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Lense XM, Hiemke C, Funk CSM, Havemann-Reinecke U, Hefner G, Menke A, Mössner R, Riemer TG, Scherf-Clavel M, Schoretsanitis G, Gründer G, Hart XM. Venlafaxine's therapeutic reference range in the treatment of depression revised: a systematic review and meta-analysis. Psychopharmacology (Berl) 2024; 241:275-289. [PMID: 37857898 PMCID: PMC10806172 DOI: 10.1007/s00213-023-06484-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION The selective serotonin and norepinephrine reuptake inhibitor venlafaxine is among the most prescribed antidepressant drugs worldwide and, according to guidelines, its dose titration should be guided by drug-level monitoring of its active moiety (AM) which consists of venlafaxine (VEN) plus active metabolite O-desmethylvenlafaxine (ODV). This indication of therapeutic drug monitoring (TDM), however, assumes a clear concentration/effect relationship for a drug, which for VEN has not been systematically explored yet. OBJECTIVES We performed a systematic review and meta-analysis to investigate the relationship between blood levels, efficacy, and adverse reactions in order to suggest an optimal target concentration range for VEN oral formulations for the treatment of depression. METHODS Four databases (MEDLINE (PubMed), PsycINFO, Web of Science Core Collection, and Cochrane Library) were systematically searched in March 2022 for relevant articles according to a previously published protocol. Reviewers independently screened references and performed data extraction and critical appraisal. RESULTS High-quality randomized controlled trials investigating concentration/efficacy relationships and studies using a placebo lead-in phase were not found. Sixty-eight articles, consisting mostly of naturalistic TDM studies or small noncontrolled studies, met the eligibility criteria. Of them, five cohort studies reported a positive correlation between blood levels and antidepressant effects after VEN treatment. Our meta-analyses showed (i) higher AM and (ii) higher ODV concentrations in patients responding to VEN treatment when compared to non-responders (n = 360, k = 5). AM concentration-dependent occurrence of tremor was reported in one study. We found a linear relationship between daily dose and AM concentration within guideline recommended doses (75-225 mg/day). The population-based concentration ranges (25-75% interquartile) among 11 studies (n = 3200) using flexible dosing were (i) 225-450 ng/ml for the AM and (ii) 144-302 ng/ml for ODV. One PET study reported an occupancy of 80% serotonin transporters for ODV serum levels above 85 ng/ml. Based on our findings, we propose a therapeutic reference range for AM of 140-600 ng/ml. CONCLUSION VEN TDM within a range of 140 to 600 ng/ml (AM) will increase the probability of response in nonresponders. A titration within the proposed reference range is recommended in case of non-response at lower drug concentrations as a consequence of VEN's dual mechanism of action via combined serotonin and norepinephrine reuptake inhibition. Drug titration towards higher concentrations will, however, increase the risk for ADRs, in particular with supratherapeutic drug concentrations.
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Affiliation(s)
- X M Lense
- Department of Molecular Neuroimaging, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Heidelberg 68159 University J5, Mannheim, Germany.
| | - C Hiemke
- Clinic of Psychiatry and Psychotherapy, University of Mainz, Mainz, Germany
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
| | - C S M Funk
- Institute of Clinical Pharmacology and Toxicology, Charité University, Berlin, Germany
| | - U Havemann-Reinecke
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
- Clinic of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - G Hefner
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
- Vitos Clinic of Forensic Psychiatry, Eltville, Germany
| | - A Menke
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
- Psychosomatic Clinic Medical Park Chiemseeblick, Bernau a. Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - R Mössner
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - T G Riemer
- Institute of Clinical Pharmacology and Toxicology, Charité University, Berlin, Germany
| | - M Scherf-Clavel
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - G Schoretsanitis
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Zürich, Zürich, Switzerland
| | - G Gründer
- Department of Molecular Neuroimaging, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Heidelberg 68159 University J5, Mannheim, Germany
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
| | - X M Hart
- Department of Molecular Neuroimaging, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Heidelberg 68159 University J5, Mannheim, Germany
- Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring", Munich, Germany
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Lense X, Gründer G, Havemann-Reinecke U, Hefner G, Menke A, Mössner R, Scherf-Clavel M, Schoretsanitis G, Hiemke C, Hart X. Is it Time to Reevaluate the Therapeutic Reference Range for the
Antidepressant Drug Venlafaxine? PHARMACOPSYCHIATRY 2022. [DOI: 10.1055/s-0042-1747655] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- X.M. Lense
- Central Institute of Mental Health Mannheim, Department of Molecular
Neuroimaging
| | - G. Gründer
- Central Institute of Mental Health Mannheim, Department of Molecular
Neuroimaging
| | | | - G. Hefner
- Vitos Clinic of Forensic Psychiatry, Eltville
| | - A. Menke
- Department of Psychosomatics Medical Park Chiemseeblick, Bernau a.
Chiemsee
| | - R. Mössner
- University of Tübingen, Department of Psychiatry und
Psychotherapy
| | - M. Scherf-Clavel
- University of Würzburg, Department of Psychiatry,
Psychosomatics and Psychotherapy
| | - G. Schoretsanitis
- University of Zurich, Department of Psychiatry, Psychotherapy and
Psychosomatics, Zurich, Switzerland
| | - C. Hiemke
- University of Mainz, Department of Psychiatry and
Psychotherapy
| | - X.M. Hart
- Central Institute of Mental Health Mannheim, Department of Molecular
Neuroimaging
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Hüffmeier U, Frey B, Becker I, Atreya I, Berking C, Mössner R, Wilsmann-Theis D, Uebe S, Kirchner P, Haskamp S. 230 Transcriptomes of MPO-deficient patients with generalized pustular psoriasis reveals expansion of CD4+ cytotoxic T cells and an involvement of complement system and interferon pathways. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Poortinga S, Balakirski G, Kromer C, Mössner R, Schön MP, Bieber T, Wilsmann-Theis D. The challenge of palmoplantar pustulosis therapy: Are Interleukin-23 inhibitors an option? J Eur Acad Dermatol Venereol 2021; 35:e907-e911. [PMID: 34309915 DOI: 10.1111/jdv.17560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/19/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- S Poortinga
- Department of Dermatology and Allergology, University Hospital of Bonn, Bonn, Germany
| | - G Balakirski
- Department of Dermatology and Allergology, University Hospital of Bonn, Bonn, Germany.,Department of Dermatology, Allergology and Dermatosurgery, HELIOS University Hospital Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
| | - C Kromer
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - R Mössner
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - M P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - T Bieber
- Department of Dermatology and Allergology, University Hospital of Bonn, Bonn, Germany
| | - D Wilsmann-Theis
- Department of Dermatology and Allergology, University Hospital of Bonn, Bonn, Germany
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Wilsmann-Theis D, Kromer C, Gerdes S, Linker C, Magnolo N, Sabat R, Reich K, Mössner R. A multicentre open-label study of apremilast in palmoplantar pustulosis (APLANTUS). J Eur Acad Dermatol Venereol 2021; 35:2045-2050. [PMID: 34077577 DOI: 10.1111/jdv.17441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Palmoplantar pustulosis (PPP) is a chronic skin disease with painful erythematous scaly or crusty lesions and pustules on the palms and soles. Apremilast is a phosphodiesterase 4 inhibitor that has proven effective in the therapy of psoriasis, psoriatic arthritis and in oral ulcers associated with Behcet's disease. OBJECTIVE To explore the efficacy of apremilast in PPP. METHODS APLANTUS was a phase 2 single-arm multicentre study of apremilast in 21 subjects with moderate-to-severe PPP. Primary endpoint was the per cent change of the Palmoplantar Pustulosis Psoriasis Area and Severity Index (PPPASI) at week 20 compared to baseline. RESULTS 20 weeks of oral treatment with apremilast in patients with moderate-to-severe PPP resulted in a significant decrease of the PPPASI with a median reduction of 57.1% (p < 0.001), and 61.9% of patients achieved at least a 50% improvement of the PPPASI relative to baseline. The total number of pustules per patient decreased significantly relative to baseline with 76.2% of patients achieving at least a 50% reduction in total pustules count at week 20. Improvement of PPP was also apparent in a significant decrease of the dermatologic life quality index (DLQI). The median DLQI score dropped from 8.5 at baseline to 2.0 at week 20 (p = 0.030). Apremilast was generally well tolerated, and no serious adverse events occurred. CONCLUSIONS Patients with PPP treated with apremilast showed benefit both in objective and subjective disease parameters. Apremilast should be investigated further in this difficult-to-treat skin condition. EudraCT number: 2016-005122-11.
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Affiliation(s)
- D Wilsmann-Theis
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - C Kromer
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - S Gerdes
- Center for Inflammatory Skin Diseases, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - C Linker
- TFS Clinic, TFS Trial Form Support GmbH, Hamburg, Germany
| | - N Magnolo
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - R Sabat
- Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Mössner
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
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Kromer C, Wilsmann-Theis D, Gerdes S, Krebs S, Pinter A, Philipp S, Mössner R. Changing within the same class: efficacy of brodalumab in plaque psoriasis after treatment with an IL-17A blocker – a retrospective multicenter study. J DERMATOL TREAT 2020; 32:878-882. [DOI: 10.1080/09546634.2020.1716932] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- C. Kromer
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | | | - S. Gerdes
- Psoriasis-Center, Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - S. Krebs
- Psoriasis-Center, Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A. Pinter
- Department of Dermatology, Venereology, and Allergology, University Hospital, Frankfurt, Frankfurt/Main, Germany
| | - S. Philipp
- Department of Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - R. Mössner
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
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Kiltz U, Braun J, Becker A, Chenot JF, Dreimann M, Hammel L, Heiligenhaus A, Hermann KG, Klett R, Krause D, Kreitner KF, Lange U, Lauterbach A, Mau W, Mössner R, Oberschelp U, Philipp S, Pleyer U, Rudwaleit M, Schneider E, Schulte TL, Sieper J, Stallmach A, Swoboda B, Winking M. [Long version on the S3 guidelines for axial spondyloarthritis including Bechterew's disease and early forms, Update 2019 : Evidence-based guidelines of the German Society for Rheumatology (DGRh) and participating medical scientific specialist societies and other organizations]. Z Rheumatol 2020; 78:3-64. [PMID: 31784900 DOI: 10.1007/s00393-019-0670-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- U Kiltz
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland.
| | - J Braun
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | | | - A Becker
- Allgemeinmedizin, präventive und rehabilitative Medizin, Universität Marburg, Karl-von-Frisch-Str. 4, 35032, Marburg, Deutschland
| | | | - J-F Chenot
- Universitätsmedizin Greifswald, Fleischmann Str. 6, 17485, Greifswald, Deutschland
| | - M Dreimann
- Zentrum für Operative Medizin, Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistraße 52, 20251, Hamburg, Deutschland
| | | | - L Hammel
- Geschäftsstelle des Bundesverbandes der DVMB, Metzgergasse 16, 97421, Schweinfurt, Deutschland
| | | | - A Heiligenhaus
- Augenzentrum und Uveitis-Zentrum, St. Franziskus Hospital, Hohenzollernring 74, 48145, Münster, Deutschland
| | | | - K-G Hermann
- Institut für Radiologie, Charité Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | | | - R Klett
- Praxis Manuelle & Osteopathische Medizin, Fichtenweg 17, 35428, Langgöns, Deutschland
| | | | - D Krause
- , Friedrich-Ebert-Str. 2, 45964, Gladbeck, Deutschland
| | - K-F Kreitner
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - U Lange
- Kerckhoff-Klinik, Rheumazentrum, Osteologie & Physikalische Medizin, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland
| | | | - A Lauterbach
- Schule für Physiotherapie, Orthopädische Universitätsklinik Friedrichsheim, Marienburgstraße 2, 60528, Frankfurt, Deutschland
| | | | - W Mau
- Institut für Rehabilitationsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle (Saale), Deutschland
| | - R Mössner
- Klinik für Dermatologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
| | | | - U Oberschelp
- , Barlachstr. 6, 59368, Werne a.d. L., Deutschland
| | | | - S Philipp
- Praxis für Dermatologie, Bernauer Str. 66, 16515, Oranienburg, Deutschland
| | - U Pleyer
- Campus Virchow-Klinikum, Charité Centrum 16, Klinik f. Augenheilkunde, Charité, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - M Rudwaleit
- Klinikum Bielefeld, An der Rosenhöhe 27, 33647, Bielefeld, Deutschland
| | - E Schneider
- Abt. Fachübergreifende Frührehabilitation und Sportmedizin, St. Antonius Hospital, Dechant-Deckersstr. 8, 52249, Eschweiler, Deutschland
| | - T L Schulte
- Klinik für Orthopädie und Unfallchirurgie, Orthopädische Universitätsklinik, Ruhr-Universität Bochum, Gudrunstr. 65, 44791, Bochum, Deutschland
| | - J Sieper
- Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Deutschland
| | - A Stallmach
- Klinik für Innere Medizin IV, Universitätsklinikum Jena, Am Klinikum 1, 07743, Jena, Deutschland
| | | | - B Swoboda
- Abteilung für Orthopädie und Rheumatologie, Orthopädische Universitätsklinik, Malteser Waldkrankenhaus St. Marien, 91054, Erlangen, Deutschland
| | | | - M Winking
- Zentrum für Wirbelsäulenchirurgie, Klinikum Osnabrück, Am Finkenhügel 3, 49076, Osnabrück, Deutschland
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Amschler K, Phillip S, Mohr J, Wilsmann-Theis D, Poortinga S, Gerdes S, Mössner R. Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab. Dermatol Online J 2020; 26:13030/qt11d602x5. [PMID: 32239902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023] Open
Abstract
The original article was published on February 15, 2020 and corrected on March 26, 2020. The revised version of the article amends the table and figure, while leaving the text largely unchanged. The changes appear in the revised online PDF copy of this article.
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Affiliation(s)
- K Amschler
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany.
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9
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Amschler K, Phillip S, Mohr J, Wilsmann-Theis D, Poortinga S, Gerdes S, Mössner R. Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab. Dermatol Online J 2020; 26:13030/qt235408bf. [PMID: 32155021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/02/2020] [Indexed: 06/10/2023] Open
Abstract
Switching of biologic agents in treatment of plaque psoriasis is a common strategy. Only a few studies are available on switching between IL17A-blockers. In a retrospective study, we identified 22 psoriasis patients who, after failing secukinumab as a first IL17A-blocker received ixekizumab with an observation period of at least 24 weeks. At last observation 10/22 patients had a good response (PASI75 or PASI<3) using ixekizumab therapy. None of five patients with primary non-response to secukinumab reached a good, durable response to ixekizumab. In conclusion, ixekizumab appears to be a therapeutic option as a second IL17A-blocker in psoriasis patients who did not show a primary non-response to secukinumab.
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Affiliation(s)
- K Amschler
- Department of Dermatology, University Medical Center Göttingen, Göttingen.
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10
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Amschler K, Phillip S, Mohr J, Wilsmann-Theis D, Poortinga S, Gerdes S, Mössner R. Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab. Dermatol Online J 2020. [DOI: 10.5070/d3262047415] [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: 11/08/2022] Open
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11
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Amschler K, Phillip S, Mohr J, Wilsmann-Theis D, Poortinga S, Gerdes S, Mössner R. Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab. Dermatol Online J 2020. [DOI: 10.5070/d3261047182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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12
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Hiemke C, Bergemann N, Clement HW, Conca A, Deckert J, Domschke K, Eckermann G, Egberts K, Gerlach M, Greiner C, Gründer G, Haen E, Havemann-Reinecke U, Hefner G, Helmer R, Janssen G, Jaquenoud E, Laux G, Messer T, Mössner R, Müller MJ, Paulzen M, Pfuhlmann B, Riederer P, Saria A, Schoppek B, Schoretsanitis G, Schwarz M, Gracia MS, Stegmann B, Steimer W, Stingl JC, Uhr M, Ulrich S, Unterecker S, Waschgler R, Zernig G, Zurek G, Baumann P. Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017. Pharmacopsychiatry 2018; 51:e1. [PMID: 29390205 DOI: 10.1055/s-0037-1600991] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Hiemke
- Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany
| | - N Bergemann
- Kitzberg Hospitals, Center for Psychosomatic Medicine and Psychotherapy, Bad Mergentheim, Germany
| | - H W Clement
- Department of Child and Adolescent Psychiatry, University of Freiburg, Freiburg, Germany
| | - A Conca
- Servizio Psichiatrico del Comprensorio Sanitario di Bolzano, Bolzano, Italy
| | - J Deckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | - K Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - K Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
| | - M Gerlach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
| | - C Greiner
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - G Gründer
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA - Translational Brain Medicine, Aachen, Germany
| | - E Haen
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - U Havemann-Reinecke
- Department of Psychiatry and Psychosomatics, University of Göttingen, Göttingen, Germany
| | - G Hefner
- Psychiatric Hospital, Vitos Klinik, Eichberg, Eltville, Germany
| | - R Helmer
- Center of Epilepsy, Bielefeld, Germany
| | - G Janssen
- Medical Laboratory Stein, Limbach Group, Mönchengladbach, Germany
| | - E Jaquenoud
- Psychiatric Hospital, Königsfelden, Brugg, Aargau, Switzerland
| | - G Laux
- Institute of Psychological Medicine, Haag in Oberbayern, Germany
| | - T Messer
- Danuviuskliniken, Psychiatric Hospital, Pfaffenhofen, Germany
| | - R Mössner
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - M J Müller
- Psychiatric Hospitals Oberberggruppe, Berlin, Germany
| | - M Paulzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA - Translational Brain Medicine, Aachen, Germany
| | - B Pfuhlmann
- Psychiatric Hospital Weisser Hirsch, Dresden, Germany
| | - P Riederer
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | - A Saria
- Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria
| | - B Schoppek
- kbo-Isar-Amper Klinikum München-Ost, Psychiatric Hospital, Munich-Haar, Germany
| | | | - M Schwarz
- Department of Laboratory Medicine, Ludwig Maximilian University, Munich, Germany
| | - M Silva Gracia
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - B Stegmann
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - W Steimer
- Institute of Clinical Chemistry and Pathobiochemistry, Technical University Munich, Munich, Germany
| | - J C Stingl
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - M Uhr
- Max Planck Institute of Psychiatry, Munich, Germany
| | - S Ulrich
- Aristo Pharma GmbH, Berlin, Germany
| | - S Unterecker
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | | | - G Zernig
- Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria.,Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria
| | - G Zurek
- Medical Laboratory Bremen, Bremen, Germany
| | - P Baumann
- Department of Psychiatry, University of Lausanne, Prilly-Lausanne, Switzerland
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13
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Mössner R, Wilsmann-Theis D, Oji V, Gkogkolou P, Löhr S, Schulz P, Körber A, Prinz JC, Renner R, Schäkel K, Vogelsang L, Peters KP, Philipp S, Reich K, Ständer H, Jacobi A, Weyergraf A, Kingo K, Kõks S, Gerdes S, Steinz K, Schill T, Griewank KG, Müller M, Frey S, Ebertsch L, Uebe S, Sticherling M, Sticht H, Hüffmeier U. The genetic basis for most patients with pustular skin disease remains elusive. Br J Dermatol 2018; 178:740-748. [PMID: 28887889 DOI: 10.1111/bjd.15867] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Rare variants in the genes IL36RN, CARD14 and AP1S3 have been identified to cause or contribute to pustular skin diseases, primarily generalized pustular psoriasis (GPP). OBJECTIVES To better understand the disease relevance of these genes, we screened our cohorts of patients with pustular skin diseases [primarily GPP and palmoplantar pustular psoriasis (PPP)] for coding changes in these three genes. Carriers of single heterozygous IL36RN mutations were screened for a second mutation in IL36RN. METHODS Coding exons of IL36RN, CARD14 and AP1S3 were sequenced in 67 patients - 61 with GPP, two with acute generalized exanthematous pustulosis and four with acrodermatitis continua of Hallopeau. We screened IL36RN and AP1S3 for intragenic copy-number variants and 258 patients with PPP for coding changes in AP1S3. Eleven heterozygous IL36RN mutations carriers were analysed for a second noncoding IL36RN mutation. Genotype-phenotype correlations in carriers/noncarriers of IL36RN mutations were assessed within the GPP cohort. RESULTS The majority of patients (GPP, 64%) did not carry rare variants in any of the three genes. Biallelic and monoallelic IL36RN mutations were identified in 15 and five patients with GPP, respectively. Noncoding rare IL36RN variants were not identified in heterozygous carriers. The only significant genotype-phenotype correlation observed for IL36RN mutation carriers was early age at disease onset. Additional rare CARD14 or AP1S3 variants were identified in 15% of IL36RN mutation carriers. CONCLUSIONS The identification of IL36RN mutation carriers harbouring additional rare variants in CARD14 or AP1S3 indicates a more complex mode of inheritance of pustular psoriasis. Our results suggest that, in heterozygous IL36RN mutation carriers, there are additional disease-causing genetic factors outside IL36RN.
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Affiliation(s)
- R Mössner
- Department of Dermatology, Georg-August-University Göttingen, Göttingen, Germany
| | - D Wilsmann-Theis
- Department of Dermatology and Allergy, University Bonn, Bonn, Germany
| | - V Oji
- Department of Dermatology, University Münster, Münster, Germany
| | - P Gkogkolou
- Department of Dermatology, University Münster, Münster, Germany
| | - S Löhr
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - P Schulz
- Department of Dermatology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - A Körber
- Department of Dermatology, University of Essen, Essen, Germany
| | - J C Prinz
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Munich, Germany
| | - R Renner
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - K Schäkel
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - L Vogelsang
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - K-P Peters
- Department of Dermatology and Allergology, Hospital Bayreuth, Bayreuth, Germany
| | - S Philipp
- Department of Dermatology and Allergy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - K Reich
- Dermatologikum Hamburg, Hamburg, Germany
| | - H Ständer
- Department of Dermatology, Klinikum Dortmund, Dortmund, Germany
| | - A Jacobi
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Weyergraf
- Department of Dermatology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - K Kingo
- Department of Dermatology, Dermatology Clinic, University of Tartu, Tartu, Estonia
| | - S Kõks
- Department of Pathophysiology, University of Tartu, Tartu, Estonia
| | - S Gerdes
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - K Steinz
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - T Schill
- Department of Dermatology and Allergy, University Bonn, Bonn, Germany
| | - K G Griewank
- Department of Dermatology, University of Essen, Essen, Germany
| | - M Müller
- Institute of Occcupational, Social and Environmental Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - S Frey
- Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - L Ebertsch
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Uebe
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Sticherling
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - H Sticht
- Bioinformatics, Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - U Hüffmeier
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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14
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Affiliation(s)
- R. Mössner
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Robert‐Koch‐Straße 40, D‐37075 Göttingen Germany
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15
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Hiemke C, Bergemann N, Clement HW, Conca A, Deckert J, Domschke K, Eckermann G, Egberts K, Gerlach M, Greiner C, Gründer G, Haen E, Havemann-Reinecke U, Hefner G, Helmer R, Janssen G, Jaquenoud E, Laux G, Messer T, Mössner R, Müller MJ, Paulzen M, Pfuhlmann B, Riederer P, Saria A, Schoppek B, Schoretsanitis G, Schwarz M, Gracia MS, Stegmann B, Steimer W, Stingl JC, Uhr M, Ulrich S, Unterecker S, Waschgler R, Zernig G, Zurek G, Baumann P. Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017. Pharmacopsychiatry 2017; 51:9-62. [PMID: 28910830 DOI: 10.1055/s-0043-116492] [Citation(s) in RCA: 533] [Impact Index Per Article: 76.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Therapeutic drug monitoring (TDM) is the quantification and interpretation of drug concentrations in blood to optimize pharmacotherapy. It considers the interindividual variability of pharmacokinetics and thus enables personalized pharmacotherapy. In psychiatry and neurology, patient populations that may particularly benefit from TDM are children and adolescents, pregnant women, elderly patients, individuals with intellectual disabilities, patients with substance abuse disorders, forensic psychiatric patients or patients with known or suspected pharmacokinetic abnormalities. Non-response at therapeutic doses, uncertain drug adherence, suboptimal tolerability, or pharmacokinetic drug-drug interactions are typical indications for TDM. However, the potential benefits of TDM to optimize pharmacotherapy can only be obtained if the method is adequately integrated in the clinical treatment process. To supply treating physicians and laboratories with valid information on TDM, the TDM task force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) issued their first guidelines for TDM in psychiatry in 2004. After an update in 2011, it was time for the next update. Following the new guidelines holds the potential to improve neuropsychopharmacotherapy, accelerate the recovery of many patients, and reduce health care costs.
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Affiliation(s)
- C Hiemke
- Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany
| | - N Bergemann
- Kitzberg Hospitals, Center for Psychosomatic Medicine and Psychotherapy, Bad Mergentheim, Germany
| | - H W Clement
- Department of Child and Adolescent Psychiatry, University of Freiburg, Freiburg, Germany
| | - A Conca
- Servizio Psichiatrico del Comprensorio Sanitario di Bolzano, Bolzano, Italy
| | - J Deckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | - K Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - K Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
| | - M Gerlach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
| | - C Greiner
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - G Gründer
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA - Translational Brain Medicine, Aachen, Germany
| | - E Haen
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - U Havemann-Reinecke
- Department of Psychiatry and Psychosomatics, University of Göttingen, Göttingen, Germany
| | - G Hefner
- Psychiatric Hospital, Vitos Klinik, Eichberg, Eltville, Germany
| | - R Helmer
- Center of Epilepsy, Bielefeld, Germany
| | - G Janssen
- Medical Laboratory Stein, Limbach Group, Mönchengladbach, Germany
| | - E Jaquenoud
- Psychiatric Hospital, Königsfelden, Brugg, Aargau, Switzerland
| | - G Laux
- Institute of Psychological Medicine, Haag in Oberbayern, Germany
| | - T Messer
- Danuviuskliniken, Psychiatric Hospital, Pfaffenhofen, Germany
| | - R Mössner
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - M J Müller
- Psychiatric Hospitals Oberberggruppe, Berlin, Germany
| | - M Paulzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA - Translational Brain Medicine, Aachen, Germany
| | - B Pfuhlmann
- Psychiatric Hospital Weisser Hirsch, Dresden, Germany
| | - P Riederer
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | - A Saria
- Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria
| | - B Schoppek
- kbo-Isar-Amper Klinikum München-Ost, Psychiatric Hospital, Munich-Haar, Germany
| | | | - M Schwarz
- Department of Laboratory Medicine, Ludwig Maximilian University, Munich, Germany
| | - M Silva Gracia
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - B Stegmann
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - W Steimer
- Institute of Clinical Chemistry and Pathobiochemistry, Technical University Munich, Munich, Germany
| | - J C Stingl
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - M Uhr
- Max Planck Institute of Psychiatry, Munich, Germany
| | - S Ulrich
- Aristo Pharma GmbH, Berlin, Germany
| | - S Unterecker
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | | | - G Zernig
- Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria.,Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria
| | - G Zurek
- Medical Laboratory Bremen, Bremen, Germany
| | - P Baumann
- Department of Psychiatry, University of Lausanne, Prilly-Lausanne, Switzerland
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16
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Abstract
The adenosine A2A receptor (A2AR) facilitates effects of calcitonin gene-related peptide and vasoactive intestinal peptide, two important neuropeptides in migraine pathophysiology, and is the molecular target of caffeine, which is used in migraine treatment. We therefore determined whether A2AR gene variation might influence migraine susceptibility Migraine patients ( n = 265) with or without aura and migraine-free controls ( n = 154) were assessed and genotyped for six genetic variants spanning the A2AR gene. A six-marker haplotype was more frequent in migraine patients with aura ( P < 0.01) but not in patients without aura, compared with the control group. This indicates that A2AR gene variation may contribute to the pathogenesis of migraine with aura.
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Affiliation(s)
- C Hohoff
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.
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17
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18
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Gutzmer R, Hassel JC, Kähler KC, Loquai C, Mössner R, Ugurel S, Zimmer L, der das Ado FKKNA. [Cutaneous side effects of anti-tumor therapy with BRAF and MEK inhibitors]. Hautarzt 2015; 65:582-9. [PMID: 24903029 DOI: 10.1007/s00105-013-2733-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND BRAF and MEK inhibitors are new targeted therapies which are used in the treatment of malignancies, in particular of malignant melanoma. SIDE EFFECTS Cutaneous side effects are common during the treatment with both types of inhibitors. These side effects include inflammatory reactions such as maculopapular and papulopustular exanthema, hand-foot syndrome, panniculitis, paronychia, photo- and radio-sensitization. As a class effect, BRAF-inhibitors induce proliferative disorders of keratinocytes and melanocytes, such as palmoplantar hyperkeratosis (as part of the hand-foot syndrome), verruciform and acanthoma-like lesions, follicular and Grover disease-like hyperkeratoses, keratoacanthomas, squamous cell carcinomas and atypical melanocytic nevi with transition to secondary melanomas. Furthermore, hair alterations and xerosis are possible. CONCLUSIONS Treatment with BRAF and MEK inhibitors requires close dermatologic monitoring of the patient. This manuscript summarizes the most frequent cutaneous side effects and their management.
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Affiliation(s)
- R Gutzmer
- Klinik für Dermatologie, Allergologie und Venerologie, Hauttumorzentrum Hannover (HTZH), Medizinische Hochschule Hannover, Ricklinger Str. 5, 30449, Hannover, Deutschland,
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19
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Mössner R, Zimmer L, Berking C, Hoeller C, Loquai C, Richtig E, Kähler K, Hassel J, Gutzmer R, Ugurel S. Erythema nodosum-like lesions during BRAF inhibitor therapy: Report on 16 new cases and review of the literature. J Eur Acad Dermatol Venereol 2015; 29:1797-806. [DOI: 10.1111/jdv.13039] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 01/19/2015] [Indexed: 01/16/2023]
Affiliation(s)
- R. Mössner
- Department of Dermatology, Venereology and Allergology; University Medical Center Göttingen; Göttingen Germany
| | - L. Zimmer
- Department of Dermatology; University of Duisburg-Essen; Essen Germany
| | - C. Berking
- Department of Dermatology and Allergology; University of Munich (LMU); Munich Germany
| | - C. Hoeller
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - C. Loquai
- Department of Dermatology; University Medical Center Mainz; Mainz Germany
| | - E. Richtig
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - K.C. Kähler
- Department of Dermatology and Venerology; Universitätsklinikum Schleswig-Holstein; Campus Kiel Germany
| | - J.C. Hassel
- Department of Dermatology and National Center for Tumor Diseases (NCT); University Hospital Heidelberg; Heidelberg Germany
| | - R. Gutzmer
- Department of Dermatology and Allergy; Skin Cancer Center; Hannover Medical School; Hannover Germany
| | - S. Ugurel
- Department of Dermatology; University of Würzburg; Würzburg Germany
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20
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Ugurel S, Loquai C, Kähler K, Hassel J, Berking C, Zimmer L, Haubitz I, Satzger I, Müller-Brenne T, Mikhaimer N, Becker J, Kilian K, Schadendorf D, Heinzerling L, Kaatz M, Utikal J, Göppner D, Pföhler C, Pflugfelder A, Mössner R, Gutzmer R. A multicenter DeCOG study on predictors of vemurafenib therapy outcome in melanoma: pretreatment impacts survival. Ann Oncol 2015; 26:573-82. [DOI: 10.1093/annonc/mdu573] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Hüffmeier U, Wätzold M, Mohr J, Schön MP, Mössner R. Successful therapy with anakinra in a patient with generalized pustular psoriasis carrying IL36RN mutations. Br J Dermatol 2015; 170:202-4. [PMID: 23909475 DOI: 10.1111/bjd.12548] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- U Hüffmeier
- Institute of Human Genetics, University of Erlangen-Nuremberg, Erlangen, Germany
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22
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Degenhardt F, Priebe L, Meier S, Lennertz L, Streit F, Witt SH, Hofmann A, Becker T, Mössner R, Maier W, Nenadic I, Sauer H, Mattheisen M, Buizer-Voskamp J, Ophoff RA, Rujescu D, Giegling I, Ingason A, Wagner M, Delobel B, Andrieux J, Meyer-Lindenberg A, Heinz A, Walter H, Moebus S, Corvin A, Rietschel M, Nöthen MM, Cichon S. Duplications in RB1CC1 are associated with schizophrenia; identification in large European sample sets. Transl Psychiatry 2013; 3:e326. [PMID: 26151896 PMCID: PMC3849960 DOI: 10.1038/tp.2013.101] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 04/13/2013] [Revised: 09/17/2013] [Accepted: 09/26/2013] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia (SCZ) is a severe and debilitating neuropsychiatric disorder with an estimated heritability of ~80%. Recently, de novo mutations, identified by next-generation sequencing (NGS) technology, have been suggested to contribute to the risk of developing SCZ. Although these studies show an overall excess of de novo mutations among patients compared with controls, it is not easy to pinpoint specific genes hit by de novo mutations as actually involved in the disease process. Importantly, support for a specific gene can be provided by the identification of additional alterations in several independent patients. We took advantage of existing genome-wide single-nucleotide polymorphism data sets to screen for deletions or duplications (copy number variations, CNVs) in genes previously implicated by NGS studies. Our approach was based on the observation that CNVs constitute part of the mutational spectrum in many human disease-associated genes. In a discovery step, we investigated whether CNVs in 55 candidate genes, suggested from NGS studies, were more frequent among 1637 patients compared with 1627 controls. Duplications in RB1CC1 were overrepresented among patients. This finding was followed-up in large, independent European sample sets. In the combined analysis, totaling 8461 patients and 112 871 controls, duplications in RB1CC1 were found to be associated with SCZ (P=1.29 × 10(-5); odds ratio=8.58). Our study provides evidence for rare duplications in RB1CC1 as a risk factor for SCZ.
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Affiliation(s)
- F Degenhardt
- Institute of Human Genetics, University of
Bonn, Bonn, Germany,Department of Genomics, Life and Brain
Center, University of Bonn, Bonn, Germany,Institute of Human Genetics, University of
Bonn, Sigmund-Freud-Straße 25, 53127
Bonn, Germany. E-mail:
| | - L Priebe
- Institute of Human Genetics, University of
Bonn, Bonn, Germany,Department of Genomics, Life and Brain
Center, University of Bonn, Bonn, Germany
| | - S Meier
- Department of Genetic Epidemiology in
Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg
University, Mannheim, Germany
| | - L Lennertz
- Department of Psychiatry, University of
Bonn, Bonn, Germany
| | - F Streit
- Department of Genetic Epidemiology in
Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg
University, Mannheim, Germany
| | - S H Witt
- Department of Genetic Epidemiology in
Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg
University, Mannheim, Germany
| | - A Hofmann
- Institute of Human Genetics, University of
Bonn, Bonn, Germany,Department of Genomics, Life and Brain
Center, University of Bonn, Bonn, Germany
| | - T Becker
- German Center for Neurodegenerative Diseases
(DZNE), Bonn, Germany,Institute for Medical Biometry,
Informatics and Epidemiology, University of Bonn, Bonn,
Germany
| | - R Mössner
- Department of Psychiatry, University of
Bonn, Bonn, Germany
| | - W Maier
- Department of Psychiatry, University of
Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases
(DZNE), Bonn, Germany
| | - I Nenadic
- Department of Psychiatry and Psychotherapy,
Jena University Hospital, Jena, Germany
| | - H Sauer
- Department of Psychiatry and Psychotherapy,
Jena University Hospital, Jena, Germany
| | - M Mattheisen
- Department of Genomics, Life and Brain
Center, University of Bonn, Bonn, Germany,Institute for Genomic Mathematics, University
of Bonn, Bonn, Germany,Channing Division of Network Medicine,
Brigham and Women's Hospital and Harvard Medical School, Boston,
MA, USA
| | - J Buizer-Voskamp
- Department of Psychiatry, Rudolf Magnus
Institute of Neuroscience, University Medical Center Utrecht,
Utrecht, The Netherlands,Department of Medical Genetics, University
Medical Center Utrecht, Utrecht, The Netherlands
| | - R A Ophoff
- Department of Psychiatry, Rudolf Magnus
Institute of Neuroscience, University Medical Center Utrecht,
Utrecht, The Netherlands,Department of Human Genetics, David Geffen
School of Medicine, University of California Los Angeles, Los
Angeles, CA, USA,Center for Neurobehavioral Genetics, Semel
Institute for Neuroscience & Human Behavior, University of California Los
Angeles, Los Angeles, CA, USA
| | | | - D Rujescu
- Molecular and Clinical Neurobiology,
Department of Psychiatry, Ludwig-Maximilians-University, Munich,
Germany,Department of Psychiatry, University of
Halle-Wittenberg, Halle, Germany
| | - I Giegling
- Molecular and Clinical Neurobiology,
Department of Psychiatry, Ludwig-Maximilians-University, Munich,
Germany,Department of Psychiatry, University of
Halle-Wittenberg, Halle, Germany
| | - A Ingason
- Department of Psychiatry, University of
Halle-Wittenberg, Halle, Germany
| | - M Wagner
- Department of Psychiatry, University of
Bonn, Bonn, Germany
| | - B Delobel
- Centre de Génétique
chromosomique, GHICL, Hôpital St-Vincent de Paul, Lille,
France
| | - J Andrieux
- Institut de Génétique
Médicale, Hopital Jeanne de Flandre, CHRU de Lille,
Lille, France
| | - A Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy,
Central Institute of Mental Health, Medical Faculty Mannheim, University of
Heidelberg, Mannheim, Germany
| | - A Heinz
- Department of Psychiatry and Psychotherapy,
Charité Campus Mitte, Berlin, Germany
| | - H Walter
- Department of Psychiatry and Psychotherapy,
Charité Campus Mitte, Berlin, Germany
| | - S Moebus
- Institute of Medical Informatics, Biometry,
and Epidemiology, University Duisburg-Essen, Essen,
Germany
| | - A Corvin
- Department of Psychiatry, Institute of
Neuroscience, Trinity College Dublin, Dublin, Ireland
| | | | - M Rietschel
- Department of Genetic Epidemiology in
Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg
University, Mannheim, Germany
| | - M M Nöthen
- Institute of Human Genetics, University of
Bonn, Bonn, Germany,Department of Genomics, Life and Brain
Center, University of Bonn, Bonn, Germany
| | - S Cichon
- Institute of Human Genetics, University of
Bonn, Bonn, Germany,Department of Genomics, Life and Brain
Center, University of Bonn, Bonn, Germany,Institute of Neuroscience and Medicine
(INM-1), Structural and Functional Organisation of the Brain, Genomic Imaging, Research
Centre Juelich, Juelich, Germany,Division of Medical Genetics, University
Hospital Basel and Department of Biomedicine, University of Basel,
Basel, Switzerland
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Rietschel M, Mattheisen M, Degenhardt F, Mühleisen TW, Kirsch P, Esslinger C, Herms S, Demontis D, Steffens M, Strohmaier J, Haenisch B, Breuer R, Czerski PM, Giegling I, Strengman E, Schmael C, Mors O, Mortensen PB, Hougaard DM, Ørntoft T, Kapelski P, Priebe L, Basmanav FF, Forstner AJ, Hoffman P, Meier S, Nikitopoulos J, Moebus S, Alexander M, Mössner R, Wichmann HE, Schreiber S, Rivandeneira F, Hofman A, Uitterlinden AG, Wienker TF, Schumacher J, Hauser J, Maier W, Cantor RM, Erk S, Schulze TG, Craddock N, Owen MJ, O'Donovan MC, Børglum AD, Rujescu D, Walter H, Meyer-Lindenberg A, Nöthen NM, Ophoff RA, Cichon S. Association between genetic variation in a region on chromosome 11 and schizophrenia in large samples from Europe. Mol Psychiatry 2012; 17:906-17. [PMID: 21747397 DOI: 10.1038/mp.2011.80] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [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: 01/12/2023]
Abstract
Recent molecular studies have implicated common alleles of small to moderate effect and rare alleles with larger effect sizes in the genetic architecture of schizophrenia (SCZ). It is expected that the reliable detection of risk variants with very small effect sizes can only be achieved through the recruitment of very large samples of patients and controls (that is tens of thousands), or large, potentially more homogeneous samples that have been recruited from confined geographical areas using identical diagnostic criteria. Applying the latter strategy, we performed a genome-wide association study (GWAS) of 1169 clinically well characterized and ethnically homogeneous SCZ patients from a confined area of Western Europe (464 from Germany, 705 from The Netherlands) and 3714 ethnically matched controls (1272 and 2442, respectively). In a subsequent follow-up study of our top GWAS results, we included an additional 2569 SCZ patients and 4088 controls (from Germany, The Netherlands and Denmark). Genetic variation in a region on chromosome 11 that contains the candidate genes AMBRA1, DGKZ, CHRM4 and MDK was significantly associated with SCZ in the combined sample (n=11 540; P=3.89 × 10(-9), odds ratio (OR)=1.25). This finding was replicated in 23 206 independent samples of European ancestry (P=0.0029, OR=1.11). In a subsequent imaging genetics study, healthy carriers of the risk allele exhibited altered activation in the cingulate cortex during a cognitive control task. The area of interest is a critical interface between emotion regulation and cognition that is structurally and functionally abnormal in SCZ and bipolar disorder.
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Affiliation(s)
- M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
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Onichtchouk D, Geier F, Messerschmidt DM, Mössner R, Taylor V, Timmer J, Driever W. Oct4/Pou5f1 controls tissue-specific repressors in early zebrafish embryo. J Stem Cells Regen Med 2010; 6:82. [PMID: 24693100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- D Onichtchouk
- University of Freiburg, Department of Biology I, Developmental Biology Unit , Freiburg, Germany
| | - F Geier
- University of Freiburg, Department of Biology I, Developmental Biology Unit , Freiburg, Germany
| | - D M Messerschmidt
- University of Freiburg, Department of Biology I, Developmental Biology Unit , Freiburg, Germany
| | - R Mössner
- University of Freiburg, Department of Biology I, Developmental Biology Unit , Freiburg, Germany
| | - V Taylor
- University of Freiburg, Department of Biology I, Developmental Biology Unit , Freiburg, Germany
| | - J Timmer
- University of Freiburg, Department of Biology I, Developmental Biology Unit , Freiburg, Germany
| | - W Driever
- University of Freiburg, Department of Biology I, Developmental Biology Unit , Freiburg, Germany
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Mössner R, Schön M. Medikamentöse Systemtherapien der Psoriasis. Akt Dermatol 2010. [DOI: 10.1055/s-0029-1243879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mössner R, Schön M. Medikamentöse Systemtherapien der Psoriasis. Akt Dermatol 2010. [DOI: 10.1055/s-0029-1214474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Uçeyler N, Schütt M, Palm F, Vogel C, Meier M, Schmitt A, Lesch KP, Mössner R, Sommer C. Lack of the serotonin transporter in mice reduces locomotor activity and leads to gender-dependent late onset obesity. Int J Obes (Lond) 2010; 34:701-11. [PMID: 20084070 DOI: 10.1038/ijo.2009.289] [Citation(s) in RCA: 33] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Mice deficient of the serotonin transporter (5-HTT ko) mice have a reduced brain serotonin content and develop late-onset obesity. To elucidate the pathophysiology of this obesity, we analyzed the expression of the interrelated weight-regulatory molecules: brain-derived neurotrophic factor (BDNF) and leptin receptor (LR) in brain areas associated with nutrition and activity. RESEARCH DESIGN AND METHODS We investigated feeding behavior, physical activity and metabolic parameters of 5-HTT ko and wild-type mice and measured the expression of BDNF and LR in brain areas associated with nutrition and activity using quantitative real-time PCR. The influence of age, gender and fasting was analyzed. RESULTS Male 5-HTT ko mice developed obesity without hyperphagia from the age of 5 months. Physical activity was reduced in old male, but not old female, 5-HTT ko mice. The BDNF gene expression in frontal cortex was elevated in young, but reduced in old 5-HTT ko mice. Fasting failed to increase the BDNF gene expression in frontal cortex of young 5 HTT ko mice and in the hypothalamus in old 5-HTT ko mice. The fasting-induced hypothalamic increase of LR was absent in both young and old 5-HTT ko mice. CONCLUSIONS We propose that low brain serotonin level due to the 5-HTT ko genotype leads to reduced physical activity and low BDNF, which together with the lack of fasting-induced hypothalamic BDNF and LR production results in late-onset obesity. Although lack of the 5-HTT is a genetic vulnerability factor for obesity, female gender is protective.
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Affiliation(s)
- N Uçeyler
- Department of Neurology, University of Würzburg, Würzburg, Germany
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Petrovsky N, Ettinger U, Quednow B, Schnell K, Mössner R, Walter H, Maier W, Wagner M. Nicotine effects on endophenotypes of schizophrenia. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mössner R, Tings T, Beckmann I, Neumann C, Paulus W, Reich K. A close look at autoimmune muscle disorders: association of Lambert–Eaton myasthenic syndrome with dermatomyositis. Scand J Rheumatol 2009; 33:271-5. [PMID: 15370725 DOI: 10.1080/03009740410005476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Dermatomyositis/polymyositis (DM/PM) and Lambert-Eaton myasthenic syndrome (LEMS) are two autoimmune disorders that have very rarely been reported to occur together in the same patient. We report on two patients with DM who were later diagnosed with concomitant LEMS, and point out diagnostic challenges in identifying LEMS in patients with DM/PM. As specific treatment for LEMS is available, it is important to identify those DM/PM patients who suffer from concomitant LEMS.
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Hüffmeier U, Lascorz J, Becker T, Schürmeier-Horst F, Magener A, Ekici AB, Endele S, Thiel CT, Thoma-Uszynski S, Mössner R, Reich K, Kurrat W, Wienker TF, Traupe H, Reis A. Characterisation of psoriasis susceptibility locus 6 (PSORS6) in patients with early onset psoriasis and evidence for interaction with PSORS1. J Med Genet 2009; 46:736-44. [PMID: 19525279 PMCID: PMC3272665 DOI: 10.1136/jmg.2008.065029] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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] [Indexed: 12/21/2022]
Abstract
BACKGROUND Psoriasis is a genetically complex, chronic inflammatory skin disease. The authors have previously identified a susceptibility locus on chromosome 19p13 (PSORS6). METHODS AND RESULTS In a follow-up linkage disequilibrium (LD) study in an independent family based cohort, the authors found evidence for association to a newly discovered microsatellite at this locus (D19SPS21, p<5.3x10(-5)). An LD based association scan in 300 trios revealed association to several single, single nucleotide polymorphisms (SNPs) in one LD block. When the authors stratified this cohort for carrying the PSORS1 risk allele at the HLA-C locus, evidence for association became much stronger at single SNP and haplotype levels (p values between 1.0x10(-4) and 8.0x10(-4)). In a replication study of 1114 patients and 937 control individuals, evidence for association was also observed after stratification to the PSORS1 risk allele. In both study groups, logistic regression showed evidence for interaction between the risk alleles at PSORS1 and PSORS6. Best p values for rs12459358 in both study groups remained significant after correction for multiple testing. The associated LD block did not comprise any known genes. Interestingly, an adjacent gene, MUC16, coding for a large glycosylated protein expressed in epithelia and of unknown function, could be shown to be also expressed in tissues relevant for pathogenesis of psoriasis such as skin and thymus. Immunohistochemical analyses of skin revealed focal staining for MUC16 in suprabasal epidermal cells. Further functional studies are required to clarify its potential role in psoriasis and identify the causal variant(s) at this locus. CONCLUSION The data establish PSORS6 as a confirmed psoriasis susceptibility locus showing interaction with PSORS1.
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Affiliation(s)
- U Hüffmeier
- Institute of Human Genetics, University Hospital Erlangen, University of Erlangen-Nuremberg, 91054 Erlangen, Germany.
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Abstract
Elucidation of the pathogenesis of schizophrenia is progressing rapidly. The importance of the glutamatergic system and the glutamate receptor GRM3 were shown in both genetic and pharmacological studies of the new drug LY2140023. The zinc finger domain-containing gene ZNF804A could be identified as a new schizophrenia susceptibility gene, while large copy number variants at 1q21.1 and 15q13.3 now are seen as monogenic causes of schizophrenia. It is anticipated that the coming years will see further rapid progress in the unraveling of the causes of schizophrenia.
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Affiliation(s)
- R Mössner
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum, Sigmund-Freud-Strasse 25, 53127, Bonn, Deutschland.
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Reich K, Krüger K, Mössner R, Augustin M. Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol 2009; 160:1040-7. [PMID: 19210498 DOI: 10.1111/j.1365-2133.2008.09023.x] [Citation(s) in RCA: 248] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Because psoriatic arthritis (PsA) usually develops years after the first manifestation of skin symptoms, in many cases the initial diagnosis of PsA depends on the dermatologist. OBJECTIVES To investigate the prevalence and clinical pattern of PsA in a daily practice population of patients with psoriasis. METHODS Patients were enrolled in an observational prospective cross-sectional cohort study at 48 community and academic centres. Demographic and medical parameters were recorded, including severity of skin symptoms (Psoriasis Area and Severity Index, PASI), previous and current treatments, concomitant diseases, and the impact of psoriasis on productivity and health-related quality of life (Dermatology Life Quality Index, DLQI). Patients with joint symptoms were referred to a rheumatologist for diagnosis and to record the activity and pattern of arthritis. RESULTS Among 1511 patients 20.6% had PsA; in 85% of the cases PsA was newly diagnosed. Of these patients more than 95% had active arthritis and 53.0% had five or more joints affected. Polyarthritis (58.7%) was the most common manifestation pattern, followed by oligoarthritis (31.6%) and arthritis mutilans (4.9%). Distal interphalangeal involvement was present in 41.0% and dactylitis in 23.7% of the patients. Compared with patients without arthritis, patients with PsA had more severe skin symptoms (mean PASI 14.3 vs. 11.5), a lower quality of life (mean DLQI 11.6 vs. 7.7) and greater impairment of productivity parameters. CONCLUSIONS The findings are consistent with a high prevalence of undiagnosed cases of active PsA among patients with psoriasis seen by dermatologists. As many of these patients also have significant skin symptoms, treatment strategies are required that are equally effective in the control of skin and joint symptoms of psoriasis.
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Affiliation(s)
- K Reich
- Dermatologikum Hamburg, Stephansplatz 5, 20354 Hamburg, Germany.
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Marziniak M, Mössner R, Kienzler C, Riederer P, Lesch KP, Sommer C. Functional polymorphisms of the 5-HT1A and 5-HT1B receptor are associated with clinical symptoms in migraineurs. J Neural Transm (Vienna) 2007; 114:1227-32. [PMID: 17417740 DOI: 10.1007/s00702-007-0713-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2005] [Accepted: 03/03/2007] [Indexed: 10/23/2022]
Abstract
Migraine is regarded as a polygenic disease and serotonergic pathways appear to play a major role in its pathogenesis. In the present study, the role of the 5-HT1A and 5-HT1B receptors in migraine was evaluated. The human 5-HT1A receptor gene transcription is modulated by a functional C-1019G promoter polymorphism. The 5-HT1B receptor is the main effector of vasoconstriction in meningeal and cerebral arteries and its functional G861C promoter polymorphism was investigated. We report a positive association of the GG genotype of the 5-HT1A promoter polymorphism with avoidance of physical activity during a migraine attack in comparison to the CC genotype (p = 0.008). Moreover, a positive association of the CC genotype of the G861C polymorphism of the 5-HT1B receptor with the reported intensity of the headache attack on the visual analogue scale was observed (CC 8.3 +/- 1.5 vs. GG 6.9 +/- 1.8; p < 0.05). An association of either polymorphism with migraine with or without aura could not be found. For the first time, our results indicate a role of allelic variation of the 5-HT1A receptor in motion related discomfort in migraineurs and a role of the 5-HT1B receptor polymorphism in headache intensity.
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Affiliation(s)
- M Marziniak
- Department of Neurology, University of Würzburg, Würzburg, Germany.
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Abstract
BACKGROUND Interleukin (IL) 19, IL-20 and IL-24 belong to the IL-10 cytokine family and have been identified to play a role in the regulation of epidermal functions and in inflammation. The genes encoding IL-19, IL-20 and IL-24 are located within a gene cluster on chromosome 1q31-32 and carry frequent genetic variations. OBJECTIVES This study investigated whether variations in the IL19, IL20 and IL24 genes that have previously been associated with plaque-type psoriasis may also play a role in palmoplantar pustulosis (PPP). PATIENTS Fifteen polymorphisms were analysed in 43 patients with PPP and in 149 healthy control subjects. RESULTS The rare allele of IL20 1380 A-->G (rs2981573) was less frequent in patients with PPP compared with healthy controls (OR 1 x 95, 95% CI 1 x 00-3 x 79). Haplotype analyses of IL19 and IL20 suggested an increased risk for PPP associated with IL20 haplotype GAA (OR 2 x 39, 95% CI 1 x 17-4 x 86) and a reduced risk for PPP associated both with IL19 haplotype GATGATA (OR 0 x 41, 95% CI 0 x 16-1 x 05) and IL20 haplotype GGG (OR 0 x 48, 95% CI 0 x 23-0 x 98). Extended haplotype analysis revealed an association of IL19/IL20 haplotype GACACCGGAA with a higher risk for PPP (OR 2 x 31, 95% CI 1 x 05-5 x 10) and of IL20/IL24 haplotype CAAAC with a reduced risk for PPP (OR 0 x 12, 95% CI 0 x 02-0 x 82). CONCLUSIONS This exploratory study supports the hypothesis that variations of genes of the IL-19 subfamily of cytokines influence susceptibility to PPP. However, due to the limited size of the study samples, this current concept should be considered as preliminary and the results need to be confirmed in future independent studies.
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Affiliation(s)
- K Kingo
- Department of Dermatology and Venereology, University of Tartu, Tartu, Estonia
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36
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Reich K, Hüffmeier U, König IR, Lascorz J, Lohmann J, Wendler J, Traupe H, Mössner R, Reis A, Burkhardt H. Tumor necrosis factor polymorphisms in psoriatic arthritis: association with the promoter polymorphism TNF-857 independent of the PSORS1 risk allele. Arthritis Res Ther 2007. [PMCID: PMC4061944 DOI: 10.1186/ar2244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mössner R, Freitag CM, Marziniak M, Moser D, Sommer C, Meyer J. The functional Val158Met variant of the COMT gene is not associated with migraine with or without aura. J Headache Pain 2006; 7:165-6. [PMID: 16767536 PMCID: PMC3451563 DOI: 10.1007/s10194-006-0293-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Accepted: 05/12/2006] [Indexed: 11/05/2022] Open
Affiliation(s)
- R. Mössner
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
- Department of Genetics and Applied
Genomics, University of Toronto,
Toronto Medical Discovery Tower, 101 College St., 14-701, Toronto, Ontario M5G 1L7 Canada
| | - C. M. Freitag
- Department of Child and Adolescent
Psychiatry, University of Homburg, Homburg, Germany
| | - M. Marziniak
- Department of Neurology, University of Würzburg, Würzburg, Germany
- Department of Neurology, University of Homburg, Homburg, Germany
| | - D. Moser
- Department of Neuro-Behavioral
Genetics, University of Trier, Trier, Germany
| | - C. Sommer
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - J. Meyer
- Department of Neuro-Behavioral
Genetics, University of Trier, Trier, Germany
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Lesch KP, Mössner R. Inactivation of 5HT transport in mice: modeling altered 5HT homeostasis implicated in emotional dysfunction, affective disorders, and somatic syndromes. Handb Exp Pharmacol 2006:417-56. [PMID: 16722245 DOI: 10.1007/3-540-29784-7_18] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Animal models have not only become an essential tool for investigating the neurobiological function of genes that are involved in the etiopathogenesis of human behavioral and psychiatric disorders but are also fundamental in the development novel therapeutic strategies. As an example, inactivation of the serotonin (5HT) transporter (5Htt, Slc6a4) gene in mice expanded our view of adaptive 5HT uptake regulation and maintenance of 5HT homeostasis in the developing human brain and molecular processes underlying anxiety-related traits, as well as affective spectrum disorders including depression. 5Htt-deficient mice have been employed as a model complementary to direct studies of genetically complex traits and disorders, with important findings in biochemical, morphological, behavioral, and pharmacological areas. Based on growing evidence for a critical role of the 5HTT in the integration of synaptic connections in the rodent, nonhuman primate, and human brain during critical periods of development and adult life, more in-depth knowledge of the molecular mechanisms implicated in these fine-tuning processes is currently evolving. Moreover, demonstration of a joint influence of the 5HTT variation and environmental sources during early brain development advanced our understanding of the mechanism of genexgene and genexenvironment interactions in the developmental neurobiology of anxiety and depression. Lastly, imaging techniques, which become increasingly elaborate in displaying the genomic influence on brain system activation in response to environmental cues, have provided the means to bridge the gap between small effects of 5HTT variation and complex behavior, as well as psychopathological dimensions. The combination of elaborate genetic, epigenetic, imaging, and behavioral analyses will continue to generate new insight into 5HTT's role as a master control gene of emotion regulation.
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Affiliation(s)
- K P Lesch
- Molecular and Clinical Psychobiology, Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstr. 15, 97080 Würzburg, Germany.
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Hofstetter HH, Mössner R, Lesch KP, Linker RA, Toyka KV, Gold R. Absence of reuptake of serotonin influences susceptibility to clinical autoimmune disease and neuroantigen-specific interferon-gamma production in mouse EAE. Clin Exp Immunol 2005; 142:39-44. [PMID: 16178854 PMCID: PMC1809476 DOI: 10.1111/j.1365-2249.2005.02901.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Serotonin (5-hydroxytryptamine, 5-HT) is one of the most extensively studied neurotransmitters of the central nervous system. It also has been identified in constituents of the immune system. Therefore serotonin has been suggested to serve as a mediator of bidirectional interactions between the nervous system and the immune system. We investigated this interaction in experimental autoimmune encephalomyelitis (EAE), a well-defined animal model of autoimmune disease of the central nervous system (CNS) mimicking features of the human disease multiple sclerosis. EAE was induced by immunization with the autoantigens myelin basic protein (MBP) or the immunodominant peptide of myelin oligodendrocyte glycoprotein (MOG) spanning amino acids 35-55 (MOGp 35-55). We studied EAE in knockout (KO) mice lacking the 5-HT transporter (5-HTT) on a C57.BL/6 background, in comparison with wild-type C57.BL/6 animals. After immunization with MOGp 35-55, or with rat MBP, the disease courses of the 5-HTT knockout mice were attenuated as compared to wildtype control mice. This difference was more pronounced in female animals. To dissect potential immune mechanisms underlying this phenomenon, histological studies of the CNS and cytokine measurements in mononuclear cells from the spleens of 5-HTT KO mice and wild-type controls were performed. We found a reduction of the inflammatory infiltrate in the CNS and of the neuroantigen-specific production of IFN-gamma in splenocytes, again accompanied by a gender difference. These findings suggest a potential role of extracellular 5-HT homeostasis in the fine-tuning of neuroantigen-specific immune responses.
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Affiliation(s)
- H H Hofstetter
- Clinical Research Group for Multiple Sclerosis, Department of Neurology, University of Würzburg, Germany
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Hüffmeier U, Steffens M, Burkhardt H, Lascorz J, Schürmeier-Horst F, Ständer M, Kelsch R, Baumann C, Küster W, Mössner R, Reich K, Wienker TF, Traupe H, Reis A. Evidence for susceptibility determinant(s) to psoriasis vulgaris in or near PTPN22 in German patients. J Med Genet 2005; 43:517-22. [PMID: 16339849 PMCID: PMC2593025 DOI: 10.1136/jmg.2005.037515] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Variant R620W of protein tyrosine phosphatase non-receptor type 22 (PTPN22) has consistently been reported as a susceptibility factor for several autoimmune diseases. We investigated its role in susceptibility to psoriasis, the relevance of possibly other disease-causing variants, and interdependency of the major risk factor for psoriasis at PSORS1. METHODS R620W was tested in a case-control study initially with 375 German patients and then with an enlarged sample of an additional 418 patients. Analyses were extended to linkage disequilibrium (LD) based haplotypes. Potential interaction between risk haplotypes of PTPN22 and the PSORS1 associated risk allele was tested by regression analysis. PTPN22 coding sequence was determined in 20 patients carrying the risk haplotype. Association and regression analysis were also performed in the extended case-control study. RESULTS R620W was not associated in either case-control study, while significant association (corrected for multiple testing) with one haplotype (C-4) of the LD block encompassing PTPN22 as well with another haplotype (B-3) within an adjacent telomeric LD block was detected. No evidence for interaction between risk haplotype C-4 and the PSORS1 associated risk allele was found. Sequencing excluded other coding variants within PTPN22 as a basis for association findings. Analysis of the extended study group confirmed association for haplotypes B-3 and C-4 and independence of risk haplotypes C-4 and PSORS1. DISCUSSION We exclude a major role of *620W in German psoriasis patients but suggest that other susceptibility determinant(s) within non-coding regions of PTPN22 or its proximity might exist acting independently of the major PSORS1 risk factor.
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Affiliation(s)
- U Hüffmeier
- Institute of Human Genetics, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
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41
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Abstract
An association study was performed in 197 migraineurs with regard to a functional serotonin (5-HT) transporter (5-HTT) gene promoter polymorphism that leads to low or high 5-HT uptake activity. The frequency of the less active short allele was increased in migraineurs with aura but not in migraineurs without aura in comparison with the control population (p < 0.001). This indicates that the 5-HTT may be involved in the polygenic etiology of migraine with aura.
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Affiliation(s)
- M Marziniak
- Department of Neurology, University of Würzburg, Germany.
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Mössner R, Reich K. [Infliximab. Role in the treatment of psoriasis]. Hautarzt 2005; 56:831-2, 834-8. [PMID: 16133635 DOI: 10.1007/s00105-005-1005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Psoriasis is one of the immune-mediated inflammatory diseases (IMIDs), in whose pathogenesis Th1-mediated immune responses are considered crucial. Infliximab is a chimeric monoclonal antibody directed against the Th1-cytokine TNF-alpha that has already been approved for the therapy of psoriatic arthritis (in combination with methotrexate). In clinical studies, infliximab has proved safe and effective in treating plaque-type psoriasis. In 80% of treated patients, the Psoriasis Area and Severity Index (PASI) decreased after 10 weeks by > or =75%. Infliximab is expected to be approved as second-line therapy in Germany this year for the treatment of psoriasis vulgaris.
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Affiliation(s)
- R Mössner
- Abteilung Dermatologie und Venerologie, Georg-August-Universität Göttingen
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Blankenburg S, König IR, Laspe P, Thoms KM, Krüger U, Mössner R, Westphal G, Volkenandt M, Reich K, Neumann C, Ziegler A, Emmert S. Assoziation von 3 Xeroderma Pigmentosum Gruppe C Gen Polymorphismen mit dem Risiko der Entwicklung eines malignen Melanoms: Eine Fall-Kontroll-Studie. Akt Dermatol 2004. [DOI: 10.1055/s-2004-832502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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44
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Mössner R, Jankowski F, Krüger U, König IR, Berking C, Westphal G, Brockmöller J, Neumann C, Ziegler A, Volkenandt M, Kaiser R, Reich K. Assoziation eines Polymorphismus im Peroxisome Proliferator-activated Receptor (PPAR)-γ Gen mit dem Risiko der Entwicklung eines Melanoms. Akt Dermatol 2004. [DOI: 10.1055/s-2004-832497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Marziniak M, Mössner R, Benninghoff J, Syagailo YV, Lesch KP, Sommer C. Association analysis of the functional monoamine oxidase A gene promotor polymorphism in migraine. J Neural Transm (Vienna) 2004; 111:603-9. [PMID: 15088153 DOI: 10.1007/s00702-004-0108-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2003] [Accepted: 01/11/2004] [Indexed: 11/26/2022]
Abstract
Migraine affects about 15% of the adult population. Serotonergic and dopaminergic systems are believed to be involved in its pathophysiology. One of the key enzymes in the degradation of serotonin and to a lesser extent of dopamine is monoamine oxidase A (MAO-A). In this study we investigated a functionally relevant gene-linked polymorphic repetitive sequence (LPR) located approximately 1.2 kb upstream of the ATG codon in the MAO-A-promotor gene. 119 patients with migraine and 229 controls were tested. The allelic distribution of the controls and the migraine patients did not show significant differences with respect to the low- and high-activity alleles. Moreover, effectiveness of the potent serotonergic antimigraine agents, triptans, which are metabolized by MAO-A, was clinically not affected by the MAO-A-LPR in our patients. These findings thus indicate that there is no association between the functional MAO-A-LPR and susceptibility to migraine.
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Affiliation(s)
- M Marziniak
- Department of Neurology, University of Würzburg, Würzburg, Germany.
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46
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Mössner R, Schmitt A. An organic cation transporter capable of transporting serotonin is upregulated in serotonin transporter-deficient mice. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mössner R, Beckmann I, Hallermann C, Neumann C, Reich K. Granulocyte colony-stimulating-factor-induced psoriasiform dermatitis resembles psoriasis with regard to abnormal cytokine expression and epidermal activation. Exp Dermatol 2004; 13:340-6. [PMID: 15186319 DOI: 10.1111/j.0906-6705.2004.00190.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Psoriasis is a chronic inflammatory skin disorder characterized by accumulation of Th1-type T cells and neutrophils, regenerative keratinocyte proliferation and differentiation, and enhanced epidermal production of antimicrobial peptides. The underlying cause is unknown, but there are some similarities with the immunologic defense program against bacteria. Development of psoriasiform skin lesions has been reported after administration of granulocyte colony-stimulating factor (G-CSF), a cytokine induced in monocytes by bacterial antigens. To further investigate the relation between this type of cytokine-induced dermatitis and psoriasis, we analyzed the cutaneous cytokine profile [tumor necrosis factor-alpha (TNF-alpha), interferon-gamma, transforming growth factor-beta1 (TGF-beta1), interleukin-10 (IL-10), IL-12p35 and p40, and IL-8] and expression of markers of epidermal activation [Ki-67, cytokeratin-16, major histocompatibility complex (MHC) class II, intercellular adhesion molecule-1 (ICAM-1)] in a patient who developed G-CSF-induced psoriasiform dermatitis by using quantitative real-time reverse transcriptase-polymerase chain reaction and immunohistology. The histologic picture resembled psoriasis with regard to epidermal hyperparakeratosis and the accumulation of lymphocytes in the upper corium. CD8(+) T cells were found to infiltrate the epidermis which was associated with an aberrant expression of Ki-67, cytokeratin-16, MHC class II, and ICAM-1 on adjacent keratinocytes. As compared to normal skin (n = 7), there was an increased expression of TNF-alpha, IL-12p40, and IL-8, a decreased expression of TGF-beta1, and a lack of IL-10, similar to the findings in active psoriasis (n = 8). Therefore, G-CSF may cause a lymphocytic dermatitis that, similar to psoriasis, is characterized by a pro-inflammatory Th1-type cytokine milieu and an epidermal phenotype indicative of aberrant maturation and acquisition of non-professional immune functions.
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Affiliation(s)
- R Mössner
- Department of Dermatology, Georg-August-University Göttingen, Germany
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Mössner R, Schmitt A, Hennig T, Benninghoff J, Gerlach M, Riederer P, Deckert J, Lesch KP. Quantitation of 5HT3 receptors in forebrain of serotonin transporter deficient mice. J Neural Transm (Vienna) 2004; 111:27-35. [PMID: 14714213 DOI: 10.1007/s00702-003-0074-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2003] [Indexed: 11/25/2022]
Abstract
Mice deficient in the serotonin transporter (5HTT) display highly elevated extracellular 5HT levels. 5HT exerts ist effects via at least fourteen different cloned 5HT receptors located pre- and postsynaptically. In contrast to the other 5HT receptors, the 5HT3 receptor is a ionotropic receptor with ligand-gated cation channel function. Since G-protein-coupled 5HT receptors show extensive adaptive changes in 5HTT-deficient mice, we investigated whether 5HT3 receptors are also altered in these mice. Using quantitative autoradiography, we found that 5HT3 receptors are upregulated in frontal cortex (+46%), parietal cortex (+42%), and in stratum oriens of the CA3 region of the hippocampus (+18%) of 5HTT knockout mice. Changes in 5HT3 receptor mRNA expression, as determined by quantitative in situ hybridisation, were less pronounced. The adaptive changes of 5HT3 receptor expression constitute a part of the complex regulatory pattern of 5HT receptors in 5HTT knockout mice.
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Affiliation(s)
- R Mössner
- Department of Psychiatry and Psychotherapy, University of Wuerzburg, Germany.
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Glatz K, Mössner R, Heils A, Lesch KP. Glucocorticoid-regulated human serotonin transporter (5-HTT) expression is modulated by the 5-HTT gene-promotor-linked polymorphic region. J Neurochem 2003; 86:1072-8. [PMID: 12911615 DOI: 10.1046/j.1471-4159.2003.01944.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Mood, emotion and cognition are modulated by serotonergic neurotransmission, while the physiological function of serotonergic synapses depends on serotonin reuptake, which is mediated by the serotonin transporter (5-HTT). Allelic variation of 5-HTT expression in humans is caused by a functional gene-promoter polymorphism with two predominant variant alleles, which are associated with variations in anxiety measures as previously reported. Here we report that administration of dexamethasone, a potent glucocorticosteroid hormone, results in an increase in 5-HTT expression in immortalized human B-lymphoblastoid cells, which express the human 5-HTT. Functional reporter gene assays as well as 5-HT uptake and inhibitor binding measures revealed a genotype-dependent dose-response to glucocorticosteroid administration, which was antagonized by RU 38486, a non-specific glucocorticosteroid hormone antagonist. The allele-specific differences after administration of dexamethasone depended on the repetitive GC-rich sequence located approximately 1.4 kb upstream of the 5-HTT gene transcription site because of absence of a significant steroid effect after transfecting a deletional mutant reporter gene construct, which lacks this repetitive promoter sequence. Our findings may contribute to explain the vulnerability to stress-related disorders in susceptible individuals, in whom further clinical studies should follow up on these in vitro findings.
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Affiliation(s)
- K Glatz
- Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080 Würzburg, Germany
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Abstract
BACKGROUND Atopic dermatitis (AD) and psoriasis are genetically determined inflammatory skin disorders characterized by abnormal cytokine production. From association studies there is evidence that functionally relevant cytokine gene polymorphisms contribute to the genetic basis of psoriasis. Association studies in AD have mostly been limited to polymorphisms of T-helper 2-type cytokines, which dominate in acute AD lesions. Unexpectedly, the results of recent genome scans indicate linkage of AD to psoriasis susceptibility loci. Therefore, AD may also be influenced by genes that modulate cutaneous inflammation independently from atopic mechanisms. OBJECTIVES To investigate further the role of cytokine gene polymorphisms in AD. METHODS Polymorphisms in the genes encoding tumour necrosis factor-alpha (TNFA-238 G/A, -308 G/A), interleukin (IL)-1beta (IL1B-511 T/C, +3953 T/C), IL-6 (IL6-174 C/G), IL-10 (IL10-1082 A/G) and the IL-1 receptor antagonist (IL1RN intron 2) were investigated in German patients with AD (n = 94) and in healthy nonatopic individuals (n = 214) by polymerase chain reaction-based methods and direct cycle sequencing. RESULTS No association was found between AD and any of the polymorphisms analysed. This is in contrast to the recently described association between psoriasis and the TNFA-238 and IL1B-511 polymorphisms. CONCLUSIONS Our data indicate that cytokine gene polymorphisms may act as specific markers of inflammatory skin diseases rather than contribute to a general disposition towards cutaneous inflammation.
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Affiliation(s)
- K Reich
- Departments of Dermatology and Occupational Health, Georg-August-University, von-Siebold-Strasse 3, D-37075 Göttingen, Germany.
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