly performed for stroke prevention in patients with nonvalvular atrial fibrillation, especially those who cannot tolerate or are ineligible for oral anticoagulation. METHODS After device implantation for LAAC, different antithrombotic regimens with varying duration of therapy are currently used. Such selection depends on patients' risk for bleeding and physicians' choice. RESULTS Device-related thrombosis remains an Achilles' heel of LAAC, and the etiology remains incompletely understood. Dual-antiplatelet therapy, and direct oral anticoagulation may have similar safety and device-related thrombosis occurrence in real-world LAAC registries compared with warfarin and aspirin. Device imaging surveillance should be routinely performed to assess for device-related thrombosis, which if diagnosed should be treated aggressively, as it is associated with higher thromboembolic risks. CONCLUSIONS Given the uncertainties and therapeutic dilemma, the authors provide an in-depth discussion of the options and rationale for antithrombotic therapy post-LAAC.
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Affiliation(s)
- Jacqueline Saw
- Division of Cardiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
| | | | | | - Matthew J Daniels
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; BHF Centre of Research Excellence, University of Oxford, Oxford, United Kingdom; Department of Cardiology, Oxford University NHS Hospitals Trust, Oxford, United Kingdom; Department of Biotechnology, Graduate School of Engineering, Osaka University, Suita, Osaka, Japan
| | - Apostolos Tzikas
- AHEPA University Hospital, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Mark Reisman
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington
| | - Bushra S Rana
- Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
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Hilbold E, Bergmann M, Fietz D, Kliesch S, Weidner W, Langeheine M, Rode K, Brehm R. Immunolocalization of DMRTB1 in human testis with normal and impaired spermatogenesis. Andrology 2019; 7:428-440. [PMID: 30920770 DOI: 10.1111/andr.12617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The transcription factor DMRTB1 plays a pivotal role in coordinating the transition between mitosis and meiosis in murine germ cells. No reliable data are available for human testis. OBJECTIVES The present study aims to examine the testicular expression pattern of DMRTB1 in men showing normal and impaired spermatogenesis. MATERIALS AND METHODS Immunohistochemistry was performed using 54 human testicular biopsy specimens and a commercial rabbit polyclonal anti-DMRTB1 primary antibody. RT-PCR complemented immunohistochemistry. To further characterize immunopositive cells and possible co-localization, the proliferation marker Ki-67, the tumor marker PLAP, and an anti-DMRT1 antibody were used. RESULTS In men with normal spermatogenesis, a strong immunoreactivity was detectable in a subset of spermatogonia (38.34 ± 2.14%). Some spermatocytes showed a weak immunostaining. Adjacent Sertoli cells were immunonegative. Compared with a hematoxylin and eosin overview staining, these immunopositive cells were almost exclusively identified as Apale and B spermatogonia and primary spermatocytes in (pre-)leptotene, zygotene, and pachytene stages. In patients with spermatogenic arrest at spermatogonial level, an altered staining pattern was found. No immunoreactivity was detected in Sertoli cells in Sertoli cell-only syndrome. In germ cell neoplasia in situ (GCNIS) tubules, except for a few (0.4 ± 0.03%), pre-invasive tumor cells were immunonegative. Seminoma cells showed no immunostaining. DISCUSSION According to previous findings in mice, it seems reasonable that DMRTB1 is expressed in these normal germ cell populations. Moreover, altered staining pattern in spermatogenic arrest at spermatogonial stage suggests a correlation with mitosis and transformation into B spermatogonia. The absence of DMRTB1 in GCNIS cells and tumor cells might be associated with uncontrolled neoplastic cell proliferation and progression into invasive germ cell tumors. Further research is required to elucidate, for example, the role of DMRTB1 in the malignant transformation of human germ cells. CONCLUSION Our data indicate a relevant role for DMRTB1 regarding the entry of spermatogonia into meiosis in men.
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Affiliation(s)
- E Hilbold
- Institute for Anatomy, University of Veterinary Medicine Hannover, Hannover, Germany
| | - M Bergmann
- Institute for Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Giessen, Germany
| | - D Fietz
- Institute for Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Giessen, Germany
| | - S Kliesch
- Department of Clinical and Surgical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany
| | - W Weidner
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - M Langeheine
- Institute for Anatomy, University of Veterinary Medicine Hannover, Hannover, Germany
| | - K Rode
- Institute for Anatomy, University of Veterinary Medicine Hannover, Hannover, Germany
| | - R Brehm
- Institute for Anatomy, University of Veterinary Medicine Hannover, Hannover, Germany
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Strasser K, Walterskirchen N, Sachet M, Birnleitner H, Beer A, Pils D, Gerner M, Schmetterer K, Bachleitner-Hofmann T, Stift A, Bergmann M, Oehler R. Differences in macrophage colonization of the colorectal cancer and normal mucosa. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Stary V, Unterleuthner D, Wolf B, Talic M, Strobl J, Beer A, Dolznig H, Bergmann M. Irradiated cancer exosomes promote M1-like polarization of macrophages and enhance their anti-tumoral responses. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kesselring T, Viquerat S, IJsseldijk L, Langeheine M, Wohlsein P, Gröne A, Bergmann M, Siebert U, Brehm R. Testicular morphology and spermatogenesis in harbour porpoises (Phocoena phocoena). Theriogenology 2019; 126:177-186. [DOI: 10.1016/j.theriogenology.2018.11.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 11/22/2018] [Accepted: 11/27/2018] [Indexed: 11/27/2022]
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35
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Laengle J, Kabiljo J, Homola J, Hunter L, Egger G, Bergmann M. Histone deacetylase inhibitors valproic acid and vorinostat enhance trastuzumab-mediated antibody-dependent cell-mediated phagocytosis. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Niemeyer J, Mentrup T, Heidasch R, Müller SA, Biswas U, Meyer R, Papadopoulou AA, Dederer V, Haug-Kröper M, Adamski V, Lüllmann-Rauch R, Bergmann M, Mayerhofer A, Saftig P, Wennemuth G, Jessberger R, Fluhrer R, Lichtenthaler SF, Lemberg MK, Schröder B. The intramembrane protease SPPL2c promotes male germ cell development by cleaving phospholamban. EMBO Rep 2019; 20:embr.201846449. [PMID: 30733280 DOI: 10.15252/embr.201846449] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 11/09/2022] Open
Abstract
Signal peptide peptidase (SPP) and the four homologous SPP-like (SPPL) proteases constitute a family of intramembrane aspartyl proteases with selectivity for type II-oriented transmembrane segments. Here, we analyse the physiological function of the orphan protease SPPL2c, previously considered to represent a non-expressed pseudogene. We demonstrate proteolytic activity of SPPL2c towards selected tail-anchored proteins. Despite shared ER localisation, SPPL2c and SPP exhibit distinct, though partially overlapping substrate spectra and inhibitory profiles, and are organised in different high molecular weight complexes. Interestingly, SPPL2c is specifically expressed in murine and human testis where it is primarily localised in spermatids. In mice, SPPL2c deficiency leads to a partial loss of elongated spermatids and reduced motility of mature spermatozoa, but preserved fertility. However, matings of male and female SPPL2c -/- mice exhibit reduced litter sizes. Using proteomics we identify the sarco/endoplasmic reticulum Ca2+-ATPase (SERCA2)-regulating protein phospholamban (PLN) as a physiological SPPL2c substrate. Accumulation of PLN correlates with a decrease in intracellular Ca2+ levels in elongated spermatids that likely contribute to the compromised male germ cell differentiation and function of SPPL2c -/- mice.
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Affiliation(s)
- Johannes Niemeyer
- Biochemical Institute, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Torben Mentrup
- Biochemical Institute, Christian-Albrechts-University of Kiel, Kiel, Germany.,Institute of Physiological Chemistry, Technische Universität Dresden, Dresden, Germany
| | - Ronny Heidasch
- Zentrum für Molekulare Biologie der Universität Heidelberg (ZMBH), DKFZ-ZMBH Allianz, Heidelberg, Germany
| | - Stephan A Müller
- DZNE - German Center for Neurodegenerative Diseases, Munich, Germany.,Neuroproteomics, School of Medicine, Klinikum rechts der Isar and Institute for Advanced Study, Technical University of Munich, Munich, Germany
| | - Uddipta Biswas
- Institute of Physiological Chemistry, Technische Universität Dresden, Dresden, Germany
| | - Rieke Meyer
- Biochemical Institute, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Alkmini A Papadopoulou
- Institute for Metabolic Biochemistry, Biomedical Center (BMC) München, Ludwig Maximilians University of Munich, Munich, Germany
| | - Verena Dederer
- Zentrum für Molekulare Biologie der Universität Heidelberg (ZMBH), DKFZ-ZMBH Allianz, Heidelberg, Germany
| | - Martina Haug-Kröper
- Institute for Metabolic Biochemistry, Biomedical Center (BMC) München, Ludwig Maximilians University of Munich, Munich, Germany
| | - Vivian Adamski
- Biochemical Institute, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Martin Bergmann
- Institute of Veterinary Anatomy, Justus Liebig University of Gießen, Gießen, Germany
| | - Artur Mayerhofer
- Cell Biology, Anatomy III, Biomedical Center (BMC) München, Ludwig Maximilians University of Munich, Munich, Germany
| | - Paul Saftig
- Biochemical Institute, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Gunther Wennemuth
- Institute of Anatomy, University Hospital, Duisburg-Essen University, Essen, Germany
| | - Rolf Jessberger
- Institute of Physiological Chemistry, Technische Universität Dresden, Dresden, Germany
| | - Regina Fluhrer
- DZNE - German Center for Neurodegenerative Diseases, Munich, Germany.,Institute for Metabolic Biochemistry, Biomedical Center (BMC) München, Ludwig Maximilians University of Munich, Munich, Germany
| | - Stefan F Lichtenthaler
- DZNE - German Center for Neurodegenerative Diseases, Munich, Germany.,Neuroproteomics, School of Medicine, Klinikum rechts der Isar and Institute for Advanced Study, Technical University of Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Marius K Lemberg
- Zentrum für Molekulare Biologie der Universität Heidelberg (ZMBH), DKFZ-ZMBH Allianz, Heidelberg, Germany
| | - Bernd Schröder
- Biochemical Institute, Christian-Albrechts-University of Kiel, Kiel, Germany .,Institute of Physiological Chemistry, Technische Universität Dresden, Dresden, Germany
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Eckert T, Goericke-Pesch S, Heydel C, Bergmann M, Kauffold J, Failing K, Wehrend A. Interaction of different Chlamydiae species with bovine spermatozoa. BMC Microbiol 2019; 19:23. [PMID: 30683062 PMCID: PMC6347757 DOI: 10.1186/s12866-019-1392-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 01/10/2019] [Indexed: 01/15/2023] Open
Abstract
Background Interaction of spermatozoa and Chlamydiae spp. might contribute to reduced fertility in cattle. To proof this hypothesis, bovine semen was incubated with viable or heat inactivated Chlamydia (C.) abortus or psittaci (Multiplicity of infection = 1) and sperm motility was monitored with a computer-assisted sperm analyzer over 24 h. Additionally, the interaction with the spermatozoa was further investigated by means of light and transmission electron microscopy (TEM). Results Only viable Chlamydiae of both species decreased sperm motility and this only after about 9 h. Taking binding rates into account, the loss of sperm motility after about 9 h could likely be a consequence of Chlamydiae attachment to the spermatozoa. About two thirds of the Chlamydiae elementary bodies were bound to the front third of the sperm, the acrosomal region. No inclusions of Chlamydiae in spermatozoa were observed in TEM after 2 h co-incubation. Conclusions As initial motility was not affected following co-incubation of viable Chlamydiae and bovine sperm, it seems likely that sperm could serve as a carrier/vehicle for Chlamydiae facilitating cervical passage of Chlamydiae spp. in cattle. Additionally, our results suggest that spermatozoa carrying Chlamydiae may have no initial disadvantage in reaching the oviduct, but are immotile at the time of ovulation what might have an impact on fertilization capacities of the individual sperm. Consequently, high concentrations of the investigated Chlamydiae in the seminal plasma or female genital tract might play a role in reduced fertility in cattle.
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Affiliation(s)
- Thomas Eckert
- Klinikum Veterinärmedizin, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals, Justus-Liebig University Giessen, Frankfurter Strasse 106, 35392, Giessen, Germany.,Institute for Veterinary-Physiology and Biochemistry, Justus-Liebig University Giessen, Frankfurter Strasse 100, 35392, Giessen, Germany
| | - Sandra Goericke-Pesch
- Klinikum Veterinärmedizin, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals, Justus-Liebig University Giessen, Frankfurter Strasse 106, 35392, Giessen, Germany. .,Department of Veterinary Clinical Sciences, Section for Veterinary Reproduction and Obstetrics, University of Copenhagen, Dyrlægevej 68, 1870, Frederiksberg C, Denmark. .,Reproductive Unit of the Clinics - Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 15, 30559, Hannover, Germany.
| | - Carsten Heydel
- Institute for Hygiene and Infectious Diseases of Animals, Justus-Liebig University Giessen, Frankfurter Strasse 85-89, 35392, Giessen, Germany
| | - Martin Bergmann
- Institute for Veterinary Anatomy, Histology and Embryology, Justus-Liebig University Giessen, Frankfurter Strasse 98, 35392, Giessen, Germany
| | - Johannes Kauffold
- Ambulatorische und Geburtshilfliche Tierklinik, Veterinärmedizinische Fakultät, University of Leipzig, An den Tierkliniken 29, 04103, Leipzig, Germany
| | - Klaus Failing
- Unit for Biomathematics and Data Processing, Justus-Liebig University Giessen, Frankfurter Str., 35392, Giessen, Germany
| | - Axel Wehrend
- Klinikum Veterinärmedizin, Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals, Justus-Liebig University Giessen, Frankfurter Strasse 106, 35392, Giessen, Germany
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Szarek M, Bergmann M, Konrad L, Schuppe HC, Kliesch S, Hedger MP, Loveland KL. Activin A target genes are differentially expressed between normal and neoplastic adult human testes: clues to gonocyte fate choice. Andrology 2018; 7:31-41. [PMID: 30315637 DOI: 10.1111/andr.12553] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human testicular germ cell tumours (TGCT) arise from germ cell neoplasia in situ (GCNIS) cells that originate from foetal germ cell precursors. Activin A is central to normal foetal testis development, and its dysregulation may contribute to TGCT aetiology. OBJECTIVE (i) To test whether the expression profiles of activin A targets in normal and neoplastic human testes indicates functional links with TGCT progression. (ii) To investigate whether activin A levels influence MMP activity in a neoplastic germ cell line. MATERIALS AND METHODS (1) Bouin's fixed, paraffin-embedded human testes were utilized for PCR-based transcript analysis and immunohistochemistry. Samples (n = 5 per group) contained the following: (i) normal spermatogenesis, (ii) GCNIS or (iii) seminoma. CXCL12, CCL17, MMP2 and MMP9 were investigated. (2) The human seminoma-derived TCam-2 cell line was exposed to activin A (24 h), and target transcripts were measured by qRT-PCR (n = 4). ELISA (n = 4) and gelatin zymography (n = 3) showed changes in protein level and enzyme activity, respectively. RESULTS (i) Cytoplasmic CXCL12 was detected in Sertoli and other somatic cells, including those surrounding seminoma cells. Anti-CCL17 labelled only the cytoplasm of Sertoli cells surrounding GCNIS, while anti-MMP2 and anti-MMP9 labelled germline and epithelial-like cells in normal and neoplastic testes. (ii) Exposing TCam-2 cells to activin A (50 ng/mL) elevated MMP2 and MMP9 transcripts (fourfold and 30-fold), while only MMP2 protein levels were significantly higher after activin A (5 ng/mL and 50 ng/mL) exposure. Importantly, gelatin zymography revealed activin A increased production of activated MMP2. DISCUSSION Detection of CCL17 only in GCNIS tumours may reflect a change in Sertoli cell phenotype to a less mature state. Stimulation of MMP2 activity by activin A in TCam-2 cells suggests activin influences TGCT by modulating the tumour niche. CONCLUSION This knowledge provides a basis for understanding how physiological changes that influence activin/TGF-β superfamily signalling may alter germ cell fate.
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Affiliation(s)
- M Szarek
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, Australia
| | - M Bergmann
- Institute of Veterinary Anatomy, Histology and Embryology, Justus-Liebig University Giessen, Giessen, Germany
| | - L Konrad
- Institute of Gynaecology and Obstetrics, Justus-Liebig University Giessen, Giessen, Germany
| | - H-C Schuppe
- Department of Urology, Paediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany
| | - S Kliesch
- Centre of Reproductive Medicine and Andrology, University Clinic, Muenster, Germany
| | - M P Hedger
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, Australia.,Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
| | - K L Loveland
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, Australia.,Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
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40
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Affiliation(s)
- Rod Balhorn
- Briar Patch Biosciences LLC, Livermore, CA, USA
| | - Klaus Steger
- Department of Urology, Pediatric Urology and Andrology, Section Molecular Andrology, Justus Liebig University, Giessen, Germany
| | - Martin Bergmann
- Department of Veterinary Anatomy, Histology and Embryology, Giessen, Germany
| | | | - Stefanie Neuhauser
- Pferdezentrum Bad Saarow, Veterinary Faculty of the University, Berlin, Germany
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Strasser K, Birnleitner H, Beer A, Sachet M, Bergmann M, Oehler R. PO-380 Regulatory T cells encounter pro-inflammatory immune cells in human colorectal cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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42
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Lambert B, Weynans L, Bergmann M. Local lubrication model for spherical particles within incompressible Navier-Stokes flows. Phys Rev E 2018; 97:033313. [PMID: 29776061 DOI: 10.1103/physreve.97.033313] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Indexed: 11/07/2022]
Abstract
The lubrication forces are short-range hydrodynamic interactions essential to describe suspension of the particles. Usually, they are underestimated in direct numerical simulations of particle-laden flows. In this paper, we propose a lubrication model for a coupled volume penalization method and discrete element method solver that estimates the unresolved hydrodynamic forces and torques in an incompressible Navier-Stokes flow. Corrections are made locally on the surface of the interacting particles without any assumption on the global particle shape. The numerical model has been validated against experimental data and performs as well as existing numerical models that are limited to spherical particles.
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Affiliation(s)
- B Lambert
- Memphis Team, INRIA, F-33400 Talence, France
| | - L Weynans
- Memphis Team, INRIA, F-33400 Talence, France
| | - M Bergmann
- Memphis Team, INRIA, F-33400 Talence, France
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43
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Bakhaus K, Bennien J, Fietz D, Sánchez-Guijo A, Hartmann M, Serafini R, Love CC, Golovko A, Wudy SA, Bergmann M, Geyer J. Sodium-dependent organic anion transporter (Slc10a6 -/-) knockout mice show normal spermatogenesis and reproduction, but elevated serum levels for cholesterol sulfate. J Steroid Biochem Mol Biol 2018; 179:45-54. [PMID: 28743544 DOI: 10.1016/j.jsbmb.2017.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/18/2017] [Indexed: 11/25/2022]
Abstract
The sodium-dependent organic anion transporter SOAT (gene name SLC10A6 in man and Slc10a6 in mice) is a plasma membrane transporter for sulfated steroids, which is highly expressed in germ cells of the testis. SOAT can transport biologically inactive sulfated steroids into specific target cells, where they can be reactivated by the steroid sulfatase (STS) to biologically active, unconjugated steroids known to regulate spermatogenesis. Significantly reduced SOAT mRNA expression was previously found in different forms of impaired spermatogenesis in man. It was supposed that SOAT plays a role for the local supply of steroids in the testis and consequently for spermatogenesis and fertility. Thus, an Slc10a6-/- Soat knockout mouse model was established by recombination-based target deletion of the Slc10a6 gene to elucidate the role of Soat in reproduction. However, the Slc10a6-/- knockout mice were fertile, produced normal litter sizes, and had normal spermatogenesis and sperm vitality. This phenotype suggests that the loss of Soat can be compensated in the knockout mice or that Soat function is not essential for reproduction. In addition to reproductive phenotyping, a comprehensive targeted steroid analysis including a set of 9 un-conjugated and 12 sulfo-conjugated steroids was performed in serum of Slc10a6-/- knockout and Slc10a6+/+ wildtype mice. Only cholesterol sulfate, corticosterone, and testosterone (only in the males) could be detected in considerable amounts. Interestingly, male Slc10a6-/- knockout mice showed significantly higher serum levels for cholesterol sulfate compared to their wildtype controls. As cholesterol sulfate has a broader impact apart from the testis, further analysis of this phenotype will include other organs such as skin and lung, which also show high Soat expression in the mouse.
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Affiliation(s)
- Katharina Bakhaus
- Institute of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Germany
| | - Josefine Bennien
- Institute of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Germany
| | - Daniela Fietz
- Department of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Germany
| | - Alberto Sánchez-Guijo
- Steroid Research and Mass Spectrometry Unit, Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany
| | - Michaela Hartmann
- Steroid Research and Mass Spectrometry Unit, Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany
| | - Rosanna Serafini
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TX, USA
| | - Charles C Love
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TX, USA
| | | | - Stefan A Wudy
- Steroid Research and Mass Spectrometry Unit, Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany
| | - Martin Bergmann
- Department of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Germany
| | - Joachim Geyer
- Institute of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Germany.
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Bakhaus K, Fietz D, Kliesch S, Weidner W, Bergmann M, Geyer J. The polymorphism L204F affects transport and membrane expression of the sodium-dependent organic anion transporter SOAT (SLC10A6). J Steroid Biochem Mol Biol 2018; 179:36-44. [PMID: 28951225 DOI: 10.1016/j.jsbmb.2017.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/13/2017] [Revised: 08/29/2017] [Accepted: 09/21/2017] [Indexed: 01/05/2023]
Abstract
Sodium-dependent organic anion transporter (SOAT) represents a membrane transporter specific for sulfated steroid hormones, which are supposed to participate in the regulation of reproductive processes. In man, SOAT shows predominant mRNA expression in the testis and here was localized to primary spermatocytes. SOAT mRNA expression is significantly downregulated in different disorders of spermatogenesis, including hypospermatogenesis. The resulting decline of SOAT-mediated transport of sulfated steroids may participate in the impairment of functional spermatogenesis. Apart from downregulation of SOAT mRNA expression, genetic polymorphisms affecting the transport function of SOAT may have the same negative effect on spermatogenesis. Therefore, in the present study we searched for functionally relevant SOAT polymorphisms, aiming to comparatively analyze their occurrence in patients with impaired spermatogenesis vs. patients with intact spermatogenesis. We found that the SOAT polymorphism L204F showed a significantly reduced transport function for DHEAS when expressed in HEK293 cells. Although the Km value was identical with that of the SOAT wildtype, the Vmax value dramatically declined for the SOAT-L204F variant (942.5 vs. 313.6pmol×mg protein-1×min-1). Although the same amount of total SOAT-L204F protein was detected in transfected HEK293 cells compared to the SOAT wildtype, plasma membrane expression was significantly reduced, which points to a plasma membrane sorting defect of the SOAT-L204F variant. Groups of 20 subjects with normal spermatogenesis and 26 subjects with hypospermatogenesis were genotyped for this polymorphism. Both groups showed nearly identical distributions of the SOAT-L204F polymorphism (∼10% heterozygous and ∼5% homozygous), indicating that this polymorphism seems not be causative for hypospermatogenesis.
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Affiliation(s)
- Katharina Bakhaus
- Institute of Pharmacology and Toxicology, Justus Liebig University Giessen, Germany
| | - Daniela Fietz
- Department of Veterinary Anatomy, Histology and Embryology, Justus Liebig University Giessen, Germany
| | - Sabine Kliesch
- Department of Clinical Andrology, Centre for Reproductive Medicine and Andrology, University Hospital Münster, Germany
| | - Wolfgang Weidner
- Clinic for Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Germany
| | - Martin Bergmann
- Department of Veterinary Anatomy, Histology and Embryology, Justus Liebig University Giessen, Germany
| | - Joachim Geyer
- Institute of Pharmacology and Toxicology, Justus Liebig University Giessen, Germany.
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45
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Affiliation(s)
- Joachim Geyer
- Institute of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Germany.
| | - Martin Bergmann
- Department of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Germany
| | - Stefan A Wudy
- Steroid Research and Mass Spectrometry Unit, Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany
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46
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Abstract
Therapy with recombinant human erythropoietin (rEPO) can correct anemia in RDT patients. However, iron deficiency can develop making treatment unsuccessful. Eighteen non-transfused RDT patients with hematocrit <26% were treated with rEPO to raise the HCT to 30–35%; then the dose was individually adjusted to maintain the HCT. The mean HCT rose from 22.3% to 31.5%. Ten patients received iron substitution before rEPO. During rEPO therapy five further patients had to be supplemented with iron; all patients needed an increase in the oral iron doses and three required i.v. iron. During the correction phase mean serum ferritin dropped from 203 μg/l to a minimum of 71 μg/l and was 102 μg/l after six months. Serum iron and TIBC changed only moderately. It thus appears that iron demand rises markedly during rEPO therapy, requiring iron substitution in most patients. Serum ferritin is the most sensitive parameter for development of iron deficiency.
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Affiliation(s)
- M. Bergmann
- Division of Nephrology, Department of Internal Medicine; J.W.-Goethe-University, Frankfurt - F.R.G
| | - P. Grützmacher
- Division of Nephrology, Department of Internal Medicine; J.W.-Goethe-University, Frankfurt - F.R.G
| | - J. Heuser
- Division of Nephrology, Department of Internal Medicine; J.W.-Goethe-University, Frankfurt - F.R.G
| | - J.P. Kaltwasser
- Division of and Hematology, Department of Internal Medicine; J.W.-Goethe-University, Frankfurt - F.R.G
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47
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Aslani F, Sebastian T, Keidel M, Fröhlich S, Elsässer HP, Schuppe HC, Klug J, Mahavadi P, Fijak M, Bergmann M, Meinhardt A, Bhushan S. Resistance to apoptosis and autophagy leads to enhanced survival in Sertoli cells. Mol Hum Reprod 2018; 23:370-380. [PMID: 28379541 DOI: 10.1093/molehr/gax022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 03/31/2017] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION What is the underlying mechanism of Sertoli cell (SC) resistance to cell death? SUMMARY ANSWER High expression of prosurvival B-cell lymphoma-2 (BCL2) proteins and inhibition of apoptosis and autophagy prolongs SC survival upon exposure to stress stimuli. WHAT IS KNOWN ALREADY In human and in experimental models of orchitis, tolerogenic SC survive stress conditions, while germ cells undergo massive apoptosis. In general, non-dividing highly differentiated cells tend to resist stress conditions for a longer time by favoring activation of prosurvival mechanisms and inhibition of cell death pathways. STUDY DESIGN, SIZE, DURATION In this cross sectional study, conditions stimulating apoptosis and autophagy were used to induce cell death in primary rat SC. Primary rat peritubular cells (PTC) and immortalized rat 93RS2 SC were used as controls. Each cell isolation was counted as one experiment (n = 1), and each experiment was repeated three to six times. PARTICIPANTS/MATERIALS, SETTING, METHODS Testis biopsy samples from infertile or subfertile patients and testis samples from rats with experimental autoimmune orchitis were used for immunohistological analysis. Primary SC were isolated from 19-day-old male Wistar rats. To maintain cell purity, cells were cultured in serum-free medium for apoptosis experiments and in medium supplemented with 1% serum for autophagy analyses. To induce apoptosis, cells were stimulated with staurosporine, borrelidin, cisplatin and etoposide for 4 or 24 h. Caspase three activation was examined by immunoblotting and enzymatic activity assay. Mitochondrial membrane potential was measured using tetramethylrhodamine methyl ester followed by flow cytometric analysis. Cytochrome c release was monitored by immunofluorescence. Cell viability was determined using the methylthiazole tetrazolium assay. To monitor autophagy flux, cells were deprived of nutrients using Hank's balanced salt solution for 1, 2 and 3 h. Formation of autophagosomes was analyzed by using immunoblotting, immunofluorescence labeling and ultrastructural analyses. Relative mRNA levels of genes involved in the regulation of apoptosis and autophagy were evaluated. Extracellular high mobility group box protein one was measured as a marker of necrosis using ELISA. MAIN RESULTS AND THE ROLE OF CHANCE SC survive the inflammatory conditions in vivo in human testis and in experimental autoimmune orchitis. Treatment with apoptosis inducing chemotherapeutics did not cause caspase three activation in isolated rat SC. Moreover, mitochondrial membrane potential and mitochondrial localization of cytochrome c were not changed by treatment with staurosporine, suggesting a premitochondrial blockade of apoptosis in SC. Expression levels of prosurvival BCL2 family members were significantly higher in SC compared to PTC at both mRNA and protein levels. Furthermore, after nutrient starvation, autophagy signaling was initiated in SC as observed by decreased levels of phosphorylated UNC- 51-like kinase -1 (ULK1). However, levels of light chain 3 II (LC3 II) and sequestosome1 (SQSTM1) remained unchanged, indicating blockade of the autophagy flux. Lysosomal activity was intact in SC as shown by accumulation of LC3 II following administration of lysosomal protease inhibitors, indicating that inhibition of autophagy flux occurs at a preceding stage. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION In this study, we have used primary SC from prepubertal rats. Caution should be taken when translating our results to adult animals, where crosstalk with other testicular cells and hormonal factors may also play a role in regulating survival of SC. WIDER IMPLICATIONS OF THE FINDINGS Our results suggest that inhibition of autophagy and apoptosis following exposure to extrinsic stress stimuli promotes SC survival, and is a possible mechanism to explain the robustness of SC in response to stress. Cell death resistance in SC is crucial for the recovery of spermatogenesis after chemotherapy treatment in cancer patients. Additionally, understanding the molecular mechanisms of SC survival unravels valuable target proteins, such as BCL2, that may be manipulated therapeutically to control cell viability depending on the context of the disease. STUDY FUNDING AND COMPETING INTEREST(S) This study was funded by the Deutsche Forschungsgemeinschaft (DFG) Grant BH93/1-1, and by the International Research Training Group between Justus Liebig University of Giessen and Monash University, Melbourne (GRK 1871/1) funded by the DFG and Monash University. The support of the Medical Faculty of Justus-Liebig University of Giessen is gratefully acknowledged. The authors declare no conflict of interest.
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Affiliation(s)
- Ferial Aslani
- Department of Anatomy and Cell Biology, Justus-Liebig University, Aulweg 123, Giessen 35392, Germany
| | - Tim Sebastian
- Department of Anatomy and Cell Biology, Justus-Liebig University, Aulweg 123, Giessen 35392, Germany
| | - Miguel Keidel
- Department of Anatomy and Cell Biology, Justus-Liebig University, Aulweg 123, Giessen 35392, Germany
| | - Suada Fröhlich
- Department of Anatomy and Cell Biology, Justus-Liebig University, Aulweg 123, Giessen 35392, Germany
| | - Hans-Peter Elsässer
- Department of Cell Biology and Cytopathology, Philipps University of Marburg, Germany
| | - Hans-Christian Schuppe
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig University, Giessen, Germany
| | - Jörg Klug
- Department of Anatomy and Cell Biology, Justus-Liebig University, Aulweg 123, Giessen 35392, Germany
| | - Poornima Mahavadi
- Department of Internal Medicine, Justus-Liebig University, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Monika Fijak
- Department of Anatomy and Cell Biology, Justus-Liebig University, Aulweg 123, Giessen 35392, Germany
| | - Martin Bergmann
- Institute of Veterinary Anatomy, Histology, and Embryology, Justus-Liebig-University, Giessen, Germany
| | - Andreas Meinhardt
- Department of Anatomy and Cell Biology, Justus-Liebig University, Aulweg 123, Giessen 35392, Germany
| | - Sudhanshu Bhushan
- Department of Anatomy and Cell Biology, Justus-Liebig University, Aulweg 123, Giessen 35392, Germany
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Lu Y, Rafiq A, Zhang Z, Aslani F, Fijak M, Lei T, Wang M, Kumar S, Klug J, Bergmann M, Chakraborty T, Meinhardt A, Bhushan S. Uropathogenic Escherichia coli virulence factor hemolysin A causes programmed cell necrosis by altering mitochondrial dynamics. FASEB J 2018; 32:4107-4120. [PMID: 29490169 DOI: 10.1096/fj.201700768r] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Uropathogenic Escherichia coli (UPEC) is the most common cause of urinary tract infections. In this study, UPEC strains harboring hemolysin A (HlyA) did not induce programmed cell death pathways by the activation of caspases. Instead, the UPEC pore-forming toxin HlyA triggered an increase in mitochondrial Ca2+ levels and manipulated mitochondrial dynamics by causing fragmentation of the mitochondrial network. Alterations in mitochondrial dynamics resulted in severe impairment of mitochondrial functions by loss of membrane potential, increase in reactive oxygen species production, and ATP depletion. Moreover, HlyA caused disruption of plasma membrane integrity that was accompanied by extracellular release of the danger-associated molecules high-mobility group box 1 (HMGB1) and histone 3 (H3). Our results indicate that UPEC induced programmed cell necrosis by irreversibly impairing mitochondrial function. This finding suggests a strategy devised by UPEC at the onset of infection to escape early innate immune response and silently propagate inside host cells.-Lu, Y., Rafiq, A., Zhang, Z., Aslani, F., Fijak, M., Lei, T., Wang, M., Kumar, S., Klug, J., Bergmann, M., Chakraborty, T., Meinhardt, A., Bhushan, S. Uropathogenic Escherichia coli virulence factor hemolysin A causes programmed cell necrosis by altering mitochondrial dynamics.
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Affiliation(s)
- Yongning Lu
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Amir Rafiq
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Zhengguo Zhang
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Ferial Aslani
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Monika Fijak
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Tao Lei
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Ming Wang
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Sanjeev Kumar
- Department of Medical Microbiology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Jörg Klug
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Martin Bergmann
- Institute of Veterinary Anatomy, Histology, and Embryology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Trinad Chakraborty
- Department of Medical Microbiology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Andreas Meinhardt
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Sudhanshu Bhushan
- Department of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
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Brütting J, Bergmann M, Weber C, Berking C, Tilgen W, Schadendorf D, Meier F. [Information services for melanoma patients and awareness among those affected]. Hautarzt 2018; 69:335-339. [PMID: 29396641 DOI: 10.1007/s00105-018-4130-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Besides medical consultations, various sources of information and support are available for melanoma patients (MP) in Germany from commercial and non-commercial providers; however, little is known about how they are perceived and accepted by MPs. MATERIAL AND METHODS Between July and October 2016 a total of 529 melanoma patients were surveyed at 27 accredited German skin cancer centers by means of a standardized questionnaire. Their awareness and satisfaction with 12 given sources of information and counseling services (print, online and by telephone) were surveyed. The sources were recommended by renowned providers from the field of (dermatological) oncology for use by MPs. RESULTS The MPs reported that the booklets called The blue advisor - skin cancer (Die Blauen Ratgeber - Hautkrebs, 43%) and Patient guidelines melanoma (Patientenleitlinie Melanom 24%) and the online domain www.hautkrebs-screening.de (23%) were the best known sources. These also met the information needs of the majority of users (65-80%). Booklets from commercial providers (between 8-16% known) were satisfactory for 42-56% of users. At 14% and 11%, respectively, the cancer counseling services (Krebsinformationsdienst) and INFONETZ Krebs as mainly telephone advisory offers were less well known. Few MPs were familiar with the skin cancer or melanoma booklets of the Austrian Cancer Aid and the Swiss Cancer League (2% each). CONCLUSION The increased awareness and acceptance of booklets as well as information from principally non-commercial providers suggest that they are more often mediated to MPs and more frequently used and accepted by those affected.
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Affiliation(s)
- J Brütting
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Fetscherstr.74, 01307, Dresden, Deutschland.
| | - M Bergmann
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Fetscherstr.74, 01307, Dresden, Deutschland
| | - C Weber
- Arbeitsgemeinschaft Dermatologische Onkologie (ADO), Saarbrücken, Deutschland
| | - C Berking
- Klinik für Dermatologie und Allergologie, Klinikum der Universität München, München, Deutschland
| | - W Tilgen
- Nationale Versorgungskonferenz Hautkrebs (NVKH), Neckargemünd, Deutschland
| | - D Schadendorf
- Klinik für Dermatologie, Universitätsklinikum Essen, Essen, Deutschland
| | - F Meier
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Fetscherstr.74, 01307, Dresden, Deutschland
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Bergmann M, Sauter-Louis C, Hirschberger J. Lebensqualität und Lebenserwartung am malignen Lymphom erkrankter Hunde unter Chemotherapie. Tierarztl Prax Ausg K 2018. [DOI: 10.1055/s-0038-1623583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Zusammenfassung
Gegenstand und Ziel: Der Erfolg palliativer Chemotherapien bei Hunden mit malignem Lymphom wurde insbesondere in Bezug auf die Lebensqualität der Tiere evaluiert. Zudem wurden Faktoren erfasst, die für die Besitzer bei der Einschätzung der Lebensqualität ihrer Tiere sowie für ihre Gesamtbewertung der Therapie eine entscheidende Rolle spielten. Material und Methoden: Die retrospektive Befragung mittels eines Fragebogens bezüglich Krankheitsverlauf und Therapie ihrer Tiere richtete sich an 207 Hundebesitzer, deren Hunde in den letzten 13 Jahren zur Chemotherapie in der Medizinischen Kleintierklinik der LudwigMaximilians-Universität München vorgestellt worden waren. Ergebnisse: 123 Besitzer (59,4%) beantworteten den Fragebogen. Bei 64 Hunden (53,3%) ließ sich aus Sicht der Besitzer mit der Chemotherapie eine Verbesserung der Lebensqualität erreichen. Nur bei 24 Hunden (20,0%) kam es zu einer Verschlechterung der Lebensqualität, die in direktem Zusammenhang mit dem Remissionsstatus und Nebenwirkungen der Chemotherapie stand. Die Remissionsrate der Hunde lag bei 83,7%. Schlussfolgerung: Der Großteil der Besitzer (65,0%) war zufrieden mit der Chemotherapie. 90 Besitzer (73,2%) würden sich erneut für eine solche Behandlung entscheiden, wobei insbesondere die Lebensverlängerung ein wichtiges Entscheidungskriterium darstellte. Klinische Relevanz: Bei Tumorpatienten, die eine palliative Chemotherapie erhalten, muss die Lebensqualität konstant überwacht werden. Nur so kann sie bei der Auswahl geeigneter Chemotherapie-Protokolle helfen und zusätzlich Besitzer und Tierarzt die Entscheidung für den weiteren Verlauf der Therapie erleichtern.
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