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Legenbauer T, Kirschbaum-Lesch I, Jörke C, Kölch M, Reis O, Berger C, Dück A, Schulte-Markwort M, Becker-Hebly I, Bienioschek S, Schroth J, Ruckes C, Deuster O, Holtmann M. Bright Light Therapy as Add-On to Inpatient Treatment in Youth With Moderate to Severe Depression: A Randomized Clinical Trial. JAMA Psychiatry 2024:2816353. [PMID: 38477894 PMCID: PMC10938243 DOI: 10.1001/jamapsychiatry.2024.0103] [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] [Received: 10/08/2023] [Accepted: 01/18/2024] [Indexed: 03/14/2024]
Abstract
Importance Major depressive disorder is one of the most common mental disorders among adolescents, entailing severe, long-term psychosocial impairment and a high risk of chronicity. In view of the large number of patients requiring treatment, along with insufficient treatment responses with small effect sizes, innovative adjunctive treatment strategies are urgently needed. Objective To investigate whether the effect of adolescent psychiatric inpatient treatment as usual for major depressive disorder can be enhanced by simultaneous use of morning bright light therapy. Design, Setting, and Participants This was a double-blind, placebo-controlled randomized parallel-group trial with enrollment between March 2018 and November 2020 and follow-up completed in May 2021. The study took place among inpatients at 4 university hospitals for child and adolescent psychiatry across Germany. Of 248 eligible youth aged 12 to 18 years fulfilling ICD-10 criteria for major depressive disorder, 227 were randomized to bright light therapy (n = 116) or placebo red light (n = 111); 151 participants completed the study. Interventions Up to 20 sessions of either morning bright light therapy with an intensity of 10 000 lux or placebo red light (100 lux) in addition to multimodal inpatient treatment as usual over 4 weeks. Main Outcomes and Measures The primary outcome was the change in Beck Depression Inventory-II (BDI-II) score from baseline to posttreatment in the intention-to-treat sample. Results Among the 224 patients included in the intention-to-treat analyses (192 girls and 32 boys; mean [SD] age, 15.5 [1.4] years), the mean (SD) BDI-II score at baseline was 37.3 (8.7). BDI-II scores were significantly reduced after 4 weeks (postassessment) by a mean of -7.5 (95% CI, -9.0 to -6.0; Hedges g = 0.71). Bright light therapy had no impact on this change (no significant group × time effect). Loss to follow-up was 31% (n = 69) at 16 weeks and 49% (n = 110) at 28 weeks. There were 10 serious adverse events throughout the whole trial, which were not considered related to study treatment. Conclusions and Relevance The findings in this study did not indicate superiority of bright light therapy over placebo red light therapy in a large sample of adolescent inpatients with moderate or severe major depressive disorder. Both groups benefited equally from treatment as usual, showing relevant symptom reduction. Trial Registration German Clinical Trials Register: DRKS00013188.
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Affiliation(s)
- Tanja Legenbauer
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Inken Kirschbaum-Lesch
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Carina Jörke
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Michael Kölch
- Department of Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Neuruppin, Germany
- Department of Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | - Olaf Reis
- Department of Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | - Christoph Berger
- Department of Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | - Alexander Dück
- Department of Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | | | - Inga Becker-Hebly
- Department of Child and Adolescent Psychiatry, Hamburg University, Hamburg, Germany
| | - Stefanie Bienioschek
- Department of Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Neuruppin, Germany
| | - Jennifer Schroth
- Department of Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Neuruppin, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Trials, University Medical Center, Mainz, Germany
| | - Oliver Deuster
- Interdisciplinary Centre for Clinical Trials, University Medical Center, Mainz, Germany
| | - Martin Holtmann
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
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Abel B, Bongartz M, Rapp K, Roigk P, Peiter J, Metz B, Finger B, Büchele G, Wensing M, Roth C, Schmidberger O, König HH, Gottschalk S, Dams J, Deuster O, Immel D, Micol W, Bauer JM, Benzinger P. Multimodal home-based rehabilitation intervention after discharge from inpatient geriatric rehabilitation (GeRas): study protocol for a multicenter randomized controlled trial. BMC Geriatr 2024; 24:69. [PMID: 38233746 PMCID: PMC10795216 DOI: 10.1186/s12877-023-04634-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Geriatric rehabilitation aims to maintain the functional reserves of older adults in order to optimize social participation and prevent disability. After discharge from inpatient geriatric rehabilitation, patients are at high risk for decreased physical capacity, increased vulnerability, and limitations in mobility. As a result, ageing in place becomes uncertain for a plethora of patients after discharge from geriatric rehabilitation and effective strategies to prevent physical decline are required. Collaboration between different health-care providers is essential to improve continuity of care after discharge from inpatient geriatric rehabilitation. The aim of this study is to evaluate the effectiveness of a multi-professional home-based intervention program (GeRas) to improve functional capacity and social participation in older persons after discharge from inpatient geriatric rehabilitation. METHODS The study is a multicenter, three-arm, randomized controlled trial with a three-month intervention period. Two hundred and seventy community-dwelling older people receiving inpatient geriatric rehabilitation will be randomized with a 1:1:1 ratio to one of the parallel intervention groups (conventional IG or tablet IG) or the control group (CG). The participants of both IGs will receive a home-based physical exercise program supervised by physical therapists, a nutritional recommendation by a physician, and social counseling by social workers of the health insurance company. The collaboration between the health-care providers and management of participants will be realized within a cloud environment based on a telemedicine platform and supported by multi-professional case conferences. The CG will receive usual care, two short handouts on general health-related topics, and facultative lifestyle counseling with general recommendations for a healthy diet and active ageing. The primary outcomes will be the physical capacity measured by the Short Physical Performance Battery and social participation assessed by the modified Reintegration to Normal Living Index, three months after discharge. DISCUSSION The GeRas program is designed to improve the collaboration between health-care providers in the transition from inpatient geriatric rehabilitation to outpatient settings. Compared to usual care, it is expected to improve physical capacity and participation in geriatric patients after discharge from inpatient geriatric rehabilitation. TRIAL REGISTRATION German Clinical Trials Register (DRKS00029559). Registered on October 05, 2022.
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Grants
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- 01NVF20017 German Innovation Fund ('New Forms of Care') coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- German Innovation Fund (‘New Forms of Care’) coordinated by the Innovation Committee of the Federal Joint Committee, Berlin, Germany
- Universitätsklinikum Heidelberg (8914)
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Affiliation(s)
- Bastian Abel
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Martin Bongartz
- Center for Geriatric Medicine, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Kilian Rapp
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Patrick Roigk
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Janine Peiter
- Geriatric Center Karlsruhe, ViDia Christian Clinics Karlsruhe, Karlsruhe, Germany
| | - Brigitte Metz
- Geriatric Center Karlsruhe, ViDia Christian Clinics Karlsruhe, Karlsruhe, Germany
| | - Benjamin Finger
- Department of Telemedicine, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Gisela Büchele
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Catharina Roth
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Oliver Schmidberger
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophie Gottschalk
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Judith Dams
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Deuster
- Interdisciplinary Center for Clinical Trials (IZKS) at the University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Désirée Immel
- AOK Baden-Württemberg, Statutory Health Insurance Company, Stuttgart, Germany
| | - William Micol
- Center for Geriatric Medicine, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen M Bauer
- Center for Geriatric Medicine, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Petra Benzinger
- Center for Geriatric Medicine, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany.
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Hess G, Hüttmann A, Witzens-Harig M, Dreyling MH, Keller U, Marks R, Ernst T, Pott C, Viardot A, Frontzek F, Trautmann M, Ruckes C, Deuster O, Rosenwald A, Theobald M, Lenz G. A phase II trial to evaluate the combination of pixantrone and obinutuzumab for patients with relapsed aggressive lymphoma: Final results of the prospective, multicentre GOAL trial. Br J Haematol 2022; 198:482-491. [PMID: 35362552 DOI: 10.1111/bjh.18161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/08/2022] [Accepted: 03/13/2022] [Indexed: 12/14/2022]
Abstract
The prognosis of patients with relapsed diffuse large B-cell lymphoma (DLBCL) remains poor with current options. Here we prospectively evaluated the combination of pixantrone with obinutuzumab for up to six cycles for patients with relapsed or refractory DLBCL. Overall response rate (ORR) was the primary end-point. Sixty-eight patients were evaluated, median age was 75 years, median number of prior lines was three (range 1-10), 52 patients (76.5%) were diagnosed with DLBCL and 16 (23.5%) patients had transformed indolent lymphoma or follicular lymphoma (FL) IIIB. ORR was 35.3% for all and 40% for evaluable patients (16.6% complete response), median progression-free survival (PFS) and overall survival (OS) were 2.8 months and 8 months, respectively. Analysis of the cell of origin revealed a superior course for patients with non-GCB (germinal centre B-cell-like) phenotype [median OS not reached (n.r.) vs 5.2 months]. Patients with one prior line had an improved outcome over patients treated in later lines (PFS n.r. vs 2.5 months). Disease progression was the main reason for premature termination. Adverse events were mainly haematologic. The combination treatment revealed no unexpected adverse events. Most relevant non-haematologic toxicity was infection in 28% of patients. In summary, pixantrone-obinutuzumab showed clinical activity with sometimes long-term remission; however, the trial failed to meet its primary end-point.
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Affiliation(s)
- Georg Hess
- Department of Internal Medicine III, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Andreas Hüttmann
- Department of Hematology, University Hospital Essen, West German Cancer Center, University of Duisburg-Essen, Essen, Germany
| | - Mathias Witzens-Harig
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Martin H Dreyling
- Department of Internal Medicine III, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Ulrich Keller
- Internal Medicine III, Technical University of Munich, Munich, Germany
| | - Reinhard Marks
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - Thomas Ernst
- Department of Internal Medicine II, Jena University Hospital, Jena, Germany
| | - Christiane Pott
- Department of Internal Medicine II, University of Schleswig-Holstein, Kiel, Germany
| | - Andreas Viardot
- Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany
| | - Fabian Frontzek
- Department of Medicine A, University Hospital Münster, Münster, Germany
| | - Marcel Trautmann
- Division of Translational Pathology, Gerhard Domagk Institute of Pathology, Münster University Hospital, Münster, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Oliver Deuster
- Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | | | - Matthias Theobald
- Department of Internal Medicine III, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Georg Lenz
- Department of Medicine A, University Hospital Münster, Münster, Germany
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4
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Wölfling K, Müller KW, Dreier M, Ruckes C, Deuster O, Batra A, Mann K, Musalek M, Schuster A, Lemenager T, Hanke S, Beutel ME. Efficacy of Short-term Treatment of Internet and Computer Game Addiction: A Randomized Clinical Trial. JAMA Psychiatry 2019; 76:1018-1025. [PMID: 31290948 PMCID: PMC6624826 DOI: 10.1001/jamapsychiatry.2019.1676] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [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: 01/21/2023]
Abstract
IMPORTANCE Internet and computer game addiction represent a growing mental health concern, acknowledged by the World Health Organization. OBJECTIVE To determine whether manualized cognitive behavioral therapy (CBT), using short-term treatment for internet and computer game addiction (STICA), is efficient in individuals experiencing internet and computer game addiction. DESIGN, SETTING, AND PARTICIPANTS A multicenter randomized clinical trial was conducted in 4 outpatient clinics in Germany and Austria from January 24, 2012, to June 14, 2017, including follow-ups. Blinded measurements were conducted. A consecutive sample of 143 men was randomized to the treatment group (STICA; n = 72) or wait-list control (WLC) group (n = 71). Main inclusion criteria were male sex and internet addiction as the primary diagnosis. The STICA group had an additional 6-month follow-up (n = 36). Data were analyzed from November 2018 to March 2019. INTERVENTIONS The manualized CBT program aimed to recover functional internet use. The program consisted of 15 weekly group and up to 8 two-week individual sessions. MAIN OUTCOMES AND MEASURES The predefined primary outcome was the Assessment of Internet and Computer Game Addiction Self-report (AICA-S). Secondary outcomes were self-reported internet addiction symptoms, time spent online on weekdays, psychosocial functioning, and depression. RESULTS A total of 143 men (mean [SD] age, 26.2 [7.8] years) were analyzed based on intent-to-treat analyses. Of these participants, 50 of 72 men (69.4%) in the STICA group showed remission vs 17 of 71 men (23.9%) in the WLC group. In logistic regression analysis, remission in the STICA vs WLC group was higher (odds ratio, 10.10; 95% CI, 3.69-27.65), taking into account internet addiction baseline severity, comorbidity, treatment center, and age. Compared with the WLC groups, effect sizes at treatment termination of STICA were d = 1.19 for AICA-S, d = 0.88 for time spent online on weekdays, d = 0.64 for psychosocial functioning, and d = 0.67 for depression. Fourteen adverse events and 8 serious adverse events occurred. A causal relationship with treatment was considered likely in 2 AEs, one in each group. CONCLUSIONS AND RELEVANCE Short-term treatment for internet and computer game addiction is a promising, manualized, short-term CBT for a broad range of internet addictions in multiple treatment centers. Further trials investigating the long-term efficacy of STICA and addressing specific groups and subgroups compared with active control conditions are required. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01434589.
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Affiliation(s)
- Klaus Wölfling
- Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Kai W. Müller
- Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael Dreier
- Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials Mainz, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Oliver Deuster
- Interdisciplinary Center for Clinical Trials Mainz, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Anil Batra
- University Hospital of Tübingen, Department of Psychiatry and Psychotherapy, Section for Addiction Research and Medicine, Tübingen, Germany
| | - Karl Mann
- Medical Faculty Mannheim, Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Michael Musalek
- Department of Psychiatry, Anton Proksch Institute, Vienna, Austria
| | - Andreas Schuster
- Department of Psychiatry, Anton Proksch Institute, Vienna, Austria
| | - Tagrid Lemenager
- Medical Faculty Mannheim, Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Sara Hanke
- University Hospital of Tübingen, Department of Psychiatry and Psychotherapy, Section for Addiction Research and Medicine, Tübingen, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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5
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Ferner M, Wachtlin D, Konrad T, Deuster O, Meinertz T, von Bardeleben S, Münzel T, Seibert-Grafe M, Breithardt G, Rostock T. Rationale and design of the RE-LATED AF—AFNET 7 trial: REsolution of Left atrial-Appendage Thrombus—Effects of Dabigatran in patients with Atrial Fibrillation. Clin Res Cardiol 2015; 105:29-36. [DOI: 10.1007/s00392-015-0883-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 06/09/2015] [Indexed: 11/30/2022]
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6
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Mengel D, Röskam S, Neff F, Balakrishnan K, Deuster O, Gold M, Oertel WH, Bacher M, Bach JP, Dodel R. Naturally occurring autoantibodies interfere with β-amyloid metabolism and improve cognition in a transgenic mouse model of Alzheimer's disease 24 h after single treatment. Transl Psychiatry 2013; 3:e236. [PMID: 23462987 PMCID: PMC3625912 DOI: 10.1038/tp.2012.151] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
There is evidence that naturally occurring antibodies directed against Aβ (nAbs-Aβ) have a role in Aβ-metabolism and Aβ-clearance. The presence of nAbs-Aβ leads to a reduction in amyloid fibrillation and thus a reduction in their toxicity. We investigated the effects of nAbs-Aβ in respect to oligomerization and used the Tg2576 transgenic mouse model in order to investigate the rapid effect with a single-dose (24 h) on oligomer breakdown and cytokine secretion along with immunohistochemical characterization of synaptic plasticity. nAbs-Aβ were able to reduce toxic oligomer concentration with an increase in Aβ-monomers. Cytokine secretion was significantly reduced. Synaptic plasticity was also improved after administration of nAbs. Finally, single treatment lead to a significant improvement in cognition. This study demonstrates the efficacy of nAbs-Aβ and presents evidence that several hallmarks of the disease are targeted by nAbs-Aβ.
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Affiliation(s)
- D Mengel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - S Röskam
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,Department of Animal Physiology, Philipps-University, Marburg, Germany
| | - F Neff
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,Institute of Pathology, Helmholtz Zentrum, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - K Balakrishnan
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - O Deuster
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,IZKS-Mainz, University Medical Center, Mainz, Germany
| | - M Gold
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - W H Oertel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - M Bacher
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,Institute of Immunology, Philipps-University, Marburg, Germany
| | - J-P Bach
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - R Dodel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,Department of Neurology, Philipps-University Marburg, Baldingerstrasse, 35041 Marburg, Germany. E-mail:
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7
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Baron N, Deuster O, Noelker C, Stüer C, Strik H, Schaller C, Dodel R, Meyer B, Bacher M. Role of macrophage migration inhibitory factor in primary glioblastoma multiforme cells. J Neurosci Res 2011; 89:711-7. [PMID: 21360573 DOI: 10.1002/jnr.22595] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 11/24/2010] [Accepted: 12/14/2010] [Indexed: 11/11/2022]
Abstract
Macrophage migration inhibitory factor (MIF) is a protein that is overexpressed in many tumors, such as colon and prostate cancer, melanoma, and glioblastoma multiforme (GBM). In its function as a cytokine, MIF induces angiogenesis, promotes cell cycle progression, and inhibits apoptosis. Recently, the molecular signal transduction has been specified: MIF has been found to be a ligand to the CD74/CD44-receptor complex and to activate the ERK1/2 MAPK cascade. In addition MIF binds to the chemokine receptors CXCR2 and CXCR4. This effects an integrin-dependent leukocyte arrest and mediates leukocyte chemotaxis. Recent work has described a clearer role of MIF in GBM tumor cell lines. The current study used human primary GBM cells. We show that inhibition of MIF with ISO-1, an inhibitor of the D-dopachrome tautomerase site of MIF, reduced the growth rate of primary GBM cells in a dose-dependent manner, and in addition ISO-1 increased protein expression of MIF and its receptors CD74, CXCR2, and CXCR4 in vitro but decreased expression of CD44. Furthermore, hypoxia as cell stressor increases the protein expression of MIF in primary GBM cells. These results underscore the importance of MIF in GBM and show that MIF and its receptors may be a promising target for the treatment of malignant gliomas.
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Affiliation(s)
- Nina Baron
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
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Bacher M, Deuster O, Aljabari B, Egensperger R, Neff F, Jessen F, Popp J, Noelker C, Reese JP, Al-Abed Y, Dodel R. The role of macrophage migration inhibitory factor in Alzheimer's disease. Mol Med 2010; 16:116-21. [PMID: 20200619 DOI: 10.2119/molmed.2009.00123] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 11/24/2009] [Indexed: 11/06/2022] Open
Abstract
Previous studies have shown that amyloid beta protein (Abeta ), the essential molecule for the formation of toxic oligomers and, subsequently, Alzheimer plaques, has been associated in vivo with the immune modulator, macrophage migration inhibitory factor (MIF) (17). To further investigate this association in vivo we used the APP transgenic mouse model. Serial brain sections of transgenic APP mice were stained for Abeta plaques and MIF and we observed MIF immunolabeling in microglial cells in association with Abeta plaques in the transgenic mouse brain sections. In addition, functional studies in murine and human neuronal cell lines revealed that Abeta-induced toxicity could be reversed significantly by a small molecule inhibitor of MIF (ISO-1). Finally, to elucidate the role of MIF in Alzheimer's Disease (AD) we measured MIF levels in the brain cytosol and cerebrospinal fluid (CSF) of AD patients and age-matched controls. Our results demonstrate a marked increase of MIF levels within the CSF of AD patients compared with controls. Combined, our results indicate a strong role for MIF in the pathogenesis of AD and furthermore suggest that inhibition of MIF may provide a valuable avenue of investigation for the prevention of disease onset, progression and/or severity.
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Affiliation(s)
- Michael Bacher
- Department of Neurology, Philipps-University Marburg, Germany
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9
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Schrader J, Deuster O, Rinn B, Schulz M, Kautz A, Dodel R, Meyer B, Al-Abed Y, Balakrishnan K, Reese JP, Bacher M. Restoration of contact inhibition in human glioblastoma cell lines after MIF knockdown. BMC Cancer 2009; 9:464. [PMID: 20038293 PMCID: PMC2810303 DOI: 10.1186/1471-2407-9-464] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Accepted: 12/28/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies of the role of the cytokine macrophage-migration-inhibitory-factor (MIF) in malignant tumors have revealed its stimulating influence on cell-cycle progression, angiogenesis and anti-apoptosis. RESULTS Here we show that in vitro targeting MIF in cultures of human malignant glioblastoma cells by either antisense plasmid introduction or anti-MIF antibody treatment reduced the growth rates of tumor cells. Of note is the marked decrease of proliferation under confluent and over-confluent conditions, implying a role of MIF in overcoming contact inhibition. Several proteins involved in contact inhibition including p27, p21, p53 and CEBPalpha are upregulated in the MIF antisense clones indicating a restoration of contact inhibition in the tumor cells. Correspondingly, we observed a marked increase in MIF mRNA and protein content under higher cell densities in LN18 cells. Furthermore, we showed the relevance of the enzymatic active site of MIF for the proliferation of glioblastoma cells by using the MIF-tautomerase inhibitor ISO-1. CONCLUSION Our study adds another puzzle stone to the role of MIF in tumor growth and progression by showing the importance of MIF for overcoming contact inhibition.
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Affiliation(s)
- Jörg Schrader
- Department of Neurology, University of Marburg, Marburg, Germany.
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Bach JP, Deuster O, Balzer-Geldsetzer M, Meyer B, Dodel R, Bacher M. The role of macrophage inhibitory factor in tumorigenesis and central nervous system tumors. Cancer 2009; 115:2031-40. [PMID: 19326434 DOI: 10.1002/cncr.24245] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Macrophage migration inhibitory factor (MIF) has been described as a protein that plays an important role in both innate and acquired immunity. Further research has shown that MIF plays a particularly critical part in cell cycle regulation and therefore in tumorigenesis as well. Over the past few years, the significance of the role of MIF in a variety of both solid and hematologic tumors has been established. More recently, interest has increased in the role of MIF in the development of central nervous system (CNS) tumors, in which it appears to influence cell cycle control. In addition, MIF has been identified as an essential actor in metastasis and angiogenesis. Vascular growth factor concentration raises because of increased levels of MIF in brain tumors. Recently, the MIF receptor complex has been described, and it appears that this may be a suitable drug target for treatment of brain tumors. In light of these findings, the authors chose to conduct a systematic search for information regarding MIF that has been published within the past 15 years using the terms "inflammation," "glioblastoma," "brain tumor," "astrocytoma," "microglia," "glioblastoma," "immune system and brain tumors," "glioblastoma and MIF," and "brain tumor and MIF." The aim of this article was thus to present a detailed review of current knowledge regarding the role of MIF in CNS tumor pathophysiology.
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Affiliation(s)
- Jan-Philipp Bach
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
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Bacher M, Al-Abed Y, Noelker C, Aljabari B, Schnell S, Deuster O, Dodel R. P3–279: MIF contributes to inflammation in the Alzheimer's disease brain. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Yousef Al-Abed
- Laboratory of Medicinal ChemistryThe Feinstein Institute for Medical ResearchManhassetNYUSA
| | | | - Bayan Aljabari
- Laboratory of Medicinal ChemistryThe Feinstein Institute for Medical ResearchManhassetNYUSA
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Dahl C, Engels S, Pott-Sperling AS, Schulte A, Sander J, Lübbe Y, Deuster O, Brune DC. Novel genes of the dsr gene cluster and evidence for close interaction of Dsr proteins during sulfur oxidation in the phototrophic sulfur bacterium Allochromatium vinosum. J Bacteriol 2005; 187:1392-404. [PMID: 15687204 PMCID: PMC545617 DOI: 10.1128/jb.187.4.1392-1404.2005] [Citation(s) in RCA: 167] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Seven new genes designated dsrLJOPNSR were identified immediately downstream of dsrABEFHCMK, completing the dsr gene cluster of the phototrophic sulfur bacterium Allochromatium vinosum D (DSM 180(T)). Interposon mutagenesis proved an essential role of the encoded proteins for the oxidation of intracellular sulfur, an obligate intermediate during the oxidation of sulfide and thiosulfate. While dsrR and dsrS encode cytoplasmic proteins of unknown function, the other genes encode a predicted NADPH:acceptor oxidoreductase (DsrL), a triheme c-type cytochrome (DsrJ), a periplasmic iron-sulfur protein (DsrO), and an integral membrane protein (DsrP). DsrN resembles cobyrinic acid a,c-diamide synthases and is probably involved in the biosynthesis of siro(heme)amide, the prosthetic group of the dsrAB-encoded sulfite reductase. The presence of most predicted Dsr proteins in A. vinosum was verified by Western blot analysis. With the exception of the constitutively present DsrC, the formation of Dsr gene products was greatly enhanced by sulfide. DsrEFH were purified from the soluble fraction and constitute a soluble alpha(2)beta(2)gamma(2)-structured 75-kDa holoprotein. DsrKJO were purified from membranes pointing at the presence of a transmembrane electron-transporting complex consisting of DsrKMJOP. In accordance with the suggestion that related complexes from dissimilatory sulfate reducers transfer electrons to sulfite reductase, the A. vinosum Dsr complex is copurified with sulfite reductase, DsrEFH, and DsrC. We therefore now have an ideal and unique possibility to study the interaction of sulfite reductase with other proteins and to clarify the long-standing problem of electron transport from and to sulfite reductase, not only in phototrophic bacteria but also in sulfate-reducing prokaryotes.
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Affiliation(s)
- Christiane Dahl
- Institut für Mikrobiologie & Biotechnologie, Rheinische Friedrich-Wilhelms-Universität Bonn, Meckenheimer Allee 168, D-53115 Bonn, Germany.
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