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Niederer, Daniel ; Keller, Matthias ; Achtnich, Andrea ; Akoto, Ralph ; Ateschrang, Atesch ; Banzer, Winfried ; Barié, Alexander ; Best, Raymond ; Ellermann, Andree ; Fischer, Andreas ; Günther, Daniel ; Herbort, Mirco ; Höher, Jürgen ; Janko, Maren Carina ; Jung, Tobias ; Krause, Matthias ; Petersen, Wolf ; Stoffels, Thomas ; Stöhr, Amelie ; Welsch, Frederic ; Stein, Thomas
Background: Although anterior cruciate ligament (ACL) tear-prevention programs may be effective in the (secondary) prevention of a subsequent ACL injury, little is known, yet, on their effectiveness and feasibility. This study assesses the effects and implementation capacity of a secondary preventive motor-control training (the Stop-X program) after ACL reconstruction.
Methods and design: A multicenter, single-blind, randomized controlled, prospective, superiority, two-arm design is adopted. Subsequent patients (18–35 years) with primary arthroscopic unilateral ACL reconstruction with autologous hamstring graft are enrolled. Postoperative guideline rehabilitation plus Classic follow-up treatment and guideline rehabilitation plus the Stop-X intervention will be compared. The onset of the Stop-X program as part of the postoperative follow-up treatment is individualized and function based. The participants must be released for the training components. The endpoint is the unrestricted return to sport (RTS) decision. Before (where applicable) reconstruction and after the clearance for the intervention (aimed at 4–8 months post surgery) until the unrestricted RTS decision (but at least until 12 months post surgery), all outcomes will be assessed once a month. Each participant is consequently measured at least five times to a maximum of 12 times. Twelve, 18 and 24 months after the surgery, follow-up-measurements and recurrence monitoring will follow. The primary outcome assessement (normalized knee-separation distance at the Drop Jump Screening Test (DJST)) is followed by the functional secondary outcomes assessements. The latter consist of quality assessments during simple (combined) balance side, balance front and single-leg hops for distance. All hop/jump tests are self-administered and filmed from the frontal view (3-m distance). All videos are transferred using safe big content transfer and subsequently (and blinded) expertly video-rated. Secondary outcomes are questionnaires on patient-reported knee function, kinesiophobia, RTS after ACL injury and training/therapy volume (frequency – intensity – type and time). All questionnaires are completed online using the participants’ pseudonym only.
Group allocation is executed randomly. The training intervention (Stop-X arm) consists of self-administered home-based exercises. The exercises are step-wise graduated and follow wound healing and functional restoration criteria. The training frequency for both arms is scheduled to be three times per week, each time for a 30 min duration. The program follows current (secondary) prevention guidelines.
Repeated measurements gain-score analyses using analyses of (co-)variance are performed for all outcomes.
Trial registration: German Clinical Trials Register, identification number DRKS00015313. Registered on 1 October 2018.
Chen, Mengzhen ; Arcari, Luca ; Engel, Jürgen ; Freiwald, Tilo ; Platschek, Steffen ; Zhou, Hui ; Zainal, Hafisyatul ; Büttner, Stefan ; Zeiher, Andreas M. ; Geiger, Helmut ; Hauser, Ingeborg A. ; Nagel, Eike ; Puntmann, Valentina O.
Background: Patients with chronic kidney disease (CKD) have considerable cardiovascular morbidity and mortality. Aortic stiffness is an independent predictor of cardiovascular risk and related to left ventricular remodeling and heart failure. Myocardial fibrosis is the pathophysiological hallmark of the failing heart.
Methods and results: An observational study of consecutive CKD patients (n = 276) undergoing comprehensive clinical cardiovascular magnetic resonance imaging. The relationship between aortic stiffness, myocardial fibrosis, left ventricular remodeling and the severity of chronic kidney disease was examined. Compared to age-gender matched controls with no known kidney disease (n = 242), CKD patients had considerably higher myocardial native T1 and central aortic PWV (p ≪ 0.001), as well as abnormal diastolic relaxation by E/e′ (mean) by echocardiography (p ≪ 0.01). A third of all patients had LGE, with similar proportions for the presence and the (ischaemic and non-ischaemic) pattern between the groups. PWV was strongly associated with and age, NT-proBNP and native T1 in both groups, but not with LGE presence or type; the associations were amplified in severe CKD stages. In multivariate analyses, PWV was independently associated with native T1 in both groups (p ≪ 0.01) with near two-fold increase in adjusted R2 in the presence of CKD (native T1 (10 ms) R2, B(95%CI) CKD vs. non-CKD 0.28, 0.2(0.15–0.25) vs. 0.18, 0.1(0.06–0.15), p ≪ 0.01).
Conclusions: Aortic stiffness and interstitial myocardial fibrosis are interrelated; this association is accelerated in the presence of CKD, but independent of LGE. Our findings reiterate the significant contribution of CKD-related factors to the pathophysiology of cardiovascular remodeling.
Ballo, Olivier Karl Friedrich ; Stratmann, Jan Alexander ; Serve, Hubert ; Steffen, Björn ; Finkelmeier, Fabian ; Brandts, Christian Hubertus
Introduction: Vacuolization is a frequently found morphological feature in acute myeloid leukemia (AML) blasts. Subcellular origin and biological function as well as prognostic impact are currently unknown. The aim of this study was to evaluate whether vacuolization correlates with clinically relevant AML features.
Materials & methods: Bone marrow smears of patients diagnosed with AML at the University Hospital Frankfurt between January 2011 and August 2013 were analyzed for blast vacuolization and correlated with clinically relevant AML features. Patients undergoing standard induction chemotherapy were further analyzed for molecular and cytogenetic features as well as treatment response and survival.
Results: 14 of 100 patients diagnosed with AML receiving standard induction chemotherapy had evidence of blast vacuolization. Positivity for vacuolization correlated with a CD15 positive immunophenotype and with a higher incidence of high-risk AML according to the European LeukemiaNet risk stratification. AML patients with blast vacuolization had a poor blast clearance after standard induction chemotherapy and poor survival.
Discussion: In conclusion, our findings demonstrate that vacuolization can easily be determined in myeloid leukemia blasts and may be a useful biomarker to predict AML risk groups as well as early treatment response rates and survival.
Function of p21 (Cip1/Waf1/CDKN1A) in migration and invasion of cancer and trophoblastic cells
(2019)
Kreis, Nina-Naomi ; Friemel, Alexandra ; Ritter, Andreas Hans ; Roth, Susanne ; Rolle, Udo ; Louwen, Frank ; Yuan, Juping
Tumor progression and pregnancy have several features in common. Tumor cells and placental trophoblasts share many signaling pathways involved in migration and invasion. Preeclampsia, associated with impaired differentiation and migration of trophoblastic cells, is an unpredictable and unpreventable disease leading to maternal and perinatal mortality and morbidity. Like in tumor cells, most pathways, in which p21 is involved, are deregulated in trophoblasts of preeclamptic placentas. The aim of the present study was to enlighten p21’s role in tumorigenic choriocarcinoma and trophoblastic cell lines. We show that knockdown of p21 induces defects in chromosome movement during mitosis, though hardly affecting proliferation and cell cycle distribution. Moreover, suppression of p21 compromises the migration and invasion capability of various trophoblastic and cancer cell lines mediated by, at least partially, a reduction of the extracellular signal-regulated kinase 3, identified using transcriptome-wide profiling, real-time PCR, and Western blot. Further analyses show that downregulation of p21 is associated with reduced matrix metalloproteinase 2 and tissue inhibitor of metalloproteinases 2. This work evinces that p21 is involved in chromosome movement during mitosis as well as in the motility and invasion capacity of trophoblastic and cancer cell lines.
Lipoxygenases (LOXs) catalyze the stereo-specific peroxidation of polyunsaturated fatty acids (PUFAs) to their corresponding hydroperoxy derivatives. Human macrophages express two arachidonic acid (AA) 15-lipoxygenating enzymes classified as ALOX15 and ALOX15B. ALOX15, which was first described in 1975, has been extensively characterized and its biological functions have been investigated in a number of cellular systems and animal models. In macrophages, ALOX15 functions to generate specific phospholipid (PL) oxidation products crucial for orchestrating the nonimmunogenic removal of apoptotic cells (ACs) as well as synthesizing precursor lipids required for production of specialized pro-resolving mediators (SPMs) that facilitate inflammation resolution. The discovery of ALOX15B in 1997 was followed by comprehensive analyses of its structural properties and reaction specificities with PUFA substrates. Although its enzymatic properties are well described, the biological functions of ALOX15B are not fully understood. In contrast to ALOX15 whose expression in human monocyte-derived macrophages is strictly dependent on Th2 cytokines IL-4 and IL-13, ALOX15B is constitutively expressed. This review aims to summarize the current knowledge on the regulation and functions of ALOX15 and ALOX15B in human macrophages.
Auburger, Georg ; Gispert, Suzana ; Torres-Odio, Sylvia ; Jendrach, Marina ; Brehm, Nadine ; Canet Pons, Júlia ; Key, Jana ; Şen, Nesli Ece
Hereditary Parkinson’s disease (PD) can be triggered by an autosomal dominant overdose of alpha-Synuclein (SNCA) as stressor or the autosomal recessive deficiency of PINK1 Serine/Threonine-phosphorylation activity as stress-response. We demonstrated the combination of PINK1-knockout with overexpression of SNCAA53T in double mutant (DM) mice to exacerbate locomotor deficits and to reduce lifespan. To survey posttranslational modifications of proteins underlying the pathology, brain hemispheres of old DM mice underwent quantitative label-free global proteomic mass spectrometry, focused on Ser/Thr-phosphorylations. As an exceptionally strong effect, we detected >300-fold reductions of phosphoThr1928 in MAP1B, a microtubule-associated protein, and a similar reduction of phosphoSer3781 in ANK2, an interactor of microtubules. MAP1B depletion is known to trigger perturbations of microtubular mitochondria trafficking, neurite extension, and synaptic function, so it was noteworthy that relevantly decreased phosphorylation was also detected for other microtubule and microfilament factors, namely MAP2S1801, MARK1S394, MAP1AT1794, KIF1AS1537, 4.1NS541, 4.1GS86, and ADD2S528. While the MAP1B heavy chain supports regeneration and growth cones, its light chain assists DAPK1-mediated autophagy. Interestingly, relevant phosphorylation decreases of DAPK2S299, VPS13DS2429, and VPS13CS2480 in the DM brain affected regulators of autophagy, which are implicated in PD. Overall, significant downregulations were enriched for PFAM C2 domains, other kinases, and synaptic transmission factors upon automated bioinformatics, while upregulations were not enriched for selective motifs or pathways. Validation experiments confirmed the change of LC3 processing as reflection of excessive autophagy in DM brain, and dependence of ANK2/MAP1B expression on PINK1 levels. Our new data provide independent confirmation in a mouse model with combined PARK1/PARK4/PARK6 pathology that MAP1B/ANK2 phosphorylation events are implicated in Parkinsonian neurodegeneration. These findings expand on previous observations in Drosophila melanogaster that the MAP1B ortholog futsch in the presynapse is a primary target of the PARK8 protein LRRK2, and on a report that MAP1B is a component of the pathological Lewy body aggregates in PD patient brains. Similarly, ANK2 gene locus variants are associated with the risk of PD, ANK2 interacts with PINK1/Parkin-target proteins such as MIRO1 or ATP1A2, and ANK2-derived peptides are potent inhibitors of autophagy.
The lipid status in patients with ulcerative colitis : Sphingolipids are disease-dependent regulated
(2019)
Bazarganipour, Sarah ; Hausmann, Johannes ; Oertel, Stephanie ; El-Hindi, Khadija ; Brachtendorf, Sebastian ; Blumenstein, Irina Ursula ; Kubesch, Alica ; Sprinzl, Kathrin ; Birod, Kerstin ; Hahnefeld, Lisa Katharina ; Trautmann, Sandra ; Thomas, Dominique Jeanette ; Herrmann, Eva ; Geisslinger, Gerd ; Schiffmann, Susanne ; Grösch, Sabine
The factors that contribute to the development of ulcerative colitis (UC), are still not fully identified. Disruption of the colon barrier is one of the first events leading to invasion of bacteria and activation of the immune system. The colon barrier is strongly influenced by sphingolipids. Sphingolipids impact cell–cell contacts and function as second messengers. We collected blood and colon tissue samples from UC patients and healthy controls and investigated the sphingolipids and other lipids by LC-MS/MS or LC-QTOFMS. The expression of enzymes of the sphingolipid pathway were determined by RT-PCR and immunohistochemistry. In inflamed colon tissue, the de novo-synthesis of sphingolipids is reduced, whereas lactosylceramides are increased. Reduction of dihydroceramides was due to posttranslational inhibition rather than altered serine palmitoyl transferase or ceramide synthase expression in inflamed colon tissue. Furthermore, in human plasma from UC-patients, several sphinglipids change significantly in comparison to healthy controls. Beside sphingolipids free fatty acids, lysophosphatidylcholines and triglycerides changed significantly in the blood of colitis patients dependent on the disease severity. Our data indicate that detraction of the sphingolipid de novo synthesis in colon tissue might be an important trigger for UC. Several lipids changed significantly in the blood, which might be used as biomarkers for disease control; however, diet-related variabilities need to be considered.
Zulauf, Nicole ; Dröge, Janis ; Klingelhöfer, Doris ; Braun, Markus ; Oremek, Gerhard ; Groneberg, Jan David Alexander
From a global viewpoint, a lot of time is spent within the indoor air compartment of vehicles. A German study on mobility has revealed that, on average, people spend 45 minutes per day inside vehicles. In recent years the number of cars has increased to around 43 million vehicles in private households. This means that more than one car can be used in every household. The ratio has been growing, especially in eastern Germany and rural areas. "Overall and especially outside the cities, the car remains by far number one mode of transport, especially in terms of mileage". Therefore, numerous international studies have addressed different aspects of indoor air hygiene, in the past years. In this paper, meaningful original studies on car indoor air pollution, related to VOCs, COx, PMs, microbials, BFRs, OPFRs, cigarettes, electronic smoking devices, high molecular weight plasticizer, and NOx are summarized in the form of a review. This present review aimed to summarize recently published studies in this important field of environmental medicine and points to the need for further studies with special recommendations for optimizing the interior air hygiene.
Martin, Lisa Maria ; Möller, Moritz ; Weiß, Ulrike ; Russe, Otto ; Scholich, Klaus ; Pierre, Sandra ; Geisslinger, Gerd ; Niederberger, Ellen
The stimulation of the AMP-activated kinase (AMPK) by 5-amino-1-β-D-ribofuranosyl-imidazole-4-carboxamide (AICAR) has been associated with antihyperalgesia and the inhibition of nociceptive signaling in the spinal cord in models of paw inflammation. The attenuated nociception comes along with a strongly reduced paw edema, indicating that peripheral antiinflammatory mechanisms contribute to antinociception. In this study, we investigated the impact of AICAR on the immune cell composition in inflamed paws, as well as the regulation of inflammatory and resolving markers in macrophages. By using fluorescence-activated cell sorting (FACS) analysis and immunofluorescence, we found a significantly increased fraction of proresolving M2 macrophages and anti-inflammatory interleukin (IL)-10 in inflamed tissue, while M1 macrophages and proinflammatory cytokines such as IL-1 were decreased by AICAR in wild type mice. In AMPKα2 knock-out mice, the M2 polarization of macrophages in the paw was missing. The results were supported by experiments in primary macrophage cultures which also showed a shift to a proresolving phenotype with decreased levels of proinflammatory mediators and increased levels of antiinflammatory mediators. However, in the cell cultures, we did not observe differences between the AMPKα2+/+ and −/− cells, thus indicating that the AICAR-induced effects are at least partially AMPK-independent. In summary, our results indicate that AICAR has potent antiinflammatory and proresolving properties in inflammation which are contributing to a reduction of inflammatory edema and antinociception.
Der menschliche Knochen besitzt, als Folge einer Verletzung oder eines chirurgischen Eingriffs, eine große Fähigkeit zur Reparatur und Regeneration. Die Knochenheilung beinhaltet ein komplexes Zusammenspiel von Zellen, Wachstumsfaktoren, Zytokinen sowie der extrazellulären Matrix (Hoerth et al. 2014). Nichtsdestotrotz führt ein Knochenbruch zu einer dramatischen Veränderung der mechanischen Belastbarkeit an der Verletzungsstelle. Der Abstand zwischen den beiden Frakturenden bildet einen entscheidenden Faktor in der Knochenheilung. Hier wird zwischen der primären, der osteonalen Knochenheilung und der sekundären, der kallusformierenden Knochenheilung unterschieden. Umso größer der Frakturspalt ist, desto größer wird die Instabilität, die Heilungsverzögerung und damit auch die Gefahr einer Pseudoarthrose (Hoerth et al., 2014; Marsell et Einhorn, 2011).
Große diaphysale Defekte werden meistens durch Traumata, Infektionen oder Tumore bedingt. Sie werden als critical size defects (CSD) bezeichnet, wenn eine chirurgische Intervention zur Heilung notwendig ist (Rosset et al., 2014). Langstreckige Knochendefekte stellen immer noch eine sehr große Herausforderung in der rekonstruktiven Chirurgie dar. Deswegen ist die Untersuchung und Weiterentwicklung von implantierbaren biomedizinischen Materialien bei der Behandlung von CSD eine wichtige Aufgabe.
Im Augenblick ist die häufigste Behandlungsmethode großer diaphysaler Defekte die Autologe Spongiosaplastik (ASP) und wird als Goldstandart der Therapie bezeichnet. Jedoch stehen die autologen Knochenmaterialien nur begrenzt zur Verfügung und verursachen viele Entnahmemorbiditäten. Darüber hinaus gibt es allogene, xenogene und synthetische Knochentransplantate. Dennoch ist noch keine der Therapiemöglichkeiten so ausgereift, dass die ASP dadurch ersetzt werden könnte. Die allogenen und xenogenen Materialien sind von der Menge unbegrenzt, besitzen aber eine niedrigere Biokompatibilität, höhere Infektionsgefahr und schlechtere Ergebnisse in der Langzeitwirkung (Wang et al., 2014).
Ein weiterer Nachteil gegenüber der ASP besteht darin, dass die synthetischen Knochenersatzmaterialien keine osteoinduktiven und osteogenen Eingenschaften besitzen. Eine Möglichkeit diese Qualitäten zu erhalten ist, sie mit Zellsuspensionen, wie z.B. bone marrow mononuclear cells (BMC), zu kombinieren und somit zu versuchen ein ausgereiftes Therapiekonzept zu entwickeln.
Zugleich beschreibt Masquelet et al. (2000) eine neue Technik, ein zweistufiges Verfahren zur Rekonstruktion von Knochendefekten. Es wird eine biologisch aktive Membran induziert, welche verschiedene Wachstumsfaktoren (wie z.B. VEGF, TGF beta1, BMP-2) sezerniert, die osteoinduktiv wirksam sind. Mit diesem operativen Verfahren wurden bereits gute klinische Ergebnisse bei Knochendefekten nach Tumorresektionen und Traumata erzielt.
Das Ziel dieser Studie ist es einen anorganischen Knochenersatzstoff von Heraeus Herafill unter Verwendung der induzierten Membrantechnik nach Masquelet am Rattenfemur zu testen. Die Forschung erfolgt dabei unter der Hypothese, dass die Korngröße des Knochenersatzmaterials Herafill in Kombination mit BMC-Besiedelung Einfluss auf die Heilung eines kritischen Knochendefekts hat.