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Kramuschke M, Renner A, Kersting A. [Burnout : Symptoms, diagnostics and treatment approaches]. Nervenarzt 2024; 95:484-493. [PMID: 38625570 DOI: 10.1007/s00115-024-01649-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/17/2024]
Abstract
Burnout syndrome is characterized by the triad of symptoms exhaustion, mental distance from work activities and a feeling of ineffectiveness. The syndrome is not an independent mental disorder but can be coded in the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) as a problem related to difficulties in coping with life (Z73) and in ICD-11 as a qualifying diagnosis (QD85). This article discusses the prevalence and comorbidities of burnout syndrome, taking the methodological difficulties in conceptualizing and operationalizing the construct into account. In addition, it provides an overview of available measurement instruments and their validation. Furthermore, it discusses work-related and individual factors in the development of burnout syndrome as well as analysis of the effectiveness of treatment options.
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Affiliation(s)
- M Kramuschke
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland.
| | - A Renner
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland
| | - A Kersting
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland
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Roehr S, Jung FU, Pabst A, Grochtdreis T, Nagl M, Renner A, Hoffmann R, Koenig HH, Kersting A, Riedel-Heller SG. A self-help app for Syrian refugees with posttraumatic stress (Sanadak): results of a randomized controlled trial. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Syrian refugees often develop posttraumatic stress as a result of the Syrian civil war and migration stressors. However, there is a lack of adequate treatments. The smartphone app Sanadak was developed and evaluated to provide cognitive behavioral therapy-based self-help in the Arabic language for Syrian refugees with posttraumatic stress.
Methods
In a randomized controlled trial, eligible individuals were allocated to the intervention group (IG; app) or control group (CG; psychoeducational reading material). Data were collected during structured face-to-face interviews at 3 assessments (preintervention/baseline, postintervention/after 4 weeks, follow-up/after 4 months). Using adjusted mixed-effects models, changes in posttraumatic stress and secondary outcomes were investigated as intention-to-treat (ITT) and per-protocol (PP) analysis.
Results
Of 170 screened individuals (aged 18-65 years), 133 were eligible and randomized to the IG (n = 65) or CG (n = 68). Although there was a pre-post reduction in posttraumatic stress, ITT showed no significant differences between IG and CG after 4 weeks (Posttraumatic Diagnostic Scale for DSM-5, Diff -0.90, 95%CI -0.24 to 0.47; P=.52) and after 4 months (Diff -0.39, 95%CI -3.24 to 2.46; P=.79). The same was true for PP. Regarding secondary outcomes, ITT indicated a treatment effect for self-stigma after 4 weeks (Self-Stigma of Mental Illness Scale/SSMIS-stereotype agreement: d = 0.86, 95%CI 0.46 to 1.25; stereotype application: d = 0.60, 95%CI 0.22 to 0.99) and after 4 months (d = 0.52, 95%CI 0.12 to 0.92; d = 0.50, 95%CI 0.10 to 0.90).
Conclusions
Sanadak reduced mild to moderate posttraumatic stress in Syrian refugees, but not superior to the control condition. Therefore, Sanadak may not be suitable as a standalone treatment. However, as the app usability was very good, no harms detected, and stigma significantly reduced, Sanadak has potential as a bridging aid within a stepped and collaborative care approach.
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Affiliation(s)
- S Roehr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - FU Jung
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - A Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - T Grochtdreis
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Nagl
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - A Renner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - R Hoffmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - H-H Koenig
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - S G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
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Omran H, Deutsch MA, Scholtz S, Renner A, Scholtz W, Hakim Meibodi K, Rudolph TK, Gummert J, Rudolph V. Impact of impaired renal function on kinetics of high-sensitive troponin I (hs-cTnI) following cardiac surgery. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Renal insufficiency might result in increased levels of cardiac troponin due to decreased elimination. Hence, the diagnostic utility of hs-cTnI might be lower in patients with impaired renal function. There is only scarce data on kinetics of high-sensitivity cardiac troponin I (hs-cTnI) following cardiac surgery with regard to renal function.
Purpose
The aim of this study was to assess the impact of impaired renal function on the kinetics of hs-cTnI following cardiac surgery differentiating between patients with and without postoperative myocardial infarction (PMI) and to analyze the prognostic value of hs-cTnI elevations in patients with impaired renal function.
Methods
We performed a retrospective analysis of all adult patients (>18 years) who underwent cardiac surgery at our hospital between Jan, 1st 2013 and May, 1st 2019.
Serial measurements of high-sensitive cardiac troponin I (hs-cTnI) were assessed from baseline up to 48 hours after surgery. Renal function was assessed based on estimated glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula with impaired renal function defined by GFR <60 ml/min. Postoperative myocardial infarction was defined by new vessel occlusion on angiography. Predictors of long-term all-cause mortality were assessed by cox regression analysis.
Results
A total of 14,465 patients were included (51.4% underwent coronary artery bypass grafting (CABG), 39.4% had valvular procedures and 9.2% thoracic aortic procedures).
Levels of hs-cTnI were higher in patients with impaired renal function in the overall collective (figure 1). However, in patients with postoperative myocardial infarction levels of hs-cTnI did not differ with regard to renal function (figure 2).
Cox regression analysis showed postoperative elevation of hs-cTnI to be a significant predictor of long-term all-cause mortality over a median follow-up of 3.0 years regardless of baseline kidney function (Hazards ratio 1.67, 95% Confidence interval [1.46–1.91], p<0.001).
Conclusion
Renal function had an impact on postoperative hs-cTnI kinetics only in patients with an uneventful postoperative course. In patients with postoperative myocardial infarction kinetics of hs-cTnI were not affected by baseline renal function. Moreover, elevated hs-cTnI levels were a significant predictor of all-cause mortality regardless of baseline renal function.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Omran
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - M A Deutsch
- Clinic for Thorac Cardiovasc Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - S Scholtz
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - A Renner
- Clinic for Thorac Cardiovasc Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - W Scholtz
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - K Hakim Meibodi
- Clinic for Thorac Cardiovasc Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - T K Rudolph
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - J Gummert
- Clinic for Thorac Cardiovasc Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - V Rudolph
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
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Renner A, Jäckle D, Kaiser J, Hoffmann R, Kersting A. IPSA-Studie: Posttraumatischer Stress nach belastenden Ereignissen im Arztberuf. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732019] [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: 10/20/2022]
Affiliation(s)
- A Renner
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universität Leipzig
| | - D Jäckle
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universität Leipzig
| | - J Kaiser
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universität Leipzig
| | - R Hoffmann
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universität Leipzig
| | - A Kersting
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universität Leipzig
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Opacic D, Ibishi A, Radakovic D, Irimi A, Deutsch MA, Renner A, Sitzer M, Gummert J. Off-Pump Coronary Artery Bypass Surgery Reduces Perioperative Stroke Rate in Patients with Asymptomatic Internal Carotid Artery Stenosis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725736] [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: 10/21/2022]
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Omran H, Deutsch M, Groezinger E, Renner A, Neumann J, Westermann D, Scholtz W, Rudolph T, Gummert J, Rudolph V, Hakim-Meibodi K. Usefulness of troponin in selecting patients for invasive coronary angiography after cardiac surgery. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Great uncertainty exists about the indication for invasive coronary angiography (ICA) in patients with suspected acute coronary syndrome following cardiac surgery.
Aim
The aim of this study was to define clinical criteria that best identify patients who benefit from ICA after cardiac surgery.
Methods
We performed a retrospective analysis of all patients who underwent cardiac surgery between January 2009 and May 2019 at our center. Exclusion criteria included pediatric patients as well as pacemaker, TAVR and LVAD implantation and heart transplantation procedures. The primary outcome was usefulness of ICA as defined by consequent PCI or re-operation due to ICA findings. ECG changes (ST-elevations) and high-sensitivity Troponin I (hsTrop I) were analyzed.
Results
48,136 patients were screened and after applying exclusion criteria 29,359 patients were finally included in the analysis (mean age 67.8±11.0 years, 31.1% females, Euroscore II 5.14±8.9%). A total of 1,171 patients (4%) underwent post-op ICA. The primary outcome occurred in 440 patients (1.5%) of which 290 underwent consequent PCI and 214 underwent consequent re-operation. Baseline characteristics are shown in table 1. Unadjusted analyses did not identify significant differences in the level of cardiac biomarkers between useful-ICA and unuseful-ICA groups.
In multivariate regression analysis, only ST-elevation on ECG predicted the primary outcome (OR 1.33, 95% CI 1.003–1.76).
Dichotomizing hsTrop I concentrations by applying the guideline-specified cut-off (>70x URL) resulted in correct classification of useful-ICA patients in 95.7%. However, the false-positive rate was also extremely high (83.6%) with a positive predictive value (PPV) of 1.6% and a negative predictive value (NPV) of 99.6% (accuracy 17.5%).
Using area under the curve (ROC) analysis following optimal cut-off values for hsTrop I were identified: in CABG patients a cut-off value of >650x URL (corresponding absolute value 17000 ng/L) was defined with a corresponding sensitivity of 83.3%, specificity of 83.6%, PPV of 8.9% and NPV of 99.6% (accuracy 83.6%). In non-CABG patients (i.e. valve or aortic procedures), the cut-off was about twice as high as that for CABG patients (1,350x URL or 35,000 ng/L) with a corresponding sensitivity of 84.1%, specificity of 89.2%, PPV of 5.9% and NPV of 99.9% (accuracy 89.1%).
Conclusion
Our study demonstrates that currently recommended cut-off concentrations of high-sensitivity troponin are not useful for guiding clinical decision-making in patients with suspected acute coronary syndrome following cardiac surgery, while substantially higher cut-off values might be useful. Those cut-off values critically depend on the type of cardiac surgery performed (CABG vs. non-CABG).
Troponin_Curves post-op
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Omran
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - M.A Deutsch
- Clinic for Thorac Cardiovasc Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - E Groezinger
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - A Renner
- Clinic for Thorac Cardiovasc Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - J Neumann
- University Heart & Vascular Center Hamburg, Clinic for Cardiology, Hamburg, Germany
| | - D Westermann
- University Heart & Vascular Center Hamburg, Clinic for Cardiology, Hamburg, Germany
| | - W Scholtz
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - T Rudolph
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - J Gummert
- Clinic for Thorac Cardiovasc Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - V Rudolph
- Clinic for General and Interv Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
| | - K Hakim-Meibodi
- Clinic for Thorac Cardiovasc Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Univ Bochum, Bad Oeynhausen, Germany
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Vishlenkova EA, Renner A. [Historical study of medical geography in Russia]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2019; 27:924-929. [PMID: 31765548 DOI: 10.32687/0869-866x-2019-27-5-924-929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 09/04/2019] [Indexed: 11/06/2022]
Abstract
This article provides an overview of the change of topics in the medical-geographical studies in Russia. It highlights the conventional nature of this science, its dependence on political, ideological and scientific demands as well as institutional difficulties. It concludes that the goal of further historical research is to focus on the restoration of synchronous meanings of medical geography, its links with other disciplines and the elucidation of Russia's participation in the transnational project of medico-geographical research.
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Affiliation(s)
- E A Vishlenkova
- National Research University Higher School of Economics; 107000, Moscow, Russia,
| | - A Renner
- Ludwig-Maximilians-Universität in Munich, Germany
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Hansen SG, Womack J, Scholz I, Renner A, Edgel KA, Xu G, Ford JC, Grey M, St Laurent B, Turner JM, Planer S, Legasse AW, Richie TL, Aguiar JC, Axthelm MK, Villasante ED, Weiss W, Edlefsen PT, Picker LJ, Früh K. Cytomegalovirus vectors expressing Plasmodium knowlesi antigens induce immune responses that delay parasitemia upon sporozoite challenge. PLoS One 2019; 14:e0210252. [PMID: 30673723 PMCID: PMC6343944 DOI: 10.1371/journal.pone.0210252] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 12/19/2018] [Indexed: 12/12/2022] Open
Abstract
The development of a sterilizing vaccine against malaria remains one of the highest priorities for global health research. While sporozoite vaccines targeting the pre-erythrocytic stage show great promise, it has not been possible to maintain efficacy long-term, likely due to an inability of these vaccines to maintain effector memory T cell responses in the liver. Vaccines based on human cytomegalovirus (HCMV) might overcome this limitation since vectors based on rhesus CMV (RhCMV), the homologous virus in rhesus macaques (RM), elicit and indefinitely maintain high frequency, non-exhausted effector memory T cells in extralymphoid tissues, including the liver. Moreover, RhCMV strain 68-1 elicits CD8+ T cells broadly recognizing unconventional epitopes exclusively restricted by MHC-II and MHC-E. To evaluate the potential of these unique immune responses to protect against malaria, we expressed four Plasmodium knowlesi (Pk) antigens (CSP, AMA1, SSP2/TRAP, MSP1c) in RhCMV 68-1 or in Rh189-deleted 68-1, which additionally elicits canonical MHC-Ia-restricted CD8+ T cells. Upon inoculation of RM with either of these Pk Ag expressing RhCMV vaccines, we obtained T cell responses to each of the four Pk antigens. Upon challenge with Pk sporozoites we observed a delayed appearance of blood stage parasites in vaccinated RM consistent with a 75-80% reduction of parasite release from the liver. Moreover, the Rh189-deleted RhCMV/Pk vectors elicited sterile protection in one RM. Once in the blood, parasite growth was not affected. In contrast to T cell responses induced by Pk infection, RhCMV vectors maintained sustained T cell responses to all four malaria antigens in the liver post-challenge. The delayed appearance of blood stage parasites is thus likely due to a T cell-mediated inhibition of liver stage parasite development. As such, this vaccine approach can be used to efficiently test new T cell antigens, improve current vaccines targeting the liver stage and complement vaccines targeting erythrocytic antigens.
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Affiliation(s)
- Scott G Hansen
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
- Oregon Health & Science University, Oregon National Primate Research Center, Beaverton, OR, United States of America
| | - Jennie Womack
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
| | - Isabel Scholz
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
| | - Andrea Renner
- US Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, MD, United States of America
| | - Kimberly A Edgel
- US Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, MD, United States of America
| | - Guangwu Xu
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
| | - Julia C Ford
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
| | - Mikayla Grey
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
| | - Brandyce St Laurent
- National Institutes of Health, Laboratory of Malaria and Vector Research, Malaria Pathogenesis and Human Immunity Unit, Rockville, MD, United States of America
| | - John M Turner
- Oregon Health & Science University, Oregon National Primate Research Center, Beaverton, OR, United States of America
| | - Shannon Planer
- Oregon Health & Science University, Oregon National Primate Research Center, Beaverton, OR, United States of America
| | - Al W Legasse
- Oregon Health & Science University, Oregon National Primate Research Center, Beaverton, OR, United States of America
| | - Thomas L Richie
- US Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, MD, United States of America
| | - Joao C Aguiar
- US Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, MD, United States of America
| | - Michael K Axthelm
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
- Oregon Health & Science University, Oregon National Primate Research Center, Beaverton, OR, United States of America
| | - Eileen D Villasante
- US Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, MD, United States of America
| | - Walter Weiss
- US Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, MD, United States of America
| | - Paul T Edlefsen
- Statistical Center for HIV/AIDS Research and Prevention, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Louis J Picker
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
- Oregon Health & Science University, Oregon National Primate Research Center, Beaverton, OR, United States of America
| | - Klaus Früh
- Oregon Health & Science University, Vaccine & Gene Therapy Institute, Beaverton, OR, United States of America
- Oregon Health & Science University, Oregon National Primate Research Center, Beaverton, OR, United States of America
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Renner A, Rausch I, Cal Gonzalez J, Frass-Kriegl R, de Lara LN, Sieg J, Laistler E, Glanzer M, Dungl D, Moser E, Beyer T, Figl M, Birkfellner W. A head coil system with an integrated orbiting transmission point source mechanism for attenuation correction in PET/MRI. Phys Med Biol 2018; 63:225014. [PMID: 30418935 DOI: 10.1088/1361-6560/aae9a9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The combination of positron emission tomography (PET) and magnetic resonance imaging (MRI) provides a benefit for diagnostic imaging. Still, attenuation correction (AC) is a challenge in PET/MRI compared to stand-alone PET and PET-computed tomography (PET/CT). In the absence of photonic transmission sources, AC in PET/MRI is usually based on retrospective segmentation of MR images or complex additional MR-sequences. However, most methods available today are still challenged by either the incorporation of cortical bone or substantial anatomical variations of subjects. This leads to a bias in quantification of tracer concentration in PET. Therefore, we have developed a fully integrated transmission source system for PET/MRI of the head to enable direct measurement of attenuation coefficients using external positron emitters, which is the reference standard in AC. Based on a setup called the 'liquid drive' presented by Jones et al (1995) two decades ago, we built a head coil system consisting of an MR-compatible hydraulic system driving a point source on a helical path around a 24-channel MR-receiver coil to perform a transmission scan. Sinogram windowing of the moving source allows for post-injection measurements. The prototype was tested in the Siemens Biograph mMR using a homogeneous water phantom and a phantom with air cavities and a Teflon (PTFE) cylinder. The second phantom was measured both with and without emission activity. For both measurements air, water and Teflon were clearly distinguishable and homogeneous regions of the phantom were successfully reproduced in the AC map. For water the linear attenuation coefficient was measured as (0.096 ± 0.005) cm-1 in accordance with the true physical value. This combined MR head coil and transmission source system is, to our knowledge, the first working example to use an orbiting point source in PET/MRI and may be helpful in providing fully-quantitative PET data in neuro-PET/MRI.
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Affiliation(s)
- A Renner
- Center for Medical Physics and Biomedical Engineering, Medical University Vienna, 1090 Vienna, Austria. Institute of Applied Physics, Vienna University of Technology, 1040 Vienna, Austria
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Renner A, Kaluza I, Marth K, Moeslinger T, Pohl W. P112 Exhaled nitric oxide is a possible biomarker for predicting complications in cystic fibrosis patients. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30408-9] [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: 10/14/2022]
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Trummer U, Novak-Zezula S, Renner A, Wilczewska I. 2.10-P10Cost savings through timely treatment for irregular migrants and European Union citizens without insurance. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- U Trummer
- Center For Health And Migration, Vienna, Austria
| | | | - A Renner
- Center For Health And Migration, Vienna, Austria
| | - I Wilczewska
- Center For Health And Migration, Vienna, Austria
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12
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Renner A, Neukam K, RÖsner T, Elert O, Lange V. Pumpless Extracorporeal Lung Assist as Supportive Therapy in a Patient with Diffuse Alveolar Hemorrhage. Int J Artif Organs 2018; 31:279-81. [DOI: 10.1177/039139880803100313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our 18-year old female patient suffered from microscopic polyangiitis. After invasive diagnostics, a diffuse alveolar hemorrhage occurred, leading to acute lung failure. In spite of differential ventilation, respiratory insufficiency and lactate-acidosis increased quickly. Due to the massive hemorrhage, a pumpless extracorporeal lung assist was implanted and, after six hours, low-dose heparinization was started. In response to this therapy, hypercapnia and acidosis improved quickly and were completely eliminated within 24 hours. Simultaneously, treatment with prednisolon and cyclophosphamid was started. After 7 days, the patient's conditions allowed weaning from the pumpless extracorporeal lung assist and after 9 days she was extubated. In conclusion, the pumpless lung assist was shown to be a very practical option to treat the most serious forms of hypercapnia, especially for patients disposed to diffuse bleeding.
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Affiliation(s)
- A. Renner
- Clinic and Polyclinic of Cardiothoracic Surgery, University of Wuerzburg, Wuerzburg - Germany
| | - K. Neukam
- Clinic and Polyclinic of Cardiothoracic Surgery, University of Wuerzburg, Wuerzburg - Germany
| | - T. RÖsner
- Clinic and Polyclinic of Cardiothoracic Surgery, University of Wuerzburg, Wuerzburg - Germany
| | - O. Elert
- Clinic and Polyclinic of Cardiothoracic Surgery, University of Wuerzburg, Wuerzburg - Germany
| | - V. Lange
- Clinic and Polyclinic of Cardiothoracic Surgery, University of Wuerzburg, Wuerzburg - Germany
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Rueegg CS, Kriemler S, Zuercher SJ, Schindera C, Renner A, Hebestreit H, Meier C, Eser P, von der Weid NX. A partially supervised physical activity program for adult and adolescent survivors of childhood cancer (SURfit): study design of a randomized controlled trial [NCT02730767]. BMC Cancer 2017; 17:822. [PMID: 29207962 PMCID: PMC5717834 DOI: 10.1186/s12885-017-3801-8] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/20/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Beyond survival of nowadays >80%, modern childhood cancer treatment strives to preserve long-term health and quality of life. However, the majority of today's survivors suffer from short- and long-term adverse effects such as cardiovascular and pulmonary diseases, obesity, osteoporosis, fatigue, depression, and reduced physical fitness and quality of life. Regular exercise can play a major role to mitigate or prevent such late-effects. Despite this, there are no data on the effects of regular exercise in childhood cancer survivors from randomized controlled trials (RCTs). Primary outcome of the current RCT is therefore the effect of a 12-months exercise program on a composite cardiovascular disease risk score in childhood cancer survivors. Secondary outcomes are single cardiovascular disease risk factors, glycaemic control, bone health, body composition, physical fitness, physical activity, quality of life, mental health, fatigue and adverse events (safety). METHODS A total of 150 childhood cancer survivors aged ≥16 years and diagnosed ≥5 years prior to the study are recruited from Swiss paediatric oncology clinics. Following the baseline assessments patients are randomized 1:1 into an intervention and control group. Thereafter, they are seen at month 3, 6 and 12 for follow-up assessments. The intervention group is asked to add ≥2.5 h of intense physical activity/week, including 30 min of strength building and 2 h of aerobic exercises. In addition, they are told to reduce screen time by 25%. Regular consulting by physiotherapists, individual web-based activity diaries, and pedometer devices are used as motivational tools for the intervention group. The control group is asked to keep their physical activity levels constant. DISCUSSION The results of this study will show whether a partially supervised exercise intervention can improve cardiovascular disease risk factors, bone health, body composition, physical activity and fitness, fatigue, mental health and quality of life in childhood cancer survivors. If the program will be effective, all relevant information of the SURfit physical activity intervention will be made available to interested clinics that treat and follow-up childhood cancer patients to promote exercise in their patients. TRIAL REGISTRATION Prospectively registered in clinicaltrials.gov [ NCT02730767 ], registration date: 10.12.2015.
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Affiliation(s)
- Corina S. Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
- Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland
| | - Simeon J. Zuercher
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland
| | - Christina Schindera
- Department of Pediatric Oncology and Hematology, University Children’s Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - Andrea Renner
- Paediatric Endocrinology, Pediatric Endocrinology Centre Zurich AG (PEZZ), Möhrlistrasse 69, 8006 Zürich, Switzerland
| | - Helge Hebestreit
- Children’s Hospital, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
| | - Christian Meier
- Division of Endocrinology, Diabetes, Metabolism and Bone Research, University Hospital Basel, Missionsstrasse 24, 4055 Basel, Switzerland
| | - Prisca Eser
- University Clinic of Cardiology, Preventive Cardiology and Sports Medicine, Inselspital, University Hospital Bern, 3010 Bern, Switzerland
| | - Nicolas X. von der Weid
- Department of Pediatric Oncology and Hematology, University Children’s Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
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Puehler T, Dia M, Ibishi A, El-Hashem G, Renner A, Hakim-Meibodi K, Ensminger S, Boergermann J, Zittermann A, Gummert J. Carotid Artery Stenosis does not Increase the Perioperative Risk of Stroke in Patients Undergoing Aortic Non-Clamping and No-touch off-pump Surgery- A Retrospective Single-Center Analysis. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598806] [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: 10/20/2022]
Affiliation(s)
- T. Puehler
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - M. Dia
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - A. Ibishi
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - G. El-Hashem
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - A. Renner
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - K. Hakim-Meibodi
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - S. Ensminger
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - J. Boergermann
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - A. Zittermann
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
| | - J. Gummert
- HDZ NRW, Ruhr Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany
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Tanios A, Braunegger-Kallinger G, Loder C, Renner A. Effectiveness of community health promotion targeting children and adolescents in rural areas. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Pühler T, Fujita B, Renner A, Hakim-Meibodi K, Bögermann J, Morshuis M, Gummert J, Ensminger S. Operative Myokardrevaskularisation bei schlechter linksventrikulärer Funktion – STICH forever? Aktuel Kardiol 2016. [DOI: 10.1055/s-0042-114219] [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: 10/20/2022]
Affiliation(s)
- T. Pühler
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen
| | - B. Fujita
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen
| | - A. Renner
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen
| | - K. Hakim-Meibodi
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen
| | - J. Bögermann
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen
| | - M. Morshuis
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen
| | - J. Gummert
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen
| | - S. Ensminger
- Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen
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Khalil M, Renner A, Langkammer C, Enzinger C, Ropele S, Stojakovic T, Scharnagl H, Bachmaier G, Pichler A, Archelos JJ, Fuchs S, Seifert-Held T, Fazekas F. Cerebrospinal fluid lipocalin 2 in patients with clinically isolated syndromes and early multiple sclerosis. Mult Scler 2016; 22:1560-1568. [DOI: 10.1177/1352458515624560] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 12/06/2015] [Indexed: 11/17/2022]
Abstract
Background: Lipocalin 2 (LCN2) may be involved in the immunopathogenesis of multiple sclerosis (MS) and might further impact on iron homoeostasis. Brain iron accumulates in MS; however, the association to iron-related proteins is still unsolved. Objective: To investigate cerebrospinal fluid (CSF) and serum LCN2, transferrin (Trf) and ferritin in early MS in relation to disease evolution and longitudinal brain iron accumulation. Methods: We analysed CSF and serum LCN2 by enzyme-linked immunosorbent assay (ELISA) and Trf and ferritin by nephelometry in 55 patients (45 clinically isolated syndrome (CIS), 10 MS, median clinical follow-up 4.8 years) and 63 controls. In patients, we assessed sub-cortical grey matter iron by 3T magnetic resonance imaging (MRI) R2* relaxometry (median imaging follow-up 2.2 years). Results: Compared to controls serum ( p < 0.01), CSF ( p < 0.001) LCN2 and CSF Trf ( p < 0.001) levels were reduced in the patients. CSF LCN2 correlated with CSF Trf ( r = 0.5, p < 0.001). In clinically stable patients, CSF LCN2 levels correlated with basal ganglia iron accumulation ( r = 0.5, p < 0.05). In CIS, higher CSF LCN2 levels were associated with conversion to clinically definite MS ( p < 0.05). Conclusion: We demonstrate altered LCN2 regulation in early MS and provide first evidence for this to be possibly linked to both clinical MS activity and iron accumulation in the basal ganglia.
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Affiliation(s)
- M Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - A Renner
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - C Langkammer
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - C Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria/Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - S Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - T Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - H Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - G Bachmaier
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - A Pichler
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - JJ Archelos
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - S Fuchs
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - T Seifert-Held
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - F Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
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Affiliation(s)
- A. Renner
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg
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19
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Niess H, Camaj P, Mair R, Renner A, Zhao Y, Jäckel C, Nelson PJ, Jauch KW, Bruns CJ. Overexpression of IFN-induced protein with tetratricopeptide repeats 3 (IFIT3) in pancreatic cancer: cellular "pseudoinflammation" contributing to an aggressive phenotype. Oncotarget 2016; 6:3306-18. [PMID: 25650658 PMCID: PMC4413655 DOI: 10.18632/oncotarget.2494] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 08/12/2014] [Accepted: 09/16/2014] [Indexed: 12/20/2022] Open
Abstract
Inflammation contributes to important traits that cancer cells acquire during malignant progression. Gene array data recently identified upregulation of interferon-induced protein with tetratricopeptide repeats 3 (IFIT3) in aggressive pancreatic cancer cells. IFIT3 belongs to the group of interferon stimulated genes (ISG), can be induced by several cellular stress stimuli and by its tetratricopeptide repeats interacts with a multitude of cellular proteins. Upregulation of IFIT3 was confirmed in the aggressive pancreatic cancer cell line L3.6pl compared with its less aggressive cell line of origin, COLO357FG. Transgenic induction of IFIT3 expression in COLO357FG resulted in greater mass of orthotopic tumors and higher prevalence of metastases. Several important traits that mediate malignancy were altered by IFIT3: increased VEGF and IL-6 secretion, chemoresistance and decreased starvation-induced apoptosis. IFIT3 showed binding to JNK and STAT1, the latter being an important inducer of IFIT3 expression. Despite still being alterable by “classical” IFN or NFκB signaling, our findings indicate constitutive - possibly auto-regulated - upregulation of IFIT3 in L3.6pl without presence of an adequate inflammatory stimulus. The transcription factor SOX9, which is linked to regulation of hypoxia-related genes, was identified as a key mediator of upregulation of the oncogene IFIT3 and thereby sustaining a “pseudoinflammatory” cellular condition.
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Affiliation(s)
- Hanno Niess
- Department of Surgery, Medical Center of the Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany
| | - Peter Camaj
- Department of Surgery, Medical Center of the Otto-von-Guericke-University, Magdeburg, Germany
| | - Ruth Mair
- Department of Surgery, Medical Center of the Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany
| | - Andrea Renner
- Department of Surgery, Medical Center of the Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany
| | - Yue Zhao
- Department of Surgery, Medical Center of the Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany
| | - Carsten Jäckel
- Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universitaet Muenchen, Arbeitsgruppe Klinische Biochemie, Munich, Germany
| | - Peter J Nelson
- Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universitaet Muenchen, Arbeitsgruppe Klinische Biochemie, Munich, Germany
| | - Karl-Walter Jauch
- Department of Surgery, Medical Center of the Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany
| | - Christiane J Bruns
- Department of Surgery, Medical Center of the Otto-von-Guericke-University, Magdeburg, Germany
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20
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Pühler T, Dia M, Zittermann A, Börgermann J, Renner A, Ensminger S, Gummert J. Off-pump Revascularization with Bilateral Mammary Artery -Single Center Proof of Concept after 5 Years. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571501] [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: 10/22/2022]
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21
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Helms S, Zittermann A, Aboud A, Hakim-Meibodi K, Börgermann J, Renner A, Gummert J. Coronary Revascularization in Diabetic Patients: 3-year Survival Data for Off-pump and on-pump Technique. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571596] [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: 10/22/2022]
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22
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Börgermann J, Preindl K, Renner A, Aboud A, Hakim K, Benzinger M, Pühler T, Ensminger S, Becker T, Zittermann A, Kuss O, Gummert J. Midterm Outcome after Anaortic and Clampless Off-pump and Conventional Coronary Artery Bypass Grafting - Analysis of 5,422 Unselected Patients. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571646] [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: 10/22/2022]
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Ostermann H, Renner A, Schneider P, Bobek J, Vogler S. A cost/benefit analysis of self-care initiatives in the European Union – who benefits, who gains? Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv170.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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24
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Schmidt-Wiborg P, Renner A. Kompetenzen für Prävention in der Gesundheitsselbsthilfe – Praxisbeispiele für die Entwicklung und den Transfer von Kompetenzen in die Praxis. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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Zhao Y, Zhao L, Ischenko I, Bao Q, Schwarz B, Nieß H, Wang Y, Renner A, Mysliwietz J, Jauch KW, Nelson PJ, Ellwart JW, Bruns CJ, Camaj P. Antisense inhibition of microRNA-21 and microRNA-221 in tumor-initiating stem-like cells modulates tumorigenesis, metastasis, and chemotherapy resistance in pancreatic cancer. Target Oncol 2015; 10:535-48. [PMID: 25639539 DOI: 10.1007/s11523-015-0360-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/15/2015] [Indexed: 02/07/2023]
Abstract
Our preliminary studies identified a small population side population (SP) cells in pancreatic cancer cells with stem cell-like properties, which were able to induce fast and aggressive tumor formation in nude mice. Gene expression analysis showed a significant difference in the expression of more than 1,300 genes in SP cells, among which a highly significant difference in microRNA expression of miR-21 and miR-221 between SP and NSP cells was identified. SP cells were identified and characterized by flow cytometry using Hoechst 33342 dye staining from a highly metastatic human pancreatic cancer cell line (L3.6pl). Antagomir transfection was performed using miRNA-21 and miRNA-221 antisense oligonucleotides (ASOs) and followed by detection of cell apoptosis, cell cycle progression, chemosensitivity, and invasion. Sorted SP cells from gemcitabine-resistant L3.6pl cells (L3.6pl(Gres)-SP) cells were orthotopically implanted in nude mice with or without miRNA-21 and miRNA-221 ASOs mono- and combination therapy. The administration of antagomir-21 and antagomir-221 significantly reduced the SP cell fraction, decreased SP cell differentiation, and downstream gene regulation, and thereby induced reduction of L3.6pl cell proliferation, invasion, and chemoresistance against gemcitabine and 5-Fluorouracil. Combination of ASOs therapy against miRNA-21 and miRNA-221 significantly inhibited primary tumor growth and metastasis compared to single antagomir treatment, especially, in L3.6plGres-SP-induced pancreatic tumor growth in vivo. These findings further indicate that the inhibition of miR-21 and miR-221 appear particularly suitable to target stem-like subpopulations and address their specific biological function to promote tumor progression in pancreatic cancer.
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Affiliation(s)
- Yue Zhao
- Department of General, Visceral und Vascular Surgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany.
| | - Lu Zhao
- Department of General, Visceral und Vascular Surgery, University of Munich, Campus Grosshadern, Munich, Germany
| | - Ivan Ischenko
- Department of General, Visceral und Vascular Surgery, University of Munich, Campus Grosshadern, Munich, Germany
| | - Qi Bao
- Department of General, Visceral und Vascular Surgery, University of Munich, Campus Grosshadern, Munich, Germany
| | - Bettina Schwarz
- Department of General, Visceral und Vascular Surgery, University of Munich, Campus Grosshadern, Munich, Germany
| | - Hanno Nieß
- Department of General, Visceral und Vascular Surgery, University of Munich, Campus Grosshadern, Munich, Germany
| | - Yan Wang
- Department of General, Visceral und Vascular Surgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Andrea Renner
- Department of General, Visceral und Vascular Surgery, University of Munich, Campus Grosshadern, Munich, Germany
| | - Josef Mysliwietz
- Institute of Molecular Immunology, Helmholtz Center Munich, Munich, Germany
| | - Karl-Walter Jauch
- Department of General, Visceral und Vascular Surgery, University of Munich, Campus Grosshadern, Munich, Germany
| | - Peter J Nelson
- Clinical Biochemistry Group, Medizinische Klinik und Poliklinik IV, University of Munich, Munich, Germany
| | - Joachim W Ellwart
- Institute of Molecular Immunology, Helmholtz Center Munich, Munich, Germany
| | - Christiane J Bruns
- Department of General, Visceral und Vascular Surgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany
| | - Peter Camaj
- Department of General, Visceral und Vascular Surgery, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany.
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Niess H, Camaj P, Renner A, Ischenko I, Zhao Y, Krebs S, Mysliwietz J, Jäckel C, Nelson PJ, Blum H, Jauch KW, Ellwart JW, Bruns CJ. Side population cells of pancreatic cancer show characteristics of cancer stem cells responsible for resistance and metastasis. Target Oncol 2014; 10:215-27. [PMID: 24950733 DOI: 10.1007/s11523-014-0323-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 05/09/2014] [Indexed: 12/12/2022]
Abstract
Cancer stem cells (CSCs) have been proposed to underlie the initiation and maintenance of tumor growth and the development of chemoresistance in solid tumors. The identification and role of these important cells in pancreatic cancer remains controversial. Here, we isolate side population (SP) cells from the highly aggressive and metastatic human pancreatic cancer cell line L3.6pl and evaluate their potential role as models for CSCs. SP cells were isolated following Hoechst 33342 staining of L3.6pl cells. SP, non-SP, and unsorted L3.6pl cells were orthotopically xenografted into the pancreas of nude mice and tumor growth observed. RNA was analyzed by whole genome array and pathway mapping was performed. Drug resistant variants of L3.6pl were developed and examined for SP proportions and evaluated for surface expression of known CSC markers. A distinct SP with the ability to self-renew and differentiate into non-SP cells was isolated from L3.6pl (0.9 % ± 0.22). SP cells showed highly tumorigenic and metastatic characteristics after orthotopic injection. Transcriptomic analysis identified modulation of gene networks linked to tumorigenesis, differentiation, and metastasization in SP cells relative to non-SP cells. Wnt, NOTCH, and EGFR signaling pathways associated with tumor stem cells were altered in SP cells. When cultured with increasing concentrations of gemcitabine, the proportion of SP cells, ABCG2(+), and CD24(+) cells were significantly enriched, whereas 5-fluorouracil (5-FU) treatment lowered the percentage of SP cells. SP cells were distinct from cells positive for previously postulated pancreatic CSC markers. The Hoechst-induced side population in L3.6pl cells comprises a subset of tumor cells displaying aggressive growth and metastasization, increased gemcitabine-, but not 5-FU resistance. The cells may act as a partial model for CSC biology.
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Affiliation(s)
- Hanno Niess
- Department of Surgery, University of Munich, Campus Großhadern, Munich, Germany
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Franz M, Berndt A, Matusiak-Brückner M, Grün K, Maschek H, Richter P, Schulz U, Gummert J, Figulla H, Renner A. Early reoccurrence of fetal ED-A+ Fibronectin and B+ Tenascin-C splicing variants after human cardiac transplantation: potential impact for targeted therapy of chronic rejection. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367306] [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: 10/25/2022]
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28
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Özpeker C, Morshuis M, Schönbrodt M, Börgermann J, Renner A, Gummert J. Aortic insufficiency development in 391 patients supported with four different cf-LVADs: A single center experience. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367118] [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: 10/25/2022]
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29
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Puehler T, Ensminger S, Schulz U, Fuchs U, Tigges-Limmer K, Börgermann J, Morshuis M, Hakim K, Oldenburg O, Niedermeyer J, Renner A, Gummert J. [Heart and combined heart-lung transplantation. Indications, chances and risks]. Herz 2014; 39:66-73. [PMID: 24452762 DOI: 10.1007/s00059-013-4042-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Orthotopic heart transplantation (HTX) is nowadays the worldwide accepted gold standard for the treatment of terminal heart failure. The main indications for HTX are non-ischemic dilatative (54%) and ischemic (37%) heart failure. In the acute phase after HTX the survival rate is approximately 90%. Good short and long-term results with survival rates ranging from 81% after 1 year to more than 50% after 11 years demonstrate that there is currently no real treatment alternative to HTX for treatment of end-stage heart failure. In the case of irreversible pulmonary hypertension in combination with end-stage heart failure or complex congenital heart syndromes, a combined heart and lung transplantation (HLTX) is necessary. Compared with HTX the short-term survival of HLTX is reduced, mostly for technical reasons. Improved long-term results after HTX and HLTX are a result of highly specialized transplantation units and effective immunosuppression. However, a major problem is the shortage of organ donors in Germany and the resulting long waiting times for patients with frequently occurring blood groups of up to 10 months for transplantation. The consequence of the latter is the ever increasing number of implanted cardiac assist devices in patients not only as a bridge to transplant but also as destination therapy.
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Affiliation(s)
- T Puehler
- Klinik für Thorax- und Kardiovaskularchirurgie, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinikum der Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland,
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Furukawa N, Kuss O, Aboud A, Schonbrodt M, Renner A, Hakim Meibodi K, Becker T, Zittermann A, Gummert JF, Borgermann J. Ministernotomy versus conventional sternotomy for aortic valve replacement: matched propensity score analysis of 808 patients. Eur J Cardiothorac Surg 2014; 46:221-6; discussion 226-7. [DOI: 10.1093/ejcts/ezt616] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Furukawa N, Aboud A, Schonbrodt M, Renner A, Hakim K, Becker T, Zittermann A, Oliver K, Gummert JF, Borgermann J. 316 * MINISTERNOTOMY VERSUS CONVENTIONAL STERNOTOMY FOR AORTIC VALVE REPLACEMENT: PROPENSITY SCORE ANALYSIS OF 808 PATIENTS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Börgermann J, Furukawa N, Aboud A, Schönbrodt M, Renner A, Hakim-Meibodi K, Becker T, Zittermann A, Kuss O, Gummert JF. Ministernotomy versus conventional sternotomy for aortic valve replacement: Propensity score analysis of 808 patients. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Renner A, Zittermann A, Aboud A, Hakim-Meibodi K, Börgermann J, Gummert JF. Clinical outcome in elderly patients undergoing mitral valve repair. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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34
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Franz M, Hilger I, Neri D, Grün K, Kossatz S, Gummert JF, Figulla HR, Berndt A, Renner A. Cardiac accumulation of a human recombinant antibody recognizing ED-A+ fibronectin after heterotopic rat heart transplantation in vivo: A new strategy to detect and treat chronic cardiac allograft rejection? Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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35
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Renner A, Zittermann A, Aboud A, Hakim-Meibodi K, Pühler T, Tschöpe D, Börgermann J, Gummert JF. Coronary Revascularization in diabetic patients: Off-pump versus on-pump surgery. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Renner A, Jägle H. Hereditäre Makuladystrophien in der Differenzialdiagnose der AMD. Klin Monbl Augenheilkd 2012; 229:905-9. [DOI: 10.1055/s-0032-1314988] [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: 10/28/2022]
Affiliation(s)
- A. Renner
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg
| | - H. Jägle
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg
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Kellner U, Renner A, Herbst S, Kellner S, Weinitz S, Weber B. Hereditäre Netzhautdystrophien. Augenheilkunde up2date 2012. [DOI: 10.1055/s-0031-1280460] [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: 10/14/2022]
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38
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Zhao Y, Bao Q, Renner A, Camaj P, Eichhorn M, Ischenko I, Angele M, Kleespies A, Jauch KW, Bruns C. Cancer stem cells and angiogenesis. Int J Dev Biol 2011; 55:477-82. [PMID: 21732274 DOI: 10.1387/ijdb.103225yz] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cancer stem cells (CSCs) or tumor initiating cells were identified and characterized as a unique subpopulation with stem cell features in many types of cancer. Current CSC studies provide novel insights regarding tumor initiation, progression, angiogenesis, resistance to therapy and interplay with the tumor micro-environment. A cancer stem cell niche has been proposed based on these findings. The niche provides the soil for CSC self-renewal and maintenance, stimulating essential signaling pathways in CSCs and leading to secretion of factors that promote angiogenesis and long term growth of CSCs. We present evidence which has emerged over the past 5 years indicating interaction of CSCs with angiogenesis in the proposed "vascular niche". Based on these findings, targeting the "cancer stem cell niche" by combining an individualized anti-CSC approach with treatment of their microenvironment may represent a novel therapeutic strategy against solid tumor systems.
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Affiliation(s)
- Yue Zhao
- Department of Surgery, Klinikum Grosshadern, LMU Munich, Munich, Germany
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39
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Börgermann J, Zittermann A, Renner A, Parsa A, Aboud A, Becker T, Hakim K, Gummert J. Clampless off-pump surgery is associated with lower mortality and morbidity than conventional coronary artery bypass grafting. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269029] [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: 10/18/2022]
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Grün K, Drescher K, Kuhnt K, Börgermann J, Hekmat K, Doenst T, Gummert J, Renner A. Heterotopic rat heart transplantation: Accumulation of Ubiquinone in the rat heart allograft depends on ischemia/reperfusion. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269253] [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: 10/18/2022]
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41
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Gummert J, Aboud A, Parsa M, Renner A, Börgermann J, Paluszkiewicz L, Mirow N, Schirmer U, Hakim K. Is minimal invasive mitral valve surgery a risk factor? - A comparison in 394 consecutive patients between 121 conventional and 273 minimal invasive procedures. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269225] [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: 10/18/2022]
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Franz M, Berndt A, Grün K, Neri D, Kosmehl H, Hekmat K, Figulla HR, Gummert J, Renner A. Extra cellular matrix remodelling in chronic cardiac allograft rejection. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269061] [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: 10/18/2022]
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Franz M, Grün K, Richter P, Brehm BR, Fritzenwanger M, Hekmat K, Neri D, Gummert J, Figulla HR, Kosmehl H, Berndt A, Renner A. Extra cellular matrix remodelling after heterotopic rat heart transplantation: gene expression profiling and involvement of ED-A+ fibronectin, alpha-smooth muscle actin and B+ tenascin-C in chronic cardiac allograft rejection. Histochem Cell Biol 2010; 134:503-17. [PMID: 20931338 DOI: 10.1007/s00418-010-0750-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2010] [Indexed: 11/29/2022]
Abstract
Chronic cardiac rejection is represented by cardiac allograft vasculopathy (CAV) and cardiac interstitial fibrosis (CIF) known to cause severe complications. These processes are accompanied by remarkable changes in the cardiac extra cellular matrix (cECM). The aim of our study was to analyse the cECM remodelling in chronic rejection and to elucidate a potential role of ED-A domain containing fibronectin (ED-A(+) Fn), alpha smooth muscle actin (ASMA) and B domain containing tenascin-C (B(+) Tn-C). A model of chronic rejection after heterotopic rat heart transplantation was used. Allografts, recipient and control hearts were subjected to histological assessment of rejection grade, to real-time PCR based analysis of 84 genes of ECM and adhesion molecules and to immunofluorescence labelling procedures, including ED-A(+) Fn, ASMA and B(+) Tn-C antibodies. Histological analysis revealed different grades of chronic rejection. By gene expression analysis, a relevant up-regulation of the majority of ECM genes in association with chronic rejection could be shown. For 8 genes, there was a relevant up-regulation in allografts as well as in the corresponding recipient hearts. Association of ASMA positive cells with the grade of chronic rejection could be proven. In CAV and also in CIF there were extensive co-depositions of ED-A(+) Fn, ASMA and B(+) Tn-C. In conclusion, chronic cardiac allograft rejection is associated with a cECM remodelling. ASMA protein deposition in CAV, and CIF is a valuable marker to detect chronic rejection. Interactions of VSMCs and Fibro-/Myofibroblasts with ED-A(+) Fn and B(+) Tn-C might functionally contribute to the development of chronic cardiac rejection.
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Affiliation(s)
- Marcus Franz
- Department of Internal Medicine I, University Hospital of Jena, Erlanger Allee 101, 07740, Jena, Germany.
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Camaj P, Ischenko I, Seeliger H, Krebs S, Renner A, Jauch KW, Bruns CJ. Abstract 3911: Dysegulation of Sox9-dependent gene expression leads to enhancement of angiogenesis and metastases in pancreatic cancer. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-3911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The understanding of invasion, angiogenesis and metastasis is essential for the development of new targeted molecular therapy against pancreatic cancer. The aim of this study is to analyse the regulation of differentially expressed genes in highly proangiogenic and prometastatic compared to low metastatic and low angiogenic pancreatic cancer cells
Materials and methods: The transcriptome of the low metastatic pancreatic cancer cell line and its highly angiogenic and metastatic derivate L3.6pl have been compared under the normoxic and hypoxic conditions using Affymetrix HGU133plus 2.0 arrays. The hierarchic cluster analysis has been performed using SOTA algorithm. Promoters of the differentially expressed genes have been analysed using oPOSSUM 2 program. Affymetrix data have been validated via qRT-PCR and via ELISA. Chromosomal DNA containing promoters of the relevant genes has been amplified via PCR and sequenced.
Results: The Affymetrix analysis revealed clusters of differentially regulated genes with regard to the cell line and the oxygen level. While VEGF expression was upregulated in FG cells under hypoxic condition, it was constitutively upregulated already under normoxic conditions in L3.6pl and no further stimulation was observed under hypoxic conditions. This regulation pattern was similar in a cluster of genes that share a promoter sequence coding for a binding site for the transcription factor Sox9. Sox9 itself shows a similar regulation, leading to the assumption that expression changes of Sox9 are involved in the different hypoxic gene expressions. Promoter analysis of Sox9 in FG and L3.6pl cells showed mutations in the promoter region in L3.6pl, while the VEGF promoter was unchanged. Further analysis has shown that this mutation is not relevant for biological function. Refined analysis revealed differential Sox9 promoter methylation as reason for observed phenomenon.
Conclusions: Proangiogenic genes such as VEGF are upregulated in the more aggressive cell line L3.6pl, compared to FG. We identified a gene cluster that is constitutively upregulated in L3.6pl, independent of hypoxia. These genes are controlled by the transcription factor Sox9. A Sox9 promoter differential methylation may be the reason for the escape from hypoxic regulation in L3.6pl cells and thus may contribute to the higher angiogenic and metastatic potential. Taken together, Sox9 may be an interesting new diagnostic and therapeutic target in pancreatic cancer progression.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3911.
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Affiliation(s)
- Peter Camaj
- 1Ludwig Maximiliam University, Munich, Germany
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Camaj P, Seeliger H, Ischenko I, Krebs S, Renner A, Jauch KW, Bruns CJ. Abstract 3901: Sox9-associated overexpression of IFIT3 leads to pancreatic cancer progression by activation of “pseudoinflammatory” pathways. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-3901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The understanding of invasion, angiogenesis and metastasis is essential for the development of new molecular therapy against cancer. Inflammation plays important role in tumour initiation and progression. Here we report the role of the transcription factor Sox9 for regulation of IFIT3 an inflammation-related and tumour-promoting protein in pancreatic cancer. For in vivo and in vitro experiments we utilized the following human pancreatic cancer cell lines: low metastatic FG, high metastatic L3.6pl, and the stable transfected cell line FG-IFIT3. To demonstrate effects on primary tumor growth and metastases in vivo we orthotopically injected the different cell lines in the pancreas of nude mice. To evaluate the VEGF depending angiogenic capacity of the different cell lines ELISA technology was used. By One STrEP technology we were able to identify IFIT3-binding partners. Chromosomal immunoprecipitation (ChIP) using anti-Sox9 antibody, followed by PCR amplifying the IFIT3-promoter was used to identify the interaction of the IFIT3 promoter with the transcription factor Sox9. To investigate Sox9-depending expression of IFIT3 (protein and RNA) we used stable transfected L3.6pl-Sox9-shRNA cells under control of the Tet-CMV promoter in presence or absence of tetracycline, respectively. Analysis of differential gene expression by gene array technology demonstrated that the IFIT3 gene is up-regulated in L3.6pl cells as compared to FG cells. Results of animal experiment and in vitro experiments clearly demonstrated tumor-promoting, pro-metastatic and pro-angiogenic features of IFIT3. RT-PCR has revealed that both treatment with IFna as well as NFkB led to up-regulation of IFIT3-RNA expression. One STrEP experiments identified JNK and STAT1 as binding partners of IFIT3. ChIP has demonstrated binding of the transcription factor Sox9 to the IFIT3 promoter. RT-PCR and immunoblot data demonstrated constitutive up-regulation of Sox9 expression in L3.6pl cells. By Western blotting and RT-PCR we could show that diminishing of Sox9 expression in stable transfected L3.6pl Sox9-shRNA cells leads to a significant down-regulation of IFIT3-epression on the RNA and protein level.
The inflammation associated protein IFIT3 is up-regulated in metastatic L3.6pl human pancreatic cancer cells and is in part responsible for the aggressive primary pancreatic tumor growth in vivo. This gene is up-regulated by IFna and NFkB. Interestingly Sox9 binds to the IFIT3P and activates its expression. Since in L3.6pl cells Sox9 is constitutively over-expressed, IFIT3 is up-regulated independent on the presence of the cytokine IFna. Therefore, the pro-inflammatory IFna-signaling pathway is activated even without actual inflammation in absence pro-inflammatory cytokine. The activation of such a “pseudo-inflammatory pathway” seems to be in part responsible for pancreatic cancer progression.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3901.
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Affiliation(s)
- Peter Camaj
- 1Ludwig Maximilian University, Munich, Germany
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Renner A, Grün K, Börgermann J, Leyh R, Gummert J, Lange V. Heterotopic rat heart transplantation: effect of oxidative stress in the rat heart allograft depends on different anesthetics. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1247082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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47
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Franz M, Berndt A, Grün K, Richter P, Kosmehl H, Neri D, Gummert J, Figulla HR, Brehm BR, Renner A. Analysis of ED-A+ fibronectin expression after heterotopic rat heart transplantation: association to cardiac allograft rejection and implications for targeted post-transplant therapy. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1247072] [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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Kellner U, Kellner S, Renner A, Fiebig B, Weinitz S, Weber B. Evidenzbasierte Diagnostik hereditärer Netzhautdystrophien 2009. Klin Monbl Augenheilkd 2009; 226:999-1011. [DOI: 10.1055/s-0028-1109684] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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49
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Hakim K, Friedrich I, Kuss O, Renner A, Gummert JF, Silber RE, Börgermann J. Long-term clinical outcome after minimally invasive direct coronary artery bypass grafting via partial inferior reversed l-shaped sternotomy (PIRLS). Thorac Cardiovasc Surg 2009. [DOI: 10.1055/s-0029-1191670] [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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50
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Renner A, Sagstetter MR, Lutz C, Hamouda K, Schramm Y, Lazariotou M, Leyh RG, Gummert JF, Lange V. Influence of different vein preparation techniques in aorto-coronary-graft operation on the integrity of the endothelium. Thorac Cardiovasc Surg 2009. [DOI: 10.1055/s-0029-1191551] [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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