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Hummel S, Friedl N, Winkler C, Ziegler AG, Achenbach P. Presymptomatic type 1 diabetes and disease severity at onset. Reply to Schneider J, Gemulla G, Kiess W et al [letter]. Diabetologia 2023; 66:2389-2390. [PMID: 37723346 PMCID: PMC10627885 DOI: 10.1007/s00125-023-06017-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 09/20/2023]
Affiliation(s)
- Sandra Hummel
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.
- German Center for Diabetes Research (DZD), Munich, Germany.
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany.
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany.
| | - Nadine Friedl
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany
| | - Anette-G Ziegler
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Peter Achenbach
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.
- German Center for Diabetes Research (DZD), Munich, Germany.
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany.
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany.
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Liu Q, Zhang W, Pei Y, Tao H, Ma J, Li R, Zhang F, Wang L, Shen L, Liu Y, Jia X, Hu Y. Gut mycobiome as a potential non-invasive tool in early detection of lung adenocarcinoma: a cross-sectional study. BMC Med 2023; 21:409. [PMID: 37904139 PMCID: PMC10617124 DOI: 10.1186/s12916-023-03095-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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/26/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The gut mycobiome of patients with lung adenocarcinoma (LUAD) remains unexplored. This study aimed to characterize the gut mycobiome in patients with LUAD and evaluate the potential of gut fungi as non-invasive biomarkers for early diagnosis. METHODS In total, 299 fecal samples from Beijing, Suzhou, and Hainan were collected prospectively. Using internal transcribed spacer 2 sequencing, we profiled the gut mycobiome. Five supervised machine learning algorithms were trained on fungal signatures to build an optimized prediction model for LUAD in a discovery cohort comprising 105 patients with LUAD and 61 healthy controls (HCs) from Beijing. Validation cohorts from Beijing, Suzhou, and Hainan comprising 44, 17, and 15 patients with LUAD and 26, 19, and 12 HCs, respectively, were used to evaluate efficacy. RESULTS Fungal biodiversity and richness increased in patients with LUAD. At the phylum level, the abundance of Ascomycota decreased, while that of Basidiomycota increased in patients with LUAD. Candida and Saccharomyces were the dominant genera, with a reduction in Candida and an increase in Saccharomyces, Aspergillus, and Apiotrichum in patients with LUAD. Nineteen operational taxonomic unit markers were selected, and excellent performance in predicting LUAD was achieved (area under the curve (AUC) = 0.9350) using a random forest model with outcomes superior to those of four other algorithms. The AUCs of the Beijing, Suzhou, and Hainan validation cohorts were 0.9538, 0.9628, and 0.8833, respectively. CONCLUSIONS For the first time, the gut fungal profiles of patients with LUAD were shown to represent potential non-invasive biomarkers for early-stage diagnosis.
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Affiliation(s)
- Qingyan Liu
- Graduate School, Chinese People's Liberation Army Medical School, Beijing, China
- Department of Oncology, Fifth Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian Distrist, Beijing, 100000, China
| | - Weidong Zhang
- Graduate School, Chinese People's Liberation Army Medical School, Beijing, China
- Department of Thoracic Surgery, First Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100000, China
| | - Yanbin Pei
- Graduate School, Chinese People's Liberation Army Medical School, Beijing, China
| | - Haitao Tao
- Department of Oncology, Fifth Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian Distrist, Beijing, 100000, China
| | - Junxun Ma
- Department of Oncology, Fifth Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian Distrist, Beijing, 100000, China
| | - Rong Li
- Department of Health Medicine, Second Medical Center of the Chinese People's Liberation Army General Hospital, Beijing, China
| | - Fan Zhang
- Department of Oncology, Fifth Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian Distrist, Beijing, 100000, China
| | - Lijie Wang
- Department of Oncology, Fifth Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian Distrist, Beijing, 100000, China
| | - Leilei Shen
- Department of Thoracic Surgery, Hainan Medical Center of the Chinese People's Liberation Army General Hospital, Hainan, China
| | - Yang Liu
- Department of Thoracic Surgery, First Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100000, China.
| | - Xiaodong Jia
- Department of Oncology, Fifth Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian Distrist, Beijing, 100000, China.
| | - Yi Hu
- Department of Oncology, Fifth Medical Center of the Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian Distrist, Beijing, 100000, China.
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Hummel S, Carl J, Friedl N, Winkler C, Kick K, Stock J, Reinmüller F, Ramminger C, Schmidt J, Lwowsky D, Braig S, Dunstheimer D, Ermer U, Gerstl EM, Weber L, Nellen-Hellmuth N, Brämswig S, Sindichakis M, Tretter S, Lorrmann A, Bonifacio E, Ziegler AG, Achenbach P. Children diagnosed with presymptomatic type 1 diabetes through public health screening have milder diabetes at clinical manifestation. Diabetologia 2023; 66:1633-1642. [PMID: 37329450 PMCID: PMC10390633 DOI: 10.1007/s00125-023-05953-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/25/2023] [Indexed: 06/19/2023]
Abstract
AIMS/HYPOTHESIS We aimed to determine whether disease severity was reduced at onset of clinical (stage 3) type 1 diabetes in children previously diagnosed with presymptomatic type 1 diabetes in a population-based screening programme for islet autoantibodies. METHODS Clinical data obtained at diagnosis of stage 3 type 1 diabetes were evaluated in 128 children previously diagnosed with presymptomatic early-stage type 1 diabetes between 2015 and 2022 in the Fr1da study and compared with data from 736 children diagnosed with incident type 1 diabetes between 2009 and 2018 at a similar age in the DiMelli study without prior screening. RESULTS At the diagnosis of stage 3 type 1 diabetes, children with a prior early-stage diagnosis had lower median HbA1c (51 mmol/mol vs 91 mmol/mol [6.8% vs 10.5%], p<0.001), lower median fasting glucose (5.3 mmol/l vs 7.2 mmol/l, p<0.05) and higher median fasting C-peptide (0.21 nmol/l vs 0.10 nmol/l, p<0.001) compared with children without previous early-stage diagnosis. Fewer participants with prior early-stage diagnosis had ketonuria (22.2% vs 78.4%, p<0.001) or required insulin treatment (72.3% vs 98.1%, p<0.05) and only 2.5% presented with diabetic ketoacidosis at diagnosis of stage 3 type 1 diabetes. Outcomes in children with a prior early-stage diagnosis were not associated with a family history of type 1 diabetes or diagnosis during the COVID-19 pandemic. A milder clinical presentation was observed in children who participated in education and monitoring after early-stage diagnosis. CONCLUSIONS/INTERPRETATION Diagnosis of presymptomatic type 1 diabetes in children followed by education and monitoring improved clinical presentation at the onset of stage 3 type 1 diabetes.
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Affiliation(s)
- Sandra Hummel
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.
- German Center for Diabetes Research (DZD), Munich, Germany.
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany.
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany.
| | - Johanna Carl
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
| | - Nadine Friedl
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany
| | - Kerstin Kick
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Joanna Stock
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
| | - Franziska Reinmüller
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Claudia Ramminger
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
| | - Jennifer Schmidt
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany
| | | | - Sonja Braig
- Pediatric Clinic of the Bayreuth Hospital, Bayreuth, Germany
| | | | - Uwe Ermer
- St Elisabeth Klinik, Neuburg an der Donau, Germany
| | | | | | | | | | | | | | | | - Ezio Bonifacio
- German Center for Diabetes Research (DZD), Munich, Germany
- Center for Regenerative Therapies Dresden, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Centre Munich at the University Clinic Carl Gustav Carus of TU Dresden and Faculty of Medicine, Dresden, Germany
| | - Anette-G Ziegler
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany
| | - Peter Achenbach
- Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.
- German Center for Diabetes Research (DZD), Munich, Germany.
- Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, Munich, Germany.
- Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany.
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Schmid-Bindert G, Vogel-Claussen J, Gütz S, Fink J, Hoffmann H, Eichhorn ME, Herth FJ. Incidental Pulmonary Nodules - What Do We Know in 2022. Respiration 2022; 101:1024-1034. [PMID: 36228594 PMCID: PMC9945197 DOI: 10.1159/000526818] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
Lung cancer (LC) is the leading cause of cancer-related mortality worldwide, and early LC diagnosis can significantly improve outcomes and survival rates in affected patients. Implementation of LC screening programs using low-dose computed tomography CT in high-risk subjects aims to detect LC as early as possible, but so far, adoption of screening programs into routine clinical care has been very slow. In recent years, the use of CT has significantly increased the rate of incidentally detected pulmonary nodules. Although most of those incidental pulmonary nodules (IPNs) are benign, some of them represent early-stage LC. Given the large number of IPNs detected in the range of several millions each year, this represents an additional, maybe even larger, opportunity to drive stage shift in LC diagnosis, next to LC screening programs. Comprehensive evaluation and targeted work-up of IPNs are mandatory to identify the malignant nodules from the crowd, and several guidelines provide radiologists and physicians' guidance on IPN assessment and management. However, IPNs still seem to be inadequately processed due to various reasons including insufficient reporting in the radiological report, missing communication between stakeholders, absence of patient tracking systems, and uncertainty regarding responsibilities for the IPN management. In recent years, several approaches such as lung nodule programs, patient tracking software, artificial intelligence, and communication software were introduced into clinical practice to address those shortcomings. This review evaluates the current situation of IPN management and highlights recent developments in process improvement to achieve first steps toward stage shift in LC diagnosis.
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Affiliation(s)
- Gerald Schmid-Bindert
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany,AstraZeneca GmbH, Hamburg, Germany,*Gerald Schmid-Bindert,
| | - Jens Vogel-Claussen
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany
| | - Sylvia Gütz
- Department of Pneumology, Cardiology, Endocrinology, Diabetology and General Internal Medicine, Sankt Elisabeth Hospital, Leipzig, Germany
| | | | - Hans Hoffmann
- Section for Thoracic Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Martin E. Eichhorn
- Department of Thoracic Surgery, Thoraxklinik, University Hospital Heidelberg, Heidelberg, Germany,Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Felix J.F. Herth
- Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany,Department of Pulmonology, and Critical Care Medicine, Thoraxklinik Universitätsklinikum Heidelberg, Heidelberg, Germany
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Probstmeier R, Kraus D, Wenghoefer M, Winter J. S100 Proteins as Biomarkers in Risk Estimations for Malignant Transformation in Oral Lesions. Methods Mol Biol 2019; 1929:763-71. [PMID: 30710310 DOI: 10.1007/978-1-4939-9030-6_48] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Oncologic relevant members of S100 proteins are described as promising biomarkers in molecular pathology for risk estimation in oral neoplasia exhibiting different stages of malignancy: gingiva as healthy tissue, irritation fibroma as benign, leukoplakia as precancerous, and oral squamous cell carcinoma as malignant entity. Gene expression levels of S100A4 (metastasin), S100A7 (psoriasin), S100A8 (calgranulin A), and S100A9 (calgranulin B) were analyzed using quantitative RT-PCR. In addition, immunohistochemistry-based microscopy was used to examine cellular localization and distribution of these biomarkers in tissue sections. The results indicate that S100 proteins represent promising biomarkers for early-stage diagnosis in oral lesions. The inclusion of expression profiles and ratios for each entity even improves their diagnostic validity.
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