1
|
Seibold J, Hönemann M, Tönjes A, Sandner B. Safe long-term therapy of Cushing's syndrome over 37 years with mitotane. Front Endocrinol (Lausanne) 2024; 15:1294415. [PMID: 38440784 PMCID: PMC10911286 DOI: 10.3389/fendo.2024.1294415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/29/2024] [Indexed: 03/06/2024] Open
Abstract
While suggested, surgery is not always possible as a first-line treatment of Cushing's Disease (CD). In such cases, patients require medical therapy in order to prevent complications resulting from hypercortisolism. Although there has been a wide expansion in pharmacological options in recent years, mitotane was the agent of choice for treating hypercortisolism decades ago. Due to the introduction of other therapies, long-term experience with mitotane remains limited. Here, we report the case of a woman with CD who was treated with mitotane for 37 years. During the treatment period, biochemical and clinical disease control was achieved and the patient had two uncomplicated pregnancies. Drug-related side effects remained moderate and could be controlled by several dose adjustments. Our case highlights the ability of mitotane to allow an effective control of hypercortisolism and to represent a safe treatment option in special situations where CD requires an alternative therapeutic approach. Furthermore, we provide a literature review of the long-term use of mitotane and reported cases of pregnancy in the context of mitotane therapy.
Collapse
Affiliation(s)
- Jonas Seibold
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Mario Hönemann
- Institute of Medical Microbiology and Virology, University of Leipzig Medical Center, Leipzig, Germany
| | - Anke Tönjes
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Benjamin Sandner
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| |
Collapse
|
2
|
Schürfeld R, Pamporaki C, Peitzsch M, Rayes N, Sabri O, Rohm S, Biemann R, Sandner B, Tönjes A, Eisenhofer G. False-positive results for pheochromocytoma associated with norepinephrine reuptake blockade. Endocr Relat Cancer 2024; 31:e230063. [PMID: 37955319 PMCID: PMC10762534 DOI: 10.1530/erc-23-0063] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 11/13/2023] [Indexed: 11/14/2023]
Abstract
Measurements of plasma metanephrines and methoxytyramine provide a sensitive test for diagnosis of pheochromocytoma/paraganglioma. False-positive results remain a problem, particularly in patients taking norepinephrine reuptake-blocking drugs. Therefore, in this retrospective observational study, we measured plasma metanephrines and methoxytyramine in 61 patients taking norepinephrine reuptake blockers (tricyclic antidepressants or serotonin-norepinephrine reuptake inhibitors) and 17 others taking selective serotonin reuptake inhibitors, all without pheochromocytoma/paraganglioma. We highlight a singular case with strongly elevated plasma normetanephrine and methoxytyramine concentrations associated with norepinephrine reuptake blockade. Data were compared to results from 252 and 1804 respective patients with and without tumors. Plasma normetanephrine was 40% higher (P < 0.0001) in patients on norepinephrine reuptake blockers and methoxytyramine was 127% higher (P = 0.0062) in patients taking tricyclic antidepressants compared to patients not taking uptake blockers and without tumors. The corresponding false-positive rates rose (P < 0.0001) from 4.8% to 23.0% for normetanephrine and from 0.9% to 28.6% for methoxytyramine. Selective serotonin reuptake inhibitors did not increase plasma concentrations of metabolites. In the highlighted case, plasma normetanephrine and methoxytyramine were elevated more than six times above upper reference limits. A pheochromocytoma/paraganglioma, however, was excluded by functional imaging. All biochemical test results normalized after discontinuation of norepinephrine reuptake blockers. These findings clarify that norepinephrine reuptake blockers usually result in mild elevations of normetanephrine and methoxytyramine that, nevertheless, significantly increase the number of false-positive results. There can, however, be exceptions where increases in normetanephrine and methoxytyramine reach pathological levels. Such exceptions may reflect failure of centrally mediated sympathoinhibition that normally occurs with the norepinephrine reuptake blockade.
Collapse
Affiliation(s)
- Robin Schürfeld
- Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Leipzig, Leipzig, Germany
| | - Christina Pamporaki
- TU Dresden, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Mirko Peitzsch
- TU Dresden, Institute of Clinical Chemistry and Laboratory Medicine, Dresden, Germany
| | - Nada Rayes
- Center of Surgery, Division of Endocrine Surgery, Department for Visceral, Transplant, Thoracic, and Vascular Surgery, University of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Silvio Rohm
- Center of Surgery, Department for Visceral, Transplant, Thoracic, and Vascular Surgery, University of Leipzig, Leipzig, Germany
- Center of Surgery, Department for Vascular Surgery, Diakonissen Hospital of Leipzig, Leipzig, Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Laboratory Medicine, University of Leipzig, Leipzig, Germany
| | - Benjamin Sandner
- Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Leipzig, Leipzig, Germany
| | - Anke Tönjes
- Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Leipzig, Leipzig, Germany
| | - Graeme Eisenhofer
- TU Dresden, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany
| |
Collapse
|
3
|
Schürfeld R, Sandner B, Hoffmann A, Klöting N, Baratashvili E, Nowicki M, Paeschke S, Kosacka J, Kralisch S, Bachmann A, Frille A, Dietel A, Stolzenburg JU, Blüher M, Zhang MZ, Harris RC, Isermann B, Stumvoll M, Tönjes A, Ebert T. Renal function is a major predictor of circulating acyl-CoA-binding protein/diazepam-binding inhibitor. Front Endocrinol (Lausanne) 2023; 14:1152444. [PMID: 37288304 PMCID: PMC10242139 DOI: 10.3389/fendo.2023.1152444] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
Objective Acyl-CoA-binding protein (ACBP)/diazepam-binding inhibitor has lately been described as an endocrine factor affecting food intake and lipid metabolism. ACBP is dysregulated in catabolic/malnutrition states like sepsis or systemic inflammation. However, regulation of ACBP has not been investigated in conditions with impaired kidney function, so far. Design/methods Serum ACBP concentrations were investigated by enzyme-linked immunosorbent assay i) in a cohort of 60 individuals with kidney failure (KF) on chronic haemodialysis and compared to 60 individuals with a preserved kidney function; and ii) in a human model of acute kidney dysfunction (AKD). In addition, mACBP mRNA expression was assessed in two CKD mouse models and in two distinct groups of non-CKD mice. Further, mRNA expression of mACBP was measured in vitro in isolated, differentiated mouse adipocytes - brown and white - after exposure to the uremic agent indoxyl sulfate. Results Median [interquartile range] serum ACBP was almost 20-fold increased in KF (514.0 [339.3] µg/l) compared to subjects without KF (26.1 [39.1] µg/l) (p<0.001). eGFR was the most important, inverse predictor of circulating ACBP in multivariate analysis (standardized β=-0.839; p<0.001). Furthermore, AKD increased ACBP concentrations almost 3-fold (p<0.001). Increased ACBP levels were not caused by augmented mACBP mRNA expression in different tissues of CKD mice in vivo or in indoxyl sulfate-treated adipocytes in vitro. Conclusions Circulating ACBP inversely associates with renal function, most likely through renal retention of the cytokine. Future studies need to investigate ACBP physiology in malnutrition-related disease states, such as CKD, and to adjust for markers of renal function.
Collapse
Affiliation(s)
- Robin Schürfeld
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Benjamin Sandner
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Annett Hoffmann
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Nora Klöting
- Helmholtz Institute for Metabolic, Obesity and Vascular Research of the Helmholtz Zentrum München at the University of Leipzig and University Hospital, Leipzig, Germany
| | - Ekaterine Baratashvili
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- Department of Cardiology, Angiology and Internal Intensive-Care Medicine, Klinikum St. Georg, Leipzig, Germany
| | - Marcin Nowicki
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Sabine Paeschke
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Joanna Kosacka
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University of Leipzig Medical Center, Leipzig, Germany
| | - Susan Kralisch
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Anette Bachmann
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Armin Frille
- Department of Respiratory Medicine, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Anja Dietel
- Department of Urology, University of Leipzig, Leipzig, Germany
| | | | - Matthias Blüher
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research of the Helmholtz Zentrum München at the University of Leipzig and University Hospital, Leipzig, Germany
| | - Ming-Zhi Zhang
- Division of Nephrology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, United States
- Department of Medicine, Nashville Veterans Affairs Hospital, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Raymond C. Harris
- Division of Nephrology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, United States
- Department of Medicine, Nashville Veterans Affairs Hospital, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Berend Isermann
- Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Michael Stumvoll
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Anke Tönjes
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Thomas Ebert
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| |
Collapse
|
4
|
Koehler VF, Berg E, Adam P, Weber GL, Pfestroff A, Luster M, Kutsch JM, Lapa C, Sandner B, Rayes N, Fuss CT, Kreissl MC, Hoster E, Allelein S, Schott M, Todica A, Fassnacht M, Kroiss M, Spitzweg C. Real-World Efficacy and Safety of Multi-Tyrosine Kinase Inhibitors in Radioiodine Refractory Thyroid Cancer. Thyroid 2021; 31:1531-1541. [PMID: 34405734 DOI: 10.1089/thy.2021.0091] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: The management of patients with locally advanced or metastatic differentiated thyroid cancer (DTC) that is refractory to radioiodine (RAI) remains a therapeutic challenge. The multi-tyrosine kinase inhibitors (TKIs) sorafenib and lenvatinib have been approved based on phase 3 clinical trials. Patients and Methods: We aimed at describing the efficacy and safety of TKI treatment of RAI-refractory DTC in a real-world setting at six German referral centers. One hundred and one patients with locally advanced or metastatic RAI-refractory DTC treated with sorafenib, lenvatinib, and/or pazopanib were included. Progression-free survival (PFS) and overall survival (OS) probabilities were estimated by using the Kaplan-Meier method. Results: Ninety-seven of 101 patients had progressive disease before TKI initiation. The median PFS for first-line treatment with sorafenib (n = 33), lenvatinib (n = 53), and pazopanib (n = 15) was 9 (95% confidence interval 5.2-12.8), 12 (4.4-19.6), and 12 months (4.4-19.6), respectively. The median OS for first-line treatment was 37 (10-64) for sorafenib, 47 (15.5-78.5) for lenvatinib, and 34 months (20.2-47.8) for pazopanib. Serious complications (e.g., hemorrhage, acute coronary syndrome, and thrombosis/venous thromboembolism) occurred in 16 out of 75 (21%) patients taking lenvatinib, in 3 out of 42 (7%) patients taking sorafenib, and in 3 out of 24 (13%) patients taking pazopanib. Conclusions: Sorafenib, lenvatinib, and pazopanib are effective treatment options in the majority of patients with RAI-refractory DTC. The PFS and six-month survival rate in patients treated with lenvatinib und pazopanib appear to compare favorably with sorafenib in the first-line treatment setting. However, a more advanced disease stage at treatment initiation in sorafenib- and pazopanib-treated patients in the era before TKI-approval and the retrospective nature of this study precludes a direct comparison of TKIs.
Collapse
Affiliation(s)
- Viktoria Florentine Koehler
- Department of Internal Medicine IV and University Hospital, LMU Munich, Munich, Germany
- Department of Internal Medicine I, Goethe University Hospital, Frankfurt, Germany
| | - Elke Berg
- Department of Internal Medicine IV and University Hospital, LMU Munich, Munich, Germany
| | - Pia Adam
- Division of Endocrinology/Diabetology, Department of Internal Medicine I, University of Würzburg, Würzburg, Germany
| | - Gian-Luca Weber
- Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
| | - Andreas Pfestroff
- Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
| | - Markus Luster
- Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
| | - Jana Maria Kutsch
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Constantin Lapa
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Benjamin Sandner
- Department of Endocrinology, Nephrology and Rheumatology and Transplant-, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Nada Rayes
- Department of Visceral-, Transplant-, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Carmina Teresa Fuss
- Division of Endocrinology/Diabetology, Department of Internal Medicine I, University of Würzburg, Würzburg, Germany
| | - Michael C Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Eva Hoster
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
| | - Stephanie Allelein
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Matthias Schott
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Andrei Todica
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Martin Fassnacht
- Division of Endocrinology/Diabetology, Department of Internal Medicine I, University of Würzburg, Würzburg, Germany
| | - Matthias Kroiss
- Department of Internal Medicine IV and University Hospital, LMU Munich, Munich, Germany
- Division of Endocrinology/Diabetology, Department of Internal Medicine I, University of Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Christine Spitzweg
- Department of Internal Medicine IV and University Hospital, LMU Munich, Munich, Germany
- Adjunct Academic Appointment, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
5
|
Adam P, Kircher S, Sbiera I, Koehler VF, Berg E, Knösel T, Sandner B, Fenske WK, Bläker H, Smaxwil C, Zielke A, Sipos B, Allelein S, Schott M, Dierks C, Spitzweg C, Fassnacht M, Kroiss M. FGF-Receptors and PD-L1 in Anaplastic and Poorly Differentiated Thyroid Cancer: Evaluation of the Preclinical Rationale. Front Endocrinol (Lausanne) 2021; 12:712107. [PMID: 34475850 PMCID: PMC8406771 DOI: 10.3389/fendo.2021.712107] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Treatment options for poorly differentiated (PDTC) and anaplastic (ATC) thyroid carcinoma are unsatisfactory and prognosis is generally poor. Lenvatinib (LEN), a multi-tyrosine kinase inhibitor targeting fibroblast growth factor receptors (FGFR) 1-4 is approved for advanced radioiodine refractory thyroid carcinoma, but response to single agent is poor in ATC. Recent reports of combining LEN with PD-1 inhibitor pembrolizumab (PEM) are promising. MATERIALS AND METHODS Primary ATC (n=93) and PDTC (n=47) tissue samples diagnosed 1997-2019 at five German tertiary care centers were assessed for PD-L1 expression by immunohistochemistry using Tumor Proportion Score (TPS). FGFR 1-4 mRNA was quantified in 31 ATC and 14 PDTC with RNAscope in-situ hybridization. Normal thyroid tissue (NT) and papillary thyroid carcinoma (PTC) served as controls. Disease specific survival (DSS) was the primary outcome variable. RESULTS PD-L1 TPS≥50% was observed in 42% of ATC and 26% of PDTC specimens. Mean PD-L1 expression was significantly higher in ATC (TPS 30%) than in PDTC (5%; p<0.01) and NT (0%, p<0.001). 53% of PDTC samples had PD-L1 expression ≤5%. FGFR mRNA expression was generally low in all samples but combined FGFR1-4 expression was significantly higher in PDTC and ATC compared to NT (each p<0.001). No impact of PD-L1 and FGFR 1-4 expression was observed on DSS. CONCLUSION High tumoral expression of PD-L1 in a large proportion of ATCs and a subgroup of PDTCs provides a rationale for immune checkpoint inhibition. FGFR expression is low thyroid tumor cells. The clinically observed synergism of PEM with LEN may be caused by immune modulation.
Collapse
MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Humanized/pharmacology
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- B7-H1 Antigen/analysis
- B7-H1 Antigen/antagonists & inhibitors
- Drug Evaluation, Preclinical/methods
- Female
- Germany
- Humans
- Male
- Middle Aged
- Phenylurea Compounds/pharmacology
- Quinolines/pharmacology
- RNA, Messenger/analysis
- Receptors, Fibroblast Growth Factor/antagonists & inhibitors
- Receptors, Fibroblast Growth Factor/genetics
- Thyroid Carcinoma, Anaplastic/chemistry
- Thyroid Carcinoma, Anaplastic/drug therapy
- Thyroid Carcinoma, Anaplastic/pathology
- Thyroid Neoplasms/chemistry
- Thyroid Neoplasms/drug therapy
- Thyroid Neoplasms/pathology
Collapse
Affiliation(s)
- Pia Adam
- Department of Internal Medicine I, Division of Endocrinology/Diabetology, University of Würzburg, Würzburg, Germany
| | - Stefan Kircher
- Institute of Pathology Würzburg, University of Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Iuliu Sbiera
- Department of Internal Medicine I, Division of Endocrinology/Diabetology, University of Würzburg, Würzburg, Germany
| | - Viktoria Florentine Koehler
- Department of Internal Medicine IV, University Hospital of Munich, LMU Munich, Munich, Germany
- Department of Medicine I, Goethe University Hospital, Frankfurt, Germany
| | - Elke Berg
- Department of Internal Medicine IV, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Thomas Knösel
- Institute of Pathology LMU, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Benjamin Sandner
- Department of Internal Medicine III, University Hospital of Leipzig, Leipzig, Germany
| | - Wiebke Kristin Fenske
- Department of Internal Medicine III, University Hospital of Leipzig, Leipzig, Germany
- Department of Internal Medicine I, Division of Endocrinology/Diabetology, University of Bonn, Bonn, Germany
| | - Hendrik Bläker
- Institute of Pathology Leipzig, University Hospital of Leipzig, Leipzig, Germany
| | - Constantin Smaxwil
- Department of Endocrine Surgery, Diakonie-Klinikum Stuttgart, Stuttgart, Germany
| | - Andreas Zielke
- Department of Endocrine Surgery, Diakonie-Klinikum Stuttgart, Stuttgart, Germany
| | - Bence Sipos
- Medical Oncology and Pulmonology, University Hospital, Tübingen, Germany
| | - Stephanie Allelein
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Matthias Schott
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Christine Dierks
- Department of Internal Medicine IV, Division of Oncology and Hematology, University of Halle (Saale), Halle (Saale), Germany
| | - Christine Spitzweg
- Department of Internal Medicine IV, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Martin Fassnacht
- Department of Internal Medicine I, Division of Endocrinology/Diabetology, University of Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Matthias Kroiss
- Department of Internal Medicine I, Division of Endocrinology/Diabetology, University of Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
- Department of Internal Medicine IV, University Hospital of Munich, LMU Munich, Munich, Germany
- *Correspondence: Matthias Kroiss,
| |
Collapse
|
6
|
Fries CM, Bae YJ, Rayes N, Sandner B, Isermann B, Stumvoll M, Fagotto V, Reincke M, Bidlingmaier M, Mandy V, Kratzsch J, Fenske WK. Prospective evaluation of aldosterone LC-MS/MS-specific cutoffs for the saline infusion test. Eur J Endocrinol 2020; 183:191-201. [PMID: 32460235 DOI: 10.1530/eje-20-0030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/26/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) has become state of the art for the quantitative analysis of steroid hormones. Although method comparisons show that aldosterone measurement using LC-MS/MS yields considerably lower levels than immunoassays (IAs), method-specific cutoff values for primary aldosteronism (PA) are largely missing. Objective of this study was to analyze the diagnostic accuracy of proposed LC-MS/MS-specific cutoff values for the saline infusion test (SIT). DESIGN AND METHODS From 2016 to 2019, 104 consecutive patients suspected of PA underwent the SIT and captopril challenge test in the tertiary medical center at the University Hospital of Leipzig, Germany. Patients with positive case confirmation underwent adrenal imaging and adrenal venous sampling for subtype classification. RESULTS Overall, proposed assay-specific PACLC-MS/MS cutoff values for the SIT achieved higher diagnostic accuracy than established PACIA values with a sensitivity and specificity of 87.5% (95% CI: 71.0-96.5) and 97% (95% CI: 89.6-99.6) for a cutoff of 120 pmol/L and 93.8% (95% CI: 79.2-99.2) and 92.5% (95% CI: 83.4-97.5) for a cutoff of 94 pmol/L. The most accurate post-SIT PACLC-MS/MS cutoff value in this study was 83 pmol/L, yielding a sensitivity and specificity of 96.9% (95% CI: 83.8-99.9) and 92.5% (95% CI: 83.4-97.5), respectively. CONCLUSIONS The present data confirm the need for the implication of lower method-specific aldosterone cutoff values for the diagnosis of PA with LC-MS/MS based aldosterone measurement.
Collapse
Affiliation(s)
- Charlotte Michaela Fries
- Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig, Leipzig, Germany
| | - Yoon Ju Bae
- Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Nada Rayes
- Endocrine Surgery, Department for Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Benjamin Sandner
- Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig, Leipzig, Germany
| | - Berend Isermann
- Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Michael Stumvoll
- Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig, Leipzig, Germany
| | - Valentina Fagotto
- Department of Medicine IV, Klinikum der Universität, Ludwig-Maximilians-Universität, München, Germany
| | - Martin Reincke
- Department of Medicine IV, Klinikum der Universität, Ludwig-Maximilians-Universität, München, Germany
| | - Martin Bidlingmaier
- Department of Medicine IV, Klinikum der Universität, Ludwig-Maximilians-Universität, München, Germany
| | - Vogel Mandy
- Leipzig Research Center for Civilization Diseases (LIFE Child), University of Leipzig, Leipzig, Germany
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Wiebke Kristin Fenske
- Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig, Leipzig, Germany
- Integrated Research and Treatment Centre for Adiposity Diseases, Department of Medicine, University of Leipzig, Leipzig, Germany
| |
Collapse
|
7
|
Jäger IM, Kohlmann J, Simon JC, Sandner B, Tönjes A, Ziemer M. Hypophysitis on immunotherapy with checkpoint inhibitors. J Dtsch Dermatol Ges 2019; 17:1168-1170. [PMID: 31701648 DOI: 10.1111/ddg.13963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Iris Marie Jäger
- Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| | - Johannes Kohlmann
- Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| | - Jan Christoph Simon
- Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| | - Benjamin Sandner
- Department of Endocrinology, Nephrology and Rheumatology, Leipzig University Medical Center, Leipzig, Germany
| | - Anke Tönjes
- Department of Endocrinology, Nephrology and Rheumatology, Leipzig University Medical Center, Leipzig, Germany
| | - Mirjana Ziemer
- Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, Leipzig, Germany
| |
Collapse
|
8
|
Jäger IM, Kohlmann J, Simon JC, Sandner B, Tönjes A, Ziemer M. Hypophysitis unter Immuntherapie mit Checkpoint‐Inhibitoren. J Dtsch Dermatol Ges 2019; 17:1168-1170. [DOI: 10.1111/ddg.13963_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Iris Marie Jäger
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Leipzig
| | - Johannes Kohlmann
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Leipzig
| | - Jan Christoph Simon
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Leipzig
| | - Benjamin Sandner
- Klinik für EndokrinologieNephrologie und RheumatologieUniversitätsklinikum Leipzig
| | - Anke Tönjes
- Klinik für EndokrinologieNephrologie und RheumatologieUniversitätsklinikum Leipzig
| | - Mirjana Ziemer
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Leipzig
| |
Collapse
|
9
|
Abstract
The syndrome of inappropriate antidiuretic hormone secretion (SIADH), also referred to as syndrome of inappropriate antidiuresis (SIAD), is the most common cause of hyponatremia characterized by extracellular hypotonicity and impaired urine dilution in the absence of any recognizable nonosmotic stimuli for the antidiuretic hormone arginine vasopressin (AVP). Hyponatremia in SIADH is primarily the result of excessive water retention caused by a combination of inappropriate antidiuresis and persistent fluid intake in the presence of impaired osmoregulated inhibition of thirst. It is sometimes aggravated by a sodium deficiency caused by a decreased intake or a secondary natriuresis in response to elevated extracellular volume. Inappropriate antidiuresis usually results from endogenous production of AVP that can be either ectopic (from a malignancy) or eutopic (from the hypothalamus/neurohypophysis). Regardless of its origin, different types of osmotic dysregulation of AVP have been reported with possibly fundamental deviations in treatment need and efficacy. A recent quantitative analysis of 50 patients with SIADH, which underwent serial measurements of copeptin during hypertonic saline infusion, revealed five distinct types of osmoregulatory defect ("type A to E") without affiliation to specific underlying diseases. In addition to apparently impaired osmoregulated inhibition of AVP release in the majority of patients, 12% of patients showed an AVP-independent mechanism of inappropriate antidiuresis, whilst 20% of them presented a reverse relation between hormone release and serum osmolality, presumably related to interrupted nonosmotic inhibitory pathways. The interference of these different types of SIAD with clinical presentation and therapy response will be a relevant subject for future research.
Collapse
Affiliation(s)
- W Fenske
- Leipzig University Medical Center, Integrated Research and Treatment Center for Adiposity Diseases, Leipzig, Germany.
| | - B Sandner
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany.
| | - M Christ-Crain
- Department of Endocrinology, University Hospital Basel, University of Basel, Switzerland.
| |
Collapse
|
10
|
Kovacs P, Miehle K, Sandner B, Stumvoll M, Blüher M. Insulin administration acutely decreases vaspin serum concentrations in humans. Obes Facts 2013; 6:86-8. [PMID: 23466514 PMCID: PMC5644680 DOI: 10.1159/000348836] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 07/17/2012] [Indexed: 11/19/2022] Open
Abstract
It has been hypothesized that insulin might mediate meal-related diurnal variation in vaspin serum concentrations. We therefore investigated whether insulin affects serum vaspin levels in humans. Vaspin serum concentrations were determined by ELISA in 10 healthy individuals, who underwent an insulin tolerance test (ITT) for the evaluation of pituitary ACTH and growth hormone reserve. The ITTs were started 08:00 am after an overnight fast with a bolus i.v. insulin dose of 0.15 IU/kg body weight (Actrapid). Blood samples were taken at -15, 0, 15, 30, 60, 90, and 120 min after insulin administration. 15 min after insulin administration, vaspin serum concentrations decreased by 19 ± 6%, continued to decrease by 42 ± 12% at 60 min and returned to 88 ± 7% of initial values 120 min after insulin administration. Our data suggest that meal-related changes in serum vaspin concentrations might be mediated by insulin.
Collapse
Affiliation(s)
- Peter Kovacs
- Department of Medicine, University of Leipzig, Leipzig, Germany.
| | | | | | | | | |
Collapse
|
11
|
Sandner B, Koch CA, Thiery J, Kratzsch J. Serum dexamethasone levels do not correlate with cortisol and body mass index of patients in the low dose dexamethasone suppression test. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-932897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
12
|
Abstract
The ring-opening polymerization of epsilon-caprolactone, delta-valerolactone (VL) and D,L-lactide, respectively, in the presence of different proportions of hydroxyapatite (HA) was catalyzed by stannous (II)octoate (SnOct2) at 130 degrees C and resulted in composites. The lactones were almost completely converted to the polymers within a reaction time of 70 up to 240 min. The number-average molecular weights Mn as determined by size exclusion chromatography decreased with increasing content of HA. The initiating efficiency of HA as calculated from the difference of the polymerization degrees P. obtained with and without HA turned out to be relatively low with ca. 11 to 0.5% for 1 to 80 wt% HA, respectively. For the polymerization of VL, the initiating efficiency of HA was on the average threefold higher. The quantitative proof of non-extractable polymer on HA by means of thermogravimetric analysis, fourier transform infrared spectroscopy with photoacoustic detection and differential scanning calorimetry confirmed the initiating efficiency of HA as mentioned above. This poly(lactone) can be debound from HA by treatment with aqueous HCl. Hence it is assumed to be ionically bound.
Collapse
Affiliation(s)
- E Helwig
- Institute of Technical and Macromolecular Chemistry, Martin-Luther-University, Halle-Wittenberg, Halle/Saale, Germany
| | | | | | | | | | | |
Collapse
|
13
|
Reiche A, Dlubek G, Weinkauf A, Sandner B, Fretwell HM, Alam AA, Fleischer G, Rittig F, Kärger J, Meyer W. Local Free Volume and Structure of Polymer Gel Electrolytes on the Basis of Alternating Copolymers. J Phys Chem B 2000. [DOI: 10.1021/jp994331d] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Reiche
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - G. Dlubek
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - A. Weinkauf
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - B. Sandner
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - H. M. Fretwell
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - A. A. Alam
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - G. Fleischer
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - F. Rittig
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - J. Kärger
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| | - W. Meyer
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, ITA Institut für innovative Technologien GmbH, Köthen, Aussenstelle Halle, Wiesenring 4, D-06210 Lieskau (Halle/S.), Germany, H. H.Wills Physics Laboratory, University of Bristol, Tyndal Avenue, Bristol BS8 1TL, U.K., Fakultät für Physik und Geowissenschaften, Institut für Experimentelle Physik, Universität Leipzig, Linnéstrasse 5, D-04103 Leipzig, Germany, and Max
| |
Collapse
|
14
|
Reiche A, Weinkauf A, Sandner B, Rittig F, Fleischer G. Alternating copolymers for novel polymer electrolytes: the electrochemical properties. Electrochim Acta 2000. [DOI: 10.1016/s0013-4686(99)00340-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
15
|
Kammer S, Albinsky K, Sandner B, Wartewig S. Polymerization of hydroxyalkyl methacrylates characterized by combination of FT-Raman and step-scan FT-i.r. photoacoustic spectroscopy. POLYMER 1999. [DOI: 10.1016/s0032-3861(98)00341-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
16
|
Sandner B, Tübke J, Werther A, Sandner R, Wartewig S, Shashkov S. Ionic association in gel electrolytes of varied polarity as studied by FT Raman spectroscopy. Electrochim Acta 1998. [DOI: 10.1016/s0013-4686(97)10054-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
17
|
Sandner B, Weinkauf A, Reiche A, Siury K, Tübke J, Wartewig S, Shashkov S. Properties of gel electrolytes based on crosslinked copolymers of oligo(ethylene glycol) dimethacrylate and cyanomethyl methacrylate. Electrochim Acta 1998. [DOI: 10.1016/s0013-4686(97)10028-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
18
|
Reiche A, Tübke J, Sandner R, Werther A, Sandner B, Fleischer G. Cationic transport in gel electrolytes on basis of oligo(ethylene glycol) dimethacrylate. Electrochim Acta 1998. [DOI: 10.1016/s0013-4686(97)10079-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
19
|
Reiche A, Cramer T, Fleischer G, Sandner R, Sandner B, Kremer F, Kärger J. Ionic Conductivity−Structure Property Relationship in Gel Electrolytes on the Basis of Oligo(ethylene glycol)23 Dimethacrylate Plasticized with Oligo(ethylene glycol)11 Dimethyl Ether. J Phys Chem B 1998. [DOI: 10.1021/jp972537d] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Reiche
- Institute of Technical and Macromolecular Chemistry, Martin-Luther-University Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, and Faculty of Physics and Geosciences, University of Leipzig, Linne'strasse 5, D-04103 Leipzig, Germany
| | - T. Cramer
- Institute of Technical and Macromolecular Chemistry, Martin-Luther-University Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, and Faculty of Physics and Geosciences, University of Leipzig, Linne'strasse 5, D-04103 Leipzig, Germany
| | - G. Fleischer
- Institute of Technical and Macromolecular Chemistry, Martin-Luther-University Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, and Faculty of Physics and Geosciences, University of Leipzig, Linne'strasse 5, D-04103 Leipzig, Germany
| | - R. Sandner
- Institute of Technical and Macromolecular Chemistry, Martin-Luther-University Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, and Faculty of Physics and Geosciences, University of Leipzig, Linne'strasse 5, D-04103 Leipzig, Germany
| | - B. Sandner
- Institute of Technical and Macromolecular Chemistry, Martin-Luther-University Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, and Faculty of Physics and Geosciences, University of Leipzig, Linne'strasse 5, D-04103 Leipzig, Germany
| | - F. Kremer
- Institute of Technical and Macromolecular Chemistry, Martin-Luther-University Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, and Faculty of Physics and Geosciences, University of Leipzig, Linne'strasse 5, D-04103 Leipzig, Germany
| | - J. Kärger
- Institute of Technical and Macromolecular Chemistry, Martin-Luther-University Halle-Wittenberg, Geusaer Strasse, D-06217 Merseburg, Germany, and Faculty of Physics and Geosciences, University of Leipzig, Linne'strasse 5, D-04103 Leipzig, Germany
| |
Collapse
|
20
|
Sandner B, Baudach S, Davy KW, Braden M, Clarke RL. Synthesis of BISGMA derivatives, properties of their polymers and composites. J Mater Sci Mater Med 1997; 8:39-44. [PMID: 15348840 DOI: 10.1023/a:1018590229166] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
2,2-Bis[4-(2 hydroxy-3-methacryloyloxy propoxy) phenyl] propane (BisGMA) is commonly the main component of the organic matrix of dental filling materials. Derivatives of BisGMA were synthesized from the diglycidyl ether of Bisphenol A (DGEBA) by the parallel reaction with methacrylic acid (MAA) and isophthalic acid as well as mixtures of methacrylic anhydride with palmitic acid and acetic anhydride, respectively, whereby MAA was partially substituted by the latter components. By this technique the structure of BisGMA monomer could be varied with regard to weight content of C=C double bonds, the hydrophilicity of the molecule as well as its flexibility or stiffness. Free-radical initiated homopolymerization of the monomers was carried out at 80 degrees C. Composites, prepared from mixtures of monomers with triethylene glycol dimethacrylate (TEGDMA) filled with 76% silica were room temperature polymerized using both redox and photoinitiated techniques. The polymerization shrinkage, diffusion coefficients of water in the crosslinked polymer, and some thermal properties of the homopolymers were determined. Mechanical properties of the resulting polymers and composites are compared to those of BisGMA itself.
Collapse
Affiliation(s)
- B Sandner
- Institut für Technische und Makromolekulare Chemie, Martin-Luther-Universität Halle-Wittenberg, D-06217 Merseburg, Germany
| | | | | | | | | |
Collapse
|
21
|
|
22
|
|
23
|
|
24
|
Sandner B, Krämer S, An BT. Einfluß von Molekülwechselwirkungen auf die radikalische Copolymerisation. III. UV-spektroskopische Bestimmung von EDA-Komplexbildungskonstanten in Comonomersystemen von Acrylnitril-Styrol Sowie deren α-Methylhomologen. ACTA ACUST UNITED AC 1979. [DOI: 10.1002/actp.1979.010300509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
25
|
Sandner B. H.-J. Cantow, G. Dall'asta, J. D. Ferry et al. (Hrsg.). Advances in polymer science. Vol. 20. New scientific aspects. IV, 227 Seiten, 95 Figuren, Lwd. Preis DM 69, -; US $ 28.30 Springer-Verlag Berlin, Heidelberg, New York 1976. Krist Techn 1977. [DOI: 10.1002/crat.19770120519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|