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Xian RP, Brunet J, Huang Y, Wagner WL, Lee PD, Tafforeau P, Walsh CL. A closer look at high-energy X-ray-induced bubble formation during soft tissue imaging. J Synchrotron Radiat 2024; 31:566-577. [PMID: 38682274 DOI: 10.1107/s160057752400290x] [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] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/02/2024] [Indexed: 05/01/2024]
Abstract
Improving the scalability of tissue imaging throughput with bright, coherent X-rays requires identifying and mitigating artifacts resulting from the interactions between X-rays and matter. At synchrotron sources, long-term imaging of soft tissues in solution can result in gas bubble formation or cavitation, which dramatically compromises image quality and integrity of the samples. By combining in-line phase-contrast imaging with gas chromatography in real time, we were able to track the onset and evolution of high-energy X-ray-induced gas bubbles in ethanol-embedded soft tissue samples for tens of minutes (two to three times the typical scan times). We demonstrate quantitatively that vacuum degassing of the sample during preparation can significantly delay bubble formation, offering up to a twofold improvement in dose tolerance, depending on the tissue type. However, once nucleated, bubble growth is faster in degassed than undegassed samples, indicating their distinct metastable states at bubble onset. Gas chromatography analysis shows increased solvent vaporization concurrent with bubble formation, yet the quantities of dissolved gasses remain unchanged. By coupling features extracted from the radiographs with computational analysis of bubble characteristics, we uncover dose-controlled kinetics and nucleation site-specific growth. These hallmark signatures provide quantitative constraints on the driving mechanisms of bubble formation and growth. Overall, the observations highlight bubble formation as a critical yet often overlooked hurdle in upscaling X-ray imaging for biological tissues and soft materials and we offer an empirical foundation for their understanding and imaging protocol optimization. More importantly, our approaches establish a top-down scheme to decipher the complex, multiscale radiation-matter interactions in these applications.
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Affiliation(s)
- R Patrick Xian
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Joseph Brunet
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Yuze Huang
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter D Lee
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Paul Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France
| | - Claire L Walsh
- Department of Mechanical Engineering, University College London, London, United Kingdom
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2
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D'Amico L, Svetlove A, Longo E, Meyer R, Senigagliesi B, Saccomano G, Nolte P, Wagner WL, Wielpütz MO, Leitz DHW, Duerr J, Mall MA, Casalis L, Köster S, Alves F, Tromba G, Dullin C. Characterization of transient and progressive pulmonary fibrosis by spatially correlated phase contrast microCT, classical histopathology and atomic force microscopy. Comput Biol Med 2024; 169:107947. [PMID: 38211385 DOI: 10.1016/j.compbiomed.2024.107947] [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: 10/09/2023] [Revised: 12/07/2023] [Accepted: 01/01/2024] [Indexed: 01/13/2024]
Abstract
Pulmonary fibrosis (PF) is a severe and progressive condition in which the lung becomes scarred over time resulting in pulmonary function impairment. Classical histopathology remains an important tool for micro-structural tissue assessment in the diagnosis of PF. A novel workflow based on spatial correlated propagation-based phase-contrast micro computed tomography (PBI-microCT), atomic force microscopy (AFM) and histopathology was developed and applied to two different preclinical mouse models of PF - the commonly used and well characterized Bleomycin-induced PF and a novel mouse model for progressive PF caused by conditional Nedd4-2 KO. The aim was to integrate structural and mechanical features from hallmarks of fibrotic lung tissue remodeling. PBI-microCT was used to assess structural alteration in whole fixed and paraffin embedded lungs, allowing for identification of fibrotic foci within the 3D context of the entire organ and facilitating targeted microtome sectioning of planes of interest for subsequent histopathology. Subsequently, these sections of interest were subjected to AFM to assess changes in the local tissue stiffness of previously identified structures of interest. 3D whole organ analysis showed clear morphological differences in 3D tissue porosity between transient and progressive PF and control lungs. By integrating the results obtained from targeted AFM analysis, it was possible to discriminate between the Bleomycin model and the novel conditional Nedd4-2 KO model using agglomerative cluster analysis. As our workflow for 3D spatial correlation of PBI, targeted histopathology and subsequent AFM is tailored around the standard procedure of formalin-fixed paraffin-embedded (FFPE) tissue specimens, it may be a powerful tool for the comprehensive tissue assessment beyond the scope of PF and preclinical research.
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Affiliation(s)
- Lorenzo D'Amico
- University of Trieste, Department of Physics, Via Alfonso Valerio 2, Trieste, 34127, Italy; Elettra Sincrotrone Trieste S.C.p.A., s.s. 14 km 163, 500 in Area Science Park, Basovizza, 34149, Italy
| | - Angelika Svetlove
- Translational Molecular Imaging, Max-Plank-Institute for Multidisciplinary Sciences, Hermann-Rein-Straße 3, Göttingen, 37075, Germany; Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), Robert-Koch-Str. 40, Göttingen, 37075, Germany
| | - Elena Longo
- Elettra Sincrotrone Trieste S.C.p.A., s.s. 14 km 163, 500 in Area Science Park, Basovizza, 34149, Italy
| | - Ruth Meyer
- Institute for X-ray Physics, University of Göttingen, Friedrich-Hund-Platz 1, Göttingen, 37077, Germany
| | - Beatrice Senigagliesi
- Interdisciplinary Institute for Neuroscience, University of Bordeaux-UMR 5297 and CNRS, 146 Rue Léo Saignat, Bordeaux, 33000, France
| | - Giulia Saccomano
- Elettra Sincrotrone Trieste S.C.p.A., s.s. 14 km 163, 500 in Area Science Park, Basovizza, 34149, Italy; University of Trieste, Department of Architecture and Engineering, Via Alfonso Valerio 6/1, Trieste, 34127, Italy
| | - Philipp Nolte
- Faculty of Engineering and Health, University of Applied Sciences and Arts, Göttingen, 37085, Germany; Institute for Diagnostic and Interventional Radiology, University Medical Center, Göttingen, 37075, Germany
| | - Willi L Wagner
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Mark O Wielpütz
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dominik H W Leitz
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charite - University Hospital Berlin, Berlin, 13353, Germany; German Center for Lung Research (DZL), associated partner site, Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, 10117, Germany
| | - Julia Duerr
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charite - University Hospital Berlin, Berlin, 13353, Germany; German Center for Lung Research (DZL), associated partner site, Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, 10117, Germany
| | - Marcus A Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charite - University Hospital Berlin, Berlin, 13353, Germany; German Center for Lung Research (DZL), associated partner site, Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, 10117, Germany
| | - Loredana Casalis
- Elettra Sincrotrone Trieste S.C.p.A., s.s. 14 km 163, 500 in Area Science Park, Basovizza, 34149, Italy
| | - Sarah Köster
- Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), Robert-Koch-Str. 40, Göttingen, 37075, Germany; Institute for X-ray Physics, University of Göttingen, Friedrich-Hund-Platz 1, Göttingen, 37077, Germany
| | - Frauke Alves
- Translational Molecular Imaging, Max-Plank-Institute for Multidisciplinary Sciences, Hermann-Rein-Straße 3, Göttingen, 37075, Germany; Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), Robert-Koch-Str. 40, Göttingen, 37075, Germany; Institute for Diagnostic and Interventional Radiology, University Medical Center, Göttingen, 37075, Germany; Department for Haematology and Medical Oncology, University Medical Center, Göttingen, 37075, Germany
| | - Giuliana Tromba
- Elettra Sincrotrone Trieste S.C.p.A., s.s. 14 km 163, 500 in Area Science Park, Basovizza, 34149, Italy
| | - Christian Dullin
- Elettra Sincrotrone Trieste S.C.p.A., s.s. 14 km 163, 500 in Area Science Park, Basovizza, 34149, Italy; Translational Molecular Imaging, Max-Plank-Institute for Multidisciplinary Sciences, Hermann-Rein-Straße 3, Göttingen, 37075, Germany; Institute for Diagnostic and Interventional Radiology, University Medical Center, Göttingen, 37075, Germany; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
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Liu BS, Ali AB, Kwan SP, Pan JM, Wagner WL, Khalil HA, Chen Z, Ackermann M, Mentzer SJ. Evolving topological order in the postnatal visceral pleura. Dev Dyn 2024. [PMID: 38169311 DOI: 10.1002/dvdy.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Changes in epithelial cell shape reflects optimal cell packing and the minimization of surface free energy, but also cell-cell interactions, cell proliferation, and cytoskeletal rearrangements. RESULTS Here, we studied the structure of the rat pleura in the first 15 days after birth. After pleural isolation and image segmentation, the analysis demonstrated a progression of epithelial order from postnatal day 1 (P1) to P15. The cells with the largest surface area and greatest shape variability were observed at P1. In contrast, the cells with the smallest surface area and most shape consistency were observed at P15. A comparison of polygonal cell geometries demonstrated progressive optimization with an increase in the number of hexagons (six-sided) as well as five-sided and seven-sided polygons. Analysis of the epithelial organization with Voronoi tessellations and graphlet motif frequencies demonstrated a developmental path strikingly distinct from mathematical and natural reference paths. Graph Theory analysis of cell connectivity demonstrated a progressive decrease in network heterogeneity and clustering coefficient from P1 to P15. CONCLUSIONS We conclude that the rat pleura undergoes a striking change in pleural structure from P1 to P15. Further, a geometric and network-based approach can provide a quantitative characterization of these developmental changes.
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Affiliation(s)
- Betty S Liu
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ali B Ali
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Stacey P Kwan
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer M Pan
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Willi L Wagner
- Translational Lung Research Center, Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
| | - Hassan A Khalil
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Zi Chen
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Chamoto K, Gibney BC, Wagner WL, Ackermann M, Khalil HA, Mentzer SJ. Vascularization of the adult mouse lung grafted onto the chick chorioallantoic membrane. Microvasc Res 2024; 151:104596. [PMID: 37625620 DOI: 10.1016/j.mvr.2023.104596] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/07/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023]
Abstract
In the later stages of angiogenesis, the vascular sprout transitions into a functional vessel by fusing with a target vessel. Although this process appears to routinely occur in embryonic tissue, the biologic rules for sprout fusion and lumenization in adult regenerating tissue are unknown. To investigate this process, we grafted portions of the regenerating post-pneumonectomy lung onto the chick chorioallantoic membrane (CAM). Grafts from all 4 lobes of the post-pneumonectomy right lung demonstrated peri-graft angiogenesis as reflected by fluorescent plasma markers; however, fluorescent microsphere perfusion primarily occurred in the lobe of the lung that is the dominant site of post-pneumonectomy angiogenesis-namely, the cardiac lobe. Vascularization of the cardiac lobe grafts was confirmed by active tissue growth (p < .05). Functional vascular connections between the cardiac lobe and the CAM vascular network were demonstrated by confocal fluorescence microscopy as well as corrosion casting and scanning electron microscopy (SEM). Bulk transcriptional profiling of the cardiac lobe demonstrated the enhanced expression of many genes relative to alveolar epithelial cell (CD11b-/CD31-) control cells, but only the upregulation of Ereg and Fgf6 compared to the less well-vascularized right upper lobe. The growth of actively regenerating non-neoplastic adult tissue on the CAM demonstrates that functional lumenization can occur between species (mouse and chick) and across the developmental spectrum (adult and embryo).
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Affiliation(s)
- Kenji Chamoto
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Barry C Gibney
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Willi L Wagner
- Institute of Functional and Clinical Anatomy, University Medical Center of Johannes Gutenberg-University, Mainz, Germany
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of Johannes Gutenberg-University, Mainz, Germany
| | - Hassan A Khalil
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Steven J Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
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5
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Liu BS, Sutlive J, Wagner WL, Khalil HA, Chen Z, Ackermann M, Mentzer SJ. Geometric and network organization of visceral organ epithelium. Front Netw Physiol 2023; 3:1144186. [PMID: 37234691 PMCID: PMC10208427 DOI: 10.3389/fnetp.2023.1144186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Mammalian epithelia form a continuous sheet of cells that line the surface of visceral organs. To analyze the epithelial organization of the heart, lung, liver and bowel, epithelial cells were labeled in situ, isolated as a single layer and imaged as large epithelial digitally combine montages. The stitched epithelial images were analyzed for geometric and network organization. Geometric analysis demonstrated a similar polygon distribution in all organs with the greatest variability in the heart epithelia. Notably, the normal liver and inflated lung demonstrated the largest average cell surface area (p < 0.01). In lung epithelia, characteristic wavy or interdigitated cell boundaries were observed. The prevalence of interdigitations increased with lung inflation. To complement the geometric analyses, the epithelia were converted into a network of cell-to-cell contacts. Using the open-source software EpiGraph, subgraph (graphlet) frequencies were used to characterize epithelial organization and compare to mathematical (Epi-Hexagon), random (Epi-Random) and natural (Epi-Voronoi5) patterns. As expected, the patterns of the lung epithelia were independent of lung volume. In contrast, liver epithelia demonstrated a pattern distinct from lung, heart and bowel epithelia (p < 0.05). We conclude that geometric and network analyses can be useful tools in characterizing fundamental differences in mammalian tissue topology and epithelial organization.
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Affiliation(s)
- Betty S. Liu
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Joseph Sutlive
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Willi L. Wagner
- Translational Lung Research Center, Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
| | - Hassan A. Khalil
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Zi Chen
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
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Dullin C, D'Amico L, Saccomano G, Longo E, Wagner WL, Reiser J, Svetlove A, Albers J, Contillo A, Abrami A, Sturari L, Tromba G, Sodini N, Dreossi D. Novel setup for rapid phase contrast CT imaging of heavy and bulky specimens. J Synchrotron Radiat 2023; 30:650-654. [PMID: 36952235 PMCID: PMC10161890 DOI: 10.1107/s1600577523001649] [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] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/23/2023] [Indexed: 05/06/2023]
Abstract
This work introduces a novel setup for computed tomography of heavy and bulky specimens at the SYRMEP beamline of the Italian synchrotron Elettra. All the key features of the setup are described and the first application to off-center computed tomography scanning of a human chest phantom (approximately 45 kg) as well as the first results for vertical helical acquisitions are discussed.
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Affiliation(s)
- Christian Dullin
- Institute for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
| | | | | | - Elena Longo
- Elettra-Synchrotrone Trieste SCpA, Trieste, Italy
| | - Willi L Wagner
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Johanna Reiser
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Angelika Svetlove
- Translational Molecular Imaging, Max Plank Institute for Multidisciplinary Sciences, Goettingen, Germany
| | - Jonas Albers
- Biological X-ray imaging, European Molecular Biology Laboratory, Hamburg Unit c/o DESY, Hamburg, Germany
| | | | | | - Luca Sturari
- Elettra-Synchrotrone Trieste SCpA, Trieste, Italy
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Liu BS, Liao M, Wagner WL, Khalil HA, Chen Z, Ackermann M, Mentzer SJ. Biomechanics of a Plant-Derived Sealant for Corneal Injuries. Transl Vis Sci Technol 2023; 12:20. [PMID: 37204800 DOI: 10.1167/tvst.12.5.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose The corneal epithelium has a glycocalyx composed of membrane-associated glycoproteins, mucins, and galactin-3. Similar to the glycocalyx in visceral tissues, the corneal glycocalyx functions to limit fluid loss and minimize frictional forces. Recently, the plant-derived heteropolysaccharide pectin has been shown to physically entangle with the visceral organ glycocalyx. The ability of pectin to entangle with the corneal epithelium is unknown. Methods To explore the potential role of pectin as a corneal bioadhesive, we assessed the adhesive characteristics of pectin films in a bovine globe model. Results Pectin film was flexible, translucent, and low profile (80 µm thick). Molded in tape form, pectin films were significantly more adherent to the bovine cornea than control biopolymers of nanocellulose fibers, sodium hyaluronate, and carboxymethyl cellulose (P < 0.05). Adhesion strength was near maximal within seconds of contact. Compatible with wound closure under tension, the relative adhesion strength was greatest at a peel angle less than 45 degrees. The corneal incisions sealed with pectin film were resistant to anterior chamber pressure fluctuations ranging from negative 51.3 ± 8.9 mm Hg to positive 214 ± 68.6 mm Hg. Consistent with these findings, scanning electron microscopy demonstrated a low-profile film densely adherent to the bovine cornea. Finally, the adhesion of the pectin films facilitated the en face harvest of the corneal epithelium without physical dissection or enzymatic digestion. Conclusions We conclude that pectin films strongly adhere to the corneal glycocalyx. Translational Relevance The plant-derived pectin biopolymer provides potential utility for corneal wound healing as well as targeted drug delivery.
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Affiliation(s)
- Betty S Liu
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthew Liao
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Willi L Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Diagnostic and Interventional Radiology, Translational Lung Research Center, University of Heidelberg, Heidelberg, Germany
| | - Hassan A Khalil
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Zi Chen
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
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Brunet J, Walsh CL, Wagner WL, Bellier A, Werlein C, Marussi S, Jonigk DD, Verleden SE, Ackermann M, Lee PD, Tafforeau P. Preparation of large biological samples for high-resolution, hierarchical, synchrotron phase-contrast tomography with multimodal imaging compatibility. Nat Protoc 2023; 18:1441-1461. [PMID: 36859614 DOI: 10.1038/s41596-023-00804-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/12/2022] [Indexed: 03/03/2023]
Abstract
Imaging across different scales is essential for understanding healthy organ morphology and pathophysiological changes. The macro- and microscale three-dimensional morphology of large samples, including intact human organs, is possible with X-ray microtomography (using laboratory or synchrotron sources). Preparation of large samples for high-resolution imaging, however, is challenging due to limitations such as sample shrinkage, insufficient contrast, movement of the sample and bubble formation during mounting or scanning. Here, we describe the preparation, stabilization, dehydration and mounting of large soft-tissue samples for X-ray microtomography. We detail the protocol applied to whole human organs and hierarchical phase-contrast tomography at the European Synchrotron Radiation Facility, yet it is applicable to a range of biological samples, including complete organisms. The protocol enhances the contrast when using X-ray imaging, while preventing sample motion during the scan, even with different sample orientations. Bubbles trapped during mounting and those formed during scanning (in the case of synchrotron X-ray imaging) are mitigated by multiple degassing steps. The sample preparation is also compatible with magnetic resonance imaging, computed tomography and histological observation. The sample preparation and mounting require 24-36 d for a large organ such as a whole human brain or heart. The preparation time varies depending on the composition, size and fragility of the tissue. Use of the protocol enables scanning of intact organs with a diameter of 150 mm with a local voxel size of 1 μm. The protocol requires users with expertise in handling human or animal organs, laboratory operation and X-ray imaging.
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Affiliation(s)
- J Brunet
- Department of Mechanical Engineering, University College London, London, UK.
- European Synchrotron Radiation Facility, Grenoble, France.
| | - C L Walsh
- Department of Mechanical Engineering, University College London, London, UK.
| | - W L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Centre Heidelberg (TLRC), German Lung Research Centre (DZL), Heidelberg, Germany
| | - A Bellier
- Laboratoire d'Anatomie des Alpes Françaises (LADAF), Université Grenoble Alpes, Grenoble, France
| | - C Werlein
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - S Marussi
- Department of Mechanical Engineering, University College London, London, UK
| | - D D Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), German Lung Research Centre (DZL), Hannover, Germany
| | - S E Verleden
- Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), University of Antwerp, Antwerp, Belgium
| | - M Ackermann
- Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Peter D Lee
- Department of Mechanical Engineering, University College London, London, UK.
- Research Complex at Harwell, Didcot, UK.
| | - Paul Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France.
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Floess M, Steinle T, Werner F, Wang Y, Wagner WL, Steinle V, Liu BS, Zheng Y, Chen Z, Ackermann M, Mentzer SJ, Giessen H. 3D stimulated Raman spectral imaging of water dynamics associated with pectin-glycocalyceal entanglement. Biomed Opt Express 2023; 14:1460-1471. [PMID: 37078053 PMCID: PMC10110326 DOI: 10.1364/boe.485314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/25/2023] [Accepted: 02/26/2023] [Indexed: 05/03/2023]
Abstract
Pectin is a heteropolysaccharide responsible for the structural integrity of the cell walls of terrestrial plants. When applied to the surface of mammalian visceral organs, pectin films form a strong physical bond with the surface glycocalyx. A potential mechanism of pectin adhesion to the glycocalyx is the water-dependent entanglement of pectin polysaccharide chains with the glycocalyx. A better understanding of such fundamental mechanisms regarding the water transport dynamics in pectin hydrogels is of importance for medical applications, e.g., surgical wound sealing. We report on the water transport dynamics in hydrating glass-phase pectin films with particular emphasis on the water content at the pectin-glycocalyceal interface. We used label-free 3D stimulated Raman scattering (SRS) spectral imaging to provide insights into the pectin-tissue adhesive interface without the confounding effects of sample fixation, dehydration, shrinkage, or staining.
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Affiliation(s)
- Moritz Floess
- 4 Physics Institute and Stuttgart Research Center of Photonic Engineering, University of Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - Tobias Steinle
- 4 Physics Institute and Stuttgart Research Center of Photonic Engineering, University of Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - Florian Werner
- 4 Physics Institute and Stuttgart Research Center of Photonic Engineering, University of Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - Yunshan Wang
- 4 Physics Institute and Stuttgart Research Center of Photonic Engineering, University of Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - Verena Steinle
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
| | - Betty S. Liu
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Yifan Zheng
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Zi Chen
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Maximilian Ackermann
- Institute of Pathology and Department of Molecular Pathology, Helios University Clinic Wuppertal, University of Witten-Herdecke, Wuppertal, Germany
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Harald Giessen
- 4 Physics Institute and Stuttgart Research Center of Photonic Engineering, University of Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
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10
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Albers J, Wagner WL, Fiedler MO, Rothermel A, Wünnemann F, Di Lillo F, Dreossi D, Sodini N, Baratella E, Confalonieri M, Arfelli F, Kalenka A, Lotz J, Biederer J, Wielpütz MO, Kauczor HU, Alves F, Tromba G, Dullin C. High resolution propagation-based lung imaging at clinically relevant X-ray dose levels. Sci Rep 2023; 13:4788. [PMID: 36959233 PMCID: PMC10036329 DOI: 10.1038/s41598-023-30870-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/02/2023] [Indexed: 03/25/2023] Open
Abstract
Absorption-based clinical computed tomography (CT) is the current imaging method of choice in the diagnosis of lung diseases. Many pulmonary diseases are affecting microscopic structures of the lung, such as terminal bronchi, alveolar spaces, sublobular blood vessels or the pulmonary interstitial tissue. As spatial resolution in CT is limited by the clinically acceptable applied X-ray dose, a comprehensive diagnosis of conditions such as interstitial lung disease, idiopathic pulmonary fibrosis or the characterization of small pulmonary nodules is limited and may require additional validation by invasive lung biopsies. Propagation-based imaging (PBI) is a phase sensitive X-ray imaging technique capable of reaching high spatial resolutions at relatively low applied radiation dose levels. In this publication, we present technical refinements of PBI for the characterization of different artificial lung pathologies, mimicking clinically relevant patterns in ventilated fresh porcine lungs in a human-scale chest phantom. The combination of a very large propagation distance of 10.7 m and a photon counting detector with [Formula: see text] pixel size enabled high resolution PBI CT with significantly improved dose efficiency, measured by thermoluminescence detectors. Image quality was directly compared with state-of-the-art clinical CT. PBI with increased propagation distance was found to provide improved image quality at the same or even lower X-ray dose levels than clinical CT. By combining PBI with iodine k-edge subtraction imaging we further demonstrate that, the high quality of the calculated iodine concentration maps might be a potential tool for the analysis of lung perfusion in great detail. Our results indicate PBI to be of great value for accurate diagnosis of lung disease in patients as it allows to depict pathological lesions non-invasively at high resolution in 3D. This will especially benefit patients at high risk of complications from invasive lung biopsies such as in the setting of suspected idiopathic pulmonary fibrosis (IPF).
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Affiliation(s)
- Jonas Albers
- Department for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
- Biological X-ray imaging, European Molecular Biology Laboratory, Hamburg Unit c/o DESY, Hamburg, Germany
| | - Willi L Wagner
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany
| | - Mascha O Fiedler
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany
- Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Anne Rothermel
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany
| | - Felix Wünnemann
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany
| | | | - Diego Dreossi
- Elettra-Sincrotrone Trieste S.C.p.A., Trieste, Italy
| | - Nicola Sodini
- Elettra-Sincrotrone Trieste S.C.p.A., Trieste, Italy
| | - Elisa Baratella
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Fulvia Arfelli
- Department of Physics, University of Trieste and INFN, Trieste, Italy
| | - Armin Kalenka
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany
- Department of Anaesthesiology and Intensive Care Medicine, District Hospital Bergstrasse, Heppenheim, Germany
- Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Joachim Lotz
- Department for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
| | - Jürgen Biederer
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany
- Faculty of Medicine, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Mark O Wielpütz
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany
| | - Frauke Alves
- Department for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
- Department for Haematology and Medical Oncology, University Medical Center Goettingen, Goettingen, Germany
- Translational Molecular Imaging, Max-Plank-Institute for Multidisciplinary Sciences, Goettingen, Germany
| | | | - Christian Dullin
- Department for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany.
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University Heidelberg, Heidelberg, Germany.
- Translational Molecular Imaging, Max-Plank-Institute for Multidisciplinary Sciences, Goettingen, Germany.
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11
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Liu BS, Valenzuela CD, Mentzer KL, Wagner WL, Khalil HA, Chen Z, Ackermann M, Mentzer SJ. Topography of pleural epithelial structure enabled by en face isolation and machine learning. J Cell Physiol 2023; 238:274-284. [PMID: 36502471 PMCID: PMC9845181 DOI: 10.1002/jcp.30927] [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: 09/15/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022]
Abstract
Pleural epithelial adaptations to mechanical stress are relevant to both normal lung function and parenchymal lung diseases. Assessing regional differences in mechanical stress, however, has been complicated by the nonlinear stress-strain properties of the lung and the large displacements with ventilation. Moreover, there is no reliable method of isolating pleural epithelium for structural studies. To define the topographic variation in pleural structure, we developed a method of en face harvest of murine pleural epithelium. Silver-stain was used to highlight cell borders and facilitate imaging with light microscopy. Machine learning and watershed segmentation were used to define the cell area and cell perimeter of the isolated pleural epithelial cells. In the deflated lung at residual volume, the pleural epithelial cells were significantly larger in the apex (624 ± 247 μm2 ) than in basilar regions of the lung (471 ± 119 μm2 ) (p < 0.001). The distortion of apical epithelial cells was consistent with a vertical gradient of pleural pressures. To assess epithelial changes with inflation, the pleura was studied at total lung capacity. The average epithelial cell area increased 57% and the average perimeter increased 27% between residual volume and total lung capacity. The increase in lung volume was less than half the percent change predicted by uniform or isotropic expansion of the lung. We conclude that the structured analysis of pleural epithelial cells complements studies of pulmonary microstructure and provides useful insights into the regional distribution of mechanical stresses in the lung.
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Affiliation(s)
- Betty S. Liu
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Cristian D. Valenzuela
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Katherine L. Mentzer
- Institute for Computational and Mathematical Engineering, Stanford University, Stanford CA
| | - Willi L. Wagner
- Translational Lung Research Center, Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
| | - Hassan A. Khalil
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Zi Chen
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
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12
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Weinheimer O, Konietzke P, Wagner WL, Weber D, Newman B, Galbán CJ, Kauczor HU, Mall MA, Robinson TE, Wielpütz MO. MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung disease. Front Pediatr 2023; 11:1068103. [PMID: 36816383 PMCID: PMC9932328 DOI: 10.3389/fped.2023.1068103] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/03/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Quantitative computed tomography (QCT) offers some promising markers to quantify cystic fibrosis (CF)-lung disease. Air trapping may precede irreversible bronchiectasis; therefore, the temporal interdependencies of functional and structural lung disease need to be further investigated. We aim to quantify airway dimensions and air trapping on chest CT of school-age children with mild CF-lung disease over two years. METHODS Fully-automatic software analyzed 144 serial spirometer-controlled chest CT scans of 36 children (median 12.1 (10.2-13.8) years) with mild CF-lung disease (median ppFEV1 98.5 (90.8-103.3) %) at baseline, 3, 12 and 24 months. The airway wall percentage (WP5-10), bronchiectasis index (BEI), as well as severe air trapping (A3) were calculated for the total lung and separately for all lobes. Mixed linear models were calculated, considering the lobar distribution of WP5-10, BEI and A3 cross-sectionally and longitudinally. RESULTS WP5-10 remained stable (P = 0.248), and BEI changed from 0.41 (0.28-0.7) to 0.54 (0.36-0.88) (P = 0.156) and A3 from 2.26% to 4.35% (P = 0.086) showing variability over two years. ppFEV1 was also stable (P = 0.276). A robust mixed linear model showed a cross-sectional, regional association between WP5-10 and A3 at each timepoint (P < 0.001). Further, BEI showed no cross-sectional, but another mixed model showed short-term longitudinal interdependencies with air trapping (P = 0.003). CONCLUSIONS Robust linear/beta mixed models can still reveal interdependencies in medical data with high variability that remain hidden with simpler statistical methods. We could demonstrate cross-sectional, regional interdependencies between wall thickening and air trapping. Further, we show short-term regional interdependencies between air trapping and an increase in bronchiectasis. The data indicate that regional air trapping may precede the development of bronchiectasis. Quantitative CT may capture subtle disease progression and identify regional and temporal interdependencies of distinct manifestations of CF-lung disease.
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Affiliation(s)
- Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Dorothea Weber
- Translational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, Germany.,Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Beverly Newman
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, United States
| | - Craig J Galbán
- Department of Radiology, University of Michigan, Ann Arbor, United States
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Marcus A Mall
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health @ Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), Associated Partner Site, Berlin, Germany
| | - Terry E Robinson
- Department of Pediatrics, Center of Excellence in Pulmonary Biology, Stanford University School of Medicine, Stanford, CA, United States
| | - Mark O Wielpütz
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
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13
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Ackermann M, Kamp JC, Werlein C, Walsh CL, Stark H, Prade V, Surabattula R, Wagner WL, Disney C, Bodey AJ, Illig T, Leeming DJ, Karsdal MA, Tzankov A, Boor P, Kühnel MP, Länger FP, Verleden SE, Kvasnicka HM, Kreipe HH, Haverich A, Black SM, Walch A, Tafforeau P, Lee PD, Hoeper MM, Welte T, Seeliger B, David S, Schuppan D, Mentzer SJ, Jonigk DD. The fatal trajectory of pulmonary COVID-19 is driven by lobular ischemia and fibrotic remodelling. EBioMedicine 2022; 85:104296. [PMID: 36206625 PMCID: PMC9535314 DOI: 10.1016/j.ebiom.2022.104296] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND COVID-19 is characterized by a heterogeneous clinical presentation, ranging from mild symptoms to severe courses of disease. 9-20% of hospitalized patients with severe lung disease die from COVID-19 and a substantial number of survivors develop long-COVID. Our objective was to provide comprehensive insights into the pathophysiology of severe COVID-19 and to identify liquid biomarkers for disease severity and therapy response. METHODS We studied a total of 85 lungs (n = 31 COVID autopsy samples; n = 7 influenza A autopsy samples; n = 18 interstitial lung disease explants; n = 24 healthy controls) using the highest resolution Synchrotron radiation-based hierarchical phase-contrast tomography, scanning electron microscopy of microvascular corrosion casts, immunohistochemistry, matrix-assisted laser desorption ionization mass spectrometry imaging, and analysis of mRNA expression and biological pathways. Plasma samples from all disease groups were used for liquid biomarker determination using ELISA. The anatomic/molecular data were analyzed as a function of patients' hospitalization time. FINDINGS The observed patchy/mosaic appearance of COVID-19 in conventional lung imaging resulted from microvascular occlusion and secondary lobular ischemia. The length of hospitalization was associated with increased intussusceptive angiogenesis. This was associated with enhanced angiogenic, and fibrotic gene expression demonstrated by molecular profiling and metabolomic analysis. Increased plasma fibrosis markers correlated with their pulmonary tissue transcript levels and predicted disease severity. Plasma analysis confirmed distinct fibrosis biomarkers (TSP2, GDF15, IGFBP7, Pro-C3) that predicted the fatal trajectory in COVID-19. INTERPRETATION Pulmonary severe COVID-19 is a consequence of secondary lobular microischemia and fibrotic remodelling, resulting in a distinctive form of fibrotic interstitial lung disease that contributes to long-COVID. FUNDING This project was made possible by a number of funders. The full list can be found within the Declaration of interests / Acknowledgements section at the end of the manuscript.
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Affiliation(s)
- Maximilian Ackermann
- Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, University of Witten/Herdecke, Germany
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Jan C. Kamp
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Christopher Werlein
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Claire L. Walsh
- Centre for Advanced Biomedical Imaging, University College London, UK
| | - Helge Stark
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Verena Prade
- Research Unit Analytical Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Rambabu Surabattula
- Institute of Translational Immunology and Research Center for Immune Therapy, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Member of the German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
| | - Catherine Disney
- Department of Mechanical Engineering, University College London, UK
| | | | - Thomas Illig
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Hannover Unified Biobank, Hannover Medical School, Hannover Medical School, Germany
| | - Diana J. Leeming
- Hannover Unified Biobank, Hannover Medical School, Hannover Medical School, Germany
| | | | - Alexandar Tzankov
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Peter Boor
- Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Mark P. Kühnel
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Florian P. Länger
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Stijn E. Verleden
- Department of Thoracic Surgery, University Hospital Antwerp Edegem, Belgium
| | - Hans M. Kvasnicka
- Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, University of Witten/Herdecke, Germany
| | - Hans H. Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Axel Haverich
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Germany
| | - Stephen M. Black
- Department of Cellular Biology and Pharmacology, Center for Translational Research, Florida International University, USA
| | - Axel Walch
- Nordic Bioscience Biomarkers and Research, Herlev, Denmark
| | - Paul Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France
| | - Peter D. Lee
- Hannover Unified Biobank, Hannover Medical School, Hannover Medical School, Germany
| | - Marius M. Hoeper
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Benjamin Seeliger
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Sascha David
- Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Detlef Schuppan
- Institute of Translational Immunology and Research Center for Immune Therapy, University Medical Center, Johannes Gutenberg University, Mainz, Germany
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Harvard Medical School, Brigham & Women's Hospital, Boston, United States
| | - Danny D. Jonigk
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Institute of Pathology, Hannover Medical School, Hannover, Germany
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14
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Xian RP, Walsh CL, Verleden SE, Wagner WL, Bellier A, Marussi S, Ackermann M, Jonigk DD, Jacob J, Lee PD, Tafforeau P. A multiscale X-ray phase-contrast tomography dataset of a whole human left lung. Sci Data 2022; 9:264. [PMID: 35654864 PMCID: PMC9163096 DOI: 10.1038/s41597-022-01353-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Received: 12/01/2021] [Accepted: 05/03/2022] [Indexed: 11/09/2022] Open
Abstract
Technological advancements in X-ray imaging using bright and coherent synchrotron sources now allows the decoupling of sample size and resolution while maintaining high sensitivity to the microstructures of soft, partially dehydrated tissues. The continuous developments in multiscale X-ray imaging resulted in hierarchical phase-contrast tomography, a comprehensive approach to address the challenge of organ-scale (up to tens of centimeters) soft tissue imaging with resolution and sensitivity down to the cellular level. Using this technique, we imaged ex vivo an entire human left lung at an isotropic voxel size of 25.08 μm along with local zooms down to 6.05-6.5 μm and 2.45-2.5 μm in voxel size. The high tissue contrast offered by the fourth-generation synchrotron source at the European Synchrotron Radiation Facility reveals the complex multiscale anatomical constitution of the human lung from the macroscopic (centimeter) down to the microscopic (micrometer) scale. The dataset provides comprehensive organ-scale 3D information of the secondary pulmonary lobules and delineates the microstructure of lung nodules with unprecedented detail.
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Affiliation(s)
- R Patrick Xian
- Department of Mechanical Engineering, University College London, London, UK.
| | - Claire L Walsh
- Department of Mechanical Engineering, University College London, London, UK
| | - Stijn E Verleden
- Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), University of Antwerp, Wilrijk, Belgium
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Centre Heidelberg (TLRC), German Lung Research Centre (DZL), Heidelberg, Germany
| | - Alexandre Bellier
- Laboratoire d'Anatomie des Alpes Françaises (LADAF), Université Grenoble Alpes, Grenoble, France
| | - Sebastian Marussi
- Department of Mechanical Engineering, University College London, London, UK
| | - Maximilian Ackermann
- Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Danny D Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), German Lung Research Centre (DZL), Hannover, Germany
| | - Joseph Jacob
- Centre for Medical Image Computing, University College London, London, UK
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Peter D Lee
- Department of Mechanical Engineering, University College London, London, UK.
| | - Paul Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France.
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15
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Liao MW, Liu BS, Wagner WL, Khalil HA, Chen Z, Ackermann M, Mentzer SJ. Kinetics of Plant‐derived Heteropolysaccharide Bioabsorption Characterized by Fluorescence‐based Microfluidics System. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.l7689] [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: 11/11/2022]
Affiliation(s)
- Matthew W. Liao
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's Hospital, Harvard Medical SchoolBostonMA
| | - Betty S. Liu
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's Hospital, Harvard Medical SchoolBostonMA
| | - Willi L. Wagner
- Department of Diagnostic and Interventional RadiologyTranslational Lung Research Center, University of HeidelbergHeidelberg
- Translational Lung Research Center, University of HeidelbergHeidelberg
| | | | - Zi Chen
- Brigham & Women's Hospital, Harvard Medical SchoolBostonMA
| | - Maximilian Ackermann
- Institute of Functional and Clinical AnatomyUniversity Medical Center of the Johannes Gutenberg‐UniversityMainz
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16
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Zhu L, Duerr J, Zhou-Suckow Z, Wagner WL, Weinheimer O, Salomon JJ, Leitz D, Konietzke P, Yu H, Ackermann M, Stiller W, Kauczor HU, Mall MA, Wielpütz MO. µCT to quantify muco-obstructive lung disease and effects of neutrophil elastase knockout in mice. Am J Physiol Lung Cell Mol Physiol 2022; 322:L401-L411. [PMID: 35080183 DOI: 10.1152/ajplung.00341.2021] [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] [Indexed: 11/22/2022] Open
Abstract
Muco-obstructive lung diseases are characterized by airway obstruction and hyperinflation, which can be quantified by imaging. Our aim was to evaluate µCT for longitudinal quantification of muco-obstructive lung disease in β-epithelial Na+ channel overexpressing (Scnn1b-TG) mice and of the effects of neutrophil elastase (NE) knockout on its progression. Lungs from wild-type (WT), NE-/-, Scnn1b-TG, and Scnn1b-TG/NE-/- mice were scanned with 9 µm resolution at 0, 5, 14 and 60 days of age, and airway and parenchymal disease was quantified. Mucus adhesion lesions (MAL) were persistently increased in Scnn1b-TG compared to WT mice from 0 days (20.25±6.50 vs. 9.60±2.07, P<0.05), and this effect was attenuated in Scnn1b-TG/NE-/- mice (5.33±3.67, P<0.001). Airway wall area percentage (WA%) was increased in Scnn1b-TG mice compared to WT from 14 days onward (59.2±6.3% vs. 49.8±9.0%, P<0.001) but was similar in Scnn1b-TG/NE-/- compared to WT at 60 days (46.4±9.2% vs. 45.4±11.5%, P=0.97). Air proportion (Air%) and mean linear intercept (Lm) were persistently increased in Scnn1b-TG compared to WT from 5 days on (53.9±4.5% vs. 30.0±5.5% and 78.82±8.44µm vs. 65.66±4.15µm, respectively, P<0.001), whereas in Scnn1b-TG/NE-/- Air% and Lm were similar to WT from birth (27.7±5.5% vs.27.2±5.9%, P =0.92 and 61.48±9.20µm vs. 61.70±6.73µm, P=0.93, respectively). Our results suggest that µCT is sensitive to detect the onset and progression of muco-obstructive lung disease and effects of genetic deletion of NE on morphology of airways and lung parenchyma in Scnn1b-TG mice, and that it may serve as a sensitive endpoint for preclinical studies of novel therapeutic interventions for muco-obstructive lung diseases.
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Affiliation(s)
- Lin Zhu
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Julia Duerr
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), associated partner Berlin, Germany
| | - Zhe Zhou-Suckow
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Johanna Jessica Salomon
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dominik Leitz
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), associated partner Berlin, Germany
| | - Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Hong Yu
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Institute of Pathology and Department of Molecular Pathology, Helios University Clinic Wuppertal, University of Witten-Herdecke, Wuppertal, Germany
| | - Wolfram Stiller
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Marcus A Mall
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), associated partner Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Mark Oliver Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
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17
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Walsh CL, Tafforeau P, Wagner WL, Jafree DJ, Bellier A, Werlein C, Kühnel MP, Boller E, Walker-Samuel S, Robertus JL, Long DA, Jacob J, Marussi S, Brown E, Holroyd N, Jonigk DD, Ackermann M, Lee PD. Imaging intact human organs with local resolution of cellular structures using hierarchical phase-contrast tomography. Nat Methods 2021; 18:1532-1541. [PMID: 34737453 PMCID: PMC8648561 DOI: 10.1038/s41592-021-01317-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022]
Abstract
Imaging intact human organs from the organ to the cellular scale in three dimensions is a goal of biomedical imaging. To meet this challenge, we developed hierarchical phase-contrast tomography (HiP-CT), an X-ray phase propagation technique using the European Synchrotron Radiation Facility (ESRF)'s Extremely Brilliant Source (EBS). The spatial coherence of the ESRF-EBS combined with our beamline equipment, sample preparation and scanning developments enabled us to perform non-destructive, three-dimensional (3D) scans with hierarchically increasing resolution at any location in whole human organs. We applied HiP-CT to image five intact human organ types: brain, lung, heart, kidney and spleen. HiP-CT provided a structural overview of each whole organ followed by multiple higher-resolution volumes of interest, capturing organotypic functional units and certain individual specialized cells within intact human organs. We demonstrate the potential applications of HiP-CT through quantification and morphometry of glomeruli in an intact human kidney and identification of regional changes in the tissue architecture in a lung from a deceased donor with coronavirus disease 2019 (COVID-19).
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Affiliation(s)
- C L Walsh
- Department of Mechanical Engineering, University College London, London, UK.
- Centre for Advanced Biomedical Imaging, University College London, London, UK.
| | - P Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France.
| | - W L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- German Lung Research Centre (DZL), Translational Lung Research Centre Heidelberg (TLRC), Heidelberg, Germany
| | - D J Jafree
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
- UCL MB/PhD Programme, Faculty of Medical Sciences, University College London, London, UK
| | - A Bellier
- French Alps Laboratory of Anatomy (LADAF), Grenoble Alpes University, Grenoble, France
| | - C Werlein
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - M P Kühnel
- Institute of Pathology, Hannover Medical School, Hannover, Germany
- German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - E Boller
- European Synchrotron Radiation Facility, Grenoble, France
| | - S Walker-Samuel
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | - J L Robertus
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - D A Long
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - J Jacob
- Centre for Medical Image Computing, University College London, London, UK
- UCL Respiratory, University College London, London, UK
| | - S Marussi
- Department of Mechanical Engineering, University College London, London, UK
| | - E Brown
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | - N Holroyd
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | - D D Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany.
- German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.
| | - M Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
- Institute of Pathology and Department of Molecular Pathology, Helios University Clinic Wuppertal, University of Witten-Herdecke, Wuppertal, Germany.
| | - P D Lee
- Department of Mechanical Engineering, University College London, London, UK.
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18
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Ackermann M, Tafforeau P, Wagner WL, Walsh C, Werlein C, Kühnel MP, Länger FP, Disney C, Bodey AJ, Bellier A, Verleden SE, Lee PD, Mentzer SJ, Jonigk DD. The Bronchial Circulation in COVID-19 Pneumonia. Am J Respir Crit Care Med 2021; 205:121-125. [PMID: 34734553 PMCID: PMC8865596 DOI: 10.1164/rccm.202103-0594im] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,HELIOS Universitatsklinikum Wuppertal, 60865, Institute of Pathology and Molecular Pathology, Wuppertal, Germany;
| | - Paul Tafforeau
- European Synchrotron Radiation Facility, 55553, Grenoble, France
| | - Willi L Wagner
- University Hospital Heidelberg, 27178, Dept. Diagnostic and Interventional Radiology, Heidelberg, Germany
| | - Claire Walsh
- University College London, 4919, Centre for Advanced Biomedical Imaging, London, United Kingdom of Great Britain and Northern Ireland
| | | | - Mark P Kühnel
- Medical School of Hannover, Institute of Pathology, Hannover, Germany
| | | | - Catherine Disney
- University College London, 4919, London, United Kingdom of Great Britain and Northern Ireland
| | - Andrew J Bodey
- Diamond Light Source Ltd, 120796, Didcot, United Kingdom of Great Britain and Northern Ireland
| | - Alexandre Bellier
- Grenoble Universites, 133618, French Alps Laboratory of Anatomy (LADAF) , Grenoble, France
| | - Stijn E Verleden
- Katholieke Universiteit Leuven and Universitair Ziekenhuis Gasthuisberg, Lung Transplant Unit, Leuven, Belgium
| | - Peter D Lee
- University College London, 4919, Department of Mechanical Engineering, London, United Kingdom of Great Britain and Northern Ireland
| | - Steven J Mentzer
- Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Danny D Jonigk
- Hannover Medical School, Institute of Pathology , Hannover, Germany
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19
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Zheng Y, Pierce AF, Wagner WL, Khalil HA, Chen Z, Servais AB, Ackermann M, Mentzer SJ. Functional Adhesion of Pectin Biopolymers to the Lung Visceral Pleura. Polymers (Basel) 2021; 13:2976. [PMID: 34503016 PMCID: PMC8433721 DOI: 10.3390/polym13172976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 01/10/2023] Open
Abstract
Pleural injuries and the associated "air leak" are the most common complications after pulmonary surgery. Air leaks are the primary reason for prolonged chest tube use and increased hospital length of stay. Pectin, a plant-derived heteropolysaccharide, has been shown to be an air-tight sealant of pulmonary air leaks. Here, we investigate the morphologic and mechanical properties of pectin adhesion to the visceral pleural surface of the lung. After the application of high-methoxyl citrus pectin films to the murine lung, we used scanning electron microscopy to demonstrate intimate binding to the lung surface. To quantitatively assess pectin adhesion to the pleural surface, we used a custom adhesion test with force, distance, and time recordings. These assays demonstrated that pectin-glycocalyceal tensile adhesive strength was greater than nanocellulose fiber films or pressure-sensitive adhesives (p < 0.001). Simultaneous videomicroscopy recordings demonstrated that pectin-glycocalyceal adhesion was also stronger than the submesothelial connective tissue as avulsed surface remnants were visualized on the separated pectin films. Finally, pleural abrasion and hyaluronidase enzyme digestion confirmed that pectin binding was dependent on the pleural glycocalyx (p < 0.001). The results indicate that high methoxyl citrus pectin is a promising sealant for the treatment of pleural lung injuries.
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Affiliation(s)
- Yifan Zheng
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.); (A.B.S.)
| | - Aidan F. Pierce
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.); (A.B.S.)
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.); (A.B.S.)
- Department of Diagnostic and Interventional Radiology, Translational Lung Research Center, University of Heidelberg, 69120 Heidelberg, Germany
| | - Hassan A. Khalil
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.); (A.B.S.)
| | - Zi Chen
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.); (A.B.S.)
| | - Andrew B. Servais
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.); (A.B.S.)
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany;
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.); (A.B.S.)
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20
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Zheng Y, Pierce AF, Wagner WL, Khalil HA, Chen Z, Funaya C, Ackermann M, Mentzer SJ. Biomaterial-Assisted Anastomotic Healing: Serosal Adhesion of Pectin Films. Polymers (Basel) 2021; 13:2811. [PMID: 34451349 PMCID: PMC8401717 DOI: 10.3390/polym13162811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 01/02/2023] Open
Abstract
Anastomotic leakage is a frequent complication of intestinal surgery and a major source of surgical morbidity. The timing of anastomotic failures suggests that leaks are the result of inadequate mechanical support during the vulnerable phase of wound healing. To identify a biomaterial with physical and mechanical properties appropriate for assisted anastomotic healing, we studied the adhesive properties of the plant-derived structural heteropolysaccharide called pectin. Specifically, we examined high methoxyl citrus pectin films at water contents between 17-24% for their adhesivity to ex vivo porcine small bowel serosa. In assays of tensile adhesion strength, pectin demonstrated significantly greater adhesivity to the serosa than either nanocellulose fiber (NCF) films or pressure sensitive adhesives (PSA) (p < 0.001). Similarly, in assays of shear resistance, pectin demonstrated significantly greater adhesivity to the serosa than either NCF films or PSA (p < 0.001). Finally, the pectin films were capable of effectively sealing linear enterotomies in a bowel simulacrum as well as an ex vivo bowel segment. We conclude that pectin is a biomaterial with physical and adhesive properties capable of facilitating anastomotic healing after intestinal surgery.
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Affiliation(s)
- Yifan Zheng
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.)
| | - Aidan F. Pierce
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.)
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.)
- Department of Diagnostic and Interventional Radiology, Translational Lung Research Center, University of Heidelberg, 69117 Heidelberg, Germany
| | - Hassan A. Khalil
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.)
| | - Zi Chen
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.)
| | - Charlotta Funaya
- Electron Microscopy Core Facility, University of Heidelberg, 69117 Heidelberg, Germany;
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, 55122 Mainz, Germany;
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (A.F.P.); (W.L.W.); (H.A.K.); (Z.C.)
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21
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Barsch F, Mamilos A, Babel M, Wagner WL, Winther HB, Schmitt VH, Hierlemann H, Teufel A, Brochhausen C. Semiautomated quantification of the fibrous tissue response to complex three-dimensional filamentous scaffolds using digital image analysis. J Biomed Mater Res A 2021; 110:353-364. [PMID: 34390322 DOI: 10.1002/jbm.a.37293] [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: 01/26/2021] [Revised: 06/24/2021] [Accepted: 07/29/2021] [Indexed: 12/12/2022]
Abstract
Fibrosis represents a relevant response to the implantation of biomaterials, which occurs not only at the tissue-material interface (fibrotic encapsulation) but also within the void fraction of complex three-dimensional (3D) biomaterial constructions (fibrotic ingrowth). Usual evaluation of the biocompatibility mostly depicts fibrosis at the interface of the biomaterial using semiquantitative scores. Here, the relations between encapsulation and infiltrating fibrotic growth are poorly represented. Virtual pathology and digital image analysis provide new strategies to assess fibrosis in a more differentiated way. In this study, we adopted a method previously used to quantify fibrosis in visceral organs to the quantification of fibrosis to 3D biomaterials. In a proof-of-concept study, we transferred the "Collagen Proportionate Area" (CPA) analysis from hepatology to the field of biomaterials. As one task of an experimental animal study, we used CPA analysis to quantify the fibrotic ingrowth into a filamentous scaffold after subcutaneous implantation. We were able to demonstrate that the application of the CPA analysis is well suited as an additional fibrosis evaluation strategy for new biomaterial constructions. The CPA method can contribute to a better understanding of the fibrotic interactions between 3D scaffolds and the host tissue responses.
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Affiliation(s)
- Friedrich Barsch
- Institute for Exercise and Occupational Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.,Institute of Pathology, University Regensburg, Regensburg, Germany
| | - Andreas Mamilos
- Institute of Pathology, University Regensburg, Regensburg, Germany
| | - Maximilian Babel
- Institute of Pathology, University Regensburg, Regensburg, Germany.,Central Biobank Regensburg, University Regensburg and University Hospital Regensburg, Regensburg, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), German Lung Research Centre (DZL), Heidelberg, Germany
| | - Hinrich B Winther
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Volker H Schmitt
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | | | - Andreas Teufel
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christoph Brochhausen
- Institute of Pathology, University Regensburg, Regensburg, Germany.,Central Biobank Regensburg, University Regensburg and University Hospital Regensburg, Regensburg, Germany
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22
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Konietzke P, Steentoft HH, Wagner WL, Albers J, Dullin C, Skornitzke S, Stiller W, Weber TF, Kauczor HU, Wielpütz MO. Consolidated lung on contrast-enhanced chest CT: the use of spectral-detector computed tomography parameters in differentiating atelectasis and pneumonia. Heliyon 2021; 7:e07066. [PMID: 34113729 PMCID: PMC8170158 DOI: 10.1016/j.heliyon.2021.e07066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/03/2021] [Accepted: 05/11/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives To investigate the value of spectral-detector computed tomography (SDCT) parameters for the quantitative differentiation between atelectasis and pneumonia on contrast-enhanced chest CT. Material and methods Sixty-three patients, 22 clinically diagnosed with pneumonia and 41 with atelectasis, underwent contrast-enhanced SDCT scans during the venous phase. CT numbers (Hounsfield Units [HU]) were measured on conventional reconstructions (CON120kVp) and the iodine concentration (Ciodine, [mg/ml]), and effective atomic number (Zeff) on spectral reconstructions, using region-of-interest (ROI) analysis. Receiver operating characteristics (ROC) and contrast-to-noise ratios (CNRs) were calculated to assess each reconstruction's potential to differentiate between atelectasis and pneumonia. Results On contrast-enhanced SDCT, the difference between atelectasis and pneumonia was significant on CON120kVp, Ciodine, and Zeff images (p < 0.001). On CON120kVp images, a threshold of 81 HU achieved a sensitivity of 93 % and a specificity of 95 % for identifying pneumonia, while Ciodine and Zeff images reached the same sensitivity but lower specificities of 85 % and 83 %. CON120kVp images showed significantly higher CNRs between normal lung and atelectasis or pneumonia with 30.63 and 27.69 compared to Ciodine images with 3.54 and 1.27 and Zeff images with 4.22 and 7.63 (p < 0.001). None of the parameters could differentiate atelectasis and pneumonia without contrast media. Conclusions Contrast-enhanced SDCT can differentiate atelectasis and pneumonia based on the spectral parameters Ciodine, and Zeff. However, they had no added value compared to CT number measurement on CON120kVp images. Furthermore, contrast media is still needed for a differentiation based on quantitative SDCT parameters.
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Affiliation(s)
- Philip Konietzke
- Diagnostic and Interventional Radiology (DiR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
- Corresponding author.
| | - Hauke H. Steentoft
- Diagnostic and Interventional Radiology (DiR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - Willi L. Wagner
- Diagnostic and Interventional Radiology (DiR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Jonas Albers
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Christian Dullin
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Stephan Skornitzke
- Diagnostic and Interventional Radiology (DiR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - Wolfram Stiller
- Diagnostic and Interventional Radiology (DiR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - Tim F. Weber
- Diagnostic and Interventional Radiology (DiR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Diagnostic and Interventional Radiology (DiR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Mark O. Wielpütz
- Diagnostic and Interventional Radiology (DiR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
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23
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Ackermann M, Wagner WL, Rellecke P, Akhyari P, Boeken U, Reinecke P. Parvovirus B19-induced angiogenesis in fulminant myocarditis. Eur Heart J 2021; 41:1309. [PMID: 32101607 DOI: 10.1093/eurheartj/ehaa092] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Maximilian Ackermann
- Institute of Pathology and Department of Molecular Pathology, Helios University Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany.,Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, Translational Lung Research Center Heidelberg (TLRC), University Heidelberg, Heidelberg, Germany
| | - Philipp Rellecke
- Department of Cardiac Surgery, University Clinics of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Payam Akhyari
- Department of Cardiac Surgery, University Clinics of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Udo Boeken
- Department of Cardiac Surgery, University Clinics of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Petra Reinecke
- Institute of Pathology, University Clinics of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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24
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Wehrse E, Klein L, Rotkopf LT, Wagner WL, Uhrig M, Heußel CP, Ziener CH, Delorme S, Heinze S, Kachelrieß M, Schlemmer HP, Sawall S. Photon-counting detectors in computed tomography: from quantum physics to clinical practice. Radiologe 2021; 61:1-10. [PMID: 33598788 DOI: 10.1007/s00117-021-00812-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Accepted: 01/19/2021] [Indexed: 12/19/2022]
Abstract
Over the last decade, a fundamentally new type of computed tomography (CT) detectors has proved its superior capabilities in both physical and preclinical evaluations and is now approaching the stage of clinical practice. These detectors are able to discriminate single photons and quantify their energy and are hence called photon-counting detectors. Among the promising benefits of this technology are improved radiation dose efficiency, increased contrast-to-noise ratio, reduced metal artifacts, improved spatial resolution, simultaneous multi-energy acquisitions, and the prospect of multi-phase imaging within a single acquisition using multiple contrast agents. Taking the conventional energy-integrating detectors as a reference, the authors demonstrate the technical principles of this new technology and provide phantom and patient images acquired by a whole-body photon-counting CT. These images serve as a basis for discussing the potential future of clinical CT.
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Affiliation(s)
- E Wehrse
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
| | - L Klein
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
| | - L T Rotkopf
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - W L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
| | - M Uhrig
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - C P Heußel
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany
- Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany
| | - C H Ziener
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Delorme
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Heinze
- Institute of Forensic and Traffic Medicine, University Hospital Heidelberg, Voßstraße 2, 69115, Heidelberg, Germany
| | - M Kachelrieß
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
| | - H-P Schlemmer
- Division of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - S Sawall
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
- Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center, Heidelberg, Germany
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25
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Walsh C, Tafforeau P, Wagner WL, Jafree DJ, Bellier A, Werlein C, Kühnel MP, Boller E, Walker-Samuel S, Robertus JL, Long DA, Jacob J, Marussi S, Brown E, Holroyd N, Jonigk DD, Ackermann M, Lee PD. Multiscale three-dimensional imaging of intact human organs down to the cellular scale using hierarchical phase-contrast tomography. bioRxiv 2021:2021.02.03.429481. [PMID: 33564772 PMCID: PMC7872374 DOI: 10.1101/2021.02.03.429481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Human organs are complex, three-dimensional and multiscale systems. Spatially mapping the human body down through its hierarchy, from entire organs to their individual functional units and specialised cells, is a major obstacle to fully understanding health and disease. To meet this challenge, we developed hierarchical phase-contrast tomography (HiP-CT), an X-ray phase propagation technique utilising the European Synchrotron Radiation Facility's Extremely Brilliant Source: the world's first high-energy 4 th generation X-ray source. HiP-CT enabled three-dimensional and non-destructive imaging at near-micron resolution in soft tissues at one hundred thousand times the voxel size whilst maintaining the organ's structure. We applied HiP-CT to image five intact human parenchymal organs: brain, lung, heart, kidney and spleen. These were hierarchically assessed with HiP-CT, providing a structural overview of the whole organ alongside detail of the organ's individual functional units and cells. The potential applications of HiP-CT were demonstrated through quantification and morphometry of glomeruli in an intact human kidney, and identification of regional changes to the architecture of the air-tissue interface and alveolar morphology in the lung of a deceased COVID-19 patient. Overall, we show that HiP-CT is a powerful tool which can provide a comprehensive picture of structural information for whole intact human organs, encompassing precise details on functional units and their constituent cells to better understand human health and disease.
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Affiliation(s)
- C Walsh
- Centre for Advanced Biomedical Imaging, University College London, U.K
| | - P Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France
| | - Willi L Wagner
- Dept of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany Translational Lung Research Centre Heidelberg (TLRC), German Lung Research Centre (DZL), Heidelberg, Germany
| | - D J Jafree
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London, UK
- UCL MB/PhD Programme, Faculty of Medical Sciences, University College London, UK
| | - A Bellier
- French Alps Laboratory of Anatomy (LADAF), Grenoble Alpes University, Grenoble, France
| | - C Werlein
- Institute of Pathology, Hannover Medical School, Hannover, Germany (Carl-Neuberg-Straße 1, 30625 Hannover)
| | - M P Kühnel
- Institute of Pathology, Hannover Medical School, Hannover, Germany (Carl-Neuberg-Straße 1, 30625 Hannover)
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH)
| | - E Boller
- European Synchrotron Radiation Facility, Grenoble, France
| | - S Walker-Samuel
- Centre for Advanced Biomedical Imaging, University College London, U.K
| | - J L Robertus
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
- National Heart & Lung Institute, Imperial College London, London, UK
| | - D A Long
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London, UK
| | - J Jacob
- Centre for Medical Image Computing, University College London, London, UK
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK
| | - S Marussi
- Department of Mechanical Engineering University College London, U.K
| | - E Brown
- Centre for Advanced Biomedical Imaging, University College London, U.K
| | - N Holroyd
- Centre for Advanced Biomedical Imaging, University College London, U.K
| | - D D Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany (Carl-Neuberg-Straße 1, 30625 Hannover)
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH)
| | - M Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
| | - P D Lee
- Department of Mechanical Engineering University College London, U.K
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26
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Wagner WL, Föhst S, Hock J, Kim YO, Popov Y, Schuppan D, Schladitz K, Redenbach C, Ackermann M. 3D analysis of microvasculature in murine liver fibrosis models using synchrotron radiation-based microtomography. Angiogenesis 2021; 24:57-65. [PMID: 33037487 PMCID: PMC7920893 DOI: 10.1007/s10456-020-09751-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022]
Abstract
Cirrhosis describes the development of excess fibrous tissue around regenerative nodules in response to chronic liver injury and usually leads to irreversible organ damage and end-stage liver disease. During the development of cirrhosis, the formation of collagenous scar tissue is paralleled by a reorganization and remodeling of the hepatic vascular system. To date, macrovascular remodeling in various cirrhosis models has been examined using three-dimensional (3D) imaging modalities, while microvascular changes have been studied mainly by two-dimensional (2D) light microscopic and electron microscopic imaging. Here, we report on the application of high-resolution 3D synchrotron radiation-based microtomography (SRμCT) for the study of the sinusoidal and capillary blood vessel system in three murine models of advanced parenchymal and biliary hepatic fibrosis. SRμCT facilitates the characterization of microvascular architecture and identifies features of intussusceptive angiogenesis in progressive liver fibrosis in a non-destructive 3D manner.
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Affiliation(s)
- Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
| | - Sonja Föhst
- Mathematics Department, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Jessica Hock
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Johann-Joachim-Becher-Weg 13, 55128, Mainz, Germany
| | - Yong Ook Kim
- Institute of Translational Immunology and Research Center for Immune Therapy (FZI), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Yury Popov
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Detlef Schuppan
- Institute of Translational Immunology and Research Center for Immune Therapy (FZI), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Katja Schladitz
- Image Processing Department, Fraunhofer ITWM, Kaiserslautern, Germany
| | - Claudia Redenbach
- Mathematics Department, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Johann-Joachim-Becher-Weg 13, 55128, Mainz, Germany.
- Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, University of Witten-Herdecke, Wuppertal, Germany.
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27
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Kommoss FK, Albers J, Schwab C, Wagner WL, Tromba G, Dullin C. Three-dimensional virtual histology of benign and malignant endometrial stromal neoplasms: a new perspective on why morphology matters. Int J Gynecol Cancer 2021; 31:934-935. [PMID: 33504548 PMCID: PMC8223668 DOI: 10.1136/ijgc-2020-002313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Felix Kf Kommoss
- Institute of Pathology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Jonas Albers
- Department of Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
| | - Constantin Schwab
- Institute of Pathology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg, German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
| | | | - Christian Dullin
- Department of Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany.,Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg, German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
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28
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Pierce A, Zheng Y, Wagner WL, Scheller HV, Mohnen D, Ackermann M, Mentzer SJ. Visualizing pectin polymer-polymer entanglement produced by interfacial water movement. Carbohydr Polym 2020; 246:116618. [PMID: 32747258 PMCID: PMC7485584 DOI: 10.1016/j.carbpol.2020.116618] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/11/2020] [Accepted: 06/06/2020] [Indexed: 01/08/2023]
Abstract
In this report, we investigated the physical conditions for creating pectin polymer-polymer (homopolymer) entanglement. The potential role of water movement in creating pectin entanglement was investigated by placing water droplets-equivalent to the water content of two gel phase films-between two glass phase films and compressing the films at variable probe velocities. Slow probe velocity (0.5 mm/sec) demonstrated no significant debonding. Corresponding videomicroscopy demonstrated an occasional water bridge, but no evidence of stranding or polymer entanglement. In contrast, fast probe velocity (5 mm/sec) resulted in 1) an increase in peak adhesion strength, 2) a progressive debonding curve, and 3) increased work of cohesion (p < .001). Corresponding videomicroscopy demonstrated pectin stranding and delamination between pectin films. Scanning electron microscopy images obtained during pectin debonding provided additional evidence of both stranding and delamination. We conclude that water movement can supply the motive force for the rapid chain entanglement between pectin films.
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Affiliation(s)
- Aidan Pierce
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Yifan Zheng
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Willi L Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Diagnostic and Interventional Radiology, Translational Lung Research Center, University of Heidelberg, Heidelberg, Germany
| | - Henrik V Scheller
- Joint BioEnergy Institute, Emeryville CA and the Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA, United States
| | - Debra Mohnen
- Complex Carbohydrate Research Center and Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA, United States
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States.
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29
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Wagner WL, Hellbach K, Fiedler MO, Salg GA, Wehrse E, Ziener CH, Merle U, Eckert C, Weber TF, Stiller W, Wielpütz MO, Dullin C, Kenngott HG, Schlemmer HP, Weigand MA, Schirmacher P, Longerich T, Kauczor HU, Kommoss FKF, Schwab C. [Microvascular changes in COVID-19]. Radiologe 2020; 60:934-942. [PMID: 32857175 PMCID: PMC7453182 DOI: 10.1007/s00117-020-00743-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Clinically, coronavirus disease 2019 (COVID-19) is associated with a wide range of symptoms, which can range from mild complaints of an upper respiratory infection to life-threatening hypoxic respiratory insufficiency and multiorgan failure. OBJECTIVE The initially identified pulmonary damage patterns, such as diffuse alveolar damage in acute lung failure, are accompanied by new findings that draw a more complex scenario. These include microvascular involvement and a wide range of associated pathologies of multiple organ systems. A back-scaling of microstructural vascular changes is possible via targeted correlation of pathological autopsy results with radiological imaging. MATERIAL AND METHODS Radiological and pathological correlation as well as microradiological imaging to investigate microvascular involvement in fatal COVID-19. RESULTS The cases of two COVID-19 patients are presented. Patient 1 showed a relative hypoperfusion in lung regions that did not have typical COVID-19 infiltrates; the targeted post-mortem correlation also showed subtle signs of microvascular damage even in these lung sections. Patient 2 showed both radiologically and pathologically advanced typical COVID-19 destruction of lung structures and the case illustrates the damage patterns of the blood-air barrier. The perfusion deficit of the intestinal wall shown in computed tomography of patient 2 could not ultimately clearly be microscopically attributed to intestinal microvascular damage. CONCLUSION In addition to microvascular thrombosis, our results indicate a functional pulmonary vasodysregulation as part of the pathophysiology during the vascular phase of COVID-19. The clinical relevance of autopsies and the integration of radiological imaging findings into histopathological injury patterns must be emphasized for a better understanding of COVID-19.
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Affiliation(s)
- W L Wagner
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
| | - K Hellbach
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M O Fiedler
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - G A Salg
- Neue Technologien und Datenwissenschaften/3D-Biodruck Einheit, Klinik für Allgemein‑, Viszeral-, und Transplantationschirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - E Wehrse
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
- Medizinische Fakultät, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland
| | - C H Ziener
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - U Merle
- Klinik für Gastroenterologie, Infektionen, Vergiftungen, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Eckert
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - T F Weber
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - W Stiller
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M O Wielpütz
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Dullin
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - H G Kenngott
- Neue Technologien und Datenwissenschaften/3D-Biodruck Einheit, Klinik für Allgemein‑, Viszeral-, und Transplantationschirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - H-P Schlemmer
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - M A Weigand
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - P Schirmacher
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
- TI Biobank, Deutsches Zentrum für Infektionsforschung (DZIF), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - T Longerich
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - H-U Kauczor
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
- Zentrum für Translationale Lungenforschung (TLRC), Deutsches Zentrum für Lungenforschung (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - F K-F Kommoss
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Schwab
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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30
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Wagner WL, Zheng Y, Pierce A, Ackermann M, Horstmann H, Kuner T, Ronchi P, Schwab Y, Konietzke P, Wünnemann F, Wielpütz MO, Kauczor HU, Mentzer SJ. Mesopolysaccharides: The extracellular surface layer of visceral organs. PLoS One 2020; 15:e0238798. [PMID: 32941441 PMCID: PMC7498049 DOI: 10.1371/journal.pone.0238798] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 08/24/2020] [Indexed: 11/18/2022] Open
Abstract
The mesothelium is a dynamic and specialized tissue layer that covers the somatic cavities (pleural, peritoneal, and pericardial) as well as the surface of the visceral organs such as the lung, heart, liver, bowel and tunica vaginalis testis. The potential therapeutic manipulation of visceral organs has been complicated by the carbohydrate surface layer-here, called the mesopolysaccharide (MPS)-that coats the outer layer of the mesothelium. The traditional understanding of MPS structure has relied upon fixation techniques known to degrade carbohydrates. The recent development of carbohydrate-preserving fixation for high resolution imaging techniques has provided an opportunity to re-examine the structure of both the MPS and the visceral mesothelium. In this report, we used high pressure freezing (HPF) as well as serial section transmission electron microscopy to redefine the structure of the MPS expressed on the murine lung, heart and liver surface. Tissue preserved by HPF and examined by transmission electron microscopy demonstrated a pleural MPS layer 13.01±1.1 um deep-a 100-fold increase in depth compared to previously reported data obtained with conventional fixation techniques. At the base of the MPS were microvilli 1.1±0.35 um long and 42±5 nm in diameter. Morphological evidence suggested that the MPS was anchored to the mesothelium by microvilli. In addition, membrane pits 97±17 nm in diameter were observed in the apical mesothelial membrane. The spatial proximity and surface density (29±4.5%) of the pits suggested an active process linked to the structural maintenance of the MPS. The striking magnitude and complex structure of the MPS indicates that it is an important consideration in studies of the visceral mesothelium.
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Affiliation(s)
- Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA, United States of America
| | - Yifan Zheng
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA, United States of America
| | - Aidan Pierce
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA, United States of America
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Heinz Horstmann
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, University of Heidelberg, Germany
| | - Thomas Kuner
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, University of Heidelberg, Germany
| | - Paolo Ronchi
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
- European Molecular Biology Laboratory, Electron Microscopy Core Facility, Heidelberg, Germany
| | - Yannick Schwab
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
- European Molecular Biology Laboratory, Electron Microscopy Core Facility, Heidelberg, Germany
- European Molecular Biology Laboratory, Cell Biology and Biophysics Unit, Heidelberg, Germany
| | - Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
| | - Felix Wünnemann
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
| | - Mark O. Wielpütz
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA, United States of America
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Kommoss FKF, Schwab C, Tavernar L, Schreck J, Wagner WL, Merle U, Jonigk D, Schirmacher P, Longerich T. The Pathology of Severe COVID-19-Related Lung Damage. Dtsch Arztebl Int 2020; 117:500-506. [PMID: 32865490 DOI: 10.3238/arztebl.2020.0500] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 05/28/2020] [Accepted: 06/22/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The histomorphological changes of lung damage in severe coronavirus disease 2019 (COVID-19) have not yet been adequately characterized. In this article, we describe the sequence of pathological changes in COVID-19 and discuss the implications for approaches to treatment. METHODS Standardized autopsies were performed on thirteen patients who had died of COVID-19. The findings were analyzed together with clinical data from the patients' medical records. RESULTS Most (77%) of the deceased patients were men. Their median age at death was 78 years (range, 41-90). Most of them had major pre-existing chronic diseases, most commonly arterial hypertension. The autopsies revealed characteristic COVID-19-induced pathological changes in the lungs, which were regarded as the cause of death in most patients. The main histological finding was sequential alveolar damage, apparently due in large measure to focal capillary microthrombus formation. Alveolar damage leads to the death of the patient either directly or by the induction of pulmonary parenchymal fibrosis. Diffuse lung damage was seen exclusively in invasively ventilated patients. CONCLUSION Autopsies are crucial for the systematic assessment of new diseases such as COVID-19: they provide a basis for further investigations of disease mechanisms and for the devising of potentially effective modes of treatment. The autopsy findings suggest that focal damage of the microvascular pulmonary circulation is a main mechanism of lethal lung disease due to the SARS-CoV-2 virus. It may also be a cause of persistent lung damage in patients who recover from severe COVID-19.
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Affiliation(s)
- Felix K F Kommoss
- Institute of Pathology, University Hospital Heidelberg; Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University Hospital Heidelberg; Department of Gastroenterology and Hepatology, University Hospital Heidelberg; Institute of Pathology, Hannover Medical School; Biomedical Research in Endstage and Obstructive Lung Dis ease Hannover (BREATH), Center for Lung Research (DZL), Hannover Medical School; TI Biobank; German Center for Infection Research (DZIF), - University Hospital Heidelberg
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Konietzke P, Weinheimer O, Wagner WL, Wuennemann F, Hintze C, Biederer J, Heussel CP, Kauczor HU, Wielpütz MO. Optimizing airway wall segmentation and quantification by reducing the influence of adjacent vessels and intravascular contrast material with a modified integral-based algorithm in quantitative computed tomography. PLoS One 2020; 15:e0237939. [PMID: 32813730 PMCID: PMC7437894 DOI: 10.1371/journal.pone.0237939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/05/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Quantitative analysis of multi-detector computed tomography (MDCT) plays an increasingly important role in assessing airway disease. Depending on the algorithms used, airway dimensions may be over- or underestimated, primarily if contrast material was used. Therefore, we tested a modified integral-based method (IBM) to address this problem. Methods Temporally resolved cine-MDCT was performed in seven ventilated pigs in breath-hold during iodinated contrast material (CM) infusion over 60s. Identical slices in non-enhanced (NE), pulmonary-arterial (PA), systemic-arterial (SA), and venous phase (VE) were subjected to an in-house software using a standard and a modified IBM. Total diameter (TD), lumen area (LA), wall area (WA), and wall thickness (WT) were measured for ten extra- and six intrapulmonary airways. Results The modified IBM significantly reduced TD by 7.6%, LA by 12.7%, WA by 9.7%, and WT by 3.9% compared to standard IBM on non-enhanced CT (p<0.05). Using standard IBM, CM led to a decrease of all airway parameters compared to NE. For example, LA decreased from 80.85±49.26mm2 at NE, to 75.14±47.96mm2 (-7.1%) at PA (p<0.001), 74.96±48.55mm2 (-7.3%) at SA (p<0.001), and to 78.95±48.94mm2 (-2.4%) at VE (p = 0.200). Using modified IBM, the differences were reduced to -3.1% at PA, -2.9% at SA and -0.7% at VE (p<0.001; p<0.001; p = 1.000). Conclusions The modified IBM can optimize airway wall segmentation and reduce the influence of CM on quantitative CT. This allows a more precise measurement as well as potentially the comparison of enhanced with non-enhanced scans in inflammatory airway disease.
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Affiliation(s)
- Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
- * E-mail:
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Felix Wuennemann
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Christian Hintze
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Kiel, Germany
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Radiologie Rein-Nahe, Bingen, Germany
| | - Juergen Biederer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Claus P. Heussel
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Mark O. Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
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Konietzke P, Mueller J, Wuennemann F, Wagner WL, Schenk JP, Alrajab A, Kauczor HU, Stahl M, Mall MA, Wielpütz MO, Sommerburg O. The value of chest magnetic resonance imaging compared to chest radiographs with and without additional lung ultrasound in children with complicated pneumonia. PLoS One 2020; 15:e0230252. [PMID: 32191736 PMCID: PMC7082029 DOI: 10.1371/journal.pone.0230252] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 02/25/2020] [Indexed: 01/15/2023] Open
Abstract
Introduction In children with pneumonia, chest x-ray (CXR) is typically the first imaging modality used for diagnostic work-up. Repeated CXR or computed tomography (CT) are often necessary if complications such as abscesses or empyema arise, thus increasing radiation exposure. The aim of this retrospective study was to evaluate the potential of radiation-free chest magnetic resonance imaging (MRI) to detect complications at baseline and follow-up, compared to CXR with and without additional lung ultrasound (LUS). Methods Paired MRI and CXR scans were retrospectively reviewed by two blinded readers for presence and severity of pulmonary abscess, consolidation, bronchial wall thickening, mucus plugging and pleural effusion/empyema using a chest MRI scoring system. The scores for MRI and CXR were compared at baseline and follow-up. Furthermore, the MRI scores at baseline with and without contrast media were evaluated. Results 33 pediatric patients (6.3±4.6 years), who had 33 paired MRI and CXR scans at baseline and 12 at follow-up were included. MRI detected significantly more lung abscess formations with a prevalence of 72.7% compared to 27.3% by CXR at baseline (p = 0.001), whereas CXR+LUS was nearly as good as MRI. MRI also showed a higher sensitivity in detecting empyema (p = 0.003). At follow-up, MRI also showed a slightly better sensitivity regarding residual abscesses. The overall severity of disease was rated higher on MRI. Contrast material did not improve detection of abscesses or empyema by MRI. Conclusion CXR and LUS seem to be sufficient in most cases. In cases where LUS cannot be realized or the combination of CXR+LUS might be not sufficient, MRI, as a radiation free modality, should be preferred to CT. Furthermore, the admission of contrast media is not mandatory in this context.
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Affiliation(s)
- Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
- * E-mail:
| | - Jan Mueller
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Felix Wuennemann
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Jens-Peter Schenk
- Department of Diagnostic and Interventional Radiology, Section Pediatric Radiology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Abdulsattar Alrajab
- Department of Diagnostic and Interventional Radiology, Section Pediatric Radiology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Mirjam Stahl
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Translational Pulmonology and Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, University Hospital of Heidelberg, Heidelberg, Germany
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Marcus A. Mall
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Translational Pulmonology and Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, University Hospital of Heidelberg, Heidelberg, Germany
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Mark O. Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Olaf Sommerburg
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Translational Pulmonology and Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, University Hospital of Heidelberg, Heidelberg, Germany
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Ackermann M, Stark H, Neubert L, Schubert S, Borchert P, Linz F, Wagner WL, Stiller W, Wielpütz M, Hoefer A, Haverich A, Mentzer SJ, Shah HR, Welte T, Kuehnel M, Jonigk D. Morphomolecular motifs of pulmonary neoangiogenesis in interstitial lung diseases. Eur Respir J 2020; 55:13993003.00933-2019. [PMID: 31806721 DOI: 10.1183/13993003.00933-2019] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/26/2019] [Indexed: 12/12/2022]
Abstract
The pathogenetic role of angiogenesis in interstitial lung diseases (ILDs) is controversial. This study represents the first investigation of the spatial complexity and molecular motifs of microvascular architecture in important subsets of human ILD. The aim of our study was to identify specific variants of neoangiogenesis in three common pulmonary injury patterns in human ILD.We performed comprehensive and compartment-specific analysis of 24 human lung explants with usual intersitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP) and alveolar fibroelastosis (AFE) using histopathology, microvascular corrosion casting, micro-comupted tomography based volumetry and gene expression analysis using Nanostring as well as immunohistochemistry to assess remodelling-associated angiogenesis.Morphometrical assessment of vessel diameters and intervascular distances showed significant differences in neoangiogenesis in characteristically remodelled areas of UIP, NSIP and AFE lungs. Likewise, gene expression analysis revealed distinct and specific angiogenic profiles in UIP, NSIP and AFE lungs.Whereas UIP lungs showed a higher density of upstream vascularity and lower density in perifocal blood vessels, NSIP and AFE lungs revealed densely packed alveolar septal blood vessels. Vascular remodelling in NSIP and AFE is characterised by a prominent intussusceptive neoangiogenesis, in contrast to UIP, in which sprouting of new vessels into the fibrotic areas is characteristic. The molecular analyses of the gene expression provide a foundation for understanding these fundamental differences between AFE and UIP and give insight into the cellular functions involved.
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Affiliation(s)
- Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany .,Institute of Pathology, Medical Faculty, Heinrich-Heine-University and University Hospital Düsseldorf, Düsseldorf, Germany.,These authors contributed equally and share first and the last authorship, respectively
| | - Helge Stark
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,These authors contributed equally and share first and the last authorship, respectively
| | - Lavinia Neubert
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | | | - Paul Borchert
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Friedemann Linz
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Willi L Wagner
- Dept of Diagnostic and Interventional Radiology, Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany.,Member of German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Wolfram Stiller
- Dept of Diagnostic and Interventional Radiology, Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany.,Member of German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Mark Wielpütz
- Dept of Diagnostic and Interventional Radiology, Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany.,Member of German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Anne Hoefer
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Axel Haverich
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.,Dept of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Steven J Mentzer
- Laboratory of Adaptive and Regenerative Biology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Harshit R Shah
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Tobias Welte
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.,Clinic of Pneumology, Hannover Medical School, Hannover, Germany
| | - Mark Kuehnel
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.,These authors contributed equally and share first and the last authorship, respectively
| | - Danny Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.,These authors contributed equally and share first and the last authorship, respectively
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35
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Pierce A, Zheng Y, Wagner WL, Scheller HV, Mohnen D, Tsuda A, Ackermann M, Mentzer SJ. Pectin biopolymer mechanics and microstructure associated with polysaccharide phase transitions. J Biomed Mater Res A 2020; 108:246-253. [PMID: 31595695 PMCID: PMC7238754 DOI: 10.1002/jbm.a.36811] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 05/19/2019] [Revised: 09/11/2019] [Accepted: 09/16/2019] [Indexed: 01/01/2023]
Abstract
Polysaccharide polymers like pectin can demonstrate striking and reversible changes in their physical properties depending upon relatively small changes in water content. Recent interest in using pectin polysaccharides as mesothelial sealants suggests that water content, rather than nonphysiologic changes in temperature, may be a practical approach to optimize the physical properties of the pectin biopolymers. Here, we used humidified environments to manipulate the water content of dispersed solution of pectins with a high degree of methyl esterification (high-methoxyl pectin; HMP). The gel phase transition was identified by a nonlinear increase in compression resistance at a water content of 50% (w/w). The gel phase was associated with a punched-out fracture pattern and scanning electron microscopy (SEM) images that revealed a cribiform (Swiss cheese-like) pectin microstructure. The glass phase transition was identified by a marked increase in resilience and stiffness. The glass phase was associated with a star-burst fracture pattern and SEM images that demonstrated a homogeneous pectin microstructure. In contrast, the burst strength of the pectin films was largely independent of water content over a range from 5 to 30% (w/w). These observations indicate the potential to use water content in the selective regulation of the physical properties of HMP biopolymers.
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Affiliation(s)
- Aidan Pierce
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Yifan Zheng
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
- Department of Diagnostic and Interventional Radiology, Translational Lung Research Center, University of Heidelberg, Heidelberg, Germany
| | - Henrik V. Scheller
- Joint BioEnergy Institute, Emeryville CA and the Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA
| | - Debra Mohnen
- Complex Carbohydrate Research Center and Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA
| | - Akira Tsuda
- Molecular and Integrative Physiological Sciences, Harvard School of Public Health, Boston, MA
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
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36
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Zheng Y, Pierce A, Wagner WL, Scheller HV, Mohnen D, Tsuda A, Ackermann M, Mentzer SJ. Analysis of pectin biopolymer phase states using acoustic emissions. Carbohydr Polym 2020; 227:115282. [PMID: 31590860 PMCID: PMC6936603 DOI: 10.1016/j.carbpol.2019.115282] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/10/2019] [Accepted: 08/31/2019] [Indexed: 11/28/2022]
Abstract
Acoustic emissions are stress or elastic waves produced by a material under external load. Since acoustic emissions are generated from within and transmitted through the substance, the acoustic signature provides insights into the physical and mechanical properties of the material. In this report, we used a constant velocity probe with force and acoustic emission monitoring to investigate the properties of glass phase and gel phase pectin films. In the gel phase films, a constant velocity uniaxial load produced periodic premonitory acoustic emissions with coincident force variations (saw-tooth pattern). SEM images of the gel phase microarchitecture indicated the presence of slip planes. In contrast, the glass phase films demonstrated early acoustic emissions, but effectively no force or acoustic evidence of periodic or premonitory emissions. Microstructural imaging of the glass phase films indicated the presence of early microcracks as well as dense polymerization of the pectin (without evidence of slip planes). We conclude that the water content in the pectin films contributes to not only the physical properties of the films, but also the stick-slip motion observed with constant uniaxial load. Further, acoustic emissions provide a sensitive and practical measure of this mechanical behavior.
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Affiliation(s)
- Yifan Zheng
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Aidan Pierce
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Willi L Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Diagnostic and Interventional Radiology, Translational Lung Research Center, Univeristy of Heidelberg, Heidelberg, Germany
| | - Henrik V Scheller
- Joint BioEnergy Institute, Emeryville CA and the Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA, United States
| | - Debra Mohnen
- Complex Carbohydrate Research Center and Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA, United States
| | - Akira Tsuda
- Molecular and Integrative Physiological Sciences, Harvard School of Public Health, Boston, MA, United States
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States.
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37
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Byun C, Zheng Y, Pierce A, Wagner WL, Scheller HV, Mohnen D, Ackermann M, Mentzer SJ. The Effect of Calcium on the Cohesive Strength and Flexural Properties of Low-Methoxyl Pectin Biopolymers. Molecules 2019; 25:E75. [PMID: 31878302 PMCID: PMC6982731 DOI: 10.3390/molecules25010075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/13/2019] [Accepted: 12/18/2019] [Indexed: 11/23/2022] Open
Abstract
Abstract: Pectin binds the mesothelial glycocalyx of visceral organs, suggesting its potential role as a mesothelial sealant. To assess the mechanical properties of pectin films, we compared pectin films with a less than 50% degree of methyl esterification (low-methoxyl pectin, LMP) to films with greater than 50% methyl esterification (high-methoxyl pectin, HMP). LMP and HMP polymers were prepared by step-wise dissolution and high-shear mixing. Both LMP and HMP films demonstrated a comparable clear appearance. Fracture mechanics demonstrated that the LMP films had a lower burst strength than HMP films at a variety of calcium concentrations and hydration states. The water content also influenced the extensibility of the LMP films with increased extensibility (probe distance) with an increasing water content. Similar to the burst strength, the extensibility of the LMP films was less than that of HMP films. Flexural properties, demonstrated with the 3-point bend test, showed that the force required to displace the LMP films increased with an increased calcium concentration (p < 0.01). Toughness, here reflecting deformability (ductility), was variable, but increased with an increased calcium concentration. Similarly, titrations of calcium concentrations demonstrated LMP films with a decreased cohesive strength and increased stiffness. We conclude that LMP films, particularly with the addition of calcium up to 10 mM concentrations, demonstrate lower strength and toughness than comparable HMP films. These physical properties suggest that HMP has superior physical properties to LMP for selected biomedical applications.
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Affiliation(s)
- Christine Byun
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (C.B.); (Y.Z.); (A.P.); (W.L.W.)
| | - Yifan Zheng
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (C.B.); (Y.Z.); (A.P.); (W.L.W.)
| | - Aidan Pierce
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (C.B.); (Y.Z.); (A.P.); (W.L.W.)
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (C.B.); (Y.Z.); (A.P.); (W.L.W.)
- Department of Diagnostic and Interventional Radiology, Translational Lung Research Center, University of Heidelberg, 69115 Heidelberg, Germany
| | - Henrik V. Scheller
- Joint BioEnergy Institute, Emeryville CA and the Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94701, USA;
| | - Debra Mohnen
- Complex Carbohydrate Research Center and Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602, USA;
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (C.B.); (Y.Z.); (A.P.); (W.L.W.)
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Buchacker T, Mühlfeld C, Wrede C, Wagner WL, Beare R, McCormick M, Grothausmann R. Assessment of the Alveolar Capillary Network in the Postnatal Mouse Lung in 3D Using Serial Block-Face Scanning Electron Microscopy. Front Physiol 2019; 10:1357. [PMID: 31824323 PMCID: PMC6881265 DOI: 10.3389/fphys.2019.01357] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 08/05/2019] [Accepted: 10/14/2019] [Indexed: 12/20/2022] Open
Abstract
The alveolar capillary network (ACN) has a large surface area that provides the basis for an optimized gas exchange in the lung. It needs to adapt to morphological changes during early lung development and alveolarization. Structural alterations of the pulmonary vasculature can lead to pathological functional conditions such as in bronchopulmonary dysplasia and various other lung diseases. To understand the development of the ACN and its impact on the pathogenesis of lung diseases, methods are needed that enable comparative analyses of the complex three-dimensional structure of the ACN at different developmental stages and under pathological conditions. In this study a newborn mouse lung was imaged with serial block-face scanning electron microscopy (SBF-SEM) to investigate the ACN and its surrounding structures before the alveolarization process begins. Most parts but not all of the examined ACN contain two layers of capillaries, which were repeatedly connected with each other. A path from an arteriole to a venule was extracted and straightened to allow cross-sectional visualization of the data along the path within a plane. This allows a qualitative characterization of the structures that erythrocytes pass on their way through the ACN. One way to define regions of the ACN supplied by specific arterioles is presented and used for analyses. Pillars, possibly intussusceptive, were found in the vasculature but no specific pattern was observed in regard to parts of the saccular septa. This study provides 3D information with a resolution of about 150 nm on the microscopic structure of a newborn mouse lung and outlines some of the potentials and challenges of SBF-SEM for 3D analyses of the ACN.
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Affiliation(s)
- Tobias Buchacker
- Institute of Functional and Applied Anatomy, Medizinische Hochschule Hannover, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Research (BREATH), Member of the German Center for Lung Research, Hanover, Germany
| | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Medizinische Hochschule Hannover, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Research (BREATH), Member of the German Center for Lung Research, Hanover, Germany.,REBIRTH Cluster of Excellence, Hanover, Germany
| | - Christoph Wrede
- Institute of Functional and Applied Anatomy, Medizinische Hochschule Hannover, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Research (BREATH), Member of the German Center for Lung Research, Hanover, Germany.,Research Core Unit Electron Microscopy, Hannover Medical School, Hanover, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology (DIR), University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Richard Beare
- Department of Medicine, Monash University, Melbourne, VIC, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | | | - Roman Grothausmann
- Institute of Functional and Applied Anatomy, Medizinische Hochschule Hannover, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Research (BREATH), Member of the German Center for Lung Research, Hanover, Germany
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Servais AB, Kienzle A, Ysasi AB, Valenzuela CD, Wagner WL, Tsuda A, Ackermann M, Mentzer SJ. Structural heteropolysaccharides as air-tight sealants of the human pleura. J Biomed Mater Res B Appl Biomater 2019; 107:799-806. [PMID: 30253044 PMCID: PMC6408304 DOI: 10.1002/jbm.b.34175] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 02/01/2018] [Revised: 04/27/2018] [Accepted: 05/18/2018] [Indexed: 01/02/2023]
Abstract
Pulmonary "air leaks," typically the result of pleural injury caused by lung surgery or chest trauma, result in the accumulation of air in the pleural space (pneumothorax). Air leaks are a major source of morbidity and prolonged hospitalization after pulmonary surgery. Previous work has demonstrated structural heteropolysaccharide (pectin) binding to the mouse pleural glycocalyx. The similar lectin-binding characteristics and ultrastructural features of the human and mouse pleural glycocalyx suggested the potential application of these polymers in humans. To investigate the utility of pectin-based polymers, we developed a simulacrum using freshly obtained human pleura. Pressure-decay leak testing was performed with an inflation maneuver that involved a 3 s ramp to a 3 s plateau pressure; the inflation was completely abrogated after needle perforation of the pleura. Using nonbiologic materials, pressure-decay leak testing demonstrated an exponential decay with a plateau phase in materials with a Young's modulus less than 5. In human pleural testing, the simulacrum was used to test the sealant function of four mixtures of pectin-based polymers. A 50% high-methoxyl pectin and 50% carboxymethylcellulose mixture demonstrated no sealant failures at transpleural pressures of 60 cmH2 O. In contrast, pectin mixtures containing 50% low-methoxyl pectin, 50% amidated low-methoxyl pectins, or 100% carboxymethylcellulose demonstrated frequent sealant failures at transpleural pressures of 40-50 cmH2 O (p < 0.001). Inhibition of sealant adhesion with enzyme treatment, dessication and 4°C cooling suggested an adhesion mechanism dependent upon polysaccharide interpenetration. We conclude that pectin-based heteropolysaccharides are a promising air-tight sealant of human pleural injuries. © 2018 Wiley Periodicals, Inc. J. Biomed. Mater. Res. Part B, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 799-806, 2019.
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Affiliation(s)
- Andrew B. Servais
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Arne Kienzle
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Alexandra B. Ysasi
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Cristian D. Valenzuela
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Akira Tsuda
- Molecular and Integrative Physiological Sciences, Harvard School of Public Health, Boston, MA
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston MA
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Wagner WL, Rothermel A, Mokry T, Sommerer C, Heußel CP, Kauczor HU. [Rare cause for acute chest pain and dyspnea in young men]. Med Klin Intensivmed Notfmed 2019; 114:342-344. [PMID: 30840095 DOI: 10.1007/s00063-019-0534-2] [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: 11/08/2018] [Revised: 12/09/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
Affiliation(s)
- W L Wagner
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland. .,Translational Lung Research Center Heidelberg (TLRC) Member of the German Center for Lung Research (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
| | - A Rothermel
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - T Mokry
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland
| | - C Sommerer
- Sektion Nephrologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C P Heußel
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.,Translational Lung Research Center Heidelberg (TLRC) Member of the German Center for Lung Research (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland.,Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik Heidelberg, Heidelberg, Deutschland
| | - H-U Kauczor
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.,Translational Lung Research Center Heidelberg (TLRC) Member of the German Center for Lung Research (DZL), Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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Neubert L, Borchert P, Shin HO, Linz F, Wagner WL, Warnecke G, Laenger F, Haverich A, Stark H, Hoeper MM, Kuehnel M, Ackermann M, Jonigk D. Comprehensive three-dimensional morphology of neoangiogenesis in pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis. J Pathol Clin Res 2019; 5:108-114. [PMID: 30697960 PMCID: PMC6463863 DOI: 10.1002/cjp2.125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/14/2019] [Accepted: 01/27/2019] [Indexed: 11/26/2022]
Abstract
Pulmonary veno‐occlusive disease (PVOD) is a rare lung disease characterized by fibrotic narrowing of pulmonary veins leading to pulmonary hypertension (PH) and finally to death by right heart failure. PVOD is often accompanied by pulmonary capillary hemangiomatosis (PCH), a marked abnormal proliferation of pulmonary capillaries. Both morphological patterns often occur together and are thought to be distinct manifestations of the same disease process and accordingly are classified together in group 1′ of the Nice classification of PH. The underlying mechanisms of these aberrant remodeling processes remain poorly understood. In this study, we investigated the three‐dimensional structure of these vascular lesions in the lung explant of a patient diagnosed with PVOD by μ‐computed tomography, microvascular corrosion casting, electron microscopy, immunohistochemistry, correlative light microscopy and gene expression analysis. We were able to describe multifocal intussusceptive neoangiogenesis and vascular sprouting as the three‐dimensional correlate of progressive PCH, a process dividing pre‐existing vessels by intravascular pillar formation previously only known from embryogenesis and tumor neoangiogenesis. Our findings suggest that venous occlusions in PVOD increase shear and stretching forces in the pulmonary capillary bloodstream and thereby induce intussusceptive neoangiogenesis. These findings can serve as a basis for novel approaches to the analysis of PVOD.
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Affiliation(s)
- Lavinia Neubert
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Paul Borchert
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Hoen-Oh Shin
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.,Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Friedemann Linz
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.,Member of German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
| | - Gregor Warnecke
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.,Departement of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Florian Laenger
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Axel Haverich
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.,Departement of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Helge Stark
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Marius M Hoeper
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.,Clinic for Pneumology, Hannover Medical School, Hannover, Germany
| | - Mark Kuehnel
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Institute of Pathology, Medical Faculty, Heinrich-Heine-University and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Danny Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany.,Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
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Abstract
RATIONALE We present a case of incidental venous contrast pooling and layering in a patient without sudden cardiac arrest or cardiogenic shock. PATIENT CONCERNS The patient presented with only discrete symptoms and did not suffer fatal cessation of the cardiac pump function during or shortly after the scan. DIAGNOSIS The patient showed stigmata of venous gravity-dependent pooling and layering of contrast medium, which has frequently been described as a sign of imminent cardiogenic shock and cardiac arrest. INTERVENTIONS A cardiologic consultation including echocardiography was initiated. OUTCOMES Echocardiography confirmed valvular heart disease and biventricular heart failure. A subsequent follow-up CT acquired 8 months after the incidental finding showed no signs of dependent contrast pooling. LESSONS Pooling and layering of contrast medium can occur in patients not suffering acute fatal cessation of the cardiac pump function. Nonetheless, any signs of venous pooling observed in CT examinations, especially gravity-dependent layering of contrast medium, are indicative of severe heart dysfunction and should prompt immediate cardio-pulmonary monitoring and increased level of medical care.
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Affiliation(s)
- Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, University of Heidelberg
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL)
| | - Daniel Spira
- Department of Diagnostic and Interventional Radiology, University of Heidelberg
| | - Florian André
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Ajith Kantharajah
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University of Heidelberg
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL)
| | - Theresa Mokry
- Department of Diagnostic and Interventional Radiology, University of Heidelberg
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Wagner WL, Wuennemann F, Pacilé S, Albers J, Arfelli F, Dreossi D, Biederer J, Konietzke P, Stiller W, Wielpütz MO, Accardo A, Confalonieri M, Cova M, Lotz J, Alves F, Kauczor HU, Tromba G, Dullin C. Towards synchrotron phase-contrast lung imaging in patients - a proof-of-concept study on porcine lungs in a human-scale chest phantom. J Synchrotron Radiat 2018; 25:1827-1832. [PMID: 30407195 DOI: 10.1107/s1600577518013401] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/20/2018] [Indexed: 05/23/2023]
Abstract
In-line free propagation phase-contrast synchrotron tomography of the lungs has been shown to provide superior image quality compared with attenuation-based computed tomography (CT) in small-animal studies. The present study was performed to prove the applicability on a human-patient scale using a chest phantom with ventilated fresh porcine lungs. Local areas of interest were imaged with a pixel size of 100 µm, yielding a high-resolution depiction of anatomical hallmarks of healthy lungs and artificial lung nodules. Details like fine spiculations into surrounding alveolar spaces were shown on a micrometre scale. Minor differences in artificial lung nodule density were detected by phase retrieval. Since we only applied a fraction of the X-ray dose used for clinical high-resolution CT scans, it is believed that this approach may become applicable to the detailed assessment of focal lung lesions in patients in the future.
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Affiliation(s)
- Willi L Wagner
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Wuennemann
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Jonas Albers
- Institute for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
| | - Fulvia Arfelli
- Department of Physics, University of Trieste and INFN, Trieste, Italy
| | | | - Jürgen Biederer
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Philip Konietzke
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Wolfram Stiller
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Mark O Wielpütz
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Agostino Accardo
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | | | - Maria Cova
- Department of Radiology, University of Trieste, ASUITS, Trieste, Italy
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
| | - Frauke Alves
- Institute for Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
| | - Hans Ulrich Kauczor
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
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Konietzke P, Weinheimer O, Wielpütz MO, Wagner WL, Kaukel P, Eberhardt R, Heussel CP, Kauczor HU, Herth FJ, Schuhmann M. Quantitative CT detects changes in airway dimensions and air-trapping after bronchial thermoplasty for severe asthma. Eur J Radiol 2018; 107:33-38. [PMID: 30292270 DOI: 10.1016/j.ejrad.2018.08.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/29/2018] [Accepted: 08/09/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Bronchial thermoplasty (BT) can be considered in the treatment of severe asthma to reduce airway smooth muscle mass and bronchoconstriction. We hypothesized that BT may thus have long-term effects on airway dimensions and air-trapping detectable by quantitative computed tomography (QCT). METHODS Paired in- and expiratory CT and inspiratory CT were acquired in 17 patients with severe asthma before and up to two years after bronchial thermoplasty and in 11 additional conservatively treated patients with serve asthma, respectively. A fully automatic software calculated the airways metrics for wall thickness (WT), wall percentage (WP), lumen area (LA) and total diameter (TD). Furthermore, lung air-trapping was quantified by determining the quotient of mean lung attenuation in expiration vs. inspiration (E/I MLA) and relative volume change in the Hounsfield interval -950 to -856 in expiration to inspiration (RVC856-950) in a generation- and lobe-based approach, respectively. RESULTS BT reduced WT for the combined analysis of the 2nd-7th airway generation significantly by 0.06 mm (p = 0.026) and WP by 2.05% (p < 0.001), whereas LA and TD did not change significantly (p = 0.147, p = 0.706). No significant changes were found in the control group. Furthermore, E/I MLA and RVC856-950 decreased significantly after BT by 12.65% and 1.77% (p < 0.001), respectively. CONCLUSION BT significantly reduced airway narrowing and air-trapping in patients with severe asthma. This can be interpreted as direct therapeutic effects caused by a reduction in airway-smooth muscle mass and changes in innervation. A reduction in air-trapping indicates an influence on more peripheral airways not directly treated by the BT procedure.
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Affiliation(s)
- Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany.
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Mark O Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Philine Kaukel
- Department of Respiratory and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Ralf Eberhardt
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Respiratory and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Claus P Heussel
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Felix J Herth
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Respiratory and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Maren Schuhmann
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany; Department of Respiratory and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
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Konietzke P, Jobst B, Wagner WL, Jarosch I, Graber R, Kenn K, Kauczor HU, Wielpütz MO. Similarities in the Computed Tomography Appearance in α1-Antitrypsin Deficiency and Smoking-Related Chronic Obstructive Pulmonary Disease in a Smoking Collective. Respiration 2018; 96:231-239. [PMID: 29940576 DOI: 10.1159/000489177] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 11/29/2017] [Accepted: 04/09/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Emphysematous destruction of lung parenchyma visible in computed tomography (CT) can be attributed to chronic obstructive pulmonary disease (COPD) or to α1-antitrypsin deficiency (AATD). OBJECTIVES We evaluated if visual semiquantitative phenotyping of CT data helps identifying individuals with AATD in a group of smokers with severe emphysema and airflow limitation. METHOD n = 14 patients with AATD and n = 15 with COPD and a minimum of 10 pack years underwent CT, clinical assessment, and full-body plethysmography. The extent and type of emphysema as well as large and small airway changes were rated semiquantitatively for each lobe using a standardized previously published scoring system. Lastly, a final diagnosis for each patient was proposed. RESULTS AATD had a significantly lower mean emphysema score than COPD, with 8.9 ± 3.4 versus 11.9 ± 3.2 (p < 0.001), respectively. Within both groups, there was significantly more emphysema in the lower lobes (p < 0.05-0.001). The COPD group showed an upper- and middle-lobe predominance of emphysema distribution when compared to the AATD group (p < 0.001). Centrilobular (CLE) and panlobular (PLE) emphysema patterns showed a uniform distribution within both groups, with a CLE predominance in the upper lung and a PLE predominance in the lower lung regions. AATD and COPD both showed significantly more airway changes in lower lobes compared to upper lobes (p = 0.05-0.001), without significant differences between both groups. CONCLUSION The typical emphysema distribution patterns seen on CT traditionally assigned to AATD and COPD were of little use in discriminating both entities. Also, airway changes could not contribute to a more precise differentiation. We conclude that a concise standardized phenotyping-driven approach to chest CT in emphysema is not sufficient to identify patients with AATD in a cohort of smokers with advanced emphysema.
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Affiliation(s)
- Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Bertram Jobst
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Inga Jarosch
- Department of Pneumology, Allergology and Sleep Medicine, Schön Klinik Berchtesgadener Land, Schönau am Königssee, Germany
| | - Ralph Graber
- Radiologische Gemeinschaftspraxis, Bad Reichenhall, Germany
| | - Klaus Kenn
- Department of Pneumology, Allergology and Sleep Medicine, Schön Klinik Berchtesgadener Land, Schönau am Königssee, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Mark O Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
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Servais AB, Valenzuela CD, Ysasi AB, Wagner WL, Kienzle A, Loring SH, Tsuda A, Ackermann M, Mentzer SJ. Pressure-decay testing of pleural air leaks in intact murine lungs: evidence for peripheral airway regulation. Physiol Rep 2018; 6:e13712. [PMID: 29845759 PMCID: PMC5974726 DOI: 10.14814/phy2.13712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 11/24/2022] Open
Abstract
The critical care management of pleural air leaks can be challenging in all patients, but particularly in patients on mechanical ventilation. To investigate the effect of central airway pressure and pleural pressure on pulmonary air leaks, we studied orotracheally intubated mice with pleural injuries. We used clinically relevant variables - namely, airway pressure and pleural pressure - to investigate flow through peripheral air leaks. The model studied the pleural injuries using a pressure-decay maneuver. The pressure-decay maneuver involved a 3 sec ramp to 30 cmH2 0 followed by a 3 sec breath hold. After pleural injury, the pressure-decay maneuver demonstrated a distinctive airway pressure time history. Peak inflation was followed by a rapid decrease to a lower plateau phase. The decay phase of the inflation maneuver was influenced by the injury area. The rate of pressure decline with multiple injuries (28 ± 8 cmH2 0/sec) was significantly greater than a single injury (12 ± 3 cmH2 O/sec) (P < 0.05). In contrast, the plateau phase pressure was independent of injury surface area, but dependent upon transpulmonary pressure. The mean plateau transpulmonary pressure was 18 ± 0.7 cm H2 O. Finally, analysis of the inflation ramp demonstrated that nearly all volume loss occurred at the end of inflation (P < 0.001). We conclude that the air flow through peripheral lung injuries was greatest at increased lung volumes and limited by peripheral airway closure. In addition to suggesting an intrinsic mechanism for limiting flow through peripheral air leaks, these findings suggest the utility of positive end-expiratory pressure and negative pleural pressure to maintain lung volumes in patients with pleural injuries.
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Affiliation(s)
- Andrew B. Servais
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's HospitalHarvard Medical SchoolBostonMassachusetts
| | - Cristian D. Valenzuela
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's HospitalHarvard Medical SchoolBostonMassachusetts
| | - Alexandra B. Ysasi
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's HospitalHarvard Medical SchoolBostonMassachusetts
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's HospitalHarvard Medical SchoolBostonMassachusetts
- Institute of Functional and Clinical AnatomyUniversity Medical Center of the Johannes Gutenberg‐UniversityMainzGermany
| | - Arne Kienzle
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's HospitalHarvard Medical SchoolBostonMassachusetts
| | - Stephen H. Loring
- Department of Anesthesia, Critical Care, and Pain MedicineBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusetts
| | - Akira Tsuda
- Molecular and Integrative Physiological SciencesHarvard School of Public HealthBostonMassachusetts
| | - Maximilian Ackermann
- Institute of Functional and Clinical AnatomyUniversity Medical Center of the Johannes Gutenberg‐UniversityMainzGermany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's HospitalHarvard Medical SchoolBostonMassachusetts
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47
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Servais AB, Valenzuela CD, Kienzle A, Ysasi AB, Wagner WL, Tsuda A, Ackermann M, Mentzer SJ. Functional Mechanics of a Pectin-Based Pleural Sealant after Lung Injury. Tissue Eng Part A 2018; 24:695-702. [PMID: 28920559 PMCID: PMC5963544 DOI: 10.1089/ten.tea.2017.0299] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 06/20/2017] [Accepted: 08/23/2017] [Indexed: 01/08/2023] Open
Abstract
Pleural injury and associated air leaks are a major influence on patient morbidity and healthcare costs after lung surgery. Pectin, a plant-derived heteropolysaccharide, has recently demonstrated potential as an adhesive binding to the glycocalyx of visceral mesothelium. Since bioadhesion is a process likely involving the interpenetration of the pectin-based polymer with the glycocalyx, we predicted that the pectin-based polymer may also be an effective sealant for pleural injury. To explore the potential role of an equal (weight%) mixture of high-methoxyl pectin and carboxymethylcellulose as a pleural sealant, we compared the yield strength of the pectin-based polymer to commonly available surgical products. The pectin-based polymer demonstrated significantly greater adhesion to the lung pleura than the comparison products (p < 0.001). In a 25 g needle-induced lung injury model, pleural injury resulted in an air leak and a loss of airway pressures. After application of the pectin-based polymer, there was a restoration of airway pressure and no measurable air leak. Despite the application of large sheets (50 mm2) of the pectin-based polymer, multifrequency lung impedance studies demonstrated no significant increase in tissue damping (G) or hysteresivity (η)(p > 0.05). In 7-day survival experiments, the application of the pectin-based polymer after pleural injury was associated with no observable toxicity, 100% survival (N = 5), and restored lung function. We conclude that this pectin-based polymer is a strong and nontoxic bioadhesive with the potential for clinical application in the treatment of pleural injuries.
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Affiliation(s)
- Andrew B. Servais
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cristian D. Valenzuela
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Arne Kienzle
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexandra B. Ysasi
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Akira Tsuda
- Molecular and Integrative Physiological Sciences, Harvard School of Public Health, Boston, Massachusetts
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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48
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Kienzle A, Servais AB, Ysasi AB, Gibney BC, Valenzuela CD, Wagner WL, Ackermann M, Mentzer SJ. Free-Floating Mesothelial Cells in Pleural Fluid After Lung Surgery. Front Med (Lausanne) 2018; 5:89. [PMID: 29675416 PMCID: PMC5895720 DOI: 10.3389/fmed.2018.00089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/22/2018] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The mesothelium, the surface layer of the heart, lung, bowel, liver, and tunica vaginalis, is a complex tissue implicated in organ-specific diseases and regenerative biology; however, the mechanism of mesothelial repair after surgical injury is unknown. Previous observations indicated seeding of denuded mesothelium by free-floating mesothelial cells may contribute to mesothelial healing. In this study, we investigated the prevalence of mesothelial cells in pleural fluid during the 7 days following pulmonary surgery. STUDY DESIGN Flow cytometry was employed to study pleural fluid of 45 patients after lung resection or transplantation. We used histologically validated mesothelial markers (CD71 and WT1) to estimate the prevalence of mesothelial cells. RESULTS The viability of pleural fluid cells approached 100%. Leukocytes and mesothelial cells were identified in the pleural fluid within the first week after surgery. The leukocyte concentration was relatively stable at all time points. In contrast, mesothelial cells, identified by CD71 and WT1 peaked on POD3. The broad expression of CD71 molecule in postoperative pleural fluid suggests that many of the free-floating non-leukocyte cells were activated or proliferative mesothelial cells. CONCLUSION We demonstrated that pleural fluid post lung surgery is a source of mesothelial cells; most of these cells appear to be viable and, as shown by CD71 staining, activated mesothelial cells. The observed peak of mesothelial cells on POD3 is consistent with a potential reparative role of free-floating mesothelial cells after pulmonary surgery.
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Affiliation(s)
- Arne Kienzle
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Andrew B. Servais
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexandra B. Ysasi
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Barry C. Gibney
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Cristian D. Valenzuela
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, United States
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49
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Kienzle A, Servais AB, Alexandra YB, Gibney BC, Cristian VD, Wagner WL, Ackermann M, Mentzer SJ. Activated mesothelial cells in pleural fluid after lung resection and transplantation. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.818.20] [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: 11/11/2022]
Affiliation(s)
- Arne Kienzle
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's Hospital, Harvard Medical SchoolBostonMA
| | - Andrew B Servais
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's Hospital, Harvard Medical SchoolBostonMA
| | - Ysasi B Alexandra
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's Hospital, Harvard Medical SchoolBostonMA
| | - Barry C Gibney
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's Hospital, Harvard Medical SchoolBostonMA
| | - Valenzuela D Cristian
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's Hospital, Harvard Medical SchoolBostonMA
| | - Willi L Wagner
- Institute of Functional and Clinical AnatomyUniversity Medical Center of the Johannes Gutenberg‐UniversityMainzGermany
| | - Maximilian Ackermann
- Institute of Functional and Clinical AnatomyUniversity Medical Center of the Johannes Gutenberg‐UniversityMainzGermany
| | - Steven J Mentzer
- Laboratory of Adaptive and Regenerative BiologyBrigham & Women's Hospital, Harvard Medical SchoolBostonMA
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50
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Servais AB, Kienzle A, Valenzuela CD, Ysasi AB, Wagner WL, Tsuda A, Ackermann M, Mentzer SJ. Structural Heteropolysaccharide Adhesion to the Glycocalyx of Visceral Mesothelium. Tissue Eng Part A 2018; 24:199-206. [PMID: 28467734 PMCID: PMC5792244 DOI: 10.1089/ten.tea.2017.0042] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 01/23/2017] [Accepted: 04/25/2017] [Indexed: 12/25/2022] Open
Abstract
Bioadhesives are biopolymers with potential applications in wound healing, drug delivery, and tissue engineering. Pectin, a plant-based heteropolysaccharide, has recently demonstrated potential as a mucoadhesive in the gut. Since mucoadhesion is a process likely involving the interpenetration of the pectin polymer with mucin chains, we hypothesized that pectin may also be effective at targeting the glycocalyx of the visceral mesothelium. To explore the potential role of pectin as a mesothelial bioadhesive, we studied the interaction of various pectin formulations with the mesothelium of the lung, liver, bowel, and heart. Tensile strength, peel strength, and shear resistance of the bioadhesive-mesothelial interaction were measured by load/displacement measurements. In both high-methoxyl pectins (HMP) and low-methoxyl pectins, bioadhesion was greatest with an equal weight % formulation with carboxymethylcellulose (CMC). The tensile strength of the high-methoxyl pectin was consistently greater than low-methoxyl or amidated low-methoxyl formulations (p < 0.05). Consistent with a mechanism of polymer-glycocalyx interpenetration, the HMP adhesion to tissue mesothelium was reversed with hydration and limited by enzyme treatment (hyaluronidase, pronase, and neuraminidase). Peel and shear forces applied to the lung/pectin adhesion resulted in a near-interface structural failure and the efficient isolation of intact en face pleural mesothelium. These data indicate that HMP, in an equal weight % mixture with CMC, is a promising mesothelial bioadhesive for use in experimental and therapeutic applications.
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Affiliation(s)
- Andrew B. Servais
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Arne Kienzle
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cristian D. Valenzuela
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexandra B. Ysasi
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Akira Tsuda
- Molecular and Integrative Physiological Sciences, Harvard School of Public Health, Boston, Massachusetts
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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