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Amirjanians, Matthieu ; Egemnazarov, Bakytbek ; Sydykov, Akylbek ; Kojonazarov, Baktybek ; Brandes, Ralf ; Luitel, Himal ; Pradhan, Kabita ; Stasch, Johannes-Peter ; Redlich, Gorden ; Weißmann, Norbert ; Grimminger, Friedrich ; Seeger, Werner ; Ghofrani, Hossein ; Schermuly, Ralph
Dysfunction of the NO/sGC/cGMP signaling pathway has been implicated in the pathogenesis of pulmonary hypertension (PH). Therefore, agents stimulating cGMP synthesis via sGC are important therapeutic options for treatment of PH patients. An unwanted effect of this novel class of drugs is their systemic hypotensive effect. We tested the hypothesis that aerosolized intra-tracheal delivery of the sGC stimulator BAY41-8543 could diminish its systemic vasodilating effect.
Pharmacodynamics and -kinetics of BAY41-8543 after single intra-tracheal delivery was tested in healthy rats. Four weeks after a single injection of monocrotaline (MCT, 60 mg/kg s.c.), rats were randomized to a two-week treatment with either placebo, BAY 41-8543 (10 mg/kg per os (PO)) or intra-tracheal (IT) instillation (3 mg/kg or 1 mg/kg).
Circulating concentrations of the drug 10 mg/kg PO and 3 mg/kg IT were comparable. BAY 41-8543 was detected in the lung tissue and broncho-alveolar fluid after IT delivery at higher concentrations than after PO administration. Systemic arterial pressure transiently decreased after oral BAY 41-8543 and was unaffected by intratracheal instillation of the drug. PO 10 mg/kg and IT 3 mg/kg regimens partially reversed pulmonary hypertension and improved heart function in MCT-injected rats. Minor efficacy was noted in rats treated IT with 1 mg/kg. The degree of pulmonary vascular remodeling was largely reversed in all treatment groups.
Intratracheal administration of BAY 41-8543 reverses PAH and vascular structural remodeling in MCT-treated rats. Local lung delivery is not associated with systemic blood pressure lowering and represents thus a further development of PH treatment with sGC stimulators.
Corvinus, Florian Matthias ; Orth, Carina ; Moriggl, Richard ; Tsareva, Svetlana ; Wagner, Stefan ; Pfitzner, Edith ; Baus, Daniela ; Kaufmann, Roland ; Huber, Lukas A. ; Zatloukal, Kurt ; Beug, Hartmut ; Öhlschläger, Peter ; Schütz, Alexander ; Halbhuber, Karl-Jürgen ; Friedrich, Karlheinz
Colorectal carcinoma (CRC) is a major cause of morbidity and mortality in Western countries. It has so far been molecularly defined mainly by alterations of the Wnt pathway. We show here for the first time that aberrant activities of the signal transducer and activator of transcription STAT3 actively contribute to this malignancy and, thus, are a potential therapeutic target for CRC. Constitutive STAT3 activity was found to be abundant in dedifferentiated cancer cells and infiltrating lymphocytes of CRC samples, but not in non-neoplastic colon epithelium. Cell lines derived from malignant colorectal tumors lost persistent STAT3 activity in culture. However, implantation of colon carcinoma cells into nude mice resulted in restoration of STAT3 activity, suggesting a role of an extracellular stimulus within the tumor microenvironment as a trigger for STAT activation. STAT3 activity in CRC cells triggered through interleukin-6 or through a constitutively active STAT3 mutant promoted cancer cell multiplication, whereas STAT3 inhibition through a dominant-negative variant impaired IL-6-driven proliferation. Blockade of STAT3 activation in CRCderived xenograft tumors slowed down their development, arguing for a contribution of STAT3 to colorectal tumor growth.
Phasentrennung als Folge der Konkurrenz zwischen "statistischer" und "chemischer" Vermischung
(1977)
The fact that common thermodynamic conditions are valid for all known types of critical phases (liquid-liquid, liquid-gas, and "gas-gas") suggests that a common principle for the interpretation of material phase instability from a molecular point of view must exist. In this paper we show that the principle of competition between "statistical mixing" (i. e. random mixing) and "chemical mixing" (i. e. mixing effected under the influence of chemical interactions) can give this common inter pretation. If the equilibrium states resulting from both types of mixing are sufficiently different, phase separation occurs. We refer to our earlier papers (since 1972) in which we have applied this principle to describe liquid-liquid phase equilibria by "chemical" models, using the equilibrium constants of exchange equilibria between nearest-neighbour complexes as a measure of "chemical" mixing. In this paper we show that the well-known reduced gas-liquid coexistence curve, T/Tc =f(q/qc), can accurately be fitted by a very simple "mixture" model of molecules A with "vacan cies", provided that the contributions of both statistical and chemical mixing are incorporated into the formula for GE. From a discussion of the application to "gas-gas" phase equilibria in the hyper critical region it results that the weight factor r, by which the contribution of statistical mixing enters into GE, must depend on the density of the gas mixture. Phase separation can only occur if, by increasing pressure, the contributions to GE of statistical and chemical mixing have reached the same order of magnitude. From an attempt to apply the same principle to solid-liquid equilibria it is shown under which external conditions a critical point for this type of phase transition can be expected.
In this paper equilibrium models for the calculation of the excess Gibbs free energy of binary liquid mixtures are developed, the component A of which undergoes chain-forming self-association whilst the component B acts as an 'inert' solvent. It is shown that the extension of the well-known chain-association model of Mecke and Kempter, in which the probability of chain prolongation is assumed to be independent of chain length, is unable to establish satisfactory results because it does not exhibit sufficient unsymmetry. Reduction of the probability of chain growth with in-creasing chain length leads to an improved model with the geometric series replaced by the exponential series. This model, in which only two parameters are used, i. e. the equilibrium constants K for mutual solvation of A and B, and ρ for self-association of A, allows fitting of isothermal experimental GE /R T literature data on cycloalkanol-cycloalkane, alkanol-alkane, and NMF -CCl4 systems within the limits of experimental error. Compared with the two-parameter Wilson equation which gives equally small standard deviations, our equilibrium model has the advantage of allowing passage from GE to HE data and of being applicable to liquid-liquid equilibria.
Ballo, Olivier Karl Friedrich ; Kreisel, Eva-Maria ; Eladly, Fagr ; Brunnberg, Uta ; Stratmann, Jan Alexander ; Hunyady, Peter Marton ; Hogardt, Michael ; Wichelhaus, Thomas A. ; Kempf, Volkhard A. J. ; Steffen, Björn ; Vehreschild, Jörg Janne ; Vehreschild, Maria J. G. T. ; Finkelmeier, Fabian ; Serve, Hubert ; Brandts, Christian Hubertus
Patients with acute myeloid leukemia (AML) are often exposed to broad-spectrum antibiotics and thus at high risk of Clostridioides difficile infections (CDI). As bacterial infections are a common cause for treatment-related mortality in these patients, we conducted a retrospective study to analyze the incidence of CDI and to evaluate risk factors for CDI in a large uniformly treated AML cohort. A total of 415 AML patients undergoing intensive induction chemotherapy between 2007 and 2019 were included in this retrospective analysis. Patients presenting with diarrhea and positive stool testing for toxin-producing Clostridioides difficile were defined to have CDI. CDI was diagnosed in 37 (8.9%) of 415 AML patients with decreasing CDI rates between 2013 and 2019 versus 2007 to 2012. Days with fever, exposition to carbapenems, and glycopeptides were significantly associated with CDI in AML patients. Clinical endpoints such as length of hospital stay, admission to ICU, response rates, and survival were not adversely affected. We identified febrile episodes and exposition to carbapenems and glycopeptides as risk factors for CDI in AML patients undergoing induction chemotherapy, thereby highlighting the importance of interdisciplinary antibiotic stewardship programs guiding treatment strategies in AML patients with infectious complications to carefully balance risks and benefits of anti-infective agents.
Reduction of naturally occurring para-and ortho-benzoquinone derivatives M to their respective radical anions M·⊖ can be accomplished under largely aprotic conditions either by cautious low-temperature reaction in THF containing an excess of (2.2.2) cryptand at a potassium mirror or by using the "mild" single electron transfer reagent tetrabutylammonium boranate R4N⊕BH4⊖ in DMF. On addition of soluble alkali tetraphenylborates Me⊕[B(C6H5)4]⊖ , their hitherto unknown radical ion pairs [M·⊖ Me⊕]· and/or triple ion radical cations [Me⊕M·⊖Me⊕]·⊕ form, which might be of biological relevance in molecular carrier and "turn off -turn on" switch processes. On addition of metal perchlorates Me⊕n(ClO4⊖)n with multiply charged counter cations Me⊕n the respective paramagnetic species [M·⊖Me⊕n]·(n-1)⊕ result. Assuming exclusive one-electron transfer reductions without any redox fragmentation reactions, ESR, ENDOR and GENERAL TRIPLE spectra are presented and discussed for the following radical anions and radical ion pairs: mitomycin C (M·⊖ and [M·⊖Mex⊕]·(x-1)⊕ with Me⊕ = Li⊕, Na⊕), streptonigrine (M·⊖ and [M·⊖Lix⊕]·(x-1)⊕), Entobex® (M·⊖ and [M·⊖Me⊕n]·(n-1)⊕ with Me⊕n = Li⊕, Na⊕, Cd⊕⊕, (H5C6)2Tl⊕) as well as brucinequinone ([M·⊖ Me⊕n]·(n-1)⊕ with Me⊕n = Li⊕, Cd⊕⊕, Pb⊕⊕, La⊕⊕⊕).
The radical anion of dimesityltetraketone (ERed, I = -0.40 V) is easily generated in THF by potassium mirror/[2.2.2]-cryptand reduction. Its contact ion pairs with Na⊕, Cs⊕ and Ba⊕⊕ counter cations, prepared in THF solution by single electron transfer from the respective metals, are characterized by their ESR/ENDOR spectra, which exhibit temperature-dependent metal couplings of aNa⊕ = 0.061 mT (190 K), aCs⊕ = 0.021 mT (190 K), and aBa⊕⊕ = 0.145 mT (295 K).
This paper contains further applications on symmetrical liquid mixtures of the molecular thermodynamic theory which has been developped in part I of this series. The essential feature of this theory is the superposition of "chemical" and “random” exchange equilibria between “complexes” formed by a given molecule and its z nearest neighbours, thus allowing a unified treatment of the thermodynamic phenomena in binary liquid mixtures using the equilibrium constant K of the ideal law of mass action and the energy w of pair interactions as parameters.
The temperature and pressure dependences of K and the evaluation of experimental excess enthalpy and excess volume data are treated. Formulas and examples for the calculation of K and w from isothermal and non-isothermal vapour-liquid equilibrium data are given. The conditions for azeotropy with minimum or maximum vapour pressure, resp., are derived. Melting curves for a symmetric eutectic system with superposed miscibility gap are discussed. Further models for partially miscible liquids with competing self-association and complex-formation are treated showing the phenomenon of two separated miscibility gaps.
A thermodynamic theory of liquid mixtures based on a simple molecular model is developed which describes the equilibrium state as the result of a coupling between a "chemical" and a "statistical" equilibrium. The intermolecular interactions are taken into account by considering "complexes" formed between a given molecule and its z nearest neighbours. The equilibrium mole fractions of these complexes are calculated by application of the ideal law of mass action to an appropriate set of "exchange equilibria". Formulae for the excess functions GE and HE and for the activities of the components are derived for the cases z=1 and z=4. GE depends on an equilibrium constant K describing the deviation from random distribution of the equilibrium mole fractions of the complexes. HE depends on K and on an energy parameter w which is related to differences of pair interactions. K and w are independent parameters, and there is no limitation in respect to amount and sign of the excess functions. The conditions for the existence of a critical solution point are formulated; at this point GE has a value of about 0.56 R T. If a model with two equilibrium constants is used allowing for instance competition between "self-association" and "complex-formation", the existence of closed miscibility gaps becomes possible. Closed miscibility curves are calculated and the conditions for their appearance are discussed. The relations between this theory and Guggenheim's statistical lattice theory of symmetrical mixtures are pointed out.
Schlenk, Richard Friedrich ; Lübbert, Michael ; Benner, Axel ; Lamparter, Alexander ; Krauter, Jürgen ; Herr, Wolfgang ; Martin, Hans ; Salih, Helmut Rainer ; Kündgen, Andrea ; Horst, Heinz August ; Brossart, Peter ; Götze, Katharina ; Nachbaur, David ; Wattad, Mohammed ; Köhne, Claus-Henning ; Fiedler, Walter ; Bentz, Martin ; Wulf, Gerald ; Held, Gerhard ; Hertenstein, Bernd ; Salwender, Hans ; Gaidzik, Verena I. ; Schlegelberger, Brigitte ; Weber, Daniela ; Döhner, Konstanze ; Ganser, Arnold ; Döhner, Hartmut
The aim of this clinical trial was to evaluate the impact of all-trans retinoic acid (ATRA) in combination with chemotherapy and to assess the NPM1 status as biomarker for ATRA therapy in younger adult patients (18-60 years) with acute myeloid leukemia (AML). Patients were randomized for intensive chemotherapy with or without open-label ATRA (45 mg/m2, days 6-8; 15 mg/m2, days 9-21). Two cycles of induction therapy were followed by risk-adapted consolidation with high-dose cytarabine or allogeneic hematopoietic cell transplantation. Due to the open label character of the study, analysis was performed on an intention-to-treat (ITT) and a per-protocol (PP) basis. One thousand one hundred patients were randomized (556, STANDARD; 544, ATRA) with 38 patients treated vice versa. Median follow-up for survival was 5.2 years. ITT analyses revealed no difference between ATRA and STANDARD for the total cohort and for the subset of NPM1-mutated AML with respect to event-free (EFS; p = 0.93, p = 0.17) and overall survival (OS; p = 0.24 and p = 0.32, respectively). Pre-specified PP analyses revealed better EFS in NPM1-mutated AML (p = 0.05) and better OS in the total cohort (p = 0.03). Explorative subgroup analyses on an ITT basis revealed better OS (p = 0.05) in ATRA for genetic low-risk patients according to ELN recommendations. The clinical trial is registered at clinicaltrialsregister.eu (EudraCT Number: 2004-004321-95).
Zamora Cardona, Juan Carlos ; Aumann, Thomas ; Bagchi, Soumya ; Bönig, Esther Sabine ; Csatlós, Margit ; Dillmann, Iris ; Dimopoulou, Christina ; Egelhof, Peter ; Eremin, Vladimir ; Furuno, Tatsuya ; Geissel, Hans ; Gernhäuser, Roman ; Harakeh, Muhsin N. ; Hartig, Anna-Lena ; Ilieva, Stoyanka ; Kalantar-Nayestanaki, Nasser ; Kiselev, Oleg A. ; Kollmus, Holger ; Kozhuharov, Christophor ; Krasznahorkay, Attila ; Kröll, Thorsten ; Kuilman, Maartje ; Litvinov, Sergey A. ; Litvinov, Yuri A. ; Mahjour-Shafiei, Masoud ; Mutterer, Manfred ; Nagae, Daisuke ; Najafi, Mohammad Ali ; Nociforo, Chiara ; Nolden, Fritz ; Popp, Ulrich ; Rigollet, Catherine ; Roy, Subhankar ; Scheidenberger, Christoph ; Schmid, Mirko von ; Steck, Markus ; Streicher, Branislav ; Stuhl, László ; Thürauf, Michael Friedrich Erhard ; Uesaka, Tomohiro ; Weick, Helmut ; Winfield, John S. ; Winters, Danyal Ferdinant Alexander ; Woods, Philip John ; Yamaguchi, Takayuki ; Yue, Ke ; Zenihiro, Juzo
A new technique developed for measuring nuclear reactions at low momentum transfer with stored beams in inverse kinematics was successfully used to study isoscalar giant resonances. The experiment was carried out at the experimental heavy-ion storage ring (ESR) at the GSI facility using a stored 58Ni beam at 100 MeV/u and an internal helium gas-jet target. In these measurements, inelastically scattered α-recoils at very forward center-of-mass angles (θcm ≤ 1.5°) were detected with a dedicated setup, including ultra-high vacuum compatible detectors. Experimental results indicate a dominant contribution of the isoscalar giant monopole resonance at this very forward angular range. It was found that the monopole contribution exhausts 79+12−11% of the energy-weighted sum rule (EWSR), which agrees with measurements performed in normal kinematics. This opens up the opportunity to investigate the giant resonances in a large domain of unstable and exotic nuclei in the near future. It is a fundamental milestone towards new nuclear reaction studies with stored ion beams.
The structurally different radical anions M⊖ of peralkylated 1-sila-2,5-diazacyclopentane-3,4-dithione and of tetrakis(isopropylthio)-p-benzoquinone are generated by reduction with potassium/2.2.2-cryptand under aprotic conditions in THF solution. On addition of Li⊕B(C6H5)4⊖, both form hitherto elusive sulfur-containing contact ion pairs, which are characterized by their ESR/ENDOR spectra.
Dultz, Georg ; Seelhof, Martin ; Herrmann, Eva ; Welker, Martin-Walter ; Friedrich-Rust, Mireen ; Teuber, Gerlinde ; Kronenberger, Bernd ; Wagner, Michael von ; Vermehren, Johannes ; Sarrazin, Christoph ; Zeuzem, Stefan ; Hofmann, Wolf-Peter
Background and Aims: In patients with advanced liver cirrhosis due to chronic hepatitis C virus (HCV) infection antiviral therapy with peginterferon and ribavirin is feasible in selected cases only due to potentially life-threatening side effects. However, predictive factors associated with hepatic decompensation during antiviral therapy are poorly defined.
Methods: In a retrospective cohort study, 68 patients with HCV-associated liver cirrhosis (mean MELD score 9.18±2.72) were treated with peginterferon and ribavirin. Clinical events indicating hepatic decompensation (onset of ascites, hepatic encephalopathy, upper gastrointestinal bleeding, hospitalization) as well as laboratory data were recorded at baseline and during a follow up period of 72 weeks after initiation of antiviral therapy. To monitor long term sequelae of end stage liver disease an extended follow up for HCC development, transplantation and death was applied (240weeks, ±SD 136weeks).
Results: Eighteen patients (26.5%) achieved a sustained virologic response. During the observational period a hepatic decompensation was observed in 36.8%. Patients with hepatic decompensation had higher MELD scores (10.84 vs. 8.23, p<0.001) and higher mean bilirubin levels (26.74 vs. 14.63 µmol/l, p<0.001), as well as lower serum albumin levels (38.2 vs. 41.1 g/l, p = 0.015), mean platelets (102.64 vs. 138.95/nl, p = 0.014) and mean leukocytes (4.02 vs. 5.68/nl, p = 0.002) at baseline as compared to those without decompensation. In the multivariate analysis the MELD score remained independently associated with hepatic decompensation (OR 1.56, 1.18–2.07; p = 0.002). When the patients were grouped according to their baseline MELD scores, hepatic decompensation occurred in 22%, 59%, and 83% of patients with MELD scores of 6–9, 10–13, and >14, respectively. Baseline MELD score was significantly associated with the risk for transplantation/death (p<0.001).
Conclusions: Our data suggest that the baseline MELD score predicts the risk of hepatic decompensation during antiviral therapy and thus contributes to decision making when antiviral therapy is discussed in HCV patients with advanced liver cirrhosis.
Graf, Christiana ; Mondorf, Antonia Maria ; Knop, Viola ; Peiffer, Kai-Henrik ; Dietz, Julia ; Friess, Julia ; Wedemeyer, Heiner ; Buggisch, Peter ; Mauß, Stefan ; Berg, Thomas ; Rausch, Michael ; Sprinzl, Martin F. ; Klinker, Hartwig ; Hinrichsen, Holger ; Bronowicki, Jean-Pierre ; Haag, Sebastian ; Hüppe, Dietrich ; Lutz, Thomas ; Poynard, Thierry ; Zeuzem, Stefan ; Friedrich-Rust, Mireen ; Sarrazin, Christoph ; Vermehren, Johannes
Background: Accurate assessment of hepatic fibrosis in patients with chronic HBeAg-negative Hepatitis B is of crucial importance not only to predict the long-term clinical course, but also to evaluate antiviral therapy indication. The aim of this study was to prospectively assess the utility of point shear wave elastography (pSWE) for longitudinal non-invasive fibrosis assessment in a large cohort of untreated patients with chronic HBeAg-negative hepatitis B virus (HBV) infection.
Methods: 407 consecutive patients with HBeAg-negative HBV infection who underwent pSWE, transient elastography (TE) as well as laboratory fibrosis markers, including fibrosis index based on four factors (FIB-4), aspartate to platelet ratio index (APRI) and FibroTest, on the same day were prospectively followed up for six years. Patients were classified into one of the three groups: inactive carriers (IC; HBV-DNA <2000 IU/mL and ALT <40 U/L); grey zone group 1 (GZ-1; HBV DNA <2000 IU/mL and ALT >40 U/L); grey zone group 2 (GZ-2; HBV-DNA >2000 IU/mL and ALT <40 U/L).
Results: pSWE results were significantly correlated with TE (r = 0.29, p < 0.001) and APRI (r = 0.17; p = 0.005). Median pSWE values did not differ between IC, GZ-1 and GZ-2 patients (p = 0.82, p = 0.17, p = 0.34). During six years of follow-up, median pSWE and TE values did not differ significantly over time (TE: p = 0.27; pSWE: p = 0.05).
Conclusion: Our data indicate that pSWE could be useful for non-invasive fibrosis assessment and follow-up in patients with HBeAg-negative chronic HBV infection.
Gröschel, Stefan ; Hübschmann, Daniel ; Raimondi, Francesco ; Horak, Peter ; Warsow, Gregor ; Fröhlich, Martina ; Klink, Barbara ; Gieldon, Laura ; Hutter, Barbara ; Kleinheinz, Kortine ; Bonekamp, David ; Marschal, Oliver ; Chudasama, Priya ; Mika, Jagoda ; Groth, Marie ; Uhrig, Sebastian ; Krämer, Stephen ; Heining, Christoph ; Heilig, Christoph E. ; Richter, Daniela ; Reisinger, Eva ; Pfütze, Katrin ; Eils, Roland ; Wolf, Stephan ; Kalle, Christof von ; Brandts, Christian Hubertus ; Scholl, Claudia ; Weichert, Wilko ; Richter, Stephan ; Bauer, Sebastian ; Penzel, Roland ; Schröck, Evelin ; Stenzinger, Albrecht ; Schlenk, Richard Friedrich ; Brors, Benedikt ; Russell, Robert B. ; Glimm, Hanno ; Schlesner, Matthias ; Fröhling, Stefan
Chordomas are rare bone tumors with few therapeutic options. Here we show, using whole-exome and genome sequencing within a precision oncology program, that advanced chordomas (n = 11) may be characterized by genomic patterns indicative of defective homologous recombination (HR) DNA repair and alterations affecting HR-related genes, including, for example, deletions and pathogenic germline variants of BRCA2, NBN, and CHEK2. A mutational signature associated with HR deficiency was significantly enriched in 72.7% of samples and co-occurred with genomic instability. The poly(ADP-ribose) polymerase (PARP) inhibitor olaparib, which is preferentially toxic to HR-incompetent cells, led to prolonged clinical benefit in a patient with refractory chordoma, and whole-genome analysis at progression revealed a PARP1 p.T910A mutation predicted to disrupt the autoinhibitory PARP1 helical domain. These findings uncover a therapeutic opportunity in chordoma that warrants further exploration, and provide insight into the mechanisms underlying PARP inhibitor resistance.