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Brunkhorst-Kanaan, Nathalie ; Trautmann, Sandra ; Schreiber, Yannick ; Thomas, Dominique Jeanette ; Kittel-Schneider, Sarah ; Gurke, Robert ; Geisslinger, Gerd ; Reif, Andreas ; Tegeder, Irmgard
Genes encoding endocannabinoid and sphingolipid metabolism pathways were suggested to contribute to the genetic risk towards attention deficit hyperactivity disorder (ADHD). The present pilot study assessed plasma concentrations of candidate endocannabinoids, sphingolipids and ceramides in individuals with adult ADHD in comparison with healthy controls and patients with affective disorders. Targeted lipid analyses of 23 different lipid species were performed in 71 mental disorder patients and 98 healthy controls (HC). The patients were diagnosed with adult ADHD (n = 12), affective disorder (major depression, MD n = 16 or bipolar disorder, BD n = 6) or adult ADHD with comorbid affective disorders (n = 37). Canonical discriminant analysis and CHAID analyses were used to identify major components that predicted the diagnostic group. ADHD patients had increased plasma concentrations of sphingosine-1-phosphate (S1P d18:1) and sphinganine-1-phosphate (S1P d18:0). In addition, the endocannabinoids, anandamide (AEA) and arachidonoylglycerol were increased. MD/BD patients had increased long chain ceramides, most prominently Cer22:0, but low endocannabinoids in contrast to ADHD patients. Patients with ADHD and comorbid affective disorders displayed increased S1P d18:1 and increased Cer22:0, but the individual lipid levels were lower than in the non-comorbid disorders. Sphingolipid profiles differ between patients suffering from ADHD and affective disorders, with overlapping patterns in comorbid patients. The S1P d18:1 to Cer22:0 ratio may constitute a diagnostic or prognostic tool.
Dubinski, Daniel ; Won, Sae-Yeon ; Behmanesh, Bedjan ; Dosch, Maximilian ; Schneider, Viktoria ; Baumgarten, Peter ; Bernstock, Joshua D. ; Voß, Martin ; Schuß, Patrick ; Konczalla, Jürgen ; Czabanka, Marcus Alexander ; Freiman, Thomas Michael ; Geßler, Florian
Background: Glioblastoma (GBM) patients are at particularly high risk for thrombotic complications. In the event of a postoperative pulmonary embolism, therapeutic anticoagulation (tAC) is indispensable. The impact of therapeutic anticoagulation on recurrence pattern in GBM is currently unknown. Methods: We conducted a matched-pair cohort analysis of 57 GBM patients with or without tAC that were matched for age, sex, gross total resection and MGMT methylation status in a ratio of 1:2. Patients’ characteristics and clinical course were evaluated using medical charts. MRI characteristics were evaluated by two independent authors blinded to the AC status. Results: The morphologic MRI appearance in first GBM recurrence showed a significantly higher presence of multifocal, midline crossing and sharp demarcated GBM recurrence patterns in patients with therapeutic tAC compared to the matched control group. Although statistically non-significant, the therapeutic tAC cohort showed increased survival. Conclusion: Therapeutic anticoagulation induced significant morphologic changes in GBM recurrences. The underlying pathophysiology is discussed in this article but remains to be further elucidated.
Magunia, Harry ; Lederer, Simone ; Verbuecheln, Raphael ; Gilot, Bryant ; Köppen, Michael ; Häberle, Helene ; Mirakaj, Valbona ; Hofmann, Pascal ; Marx, Gernot ; Bickenbach, Johannes ; Nohe, Boris ; Lay, Michael ; Spies, Claudia D. ; Edel, Andreas ; Schiefenhövel, Fridtjof ; Rahmel, Tim ; Putensen, Christian ; Sellmann, Timur ; Koch, Thea ; Brandenburger, Timo ; Kindgen-Milles, Detlef ; Brenner, Thorsten ; Berger, Marc ; Zacharowski, Kai ; Adam, Elisabeth ; Posch, Matthias ; Mörer, Onnen ; Scheer, Christian S. ; Sedding, Daniel ; Weigand, Markus A. ; Fichtner, Falk ; Nau, Carla ; Prätsch, Florian ; Wiesmann, Thomas ; Koch, Christian ; Schneider, Gerhard ; Lahmer, Tobias ; Straub, Andreas ; Meiser, Andreas ; Weiß, Manfred ; Jungwirth, Bettina ; Wappler, Frank ; Meybohm, Patrick ; Herrmann, Johannes ; Malek, Nisar Peter ; Kohlbacher, Oliver ; Biergans, Stephanie ; Rosenberger, Peter
Background: Intensive Care Resources are heavily utilized during the COVID-19 pandemic. However, risk stratification and prediction of SARS-CoV-2 patient clinical outcomes upon ICU admission remain inadequate. This study aimed to develop a machine learning model, based on retrospective & prospective clinical data, to stratify patient risk and predict ICU survival and outcomes. Methods: A Germany-wide electronic registry was established to pseudonymously collect admission, therapeutic and discharge information of SARS-CoV-2 ICU patients retrospectively and prospectively. Machine learning approaches were evaluated for the accuracy and interpretability of predictions. The Explainable Boosting Machine approach was selected as the most suitable method. Individual, non-linear shape functions for predictive parameters and parameter interactions are reported. Results: 1039 patients were included in the Explainable Boosting Machine model, 596 patients retrospectively collected, and 443 patients prospectively collected. The model for prediction of general ICU outcome was shown to be more reliable to predict “survival”. Age, inflammatory and thrombotic activity, and severity of ARDS at ICU admission were shown to be predictive of ICU survival. Patients’ age, pulmonary dysfunction and transfer from an external institution were predictors for ECMO therapy. The interaction of patient age with D-dimer levels on admission and creatinine levels with SOFA score without GCS were predictors for renal replacement therapy. Conclusions: Using Explainable Boosting Machine analysis, we confirmed and weighed previously reported and identified novel predictors for outcome in critically ill COVID-19 patients. Using this strategy, predictive modeling of COVID-19 ICU patient outcomes can be performed overcoming the limitations of linear regression models. Trial registration “ClinicalTrials” (clinicaltrials.gov) under NCT04455451.
Bein, Julia ; Flinner, Nadine ; Häupl, Björn ; Mathur, Aastha ; Schneider, Olga ; Abu-Ayyad, Marwa ; Hansmann, Martin-Leo ; Piel, Matthieu ; Oellerich, Thomas ; Hartmann, Sylvia
Classic Hodgkin lymphoma (cHL) is usually characterized by a low tumour cell content, derived from crippled germinal centre B cells. Rare cases have been described in which the tumour cells show clonal T-cell receptor rearrangements. From a clinicopathological perspective, it is unclear if these cases should be classified as cHL or anaplastic large T-cell lymphoma (ALCL). Since we recently observed differences in the motility of ALCL and cHL tumour cells, here, we aimed to obtain a better understanding of T-cell-derived cHL by investigating their global proteomic profiles and their motility. In a proteomics analysis, when only motility-associated proteins were regarded, T-cell-derived cHL cell lines showed the highest similarity to ALK− ALCL cell lines. In contrast, T-cell-derived cHL cell lines presented a very low overall motility, similar to that observed in conventional cHL. Whereas all ALCL cell lines, as well as T-cell-derived cHL, predominantly presented an amoeboid migration pattern with uropod at the rear, conventional cHL never presented with uropods. The migration of ALCL cell lines was strongly impaired upon application of different inhibitors. This effect was less pronounced in cHL cell lines and almost invisible in T-cell-derived cHL. In summary, our cell line-derived data suggest that based on proteomics and migration behaviour, T-cell-derived cHL is a neoplasm that shares features with both cHL and ALCL and is not an ALCL with low tumour cell content. Complementary clinical studies on this lymphoma are warranted.