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Although direct-acting antiviral medications effectively cure hepatitis C in most patients, sometimes treatment selects for resistant viruses, causing antiviral drugs to be either ineffective or only partially effective. Multidrug resistance is common in patients for whom DAA treatment fails. Older patients and patients with advanced liver diseases are more likely to select drug-resistant viruses. Collective efforts from international communities and governments are needed to develop an optimal approach to managing drug resistance and preventing the transmission of resistant viruses.
The assembly of a specific polymeric ubiquitin chain on a target protein is a key event in the regulation of numerous cellular processes. Yet, the mechanisms that govern the selective synthesis of particular polyubiquitin signals remain enigmatic. The homologous ubiquitin-conjugating (E2) enzymes Ubc1 (budding yeast) and Ube2K (mammals) exclusively generate polyubiquitin linked through lysine 48 (K48). Uniquely among E2 enzymes, Ubc1 and Ube2K harbor a ubiquitin-binding UBA domain with unknown function. We found that this UBA domain preferentially interacts with ubiquitin chains linked through lysine 63 (K63). Based on structural modeling, in vitro ubiquitination experiments, and NMR studies, we propose that the UBA domain aligns Ubc1 with K63-linked polyubiquitin and facilitates the selective assembly of K48/K63-branched ubiquitin conjugates. Genetic and proteomics experiments link the activity of the UBA domain, and hence the formation of this unusual ubiquitin chain topology, to the maintenance of cellular proteostasis.
Severe acute graft versus host disease (GvHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation. Human mesenchymal stromal cells (MSCs) play an important role in endogenous tissue repair and possess strong immune-modulatory properties making them a promising tool for the treatment of steroid-refractory GvHD. To date, a few reports exist on the use of MSCs in treatment of GvHD in children indicating that children tend to respond better than adults, albeit with heterogeneous results. We here present a review of the literature and the clinical course of two instructive pediatric patients with acute steroid-refractory GvHD after haploidentical stem cell transplantation, which exemplify the beneficial effects of third-party transplanted MSCs in treatment of acute steroid-refractory GvHD. Moreover, we provide a meta-analysis of clinical studies addressing the outcome of patients with steroid-refractory GvHD and treatment with MSCs in adults and in children (n = 183; 122 adults, 61 children). Our meta-analysis demonstrates that the overall response-rate is high (73.8%) and confirms, for the first time, that children indeed respond better to treatment of GvHD with MSCs than adults (complete response 57.4% vs. 45.1%, respectively). These data emphasize the significance of this therapeutic approach especially in children and indicate that future prospective studies are needed to assess the reasons for the observed differential response-rates in pediatric and adult patients. Additional file 1: MSCs expansion and release criteria.his file contains a detailed description of the MSCs expansion and release criteria for Case A and Case B.
Specific protocols define eligibility, conditioning, donor selection, graft composition and prophylaxis of graft vs. host disease for children and young adults undergoing hematopoietic stem cell transplant (HSCT). However, international protocols rarely, if ever, detail supportive care, including pharmaceutical infection prophylaxis, physical protection with face masks and cohort isolation or food restrictions. Supportive care suffers from a lack of scientific evidence and implementation of practices in the transplant centers brings extensive restrictions to the child's and family's daily life after HSCT. Therefore, the Board of the Pediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT) held a series of dedicated workshops since 2017 with the aim of initiating the production of a set of minimal recommendations. The present paper describes the consensus reached within the field of infection prophylaxis.
Proteins encoded by small open reading frames (sORFs) have a widespread occurrence in diverse microorganisms and can be of high functional importance. However, due to annotation biases and their technically challenging direct detection, these small proteins have been overlooked for a long time and were only recently rediscovered. The currently rapidly growing number of such proteins requires efficient methods to investigate their structure–function relationship. Herein, a method is presented for fast determination of the conformational properties of small proteins. Their small size makes them perfectly amenable for solution-state NMR spectroscopy. NMR spectroscopy can provide detailed information about their conformational states (folded, partially folded, and unstructured). In the context of the priority program on small proteins funded by the German research foundation (SPP2002), 27 small proteins from 9 different bacterial and archaeal organisms have been investigated. It is found that most of these small proteins are unstructured or partially folded. Bioinformatics tools predict that some of these unstructured proteins can potentially fold upon complex formation. A protocol for fast NMR spectroscopy structure elucidation is described for the small proteins that adopt a persistently folded structure by implementation of new NMR technologies, including automated resonance assignment and nonuniform sampling in combination with targeted acquisition.
Despite recent advances in the treatment of metastatic prostate cancer (PCa), resistance development after taxane treatments is inevitable, necessitating effective options to combat drug resistance. Previous studies indicated antitumoral properties of the natural compound amygdalin. However, whether amygdalin acts on drug-resistant tumor cells remains questionable. An in vitro study was performed to investigate the influence of amygdalin (10 mg/mL) on the growth of a panel of therapy-naïve and docetaxel- or cabazitaxel-resistant PCa cell lines (PC3, DU145, and LNCaP cells). Tumor growth, proliferation, clonal growth, and cell cycle progression were investigated. The cell cycle regulating proteins (phospho)cdk1, (phospho)cdk2, cyclin A, cyclin B, p21, and p27 and the mammalian target of rapamycin (mTOR) pathway proteins (phospho)Akt, (phospho)Raptor, and (phospho)Rictor as well as integrin β1 and the cytoskeletal proteins vimentin, ezrin, talin, and cytokeratin 8/18 were assessed. Furthermore, chemotactic activity and adhesion to extracellular matrix components were analyzed. Amygdalin dose-dependently inhibited tumor growth and reduced tumor clones in all (parental and resistant) PCa cell lines, accompanied by a G0/G1 phase accumulation. Cell cycle regulating proteins were significantly altered by amygdalin. A moderate influence of amygdalin on tumor cell adhesion and chemotaxis was observed as well, paralleled by modifications of cytoskeletal proteins and the integrin β1 expression level. Amygdalin may, therefore, block tumor growth and disseminative characteristics of taxane-resistant PCa cells. Further studies are warranted to determine amygdalin’s value as an antitumor drug.
Background: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. Methods: We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. Results: We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. Conclusions: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.
Background: Differential RNA-Seq (dRNA-Seq) is a recently developed method of performing primary transcriptome analyses that allows for the genome-wide mapping of transcriptional start sites (TSSs) and the identification of novel transcripts. Although the transcriptomes of diverse bacterial species have been characterized by dRNA-Seq, the transcriptome analysis of archaeal species is still rather limited. Therefore, we used dRNA-Seq to characterize the primary transcriptome of the model archaeon Haloferax volcanii.
Results: Three independent cultures of Hfx. volcanii grown under optimal conditions to the mid-exponential growth phase were used to determine the primary transcriptome and map the 5′-ends of the transcripts. In total, 4749 potential TSSs were detected. A position weight matrix (PWM) was derived for the promoter predictions, and the results showed that 64 % of the TSSs were preceded by stringent or relaxed basal promoters. Of the identified TSSs, 1851 belonged to protein-coding genes. Thus, fewer than half (46 %) of the 4040 protein-coding genes were expressed under optimal growth conditions. Seventy-two percent of all protein-coding transcripts were leaderless, which emphasized that this pathway is the major pathway for translation initiation in haloarchaea. A total of 2898 of the TSSs belonged to potential non-coding RNAs, which accounted for an unexpectedly high fraction (61 %) of all transcripts. Most of the non-coding TSSs had not been previously described (2792) and represented novel sequences (59 % of all TSSs). A large fraction of the potential novel non-coding transcripts were cis-antisense RNAs (1244 aTSSs). A strong negative correlation between the levels of antisense transcripts and cognate sense mRNAs was found, which suggested that the negative regulation of gene expression via antisense RNAs may play an important role in haloarchaea. The other types of novel non-coding transcripts corresponded to internal transcripts overlapping with mRNAs (1153 iTSSs) and intergenic small RNA (sRNA) candidates (395 TSSs).
Conclusion: This study provides a comprehensive map of the primary transcriptome of Hfx. volcanii grown under optimal conditions. Fewer than half of all protein-coding genes have been transcribed under these conditions. Unexpectedly, more than half of the detected TSSs belonged to several classes of non-coding RNAs. Thus, RNA-based regulation appears to play a more important role in haloarchaea than previously anticipated.
Polazeći od teorije paralelne arhitekture koja sve jezične razine smatra generativnima, u radu se iznose rezultati istraživanja suodnosa između reda riječi, tj. reda rečeničnih sastavnica na sintaktičkoj i na fonološkoj razini, i informacijske strukture kao sastavnice rečenične gramatike. Analiza u kojoj je informacijska struktura ravnopravna razina, a ne izvanjska, pragmatički uvjetovana sastavnica, omogućuje semantički informirano tumačenje varijacija u redu riječi u hrvatskom jeziku. Istraživanje rezultati kojega se iznose metodološki predstavlja premošćivanje jaza između formalnih i funkcionalnih pristupa. Kao primjer se uzima hrvatski, koji se tradicionalno smatra jezikom u kojem je red sintaktičkih komponenata (relativno) slobodan, dok se za položaj klitika u njemu smatra da je (relativno) ograničen. Na brojnim primjerima u radu pokazuje se kako klitike i grozdovi klitika svojim smještajem unutar linearnog rečeničnog ustrojstva ne predstavljaju nepravilnost sustava, nego oblik dinamiziranja rečeničnoga sadržaja koji izvorni govornici prihvaćaju kao otvorenu mogućnost. U dosadašnjim su se istraživanjima takvoj analizi postavljale dvije ključne prepreke. Prva se tiče bavljenja isključivo tzv. „neutralnim”, kontekstualno neuvjetovanim tipovima rečenica, dakle onima koje uglavnom odgovaraju na pitanje O čemu se radi? Druga se tiče nedostatka empirijskih istraživanja, kako korpusnih, tako i psiholingvističkih, kojima se otvara potpuno nov uvid u jezičnu strukturu i istančane mogućnosti njezine izražajnosti na informacijskoj razini. U radu se bavim obama uočenim problemima.
HIV ist heutzutage eine gut behandelbare, chronische Erkrankung. Insbesondere bei chronischen Erkrankungen ist es entscheidend, auch die psychischen und physischen Auswirkungen auf die Lebenssituation zu untersuchen und dabei auch geschlechtsspezifische Aspekte in der gesundheitsbezogenen Lebensqualität von PLWH mit einzuschließen.
Ziel dieser monozentrischen Beobachtungsstudie ist es, die gesundheitsbezogene Lebensqualität von Patientinnen und Patienten des HIVCENTERs Frankfurt darzustellen und diesbezügliche Einflussfaktoren zu identifizieren. Im Zuge dessen wurden zusätzlich geschlechtsspezifische Unterschiede ausgewertet. Der Mental Component Score stellte die primäre Zielgröße der Studie dar, der Physical Component Score die sekundäre.
Zur Erhebung der gesundheitsbezogenen Lebensqualität wurde der SF-12v2 Fragebogen verwendet, der insgesamt zwölf Fragen beinhaltet. Inhaltlich gliedert sich der Bogen in acht Skalen und zwölf Items, die den Mental- und Physical Component Score bilden. Zur näheren Erfassung der aktuellen Lebenssituation der Patientinnen und Patientinnen des HIVCENTERs Frankfurt, wurde ein eigens für die Studie entwickelter Fragebogen verwendet. Dieser erfasste mit 19 Fragen unter anderem soziodemographische Daten, sowie Parameter zu Religiosität oder Sexualität. Retrospektive Daten aus der Epidem-Datenbank des HIVCENTERs und aus den Patientinnen- und Patientenakten wurden ebenfalls in die Auswertung einbezogen.
Die statistische Auswertung beinhaltete neben deskriptiven Methoden, einfache Varianzanalysen für geschlechtsunabhängige Zusammenhänge und Varianzanalysen mit Interaktion für das Geschlecht zur Ermittlung von geschlechtsspezifischen Einflussgrößen. Des Weiteren wurden Spearmankorrelationen berechnet und zur Identifikation von potenziellen Prädiktoren Regressionen mit Rückwärtsausschluss durchgeführt. Für beide Zielgrößen wurde identisch verfahren. Alle statistischen Tests waren zweiseitig und nutzen ein Signifikanzniveau von alpha=5%.
Im Zeitraum von September 2016 bis Mai 2017 wurden insgesamt 275 Patientinnen und Patienten in die Studie eingeschlossen, darunter 123 Frauen, 150 Männer und 2 transgender Personen. Letztere wurden aufgrund der geringen Fallzahl nicht über die deskriptive Statistik hinaus in den Berechnungen berücksichtigt. Das durchschnittliche Alter in der Studienpopulation betrug 46 Jahre. Frauen hatten ein Durchschnittsalter von 44, Männer von 48 Jahren. 97% der Patientinnen und Patienten waren zum Erhebungszeitpunkt unter antiretroviraler Therapie. Im Durchschnitt erzielten die Teilnehmerinnen und Teilnehmer im Vergleich mit der Referenzpopulation einen unterdurchschnittlichen Mental Component Score von 46. Die Frauen der Studie erzielten einen signifikant schlechteren MCS als die Männer (45 vs. 48; p=0,02). Im Kontext mit den übrigen Prädiktoren des Regressionsmodells erreichten Frauen einen um durchschnittlich 13 Punkte schlechteren MCS als Männer (B=-13; p=<0,001). Als geschlechtsunabhängige negative Prädiktoren auf den MCS stellten sich unter anderem regelmäßiger Alkohol- und Drogenkonsum heraus, sowie das Unterlassen von regelmäßigem Sport oder eine negative Zukunftsaussicht. Als geschlechtsabhängiger negativer Prädiktor erwies sich bei den Frauen eine afrikanische versus westeuropäische Herkunft (B=-5; p=0,028). Arbeitslosigkeit stellte sich bei Männern als geschlechtsabhängiger negativer Prädiktor heraus (B=-5; p=0,033).
Vorliegende Dissertation macht deutlich, dass PLWH auch heute noch eine unterdurchschnittliche gesundheitsbezogene Lebensqualität aufweisen und darüber hinaus deutliche geschlechtsabhängige Unterschiede existieren. HIV-positive Frauen erreichten in dieser Studie signifikant schlechtere Werte für den Mental Component Score als Männer und waren hinsichtlich negativer Einflussgrößen überrepräsentiert. Anhand der hier verwendeten Fragebögen wird es behandelnden Ärztinnen und Ärzten innerhalb der Routinesprechstunde ermöglicht, ein regelmäßiges Monitoring der HRQoL durchzuführen und auch ihren Verlauf zu beurteilen. Zudem wäre ein Screening nach den in dieser Arbeit ermittelten negativen Prädiktoren der HRQoL möglich, wodurch entsprechenden Patientinnen und Patienten ein zielgruppenspezifisches Angebot erhalten könnten.
Verschiedene sprachwissenschaftliche Denkansätze und Ausgangspunkte bringen von denselben Forschungsansätzen ausgehend unterschiedliche Methoden und theoretische Auffassungen hervor. Als Produkte verschiedener Forschungsverfahren ergeben sich in demselben Teilbereich manchmal auch kontroverse Definitionen. Die Problematik der Kollokationen ist auch eine umstrittene Frage der Linguistik. Die Umstrittenheit betrifft sowohl die Fragen der Deskription des Charakters dieser sprachlichen Erscheinungen als auch deren Abgrenzung, sprachwissenschaftliche Einreihung und Klassifikation.
In dieser Studie befassen wir uns mit der Darstellung der Heterogenität von Kollokationsauffassungen sowohl in der einheimischen als auch in der internationalen Linguistik...
Background: Natural history museums receive a rapidly growing number of requests for tissue samples from preserved specimens for DNA-based studies. Traditionally, dried vertebrate specimens were treated with arsenic because of its toxicity and insect-repellent effect. Arsenic has negative effects on in vivo DNA repair enzymes and consequently may inhibit PCR performance. In bird collections, foot pad samples are often requested since the feet were not regularly treated with arsenic and because they are assumed to provide substantial amounts of DNA. However, the actual influence of arsenic on DNA analyses has never been tested. Findings: PCR success of both foot pad and body skin samples was significantly lower in arsenic-treated samples. In general, foot pads performed better than body skin samples. Moreover, PCR success depends on collection date in which younger samples yielded better results. While the addition of arsenic solution to the PCR mixture had a clear negative effect on PCR performance after the threshold of 5.4 μg/μl, such high doses of arsenic are highly unlikely to occur in dried zoological specimens. Conclusions: While lower PCR success in older samples might be due to age effects and/or DNA damage through arsenic treatment, our results show no inhibiting effect on DNA polymerase. We assume that DNA degradation proceeds more rapidly in thin tissue layers with low cell numbers that are susceptible to external abiotic influences. In contrast, in thicker parts of a specimen, such as foot pads, the outermost horny skin may act as an additional barrier. Since foot pads often performed better than body skin samples, the intention to preserve morphologically important structures of a specimen still conflicts with the aim to obtain optimal PCR success. Thus, body skin samples from recently collected specimens should be considered as alternative sources of DNA.
In zahlreichen, in der Einleitung bereits näher beschriebenen Studien konnte anxiolytische Wirksamkeit des patentierten ätherischen Öls Silexan sowohl im Tiermodell, als auch am Menschen zur Therapie subsyndromaler und generalisierter Angsterkrankungen demonstriert werden.
Das Ziel der vorliegenden Dissertation war es, den zugrunde liegenden pharmakologischen Wirkmechanismus zu untersuchen. Nach eingehender Analyse der Targets klassischer Anxiolytika, richtete sich der Fokus auf spannungsabhängige Calciumkanäle, die die Bindungsstelle des Gabapentinoids Pregabalin enthalten. Die mögliche Modulation der Kanäle wurde an PC-Zellen, einem Modell neuronaler Vorläuferzellen, murinen Synaptosomen, aber auch in primären Neuronen der für die Genese der Angsterkrankungen relevanten Hirnareale Hippocampus und Cortex untersucht. Die Kanalexpression, sowie - distribution in den unterschiedlichen Geweben wurde charakterisiert und die Frage erörtert, ob Silexan spezifische Modulation eines bestimmten Kanalsubtyps vermittelt oder unspezifisch alle Kanäle dieser Gattung inhibiert. Um dies näher zu beleuchten wurden elektrophysiologische Messungen an transfizierten Zellen durchgeführt, die jeweils nur einen Subtyp der Familie spannungsabhängiger Calciumkanäle exprimieren. Zur weiteren Aufklärung des Wirkmechanismus wurde auch die mögliche Involvierung G-Protein gekoppelter Rezeptoren ermittelt.
Der zweite Teil der vorliegenden Untersuchung widmet sich der Klärung potentieller antidepressiver Wirkungen durch mögliche neurotrophe Effekte. Primäre hippocampale Neurone und PC12-Zellen wurden hierzu u.a. auf prä- und postsynaptische Marker, Ausdifferenzierungsmarker, sowie Neuritenwachstum hin analysiert.
Recent clinical data support the clinical use of oral lavender oil in patients suffering from subsyndromal anxiety. We identified the molecular mechanism of action that will alter the perception of lavender oil as a nonspecific ingredient of aromatherapy to a potent anxiolytic inhibiting voltage dependent calcium channels (VOCCs) as highly selective drug target. In contrast to previous publications where exorbitant high concentrations were used, the effects of lavender oil in behavioral, biochemical, and electrophysiological experiments were investigated in physiological concentrations in the nanomolar range, which correlate to a single dosage of 80 mg/d in humans that was used in clinical trials. We show for the first time that lavender oil bears some similarities with the established anxiolytic pregabalin. Lavender oil inhibits VOCCs in synaptosomes, primary hippocampal neurons and stably overexpressing cell lines in the same range such as pregabalin. Interestingly, Silexan does not primarily bind to P/Q type calcium channels such as pregabalin and does not interact with the binding site of pregabalin, the α2δ subunit of VOCCs. Lavender oil reduces non-selectively the calcium influx through several different types of VOCCs such as the N-type, P/Q-type and T-type VOCCs. In the hippocampus, one brain region important for anxiety disorders, we show that inhibition by lavender oil is mainly mediated via N-type and P/Q-type VOCCs. Taken together, we provide a pharmacological and molecular rationale for the clinical use of the oral application of lavender oil in patients suffering from anxiety.
Gloydius is a widespread pitviper group occurring from Eastern Europe to Korea and Siberia, with only one known species, G. himalayanus (Günther, 1864), found south of the Himalayas. We provide combined genetic and morphological data for G. himalayanus from specimens collected from Himachal Pradesh, India. Bayesian Inference and Maximum Likelihood phylogenetic analysis were performed on four concatenated mitochondrial genes, along with a multi-locus coalescent analysis of these and five additional nuclear genes. Our results indicate that G. himalayanus from the Chamba Valley, in western Himachal Pradesh, are highly distinct from the remaining studied populations. Haplotype networks of each nuclear locus showed that G. himalayanus contains high haplotype diversity with low haplotype sharing between the Chamba Valley population and populations from further west. Principal component analysis and canonical variate analysis conducted on morphological data of live and museum specimens also highlight the morphological distinctiveness of the Chamba population and we herein describe this population as a new species, Gloydius chambensis sp. nov. Recent descriptions of other new species of snakes from this valley underscores its isolation and suggests that further herpetological investigation of the highly dissected landscapes of the western Himalayas is needed to assess the true diversity of the region.
CD8+ T cells are key players in immunity against intracellular infections and tumors. The main cytokine associated with these protective responses is interferon-γ (IFN-γ), whose production is known to be regulated at the transcriptional level during CD8+ T cell differentiation. Here we found that microRNAs constitute a posttranscriptional brake to IFN-γ expression by CD8+ T cells, since the genetic interference with the Dicer processing machinery resulted in the overproduction of IFN-γ by both thymic and peripheral CD8+ T cells. Using a gene reporter mouse for IFN-γ locus activity, we compared the microRNA repertoires associated with the presence or absence of IFN-γ expression. This allowed us to identify a set of candidates, including miR-181a and miR-451, which were functionally tested in overexpression experiments using synthetic mimics in peripheral CD8+ T cell cultures. We found that miR-181a limits IFN-γ production by suppressing the expression of the transcription factor Id2, which in turn promotes the Ifng expression program. Importantly, upon MuHV-4 challenge, miR-181a-deficient mice showed a more vigorous IFN-γ+ CD8+ T cell response and were able to control viral infection significantly more efficiently than control mice. These data collectively establish a novel role for miR-181a in regulating IFN-γ–mediated effector CD8+ T cell responses in vitro and in vivo.
Die Herzinsuffizienz im hohen Lebensalter spielt wegen der demografischen Entwicklung in Deutschland eine zunehmende Rolle im perioperativen Setting der Herzchirurgie. Auch nehmen strukturelle Schäden und Dysfunktionen am Herzen aufgrund von chronischen kardiovaskulären Erkrankungen zu. Diese bedürfen oftmals einer operativen Intervention als Therapie. Zum perioperativen Monitoring werden verschiedene Laborwerte herangezogen, um mögliche Komplikationen frühzeitig zu erkennen. In der vorliegenden Studie wurde das Augenmerk auf Hochrisikopatienten mit Herzinsuffizienz gelegt. Die Fragestellung behandelt, ob sich gewisse Entzündungsmarker bei Hochrisikopatienten, vor allem im hohen Lebensalter, bei verschiedenen Risikogruppen unterscheiden. Es handelt sich um eine prospektive Beobachtungsstudie, in der 94 Patienten perioperativ untersucht wurden. Diese wurden in zwei Gruppen mit jeweils 47 Patienten unterteilt. Die eine enthielt Patienten unter 75 Jahren mit einer linksventrikulären Ejektionsfraktion <35%, einer operationsbedürftigen Mehrklappen-Erkrankung oder einer Herzklappendysfunktion, kombiniert mit einer operationswürdigen koronaren Herzkrankheit. In der zweiten Gruppe wählte man Patienten in einem Alter ab 75 Jahren mit einer operationsbedürftigen Herzkrankheit. Bestimmt wurden die Entzündungsparameter CRP, Procalcitonin, Interleukin 6 und Interleukin 8. Zusätzlich wurde NT-pro-BNP als Marker für Herzinsuffizienz bestimmt. Die Blutentnahmen erfolgten präoperativ, unmittelbar postoperativ, am 1.,2. und 5. Tag postoperativ. Die präoperativen Werte wurden mit dem Risikoprofil der Patienten in Korrelation gesetzt. Dabei stach heraus, dass bei Patienten mit stattgehabter kardialer Dekompensation die Werte von CRP, NT-proBNP, IL6 und IL8 signifikant erhöht waren. Postoperativ erlitten diese Patienten häufiger eine Rethorakotomie. Außerdem ergab sich ein signifikanter Zusammenhang zwischen der Höhe der postoperativen Entzündungsparameter und dem Auftreten einer postoperativen Sepsis oder Infektion. Hier zeigte sich, dass CRP erst ab dem 5. Tag postoperativ als Indikator für eine solche gewertet werden kann, während Procalcitonin, IL6 und IL8 schon unmittelbar postoperativ als Parameter für das Auftreten einer Sepsis oder Infektion herangezogen werden können. In der vorliegenden Studie wurden jedoch nicht die Zeitpunkte der postoperativen Komplikationen bestimmt, was eine Prüfung auf Unterschied mit den postoperativen Etnzündungswerten erschwert. Zwischen den perioperativen Verläufen der bestimmten Parameter gab es zwischen den beiden Gruppen keinen signifikanten Unterschied. Dies impliziert, dass eine Ejektionsfraktion <35%/eine Mehrklappen-Erkrankung und ein Alter über 75 Jahren bei gröstenteils normwertiger EF als ebenbürtige Risikofaktoren angesehen werden können.