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Lascaris B, Hoffmann RF, Nijsten MW, Porte RJ, de Meijer VE. Continuous Renal Replacement Therapy During Long-term Normothermic Machine Perfusion of Human Donor Livers for up to 7 D. Transplant Direct 2024; 10:e1568. [PMID: 38274473 PMCID: PMC10810577 DOI: 10.1097/txd.0000000000001568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/28/2023] [Indexed: 01/27/2024] Open
Abstract
Background Normothermic machine perfusion (NMP) is used to preserve and test donor livers before transplantation. During NMP, the liver is metabolically active and produces waste products, which are released into the perfusate. In this study, we describe our simplified and inexpensive setup that integrates continuous renal replacement therapy (CRRT) with NMP for up to 7 d. We also investigated if the ultrafiltrate could be used for monitoring perfusate concentrations of small molecules such as glucose and lactate. Methods Perfusate composition (urea, osmolarity, sodium, potassium, chloride, calcium, magnesium, phosphate, glucose, and lactate) was analyzed from 56 human NMP procedures without CRRT. Next, in 6 discarded human donor livers, CRRT was performed during NMP by integrating a small dialysis filter (0.2 m2) into the circuit to achieve continuous ultrafiltration combined with continuous fluid substitution for up to 7 d. Results Within a few hours of NMP without CRRT, a linear increase in osmolarity and concentrations of urea and phosphate to supraphysiological levels was observed. After integration of CRRT into the NMP circuit, the composition of the perfusate was corrected to physiological values within 12 h, and this homeostasis was maintained during NMP for up to 7 d. Glucose and lactate levels, as measured in the CRRT ultrafiltrate, were strongly correlated with perfusate levels (r = 0.997, P < 0.001 and r = 0.999, P < 0.001, respectively). Conclusions The integration of CRRT into the NMP system corrected the composition of the perfusate to near-physiological values, which could be maintained for up to 7 d. The ultrafiltrate can serve as an alternative to the perfusate to monitor concentrations of small molecules without potentially compromising sterility.
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Affiliation(s)
- Bianca Lascaris
- Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- UMCG Comprehensive Transplant Center, Groningen, The Netherlands
| | - Roland F. Hoffmann
- Department of Cardiothoracic Surgery, Section Extracorporeal Circulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maarten W.N. Nijsten
- Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Robert J. Porte
- Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Division of HPB and Transplant Surgery, Department of Surgery, Erasmus MC Transplant Institute, Rotterdam, The Netherlands
| | - Vincent E. de Meijer
- Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- UMCG Comprehensive Transplant Center, Groningen, The Netherlands
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2
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Arrigoni SC, van der Maaten JMAA, Roofthooft MTR, Hoffmann RF, Berger RMF, Ebels T. Intraoperative transit-time flow measurement of caval veins before and after bidirectional cavopulmonary anastomosis. Cardiol Young 2023:1-7. [PMID: 38037796 DOI: 10.1017/s104795112300402x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Haemodynamic changes in caval venous flow distribution occurring during bidirectional cavopulmonary anastomosis operation are still largely unknown. METHODS Transit time flow measurements were performed in 15 cavopulmonary anastomosis operations. Superior and inferior caval vein flows were measured before and after the cavopulmonary anastomosis. Ratio of superior caval vein to overall caval veins flow was calculated. RESULTS Mean superior caval vein flow ratio before cavopulmonary anastomosis was higher than previously reported for healthy children. Superior caval vein flow ratio decreased in 14/15 patients after cavopulmonary anastomosis: mean 0.63 ± 0.12 before versus 0.43 ± 0.14 after. No linear correlation between intraoperative superior caval vein pressure and superior caval vein flow after cavopulmonary anastomosis was found. Neither Nakata index nor pulmonary vascular resistance measured at preoperative cardiac catheterisation correlated with intraoperative flows. None of patients died or required a take down. CONCLUSIONS The higher mean superior caval vein flow ratio before cavopulmonary anastomosis compared to healthy children suggests flow redistribution in univentricular physiology to protect brain and neurodevelopment. The decrease of superior caval vein flow ratio after cavopulmonary anastomosis may reflect the flow redistribution related to trans-pulmonary gradient. The lack of correlation between superior caval vein pressure and superior caval vein flow could be explained by limited sample size and multifactorial determinants of caval veins flow, although pressure remain essential. Larger sample of measurements are needed to find flow range potentially predictive for clinical failure. To authors' knowledge, this is the first intraoperative flow measurement of both caval veins during cavopulmonary operations.
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Affiliation(s)
- Sara C Arrigoni
- Department of Cardiothoracic Surgery, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Joost M A A van der Maaten
- Department of Anesthesiology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Marc T R Roofthooft
- Department of Pediatric Cardiology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Roland F Hoffmann
- Department of Cardiothoracic Surgery, Section Extracorporeal Circulation University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Rolf M F Berger
- Department of Pediatric Cardiology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Tjark Ebels
- Department of Cardiothoracic Surgery, University of Groningen, University Medical Center, Groningen, The Netherlands
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3
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van Minnen O, Oude Lansink-Hartgring A, Hoffmann RF, van den Bergh WM. Risk factors for elective and emergency oxygenator exchanges during veno-venous extracorporeal membrane oxygenation. Perfusion 2023:2676591231168642. [PMID: 36995209 DOI: 10.1177/02676591231168642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND Despite systemic anticoagulation and antithrombotic surface coating, oxygenator dysfunction remains one of most common technical complications of Extracorporeal membrane oxygenation (ECMO). Several parameters have been associated with an oxygenator exchange, but no guidelines for when to perform an exchange are published. An exchange, especially an emergency exchange, has a risk of complications. Therefore, a delicate balance between oxygenator dysfunction and the exchange of the oxygenator exists. This study aimed to identify risk factors and predictors for elective and emergency oxygenator exchanges. METHODS This observational cohort study included all adult patients supported with veno-venous extracorporeal membrane oxygenation (V-V ECMO). We compared patients' characteristics and laboratory values of patients with and without an oxygenator exchange and between an elective and emergency exchange, defined as an exchange outside office hours. Risk factors for an oxygenator exchange were identified with cox regression analyses, and risk factors for an emergency exchange were identified with logistic regression analyses. RESULTS We included forty-five patients in the analyses. There were twenty-nine oxygenator exchanges in nineteen patients (42%). More than a third of the exchanges were emergency exchanges. Higher partial pressure of carbon dioxide (PaCO2), transmembrane pressure difference (ΔP), and hemoglobin (Hb) were associated with an oxygenator exchange. Lower lactate dehydrogenase (LDH) was the only risk factor for an emergency exchange. CONCLUSION Oxygenator exchange is frequent during V-V ECMO support. PaCO2, ΔP and Hb were associated with an oxygenator exchange and lower LDH with the risk of an emergency exchange.
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Affiliation(s)
- Olivier van Minnen
- Department of Critical Care of the University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Roland F Hoffmann
- Department of Cardiothoracic Surgery, Section Extracorporeal Circulation of the University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Walter M van den Bergh
- Department of Critical Care of the University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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4
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Hoffmann RF, Horsten S, Mariani MA, de Vries AJ. Clinical monitoring of activated clotting time during cardiothoracic surgery: comparing the Hemochron ® Response and Hemochron ® Signature Elite. Perfusion 2023; 38:285-291. [PMID: 34596463 PMCID: PMC9932611 DOI: 10.1177/02676591211049316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The Activated Clotting Time (ACT) is commonly used to manage anticoagulation during cardiac surgery. The aim of this study was to compare the older manually operated Hemochron® Response and the automated Hemochron® Signature Elite. METHODS In this observational study the clinically relevant differences of both devices were investigated simultaneously, using duplicate measurements, in 29 patients who underwent a Coronary Artery Bypass Grafting (CABG) or Aortic Valve Replacement (AVR) in order to determine reliability, bias, and to detect which method has the lowest variation. Blood samples were obtained from the arterial line prior to surgery, after administration of 300 IU/kg heparin, 5 minutes after initiation of cardiopulmonary bypass and successively every 30 minutes, and after protamine administration. RESULTS A total of 202 measurements were performed. Of these 10 measurements were out of range in the Response and 9 in the Elite. About 27 single unstable magnet errors were seen in the Response versus no measurement errors in the Elite. No statistically significant differences between the Response (p = 0.22, Wilcoxon rank) and Elite (p = 0.064) duplicates were observed. The Response values were consistently higher during heparinization than the Elite measurements (p = 0.002, repeated measurements) with an average positive bias of around 56 seconds during heparinization (Bland-Altman). Overall, the coefficient of variation (CoV) increased during heparinization. CONCLUSION The Elite was more reliable, but the variation was higher for the Elite than the Response. The observed positive bias in the Response compared to the Elite could affect heparin administration during surgery making the two systems not interchangeable.
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Affiliation(s)
- Roland F Hoffmann
- Department of Cardiothoracic Surgery,
Section Extracorporeal Circulation, University of Groningen, University Medical
Center Groningen, Groningen, The Netherlands,Roland F Hoffmann, Department of
Cardiothoracic Surgery, Section Extracorporeal Circulation, University of
Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen,
The Netherlands.
| | - Sandra Horsten
- Department of Cardiothoracic Surgery,
Section Extracorporeal Circulation, University of Groningen, University Medical
Center Groningen, Groningen, The Netherlands
| | - Massimo A Mariani
- Department of Cardiothoracic Surgery,
Section Thoracic Surgery, University of Groningen, University Medical Center
Groningen, Groningen, The Netherlands
| | - Adrianus J de Vries
- Department of Anesthesiology,
University of Groningen, University Medical Center Groningen, Groningen, The
Netherlands
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5
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van Gisbergen MW, Offermans K, Voets AM, Lieuwes NG, Biemans R, Hoffmann RF, Dubois LJ, Lambin P. Mitochondrial Dysfunction Inhibits Hypoxia-Induced HIF-1α Stabilization and Expression of Its Downstream Targets. Front Oncol 2020; 10:770. [PMID: 32509579 PMCID: PMC7248342 DOI: 10.3389/fonc.2020.00770] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/21/2020] [Indexed: 12/13/2022] Open
Abstract
mtDNA variations often result in bioenergetic dysfunction inducing a metabolic switch toward glycolysis resulting in an unbalanced pH homeostasis. In hypoxic cells, expression of the tumor-associated carbonic anhydrase IX (CAIX) is enhanced to maintain cellular pH homeostasis. We hypothesized that cells with a dysfunctional oxidative phosphorylation machinery display elevated CAIX expression levels. Increased glycolysis was observed for cytoplasmic 143B mutant hybrid (m.3243A>G, >94.5%) cells (p < 0.05) and 143B mitochondrial DNA (mtDNA) depleted cells (p < 0.05). Upon hypoxia (0.2%, 16 h), genetic or pharmacological oxidative phosphorylation (OXPHOS) inhibition resulted in decreased CAIX (p < 0.05), vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1-alpha (HIF-1α) expression levels. Reactive oxygen species (ROS) and prolyl-hydroxylase 2 (PHD2) levels could not explain these observations. In vivo, tumor take (>500 mm3) took longer for mutant hybrid xenografts, but growth rates were comparable with control tumors upon establishment. Previously, it has been shown that HIF-1α is responsible for tumor establishment. In agreement, we found that HIF-1α expression levels and the pimonidazole-positive hypoxic fraction were reduced for the mutant hybrid xenografts. Our results demonstrate that OXPHOS dysfunction leads to a decreased HIF-1α stabilization and subsequently to a reduced expression of its downstream targets and hypoxic fraction in vivo. In contrast, hypoxia-inducible factor 2-alpha (HIF-2α) expression levels in these xenografts were enhanced. Inhibition of mitochondrial function is therefore an interesting approach to increase therapeutic efficacy in hypoxic tumors.
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Affiliation(s)
- Marike W van Gisbergen
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
| | - Kelly Offermans
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
| | - An M Voets
- Department of Clinical Genomics, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Natasja G Lieuwes
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
| | - Rianne Biemans
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
| | - Roland F Hoffmann
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ludwig J Dubois
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
| | - Philippe Lambin
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
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Hoffmann RF, Jonker MR, Brandenburg SM, de Bruin HG, Ten Hacken NHT, van Oosterhout AJM, Heijink IH. Mitochondrial dysfunction increases pro-inflammatory cytokine production and impairs repair and corticosteroid responsiveness in lung epithelium. Sci Rep 2019; 9:15047. [PMID: 31636329 PMCID: PMC6803636 DOI: 10.1038/s41598-019-51517-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 09/25/2019] [Indexed: 12/13/2022] Open
Abstract
COPD is characterized by chronic lung inflammation and irreversible lung tissue damage. Inhaled noxious gases, including cigarette smoke, are the major risk factor for COPD. Inhaled smoke first encounters the epithelial lining of the lungs, causing oxidative stress and mitochondrial dysfunction. We investigated whether a mitochondrial defect may contribute to increased lung epithelial pro-inflammatory responses, impaired epithelial repair and reduced corticosteroid sensitivity as observed in COPD. We used wild-type alveolar epithelial cells A549 and mitochondrial DNA-depleted A549 cells (A549 Rho-0) and studied pro-inflammatory responses using (multiplex) ELISA as well as epithelial barrier function and repair (real-time impedance measurements), in the presence and absence of the inhaled corticosteroid budesonide. We observed that A549 Rho-0 cells secrete higher levels of pro-inflammatory cytokines than wild-type A549 cells and display impaired repair upon wounding. Budesonide strongly suppressed the production of neutrophil attractant CXCL8, and promoted epithelial integrity in A549 wild-type cells, while A549 Rho-0 cells displayed reduced corticosteroid sensitivity compared to wild-type cells. The reduced corticosteroid responsiveness may be mediated by glycolytic reprogramming, specifically glycolysis-associated PI3K signaling, as PI3K inhibitor LY294002 restored the sensitivity of CXCL8 secretion to corticosteroids in A549 Rho-0 cells. In conclusion, mitochondrial defects may lead to increased lung epithelial pro-inflammatory responses, reduced epithelial repair and reduced corticosteroid responsiveness in lung epithelium, thus potentially contributing to the pathogenesis of COPD.
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Affiliation(s)
- R F Hoffmann
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands
| | - M R Jonker
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands
| | - S M Brandenburg
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
| | - H G de Bruin
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands
| | - N H T Ten Hacken
- University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, The Netherlands
| | - A J M van Oosterhout
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands
| | - I H Heijink
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands.
- University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands.
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, The Netherlands.
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7
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van Gisbergen MW, Voets AM, Biemans R, Hoffmann RF, Drittij-Reijnders MJ, Haenen GRMM, Heijink IH, Rouschop KMA, Dubois LJ, Lambin P. Distinct radiation responses after in vitro mtDNA depletion are potentially related to oxidative stress. PLoS One 2017; 12:e0182508. [PMID: 28771582 PMCID: PMC5542624 DOI: 10.1371/journal.pone.0182508] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/19/2017] [Indexed: 01/29/2023] Open
Abstract
Several clinically used drugs are mitotoxic causing mitochondrial DNA (mtDNA) variations, and thereby influence cancer treatment response. We hypothesized that radiation responsiveness will be enhanced in cellular models with decreased mtDNA content, attributed to altered reactive oxygen species (ROS) production and antioxidant capacity. For this purpose BEAS-2B, A549, and 143B cell lines were depleted from their mtDNA (ρ0). Overall survival after irradiation was increased (p<0.001) for BEAS-2B ρ0 cells, while decreased for both tumor ρ0 lines (p<0.05). In agreement, increased residual DNA damage was observed after mtDNA depletion for A549 and 143B cells. Intrinsic radiosensitivity (surviving fraction at 2Gy) was not influenced. We investigated whether ROS levels, oxidative stress and/or antioxidant responses were responsible for altered radiation responses. Baseline ROS formation was similar between BEAS-2B parental and ρ0 cells, while reduced in A549 and 143B ρ0 cells, compared to their parental counterparts. After irradiation, ROS levels significantly increased for all parental cell lines, while levels for ρ0 cells remained unchanged. In order to investigate the presence of oxidative stress upon irradiation reduced glutathione: oxidized glutathione (GSH:GSSG) ratios were determined. Irradiation reduced GSH:GSSG ratios for BEAS-2B parental and 143B ρ0, while for A549 this ratio remained equal. Additionally, changes in antioxidant responses were observed. Our results indicate that mtDNA depletion results in varying radiation responses potentially involving variations in cellular ROS and antioxidant defence mechanisms. We therefore suggest when mitotoxic drugs are combined with radiation, in particular at high dose per fraction, the effect of these drugs on mtDNA copy number should be explored.
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Affiliation(s)
- Marike W. van Gisbergen
- Department of Radiation Oncology (MaastRO Lab), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- * E-mail:
| | - An M. Voets
- Department of Radiation Oncology (MaastRO Lab), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Clinical Genomics, GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rianne Biemans
- Department of Radiation Oncology (MaastRO Lab), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Roland F. Hoffmann
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marie-José Drittij-Reijnders
- Department of Toxicology, NUTRIM - School for Nutrition, Toxicology, and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Guido R. M. M. Haenen
- Department of Toxicology, NUTRIM - School for Nutrition, Toxicology, and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Irene H. Heijink
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands
| | - Kasper M. A. Rouschop
- Department of Radiation Oncology (MaastRO Lab), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ludwig J. Dubois
- Department of Radiation Oncology (MaastRO Lab), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Philippe Lambin
- Department of Radiation Oncology (MaastRO Lab), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
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8
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Hoffmann RF, Moshkin YM, Mouton S, Grzeschik NA, Kalicharan RD, Kuipers J, Wolters AHG, Nishida K, Romashchenko AV, Postberg J, Lipps H, Berezikov E, Sibon OCM, Giepmans BNG, Lansdorp PM. Guanine quadruplex structures localize to heterochromatin. Nucleic Acids Res 2017; 45:6253. [PMID: 28449026 PMCID: PMC5449592 DOI: 10.1093/nar/gkx301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Roland F Hoffmann
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Yuri M Moshkin
- Department of Biochemistry, Erasmus University Medical Center, Dr. Molewaterplein 50, NL-3015 GE Rotterdam, The Netherlands
| | - Stijn Mouton
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Nicola A Grzeschik
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Ruby D Kalicharan
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Jeroen Kuipers
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Anouk H G Wolters
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Kazuki Nishida
- Faculty of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Aleksander V Romashchenko
- Department of Biochemistry, Erasmus University Medical Center, Dr. Molewaterplein 50, NL-3015 GE Rotterdam, The Netherlands.,Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Jan Postberg
- Helios Medical Centre Wuppertal, Paediatrics Centre, Witten/Herdecke University, Wuppertal, Germany
| | - Hans Lipps
- Institute of Cell Biology, Centre for Biomedical Education and Research, Witten/Herdecke University, Witten, Germany
| | - Eugene Berezikov
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands.,Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Ody C M Sibon
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Ben N G Giepmans
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Peter M Lansdorp
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands.,Terry Fox Laboratory, British Columbia Cancer Agency and Department of Medicine, University of British Columbia Vancouver, BC, V5Z 1L3, Canada
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Keane SM, Culligan EP, Hoffmann RF, Gahan CGM, Hill C, Snelling WJ, Sleator RD. Shedding light on betL*: pPL2-lux mediated real-time analysis of betL* expression in Listeria monocytogenes. Bioengineered 2016; 7:116-9. [PMID: 27212260 DOI: 10.1080/21655979.2016.1171438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
We propose a mechanism of action for the betL* mutation which is based on DNA topology. Removing a single thymine residue from the betL σ(A) promoter's -10 and -35 spacer results in a 'twist'-mediated activation of transcription which accounts for the osmotolerance phenotype observed for strains expressing betL*.
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Affiliation(s)
- Shauna M Keane
- a Department of Biological Sciences , Cork Institute of Technology , Rossa Avenue, Bishopstown, Cork , Ireland
| | - Eamonn P Culligan
- a Department of Biological Sciences , Cork Institute of Technology , Rossa Avenue, Bishopstown, Cork , Ireland
| | - Roland F Hoffmann
- b APC Microbiome Institute, University College Cork , College Road, Cork , Ireland
| | - Cormac G M Gahan
- b APC Microbiome Institute, University College Cork , College Road, Cork , Ireland.,c School of Microbiology, University College Cork , College Road, Cork , Ireland.,d School of Pharmacy, University College Cork , College Road, Cork , Ireland
| | - Colin Hill
- b APC Microbiome Institute, University College Cork , College Road, Cork , Ireland.,c School of Microbiology, University College Cork , College Road, Cork , Ireland
| | - William J Snelling
- e Biomedical Sciences Research Institute, Ulster University , Northern Ireland
| | - Roy D Sleator
- a Department of Biological Sciences , Cork Institute of Technology , Rossa Avenue, Bishopstown, Cork , Ireland.,b APC Microbiome Institute, University College Cork , College Road, Cork , Ireland
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10
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Hoffmann RF, Moshkin YM, Mouton S, Grzeschik NA, Kalicharan RD, Kuipers J, Wolters AHG, Nishida K, Romashchenko AV, Postberg J, Lipps H, Berezikov E, Sibon OCM, Giepmans BNG, Lansdorp PM. Guanine quadruplex structures localize to heterochromatin. Nucleic Acids Res 2015; 44:152-63. [PMID: 26384414 PMCID: PMC4705689 DOI: 10.1093/nar/gkv900] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/21/2015] [Indexed: 12/27/2022] Open
Abstract
Increasing amounts of data support a role for guanine quadruplex (G4) DNA and RNA structures in various cellular processes. We stained different organisms with monoclonal antibody 1H6 specific for G4 DNA. Strikingly, immuno-electron microscopy showed exquisite specificity for heterochromatin. Polytene chromosomes from Drosophila salivary glands showed bands that co-localized with heterochromatin proteins HP1 and the SNF2 domain-containing protein SUUR. Staining was retained in SUUR knock-out mutants but lost upon overexpression of SUUR. Somatic cells in Macrostomum lignano were strongly labeled, but pluripotent stem cells labeled weakly. Similarly, germline stem cells in Drosophila ovaries were weakly labeled compared to most other cells. The unexpected presence of G4 structures in heterochromatin and the difference in G4 staining between somatic cells and stem cells with germline DNA in ciliates, flatworms, flies and mammals point to a conserved role for G4 structures in nuclear organization and cellular differentiation.
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Affiliation(s)
- Roland F Hoffmann
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Yuri M Moshkin
- Department of Biochemistry, Erasmus University Medical Center, Dr. Molewaterplein 50, NL-3015 GE Rotterdam, The Netherlands
| | - Stijn Mouton
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Nicola A Grzeschik
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Ruby D Kalicharan
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Jeroen Kuipers
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Anouk H G Wolters
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Kazuki Nishida
- Faculty of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Aleksander V Romashchenko
- Department of Biochemistry, Erasmus University Medical Center, Dr. Molewaterplein 50, NL-3015 GE Rotterdam, The Netherlands Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Jan Postberg
- Helios Medical Centre Wuppertal, Paediatrics Centre, Witten/Herdecke University, Wuppertal, Germany
| | - Hans Lipps
- Institute of Cell Biology, Centre for Biomedical Education and Research, Witten/Herdecke University, Witten, Germany
| | - Eugene Berezikov
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Ody C M Sibon
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Ben N G Giepmans
- Department of Cell Biology, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands
| | - Peter M Lansdorp
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Centre Groningen, A. Deusinglaan 1, NL-9713 AV Groningen, The Netherlands Terry Fox Laboratory, British Columbia Cancer Agency and Department of Medicine, University of British Columbia Vancouver, BC, V5Z 1L3, Canada
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11
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Ngkelo A, Hoffmann RF, Durham AL, Marwick JA, Brandenburg SM, de Bruin HG, Jonker MR, Rossios C, Tsitsiou E, Caramori G, Contoli M, Casolari P, Monaco F, Andò F, Speciale G, Kilty I, Chung KF, Papi A, Lindsay MA, Ten Hacken NHT, van den Berge M, Timens W, Barnes PJ, van Oosterhout AJ, Adcock IM, Kirkham PA, Heijink IH. Glycogen synthase kinase-3β modulation of glucocorticoid responsiveness in COPD. Am J Physiol Lung Cell Mol Physiol 2015; 309:L1112-23. [PMID: 26320152 PMCID: PMC4652154 DOI: 10.1152/ajplung.00077.2015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 08/06/2015] [Indexed: 01/24/2023] Open
Abstract
In chronic obstructive pulmonary disease (COPD), oxidative stress regulates the inflammatory response of bronchial epithelium and monocytes/macrophages through kinase modulation and has been linked to glucocorticoid unresponsiveness. Glycogen synthase-3β (GSK3β) inactivation plays a key role in mediating signaling processes upon reactive oxygen species (ROS) exposure. We hypothesized that GSK3β is involved in oxidative stress-induced glucocorticoid insensitivity in COPD. We studied levels of phospho-GSK3β-Ser9, a marker of GSK3β inactivation, in lung sections and cultured monocytes and bronchial epithelial cells of COPD patients, control smokers, and nonsmokers. We observed increased levels of phospho-GSK3β-Ser9 in monocytes, alveolar macrophages, and bronchial epithelial cells from COPD patients and control smokers compared with nonsmokers. Pharmacological inactivation of GSK3β did not affect CXCL8 or granulocyte-macrophage colony-stimulating factor (GM-CSF) expression but resulted in glucocorticoid insensitivity in vitro in both inflammatory and structural cells. Further mechanistic studies in monocyte and bronchial epithelial cell lines showed that GSK3β inactivation is a common effector of oxidative stress-induced activation of the MEK/ERK-1/2 and phosphatidylinositol 3-kinase/Akt signaling pathways leading to glucocorticoid unresponsiveness. In primary monocytes, the mechanism involved modulation of histone deacetylase 2 (HDAC2) activity in response to GSK3β inactivation. In conclusion, we demonstrate for the first time that ROS-induced glucocorticoid unresponsiveness in COPD is mediated through GSK3β, acting as a ROS-sensitive hub.
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Affiliation(s)
- Anta Ngkelo
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Roland F Hoffmann
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
| | - Andrew L Durham
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - John A Marwick
- Medical Research Council Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh Medical School, Edinburgh, United Kingdom
| | - Simone M Brandenburg
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
| | - Harold G de Bruin
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
| | - Marnix R Jonker
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
| | - Christos Rossios
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Eleni Tsitsiou
- Respiratory Research Group, Faculty of Medical and Human Sciences, University of Manchester, and National Institute for Health Research Translational Research Facility in Respiratory Medicine, University Hospital of South Manchester, Manchester, United Kingdom
| | - Gaetano Caramori
- Dipartimento di Scienze Mediche, Sezione di Medicina Interna e Cardiorespiratoria, Centro per lo Studio delle Malattie Infiammatorie Croniche delle Vie Aeree e Patologie Fumo Correlate dell'Apparato Respiratorio (formerly termed Centro di Ricerca su Asma e BPCO), Università di Ferrara, Ferrara, Italy
| | - Marco Contoli
- Dipartimento di Scienze Mediche, Sezione di Medicina Interna e Cardiorespiratoria, Centro per lo Studio delle Malattie Infiammatorie Croniche delle Vie Aeree e Patologie Fumo Correlate dell'Apparato Respiratorio (formerly termed Centro di Ricerca su Asma e BPCO), Università di Ferrara, Ferrara, Italy
| | - Paolo Casolari
- Dipartimento di Scienze Mediche, Sezione di Medicina Interna e Cardiorespiratoria, Centro per lo Studio delle Malattie Infiammatorie Croniche delle Vie Aeree e Patologie Fumo Correlate dell'Apparato Respiratorio (formerly termed Centro di Ricerca su Asma e BPCO), Università di Ferrara, Ferrara, Italy
| | - Francesco Monaco
- Thoracic Surgery Unit, Cardiovascular and Thoracic Department, University of Messina, Messina, Italy
| | - Filippo Andò
- Pneumology Unit, Cardiovascular and Thoracic Department, University of Messina, Italy
| | - Giuseppe Speciale
- Department of Human Pathology "Gaetano Barresi," University of Messina, Messina, Italy
| | - Iain Kilty
- Pfizer, Inflammation and Remodeling Research Unit, Cambridge, Massachusetts
| | - Kian F Chung
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Alberto Papi
- Dipartimento di Scienze Mediche, Sezione di Medicina Interna e Cardiorespiratoria, Centro per lo Studio delle Malattie Infiammatorie Croniche delle Vie Aeree e Patologie Fumo Correlate dell'Apparato Respiratorio (formerly termed Centro di Ricerca su Asma e BPCO), Università di Ferrara, Ferrara, Italy
| | - Mark A Lindsay
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, United Kingdom
| | - Nick H T Ten Hacken
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, The Netherlands; and University of Groningen, University Medical Center Groningen, Groningen, Groningen Research Institute for Asthma Research Institute, Groningen, The Netherlands
| | - Maarten van den Berge
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, The Netherlands; and University of Groningen, University Medical Center Groningen, Groningen, Groningen Research Institute for Asthma Research Institute, Groningen, The Netherlands
| | - Wim Timens
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Groningen, Groningen Research Institute for Asthma Research Institute, Groningen, The Netherlands
| | - Peter J Barnes
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Antoon J van Oosterhout
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Groningen, Groningen Research Institute for Asthma Research Institute, Groningen, The Netherlands
| | - Ian M Adcock
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom;
| | - Paul A Kirkham
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Irene H Heijink
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, The Netherlands; and University of Groningen, University Medical Center Groningen, Groningen, Groningen Research Institute for Asthma Research Institute, Groningen, The Netherlands
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12
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Telenga ED, Hoffmann RF, Ruben t'Kindt, Hoonhorst SJM, Willemse BWM, van Oosterhout AJM, Heijink IH, van den Berge M, Jorge L, Sandra P, Postma DS, Sandra K, ten Hacken NHT. Untargeted lipidomic analysis in chronic obstructive pulmonary disease. Uncovering sphingolipids. Am J Respir Crit Care Med 2014; 190:155-64. [PMID: 24871890 DOI: 10.1164/rccm.201312-2210oc] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Cigarette smoke is the major risk factor in the development of chronic obstructive pulmonary disease (COPD). Lipidomics is a novel and emerging research field that may provide new insights in the origins of chronic inflammatory diseases, such as COPD. OBJECTIVES To investigate whether expression of the sputum lipidome is affected by COPD or cigarette smoking. METHODS Lipid expression was investigated with liquid chromatography and high-resolution quadrupole time-of-flight mass spectrometry in induced sputum comparing smokers with and without COPD, and never-smokers. Changes in lipid expression after 2-month smoking cessation were investigated in smokers with and without COPD. MEASUREMENTS AND MAIN RESULTS More than 1,500 lipid compounds were identified in sputum. The class of sphingolipids was significantly higher expressed in smokers with COPD than in smokers without COPD. At single compound level, 168 sphingolipids, 36 phosphatidylethanolamine lipids, and 5 tobacco-related compounds were significantly higher expressed in smokers with COPD compared with smokers without COPD. The 13 lipids with a high fold change between smokers with and without COPD showed high correlations with lower lung function and inflammation in sputum. Twenty (glyco)sphingolipids and six tobacco-related compounds were higher expressed in smokers without COPD compared with never-smokers. Two-month smoking cessation reduced expression of 26 sphingolipids in smokers with and without COPD. CONCLUSIONS Expression of lipids from the sphingolipid pathway is higher in smokers with COPD compared with smokers without COPD. Considering their potential biologic properties, they may play a role in the pathogenesis of COPD.
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13
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Hoffmann RF, Zarrintan S, Brandenburg SM, Kol A, de Bruin HG, Jafari S, Dijk F, Kalicharan D, Kelders M, Gosker HR, Ten Hacken NH, van der Want JJ, van Oosterhout AJ, Heijink IH. Prolonged cigarette smoke exposure alters mitochondrial structure and function in airway epithelial cells. Respir Res 2013; 14:97. [PMID: 24088173 PMCID: PMC3852998 DOI: 10.1186/1465-9921-14-97] [Citation(s) in RCA: 197] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 09/26/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cigarette smoking is the major risk factor for COPD, leading to chronic airway inflammation. We hypothesized that cigarette smoke induces structural and functional changes of airway epithelial mitochondria, with important implications for lung inflammation and COPD pathogenesis. METHODS We studied changes in mitochondrial morphology and in expression of markers for mitochondrial capacity, damage/biogenesis and fission/fusion in the human bronchial epithelial cell line BEAS-2B upon 6-months from ex-smoking COPD GOLD stage IV patients to age-matched smoking and never-smoking controls. RESULTS We observed that long-term CSE exposure induces robust changes in mitochondrial structure, including fragmentation, branching and quantity of cristae. The majority of these changes were persistent upon CSE depletion. Furthermore, long-term CSE exposure significantly increased the expression of specific fission/fusion markers (Fis1, Mfn1, Mfn2, Drp1 and Opa1), oxidative phosphorylation (OXPHOS) proteins (Complex II, III and V), and oxidative stress (Mn-SOD) markers. These changes were accompanied by increased levels of the pro-inflammatory mediators IL-6, IL-8, and IL-1β. Importantly, COPD primary bronchial epithelial cells (PBECs) displayed similar changes in mitochondrial morphology as observed in long-term CSE-exposure BEAS-2B cells. Moreover, expression of specific OXPHOS proteins was higher in PBECs from COPD patients than control smokers, as was the expression of mitochondrial stress marker PINK1. CONCLUSION The observed mitochondrial changes in COPD epithelium are potentially the consequence of long-term exposure to cigarette smoke, leading to impaired mitochondrial function and may play a role in the pathogenesis of COPD.
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Affiliation(s)
- Roland F Hoffmann
- Department of Pathology and Medical Biology, Laboratory of Allergology and Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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14
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Hoffmann RF, McLernon S, Feeney A, Hill C, Sleator RD. A single point mutation in the listerial betL σ(A)-dependent promoter leads to improved osmo- and chill-tolerance and a morphological shift at elevated osmolarity. Bioengineered 2013; 4:401-7. [PMID: 23478432 PMCID: PMC3937201 DOI: 10.4161/bioe.24094] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Betaine uptake in Listeria monocytogenes is mediated by three independent transport systems, the simplest of which in genetic terms is the secondary transporter BetL. Using a random mutagenesis approach, based on the E. coli XL1 Red mutator strain, we identified a single point mutation in a putative promoter region upstream of the BetL coding region which leads to a significant increase in betL transcript levels under osmo- and chill-stress conditions and a concomitant increase in stress tolerance. Furthermore, the mutation appears to counter the heretofore unreported “twisted” cell morphology observed for L. monocytogenes grown at elevated osmolarities in tryptone soy broth.
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Affiliation(s)
- Roland F Hoffmann
- Alimentary Pharmabiotic Centre; University College Cork; Cork, Ireland; Department of Biological Sciences; Cork Institute of Technology; Cork, Ireland
| | - Susan McLernon
- Alimentary Pharmabiotic Centre; University College Cork; Cork, Ireland
| | - Audrey Feeney
- Department of Biological Sciences; Cork Institute of Technology; Cork, Ireland
| | - Colin Hill
- Alimentary Pharmabiotic Centre; University College Cork; Cork, Ireland
| | - Roy D Sleator
- Alimentary Pharmabiotic Centre; University College Cork; Cork, Ireland; Department of Biological Sciences; Cork Institute of Technology; Cork, Ireland
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15
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Lo Tam Loi AT, Hoonhorst SJM, Franciosi L, Bischoff R, Hoffmann RF, Heijink I, van Oosterhout AJM, Boezen HM, Timens W, Postma DS, Lammers JW, Koenderman L, ten Hacken NHT. Acute and chronic inflammatory responses induced by smoking in individuals susceptible and non-susceptible to development of COPD: from specific disease phenotyping towards novel therapy. Protocol of a cross-sectional study. BMJ Open 2013; 3:e002178. [PMID: 23377993 PMCID: PMC3586075 DOI: 10.1136/bmjopen-2012-002178] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 10/03/2012] [Revised: 12/17/2012] [Accepted: 01/03/2013] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with pulmonary and extra-pulmonary manifestations. Although COPD is a complex disease, diagnosis and staging are still based on simple spirometry measurements. Different COPD phenotypes exist based on clinical, physiological, immunological and radiological observations. Cigarette smoking is the most important risk factor for COPD, but only 15-20% of smokers develop the disease, suggesting a genetic predisposition. Unfortunately, little is known about the pathogenesis of COPD, and even less on the very first steps that are associated with an aberrant response to smoke exposure. This study aims to investigate the underlying local and systemic inflammation of different clinical COPD phenotypes, and acute effects of cigarette smoke exposure in individuals susceptible and non-susceptible for the development of COPD. Furthermore, we will investigate mechanisms associated with corticosteroid insensitivity. Our study will provide valuable information regarding the pathogenetic mechanisms underlying the natural course of COPD. METHODS AND ANALYSIS This cross-sectional study will include young and old individuals susceptible or non-susceptible to develop COPD. At a young age (18-40 years) 60 'party smokers' will be included who are called susceptible or non-susceptible based on COPD prevalence in smoking family members. In addition, 30 healthy smokers (age 40-75 years) and 110 COPD patients will be included. Measurements will include questionnaires, pulmonary function, low-dose CT scanning of the lung, body composition, 6 min walking distance and biomarkers in peripheral blood, sputum, urine, exhaled breath condensate, epithelial lining fluid, bronchial brushes and biopsies. Non-biased approaches such as proteomics will be performed in blood and epithelial lining fluid. ETHICS AND DISSEMINATION This multicentre study was approved by the medical ethical committees of UMC Groningen and Utrecht, the Netherlands. The study findings will be presented at conferences and will be reported in peer-reviewed journals. TRIAL REGISTRATION ClinicalTrials.gov, NCT00807469 (study 1) and NCT00850863 (study 2).
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Affiliation(s)
- Adèle T Lo Tam Loi
- Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Susan J M Hoonhorst
- Department of Pulmonary Disease, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
| | - Lorenza Franciosi
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
- Department of Pharmacy, Analytical Biochemistry, University of Groningen, Groningen, The Netherlands
| | - Rainer Bischoff
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
- Department of Pharmacy, Analytical Biochemistry, University of Groningen, Groningen, The Netherlands
| | - Roland F Hoffmann
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Irene Heijink
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Antoon J M van Oosterhout
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H Marike Boezen
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wim Timens
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dirkje S Postma
- Department of Pulmonary Disease, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
| | - Jan-Willem Lammers
- Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Leo Koenderman
- Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nick H T ten Hacken
- Department of Pulmonary Disease, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
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16
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Zijlstra GJ, Ten Hacken NHT, Hoffmann RF, van Oosterhout AJM, Heijink IH. Interleukin-17A induces glucocorticoid insensitivity in human bronchial epithelial cells. Eur Respir J 2011; 39:439-45. [PMID: 21828034 DOI: 10.1183/09031936.00017911] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A subset of asthma patients suffer from glucocorticoid (GC) insensitivity. T-helper cell type 17 cells have an emerging role in GC insensitivity, although the mechanisms are still poorly understood. We investigated whether interleukin (IL)-17A induces GC insensitivity in airway epithelium by studying its effects on responsiveness of tumour necrosis factor (TNF)-α-induced IL-8 production to budesonide in human bronchial epithelial 16HBE cells. We unravelled the underlying mechanism by the use of specific pathway inhibitors, reporter and overexpression constructs and a histone deacetylase (HDAC) activity assay. We demonstrated that IL-17A-induced IL-8 production is normally sensitive to GCs, while IL-17A pre-treatment significantly reduced the sensitivity of TNF-α-induced IL-8 production to budesonide. IL-17A activated the p38, extracellular signal-related kinase (ERK) and phosphoinositide-3-kinase (PI3K) pathways, and the latter appeared to be involved in IL-17A-induced GC insensitivity. Furthermore, IL-17A reduced HDAC activity, and overexpression of HDAC2 reversed IL-17A-induced GC insensitivity. In contrast, IL-17A did not affect budesonide-induced transcriptional activity of the GC receptor, suggesting that IL-17A does not impair the actions of the ligated GC receptor. In conclusion, we have shown for the first time that IL-17A induces GC insensitivity in airway epithelium, which is probably mediated by PI3K activation and subsequent reduction of HDAC2 activity. Thus, blockade of IL-17A or downstream signalling molecule PI3K may offer new strategies for therapeutic intervention in GC-insensitive asthma.
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Affiliation(s)
- G J Zijlstra
- Laboratory of Allergology and Pulmonary Diseases Dept of Pathology and Medical Biology GRIAC Research Institute University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
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17
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Abstract
Traumatic ruptures of tendons in the region of the knee joint are often accompanied by substantial degenerative and inflammatory alterations, especially when the patella and quadriceps tendons are affected. Isolated ruptures of the tendon of the distal biceps femoris muscle at the dorsolateral aspect of the knee are rare and result in an acute reduction of flexion capability. However, tears of the biceps femoris tendon are not associated with degenerative changes. This article reports on the diagnosis and treatment of a 27-year-old football player who suffered an acute isolated rupture of the biceps femoris tendon.
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Affiliation(s)
- O Rehm
- Abteilung für Unfallchirurgie und orthopädische Chirurgie, BG-Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland.
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18
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Emslie GJ, Armitage R, Weinberg WA, Rush AJ, Mayes TL, Hoffmann RF. Sleep polysomnography as a predictor of recurrence in children and adolescents with major depressive disorder. Int J Neuropsychopharmacol 2001; 4:159-68. [PMID: 11466166 DOI: 10.1017/s1461145701002383] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2000] [Revised: 02/14/2001] [Indexed: 11/06/2022] Open
Abstract
Adults with major depressive disorder (MDD) demonstrate certain sleep polysomnographic abnormalities, including sleep continuity disturbances, reduced slow-wave sleep, shortened rapid eye movement (REM) latency, and increased REM density. Findings of sleep EEG studies in depressed children and adolescents have yielded conflicting results, possibly because of methodological variations across the studies. Generally, however, studies have demonstrated that depressed children and adolescents exhibit less sleep continuity and non-REM sleep differences in comparison with control subjects than do adults. Thus, results from adult sleep polysomnography studies cannot necessarily be generalized to children and adolescents. Depressed adults who have reduced REM latency during the symptomatic episode appear more likely to have a relapse once treatment is discontinued than those with normal REM latency. No studies of the relationship between sleep polysomnographic variables and clinical course have been reported in depressed children and adolescents. Data for baseline clinical variables and 3 nights of sleep polysomnography were examined in 113 depressed children (< or = 12 yr; n = 51) and adolescents (> or = 13 yr; n = 62) (56 in-patients and 57 outpatients) where data was available on at least 1 yr of naturalistic follow-up. Subjects came from 2 studies of sleep polysomnography in children and adolescents with MDD. Clinical course was assessed using the Kiddie-Longitudinal Interval Follow-Up Evaluation (K-LIFE). This interview was used to define recovery from the index episode of MDD and recurrence, a new episode of meeting full criteria for MDD. Clinically, within 1 yr of initial evaluation 102/113 subjects had recovered from their index episode of depression (minimal or no symptoms for 60 d). Of the 102 subjects who recovered, 36 (35.3%) had a recurrence of MDD. The majority of subjects (55%) who had a recurrence were not on medication at the time of recurrence. Subjects who had a recurrence were more likely to report suicidal thoughts or attempts at baseline compared to those without a recurrence (67 vs. 37%; F = 8.77; p = 0.004). On baseline sleep polysomnography, subjects with a later recurrence had decreased sleep efficiency and delayed sleep onset (sleep latency > 10 min). Probability of recurrence at 12 months was 0.39 compared to 0.15 in subjects with non-delayed sleep onset (p = 0.005). Baseline suicidal ideation and sleep dysregulation on sleep polysomnography predicted recurrence in a large sample of depressed children and adolescents. Depression in children and adolescents is frequently a chronic, recurrent illness. Factors that can predict clinical course are important in increasing our understanding of depression in this age group.
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Affiliation(s)
- G J Emslie
- Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, 75390-8589, USA.
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19
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Abstract
BACKGROUND Quantitative EEG studies have identified a number of sleep abnormalities in adults with major depressive disorders (MDD), including a reduction in the amplitude of delta activity during NREM sleep. To date, these methodologies have not been used in early onset MDD. METHODS Delta activity during NREM sleep was compared in eight symptomatic but unmedicated adolescent females with MDD and eight age- and gender-matched healthy controls. RESULTS The depressed group showed significantly lower delta amplitude and power in the first NREM sleep period. By contrast, standard sleep architecture did not differentiate between groups. LIMITATIONS Given the sample size, this study is best viewed as tentative. In addition, it has yet to be determined whether adolescent males with MDD also show delta sleep abnormalities. Further, failure to find between-group differences in REM latency or other macroarchitectural measures may be due to the small sample size. CONCLUSIONS The findings of this study underscore the utility of quantitative sleep EEG techniques in early onset MDD. The results of the present study do, however, diverge from reports in adults with MDD, where delta abnormalities are more prevalent in men. Such findings suggest that the maturational time course of sleep EEG disturbances may differ for males and females with depression. Early emergence of delta abnormalities in depression may be of relevance to clinical course of illness.
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Affiliation(s)
- R Armitage
- Sleep Study Unit, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75235-9070, USA.
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20
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Abstract
We used a standardized model of calf tibial bone to investigate the influence of screw diameter and length on interference fit fixation of a three-stranded semitendinosus tendon graft for anterior cruciate ligament reconstruction. Biodegradable poly-(L-lactide) interference screws with a diameter of 7, 8, and 9 mm and a length of 23 and 28 mm were used. We examined results in three groups of 10 specimens each: group 1, screw diameter equaled graft diameter and screw length was 23 mm; group 2, screw diameter equaled graft diameter plus 1 mm and screw length was 23 mm; group 3, screw diameter equaled graft diameter and screw length was 28 mm. The mean pull-out forces in groups 1, 2, and 3 were 367.2+/-78 N, 479.1+/-111.1 N, and 537.4+/-139.1 N, respectively. The force data from groups 2 and 3 were significantly higher than those from group 1. These results indicate that screw geometry has a significant influence on hamstring tendon interference fit fixation. Increasing screw length improves fixation strength more than oversizing the screw diameter. This is important, especially for increasing tibial fixation strength because the tibial graft fixation site has been considered to be the weak link of such a reconstruction.
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Affiliation(s)
- A Weiler
- Department of Trauma and Reconstructive Surgery, Sports Traumatology and Arthroscopy Service, Charité, Humboldt-University of Berlin, Germany
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21
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Abstract
Biodegradable implants are increasingly used in the field of operative sports medicine. Today, a tremendous variety of implants such as interference screws, staples, sutures, tacks, suture anchors, and devices for meniscal repair are available. These implants consist of different biodegradable polymers that have substantially different raw material characteristics such as in vivo degradation, host-tissue response, and osseous replacement. Because these devices have become the standard implant for several operative procedures, it is essential to understand their biological base. The purpose of this report is to provide a comprehensive insight into biodegradable implant biology for a better understanding of the advantages and risks associated with using these implants in the field of operative sports medicine. In particular, in vivo degradation, biocompatibility, and the osseous replacement of the implants are discussed. A standardized classification system to document and treat possible adverse tissue reactions is given, with special regard to extra-articular and intra-articular soft-tissue response and to osteolytic lesions.
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Affiliation(s)
- A Weiler
- Division of Sports Traumatology and Arthroscopy, Department of Trauma and Reconstructive Surgery, Virchow Clinic, Humboldt University of Berlin, Berlin, Germany.
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22
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Armitage R, Emslie GJ, Hoffmann RF, Weinberg WA, Kowatch RA, Rintelmann J, Rush AJ. Ultradian rhythms and temporal coherence in sleep EEG in depressed children and adolescents. Biol Psychiatry 2000; 47:338-50. [PMID: 10686269 DOI: 10.1016/s0006-3223(99)00129-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It has been suggested that a primary ultradian (80-120 minute) rhythm disturbance in EEG underlies sleep abnormalities in adults with depression. The present study evaluated ultradian rhythm disturbances in childhood and adolescent depression. METHODS Sleep macroarchitecture and temporal coherence in quantitative EEG rhythms were investigated in 50 medication-free outpatients with major depression (25 children and 25 adolescents) and 15 healthy normal controls (5 children and 10 adolescents). RESULTS Few of the macroarchitectural measures showed significant group effects. In fact, age and sex effects were stronger than disease-dependent components. Temporal coherence of EEG rhythms during sleep did differentiate those with MDD from controls. Both depressed children and adolescents had lower intrahemispheric coherence, whereas interhemispheric was only lower in depressed adolescents in comparison with controls. Gender differences were evident in adolescents, but not children, with MDD with lowest interhemispheric coherence in adolescent girls. CONCLUSIONS These findings are in keeping with increased risk for depression in females beginning at adolescence and extending throughout adulthood. It was suggested that low temporal coherence in depression reflects a disruption in the fundamental basic rest-activity cycle of arousal and organization in the brain that is strongly influenced by gender.
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Affiliation(s)
- R Armitage
- The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75235-9070, USA
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23
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Abstract
BACKGROUND Recent studies have suggested that major depressive disorders are associated with a breakdown in the organization of ultradian rhythm in sleep EEG. The present study used cross-spectral analysis of sleep EEG to confirm this finding, in a larger-scale study, evaluating the influence of gender and age on ultradian rhythms in depression. METHODS Temporal coherence of ultradian (80-120 min) rhythms in beta, theta and delta, recorded from central and parietal sites, were compared in 120 symptomatic, unmedicated, depressed outpatients and 59 healthy normal controls. RESULTS Few macro-architectural differences were noted between patients and controls. However, interhemispheric beta and theta coherence and intrahemispheric coherence between beta and delta rhythms were significantly lower in depressed patients. Coherence measures were lowest in women with depression and highest in men in the control group, but were not strongly influenced by age. Over 65% of depressed patients were > or = 2 standard deviations below normal on at least one coherence measure, in sharp contrast to less than 10% of patients on macro-architectural variables. CONCLUSIONS It was concluded that dysregulation of ultradian rhythms characterizes the majority of depressed out-patients, primarily women, even when macro-architecture did not differentiate groups. The outcome of this study supports the view that the pathophysiology of depression is strongly influenced by gender. It was suggested that low temporal coherence in depression reflects a breakdown in the organization of sleep EEG rhythms within and between the two hemispheres.
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Affiliation(s)
- R Armitage
- Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, USA
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24
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Abstract
STUDY DESIGN A case of a bisegmental rotational fracture dislocation in the pediatric cervical spine is presented. OBJECTIVES To highlight the problems in the diagnostics and surgical management of this rare type of injury. SUMMARY OF BACKGROUND DATA Fractures of the cervical spine are relatively uncommon in childhood. To the authors' knowledge, this is the first reported case of a bisegmental rotational fracture dislocation in the pediatric cervical spine managed by a combined anteroposterior approach. METHODS A 6-year-old girl was hit by a car as a pedestrian. In addition to an open fracture dislocation of the Lisfranc joint in the right foot, she sustained a bisegmental fracture dislocation at the lower cervical spine (C3-C5) with no neurologic deficit. The complete diagnosis of a locked rotational fracture dislocation could be established only by using computed tomography scans with three-dimensional reconstructions. The injury was managed with a combined anteroposterior open reduction and a bisegmental anterior fusion. RESULTS Implant removal was performed after bony fusion 6 months after surgery. At follow-up assessment 2.5 years later, the girl had a good radiologic result and a full and pain-free functional recovery. CONCLUSIONS Bisegmental rotational fracture dislocations in pediatric cervical spines are not easily diagnosed and may require three-dimensional computed tomography scan reconstructions for complete assessment. In such rare cases, a combined anteroposterior surgical procedure may be indicated, with a bisegmental anterior fusion providing a good functional result.
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Affiliation(s)
- R F Hoffmann
- Humboldt University of Berlin, Virchow Clinic, Department of Trauma and Reconstructive Surgery, Berlin, Germany
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25
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Hoffmann RF, Peine R, Bail HJ, Südkamp NP, Weiler A. Initial fixation strength of modified patellar tendon grafts for anatomic fixation in anterior cruciate ligament reconstruction. Arthroscopy 1999; 15:392-9. [PMID: 10355715 DOI: 10.1016/s0749-8063(99)70057-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Recently it has been shown that anatomic tibial graft fixation in anterior cruciate ligament (ACL) reconstruction is preferable in order to increase isometry and knee stability. To facilitate anatomic patellar tendon graft fixation, customized graft length shortening is necessary. The purpose of this study was to compare the initial fixation strength of four different shortened patellar tendon grafts including three bone plug flip techniques and direct patellar tendon-to-bone interference fit fixation in a model with standardized bone density. Ninety calf tibial plateaus (22 to 24 weeks old) with adjacent patella and extensor ligaments were used. Tendon grafts were shortened by flipping the bone plug over the tendon leaving a tendon-tendon-bone (TTB) construct and, as the first modification in the opposite direction resulting in a tendon-bone-tendon (TBT) construct. The second modification consisted of the TBT construct with interference screw position at the lateral aspect of the bone plug (TBTlat). As the fourth modification the tendon graft was directly fixed (Tdirect) with an interference screw. In addition, a round-threaded titanium (RCI; Smith & Nephew DonJoy, Carlsbad, CA), a round-threaded biodegradable screw (Sysorb; Sulzer Orthopedics, Münsingen, Switzerland), and a conventional titanium interference screw (Arthrex Inc, Naples, FL) were compared. We found that TTB (mean 441 N for biodegradable screw, 357 N for RCI screw, 384 N for conventional screw) and TBT (mean 407 N for biodegradable screw, 204 N for RCI screw, 392 N for conventional screw) construct fixation achieves comparable fixation strength, although failure in the TTB was due to tendon strip off at its ligamentous insertion. The highest failure load was found in TBTlat fixation (mean 610 N for biodegradable screw, 479 N for RCI screw). Therefore, this technique should be recommended when using a tendon flip technique. The failure load for Tdirect fixation (mean 437 N for biodegradable screw, 364 N for RCI screw) was similar to that of TTB and TBT fixation, which may indicate that a patellar-tendon graft harvested without its patellar bone plug and directly fixed with an interference screw is equivalent to a flipped graft. This may additionally reduce harvest site morbidity and eliminates the risk of patellar fracture. The fixation strength of round-threaded biodegradable and conventional titanium interference screws was similar, whereas that of round-threaded titanium screws was significantly lower in the patellar tendon flip-techniques. However, it should be taken into consideration that round-threaded titanium screws are proposed for direct tendon-to-bone fixation.
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Affiliation(s)
- R F Hoffmann
- Department of Trauma and Reconstructive Surgery, Charité, Campus Virchow-Klinikum, Humboldt-University of Berlin, Germany
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26
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Weiler A, Hoffmann RF, Südkamp NP, Siepe CJ, Haas NP. [Replacement of the anterior cruciate ligament. Biomechanical studies for patellar and semitendinosus tendon fixation with a poly(D,L-lactide) interference screw]. Unfallchirurg 1999; 102:115-23. [PMID: 10098418 DOI: 10.1007/s001130050382] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Anterior cruciate ligament (ACL) reconstruction using autologous hamstring tendons are being performed more frequently and satisfactory results have been reported. Advantages such as low donor site morbidity and ease of harvest as well as disadvantages like low initial construct stiffness have been described. Recently, it has been demonstrated that graft fixation close to the original ACL insertion sites increases anterior knee stability and graft isometry. Hamstring tendon fixation techniques using interference screws offer this possibility. To reduce the risk of graft laceration, a round threaded titanium interference screw (RCI) was developed. To improve initial fixation strength, fixation techniques for hamstring tendons with separate or attached tibial bone plugs were introduced. However, data on fixation strength do not yet exist. With respect to the proposed advantages of biodegradable implants, like undistorted magnetic resonance imaging, uncompromised revision surgery and a decreased potential of graft laceration during screw insertion, we performed pullout tests of round threaded biodegradable and round threaded titanium interference screw fixation of semitendinosus (ST) grafts with and without distally attached tibial bone plugs. Data were compared with bone-tendon-bone (BTB) graft fixation using biodegradable and conventional titanium interference screws. We used 56 proximal calf tibiae to compare maximum pullout force, screw insertion torque, and stiffness of fixation for biodegradable direct ST tendon and bone plug fixation (group I: without bone plug, group II: with bone plug) versus titanium interference screw fixation (group III: without bone plug, group IV: with bone plug). A round threaded biodegradable poly-(D, L-lactide) (Sysorb) and a round threaded titanium interference screw (RCI) were used. As a control calf bone-tendon-bone (BTB) grafts fixed with either poly-(D, L-lactide) (group V) or conventional titanium (group VI) interference screws were used. ST tendons were harvested either with or without their distally attached tibial bone plugs from human cadavers and were folded to a three-stranded graft. Specimen were loaded in a material testing machine with the applied load parallel to the long axis of the bone tunnel. Maximum pullout force of ST bone plug (group III: 717 N +/- 90, group IV: 602 N +/- 117) fixation was significantly higher than that of direct tendon (group I: 507 N +/- 93, group III: 419 N +/- 77) fixation. Maximum pullout force of biodegradable screw ST fixation was higher than that of titanium screw fixation in both settings. There was no significant difference in pullout force between biodegradable (713 N +/- 210) and titanium (822 N +/- 130) BTB graft fixation or between ST fixation with bone plug and biodegradable screw with BTB fixation. Pullout force of hamstring tendon interference screw fixation can be improved by using a biodegradable implant. In addition, initial pullout force can be greatly improved by harvesting the hamstring tendon graft with its distally attached tibial bone plug. This may be important, especially in improving tibial graft fixation. This study encourages further research in tendon-bone healing with direct interference screw fixation to confirm the potential of this advanced method.
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Affiliation(s)
- A Weiler
- Unfall- und Wiederherstellungschirurgie, Charité, Campus Virchow-Klinikum, Humboldt-Universität zu Berlin
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27
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Weiler A, Windhagen HJ, Raschke MJ, Laumeyer A, Hoffmann RF. Biodegradable interference screw fixation exhibits pull-out force and stiffness similar to titanium screws. Am J Sports Med 1998; 26:119-26. [PMID: 9474412 DOI: 10.1177/03635465980260010401] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recently, increased interest in biodegradable interference screws for bone-tendon-bone graft fixation has led to numerous screws becoming available. The implants are made from different polymers and have different designs, which might influence their mechanical properties. Several studies have reported a wide range of mechanical results for these screws using different biomechanical models. The aim of the present study is to compare reliable biomechanical data for six different biodegradable interference screws, consisting of five different polymers, with a conventional titanium screw in a standardized model. Seventy proximal calf tibias were used to determine maximal pull-out force, stiffness of fixation, and insertion torque for interference screw fixation of bone-tendon-bone grafts. Additionally, maximal torque at failure was determined. Data were analyzed with respect to aspects of screw design, such as drive and thread shape. Five of the six biodegradable screws provided initial pull-out force and stiffness of fixation comparable with that of a conventional titanium screw. Torque at failure can be greatly increased by adapting the drive design to the mechanical properties of the polymeric raw material. A correlation between pull-out force and thread height indicates that fixation rigidity depends on screw design, even in a biodegradable implant.
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Affiliation(s)
- A Weiler
- Humboldt University of Berlin, Medical Faculty Charité, Virchow Clinic, Germany
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28
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Abstract
It has recently been shown that graft fixation close to the ACL insertion site is optimal in order to increase anterior knee stability. Hamstring tendon fixation using interference screws offers this possibility and a round threaded titanium interference screw has been previously developed. The use of a round threaded biodegradable interference screw may be equivalent. In addition, to increase initial fixation strength, graft harvest with a distally attached bone plug may be advantageous, but biomechanical data do not exist. This study compares the initial pullout force, stiffness of fixation, and failure modes of three strand semitendinosus grafts in 36 proximal calf tibiae using either biodegradable poly-(D,L-lactide) (Sysorb; Sulzer Orthopaedics Ltd, Münsingen, Switzerland) or round threaded titanium (RCI; Smith & Nephew DonJoy, Carlsbad, CA) interference screws, harvested either without (biodegradable: group I, titanium III) or with (biodegradable: group II, titanium: group IV) attached tibial bone plugs. Maximum pullout force in group I (507 +/- 93 N) was significantly higher than in group III (419 +/- 77 N). Pullout force of bone plug fixation was significantly higher than that of direct tendon fixation (717 +/- 90 N in group II and 602 +/- 117 N in group IV). Pullout force of biodegradable fixation was significantly higher in both settings. These results indicate that initial pullout force of hamstring-tendon graft interference screw fixation can be increased by using a biodegradable interference screw. In addition, initial pullout force of hamstring-tendon graft fixation with an interference screw can be greatly increased by harvesting the graft with its distally attached tibial bone plug.
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Affiliation(s)
- A Weiler
- Virchow Klinikum, Humboldt-University of Berlin, Germany
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29
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Abstract
Previous research reported changes in steady-state brain electrical activity during sleep. However, due to the quasi-linear nature of the Direct Current (DC) changes, artifact contamination was a potential confound. The present study was performed to further explore DC potentials and to help establish its validity. Twenty-five male university students (13 control and 12 sleep-deprived; mean age 19 y (range 17-27 y) served as subjects. During wakefulness, subjects were tested every hour while standard EEG activity recordings were made, as well as DC measurement. Split plot analyses of variance (ANOVAs) revealed that changes in DC activity levels differed between the two groups. The control subjects showed the same pattern of decreasing DC observed previously with a return to baseline levels during waking hours. The sleep-deprived subjects showed a smaller decrease in DC level through the night, followed by a rise in DC level that continued until the end of the 24 h study. It was concluded that DC measurement reflects changes in brain state associated with fatigue that are not attributable to artifactual processes.
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Haas NP, Hoffmann RF, Mauch C, von Fournier C, Südkamp NP. The management of polytraumatized patients in Germany. Clin Orthop Relat Res 1995:25-35. [PMID: 7671524] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Polytrauma care in Germany is well organized and follows clear-cut demands: (1) to reduce the therapy-free interval, (2) to ensure qualified and sufficient preclinical treatment, (3) to minimize transportation time, and (4) to immediately transport the patient to an adequate level trauma center. These concepts include wide use of rescue helicopters that are based in 51 stations and cover the entire country. In addition, there is a countrywide system of emergency physician ambulances. All rescue forces are coordinated by special rescue coordination centers to ensure maximum efficacy. Specially trained emergency physicians are taken to the scenes of accidents in the helicopters or emergency physician ambulances and provide aggressive and advanced shock and trauma treatment at the scene. The patients then are carried to high level trauma centers by air transport. In the trauma centers, standardized diagnostic and treatment protocols are applied by trauma surgery teams who care for the entire trauma, including orthopaedic trauma. In addition to stopping mass bleeding, basic concepts include aggressive infusion shock therapy, early machine oxygenation, and instant stabilization of all open, all major pelvic, and all lower limb long bone fractures. These management concepts have decreased the lethality numbers in polytrauma from 40% in 1972 to 18% in 1991. Most polytrauma survivors can be rehabilitated socially to an excellent to acceptable degree.
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Affiliation(s)
- N P Haas
- Humboldt-Universität zu Berlin, Virchow Clinic, Department of Trauma Surgery and Reconstructive Surgery, Germany
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31
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Abstract
Twelve male undergraduate students were deprived of sleep for one night and were tested with a series of cognitive tasks. Their performance was compared to the performance of thirteen control subjects. Two hourly tasks and three occasional tasks were administered in order to examine cognitive performance following sleep loss. In an attempt to replicate the findings of Horne (1988a), the figural form of the Torrance Tests of Creative Thinking was administered. To explore the effects of short-term sleep deprivation on attention, the following tasks were also administered: a working memory task, a trail-making task, a vowel/consonant discrimination task, and a letter recognition task. Results of the Torrance test, trail-making task and letter recognition task revealed decreases in cognitive abilities following sleep loss, although all tasks required less than 10 minutes to administer. The results of this study suggest that cognitive measures following sleep deprivation have not been adequately explored. Results support the hypothesis that sleep serves a function of cognitive restitution, particularly in the maintenance of attentional mechanisms.
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Affiliation(s)
- F Wimmer
- Department of Psychology, Carleton University, Ottawa, Canada
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32
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Abstract
This research examined the relationship between cortical activation, defined by electroencephalographic (EEG) measures, and the ability to recall dreams following awakenings from Stage 2 sleep. Period-analyzed EEG data from 40 subjects were examined for the preawakening, postawakening, and preawakening-to-postawakening time intervals. Recall differed from nonrecall at the postawakening and preawakening-to-postawakening periods on measures of muscle activity and time spent in the sigma (12-16 Hz) frequency band. There were no distinctions in recall ability on EEG hemispheric asymmetry measures. Generally, the findings do not support the hypothesis linking increased recall ability to increases in cortical activation prior to awakening. However, the recall groups depicted a different pattern of arousal in their transition from sleep to wakefulness.
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Affiliation(s)
- C R Morel
- Department of Psychology, Carleton University, Ottawa, ON, Canada
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33
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Pigeau RA, Hoffmann RF, Moffitt AR. A multivariate comparison between two EEG analysis techniques: period analysis and fast Fourier transform. Electroencephalogr Clin Neurophysiol 1981; 52:656-8. [PMID: 6172266 DOI: 10.1016/0013-4694(81)91441-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The present study investigated the statistical correspondence between two frequently used methods of analysing tonic EEG activity: (1) period analysis and (2) Fast Fourier Transforms (FFTs). For replication purposes, independent statistical analyses were carried out on the EEG of sleeping subjects and of awake subjects performing a cognitive task. From the results of two canonical correlations, the first two canonical variates were sufficient to account for 97% (awake group) and 99% (sleeping group) of the variance between the separate linear composites of all FFT and period analysis variables. Linear regressions of the 3 dependent measures generated by period analysis onto each respective FFT measure gave high and significant multiple correlations for all frequencies. Zero-order correlations were also gathered and discussed. It is concluded that period analytic and FFT analysed EEG share similar types of information and that period analysis can be used more often in EEG research.
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Hoffmann RF, Moffitt AR, Shearer JC, Sussman PS, Wells RB. Conceptual and methodological considerations towards the development of computer-controlled research on the electro-physiology of sleep. Waking Sleeping 1979; 3:1-16. [PMID: 227176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A critical discussion of the visual scoring approach to the measurement of sleep electrophysiology details some theoretical shortcomings of that procedural model. An alternative approach employing high-speed, general purpose digital computers is then presented. It is argued that the measurement potential of computers is barely tapped by using computers to score sleep stages and the advantages of collecting data which are suitable for parametric and multivariate statistical analysis are described. Researchers are urged to include detailed reports on their procedural choices along with a discussion of the methodological implications of these procedures. Examples of computer collected data are presented along with a description of some simple data reduction strategies.
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35
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Hoffmann RF. Developmental changes in human infant visual-evoked potentials to patterned stimuli recorded at different scalp locations. Child Dev 1978; 49:110-8. [PMID: 657887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Visual-evoked potentials (VEPs) to patterned stimuli were recorded from 4 different scalp locations in 2 groups of infant subjects (ages 6 weeks and 10 weeks). Seven VEP components were identified that changed in amplitude as a function of changes in the amount of contour in the stimuli presented. Developmental shifts in these effects were interpreted to indicate a change in the physiological locus of control of infant visual preferences from a subcortical to a cortical locus over the age range examined.
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36
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Karmel BZ, Hoffmann RF, Fegy MJ. Processing of contour information by human infants evidenced by pattern-dependent evoked potentials. Child Dev 1974; 45:39-48. [PMID: 4820284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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37
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Hoffmann RF. Patient council gets results. Hosp Community Psychiatry 1966; 17:277-8. [PMID: 5947939 DOI: 10.1176/ps.17.9.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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