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Mutations of the isocitrate dehydrogenase-1 (IDH1) and IDH2 genes are among the most frequent alterations in acute myeloid leukemia (AML) and can be found in ∼20% of patients at diagnosis. Among 4930 patients (median age, 56 years; interquartile range, 45-66) with newly diagnosed, intensively treated AML, we identified IDH1 mutations in 423 (8.6%) and IDH2 mutations in 575 (11.7%). Overall, there were no differences in response rates or survival for patients with mutations in IDH1 or IDH2 compared with patients without mutated IDH1/2. However, distinct clinical and comutational phenotypes of the most common subtypes of IDH1/2 mutations could be associated with differences in outcome. IDH1-R132C was associated with increased age, lower white blood cell (WBC) count, less frequent comutation of NPM1 and FLT3 internal tandem mutation (ITD) as well as with lower rate of complete remission and a trend toward reduced overall survival (OS) compared with other IDH1 mutation variants and wild-type (WT) IDH1/2. In our analysis, IDH2-R172K was associated with significantly lower WBC count, more karyotype abnormalities, and less frequent comutations of NPM1 and/or FLT3-ITD. Among patients within the European LeukemiaNet 2017 intermediate- and adverse-risk groups, relapse-free survival and OS were significantly better for those with IDH2-R172K compared with WT IDH, providing evidence that AML with IDH2-R172K could be a distinct entity with a specific comutation pattern and favorable outcome. In summary, the presented data from a large cohort of patients with IDH1/2 mutated AML indicate novel and clinically relevant findings for the most common IDH mutation subtypes.
Non-standard errors
(2021)
In statistics, samples are drawn from a population in a data-generating process (DGP). Standard errors measure the uncertainty in sample estimates of population parameters. In science, evidence is generated to test hypotheses in an evidence-generating process (EGP). We claim that EGP variation across researchers adds uncertainty: non-standard errors. To study them, we let 164 teams test six hypotheses on the same sample. We find that non-standard errors are sizeable, on par with standard errors. Their size (i) co-varies only weakly with team merits, reproducibility, or peer rating, (ii) declines significantly after peer-feedback, and (iii) is underestimated by participants.
Simple Summary: Acute myeloid leukemia (AML) is a genetically heterogeneous disease. Clinical phenotypes of frequent mutations and their impact on patient outcome are well established. However, the role of rare mutations often remains elusive. We retrospectively analyzed 1529 newly diagnosed and intensively treated AML patients for mutations of BCOR and BCORL1. We report a distinct co-mutational pattern that suggests a role in disease progression rather than initiation, especially affecting mechanisms of DNA-methylation. Further, we found loss-of-function mutations of BCOR to be independent markers of poor outcomes in multivariable analysis. Therefore, loss-of-function mutations of BCOR need to be considered for AML management, as they may influence risk stratification and subsequent treatment allocation.
Abstract: Acute myeloid leukemia (AML) is characterized by recurrent genetic events. The BCL6 corepressor (BCOR) and its homolog, the BCL6 corepressor-like 1 (BCORL1), have been reported to be rare but recurrent mutations in AML. Previously, smaller studies have reported conflicting results regarding impacts on outcomes. Here, we retrospectively analyzed a large cohort of 1529 patients with newly diagnosed and intensively treated AML. BCOR and BCORL1 mutations were found in 71 (4.6%) and 53 patients (3.5%), respectively. Frequently co-mutated genes were DNTM3A, TET2 and RUNX1. Mutated BCORL1 and loss-of-function mutations of BCOR were significantly more common in the ELN2017 intermediate-risk group. Patients harboring loss-of-function mutations of BCOR had a significantly reduced median event-free survival (HR = 1.464 (95%-Confidence Interval (CI): 1.005–2.134), p = 0.047), relapse-free survival (HR = 1.904 (95%-CI: 1.163–3.117), p = 0.01), and trend for reduced overall survival (HR = 1.495 (95%-CI: 0.990–2.258), p = 0.056) in multivariable analysis. Our study establishes a novel role for loss-of-function mutations of BCOR regarding risk stratification in AML, which may influence treatment allocation.
During translation initiation, the heterotrimeric archaeal translation initiation factor 2 (aIF2) recruits the initiator tRNAi to the small ribosomal subunit. In the stationary growth phase and/or during nutrient stress, Sulfolobus solfataricus aIF2 has a second function: It protects leaderless mRNAs against degradation by binding to their 5′‐ends. The S. solfataricus protein Sso2509 is a translation recovery factor (Trf) that interacts with aIF2 and is responsible for the release of aIF2 from bound mRNAs, thereby enabling translation re‐initiation. It is a member of the domain of unknown function 35 (DUF35) protein family and is conserved in Sulfolobales as well as in other archaea. Here, we present the X‐ray structure of S. solfataricus Trf solved to a resolution of 1.65 Å. Trf is composed of an N‐terminal rubredoxin‐like domain containing a bound zinc ion and a C‐terminal oligosaccharide/oligonucleotide binding fold domain. The Trf structure reveals putative mRNA binding sites in both domains. Surprisingly, the Trf protein is structurally but not sequentially very similar to proteins linked to acyl‐CoA utilization—for example, the Sso2064 protein from S. solfataricus—as well as to scaffold proteins found in the acetoacetyl‐CoA thiolase/high‐mobility group‐CoA synthase complex of the archaeon Methanothermococcus thermolithotrophicus and in a steroid side‐chain‐cleaving aldolase complex from the bacterium Thermomonospora curvata. This suggests that members of the DUF35 protein family are able to act as scaffolding and binding proteins in a wide variety of biological processes.
A comprehensive set of stratospheric balloon and aircraft samples was analyzed for the position-dependent isotopic composition of nitrous oxide (N2O). Results for a total of 220 samples from between 1987 and 2003 are presented, nearly tripling the number of mass-spectrometric N2O isotope measurements in the stratosphere published to date. Cryogenic balloon samples were obtained at polar (Kiruna/Sweden, 68° N), mid-latitude (southern France, 44° N) and tropical sites (Hyderabad/India, 18° N). Aircraft samples were collected with a newly-developed whole air sampler on board of the high-altitude aircraft M55 Geophysica during the EUPLEX 2003 campaign. For mixing ratios above 200 nmol mol−1, relative isotope enrichments (δ values) and mixing ratios display a compact relationship, which is nearly independent of latitude and season and which can be explained equally well by Rayleigh fractionation or mixing. However, for mixing ratios below 200 nmol mol−1 this compact relationship gives way to meridional, seasonal and interannual variations. A comparison to a previously published mid-latitude balloon profile even shows large zonal variations, justifying the use of three-dimensional (3-D) models for further data interpretation.
In general, the magnitude of the apparent fractionation constants (i.e., apparent isotope effects) increases continuously with altitude and decreases from the equator to the North Pole. Only the latter observation can be understood qualitatively by the interplay between the time-scales of N2O photochemistry and transport in a Rayleigh fractionation framework. Deviations from Rayleigh fractionation behavior also occur where polar vortex air mixes with nearly N2O-free upper stratospheric/mesospheric air (e.g., during the boreal winters of 2003 and possibly 1992). Aircraft observations in the polar vortex at mixing ratios below 200 nmol mol−1 deviate from isotope variations expected for both Rayleigh fractionation and two-end-member mixing, but could be explained by continuous weak mixing between intravortex and extravortex air (Plumb et al., 2000). However, it appears that none of the simple approaches described here can capture all features of the stratospheric N2O isotope distribution, again justifying the use of 3-D models. Finally, correlations between 18O/16O and average 15N/14N isotope ratios or between the position-dependent 15N/14N isotope ratios show that photo-oxidation makes a large contribution to the total N2O sink in the lower stratosphere (possibly up to 100% for N2O mixing ratios above 300 nmol mol−1). Towards higher altitudes, the temperature dependence of these isotope correlations becomes visible in the stratospheric observations.
A comprehensive set of stratospheric balloon and aircraft samples was analyzed for the position-dependent isotopic composition of nitrous oxide (N2O). Results for a total of 220 samples from between 1987 and 2003 are presented, nearly tripling the number of mass-spectrometric N2O isotope measurements in the stratosphere published to date. Cryogenic balloon samples were obtained at polar (Kiruna/Sweden, 68° N), mid-latitude (southern France, 44° N) and tropical sites (Hyderabad/India, 18° N). Aircraft samples were collected with a newly-developed whole air sampler on board of the high-altitude aircraft M55 Geophysica during the EUPLEX 2003 campaign. All samples were analyzed by laboratory mass spectrometry for their 18O/16O and position-dependent 15N/14N isotope ratios with very high precision (standard deviation about 0.15 per mil for 18O/16O and average 15N/14N ratios, about 0.5 per mil for 15NNO/14NNO and N15NO/N14NO ratios). For mixing ratios above 200 nmol mol−1, relative isotope enrichments (δ values) and mixing ratios display a compact relationship, which is nearly independent of latitude and season and which can be explained equally well by Rayleigh fractionation or mixing. However, for mixing ratios below 200 nmol mol−1 this compact relationship gives way to meridional, seasonal and interannual variations. A comparison to a previously published mid-latitude balloon profile even shows large zonal variations, justifying the use of three-dimensional models for further data interpretation.
In general, the magnitude of the apparent fractionation constants (apparent isotope effects) increases continuously with altitude and decreases from the equator to the North pole, which can be qualitatively understood by the interplay between the time-scales of N2O photochemistry and transport. Deviations from this behavior occur where polar vortex air mixes with nearly N2O-free upper stratospheric/mesospheric air (e.g., during the boreal winter of 2003 and possibly 1992). Aircraft observations in the polar vortex at mixing ratios below 200 nmol mol−1 deviate from isotope variations expected for both Rayleigh fractionation and end-member mixing, but could be explained by continuous weak mixing between intravortex and extravortex air (Plumb et al., 2000). Finally, correlations between 18O/16O and average 15N/14N isotope ratios or between the position-dependent 15N/14N isotope ratios show that photo-oxidation makes a large contribution to the total N2O sink in the lower stratosphere (up to 100%). Towards higher altitudes, the temperature dependence of these isotope correlations becomes visible in the stratospheric observations.
The bile acid activated transcription factor farnesoid X receptor (FXR) regulates numerous metabolic processes and is a rising target for the treatment of hepatic and metabolic disorders. FXR agonists have revealed efficacy in treating non-alcoholic steatohepatitis (NASH), diabetes and dyslipidemia. Here we characterize imatinib as first-in-class allosteric FXR modulator and report the development of an optimized descendant that markedly promotes agonist induced FXR activation in a reporter gene assay and FXR target gene expression in HepG2 cells. Differential effects of imatinib on agonist-induced bile salt export protein and small heterodimer partner expression suggest that allosteric FXR modulation could open a new avenue to gene-selective FXR modulators.
Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs.
Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel.
Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1–25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0–88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE- syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%—subcutaneous; 29%—intravenous; 1%—unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy.
Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment.
Background: Although being considered as a rarely observed HIV-1 protease mutation in clinical isolates, the L76V-prevalence increased 1998-2008 in some European countries most likely due to the approval of Lopinavir, Amprenavir and Darunavir which can select L76V. Beside an enhancement of resistance, L76V is also discussed to confer hypersusceptibility to the drugs Atazanavir and Saquinavir which might enable new treatment strategies by trying to take advantage of particular mutations. Results: Based on a cohort of 47 L76V-positive patients, we examined if there might exist a clinical advantage for L76V-positive patients concerning long-term success of PI-containing regimens in patients with limited therapy options. Genotypic- and phenotypic HIV-resistance tests from 47 mostly multi-resistant, L76V-positive patients throughout Germany were accomplished retrospectively 1999-2009. Five genotype-based drug-susceptibility predictions received from online interpretation-tools for Atazanavir, Saquinavir, Amprenavir and Lopinavir, were compared to phenotype-based predictions that were determined by using a recombinant virus assay along with a Virtual Phenotype™(Virco). The clinical outcome of the L76V-adapted follow-up therapy was determined by monitoring viral load for 96 weeks. Conclusions: In this analysis, the mostly used interpretation systems overestimated the L76V-mutation concerning Atazanavir- and SQV resistance. In fact, a clear benefit in drug susceptibility for these drugs was observed in phenotype analysis after establishment of L76V. More importantly, long-term therapy success was significantly higher in patients receiving Atazanavir and/or Saquinavir plus one L76V-selecting drug compared to patients without L76V-selecting agents (p = 0.002). In case of L76V-occurrence ATV and/or SQV may represent encouraging options for patients in deep salvage situations.
Magnetische Quadrupole und Solenoide sind ein elementarer Bestandteil einer Beschleunigeranlage und begrenzen die transversale Ausdehnung eines Teilchenstrahls durch eine Reflexion der Teilchen in Richtung der Beschleunigerachse. Die konventionelle Bauweise als Elektromagnet besteht aus einem Eisenjoch welches mit Spulen umwickelt ist. In dieser Arbeit werden diese Magnetstrukturen auf Basis von Permanentmagneten designt und hinsichtlich ihrer Qualität zum Strahltransport optimiert, sowie Feldmessungen an permanentmagnetischen Quadrupolen durchgeführt. Diese wurden mit 3D-gedruckten Halterungen aus Kunststoff gefertigt, was eine Vielzahl von Formvariationen ermöglicht. Darauf aufbauend wurde ein im Vakuum befindlicher Aufbau entwickelt, mit welchem die Strahlenvelope im inneren eines permanentmagnetischen Quadrupol Tripletts diagnostiziert werden kann. Dies greift auf ein am Institut für angewandte Physik entwickeltes System zur nicht-invasiven Strahldiagnose mithilfe von Raspberry Pi Einplatinencomputern und Kameras in starken Magnetfeldern zurück.
Die in dieser Arbeit vorgestellte Konfiguration eines PMQ’s ist eine Weiterentwicklung des am CERN im Linac4, einem Alvarez-Driftröhrenbeschleuniger zur Beschleunigung von H– , verwendeten Designs. Bei diesem sind je acht quaderförmige Permanentmagnete aus Samarium Cobalt (SmCo) in die Driftröhren des Beschleunigers integriert.
Darauf aufbauend wurden die geometrischen Designparameter hinsichtlich ihres Einflusses auf die Qualität des Magnetfelds untersucht. In einem magnetischen Quadrupol zur Strahlfokussierung wird dies durch einen linearen Anstieg des Magnetfeldes von Quadrupolachse zu Polflächen charakterisiert. Das Design wurde im Zuge dessen zur Verwendung von industriellen Standardgeometrien von Quadermagneten und der Erhöhung der magnetischen Flussdichte erweitert. Dazu wurde untersucht wie sich das Hinzufügen von zusätzlichen Magneten auswirkt und ob eine bessere Feldqualität durch andere Magnetformen erreicht wird.
Die Kombination mehrerer PMQ in geringem Abstand (<10 mm) führt abhängig von der Geometrie der PMQ-Singlets zu einer erheblichen Verschlechterung der Feldlinearität, was eine Erhöhung des besetzten Phasenraumvolumens der Teilchen nach sich zieht.
Am Beispiel von PMQ-Tripletts werden die zu beachtenden Designparameter analysiert und Lösungsansätze vorgestellt. Die auftretenden Effekte werden anhand von Strahldynamiksimulation veranschaulicht. Für eine Anwendung der vorgestellten Designs wurde eine Magnethülle mit einer Wabenstruktur zur Aufnahme der Einzelmagnete entwickelt. Diese besteht aus zwei Halbschalen, welche jeweils den Kompletteinschluss aller Magnete garantiert und eine einfache Montage um ein Strahlrohr ermöglicht. Diese wurden in der Institutswerkstatt aus Kunststoff via 3D-Druck gefertigt. Aufgrund der höheren erreichbaren Magnetisierung wurden Neodym-Eisen-Bor-Magnete (Nd2F14B, Br =1,36 T) für den Bau der entwickelten Strukturen verwendet. Für eine Magnetfeldmessung zur Bestätigung der magnetostatischen Simulationen und einer Bewertung der Druckqualität wurde eine motorisierte xyz-Stage zur Bewegung einer Hallsonde aufgebaut. Die Messungen zeigen eine gute Zentrierung des Magnetfeldes, sodass PMQ mit einer Kunststoffhalterung eine schnelle und billige Möglichkeit sind, kurzfristig eine Quadrupol-Konfiguration aufzubauen. Die Kosten belaufen sich für einen einzelnen PMQ je nach Länge auf 50€ bis 100€.
Basierend auf der PMQ-Struktur wurde ein PMQ-Triplett in ein Vakuum versetzt und mit Raspberry Pi Kameras im Zwischenraum der Singlets ausgestattet. Dies ermöglichte die Aufnahme der Strahlenvelope innerhalb des Tripletts anhand der durch einen Heliumstrahl induzierten Fluoreszenz und erste Erkenntnisse für notwendige Weiterentwicklungen wurden gesammelt. Auf den genauen technischen Aufbau wird im abschließenden Kapitel der Arbeit detailliert eingegangen.
In der einfachsten Form wird ein PM-Solenoid anhand eines einzelnen axial magnetisierten Hohlzylinders realisiert und erzeugt näherungsweise die Feldverteilung einer Zylinderspule. Durch die radialen Magnetfeldkomponenten an den Rändern des Solenoiden erhalten Teilchen eine tangentiale Geschwindigkeitskomponente und führen eine Gyrationsbewegung entlang der Solenoidachse aus. Diese reduziert den Strahlradius und die Teilchen behalten eine Geschwindigkeitskomponente, welche zur Solenoidachse zeigt. Für eine Maximierung dieser Fokussierung muss das Magnetfeld auf die Zylinderachse konzentriert werden. Insbesondere bei einer Verlängerung des Hohlzylinders wird die Kopplung der Polflächen über das Innenvolumen abgeschwächt. Aufgrund dessen wurde ein Design bestehend aus drei Hohlzylindersegmenten entwickelt. Dieses setzt sich aus zwei radial und einem axial magnetisierten Hohlzylinder zusammen und erhöht die mittlere magnetische Flussdichte für ausgewählte Geometrien um einen Faktor zwei im Vergleich zu einem einzelnen Hohlzylinder gleicher Geometrie. Dies ist gleichzusetzen mit einer Vervierfachung der Fokussierstärke, welche quadratisch mit der mittleren magnetischen Flussdichte skaliert. Die Strahldynamischen Konsequenzen werden anhand von Simulationen mit generierten Magnetfeldverteilungen erläutert. Für eine kostengünstige Bauweise wurde eine Design basierend auf quaderförmigen Magneten entwickelt.