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Jansen TS, Güney G, Ganse B, Monje MHG, Schulz JB, Dafotakis M, Hoog Antink C, Braczynski AK. Video-based analysis of the blink reflex in Parkinson's disease patients. Biomed Eng Online 2024; 23:43. [PMID: 38654246 PMCID: PMC11036732 DOI: 10.1186/s12938-024-01236-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
We developed a video-based tool to quantitatively assess the Glabellar Tap Reflex (GTR) in patients with idiopathic Parkinson's disease (iPD) as well as healthy age-matched participants. We also video-graphically assessed the effect of dopaminergic medication on the GTR in iPD patients, as well as the frequency and blinking duration of reflex and non-reflex blinks. The Glabellar Tap Reflex is a clinical sign seen in patients e.g. suffering from iPD. Reliable tools to quantify this sign are lacking. METHODS We recorded the GTR in 11 iPD patients and 12 healthy controls (HC) with a consumer-grade camera at a framerate of at least 180 images/s. In these videos, reflex and non-reflex blinks were analyzed for blink count and blinking duration in an automated fashion. RESULTS With our setup, the GTR can be extracted from high-framerate cameras using landmarks of the MediaPipe face algorithm. iPD patients did not habituate to the GTR; dopaminergic medication did not alter that response. iPD patients' non-reflex blinks were higher in frequency and higher in blinking duration (width at half prominence); dopaminergic medication decreased the median frequency (Before medication-HC: p < 0.001, After medication-HC: p = 0.0026) and decreased the median blinking duration (Before medication-HC: p = 0.8594, After medication-HC: p = 0.6943)-both in the direction of HC. CONCLUSION We developed a quantitative, video-based tool to assess the GTR and other blinking-specific parameters in HC and iPD patients. Further studies could compare the video data to electromyogram (EMG) data for accuracy and comparability, as well as evaluate the specificity of the GTR in patients with other neurodegenerative disorders, in whom the GTR can also be present. SIGNIFICANCE The video-based detection of the blinking parameters allows for unobtrusive measurement in patients, a safer and more comfortable option.
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Affiliation(s)
- Talisa S Jansen
- Department of Neurology, RWTH University Hospital, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Gökhan Güney
- KIS*MED (AI Systems in Medicine Lab) Technische Universität Darmstadt, Darmstadt, Germany
| | - Bergita Ganse
- Innovative Implant Development, Saarland University, Homburg, Germany
| | - Mariana H G Monje
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Jörg B Schulz
- Department of Neurology, RWTH University Hospital, Aachen, Germany
- Jülich Aachen Research Alliance (JARA), JARA-Institute Molecular Neuroscience and Neuroimaging, FZ Jülich and RWTH University, Jülich, Germany
| | - Manuel Dafotakis
- Department of Neurology, RWTH University Hospital, Aachen, Germany
| | - Christoph Hoog Antink
- KIS*MED (AI Systems in Medicine Lab) Technische Universität Darmstadt, Darmstadt, Germany.
| | - Anne K Braczynski
- Department of Neurology, RWTH University Hospital, Aachen, Germany
- Institut für Physikalische Biologie, Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
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Güney G, Jansen TS, Dill S, Schulz JB, Dafotakis M, Hoog Antink C, Braczynski AK. Video-Based Hand Movement Analysis of Parkinson Patients before and after Medication Using High-Frame-Rate Videos and MediaPipe. Sensors (Basel) 2022; 22:7992. [PMID: 36298342 PMCID: PMC9611677 DOI: 10.3390/s22207992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/29/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Tremor is one of the common symptoms of Parkinson's disease (PD). Thanks to the recent evolution of digital technologies, monitoring of PD patients' hand movements employing contactless methods gained momentum. Objective: We aimed to quantitatively assess hand movements in patients suffering from PD using the artificial intelligence (AI)-based hand-tracking technologies of MediaPipe. Method: High-frame-rate videos and accelerometer data were recorded from 11 PD patients, two of whom showed classical Parkinsonian-type tremor. In the OFF-state and 30 Minutes after taking their standard oral medication (ON-state), video recordings were obtained. First, we investigated the frequency and amplitude relationship between the video and accelerometer data. Then, we focused on quantifying the effect of taking standard oral treatments. Results: The data extracted from the video correlated well with the accelerometer-based measurement system. Our video-based approach identified the tremor frequency with a small error rate (mean absolute error 0.229 (±0.174) Hz) and an amplitude with a high correlation. The frequency and amplitude of the hand movement before and after medication in PD patients undergoing medication differ. PD Patients experienced a decrease in the mean value for frequency from 2.012 (±1.385) Hz to 1.526 (±1.007) Hz and in the mean value for amplitude from 8.167 (±15.687) a.u. to 4.033 (±5.671) a.u. Conclusions: Our work achieved an automatic estimation of the movement frequency, including the tremor frequency with a low error rate, and to the best of our knowledge, this is the first paper that presents automated tremor analysis before/after medication in PD, in particular using high-frame-rate video data.
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Affiliation(s)
- Gökhan Güney
- KIS*MED (AI Systems in Medicine), Technische Universität Darmstadt, Merckstraße 25, 64283 Darmstadt, Germany
| | - Talisa S. Jansen
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany
| | - Sebastian Dill
- KIS*MED (AI Systems in Medicine), Technische Universität Darmstadt, Merckstraße 25, 64283 Darmstadt, Germany
| | - Jörg B. Schulz
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany
- Jülich Aachen Research Alliance (JARA)–JARA-Institute Molecular Neuroscience and Neuroimaging, FZ Jülich and RWTH University, 52428 Jülich, Germany
| | - Manuel Dafotakis
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany
| | - Christoph Hoog Antink
- KIS*MED (AI Systems in Medicine), Technische Universität Darmstadt, Merckstraße 25, 64283 Darmstadt, Germany
| | - Anne K. Braczynski
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany
- Institut für Physikalische Biologie, Düsseldorf, Heinrich-Heine University, 40225 Düsseldorf, Germany
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Braczynski AK, Sevenich M, Gering I, Kupreichyk T, Agerschou ED, Kronimus Y, Habib P, Stoldt M, Willbold D, Schulz JB, Bach JP, Falkenburger BH, Hoyer W. Alpha-Synuclein-Specific Naturally Occurring Antibodies Inhibit Aggregation In Vitro and In Vivo. Biomolecules 2022; 12:biom12030469. [PMID: 35327661 PMCID: PMC8946620 DOI: 10.3390/biom12030469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 02/28/2022] [Accepted: 03/15/2022] [Indexed: 12/14/2022] Open
Abstract
Parkinson’s disease (PD) is associated with motor and non-motor symptoms and characterized by aggregates of alpha-synuclein (αSyn). Naturally occurring antibodies (nAbs) are part of the innate immune system, produced without prior contact to their specific antigen, and polyreactive. The abundance of nAbs against αSyn is altered in patients with PD. In this work, we biophysically characterized nAbs against αSyn (nAbs-αSyn) and determined their biological effects. nAbs-αSyn were isolated from commercial intravenous immunoglobulins using column affinity purification. Biophysical properties were characterized using a battery of established in vitro assays. Biological effects were characterized in HEK293T cells transiently transfected with fluorescently tagged αSyn. Specific binding of nAbs-αSyn to monomeric αSyn was demonstrated by Dot blot, ELISA, and Surface Plasmon Resonance. nAbs-αSyn did not affect viability of HEK293T cells as reported by Cell Titer Blue and LDH Assays. nAbs-αSyn inhibited fibrillation of αSyn reported by the Thioflavin T aggregation assay. Altered fibril formation was confirmed with atomic force microscopy. In cells transfected with EGFP-tagged αSyn we observed reduced formation of aggresomes, perinuclear accumulations of αSyn aggregates. The results demonstrate that serum of healthy individuals contains nAbs that specifically bind αSyn and inhibit aggregation of αSyn in vitro. The addition of nAbs-αSyn to cultured cells affects intracellular αSyn aggregates. These findings help understanding the role of the innate immune systems for the pathogenesis of PD and suggest that systemic αSyn binding agents could potentially affect neuronal αSyn pathology.
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Affiliation(s)
- Anne K. Braczynski
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany; (A.K.B.); (P.H.); (J.B.S.); (J.-P.B.)
- Institut für Physikalische Biologie, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany; (T.K.); (E.D.A.); (M.S.); (D.W.)
| | - Marc Sevenich
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, 52428 Jülich, Germany; (M.S.); (I.G.)
- Priavoid GmbH, 40225 Düsseldorf, Germany
| | - Ian Gering
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, 52428 Jülich, Germany; (M.S.); (I.G.)
| | - Tatsiana Kupreichyk
- Institut für Physikalische Biologie, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany; (T.K.); (E.D.A.); (M.S.); (D.W.)
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, 52428 Jülich, Germany; (M.S.); (I.G.)
| | - Emil D. Agerschou
- Institut für Physikalische Biologie, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany; (T.K.); (E.D.A.); (M.S.); (D.W.)
| | - Yannick Kronimus
- Department of Geriatric Medicine, University Hospital Essen, University Duisburg-Essen, 47057 Duisburg, Germany;
| | - Pardes Habib
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany; (A.K.B.); (P.H.); (J.B.S.); (J.-P.B.)
- Institute of Biochemistry and Molecular Immunology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
| | - Matthias Stoldt
- Institut für Physikalische Biologie, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany; (T.K.); (E.D.A.); (M.S.); (D.W.)
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, 52428 Jülich, Germany; (M.S.); (I.G.)
| | - Dieter Willbold
- Institut für Physikalische Biologie, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany; (T.K.); (E.D.A.); (M.S.); (D.W.)
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, 52428 Jülich, Germany; (M.S.); (I.G.)
| | - Jörg B. Schulz
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany; (A.K.B.); (P.H.); (J.B.S.); (J.-P.B.)
- JARA-Institute Molecular Neuroscience and Neuroimaging, Jülich Aachen Research Alliance, FZ Jülich and RWTH University, 52428 Jülich, Germany
| | - Jan-Philipp Bach
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany; (A.K.B.); (P.H.); (J.B.S.); (J.-P.B.)
| | - Björn H. Falkenburger
- Department of Neurology, RWTH University Hospital, 52074 Aachen, Germany; (A.K.B.); (P.H.); (J.B.S.); (J.-P.B.)
- Department of Neurology, University Hospital Carl Gustav Carus, 01307 Dresden, Germany
- Correspondence: (B.H.F.); (W.H.)
| | - Wolfgang Hoyer
- Institut für Physikalische Biologie, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany; (T.K.); (E.D.A.); (M.S.); (D.W.)
- Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, 52428 Jülich, Germany; (M.S.); (I.G.)
- Correspondence: (B.H.F.); (W.H.)
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Hoog Antink C, Braczynski AK, Ganse B. Learning from machine learning: prediction of age-related athletic performance decline trajectories. GeroScience 2021; 43:2547-2559. [PMID: 34241807 PMCID: PMC8599600 DOI: 10.1007/s11357-021-00411-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/23/2021] [Indexed: 01/21/2023] Open
Abstract
Factors that determine individual age-related decline rates in physical performance are poorly understood and prediction poses a challenge. Linear and quadratic regression models are usually applied, but often show high prediction errors for individual athletes. Machine learning approaches may deliver more accurate predictions and help to identify factors that determine performance decline rates. We hypothesized that it is possible to predict the performance development of a master athlete from a single measurement, that prediction by a machine learning approach is superior to prediction by the average decline curve or an individually shifted decline curve, and that athletes with a higher starting performance show a slower performance decline than those with a lower performance. The machine learning approach was implemented using a multilayer neuronal network. Results showed that performance prediction from a single measurement is possible and that the prediction by a machine learning approach was superior to the other models. The estimated performance decline rate was highest in athletes with a high starting performance and a low starting age, as well as in those with a low starting performance and high starting age, while the lowest decline rate was found for athletes with a high starting performance and a high starting age. Machine learning was superior and predicted trajectories with significantly lower prediction errors compared to conventional approaches. New insights into factors determining decline trajectories were identified by visualization of the model outputs. Machine learning models may be useful in revealing unknown factors that determine the age-related performance decline.
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Affiliation(s)
| | - Anne K Braczynski
- Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany.,Institut für physikalische Biologie, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Bergita Ganse
- Innovative Implant Development, Department of Surgery, Saarland University, Homburg, Germany. .,Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany.
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5
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Braczynski AK, Ganse B, Ridwan S, Schlenstedt C, Schulz JB, Hoog Antink C. YouTube Videos on Parkinson's Disease are a Relevant Source of Patient Information. J Parkinsons Dis 2021; 11:833-842. [PMID: 33682733 DOI: 10.3233/jpd-202513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is the most frequent movement disorder. Patients access YouTube, one of the largest video databases in the world, to retrieve health-related information increasingly often. OBJECTIVE We aimed to identify high-quality publishers, so-called "channels" that can be recommended to patients. We hypothesized that the number of views and the number of uploaded videos were indicators for the quality of the information given by a video on PD. METHODS YouTube was searched for 8 combinations of search terms that included "Parkinson" in German. For each term, the first 100 search results were analyzed for source, date of upload, number of views, numbers of likes and dislikes, and comments. The view ratio (views / day) and the likes ratio (likes * 100 / [likes + dislikes]) were determined to calculate the video popularity index (VPI). The global quality score (GQS) and title - content consistency index (TCCI) were assessed in a subset of videos. RESULTS Of 800 search results, 251 videos met the inclusion criteria. The number of views or the publisher category were not indicative of higher quality video content. The number of videos uploaded by a channel was the best indicator for the quality of video content. CONCLUSION The quality of YouTube videos relevant for PD patients is increased in channels with a high number of videos on the topic. We identified three German channels that can be recommended to PD patients who prefer video over written content.
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Affiliation(s)
- Anne K Braczynski
- Department of Neurology, RWTH University Hospital, Aachen, Germany.,Institut für Physikalische Biologie, Heinrich-Heine University, Düsseldorf, Germany.,Institute of Biological Information Processing (IBI-7: Structural Biochemistry), Forschungszentrum Jülich, Jülich, Germany
| | - Bergita Ganse
- Research Centre for Musculoskeletal Science & Sports Medicine, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom.,Innovative Implant Development, Saarland University Hospital, Homburg, Germany
| | - Stephanie Ridwan
- Department of Diagnostic and Interventional Neuroradiology, RWTH University Hospital, Aachen, Germany
| | - Christian Schlenstedt
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH University Hospital, Aachen, Germany.,Jülich Aachen Research Alliance (JARA) -JARA-Institute Molecular Neuroscience and Neuroimaging, FZ Jülich and RWTH University, Jülich and Aachen, Germany
| | - Christoph Hoog Antink
- Medical Information Technology (MedIT), Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany.,Biomedical Engineering, TU Darmstadt, Darmstadt, Germany
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6
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Hoog Antink C, Braczynski AK, Kleerekoper A, Degens H, Ganse B. Longitudinal Master Track and Field Performance Decline Rates Are Lower and Performance Is Better Compared to Athletes Competing Only Once. J Gerontol A Biol Sci Med Sci 2021; 76:1376-1381. [PMID: 33606016 DOI: 10.1093/gerona/glab049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/18/2020] [Indexed: 11/14/2022] Open
Abstract
In master athletics research, cross-sectional data are easier to obtain than longitudinal data. While cross-sectional data give the age-related performance decline for a population, longitudinal data show individual trajectories. It is not known whether athletes who repeatedly compete have (a) a better performance and (b) a slower age-related decline in performance than that obtained from cross-sectional data from athletes competing only once. To investigate this, we analyzed 33 254 results of 14 118 male athletes from 8 disciplines in the database of "Swedish Veteran Athletics." For each discipline and for the pooled data of all disciplines, quadratic models of the evolution of performance over time were analyzed by ANCOVA/ANOCOVA using MATLAB. The performance was higher in athletes with 2 or more data points compared to those with only n = 1 (p < .001), with further increases in performance with an increasing number of data points per athlete. The estimated performance decline was lower in people with 2 or more results (sprint, 10 km, jumps; p < .001). In conclusion, we showed that longitudinal data are associated with higher performance and lower performance decline rates.
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Affiliation(s)
- Christoph Hoog Antink
- Medical Information Technology (MedIT), Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Germany.,Biomedical Engineering, TU Darmstadt, Darmstadt, Germany
| | - Anne K Braczynski
- Department of Neurology, RWTH Aachen University Hospital, Germany.,Institut für Physikalische Biologie, Heinrich Heine University Düsseldorf, Germany
| | - Anthony Kleerekoper
- Department of Computing and Mathematics, Faculty of Science and Engineering, Manchester Metropolitan University, UK
| | - Hans Degens
- Research Centre for Musculoskeletal Science & Sports Medicine, Faculty of Science and Engineering, Manchester Metropolitan University, UK.,Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Bergita Ganse
- Research Centre for Musculoskeletal Science & Sports Medicine, Faculty of Science and Engineering, Manchester Metropolitan University, UK.,Innovative Implant Development, Orthopaedic Trauma Surgery, Saarland University, Homburg, Germany
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Braczynski AK, Gfroerer S, Beschorner R, Harter PN, Baumgarten P, Rolle U, Mittelbronn M. Cholinergic innervation and ganglion cell distribution in Hirschsprung's disease. BMC Pediatr 2020; 20:399. [PMID: 32838761 PMCID: PMC7445925 DOI: 10.1186/s12887-020-02299-z] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 08/17/2020] [Indexed: 02/08/2023] Open
Abstract
Background The diagnostic gold standard of Hirschsprung’s disease (HD) is based on the histopathological assessment of colorectal biopsies. Although data on cholinergic innervation and ganglion cell (GC) distribution exist, only few studies have examined these two key features together. We assessed the pattern of cholinergic innervation and the amount of GCs in colorectal specimens of 14 HD patients. Methods We established a semi-quantitative score for cholinergic innervation using acetylcholinesterase (AChE) enzyme histochemistry and quantitatively analyzed the number of GCs via NADH tetrazolium reductase (NADH) enzyme histochemistry. We examined both the entire length of the resected specimens as well as defined areas of the transition zone of both pathological and healthy appearing segment. Results High AChE score values were associated with absence of GCs, and AChE scores were inversely correlated with the number of GCs. Nevertheless, we observed several cases in which one of the two features revealed a normal distribution pattern, whereas the other still displayed pathological features. Conclusions Our data support the need for transmural colon biopsies, to enable the best evaluation of both cholinergic innervation and GCs for a reliable assessment of HD.
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Affiliation(s)
- Anne K Braczynski
- Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany.,Department of Physical Biology, Heinrich-Heine University, Düsseldorf, Germany.,Institute of Biological Information Processing (IBI-7: Structural Biochemistry, Forschungszentrum Jülich, Jülich, Germany.,Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany
| | - Stefan Gfroerer
- Department of Pediatric Surgery, Helios Hospital Berlin-Buch, Berlin, Germany
| | - Rudi Beschorner
- Institute of Pathology and Neuropathology, Eberhard-Karls University, Tuebingen, Germany
| | - Patrick N Harter
- Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Peter Baumgarten
- Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany.,Department of Neurosurgery, Goethe University, Frankfurt, Germany
| | - Udo Rolle
- Department of Pediatric Surgery, University of Frankfurt am Main, Frankfurt, Germany.,University Children's Hospital, Goethe University, Frankfurt, Germany
| | - Michel Mittelbronn
- Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany. .,Department of Oncology (DONC), Luxembourg Institute of Health (LIH), Strassen, Luxembourg. .,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg City, Luxembourg. .,National Center of Pathology (NCP), Laboratoire national de santé (LNS), 1, Rue Louis Rech, L-3555, Dudelange, Luxembourg. .,Luxembourg Center of Neuropathology (LCNP), 1, Rue Louis Rech, L-3555, Dudelange, Luxembourg.
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8
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Devraj G, Guérit S, Seele J, Spitzer D, Macas J, Khel MI, Heidemann R, Braczynski AK, Ballhorn W, Günther S, Ogunshola OO, Mittelbronn M, Ködel U, Monoranu CM, Plate KH, Hammerschmidt S, Nau R, Devraj K, Kempf VAJ. HIF-1α is involved in blood-brain barrier dysfunction and paracellular migration of bacteria in pneumococcal meningitis. Acta Neuropathol 2020; 140:183-208. [PMID: 32529267 PMCID: PMC7360668 DOI: 10.1007/s00401-020-02174-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
Bacterial meningitis is a deadly disease most commonly caused by Streptococcus pneumoniae, leading to severe neurological sequelae including cerebral edema, seizures, stroke, and mortality when untreated. Meningitis is initiated by the transfer of S. pneumoniae from blood to the brain across the blood-cerebrospinal fluid barrier or the blood-brain barrier (BBB). The underlying mechanisms are still poorly understood. Current treatment strategies include adjuvant dexamethasone for inflammation and cerebral edema, followed by antibiotics. The success of dexamethasone is however inconclusive, necessitating new therapies for controlling edema, the primary reason for neurological complications. Since we have previously shown a general activation of hypoxia inducible factor (HIF-1α) in bacterial infections, we hypothesized that HIF-1α, via induction of vascular endothelial growth factor (VEGF) is involved in transmigration of pathogens across the BBB. In human, murine meningitis brain samples, HIF-1α activation was observed by immunohistochemistry. S. pneumoniae infection in brain endothelial cells (EC) resulted in in vitro upregulation of HIF-1α/VEGF (Western blotting/qRT-PCR) associated with increased paracellular permeability (fluorometry, impedance measurements). This was supported by bacterial localization at cell-cell junctions in vitro and in vivo in brain ECs from mouse and humans (confocal, super-resolution, electron microscopy, live-cell imaging). Hematogenously infected mice showed increased permeability, S. pneumoniae deposition in the brain, along with upregulation of genes in the HIF-1α/VEGF pathway (RNA sequencing of brain microvessels). Inhibition of HIF-1α with echinomycin, siRNA in bEnd5 cells or using primary brain ECs from HIF-1α knock-out mice revealed reduced endothelial permeability and transmigration of S. pneumoniae. Therapeutic rescue using the HIF-1α inhibitor echinomycin resulted in increased survival and improvement of BBB function in S. pneumoniae-infected mice. We thus demonstrate paracellular migration of bacteria across BBB and a critical role for HIF-1α/VEGF therein and hence propose targeting this pathway to prevent BBB dysfunction and ensuing brain damage in infections.
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Affiliation(s)
- Gayatri Devraj
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
| | - Sylvaine Guérit
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Jana Seele
- Institute of Neuropathology, University Medical Center, Göttingen, Germany ,Department of Geriatrics, Evangelisches Krankenhaus, Göttingen-Weende, Germany
| | - Daniel Spitzer
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Jadranka Macas
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Maryam I. Khel
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Roxana Heidemann
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Anne K. Braczynski
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Department of Neurology, Technische Hochschule University Hospital, Aachen, Germany
| | - Wibke Ballhorn
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
| | - Stefan Günther
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | | | - Michel Mittelbronn
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Luxembourg Centre of Neuropathology (LCNP), Luxembourg, Luxembourg ,Laboratoire National de Santé (LNS), Dudelange, Luxembourg ,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg, Luxembourg ,NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
| | - Uwe Ködel
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany
| | - Camelia M. Monoranu
- Department of Neuropathology, Institute of Pathology, Julius Maximilians University, Würzburg, Germany
| | - Karl H. Plate
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Roland Nau
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Kavi Devraj
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany. .,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.
| | - Volkhard A. J. Kempf
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
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9
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Braczynski AK, Capper D, Jones DTW, Schittenhelm J, Stichel D, von Deimling A, Harter PN, Mittelbronn M. High density DNA methylation array is a reliable alternative for PCR-based analysis of the MGMT promoter methylation status in glioblastoma. Pathol Res Pract 2019; 216:152728. [PMID: 31784096 DOI: 10.1016/j.prp.2019.152728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/08/2019] [Accepted: 11/10/2019] [Indexed: 10/25/2022]
Abstract
AIM MGMT promoter methylation status is an important biomarker predicting survival and response to chemotherapy in patients suffering from glioblastoma. Since new diagnostic methods such as methylome-based classification of brain tumors are more and more frequently performed, we aimed at comparing the suitability of calculating the MGMT promoter methylation status in a quantitative manner from the methylome profiling as compared to the classic gold standard assessment by PCR. METHODS Our cohort consisted of 39 cases diagnosed as "glioblastoma, IDH-wildtype" of which the MGMT promoter methylation status was analyzed with both methylation-specific PCR and high density DNA methylation array using the STP-27 algorithm. Contradictory results were validated by pyrosequencing. RESULTS The inter-method reliability reached 77% (kappa-coefficient: 0.58) when also cases with an inconclusive result in one or the other method were taken into account. When only cases with conclusive results in both methods were considered, a very high inter-method reliability of 91% (kappa-coefficient: 0.86) could be achieved. For "methylated" cases, no contradictory results were obtained. For the remaining two cases with discrepant results subsequent pyrosequencing analyses spoke in favor of each previously applied method once. CONCLUSION In addition to its benefits for molecular subgrouping and copy number analysis of brain tumors, DNA-methylation based classification is a highly reliable tool for the assessment of MGMT promoter methylation status in glioblastoma patients.
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Affiliation(s)
- Anne K Braczynski
- Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany; Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany
| | - David Capper
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany; Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Neuropathology, Charité Universitätsmedizin Berlin and German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ) Heidelberg, Germany
| | - David T W Jones
- Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
| | - Jens Schittenhelm
- Department of Neuropathology, Institute of Pathology and Neuropathology, Eberhard-Karls University and Comprehensive Cancer Center Tuebingen-Stuttgart, Tuebingen, Germany
| | - Damian Stichel
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany; Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany; Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Patrick N Harter
- Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany; German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Michel Mittelbronn
- Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany; NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health (LIH), Luxembourg; Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg; National Center of Pathology (NCP), Laboratoire national de santé (LNS), Dudelange, Luxembourg; Luxembourg Centre of Neuropathology (LCNP), Luxembourg.
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10
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Capper D, Jones DTW, Sill M, Hovestadt V, Schrimpf D, Sturm D, Koelsche C, Sahm F, Chavez L, Reuss DE, Kratz A, Wefers AK, Huang K, Pajtler KW, Schweizer L, Stichel D, Olar A, Engel NW, Lindenberg K, Harter PN, Braczynski AK, Plate KH, Dohmen H, Garvalov BK, Coras R, Hölsken A, Hewer E, Bewerunge-Hudler M, Schick M, Fischer R, Beschorner R, Schittenhelm J, Staszewski O, Wani K, Varlet P, Pages M, Temming P, Lohmann D, Selt F, Witt H, Milde T, Witt O, Aronica E, Giangaspero F, Rushing E, Scheurlen W, Geisenberger C, Rodriguez FJ, Becker A, Preusser M, Haberler C, Bjerkvig R, Cryan J, Farrell M, Deckert M, Hench J, Frank S, Serrano J, Kannan K, Tsirigos A, Brück W, Hofer S, Brehmer S, Seiz-Rosenhagen M, Hänggi D, Hans V, Rozsnoki S, Hansford JR, Kohlhof P, Kristensen BW, Lechner M, Lopes B, Mawrin C, Ketter R, Kulozik A, Khatib Z, Heppner F, Koch A, Jouvet A, Keohane C, Mühleisen H, Mueller W, Pohl U, Prinz M, Benner A, Zapatka M, Gottardo NG, Driever PH, Kramm CM, Müller HL, Rutkowski S, von Hoff K, Frühwald MC, Gnekow A, Fleischhack G, Tippelt S, Calaminus G, Monoranu CM, Perry A, Jones C, Jacques TS, Radlwimmer B, Gessi M, Pietsch T, Schramm J, Schackert G, Westphal M, Reifenberger G, Wesseling P, Weller M, Collins VP, Blümcke I, Bendszus M, Debus J, Huang A, Jabado N, Northcott PA, Paulus W, Gajjar A, Robinson GW, Taylor MD, Jaunmuktane Z, Ryzhova M, Platten M, Unterberg A, Wick W, Karajannis MA, Mittelbronn M, Acker T, Hartmann C, Aldape K, Schüller U, Buslei R, Lichter P, Kool M, Herold-Mende C, Ellison DW, Hasselblatt M, Snuderl M, Brandner S, Korshunov A, von Deimling A, Pfister SM. DNA methylation-based classification of central nervous system tumours. Nature 2018; 555:469-474. [PMID: 29539639 PMCID: PMC6093218 DOI: 10.1038/nature26000] [Citation(s) in RCA: 1580] [Impact Index Per Article: 263.3] [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: 05/05/2017] [Accepted: 02/13/2018] [Indexed: 02/07/2023]
Abstract
Accurate pathological diagnosis is crucial for optimal management of patients with cancer. For the approximately 100 known tumour types of the central nervous system, standardization of the diagnostic process has been shown to be particularly challenging-with substantial inter-observer variability in the histopathological diagnosis of many tumour types. Here we present a comprehensive approach for the DNA methylation-based classification of central nervous system tumours across all entities and age groups, and demonstrate its application in a routine diagnostic setting. We show that the availability of this method may have a substantial impact on diagnostic precision compared to standard methods, resulting in a change of diagnosis in up to 12% of prospective cases. For broader accessibility, we have designed a free online classifier tool, the use of which does not require any additional onsite data processing. Our results provide a blueprint for the generation of machine-learning-based tumour classifiers across other cancer entities, with the potential to fundamentally transform tumour pathology.
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Affiliation(s)
- David Capper
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neuropathology, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David T W Jones
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martin Sill
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Volker Hovestadt
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniel Schrimpf
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dominik Sturm
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Koelsche
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lukas Chavez
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David E Reuss
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annekathrin Kratz
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annika K Wefers
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristin Huang
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristian W Pajtler
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Leonille Schweizer
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neuropathology, Berlin, Germany
| | - Damian Stichel
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Adriana Olar
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA
- Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA
- Hollings Cancer Center, Charleston, South Carolina 29425, USA
| | - Nils W Engel
- Department of Oncology and Hematology with Sections Bone Marrow Transplant and Pneumology, Hubertus Wald Tumorzentrum/University Cancer Center Hamburg, University Medical Center Hamburg, Hamburg, Germany
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University, Munich, Germany
| | - Kerstin Lindenberg
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Patrick N Harter
- Institute of Neurology (Edinger Institute), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, German Cancer Research Center (DKFZ) Heidelberg, Germany
| | - Anne K Braczynski
- Institute of Neurology (Edinger Institute), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, German Cancer Research Center (DKFZ) Heidelberg, Germany
| | - Karl H Plate
- Institute of Neurology (Edinger Institute), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, German Cancer Research Center (DKFZ) Heidelberg, Germany
| | - Hildegard Dohmen
- Institute of Neuropathology, University of Giessen, Giessen, Germany
| | - Boyan K Garvalov
- Institute of Neuropathology, University of Giessen, Giessen, Germany
| | - Roland Coras
- Neuropathological Institute, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Annett Hölsken
- Neuropathological Institute, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Ekkehard Hewer
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Melanie Bewerunge-Hudler
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias Schick
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Roger Fischer
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudi Beschorner
- Institute of Pathology and Neuropathology, Department of Neuropathology, University Hospital Tübingen, Tübingen, Germany
| | - Jens Schittenhelm
- Institute of Pathology and Neuropathology, Department of Neuropathology, University Hospital Tübingen, Tübingen, Germany
| | - Ori Staszewski
- Institute of Neuropathology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Khalida Wani
- Department of Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Pascale Varlet
- Department of Neuropathology, Centre Hospitalier Sainte Anne, Paris, France
| | - Melanie Pages
- Department of Neuropathology, Centre Hospitalier Sainte Anne, Paris, France
| | - Petra Temming
- Pediatrics III, Pediatric Oncology and Hematology, University Hospital Essen, Essen, Germany
| | - Dietmar Lohmann
- Eye Cancer Research Group, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Florian Selt
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
- CCU Pediatric Oncology (G340), German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Hendrik Witt
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Till Milde
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
- CCU Pediatric Oncology (G340), German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Olaf Witt
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
- CCU Pediatric Oncology (G340), German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Academic Medisch Centrum (AMC), University of Amsterdam, Amsterdam, The Netherlands
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Amsterdam, The Netherlands
| | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Elisabeth Rushing
- Department of Neuropathology, University Hospital Zurich, Zurich, Switzerland
| | | | - Christoph Geisenberger
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
- Hubrecht Institute-KNAW (Royal Netherlands Academy of Arts and Sciences), Uppsalalaan 8, 3584 CT Utrecht, The Netherlands
| | - Fausto J Rodriguez
- Division of Neuropathology of the Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Albert Becker
- Department of Neuropathology, University of Bonn, Bonn, Germany
| | - Matthias Preusser
- Department of Medicine I, Comprehensive Cancer Center Vienna, CNS Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria
| | | | - Rolf Bjerkvig
- Department of Biomedicine, University of Bergen, Bergen, Norway
- NORLUX Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Jane Cryan
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Michael Farrell
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Martina Deckert
- Department of Neuropathology, University Hospital of Cologne, Cologne, Germany
| | - Jürgen Hench
- Department of Neuropathology, Institute of Pathology, Basel University Hospital, Basel, Switzerland
| | - Stephan Frank
- Department of Neuropathology, Institute of Pathology, Basel University Hospital, Basel, Switzerland
| | | | | | | | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - Silvia Hofer
- Division of Oncology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Stefanie Brehmer
- Department of Neurosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marcel Seiz-Rosenhagen
- Department of Neurosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniel Hänggi
- Department of Neurosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Volkmar Hans
- Institut für Neuropathologie, Evangelisches Krankenhaus Bielefeld gGmbH, Bielefeld, Germany
- Institut für Neuropathologie, Universitätskinikum Essen, Essen, Germany
| | - Stephanie Rozsnoki
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Jordan R Hansford
- Children's Cancer Centre, Royal Children's Hospital, University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Patricia Kohlhof
- Institute for Pathology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Bjarne W Kristensen
- Department of Pathology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Matt Lechner
- University College London Cancer Institute and University College London Hospitals, London, UK
| | - Beatriz Lopes
- Department of Pathology, University of Virginia, Charlottesville, Virginia, USA
| | - Christian Mawrin
- Institute of Neuropathology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Ralf Ketter
- Department of Neurosurgery, University Hospital Saarland, Homburg, Saar, Germany
| | - Andreas Kulozik
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ziad Khatib
- Nicklaus Children's Hospital Brain Institute, Miami, Florida 33155, USA
| | - Frank Heppner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neuropathology, Berlin, Germany
- Cluster of Excellence, NeuroCure, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Arend Koch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neuropathology, Berlin, Germany
| | - Anne Jouvet
- Département de Pathologie et Neuropathologie, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France
| | - Catherine Keohane
- Department of Neuropathology, Cork University Hospital, Cork, Ireland
| | - Helmut Mühleisen
- Department of Pathology, Ludwigsburg Hospital, Ludwigsburg, Germany
| | - Wolf Mueller
- Department of Neuropathology, Leipzig University, Leipzig, Germany
| | - Ute Pohl
- Department of Cellular Pathology, Queen's Hospital, Romford, UK
| | - Marco Prinz
- Institute of Neuropathology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
- BIOSS Centre for Biological Signalling Studies, University of Freiburg, Freiburg, Germany
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marc Zapatka
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicholas G Gottardo
- Department of Pediatric Oncology and Haematology, Princess Margaret Hospital for Children, GPO Box D184, Perth, Western Australia 6840, Australia
- Telethon Kids Institute, University of Western Australia, PO Box 855, Perth, Western Australia 6872, Australia
- School of Paediatrics and Child Health, University of Western Australia, GPO Box D184, Perth, Western Australia 6840, Australia
| | - Pablo Hernáiz Driever
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christof M Kramm
- Division of Pediatric Hematology and Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Hermann L Müller
- Department of Pediatrics and Pediatric Hematology/Oncology, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, 26133 Oldenburg, Germany
| | - Stefan Rutkowski
- Department for Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Katja von Hoff
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department for Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Michael C Frühwald
- Children's Hospital Augsburg, Swabian Children's Cancer Centre, Augsburg, Germany
| | - Astrid Gnekow
- Children's Hospital Augsburg, Swabian Children's Cancer Centre, Augsburg, Germany
| | - Gudrun Fleischhack
- Pediatrics III, Pediatric Oncology and Hematology, University Hospital Essen, Essen, Germany
| | - Stephan Tippelt
- Pediatrics III, Pediatric Oncology and Hematology, University Hospital Essen, Essen, Germany
| | - Gabriele Calaminus
- Department of Pediatric Hematology/Oncology, University of Bonn Medical Center, Bonn, Germany
| | - Camelia-Maria Monoranu
- Department of Neuropathology, Insitute of Pathology, Comprehensive Cancer Center (CCC) Mainfranken, University of Würzburg, Würzburg, Germany
| | - Arie Perry
- Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Chris Jones
- Division of Molecular Pathology, Institute of Cancer Research, London, UK
| | - Thomas S Jacques
- Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health and Histopathology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Bernhard Radlwimmer
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marco Gessi
- Department of Neuropathology, University of Bonn, Bonn, Germany
| | - Torsten Pietsch
- Department of Neuropathology, University of Bonn, Bonn, Germany
| | - Johannes Schramm
- Medical Faculty, University of Bonn Medical School, Bonn, Germany
| | - Gabriele Schackert
- Department of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Manfred Westphal
- Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Reifenberger
- Department of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pieter Wesseling
- Department of Pathology, Princess Máxima Center for Pediatric Oncology and University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Vincent Peter Collins
- Department of Pathology, Division of Molecular Histopathology, University of Cambridge, Cambridge, UK
| | - Ingmar Blümcke
- Neuropathological Institute, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Annie Huang
- Department of Pediatrics, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Nada Jabado
- Division of Hematology/Oncology, McGill University, Montreal, Quebec, Canada
| | - Paul A Northcott
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Werner Paulus
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Amar Gajjar
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Giles W Robinson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Michael D Taylor
- Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Zane Jaunmuktane
- Division of Neuropathology, UCL Hospitals, Institute of Neurology, University College London, Queen Square, WC1N 3BG London, UK
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, WC1N 3BG London, UK
- Department of Neurodegeneration, Institute of Neurology, University College London, Queen Square, WC1N 3BG London, UK
| | | | - Michael Platten
- Department of Neurology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Unterberg
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias A Karajannis
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Michel Mittelbronn
- Institute of Neurology (Edinger Institute), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, German Cancer Research Center (DKFZ) Heidelberg, Germany
- NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg, Luxembourg
- Laboratoire national de santé (LNS), Dudelange, Luxembourg
- Luxembourg Centre of Neuropathology (LCNP), Luxembourg, Luxembourg
| | - Till Acker
- Institute of Neuropathology, University of Giessen, Giessen, Germany
| | - Christian Hartmann
- Department of Neuropathology, Hannover Medical School (MHH), Hannover, Germany
| | - Kenneth Aldape
- Department of Pathology, University of Toronto, Toronto, Ontario, Canada
| | - Ulrich Schüller
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University, Munich, Germany
- Institute of Neuropathology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
- Research Institute Children's Cancer Center, Hamburg, Germany
- Department of Pediatric Hematology and Oncology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Rolf Buslei
- Neuropathological Institute, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
- Section Neuropathology, Institute of Pathology, Sozialstiftung Bamberg, Klinikum am Bruderwald, Bamberg, Germany
| | - Peter Lichter
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marcel Kool
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - David W Ellison
- Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Matija Snuderl
- Division of Neuropathology, Department of Pathology, NYU Langone Medical Center, New York, New York, USA
| | - Sebastian Brandner
- Division of Neuropathology, UCL Hospitals, Institute of Neurology, University College London, Queen Square, WC1N 3BG London, UK
- Department of Neurodegeneration, Institute of Neurology, University College London, Queen Square, WC1N 3BG London, UK
| | - Andrey Korshunov
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefan M Pfister
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
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11
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Jennewein L, Ronellenfitsch MW, Antonietti P, Ilina EI, Jung J, Stadel D, Flohr LM, Zinke J, von Renesse J, Drott U, Baumgarten P, Braczynski AK, Penski C, Burger MC, Theurillat JP, Steinbach JP, Plate KH, Dikic I, Fulda S, Brandts C, Kögel D, Behrends C, Harter PN, Mittelbronn M. Diagnostic and clinical relevance of the autophago-lysosomal network in human gliomas. Oncotarget 2018; 7:20016-32. [PMID: 26956048 PMCID: PMC4991435 DOI: 10.18632/oncotarget.7910] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/15/2016] [Indexed: 12/19/2022] Open
Abstract
Recently, the conserved intracellular digestion mechanism ‘autophagy’ has been considered to be involved in early tumorigenesis and its blockade proposed as an alternative treatment approach. However, there is an ongoing debate about whether blocking autophagy has positive or negative effects in tumor cells. Since there is only poor data about the clinico-pathological relevance of autophagy in gliomas in vivo, we first established a cell culture based platform for the in vivo detection of the autophago-lysosomal components. We then investigated key autophagosomal (LC3B, p62, BAG3, Beclin1) and lysosomal (CTSB, LAMP2) molecules in 350 gliomas using immunohistochemistry, immunofluorescence, immunoblotting and qPCR. Autophagy was induced pharmacologically or by altering oxygen and nutrient levels. Our results show that autophagy is enhanced in astrocytomas as compared to normal CNS tissue, but largely independent from the WHO grade and patient survival. A strong upregulation of LC3B, p62, LAMP2 and CTSB was detected in perinecrotic areas in glioblastomas suggesting micro-environmental changes as a driver of autophagy induction in gliomas. Furthermore, glucose restriction induced autophagy in a concentration-dependent manner while hypoxia or amino acid starvation had considerably lesser effects. Apoptosis and autophagy were separately induced in glioma cells both in vitro and in vivo. In conclusion, our findings indicate that autophagy in gliomas is rather driven by micro-environmental changes than by primary glioma-intrinsic features thus challenging the concept of exploitation of the autophago-lysosomal network (ALN) as a treatment approach in gliomas.
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Affiliation(s)
- Lukas Jennewein
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany
| | - Michael W Ronellenfitsch
- Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Patrick Antonietti
- Experimental Neurosurgery, Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany
| | - Elena I Ilina
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany
| | - Jennifer Jung
- Institute of Biochemistry II, Goethe University, Frankfurt am Main, Germany
| | - Daniela Stadel
- Institute of Biochemistry II, Goethe University, Frankfurt am Main, Germany
| | - Lisa-Marie Flohr
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany
| | - Jenny Zinke
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany
| | - Janusz von Renesse
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany
| | - Ulrich Drott
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany
| | - Peter Baumgarten
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany.,Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany
| | - Anne K Braczynski
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany
| | - Cornelia Penski
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael C Burger
- Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany
| | | | - Joachim P Steinbach
- Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Karl-Heinz Plate
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ivan Dikic
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Institute of Biochemistry II, Goethe University, Frankfurt am Main, Germany
| | - Simone Fulda
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Institute for Experimental Cancer Research in Pediatrics, Goethe University, Frankfurt am Main, Germany
| | - Christian Brandts
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt am Main, Germany
| | - Donat Kögel
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Experimental Neurosurgery, Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany
| | - Christian Behrends
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Institute of Biochemistry II, Goethe University, Frankfurt am Main, Germany
| | - Patrick N Harter
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michel Mittelbronn
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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12
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Braczynski AK, Brockmann MA, Scholz T, Bach JP, Schulz JB, Tauber SC. Anterior sacral meningocele infected with Fusobacterium in a patient with recently diagnosed colorectal carcinoma - a case report. BMC Neurol 2017; 17:212. [PMID: 29216848 PMCID: PMC5721539 DOI: 10.1186/s12883-017-0992-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 11/28/2017] [Indexed: 11/18/2022] Open
Abstract
Background Anterior sacral meningoceles are rare, and usually occur with other malformations of the posterior lower spine. While these are more frequently reported in pediatric cohorts, we report a case in an elderly woman. Case presentation We report on a 71 year-old woman with a recently diagnosed colorectal adenocarcinoma who presented with a severe bacterial meningitis. The cerebrospinal fluid cell count revealed a pleocytosis of 80,000 cells/μl and a severe disturbance of the blood-brain-barrier. Fusobacterium nucleatum was cultured as the causing pathogen. A lumbar MRI showed, in addition to contrast-enhancing meninges as sign of inflammation, a presacral mass. In the next step, the mass was diagnosed as an anterior sacral meningocele connected to the gut. An adequate antibiotic was used to treat the leptomeningitis. The connection between gut and meningocele was closed surgically and the patient recovered well and underwent further treatment of her colorectal adenocarcinoma. Conclusion We report on a case of meningitis with an anterior sacral meningocele that was connected to the gut in a patient with a infiltrative colorectal adenocarcinoma. Anatomic variants have to be considered as rare causes of meningitis with typical intestinal germs.
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Affiliation(s)
- Anne K Braczynski
- Department of Neurology, RWTH University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Marc A Brockmann
- Department of Diagnostic and Interventional Neuroradiology, RWTH University Hospital, Aachen, Germany
| | - Torben Scholz
- Department of Neurosurgery, RWTH University Hospital, Aachen, Germany
| | - Jan-Philipp Bach
- Department of Neurology, RWTH University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Simone C Tauber
- Department of Neurology, RWTH University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany
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13
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Braczynski AK, Schulz JB, Bach JP. Vaccination strategies in tauopathies and synucleinopathies. J Neurochem 2017; 143:467-488. [PMID: 28869766 DOI: 10.1111/jnc.14207] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/07/2017] [Accepted: 08/23/2017] [Indexed: 01/01/2023]
Abstract
Vaccination therapies constitute potential treatment options in neurodegenerative disorders such as Alzheimer disease or Parkinson disease. While a lot of research has been performed on vaccination against extracellular amyloid β, the focus recently shifted toward vaccination against the intracellular proteins tau and α-synuclein, with promising results in terms of protein accumulation reduction. In this review, we briefly summarize lessons to be learned from clinical vaccination trials in Alzheimer disease that target amyloid β. We then focus on tau and α-synuclein. For both proteins, we provide important data on protein immunogenicity, and put them into context with data available from both animals and human vaccination trials targeted at tau and α-synuclein. Together, we give a comprehensive overview about current clinical data, and discuss associated problems.
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Affiliation(s)
- Anne K Braczynski
- Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany.,Jülich Aachen Research Alliance (JARA) - JARA-Institute Molecular Neuroscience and Neuroimaging, FZ Jülich and RWTH University, Aachen, Germany
| | - Jan-Philipp Bach
- Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany
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14
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Diamanti MA, Gupta J, Bennecke M, De Oliveira T, Ramakrishnan M, Braczynski AK, Richter B, Beli P, Hu Y, Saleh M, Mittelbronn M, Dikic I, Greten FR. IKKα controls ATG16L1 degradation to prevent ER stress during inflammation. J Exp Med 2017; 214:423-437. [PMID: 28082356 PMCID: PMC5294863 DOI: 10.1084/jem.20161867] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [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] [Received: 11/04/2016] [Revised: 11/29/2016] [Accepted: 12/27/2016] [Indexed: 12/29/2022] Open
Abstract
Inhibition of the IκB kinase complex (IKK) has been implicated in the therapy of several chronic inflammatory diseases including inflammatory bowel diseases. In this study, using mice with an inactivatable IKKα kinase (IkkαAA/AA), we show that loss of IKKα function markedly impairs epithelial regeneration in a model of acute colitis. Mechanistically, this is caused by compromised secretion of cytoprotective IL-18 from IKKα-mutant intestinal epithelial cells because of elevated caspase 12 activation during an enhanced unfolded protein response (UPR). Induction of the UPR is linked to decreased ATG16L1 stabilization in IkkαAA/AA mice. We demonstrate that both TNF-R and nucleotide-binding oligomerization domain stimulation promote ATG16L1 stabilization via IKKα-dependent phosphorylation of ATG16L1 at Ser278. Thus, we propose IKKα as a central mediator sensing both cytokine and microbial stimulation to suppress endoplasmic reticulum stress, thereby assuring antiinflammatory function during acute intestinal inflammation.
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Affiliation(s)
- Michaela A Diamanti
- Institute for Tumor Biology and Experimental Therapy, Georg-Speyer-Haus, 60596 Frankfurt am Main, Germany
| | - Jalaj Gupta
- Institute for Tumor Biology and Experimental Therapy, Georg-Speyer-Haus, 60596 Frankfurt am Main, Germany
| | - Moritz Bennecke
- Institute of Molecular Immunology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany
| | - Tiago De Oliveira
- Institute for Tumor Biology and Experimental Therapy, Georg-Speyer-Haus, 60596 Frankfurt am Main, Germany
| | - Mallika Ramakrishnan
- Institute for Tumor Biology and Experimental Therapy, Georg-Speyer-Haus, 60596 Frankfurt am Main, Germany
| | - Anne K Braczynski
- Edinger Institute (Institute of Neurology), Goethe University Hospital, Goethe University, 60323 Frankfurt, Germany
| | - Benjamin Richter
- Institute of Biochemistry II, Buchmann Institute for Molecular Life Sciences, Goethe University School of Medicine, Goethe University, 60323 Frankfurt, Germany
| | - Petra Beli
- Institute of Molecular Biology, 55128 Mainz, Germany
| | - Yinling Hu
- Cancer and Inflammation Program, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702
| | - Maya Saleh
- Department of Biochemistry, McGill University, Montreal, Quebec H3G 1Y6, Canada
| | - Michel Mittelbronn
- Edinger Institute (Institute of Neurology), Goethe University Hospital, Goethe University, 60323 Frankfurt, Germany
| | - Ivan Dikic
- Institute of Biochemistry II, Buchmann Institute for Molecular Life Sciences, Goethe University School of Medicine, Goethe University, 60323 Frankfurt, Germany
| | - Florian R Greten
- Institute for Tumor Biology and Experimental Therapy, Georg-Speyer-Haus, 60596 Frankfurt am Main, Germany
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15
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Braczynski AK, Harter PN, Zeiner PS, Drott U, Tews DS, Preusse C, Penski C, Dunst M, Weis J, Stenzel W, Mittelbronn M. C5b-9 deposits on endomysial capillaries in non-dermatomyositis cases. Neuromuscul Disord 2016; 26:283-91. [PMID: 27020463 DOI: 10.1016/j.nmd.2016.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 02/22/2016] [Accepted: 02/26/2016] [Indexed: 11/28/2022]
Abstract
Deposits of the terminal-membrane-attack-complex (MAC) C5b-9 on perfascicular endomysial capillaries are generally regarded as diagnostic hallmark of dermatomyositis (DM). Although the pathophysiology is not clear, C5b-9 deposits on capillaries seem to be associated with microinfarctions and vascular damage. Here, we report on a series of 19 patients presenting with C5b-9 accumulation on endomysial capillaries in the absence of features for DM. To decipher differences in the capillary C5b-9 accumulation pattern between DM and non-DM cases, we assessed the extent of endomysial capillary C5b-9 deposits related to capillary density and extent of myofiber necrosis by immunohistochemistry in 12 DM and 8 control patients. We found similar numbers of C5b-9-positive myofibers in both DM and non-DM C5b-9(+) cases. The distribution pattern differed as DM cases showed significantly more perifascicular capillary C5b-9 deposits as compared to non-DM cases, which presented stronger endomysial capillary C5b-9 deposits in a diffuse pattern. While total capillary density was not differing, DM patients displayed significantly more C5b-9(+) necrotic fibers as compared to non-DM C5b-9(+). In summary, endomysial capillary C5b-9 deposits are present in a variety of non-DM cases, however with differing distribution pattern. In conclusion, capillary C5b-9(+) deposits should be assessed critically, taking into consideration the distribution pattern.
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Affiliation(s)
- Anne K Braczynski
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Patrick N Harter
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Pia S Zeiner
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Ulrich Drott
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | | | | | - Cornelia Penski
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Maika Dunst
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Joachim Weis
- Institute of Neuropathology, RWTH, Aachen, Germany
| | | | - Michel Mittelbronn
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany.
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16
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Zeiner PS, Preusse C, Blank AE, Zachskorn C, Baumgarten P, Caspary L, Braczynski AK, Weissenberger J, Bratzke H, Reiß S, Pennartz S, Winkelmann R, Senft C, Plate KH, Wischhusen J, Stenzel W, Harter PN, Mittelbronn M. MIF Receptor CD74 is Restricted to Microglia/Macrophages, Associated with a M1-Polarized Immune Milieu and Prolonged Patient Survival in Gliomas. Brain Pathol 2014; 25:491-504. [PMID: 25175718 DOI: 10.1111/bpa.12194] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 08/18/2014] [Indexed: 01/05/2023] Open
Abstract
The macrophage migration inhibitory factor (MIF) receptor CD74 is overexpressed in various neoplasms, mainly in hematologic tumors, and currently investigated in clinical studies. CD74 is quickly internalized and recycles after antibody binding, therefore it constitutes an attractive target for antibody-based treatment strategies. CD74 has been further described as one of the most up-regulated molecules in human glioblastomas. To assess the potential relevance for anti-CD74 treatment, we determined the cellular source and clinicopathologic relevance of CD74 expression in human gliomas by immunohistochemistry, immunofluorescence, immunoblotting, cell sorting analysis and quantitative polymerase chain reaction (qPCR). Furthermore, we fractionated glioblastoma cells and glioma-associated microglia/macrophages (GAMs) from primary tumors and compared CD74 expression in cellular fractions with whole tumor lysates. Our results show that CD74 is restricted to GAMs in vivo, while being absent in tumor cells, the latter strongly expressing its ligand MIF. Most interestingly, a higher amount of CD74-positive GAMs was associated with beneficial patient survival constituting an independent prognostic parameter and with an anti-tumoral M1 polarization. In summary, CD74 expression in human gliomas is restricted to GAMs and positively associated with patient survival. In conclusion, CD74 represents a positive prognostic marker most probably because of its association with an M1-polarized immune milieu in high-grade gliomas.
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Affiliation(s)
- Pia S Zeiner
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | | | - Anna-Eva Blank
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Cornelia Zachskorn
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Peter Baumgarten
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Neurosurgery, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Lixi Caspary
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Anne K Braczynski
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jakob Weissenberger
- Department of Experimental Neurosurgery, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Hansjürgen Bratzke
- Institute of Forensic Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Sandy Reiß
- Miltenyi Biotec, Bergisch Gladbach, Germany
| | | | - Ria Winkelmann
- Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Christian Senft
- Department of Experimental Neurosurgery, Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Neurosurgery, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Karl H Plate
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jörg Wischhusen
- Junior Research Group "Tumour Progression and Immune Escape", Interdisciplinary Center for Clinical Research, Department for Obstetrics and Gynecology, University of Würzburg, Würzburg, Germany
| | | | - Patrick N Harter
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michel Mittelbronn
- Edinger Institute, Institute of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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17
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Baumgarten P, Michaelis M, Rothweiler F, Starzetz T, Rabenau HF, Berger A, Jennewein L, Braczynski AK, Franz K, Seifert V, Steinbach JP, Allwinn R, Mittelbronn M, Cinatl J. Human cytomegalovirus infection in tumor cells of the nervous system is not detectable with standardized pathologico-virological diagnostics. Neuro Oncol 2014; 16:1469-77. [PMID: 25155358 PMCID: PMC4201076 DOI: 10.1093/neuonc/nou167] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 07/13/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Experimental findings have suggested that human cytomegalovirus (HCMV) infection of tumor cells may exert oncomodulatory effects that enhance tumor malignancy. However, controversial findings have been published on the presence of HCMV in malignant tumors. Here, we present the first study that systematically investigates HCMV infection in human nervous system tumors by highly sensitive immunohistochemistry in correlation with the HCMV serostatus of the patients. METHODS Immunohistochemical and quantitative PCR-based methods to detect different HCMV antigens and genomic HCMV DNA were optimized prior to the investigation of pathological samples. Moreover, the pathological results were matched with the HCMV serostatus of the patients. RESULTS HCMV immediate-early, late, and pp65 antigens could be detected in single cells from HCMV strain Hi91-infected UKF-NB-4 neuroblastoma cells after 1:1024 dilution with noninfected UKF-NB-4 cells. Genomic HCMV DNA could be detected in copy numbers as low as 430 copies/mL. However, we did not detect HCMV in tumors from a cohort of 123 glioblastoma, medulloblastoma, or neuroblastoma patients. Notably, we detected nonspecifically positive staining in tumor tissues of HCMV seropositive and seronegative glioblastoma patients. The HCMV serostatus of 67 glioblastoma patients matched the general epidemiological prevalence data for Western countries (72% of female and 57% of male glioblastoma patients were HCMV seropositive). Median survival was not significantly different in HCMV seropositive versus seronegative glioblastoma patients. CONCLUSIONS The prevalence of HCMV-infected tumor cells may be much lower than previously reported based on highly sensitive detection methods.
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Affiliation(s)
- Peter Baumgarten
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Martin Michaelis
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Florian Rothweiler
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Tatjana Starzetz
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Holger F Rabenau
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Annemarie Berger
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Lukas Jennewein
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Anne K Braczynski
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Kea Franz
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Volker Seifert
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Joachim P Steinbach
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Regina Allwinn
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Michel Mittelbronn
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
| | - Jindrich Cinatl
- Neurological Institute (Edinger Institute), Goethe University, Frankfurt am Main, Germany (P.B., T.S., L.J., A.K.B., Mi.M.); Institute of Medical Virology, Goethe University, Frankfurt am Main, Germany (Ma.M., F.R., H.F.R., A.B., R.A., J.C.); German Cancer Consortium, Heidelberg, Germany (J.P.S., Mi.M.); German Cancer Research Center, Heidelberg, Germany (J.P.S., Mi.M.); Department of Neurosurgery, Goethe University, Frankfurt am Main, Germany (K.F., V.S.); Senckenberg Institute of Neurooncology, University of Frankfurt am Main, Germany (K.F., J.P.S.)
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Weise LM, Harter PN, Eibach S, Braczynski AK, Dunst M, Rieger J, Bähr O, Hattingen E, Steinbach JP, Plate KH, Seifert V, Mittelbronn M. Confounding Factors in Diagnostics of MGMT Promoter Methylation Status in Glioblastomas in Stereotactic Biopsies. Stereotact Funct Neurosurg 2014; 92:129-39. [DOI: 10.1159/000360582] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 02/12/2014] [Indexed: 11/19/2022]
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