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Qu D, Schürmann P, Rothämel T, Fleßner J, Rehberg D, Dörk T, Klintschar M. Revisiting the association of sudden infant death syndrome (SIDS) with polymorphisms of NHE3 and IL13. Int J Legal Med 2024; 138:743-749. [PMID: 38091065 PMCID: PMC11003888 DOI: 10.1007/s00414-023-03139-2] [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: 10/04/2023] [Accepted: 11/20/2023] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Disturbances of the central nervous system and immune system are thought to play a role in sudden infant death syndrome (SIDS). Dysregulated expression of sodium (Na+)/hydrogen (H+) exchanger 3 (NHE3) in the brainstem and of interleukin 13 (IL13) in the lungs has been observed in SIDS. An association of single-nucleotide polymorphisms (SNPs) in NHE3 and IL13 with SIDS has been proposed, but controversial results were reported. Therefore, there is a need to revisit the association of SNPs in NHE3 and IL13 with SIDS. METHODS Genotyping of rs71597645 (G1131A) and rs2247114 (C2405T) in NHE3 and rs20541 (+ 4464A/G) in IL13 was performed in 201 SIDS cases and 338 controls. A meta-analysis was performed after merging our data with previously published data (all from European populations). RESULTS Polymorphisms rs2247114 (NHE3) and rs20541 (IL13) were significantly associated with SIDS overall and in multiple subgroups, but no association was found for rs71597645 (NHE3). After combining our data with previously published data, a fixed-effect meta-analysis showed that rs2247114 in NHE3 retained a significant association with SIDS under a recessive model (OR 2.78, 95%CI 1.53 to 5.06; p = 0.0008). CONCLUSION Our findings suggest an association of NHE3 variant rs2247114 (C2405T), though not rs71597645 (NHE3), with SIDS. A potential role of rs20541 (IL13) still has to be elucidated. Especially NHE3 seems to be an interesting topic for future SIDS research.
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Affiliation(s)
- Dong Qu
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Peter Schürmann
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thomas Rothämel
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jessica Fleßner
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Daniela Rehberg
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Dziadosz M, Rosenberger W, Bolte K, Klintschar M, Teske J. Phenibut screening and quantification with liquid chromatography-tandem mass spectrometry and its application to driving cases. J Forensic Sci 2024; 69:725-729. [PMID: 38146811 DOI: 10.1111/1556-4029.15455] [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] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023]
Abstract
An analytical strategy for identification by an LC-MS/MS multitarget screening method and a suitable LC-MS/MS based quantification were developed for the psychotropic drug phenibut. The samples analyzed were collected during traffic control and were associated with driving under the influence of drugs. A positive sample for phenibut was identified in a single case of driving under the influence. The quantification revealed a drug concentration of 1.9 μg/mL. An interaction with blood alcohol (BAC = 0.10%) was discussed as the explanation of the way of driving and deficit manifestations observed (swaying, nystagmus, quivering of the eyelid, and reddened eyes). According to the available information, the quantified phenibut concentration could be explained by an intake of four tablets (self-reported) during the day containing 250 mg of the drug. Chromatography was performed with a Luna 5 μm C18 (2) 100 A, 150 mm × 2 mm analytical column, and a buffer system consisted of 10 mM ammonium acetate and 0.1% acetic acid (v/v) included in mobile phases marked as A (H2 O/methanol = 95/5, v/v) and B (H2 O/methanol = 3/97, v/v). An effective limit of detection (LOD = 0.002 μg/mL) could be achieved for the multitarget screening method. The quantification of phenibut was performed on a second LC-MS/MS system with LOD/LOQ values of 0.22/0.40 μg/mL. Since phenibut quantification data are rare, the presented information can be used with caution for evaluation of positive cases in the future.
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Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | | | - Katarina Bolte
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Jörg Teske
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
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Qu D, Preuss V, Hagemeier L, Radomsky L, Beushausen K, Keil J, Nora S, Vennemann B, Falk CS, Klintschar M. Age-related cytokine imbalance in the thymus in sudden infant death syndrome (SIDS). Pediatr Res 2024; 95:949-958. [PMID: 37679518 PMCID: PMC10920197 DOI: 10.1038/s41390-023-02809-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Sudden infant death syndrome (SIDS) has been considered to be triggered by a combination of underlying immune dysregulation and infections. The thymus is a crucial lymphatic organ responsible for T cell development in infancy. We hypothesized that an altered thymic immune status may be detectable by intrathymic cytokine profiling in SIDS. METHODS 27 cytokines in protein lysates of thymus tissue and thymus weights were assessed in 26 SIDS cases and 16 infants who died of other reasons. RESULTS Seventeen out of 27 cytokines were increased in thymic tissue of SIDS compared to controls without infections, and the most significant discrepancy was in infants younger than 20 weeks. The thymic cytokine profiles in SIDS cases were similar to those in controls with severe infection; however, the magnitude of the cytokine concentration elevation in SIDS was less pronounced, indicating sub-clinical infections in SIDS. In contrast to SIDS, intrathymic cytokine concentrations and thymus weight were increased with age in control children. CONCLUSIONS Elevated thymic cytokine expression and thymus weight, as well as impaired age-related alterations in SIDS, may be influenced by subclinical infection, which may play a role in initiating SIDS in infants with a compromised immune response. IMPACT STATEMENT Increased thymic weight and cytokine concentration may suggest possible subclinical infection in SIDS. Elevated thymic weight and cytokine concentration mainly in SIDS cases aged <20 weeks. Age-related impairment in the thymic weight and cytokine expression may be impaired by subclinical infection in SIDS.
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Affiliation(s)
- Dong Qu
- Institute of Legal Medicine, Hannover Medical School, Hannover, Germany
| | - Vanessa Preuss
- Institute of Legal Medicine, Hannover Medical School, Hannover, Germany
| | - Lars Hagemeier
- Institute of Legal Medicine, Hannover Medical School, Hannover, Germany
| | - Lena Radomsky
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research, DZIF, TTU-IICH, Hannover-Braunschweig site, Hannover, Germany
| | - Kerstin Beushausen
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Jana Keil
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Schaumann Nora
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Christine S Falk
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research, DZIF, TTU-IICH, Hannover-Braunschweig site, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Hannover, Germany.
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Dziadosz M, Rosenberger W, Klintschar M, Teske J. The analysis of ramipril/ramiprilat concentration in human serum with liquid chromatography-tandem mass spectrometry - interpretation of high concentrations for the purposes of forensic toxicology. Forensic Sci Med Pathol 2024; 20:100-105. [PMID: 37060536 PMCID: PMC10944385 DOI: 10.1007/s12024-023-00621-6] [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] [Accepted: 03/27/2023] [Indexed: 04/16/2023]
Abstract
Ramipril is a popular angiotensin-converting enzyme inhibitor applied in the treatment of hypertension. Its therapeutic effect is oriented on the concentration of the active metabolite ramiprilat. The information about toxic drug levels is missing in the literature. Therefore, the aim of this work was an indication of possible toxic ranges based on the analysis of real samples with high ramiprilat concentrations. For these purposes, an appropriate analytical LC-MS/MS method was developed and validated according to forensic guidelines and applied in the routine. Most real samples targeted for ramipril/ramiprilat were associated with the typical therapeutic drug range of 1-40 ng/mL described in the literature. However, higher drug levels with ramiprilat concentrations above 100 ng/mL could also be observed infrequently in cases of driving under the influence of drugs or attempted suicides. To the best of the author's knowledge, this is the first time antemortem ramipril and ramiprilat concentrations associated with driving under the influence of drugs and suicide attempts were discussed from a forensic point of view. The collected data enabled an indication of the ramiprilat toxic concentration range from about 600 ng/mL to at least 3500 ng/mL. The toxic concentration range discussed can be applied in the forensic practice as a reference for future cases.
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Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Wolfgang Rosenberger
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jörg Teske
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Chung B, Wang Y, Thiel M, Rostami F, Rogoll A, Hirsch VG, Malik Z, Bührke A, Bär C, Klintschar M, Schmitto JD, Vogt C, Werlein C, Jonigk D, Bauersachs J, Wollert KC, Kempf T. Pre-emptive iron supplementation prevents myocardial iron deficiency and attenuates adverse remodelling after myocardial infarction. Cardiovasc Res 2023; 119:1969-1980. [PMID: 37315201 DOI: 10.1093/cvr/cvad092] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/20/2023] [Accepted: 04/08/2023] [Indexed: 06/16/2023] Open
Abstract
AIMS Heart failure (HF) after myocardial infarction (MI) is a major cause of morbidity and mortality. We sought to investigate the functional importance of cardiac iron status after MI and the potential of pre-emptive iron supplementation in preventing cardiac iron deficiency (ID) and attenuating left ventricular (LV) remodelling. METHODS AND RESULTS MI was induced in C57BL/6J male mice by left anterior descending coronary artery ligation. Cardiac iron status in the non-infarcted LV myocardium was dynamically regulated after MI: non-haem iron and ferritin increased at 4 weeks but decreased at 24 weeks after MI. Cardiac ID at 24 weeks was associated with reduced expression of iron-dependent electron transport chain (ETC) Complex I compared with sham-operated mice. Hepcidin expression in the non-infarcted LV myocardium was elevated at 4 weeks and suppressed at 24 weeks. Hepcidin suppression at 24 weeks was accompanied by more abundant expression of membrane-localized ferroportin, the iron exporter, in the non-infarcted LV myocardium. Notably, similarly dysregulated iron homeostasis was observed in LV myocardium from failing human hearts, which displayed lower iron content, reduced hepcidin expression, and increased membrane-bound ferroportin. Injecting ferric carboxymaltose (15 µg/g body weight) intravenously at 12, 16, and 20 weeks after MI preserved cardiac iron content and attenuated LV remodelling and dysfunction at 24 weeks compared with saline-injected mice. CONCLUSION We demonstrate, for the first time, that dynamic changes in cardiac iron status after MI are associated with local hepcidin suppression, leading to cardiac ID long term after MI. Pre-emptive iron supplementation maintained cardiac iron content and attenuated adverse remodelling after MI. Our results identify the spontaneous development of cardiac ID as a novel disease mechanism and therapeutic target in post-infarction LV remodelling and HF.
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Affiliation(s)
- Bomee Chung
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Yong Wang
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Marleen Thiel
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Fatemeh Rostami
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Anika Rogoll
- Institute for Analytical Chemistry, TU Bergakademie, Leipziger Straße 29, 09599 Freiberg, Germany
| | - Valentin G Hirsch
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Zulaikha Malik
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Anne Bührke
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Michael Klintschar
- Institute of Forensic Medicine, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Jan D Schmitto
- Department of Cardiac-, Thoracic-, Transplantation, and Vascular Surgery, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Carla Vogt
- Institute for Analytical Chemistry, TU Bergakademie, Leipziger Straße 29, 09599 Freiberg, Germany
| | - Christopher Werlein
- Institute of Pathology and German Centre for Lung Research, Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Danny Jonigk
- Institute of Pathology and German Centre for Lung Research, Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Kai C Wollert
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Tibor Kempf
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
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Klintschar M, Wöllner K, Hagemeier L, Engelmann TA, Mahlmann J, Lunow A, Wolff-Maras R. Pulmonary thromboembolism and obesity in forensic pathologic case work. Forensic Sci Med Pathol 2023; 19:192-197. [PMID: 36943647 PMCID: PMC10329082 DOI: 10.1007/s12024-023-00602-9] [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] [Accepted: 02/22/2023] [Indexed: 03/23/2023]
Abstract
328 autopsy cases of fatal pulmonary thromboembolism (PE) were compared to 984 age- and sex-matched controls to evaluate the association between obesity and PE in a forensic context. Both PE and control cases had a mean age of 67,8 years (male 62,9 years, females 71,7 years). The percentage of morbidly obese persons with a body mass index (BMI) of above 40 or abdominal subcutaneous adipose tissue of above 4 cm was higher in the PE group (8,39% vs. 4,67% and 29.45% vs. 23.40%, respectively). On the other side, that of very slim persons (BMI below 18.5 or adipose tissue below 3 cm) was significantly smaller (4,27% vs. 7,52% and 47.55% vs. 56,60%). We thus found a strong association between being overweight and death from PE, while slim persons seem to be at an advantage. As the group of underweight persons includes those suffering from chronic diseases with reduced mobility or hypercoagulability (e.g. tumor kachexia or sarkopenia due to immobilisation), this finding is to some extent unexpected.
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Affiliation(s)
- Michael Klintschar
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Kirsten Wöllner
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Lars Hagemeier
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Theresa A Engelmann
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Jan Mahlmann
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Alessia Lunow
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Roman Wolff-Maras
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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Meyer-Bockenkamp F, Proskynitopoulos PJ, Glahn A, Muschler M, Hagemeier L, Preuss V, Klintschar M, Achenbach J, Frieling H, Rhein M. Cytosine methylation in GABA B1 receptor identifies alcohol-related changes for men in blood and brain tissues. Alcohol Alcohol 2023; 58:308-314. [PMID: 37041103 DOI: 10.1093/alcalc/agad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/13/2023] Open
Abstract
AIMS Alcohol use alters the reward signaling processes contributing to the development of addiction. We studied the effects of alcohol use disorder (AUD) on brain regions and blood of deceased women and men to examine sex-dependent differences in epigenetic changes associated with AUD. We investigated the effects of alcohol use on the gene promoter methylation of GABBR1 coding for GABAB receptor subunit 1 in blood and brain. METHODS We chose six brain regions associated with addiction and the reward pathway (nucleus arcuatus, nucleus accumbens, the mamillary bodies, amygdala, hippocampus and anterior temporal cortex) and performed epigenetic profiling of the proximal promoter of the GABBR1 gene of post-mortem brain and blood samples of 17 individuals with AUD pathology (4 female, 13 male) and 31 healthy controls (10 female, 21 male). RESULTS Our results show sex-specific effects of AUD on GABBR1 promoter methylation. Especially, CpG -4 showed significant tissue-independent changes and significantly decreased methylation levels for the AUD group in the amygdala and the mammillary bodies of men. We saw prominent and consistent change in CpG-4 across all investigated tissues. For women, no significant loci were observed. CONCLUSION We found sex-dependent differences in GABBR1 promoter methylation in relation to AUD. CpG-4 hypomethylation in male individuals with AUD is consistent for most brain regions. Blood shows similar results without reaching significance, potentially serving as a peripheral marker for addiction-associated neuronal adaptations. Further research is needed to discover more contributing factors in the pathological alterations of alcohol addiction to offer sex-specific biomarkers and treatment.
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Affiliation(s)
- Fiona Meyer-Bockenkamp
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl- Neuberg Str. 1, 30625 Hannover, Germany
| | - Phileas J Proskynitopoulos
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl- Neuberg Str. 1, 30625 Hannover, Germany
| | - Alexander Glahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl- Neuberg Str. 1, 30625 Hannover, Germany
| | - Marc Muschler
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl- Neuberg Str. 1, 30625 Hannover, Germany
| | - Lars Hagemeier
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany
| | - Vanessa Preuss
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany
| | - Johannes Achenbach
- Department of Anesthesiology and Intensive Care Medicine, Pain Clinic, KRH Hannover Nordstadt, Haltenhoffstraße 41, 30167 Hannover, Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl- Neuberg Str. 1, 30625 Hannover, Germany
| | - Mathias Rhein
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl- Neuberg Str. 1, 30625 Hannover, Germany
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Uzuntas E, Schürmann P, Rothämel T, Dörk T, Klintschar M. Polymorphisms of the hypothalamic-pituitary-adrenal axis may lead to an inadequate response to stress and contribute to sudden infant death syndrome. Acta Paediatr 2023. [PMID: 36945818 DOI: 10.1111/apa.16772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/03/2023] [Accepted: 03/20/2023] [Indexed: 03/23/2023]
Abstract
AIM Impaired resilience to stress may be a factor in sudden infant death syndrome (SIDS). However, no comprehensive studies have been performed on polymorphisms that are relevant to the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the stress hormone cortisol. METHODS We analysed 22 relevant single nucleotide polymorphisms (SNPs) in 206 anonymised SIDS cases who died at a mean of 131 days (range 5-343) and 256 adult controls who were recruited from paternity testing cases. Additional stratified analyses were performed for sex, age and season of death. Both the cases and the controls were Caucasian. RESULTS Variants for rs2235543 (HSD11B1), rs3779250 (CRHR2) were associated with SIDS in the overall analysis, and borderline for rs2446432 (CRH), at least before corrections for multiple testing. A combination of these three variants was observed in 52.9% of SIDS cases but only 43.0% of controls (p= 0.039). Five or more variants showed an association in the subgroups. CONCLUSION Our findings suggest that the HPA axis influences SIDS and supports the hypothesis that an inadequate stress response may add to the risk. The associated variants for rs2235543, rs3779250 and rs2446432 appeared to decrease the cortisol concentration and impair an appropriate stress response.
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Affiliation(s)
- Elanur Uzuntas
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Peter Schürmann
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Thomas Rothämel
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
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Arfmann W, Achenbach J, Meyer-Bockenkamp F, Proskynitopoulos PJ, Groh A, Muschler MAN, Glahn A, Hagemeier L, Preuss V, Klintschar M, Frieling H, Rhein M. Comparing DRD2 Promoter Methylation Between Blood and Brain in Alcohol Dependence. Alcohol Alcohol 2023; 58:216-223. [PMID: 36747480 DOI: 10.1093/alcalc/agad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 02/08/2023] Open
Abstract
AIMS The dopamine receptor D2 (DRD2) is substantially involved in several forms of addiction. In addition to genetic polymorphisms, epigenetic mechanisms have emerged as an important means of regulation. Previously, DRD2 hypo- and hyper-methylation have been observed in alcohol use disorder (AUD). Blood samples are commonly used as a surrogate marker of epigenetic alterations in epigenetic research, but few specific comparisons between blood and brain tissue samples in AUD exist. METHODS We used post-mortem brain tissue samples of 17 deceased patients with AUD and 31 deceased controls to investigate the relationship between blood and brain methylation of the DRD2 promoter. RESULTS When investigating individual cytosine methylation sites (CpG), several significant differences were found in the nucleus accumbens and hippocampus in the study population. Investigating binding sites with significant differences in methylation levels revealed hypomethylated CpGs targeting mainly activating transcription factors. CONCLUSION These findings support an altered transcription of the DRD2 gene in AUD specimens with a consecutively changed reward response in the brain. While methylation between specific brain regions and blood is comparable, our study further suggests that blood methylation cannot provide meaningful perspectives on DRD2 promoter methylation in the brain.
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Affiliation(s)
- Wiebke Arfmann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Johannes Achenbach
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
- Department of Anesthesiology and Intensive Care Medicine, Pain Clinic, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Fiona Meyer-Bockenkamp
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Phileas J Proskynitopoulos
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Adrian Groh
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Marc A N Muschler
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Alexander Glahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Lars Hagemeier
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Vanessa Preuss
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Mathias Rhein
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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10
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Qu D, Schürmann P, Rothämel T, Dörk T, Klintschar M. Variants in genes encoding the SUR1-TRPM4 non-selective cation channel and sudden infant death syndrome (SIDS): potentially increased risk for cerebral edema. Int J Legal Med 2022; 136:1113-1120. [PMID: 35474489 PMCID: PMC9170623 DOI: 10.1007/s00414-022-02819-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/21/2022] [Indexed: 11/28/2022]
Abstract
Increasing evidence suggests that brain edema might play an important role in the pathogenesis of sudden infant death syndrome (SIDS) and that variants of genes for cerebral water channels might be associated with SIDS. The role of the sulfonylurea receptor 1 (SUR1)-transient receptor potential melastatin 4 (TRPM4) non-selective cation channel in cerebral edema was demonstrated by extensive studies. Therefore, we hypothesized that variants at genes of the SUR1-TRPM4 channel complex might be linked to SIDS. Twenty-four polymorphisms in candidate genes involved in the SUR1-TRPM4 non-selective cation channel were investigated in 185 SIDS cases and 339 controls. One (rs11667393 in TRPM4) of these analyzed SNPs reached nominal significance regarding an association with SIDS in the overall analysis (additive model: p = 0.015, OR = 1.438, 95% CI = 1.074-1.925; dominant model: p = 0.036; OR = 1.468, 95% CI = 1.024-2.106). In the stratified analysis, further 8 variants in ABCC8 (encoding SUR1) or TRPM4 showed pronounced associations. However, none of the results remained significant after correction for multiple testing. This preliminary study has provided the first evidence for a genetic role of the SUR1-TRPM4 complex in the etiology of SIDS, and we suggest that our initial results should be evaluated by further studies.
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Affiliation(s)
- Dong Qu
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Peter Schürmann
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thomas Rothämel
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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11
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Greer M, Mueller C, Vagi R, Wolf-Maras R, Klintschar M, Jaeger B, Schwerk N, Fuehner T, Salman J, Hoeper M, Haverich A, Ius F. Out of the Frying-Pan and into the Fire: Transplant Candidate Selection in Acute Lung Failure Due to SARS-CoV-2 Infection. J Heart Lung Transplant 2022. [PMCID: PMC8988482 DOI: 10.1016/j.healun.2022.01.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The COVID-19 pandemic led to unprecedented rates of acute lung failure (ALF), and a rise in lung transplantation (LTx) referrals. Data on LTx in ALF is limited to LTx outcomes, and the unpredictable course of SARS-CoV-2 makes candidate selection challenging. This study summarizes our experiences, in both patients transplanted and those we declined. Methods LTx referrals for ALF due to SARS-CoV-2 between 01Apr20-01Oct21 were reviewed. Set parameters were collected prospectively. Acceptance criteria reflected previous guidance. Cases were discussed at our multi-disciplinary meeting and suitable candidates evaluated at source before transfer for consent and listing. Internal follow-up and external data from declined patients were retrospectively analysed, with survival to discharge and length of hospital stay as end-points. Results 45 patients were referred (78% male). Median age was 55.8 [IQR 47.6-59.8] years. 36 (80%) required both mechanical ventilation and vvECMO, of median duration 46 [31-82] and 34 [24-72] days respectively. Consolidation was the commonest CT finding (47%). Bacterial colonisation (23/45, 51%), coagulopathy (21/45, 47%) and hepatic dysfunction (11/45, 24%) were common. Twenty-two patients were conscious, of whom 21 were evaluated. Five patients died during evaluation, from either sepsis or bleeding. One failed evaluation, and one withdrew consent. Six patients improved, making urgent LTx unnecessary, with 5 attending our review clinic. Of the 8 patients successfully evaluated, one died unexpectantly awaiting transfer, one improved at listing and a further patient died of sepsis after listing. Three patients underwent LTx, all being discharged home at 3 months post-LTx. Conclusion LTx candidate selection in critically ill SARS-CoV2 patients is challenging. Late recovery, particularly in non-fibrotic ALF is not unusual. Decision-making needs to include “acceptable morbidity” as a prelude to delayed evaluation and perhaps listing. More data is needed about declined candidates, particularly unweanable sedated patients with single-organ failure. Even successful awake recipients may experience significant psychological injury, underlining previous arguments in sedated patients. Equity to all candidates needs consideration, given the extraordinary demands on organ availability and care resources.
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12
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Preuss V, Wöllner K, Vennemann B, Fieguth A, Hagemeier L, Klintschar M. Fatal anogenital exenteration of the intestine. Forensic Sci Med Pathol 2022; 18:64-68. [PMID: 34677793 PMCID: PMC8921022 DOI: 10.1007/s12024-021-00433-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 12/01/2022]
Abstract
A case of a sadistically motivated homicide with extraordinary injuries is reported. A 32-year-old woman was naked with signs of severe blunt trauma and oral, vaginal and anal penetration. At the crime scene, the intestine lay next to the woman without connection to the body. During the trial before the criminal court, the perpetrator admitted fisting and inserting several objects into the vagina, anus and oral cavity. Moreover, after anal and vaginal insertion of the hands, large parts of the intestine were torn and pulled out through the anus and the vagina. The results of the forensic pathological examination and additional investigation are discussed and compared with the pertinent literature. This extraordinary case of a sadistically motivated homicide ended with a final judgment that is extremely rare in German jurisdiction.
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Affiliation(s)
- Vanessa Preuss
- Institute of Forensic Medicine, Hanover Medical School, Oldenburg Division, Pappelallee 4, 26122, Oldenburg, Germany.
| | - Kirsten Wöllner
- Institute of Forensic Medicine, Hanover Medical School, Oldenburg Division, Pappelallee 4, 26122, Oldenburg, Germany
| | - Benedikt Vennemann
- Institute of Forensic Medicine, Hanover Medical School, Oldenburg Division, Pappelallee 4, 26122, Oldenburg, Germany
| | - Armin Fieguth
- Institute of Forensic Medicine, Hanover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Lars Hagemeier
- Institute of Forensic Medicine, Hanover Medical School, Oldenburg Division, Pappelallee 4, 26122, Oldenburg, Germany
| | - Michael Klintschar
- Institute of Forensic Medicine, Hanover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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13
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Arens A, Teske J, Klintschar M, Mischke R, Dziadosz M. Antemortem and postmortem rodenticide analysis in forensic toxicology as a part of an LC-MS/MS-based multi-target screening strategy. Drug Test Anal 2022; 14:1149-1154. [PMID: 34997698 DOI: 10.1002/dta.3222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/23/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 11/07/2022]
Abstract
Since rodenticides represent a substance group relevant in toxicological analyses, the aim of this work was the development of a complex multi-target screening strategy for the identification with liquid chromatography-tandem mass spectrometry. A simple protein precipitation was used as the sample preparation strategy. Further, a Luna 5 μm C18 (2) 100 Å, 150 × 2 mm analytical column was applied for the separation of relevant analytes with a Shimadzu HPLC. Signal detection was performed with a SCIEX API 5500 QTrap MS/MS system. The rodenticides investigated (α-chloralose, brodifacoum, bromadiolone, coumatetralyl, difenacoum, and warfarin) could be incorporated effectively into a multi-target screening strategy covering about 250 substances representing different groups with a limit of detection appropriate for substance identification. The strategy can easily be modified to perform semi-quantitative measurements for this substance group and could be supplemented by quantification based on standard addition.
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Affiliation(s)
- Annabel Arens
- Institute of Legal Medicine, Hannover Medical School, Hannover, Germany
| | - Jörg Teske
- Institute of Legal Medicine, Hannover Medical School, Hannover, Germany
| | | | - Reinhard Mischke
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School, Hannover, Germany
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14
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Dziadosz M, Klintschar M, Teske J. Signal Separated Quantification of γ-Hydroxybutyrate With Liquid Chromatography-Tandem Mass Spectrometry in Human Urine and Serum as an Improvement of the Analyte Adduct Ion Based Quantification. J Anal Toxicol 2021; 46:676-682. [PMID: 34283214 DOI: 10.1093/jat/bkab083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of the work was the development and validation of an LC-MS/MS γ-hydroxybutyrate (GHB) quantification method in urine and human serum by the use of the analyte adduct ion formation strategy. A combined detection with a conventional precursor ion in the negative electrospray mode and additionally GHB adduct ions with both sodium acetate and lithium acetate was in focus. Therefore GHB quantification based on separated MS/MS signals. Two tandem mass spectrometers representing different MS/MS generations (Sciex API 4000 QTrap and Sciex API 5500 QTrap) were used for method validation and comparison. Shimadzu HPLC Systems equipped with a Luna 5 µm C18 (2) 100 A, 150 mm × 2 mm analytical column were applied successfully for sample analyses. Infusion experiments were performed for adduct identification and analyte detection optimisation. Sample preparation could be limited to a simple and fast protein precipitation/sample dilution. An effective signal separated GHB quantification with three independent precursor ions representing separated areas of the mass spectrum was developed, validated according to forensic guidelines and applied in the routine. The developed and applied strategy resulted in a higher safety factor for the analyte quantification performed in the forensic toxicology. A relevant analytical improvement could be achieved with this alternative adduct based GHB analysis since a good correlation of analyte concentrations calculated on the basis of separated signals was stated as useful analytical information.
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Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
| | - Jörg Teske
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
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15
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Rosenberger W, Teske J, Klintschar M, Dziadosz M. Detection of pharmaceuticals in "dirty sprite" using gas chromatography and mass spectrometry. Drug Test Anal 2021; 14:539-544. [PMID: 34142460 DOI: 10.1002/dta.3116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 11/08/2022]
Abstract
Dirty Sprite, also known as "lean" or "purple drank", is a preparation associated with the presence of codeine and promethazine. These drinks, predominantly used by young people, are mixtures of, for example, soft drinks, prescription medicines, and prescription cough syrups. The use of these illicit preparations started in Texas in the 1960s and become popularized in the 1990s. However, the misuse of these cocktails has become more common in other countries to date, for example, in Thailand. Given the illicit nature of these preparations and the lack of information available on the composition of these products, there is a need to identify and quantify the drugs that may be present. Three samples of Dirty Sprite were analyzed using GC-MS after liquid/liquid-extraction under acidic and basic conditions. Since the acidic extraction did not show the detection of relevant substances, samples were alkalized to pH ≥ 9, followed by extraction with 1-chlorobutane. GC-MS screening revealed the identification of codeine, dihydrocodeine, promethazine and impurities of cocaine. A selected ion monitoring method was developed for the quantification of these compounds using lemonade as a calibration matrix. Quantitative analysis showed concentrations of 130-mg/L codeine, 75-mg/L promethazine, and 3.4-mg/L cocaine in sample 1; 74-mg/L promethazine and 91-mg/L dihydrocodeine in sample 2; and 130-mg/L codeine combined with 68-mg/L promethazine in sample 3. The results also illustrate that the consumption of drugs detected in Dirty Sprite samples could lead to health risks given that these prescription medicines are consumed outside the medical environment.
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Affiliation(s)
| | - Jörg Teske
- Hannover Medical School, Institute of Legal Medicine, Hannover, Germany
| | | | - Marek Dziadosz
- Hannover Medical School, Institute of Legal Medicine, Hannover, Germany
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16
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Kanngießer K, Kono N, Suhren JT, Klintschar M. [Case report: death of a 2-year-old girl with postmortem diagnosis of a rare coronary artery vasculitis typical for Kawasaki syndrome]. Rechtsmedizin (Berl) 2021; 32:47-51. [PMID: 33907354 PMCID: PMC8063163 DOI: 10.1007/s00194-021-00482-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/02/2022]
Abstract
Coronary artery autoimmune vasculitis (Kawasaki syndrome) is at least in Germany a very rare condition, that typically manifests in childhood. The symptoms are often unspecific and complications with vascular aneurysms, thrombosis and myocardial infarction can occur. Multiple cases of Kawasaki-like symptoms in children with positive SARS-CoV‑2 test results have been reported during the course of the COVID-19 pandemic the past year.This case study reports on a 2-year-old child who had fever over 6 days and after a temporary improvement, died within 1 day (pre-COVID19 era).The autopsy showed autoimmune vasculitis of the right and left main coronary artery consistent with Kawasaki syndrome with aneurysm formation, acute thrombosis and myocardial infarction.In the case of macroscopically conspicuous dilated and/or thrombosed coronary arteries and/or myocardial infarction in children, a Kawasaki syndrome should be excluded in addition to other differential diagnoses.
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Affiliation(s)
- K Kanngießer
- Institut für Rechtsmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Deutschland
| | - N Kono
- Institut für Rechtsmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Deutschland
| | - J-T Suhren
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Deutschland
| | - M Klintschar
- Institut für Rechtsmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Deutschland
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17
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Bolte K, Dziadosz M, Kono N, Vennemann B, Klintschar M, Teske J. Determination of drugs in exhumed liver and brain tissue after over 9 years of burial by liquid chromatography-tandem mass spectrometry-Part 2: Benzodiazepines, opioids, and further drugs. Drug Test Anal 2021; 13:1318-1330. [PMID: 33723920 DOI: 10.1002/dta.3029] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/05/2022]
Abstract
In this publication, benzodiazepines, opioids, and further drugs were analyzed in exhumed brain and liver tissue samples in 116 cases (total) after 9.5-16.5 years of burial. Solid phase extraction followed by liquid chromatography-tandem mass spectrometry was applied. Data from literature is listed summarizing the detectability of the presented analytes after a certain time of burial. In our study, 60% of the analyzed benzodiazepines, 100% of the opioids, and 82% of further drugs were detectable. Only the benzodiazepines lorazepam, nitrazepam, flunitrazepam, and its metabolite norflunitrazepam, and the drugs butylscopolamine, metronidazole, and omeprazole were not detectable at all. Percentage of positive findings (total, and separately for brain and liver tissue) and postmortem period are listed for each analyte. Correlation of detectability depending on postmortem period and condition of tissue are presented exemplarily for midazolam. No substantial correlation was observed. Despite a long time of burial, most benzodiazepines, opioids, and further drugs were detectable in the examined tissue samples. Our results may be a good support for future exhumations in which toxicological analyses are relevant.
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Affiliation(s)
- Katarina Bolte
- Institute for Forensic Medicine, Hannover Medical School, Hannover, Germany
| | - Marek Dziadosz
- Institute for Forensic Medicine, Hannover Medical School, Hannover, Germany
| | - Naomi Kono
- Institute for Forensic Medicine, Hannover Medical School, Hannover, Germany
| | - Benedikt Vennemann
- Institute for Forensic Medicine, Hannover Medical School, Oldenburg, Germany
| | - Michael Klintschar
- Institute for Forensic Medicine, Hannover Medical School, Hannover, Germany
| | - Jörg Teske
- Institute for Forensic Medicine, Hannover Medical School, Hannover, Germany
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18
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Dziadosz M, Bolte K, Rosenberger W, Klintschar M, Teske J. Interpretation of melperone intoxication: post-mortem concentration distribution and interpretation of intoxication data. Drug Metab Pers Ther 2021; 36:233-237. [PMID: 34412172 DOI: 10.1515/dmpt-2020-0181] [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] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/28/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Since melperone abuse with lethal intoxication is common, expert opinions based on therapeutical and lethal concentration ranges can be considered as important. Because there is a lack of information about fatalities caused by melperone mono-intoxications and data on tissue samples with concentration distribution, the aim of this work is the examination of lethal concentration ranges of melperone and drug quantification in different matrices. METHODS An LC-MS/MS method was applied for analyses performed in blood and tissue samples. Quantification based on standard addition and sample preparation on liquid-liquid extraction with 1-chlorobutane. An appropriate tissue homogenization was performed ahead of extraction with an IKA Ultra-Turrax-Tube-Drive®. A Luna 5 µm C18 (2) 100 Å, 150 × 2 mm analytical column was used for chromatographic separation and the elution was performed with two mobile phases consisted of A (H2O/methanol = 95/5, v/v) and B (H2O/methanol = 3/97, v/v) both with 10 mM ammonium acetate and 0.1% acetic acid. RESULTS A multi-drug LC-MS/MS analytical method developed was applied successfully for melperone quantification in different post-mortem matrices. No analytical problems could be identified during method development and analyses of real samples. The melperone lethal concentration calculated in femoral blood of the drug mono-intoxication investigated was 10 mg/L. Melperone concentration distribution was presented for the first time. CONCLUSIONS The lethal reference concentration of melperone in femoral blood of 17.1 mg/L pointed out in different reference lists should be used with caution. Instead, a lower lethal melperone concentration should be considered. The post-mortem concentration distribution of the drug presented could be helpful in the interpretation of cases where no blood samples are available.
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Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Katarina Bolte
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | | | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Jörg Teske
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
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19
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Dziadosz M, Bolte K, Rosenberger W, Klintschar M, Teske J. Interpretation of melperone intoxication: post-mortem concentration distribution and interpretation of intoxication data. Drug Metab Pers Ther 2021; 0:dmdi-2020-0181. [PMID: 33770824 DOI: 10.1515/dmdi-2020-0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/28/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Since melperone abuse with lethal intoxication is common, expert opinions based on therapeutical and lethal concentration ranges can be considered as important. Because there is a lack of information about fatalities caused by melperone mono-intoxications and data on tissue samples with concentration distribution, the aim of this work is the examination of lethal concentration ranges of melperone and drug quantification in different matrices. METHODS An LC-MS/MS method was applied for analyses performed in blood and tissue samples. Quantification based on standard addition and sample preparation on liquid-liquid extraction with 1-chlorobutane. An appropriate tissue homogenization was performed ahead of extraction with an IKA Ultra-Turrax-Tube-Drive®. A Luna 5 µm C18 (2) 100 Å, 150 × 2 mm analytical column was used for chromatographic separation and the elution was performed with two mobile phases consisted of A (H2O/methanol = 95/5, v/v) and B (H2O/methanol = 3/97, v/v) both with 10 mM ammonium acetate and 0.1% acetic acid. RESULTS A multi-drug LC-MS/MS analytical method developed was applied successfully for melperone quantification in different post-mortem matrices. No analytical problems could be identified during method development and analyses of real samples. The melperone lethal concentration calculated in femoral blood of the drug mono-intoxication investigated was 10 mg/L. Melperone concentration distribution was presented for the first time. CONCLUSIONS The lethal reference concentration of melperone in femoral blood of 17.1 mg/L pointed out in different reference lists should be used with caution. Instead, a lower lethal melperone concentration should be considered. The post-mortem concentration distribution of the drug presented could be helpful in the interpretation of cases where no blood samples are available.
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Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Katarina Bolte
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | | | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Jörg Teske
- Institute of Legal Medicine, Hannover Medical School (MHH), Hannover, Germany
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20
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Abstract
Pulmonary embolism (PE) is a complex multi-factorial disease and represents one manifestation of venous thromboembolism (VTE). Most commonly PE constitutes a complication of VTE’s other clinical presentation deep vein thrombosis (DVT). The majority of studies concerning risk factors do not distinguish between PE and DVT. The risk factors are often estimated to be alike, but the prevalence and the risk associated with the major genetic factor Factor V Leiden differ between the two disease states. We have investigated the association of 22 SNPs with PE in 185 PE case and 375 healthy control subjects. At p = 0.05, eight SNPs presented with nominally significant evidence of association (EOA), although no significantly different genotype distributions remained between cases and controls after Bonferroni correction. Three of these variants (rs1800790, rs3813948, rs6025) showed EOA in the main analysis, and five variants (rs169713, rs1801131, rs4524, rs5985 and rs8176592) demonstrated EOAs in subgroups. Genomic variation modulating Factor V, Factor XIII, Beta fibrinogen (FGB), TFPI or HIVEP1 should be worth to be followed in subsequent studies. The findings of this study support the view that PE represents a complex disease with many factors contributing relatively small effects. Larger sample sizes will be required to reliably detect these small effects.
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Affiliation(s)
- Lisa Meißner
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Peter Schürmann
- Gynaecology Research Unit, Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Lars Hagemeier
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany.
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21
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Bolte K, Dziadosz M, Kono N, Vennemann B, Klintschar M, Teske J. Determination of drugs in exhumed liver and brain tissue after over 9 years of burial by liquid chromatography-tandem mass spectrometry-Part 1: Cardiovascular drugs. Drug Test Anal 2020; 13:595-603. [PMID: 33017092 DOI: 10.1002/dta.2940] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/17/2020] [Accepted: 09/25/2020] [Indexed: 11/06/2022]
Abstract
This paper should serve as support for future exhumations in which an analysis of cardiovascular drugs is issued after over 9 years of burial. Amiodarone, amlodipine, atropine, bisoprolol, cafedrine, clonidine, esmolol, furosemide, hydrochlorothiazide, lisinopril, nifedipine, nitrendipine, phenprocoumon, torsemide verapamil, and xipamide were determined in liver and brain tissue of over 100 cases in which exhumation was performed after over 9 years of burial. Diagrams, showing the detectability depending on postmortem period as well as condition of tissues, are presented for furosemide.
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Affiliation(s)
- Katarina Bolte
- Hannover Medical School, Institute for Forensic Medicine, Hannover, Niedersachsen, Germany
| | - Marek Dziadosz
- Hannover Medical School, Institute for Forensic Medicine, Hannover, Niedersachsen, Germany
| | - Naomi Kono
- Hannover Medical School, Institute for Forensic Medicine, Hannover, Niedersachsen, Germany
| | - Benedikt Vennemann
- Hannover Medical School, Institute for Forensic Medicine, Oldenburg, Niedersachsen, Germany
| | - Michael Klintschar
- Hannover Medical School, Institute for Forensic Medicine, Hannover, Niedersachsen, Germany
| | - Jörg Teske
- Hannover Medical School, Institute for Forensic Medicine, Hannover, Niedersachsen, Germany
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Qu D, Qiao DF, Klintschar M, Qu Z, Yue X. High-throughput 16S rDNA sequencing assisting in the detection of bacterial pathogen candidates: a fatal case of necrotizing fasciitis in a child. Int J Legal Med 2020; 135:399-407. [PMID: 32895762 DOI: 10.1007/s00414-020-02421-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/02/2020] [Indexed: 12/19/2022]
Abstract
Postmortem detection of pathogens in infectious deaths is quite important for diagnosing the cause of death and public health. However, it is difficult to detect possible bacterial pathogens in forensic practice using conventional methods like bacterial culture, especially in cases with putrefaction and antibiotic treatment. We report a fatal case caused by necrotizing fasciitis due to bacterial infection. An 8-year-old girl was found dead during sleep 4 days after a minor trauma to her left knee. The gross autopsy suggested that bacterial soft tissue infection might be the cause of death, and the microscopic examination confirmed the diagnosis. The slight putrefaction found at gross autopsy might interfere through postmortem bacterial translocation and reproduction with bacterial culture. High-throughput 16S rDNA sequencing was employed to identify possible pathogens. Bacterial DNA sequencing results suggested Streptococcus pyogenes and Staphylococcus, typical pathogens of necrotizing fasciitis in the tissue. 16S rDNA sequencing might thus be a useful tool for accurate detection of pathogens in forensic practice.
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Affiliation(s)
- Dong Qu
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, China.,Institute of Legal Medicine, Hannover Medical School, 30625, Hannover, Germany
| | - Dong-Fang Qiao
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, 30625, Hannover, Germany
| | - Zhi Qu
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, 30625, Hannover, Germany
| | - Xia Yue
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, 510515, China.
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23
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Abstract
We report a rare case of fatal intoxication in a 40-year-old man caused by injection of a fluid containing organic mercury, allegedly in an attack with a syringe fixed to the tip of an umbrella. The man suffered from severe neurological symptoms and progressive multiorgan failure and died 10 months later in refractory status epilepticus. Autopsy revealed severe brain atrophy and non-specific kidney damage. Neuropathological examination showed neuronal loss especially in the occipital lobe, distinct granule cell necrosis in the cerebellum and Wallerian degeneration in the brainstem. Postmortem toxicological analysis revealed extremely increased levels of mercury in liver and kidney tissue as well as methylmercury levels in peripheral blood.
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Affiliation(s)
- Anne Albers
- Department of Forensic Medicine, Hannover Medical School, Hannover, Germany
| | - Ursula Gies
- Department of Neuropathology, Medical Centre Bremen-Mitte, Bremen, Germany
| | | | - Michael Klintschar
- Department of Forensic Medicine, Hannover Medical School, Hannover, Germany.
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24
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Serth J, Peters I, Dubrowinskaja N, Reese C, Albrecht K, Klintschar M, Lafos M, Grote A, Becker A, Hennenlotter J, Stenzl A, Tezval H, Kuczyk MA. Age-, tumor-, and metastatic tissue-associated DNA hypermethylation of a T-box brain 1 locus in human kidney tissue. Clin Epigenetics 2020; 12:33. [PMID: 32070431 PMCID: PMC7029553 DOI: 10.1186/s13148-020-0823-x] [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] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/03/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND While a considerable number of tumor-specific hypermethylated loci have been identified in renal cell cancer (RCC), DNA methylation of loci showing successive increases in normal, tumoral, and metastatic tissues could point to genes with high relevance both for the process of tumor development and progression. Here, we report that DNA methylation of a locus in a genomic region corresponding to the 3'UTR of the transcription factor T-box brain 1 (TBR1) mRNA accumulates in normal renal tissues with age and possibly increased body mass index. Moreover, a further tissue-specific increase of methylation was observed for tumor and metastatic tissue samples. RESULTS Biometric analyses of the TCGA KIRC methylation data revealed candidate loci for age-dependent and tumor-specific DNA methylation within the last exon and in a genomic region corresponding to the 3'UTR TBR1 mRNA. To evaluate whether methylation of TBR1 shows association with RCC carcinogenesis, we measured 15 tumor cell lines and 907 renal tissue samples including 355 normal tissues, 175 tissue pairs of normal tumor adjacent and corresponding tumor tissue as well 202 metastatic tissues samples of lung, bone, and brain metastases by the use of pyrosequencing. Statistical evaluation demonstrated age-dependent methylation in normal tissue (R = 0.72, p < 2 × 10-16), association with adiposity (P = 0.019) and tumor-specific hypermethylation (P = 6.1 × 10-19) for RCC tissues. Comparison of tumor and metastatic tissues revealed higher methylation in renal cancer metastases (P = 2.65 × 10-6). CONCLUSIONS Our analyses provide statistical evidence of association between methylation of TBR1 and RCC development and disease progression.
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Affiliation(s)
- Jürgen Serth
- Klinik für Urologie und urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str.1, D-30625, Hannover, Germany.
| | - Inga Peters
- Klinik für Urologie und urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str.1, D-30625, Hannover, Germany
| | - Natalia Dubrowinskaja
- Klinik für Urologie und urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str.1, D-30625, Hannover, Germany
| | - Christel Reese
- Klinik für Urologie und urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str.1, D-30625, Hannover, Germany
| | - Knut Albrecht
- Brandenburgisches Landesinstitut für Rechtsmedizin, Lindstedter Chaussee 6, D-14469, Potsdam, Germany
| | - Michael Klintschar
- Institut für Rechtsmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str.1, D-30625, Hannover, Germany
| | - Marcel Lafos
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str.1, D-30625, Hannover, Germany
| | - Alexander Grote
- Evangelisches Klinikum Bethel, Klinik für Neurochirurgie, Burgsteig 13, D-33617, Bielefeld, Germany
| | - Albert Becker
- Institut für Neuropathologie, Universitätsklinikum Bonn, Sigmund Freud Str. 25, D-53105, Bonn, Germany
| | - Jörg Hennenlotter
- Universitätsklinikum Tübingen, Klinik für Urologie, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Arnulf Stenzl
- Universitätsklinikum Tübingen, Klinik für Urologie, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Hossein Tezval
- Klinik für Urologie und urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str.1, D-30625, Hannover, Germany
| | - Markus A Kuczyk
- Klinik für Urologie und urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str.1, D-30625, Hannover, Germany
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25
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Schmidt N, Schücker K, Krause I, Dörk T, Klintschar M, Hummel S. Genome‐wide SNP typing of ancient DNA: Determination of hair and eye color of Bronze Age humans from their skeletal remains. Am J Phys Anthropol 2020; 172:99-109. [DOI: 10.1002/ajpa.23996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/21/2019] [Accepted: 12/13/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Nicole Schmidt
- Department of Historical Anthropology and Human EcologyUniversity of Göttingen Göttingen Germany
| | - Katharina Schücker
- Department of Historical Anthropology and Human EcologyUniversity of Göttingen Göttingen Germany
- Max‐Planck‐Institute for Biophysical Chemistry Göttingen Germany
| | - Ina Krause
- Department of Historical Anthropology and Human EcologyUniversity of Göttingen Göttingen Germany
| | - Thilo Dörk
- Gynaecological Research UnitHannover Medical School Hannover Germany
| | | | - Susanne Hummel
- Department of Historical Anthropology and Human EcologyUniversity of Göttingen Göttingen Germany
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26
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Abstract
We report on a 56-year-old male who was found dead on railroad tracks, equipped with overhead high-voltage power lines (15,000 V AC). Apparently, the body had been hit by a passing train and completely severed at the mid-abdominal level. Based on this apparently unequivocal finding, the police initially assumed a fatal railway accident or suicide. However, close examination of the deceased's clothes revealed heat damage to at least four overlying layers of clothing in different locations. The rubber soles of his heavy leather shoes showed small holes in blackened areas underneath the toes. Furthermore, both socks revealed tears and fabric defects with burnt rims, again most prominent in the area of the toes. Skin burns, consistent with electric burns, and blistering were detected on the deceased's hands and feet. A broken fishing rod was found in the proximity. On autopsy, multiple injuries caused by severe blunt force with subsequent skull fracture and brain laceration as well as multiple injuries to the spinal column and rib fractures were found and visceral organs displayed multiple lacerations. However, the lack of relevant hematomas argues that these injuries were inflicted postmortem. Histological examination confirmed the presence of electric burns from electrocution. Based on the results of the forensic-pathological examination and additional investigations carried out at the scene of death, we could demonstrate that this highly unusual death was caused by an electrocution after contact of the fishing rod with the high-voltage power line and not by overrunning by the train.
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Affiliation(s)
- Vanessa Preuss
- Oldenburg Division, Institute of Forensic Medicine, Hannover Medical School, Pappelallee 4, 26122, Oldenburg, Germany.
| | - Benedikt Vennemann
- Oldenburg Division, Institute of Forensic Medicine, Hannover Medical School, Pappelallee 4, 26122, Oldenburg, Germany
| | - Michael Klintschar
- Institute of Forensic Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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27
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Savov P, Budde S, Tsamassiotis S, Windhagen H, Klintschar M, Ettinger M. Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation? Arch Orthop Trauma Surg 2020; 140:827-833. [PMID: 32157370 PMCID: PMC7244460 DOI: 10.1007/s00402-020-03394-7] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Computed tomography-based three-dimensional models may allow the accurate determination of the center of rotation, lateral and anterior femoral offsets, and the required implant size in total hip arthroplasty. In this cadaver study, the accuracy of anatomical reconstruction was evaluated using a three-dimensional planning tool. MATERIALS AND METHODS A total of eight hip arthroplasties were performed on four bilateral specimens. Based on a computed tomography scan, the position and size of the prosthesis were templated with respect to the anatomical conditions. RESULTS On average, all parameters were reconstructed to an accuracy of 4.5 mm and lie within the limits recommended in the literature. All prostheses were implanted with the templated size. CONCLUSIONS The exact anatomy of the patient and the required size and position of the prosthesis were precisely analyzed using a templating software. Based on the present findings, the development of template-directed instrumentation is conceivable using this method. However, further technical features (e.g., navigation or robot-assisted surgery) are required for improved precision for implant positioning.
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Affiliation(s)
- P. Savov
- grid.10423.340000 0000 9529 9877Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hanover, Germany
| | - S. Budde
- grid.10423.340000 0000 9529 9877Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hanover, Germany
| | - S. Tsamassiotis
- grid.10423.340000 0000 9529 9877Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hanover, Germany
| | - H. Windhagen
- grid.10423.340000 0000 9529 9877Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hanover, Germany
| | - M. Klintschar
- grid.10423.340000 0000 9529 9877Institute for Forensic Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hanover, Germany
| | - M. Ettinger
- grid.10423.340000 0000 9529 9877Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hanover, Germany
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28
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Leifheit-Nestler M, Kirchhoff F, Nespor J, Richter B, Soetje B, Klintschar M, Heineke J, Haffner D. Fibroblast growth factor 23 is induced by an activated renin-angiotensin-aldosterone system in cardiac myocytes and promotes the pro-fibrotic crosstalk between cardiac myocytes and fibroblasts. Nephrol Dial Transplant 2019; 33:1722-1734. [PMID: 29425341 DOI: 10.1093/ndt/gfy006] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/18/2017] [Indexed: 12/18/2022] Open
Abstract
Background Fibroblast growth factor 23 (FGF23) is discussed as a new biomarker of cardiac hypertrophy and mortality in patients with and without chronic kidney disease (CKD). We previously demonstrated that FGF23 is expressed by cardiac myocytes, enhanced in CKD and induces cardiac hypertrophy via activation of FGF receptor 4 independent of its co-receptor klotho. The impact of FGF23 on cardiac fibrosis is largely unknown. Methods By conducting a retrospective case-control study including myocardial autopsy samples from 24 patients with end-stage CKD and in vitro studies in cardiac fibroblasts and myocytes, we investigated the pro-fibrotic properties of FGF23. Results The accumulation of fibrillar collagens I and III was increased in myocardial tissue of CKD patients and correlated with dialysis vintage, klotho deficiency and enhanced cardiac angiotensinogen (AGT) expression. Using human fibrosis RT2 Profiler PCR array analysis, transforming growth factor (TGF)-β and its related TGF-β receptor/Smad complexes, extracellular matrix remodeling enzymes and pro-fibrotic growth factors were upregulated in myocardial tissue of CKD patients. FGF23 stimulated cell proliferation, migration, pro-fibrotic TGF-β receptor/Smad complexes and collagen synthesis in cultured cardiac fibroblasts. In isolated cardiac myocytes, FGF23 enhanced collagen remodeling, expression of pro-inflammatory genes and pro-survival pathways and induced pro-hypertrophic genes. FGF23 stimulated AGT expression in cardiac myocytes and angiotensin II and aldosterone, as components of the renin-angiotensin-aldosterone system (RAAS), induced FGF23 in cardiac myocytes. Conclusions Our data demonstrate that activated RAAS induces FGF23 expression in cardiac myocytes and thereby stimulates a pro-fibrotic crosstalk between cardiac myocytes and fibroblasts, which may contribute to myocardial fibrosis in CKD.
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Affiliation(s)
- Maren Leifheit-Nestler
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Felix Kirchhoff
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Julia Nespor
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Beatrice Richter
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany.,Department of Medicine and Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Birga Soetje
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
| | - Michael Klintschar
- Institute for Forensic Medicine, Hannover Medical School, Hannover, Germany
| | - Joerg Heineke
- Department of Cardiology and Angiology, Rebirth-Cluster of Excellence, Hannover Medical School, Hannover, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany
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29
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Kerbacher S, Pfeifer M, Riener-Hofer R, Berzlanovich A, Eogan M, Galić Mihic A, Haring G, Hejna P, Höller J, Hostiuc S, Klintschar M, Kováč P, Krauskopf A, Leski S, Malacka M, Schwark T, Sprenger H, Verzeletti A, Vieira DN, Wolf S, Yen K. Overview of clinical forensic services in various countries of the European Union. Forensic Sci Res 2019; 5:74-84. [PMID: 32490313 PMCID: PMC7241523 DOI: 10.1080/20961790.2019.1656881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 11/23/2022] Open
Abstract
Examination of a person who has been a victim of a physical or sexual assault may be very
important for upcoming legal proceedings. In the context of a clinical forensic
examination, physical findings are recorded and biological trace material is gathered and
secured. Ideally, all forensic findings are documented in a detailed report combined with
photographic documentation, which employs a forensic scale to depict the size of the
injuries. However, the integrity of such forensic findings depends particularly on two
factors. First, the examination needs to be conducted professionally to ensure that the
findings are properly admissible as court evidence. Second, the examination should take
place as soon as possible because the opportunity to successfully secure biological
samples declines rapidly with time. Access to low-threshold clinical forensic examinations
is not evenly provided in all member states of the European Union (EU); in some states,
they are not available at all. As part of the JUSTeU! (Juridical
standards for clinical forensic examinations of victims of violence in
Europe) project, the Ludwig Boltzmann Institute for Clinical Forensic
Imaging in Graz, Austria created (in cooperation with its international partner
consortium) a questionnaire: the purpose was to collect information about support for
victims of physical and/or sexual assault in obtaining a low-threshold clinical forensic
examination in various countries of the EU. Our paper provides a summary of the responses
and an overview of the current situation concerning provided clinical forensic
services.
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Affiliation(s)
- Sophie Kerbacher
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Ludwig Boltzmann Gesellschaft, Graz, Austria
| | - Michael Pfeifer
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Ludwig Boltzmann Gesellschaft, Graz, Austria
| | - Reingard Riener-Hofer
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Ludwig Boltzmann Gesellschaft, Graz, Austria
| | | | - Maeve Eogan
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - Anita Galić Mihic
- Institute of Forensic Medicine and Criminalistics, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Gregor Haring
- Department for Forensic Medicine and Deontology, University of Ljubljana, Ljubljana, Slovenia
| | - Petr Hejna
- Department of Forensic Medicine, Charles University and University Hospital, Hradec Kralove, Czech Republic
| | - Johannes Höller
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Ludwig Boltzmann Gesellschaft, Graz, Austria
| | - Sorin Hostiuc
- Department of Legal Medicine, National Institute of Legal Medicine, Bucharest, Romania
| | - Michael Klintschar
- Department for Legal Medicine, Hannover Medical School, Hannover, Germany
| | - Peter Kováč
- Forensic.sk, Inštitút Forenzných Medicínskych Expertíz, Bratislava, Slovakia
| | - Astrid Krauskopf
- Institute of Forensic and Traffic Medicine, University of Heidelberg, Heidelberg, Germany
| | - Simone Leski
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Ludwig Boltzmann Gesellschaft, Graz, Austria
| | - Michal Malacka
- Faculty of Law, Palacký University Olomouc, Olomouc, Czech Republic
| | - Thorsten Schwark
- Department of Forensic Medicine, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Hanna Sprenger
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Ludwig Boltzmann Gesellschaft, Graz, Austria
| | - Andrea Verzeletti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Duarte Nuno Vieira
- Department of Forensic Medicine, Ethics and Medical Law, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sylvia Wolf
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Ludwig Boltzmann Gesellschaft, Graz, Austria
| | - Kathrin Yen
- Institute of Forensic and Traffic Medicine, University of Heidelberg, Heidelberg, Germany
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30
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Korf-Klingebiel M, Reboll MR, Grote K, Schleiner H, Wang Y, Wu X, Klede S, Mikhed Y, Bauersachs J, Klintschar M, Rudat C, Kispert A, Niessen HW, Lübke T, Dierks T, Wollert KC. Heparan Sulfate-Editing Extracellular Sulfatases Enhance VEGF Bioavailability for Ischemic Heart Repair. Circ Res 2019; 125:787-801. [PMID: 31434553 DOI: 10.1161/circresaha.119.315023] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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] [Indexed: 12/26/2022]
Abstract
RATIONALE Mechanistic insight into the inflammatory response after acute myocardial infarction may inform new molecularly targeted treatment strategies to prevent chronic heart failure. OBJECTIVE We identified the sulfatase SULF2 in an in silico secretome analysis in bone marrow cells from patients with acute myocardial infarction and detected increased sulfatase activity in myocardial autopsy samples. SULF2 (Sulf2 in mice) and its isoform SULF1 (Sulf1) act as endosulfatases removing 6-O-sulfate groups from heparan sulfate (HS) in the extracellular space, thus eliminating docking sites for HS-binding proteins. We hypothesized that the Sulfs have a role in tissue repair after myocardial infarction. METHODS AND RESULTS Both Sulfs were dynamically upregulated after coronary artery ligation in mice, attaining peak expression and activity levels during the first week after injury. Sulf2 was expressed by monocytes and macrophages, Sulf1 by endothelial cells and fibroblasts. Infarct border zone capillarization was impaired, scar size increased, and cardiac dysfunction more pronounced in mice with a genetic deletion of either Sulf1 or Sulf2. Studies in bone marrow-chimeric Sulf-deficient mice and Sulf-deficient cardiac endothelial cells established that inflammatory cell-derived Sulf2 and endothelial cell-autonomous Sulf1 promote angiogenesis. Mechanistically, both Sulfs reduced HS sulfation in the infarcted myocardium, thereby diminishing Vegfa (vascular endothelial growth factor A) interaction with HS. Along this line, both Sulfs rendered infarcted mouse heart explants responsive to the angiogenic effects of HS-binding Vegfa164 but did not modulate the angiogenic effects of non-HS-binding Vegfa120. Treating wild-type mice systemically with the small molecule HS-antagonist surfen (bis-2-methyl-4-amino-quinolyl-6-carbamide, 1 mg/kg/day) for 7 days after myocardial infarction released Vegfa from HS, enhanced infarct border-zone capillarization, and exerted sustained beneficial effects on cardiac function and survival. CONCLUSIONS These findings establish HS-editing Sulfs as critical inducers of postinfarction angiogenesis and identify HS sulfation as a therapeutic target for ischemic tissue repair.
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Affiliation(s)
- Mortimer Korf-Klingebiel
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | - Marc R Reboll
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | - Karsten Grote
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | - Hauke Schleiner
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | - Yong Wang
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | - Xuekun Wu
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | - Stefanie Klede
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | - Yuliya Mikhed
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
| | | | - Carsten Rudat
- Institute of Molecular Biology (C.R., A.K.), Hannover Medical School, Germany
| | - Andreas Kispert
- Institute of Molecular Biology (C.R., A.K.), Hannover Medical School, Germany
| | - Hans W Niessen
- Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands (H.W.N.)
| | - Torben Lübke
- Department of Chemistry, Biochemistry I, Bielefeld University, Germany (T.L., T.D.)
| | - Thomas Dierks
- Department of Chemistry, Biochemistry I, Bielefeld University, Germany (T.L., T.D.)
| | - Kai C Wollert
- From the Division of Molecular and Translational Cardiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., K.C.W.), Hannover Medical School, Germany.,Department of Cardiology and Angiology (M.K.-K., M.R.R., K.G., H.S., Y.W., X.W., S.K., Y.M., J.B., K.C.W.), Hannover Medical School, Germany
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Henning K, Teske J, Klintschar M, Dziadosz M. Postmortem findings of pipamperone after fatal intoxications and its distribution in body fluids and tissues. Drug Test Anal 2019; 11:626-630. [DOI: 10.1002/dta.2574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 11/08/2022]
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Hafke A, Schürmann P, Rothämel T, Dörk T, Klintschar M. Evidence for an association of interferon gene variants with sudden infant death syndrome. Int J Legal Med 2019; 133:863-869. [PMID: 30617847 DOI: 10.1007/s00414-018-1974-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 11/20/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is evidence that inflammation plays a role in the etiology of sudden infant death syndrome (SIDS). Immune system dysregulation seems to be the background of higher infection susceptibility in SIDS infants. This phenotype is possibly determined by genetic factors. METHODS Twenty-three single nucleotide polymorphisms (SNPs) in the following 13 candidate genes governing the immune system were successfully genotyped in 251 Caucasian SIDS cases and 336 controls from Germany: ADAR1, CSF2RB, DDX58, IFNA1, IFNA21, IFNA8, IFNAR2, IFNG, IL6, MX2, OAS1, OAS3, and TNFA. Associations between genotypes and SIDS were then statistically evaluated using logistic regression analyses. RESULTS Overall analysis revealed statistically significant results for two variants in interferon gamma (IFNG) (rs2069705: OR 1.40 (1.07; 1.83), p = 0.01; and rs2069727: OR 0.75 (0.59; 0.96), p = 0.02) and for one variant in interferon alpha 8 (IFNA8) (rs1330321: OR 1.85 (1.06; 3.21), p = 0.03). Haplotype analyses identified a three-marker risk IFNG haplotype rs2069727-rs2069718-rs2069705 associated with SIDS (OR = 1.62, 95% CI 1.23-2.13; p = 0.0003). Subgroup associations were found for variants in adenosine deaminase acting on RNA1 (ADAR1), 2',5'-oligoadenylate synthetase-1 (OAS1) and colony stimulating factor 2 receptor beta common subunit (CSF2RB). CONCLUSION In summary, this large study of 251 SIDS cases for common variants in 13 candidate genes governing the immune system has provided first evidence for a role of IFNG in the etiology of SIDS and should stimulate further research into the clinicopathological relevance of immunomodulatory genes for this fatal syndrome.
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Affiliation(s)
- Angelina Hafke
- Institute of Legal Medicine (OE 5500), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Peter Schürmann
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Thomas Rothämel
- Institute of Legal Medicine (OE 5500), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine (OE 5500), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Henning K, Dziadosz M, Klintschar M, Piep B, Teske J. Analyzing histological material to determine ajmaline and other drugs using high-performance liquid chromatography/tandem mass spectrometry. Drug Test Anal 2018; 10:1488-1490. [DOI: 10.1002/dta.2450] [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] [Received: 05/09/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Katarina Henning
- Toxicology, Hannover Medical School; Institute for Forensic Medicine; Germany
| | - Marek Dziadosz
- Toxicology, Hannover Medical School; Institute for Forensic Medicine; Germany
| | | | - Birgit Piep
- Department of Molecular- und Cellphysiology, Centre for Physiology,; Hannover Medical School; Germany
| | - Jörg Teske
- Toxicology, Hannover Medical School; Institute for Forensic Medicine; Germany
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Dziadosz M, Teske J, Henning K, Klintschar M, Nordmeier F. LC–MS/MS screening strategy for cannabinoids, opiates, amphetamines, cocaine, benzodiazepines and methadone in human serum, urine and post-mortem blood as an effective alternative to immunoassay based methods applied in forensic toxicology for preliminary examination. Forensic Chem 2018. [DOI: 10.1016/j.forc.2017.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dziadosz M, Klintschar M, Teske J. Imatinib quantification in human serum with LC-MS3 as an effective way of protein kinase inhibitor analysis in biological matrices. Drug Metab Pers Ther 2017; 32:147-150. [PMID: 28787270 DOI: 10.1515/dmpt-2017-0016] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/13/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND As imatinib gained a lot of attention in the field of medicine, appropriate methods are needed for drug analysis. LC-MS/MS combined with complex sample preparation and column enrichment is usually the method of choice when high sensitivity is necessary. The application of LC-MS3 in imatinib quantification has not been discussed in the literature. METHODS An LC-MS3 imatinib quantification method was developed and validated in human serum. The sample preparation was based on the liquid-liquid extraction of 50 μL human serum. Chromatographic separation was performed using a Luna 5 μm C18 (2) 100 A, 150 mm×2 mm column and the elution was done using a mobile phase consisting of A (H2O/methanol=95/5, v/v) and B (H2O/methanol=3/97, v/v), both with 10 mM ammonium acetate and 0.1% acetic acid. RESULTS The conditions applied resulted in a limit of detection/quantification value of 0.14/0.45 ng/mL reached without a sophisticated sample preparation technique or enrichment column application. It could be demonstrated that MS3 detection is a very effective way of sensitive imatinib quantification. Further, it could be stated that the strategy presented can be very useful for a sensitive analysis of other protein kinase inhibitors, because their molecule structure is appropriate for MS3 detection. CONCLUSIONS The presented analytical strategy is an effective way of protein kinase inhibitor analysis in human serum.
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Reboll MR, Korf-Klingebiel M, Klede S, Polten F, Brinkmann E, Reimann I, Schönfeld HJ, Bobadilla M, Faix J, Kensah G, Gruh I, Klintschar M, Gaestel M, Niessen HW, Pich A, Bauersachs J, Gogos JA, Wang Y, Wollert KC. EMC10 (Endoplasmic Reticulum Membrane Protein Complex Subunit 10) Is a Bone Marrow-Derived Angiogenic Growth Factor Promoting Tissue Repair After Myocardial Infarction. Circulation 2017; 136:1809-1823. [PMID: 28931551 DOI: 10.1161/circulationaha.117.029980] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 06/16/2017] [Accepted: 08/31/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Clinical trials of bone marrow cell-based therapies after acute myocardial infarction (MI) have produced mostly neutral results. Treatment with specific bone marrow cell-derived secreted proteins may provide an alternative biological approach to improving tissue repair and heart function after MI. We recently performed a bioinformatic secretome analysis in bone marrow cells from patients with acute MI and discovered a poorly characterized secreted protein, EMC10 (endoplasmic reticulum membrane protein complex subunit 10), showing activity in an angiogenic screen. METHODS We investigated the angiogenic potential of EMC10 and its mouse homolog (Emc10) in cultured endothelial cells and infarcted heart explants. We defined the cellular sources and function of Emc10 after MI using wild-type, Emc10-deficient, and Emc10 bone marrow-chimeric mice subjected to transient coronary artery ligation. Furthermore, we explored the therapeutic potential of recombinant Emc10 delivered by osmotic minipumps after MI in heart failure-prone FVB/N mice. RESULTS Emc10 signaled through small GTPases, p21-activated kinase, and the p38 mitogen-activated protein kinase (MAPK)-MAPK-activated protein kinase 2 (MK2) pathway to promote actin polymerization and endothelial cell migration. Confirming the importance of these signaling events in the context of acute MI, Emc10 stimulated endothelial cell outgrowth from infarcted mouse heart explants via p38 MAPK-MK2. Emc10 protein abundance was increased in the infarcted region of the left ventricle and in the circulation of wild-type mice after MI. Emc10 expression was also increased in left ventricular tissue samples from patients with acute MI. Bone marrow-derived monocytes and macrophages were the predominant sources of Emc10 in the infarcted murine heart. Emc10 KO mice showed no cardiovascular phenotype at baseline. After MI, however, capillarization of the infarct border zone was impaired in KO mice, and the animals developed larger infarct scars and more pronounced left ventricular remodeling compared with wild-type mice. Transplanting KO mice with wild-type bone marrow cells rescued the angiogenic defect and ameliorated left ventricular remodeling. Treating FVB/N mice with recombinant Emc10 enhanced infarct border-zone capillarization and exerted a sustained beneficial effect on left ventricular remodeling. CONCLUSIONS We have identified Emc10 as a previously unknown angiogenic growth factor that is produced by bone marrow-derived monocytes and macrophages as part of an endogenous adaptive response that can be enhanced therapeutically to repair the heart after MI.
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Affiliation(s)
- Marc R Reboll
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Mortimer Korf-Klingebiel
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Stefanie Klede
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Felix Polten
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Eva Brinkmann
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Ines Reimann
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Hans-Joachim Schönfeld
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Maria Bobadilla
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Jan Faix
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - George Kensah
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Ina Gruh
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Michael Klintschar
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Matthias Gaestel
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Hans W Niessen
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Andreas Pich
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Johann Bauersachs
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Joseph A Gogos
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Yong Wang
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.)
| | - Kai C Wollert
- From Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology (M.R.R., M.K.-K., S.K., E.B., I.R., Y.W., K.C.W.), Core Unit Proteomics, Institute of Toxicology (F.P., A.P.), Department of Biophysical Chemistry (J.F.), Leibniz Research Laboratories for Biotechnology and Artificial Organs, Department of Cardiothoracic, Transplantation, and Vascular Surgery (G.K., I.G.), Institute of Legal Medicine (M.K.), Institute of Physiological Chemistry (M.G.), and Department of Cardiology and Angiology (J.B.), Hannover Medical School, Germany; F. Hoffmann-La Roche, Pharma Research and Early Development, Basel, Switzerland (H.-J.S., M.B.); Department of Pathology and Department of Cardiac Surgery, Institute for Cardiovascular Research, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands (H.W.N.); and Department of Physiology and Cellular Biophysics and Department of Neuroscience, College of Physicians and Surgeons, Columbia University, New York, NY (J.A.G.).
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Dziadosz M, Klintschar M, Teske J. Postmortem concentration distribution in fatal cases involving the synthetic opioid U-47700. Int J Legal Med 2017; 131:1555-1556. [DOI: 10.1007/s00414-017-1593-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/06/2017] [Indexed: 11/28/2022]
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Dziadosz M, Klintschar M, Teske J. Simple protein precipitation-based analysis of Δ9-tetrahydrocannabinol and its metabolites in human serum by liquid chromatography–tandem mass spectrometry. Forensic Toxicol 2016. [DOI: 10.1007/s11419-016-0344-7] [Citation(s) in RCA: 5] [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: 11/24/2022]
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Omar M, Dratzidis A, Klintschar M, Kwisda S, Krettek C, Ettinger M. Are porcine flexor digitorum profundus tendons suitable graft substitutes for human hamstring tendons in biomechanical in vitro-studies? Arch Orthop Trauma Surg 2016; 136:681-6. [PMID: 26899033 DOI: 10.1007/s00402-016-2425-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 08/17/2015] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Although a plenty of studies exist assessing the strength of ligamentous fixation techniques using porcine flexor digitorum profundus tendons as graft substitutes for human hamstring tendons, there is no biomechanical study comparing these two tendons. To interpret the results obtained with porcine flexor digitorum profundus tendons, knowledge of their biomechanical properties is essential. The purpose of this study was to compare the biomechanical properties of human hamstring tendons and porcine flexor digitorum profundus tendons. MATERIALS AND METHODS A total of six human hamstring tendons and six porcine flexor digitorum profundus tendons were analysed in this study. Quadruple-bundle human hamstring tendons and double-bundle porcine flexor digitorum profundus tendons with a diameter of 9 mm were used. Specimens were placed into a tensile loading fixation of a servohydraulic testing machine. Biomechanical analysis included pretensioning of the constructs at 50 N for 10 min following cyclic loading of 1500 cycles between 50 and 200 N at 0.5 Hz for measurement of elongation. Subsequently, ultimate failure load and failure mode analysis were performed with a ramp speed of 20 mm/min. RESULTS Human hamstring tendons showed significantly higher maximum load to failure values compared to porcine flexor digitorum profundus tendons (1597 ± 179.6 N vs. 1109 ± 101.9 N; p = 0.035). Human hamstring tendons yielded significantly lower initial elongation during preload, but not during cyclical loading. CONCLUSIONS When porcine flexor digitorum profundus tendons are used as graft substitutes for human hamstring tendons in biomechanical studies, maximum load to failure is underestimated while elongation is comparable to that of human hamstring tendons. Transferring results of biomechanical studies into clinical practice, the lower maximum load to failure of porcine flexor digitorum profundus tendons needs to be taken into consideration.
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Affiliation(s)
- Mohamed Omar
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Antonios Dratzidis
- Orthopaedic Surgery Department, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Forensic Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Sebastian Kwisda
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Christian Krettek
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Max Ettinger
- Orthopaedic Surgery Department, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany
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Dziadosz M, Klintschar M, Teske J. Sample pooling as an effective way of simultaneous analysis of new designer drugs together with synthetic cannabinoids in human serum provided by therapy and forensic psychiatric centres. Med Sci Law 2016; 56:155-156. [PMID: 27044924 DOI: 10.1177/0025802415587319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School (MHH), Germany
| | | | - Jörg Teske
- Institute of Legal Medicine, Hannover Medical School (MHH), Germany
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Fard D, Läer K, Rothämel T, Schürmann P, Arnold M, Cohen M, Vennemann M, Pfeiffer H, Bajanowski T, Pfeufer A, Dörk T, Klintschar M. Candidate gene variants of the immune system and sudden infant death syndrome. Int J Legal Med 2016; 130:1025-1033. [PMID: 26975745 DOI: 10.1007/s00414-016-1347-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 11/18/2015] [Accepted: 02/19/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Sudden infant death syndrome (SIDS) causes early infant death with an incidence between 0.5 and 2.5 cases among 1000 live births. Besides central sleep apnea and thermal dysregulation, infections have been repeatedly suggested to be implicated in SIDS etiology. METHODS To test the risk contribution of common genetic variants related to infection, we genotyped 40 single-nucleotide polymorphisms (SNPs) from 15 candidate genes for association with SIDS in a total of 579 cases and 1124 controls from Germany and the UK in a two-stage case control design. RESULTS The discovery-stage series (267 SIDS cases and 303 controls) revealed nominally significant associations for variants in interleukin 6 (IL6) (rs1880243), interleukin 10 (IL10) (rs1800871, rs1800872), and mannose-binding lectin 2 (MBL2) (rs930506), and for several other variants in subgroups. Meta-analyses were then performed in adding genotype information from a genome-wide association study of another 312 European SIDS cases and 821 controls. Overall associations were observed for two independent variants in MBL2: rs930506 in a co-dominant model (odds ratio (OR) = 0.82, p = 0.04) and rs1838065 in a dominant model (OR = 1.27, p = 0.03). CONCLUSION Our study did not replicate published associations of IL10 variants with SIDS. However, the evidence for two independent MBL2 variants in the combined analysis of two large series seems consistent with the hypothesis that infection may play a role in SIDS pathogenesis.
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Affiliation(s)
- Delnaz Fard
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Katharina Läer
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Thomas Rothämel
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Peter Schürmann
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Matthias Arnold
- Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Marta Cohen
- Sheffield Children's Hospital NHS Trust, Western Bank, Sheffield, S10 2TH, UK
| | - Mechtild Vennemann
- Institute of Legal Medicine, Universität Münster, Roentgenstr. 23, 48149, Münster, Germany
| | - Heidi Pfeiffer
- Institute of Legal Medicine, Universität Münster, Roentgenstr. 23, 48149, Münster, Germany
| | - Thomas Bajanowski
- Institut of Legal Medicine, Universität Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Arne Pfeufer
- Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany.
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Schäfer T, Klintschar M, Lichtinghagen R, Plagemann I, Smith A, Budde E, Hagemeier L. Xanthochromia of the skull bone associated with HbA1c. Forensic Sci Int 2016; 260:54-58. [PMID: 26799427 DOI: 10.1016/j.forsciint.2015.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/02/2015] [Revised: 12/22/2015] [Accepted: 12/23/2015] [Indexed: 01/03/2023]
Abstract
The color of the surface of 105 skull bones (part of the parietal bone) was determined using a portable spectral colorimeter (spectro color(®)). By this means it was possible to characterize the color objectively according to the L*a*b* color system defined by the "International Commission de l'Eclairage" (CIE). Biochemical markers of carbohydrate metabolism, HbA1c from venous blood, and glucose/lactate concentrations from vitreous humor, were also determined, for assessment of the ante-mortem plasma glucose concentration using Traub's sum formula. As biochemical markers for lipid metabolism disorder, cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL) and very low density lipoprotein (VLDL) were all determined from venous blood. There is a significant correlation of bone yellowing with HbA1c (p<0.001) and age (p<0.001). The literature asserts a significant correlation between diabetic condition and yellowing of the skull bone. Despite efforts to find the substance responsible for the yellowing of the bone in chronic metabolism disorder, no significant correlation was found between bone color and lipoproteins/bone extracted lipid acids.
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Affiliation(s)
- T Schäfer
- Institute of Forensic Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - M Klintschar
- Institute of Forensic Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - R Lichtinghagen
- Institute for Clinical Chemistry, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - I Plagemann
- Institute of Food Chemistry, Leibniz Universität Hannover, Callinstraße 5, 30167 Hannover, Germany
| | - A Smith
- Institute of Biometry, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - E Budde
- Institute of Biometry, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - L Hagemeier
- Institute of Forensic Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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Dziadosz M, Klintschar M, Teske J. Monitoring of Levamisole Concentration in Serum of Traffic Participants after Cocaine Consumption. J Forensic Sci 2016; 61 Suppl 1:S250-1. [DOI: 10.1111/1556-4029.12952] [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] [Received: 11/28/2014] [Revised: 02/26/2015] [Accepted: 03/07/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine; Hannover Medical School (MHH); Carl-Neuberg-Str. 1 D-30625 Hannover Germany
| | - Michael Klintschar
- Institute of Legal Medicine; Hannover Medical School (MHH); Carl-Neuberg-Str. 1 D-30625 Hannover Germany
| | - Jörg Teske
- Institute of Legal Medicine; Hannover Medical School (MHH); Carl-Neuberg-Str. 1 D-30625 Hannover Germany
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Leifheit-Nestler M, Große Siemer R, Flasbart K, Richter B, Kirchhoff F, Ziegler WH, Klintschar M, Becker JU, Erbersdobler A, Aufricht C, Seeman T, Fischer DC, Faul C, Haffner D. Induction of cardiac FGF23/FGFR4 expression is associated with left ventricular hypertrophy in patients with chronic kidney disease. Nephrol Dial Transplant 2015; 31:1088-99. [PMID: 26681731 DOI: 10.1093/ndt/gfv421] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/18/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In chronic kidney disease (CKD), serum concentrations of fibroblast growth factor 23 (FGF23) increase progressively as glomerular filtration rate declines, while renal expression of the FGF23 coreceptor Klotho decreases. Elevated circulating FGF23 levels are strongly associated with mortality and with left ventricular hypertrophy (LVH), which is a major cause of cardiovascular death in CKD patients. The cardiac FGF23/FGF receptor (FGFR) system and its role in the development of LVH in humans have not been addressed previously. METHODS We conducted a retrospective case-control study in 24 deceased patients with childhood-onset end-stage renal disease (dialysis: n = 17; transplanted: n = 7), and 24 age- and sex-matched control subjects. Myocardial autopsy samples of the left ventricle were evaluated for expression of endogenous FGF23, FGFR isoforms, Klotho, calcineurin and nuclear factor of activated T-cells (NFAT) by immunohistochemistry, immunofluorescence microscopy, qRT-PCR and western blotting. RESULTS The majority of patients presented with LVH (67%). Human cardiomyocytes express full-length FGF23, and cardiac FGF23 is excessively high in patients with CKD. Enhanced myocardial expression of FGF23 in concert with Klotho deficiency strongly correlates with the presence of LVH. Cardiac FGF23 levels associate with time-averaged serum phosphate levels, up-regulation of FGFR4 and activation of the calcineurin-NFAT signaling pathway, an established mediator of cardiac remodelling and LVH. These changes are detected in patients on dialysis but not in those with a functioning kidney transplant. CONCLUSIONS Our results indicate a strong association between LVH and enhanced expression levels of FGF23, FGFR4 and calcineurin, activation of NFAT and reduced levels of soluble Klotho in the myocardium of patients with CKD. These alterations are not observed in kidney transplant patients.
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Affiliation(s)
- Maren Leifheit-Nestler
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Robert Große Siemer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Kathrin Flasbart
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Beatrice Richter
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Felix Kirchhoff
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Wolfgang H Ziegler
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Michael Klintschar
- Institute for Forensic Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Jan U Becker
- Institute of Pathology, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Andreas Erbersdobler
- Institute of Pathology, University Hospital Rostock, Strempelstr. 14, 18055 Rostock, Germany
| | - Christoph Aufricht
- Division of Pediatric Nephrology, University Children's Hospital Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Tomas Seeman
- Division of Pediatric Nephrology, University Children's Hospital Motol, V Uvalu 84, 15006, Prague, Czech Republic
| | - Dagmar-Christiane Fischer
- Department of Pediatrics, University Hospital Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany
| | - Christian Faul
- Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, 1580 NW 10th Avenue (R-762), Miami, FL 33136, USA
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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Kosfeld A, Kreuzer M, Daniel C, Brand F, Schäfer AK, Chadt A, Weiss AC, Riehmer V, Jeanpierre C, Klintschar M, Bräsen JH, Amann K, Pape L, Kispert A, Al-Hasani H, Haffner D, Weber RG. Whole-exome sequencing identifies mutations of TBC1D1 encoding a Rab-GTPase-activating protein in patients with congenital anomalies of the kidneys and urinary tract (CAKUT). Hum Genet 2015; 135:69-87. [PMID: 26572137 DOI: 10.1007/s00439-015-1610-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 11/04/2015] [Indexed: 01/06/2023]
Abstract
Congenital anomalies of the kidneys and urinary tract (CAKUT) are genetically highly heterogeneous leaving most cases unclear after mutational analysis of the around 30 causative genes known so far. Assuming that phenotypes frequently showing dominant inheritance, such as CAKUT, can be caused by de novo mutations, de novo analysis of whole-exome sequencing data was done on two patient-parent-trios to identify novel CAKUT genes. In one case, we detected a heterozygous de novo frameshift variant in TBC1D1 encoding a Rab-GTPase-activating protein regulating glucose transporter GLUT4 translocation. Sequence analysis of 100 further CAKUT cases yielded three novel or rare inherited heterozygous TBC1D1 missense variants predicted to be pathogenic. TBC1D1 mutations affected Ser237-phosphorylation or protein stability and thereby act as hypomorphs. Tbc1d1 showed widespread expression in the developing murine urogenital system. A mild CAKUT spectrum phenotype, including anomalies observed in patients carrying TBC1D1 mutations, was found in kidneys of some Tbc1d1 (-/-) mice. Significantly reduced Glut4 levels were detected in kidneys of Tbc1d1 (-/-) mice and the dysplastic kidney of a TBC1D1 mutation carrier versus controls. TBC1D1 and SLC2A4 encoding GLUT4 were highly expressed in human fetal kidney. The patient with the truncating TBC1D1 mutation showed evidence for insulin resistance. These data demonstrate heterozygous deactivating TBC1D1 mutations in CAKUT patients with a similar renal and ureteral phenotype, and provide evidence that TBC1D1 mutations may contribute to CAKUT pathogenesis, possibly via a role in glucose homeostasis.
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Affiliation(s)
- Anne Kosfeld
- Department of Human Genetics, OE 6300, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Martin Kreuzer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Christoph Daniel
- Department of Nephropathology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Frank Brand
- Department of Human Genetics, OE 6300, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | | | - Alexandra Chadt
- German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich-Heine-University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Düsseldorf, Germany
| | - Anna-Carina Weiss
- Institute of Molecular Biology, Hannover Medical School, Hannover, Germany
| | - Vera Riehmer
- Department of Human Genetics, OE 6300, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Cécile Jeanpierre
- Institut National de la Santé et de la Recherche Médicale UMR1163, Hôpital Necker-Enfants Malades, 75015, Paris, France.,Institut Imagine, Université Paris Descartes - Sorbonne Paris Cité, 75015, Paris, France
| | - Michael Klintschar
- Department of Legal Medicine, Hannover Medical School, Hannover, Germany
| | | | - Kerstin Amann
- Department of Nephropathology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Lars Pape
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Andreas Kispert
- Institute of Molecular Biology, Hannover Medical School, Hannover, Germany
| | - Hadi Al-Hasani
- German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich-Heine-University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Düsseldorf, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Ruthild G Weber
- Department of Human Genetics, OE 6300, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Bulbul O, Filoglu G, Zorlu T, Altuncul H, Freire-Aradas A, Söchtig J, Ruiz Y, Klintschar M, Triki-Fendri S, Rebai A, Phillips C, Lareu MV, Carracedo Á, Schneider PM. Inference of biogeographical ancestry across central regions of Eurasia. Int J Legal Med 2015; 130:73-9. [DOI: 10.1007/s00414-015-1246-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 08/10/2015] [Indexed: 11/28/2022]
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Abstract
Sudden infant death syndrome (SIDS) is a multifactorial syndrome and assumingly, among other mechanisms, a deficit in respiratory control leads to a failure of arousal and autoresuscitation when the child is challenged by a stressful homeostatic event, e.g., hypoxia. We hypothesize that genetic polymorphisms involved in respiratory control mediated in the medulla oblongata contribute to SIDS. Therefore, a total of 366 SIDS cases and 421 controls were genotyped for 48 SNPs in 41 candidate genes. Genotyping was performed using Fluidigm nanofluidic technology. Results were obtained for 356 SIDS and 406 controls and 38 SNPs. After correction for multiple testing, one SNP retained a nominally significant association with seasonal SIDS: rs1801030 in the phenol sulfotransferase 1A1 gene (subgroup: death occurring during summer). A borderline association could be also observed for rs563649 in the opioid receptor μ1 gene in a recessive model (subgroup: death occurring during autumn). As a conclusion, although these data suggest two SNPs to be associated with different subgroups of SIDS cases, none of them can fully explain the SIDS condition, consistent with its multifactorial etiology. Given the great complexity of respiratory control and our initial findings reported here, we believe it is worthwhile to further investigate genes involved in the respiratory system.
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Affiliation(s)
- Katharina Läer
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str.1, D-30625, Hannover, Germany
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Rhein M, Hagemeier L, Klintschar M, Muschler M, Bleich S, Frieling H. DNA methylation results depend on DNA integrity-role of post mortem interval. Front Genet 2015; 6:182. [PMID: 26042147 PMCID: PMC4435253 DOI: 10.3389/fgene.2015.00182] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 01/03/2015] [Accepted: 04/29/2015] [Indexed: 11/13/2022] Open
Abstract
Major questions of neurological and psychiatric mechanisms involve the brain functions on a molecular level and cannot be easily addressed due to limitations in access to tissue samples. Post mortem studies are able to partly bridge the gap between brain tissue research retrieved from animal trials and the information derived from peripheral analysis (e.g., measurements in blood cells) in patients. Here, we wanted to know how fast DNA degradation is progressing under controlled conditions in order to define thresholds for tissue quality to be used in respective trials. Our focus was on the applicability of partly degraded samples for bisulfite sequencing and the determination of simple means to define cut-off values. After opening the brain cavity, we kept two consecutive pig skulls at ambient temperature (19–21°C) and removed cortex tissue up to a post mortem interval (PMI) of 120 h. We calculated the percentage of degradation on DNA gel electrophoresis of brain DNA to estimate quality and relate this estimation spectrum to the quality of human post mortem control samples. Functional DNA quality was investigated by bisulfite sequencing of two functionally relevant genes for either the serotonin receptor 5 (SLC6A4) or aldehyde dehydrogenase 2 (ALDH2). Testing our approach in a heterogeneous collective of human blood and brain samples, we demonstrate integrity of measurement quality below the threshold of 72 h PMI. While sequencing technically worked for all timepoints irrespective of conceivable DNA degradation, there is a good correlation between variance of methylation to degradation levels documented in the gel (R2 = 0.4311, p = 0.0392) for advancing post mortem intervals (PMI). This otherwise elusive phenomenon is an important prerequisite for the interpretation and evaluation of samples prior to in-depth processing via an affordable and easy assay to estimate identical sample quality and thereby comparable methylation measurements.
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Affiliation(s)
- Mathias Rhein
- Laboratory for Molecular Neuroscience, Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School Hannover, Germany ; Department of Legal Medicine, Hannover Medical School Hannover, Germany
| | - Lars Hagemeier
- Department of Legal Medicine, Hannover Medical School Hannover, Germany
| | | | - Marc Muschler
- Laboratory for Molecular Neuroscience, Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School Hannover, Germany
| | - Stefan Bleich
- Laboratory for Molecular Neuroscience, Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School Hannover, Germany
| | - Helge Frieling
- Laboratory for Molecular Neuroscience, Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School Hannover, Germany
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Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine; Hannover Medical School (MHH); Carl-Neuberg-Str. 1 D-30625 Hannover Germany
| | - Michael Klintschar
- Institute of Legal Medicine; Hannover Medical School (MHH); Carl-Neuberg-Str. 1 D-30625 Hannover Germany
| | - Jörg Teske
- Institute of Legal Medicine; Hannover Medical School (MHH); Carl-Neuberg-Str. 1 D-30625 Hannover Germany
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Dziadosz M, Klintschar M, Teske J. Letter to the Editor-The Problem of Caffeine Consumption in the Bodybuilding Scene. J Forensic Sci 2015; 60:542-3. [DOI: 10.1111/1556-4029.12688] [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: 11/29/2022]
Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine; Hannover Medical School (MHH); Hannover Germany
| | - Michael Klintschar
- Institute of Legal Medicine; Hannover Medical School (MHH); Hannover Germany
| | - Jörg Teske
- Institute of Legal Medicine; Hannover Medical School (MHH); Hannover Germany
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