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Pöhlchen D, Fietz J, Czisch M, Sämann PG, Spoormaker VI, Binder E, Brückl T, Erhardt A, Grandi N, Lucae S, von Muecke-Heim I, Ziebula J. Startle Latency as a Potential Marker for Amygdala-Mediated Hyperarousal. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging 2022; 8:406-416. [PMID: 35577304 DOI: 10.1016/j.bpsc.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Fear-related disorders are characterized by hyperexcitability in reflexive circuits and maladaptive associative learning mechanisms. The startle reflex is suited to investigate both processes, either by probing it under baseline conditions or by deriving it in fear conditioning studies. In anxiety research, the amplitude of the fear-potentiated startle has been shown to be influenced by amygdalar circuits and has typically been the readout of interest. In schizophrenia research, prolonged startle peak latency under neutral conditions is an established readout, thought to reflect impaired processing speed. We therefore explored whether startle latency is an informative readout for human anxiety research. METHODS We investigated potential similarities and differences of startle peak latency and amplitude derived from a classical fear conditioning task in a sample of 206 participants with varying severity levels of anxiety disorders and healthy control subjects. We first reduced startle response to stable components and regressed individual amygdala gray matter volumes onto the resulting startle measures. We then probed time, stimulus, and group effects of startle latency. RESULTS We showed that startle latency and startle amplitude were 2 largely uncorrelated measures; startle latency, but not amplitude, showed a sex-specific association with gray matter volume of the amygdala; startle latencies showed a fear-dependent task modulation; and patients with fear-related disorders displayed shorter startle latencies throughout the fear learning task. CONCLUSIONS These data provide support for the notion that probing startle latencies under threat may engage amygdala-modulated threat processing, making them a complementary marker for human anxiety research.
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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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von Rosenberg SJ, Weber GM, Erhardt A, Höller U, Wehr UA, Rambeck WA. Tolerance evaluation of overdosed dietary levels of 25-hydroxyvitamin D3
in growing piglets. J Anim Physiol Anim Nutr (Berl) 2015; 100:371-80. [DOI: 10.1111/jpn.12355] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/03/2015] [Indexed: 01/16/2023]
Affiliation(s)
- S. J. von Rosenberg
- Institute for Animal Nutrition; Ludwig-Maximilians-University Munich; Oberschleissheim Germany
| | - G. M. Weber
- DSM Nutritional Products Limited; Nutrition Innovation Center; Kaiseraugst Switzerland
| | - A. Erhardt
- Institute for Animal Nutrition; Ludwig-Maximilians-University Munich; Oberschleissheim Germany
| | - U. Höller
- DSM Nutritional Products Limited; Nutrition Innovation Center; Kaiseraugst Switzerland
| | - U. A. Wehr
- Institute for Animal Nutrition; Ludwig-Maximilians-University Munich; Oberschleissheim Germany
| | - W. A. Rambeck
- Institute for Animal Nutrition; Ludwig-Maximilians-University Munich; Oberschleissheim Germany
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Meller S, Gerber PA, Kislat A, Hevezi P, Göbel T, Wiesner U, Kellermann S, Bünemann E, Zlotnik A, Häussinger D, Erhardt A, Homey B. Allergic sensitization to pegylated interferon-α results in drug eruptions. Allergy 2015; 70:775-83. [PMID: 25831972 DOI: 10.1111/all.12618] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND The introduction of pegylated interferon (PEG-IFN)-α in the treatment of chronic hepatitis C has led to an increase in sustained virological response. Despite reduced immunogenicity of the pegylated form in comparison with native interferon (IFN)-α, a high frequency of adverse cutaneous reactions has been reported with pegylated IFN-α. Here, we aimed to investigate the immunological mechanisms underlying pegylated IFN-α-induced drug eruptions. METHODS Hepatitis C patients suffering from drug eruptions in association with administration of pegylated interferons were enrolled in the study (n = 22). Subjects were tested for sensitivity to pegylated IFN-α2a , pegylated IFN-α2b , or ribavirin using intradermal, scratch, and/or patch tests, as well as lymphocyte activation tests (LATs). Skin biopsies obtained from pegylated IFN-α-associated exanthemas, as well as from localized inflammatory skin reactions at pegylated IFN-α injection sites, were analyzed for the expression of relevant chemokines by quantitative real-time PCR and immunohistochemistry. RESULTS A subset of patients suffering from pegylated IFN-α-associated exanthemas displayed positive intradermal tests to PEG-IFNs but not to conventional IFN (11/22). In selected patients, this observation correlated with the presence of pegylated IFN-specific T cells (3/11). Chemokine profiles of inflammatory skin reactions at the injection sites reflected an IFN-α-signature, whereas lesional skin of exanthemas showed induction of TH2-associated chemokines. CONCLUSIONS Our results indicate that specific sensitizations are one cause of exanthemas under therapy with PEG-IFNs. Clinical proof-of-concept analyses demonstrate that affected patients may benefit from a switch to conventional, nonpegylated drugs, enabling IFN-α therapy continuation without drug-associated skin eruptions.
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Affiliation(s)
- S. Meller
- Department of Dermatology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - P. A. Gerber
- Department of Dermatology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - A. Kislat
- Department of Dermatology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - P. Hevezi
- Department of Dermatology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
- Physiology and Biophysics; University of California Irvine; Irvine CA USA
| | - T. Göbel
- Clinic of Gastroenterology, Hepatology and Infectiology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - U. Wiesner
- Department of Dermatology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - S. Kellermann
- Department of Dermatology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - E. Bünemann
- Department of Dermatology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - A. Zlotnik
- Physiology and Biophysics; University of California Irvine; Irvine CA USA
| | - D. Häussinger
- Clinic of Gastroenterology, Hepatology and Infectiology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - A. Erhardt
- Clinic of Gastroenterology, Hepatology and Infectiology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
| | - B. Homey
- Department of Dermatology; Medical Faculty; Heinrich-Heine-University; Duesseldorf Germany
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Zannas A, Carrillo-Roa T, Iurato S, Ressler K, Nemeroff C, Smith A, Lange J, Bradley B, Heim C, Brückl T, Ising M, Wray N, Erhardt A, Binder E, Mehta D. Lifetime Stress Accelerates Epigenetic Aging. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31949-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Calle Serrano B, Großhennig A, Homs M, Heidrich B, Erhardt A, Deterding K, Jaroszewicz J, Bremer B, Koch A, Cornberg M, Manns MP, Buti M, Wedemeyer H. Development and evaluation of a baseline-event-anticipation score for hepatitis delta. J Viral Hepat 2014; 21:e154-63. [PMID: 24673975 PMCID: PMC4263246 DOI: 10.1111/jvh.12251] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 01/02/2014] [Indexed: 12/13/2022]
Abstract
Hepatitis delta is considered the most severe form of viral hepatitis, but variables associated with disease progression are poorly defined. This study aimed to identify risk factors associated with worse clinical outcome in patients with hepatitis delta and to develop a clinical score to determine their risk of experiencing liver-related morbidity or mortality. We followed 75 HBsAg-anti-HDV-positive patients with hepatitis delta for up to 16 years (median 5 years). The baseline-event-anticipation score (BEA score) was developed based on variables associated with the development of liver-related clinical complications. Age, region of origin, presence of cirrhosis, albumin, INR, hyperbilirubinemia and thrombocytopenia were all associated with the development of an event in the training cohort. The BEA score included age, sex, region of origin, bilirubin, platelets and INR. Points were allocated according to hazard ratios, and three risk groups were defined: BEA-A mild risk, BEA-B moderate risk and BEA-C high risk. Hazard ratios of BEA-B and BEA-C patients for liver-related clinical endpoints were 9.01 and 25.27 vs BEA-A with an area under curve of the receiving operating characteristic curve of 0.88. The accuracy of the BEA score was confirmed in two independent validation cohorts followed in Barcelona (n = 77) and Düsseldorf (n = 62). Delta hepatitis is associated with a very severe long-term outcome. The BEA score is easy to apply and predicts with a very high accuracy the development of liver-related complications in patients with hepatitis delta.
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Affiliation(s)
- B Calle Serrano
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,German Center for Infection Research (DZIF), Partner Side HepNet Study-HouseHannover, Germany
| | - A Großhennig
- Institute for Biostatistics Hannover Medical SchoolHannover, Germany
| | - M Homs
- Liver Unit, Hospital General Universitario Vall d'Hebron and CIBERehd of Instituto Carlos IIIBarcelona, Spain
| | - B Heidrich
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical SchoolHannover, Germany
| | - A Erhardt
- Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine-UniversityDusseldorf, Germany
| | - K Deterding
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany
| | - J Jaroszewicz
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,Department of Infectious Diseases and Hepatology, Medical University of BialystokBialystok, Poland
| | - B Bremer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany
| | - A Koch
- Institute for Biostatistics Hannover Medical SchoolHannover, Germany
| | - M Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany
| | - M P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,Liver Unit, Hospital General Universitario Vall d'Hebron and CIBERehd of Instituto Carlos IIIBarcelona, Spain
| | - M Buti
- Institute for Biostatistics Hannover Medical SchoolHannover, Germany
| | - H Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,German Center for Infection Research (DZIF), Partner Side HepNet Study-HouseHannover, Germany,Liver Unit, Hospital General Universitario Vall d'Hebron and CIBERehd of Instituto Carlos IIIBarcelona, Spain
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7
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Beggel B, Münk C, Däumer M, Hauck K, Häussinger D, Lengauer T, Erhardt A. Full genome ultra-deep pyrosequencing associates G-to-A hypermutation of the hepatitis B virus genome with the natural progression of hepatitis B. J Viral Hepat 2013; 20:882-9. [PMID: 24304458 DOI: 10.1111/jvh.12110] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 03/19/2013] [Indexed: 12/12/2022]
Abstract
Human APOBEC3 (A3) cytosine deaminases are antiviral restriction factors capable of editing the genome the hepatitis B virus (HBV). Despite the importance of the human A3 protein family for the innate immune response little is known about the clinical relevance for hepatitis B. The aim of this study was to utilize ultra-deep pyrosequencing (UDPS) data to analyse the phenomenon of G-to-A hypermutation of the complete HBV genome and to relate it to fundamental characteristics of patients with chronic hepatitis B. By analysing the viral population of 80 treatment naïve patients (47 HBeAg-positive and 33 HBeAg-negative), we identified an unequal distribution of G-to-A hypermutations across the genome. Our data indicate that G-to-A hypermutation occurs predominantly in a region between nucleotide positions 600 and 1800 a region which is usually single stranded in matured HBV particles. This implies that A3 likely edits HBV in the virion. Hypermutation rates for HBeAg-negative patients were more than 10-fold higher than those of HBeAg-positive patients. For HBeAg-negative patients higher hypermutation rates were significantly associated with the degree of fibrosis. Additionally, we found that for HBeAg-positive chronic hepatitis G-to-A hypermutation rates were significantly associated with the relative prevalence of the G1764A mutation, which is related to HBeAg seroconversion. In total, our data imply an important association of hypermutation mediated by A3 deaminases with the natural progression of chronic hepatitis B infections both in terms of HBeAg seroconversion and disease progression towards cirrhosis.
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Affiliation(s)
- B Beggel
- Department of Computational Biology and Applied Algorithmics, Max Planck Institute for Informatics, Saarbrücken, Germany
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Erhardt A, Lucae S, Ising M, Holsboer F, Binder EB. Association of PACAP and PACAPR1 gene variants with unipolar depression and panic disorder. Pharmacopsychiatry 2013. [DOI: 10.1055/s-0033-1353350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Burgazli KM, Mericliler M, Greiner H, Göbel T, Erhardt A. Pneumatosis intestinalis: a rare cause of lower gastrointestinal bleeding. Eur Rev Med Pharmacol Sci 2013; 17:2293-2294. [PMID: 24065220] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Pneumatosis intestinalis is an uncommon condition characterized by the presence of gas in the bowel wall. We present the case of a 49-year-old man admitted to our Clinic for his 4 day long haematochezia. Colonoscopy revealed pneumatosis coli as a cause of the lower gastrointestinal bleeding. A wide range of diagnostic methods didn't show any underlying disease related to the bleeding, other than the presence of gas. Patient is reported in order to draw attention to the primary pneumatosis coli presented as a rare cause of haematochezia.
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Affiliation(s)
- K M Burgazli
- Department of Internal Medicine and Angiology, Wuppertal Research and Medical Center, Wuppertal, Germany.
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Göbel T, Blondin D, Kolligs F, Bölke E, Erhardt A. [Current therapy of hepatocellular carcinoma with special consideration of new and multimodal treatment concepts]. Dtsch Med Wochenschr 2013; 138:1425-30. [PMID: 23801265 DOI: 10.1055/s-0033-1343232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The incidence of hepatocellular carcinoma (HCC) is increasing worldwide due to the growing number of hepatitis C related HCCs. In more than 80% of the patients, HCC arises in a cirrhotic liver. Furthermore, more than half of the patients have an advanced Child-Pugh score or an inoperable tumor stage at the initial diagnosis. Recommendations for the treatment of HCC by national and international guidelines rely on the BCLC ("Barcelona Clinic for Liver Cancer") algorithm. Depending on the stage of liver function and tumor disease it recommends resection, liver transplantation, radiofrequency thermal ablation (RFA), transarterial chemoembolisation (TACE), systemic therapy with sorafenib or best supportive care, but does neither take into consideration combination of therapies nor new therapy modalities. However, there is increasing evidence that combinations i. e. sorafenib with TACE or combination of locoregional techniques enhance effectivity and tumor control compared to monotherapies. TACE with drug-eluting beads, selective internal radiotherapy (SIRT) and new locoregional therapy procedures like microwave ablation (MWA) are further promising therapeutic approaches. Patients with HCC should be discussed in a local tumor board in order to provide the optimal and most individual way of treatment.
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Affiliation(s)
- T Göbel
- Klinik für Innere Medizin II - Gastroenterologie, Hepatologie und Diabetologie, Petrus-Krankenhaus Wuppertal.
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Müller-Krebs S, Schmidt S, Erhardt A, Nawroth PP, Schwenger V. Protektion vor diabetischer Nephropathie durch Glyoxalase I. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Erhardt A, Akula N, Schumacher J, Czamara D, Karbalai N, Müller-Myhsok B, Mors O, Borglum A, Kristensen AS, Woldbye DPD, Koefoed P, Eriksson E, Maron E, Metspalu A, Nurnberger J, Philibert RA, Kennedy J, Domschke K, Reif A, Deckert J, Otowa T, Kawamura Y, Kaiya H, Okazaki Y, Tanii H, Tokunaga K, Sasaki T, Ioannidis JPA, McMahon FJ, Binder EB. Replication and meta-analysis of TMEM132D gene variants in panic disorder. Transl Psychiatry 2012; 2:e156. [PMID: 22948381 PMCID: PMC3565207 DOI: 10.1038/tp.2012.85] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A recent genome-wide association study in patients with panic disorder (PD) identified a risk haplotype consisting of two single-nucleotide polymorphisms (SNPs) (rs7309727 and rs11060369) located in intron 3 of TMEM132D to be associated with PD in three independent samples. Now we report a subsequent confirmation study using five additional PD case-control samples (n = 1670 cases and n = 2266 controls) assembled as part of the Panic Disorder International Consortium (PanIC) study for a total of 2678 cases and 3262 controls in the analysis. In the new independent samples of European ancestry (EA), the association of rs7309727 and the risk haplotype rs7309727-rs11060369 was, indeed, replicated, with the strongest signal coming from patients with primary PD, that is, patients without major psychiatric comorbidities (n = 1038 cases and n = 2411 controls). This finding was paralleled by the results of the meta-analysis across all samples, in which the risk haplotype and rs7309727 reached P-levels of P = 1.4e-8 and P = 1.1e-8, respectively, when restricting the samples to individuals of EA with primary PD. In the Japanese sample no associations with PD could be found. The present results support the initial finding that TMEM132D gene contributes to genetic susceptibility for PD in individuals of EA. Our results also indicate that patient ascertainment and genetic background could be important sources of heterogeneity modifying this association signal in different populations.
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Affiliation(s)
- A Erhardt
- Max-Planck-Institute of Psychiatry, Munich, Germany.
| | - N Akula
- Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - J Schumacher
- Institute for Human Genetics, University of Bonn, Bonn, Germany
| | - D Czamara
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - N Karbalai
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | | | - O Mors
- Department of Psychiatry, Aarhus University, Aarhus, Denmark
| | - A Borglum
- Department of Biomedicine, Human Genetics, Aarhus University, Aarhus, Denmark
| | - A S Kristensen
- Department of Psychiatry, Aarhus University, Aarhus, Denmark
| | - D P D Woldbye
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - P Koefoed
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - E Eriksson
- University of Gothenburg, Gothenburg, Sweden
| | - E Maron
- University of Tartu, Tartu, Estonia
| | - A Metspalu
- Estonian Biocentre, Tartu, Estonia,Estonian Genome Center, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - J Nurnberger
- Department of Psychiatry, Indiana University, Indianapolis, IN, USA
| | - R A Philibert
- Behavioural Genetics, University of Iowa, Iowa, IA, USA
| | - J Kennedy
- University of Toronto, Toronto, Canada
| | - K Domschke
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - A Reif
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - J Deckert
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - T Otowa
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Y Kawamura
- Research Center for Panic Disorder, Nagoya Mental Clinic, Nagoya, Japan
| | - H Kaiya
- Akasaka Mental Clinic, Tokyo, Japan,Research Center for PanIC Disorder, Nagoya, Japan
| | - Y Okazaki
- Department of Neurology, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - H Tanii
- Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Mie, Japan
| | - K Tokunaga
- Department of Human Genetics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - T Sasaki
- Laboratory of Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - J P A Ioannidis
- Stanford Prevention Research Center, Departments of Medicine, Health Research and Policy, and Statistics, Stanford University, Stanford, CA, USA
| | - F J McMahon
- Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - E B Binder
- Max-Planck-Institute of Psychiatry, Munich, Germany
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Mederacke I, Yurdaydin C, Großhennig A, Erhardt A, Cakaloglu Y, Yalcin K, Gurel S, Zeuzem S, Zachou K, Chatzikyrkou C, Bozkaya H, Dalekos GN, Manns MP, Wedemeyer H. Renal function during treatment with adefovir plus peginterferon alfa-2a vs either drug alone in hepatitis B/D co-infection. J Viral Hepat 2012; 19:387-95. [PMID: 22571900 DOI: 10.1111/j.1365-2893.2011.01560.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Long-term safety of treatment with hepatitis B virus (HBV) polymerase inhibitors is a concern. Adefovir dipivoxil (ADV) therapy has previously been associated with impairment of renal function. Limited data are available on the safety of combination therapy with nucleos(t)ide analogues and interferon alfa (IFNα). The aim of this analysis was to assess the renal function during combination therapy with peginterferon alfa-2a (PegIFNα-2a) plus ADV vs either drug alone in patients with hepatitis B/D co-infection. We performed a retrospective analysis of renal function data of patients treated in the Hep-Net/International Delta Hepatitis Intervention Trial 1(HIDIT-1-trial), a European multicenter study to investigate the efficacy of 48 weeks of therapy with PegIFNα-2a+ADV vs either drug alone in 90 patients with chronic hepatitis B/D co-infection. Glomerular filtration rates (GFR) were calculated by Cockcroft-Gault (CG), abbreviated Modification of Diet in Renal Disease (MDRD) study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. After 48 weeks of therapy GFR values were significantly lower in patients receiving adefovir-containing treatment vs PegIFNα-2a alone [mean difference 16.1 mL/min (CG) and 10.2 mL/min (MDRD), respectively, P < 0.05] while no differences were observed between patients receiving adefovir alone vs combination treatment. Twenty-four weeks after treatment GFR values did not differ between treatment arms. A decrease in GFR ≥ 20% was observed more often in patients during adefovir-containing treatment vs PegIFNα-2a alone (P < 0.05) which was confirmed by Kaplan-Meier analysis. Adefovir-containing but not PegIFNα-2a treatment was associated with a decrease in GFR values in about one-fifth of patients. Combination treatment of PegIFNα-2a+ADV in chronic hepatitis B/D co-infection did not lead to any further impairment of kidney function.
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Affiliation(s)
- I Mederacke
- Department of Gastroenterology, Hannover Medical School, Hannover, Germany
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Kessler T, Thiele K, Solano M, Arck P, Tiegs G, Erhardt A. Acetaminophen application during murine pregnancy triggers metabolic and immunological changes in dams and impairs fetal development. J Reprod Immunol 2012. [DOI: 10.1016/j.jri.2012.03.272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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15
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Akanay-Diesel S, Hoff NP, Kürle S, Haes J, Erhardt A, Häussinger D, Schulte KW, Bölke E, Matuschek C, Budach W, Gerber PA, Homey B. Sunitinib induced pyoderma gangrenosum-like ulcerations. Eur J Med Res 2012; 16:491-4. [PMID: 22027642 PMCID: PMC3351806 DOI: 10.1186/2047-783x-16-11-491] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Pyoderma gangrenosum is a non-infectious neutro?philic skin disease commonly associated with underlying systemic diseases. Histopathological and laboratory diagnostics are unspecific in the majority of the cases and the diagnosis is made in accordance with the clinical picture. Here, we report the case of a 69-year old man with progredient pyoderma gangrenosum-like ulcerations under treatment with sunitinib due to hepatocellular carcinoma. A conventional ulcer therapy did not lead to a regression of the lesions. Solely cessation of sunitinib therapy resulted in an improvement of the ulcerations. Sunitinib is a multikinase inhibitor that targets the PDGF-α- and ?β-, VEGF-1-3-, KIT-, FLT3-, CSF-1- and RET-receptor, thereby impairing tumour proliferation, pathological angiogenesis and metastasation. Here, we demonstrate that pyoderma gangrenosum-like ulcers may represent a serious side effect of sunitinib-based anti-cancer treatment.
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Affiliation(s)
- S Akanay-Diesel
- Universitätsklinikum Düsseldorf, Heinrich Heine Universität, Duesseldorf, Germany
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16
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Matuschek C, Rudoy M, Peiper M, Gerber PA, Hoff NP, Buhren BA, Flehmig B, Budach W, Knoefel WT, Bojar H, Prisack HB, Steinbach G, Shukla V, Schwarz A, Kammers K, Erhardt A, Scherer A, Bölke E, Schauer M. Do insulin-like growth factor associated proteins qualify as a tumor marker? Results of a prospective study in 163 cancer patients. Eur J Med Res 2011; 16:451-6. [PMID: 22024424 PMCID: PMC3400976 DOI: 10.1186/2047-783x-16-10-451] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Insulin-like growth factor (IGF)-1, -2 and Insulin like growth factor binding proteins (IGFBP) are involved in the proliferation and differentiation of cells. It has never been evaluated, if the IGF-system can serve as a tumor marker in neoplasms. METHODS In our prospective study 163 patients with colorectal cancer (22), prostate cancer (21), head and neck tumors (17), lymphomas (20), lung cancer (34) and other entities (49) were analysed for their IGF and IGFBP serum levels at the beginning and the end of radiotherapy and compared to 13 healthy people. Subgroups of patients with local tumor disease versus metastatic disease, primary and recurrent therapy and curative versus palliative therapy were compared. RESULTS The serum levels of IGF-2 were significantly elevated in patients with prostate and colorectal cancer. However, sensitivity and specificity were only 70%. IGFBP-2 serum levels were elevated in patients with head and neck tumors. Again sensitivity and specificity were only 73%. A difference between local disease and metastatic disease could not be found. A difference between IGF serum levels before and after radiotherapy could not be detected. CONCLUSION The IGF-system cannot serve as a new tumor marker. The detected differences are very small, sensitivity and specificity are too low. IGF measurement is not useful for the evaluation of the success of radiotherapy in malignancies.
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Affiliation(s)
- C Matuschek
- Department of Radiation Therapy and Radiooncology, Universitätsklinikum Düsseldorf, Heinrich Heine Universität, Duesseldorf, Germany
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17
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Matuschek C, Bölke E, Zahra T, Knoefel WT, Peiper M, Budach W, Erhardt A, Scherer A, Baldus SE, Gerber PA, Buhren BA, Schauer M, Hoff NP, Gattermann N, Orth K. Trimodal therapy in squamous cell carcinoma of the esophagus. Eur J Med Res 2011; 16:437-44. [PMID: 22024422 PMCID: PMC3400974 DOI: 10.1186/2047-783x-16-10-437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Patients with ESCC (squamous cell carcinoma of the esophagus) are most commonly diagnosed with locally advanced tumor stages. Early metastatic disease and late diagnosis are common reasons responsible for this tumor's poor clinical outcome. The prognosis of esophageal cancer is very poor because patients usually do not have symptoms in early disease stages. Squamous cell carcinoma of the esophagus frequently complicates patients with multiple co-morbidities and these patients often require interdisciplinary diagnosis and treatment procedures. At present time, neoadjuvant radiation therapy and chemotherapy followed by surgery are regarded as the international standard of care. Meta-analyses have confirmed that this approach provides the patient with better local tumor control and an increased overall survival rate. It is recommended that patients with positive tumor response to neoadjuvant therapy and who are poor surgical candidates should consider definitive radiochemotherapy without surgery as a treatment option. In future, EGFR antibodies may also be administered to patients during therapy to improve the current treatment effectiveness. Positron-emission tomography proves to be an early response-imaging tool used to evaluate the effect of the neoadjuvant therapy and could be used as a predictive factor for the survival rate in ESCC. The percentage proportions of residual tumor cells in the histopathological analyses represent a gold standard for evaluating the response rate to radiochemotherapy. In the future, early response evaluation and molecular biological tests could be important diagnostic tools in influencing the treatment decisions of ESCC patients.
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Affiliation(s)
- C Matuschek
- Klinik für Strahlentherapie und Radiologische Onkologie, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
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18
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Bölke E, Peiper M, Knoefel WT, Baldus SE, Schauer M, Matuschek C, Gerber PA, Hoff NP, Budach W, Gattermann N, Erhardt A, Scherer A, Buhren BA, Orth K. [Multimodal therapy in locally advanced gastric cancer]. Dtsch Med Wochenschr 2011; 136:2205-11. [PMID: 22009175 DOI: 10.1055/s-0031-1292034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Locally advanced gastric cancers are characterized by poor prognosis. Clinical outcome can be improved if surgery becomes part of a multimodal treatment approach. The purpose of neoadjuvant treatment includes downsizing of the primary tumor, improvement of the T- and N- categories, and early therapy of micrometastasis. Several controlled clinical trials showed that neoadjuvant chemotherapy as well as neoadjuvant combined radio-chemotherapy, especially for tumors of the gastroesophageal junction, can improve the rate of primary R0 resections, relapse-free survival, and overall survival. While patients with locally advanced tumors clearly benefit from this strategy, the approach is still controversial in patients with early stage disease. Nonresponders do not benefit from neoadjuvant therapy. Therefore, response evaluation and response prediction are of great importance. After successful neoadjuvant chemotherapy, patients should undergo gastrectomy with D(2)-lymphadenectomy because of a high probability of lymph node metastasis. This article summarizes current developments in this field.
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Affiliation(s)
- E Bölke
- Klinik für Strahlentherapie und Radiologische Onkologie, Universitätsklinik Düsseldorf.
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Cornberg M, Protzer U, Petersen J, Wedemeyer H, Berg T, Jilg W, Erhardt A, Wirth S, Sarrazin C, Dollinger MM, Schirmacher P, Dathe K, Kopp IB, Zeuzem S, Gerlich WH, Manns MP. [Prophylaxis, diagnosis and therapy of hepatitis B virus infection - the German guideline]. Z Gastroenterol 2011; 49:871-930. [PMID: 21748700 DOI: 10.1055/s-0031-1273462] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- M Cornberg
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
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Erhardt A, Zhu E, Blondin D, Kubitz R, Knoefel WT, Mödder U, Häussinger D. [Increasing number and improved survival of patients with hepatocellular carcinoma from 1988 to 2007: data of a German university clinic]. Z Gastroenterol 2011; 49:720-7. [PMID: 21638238 DOI: 10.1055/s-0029-1246060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Hepatocellular carcinoma (HCC) ranks sixth regarding prevalence and third regarding mortality among malignant tumours worldwide. The aim of the present study was to determine changes of clinical-epidemiological parameters and survival rates during two decades. PATIENTS AND METHODS A total of 441 consecutive patients with HCC admitted to the University Clinic Düsseldorf between January 1988 and December 2007 were included. For comparison, this time period was divided into two decades (1988 - 1997 and 1998 - 2007). RESULTS The number of newly diagnosed HCCs has tripled in the years 1998 - 2007 compared to the years 1988 - 1997. HCV-associated HCCs increased from 28 % in the years 1988 - 1997 to 38 % (p < 0.05) in the years 1998 - 2007. Tumour size, Okuda and BCLC stages decreased during the observation period (both p < 0.001 and p < 0.05). Median overall survival improved during the observation period from 6 [95 % CI: 4.83 - 7.17] to 9 months ]95 % CI: 7.31 - 10.69]; p < 0.0001) as did the 1-year and 5-year survival rates from 22 % to 42 % (p < 0.019) and from 0 % to 9 % (p < 0.001), respectively. The proportion of treated patients compared to patients with best supportive care as well as the proportion of patients receiving a multimodal therapy compared to patients with a single treatment regimen increased in the second decade (55 % vs. 79 %: p < 0.005; 5.4 % vs. 23 %: p < 0.0001). Multimodal therapy was an independent predictor for prolonged survival in a multivariate analysis including Child-Pugh score, BCLC stage, tumour size, and gender (odds ratio 2,77; 95 % CI: 1.44 - 5.31). CONCLUSION Improved screening as well as broader and improved treatment options may have contributed to the increasing survival rates.
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Affiliation(s)
- A Erhardt
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Heinrich-Heine-Universität Düsseldorf.
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Kubitz R, Bode J, Erhardt A, Graf D, Kircheis G, Müller-Stöver I, Reinehr R, Reuter S, Richter J, Sagir A, Schmitt M, Donner M. Cholestatic liver diseases from child to adult: the diversity of MDR3 disease. Z Gastroenterol 2011; 49:728-36. [PMID: 21638239 DOI: 10.1055/s-0031-1273427] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The phospholipidfloppase MDR3 (gene symbol: ABCB4) is expressed in the canalicular membrane of hepatocytes and mediates the biliary excretion of phosphatidylcholine, which is required for the formation of mixed micelles in bile. Several mutations of ABCB4 have been identified, which cause cholestatic liver diseases of varying severity including progressive familial intrahepatic cholestasis type 3 (PFIC-3), intrahepatic cholestasis of pregnancy (ICP) and the low phospholipid associated cholelithiasis syndrome (LPAC). Here, we report on four new (S1076N; L 23Hfs16X; c.286 + 1G > A; Q 1181E) and one known (S27G) MDR3 mutations in eight patients of three families. The patients presented with a wide spectrum of liver diseases. The clinical presentation and decisive laboratory findings or the association to a trend-setting family history led to the identification of the genetic background in these patients. Even the same mutation may be associated with varying disease progression.
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Affiliation(s)
- R Kubitz
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf.
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Erhardt A, Kolligs FT, Dollinger MM, Schott E, Wege H, Bitzer M, Gog C, Raedle J, Schuchmann M, Walter C, Blondin D, Ohmann C, Haeussinger D. TACE plus sorafenib for the treatment of hepatocellular carcinoma: Final results of the multicenter SOCRATES trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Buttenschøn HN, Kristensen AS, Buch HN, Andersen JH, Bonde JP, Grynderup M, Hansen AM, Kolstad H, Kaergaard A, Kaerlev L, Mikkelsen S, Thomsen JF, Koefoed P, Erhardt A, Woldbye DPD, Børglum AD, Mors O. The norepinephrine transporter gene is a candidate gene for panic disorder. J Neural Transm (Vienna) 2011; 118:969-76. [PMID: 21416264 DOI: 10.1007/s00702-011-0624-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 03/03/2011] [Indexed: 02/06/2023]
Abstract
Panic disorder (PD) is an anxiety disorder characterized by recurrent panic attacks with a lifetime prevalence of 4.7%. Genetic factors are known to contribute to the development of the disorder. Several lines of evidence point towards a major role of the norepinephrine system in the pathogenesis of PD. The SLC6A2 gene is located on chromosome 16q12.2 and encodes the norepinephrine transporter (NET), responsible for the reuptake of norepinephrine into presynaptic nerve terminals. The aim of the present study was to analyze genetic variants located within the NET gene for association with PD. The case-control sample consisted of 449 patients with PD and 279 ethnically matched controls. All cases fulfilled the ICD-10 diagnostic criteria for PD. Genotyping was performed using the Sequenom platform (Sequenom, Inc, San Diego, USA). To test for allelic and haplotypic association, the PLINK software was used, and COMBASSOC was applied to test for gene-wise association. After quality control 29 single nucleotide polymorphisms (SNPs) spanning the gene-region were successfully analyzed. Seven SNPs located within the 5' end of the gene were significantly associated with PD. Furthermore, the NET gene showed overall evidence for association with the disease (P = 0.000035). In conclusion, the present study indicates that NET could be a susceptibility gene for PD.
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Affiliation(s)
- H N Buttenschøn
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Skovagervej 2, 8240 Risskov, Denmark.
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Blondin D, Erhardt A, Crynen K, Sagir A, Scherer A, Kröpil P, Häussinger D, Mödder U, Kubitz R. [Diagnosis of focal liver lesions in cirrhotic patients: comparison of contrast-enhanced ultrasound using sulphur hexafluoride (SF6) microbubbles and MRI using Gd-EOB-DTPA]. Z Gastroenterol 2011; 49:23-9. [PMID: 21225534 DOI: 10.1055/s-0029-1245781] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM The diagnostic accuracies of contrast-enhanced sonography and hepatobiliary contrast-enhanced MRI of the liver in evaluating focal liver lesions in patients with liver cirrhosis were compared. MATERIAL AND METHODS In 33 patients (25 men, 8 women, mean age 63.2 ± 11.2 years) MRI of the liver using Gd-EOB-DTPA (Primovist®, Bayer Schering Pharma, Berlin) was performed. Axial T(2)-weighted, unenhanced T(1)-weighted and enhanced T(1)-weighted scans during arterial, portal venous and late phases were acquired, followed by coronary T(1)-weighted and axial fat-suppressed T(1)-weighted scans 15 minutes post contrast application. In all patients within 4 weeks contrast-enhanced sonography using sulfur hexafluoride microbubbles (SonoVue®, Nycomed, Germany) was obtained. RESULTS Cirrhosis of the liver was related to viral infection in 45.4% and to alcoholism in 39.4%. All hepatic lesions were confirmed by histologic examination. Sensitivity and specificity of MRI were 90.2% and 83.3%, compared to contrast-enhanced sonography with 92.7 % and 50 %, respectively. Positive and negative predictive values were 97.4% and 55.5 % for MRI and 90.5% and 50% for contrast-enhanced sonography, respectively. DISCUSSION In this retrospective study MRI using Gd-EOB-DTPA as well as contrast-enhanced sonography using sulfur hexafluoride microbubbles gave excellent results in detecting HCC in patients suffering from liver cirrhosis. Although the specificity was higher for MRI, the accuracy showed no significant difference between these two imaging techniques.
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Affiliation(s)
- D Blondin
- Institut für Radiologie, Heinrich-Heine-Universität Düsseldorf.
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Donner MG, Erhardt A, Häussinger D. [Metabolic disorders of the liver.Part 2: glycogen storage diseases, hereditary fructose intolerance, galactosemia and hepatic porphyrias]. Dtsch Med Wochenschr 2010; 135:2540-7. [PMID: 21140331 DOI: 10.1055/s-0030-1269424] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M G Donner
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universität Düsseldorf
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Erhardt A, Donner MG, Häussinger D. [Metabolic disorders of the liver. Part 1: Hemochromatosis, Wilson's disease, α(1)-antitrypsin-deficiency, Gaucher's disease]. Dtsch Med Wochenschr 2010; 135:2481-8. [PMID: 21120788 DOI: 10.1055/s-0030-1269419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Erhardt
- Klinik für Gastroenterologie, Hepatologie und Infektiologie
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Erhardt A, Hoernke M, Heinzel-Pleines U, Sagir A, Göbel T, Häussinger D. Retrospective analysis of chronic hepatitis D in a West German University Clinic over two decades: migratory pattern, prevalence and clinical outcome. Z Gastroenterol 2010; 48:813-7. [PMID: 20687016 DOI: 10.1055/s-0028-1109984] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND/AIMS Epidemiology, clinical features and long term-course of chronic hepatitis D were addressed in a non-endemic Central European area. METHODS Sixty-seven patients with chronic hepatitis D were identified among 1307 HBsAg carriers at the university hospital Düsseldorf during two decades (1989 - 2008) and followed for a mean of 7 +/- 6 years. Forty-one of these were treated with IFN-alfa for at least six months. RESULTS Hepatitis D prevalence increased from 4.1 to 6.2 % among HBsAg carriers during the two decades (p < 0.06). Patients originating from the former Soviet Union (32.1 vs. 46.2 %) and Africa (0 vs. 17.9 %) became more frequent whereas the prevalence of patients from Southern Europe declined (46.5 vs.17.9 % p < 0.03). The time span between the diagnosis of hepatitis B and D was 4.8 +/- 7 years (p < 0.0001). A sustained virological response to interferon-alfa was achieved in 19.5 % of the patients. The yearly incidence rates for death, HCC and complications were 3.2 %, 2.7 % and 8 % among patients with liver cirrhosis. Estimated survival and complication-free survival during 12 years were 72 % and 45 % in cirrhotic compared to 100 % in non-cirrhotic patients (p < 0.008 and p < 0.0001, respectively). CONCLUSION Hepatitis D in western Germany appears to be on the increase and has a migration background that should be considered in clinical practice. Clinical outcome and response to IFN are as poor as in endemic regions, indicating the need to improve early diagnosis.
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Affiliation(s)
- A Erhardt
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf.
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Ditzen C, Varadarajulu J, Czibere L, Gonik M, Targosz BS, Hambsch B, Bettecken T, Kessler MS, Frank E, Bunck M, Teplytska L, Erhardt A, Holsboer F, Müller-Myhsok B, Landgraf R, Turck CW. Proteomic-based genotyping in a mouse model of trait anxiety exposes disease-relevant pathways. Mol Psychiatry 2010; 15:702-11. [PMID: 19139748 DOI: 10.1038/mp.2008.146] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In our biomarker identification efforts, we have reported earlier on a protein that differs in its electrophoretic mobility between mouse lines bred either for high or low trait anxiety. The altered electrophoretic behavior of enolase phosphatase (EP) is now identified to be caused by two single-nucleotide polymorphisms. In both cases, the genetic polymorphism introduces an amino acid change in the protein's sequence resulting in differential mobility on SDS gels. This was shown by recombinantly expressing the two EP isoforms. Functional studies indicate that the EP isoform from the high anxiety mouse line has a lower enzymatic activity than does its low anxiety mouse counterpart. EP is a member of the methionine salvage pathway that is responsible for the synthesis of S-adenosyl-L-methionine, a natural compound with potential antidepressant activities. In addition, it is linked to the polyamine pathway whose members have functions in anxiety/depression-related behaviors. In a freely-segregating F2 panel, both single-nucleotide polymorphisms were significantly associated with locomotion-independent trait anxiety, further supporting a functional role of EP for this phenotype. The study shows that proteomic analysis can reveal genotypic differences relevant for the phenotype. The identified protein alterations, in turn, can expose metabolic pathways pertinent to the behavioral phenotype.
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Affiliation(s)
- C Ditzen
- Max Planck Institute of Psychiatry, Munich, Germany
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Thoeringer CK, Erhardt A, Sillaber I, Mueller MB, Ohl F, Holsboer F, Keck ME. Long-term anxiolytic and antidepressant-like behavioural effects of tiagabine, a selective GABA transporter-1 (GAT-1) inhibitor, coincide with a decrease in HPA system activity in C57BL/6 mice. J Psychopharmacol 2010; 24:733-43. [PMID: 19346277 DOI: 10.1177/0269881109103091] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Gamma-aminobutyric acid (GABA) system plays a pivotal role in the pathophysiology of anxiety and mood disorders. This study was aimed to assess the anxiolytic and antidepressant-like properties of tiagabine, an inhibitor of the GABA transporter-1 (GAT-1), after acute and chronic administration in C57BL/6JOlaHsD mice with paroxetine as a positive control. In first experiments, the acute administration of tiagabine (7.5 mg/kg, orally [PO]) and paroxetine (10 mg/kg PO) induced anxiolytic effects in the elevated plus maze test and the modified hole board test and an antidepressant-like effect in the forced swim test. Chronic application of tiagabine (7.5 mg/kg PO) and paroxetine (10 mg/kg PO) for 22 days revealed an anxiolytic and antidepressant-like efficacy of tiagabine only. In a further experiment, we analysed the impact of chronic tiagabine versus paroxetine treatment on the hypothalamic-pituitary-adrenocortical (HPA) system regulation. GAT-1 blockade induced a setpoint-shift of the stress hormone system toward lower levels as indicated by decreased plasma corticosterone concentrations and attenuated gene expression levels of corticotropin-releasing factor in the paraventricular nucleus of the hypothalamus and of hippocampal steroid receptors. This data indicate that both acute and long-term anxiolytic and antidepressant-like properties of brain GAT-1 inhibition coincide with a reduction in HPA system activity in mice.
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Unschuld PG, Ising M, Roeske D, Erhardt A, Specht M, Ripke S, Uhr M, Kloiber S, Müller-Myhsok B, Holsboer F, Binder EB. Polymorphisms in the gene encoding the neuropeptide galanin are associated with HPA-axis dysregulation and symptome severity in major-depressive- and anxiety-disorder patients. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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31
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Kröpil P, Cohnen M, Miese F, Walther C, Mehnert S, Erhardt A, Beck A, Mödder U, Blondin D. Verbessert intravenöses, niedrigdosiertes Morphin die Darstellung der Gallengänge in der Magnetresonanz-Cholangiographie? ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Erhardt A, Müller MB, Rödel A, Welt T, Ohl F, Holsboer F, Keck ME. Consequences of chronic social stress on behaviour and vasopressin gene expression in the PVN of DBA/2OlaHsd mice--influence of treatment with the CRHR1-antagonist R121919/NBI 30775. J Psychopharmacol 2009; 23:31-9. [PMID: 18515457 DOI: 10.1177/0269881108089813] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Accumulating evidence suggests that corticotropin-releasing hormone (CRH) neurocircuitry modulate the neuroendocrine and behavioural phenotypes in depression and anxiety. Thus, the administration of the selective CRH-receptor 1 (CRHR1)-antagonist R121919/NBI 30775 has proven its ability to act as an anxiolytic in rats. It is still unclear whether vasopressinergic neuronal circuits, which are known to be involved in the regulation of emotionality, are affected by R121919/NBI 30775. Using DBA/2OlaHsd mice, we investigated the effects of chronic social defeat and concomitant treatment with R121919/NBI 30775 on 1) the behavioural profile in the modified hole board test and 2) in-situ hybridization analysis-based expression of arginine vasopressin (AVP) and CRH mRNA in both the hypothalamic paraventricular nucleus and supraoptic nucleus. The results suggest that chronic social defeat leads to increased avoidance behaviour and reduction in directed exploration, general exploration, and locomotion. Chronic treatment with the CRHR1-antagonist was effective in reversing the directed exploration to control level. The dissection of the antagonist-treated group into responders and non-responders using the parameter time spent on board revealed further positive effects of R121919/NBI 30775 on avoidance behaviour and locomotion. Behavioural changes were accompanied by alterations in AVP gene expression in the paraventricular nucleus. Taken together, the anxiolytic action of the CRHR1 antagonist was found in a subgroup of animals only, and further studies have to be done to clarify the inter-individual biological differences in response patterns to this compound to optimise its application under clinical conditions.
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Affiliation(s)
- A Erhardt
- MD Max Planck Institute of Psychiatry, Munich, Germany.
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33
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Cornberg M, Protzer U, Dollinger MM, Petersen J, Wedemeyer H, Berg T, Jilg W, Erhardt A, Wirth S, Schirmacher P, Fleig WE, Manns MP. The German guideline for the management of hepatitis B virus infection: short version. J Viral Hepat 2008; 15 Suppl 1:1-21. [PMID: 18713127 DOI: 10.1111/j.1365-2893.2008.01013.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- M Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
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Cornberg M, Protzer U, Dollinger MM, Petersen J, Wedemeyer H, Berg T, Jilg W, Erhardt A, Wirth S, Schirmacher P, Fleig WE, Manns MP. Prophylaxis, diagnosis and therapy of hepatitis B virus (HBV) infection: the German guidelines for the management of HBV infection. Z Gastroenterol 2008; 45:1281-328. [PMID: 18080231 DOI: 10.1055/s-2007-963714] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- M Cornberg
- Abteilung Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
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Erhardt A, Lucae S, Kern N, Unschuld PG, Ising M, Lieb R, Uhr M, Hohoff C, Deckert J, Bandelow B, Maier W, Binder EB, Müller-Myhsok B, Keck ME, Holsboer F. Association of polymorphisms in the angiotensin-converting enzyme gene with syndromal panic attacks. Mol Psychiatry 2008; 13:242-3. [PMID: 18285758 DOI: 10.1038/sj.mp.4002094] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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36
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Blondin D, Janssen H, Andersen K, Lanzmann R, Erhardt A, Vogt C, Mödder U, Cohnen M. Wertigkeit der MRT mit Primovist und der Sonographie mit SonoVue in der Diagnostik fokaler Leberläsionen bei Patienten mit Leberzirrhose. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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37
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Heck A, Lieb R, Ellgas A, Pfister H, Lucae S, Erhardt A, Himmerich H, Horstmann S, Kloiber S, Ripke S, Müller-Myhsok B, Bettecken T, Uhr M, Holsboer F, Ising M. Polymorphisms in the angiotensin-converting enzyme gene region predict coping styles in healthy adults and depressed patients. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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38
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Heck A, Lieb R, Ellgas A, Pfister H, Lucae S, Erhardt A, Himmerich H, Horstmann S, Kloiber S, Ripke S, Müller-Myhsok B, Bettecken T, Uhr M, Holsboer F, Ising M. Polymorphisms in the angiotensin-converting enzyme gene region predict coping styles in healthy adults and depressed patients. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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39
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Unschuld PG, Ising M, Erhardt A, Lucae S, Kohli M, Kloiber S, Salyakina D, Thoeringer CK, Lieb R, Uhr M, Binder EB, Müller-Myhsok B, Holsboer F, Keck ME. Polymorphisms in the galanin gene are associated with symptom-severity in female patients suffering from panic disorder. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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40
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Sagir A, Heintges T, Akyazi Z, Oette M, Erhardt A, Häussinger D. Therapy outcome in patients with chronic hepatitis C: role of therapy supervision by expert hepatologists. J Viral Hepat 2007; 14:633-8. [PMID: 17697015 DOI: 10.1111/j.1365-2893.2007.00854.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Previous large multicentre trials reported sustained virological response (SVR) rates of 45-80% in chronically infected hepatitis C virus (HCV) patients. However, it is unclear whether such a treatment success is also achieved in daily routine and to what extent it depends on expert hepatological supervision. This was retrospectively analysed in patients presenting at our outpatient department during May 1997 and March 2004 and receiving at least one treatment dose. A total of 302 treatment-naive HCV patients [72% genotypes 1 or 4 (n = 215), 25% genotypes 2/3 (n = 78) and 3% undetermined genotype (n = 9)] were included in the analysis. Out of these, 196 patients consulted an expert hepatologist at least once every 3 months during treatment [regular visitors (RV)], whereas in 106 patients treatment was performed and supervised by a general practitioner (irregular visitors). Both patient groups did not differ in their baseline characteristics. However, the virological response rates at the end of treatment (ETR; 146/196, 74%vs 51/106, 48%, P < 0.001) and 6 months thereafter (SVR; 129/196, 66%vs 36/106, 34%, P < 0.001) were significantly higher in RV. In patients treated with pegylated-interferon (PEG-IFN)/ribavirin, this difference was statistically highly significant (P < 0.001) for HCV genotypes 1 and 4 (treated patients: SVR: 62/101, 61%vs 14/51, 27%, P < 0.001), but not for genotypes 2/3. SVR rates were also significantly better in RV with advanced liver damage [SVR 69% (22/32) vs 25% (5/20), P = 0.004]. In regular and irregular visitors treatment was discontinued in 7% (14/196) and 15% (16/106) respectively (P = 0.015). Patients with unfavourable genotypes 1 and 4 or with advanced liver damage benefit from HCV therapy supervision by a specialist, probably because of less frequent treatment interruptions or dose reductions.
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Affiliation(s)
- A Sagir
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinik Düsseldorf, Moorenstr, Düsseldorf, Germany
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Erhardt A, Unschuld PG, Ripke S, Lucae S, Kohli M, Kloiber S, Puetz B, Heck A, Ellgas A, Pfister H, Ising M, Bettecken T, Müller-Myhsok B, Keck ME, Holsboer F. A genome-wide association study in patients with panic and anxiety disorders. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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42
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Chechko N, Czisch M, Erhardt A, Hoehn D, Wehrle R, Sämann P. Control of the anterior cingulate/mPFC over the amygdala: a longitudinal fMRI study in patients with panic disorder. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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43
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Cornberg M, Protzer U, Dollinger MM, Petersen J, Wedemeyer H, Berg T, Jilg W, Erhardt A, Wirth S, Schirmacher P, Fleig WE, Manns MP. [Prophylaxis, Diagnosis and Therapy of Hepatitis-B-Virus-(HBV-)Infection: upgrade of the guideline, AWMF-Register 021/011]. Z Gastroenterol 2007; 45:525-74. [PMID: 17554641 DOI: 10.1055/s-2007-963232] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M Cornberg
- Die Institutsangaben sind am Ende des Beitrags gelistet
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Abstract
BACKGROUND AND OBJECTIVE Detection of liver cirrhosis has numerous implications because of the potential sequelae of cirrhosis. Transient elastography (Fibroscan), was evaluated as a novel, non-invasive means of assessing cirrhosis by measuring liver stiffness. METHODS 147 consecutive patients with different forms of liver disease and histologically determined stages of liver fibrosis were prospectively studied by transient elastography. 48 patients had liver cirrhosis. RESULTS The number of transient elastographic measurements per patient was 12+/-4 (range 6 - 30). Valid elastography measurements were available for 135 out of 147 patients (92 %). The results of transient elastography correlated positively with the histological score of liver fibrosis (r = 0.8; 95 % CI: 0.72 - 0.85; p < 0.001). Areas under the receiver operating characteristic curve (AUROC) were 0.91 for > or = F3 fibrosis (95 % CI: 0.85 - 0.96) and 0.94 for cirrhosis (95 % CI: 0.90 - 0.98). Using a cut-off value of 13 kPa for detection of liver cirrhosis a sensitivity of 90 %, a specificity of 82 %, a positive predictive value of 71 % and a negative predictive value of 95 % were obtained. CONCLUSIONS Measuring liver stiffness by transient elastography proved to be an easy method to assess liver cirrhosis. In combination with clinical signs, ultrasound and biochemical markers noninvasive diagnosis of liver cirrhosis will be further improved.
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Affiliation(s)
- A Erhardt
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Heinrich-Heine-Universität, Düsseldorf.
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Nitschman S, Erhardt A, Häussinger A. [Therapy with entecavir in chronic hepatitis B. BEHoLD-Study (Benefits of Entecavir for Hepatitis B Liver Disease)]. Internist (Berl) 2007; 48:208-10. [PMID: 17226008 DOI: 10.1007/s00108-006-1787-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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46
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Blondin D, Crynen K, Janssen H, Erhardt A, Mödder U, Cohnen M. Wertigkeit der MRT der Leber mit Gd-EOB-DTPA bei Patienten mit Leberzirrhose. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lukic I, Stoyanov S, Erhardt A, Nawroth P, Bierhaus A. Cell-cell interactions in diabetic neuropathy. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Affiliation(s)
- S Koch
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf.
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Erhardt A, Unschuld PG, Kern N, Welt T, Ising M, Keck ME. Responsiveness of the hypothalamic-pituitary-adrenocortical system in patients with agoraphobia and panic attacks. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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50
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Welt T, Roedel A, Ohl F, Erhardt A, Keck ME. The explorative-reduced (EXR002) C3H mice–a new mouse model of depression? Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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