Proteolytic Activity of the Paracaspase MALT1 Is Involved in Epithelial Restitution and Mucosal Healing - Wittner, Leonie; Wagener, Lukas; Wiese, Jakob J.; Stolzer, Iris; Krug, Susanne M.; Naschberger, Elisabeth; Jackstadt, Rene; Beyaert, Rudi; Atreya, Raja; Kühl, Anja A.; Sturm, Gregor; Gonzalez-Acera, Miguel; et al. (International Journal of Molecular Sciences, 2023)
The paracaspase MALT1 is a crucial regulator of immune responses in various cellular contexts. Recently, there is increasing evidence suggesting that MALT1 might represent a novel key player in mucosal inflammation. However, the molecular mechanisms underlying this process and the targeted cell population remain unclear. In this study, we investigate the role of MALT1 proteolytic activity in the context of mucosal inflammation. We demonstrate a significant enrichment of MALT1 gene and protein expression in colonic epithelial cells of UC patients, as well as in the context of experimental colitis. Mechanistically we demonstrate that MALT1 protease function inhibits ferroptosis, a form of iron-dependent cell death, upstream of NF-κB signaling, which can promote inflammation and tissue damage in IBD. We further show that MALT1 activity contributes to STAT3 signaling, which is essential for the regeneration of the intestinal epithelium after injury. In summary, our data strongly suggests that the protease function of MALT1 plays a critical role in the regulation of immune and inflammatory responses, as well as mucosal healing. Understanding the mechanisms by which MALT1 protease function regulates these processes may offer novel therapeutic targets for the treatment of IBD and other inflammatory diseases.
CRIS-Team Scopus Importer:2023-05-19
Keywords: ferroptosis; mucosal wound healing; ulcerative colitis

Proteolytic processing of galectin-3 by meprin metalloproteases is crucial for host-microbiome homeostasis - Bülck, Cynthia; Nyström, Elisabeth E.L.; Koudelka, Tomas; Mannbar-Frahm, Michael; Andresen, Gerrit; Radhouani, Mariem; Tran, Florian; Scharfenberg, Franka; Schrell, Friederike; Armbrust, Fred; Dahlke, Eileen; Zhao, Bei; et al. (Science Advances, 2023)
The metalloproteases meprin α and meprin β are highly expressed in the healthy gut but significantly decreased in inflammatory bowel disease, implicating a protective role in mucosal homeostasis. In the colon, meprin α and meprin β form covalently linked heterodimers tethering meprin α to the plasma membrane, therefore presenting dual proteolytic activity in a unique enzyme complex. To unravel its function, we applied N-terminomics and identified galectin-3 as the major intestinal substrate for meprin α/β heterodimers. Galectin-3-deficient and meprin α/β double knockout mice show similar alterations in their microbiome in comparison to wild-type mice. We further demonstrate that meprin α/β heterodimers differentially process galectin-3 upon bacterial infection, in germ-free, conventionally housed (specific pathogen-free), or wildling mice, which in turn regulates the bacterial agglutination properties of galectin-3. Thus, the constitutive cleavage of galectin-3 by meprin α/β heterodimers may play a key role in colon host-microbiome homeostasis.
CRIS-Team Scopus Importer:2023-04-14

Pruritus bei systemischen Erkrankungen - Kremer, Andreas; Mettang, T. (Internist, 2019)
Chronic pruritus is a symptom of various internal disorders. In contrast to dermatological diseases, pruritus does not present with primary skin alterations in these patients. However, intense scratching my cause secondary skin changes such as abrasion, excoriation, prurigo nodularis, or in rare cases even scarring. The most common internal causes for chronic pruritus are chronic kidney disease, hepatobiliary, and hematological disorders as well as adverse drug reactions. Pruritus is less commonly seen in patients with endocrine or metabolic diseases, malabsorption syndromes, infectious diseases, and solid tumors. The pathogenesis of pruritus in these disorders remains largely elusive, albeit first insights have been gained for uremic and cholestatic pruritus. Antipruritic treatment is therefore symptomatic in most cases and may represent a clinical challenge. The calcium channel blockers gabapentin and pregabalin have the best proven efficacy in chronic kidney disease associated pruritus. In Japan, nalfurafine, a κ-opioid receptor agonist, has been licensed for this indication. UVB light may also attenuate uremic symptoms. In patients suffering from hepatobiliary disorders the sequestrant cholestyramine and the enzyme inducer rifampicin are effective. Furthermore, bezafibrate, the μ‑opioid receptor antagonists and, in Japan, nalfurafine may be used to ameliorate cholestatic pruritus. So far, no randomized controlled trials have been performed for chronic itch in other internal disorders. Antipruritic treatment is symptom-based with a focus on the effective therapy of the underlying disease.
CRIS-Team Scopus Importer:2019-07-12
Keywords: Antipruritics; Cholestasis; Itching; Lymphoma; Renal insufficiency; chronic

Pruritus in cholestasis: facts and fiction - Beuers, Ulrich; Kremer, Andreas; Bolier, Ruth; Elferink, Ronald P. J. Oude (Hepatology, 2014)
Pruritus is a common symptom in patients with cholestatic liver diseases such as primary biliary cirrhosis, primary sclerosing cholangitis, intrahepatic cholestasis of pregnancy, or hereditary pediatric cholestatic disorders and may accompany, although less frequently, many other liver diseases. Recent findings indicate that lysophosphatidic acid (LPA), a potent neuronal activator, and autotaxin (ATX; ectonucleotide pyrophosphatase/phosphodiesterase 2), the enzyme which forms LPA, may form a key element of the long-sought pruritogenic signaling cascade in cholestatic patients suffering from itch. Serum ATX, but no other pruritogen candidate studied so far, correlates with pruritus intensity and responds to therapeutic interventions. In this comprehensive review, we provide a short update on actual insights in signal transmission related to pruritus and discuss pruritogen candidates in cholestasis. We also summarize evidence-based and guideline-approved as well as experimental therapeutic approaches for patients suffering from pruritus in cholestasis.
EVALuna2:1864

Pruritus in Psoriasis - Correlation to the Severity of the clinical appearance of the Skin? - Achterberg, Fritz Leonard; Kremer, Andreas; Sticherling, Michael (JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, 2019)
CRIS-Team WoS Importer:2019-05-17

Pruritus in systemic diseases : Common and rare etiologies - Kremer, Andreas; Mettang, T. (Hautarzt, 2016)
Chronic pruritus is a symptom of various internal disorders. In contrast to dermatological diseases, pruritus does not present with primary skin alterations in these patients. However, intense scratching may cause secondary skin changes such as abrasion, excoriation, prurigo nodularis, or in rare cases even scaring. The most common internal medicine causes for chronic pruritus are chronic kidney disease, hepatobiliary and hematological disorders as well as adverse drug reactions. Pruritus is less commonly seen in patients with endocrine or metabolic diseases, malabsorption syndromes, infectious diseases and solid tumors. The pathogenesis of pruritus in these disorders remains largely elusive, albeit preliminary insights have been gained for uremic and cholestatic pruritus. Antipruritic treatment is therefore symptomatic in most cases and may represent a clinical challenge. The calcium channel blockers gabapentin and pregabalin have the best proven efficacy in chronic kidney disease-associated pruritus. In Japan nalfurafine, a ?-opioid receptor agonist, has been licensed for this indication. UVB light may also attenuate uremic symptoms. In patients suffering from hepatobiliary disorders the sequestrant cholestyramine and the enzyme inducer rifampicin are effective. Furthermore, ?-opioid receptor antagonists and sertraline may be used to ameliorate cholestatic pruritus. So far, no randomized controlled trials have been performed for chronic itch in other internal medicine disorders. Antipruritic treatment is mainly based on effective therapy of the underlying disease.
EVALuna2:2200

Pruritus strongly reduces quality of life in PBC patients - real life data from a large national survey - Hönig, Stefanie; Herder, B.; Kautz, A.; Trautwein, C.; Kremer, Andreas (JOURNAL OF HEPATOLOGY, 2018)
CRIS-Team WoS Importer:2019-03-26

Pseudo-HE images derived from CARS/TPEF/SHG multimodal imaging in combination with Raman-spectroscopy as a pathological screening tool - Bocklitz, Thomas W.; Salah, Firas Subhi; Vogler, Nadine; Heuke, Sandro; Chernavskaia, Olga; Schmidt, Carsten; Waldner, Maximilian; Greten, Florian R.; Braeuer, Rolf; Schmitt, Michael; Stallmach, Andreas; Petersen, Iver; et al. (BMC Cancer, 2016)
Due to the steadily increasing number of cancer patients worldwide the early diagnosis and treatment of cancer is a major field of research. The diagnosis of cancer is mostly performed by an experienced pathologist via the visual inspection of histo-pathological stained tissue sections. To save valuable time, low quality cryosections are frequently analyzed with diagnostic accuracies that are below those of high quality embedded tissue sections. Thus, alternative means have to be found that enable for fast and accurate diagnosis as the basis of following clinical decision making.In this contribution we will show that the combination of the three label-free non-linear imaging modalities CARS (coherent anti-Stokes Raman-scattering), TPEF (two-photon excited autofluorescence) and SHG (second harmonic generation) yields information that can be translated into computational hematoxylin and eosin (HE) images by multivariate statistics. Thereby, a computational HE stain is generated resulting in pseudo-HE overview images that allow for identification of suspicious regions. The latter are analyzed further by Raman-spectroscopy retrieving the tissue's molecular fingerprint.The results suggest that the combination of non-linear multimodal imaging and Raman-spectroscopy possesses the potential as a precise and fast tool in routine histopathology.As the key advantage, both optical methods are non-invasive enabling for further pathological investigations of the same tissue section, e.g. a direct comparison with the current pathological gold-standard.
EVALuna2:2155

PU.1 controls fibroblast polarization and tissue fibrosis - Wohlfahrt, Thomas; Rauber, Simon; Uebe, Steffen; Luber, Markus; Soare, Alina; Ekici, Arif Bülent; Weber, Stefanie; Matei, Alexandru-Emil; Chen, Chih Wei; Maier, Christiane; Karouzakis, Emmanuel; Kiener, Hans P.; et al. (Nature, 2019)
Fibroblasts are polymorphic cells with pleiotropic roles in organ morphogenesis, tissue homeostasis and immune responses. In fibrotic diseases, fibroblasts synthesize abundant amounts of extracellular matrix, which induces scarring and organ failure. By contrast, a hallmark feature of fibroblasts in arthritis is degradation of the extracellular matrix because of the release of metalloproteinases and degrading enzymes, and subsequent tissue destruction. The mechanisms that drive these functionally opposing pro-fibrotic and pro-inflammatory phenotypes of fibroblasts remain unknown. Here we identify the transcription factor PU.1 as an essential regulator of the pro-fibrotic gene expression program. The interplay between transcriptional and post-transcriptional mechanisms that normally control the expression of PU.1 expression is perturbed in various fibrotic diseases, resulting in the upregulation of PU.1, induction of fibrosis-associated gene sets and a phenotypic switch in extracellular matrix-producing pro-fibrotic fibroblasts. By contrast, pharmacological and genetic inactivation of PU.1 disrupts the fibrotic network and enables reprogramming of fibrotic fibroblasts into resting fibroblasts, leading to regression of fibrosis in several organs.
EVALuna2:35476

PU.1-driven Th9 Cells Promote Colorectal Cancer in Experimental Colitis Models Through Il-6 Effects in Intestinal Epithelial Cells - Gerlach, Katharina; Popp, Vanessa; Wirtz, Stefan; Al-Saifi, Ragheed; Gonzalez Acera, Miguel; Atreya, Raja; Dregelis, Theresa; Vieth, Michael; Fichtner-Feigl, Stefan; Mckenzie, Andrew N. J.; Rosenbauer, Frank; Weigmann, Benno; et al. (Journal of Crohns & Colitis, 2022)
Background and Aims Colorectal cancer [CRC] is one of the most frequent malignancies, but the molecular mechanisms driving cancer growth are incompletely understood. We characterised the roles of the cytokine IL-9 and Th9 cells in regulating CRC development. Methods CRC patient samples and samples from AOM/DSS treated mice were analysed for expression of IL-9, CD3, and PU.1 by FACS analysis and immunohistochemistry. IL-9 citrine reporter mice, IL-9 knockout mice, and PU.1 and GATA3 CD4-Cre conditional knockout mice were studied in the AOM/DSS model. DNA minicircles or hyper-IL-6 were used for overexpression of cytokines in vivo. Effects of IL-6 and IL-9 were determined in organoid and T cell cultures. Claudin2/3 expression was studied by western blotting and bacterial translocation by FISH. Results We uncovered a significant expansion of IL-9- and PU.1-expressing mucosal Th9 cells in CRC patients, with particularly high levels in patients with colitis-associated neoplasias. PU.1(+) Th9 cells accumulated in experimental colorectal neoplasias. Deficiency of IL-9 or inactivation of PU.1 in T cells led to impaired tumour growth in vivo, suggesting a protumoral role of Th9 cells. In contrast, GATA3 inactivation did not affect Th9-mediated tumour growth. Mechanistically, IL-9 controls claudin2/3 expression and T cell-derived IL-6 production in colorectal tumours. IL-6 abrogated the anti-proliferative effects of IL-9 in epithelial organoids in vivo. IL-9-producing Th9 cells expand in CRC and control IL-6 production by T cells. Conclusions IL-9 is a crucial regulator of tumour growth in colitis-associated neoplasias and emerges as potential target for therapy.
CRIS-Team WoS Importer:2022-09-16

Public spirometry for primary prevention of COPD - Zirlik, Sabine; Wich, Christina; Frieser, Markus; Hildner, Kai; Kleye, Christin; Neurath, Markus; Fuchs, Florian S. (Journal of Evaluation in Clinical Practice, 2014)
The most effective action for primary prevention of chronic obstructive lung disease is smoking cessation early enough. In secondary prevention, smokers with airway obstruction were more likely to quit smoking. The aim of this study was to evaluate the impact of a public spirometry on smoking habits in terms of primary prevention.Spirometry with its medical analysis was offered to visitors of a local public event called 'Lange Nacht der Wissenschaften' ('Long night of sciences'). The impact of results on smoking habits was evaluated in all smokers with an anonymized questionnaire afterwards.Two hundred fifty-seven people with the median age of 30 years (interquartile range 22-46) were examined. Out of 44 current smokers (17.1%), only two individuals showed a prebronchodilator FEV1/forced vital capacity-value <0.7. Fourteen smokers stated to have an increased motivation to quit smoking whereas 28 smokers declared that their motivation to quit smoking was independent of spirometry result. These smokers were significantly younger (median age 28 vs. 40 years, P = 0.025) without differences in spirometry results or smoking habits.In an unselected population with a high amount of younger adults, normal spirometry did not show a short-term benefit for primary prevention of chronic obstructive lung disease in terms of increasing motivation to quit smoking.
EVALuna2:1869

Purple urine in a patient after recovery from a SARS-CoV-2 infection - Vetter, Marcel; Kaufmann, Matthias; Neurath, Markus; Kremer, Andreas (International Journal of Infectious Diseases, 2021)
CRIS-Team Scopus Importer:2021-04-02
Keywords: COVID-19; PUBS; Purple urine bag syndrome

Quality of life of young adults after a growth hormone therapy with childhood onset - Quitmann, J. H.; Rohenkohl, A. C.; Kammerer, U.; Schöfl, Christof; Bullinger, M.; Dörr, Helmuth-Günther (Deutsche Medizinische Wochenschrift, 2014)
Little is known about the health-related quality of life of young adults with childhood onset idiopathic growth hormone deficiency or neurosecretory dysfunction of growth hormone secretion, who have been treated with recombinant human growth hormone (GH).Patients were diagnosed and treated with human growth hormone at the University Children´s Hospital in Erlangen (n=85). The data of both groups were merged for analysis, because no difference between idiopathic growth hormone deficiency and neurosecretory dysfunction of growth hormone secretion in auxological. Data were found. Health-related quality of life was cross- sectionally assessed after the end of growth hormone therapy with the Short Form-36 Health Survey and the Nottingham Health Profiles for which population based norm data are available.At the time of the survey, the patients (53 m, 32 f) were 23.5 ± 4.6 years old. At start of GH therapy, age was 10.5 ± 2.8 and at the end 16.3 ± 1,4 years. At start, height SDS was -3.20 ± 1.06. GH dose was 0,026 ± 0,012 mg/kg/d (daily s. c.-injections). The increase in height SDS after the end of GH therapy was 1.69 ± 1.22. Compared to the reference population, patients reported significantly lower scores on the scales energy level, vitality, social functioning, indicating a greater social isolation, a stronger emotional reaction, an increased loss of mobility and a worse psychological state.Young adults report specific impairments after completion of GH therapy.
EVALuna2:1888

Quality of Life, Tumour Heterogeneity and Biomarker Levels in Patients with Progressive Pancreatic or Midgut Neuroendocrine Tumours: Baseline Data from CLARINET FORTE - Ruszniewski, P.; Cwikla, J.; Lombard-Bohas, C.; Borbath,; Shah, T.; Pape, U. F.; Truong Thanh, X. M.; Houchard, A.; Pavel, Marianne Ellen (NEUROENDOCRINOLOGY, 2020)
CRIS-Team WoS Importer:2020-04-10

Quantitative contrast-enhanced ultrasound for monitoring vedolizumab therapy in inflammatory bowel disease patients: a pilot study - Görtz, Rüdiger; Klett, Daniel; Wildner, Dane; Atreya, Raja; Neurath, Markus; Strobel, Deike (Acta Radiologica, 2018)
Background Microvascularization of the bowel wall can be visualized and quantified non-invasively by software-assisted analysis of derived time-intensity curves. Purpose To perform software-based quantification of bowel wall perfusion using quantitative contrast-enhanced ultrasound (CEUS) according to clinical response in patients with inflammatory bowel disease treated with vedolizumab. Material and Methods In a prospective study, in 18 out of 34 patients, high-frequency ultrasound of bowel wall thickness using color Doppler flow combined with CEUS was performed at baseline and after 14 weeks of treatment with vedolizumab. Clinical activity scores at week 14 were used to differentiate between responders and non-responders. CEUS parameters were calculated by software analysis of the video loops. Results Nine of 18 patients (11 with Crohn's disease and seven with ulcerative colitis) showed response to treatment with vedolizumab. Overall, the responder group showed a significant decrease in the semi-quantitative color Doppler vascularization score. Amplitude-derived CEUS parameters of mural microvascularization such as peak enhancement or wash-in rate decreased in responders, in contrast with non-responders. Time-derived parameters remained stable or increased during treatment in all patients. Conclusion Analysis of bowel microvascularization by CEUS shows statistically significant changes in the wash-in-rate related to response of vedolizumab therapy.
EVALuna2:35140

Quantitative perfusion analysis in pancreatic contrast enhanced ultrasound (DCE-US): a promising tool for the differentiation between autoimmune pancreatitis and pancreatic cancer - Vitali, Francesco; Pfeifer, Lukas; Janson, C.; Görtz, Rüdiger; Neurath, Markus; Strobel, Deike; Wildner, Dane (Zeitschrift für Gastroenterologie, 2015)
In the work-up of focal pancreatic lesions autoimmune pancreatitis (AIP) is a rare differential diagnosis to pancreatic cancer (PC) with similar clinical constellations. The aim of our study was to compare differences between proven AIP and PC using transabdominal dynamic contrast enhanced ultrasound (DCE-US). Therefore we recorded 3-minute-clips of CEUS examinations and analyzed perfusion parameters with VueBox(®)-quantification software. To obtain DCE-US Parameters, Regions-of-Interest were selected within the lesions and the surrounding pancreas parenchyma, serving as reference tissue. We compared 3 patients with AIP (mean age: 58 years; lesion mean size: 40 mm) to 17 patients with PC (mean age: 68 years; lesion mean size: 35.9 mm). Significant differences between PC and parenchyma could be found in the following parameters: Peak-Enhancement (PE), Wash-in-and-Wash-out-AUC, Wash-in Perfusion-Index. PE of AIP was comparable to normal parenchyma. The relation of PE between parenchyma and lesion (?PE) AIP and PC was significantly different [AIP: 0.21 (± 0.06); PC: 0.81 (± 0.1); p < 0.01]. PE of neoplastic lesions was significantly lower as AIP and normal parenchyma (p < 0.01). Therefore perfusion analysis in DCE-US can help to differentiate hypovascular PC from AIP presenting nearly isovascular time intensity curves. Diagnostic accuracy of DCE-US in this setting has to be validated in future prospective studies in comparison to CT and MRI.
EVALuna2:1985

QuickView video preview software of colon capsule endoscopy: reliability in presenting colorectal polyps as compared to normal mode reading - Farnbacher, Michael J.; Krause, Horst H.; Hagel, Alexander; Raithel, Martin; Neurath, Markus; Schneider, Thomas (Scandinavian Journal of Gastroenterology, 2014)
OBJECTIVE. Colon capsule endoscopy (CCE) proved to be highly sensitive in detection of colorectal polyps (CP). Major limitation is the time-consuming video reading. The aim of this prospective, double-center study was to assess the theoretical time-saving potential and its possible impact on the reliability of "QuickView" (QV), in the presentation of CP as compared to normal mode (NM). METHODS. During NM reading of 65 CCE videos (mean patient´s age 56 years), all frames showing CPs were collected and compared to the number of frames presented by QV at increasing QV settings (10, 20, ... 80%). Reliability of QV in presenting polyps <6 mm and >=6 mm (significant polyp), and identifying patients for subsequent therapeutic colonoscopy, capsule egestion rate, cleansing level, and estimated time-saving potential were assessed. RESULTS. At a 30% QV setting, the QV video presented 89% of the significant polyps and 86% of any polyps with >=1 frame (per-polyp analysis) identified in NM before. At a 10% QV setting, 98% of the 52 patients with significant polyps could be identified (per-patient analysis) by QV video analysis. Capsule excretion rate was 74% and colon cleanliness was adequate in 85%. QV´s presentation rate correlates to the QV setting, the polyp size, and the number of frames per finding. CONCLUSIONS. Depending on its setting, the reliability of QV in presenting CP as compared to NM reading is notable. However, if no significant polyp is presented by QV, NM reading must be performed afterwards. The reduction of frames to be analyzed in QV might speed up identification of candidates for therapeutic colonoscopy.
EVALuna2:1915

Radical intended surgery for highly selected stage IV neuroendocrine neoplasms G3 - Merola, Elettra; Falconi, Massimo; Rinke, Anja; Staettner, Stefan; Krendl, Felix; Partelli, Stefano; Andreasi, Valentina; Gress, Thomas M.; Pascher, Andreas; Arsenic, Ruza; Doglioni, Claudio; Kaemmerer, Daniel; et al. (American Journal of Surgery, 2020)
Background: Stage IV gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) G3 are the NENs with the worst prognosis. According to ENETS guidelines, platinum-based chemotherapy is the standard treatment for this population. Surgery is only considered in highly selected “resectable” NENs with usually lower Ki67. However, the role of surgery with curative intent has been poorly investigated. Objective: To describe, in a retrospective series of stage IV GEP-NENs G3, overall survival (OS) and recurrence-free survival (RFS) rates after curatively intended surgery. Methods: Multicenter analysis of stage IV GEP-NENs G3 receiving radical resection (R0/R1) from 2007 to 2017, with minimum post-surgical follow-up time of 3 months. Results: Fifteen patients from 6 NEN referral centers, with median follow-up of 29 months (8-86), were included. Eight cases had a neuroendocrine carcinoma (NEC) and 7 a neuroendocrine tumor G3 (NET G3). Median OS after radical surgery was 59 months. All patients recurred, with a median RFS of 8 months. Conclusions: Radical surgery might be considered for highly selected stage IV GEP-NENs G3. Larger series are needed to confirm these results.
CRIS-Team Scopus Importer:2020-03-31
Keywords: Neuroendocrine neoplasms G3; Overall survival; Recurrence; Stage IV; Surgery

Radical Resection in Entero-Pancreatic Neuroendocrine Tumors: Recurrence-Free Survival Rate and Definition of a Risk Score for Recurrence - Merola, Elettra; Pascher, A.; Rinke, A.; Bartsch, D. K.; Zerbi, A.; Nappo, G.; Carnaghi, C.; Ciola, M.; Mcnamara, M. G.; Zandee, W.; Bertani, E.; Marcucci, S.; et al. (Annals of Surgical Oncology, 2022)
Background Surgery with radical intent is the only potentially curative option for entero-pancreatic neuroendocrine tumors (EP-NETs) but many patients develop recurrence even after many years. The subset of patients at high risk of disease recurrence has not been clearly defined to date. Objective The aim of this retrospective study was to define, in a series of completely resected EP-NETs, the recurrence-free survival (RFS) rate and a risk score for disease recurrence. Patients and Methods This was a multicenter retrospective analysis of sporadic pancreatic NETs (PanNETs) or small intestine NETs (SiNETs) [G1/G2] that underwent R0/R1 surgery (years 2000-2016) with at least a 24-month follow-up. Survival analysis was performed using the Kaplan-Meier method and risk factor analysis was performed using the Cox regression model. Results Overall, 441 patients (224 PanNETs and 217 SiNETs) were included, with a median Ki67 of 2% in tumor tissue and 8.2% stage IV disease. Median RFS was 101 months (5-year rate 67.9%). The derived prognostic score defined by multivariable analysis included prognostic parameters, such as TNM stage, lymph node ratio, margin status, and grading. The score distinguished three risk categories with a significantly different RFS (p < 0.01). Conclusions Approximately 30% of patients with EP-NETs recurred within 5 years after radical surgery. Risk factors for recurrence were disease stage, lymph node ratio, margin status, and grading. The definition of risk categories may help in selecting patients who might benefit from adjuvant treatments and more intensive follow-up programs.
CRIS-Team WoS Importer:2022-06-03

Rapid qPCR-based quantitative immune cell phenotyping in mouse tissues - Huang, Jinghao; Demmler, Richard; Mohamed Abdou, Mariam; Thoma, Oana-Maria; Weigmann, Benno; Waldner, Maximilian; Stürzl, Michael; Naschberger, Elisabeth (Journal of Investigative Medicine, 2024)
The immune microenvironment plays an important role in the regulation of diseases. The characterization of the cellular composition of immune cell infiltrates in diseases and respective models is a major task in pathogenesis research and diagnostics. For the assessment of immune cell populations in tissues, fluorescence-activated cell sorting (FACS) or immunohistochemistry (IHC) are the two most common techniques presently applied, but they are cost intensive, laborious, and sometimes limited by the availability of suitable antibodies. Complementary rapid qPCR-based approaches exist for the human situation but are lacking for experimental mouse models. Accordingly, we developed a robust, rapid RT-qPCR-based approach to determine and quantify the abundance of prominent immune cell populations such as T cells, helper T (Th) cells, cytotoxic T cells, Th1 cells, B cells, and macrophages in mouse tissues. The results were independently validated by the gold standards IHC and FACS in corresponding tissues and showed high concordance.
CRIS-Team Scopus Importer:2023-12-22
Keywords: FACS; IHC; immune cell phenotyping; mouse tissue; RT-qPCR

Rapid response flow cytometric assay for the detection of antibody responses to SARS-CoV-2 - Lapuente, Dennis; Maier, Clara; Irrgang, Pascal; Hübner, Julian; Peter, Antonia Sophia; Hoffmann, Markus; Enßer, Armin; Ziegler, Katharina; Winkler, Thomas; Birkholz, Torsten; Kremer, Andreas; Steininger, Philipp; et al. (European Journal of Clinical Microbiology & Infectious Diseases, 2020)
SARS-CoV-2 has emerged as a previously unknown zoonotic coronavirus that spread worldwide causing a serious pandemic. While reliable nucleic acid–based diagnostic assays were rapidly available, only a limited number of validated serological assays were available in the early phase of the pandemic. Here, we evaluated a novel flow cytometric approach to assess spike-specific antibody responses.HEK 293T cells expressing SARS-CoV-2 spike protein in its natural confirmation on the surface were used to detect specific IgG and IgM antibody responses in patient sera by flow cytometry. A soluble angiotensin-converting-enzyme 2 (ACE-2) variant was developed as external standard to quantify spike-specific antibody responses on different assay platforms. Analyses of 201 pre-COVID-19 sera proved a high assay specificity in comparison to commercially available CLIA and ELISA systems, while also revealing the highest sensitivity in specimens from PCR-confirmed SARS-CoV-2-infected patients. The external standard allowed robust quantification of antibody responses among different assay platforms. In conclusion, our newly established flow cytometric assay allows sensitive and quantitative detection of SARS-CoV-2-specific antibodies, which can be easily adopted in different laboratories and does not rely on external supply of assay kits. The flow cytometric assay also provides a blueprint for rapid development of serological tests to other emerging viral infections
CRIS-Team Scopus Importer:2020-10-30
Keywords: Antibodies; Coronavirus; Flow cytometry; SARS-CoV-2; Serology

Rapid single-cell physical phenotyping of mechanically dissociated tissue biopsies - Soteriou, Despina; Kubankova, Marketa; Schweitzer, Christine; Lopez Posadas, Rocío; Pradhan, Rashmita; Thoma, Oana-Maria; Györfi, Andrea-Hermina; Matei, Alexandru-Emil; Waldner, Maximilian; Distler, Jörg; Scheuermann, Stefan; Langejuergen, Jens; et al. (Nature Biomedical Engineering, 2023)
A method for the sequential assessment of the physical phenotypes of suspended cells singularized from tissue biopsies by mechanical dissociation allows for rapid diagnoses.
CRIS-Team WoS Importer:2023-05-05

Rare frameshift mutation in SERPINA3 contributes to generalized pustular psoriasis - Hüffmeier, Ulrike; Sticht, Heinrich; Wenzel, J.; Wilsmann-Theis, D.; Wolff, K.; Löhr, Sabine; Frey, Benjamin; Hahn, M.; Ekici, Arif Bülent; Uebe, S.; Thiel, Christian; Wiesmann da Silva Reis, André; et al. (EUROPEAN JOURNAL OF HUMAN GENETICS, 2019)
CRIS-Team WoS Importer:2019-10-25

Rare Loss-of-Function Mutation in SERPINA3 in Generalized Pustular Psoriasis - Frey, Silke; Sticht, Heinrich; Wilsmann-Theis, Dagmar; Gerschütz, Anne; Wolf, Katharina; Löhr, Sabine; Haskamp, Stefan; Frey, Benjamin; Hahn, Madelaine; Ekici, Arif Bülent; Uebe, Steffen; Thiel, Christian; et al. (Journal of Investigative Dermatology, 2020)
CRIS-Team Scopus Importer:2020-03-06

Raster-Scanning Optoacoustic Mesoscopy for Gastrointestinal Imaging at High Resolution - Knieling, Ferdinand; Menezes, Jean Gonzales; Claussen, Jing; Schwarz, Mathias; Neufert, Clemens; Fahlbusch, Fabian B.; Rath, Timo; Thoma, Oana-Maria; Kramer, Viktoria; Menchicchi, Bianca; Kersten, Christina; Scheibe, Kristina; et al. (Gastroenterology, 2018)
EVALuna2:33792

Rationale for IL-36 receptor antibodies in ulcerative colitis - Neufert, Clemens; Neurath, Markus; Atreya, Raja (Expert Opinion on Biological Therapy, 2019)
CRIS-Team Scopus Importer:2019-12-10
Keywords: IL-36; IL-36R; tissue remodeling; ulcerative colitis

Real Life Study of Lenvatinib Therapy for Hepatocellular Carcinoma: RELEVANT Study - Casadei-Gardini, Andrea; Rimini, Margherita; Kudo, Masatoshi; Shimose, Shigeo; Tada, Toshifumi; Suda, Goki; Goh, Myung Ji; Jefremow, Andre; Scartozzi, Mario; Cabibbo, Giuseppe; Campani, Claudia; Tamburini, Emiliano; et al. (Liver Cancer, 2022)
Introduction: In the REFLECT trial, lenvatinib was found to be noninferior compared to sorafenib in terms of overall survival. Here, we analyze the effects of lenvatinib in the real-life experience of several centers across the world and identify clinical factors that could be significantly associated with survival outcomes. Methods: The study population was derived from retrospectively collected data of HCC patients treated with lenvatinib. The overall cohort included western and eastern populations from 23 center in five countries. Results: We included 1,325 patients with HCC and treated with lenvatinib in our analysis. Median OS was 16.1 months. Overall response rate was 38.5%. Multivariate analysis for OS highlighted that HBsAg positive, NLR >3, and AST >38 were independently associated with poor prognosis in all models. Conversely, NAFLD/NASH-related etiology was independently associated with good prognosis. Median progression-free survival was 6.3 months. Multivariate analysis for progression-free survival revealed that NAFLD/NASH, BCLC, NLR, and AST were independent prognostic factors for progression-free survival. A proportion of 75.2% of patients suffered from at least one adverse effect during the study period. Multivariate analysis exhibited the appearance of decreased appetite grade ≥2 versus grade 0-1 as an independent prognostic factor for worse progression-free survival. 924 patients of 1,325 progressed during lenvatinib (69.7%), and 827 of them had a follow-up over 2 months from the beginning of second-line treatment. From first-line therapy, the longest median OS was obtained with the sequence lenvatinib and immunotherapy (47.0 months), followed by TACE (24.7 months), ramucirumab (21.2 months), sorafenib (15.7 months), regorafenib (12.7 months), and best supportive care (10.8 months). Conclusions: Our study confirms in a large and global population of patients with advanced HCC, not candidates for locoregional treatment the OS reported in the registration study and a high response rate with lenvatinib.
CRIS-Team Scopus Importer:2022-12-23
Keywords: ALBI; Hepatocellular carcinoma; Lenvatinib; Neutrophils to lymphocyte ratio; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Outcome; Second line; Tyrosine kinase inhibitors

Real-time colorectal polyp detection using a novel computer-aided detection system (CADe): a feasibility study - Soons, E.; Rath, Timo; Hazewinkel, Y.; Van Dop, W. A.; Esposito, D.; Testoni, P. A.; Siersema, P. D. (International Journal of Colorectal Disease, 2022)
Background and aims Colonoscopy aims to early detect and remove precancerous colorectal polyps, thereby preventing development of colorectal cancer (CRC). Recently, computer-aided detection (CADe) systems have been developed to assist endoscopists in polyp detection during colonoscopy. The aim of this study was to investigate feasibility and safety of a novel CADe system during real-time colonoscopy in three European tertiary referral centers. Methods Ninety patients undergoing colonoscopy assisted by a real-time CADe system (DISCOVERY; Pentax Medical, Tokyo, Japan) were prospectively included. The CADe system was turned on only at withdrawal, and its output was displayed on secondary monitor. To study feasibility, inspection time, polyp detection rate (PDR), adenoma detection rate (ADR), sessile serrated lesion (SSL) detection rate (SDR), and the number of false positives were recorded. To study safety, (severe) adverse events ((S)AEs) were collected. Additionally, user friendliness was rated from 1 (worst) to 10 (best) by endoscopists. Results Mean inspection time was 10.8 +/- 4.3 min, while PDR was 55.6%, ADR 28.9%, and SDR 11.1%. The CADe system users estimated that < 20 false positives occurred in 81 colonoscopy procedures (90%). No (S)AEs related to the CADe system were observed during the 30-day follow-up period. User friendliness was rated as good, with a median score of 8/10. Conclusion Colonoscopy with this novel CADe system in a real-time setting was feasible and safe. Although PDR and SDR were high compared to previous studies with other CADe systems, future randomized controlled trials are needed to confirm these detection rates. The high SDR is of particular interest since interval CRC has been suggested to develop frequently through the serrated neoplasia pathway.
CRIS-Team WoS Importer:2022-10-07

Real-world Comparative Effectiveness of Ustekinumab vs Anti-TNF in Crohn's Disease With Propensity Score Adjustment: Induction Phase Results From the Prospective, Observational RUN-CD Study - Bokemeyer, Bernd; Plachta-Danielzik, Sandra; Di Giuseppe, Romina; Mohl, Wolfgang; Teich, Niels; Hoffstadt, Martin; Schweitzer, Axel; Von Der Ohe, Manfred; Gauss, Annika; Atreya, Raja; Krause, Thomas; Blumenstein, Irina; et al. (Inflammatory Bowel Diseases, 2023)
Background In addition to randomized controlled trials (RCTs), real-world studies on the effectiveness of ustekinumab (UST) in Crohn's disease (CD) are required inasmuch as RCTs are usually confined to selected patients, which may not represent everyday clinical practice. Within the framework of the prospective real-world RUN-CD registry, a total of approximately 900 CD patients from 44 inflammatory bowel disease centers from all over Germany starting a new therapy with UST or other biologics were screened for a real-world evidence (RWE) comparison of CD patients with UST vs antitumor necrosis factor (TNF). Methods A total of 618 CD patients with a nonrandomized biological therapy were qualified for this induction phase effectiveness RUN-CD study of UST vs anti-TNF. To reduce selection bias in estimations of treatment effects, the propensity score with inverse probability of treatment weighting was implemented. The results were reported as odds ratio (OR) and 95% confidence interval (CI). Results A total of 339 UST and 279 anti-TNF patients were analyzed. The effectiveness of UST vs anti-TNF in terms of clinical remission (UST 65.4% vs anti-TNF 63.0%; OR, 1.11; 95% CI, 0.71-1.74) and steroid-free remission (UST 51.0% vs anti-TNF 53.8%; OR, 0.94; 95% CI, 0.60-1.47) was comparable at the end of induction therapy. Similar results were observed in the bio-naive and bio-experienced UST vs anti-TNF groups. For both, the remission rates were higher in the bio-naive than in the bio-experienced groups (P < .05). Conclusions In this prospective, observational RUN-CD study, the RWE head-to-head comparison of UST vs anti-TNF showed similar induction effectiveness in both groups, remarkably higher than those found in prior RCTs.
CRIS-Team WoS Importer:2023-02-17

Real-World Data for Lenvatinib in Hepatocellular Carcinoma (ELEVATOR): A Retrospective Multicenter Study - Welland, Sabrina; Leyh, Catherine; Finkelmeier, Fabian; Jefremow, André; Shmanko, Kateryna; Gonzalez-Carmona, Maria A.; Kandulski, Arne; Jeliazkova, Petia; Best, Jan; Fründt, Thorben W.; Djanani, Angela; Pangerl, Maria; et al. (Liver Cancer, 2022)
Background Lenvatinib is approved as first-line treatment for patients with advanced hepatocellular carcinoma (HCC). The efficacy of lenvatinib in Caucasian real-world patients is insufficiently defined. The purpose of this study was to evaluate the efficacy of lenvatinib in a multi-center cohort (ELEVATOR) from Germany and Austria. Methods A retrospective data analysis of 205 patients treated with first-line systemic lenvatinib at 14 different sites was conducted. Overall survival, progression free survival, overall response rate and adverse event rates were assessed and analyzed. Results Patients receiving lenvatinib in the real-world setting reached a median overall survival of 12.8 months, which was comparable to the results reported from the REFLECT study. Median overall survival (mOS) and progression free survival (mPFS) was superior in those patients who met the inclusion criteria of the REFLECT study compared to patients who failed to meet the inclusion criteria (mOS 15.6 vs 10.2 months, HR 0.55, 95% CI 0.38-0.81, p=0.002; mPFS 8.1 vs 4.8 months HR 0.65, 95% CI 0.46-0.91, p=0.0015). For patients with an impaired liver function according to the Albumin-Bilirubin (ALBI) grade, or reduced ECOG performance status ≥2, survival was significantly shorter compared to patients with sustained liver function (ALBI grade 1) and good performance status (ECOG performance status 0), respectively (HR 1.69, 95% CI 1.07-2.66, p=0.023; HR 2.25, 95% CI 1.19-4.23, p=0.012). Additionally, macrovascular invasion (HR 1.55, 95% CI 1.02-2.37, p=0.041) and an AFP ≥200 ng/mL (HR 1.56, 95% CI 1.03-2.34, p=0.034) were confirmed as independent negative prognostic factors in our cohort of patients with advanced HCC. Conclusion Overall, our data confirm the efficacy of lenvatinib as first-line treatment and did not reveal new or unexpected side effects in a large retrospective Caucasian real-world cohort, supporting the use of lenvatinib as meaningful alternative for patients that cannot be treated with IO-based combinations in first-line HCC.
CRIS-Team Scopus Importer:2022-07-01
Keywords: Albumin-bilirubin grade; Hepatocellular carcinoma; Lenvatinib; Liver function; Real-world cohort; REFLECT study

Real World Evidence on the comparative effectiveness of Ustekinumab vs anti-TNF in Crohn's disease with Propensity Score adjustment: maintenance phase results from the prospective observational RUN-CD study - Bokemeyer, B.; Plachta-Danielzik, S.; Di Giuseppe, R.; Deppe, H.; Mohl, W.; Teich, N.; Hoffstadt, M.; Schweitzer, A.; Von Der Ohe, M.; Gauss, A.; Atreya, Raja; Krause, T.; et al. (JOURNAL OF CROHNS & COLITIS, 2022)
CRIS-Team WoS Importer:2022-05-13

Real World Evidence on the effectiveness of ustekinumab in Crohn's Disease: Induction phase results from the prospective, observational RUN-CD Study - Bokemeyer, B.; Plachta-Danielzik, S.; Di Giuseppe, R.; Mohl, W.; Teich, N.; Hoffstadt, M.; Schweitzer, A.; Von Der Ohe, M.; Gauss, A.; Atreya, Raja; Krause, T.; Blumenstein, I.; et al. (JOURNAL OF CROHNS & COLITIS, 2021)
CRIS-Team WoS Importer:2021-11-19

Rear Window—What Can the Gut Tell Us About Long-COVID? - Leppkes, Moritz; Neurath, Markus (Gastroenterology, 2022)
CRIS-Team Scopus Importer:2022-08-05

Recording and Optimizing the Nutritional Behavior of oncological Patients by using a Smartphone App (OncoFood) - Orlemann, Till; Zenker, Björn; Reljic, Dejan; Meyer, Julia; Oberlaender, Jana; Herrmann, Hans Joachim; Eskofier, Björn; Neurath, Markus; Zopf, Yurdagül (2018)
EVALuna2:35184

Rectal Cancer Presenting with Absceding Infection Due to Fusobacterium nucleatum - Zundler, Sebastian; Mardin, Christian; Bertz, Simone; Vitali, Francesco; Strauss, Richard; Fürst, Julia; Neurath, Markus; Strobel, Deike (Pathogens, 2022)
Intestinal microbiota such as Fusobacterium nucleatum play an important role in the pathogenesis of colorectal cancer. Here, we describe the case of a 47-year-old patient presenting with endophthalmitis and a liver abscess due to Fusobacterium nucleatum that prompted the diagnosis of colorectal cancer as the most likely source of infection. This case highlights that colorectal cancer needs to be considered in patients with systemic infection with Fusobacterium nucleatum and colonoscopy should be performed.
CRIS-Team Scopus Importer:2022-11-04
Keywords: endophthalmitis; Fusobacterium nucleatum; liver abscess; rectal cancer

Rectal Delivery of a DNAzyme That Specifically Blocks the Transcription Factor GATA3 and Reduces Colitis in Mice - Popp, Vanessa; Gerlach, Katharina; Mott, Stefanie; Turowska, Agnieszka; Garn, Holger; Atreya, Raja; Lehr, Hans-Anton; Ho, I-Cheng; Renz, Harald; Weigmann, Benno; Neurath, Markus (Gastroenterology, 2017)
BACKGROUND & AIMS: GATA3 is a transcription factor that regulates T-cell production of cytokines. We investigated the role of GATA3 in development of colitis in mice. METHODS: We performed quantitative polymerase chain reaction and immunofluorescence analyses of colon tissues from patients with Crohn's disease (n = 61) or ulcerative colitis (UC, n = 74) or from patients without inflammatory bowel diseases (n = 22), to measure levels of GATA3. Colitis was induced by administration of oxazolone or 2,4,6-trinitrobenzenesulfonic acid to control mice, mice with T-cell-specific deletion of GATA3, and mice with deletion of tumor necrosis factor receptor (TNFR) 1 and TNFR2 (TNFR double knockouts); some mice were given a GATA3-specific DNAzyme (hgd40) or a control DNAzyme via intrarectal administration, or systemic injections of an antibody to TNF before or during sensitization and challenge phase of colitis induction. Colon tissues were collected and immunofluorescence and histochemical analyses were performed. Lamina propria mononuclear cells and T cells were isolated and analyzed by flow cytometry or cytokine assays. Colonic distribution of labeled DNAzyme and inflammation were monitored by in vivo imaging (endoscopy) of mice. RESULTS: Levels of GATA3 messenger RNA were higher in colon tissues from patients with UC, but not ileal Crohn's disease, than control tissues; levels of GATA3 correlated with levels of inflammatory cytokines (interleukin [IL] 9, IL17A, IL6, IL5, IL4, IL13, and TNF). We observed increased expression of GATA3 by lamina propria T cells from mice with colitis compared with controls. Mice with T-cell-specific deletion of GATA3 did not develop colitis and their colonic tissues did not produce inflammatory cytokines (IL6, IL9, or IL13). The DNAzyme hgd40 inhibited expression of GATA3 messenger RNA by unstimulated and stimulated T cells, and distributed throughout the inflamed colons of mice with colitis. Colon tissues from mice given hgd40 had reduced expression of GATA3 messenger RNA, compared with mice given a control DNAzyme. Mice given hgd40 did not develop colitis after administration of oxazolone or 2,4,6-trinitrobenzenesulfonic acid; lamina propria cells from these mice expressed lower levels of IL6, IL9, and IL13 than cells from mice given the control DNAzyme. Mini-endoscopic images revealed that hgd40 and anti-TNF reduced colon inflammation over 3 days; hgd40 reduced colitis in TNFR double-knockout mice. CONCLUSIONS: Levels of GATA3 are increased in patients with UC and correlate with production of inflammatory cytokines in mice and humans. A DNAzyme that prevents expression of GATA3 reduces colitis in mice, independently of TNF, and reduces levels of cytokines in the colon. This DNAzyme might be developed for treatment of patients with UC.
EVALuna2:33833

Recurrent Ileal Invagination in Crohn's Disease - Görtz, Rüdiger; Atreya, Raja; Neurath, Markus (Deutsches Ärzteblatt international, 2020)
CRIS-Team WoS Importer:2020-05-05

Recurrent shock and pulmonary edema due to acetazolamide medication after cataract surgery - Zimmermann, S.; Achenbach, Susanne; Wolf, M.; Janka, Rolf Matthias; Marwan, M.; Mahler, V. (Heart & Lung, 2014)
We report a patient with recurrent shock and transient non-cardiogenic pulmonary edema within a period of two months - every time occurring after cataract surgery and a single oral dose of standard post-operative medication with acetazolamide.Records of the intensive care unit, review of the literature.This case demonstrates a rare but severe side effect of acetazolamide. We also present a review of the literature to raise the awareness of health care providers for this special form of non-cardiogenic pulmonary edema.
EVALuna2:11868

Reframing immune-mediated inflammatory diseases - Boutrid, Nada; Rahmoune, Hakim; Schett, Georg; McInnes, Iain; Neurath, Markus (New England Journal of Medicine, 2021)
We were surprised to find that celiac disease was not among the panel of disorders discussed by Schett et al. (Aug. 12 issue)1 in their review article on cytokines and immune-mediated inflammatory conditions. It is well established that cytokine release is at the core of the structural damage and subsequent clinical manifestations in celiac disease, and we note in particular the evolving role of interleukins (mainly interleukin-15).2 In fact, interleukin-15 has a crucial role in innate and adaptive immune responses and is overexpressed in various autoimmune conditions, including celiac disease.3 This interleukin-15 action is orchestrated by tumor necrosis factor α and implicates the innate lymphoid cells; these two components are involved in the celiac-immunomediated enteropathy and several extraintestinal manifestations of celiac disease.4 It is not surprising that numerous trials — including trials in animal models and clinical trials, notably the PRV-015 in Gluten-free Diet Non-responsive Celiac Disease (PROACTIVE) trial5 — are exploring the option of blocking interleukin-15 to decrease or resolve lesions caused by celiac disease.5
CRIS-Team Scopus Importer:2021-12-10

Reframing Immune-Mediated Inflammatory Diseases through Signature Cytokine Hubs - Schett, Georg; Mcinnes, Iain B.; Neurath, Markus (New England Journal of Medicine, 2021)
Immune-mediated inflammatory diseases (IMIDs) are a heterogeneous group of diseases characterized by chronic inflammation and organ damage. IMIDs were traditionally classified on the basis of the predominant organ involvement. Improving the pathogenic characterization of IMIDs, however, should allow for a refined mechanistic understanding of these diseases and should make it possible to develop a molecular-based classification. The transition from organ-based to molecular-based classification was initiated by insights into associated genetic mutations and polymorphisms of key immune pathways and the development of monoclonal antibodies that target signature cytokine hubs in IMIDs. As compared with an organ-based classification, molecular classification better addresses pathophysiological commonalities across IMIDs that affect different organs but also accounts for substantial mechanistic differences among IMIDs that affect the same organ (Fig. 1).
CRIS-Team Scopus Importer:2021-08-27

Regional transplant rates depend more on physician-dependent variables than on proximity to transplant center - Payani, Elnaz; Börner, Nikolaus; Kolliogiannis, Dionysios; Brunner, Stefan; Klein, Ingo; Ehmer, Ursula; Denk, Gerald; Lange, Christian M.; Ograja, Klaudja; Dietrich, Peter; Werner, Jens; Guba, Markus (Langenbecks Archives of Surgery, 2023)
Purpose: The objective of this work was to uncover inequalities in access to liver transplantation in Bavaria, Germany. Methods: For this purpose, the annual transplantation rate per 1 million inhabitants for the respective districts was determined from the aggregated postal codes of the place of residence of transplanted patients. The variables examined were proximity and travel time to the nearest transplant center, as well as the care category of the regional hospital. In addition, we assessed whether the head of gastroenterology at the regional hospital through which liver transplant candidates are referred was trained at a liver transplant center. Results: We could not demonstrate a direct relationship between proximity or travel time to the nearest transplant center and access to liver transplantation. Multivariate regression analysis shows that liver transplant training (p < 0.0001) of the chief physician (gastroenterologist) of the regional hospital was the most decisive independent factor for access to liver transplantation within a district. Conclusion: We show that the transplant training experience of the head of gastroenterology at a regional hospital is an independent factor for the regional transplantation rate. Therefore, it appears important to maintain some liver transplant expertise outside the transplant centers in order to properly identify and assign potential transplant candidates for transplantation.
CRIS-Team Scopus Importer:2023-05-26
Keywords: Disparities in liver transplantation; Liver transplantation; Proximity to liver transplant center; Socioeconomic factors

Regression of apoptosis-resistant colorectal tumors by induction of necroptosis in mice - He, Gui-Wei; Günther, Claudia; Thonn, Veronika; Yu, Yu-Qiang; Martini, Eva; Buchen, Barbara; Neurath, Markus; Stürzl, Michael; Becker, Christoph (Journal of Experimental Medicine, 2017)
Cancer cells often acquire capabilities to evade cell death induced by current chemotherapeutic treatment approaches. Caspase-8, a central initiator of death receptor-mediated apoptosis, for example, is frequently inactivated in human cancers via multiple mechanisms such as mutation. Here, we show an approach to overcome cell death resistance in caspase-8-deficient colorectal cancer (CRC) by induction of necroptosis. In both a hereditary and a xenograft mouse model of caspase-8-deficient CRC, second mitochondria-derived activator of caspase (SMAC) mimetic treatment induced massive cell death and led to regression of tumors. We further demonstrate that receptor-interacting protein kinase 3 (RIP3), which is highly expressed in mouse models of CRC and in a subset of human CRC cell lines, is the deciding factor of cancer cell susceptibility to SMAC mimetic-induced necroptosis. Thus, our data implicate that it may be worthwhile to selectively evaluate the efficacy of SMAC mimetic treatment in CRC patients with caspase-8 deficiency in clinical trials for the development of more effective personalized therapy.
EVALuna2:15307

Regulation and Function of Interferon-Lambda (IFNλ) and Its Receptor in Asthma - Krammer, Susanne; Sicorschi Gutu, Cristina; Grund, Janina; Zirlik, Sabine; Finotto, Susetta; Chiriac, Mircea-Teodor (Frontiers in Immunology, 2021)
Asthma is a chronic respiratory disease affecting people of all ages, especially children, worldwide. Origins of asthma are suggested to be placed in early life with heterogeneous clinical presentation, severity and pathophysiology. Exacerbations of asthma disease can be triggered by many factors, including viral respiratory tract infections. Rhinovirus (RV) induced respiratory infections are the predominant cause of the common cold and also play a crucial role in asthma development and exacerbations. Rhinovirus mainly replicates in epithelial cells lining the upper and lower respiratory tract. Type III interferons, also known as interferon-lambda (IFNλ), are potent immune mediators of resolution of infectious diseases but they are known to be involved in autoimmune diseases as well. The protective role of type III IFNs in antiviral, antibacterial, antifungal and antiprotozoal functions is of major importance for our innate immune system. The IFNλ receptor (IFNλR) is expressed in selected types of cells like epithelial cells, thus orchestrating a specific immune response at the site of viruses and bacteria entry into the body. In asthma, IFNλ restricts the development of TH2 cells, which are induced in the airways of asthmatic patients. Several studies described type III IFNs as the predominant type of interferon increased after infection caused by respiratory viruses. It efficiently reduces viral replication, viral spread into the lungs and viral transmission from infected to naive individuals. Several reports showed that bronchial epithelial cells from asthmatic subjects have a deficient response of type III interferon after RV infection ex vivo. Toll like Receptors (TLRs) recognize pathogen-associated molecular patterns (PAMPs) expressed on infectious agents, and induce the development of antiviral and antibacterial immunity. We recently discovered that activation of TLR7/8 resulted in enhanced IFNλ receptor mRNA expression in PBMCs of healthy and asthmatic children, opening new therapeutic frontiers for rhinovirus-induced asthma. This article reviews the recent advances of the literature on the regulated expression of type III Interferons and their receptor in association with rhinovirus infection in asthmatic subjects.
CRIS-Team Scopus Importer:2021-12-10
Keywords: asthma; epithelial cells; exacerbation; interferon; rhinovirus; TLR7/8

Regulation and pathophysiological role of epithelial turnover in the gut. - Günther, Claudia; Buchen, Barbara; Neurath, Markus; Becker, Christoph (Seminars in Cell & Developmental Biology, 2014)
Cell death in the intestinal epithelium has to be tightly controlled. Excessive or misplaced epithelial cell death can result in barrier dysfunction and, as a consequence thereof, uncontrolled translocation of components of the microbial flora from the lumen into the bowel wall. Susceptibility to gastrointestinal infections or chronic inflammation of the gut, as observed in patients with inflammatory bowel disease, can be the result of such dysregulation. Conversely, defects in cell death initiation might lead to an irregular accumulation of epithelial cells and cause intestinal cancer development. Until recently, activation of caspases in the intestinal epithelium was considered as a potential contributor to barrier dysfunction and as a pathogenic factor in the development of intestinal inflammation. Thus blocking of caspases appeared to be a potential therapeutic option for patients with inflammatory bowel disease. Recent studies on necroptosis however demonstrated that also inhibition of caspases can cause barrier dysfunction and intestinal inflammation. Caspase-8 on top of its functions in the extrinsic apoptosis pathway also controls necroptosis and turns out to be an essential molecule in regulating tissue homeostasis in the gut. Epithelial caspase-8 therefore emerges as a checkpoint not only of cell survival and cell death, but also as a regulator of the mode of cell death. According to this model, both excessive activity as well as a lack of activity of caspase-8 results in epithelial cell death and intestinal inflammation and caspase-8 needs to be tightly controlled to warrant tissue homeostasis in the gut.
Keywords: Inflammation; Necroptosis; Ripoptosome

REGULATION OF ARTHRITIS BY TYPE 2 INNATE LYMPHOID CELLS - Omata, Yasunori; Lucas, Sebastien; Garcia, Mireia; Wirtz, Stefan; Bozec, Aline; Schett, Georg; Zaiss, Mario (2017)
EVALuna2:13496

Regulation of autoantibody activity by the IL-23-TH17 axis determines the onset of autoimmune disease. - Pfeifle, René; Rothe, Tobias; Ipseiz, Natacha; Scherer, Hans U.; Culemann, Stephan; Harre, Ulrike; Ackermann, Jochen; Seefried, Martina; Kleyer, Arnd; Uderhardt, Stefan; Haugg, Benjamin; Huebert, Axel J.; et al. (Nature Immunology, 2017)
The checkpoints and mechanisms that contribute to autoantibody-driven disease are as yet incompletely understood. Here we identified the axis of interleukin 23 (IL-23) and the TH17 subset of helper T cells as a decisive factor that controlled the intrinsic inflammatory activity of autoantibodies and triggered the clinical onset of autoimmune arthritis. By instructing B cells in an IL-22- and IL-21-dependent manner, TH17 cells regulated the expression of β-galactoside α2,6-sialyltransferase 1 in newly differentiating antibody-producing cells and determined the glycosylation profile and activity of immunoglobulin G (IgG) produced by the plasma cells that subsequently emerged. Asymptomatic humans with rheumatoid arthritis (RA)-specific autoantibodies showed identical changes in the activity and glycosylation of autoreactive IgG antibodies before shifting to the inflammatory phase of RA; thus, our results identify an IL-23-TH17 cell-dependent pathway that controls autoantibody activity and unmasks a preexisting breach in immunotoleranc

Regulation of Human Innate Lymphoid Cells in the Context of Mucosal Inflammation - Schulz-Kuhnt, Anja; Wirtz, Stefan; Neurath, Markus; Atreya, Imke (Frontiers in Immunology, 2020)
Since their identification as a unique cell population, innate lymphoid cells (ILCs) have revolutionized our understanding of immune responses, leaving their impact on multiple inflammatory and fibrotic pathologies without doubt. Thus, a tightly controlled regulation of local ILC numbers and their activity is of crucial importance. Even though this has been extensively studied in murine ILCs in the last few years, our knowledge of human ILCs is still lagging behind. Our review article will therefore summarize recent insights into the function of human ILCs and will particularly focus on their regulation under inflammatory conditions. The quality and intensity of ILC involvement into local immune responses at mucosal sites of the human body can potentially be modulated via three different axes: (1) activation of tissue-resident mature ILCs, (2) plasticity and local transdifferentiation of specific ILC subsets, and (3) tissue migration and accumulation of peripheral ILCs. Despite a still ongoing scientific effort in this field, already existing data on the fate of human ILCs under different pathologic conditions clearly indicate that all three of these mechanisms are of relevance for the clinical course of chronic inflammatory and autoimmune diseases and might likewise provide new target structures for future therapeutic strategies.
CRIS-Team Scopus Importer:2020-07-17
Keywords: cytokine; human immune system; ILC plasticity; innate lymphoid cells; mucosal inflammation; tissue migration

Relation between objective tumour shrinkage and progression-free survival (PFS) in the NETTER-1 population - Pavel, Marianne Ellen; Broberg, P.; Caplin, M.; Ruszniewski, P.; Strosberg, J.; Santoro, P.; Ravasi, L.; Krenning, E. (ANNALS OF ONCOLOGY, 2019)
CRIS-Team WoS Importer:2019-11-08

Relationship between metabolic toxicity and efficacy of everolimus in patients with neuroendocrine tumors: A pooled analysis from the randomized, phase 3 RADIANT-3 and RADIANT-4 trials - Fazio, Nicola; Carnaghi, Carlo; Buzzoni, Roberto; Valle, Juan W.; Herbst, Fabian; Ridolfi, Antonia; Strosberg, Jonathan; Kulke, Matthew H.; Pavel, Marianne Ellen; Yao, James C. (Cancer, 2021)
BACKGROUND: Hyperglycemia and hypercholesterolemia are class effects of mammalian target of rapamycin inhibitors such as everolimus. This post hoc pooled analysis assessed the potential impact of these events on the efficacy of everolimus. METHODS: Patients with advanced, low- or intermediate-grade pancreatic, gastrointestinal, or lung neuroendocrine tumors received either oral everolimus at 10 mg/d or a placebo in the RAD001 in Advanced Neuroendocrine Tumors 3 (RADIANT-3) and RAD001 in Advanced Neuroendocrine Tumors 4 (RADIANT-4) trials. A landmark progression-free survival (PFS) analysis by central review was performed for patients treated for at least 16 weeks (n = 308) and according to the occurrence of any-grade adverse events (AEs) within this treatment period. RESULTS: The overall PFS with everolimus from the pooled analysis was 11.4 months (95% confidence interval, 11.01-13.93 months), which was consistent with the findings of RADIANT-3 and RADIANT-4. Overall, 19.1% and 9.8% of patients in RADIANT-3 and 11.9% and 6.4% of patients in RADIANT-4 developed any-grade hyperglycemia and hypercholesterolemia, respectively (regardless of the study drug). The duration of everolimus exposure was longer in patients who developed these AEs versus patients without these AEs. Overall, 308 patients were exposed to treatment for at least 16 weeks (hyperglycemia, 39 of 269 patients; hypercholesterolemia, 20 of 288 patients). No association was observed between the development of these AEs and PFS (18.8 and 14.1 months with and without hyperglycemia, respectively, and 14.1 and 14.8 months with and without hypercholesterolemia, respectively). CONCLUSIONS: Although limitations apply because of the small number of AEs observed, there was no significant impact of these AEs on PFS; this suggests similar efficacy in the presence or absence of these events.
CRIS-Team Scopus Importer:2021-06-11
Keywords: adverse events; everolimus; landmark analysis; mammalian target of rapamycin (mTOR) inhibitors; RAD001 in Advanced Neuroendocrine Tumors 3 (RADIANT-3); RAD001 in Advanced Neuroendocrine Tumors 4 (RADIANT-4); targeted therapy

Relationship between Metabolic Toxicity and Efficacy of Everolimus in Patients with Neuroendocrine Tumors (NETs): A Pooled Analysis from the Randomized, Phase 3 RADIANT-3 and RADIANT-4 Trials - Fazio, N.; Carnaghi, C.; Buzzoni, R.; Valle, J.; Herbst, F.; Ridolfi, A.; Strosberg, J.; Kulke, M.; Pavel, Marianne Ellen; Yao, J. C. (2018)
EVALuna2:34121

Relationship Between Metabolic Toxicity and Efficacy of Everolimus in Patients With Neuroendocrine Tumors (NETs): A Pooled Analysis From the Randomized, Phase 3 RADIANT-3, and RADIANT-4 Trials - Fazio, Nicola; Carnaghi, Carlo; Valle, Juan W.; Herbst, Fabian; Ridolfi, Antonia; Strosberg, Jonathan; Kulke, Matthew Helmut; Pavel, Marianne Ellen; Yao, James C. (2019)
EVALuna2:216073

Relationship Between Symptoms and Health-related Quality-of-life Benefits in Patients With Carcinoid Syndrome: Post Hoc Analyses From TELESTAR - Cella, David; Beaumont, Jennifer L.; Hudgens, Stacie; Marteau, Florence; Feuilly, Marion; Houchard, Aude; Lapuerta, Pablo; Ramage, John; Pavel, Marianne Ellen; Hoersch, Dieter; Kulke, Matthew H. (Clinical Therapeutics, 2018)
PURPOSE: Patients with metastatic neuroendocrine tumors and carcinoid syndrome (CS) may experience chronic, recurring symptoms despite somatostatin analogue therapy. Little is known about the relationship between bowel movement (BM) frequency, patient-reported symptoms and health-related quality of life (QoL). Data from the TELESTAR study were used in exploratory, post hoc analyses to understand the relationship between durable reductions in BM frequency, symptom relief, and health-related QoL. METHODS: Patients with metastatic neuroendocrine tumors and CS in the Phase III TELESTAR study were randomized (1:1:1) to receive telotristat ethyl (TE) 250 mg, TE 500 mg, or placebo three times daily (TID) during a 12-week double-blind treatment period (DBTP). All patients received TE 500 mg TID in an open-label extension (OLE) to Week 48. Durable response was predefined. Analyses compared durable responders (DRs) and non-durable responders (NDRs), irrespective of treatment group, at Weeks 12, 24, and 48. FINDINGS: At the start of the DBTP, 135 patients were randomized, 45 patients each to TE 250 mg, TE 500 mg, and placebo. After the 12-week DBTP, 48 of 135 patients were DRs (TE 250 mg, n = 20; TE 500 mg, n = 19; placebo, n = 9). Of the 115 patients who entered the OLE, 35 were DRs initially randomized to TE 250 mg (n = 18) or 500 mg (n = 17), 29 of whom maintained a durable response throughout the OLE. Of the 71 DBTP-NDRs (inclusive of patients initially randomized to placebo), 28 became OLE-DRs. There were 29 NDRs initially randomized to placebo who entered the OLE, 16 of whom became DRs when switched to TE 500 mg. DRs during the DBTP had greater symptom improvements in the DBTP; these improvements continued over the OLE. DBTP-DRs also maintained more meaningful QoL improvements in EORTC QLQ-C30 global health status, nausea and vomiting, pain, diarrhea, and EORTC QLQ-GINET21 gastrointestinal symptoms over the DBTP and OLE periods than DBTP-NDRs. IMPLICATIONS: These results suggest that sustained improvements in BM frequency in patients with CS may have multifaceted, long-term effects on a patient's well-being. ClinicalTrials.gov identifiers: NCT01677910.
EVALuna2:207999

RELMα-expressing macrophages protect against fatal lung damage and reduce parasite burden during helminth infection - Krljanac, Branislav; Schubart, Christoph; Naumann, Ronald; Wirtz, Stefan; Culemann, Stephan; Krönke, Gerhard; Vöhringer, David (Science immunology, 2019)
Alternatively activated macrophages (AAMs) can contribute to wound healing, regulation of glucose and fat metabolism, resolution of inflammation, and protective immunity against helminths. Their differentiation, tissue distribution, and effector functions are incompletely understood. Murine AAMs express high levels of resistin-like molecule (RELM) α, an effector protein with potent immunomodulatory functions. To visualize RELMα+ macrophages (MΦs) in vivo and evaluate their role in defense against helminths, we generated RELMα reporter/deleter mice. Infection with the helminth Nippostrongylus brasiliensis induced expansion of RELMα+ lung interstitial but not alveolar MΦs in a STAT6-dependent manner. RELMα+ MΦs were required for prevention of fatal lung damage during primary infection. Furthermore, protective immunity was lost upon specific deletion of RELMα+ MΦs during secondary infection. Thus, RELMα reporter/deleter mice reveal compartmentalization of AAMs in different tissues and demonstrate their critical role in resolution of severe lung inflammation and protection against migrating helminths.
CRIS-Team Scopus Importer:2019-06-18

Remote photoacoustic sensing using speckle-analysis - Lengenfelder, Benjamin; Mehari, Fanuel; Hohmann, Martin; Heinlein, Markus; Chelales, Erika; Waldner, Maximilian; Klämpfl, Florian; Zalevsky, Zeev; Schmidt, Michael (Scientific Reports, 2019)
Laser surgery is a rising surgical technique, which offers several advantages compared to the traditional scalpel. However, laser surgery lacks a contact-free feedback system which offers high imaging contrast to identify the tissue type ablated and also a high penetration depth. Photoacoustic imaging has the potential to fill this gap. Since photoacoustic detection is commonly contact based, a new non-interferometric detection technique based on speckle-analysis for remote detection is presented in this work. Phantom and ex-vivo experiments are carried out in transmission and reflection-mode for proof of concept. In summary, the potential of the remote speckle sensing technique for photoacoustic detection is demonstrated. In future, this technique might be applied for usage as a remote feedback system for laser surgery, which could help to broaden the applications of lasers as smart surgical tool
Keywords: Laser surgery; Photoacoustic

Renal neuroendocrine tumors: clinical and molecular pathology with an emphasis on frequent association with ectopic Cushing syndrome - Kasajima, Atsuko; Pfarr, Nicole; von Werder, Alexander; Schwamborn, Kristina; Gschwend, Jürgen; Din, Nasir Ud; Esposito, Irene; Weichert, Wilko; Pavel, Marianne Ellen; Agaimy, Abbas; Klöppel, Günter (Virchows Archiv, 2023)
Renal neuroendocrine tumors (RenNETs) are rare malignancies with largely unknown biology, hormone expression, and genetic abnormalities. This study aims to improve our understanding of the RenNETs with emphasis of functional, hormonal, and genetic features. Surgically resected RenNETs (N = 13) were retrieved, and immunohistochemistry and next-generation sequencing (NGS) were performed in all cases. In addition, all published RenNETs were systematically reviewed. Our cohort (4 men and 9 women, mean age 42, mean tumor size 7.6 cm) included 2 patients with Cushing syndrome (CS). WHO grade (23% G1, 54% G2, and 23% G3) and tumor progression did not correlate. CS-associated RenNETs (CS-RenNETs) showed a solid and eosinophilic histology and stained for ACTH, while the remaining non-functioning tumors had a trabecular pattern and expressed variably hormones somatostatin (91%), pancreatic polypeptide (63%), glucagon (54%), and serotonin (18%). The transcription factors ISL1 and SATB2 were expressed in all non-functioning, but not in CS-RenNETs. NGS revealed no pathogenic alterations or gene fusions. In the literature review (N = 194), 15 (8%) of the patients had hormonal syndromes, in which CS being the most frequent (7/15). Large tumor size and presence of metastasis were associated with shorter patients’ survival (p < 0.01). RenNETs present as large tumors with metastases. CS-RenNETs differ through ACTH production and solid-eosinophilic histology from the non-functioning trabecular RenNETs that produce pancreas-related hormones and express ISL1 and SATB2. MEN1 or DAXX/ARTX abnormalities and fusion genes are not detected in RenNETs, indicating a distinct yet unknown molecular pathogenesis.
CRIS-Team Scopus Importer:2023-07-21
Keywords: Hormone; ISL1; Kidney; Neuroendocrine neoplasms; SATB2

Reply to Heatley and Bell - Rabenstein, Thomas; Naegele-Jackson, Susanne; Hahn, Eckhart Georg; Sackmann, Michael; Maiß, Jürgen (Endoscopy, 2003)
UnivIS-Import:2015-04-14:Pub.2003.zwiss.rrze.ksys.replyt

Reply: To PMID 24807046 - Elferink, Ronald Oude; Bolier, Ruth; Kremer, Andreas; Beuers, Ulrich (Hepatology, 2015)
EVALuna2:2021

Resection of rectal carcinoids with the newly introduced endoscopic full-thickness resection device - Grauer, Martin; Gschwendtner, Andreas; Schaefer, Claus; Neumann, Helmut (Endoscopy, 2016)
EVALuna2:2097

Residual homing of alpha 4 beta 7-expressing beta 1(+)PI16(+) regulatory T cells with potent suppressive activity correlates with exposure-efficacy of vedolizumab - Becker, Emily; Dedden, Mark; Gall, Christine; Wiendl, Maximilian; Ekici, Arif Bülent; Schulz-Kuhnt, Anja; Schweda, Anna; Bosch-Voskens, Caroline; Hegazy, Ahmed; Vitali, Francesco; Atreya, Raja; Müller, Tanja; et al. (Gut, 2021)
Objective The anti-alpha 4 beta 7 integrin antibody vedolizumab is administered at a fixed dose for the treatment of IBDs. This leads to a wide range of serum concentrations in patients and previous studies had suggested that highest exposure levels are associated with suboptimal clinical response. We aimed to determine the mechanisms underlying these non-linear exposure-efficacy characteristics of vedolizumab. Design We characterised over 500 samples from more than 300 subjects. We studied the binding of vedolizumab to T cells and investigated the functional consequences for dynamic adhesion, transmigration, gut homing and free binding sites in vivo. Employing single-cell RNA sequencing, we characterised alpha 4 beta 7 integrin-expressing T cell populations 'resistant' to vedolizumab and validated our findings in vitro and in samples from vedolizumab-treated patients with IBD. We also correlated our findings with a post-hoc analysis of the Gemini II and III studies. Results Regulatory T (T-Reg) cells exhibited a right-shifted vedolizumab binding profile compared with effector T (T-Eff) cells. Consistently, in a certain concentration range, the residual adhesion, transmigration, homing of and availability of functional alpha 4 beta 7 on T-Reg cells in vivo was higher than that of/on T-Eff cells. We identified a vedolizumab-'resistant' alpha 4 beta 7-expressing beta 1(+)PI16(+) T-Reg cell subset with pronounced regulatory properties as the substrate for this effect. Our observations correlated with exposure-efficacy data from Gemini II and III trials. Conclusion Completely blocking T-Eff cell trafficking with vedolizumab, while simultaneously permitting residual homing of powerful T-Reg cells in an optimal 'therapeutic window' based on target exposure levels might be a strategy to optimise treatment outcomes in patients with IBD.
CRIS-Team WoS Importer:2021-12-10

Resolution of acute intestinal graft-versus-host disease - Thiagarajan, Sindhu; Neurath, Markus; Hildner, Kai (Seminars in Immunopathology, 2019)
Allogeneic transplantation of hematopoietic stem cells (allo-HCT) represents an increasingly employed therapeutic approach to potentially cure patients suffering from life-threatening malignant and autoimmune disorders. Despite its lifesaving potential, immune-mediated allo-reactivity inherent to the allogeneic transplantation can be observed within up to 50% of all allo-HCT patients regularly resulting in the manifestation of acute and/or chronic graft-versus-host disease (GvHD). Mechanistically, especially donor T cells are assumed to chiefly drive inflammation that can occur in virtually all organs, with the skin, liver, and gut representing as the most frequently affected anatomic sites. Especially in the presence of intestinal manifestations of GvHD, the risk that the disease takes a life-threatening, potentially fatal course is significantly increased. In the light of a rapid gain of knowledge in respect to decode innate and adaptive immunity related mechanisms as, e.g., cytokine networks, intracellular signaling pathways or environmental triggers as, e.g., the intestinal microbiota and the development of novel therapeutic approaches, detailed insight into endogenous mechanisms seeking to counterbalance the proinflammatory machinery or to proactively foster signals promoting the resolution of allo-driven intestinal inflammation is emerging. Here, we seek to highlight the key aspects of those mechanisms involved in and contributing to the resolution of GvHD-associated intestinal inflammation. Concomitantly, we would like to briefly outline and discuss promising future experimental targets suitable to be therapeutically employed to directionally deflect the tissue response from a proinflammatory to an inflammation-resolving type of intestinal GvHD after allo-HCT.
CRIS-Team WoS Importer:2019-11-15

Resolution of chronic inflammatory disease: universal and tissue-specific concepts - Schett, Georg; Neurath, Markus (Nature Communications, 2018)
Inflammation and its resolution is under-studied in medicine despite being essential for understanding the development of chronic inflammatory disease. In this review article, we discuss the resolution of inflammation in both a biological and translational context. We introduce the concept of impaired resolution leading to diseases like rheumatoid arthritis, Crohn's disease, and asthma, as well as the cellular and molecular components that contribute to resolution of joint, gut, and lung inflammation, respectively. Finally, we discuss potential intervention strategies for fostering the resolution process, and their implications for the therapy of inflammatory diseases.
EVALuna2:34476

Resolution of Crohn’s disease - Schmitt, Heike; Neufert, Clemens; Neurath, Markus; Atreya, Raja (Seminars in Immunopathology, 2019)
Crohn’s disease (CD) is characterized by chronic inflammation of the gastrointestinal tract and represents one of the main inflammatory bowel disease (IBD) forms. The infiltration of immune cells into the mucosa and uncontrolled production of pro-inflammatory cytokines and other mediators trigger the chronic inflammatory reaction in the intestine [1]. The inflammatory setting consists of subsequent events that comprise an induction phase, the peak of inflammation which is subsequently followed by the resolution phase. The induction phase, which represents the first phase of inflammation, is important for the rapid and efficient activation of the immune system for sufficient host defense. The permanent sensing of exogenous or endogenous danger signals enables the fast initiation of the inflammatory reaction. The immune cell infiltrate initiates an inflammatory cascade where released lipid and protein mediators play an indispensable role [2, 3]. The last decades of research strongly suggest that resolution of inflammation is similarly a tightly coordinated and active process. The basic concept that resolution of inflammation has to be regarded as an active process has been thoroughly described by others [4–6]. The following review focuses on mechanisms, pathways, and specific mediators that are actively involved in the resolution of inflammation in CD.
CRIS-Team Scopus Importer:2019-11-01
Keywords: Anti-TNF therapy; Apoptosis; Crohn’s disease; IL23; Intestine; Resolution of inflammation

Resolution of inflammation by interleukin-9-producing type 2 innate lymphoid cells - Rauber, Simon; Luber, Markus; Weber, Stefanie; Maul, Lisa; Soare, Alina; Wohlfahrt, Thomas; Lin, Neng-Yu; Dietel, Katharina; Bozec, Aline; Herrmann, Martin; Kaplan, Mark H.; Weigmann, Benno; et al. (Nature Medicine, 2017)
Inflammatory diseases such as arthritis are chronic conditions that fail to resolve spontaneously. While the cytokine and cellular pathways triggering arthritis are well defined, those responsible for the resolution of inflammation are incompletely characterized. Here we identified interleukin (IL)-9-producing type 2 innate lymphoid cells (ILC2s) as the mediators of a molecular and cellular pathway that orchestrates the resolution of chronic inflammation. In mice, the absence of IL-9 impaired ILC2 proliferation and activation of regulatory T (Treg) cells, and resulted in chronic arthritis with excessive cartilage destruction and bone loss. In contrast, treatment with IL-9 promoted ILC2-dependent Treg activation and effectively induced resolution of inflammation and protection of bone. Patients with rheumatoid arthritis in remission exhibited high numbers of IL-9(+) ILC2s in joints and the circulation. Hence, fostering IL-9-mediated ILC2 activation may offer a novel therapeutic approach inducing resolution of inflammation rather than suppression of inflammatory responses.
EVALuna2:13255

Resolution of inflammation: from basic concepts to clinical application - Neurath, Markus (Seminars in Immunopathology, 2019)
CRIS-Team Scopus Importer:2019-12-10

Resolution of ulcerative colitis - Neurath, Markus; Leppkes, Moritz (Seminars in Immunopathology, 2019)
Ulcerative colitis designates an idiopathic chronic inflammatory bowel disease leading to bloody diarrhea and inflammatory alterations mostly restricted to the large intestine. Many studies continue to unravel important aspects of its etiopathogenesis, and recent pharmaceutical developments broaden the arsenal of therapeutic opportunity. In this review, we delve into the cellular and molecular determinants of successful resolution of ulcerative colitis, describing novel insights in each of the phases of mucosal healing starting from damaging insults to the mucosa, epithelial restitution, and its adaption to inflammation as well as lymphocyte-driven maintenance and resolution of chronic inflammation. Additionally, molecular switches from inflammation to resolution are explored, paving the way for future avenues to resolve ulcerative colitis.
CRIS-Team Scopus Importer:2019-07-23
Keywords: Epithelium; Intestine; Lymphocytes; Resolution of inflammation; Ulcerative colitis

Response heterogeneity as a new biomarker of treatment response in patients with neuroendocrine tumors - Dromain, Clarisse; Pavel, Marianne Ellen; Ronot, Maxime; Schaefer, Niklaus; Mandair, Dalvinder; Gueguen, Delphine; Cheng, Catherine; Dehaene, Olivier; Schutte, Kathryn; Cahané, David; Jégou, Simon; Balazard, Félix (Future Oncology, 2023)
Aim: The RAISE project aimed to find a surrogate end point to predict treatment response early in patients with enteropancreatic neuroendocrine tumors (NET). Response heterogeneity, defined as the coexistence of responding and non-responding lesions, has been proposed as a predictive marker for progression-free survival (PFS) in patients with NETs. Patients & methods: Computerized tomography scans were analyzed from patients with multiple lesions in CLARINET (NCT00353496; n = 148/204). Cox regression analyses evaluated association between response heterogeneity, estimated using the standard deviation of the longest diameter ratio of target lesions, and NET progression. Results: Greater response heterogeneity at a given visit was associated with earlier progression thereafter: week 12 hazard ratio (HR; 95% confidence interval): 1.48 (1.20-1.82); p < 0.001; n = 148; week 36: 1.72 (1.32-2.24); p < 0.001; n = 108. HRs controlled for sum of longest diameter ratio: week 12: 1.28 (1.04-1.59); p = 0.020 and week 36: 1.81 (1.20-2.72); p = 0.005. Conclusion: Response heterogeneity independently predicts PFS in patients with enteropancreatic NETs. Further validation is required. Plain language summary - Response heterogeneity as a new biomarker of treatment response in patients with neuroendocrine tumors Neuroendocrine tumors (NET) are rare, slow-growing cancers that can grow in various parts of the body. By understanding how NETs are responding to treatment, doctors can choose the best treatment for a patient and monitor whether the treatment needs to be changed. Treatment response is determined using ‘Response Evaluation Criteria in Solid Tumors (RECIST)': a technique which measures the size of tumors to assess whether they are shrinking. However, RECIST is not always useful in NETs, which grow slowly and rarely shrink. ‘Response heterogeneity' describes the situation in which some tumors respond well to treatment, while other tumors in the same patient do not. Response heterogeneity may be important in understanding how tumors are responding to treatment and predicting outcomes for patients. Until now, the link between response heterogeneity and treatment response has not been studied in patients with NETs. The RAISE project examined data from a clinical trial of patients with NETs treated with lanreotide. In RAISE, response heterogeneity was estimated using imaging scans of NETs. Response heterogeneity was compared with factors such as tumor size and amounts of certain molecules found in the blood, to see how well response heterogeneity could predict outcomes for patients with NETs. In this study, response heterogeneity was linked with worse outcomes for patients. Therefore, it may be useful in understanding how NETs respond to treatment. Further research is needed in a different group of patients with NETs, and in patients receiving other treatments, to better understand response heterogeneity.
CRIS-Team Scopus Importer:2023-11-24
Keywords: biomarker; neuroendocrine tumors; progression-free survival; RECIST; response heterogeneity

Results of a Multicentric Retrolective Study of Teduglutide Treatment in Benign Short Bowel Syndrome in Germany - Pevny, Sophie; Wehkamp, Jan; Zopf, Yurdagül; Blumenstein, Irina; Von Websky, Martin W.; Schiefke, Ingolf; Buettner, Janine; Sebastian, Maasberg; Pape, Ulrich-Frank (TRANSPLANTATION, 2019)
CRIS-Team WoS Importer:2019-08-30

Retinal Microcirculation as a Correlate of a Systemic Capillary Impairment After Severe Acute Respiratory Syndrome Coronavirus 2 Infection - Hohberger, Bettina; Ganslmayer, Marion; Lucio, Marianna; Kruse, Friedrich; Hoffmanns, Jakob; Moritz, Michael; Rogge, Lennart; Heltmann, Felix; Szewczykowski, Charlotte; Fürst, Julia; Raftis, Maximilian; Bergua, Antonio; et al. (Frontiers in Medicine, 2021)
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), affects the pulmonary systems via angiotensin-converting enzyme-2 (ACE-2) receptor, being an entry to systemic infection. As COVID-19 disease features ACE-2 deficiency, a link to microcirculation is proposed. Optical coherence tomography angiography (OCT-A) enables non-invasive analysis of retinal microvasculature. Thus, an impaired systemic microcirculation might be mapped on retinal capillary system. As recent OCT-A studies, analyzing microcirculation in two subdivided layers, yielded contrary results, an increased subdivision of retinal microvasculature might offer an even more fine analysis. The aim of the study was to investigate retinal microcirculation by OCT-A after COVID-19 infection in three subdivided layers (I). In addition, short-term retinal affections were monitored during COVID-19 disease (II). Considering (I), a prospective study (33 patientspost−COVID and 28 controls) was done. Macula and peripapillary vessel density (VD) were scanned with the Spectralis II. Macula VD was measured in three layers: superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). Analysis was done by the EA-Tool, including an Anatomical Positioning System and an analysis of peripapillary VD by implementing Bruch's membrane opening (BMO) landmarks. Overall, circular (c1, c2, and c3) and sectorial VD (s1-s12) was analyzed. Considering (II), in a retrospective study, 29 patients with severe complications of COVID-19 infection, hospitalized at the intensive care unit, were monitored for retinal findings at bedside during hospitalization. (I) Overall (p = 0.0133) and circular (c1, p = 0.00257; c2, p = 0.0067; and c3, p = 0.0345). VD of the ICP was significantly reduced between patientspost−COVID and controls, respectively. Overall (p = 0.0179) and circular (c1, p = 0.0189) peripapillary VD was significantly reduced between both groups. Subgroup analysis of hospitalized vs. non-hospitalized patientspost−COVID yielded a significantly reduced VD of adjacent layers (DCP and SVP) with increased severity of COVID-19 disease. Clinical severity parameters showed a negative correlation with VD (ICP) and peripapillary VD. (II) Funduscopy yielded retinal hemorrhages and cotton wool spots in 17% of patients during SARS-CoV-2 infection. As VD of the ICP and peripapillary regions was significantly reduced after COVID-19 disease and showed a link to clinical severity markers, we assume that the severity of capillary impairment after COVID-19 infection is mapped on retinal microcirculation, visualized by non-invasive OCT-A.
CRIS-Team Scopus Importer:2021-08-06
Keywords: COVID-19; macula; microcirculation; OCT-angiography; optic nerve head; retina; SARS-CoV-2

Retrograde inspection vs standard forward view for the detection of colorectal adenomas during colonoscopy: A back-to-back randomized clinical trial - Rath, Timo; Pfeifer, Lukas; Neufert, Clemens; Kremer, Andreas; Leppkes, Moritz; Hoffman, Arthur; Neurath, Markus; Zopf, Steffen (World Journal of Gastroenterology, 2020)
BACKGROUND: The adenoma detection rate (ADR) is inversely associated with the incidence of interval colorectal cancer and serves as a benchmark quality criterion during screening colonoscopy. However, adenoma miss rates reach up to 26% and studies have shown that a second inspection of the right colon in retroflected view (RFV) can increase ADR. AIM: To assess whether inspection of the whole colon in RFV compared to standard forward view (SFV) can increase ADR. METHODS: Patients presenting for screening or surveillance colonoscopy were invited to participate in this randomized controlled trial and randomized into two arms. In RFV arm colonoscopy was initially performed with SFV, followed by a second inspection of the whole colon in RFV. In the SFV arm first withdrawal was performed with SFV, followed by a second inspection of the whole colon again with SFV. Number, size and morphology of polyps found during first and second inspection in each colonic segment were recorded and all polyps were removed and sent for histopathology in separate containers. RESULTS: Two hundred and five patients were randomly assigned to the RFV (n = 101) and SFV (n = 104) arm. In the RFV arm, both polyp detection rate (PDR) and ADR were increased under second inspection in RFV (PDR 1st SFV: 39.8%, PDR 2nd RFV: 46.6%; ADR 1st SFV: 35.2%, ADR 2nd RFV: 42%). Likewise, in the SFV arm, PDR and ADR were increased under second inspection (PDR 1st SFV: 37.5%, PDR 2nd SFV: 46.6%; ADR 1st SFV: 34.1%, ADR 2nd SFV: 44.3%) with no significant differences in ADR and PDR between the SFV and RFV arm. Mean number of adenomas per patient (APP) was increased in the RFV and SFV (APP RFV arm: 1st SFV: 1.71; 2nd RFV: 2.38; APP SFV arm: 1st SFV: 1.83, 2nd SFV:2.2). The majority of adenomas additionally found during second inspection in RFV or in SFV were located in the transverse and left-sided colon and were > 5 mm in size. CONCLUSION: Second inspection of the whole colon leads to increased adenoma detection with no differences between SFV and RFV. Hence, increased detection is most likely a feature of the second inspection itself but not of the inspection mode.
CRIS-Team Scopus Importer:2020-05-22
Keywords: Adenoma; Adenoma detection rate; Colonoscopy; Colorectal cancer

Review and Analysis of German Mobile Apps for Inflammatory Bowel Disease Management Using the Mobile Application Rating Scale: Systematic Search in App Stores and Content Analysis - Gerner, Maximilian; Vuillerme, Nicolas; Aubourg, Timothée; Messner, Eva Maria; Terhorst, Yannik; Hörmann, Verena; Ganzleben, Ingo; Schenker, Hannah; Schett, Georg; Atreya, Raja; Neurath, Markus; Knitza, Johannes; et al. (JMIR mHealth and uHealth, 2022)
Background: Patients suffering from inflammatory bowel disease (IBD) frequently need long-term medical treatment. Mobile apps promise to complement and improve IBD management, but so far there has been no scientific analysis of their quality. Objective: This study evaluated the quality of German mobile apps targeting IBD patients and physicians treating IBD patients using the Mobile Application Rating Scale (MARS). Methods: The German Apple App Store and Google Play Store were systematically searched to identify German IBD mobile apps for patient and physician use. MARS was used by 6 physicians (3 using Android smartphones and 3 using iPhones) to independently assess app quality. Apps were randomly assigned so that the 4 apps with the most downloads were rated by all raters and the remaining apps were rated by 1 Android and 1 iOS user. Results: In total, we identified 1764 apps in the Apple App Store and Google Play Store. After removing apps that were not related to IBD (n=1386) or not available in German (n=317), 61 apps remained. After removing duplicates (n=3) and apps for congresses (n=7), journals (n=4), and clinical studies (n=6), as well as excluding apps that were available in only 1 of the 2 app stores (n=20) and apps that could only be used with an additional device (n=7), we included a total of 14 apps. The app “CED Dokumentation und Tipps” had the highest overall median MARS score at 4.11/5. On the whole, the median MARS scores of the 14 apps ranged between 2.38/5 and 4.11/5. As there was no significant difference between iPhone and Android raters, we used the Wilcoxon comparison test to calculate P values. Conclusions: The MARS ratings showed that the quality of German IBD apps varied. We also discovered a discrepancy between app store ratings and MARS ratings, highlighting the difficulty of assessing perceived app quality. Despite promising results from international studies, there is little evidence for the clinical benefits of German IBD apps. Clinical studies and patient inclusion in the app development process are needed to effectively implement mobile apps in routine care.
CRIS-Team Scopus Importer:2022-05-20
Keywords: app store; chronic disease; Crohn disease; IBD; IBS; inflammatory bowel disease; mHealth; mobile apps; quality; rating; rating scale; telemedicine; ulcerative colitis; usability

RFA: THE treatment option in esophageal squamous cell carcinoma? - Neumann, Helmut; Vieth, Michael (Gastrointestinal Endoscopy, 2014)
EVALuna2:1897

Rhinovirus Suppresses TGF-β-GARP Presentation by Peripheral NK Cells - Krammer, Susanne; Yang, Zuqin; Mitländer, Hannah; Grund, Janina; Trump, Sonja; Mittler, Susanne; Zirlik, Sabine; Neurath-Finotto, Susetta (Cells, 2023)
Asthma is a chronic airway disease whose exacerbations are often triggered by rhinovirus infection. TGF-β1 induces rhinovirus replication in infected cells. Moreover, TGF-β1 is a pleiotropic mediator that is produced by many immune cells in the latent, inactive form bound to the latency-associated peptide (LAP) and to the transmembrane protein glycoprotein A repetitions predominant (GARP). In this study we wanted to investigate the effect of rhinovirus infection on the TGF-β secretion and the downstream signaling via TGF-βRI/RII in peripheral blood mononuclear cells from control and asthmatic patients after rhinovirus infection ex vivo. Here, we found a significant upregulation of TGF-βRII in untouched PBMCs of asthmatics as well as a suppression of TGF-β release in the rhinovirus-infected PBMC condition. Moreover, consistent with an effect of TGF-β on Tregs, PBMCs infected with RV induced Tregs, and TGF-βRII directly correlated with RV1b mRNA. Finally, we found via flow cytometry that NK cells expressed less GARP surface-bound TGF-β, while cytokine-producing NKbright cells were induced. In summary, we show that rhinovirus infection inhibits TGF-β release in PBMCs, which results in the activation of both Treg and NK cells.
CRIS-Team Scopus Importer:2023-01-20
Keywords: asthma; NK cells; rhinovirus; TGF-β; TGF-β RI; TGF-β RII

Rho GTPases as Key Molecular Players within Intestinal Mucosa and GI Diseases - Pradhan, Rashmita; Ngo, Phuong A.; Martínez Sánchez, Luz del Carmen; Neurath, Markus; Lopez Posadas, Rocío (Cells, 2021)
Rho proteins operate as key regulators of the cytoskeleton, cell morphology and trafficking. Acting as molecular switches, the function of Rho GTPases is determined by guanosine triphosphate (GTP)/guanosine diphosphate (GDP) exchange and their lipidation via prenylation, allowing their binding to cellular membranes and the interaction with downstream effector proteins in close proximity to the membrane. A plethora of in vitro studies demonstrate the indispensable function of Rho proteins for cytoskeleton dynamics within different cell types. However, only in the last decades we have got access to genetically modified mouse models to decipher the intricate regulation between members of the Rho family within specific cell types in the complex in vivo situation. Translationally, alterations of the expression and/or function of Rho GTPases have been associated with several pathological conditions, such as inflammation and cancer. In the context of the GI tract, the continuous crosstalk between the host and the intestinal microbiota requires a tight regulation of the complex interaction between cellular components within the intestinal tissue. Recent studies demonstrate that Rho GTPases play important roles for the maintenance of tissue homeostasis in the gut. We will summarize the current knowledge on Rho protein function within individual cell types in the intestinal mucosa in vivo, with special focus on intestinal epithelial cells and T cells.
CRIS-Team WoS Importer:2021-02-05

Rifaximin and Saccharomyces boulardii increase stress resilience in TNBS-induced colitis - Konturek, P.; Zopf, Yurdagül; Dieterich, Walburga; Wirtz, Stefan; Neurath, Markus; Brzozowski, T. (2018)
EVALuna2:34076

RIPK1 ensures intestinal homeostasis by protecting the epithelium against apoptosis - Takahashi, Nozomi; Vereecke, Lars; Bertrand, Mathieu J. M.; Duprez, Linde; Berger, Scott B.; Divert, Tatyana; Goncalves, Amanda; Sze, Mozes; Gilbert, Barbara; Kourula, Stephanie; Goossens, Vera; Lefebvre, Sylvie; et al. (Nature, 2014)
Receptor interacting protein kinase 1 (RIPK1) has an essential role in the signalling triggered by death receptors and pattern recognition receptors. RIPK1 is believed to function as a node driving NF-?B-mediated cell survival and inflammation as well as caspase-8 (CASP8)-dependent apoptotic or RIPK3/MLKL-dependent necroptotic cell death. The physiological relevance of this dual function has remained elusive because of the perinatal death of RIPK1 full knockout mice. To circumvent this problem, we generated RIPK1 conditional knockout mice, and show that mice lacking RIPK1 in intestinal epithelial cells (IECs) spontaneously develop severe intestinal inflammation associated with IEC apoptosis leading to early death. This early lethality was rescued by antibiotic treatment, MYD88 deficiency or tumour-necrosis factor (TNF) receptor 1 deficiency, demonstrating the importance of commensal bacteria and TNF in the IEC Ripk1 knockout phenotype. CASP8 deficiency, but not RIPK3 deficiency, rescued the inflammatory phenotype completely, indicating the indispensable role of RIPK1 in suppressing CASP8-dependent apoptosis but not RIPK3-dependent necroptosis in the intestine. RIPK1 kinase-dead knock-in mice did not exhibit any sign of inflammation, suggesting that RIPK1-mediated protection resides in its kinase-independent platform function. Depletion of RIPK1 in intestinal organoid cultures sensitized them to TNF-induced apoptosis, confirming the in vivo observations. Unexpectedly, TNF-mediated NF-?B activation remained intact in these organoids. Our results demonstrate that RIPK1 is essential for survival of IECs, ensuring epithelial homeostasis by protecting the epithelium from CASP8-mediated IEC apoptosis independently of its kinase activity and NF-?B activation.
EVALuna2:1912

Risankizumab in patients with moderate to severe Crohn's disease: an open-label extension study - Feagan, Brian G.; Panes, Julian; Ferrante, Marc; Kaser, Arthur; D'Haens, Geert R.; Sandborn, William J.; Louis, Edouard; Neurath, Markus; Franchimont, Denis; Dewit, Olivier; Seidler, Ursula; Kim, Kyung-Jo; et al. (Lancet Gastroenterology and Hepatology, 2018)
BACKGROUND: Risankizumab, an anti-interleukin 23 antibody, was superior to placebo in achieving clinical and endoscopic remission at week 12 in a randomised, phase 2 induction study in patients with moderately to severely active Crohn's disease. Here we aimed to assess the efficacy and safety of extended intravenous induction and subcutaneous maintenance therapy with risankizumab. METHODS: All patients who completed the 12-week induction phase of the double-blind phase 2 induction study were included in this open-label extension study. Patients who did not achieve deep remission, defined as clinical remission (Crohn's Disease Activity Index [CDAI] <150) and endoscopic remission (Crohn's Disease Endoscopic Index of Severity [CDEIS] ≤4, or ≤2 for patients with isolated ileitis), at week 12 received open-label intravenous therapy with 600 mg risankizumab every 4 weeks for 12 weeks; patients in deep remission at week 12 entered a 12-week washout phase. Patients in clinical remission at week 26 were invited to participate in the maintenance phase of the study, in which they received open-label subcutaneous risankizumab (180 mg) every 8 weeks for 26 weeks. 26-week efficacy endpoints were the proportion of patients in clinical remission (CDAI <150), and the proportion of patients who achieved clinical response (either CDAI of <150 or a reduction from baseline of at least 100 points). 52-week efficacy endpoints were the proportion of patients achieving: clinical remission; clinical response; endoscopic response (>50% CDEIS reduction from baseline); endoscopic remission, as defined previously; mucosal healing; and deep remission. Safety was assessed in patients who received at least one dose of the study drug during the open-label phases of the study. This study is registered with ClinicalTrials.gov, number NCT02031276. FINDINGS: Of the 108 patients who completed the 12-week double-blind induction trial, six patients were in deep remission and entered the 12-week washout phase. 102 patients were not in deep remission, 101 of whom received 12 weeks of 600 mg risankizumab (33 from the original placebo group, 34 from the 200 mg risankizumab group, and 34 from the 600 mg risankizumab group); the other patient declined to continue the study. At week 26, 54 (53%) of 101 patients treated with 600 mg rizankizumab were in clinical remission. Among patients included in the open-label extension trial, clinical remission rates at week 26 versus week 12 were: 18 (55%) versus six (18%) of 33 patients in the original placebo group; 20 (59%) versus seven (21%) of 34 patients in the original 200 mg risankizumab group; and 16 (47%) versus nine (26%) of 34 patients in the original 600 mg risankizumab group. 62 patients received risankizumab maintenance treatment, including the 54 patients who achieved clinical remission at week 26, the six patients who had achieved deep remission at week 12, and one patient because of a protocol violation. At week 52, clinical remission was maintained in 44 (71%) patients; 50 (81%) patients had a clinical response, 22 (35%) patients were in endoscopic remission, and 34 (55%) patients had an endoscopic response. 15 (24%) patients had mucosal healing and 18 (29%) patients achieved deep remission at week 52. Risankizumab was well tolerated with no new safety signals noted. The most frequent treatment-emergent adverse events were arthralgia (25 [22%] of 115 patients), headache (23 [20%]), abdominal pain (21 [18%]), nasopharyngitis (18 [16%]), nausea (18 [16%]), and pyrexia (15 [13%]). Most adverse events were mild or moderate and considered to be unrelated to study treatment. There were no treatment-related deaths. INTERPRETATION: Extended induction treatment with open-label intravenous risankizumab was effective in increasing clinical response and remission rates at week 26. Open-label subcutaneous risankizumab maintained remission until week 52 in most patients who were in clinical remission at week 26. Selective blockade of interleukin 23 warrants further investigation as a treatment for Crohn's disease. FUNDING: Boehringer Ingelheim.
EVALuna2:35139

Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation - Montano-Loza, Aldo J.; Ronca, Vincenzo; Ebadi, Maryam; Hansen, Bettina E.; Hirschfield, Gideon; Elwir, Saleh; Alsaed, Mohamad; Milkiewicz, Piotr; Janik, Maciej K.; Marschall, Hanns Ulrich; Burza, Maria Antonella; Efe, Cumali; et al. (Journal of Hepatology, 2022)
Background & Aims: Autoimmune hepatitis can recur after liver transplantation (LT), though the impact of recurrence on patient and graft survival has not been well characterized. We evaluated a large, international, multicenter cohort to identify the probability and risk factors associated with recurrent AIH and the association between recurrent disease and patient and graft survival. Methods: We included 736 patients (77% female, mean age 42±1 years) with AIH who underwent LT from January 1987 through June 2020, among 33 centers in North America, South America, Europe and Asia. Clinical data before and after LT, biochemical data within the first 12 months after LT, and immunosuppression after LT were analyzed to identify patients at higher risk of AIH recurrence based on histological diagnosis. Results: AIH recurred in 20% of patients after 5 years and 31% after 10 years. Age at LT ≤42 years (hazard ratio [HR] 3.15; 95% CI 1.22-8.16; p = 0.02), use of mycophenolate mofetil post-LT (HR 3.06; 95% CI 1.39-6.73; p = 0.005), donor and recipient sex mismatch (HR 2.57; 95% CI 1.39-4.76; p = 0.003) and high IgG pre-LT (HR 1.04; 95% CI 1.01-1.06; p = 0.004) were associated with higher risk of AIH recurrence after adjusting for other confounders. In multivariate Cox regression, recurrent AIH (as a time-dependent covariate) was significantly associated with graft loss (HR 10.79, 95% CI 5.37-21.66, p <0.001) and death (HR 2.53, 95% CI 1.48-4.33, p = 0.001). Conclusion: Recurrence of AIH following transplant is frequent and is associated with younger age at LT, use of mycophenolate mofetil post-LT, sex mismatch and high IgG pre-LT. We demonstrate an association between disease recurrence and impaired graft and overall survival in patients with AIH, highlighting the importance of ongoing efforts to better characterize, prevent and treat recurrent AIH. Lay summary: Recurrent autoimmune hepatitis following liver transplant is frequent and is associated with some recipient features and the type of immunosuppressive medications use. Recurrent autoimmune hepatitis negatively affects outcomes after liver transplantation. Thus, improved measures are required to prevent and treat this condition.
CRIS-Team Scopus Importer:2022-04-15
Keywords: autoimmune liver disease; graft survival; liver transplantation; recurrent disease; survival

Role and benefits of infectious diseases (ID) specialists in the COVID-19 pandemics - Tscharntke, Lene; Jung, Norma; Rieg, Siegbert; Spinner, Christoph; Hanses, Frank; Borgmann, Stefan; Wille, Kai; Ruethrich, Maria; Hower, Martin; Vehreschild, Maria; Von Bergwelt-Baildon, Michael; Merle, Uta; et al. (INFECTION, 2021)
CRIS-Team WoS Importer:2021-04-09

Role of IFN-gamma-activation of distinct tumor and stromal cell populations in colorectal carcinoma pathogenesis - Britzen-Laurent, Nathalie; Guo, Wei; Langer, Victoria; Khoziainova, Svetlana; Weisenburger, Thomas; Winkler, Thomas; Straube, Julia; Waldner, Maximilian; Becker, Christoph; Naschberger, Elisabeth; Skottke, Lisa; Tripal, Philipp; et al. (CANCER RESEARCH, 2019)
CRIS-Team WoS Importer:2019-10-22

Role of nuclear factor of activated T cells 2 (NFATc2) in allergic asthma - Jakobi, Marielena; Kiefer, Alexander; Mirzakhani, Hooman; Rauh, Manfred; Zimmermann, Theodor; Xepapadaki, Paraskevi; Stanic, Barbara; Akdis, Mubeccel; Papadopoulos, Nikolaos G.; Raby, Benjamin A.; Weiss, Scott T.; Neurath-Finotto, Susetta (Immunity, Inflammation and Disease, 2020)
Background: We recently described increased NFATc1, IRF4, and NIP45 messenger RNA (mRNA) expression in peripheral blood mononuclear cells (PBMCs) of asthmatic children and adults with multiple allergies. Objective: NFATc2 has been described to associate with IRF4 to induce interleukin-4, and to be inhibited by T-bet. Here, we analyzed the role of NFATc2 in asthmatic children and adults. Methods: PBMCs were isolated from the blood of control of asthmatics subjects. Some PBMCs were analyzed untreated and some cultured with and without phytohemagglutinin. Then, RNA was extracted from the cells and cytokines were measured in the supernatants via enzyme-linked immunosorbent assay or multiplex analysis. RNA was then reverse-transcribed and NFATc1, NFATC2, IRF4, and T-bet mRNA were analyzed by real-time polymerase chain reaction. In addition, in peripheral blood cells, NFATc2 expression was analyzed, in a population of asthmatic children and adults from the Asthma BRIDGE study. Results: In addition to NFATc1 and NIP45, also NFATc2 was found upregulated in PBMCs and peripheral blood cells from asthmatic children and adults with allergic asthma. Moreover, NFATc1 directly correlated with lymphocytes number whereas NFATc2 correlated with peripheral eosinophilia in asthma. Conclusions: In addition to NFATc1 and NIP45, NFATc2 was found upregulated in asthma. Moreover, NFATc1 mRNA correlated with lymphocytes both in control and asthma, and NFATC1 and NFATc2 mRNA showed a direct correlation with eosinophils in controls but not in asthma, indicating that NFATc1 is associated with lymphocytes and not eosinophils in asthma. Clinical Significance: Targeting NFATc2 in T lymphocytes might ameliorate the allergic phenotype in asthmatic subjects.
CRIS-Team Scopus Importer:2020-10-30
Keywords: allergy processes; animals; eosinophils cells; human; T cells

Role of Surgical Pathologist for the Detection of Immuno-oncologic Predictive Factors in Non-small Cell Lung Cancers - Mohanty, Sambit K.; Mishra, Sourav K.; Amin, Mahul B.; Agaimy, Abbas; Fuchs, Florian (Advances in Anatomic Pathology, 2023)
Until very recently, surgery, chemotherapy, and radiation therapy have been the mainstay of treatment in non-small cell carcinomas (NSCLCs). However, recent advances in molecular immunology have unveiled some of the complexity of the mechanisms regulating cellular immune responses and led to the successful targeting of immune checkpoints in attempts to enhance antitumor T-cell responses. Immune checkpoint molecules such as cytotoxic T-lymphocyte associated protein-4, programmed cell death protein-1, and programmed death ligand (PD-L) 1 have been shown to play central roles in evading cancer immunity. Thus, these molecules have been targeted by inhibitors for the management of cancers forming the basis of immunotherapy. Advanced NSCLC has been the paradigm for the benefits of immunotherapy in any cancer. Treatment decisions are made based on the expression of PD-L1 on the tumor cells and the presence or absence of driver mutations. Patients with high PD-L1 expression (≥50%) and no driver mutations are treated with single-agent immunotherapy whereas, for all other patients with a lower level of PD-L1 expression, a combination of chemotherapy and immunotherapy is preferred. Thus, PD-L1 blockers are the only immunotherapeutic agents approved in advanced NSCLC without any oncogenic driver mutations. PD-L1 immunohistochemistry, however, may not be the best biomarker in view of its dynamic nature in time and space, and the benefits may be seen regardless of PD -L1 expression. Each immunotherapy molecule is prescribed based on the levels of PD-L1 expression as assessed by a Food and Drug Administration-approved companion diagnostic assay. Other biomarkers that have been studied include tumor mutational burden, the T-effector signature, tumor-infiltrating lymphocytes, radiomic assays, inflammation index, presence or absence of immune-related adverse events and specific driver mutations, and gut as well as local microbiome. At the current time, none of these biomarkers are routinely used in the clinical decision-making process for immunotherapy in NSCLC. However, in individual cases, they can be useful adjuncts to conventional therapy. This review describes our current understanding of the role of biomarkers as predictors of response to immune checkpoint molecules. To begin with a brief on cancer immunology in general and in NSCLC, in particular, is discussed. In the end, recent advancements in laboratory techniques for refining biomarker assays are described.
CRIS-Team Scopus Importer:2023-04-21
Keywords: immune checkpoint inhibitors; immune checkpoints; NSCLC; PD-1; PD-L1; TPS

Role of the IL23/IL17 Pathway in Crohn’s Disease - Schmitt, Heike; Neurath, Markus; Atreya, Raja (Frontiers in Immunology, 2021)
Crohn’s disease (CD) is a chronic relapsing disorder of the gastrointestinal tract and represents one of the main entities of inflammatory bowel disease (IBD). CD affects genetically susceptible patients that are influenced by environmental factors and the intestinal microbiome, which results in excessive activation of the mucosal immune system and aberrant cytokine responses. Various studies have implicated the pro-inflammatory cytokines IL17 and IL23 in the pathogenesis of CD. IL23 is a member of the IL12 family of cytokines and is able to enhance and affect the expansion of pathogenic T helper type 17 (Th17) cells through various mechanisms, including maintenance of Th17 signature genes, upregulation of effector genes or suppression of repressive factors. Moreover, IL17 and IL23 signaling is able to induce a cascade of pro-inflammatory molecules like TNF, IFNγ, IL22, lymphotoxin, IL1β and lipopolysaccharide (LPS). Here, IL17A and TNF are known to mediate signaling synergistically to drive expression of inflammatory genes. Recent advances in understanding the immunopathogenetic mechanisms underlying CD have led to the development of new biological therapies that selectively intervene and inhibit inflammatory processes caused by pro-inflammatory mediators like IL17 and IL23. Recently published data demonstrate that treatment with selective IL23 inhibitors lead to markedly high response rates in the cohort of CD patients that failed previous anti-TNF therapy. Macrophages are considered as a main source of IL23 in the intestine and are supposed to play a key role in the molecular crosstalk with T cell subsets and innate lymphoid cells in the gut. The following review focuses on mechanisms, pathways and specific therapies in Crohn’s disease underlying the IL23/IL17 pathway.
CRIS-Team Scopus Importer:2021-04-23
Keywords: anti-TNF therapy; Crohn’s disease; IL17/IL23 axis; inflammation; intestinal immunity; non-responder; resistance to apoptosis

Role of the IL-2 inducible tyrosine kinase ITK and its inhibitors in disease pathogenesis - Lechner, Kristina S.; Neurath, Markus; Weigmann, Benno (Journal of Molecular Medicine, 2020)
ITK (IL-2-inducible tyrosine kinase) belongs to the Tec family kinases and is mainly expressed in T cells. It is involved in TCR signalling events driving processes like T cell development as well as Th2, Th9 and Th17 responses thereby controlling the expression of pro-inflammatory cytokines. Studies have shown that ITK is involved in the pathogenesis of autoimmune diseases as well as in carcinogenesis. The loss of ITK or its activity either by mutation or by the use of inhibitors led to a beneficial outcome in experimental models of asthma, inflammatory bowel disease and multiple sclerosis among others. In humans, biallelic mutations in the ITK gene locus result in a monogenetic disorder leading to T cell dysfunction; in consequence, mainly EBV infections can lead to severe immune dysregulation evident by lymphoproliferation, lymphoma and hemophagocytic lymphohistiocytosis. Furthermore, patients who suffer from angioimmunoblastic T cell lymphoma have been found to express significantly more ITK. These findings put ITK in the strong focus as a target for drug development.
CRIS-Team Scopus Importer:2020-08-28
Keywords: Autoimmune diseases; Cancer; Inhibitor; ITK

ROS Ameriolates the Clinical Course of Murine Lupus - Hahn, Jonas; Kienhoefer, Deborah; Stoof, Julia; Csepregi, Janka Zsofia; Hultqvist, Malin; Leppkes, Moritz; Herrmann, Martin; Mocsai, Atilla; Schett, Georg; Hoffmann, Markus (2016)
EVALuna2:35053

ROS is the boss - Hahn, Jonas; Kienhofer, Deborah; Stoof, Julia; Csepregi, Janka Zsofia; Reinwald, Christiane; Maueröder, Christian; Urbonaviciute, Vilma; Munoz, Luis Enrique; Hultqvist, Malin; Podolska, Malgorzata; Biermann, Mona; Leppkes, Moritz; et al. (2017)
EVALuna2:13467

Round-Robin test for the histological diagnosis of acute colonic Graft-versus-Host disease validating established histological criteria and grading systems - Hippe, Katrin; Kreft, Andreas; Reu-Hofer, Simone; Rosenwald, Andreas; Ferrazzi, Fulvia; Daniel, Christoph; Amann, Kerstin Ute; Kraus, Sabrina; Holler, Ernst; Kandulski, Arne; Hirsch, Daniela; Buttner, Anke; et al. (Virchows Archiv, 2023)
Histomorpholgy is one of the mainstays of acute Graft-versus-host disease (GvHD) diagnosis. However, concerns about reproducibility and the most appropriate grading system question its usefulness. Our aim was to assess histomorphological parameters and previously reported grading systems for GvHD regarding reproducibility and validity. Moreover, we propose that sum scores, derived by combining separately scored morphological parameters into a total score, might provide a simplified but equally effective means to grade GvHD. A total of 123 colon biopsies were assessed across four pathologists for intestinal GvHD using a Round-Robin test and results were correlated with clinical findings. Interobserver reproducibility was high for histological parameters that were evaluated as indicators of acute GvHD. Published grading systems were moderately reproducible (ICC 0.679–0.769) while simplified sum scores, in comparison, showed better interrater reliability (ICC 0.818–0.896). All grading systems and sum scores were associated with clinical signs of GvHD and in part with therapy response and survival. However, they were not able to stratify patients according to the clinical severity of GvHD. In a hot-spot analysis 1 crypt apoptotic body (CAB) in 10 crypts was a reasonable cut-off value for minimal diagnostic criteria of GvHD. In conclusion, histology can contribute to the diagnosis of GvHD and is reproducible. Published grading systems are able to reflect clinical findings as are simplified sum scores, which showed improved reproducibility and might be easier to handle as they are based on adding up histological parameters rather than transferring histological findings into a separate grading system. Sum scores will have to be further tested in a prospective setting.
CRIS-Team Scopus Importer:2023-05-26
Keywords: Acute Graft-versus-host disease; Colon biopsy; Grading; Interobserver agreement; Round-Robin test

S2k guideline: Diagnosis and treatment of chronic pruritus - Ständer, Sonja; Zeidler, Claudia; Augustin, Matthias; Darsow, Ulf; Kremer, Andreas; Legat, Franz J.; Koschmieder, Steffen; Kupfer, Jörg; Mettang, Thomas; Metz, Martin; Nast, Alexander; Raap, Ulrike; et al. (Journal der Deutschen Dermatologischen Gesellschaft, 2022)
Pruritus is a cross-disciplinary leading symptom of numerous diseases and represents an interdisciplinary diagnostic and therapeutic challenge. In contrast to acute pruritus, chronic pruritus (CP) is a symptom of various diseases that is usually difficult to treat. Scratching and the development of scratch-associated skin lesions can alter the original skin status. In the presence of an itch-scratch-cycle, even secondary diseases such as chronic prurigo can develop. Chronic pruritus leads to considerable subjective suffering of those affected, which can result in restrictions on the health-related quality of life such as sleep disturbances, anxiety, depressiveness, experience of stigmatization and/or social withdrawal up to clinically relevant psychic comorbidities. Medical care of patients should therefore include (a) interdisciplinary diagnosis and therapy of the triggering underlying disease, (b) therapy of the secondary symptoms of pruritus (dermatological therapy, sleep promotion, in the case of an accompanying or underlying psychological or psychosomatic disease an appropriate psychological-psychotherapeutic treatment) and (c) symptomatic antipruritic therapy. The aim of this interdisciplinary guideline is to define and standardize the therapeutic procedure as well as the interdisciplinary diagnosis of CP. This is the short version of the updated S2k-guideline for chronic pruritus. The long version can be found at www.awmf.org.
CRIS-Team Scopus Importer:2022-10-28

S2k Guidelines for the diagnosis and treatment of chronic pruritus - update - short version - Staender, Sonja; Zeidler, Claudia; Augustin, Matthias; Bayer, Gudrun; Kremer, Andreas; Legat, Franz J.; Maisel, Peter; Mettang, Thomas; Metz, Martin; Nast, Alexander; Niemeier, Volker; Raap, Ulrike; et al. (Journal der Deutschen Dermatologischen Gesellschaft, 2017)
Associated with a host of different diseases, pruritus is a cardinal symptom that poses an interdisciplinary diagnostic and therapeutic challenge. Over time, that symptom may progress independently of the initial cause, thus losing its function as a warning sign and turning into a clinically relevant disease of its own. In Germany, approximately 13.5 % of the general population are affected by chronic pruritus, with an incidence of 7 %. All forms of chronic pruritus require targeted treatment consisting of (a) diagnosis and management of the underlying disease, (b) dermatological treatment of primary or secondary (for example, dry skin, scratch lesions) symptoms, (c) symptomatic antipruritic treatment, and (d) psychological/psychotherapeutic treatment in case of an underlying or associated psychological or psychosomatic condition. Medical care of patients with chronic pruritus should therefore include an interdisciplinary approach, in particular with respect to diagnosis and therapy of the underlying disease as well as in terms of the management of treatment and adverse events. The objective of the present interdisciplinary guidelines is to define and standardize diagnostic and therapeutic procedures in patients with chronic pruritus. This is a short version of the current S2 guidelines on chronic pruritus. The long version may be found at www.awmf.org.
EVALuna2:33898

S2k Leitlinie: Diagnostik und Therapie des chronischen Pruritus - Ständer, Sonja; Zeidler, Claudia; Augustin, Matthias; Darsow, Ulf; Kremer, Andreas; Legat, Franz J.; Koschmieder, Steffen; Kupfer, Jörg; Mettang, Thomas; Metz, Martin; Nast, Alexander; Raap, Ulrike; et al. (Journal der Deutschen Dermatologischen Gesellschaft, 2022)
CRIS-Team Scopus Importer:2022-10-28

S3 Guideline - Diagnosis and treatment of biliary carcinomas: Long version 2.0 - June 2021 - AWMF Register No.: 032-053OL S3-Leitlinie - Diagnostik und Therapie biliärer Karzinome - Bitzer, M.; Voesch, S.; Albert, J.; Bartenstein, P.; Bechstein, W.; Blödt, S.; Brunner, T.; Dombrowski, F.; Evert, M.; Follmann, M.; La Fougère, C.; Freudenberger, P.; et al. (Zeitschrift für Gastroenterologie, 2022)
CRIS-Team Scopus Importer:2022-02-25

S3-Leitlinie Diagnostik und Therapie biliärer Karzinome – Langversion - Bitzer, Michael; Groß, Sabrina; Albert, Jörg; Boda-Heggemann, Judit; Brunner, Thomas; Caspari, Reiner; De Toni, Enrico; Dombrowski, Frank; Evert, Matthias; Geier, Andreas; Gkika, Eleni; Götz, Martin; et al. (Zeitschrift für Gastroenterologie, 2023)
CRIS-Team Scopus Importer:2023-04-21

S3-Leitlinie „Diagnostik und Therapie des Hepatozellulären Karzinoms“ – Kurzversion - Groß, Sabrina; Bitzer, Michael; Albert, Jörg; Blödt, Susanne; Boda-Heggemann, Judit; Brunner, Thomas; Caspari, Reiner; De Toni, Enrico; Dombrowski, Frank; Evert, Matthias; Follmann, Markus; Freudenberger, Paul; et al. (Zeitschrift für Gastroenterologie, 2024)
CRIS-Team Scopus Importer:2024-01-19

Safety analysis of the run-in phase (1st and 2nd cohort) of the IMMUNIB trial (AIO-HEP-0218/ass) - An open-label, single-arm phase II study evaluating safety and efficacy of immunotherapy with nivolumab in combination with lenvatinib in advanced stage HCC - Vogel, A.; Mueller, D. W.; De Toni, E.; Siegler, G. M.; Lindig, U.; Mueller, T.; Schultheiss, M.; Geissler, M.; Krammer-Steiner, B.; Reichart, A.; Lammert, F.; Prause, C.; et al. (ANNALS OF ONCOLOGY, 2020)
CRIS-Team WoS Importer:2020-10-30

Safety and Efficacy of 14-Day Dosing Interval of Lanreotide Autogel/Depot (LAN) for Pts with Pancreatic or Midgut Neuroendocrine Tumours (NETs) Progressing on LAN Every 28 Days: Prospective, Open-label, International, Phase 2 CLARINET FORTE Study - Pavel, Marianne Ellen; Dromain, C.; Thanh, Truong X. M.; Houchard, A. (NEUROENDOCRINOLOGY, 2019)
CRIS-Team WoS Importer:2019-03-26

Safety and efficacy of combining biologics or small molecules for inflammatory bowel disease or immune-mediated inflammatory diseases: A European retrospective observational study - Goessens, Laurent; Colombel, Jean Frédéric; Outtier, An; Ferrante, Marc; Sabino, Joao; Judge, Ciaran; Saeidi, Reza; Rabbitt, Louise; Armuzzi, Alessandro; Domenech, Eugeni; Michalopoulos, George; Cremer, Anneline; et al. (United European Gastroenterology Journal, 2021)
Background and aims: Few data are available regarding the combination of biologics or small molecules in inflammatory bowel disease (IBD) patients. We report safety and efficacy of such combinations through a retrospective multicentre series. Methods: Combination therapy was defined as the concomitant use of two biologics or one biologic with a small molecule. Patient demographics, disease characteristics and types of combinations were recorded. Safety was evaluated according to the occurrence of serious infection, opportunistic infection, hospitalisation, life-threatening event, worsening of IBD or immune-mediated inflammatory diseases (IMID), cancer and death. Efficacy was evaluated as the physician global assessment of the combination and comparison of clinical/endoscopic scores of IBD/IMID activity prior and during combination. Results: A total of 104 combinations were collected in 98 patients. Concomitant IMID were present in 41 patients. Reasons for starting combination therapy were active IBD (67%), active IMID or extra-intestinal manifestations (EIM) (22%), both (10%) and unclassified in 1. Median duration of combination was 8 months (interquartile range 5–16). During 122 patient-years of follow-up, 42 significant adverse events were observed, mostly related to uncontrolled IBD. There were 10 significant infections, 1 skin cancer and no death. IBD disease activity was clinically improved in 70% and IMID/EIM activity in 81% of the patients. Overall, combination was continued in 55% of the patients. Conclusions: Combination of biologics and small molecules in patients with IBD and IMID/EIM seems to be a promising therapeutic strategy but is also associated with a risk of opportunistic infections or infections leading to hospitalisation in 10%.
CRIS-Team Scopus Importer:2021-11-05
Keywords: biologics; combination therapy; immune mediated inflammatory disease; inflammatory bowel disease; safety; small molecules; treatment

Safety and efficacy of intravenous cyclophosphamide pulse therapy in therapy refractory Crohn's disease patients - Hirschmann, S; Atreya, Raja; Englbrecht, Matthias; Neurath, Markus (Journal of Physiology and Pharmacology, 2017)
A major challenge in the management of persistently active Crohn's disease patient's refractory to treatment regimen following the current guidelines is the induction of remission, which is a prerequisite for subsequent maintenance therapy. The aim of this study was to evaluate both the clinical and endoscopic benefit of intravenous cyclophosphamide pulse therapy in patients with active and therapy refractory Crohn's disease. Nine patients with acute moderate to severe Crohn's disease, not responding to conventional as well as biological therapy regimen received 3 - 9 cycles of monthly treatments with intravenous cyclophosphamide (680 - 1000 mg) in an uncontrolled setting and were retrospectively analyzed. Eight of nine patients (88.9%) had a clinical response (measured by a decrease in the Harvey-Bradshaw index, HBI >= 3) and two of nine patients (22.2%) achieved clinical remission (HBI <= 4) at week 8 after two applications of intravenous cyclophosphamide therapy. These response and remission rates remained unchanged after individual completion of cyclophosphamide therapy. Median HBI decreased from 18 (7 - 25) at the beginning of therapy to 7 (3 - 18) at week 8. 5 of 9 patients (56%) showed endoscopic response (defined by a reduction of ulcers) and one patient (11%) reached endoscopic remission (defined by the absence of ulcers) after the last application of cyclophosphamide. Arthralgia, which was present in 4 of 9 (44%) patients, was unchanged in most patients after cyclophosphamide therapy, although one patient described a marked reduction in joint pain. Cyclophosphamide pulse therapy was well tolerated during the whole treatment course in all subjects. One patient with long-standing Crohn's disease was diagnosed with a high-grade intraepithelial neoplasia in the rectum and underwent surgical intervention, where the diagnosis of an early stage adenocarcinoma was made. We concluded that intravenous cyclophosphamide pulse therapy was well tolerated by most patients and effective for inducing clinical and endoscopic response and remission in patients with therapy refractory Crohn's disease. In patients who are unresponsive to available therapies, including available biological treatment options, cyclophosphamide therefore represents a potential option to induce therapeutic response, which must then be maintained by other treatment modalities.
EVALuna2:13423

Safety and tolerability of a single infusion of autologous ex vivo expanded regulatory T cells in adults with ulcerative colitis (ER-TREG 01): protocol of a phase 1, open-label, fast-track dose-escalation clinical trial - Voskens, Caroline; Stoica, Diane; Roessner, Susanne; Vitali, Francesco; Zundler, Sebastian; Rosenberg, Marita; Wiesinger, Manuel; Wunder, Jutta; Siegmund, Britta; Schuler-Thurner, Beatrice; Schuler, Gerold; Berking, Carola; et al. (BMJ Open, 2021)
Introduction Accumulating evidence suggests that the adoptive transfer of ex vivo expanded regulatory T cells (Treg) may overcome colitogenic immune responses in patients with inflammatory bowel diseases. The objective of the ER-TREG 01 trial is to assess safety and tolerability of a single infusion of autologous ex vivo expanded Treg in adults with ulcerative colitis.
CRIS-Team WoS Importer:2021-12-24

SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases - Simon, David; Tascilar, Koray; Fagni, Filippo; Krönke, Gerhard; Kleyer, Arnd; Meder, Christine; Meder, Christine; Atreya, Raja; Leppkes, Moritz; Kremer, Andreas E.; Pachowsky, Milena; Schuch, Florian; et al. (Annals of the Rheumatic Diseases, 2021)
Objectives: To better understand the factors that influence the humoral immune response to vaccination against SARS-CoV-2 in patients with immune-mediated inflammatory diseases (IMIDs). Methods: Patients and controls from a large COVID-19 study, with (1) no previous history of COVID-19, (2) negative baseline anti-SARS-CoV-2 IgG test and (3) SARS-CoV-2 vaccination at least 10 days before serum collection were measured for anti-SARS-CoV-2 IgG. Demographic, disease-specific and vaccination-specific data were recorded. Results: Vaccination responses from 84 patients with IMID and 182 controls were analysed. While all controls developed anti-SARS-CoV-2 IgG, five patients with IMID failed to develop a response (p=0.003). Moreover, 99.5% of controls but only 90.5% of patients with IMID developed neutralising antibody activity (p=0.0008). Overall responses were delayed and reduced in patients (mean (SD): 6.47 (3.14)) compared with controls (9.36 (1.85); p<0.001). Estimated marginal means (95% CI) adjusted for age, sex and time from first vaccination to sampling were 8.48 (8.12-8.85) for controls and 6.90 (6.45-7.35) for IMIDs. Significantly reduced vaccination responses pertained to untreated, conventionally and anticytokine treated patients with IMID. Conclusions: Immune responses against the SARS-CoV-2 are delayed and reduced in patients with IMID. This effect is based on the disease itself rather than concomitant treatment.
CRIS-Team Scopus Importer:2021-05-21
Keywords: biological therapy; COVID-19; epidemiology; vaccination

SARS-CoV-2 Virus Manifestations in the Gastrointestinal Tract: Therapeutic Implications - Jefremow, Andre; Neurath, Markus (Visceral Medicine, 2020)
Background: About 1 year ago a novel virus - SARS-CoV-2 - began to spread around the world. It can lead to the disease COVID-19, which has caused more than 1 million deaths already. Summary: While it was first recognized as a disease leading to pneumonia and lung failure, we know by now that COVID-19 is more complex. COVID-19 is a systemic hyperinflammatory disease affecting not only the lungs, but also many other organs. Especially the gastrointestinal (GI) tract is often involved in COVID-19. Key Messages: This review provides an overview of the different affected organs of the GI tract and offers information on how gastroenterologists should take care of their patients with different GI disorders.
CRIS-Team WoS Importer:2020-12-11

SCAMP3 is regulated by miR-128-3p and promotes the metastasis of hepatocellular carcinoma cells through EGFR-MAPK p38 signaling pathway - Kang, Le; Zhang, Zehua; Zhao, Ying (American Journal of Translational Research, 2021)
Purpose: To explore the regulatory mechanism of secretory carrier membrane protein 3 (SCAMP3) and miR-128-3p in hepatocellular carcinoma (HCC). Patients and methods: Cancer tissues and adjacent tissues of 52 HCC patients treated in our hospital were collected to explore the prognostic factors affecting their 3-year survival. HCC cells were purchased, the gene expression of Huh-7 and MHCC97 were adjusted by transfection, and the levels of SCAMP3, miR-128-3p, EGFR, p-EGFR, MAPK p38, p-MAPK p38, N-cadherin, vimentin, E-cadherin, cell proliferation, migration, invasion, apoptosis and epithelial-mesenchymal transition (EMT) were detected. A nude mouse model of HCC was constructed to verify the effects of transfection of mimics. Results: SCAMP3 was elevated in HCC patients and cancer tissues of HCC patients, while miR-128-3p showed opposite effects. High level SCAMP3 and low level miR-128-3p were related to poor prognosis of HCC. Both of them were correlated with excessive drinking history, N-stage, M-stage and pathological differentiation degree of HCC patients, as well as prognostic factors of HCC patients. SCAMP3 up-regulation or miR-128-3p down-regulation could promote HCC cell proliferation, migration, invasion, and transcription and protein levels of EGFR, p-EGFR, MAPK p38, p-MAPK p38, N-cadherin and vimentin, and inhibit HCC cell apoptosis and transcription and protein levels of E-cadherin. Dual luciferase reporter identified the targeting relationship between SCAMP3 and miR-128-3p. When both SCAMP3 and miR-128-3p were elevated or reduced, the biological manifestation of cells was not different from that of miR-NC transfected with unrelated sequences. Besides, miR-128-3p inhibited tumor growth in the HCC model in nude mice. Conclusion: SCAMP3 can be controlled by miR-128-3p and can mediate the EGFR-MAPK p38 signaling pathway to inhibit HCC cell metastasis, which is expected to become a promising therapeutic target for HCC.
CRIS-Team Scopus Importer:2021-01-22
Keywords: EGFR-MAPK p38; Hepatocellular carcinoma; Metastasis; MiR-128-3p; SCAMP3

Scavenging of bacteria or bacterial products by magnetic particles functionalized with a broad-spectrum pathogen recognition receptor motif offers diagnostic and therapeutic applications - Friedrich, Bernhard; Lyer, Stefan; Janko, Christina; Unterweger, Harald; Brox, Regine; Cunningham, Sarah; Dutz, Silvio; Taccardi, Nicola; Bikker, Floris J.; Hurle, Katrin; Sebald, Heidi; Lenz, Malte; et al. (Acta Biomaterialia, 2022)
Sepsis is a dysregulated host response of severe bloodstream infections, and given its frequency of occurrence and high mortality rate, therapeutic improvements are imperative. A reliable biomimetic strategy for the targeting and separation of bacterial pathogens in bloodstream infections involves the use of the broad-spectrum binding motif of human GP-340, a pattern-recognition receptor of the scavenger receptor cysteine rich (SRCR) superfamily that is expressed on epithelial surfaces but not found in blood. Here we show that these peptides, when conjugated to superparamagnetic iron oxide nanoparticles (SPIONs), can separate various bacterial endotoxins and intact microbes (E. coli, S. aureus, P. aeruginosa and S. marcescens) with high efficiency, especially at low and thus clinically relevant concentrations. This is accompanied by a subsequent strong depletion in cytokine release (TNF, IL-6, IL-1β, Il-10 and IFN-γ), which could have a direct therapeutic impact since escalating immune responses complicates severe bloodstream infections and sepsis courses. SPIONs are coated with aminoalkylsilane and capture peptides are orthogonally ligated to this surface. The particles behave fully cyto- and hemocompatible and do not interfere with host structures. Thus, this approach additionally aims to dramatically reduce diagnostic times for patients with suspected bloodstream infections and accelerate targeted antibiotic therapy. Statement of significance: Sepsis is often associated with excessive release of cytokines. This aspect and slow diagnostic procedures are the major therapeutic obstacles. The use of magnetic particles conjugated with small peptides derived from the binding motif of a broad-spectrum mucosal pathogen recognition protein GP-340 provides a highly efficient scavenging platform. These peptides are not found in blood and therefore are not subject to inhibitory mechanisms like in other concepts (mannose binding lectine, aptamers, antibodies). In this work, data are shown on the broad bacterial binding spectrum, highly efficient toxin depletion, which directly reduces the release of cytokines. Host cells are not affected and antibiotics not adsorbed. The particle bound microbes can be recultured without restriction and thus be used directly for diagnostics.
CRIS-Team Scopus Importer:2022-03-11
Keywords: GP-340; Magnetic nanoparticles; Pathogen binding; Sepsis; SRCR domain

Screening for Acromegaly in Patients with Carpal Tunnel Syndrome: A Prospective Study (ACROCARP) - Zoicas, Flavius; Kleindienst, Andrea; Mayr, Bernhard; Buchfelder, Michael; Megele, R.; Schöfl, Christof (Hormone and Metabolic Research, 2016)
Early diagnosis of acromegaly prevents irreversible comorbidities and facilitates surgical cure. Carpal tunnel syndrome (CTS) is common in acromegaly and patients have often undergone surgery for CTS prior to the diagnosis of acromegaly. We hypothesized that screening CTS-patients for acromegaly could facilitate active case-finding. We prospectively enrolled 196 patients [135 women, 56.9 (range 23-103) years] who presented with CTS for surgery. Patients were asked about 6 symptoms suggestive of acromegaly using a questionnaire calculating a symptom score (0-6 points), and insulin-like-growth factor 1 (IGF-1) was measured. If IGF-1 was increased, IGF-1 measurement was repeated, and random growth hormone (GH) and/or an oral glucose tolerance test (OGTT) with assessment of GH-suppression were performed. The mean symptom score was 1.7±1.3 points. Three patients reported the maximal symptom score of 6 points, but none of them had an increased IGF-1. There was no correlation between the symptom score and IGF-1-SDS (standard deviation score) (r=0.026; p=0.71). Four patients had an IGF-1>2 SDS. In 2 patients acromegaly was ruled out using random GH and OGTT. One patient had normal IGF-1 and random GH at follow-up. One patient refused further diagnostics. In this prospective cohort of patients with CTS, the observed frequency of acromegaly was at most 0.51% (95% CI 0.03 to 2.83%). In this prospective study, none of the 196 patients with CTS had proven acromegaly. Thus, we see no evidence to justify general screening of patients with CTS for acromegaly.
EVALuna2:2072

Scurvy : A rare differential diagnosis of rheumatic diseases - Hofheinz, K.; Ganzleben, Ingo; Schliep, S.; Wacker, J.; Schett, Georg; Manger, Bernhard (Zeitschrift für Rheumatologie, 2016)
In December 2014 a patient presented to our clinic with the clinical symptoms of vasculitis. However, treatment with glucocorticoids did not lead to any improvement; therefore, the differential diagnostics were extended to other indications and ultimately led to the diagnosis of scurvy.This article describes the clinical picture of scurvy and its relationship to rheumatic diseases based on a clinical case and additional information from the literature. Differences and similarities with important rheumatological disease symptoms are presented.Scurvy is a rare hypovitaminosis disease which can be manifested in different forms. In addition to vasculitis the symptoms can also resemble arthritis and hemarthrosis is a typical finding. These symptoms can be accompanied by unspecific manifestations, such as muscle pain and due to impaired collagen synthesis characteristic features, such as corkscrew hair can be observed. The causal therapy of scurvy is substitution of ascorbic acid.Scurvy is a rare differential diagnosis in the context of rheumatic diseases. The indications for scurvy can be a lack of response to immunosuppressive and immunomodulatory drugs as well as individual symptoms, such as corkscrew hair.
EVALuna2:2047

Seasonal Variation in Blood Pressure in 162,135 Patients With Type 1 or Type 2 Diabetes Mellitus - Hermann, Julia M.; Rosenbauer, Joachim; Dost, Axel; Steigleder-Schweiger, Claudia; Kiess, Wieland; Schöfl, Christof; Holl, Reinhard W. (Journal of Clinical Hypertension, 2016)
Seasonal variation in blood pressure (BP) has been observed in different populations. However, only few studies have focused on BP seasonality in diabetic patients. This study examined the seasonal patterns in BP in 62,589 patients with type 1 diabetes mellitus (T1DM) and in 99,546 patients with type 2 diabetes mellitus (T2DM) from the German/Austrian Diabetes Follow-up Registry. Adjusted mean BP values revealed seasonal cycles of 12 months, with higher BP in colder months. Using harmonic regression models, the estimated systolic BP difference throughout the year was 2.28/2.48 mm Hg in T1DM/T2DM (both P<.001). Interestingly, seasonal variation in diastolic BP was larger in T1DM than in T2DM (1.24/0.64 mm Hg, P<.001). A sex difference was observed in T1DM only, while age differences occurred in both types of diabetes. Correlations between BP and potentially related factors such as outdoor temperature indicated that reasons underlying BP seasonality are likely to be complex and vary by subgroup.
EVALuna2:2103

Segment-Based Spotting of Bowel Sounds Using Pretrained Models in Continuous Data Streams - Baronetto, Annalisa; Graf, Luisa; Fischer, Sarah; Neurath, Markus; Amft, Oliver (IEEE journal of biomedical and health informatics, 2023)
We analyse pretrained and non-pretrained deep neural models to detect 10-seconds Bowel Sounds (BS) audio segments in continuous audio data streams. The models include MobileNet, EfficientNet, and Distilled Transformer architectures. Models were initially trained on AudioSet and then transferred and evaluated on 84 hours of labelled audio data of eighteen healthy participants. Evaluation data was recorded in a semi-naturalistic daytime setting including movement and background noise using a smart shirt with embedded microphones. The collected dataset was annotated for individual BS events by two independent raters with substantial agreement (Cohen's Kappa κ =0.74). Leave-One-Participant-Out cross-validation for detecting 10-second BS audio segments, i.e. segment-based BS spotting, yielded a best F1 score of 73% and 67%, with and without transfer learning respectively. The best model for segment-based BS spotting was EfficientNet-B2 with an attention module. Our results show that pretrained models could improve F1 score up to 26%, in particular, increasing robustness against background noise. Our segment-based BS spotting approach reduces the amount of audio data to be reviewed by experts from 84 h to 11 h, thus by 87%.
CRIS-Team Scopus Importer:2023-06-02
Keywords: audio tagging; Bowel sound detection; Convolution; Data models; deep learning; Feature extraction; Neural networks; Recording; Training; transfer learning; Transfer learning

Seladelpar (MBX-8025), a selective PPAR-δ agonist, in patients with primary biliary cholangitis with an inadequate response to ursodeoxycholic acid: a double-blind, randomised, placebo-controlled, phase 2, proof-of-concept study - Jones, David; Boudes, Pol F.; Swain, Mark G.; Bowlus, Christopher L.; Galambos, Michael R.; Bacon, Bruce R.; Doerffel, Yvonne; Gitlin, Norman; Gordon, Stuart C.; Odin, Joseph A.; Sheridan, David; Woerns, Markus-Alexander; et al. (Lancet Gastroenterology and Hepatology, 2017)
BACKGROUND: Many patients with primary biliary cholangitis have an inadequate response to first-line therapy with ursodeoxycholic acid. Seladelpar is a potent, selective agonist for the peroxisome proliferator-activated receptor-delta (PPAR-δ), which is implicated in bile acid homoeostasis. This first-in-class study evaluated the anti-cholestatic effects and safety of seladelpar in patients with an inadequate response to ursodeoxycholic acid. METHODS: The study was a 12-week, double-blind, placebo-controlled, phase 2 trial of patients with alkaline phosphatase of at least 1·67 times the upper limit of normal (ULN) despite treatment with ursodeoxycholic acid. Patients, recruited at 29 sites in North America and Europe, were randomly assigned to placebo, seladelpar 50 mg/day, or seladelpar 200 mg/day while ursodeoxycholic acid was continued. Randomisation was done centrally (1:1:1) by a computerised system using an interactive voice-web response system with a block size of three. Randomisation was stratified by region (North America and Europe). The primary outcome was the percentage change from baseline in alkaline phosphatase over 12 weeks, analysed in the modified intention-to-treat (ITT) population (any randomised patient who received at least one dose of medication and had at least one post-baseline alkaline phosphatase evaluation). This study is registered with ClinicalTrials.gov (NCT02609048) and the EU Clinical Trials Registry (EudraCT2015-002698-39). FINDINGS: Between Nov 4, 2015, and May 26, 2016, 70 patients were screened at 29 sites in North America and Europe. During recruitment, three patients treated with seladelpar developed fully reversible, asymptomatic grade 3 alanine aminotransferase increases (one on 50 mg, two on 200 mg), ranging from just over five to 20 times the ULN; as a result, the study was terminated after 41 patients were randomly assigned. The modified ITT population consisted of 12 patients in the placebo group, 13 in the seladelpar 50 mg group, and 10 in the seladelpar 200 mg group. Mean changes from baseline in alkaline phosphatase were -2% (SD 16) in the placebo group, -53% (14) in the seladelpar 50 mg group, and -63% (8) in the seladelpar 200 mg group. Changes in both seladelpar groups versus placebo were significant (p<0·0001 for both groups vs placebo), with no significant difference between the two seladelpar groups (p=0·1729). All five patients who received seladelpar for 12 weeks had normal alkaline phosphatase values at the end of treatment, based on a central laboratory ULN for alkaline phosphatase of 116 U/L. The most frequently reported adverse events were pruritus (16%; one patient on placebo, four on seladelpar 50 mg, and one on seladelpar 200 mg), nausea (13%; one patient on placebo, three on seladelpar 50 mg, and one on seladelpar 200 mg), diarrhoea (10%; two patients on placebo, one on seladelpar 50 mg, and one on seladelpar 200 mg), dyspepsia (8%; two patients on seladelpar 50 mg and one on seladelpar 200 mg), muscle spasms (8%; three patients on seladelpar 200 mg), myalgia (8%; one patient on placebo and two on seladelpar 200 mg), and dizziness (8%; one patient on placebo and two on seladelpar 50 mg). INTERPRETATION: Seladelpar normalised alkaline phosphatase levels in patients who completed 12 weeks of treatment. However, treatment was associated with grade 3 increases in aminotransferases and the study was stopped early. The effects of seladelpar should be explored at lower doses. FUNDING: CymaBay Therapeutics.
EVALuna2:35253

Selective expression of constitutively activated STAT6 in intestinal epithelial cells promotes differentiation of secretory cells and protection against helminths - Schubart, Christoph; Krljanac, Branislav; Otte, Manuel; Symowski, Cornelia; Martini, Eva; Günther, Claudia; Becker, Christoph; Daniel, Christoph; Vöhringer, David (Mucosal Immunology, 2018)
Intestinal epithelial cells (IECs) constitute an important barrier between host and pathogen. Immune mechanisms that provide protection against gastrointestinal helminths often require IL-4Rα-induced activation of STAT6-regulated genes in IECs. However, it is not known whether STAT6 activation in IECs enhances protective immunity against helminths. Furthermore, the regulation of proliferation and differentiation processes of the intestinal epithelium by IEC-intrinsic STAT6 signaling remains unclear. To address these questions, we generated mice with specific expression of a constitutively active version of STAT6 in IECs. These VillinCre_STAT6vt mice show accumulation of secretory IECs, increased proliferation of IECs and lengthening of the small intestine. They rapidly expelled Nippostrongylus brasiliensis worms even in the absence of T cells. Furthermore, primary infection with Heligmosomoides polygyrus resulted in larval trapping in the submucosa and the fecundity of adult worms was severely impaired. Our results reveal an important IEC-intrinsic role of STAT6-regulated genes for intestinal homeostasis and protective immunity against helminths.
EVALuna2:35396

Selective Expression of the MAPK Phosphatase Dusp9/MKP-4 in Mouse Plasmacytoid Dendritic Cells and Regulation of IFN-? Production - Niedzielska, Magdalena; Mohamed Raffi, Faizal Ali; Tel, Jurjen; Muench, Sandra; Jozefowski, Katrin; Alati, Nour; Lahl, Katharina; Mages, Joerg; Billmeier, Ulrike; Schiemann, Matthias; Appelt, Uwe K.; Wirtz, Stefan; et al. (Journal of Immunology, 2015)
Plasmacytoid dendritic cells (pDCs) efficiently produce large amounts of type I IFN in response to TLR7 and TLR9 ligands, whereas conventional DCs (cDCs) predominantly secrete high levels of the cytokines IL-10 and IL-12. The molecular basis underlying this distinct phenotype is not well understood. In this study, we identified the MAPK phosphatase Dusp9/MKP-4 by transcriptome analysis as selectively expressed in pDCs, but not cDCs. We confirmed the constitutive expression of Dusp9 at the protein level in pDCs generated in vitro by culture with Flt3 ligand and ex vivo in sorted splenic pDCs. Dusp9 expression was low in B220(-) bone marrow precursors and was upregulated during pDC differentiation, concomitant with established pDC markers. Higher expression of Dusp9 in pDCs correlated with impaired phosphorylation of the MAPK ERK1/2 upon TLR9 stimulation. Notably, Dusp9 was not expressed at detectable levels in human pDCs, although these displayed similarly impaired activation of ERK1/2 MAPK compared with cDCs. Enforced retroviral expression of Dusp9 in mouse GM-CSF-induced cDCs increased the expression of TLR9-induced IL-12p40 and IFN-?, but not of IL-10. Conditional deletion of Dusp9 in pDCs was effectively achieved in Dusp9(flox/flox); CD11c-Cre mice at the mRNA and protein levels. However, the lack of Dusp9 in pDC did not restore ERK1/2 activation after TLR9 stimulation and only weakly affected IFN-? and IL-12p40 production. Taken together, our results suggest that expression of Dusp9 is sufficient to impair ERK1/2 activation and enhance IFN-? expression. However, despite selective expression in pDCs, Dusp9 is not essential for high-level IFN-? production by these cells.
EVALuna2:2008

Semantic segmentation of non-linear multimodal images for disease grading of inflammatory bowel disease: A segnet-based application - Pradhan, Pranita; Meyer, Tobias; Stallmach, Andreas; Waldner, Maximilian; Schmitt, Michael; Popp, Jürgen; Bocklitz, Thomas; Vieth, Michael (ICPRAM 2019 - Proceedings of the 8th International Conference on Pattern Recognition Applications and Methods, 2019)
Non-linear multimodal imaging, the combination of coherent anti-stokes Raman scattering (CARS), two-photon excited fluorescence (TPEF) and second harmonic generation (SHG), has shown its potential to assist the diagnosis of different inflammatory bowel diseases (IBDs). This label-free imaging technique can support the 'gold-standard' techniques such as colonoscopy and histopathology to ensure an IBD diagnosis in clinical environment. Moreover, non-linear multimodal imaging can measure biomolecular changes in different tissue regions such as crypt and mucosa region, which serve as a predictive marker for IBD severity. To achieve a real-time assessment of IBD severity, an automatic segmentation of the crypt and mucosa regions is needed. In this paper, we semantically segment the crypt and mucosa region using a deep neural network. We utilized the SegNet architecture (Badrinarayanan et al., 2015) and compared its results with a classical machine learning approach. Our trained SegNet model achieved an overall F1 score of 0.75. This model outperformed the classical machine learning approach for the segmentation of the crypt and mucosa region in our study.
CRIS-Team Scopus Importer:2019-05-02
Keywords: Inflammatory Bowel Disease; Non-linear Multimodal Imaging; Semantic Segmentation

Sensitive and specific detection of EML4-ALK rearrangements in non-small cell lung cancer (NSCLC) specimens by multiplex amplicon RNA massive parallel sequencing - Moskalev, Evgeny; Frohnauer, Judith; Merkelbach-Bruse, Sabine; Schildhaus, Hans-Ulrich; Dimmler, Arno; Schubert, Thomas; Boltze, Carsten; Koenig, Helmut; Fuchs, Florian; Sirbu, Horia; Rieker, Ralf J.; Agaimy, Abbas; et al. (Lung Cancer, 2014)
Recurrent gene fusions of anaplastic lymphoma receptor tyrosine kinase (ALK) and echinoderm microtubule-associated protein-like 4 (EML4) have been recently identified in 5% of non-small cell lung cancers (NSCLCs) and are targets for selective tyrosine kinase inhibitors. While fluorescent in situ hybridization (FISH) is the current gold standard for detection of EML4-ALK rearrangements, several limitations exist including high costs, time-consuming evaluation and somewhat equivocal interpretation of results. In contrast, targeted massive parallel sequencing has been introduced as a powerful method for simultaneous and sensitive detection of multiple somatic mutations even in limited biopsies, and is currently evolving as the method of choice for molecular diagnostic work-up of NSCLCs.We developed a novel approach for indirect detection of EML4-ALK rearrangements based on 454 massive parallel sequencing after reverse transcription and subsequent multiplex amplification (multiplex ALK RNA-seq) which takes advantage of unbalanced expression of the 5' and 3' ALK mRNA regions. Two lung cancer cell lines and a selected series of 32 NSCLC samples including 11 cases with EML4-ALK rearrangement were analyzed with this novel approach in comparison to ALK FISH, ALK qRT-PCR and EML4-ALK RT-PCR.The H2228 cell line with known EML4-ALK rearrangement showed 171 and 729 reads for 5' and 3' ALK regions, respectively, demonstrating a clearly unbalanced expression pattern. In contrast, the H1299 cell line with ALK wildtype status displayed no reads for both ALK regions. Considering a threshold of 100 reads for 3' ALK region as indirect indicator of EML4-ALK rearrangement, there was 100% concordance between the novel multiplex ALK RNA-seq approach and ALK FISH among all 32 NSCLC samples.Multiplex ALK RNA-seq is a sensitive and specific method for indirect detection of EML4-ALK rearrangements, and can be easily implemented in panel based molecular diagnostic work-up of NSCLCs by massive parallel sequencing.
EVALuna2:1847

Sequential Therapies in Well-Differentiated Gastrointestinal Neuroendocrine Tumors G3 (NET G3): Platinum-Based vs. Platinum-Free Regimens - Dal Buono, A.; Merola, E.; Delle Fave, G.; Wiedenmann, B.; Pavel, Marianne Ellen (2018)
EVALuna2:34081

SERIO - Side Effect Registry Immuno-Oncology Side Effect Registry for rare, severe and complex Side Effects of Immunotherapy - Kramer, Rafaela; Mentzer, D.; Erdmann, M.; Knauss, S.; Broeckelmann, P. J.; Hassel, J. C.; Ugurel, S.; Pavel, Marianne Ellen; Nickel, Franziska; Landendinger, M.; Fuchs, Friederike; Meidenbauer, Norbert; et al. (JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, 2020)
CRIS-Team WoS Importer:2020-09-11

Serio - Side Effect Registry in Immuno-Oncology - Koutzamanidis, Rafaela; Mentzer, Dirk; Knauss, Samuel; Broeckelmann, Paul J.; Hassel, Jessica Cecile; Ugurel-Becker, Selma; Pavel, Marianne Ellen; Nickel, Florian; Landendinger, Melanie; Fuchs, Florian; Meidenbauer, Norbert; Jefremow, Andre; et al. (ONCOLOGY RESEARCH AND TREATMENT, 2020)
CRIS-Team WoS Importer:2020-03-20

Seroprevalence of SARS-CoV2 in IBD patients treated with biologic therapy - Berte, Roberto; Mazza, Stefano; Stefanucci, Marta Rachele; Noviello, Daniele; Costa, Stefania; Ciafardini, Clorinda; Mileti, Erika; Mapelli, Marina; Pasqualato, Sebastiano; Pinto, Sergio; Favale, Agnese; Vecchi, Maurizio; et al. (Journal of Crohns & Colitis, 2021)
Background and Aims: A similar course of COVID-19 in patients with inflammatory bowel diseases [IBD] and in the general population has been reported. However, disease prevalence in IBD patients is presently unknown. In this prospective observational study, we aimed at determining SARS-CoV2 infection prevalence in IBD patients treated with biologic therapy. Methods: From IBD patients under biologic therapy and recruited from three different locations in Italy and Germany, 354 sera were evaluated for antibody presence by RBD ELISA. Control groups were: i] age-matched healthy subjects tested in the same time period in Milan, Italy; ii] healthy subjects collected in the pre-COVID era; iii] IBD patients under biologic therapy collected in the pre-COVID era. Results: Eight out of 354 patients tested positive for the anti-RBD-SARS-CoV2 IgG antibody [prevalence 2.3%]. The percentage of IgG-positive patients among those recruited from Milan was significantly higher than among those recruited from other locations [prevalence 5.4% vs 0.4%, p<0.005]. IgG-positive patients reported a significantly higher incidence of fever, anosmia, and ageusia, and were more likely to have entered into close contact with COVID-19-positive subjects before the study enrolment. Conclusions: Seroprevalence of SARS-CoV2 in IBD patients treated with biologic therapy reflects values measured in the local general population. Specific symptoms and contact history with SARS-CoV2-infected individuals strongly increase the likelihood of SARS-CoV2 seropositivity.
CRIS-Team Scopus Importer:2021-06-04
Keywords: anti-SARS-CoV2 antibodies; COVID-19; IBD; seroconversion

Serum Autotaxin Activity Correlates With Pruritus in Pediatric Cholestatic Disorders - Kremer, Andreas; Gonzales, Emmanuel; Schaap, Frank G.; Elferink, Ronald P. J. Oude; Jacquemin, Emmanuel; Beuers, Ulrich (Journal of Pediatric Gastroenterology and Nutrition, 2016)
Pruritus is a common symptom of cholestatic liver disorders. The present study aimed at evaluating autotaxin (ATX), a lysophospholipase recently identified as potential cause for cholestatic pruritus, in pediatric cholestatic diseases presenting with or without itching.A cohort of 45 children consisting of 14 patients experiencing itching (Alagille syndrome [n = 10], complete extrahepatic biliary atresia [n = 2], neonatal sclerosing cholangitis (n = 1), progressive familial intrahepatic cholestasis type 2 [n = 1]), 9 patients with bile acid synthesis defects (3?-hydroxy-C27-steroid-oxidoreductase [n = 7] and ?-3-oxosteroid-5?-reductase deficiency [n = 2]), and 22 healthy children were studied. Serum ATX activity and total serum bile salt were determined enzymatically, ATX protein content was semiquantified by Western blotting. Using real-time polymerase chain reaction, ATX mRNA expression was studied in HepG2 cells treated with farnesoid-X-receptor agonists or vehicle.Serum ATX activity was increased in pruritic children with Alagille and other cholestatic syndromes (mean ± standard deviation: 16.1 ± 4.3 nmol · mL · min) compared with children with nonpruritic cholestatic diseases with bile acid synthesis defects (10.4 ± 4.7 nmol · mL · min; P < 0.01) and healthy controls (7.6 ± 2.3 nmol · mL · min; P < 0.001). ATX protein levels closely correlated with serum ATX activity. Serum ATX activity and total serum bile salt showed a linear correlation with itch intensity (r = 0.66, P < 0.001 and r = 0.80, P < 0.001, respectively). No correlation was observed between ATX activity and bilirubin. ATX mRNA expression in HepG2 cells was not induced by farnesoid-X-receptor ligands.Serum ATX activity correlated with itch intensity in children with cholestatic diseases. Bile salts did not increase ATX expression in vitro. ATX inhibitors may be useful antipruritic agents in pediatric cholestatic disorders.
EVALuna2:2105

Serum Autotaxin is a Marker of the Severity of Liver Injury and Overall Survival in Patients with Cholestatic Liver Diseases - Wunsch, Ewa; Krawczyk, Marcin; Milkiewicz, Malgorzata; Trottier, Jocelyn; Barbier, Olivier; Neurath, Markus; Lammert, Frank; Kremer, Andreas; Milkiewicz, Piotr (Scientific Reports, 2016)
Autotaxin (ATX) is involved in the synthesis of lysophosphatidic acid. Both have recently been linked to cholestatic pruritus and liver injury. We aimed to investigate whether ATX is an indicator of cholestatic liver injury, health-related quality of life (HRQoL) and prognosis based on a group of 233 patients, 118 with primary biliary cholangitis (PBC) and 115 with primary sclerosing cholangitis (PSC). Patients were followed for 1-60 months, cumulative survival rates were calculated. ATX activity was significantly higher in both groups than in the 103 controls, particularly in patients with cirrhosis and in patients with longer disease duration. Ursodeoxycholic acid (UDCA) non-responders with PBC exhibited increased ATX activity. ATX activity was correlated with liver biochemistry, MELD, Mayo Risk scores and was associated with worse disease-specific HRQoL aspects. In both groups, Cox model analysis indicated that ATX was a negative predictor of survival. Increased ATX levels were associated with a 4-fold higher risk of death/liver transplantation in patients with PBC and a 2.6-fold higher risk in patients with PSC. We conclude that in patients with cholestatic conditions, ATX is not only associated with pruritus but also indicates impairment of other HRQoL aspects, liver dysfunction, and can serve as a predictor of survival.
EVALuna2:2194

Serum IP-10 levels and increased DPPIV activity are linked to circulating CXCR3+ T cells in cholestatic HCV patients - Rau, Monika; Schmitt, Johannes; Berg, Thomas; Kremer, Andreas; Stieger, Bruno; Spanaus, Katharina; Bengsch, Bertram; Romero, Marta R.; Marin, Jose J.; Keitel, Verena; Klinker, Hartwig; Tony, Hans-Peter; et al. (PLoS ONE, 2018)
BACKGROUND & AIMS: Serum interferon-gamma-inducible protein-10 (IP-10) is elevated in cholestatic liver diseases and predicts response to antiviral therapy in patients with chronic hepatitis C virus (HCV) infection. Dipeptidylpeptidase 4 (DPPIV) cleaves active IP-10 into an inactive form, which inhibits recruitment of CXCR3+ T cells to the liver. In this study the link between IP-10 levels, DPPIV activity in serum and CXCR3+ T cells is analysed in cholestatic and non-cholestatic liver patients. METHODS: In serum DPPIV activity (by enzymatic assay), IP-10 (by ELISA) and bile acids (BA) (by enzymatic assay) were analysed in 229 naive HCV genotype (GT) 1 patients and in 16 patients with cholestatic liver disease. In a prospective follow-up (FU) cohort of 27 HCV GT 1 patients peripheral CD3+CXCR3+, CD4+CXCR3+ and CD8+CXCR3+ cells were measured by FACS. RESULTS: In 229 HCV patients serum IP-10 levels correlated positively to DPPIV serum activity. Higher IP-10 levels and DPPIV activity were detected in cholestatic and in cirrhotic HCV patients. Increased IP-10 serum levels were associated with therapeutic non-response to antiviral treatment with pegylated-interferon and ribavirin. In the HCV FU cohort elevated IP-10 serum levels and increased BA were associated with higher frequencies of peripheral CD3+CXCR3+, CD4+CXCR3+ and CD8+CXCR3+ T cells. Positive correlation between serum IP-10 levels and DPPIV activity was likewise validated in patients with cholestatic liver diseases. CONCLUSIONS: A strong correlation between elevated serum levels of IP-10 and DPPIV activity was seen in different cholestatic patient groups. Furthermore, in cholestatic HCV patients a functional link to increased numbers of peripheral CXCR3+ immune cells could be observed. The source of DPPIV release in cholestatic patients remains open.
EVALuna2:35126

Serum miRNAs Support the Indication for MRI-Ultrasound Fusion-Guided Biopsy of the Prostate in Patients with Low-PI-RADS Lesions - Keck, Bastian; Borkowetz, Angelika; Pöllmann, Julia; Jansen, Thilo; Fischer, Moritz; Fuessel, Susanne; Kahlmeyer, Andreas; Wirth, Manfred; Huber, Johannes; Cavallaro, Alexander Josef; Hammon, Matthias; Platzek, Ivan; et al. (Cells, 2021)
Multiparametric MRI (mpMRI) and targeted biopsy of the prostate enhance the tumor detection rate. However, the prediction of clinically significant prostate cancer (PCa) is still limited. Our study tested the additional value of serum levels of selected miRNAs in combination with clinical and mpMRI information for PCa prediction and classification. A total of 289 patients underwent targeted mpMRI-ultrasound fusion-guided prostate biopsy complemented by systematic biopsy. Serum miRNA levels of miRNAs (miR-141, miR-375, miR-21-5p, miR-320b, miR-210-3p, let-7c, and miR-486) were determined by quantitative PCR. Detection of any PCa and of significant PCa were the outcome variables. The patient age, pre-biopsy PSA level, previous biopsy procedure, PI-RADS score, and serum miRNA levels were covariates for regularized binary logistic regression models. The addition of miRNA expression of miR-486 and let-7c to the baseline model, containing only clinical parameters, increased the predictive accuracy. Particularly in patients with PI-RADS ≤3, we determined a sensitivity for detecting significant PCa (Gleason score ≥ 7a corresponding to Grade group ≥2) of 95.2%, and an NPV for absence of significant PCa of 97.1%. This accuracy could be useful to support patient counseling in selected cases.
CRIS-Team Scopus Importer:2021-06-18
Keywords: diagnosis; microRNA; miRNA; mpMRI; PI-RADS; prostate biopsy; prostate cancer

Severe Acute Respiratory Syndrome Coronavirus 2 Attachment Receptor Angiotensin-Converting Enzyme 2 Is Decreased in Crohn's Disease and Regulated By Microbial and Inflammatory Signaling - Patankar, Jay Vasant; Lehmann, Malte; Kühl, Anja A.; Atreya, Raja; Becker, Christoph; Gonzalez-Acera, Miguel; Schmitt, Heike; Gamez-Belmonte, Reyes; Mahapatro, Mousumi; Diemand, Leonard; Hartmann, Leonie; Mascia, Fabrizio; et al. (Gastroenterology, 2021)
CRIS-Team Scopus Importer:2021-02-12

Severity of COVID-19 disease is related to hyperactivation and altered migratory capacity of T cells - Spörl, Silvia; Kremer, Anna-Lena; Aigner, Michael; Eisenhauer, Nina; Koch, P.; Meretuk, L.; Loeffler, P.; Lutzny-Geier, Gloria; Vetter, Marcel; Bruns, Heiko; Mackensen, Andreas; Kremer, Andreas; et al. (ONCOLOGY RESEARCH AND TREATMENT, 2021)
CRIS-Team WoS Importer:2022-03-25

Sex-dependent differences in the in vivo respiratory phenotype of the TASK-1 potassium channel knockout mouse - Jungbauer, Stefan; Buehler, Philipp Karl; Neubauer, Jacqueline; Haas, Cordula; Heitzmann, Dirk; Tegtmeier, Ines; Sterner, Christina; Barhanin, Jacques; Georgieff, Michael; Warth, Richard; Thomas, Jörg (Respiratory Physiology & Neurobiology, 2016)
TASK-1 potassium channels have been implicated in central and peripheral chemoreception; however, the precise contribution of TASK-1 for the control of respiration is still under debate. Here, we investigated the respiration of unrestrained adult and neonatal TASK-1 knockout mice (TASK-1(-/-)) using a plethysmographic device. Respiration in adult female TASK-1(-/-) mice under control (21% O2), hypoxia and hypercapnia was unaffected. Under acute hypoxia male TASK-1(-/-) mice exhibited a reduced increase of the respiratory frequency (fR) compared to wildtypes. However, the tidal volume (VT) of male TASK-1(-/-) mice was strongly enhanced. The volatile anesthetic isoflurane induced in male TASK-1(-/-) and male wild type mice (TASK-1(+/+)) a similar respiratory depression. Neonatal TASK-1(-/-) mice demonstrated a 30-40% decrease of the minute volume, caused by a reduction of the fR under control condition (21% O2). Under hypoxia, neonatal TASK-1(-/-) mice more frequently stopped breathing (apnea>3s) suggesting an increased hypoxia-sensitivity. As reported before, this increased hypoxia sensitivity had no influence on the survival rate of neonatal TASK-1(-/-) mice. In adult and neonatal mice, TASK-1 gene deletion induced a significant prolongation of the relaxation time (RT), which is a parameter for expiration kinetics. Additionally, screening for mutations in the human TASK-1 gene in 155 cases of sudden infant death syndrome (SIDS) was inconclusive. In conclusion, these data are suggestive for an increased hypoxia-sensitivity of neonatal TASK-1(-/-) mice, however, without causing an increase in neonatal lethality. In adult female TASK-1(-/-) mice respiration was unaffected, whereas adult male TASK-1(-/-) mice showed a modified breathing pattern. These results are suggestive for sex-specific mechanisms for compensating the inactivation of TASK-1 in mice.
EVALuna2:2227

Shear Wave Dispersion Imaging for the Characterization of Focal Liver Lesions - A Pilot study - Jesper, Daniel; Fiedler, Steffen; Klett, Daniel; Waldner, Maximilian; Schellhaas, Barbara; Zundler, Sebastian; Neurath, Markus; Pfeifer, Lukas (Ultraschall in der Medizin, 2021)
Purpose Shear wave dispersion imaging is a novel ultrasound-based technique, which analyzes the speed of different shear wave components depending on their frequency. The dispersion of shear wave speed correlates with the viscosity of the liver parenchyma. The aim of this prospective study was to evaluate the use of shear wave dispersion imaging in focal liver lesions in the non-cirrhotic liver. Methods Patients with unclear focal liver lesions in B-mode ultrasound were prospectively assigned to shear wave dispersion imaging (m/s/kHz). Measurements were conducted within the lesion and in the liver parenchyma of the right liver lobe using an intercostal window. Histology and contrast-enhanced ultrasound served as the reference for the characterization of the lesions. Results Out of 46 patients included in this study, 24 had liver metastases and 22 had benign liver lesions. Benign lesions consisted mostly of hemangiomas (n=12) and focal nodular hyperplasia (n=8). Malignant lesions showed significantly lower shear wave dispersion (13.0±2.45 m/s/kHz) compared to benign tumors (15.2±2.74 m/s/kHz, p<0.01). In further subgroup analysis, the difference was significant for hemangiomas (15.32±2.42 m/s/kHz, p=0.04) but not for FNHs (14.98±3.36 m/s/kHz, p=0.38). The dispersion of reference liver parenchyma did not differ significantly between the groups (p=0.54). Conclusion The quantification of viscosity by shear wave dispersion is a new parameter for the characterization of focal liver lesions with higher dispersion values in hemangiomas and lower dispersion values in metastases. However, it cannot differentiate reliably between benign and malignant lesions.
CRIS-Team Scopus Importer:2021-10-29
Keywords: focal liver lesion; shear wave dispersion; shear wave elastography; ultrasound

Shedding light on pediatric diseases: multispectral optoacoustic tomography at the doorway to clinical applications. - Regensburger, Adrian; Wagner, Alexandra; Claussen, Jing; Waldner, Maximilian; Knieling, Ferdinand (Molecular and Cellular Pediatrics, 2020)
Optoacoustic imaging (OAI), or photoacoustic imaging (PAI), has fundamentally influenced basic science by providing high-resolution visualization of biological mechanisms. With the introduction of multispectral optoacoustic tomography (MSOT), these technologies have now moved closer to clinical applications. MSOT utilizes short-pulsed near-infrared laser light to induce thermoelastic expansion in targeted tissues. This results in acoustic pressure waves, which are used to resolve specific endo- and exogenous chromophores. Especially in the pediatric population, this non-invasive imaging approach might hold fundamental advantages compared to conventional cross-sectional imaging modalities. As this technology allows the visualization of quantitative molecular tissue composition at high spatial resolution non-invasively in sufficient penetration depth, it paves the way to personalized medicine in pediatric diseases.
EVALuna2:383218

Siglec-H-Deficient Mice Show Enhanced Type I IFN Responses, but Do Not Develop Autoimmunity After Influenza or LCMV Infections - Szumilas, Nadine; Corneth, Odilia B.J.; Lehmann, Christian; Schmitt, Heike; Cunz, Svenia; Cullen, Jolie G.; Chu, Talyn; Marosán, Anita; Mócsai, Attila; Benes, Vladimir; Zehn, Dietmar; Dudziak, Diana; et al. (Frontiers in Immunology, 2021)
Siglec-H is a DAP12-associated receptor on plasmacytoid dendritic cells (pDCs) and microglia. Siglec-H inhibits TLR9-induced IFN-α production by pDCs. Previously, it was found that Siglec-H-deficient mice develop a lupus-like severe autoimmune disease after persistent murine cytomegalovirus (mCMV) infection. This was due to enhanced type I interferon responses, including IFN-α. Here we examined, whether other virus infections can also induce autoimmunity in Siglec-H-deficient mice. To this end we infected Siglec-H-deficient mice with influenza virus or with Lymphocytic Choriomeningitis virus (LCMV) clone 13. With both types of viruses we did not observe induction of autoimmune disease in Siglec-H-deficient mice. This can be explained by the fact that both types of viruses are ssRNA viruses that engage TLR7, rather than TLR9. Also, Influenza causes an acute infection that is rapidly cleared and the chronicity of LCMV clone 13 may not be sufficient and may rather suppress pDC functions. Siglec-H inhibited exclusively TLR-9 driven type I interferon responses, but did not affect type II or type III interferon production by pDCs. Siglec-H-deficient pDCs showed impaired Hck expression, which is a Src-family kinase expressed in myeloid cells, and downmodulation of the chemokine receptor CCR9, that has important functions for pDCs. Accordingly, Siglec-H-deficient pDCs showed impaired migration towards the CCR9 ligand CCL25. Furthermore, autoimmune-related genes such as Klk1 and DNase1l3 are downregulated in Siglec-H-deficient pDCs as well. From these findings we conclude that Siglec-H controls TLR-9-dependent, but not TLR-7 dependent inflammatory responses after virus infections and regulates chemokine responsiveness of pDCs.
CRIS-Team Scopus Importer:2021-09-17
Keywords: Interferon-alpha; plasmacytoid dendritic cells; Siglec; SLE; TLR9

Similar Inhibition of Dynamic Adhesion of Lymphocytes From IBD Patients to MAdCAM-1 by Vedolizumab and Etrolizumab-s - Binder, Marie-Theres; Becker, Emily; Wiendl, Maximilian; Schleier, Lena; Fuchs, Florian; Leppkes, Moritz; Atreya, Raja; Neufert, Clemens; Atreya, Imke; Neurath, Markus; Zundler, Sebastian (Inflammatory Bowel Diseases, 2018)
Background: Although anti-adhesion therapies are a novel mainstay in the treatment of inflammatory bowel diseases (IBDs), the mechanisms controlling integrin-dependent gut homing are poorly elucidated, and the available techniques for translational functional investigations are limited. Methods: We used dynamic adhesion assays to study adhesion of CD4+ T cells, CD8+ T cells, CD19+ B cells, and granulocytes to the addressins MAdCAM-1, VCAM-1, and ICAM-1. The effects of vedolizumab, natalizumab, etrolizumab-s, anti-CD11a, and anti-CD18 antibodies were explored. Results: Adhesion of peripheral blood leukocytes from IBD patients and control donors could be validly assessed, and integrin-mediated addressin adhesion could be specifically inhibited by anti-integrin antibodies. Numbers of adhering cells were partly, but not completely, related to integrin expression. Vedolizumab and etrolizumab-s resulted in similar reduction of adhesion to MAdCAM-1, and preliminary data proposed an association of dynamic adhesion to MAdCAM-1 with response to vedolizumab therapy. Conclusions: Dynamic adhesion assays are an easy and broadly applicable method for IBD research that is useful for future translational studies and potentially also for supporting clinical treatment decisions. 10.1093/ibd/izy077_video1izy077_Video_15786486962001.
EVALuna2:35167

Smad7 Antisense Oligonucleotide-Based Therapy in Crohn's Disease: Is it Time to Re-Evaluate? - Monteleone, Giovanni; Stolfi, Carmine; Marafini, Irene; Atreya, Raja; Neurath, Markus (Molecular Diagnosis & Therapy, 2022)
Abundant preclinical work showed that in Crohn's disease (CD), the defective activity of the immunosuppressive cytokine tumor necrosis factor (TGF)-beta 1 due to high levels of the intracellular inhibitor Smad7 contributes to amplify the tissue-damaging inflammatory response. Consistently, phase I and II studies documented clinical and endoscopic benefit in active CD patients treated with mongersen, an oral antisense oligonucleotide targeting Smad7. However, a multicenter, randomized, double-blind, placebo-controlled, phase III study was prematurely discontinued as a futility analysis showed that mongersen was not effective in CD patients. The reasons why the phase III study failed despite the fact that previous clinical trials documented the efficacy of the drug remain unknown. The primary objective of this Viewpoint was to provide clues about the factors explaining discrepancies among the clinical trials. We illustrate the recent data indicating that the various batches of mongersen, used during the phase III program, are chemically different, with some of them being unable to downregulate Smad7 expression. Overall, these findings suggest the necessity of new clinical studies to further evaluate the efficacy of chemically homogenous batches of mongersen in patients with inflammatory bowel diseases (IBDs), and, at the same time, they can help understand the failure of other clinical trials with antisense oligonucleotides in IBD (i.e. alicaforsen).
CRIS-Team WoS Importer:2022-07-29

Smad7 induces plasticity in tumor-infiltrating Th17 cells and enables TNF-alpha-mediated killing of colorectal cancer cells - Rizzo, Angelamaria; De Mare, Vincenzo; Rocchi, Chiara; Stolfi, Carmine; Colantoni, Alfredo; Neurath, Markus; Macdonald, Thomas T.; Pallone, Francesco; Monteleone, Giovanni; Fantini, Massimo C. (Carcinogenesis, 2014)
Transforming growth factor-beta (TGF-?) is deeply involved in colorectal cancer development and the disruption of the TGF-? signaling in dysplastic cells is required for tumor to grow. Nevertheless, tumor cells express TGF-? to escape the immune surveillance mediated by T cells. T-cell expression of Smad7, an intracellular inhibitor of the TGF-? signaling, protects against colitis-associated colorectal cancer. However, whether Smad7 in T cells might influence colorectal cancer growth independently of chronic inflammation and which T-cell subset is involved in this process is unknown. To address this issue, T-cell-specific Smad7 transgenic mice and wild-type (WT) littermates were subcutaneously transplanted with syngenic MC38 colon carcinoma cells. Smad7Tg mice were resistant to tumor development compared with WT mice and protection was dependent on CD4(+) T cells. Smad7 expression in T cells increased the number of tumor-infiltrating Tbet/ROR-?-t double-positive CD4 T cells characterized by the expression of tumor necrosis factor-alpha (TNF-?) and interferon-gamma but lower IL17A. The low expression of IL17A caused by the Smad7 expression in tumor-infiltrating CD4(+) T cells enabled the TNF-?-mediated killing of cancer cells both in vitro and in vivo, thus indicating that the Smad7-mediated plastic effect on T-cell phenotype induces protection against colorectal cancer.
EVALuna2:1879

Small and diminutive polyps: No cancer, no risk! - Neumann, Helmut; Hassan, Cesare (Digestive and Liver Disease, 2017)
EVALuna2:33926

Small but powerful: will nanoparticles be the future state‐of‐the‐art therapy for IBD? - Lechner, Kristina; Zeeshan, Mahira; Noack, Maxi; Ali, Hussain; Neurath, Markus; Weigmann, Benno (Expert Opinion on Drug Delivery, 2022)
Introduction: Inflammatory bowel disease (IBD) is the inflammatory condition of the gastrointestinal tract particularly affecting the colon and the ileum. IBD patients can have a very poor quality of life because of the limited therapeutic efficacy and accompanied adverse effects. Areas covered: The potential ways to employ nanoparticles to deliver drugs to a certain site of inflammation are discussed. The focus was set on the microenvironment in the gut as well as the mucosa, epithelial layer and the microbiota. Moreover, experimental animal colitis models were nanoparticles were used as a potential treatment are presented. Lastly, challenges for the potential clinical use in humans are discussed. Expert opinion: Although there still remain many open questions e.g. regarding the toxicity, the metabolism or the pharmacokinetics of nanoparticles further research on this topic could overcome these challenges. For example, instead of synthetically engineered particles, biodegradable components could be used. Since there have been a lot pf promising results in the recent years, we are sure that in the future nanoparticles will be developed in a way to ensure safe and targeted delivery of drugs to the site of inflammation.
CRIS-Team Scopus Importer:2022-03-18
Keywords: colon targeting; IBD; nanocarrier; nanoparticles; T cells

Small leucine-rich proteoglycans inhibit CNS regeneration by modifying the structural and mechanical properties of the lesion environment - Kolb, Julia; Tsata, Vasiliki; John, Nora; Kim, Kyoohyun; Möckel, Conrad; Rosso, Gonzalo; Kurbel, Veronika; Parmar, Asha; Sharma, Gargi; Karandasheva, Kristina; Abuhattum, Shada; Lyraki, Olga; et al. (Nature Communications, 2023)
Extracellular matrix (ECM) deposition after central nervous system (CNS) injury leads to inhibitory scarring in humans and other mammals, whereas it facilitates axon regeneration in the zebrafish. However, the molecular basis of these different fates is not understood. Here, we identify small leucine-rich proteoglycans (SLRPs) as a contributing factor to regeneration failure in mammals. We demonstrate that the SLRPs chondroadherin, fibromodulin, lumican, and prolargin are enriched in rodent and human but not zebrafish CNS lesions. Targeting SLRPs to the zebrafish injury ECM inhibits axon regeneration and functional recovery. Mechanistically, we find that SLRPs confer mechano-structural properties to the lesion environment that are adverse to axon growth. Our study reveals SLRPs as inhibitory ECM factors that impair axon regeneration by modifying tissue mechanics and structure, and identifies their enrichment as a feature of human brain and spinal cord lesions. These findings imply that SLRPs may be targets for therapeutic strategies to promote CNS regeneration.<br
Keywords: Biophysics; Mechanisms of disease; Spinal cord injury

SMARCA4-deficient pulmonary adenocarcinoma: clinicopathological, immunohistochemical, and molecular characteristics of a novel aggressive neoplasm with a consistent TTF1neg/CK7pos/HepPar-1pos immunophenotype - Agaimy, Abbas; Fuchs, Florian; Moskalev, Evgeny; Sirbu, Horia; Hartmann, Arndt; Haller, Florian (Virchows Archiv, 2017)
Alterations in SMARCA4, a member of the chromatin remodeling Switch Sucrose Non-Fermentable (SWI/SNF) complex, characterize a subset of non-small cell lung cancer (NSCLC), but detailed morphological and immunophenotypic description of this tumor type is lacking. We describe 20 NSCLC cases found on routine screening not to express SMARCA4 by immunohistochemistry (IHC). These tumors were stained for CK7, TTF1, SMARCA2, SMARCA4, SMARCB1, and HepPar-1 and analyzed for molecular alterations, using a 160 cancer-related gene panel including the full coding sequence of SMARCA4. Patients were eight females and 12 males aged 41 to 76 (median, 60). Of 18 tumors with detailed data, 14 presented with synchronous distant metastases (M1). Histological examination showed predominantly solid adenocarcinoma (n = 15), frankly rhabdoid (n = 3) and mucinous (n = 2) patterns. Except for the rhabdoid cases, all tumors showed at least focal unequivocal glands and lacked squamous differentiation, justifying a diagnosis of adenocarcinoma. IHC showed a distinctive uniform immunophenotype (CK7+/HepPar-1+/TTF1-) in 18/20 cases. Only 2/16 cases showed limited weak expression of neuroendocrine markers. EGFR mutations and EML4-ALK and ROS1 gene rearrangements were not found in any of the examined cases. Next-generation sequencing, using a 160 cancer-related gene panel, revealed concurrent SMARCA4 and TP53 mutations in nine of the 12 (75%) successfully tested cases. Our study highlights (1) the morphological diversity of SMARCA4-deficient lung adenocarcinoma, (2) the consistent absence of expression of TTF1 in the presence of expression of HepPar-1, (3) absence of EGFR driver mutations, and (4) frequent inactivating SMARCA4 mutations as underlying mechanism of the observed SMARCA4 protein loss. SMARCA4-deficient pulmonary adenocarcinoma is emerging as a distinctive, albeit phenotypically heterogeneous molecular subgroup of TTF1-negative NSCLC. Uniform HepPar-1 expression in this subset of NSCLC may represent a diagnostic pitfall and merits further studies to explore the mechanisms involved.
EVALuna2:34083

Smartphone-based multimodal tethered capsule endoscopic platform for white-light, narrow-band, and fluorescence/autofluorescence imaging - Sharma, Gargi; Thoma, Oana-Maria; Blessing, Katharina; Gal, Robert; Waldner, Maximilian; Singh, Kanwarpal (Journal of Biophotonics, 2020)
Multimodal low-cost endoscopy is highly desirable in poor resource settings such as in developing nations. In this work, we developed a smartphone-based low-cost, reusable tethered capsule endoscopic platform that allows white-light, narrowband, and fluorescence/autofluorescence imaging of the esophagus. The ex-vivo studies of swine esophagus were performed and compared with a commercial endoscope to test the white-light imaging capabilities of the endoscope. The efficacy of the capsule for narrow-band imaging was tested by imaging the vascularization of the tongue. To determine the autofluorescence/fluorescence capability of the endoscope, fluorescein dye with different concentrations was imaged. Furthermore, swine esophagus injected with fluorescein dye was imaged using the fluorescence/autofluorescence and the white-light imaging modules, ex-vivo. The overall cost of the capsules is approximately 12 euro, 15 euro, and 42 euro for the white light imaging, the narrow-band imaging, and the fluorescence/autofluorescence imaging respectively. In addition, the cost of the laser source module required for the narrow-band imaging and the fluorescence/autofluorescence imaging is approximately 218 euro. This device will open the possibility of imaging the esophagus in underprivileged areas.
CRIS-Team WoS Importer:2020-11-27

Smartphone-based multimodal tethered capsule endoscopic platform for white-light, narrow-band, and fluorescence/autofluorescence imaging - Sharma, Gargi; Thoma, Oana-Maria; Blessing, Katharina; Gall, Robert; Waldner, Maximilian; Singh, Kanwarpal (TRANSLATIONAL BIOPHOTONICS: DIAGNOSTICS AND THERAPEUTICS, 2021)
Multimodal low-cost endoscopy is desirable in poor resource settings. Here, we developed smartphone-based low-cost, reusable tethered capsule endoscope that allows white-light, narrowband, and fluorescence/autofluorescence imaging of esophagus Endoscopy is an integral part of the healthcare system for the diagnosis of diseases in the gastrointestinal tract. There are different types of endoscopes such as white-light [1], narrow-band [2], autofluorescence [3], confocal [4], Raman [5] imaging endoscopes, etc. which are used clinically as diagnostic or research tools. Out of these, white-light, narrow-band, and autofluorescence-based imaging techniques are the most commonly used for the diagnosis of complications related to the gastrointestinal tract. In this work, we demonstrate a smartphone-compatible, low-cost, reusable tethered capsule endoscopic platform capable of performing the three commonly used imaging modalities; white-light imaging (WLI), narrow-band imaging (NBI), and fluorescence/autofluorescence imaging (FI/AFI). Figure 1 (a) shows the design of our low-cost endoscope. We used an off the shelf USB powered camera fitted with white light LED’s around it for detection and illumination respectively. The camera unit was housed in 10 mm outer diameter, 6 mm inner diameter, and 26 mm long capsule. The capsule was fabricated in-house from transparent Fluorinated ethylene propylene (FEP). The camera processor transferred the images to the USB port using 5 electrical wires of diameter 0.15 mm each. These wires were placed in a reinforced polytetrafluoroethylene sheath. The camera, the video processor, and the LED light source were all operated by a 5V power supply delivered from a USB connection. The power emitted from the LED source was approximately 2.8 mW and an image size of 640×480 pixels was provided by the camera. This whole unit served as a tethered capsule WLI endoscop
CRIS-Team WoS Importer:2022-06-10
Keywords: Endoscopes; Endoscopy; Cameras; Light emitting diodes; Esophagus; Light sources; Medicine; Multimode fibers; Tongue; Video processing

SMYD2 Inhibition Downregulates TMPRSS2 and Decreases SARS-CoV-2 Infection in Human Intestinal and Airway Epithelial Cells - Yu, Yidong; Herrmann, Alexandra; Thonn, Veronika; Cordsmeier, Arne; Neurath, Markus; Enßer, Armin; Becker, Christoph (Cells, 2022)
The COVID-19 pandemic caused by SARS-CoV-2 has lasted for more than two years. Despite the presence of very effective vaccines, the number of virus variants that escape neutralizing antibodies is growing. Thus, there is still a need for effective antiviral treatments that target virus replication independently of the circulating variant. Here, we show for the first time that deficiency or pharmacological inhibition of the cellular lysine-methyltransferase SMYD2 decreases TMPRSS2 expression on both mRNA and protein levels. SARS-CoV-2 uses TMPRSS2 for priming its spike protein to infect target cells. Treatment of cultured cells with the SMYD2 inhibitors AZ505 or BAY598 significantly inhibited viral replication. In contrast, treatment of Vero E6 cells, which do not express detectable amounts of TMPRSS2, had no effect on SARS-CoV-2 infection. Moreover, by generating a recombinant reporter virus that expresses the spike protein of the Delta variant of SARS-CoV-2, we demonstrate that BAY598 exhibits similar antiviral activity against this variant of concern. In summary, SMYD2 inhibition downregulates TMPRSS2 and blocks viral replication. Targeting cellular SMYD2 represents a promising tool to curtail SARS-CoV-2 infection.
CRIS-Team Scopus Importer:2022-04-29
Keywords: antiviral treatment; AZ505; BAY598; COVID-19; SARS-CoV-2; SMYD2; TMPRSS2

SMYD2 targets RIPK1 and restricts TNF-induced apoptosis and necroptosis to support colon tumor growth - Yu, Yidong; Thonn, Veronika; Patankar, Jay; Thoma, Oana-Maria; Waldner, Maximilian; Zielinska, Marta; Bao, Lili; Gonzalez Acera, Miguel; Wallmueller, Stefan; Engel, Felix; Stürzl, Michael; Neurath, Markus; et al. (Cell Death & Disease, 2022)
SMYD2 is a histone methyltransferase, which methylates both histone H3K4 as well as a number of non-histone proteins. Dysregulation of SMYD2 has been associated with several diseases including cancer. In the present study, we investigated whether and how SMYD2 might contribute to colorectal cancer. Increased expression levels of SMYD2 were detected in human and murine colon tumor tissues compared to tumor-free tissues. SMYD2 deficiency in colonic tumor cells strongly decreased tumor growth in two independent experimental cancer models. On a molecular level, SMYD2 deficiency sensitized colonic tumor cells to TNF-induced apoptosis and necroptosis without affecting cell proliferation. Moreover, we found that SMYD2 targeted RIPK1 and inhibited the phosphorylation of RIPK1. Finally, in a translational approach, pharmacological inhibition of SMYD2 attenuated colonic tumor growth. Collectively, our data show that SMYD2 is crucial for colon tumor growth and inhibits TNF-induced apoptosis and necroptosis.
CRIS-Team WoS Importer:2022-01-21

Soluble CD83 ameliorates experimental colitis in mice - Eckhardt, Jenny; Kreiser, Simon; Döbbeler, Marina; Nicolette, C.; Debenedette, M. A.; Tcherepanova, I. Y.; Ostalecki, Christian; Pommer, A. J.; Becker, Christoph; Günther, Claudia; Zinser, E.; Mak, T. W.; et al. (Mucosal Immunology, 2014)
The physiological balance between pro- and anti-inflammatory processes is dysregulated in inflammatory bowel diseases (IBD) as in Crohn's disease and ulcerative colitis. Conventional therapy uses anti-inflammatory and immunosuppressive corticosteroids to treat acute-phase symptoms. However, low remission rate and strong side effects of these therapies are not satisfying. Thus, there is a high medical need for new therapeutic strategies. Soluble CD83, the extracellular domain of the transmembrane CD83 molecule, has been reported to have interesting therapeutic and immunosuppressive properties by suppressing dendritic cell (DC)-mediated T-cell activation and inducing tolerogenic DCs. However, the expression and function of CD83 in IBD is still unknown. Here, we show that CD83 expression is upregulated by different leukocyte populations in a chemical-induced murine colitis model. Furthermore, in this study the potential of sCD83 to modulate colitis using an experimental murine colitis model was investigated. Strikingly, sCD83 ameliorated the clinical disease symptoms, drastically reduced mortality, and strongly decreased inflammatory cytokine expression in mesenteric lymph nodes and colon. The infiltration of macrophages and granulocytes into colonic tissues was vigorously inhibited. Mechanistically, we could show that sCD83-induced expression of indolamine 2,3-dioxygenase is essential for its protective effects.
EVALuna2:1840

Soluble CD83 Triggers Resolution of Arthritis and Sustained Inflammation Control in IDO Dependent Manner - Royzman, Dmytro; Andrev, Darja; Stich, Lena; Rauh, Manfred; Bäuerle, Tobias; Ellmann, Stephan; Boon, Louis; Kindermann, Markus; Peckert, Katrin; Bozec, Aline; Schett, Georg; Steinkasserer, Alexander; et al. (Frontiers in Immunology, 2019)
Interference with autoimmune-mediated cytokine production is a key yet poorly developed approach to treat autoimmune and inflammatory diseases such as rheumatoid arthritis. Herein, we show that soluble CD83 (sCD83) enhances the resolution of autoimmune antigen-induced arthritis (AIA) by strongly reducing the expression levels of cytokines such as IL-17A, IFN gamma, IL-6, and TNF alpha within the joints. Noteworthy, also the expression of RANKL, osteoclast differentiation, and joint destruction was significantly inhibited by sCD83. In addition, osteoclasts which were cultured in the presence of synovial T cells, derived from sCD83 treated AIA mice, showed a strongly reduced number of multinuclear large osteoclasts compared to mock controls. Enhanced resolution of arthritis by sCD83 was mechanistically based on IDO, since inhibition of IDO by 1-methyltryptophan completely abrogated sCD83 effects on AIA. Blocking experiments, using anti-TGF-beta antibodies further revealed that also TGF-beta is mechanistically involved in the sCD83 induced reduction of bone destruction and cartilage damage as well as enhanced resolution of inflammation. Resolution of arthritis was associated with increased numbers of regulatory T cells, which are induced in a sCD83-IDO-TGF-beta dependent manner. Taken together, sCD83 represents an interesting approach for downregulating cytokine production, inducing regulatory T cells and inducing resolution of autoimmune arthritis.
CRIS-Team WoS Importer:2019-04-12

Sonographische Differenzialdiagnostik fokaler Leberläsionen - Zundler, Sebastian; Strobel, Deike (Die Gastroenterologie, 2023)
Rapid diagnostic assessment is crucial for the clinical management of focal liver lesions. In addition to standard B-mode sonography, color-coded Doppler sonography and contrast-enhanced ultrasound are widely used for the classification of liver tumors. In gastroenterology, clinical sonography plays an important role in the detection of tumors, in the follow-up of oncological patients and for the screening for hepatocellular carcinoma. Thereby, correctly classifying focal liver lesions essentially requires the interpretation of ultrasound findings in the clinical context (e.g., incidental finding, known risk factors, history of liver cirrhosis or malignant disease). In this review, we summarize the available ultrasound techniques for the characterization of focal liver lesions and discuss their importance and relevance for the differential diagnosis and further diagnostic and therapeutic management.
CRIS-Team WoS Importer:2023-03-03

Spartalizumab in metastatic, well/poorly differentiated neuroendocrine neoplasms - Yao, James C.; Strosberg, Jonathan; Fazio, Nicola; Pavel, Marianne Ellen; Bergsland, Emily; Ruszniewski, Philippe; Halperin, Daniel M.; Li, Daneng; Tafuto, Salvatore; Raj, Nitya; Campana, Davide; Hijioka, Susumu; et al. (Endocrine-Related Cancer, 2021)
Spartalizumab, a humanized anti-programmed death protein 1 (PD-1) MAB, was evaluated in patients with well-differentiated metastatic grade 1/2 neuroendocrine tumors (NET) and poorly differentiated gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC). In this phase II, multicenter, single-arm study, patients received spartalizumab 400 mg every 4 weeks until confirmed disease progression or unacceptable toxicity. The primary endpoint was confirmed overall response rate (ORR) according to blinded independent review committee using response evaluation criteria in solid tumors 1.1. The study enrolled 95 patients in the NET group (30, 32 and 33 in the thoracic, gastrointestinal, and pancreatic cohorts, respectively), and 21 patients in the GEP-NEC group. The ORR was 7.4% (95% CI: 3.0, 14.6) in the NET group (thoracic, 16.7%; gastrointestinal, 3.1%; pancreatic, 3.0%), which was below the predefined success criterion of ≥10%, and 4.8% (95% CI: 0.1, 23.8) in the GEP-NEC group. In the NET and GEP-NEC groups, the 12-month progression-free survival was 19.5 and 0%, respectively, and the 12-month overall survival was 73.5 and 19.1%, respectively. The ORR was higher in patients with ≥1% PD-L1 expression in immune/tumor cells or ≥1% CD8+ cells at baseline. The most common adverse events considered as spartalizumab-related included fatigue (29.5%) and nausea (10.5%) in the NET group, and increased aspartate and alanine aminotransferases (each 14.3%) in the GEP-NEC group. The efficacy of spartalizumab was limited in this heterogeneous and heavily pre-treated population; however, the results in the thoracic cohort are encouraging and warrants further investigation. Adverse events were manageable and consistent with previous experience.
CRIS-Team Scopus Importer:2021-05-14
Keywords: Gastroenteropancreatic neuroendocrine carcinomas; Neuroendocrine tumors; Programmed death protein 1 inhibitor; Spartalizumab

Spätfolgen nach Immuntherapie: Immunvermittelte Nebenwirkungen von Checkpointinhibitoren - Duong, Sophie L.; Zierold, Sarah; Kramer, Rafaela; Reincke, Martin; Kerl-French, Katrin; Boehmerle, Wolfgang; Pavel, Marianne Ellen; Weckbach, Ludwig; French, Lars E.; Knauss, Samuel; Heinzerling, Lucie (Onkologe, 2021)
Background: Immune checkpoint inhibitors (ICIs) are potent immunotherapeutic agents for many tumor entities. However, ICIs can induce immune-related adverse events (irAE) that can potentially affect any organ system, causing life-changing sequelae or even death. These irAEs can occur months after termination of immunotherapy and long-term effects may persist for years after finishing therapy. Due to expanding clinical indications for ICIs including therapy in earlier tumor stages, the risk–benefit analysis needs to take into account these long-term side effects. Objectives: The sequelae of ICI therapy are reviewed and the international online registry Side Effect Registry Immuno-Oncology (SERIO) for the unified collection and characterization of irAEs is introduced. Materials and methods: We analyzed data from SERIO and performed a selective literature search in the databases PubMed, Cochrane Central Register of Controlled Trials and Google Scholar to characterize, analyze and summarize long-term sequelae of irAE induced by ICI therapy. Results: The most commonly observed irAEs with long-term sequelae involve the skin (leucotrichia, melanoma-associated hypopigmentation) and endocrine irAEs (thyroiditis, hypophysitis, adrenalitis and diabetes). While the former is especially stigmatizing, endocrine irAEs usually require long-term hormone substitution. Neurologic and cardiologic irAEs are relatively rare, but they are associated with severe complications leading to increased morbidity and mortality. Conclusions: Until now, prospective data about long-term consequences of irAEs are lacking. The SERIO registry addresses this need as irAEs are collected to enable long-term follow-up and optimized management.
CRIS-Team Scopus Importer:2021-05-21
Keywords: Benefit-risk assessment; Data collection; Hypopigmentation; Neoplasms; Registries

Specific Induction of Double Negative B Cells During Protective and Pathogenic Immune Responses - Ruschil, Christoph; Gabernet, Gisela; Lepennetier, Gildas; Heumos, Simon; Kaminski, Miriam; Hracsko, Zsuzsanna; Irmler, Martin; Beckers, Johannes; Ziemann, Ulf; Nahnsen, Sven; Owens, Gregory P.; Bennett, Jeffrey L.; et al. (Frontiers in Immunology, 2020)
Double negative (DN) (CD19(+)CD20(low)CD27(-)IgD(-)) B cells are expanded in patients with autoimmune and infectious diseases; however their role in the humoral immune response remains unclear. Using systematic flow cytometric analyses of peripheral blood B cell subsets, we observed an inflated DN B cell population in patients with variety of active inflammatory conditions: myasthenia gravis, Guillain-Barre syndrome, neuromyelitis optica spectrum disorder, meningitis/encephalitis, and rheumatic disorders. Furthermore, we were able to induce DN B cells in healthy subjects following vaccination against influenza and tick borne encephalitis virus. Transcriptome analysis revealed a gene expression profile in DN B cells that clustered with naive B cells, memory B cells, and plasmablasts. Immunoglobulin VH transcriptome sequencing and analysis of recombinant antibodies revealed clonal expansion of DN B cells that were targeted against the vaccine antigen. Our study suggests that DN B cells are expanded in multiple inflammatory neurologic diseases and represent an inducible B cell population that responds to antigenic stimulation, possibly through an extra-follicular maturation pathway.
CRIS-Team WoS Importer:2021-01-22

SPIONs functionalized with small peptides for binding of lipopolysaccharide, a pathophysiologically relevant microbial product. - Karawacka, Weronika; Janko, Christina; Unterweger, Harald; Mühlberger, Marina; Lyer, Stefan; Taccardi, Nicola; Mokhir, Andriy; Jira, Wolfgang; Peukert, Wolfgang; Boccaccini, Aldo R.; Kolot, Mikhail; Strauss, Richard; et al. (Colloids and Surfaces B-Biointerfaces, 2018)
Systemic inflammation such as sepsis represents an acute life-threatening condition, to which often no timely remedy can be found. A promising strategy may be to functionalize magnetic nanoparticles with specific peptides, derived from the binding motives of agglutinating salivary proteins, that allow immobilization of pathogens. In this work, superparamagnetic iron oxide nanoparticles with stable polycondensed aminoalkylsilane layer were developed, to which the heterobifunctional linkers N-succinimidyl 3-(2-pyridyldithio)-propanoate (SDPD) and N-succinimidyl bromoacetate (SBA) were bound. These linkers were further chemoselectively reacted with the thiol group of singularly present cysteines of selected peptides. The resulting functional nanoparticles underwent a detailed physicochemical characterization. The biocompatibility of the primarily coated aminoalkylsilane particles was also investigated. To test the pathogen-binding efficacy of the particles, the lipopolysaccharide-immobilization capacity of the peptide-coated particles was compared with free peptides. Here, one particle-bound peptide species succeeded in capturing 90% of the toxin, whereas the degree of immobilization of the toxin with a system that varied in the sequence of the peptide dropped to 35%. With these promising results, we hope to develop extracorporeal magnetic clearance systems for removing pathogens from the human body in order to accelerate diagnosis and alleviate acute disease conditions such as sepsis.

Spontaneous activity of specific C-nociceptor subtypes from diabetic patients and mice: Involvement of reactive dicarbonyl compounds and (sensitized) transient receptor potential channel A1 - Becker, Anna; Babes, Alexandru; Düll, Miriam; Khalil, Mohammad; Kender, Zoltan; Gröner, Jan; Namer, Barbara; Reeh, Peter; Sauer, Susanne (Journal of the Peripheral Nervous System, 2023)
Background: Diabetic metabolism causes changes of the chemical milieu including accumulation of reactive carbonyl species, for example, methylglyoxal (MGO). MGO activates chemosensitive TRPA1 on nociceptors, but the contribution to neuronal pathophysiology causing pain and hyperalgesia in diabetic neuropathy is not fully understood. Methods: We employed single-nerve-fiber recordings in type 2 diabetes patients with (spDN) and without cutaneous pain (DN) and in streptozotocin-diabetic and healthy mice. In mice, we measured Ca++ transients in cultured DRG neurons and stimulated CGRP release from hairy skin. Results: In diabetic patients, we recorded a large proportion of pathologically altered nerve C-fibers (79%). In spDN patients we found a higher percentage (72%) of spontaneously active C-nociceptors than in DN patients (15%). The proportion of spontaneous activity was highest among pathological fibers with mechanoinsensitive fiber properties which are particularly sensitive to MGO in contrast to mechanosensitive fibers. Mouse polymodal nociceptors, in contrast to purely mechanosensitive C-fibers, showed highest prevalence of TRPA1-related chemosensitivity. In diabetic mice about 37% of polymodal nociceptors developed spontaneous activity and exhibited significantly greater MGO responses, indicating sensitized TRPA1 receptors. Low-threshold mechanosensitive Aδ-fibers were vigorously activated by MGO but independently of TRPA1 activation. Interpretation: Our translational findings suggest that TRPA1-expressing C-nociceptors, which in human correspond to mechanoinsensitive and in mice to polymodal nociceptors, are especially vulnerable to develop spontaneous activity. Those two different nociceptor classes might share the functional role as dicarbonyl-sensitive chemosensors and represent the critical nociceptor population that support the development of pain and hyperalgesia in diabetic neuropathy.
CRIS-Team Scopus Importer:2023-05-19
Keywords: calcitonin gene-related peptide; cutaneous nociceptor; excitability; mechanoinsensitive C-fiber; methylglyoxal; microneurography; neuropathic pain

Staining and magnifying the mucosa: are biopsies no longer required? - Neumann, Helmut; Moenkemueller, Klaus (Endoscopy, 2014)
EVALuna2:1889

Standardized Diagnosis and Documentation of Contrast Liver Ultrasonography (CEUS LI-RADS) - Schellhaas, Barbara (Zeitschrift für Gastroenterologie, 2018)
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STAT1 coordinates intestinal epithelial cell death during gastrointestinal infection upstream of Caspase-8 - Stolzer, Iris; Schickedanz, Laura; Chiriac, Mircea T.; López-Posadas, Rocío; Grassl, Guntram A.; Mattner, Jochen; Wirtz, Stefan; Neurath, Markus; Günther, Claudia; Winner, Beate (Mucosal Immunology, 2021)
Intestinal homeostasis and the maintenance of the intestinal epithelial barrier are essential components of host defense during gastrointestinal Salmonella Typhimurium infection. Both require a strict regulation of cell death. However, the molecular pathways regulating epithelial cell death have not been completely understood. Here, we elucidated the contribution of central mechanisms of regulated cell death and upstream regulatory components during gastrointestinal infection. Mice lacking Caspase-8 in the intestinal epithelium are highly sensitive towards bacterial induced enteritis and intestinal inflammation, resulting in an enhanced lethality of these mice. This phenotype was associated with an increased STAT1 activation during Salmonella infection. Cell death, barrier breakdown and systemic infection were abrogated by an additional deletion of STAT1 in Casp8ΔIEC mice. In the absence of epithelial STAT1, loss of epithelial cells was abolished which was accompanied by a reduced Caspase-8 activation. Mechanistically, we demonstrate that epithelial STAT1 acts upstream of Caspase-8-dependent as well as -independent cell death and thus might play a major role at the crossroad of several central cell death pathways in the intestinal epithelium. In summary, we uncovered that transcriptional control of STAT1 is an essential host response mechanism that is required for the maintenance of intestinal barrier function and host survival.
CRIS-Team Scopus Importer:2021-09-17

STAT1 deficiency supports PD-1/PD-L1 signaling resulting in dysfunctional TNFα mediated immune responses in a model of NSCLC - Friedrich, Juliane; Heim, Lisanne; Trufa, Denis; Sirbu, Horia; Rieker, Ralf; Neurath-Finotto, Susetta; Chiriac, Mircea-Teodor (Oncotarget, 2018)
In this study we described that Signal Transducer and Activator of Transcription 1 (STAT1) is a key point regulator of PD-1 in tumour infiltrating lymphocytes and PD-L1 in Tumour associated macrophages (TAM) in NSCLC. In our murine model of adenocarcinoma targeted deletion of Stat1 was found associated with enhanced tumour growth, impaired differentiation into M1-like macrophages from the bone marrow, the accumulation of tumor associated macrophages overexpressing PD-L1 and impaired T cell responses in the tumor microenvironment by affecting TNFα responses. In our human NSCLC patient cohort we found that loss of isoforms STAT1 α and STAT1β mRNA in the tumoural region of the lung correlates with increased tumor size in NSCLC patients. Therefore, STAT1 isoform regulation could be considered for future therapeutical strategies associated to current immune-checkpoint blockade therapy in NSCLC.
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STAT2 Controls Colorectal Tumorigenesis and Resistance to Anti-Cancer Drugs - Chiriac, Mircea-Teodor; Hracsko, Zsuzsanna; Becker, Christoph; Neurath, Markus (Cancers, 2023)
Colorectal cancer (CRC) is a significant socioeconomic burden in modern society and is accountable for millions of premature deaths each year. The role of signal transducer and activator of transcription 2 (STAT2)-dependent signaling in this context is not yet fully understood, and no therapies targeting this pathway are currently being pursued. We investigated the role of STAT2 in CRC using experimental mouse models coupled with RNA-sequencing (RNA-Seq) data and functional assays with anti-cancer agents in three-dimensional tumoroids. Stat2−/− mice showed greater resistance to the development of CRC in both inflammation-driven and inflammation-independent experimental CRC models. In ex vivo studies, tumoroids derived from Stat2−/− mice with the multiple intestinal neoplasia (Min) mutant allele of the adenomatous polyposis coli (Apc) locus exhibited delayed growth, were overall smaller and more differentiated as compared with tumoroids from ApcMin/+ wildtype (WT) mice. Notably, tumoroids from ApcMin/+ Stat2−/− mice were more susceptible to anti-cancer agents inducing cell death by different mechanisms. Our findings clearly indicated that STAT2 promotes CRC and suggested that interventions targeting STAT2-dependent signals might become an attractive therapeutic option for patients with CRC.
CRIS-Team Scopus Importer:2023-12-15
Keywords: anti-cancer therapy; Apc; colorectal cancer mouse model; STAT2; tumoroid

STAT3 Activation in Th17 and Th22 Cells Controls IL-22-Mediated Epithelial Host Defense during Infectious Colitis - Backert, Ingo; Koralov, Sergei B.; Wirtz, Stefan; Kitowski, Vera; Billmeier, Ulrike; Martini, Eva; Hofmann, Katharina; Hildner, Kai; Wittkopf, Nadine; Brecht, Katrin; Waldner, Maximilian; Rajewsky, Klaus; et al. (Journal of Immunology, 2014)
The Citrobacter rodentium model mimics the pathogenesis of infectious colitis and requires sequential contributions from different immune cell populations, including innate lymphoid cells (ILCs) and CD4(+) lymphocytes. In this study, we addressed the role of STAT3 activation in CD4(+) cells during host defense in mice against C. rodentium. In mice with defective STAT3 in CD4(+) cells (Stat3(?CD4)), the course of infection was unchanged during the innate lymphoid cell-dependent early phase, but significantly altered during the lymphocyte-dependent later phase. Stat3(?CD4) mice exhibited intestinal epithelial barrier defects, including downregulation of antimicrobial peptides, increased systemic distribution of bacteria, and prolonged reduction in the overall burden of C. rodentium infection. Immunomonitoring of lamina propria cells revealed loss of virtually all IL-22-producing CD4(+) lymphocytes, suggesting that STAT3 activation was required for IL-22 production not only in Th17 cells, but also in Th22 cells. Notably, the defective host defense against C. rodentium in Stat3(?CD4) mice could be fully restored by specific overexpression of IL-22 through a minicircle vector-based technology. Moreover, expression of a constitutive active STAT3 in CD4(+) cells shaped strong intestinal epithelial barrier function in vitro and in vivo through IL-22, and it promoted protection from enteropathogenic bacteria. Thus, our work indicates a critical role of STAT3 activation in Th17 and Th22 cells for control of the IL-22-mediated host defense, and strategies expanding STAT3-activated CD4(+) lymphocytes may be considered as future therapeutic options for improving intestinal barrier function in infectious coliti
EVALuna2:1843

STAT3 activation through IL-6/IL-11 in cancer-associated fibroblasts promotes colorectal tumour development and correlates with poor prognosis - Heichler, Christina; Scheibe, Kristina; Schmied, Anabel; Geppert, Carol-Immanuel; Schmid, Benjamin; Wirtz, Stefan; Thoma, Oana Maria; Kramer, Viktoria; Waldner, Maximilian; Büttner, Christian; Farin, Henner; Pešić, Marina; et al. (Gut, 2019)
Objective: Cancer-associated fibroblasts (CAFs) influence the tumour microenvironment and tumour growth. However, the role of CAFs in colorectal cancer (CRC) development is incompletely understood. Design: We quantified phosphorylation of STAT3 (pSTAT3) expression in CAFs of human colon cancer tissue using a tissue microarray (TMA) of 375 patients, immunofluorescence staining and digital pathology. To investigate the functional role of CAFs in CRC, we took advantage of two murine models of colorectal neoplasia and advanced imaging technologies. In loss-of-function and gain-of-function experiments, using genetically modified mice with collagen type VI (COLVI)-specific signal transducer and activator of transcription 3 (STAT3) targeting, we evaluated STAT3 signalling in fibroblasts during colorectal tumour development. We performed a comparative gene expression profiling by whole genome RNA-sequencing of fibroblast subpopulations (COLVI+ vs COLVI-) on STAT3 activation (IL-6 vs IL-11). Results: The analysis of pSTAT3 expression in CAFs of human TMAs revealed a negative correlation of increased stromal pSTAT3 expression with the survival of colon cancer patients. In the loss-of-function and gain-of-function approach, we found a critical role of STAT3 activation in fibroblasts in driving colorectal tumourigenesis in vivo. With different imaging technologies, we detected an expansion of activated fibroblasts in colorectal neoplasias. Comparative gene expression profiling of fibroblast subpopulations on STAT3 activation revealed the regulation of transcriptional patterns associated with angiogenesis. Finally, the blockade of proangiogenic signalling significantly reduced colorectal tumour growth in mice with constitutive STAT3 activation in COLVI+ fibroblasts. Conclusion: Altogether our work demonstrates a critical role of STAT3 activation in CAFs in CRC development.
CRIS-Team Scopus Importer:2019-11-19
Keywords: colorectal cancer

Store-operated calcium entry is reduced in spastin-linked hereditary spastic paraplegia - Winner, Beate; Rizo Garza, Tania; Gebhardt, Lisa; Riedlberger, Julia; Eberhardt, Esther; Fester, Lars; Alansary, Dalia; Winkler, Jürgen; Turan, Sören; Arnold, Philipp; Niemeyer, Barbara; Fischer, Michael (2022)
Pathogenic variants in SPAST, the gene coding for spastin, are the single most common cause of hereditary spastic paraplegia, a progressive motor neuron disease. Spastin regulates key cellular functions, including microtubule-severing and endoplasmic reticulum-morphogenesis. However, it remains unclear how alterations in these cellular functions due to SPAST pathogenic variants result in motor neuron dysfunction. Since spastin influences both microtubule network and endoplasmic reticulum structure, we hypothesized that spastin is necessary for the regulation of Ca2+ homeostasis via store-operated calcium entry. Here, we show that the lack of spastin enlarges the endoplasmic reticulum and reduces store-operated calcium entry. In addition, elevated levels of different spastin variants induced clustering of STIM1 within the endoplasmic reticulum, altered the transport of STIM1 to the plasma membrane and reduced store-operated calcium entry, which could be rescued by exogenous expression of STIM1. Importantly, store-operated calcium entry was strongly reduced in induced pluripotent stem cell-derived neurons from hereditary spastic paraplegia patients with pathogenic variants in SPAST resulting in spastin haploinsufficiency. These neurons developed axonal swellings in response to lack of spastin. We were able to rescue both store-operated calcium entry and axonal swellings in SPAST patient neurons by restoring spastin levels, using CRISPR/Cas9 to correct the pathogenic variants in SPAST. These findings demonstrate that proper amounts of spastin are a key regulatory component for store-operated calcium entry mediated Ca2+ homeostasis and suggest store-operated calcium entry as a disease relevant mechanism of spastin-linked motor neuron disease.Rizo et al. use iPSC-derived neurons from patients to investigate how pathogenic variants in SPAST give rise to hereditary spastic paraplegia. They show that dysregulation of spastin, a microtubule- and ER-remodelling protein encoded by SPAST, alters the dynamics of the ER, resulting in aberrant Ca2+ regulation.
Keywords: spastin; STIM1; microtubules; endoplasmic reticulum; store-operated calcium entry

Strategies for targeting cytokines in inflammatory bowel disease - Neurath, Markus (Nature reviews. Immunology, 2024)
Cytokines produced by immune cells contribute to the development and perpetuation of inflammatory bowel disease (IBD), namely Crohn’s disease and ulcerative colitis, by regulating various aspects of the inflammatory response. Pro-inflammatory cytokines trigger chronic intestinal inflammation, tissue damage, carcinogenesis and perpetuation of disease and suppress the resolution of inflammation in IBD. The clinical success of antibodies that neutralize tumour necrosis factor (TNF) and the cytokine IL-12p40 in individuals with IBD has underscored this concept. Moreover, genetic and preclinical studies have emphasized the crucial role of IL-23 in IBD, leading to clinical approval of antibodies targeting this cytokine. Multiple studies have also investigated the administration of cytokines with assumed anti-inflammatory effects, but this approach has yet to show any real clinical benefit in individuals with IBD. Recent studies have targeted the cytokine network through the use of multi-cytokine blockers (for example, Janus kinase (JAK) inhibitors), IL-2-induced regulatory T cells or advanced combination therapies that use multiple cytokine blockers simultaneously (for example, anti-TNF along with anti-IL-23 antibodies). This Review will focus on our current understanding of how cytokines produced by innate and adaptive immune cells contribute to IBD pathogenesis and discuss how their modulation may inform future treatments for IBD.
CRIS-Team Scopus Importer:2024-03-29

Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases - De With, K.; Allerberger, F.; Amann, S.; Apfalter, P.; Brodt, H. -R.; Eckmanns, T.; Fellhauer, M.; Geiss, H. K.; Janata, O.; Krause, R.; Lemmen, S.; Meyer, E.; et al. (Infection, 2016)
In the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was developed by the German Society for Infectious Diseases in association with the following societies, associations and institutions: German Society of Hospital Pharmacists, German Society for Hygiene and Microbiology, Paul Ehrlich Society for Chemotherapy, The Austrian Association of Hospital Pharmacists, Austrian Society for Infectious Diseases and Tropical Medicine, Austrian Society for Antimicrobial Chemotherapy, Robert Koch Institute.A structured literature research was performed in the databases EMBASE, BIOSIS, MEDLINE and The Cochrane Library from January 2006 to November 2010 with an update to April 2012 (MEDLINE and The Cochrane Library). The grading of recommendations in relation to their evidence is according to the AWMF Guidance Manual and Rules for Guideline Development.The guideline provides the grounds for rational use of antibiotics in hospital to counteract antimicrobial resistance and to improve the quality of care of patients with infections by maximising clinical outcomes while minimising toxicity. Requirements for a successful implementation of ABS programmes as well as core and supplemental ABS strategies are outlined. The German version of the guideline was published by the German Association of the Scientific Medical Societies (AWMF) in December 2013.
EVALuna2:2073

Streptozotocin, 1982-2022: Forty Years from the FDA's Approval to Treat Pancreatic Neuroendocrine Tumors - Capdevila, Jaume; Ducreux, Michel; García Carbonero, Rocio; Grande, Enrique; Halfdanarson, Thorvardur; Pavel, Marianne Ellen; Tafuto, Salvatore; Welin, Staffan; Valentí, Vicente; Salazar, Ramón (Neuroendocrinology, 2022)
In May 1982, the US Food and Drug Administration (FDA) approved the use of streptozotocin to treat pancreatic neuroendocrine tumors (panNETs). Thus, this year marks 40 years since that landmark date. This review of streptozotocin to treat panNETs is intended to commemorate this anniversary. A historical perspective of the chemical structure, pharmacokinetics, and mechanism of action of streptozotocin is followed by data from prospective and retrospective clinical studies. The last section of the review addresses the latest aspects and takes note of the prospects that lie ahead on the future horizon of the use of streptozotocin to treat panNETs, including ongoing clinical trials.
CRIS-Team Scopus Importer:2022-12-02
Keywords: Historical review; Pancreatic neuroendocrine tumors; Streptozotocin

Stresswahrnehmung, Persönlichkeitsmerkmale, psychosoziale Beeinträchtigungen und Bewältigungsstrategien bei Patienten mit chronisch-entzündlichen Darmerkrankungen - Petruo, Vanessa A.; Krauss, Ekaterina; Kleist, Anika; Hardt, Juliane; Hake, Karsten; Peirano, Julia; Krause, Thomas; Ehehalt, Robert; von Arnauld de la Perriére, Philipp; Büning, Jürgen; Treml, Oliver; Krauss, Norbert; et al. (Zeitschrift für Gastroenterologie, 2019)
BACKGROUND AND AIMS: This study examined differences in personality, psychological distress, and stress coping in inflammatory bowel disease (IBD) depending on type of disease and disease activity. We compared patients suffering from Crohn's disease (CD) and ulcerative colitis (UC) with controls. While the literature is replete with distinctive features of the pathogenesis of IBD, the specific differences in psychological impairments are not well studied. METHODS: In this German national multicenter study, participants were recruited from 32 centers. Two hundred ninety-seven questionnaires were included, delivering vast information on disease status and psychological well-being based on validated instruments with a total of 285 variables. RESULTS: CD patients were more affected by psychological impairments than patients suffering from UC or controls. Importantly, patients with active CD scored higher in neuroticism (p < 0.01), psychological distress (p < 0.001) and maladaptive stress coping (escape, p = 0.03; rumination, p < 0.03), but less need for social support (p = 0.001) than controls. In contrast, patients suffering from active UC showed psychological distress (p < 0.04) and maladaptive coping (avoidance, p < 0.03; escape, p = 0.01). Patients in remission seemed to be less affected. In particular, patients with UC in remission were not inflicted by psychological impairments. The group of CD patients in remission however, showed insecurity (p < 0.01) and paranoid ideation (p = 0.04). CONCLUSIONS: We identified specific aspects of psychological impairment in IBD depending on disease and disease activity. Our results underscore the need for psychological support and treatment particularly in active CD.
CRIS-Team Scopus Importer:2019-05-02

Structural insights into heme binding to IL-36α proinflammatory cytokine - Wißbrock, Amelie; Goradia, Nishit B.; Kumar, Amit; Paul George, Ajay Abisheck; Kühl, Toni; Bellstedt, Peter; Ramachandran, Ramadurai; Hoffmann, Patrick; Galler, Kerstin; Popp, Jürgen; Neugebauer, Ute; Hampel, Kornelia; et al. (Scientific Reports, 2019)
Cytokines of the interleukin (IL)-1 family regulate immune and inflammatory responses. The recently discovered IL-36 family members are involved in psoriasis, rheumatoid arthritis, and pulmonary diseases. Here, we show that IL-36α interacts with heme thereby contributing to its regulation. Based on in-depth spectroscopic analyses, we describe two heme-binding sites in IL-36α that associate with heme in a pentacoordinated fashion. Solution NMR analysis reveals structural features of IL-36α and its complex with heme. Structural investigation of a truncated IL-36α supports the notion that the N-terminus is necessary for association with its cognate receptor. Consistent with our structural studies, IL-36-mediated signal transduction was negatively regulated by heme in synovial fibroblast-like synoviocytes from rheumatoid arthritis patients. Taken together, our results provide a structural framework for heme-binding proteins and add IL-1 cytokines to the group of potentially heme-regulated proteins.
CRIS-Team Scopus Importer:2019-11-26

STW-5 exerts anti- nociceptive and anti-inflammatory effects - Engel, Matthias; Khalil, M.; Zhang, Z. (2018)
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Subjective and Objective Olfactory Abnormalities in Crohn's disease - Fischer, Marie; Zopf, Yurdagül; Elm, Cornelia; Pechmann, Georg; Hahn, Eckhart Georg; Schwab, Dieter; Kornhuber, Johannes; Thürauf, Norbert (Chemical Senses, 2014)
The pathogenesis of Crohn's disease (CD) is still unknown, but the involvement of the olfactory system in CD appears possible. No study to date has systematically assessed the olfactory function in CD patients. We investigated the olfactory function in CD patients in active (n = 31) and inactive disease (n = 27) and in a control group of age- and sex-matched healthy subjects (n = 35). Subjective olfactory testing was applied using the Sniffin' Sticks test. For olfactory testing, olfactory event-related potentials (OERPs) were obtained with a 4-channel olfactometer using phenyl ethyl alcohol (PEA) and hydrogen sulfide (H2S). Carbon dioxide (CO2) was employed as control stimulus, and chemosomatosensory event-related potentials (CSSERPs) were registered. Results of the Sniffin' Sticks test revealed significantly different olfactory hedonic judgment with increased olfactory hedonic estimates for pleasant odorants in CD patients in active disease compared with healthy subjects. A statistical trend was found toward lower olfactory thresholds in CD patients. In objective olfactory testing, CD patients showed lower amplitudes of OERPs and CSSERPs. Additionally, OERPs showed significantly shorter N1- and P2 latencies following stimulation of the right nostril with H2S in CD patients in inactive disease compared with controls. Our study demonstrates specific abnormalities of olfactory perception in CD patients.
EVALuna2:1836

Submucosal injection of the oligonucleotide STNM01 is able to induce clinical remission, mucosal healing and histological response in left-sided ulcerative colitis patients with moderate-to-severe disease - Atreya, Raja; Kuehbacher, T.; Waldner, Maximilian; Hirschmann, S.; Drvarov, O.; Abu Hashem, R.; Maaser, C.; Kucharzik, T.; Dinter, J.; Schramm, C.; Mertens, J.; Holler, B.; et al. (2017)
EVALuna2:33827

Subtype specific expression of radioligand targets in the prospective Real World clinico-pathological register trial BRIDGister - Wirtz, R.; Friedersdorff, F.; Barski, D.; Otto, T.; Bug, R.; Veltrup, E.; Kilic, E.; Hake, R.; Eidt, S.; Waldner, M.; Grabowski, P.; Pavel, Marianne Ellen; et al. (EUROPEAN UROLOGY, 2022)
CRIS-Team WoS Importer:2022-07-22

Successful cyclosporin and ustekinumab combination therapy in a patient with severe steroid-refractory ulcerative colitis - Ganzleben, Ingo; Geppert, Carol-Immanuel; Osaba, Lourdes; Hirschmann, Simon; Nägel, Andreas; Glück, Christian; Hoffman, Arthur; Rath, Timo; Nagore, Daniel; Neurath, Markus; Atreya, Raja (Therapeutic Advances in Gastroenterology, 2020)
The therapeutic management of patients with severe steroid-refractory ulcerative colitis still represents a critical clinical challenge. In this setting, cyclosporin is an effective and rapidly acting induction treatment that is applied in combination with maintenance therapeutic agents like thiopurines or vedolizumab. Here, we present the case of a 33-year-old ulcerative colitis patient with severe steroid-refractory ulcerative colitis who refused surgical intervention and previously demonstrated no long-term benefit to anti-TNF antibody, vedolizumab, cyclosporin, thiopurines or tofacitinib treatment. Intravenous cyclosporin therapy was re-initiated in the patient and, after signs of clinical response, therapy with ustekinumab was additionally applied. After 11 weeks of well tolerated cyclosporin and ustekinumab combination therapy, cyclosporin was discontinued upon clinical and endoscopic remission. Subsequently, ustekinumab treatment has been effective in maintaining remission during the follow-up period of 195 days.
CRIS-Team Scopus Importer:2020-10-23
Keywords: cyclosporin; trough levels; ulcerative colitis; ustekinumab

Successful Long-term Treatment of Diversion Colitis with Topical Coconut Oil Application - Zundler, Sebastian; Dietz, Lisa; Matzel, Klaus E.; Geppert, Carol-Immanuel; Becker, Emily; Rath, Timo; Neurath, Markus; Atreya, Raja (American Journal of Gastroenterology, 2018)
CRIS-Team WoS Importer:2019-02-22

Successful Multidisciplinary Treatment with Secondary Metastatic Liver Resection after Downsizing by Palliative Second-Line Treatment of Colorectal Cancer: A Curative Option - Wein, Axel; Görtz, Rüdiger; Wolff, Kerstin; Ostermeier, Nicola; Busse, Daniel; Kremer, Andreas; Koch, Franz; Hagel, Alexander; Farnbacher, Michael; Kammerer, Ferdinand J.; Neurath, Markus; Grützmann, Robert; et al. (Case Reports in Oncology, 2016)
The prognostic outcome following progression after palliative first-line treatment for patients suffering from metastatic colorectal adenocarcinoma is generally poor. Long-term relapse-free survival with palliative second-line treatment may be achieved in only a limited number of individual cases.A 37-year-old patient presented with bilobar liver metastases of colon cancer confirmed by histology with wild-type K-RAS (exon 2). Due to progressive disease after eight cycles of first-line therapy with FOLFIRI plus cetuximab, second-line chemotherapy with modified FOLFOX4 (mFOLFOX4) plus bevacizumab was initiated. During four cycles of mFOLFOX4 plus bevacizumab (2 months), no higher-grade toxicity occurred. Liver MRI with contrast medium revealed downsizing of the segment II/III metastases, as well as regressive, small, faint, hardly definable lesions in segments VI and IVb. The interdisciplinary tumor board of the University of Erlangen thus decided to perform resection of the liver metastases. Segments II and III were resected, and the liver metastases in segments IVa and VI were excised (R0). Histopathology confirmed three of the R0-resected metastases to be completely necrotic, with residual scarring. As perioperative therapy, four additional cycles of mFOLFOX4 plus bevacizumab were administered postoperatively. No higher-grade toxicity was observed. Three years after the initial diagnosis, the patient is relapse free, professionally fully reintegrated, and has an excellent performance status.Patients suffering from metastatic colorectal cancer may benefit from multidisciplinary treatment with secondary metastatic liver resection after downsizing by palliative second-line treatment. In individual cases, patients may even have a curative treatment option, provided that close interdisciplinary collaboration exists.
EVALuna2:2220

Successful therapy of Clostridium difficile infection with fecal microbiota transplantation - Konturek, P C; Koziel, J; Dieterich, Walburga; Haziri, D; Wirtz, Stefan; Glowczyk, I; Konturek, K; Neurath, Markus; Zopf, Yurdagül (Journal of Physiology and Pharmacology, 2016)
Clostridium difficile infection (CDI) is the most common cause of infectious diarrhea and represents an important burden for healthcare worldwide. Symptoms of severe CDI include watery, foul-smelling diarrhea, peripheral leucocytosis, increased C-reactive protein (CRP), acute renal failure, hypotension and pseudomembranous colitis. Recent studies indicate that the main cause of CDI is dysbiosis, an imbalance in the normal gut microbiota. The restoration of a healthy gut microbiota composition via fecal microbiota transplantation (FMT) recently became more popular. The aim of the present study was to assess the effect of FMT on the healing of CDI and to analyze the changes in the level of pro-inflammatory markers (C-reactive protein, fecal calprotectin) and pro-inflammatory cytokines. Eighteen patients with CDI were included in our study (6 males and 12 females) with recurrent and/or severe CDI. The FMT was performed in 17 patients using colonoscopy, including 16 patients receiving a one-time FMT and 1 patient who needed 2 additional FMTs. One patient was treated with a single round of FMT using push-and-pull enteroscopy. In all CDI patients, before and 3 weeks after FMT, the following parameters were analyzed: C-reactive protein, fecal calprotectin, and plasma interleukin (IL)-6, IL-8 and IL-12, and tumor necrosis factor-alpha (TNF-?). In addition, the plasma level of LL-37, a cathelicidine peptide was assessed by fluorescence-activated cell sorting (FACS) before and 3 months after FMT. Finally, in 7 patients a microbiome analysis was performed by sequencing of 16SrRNA in stool probes obtained before and 3 weeks after FMT. The healing rate of CDI was 94%. In all successfully treated patients no recurrent CDI was observed during follow-up (16 months). The serum level of pro-inflammatory cytokines (TNF-?, IL-1?, IL-6, IL-8 and IL-12) significantly decreased after FMT. Similarly, CRP and fecal calprotectin normalized after FMT. 3 months after FMT a significant increase of LL-37 in the plasma of successfully treated patients was monitored. The sequencing analysis demonstrated an elevated abundance of beneficial bacterial species such as Lactobacillaceae, Ruminococcaceae, Desulfovibrionaceae, Sutterellaceae and Porphyromonodacea after FMT. No serious side effects were observed. We concluded that FMT represented a very effective and safe treatment of recurrent and/or severe CDI and led to favorable shifts in the composition of gut microbiome.
EVALuna2:2225

Successful Therapy of Crohn's Disease-Associated Pulmonary Necrobiotic Nodules on Ustekinumab Therapy - Ganzleben, Ingo; Hirschmann, Simon; Köhler, Juliane; Fuchs, Florian; Rieker, Ralf; Baer, Eva; Klenske, Entcho; Nagore, Daniel; Neurath, Markus; Atreya, Raja (American Journal of Gastroenterology, 2020)
CRIS-Team Scopus Importer:2020-07-10

Successful treatment of COVID-19 infection with convalescent plasma in B-cell-depleted patients may promote cellular immunity - Kremer, Andreas E.; Kremer, Anita; Willam, Carsten; Völkl, Simon; Verhagen, Johan; Achenbach, Susanne; van der Meijden, Edith; Lang, Vanessa; Aigner, Michael; Maier, Clara; Tenbusch, Matthias; Korn, Klaus; et al. (European Journal of Immunology, 2021)
Treatment with convalescent plasma has been shown to be safe in coronavirus disease in 2019 (COVID-19) infection, although efficacy reported in immunocompetent patients varies. Nevertheless, neutralizing antibodies are a key requisite in the fight against viral infections. Patients depleted of antibody-producing B cells, such as those treated with rituximab (anti-CD20) for hematological malignancies, lack a fundamental part of their adaptive immunity. Treatment with convalescent plasma appears to be of general benefit in this particularly vulnerable cohort. We analyzed clinical course and inflammation markers of three B-cell-depleted patients suffering from COVID-19 who were treated with convalescent plasma. In addition, we measured serum antibody levels as well as peripheral blood CD38/HLA-DR-positive T-cells ex vivo and CD137-positive T-cells after in vitro stimulation with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-derived peptides in these patients. We observed that therapy with convalescent plasma was effective in all three patients and analysis of CD137-positive T-cells after stimulation with SARS-CoV-2 peptides showed an increase in peptide-specific T-cells after application of convalescent plasma. In conclusion, we here demonstrate efficacy of convalescent plasma therapy in three B-cell-depleted patients and present data that suggest that while application of convalescent plasma elevates systemic antibody levels only transiently, it may also boost specific T-cell responses.
CRIS-Team Scopus Importer:2021-09-17
Keywords: B-cell deficiency; convalescent plasma; COVID-19; SARS-CoV-2; T-cell immunity

Successful treatment of COVID-19 with convalescent plasma in B-cell depleted patients may promote cellular immunity - Kremer, Andreas; Kremer, Anita; Willam, Carsten; Verhagen, Johan; Achenbach, Susanne; Van Der Meiden, E.; Lang, Vanessa; Aigner, M.; Maier, Clara; Tenbusch, Matthias; Korn, Klaus; Lutzny-Geier, Gloria; et al. (ONCOLOGY RESEARCH AND TREATMENT, 2021)
CRIS-Team WoS Importer:2022-03-25

Surface Design Options in Polymer- and Lipid-Based siRNA Nanoparticles Using Antibodies - Gabel, Michael; Knauß, Annkathrin; Fischer, Dagmar; Neurath, Markus; Weigmann, Benno (International Journal of Molecular Sciences, 2022)
The mechanism of RNA interference (RNAi) could represent a breakthrough in the therapy of all diseases that arise from a gene defect or require the inhibition of a specific gene expression. In particular, small interfering RNA (siRNA) offers an attractive opportunity to achieve a new milestone in the therapy of human diseases. The limitations of siRNA, such as poor stability, inefficient cell uptake, and undesired immune activation, as well as the inability to specifically reach the target tissue in the body, can be overcome by further developments in the field of nanoparticulate drug delivery. Therefore, types of surface modified siRNA nanoparticles are presented and illustrate how a more efficient and safer distribution of siRNA at the target site is possible by modifying the surface properties of nanoparticles with antibodies. However, the development of such efficient and safe delivery strategies is currently still a major challenge. In consideration of that, this review article aims to demonstrate the function and targeted delivery of siRNA nanoparticles, focusing on the surface modification via antibodies, various lipid- and polymer-components, and the therapeutic effects of these delivery systems.
CRIS-Team Scopus Importer:2022-12-09
Keywords: antibody; gene delivery; lipid nanoparticle; polymer nanoparticle; siRNA; surface-functionalized nanoparticles; targeted drug delivery

Surgery with Radical Intent: Is There an Indication for G3 Neuroendocrine Neoplasms? - Merola, Elettra; Rinke, Anja; Partelli, Stefano; Gress, Thomas M.; Andreasi, Valentina; Kollar, Attila; Perren, Aurel; Christ, Emanuel; Panzuto, Francesco; Pascher, Andreas; Jann, Henning; Arsenic, Ruza; et al. (Annals of Surgical Oncology, 2019)
Background: While platinum-based chemotherapy represents the standard treatment for advanced grade 3 (G3) neuroendocrine neoplasms (NENs) according to the European Neuroendocrine Tumor Society guidelines, the role of radical-intended surgery in these patients, as well as the use of adjuvant chemotherapy, are still controversial. The aim of the present work is to describe, in a retrospective series of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) G3, the overall survival (OS) rate and risk factors for death after radical surgery. Secondary aims are the description of median recurrence-free survival (RFS) and of the role of adjuvant chemotherapy. Patients and Methods: Multicenter analysis of a series of stage I–III GEP-NEN G3 patients receiving radical surgery (R0/R1) with/without adjuvant chemotherapy was performed. Results: Sixty patients from eight neuroendocrine tumor (NET) referral centers, with median follow-up of 23 months (5–187 months) were evaluated. While 28.6% of cases had NET G3, 71.4% had neuroendocrine carcinoma G3 (NEC G3). The 2-year OS rate after radical surgery was 64.5%, with a statistically significant difference in terms of Ki67 threshold (cut-off 55%, P = 0.03) and tumor differentiation (NEC G3 vs. NET G3, P = 0.03). Median RFS after radical surgery was 14 months, and 2-year RFS rate was 44.9%. Use of adjuvant chemotherapy provided no benefit in terms of either OS or RFS in this series. Conclusions: Surgery with radical intent might represent a valid option for GEP-NEN G3 patients with locoregional disease, especially with Ki67 value ≤ 55%.
CRIS-Team Scopus Importer:2019-11-26

Surveillance strategies for colitis-associated cancer: state of the art and future perspectives - Tontini, Gian Eugenio; Rath, Timo; Pastorelli, Luca; Vecchi, Maurizio; Neumann, Helmut (Expert Review of Gastroenterology and Hepatology, 2017)
INTRODUCTION: Colitis-associated cancer (CAC) represents a concrete risk of morbidity and mortality in patients with long lasting inflammatory bowel diseases. Surveillance colonoscopy is a rapidly evolving research field with profound changes from the traditional approach based on scheduled controls and random biopsy protocols. Areas covered: A literature search was performed using PubMed/Embase to review the latest evidence supporting the need for surveillance colonoscopy. By focusing on the most promising recent advances in this field, we provide a state-of-the-art overview of the current gold standards for the diagnosis and management of colitis-associated dysplasia. Expert commentary: Evidence-based and emerging data have questioned the efficacy and effectiveness of both standard surveillance colonoscopy and random biopsy protocols. The latest guidelines endorse early initiation of surveillance programs, risk-profiling assessment of colonoscopy intervals and standardized use of advanced imaging modalities to detect early dysplasia. Current trends clearly reveal increased attention to direct visualization and endoscopic management of visible dysplastic lesions, even in patients with longstanding colitis. Emerging technological advances in gastrointestinal endoscopy are expected to change the endoscopic surveillance protocols in the near future.
EVALuna2:33907

Survey of Challenges in Access to Diagnostics and Treatment for Neuroendocrine Tumor (NET) Patients (SCAN): PRRT in the Treatment of Neuroendocrine Tumor (NET) Patients - Dureja, S.; Kolarova, T.; Mcdonnell, M.; Van Genechten, D.; Bouvier, C.; Gellerman, E.; O'Toole, D.; Singh, H.; Chen, J.; Howe, J.; Singh, S.; Pavel, Marianne Ellen; et al. (EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2021)
CRIS-Team WoS Importer:2022-01-07

Survey of Challenges in Access to Diagnostics and Treatment for Neuroendocrine Tumor (NET) Patients (SCAN) - USA and Canada vs Global Diagnosis of NETs - Gellerman, E.; Herman, J.; Mcdonnell, M.; Van Genechten, D.; Pavel, Marianne Ellen; O'Toole, D.; Singh, H.; Chen, J.; Howe, J.; Singh, S.; Bouvier, C.; Rodien-Louw, C.; et al. (PANCREAS, 2021)
CRIS-Team WoS Importer:2021-05-21

Survivin is a guardian of the intestinal stem cell niche and its expression is regulated by TGF-? - Martini, Eva; Schneider, Evelyn; Neufert, Clemens; Neurath, Markus; Becker, Christoph (Cell Cycle, 2016)
As an inhibitor of apoptosis (IAP) family member, Survivin is known for its role during regulation of apoptosis. More recently its function as a cell cycle regulator has become evident. Survivin was shown to play a pivotal role during embryonic development and is highly expressed in regenerative tissue as well as in many cancer types. We examined the function of Survivin during mouse intestinal organogenesis and in gut pathophysiology. We found high expression of Survivin in experimentally induced colon cancer in mice but also in colon tumors of humans. Moreover, Survivin was regulated by TGF-? and was found to be highly expressed during mucosal healing following intestinal inflammation. We identified that expression of Survivin is essential early on in life, as specific deletion of Survivin in Villin expressing cells led to embryonic death around day 12 post coitum. Together with our recent study on the role of Survivin in the gut of adult mice our data demonstrate that Survivin is an essential guardian of embryonic gut development and adult gut homeostasis protecting the epithelium from cell death promoting the proliferation of intestinal stem and progenitor cells.
EVALuna2:2186

Swept source cross-polarized optical coherence tomography for any input polarized light - Sharma, Gargi; Sharma, Shivani; Blessing, Katharina; Hartl, Georg; Waldner, Maximilian; Singh, Kanwarpal (Journal of Optics, 2020)
Cross polarized optical coherence tomography (OCT) offers enhanced contrast in certain pathological conditions. Traditional cross-polarized OCT systems require a defined input polarization and thus require several polarization controlling elements increasing the overall complexity of the system. Our proposed system requires a single quarter wave plate as a polarization controller thus simplifying the system significantly. The majority of cross-polarized OCT systems are spectrometer based, which suffers from slow speed and low signal to noise ratio. In this work, we present a swept source based cross-polarized OCT system that works for any input polarization state. The system was tested against known birefringent materials such as quarter wave plate. Furthermore, biological samples such as finger, nail and chicken breast were imaged to demonstrate the potential of our technique.
CRIS-Team WoS Importer:2020-04-03

Systematic Investigation of CMTM Family Genes Suggests Relevance to Glioblastoma Pathogenesis and CMTM1 and CMTM3 as Priority Targets - Delic, Sabit; Thuy, Andreas; Schulze, Markus; Proescholdt, Martin A.; Dietrich, Peter; Boßerhoff, Anja Katrin; Riemenschneider, Markus J. (Genes Chromosomes & Cancer, 2015)
The novel CKLF-like Marvel Transmembrane Domain-containing gene family (CMTM) consists of 8 members (CMTM1-8). As little is known about the oncogenic impact of these genes, we aimed to systematically investigate the relevance of CMTMs to glioblastoma pathogenesis. We performed mRNA expression analyses and survival correlations in glioblastoma patients. Moreover, we analyzed the impact of RNAi-based silencing and overexpression of CMTM family genes on tumor cell proliferation and invasion in vitro. CMTMs appeared to be widely regulated in the group of glioblastomas relative to non-neoplastic brain (NB) tissue (significant upregulation for CMTM2, 3, and 6 and significant downregulation for CMTM 4 and 8). For CMTM1, 5 and 7, we found aberrant expression levels in individual tumors. Functionally, CMTM1, 3, and 7 promoted tumor cell invasion, while CMTM1 additionally enhanced cell proliferation. In a large clinically annotated dataset, higher CMTM1 and 3 expression was significantly correlated with shorter overall survival. Our data thus suggest CMTM1 and 3 as priority targets in glioblastomas. Using a human phosphokinase protein expression profiling assay, we can provide first insights into signalling of these two genes that might be conveyed by growth factor receptor, Src family kinase and WNT activation.
CRIS-Team Scopus Importer:2022-08-05

Systemic Anti-Cancer Therapies Impair the Nutritional Status of Neuroendocrine Tumor Patients - Pevny, S.; Maasberg, S.; Karber, M.; Knappe-Drzikova, B.; Weylandt, K. H.; Jann, H.; Pavel, Marianne Ellen; Wiedenmann, B.; Pape, U. F. (2019)
EVALuna2:216085

Systemic Anti-Cancer Therapies in Neuroendocrine Tumor Patients Impair Nutritional Status - Pevny, S.; Maasberg, S.; Karber, M.; Knappe-Drzikova, B.; Weylandt, K. H.; Pavel, Marianne Ellen; Wiedenmann, B.; Jann, H.; Pape, U. F. (2018)
EVALuna2:34124

Systemic desensitization through TRPA1 channels by capsazepine and mustard oil - a novel strategy against inflammation and pain - Kistner, Katrin; Siklosi, Norbert; Babes, Alexandru; Khalil, Mohammad; Selescu, Tudor; Zimmermann, Katharina; Wirtz, Stefan; Becker, Christoph; Neurath, Markus; Reeh, Peter; Engel, Matthias (Scientific Reports, 2016)
We demonstrate a novel dual strategy against inflammation and pain through body-wide desensitization of nociceptors via TRPA1. Attenuation of experimental colitis by capsazepine (CPZ) has long been attributed to its antagonistic action on TRPV1 and associated inhibition of neurogenic inflammation. In contrast, we found that CPZ exerts its anti-inflammatory effects via profound desensitization of TRPA1. Micromolar CPZ induced calcium influx in isolated dorsal root ganglion (DRG) neurons from wild-type (WT) but not TRPA1-deficient mice. CPZ-induced calcium transients in human TRPA1-expressing HEK293t cells were blocked by the selective TRPA1 antagonists HC 030031 and A967079 and involved three cysteine residues in the N-terminal domain. Intriguingly, both colonic enemas and drinking water with CPZ led to profound systemic hypoalgesia in WT and TRPV1(-/-) but not TRPA1(-/-) mice. These findings may guide the development of a novel class of disease-modifying drugs with anti-inflammatory and anti-nociceptive effects.
EVALuna2:2084

Systemic Markers of Inflammation in Neuroendocrine Tumors (NETs) and Outcomes With Everolimus: A Pooled Analysis From the Randomized, Phase 3 RADIANT-3, and RADIANT-4 Trials - Chan, David L.; Yao, James C.; Camaghi, Carlo; Herbst, Fabian; Ridolfi, Antonia; Strosberg, Jonathan; Kulke, Matthew H.; Pavel, Marianne Ellen; Singh, Simron (2019)
EVALuna2:216072

Systemic Markers of Inflammation in Neuroendocrine Tumors (NETs) and Outcomes with Everolimus: A Pooled Analysis from the Randomized, Phase 3 RADIANT-3 and RADIANT-4 Trials - Chan, D. L.; Yao, J. C.; Carnaghi, C.; Buzzoni, R.; Herbst, F.; Ridolfi, A.; Strosberg, J.; Kulke, M.; Pavel, Marianne Ellen; Singh, S. (2018)
EVALuna2:34116

T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly - Potorac, Iulia; Petrossians, Patrick; Daly, Adrian F.; Alexopoulou, Orsalia; Borot, Sophie; Sahnoun-Fathallah, Mona; Castinetti, Frederic; Devuyst, France; Jaffrain-Rea, Marie-Lise; Briet, Claire; Luca, Florina; Lapoirie, Marion; et al. (Endocrine-Related Cancer, 2016)
GH-secreting pituitary adenomas can be hypo-, iso- or hyper-intense on T2-weighted MRI sequences. We conducted the current multicenter study in a large population of patients with acromegaly to analyze the relationship between T2-weighted signal intensity on diagnostic MRI and hormonal and tumoral responses to somatostatin analogs (SSA) as primary monotherapy. Acromegaly patients receiving primary SSA for at least 3 months were included in the study. Hormonal, clinical and general MRI assessments were performed and assessed centrally. We included 120 patients with acromegaly. At diagnosis, 84, 17 and 19 tumors were T2-hypo-, iso- and hyper-intense, respectively. SSA treatment duration, cumulative and mean monthly doses were similar in the three groups. Patients with T2-hypo-intense adenomas had median SSA-induced decreases in GH and IGF-1 of 88% and 59% respectively, which were significantly greater than the decreases observed in the T2-iso- and hyper-intense groups (P < 0.001). Tumor shrinkage on SSA was also significantly greater in the T2-hypo-intense group (38%) compared with the T2-iso- and hyper-intense groups (8% and 3%, respectively; P < 0.0001). The response to SSA correlated with the calculated T2 intensity: the lower the T2-weighted intensity, the greater the decrease in random GH (P < 0.0001, r = 0.22), IGF-1 (P < 0.0001, r = 0.14) and adenoma volume (P < 0.0001, r = 0.33). The T2-weighted signal intensity of GH-secreting adenomas at diagnosis correlates with hormone reduction and tumor shrinkage in response to primary SSA treatment in acromegaly. This study supports its use as a generally available predictive tool at diagnosis that could help to guide subsequent treatment choices in acromegaly.
EVALuna2:2210

Taking endoscopy to a higher dimension: Computer Aided 3-D NOTES - Höller, Kurt Emmerich; Petrunina, Maria; Penne, Jochen; Schneider, Armin; Wilhelm, Dirk; Feußner, Hubertus; Hornegger, Joachim (Proceedings of the 4th Russian-Bavarian Conference on Biomedical Engineering, 2008)

Targeted deletion of Interleukin-3 results in asthma exacerbations - Kölle, Julia; Zimmermann, Theodor; Kiefer, Alexander; Rieker, Ralf; Xepapadaki, Paraskevi; Zundler, Sebastian; Papadopoulos, Nikolaos G.; Finotto, Susetta (iScience, 2022)
The cytokine interleukin-3 (IL-3) acts on early hematopoietic precursor cells. In humans, Treg cells secrete IL-3 and repress inflammatory cells except for basophils. The present study aims to elucidate the contribution of IL-3 in the development and the course of allergic asthma. We therefore analyzed the secretion of IL-3 in PBMCs and total blood cells in two cohorts of pre-school children with and without asthma. In a murine model of allergic asthma, we analyzed the phenotype of IL-3−/− mice compared to wild-type mice. PBMCs from asthmatic children showed increased IL-3 secretion, which directly correlated with improved lung function. IL-3−/− asthmatic mice showed increased asthmatic traits. Moreover, IL-3-deficient mice had a defect in T regulatory cells in the lung. In conclusion, IL-3 downregulation was found associated with more severe allergic asthma in pre-school children. Consistently, targeting IL-3 resulted in an induced pathophysiological response in a murine model of allergic asthma.
CRIS-Team Scopus Importer:2022-07-15
Keywords: Biological sciences; immune response; Immunology

Targeted deletion of NFAT-Interacting-Protein-(NIP) 45 resolves experimental asthma by inhibiting Innate Lymphoid Cells group 2 (ILC2) - Koch, Sonja; Knipfer, Lisa; Kölle, Julia; Mirzakhani, Hooman; Graser, Anna; Zimmermann, Theodor; Kiefer, Alexander; Melichar, Volker O.; Rascher, Wolfgang; Papadopoulos, Nikolaos G.; Rieker, Ralf; Raby, Benjamin A.; et al. (Scientific Reports, 2019)
Here we investigated the role of NFAT-interacting protein (NIP)-45, an Interleukin (IL)-4 inducing Transcription Factor, and its impact on the differentiation of Group 2 Innate -Lymphoid -Cells (ILC2s) in the pathogenesis of asthma. NIP45, a transcription factor regulating NFATc1 activity, mRNA was found to be induced in the Peripheral Blood mononuclear cells (PMBCs) of asthmatic pre-school children with allergies and in the peripheral blood CD4+ T cells from adult asthmatic patients. In PBMCs of asthmatic and control children, NIP45 mRNA directly correlated with NFATc1 but not with T-bet. Targeted deletion of NIP45 in mice resulted in a protective phenotype in experimental asthma with reduced airway mucus production, airway hyperresponsiveness and eosinophils. This phenotype was reversed by intranasal delivery of recombinant r-IL-33. Consistently, ILC2s and not GATA3+ CD4+ T-cells were decreased in the lungs of asthmatic NIP45−/− mice. Reduced cell number spleen ILC2s could be differentiated from NIP45−/− as compared to wild-type mice after in vivo injection of a microcircle-DNA vector expressing IL-25 and decreased cytokines and ILC2 markers in ILC2 differentiated from the bone marrow of NIP45−/− mice. NIP45 thus emerges as a new therapeutic target for the resolution of the airway pathology, down-regulation of ILC2s and mucus production in asthma.
CRIS-Team Scopus Importer:2019-11-08

Targeted inhibition of the WEE1 kinase as a novel therapeutic strategy in neuroendocrine neoplasms - Weindl, Lena; Atreya, Imke; Dietrich, Peter; Neubeck, Sabine; Neurath, Markus; Pavel, Marianne Ellen (Endocrine-Related Cancer, 2021)
Neuroendocrine neoplasms (NENs) represent a rare and heterogeneous group of malignancies, sharing features of both neural and endocrine cells. NENs G3 appear as a highly aggressive subset with a poor prognosis and limited therapeutic options. The small-molecule inhibitor of the WEE1 tyrosine kinase, adavosertib (AZD1775), has previously demonstrated potent anti-tumor effects on various types of cancer in preclinical and clinical studies. However, the role of adavosertib in NENs G3 had remained elusive. We evaluated the effects of adavosertib on pancreatic (BON-1, QGP-1) and bronchopulmonary (NCI-H720) neuroendocrine tumor cell lines applying 2D and 3D spheroid models. We newly demonstrated that adavosertib is sufficient to reduce cell viability and proliferation in neuroendocrine cell lines with features of high-grade NENs. As underlying mechanisms, we identified adavosertib-mediated DNA double-strand breaks and a G2/M cell cycle checkpoint abrogation leading into mitotic catastrophe and cancer cell apoptosis. Silencing of WEE1 via siRNA transfection resulted in a phenotype similar to adavosertib treatment. Together, inhibition of the WEE1 tyrosine kinase applying adavosertib on NENs G3 outlines a promising novel therapeutic strategy.
CRIS-Team Scopus Importer:2021-08-20
Keywords: 3D cell culture; Cell cycle; G3; Neuroendocrine neoplasm; WEE1

Target heterogeneity in oncology: The best predictor for differential response to radioligand therapy in neuroendocrine tumors and prostate cancer - Puranik, Ameya D.; Dromain, Clarisse; Fleshner, Neil; Sathekge, Mike; Pavel, Marianne Ellen; Eberhardt, Nina; Zengerling, Friedemann; Marienfeld, Ralf; Grunert, Michael; Prasad, Vikas (Cancers, 2021)
Tumor or target heterogeneity (TH) implies presence of variable cellular populations having different genomic characteristics within the same tumor, or in different tumor sites of the same patient. The challenge is to identify this heterogeneity, as it has emerged as the most common cause of ‘treatment resistance’, to current therapeutic agents. We have focused our discussion on ‘Prostate Cancer’ and ‘Neuroendocrine Tumors’, and looked at the established methods for demonstrating heterogeneity, each with its advantages and drawbacks. Also, the available theranostic radiotracers targeting PSMA and somatostatin receptors combined with targeted systemic agents, have been described. Lu-177 labeled PSMA and DOTATATE are the ‘standard of care’ radionuclide therapeutic tracers for management of progressive treatment-resistant prostate cancer and NET. These approved therapies have shown reasonable benefit in treatment outcome, with improvement in quality of life parameters. Various biomarkers and predictors of response to radionuclide therapies targeting TH which are currently available and those which can be explored have been elaborated in details. Imaging-based features using artificial intelligence (AI) need to be developed to further predict the presence of TH. Also, novel theranostic tools binding to newer targets on surface of cancer cell should be explored to overcome the treatment resistance to current treatment regimens.
CRIS-Team Scopus Importer:2021-07-30
Keywords: Ga-68; Heterogeneity; Neuroendocrine tumor; PET/CT; Prostate Cancer; PSMA; Theranostics

Targeting cytokines in inflammatory bowel disease. - Neurath, Markus (Science Translational Medicine, 2022)
Targeting cytokines in inflammatory bowel disease (IBD) is a useful clinical approach. Potential therapies for IBD include regulatory T cell transfer to restore cytokine balance, blocking proinflammatory cytokines (e.g., IL-12 and IL-23) or their receptors (sIL-6R and IL-36R), or inhibiting signaling kinases (e.g., JAK). An emerging trend in IBD therapy is to combine several anti-cytokine agents simultaneously.
EVALuna2:540209

Targeting immune cell circuits and trafficking in inflammatory bowel disease - Neurath, Markus (Nature Immunology, 2019)
Inflammatory bowel diseases (IBDs) such as Crohn’s disease and ulcerative colitis are characterized by uncontrolled activation of intestinal immune cells in a genetically susceptible host. Due to the progressive and destructive nature of the inflammatory process in IBD, complications such as fibrosis, stenosis or cancer are frequently observed, which highlights the need for effective anti-inflammatory therapy. Studies have identified altered trafficking of immune cells and pathogenic immune cell circuits as crucial drivers of mucosal inflammation and tissue destruction in IBD. A defective gut barrier and microbial dysbiosis induce such accumulation and local activation of immune cells, which results in a pro-inflammatory cytokine loop that overrides anti-inflammatory signals and causes chronic intestinal inflammation. This Review discusses pathogenic cytokine responses of immune cells as well as immune cell trafficking as a rational basis for new translational therapies in IBD.
CRIS-Team Scopus Importer:2019-07-09

Targeting Immune Cell Trafficking – Insights From Research Models and Implications for Future IBD Therapy - Wiendl, Maximilian; Becker, Elisabeth; Müller, Tanja; Voskens, Caroline; Neurath, Markus; Zundler, Sebastian (Frontiers in Immunology, 2021)
Inflammatory bowel diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC) are multifactorial diseases with still unknown aetiology and an increasing prevalence and incidence worldwide. Despite plentiful therapeutic options for IBDs, the lack or loss of response in certain patients demands the development of further treatments to tackle this unmet medical need. In recent years, the success of the anti-α4β7 antibody vedolizumab highlighted the potential of targeting the homing of immune cells, which is now an important pillar of IBD therapy. Due to its complexity, leukocyte trafficking and the involved molecules offer a largely untapped resource for a plethora of potential therapeutic interventions. In this review, we aim to summarise current and future directions of specifically interfering with immune cell trafficking. We will comment on concepts of homing, retention and recirculation and particularly focus on the role of tissue-derived chemokines. Moreover, we will give an overview of the mode of action of drugs currently in use or still in the pipeline, highlighting their mechanisms and potential to reduce disease burden.
CRIS-Team Scopus Importer:2021-06-04
Keywords: homing; IBD; retention; T cell; therapy; trafficking

Targeting Immune Cell Wiring in Ulcerative Colitis - Neurath, Markus; Chiriac, Mircea T. (Immunity, 2019)
The cytokine TNF is thought to play a major role in the immunopathogenesis of ulcerative colitis, and anti-TNF antibodies are considered as cornerstones of clinical therapy. Two clinical trials published in The New England Journal of Medicine now challenge this paradigm and suggest new avenues for research. The cytokine TNF is thought to play a major role in the immunopathogenesis of ulcerative colitis, and anti-TNF antibodies are considered as cornerstones of clinical therapy. Two clinical trials published in The New England Journal of Medicine now challenge this paradigm and suggest new avenues for research.
CRIS-Team Scopus Importer:2019-11-19

Targeting Inflammatory T Helper Cells via Retinoic Acid-Related Orphan Receptor Gamma t Is Ineffective to Prevent Allo-Response-Driven Colitis - Buchele, Vera; Abendroth, Benjamin; Buettner-Herold, Maike; Vogler, Tina; Rothamer, Johanna; Ghimire, Sakhila; Ullrich, Evelyn; Holler, Ernst; Neurath, Markus; Hildner, Kai (Frontiers in Immunology, 2018)
Intestinal graft-versus-host disease (GvHD) is a life-threatening, inflammatory donor T cell-mediated complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). In the light of the reported efficacy of interleukin-23 (IL-23)-blockade to mitigate syngeneic intestinal inflammation in inflammatory bowel disease patients, targeting IL-23 and thereby interleukin-17a (IL-17a) producing T helper (Th17) cells as the T cell subset assumed to be mostly regulated by IL-23, has emerged as a putatively general concept to harness immune-mediated mucosal inflammation irrespective of the underlying trigger. However, the role of Th17 cells during allo-response driven colitis remains ambiguous due to a series of studies with inconclusive results. Interestingly, we recently identified granulocyte-macrophage colony-stimulating factor (GM-CSF+) T cells to be promoted by interleukin-7 (IL-7) signaling and controlled by the activating protein-1 transcription factor family member basic leucine zipper transcription factor ATF-like (BATF) as critical mediators of intestinal GvHD in mice. Given the dual role of BATF, the contribution of IL-23-mediated signaling within donor T cells and bona fide Th17 cells remains to be delineated from the regulation of GM-CSF+ T cells in the absence of BATF. Here, we found in a complete MHC class I-mismatched model that genetic inactivation of the IL-23 receptor (IL-23R) or the transcription factor retinoic acid-related orphan receptor gamma t (RORγt) within donor T cells similarly ablated Th17 cell formation in vivo but preserved the T cells' ability to induce intestinal GvHD in a compared to wild-type controls indistinguishable manner. Importantly, RORγt-independent manifestation of intestinal GvHD was completely dependent on BATF-regulated GM-CSF+ T cells as BATF/RORγt double-deficient T cells failed to induce colitis and the antibody-mediated blockage of IL-7/IL-7R interaction and GM-CSF significantly diminished signs of intestinal GvHD elicited by RORγt-deficient donor T cells. Finally, in analogy to our murine studies, colonic RORC expression levels inversely correlated with the presence of GvHD in allo-HSCT patients. Together, this study provides a crucial example of a BATF-dependent, however, IL-23R signaling- and RORγt-, i.e., Th17 fate-independent regulation of a colitogenic T cell population critically impacting the current understanding of intestinal GvHD.
EVALuna2:34273

Targeting interleukins for the treatment of inflammatory bowel disease-what lies beyond anti-TNF therapy? - Mclean, Mairi H.; Neurath, Markus; Durum, Scott K. (Inflammatory Bowel Diseases, 2014)
: Inflammatory bowel disease accounts for significant patient morbidity in the Western world. Several immunosuppressive therapies are available but are associated with potential significant adverse effects. In addition, there remains a cohort of patients with refractory or relapsing disease. Therefore, the search for novel therapeutic agents continues. In this review, we evaluate the role of a number of designated cytokines that are candidates in the pathogenesis of inflammatory bowel disease and discuss how their manipulation has been explored as a therapeutic strategy for this disease. The interleukins (ILs) chosen for discussion reflect those that currently show most promise as future therapeutic targets, as well as discussing the role of some of the most recently identified ILs, such as IL-27, IL-33, IL-35, and IL-22, in this context.
EVALuna2:1898

Targeting mucosal healing in Crohn’s disease: what the clinician needs to know - Klenske, Entcho; Bojarski, Christian; Waldner, Maximilian; Rath, Timo; Neurath, Markus; Atreya, Raja (Therapeutic Advances in Gastroenterology, 2019)
In recent years, mucosal healing has emerged as a key therapeutic goal in the clinical management of patients with Crohn’s disease, as it has been associated with improved long-term clinical outcomes. With the vast improvements in endoscopic imaging techniques and the increase in available treatment options, which reportedly are able to induce mucosal healing, the practising physician is left to wonder: how is endoscopic mucosal healing exactly defined in Crohn’s disease, and how can it effectively be achieved and monitored in daily clinical practice? Within this review, we will give an overview of the ongoing debate about the definition of mucosal healing and the modalities to monitor inflammation, and finally present available therapies with the capacity to induce mucosal healing.
CRIS-Team Scopus Importer:2019-06-25
Keywords: Crohn’s disease; endoscopy; imaging; mucosal healing

Targeting Muscular Hemoglobin Content for Classification of Peripheral Arterial Disease by Noninvasive Multispectral Optoacoustic Tomography - Günther, Josefine; Knieling, Ferdinand; Träger, Anna P.; Lang, Werner; Meyer, Alexander; Regensburger, Adrian; Wagner, Alexandra; Trollmann, Regina; Wölfle, Joachim; Klett, Daniel; Uter, Wolfgang; Uder, Michael; et al. (Journal of the American College of Cardiology : Cardiovascular imaging, 2023)
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Targeting of the Tec Kinase ITK Drives Resolution of T Cell–Mediated Colitis and Emerges as Potential Therapeutic Option in Ulcerative Colitis - Lechner-Grimm, Kristina; Mott, Stefanie; Al-Saifi, Ragheed; Knipfer, Lisa; Wirtz, Stefan; Atreya, Raja; Vieth, Michael; Rath, Timo; Fraass, Tina; Winter, Zoltan; August, Avery; Luban, Jeremy; et al. (Gastroenterology, 2021)
Background & Aims: The molecular checkpoints driving T cell activation and cytokine responses in ulcerative colitis (UC) are incompletely understood. Here, we studied the Tec kinase ITK in UC. Methods: We analyzed patients with inflammatory bowel disease (n = 223) and evaluated ITK activity as well as the functional effects of cyclosporine-A (CsA). In addition, 3 independent murine colitis models were used to investigate the functional role of ITK. Finally, the activity of ITK was blocked via pharmacological inhibitors and genetically engineered mice. Readout parameters were mini-endoscopy, histopathology, mucosal T cell apoptosis, and cytokine production. Results: We found an expansion of pITK-expressing mucosal CD4+ T cells in UC rather than Crohn's disease that correlated with disease severity. CsA suppressed activation of ITK in cultured CD4+ T cells and calcineurin-containing microclusters adjacent to the T cell receptor signaling complex. Functionally, the capacity of CsA to suppress activity of experimental colitis was critically dependent on ITK. Genetic inactivation of Itk via gene targeting or induction of allele-sensitive Itk mutants prevented experimental colitis in 3 colitis models, and treatment with pharmacological ITK blockers suppressed established colitis. In addition, ITK controlled apoptosis and activation of mucosal Th2 and Th17 lymphocytes via NFATc2 signaling pathways. Conclusions: ITK activation was detected in UC and could be down-regulated in cultured T cells by CsA administration. Selective targeting of ITK emerges as an attractive approach for treatment of chronic intestinal inflammation and potentially UC by driving resolution of mucosal inflammation.
CRIS-Team Scopus Importer:2021-09-24
Keywords: Cyclosporine A; Cytokines; IBD; ITK; Therapeutic Strategies

Targeting STAT3 Signaling in COL1+ Fibroblasts Controls Colitis-Associated Cancer in Mice - Heichler, Christina; Schmied, Anabel; Enderle, Karin; Scheibe, Kristina; Murawska, Marta; Schmid, Benjamin; Waldner, Maximilian; Neurath, Markus; Neufert, Clemens (Cancers, 2022)
Colorectal cancer (CRC) is a common disease and has limited treatment options. The importance of cancer-associated fibroblasts (CAFs) within the tumor microenvironment (TME) in CRC has been increasingly recognized. However, the role of CAF subsets in CRC is hardly understood and opposing functions of type I (COL1+) vs. type VI (COL6+) collagen-expressing subsets were reported before with respect to NFκB-related signaling. Here, we have focused on COL1+ fibroblasts, which represent a frequent CAF population in CRC and studied their role upon STAT3 activation in vivo. Using a dual strategy with a conditional gain-of-function and a conditional loss-of-function approach in an in vivo model of colitis-associated cancer, tumor development was evaluated by different readouts, including advanced imaging methodologies, e.g., light sheet microscopy and CT-scan. Our data demonstrate that the inhibition of STAT3 activation in COL1+ fibroblasts reduces tumor burden, whereas the constitutive activation of STAT3 promotes the development of inflammation-driven CRC. In addition, our work characterizes the co-expression and distribution of type I and type VI collagen by CAFs in inflammation-associated colorectal cancer using reporter mice. This work indicates a critical contribution of STAT3 signaling in COL1+ CAFs, suggesting that the blockade of STAT3 activation in type I collagen-expressing fibroblasts could serve as promising therapeutic targets in colitis-associated CRC. In combination with previous work by others and us, our current findings highlight the context-dependent roles of COL1+ CAFs and COL6+ CAFs that might be variable according to the specific pathway activated.
CRIS-Team Scopus Importer:2022-03-25
Keywords: AOM/DSS model; Collagen; Colorectal cancer; Fibroblast; Inflammation; Tumorigenesis

Targeting zonulin and intestinal epithelial barrier function to prevent onset of arthritis - Tajik, Narges; Frech, Michael; Schulz, Oscar; Schälter, Fabian; Lucas, Sébastien; Azizov, Vugar; Dürholz, Kerstin; Steffen, Franziska; Omata, Yasunori; Rings, Andreas; Bertog, Marko; Rizzo, Aroldo; et al. (Nature Communications, 2020)
Gut microbial dysbiosis is associated with the development of autoimmune disease, but the mechanisms by which microbial dysbiosis affects the transition from asymptomatic autoimmunity to inflammatory disease are incompletely characterized. Here, we identify intestinal barrier integrity as an important checkpoint in translating autoimmunity to inflammation. Zonulin family peptide (zonulin), a potent regulator for intestinal tight junctions, is highly expressed in autoimmune mice and humans and can be used to predict transition from autoimmunity to inflammatory arthritis. Increased serum zonulin levels are accompanied by a leaky intestinal barrier, dysbiosis and inflammation. Restoration of the intestinal barrier in the pre-phase of arthritis using butyrate or a cannabinoid type 1 receptor agonist inhibits the development of arthritis. Moreover, treatment with the zonulin antagonist larazotide acetate, which specifically increases intestinal barrier integrity, effectively reduces arthritis onset. These data identify a preventive approach for the onset of autoimmune disease by specifically targeting impaired intestinal barrier function.
CRIS-Team Scopus Importer:2020-05-05

T cell aging in patients with colorectal cancer—what do we know so far? - Thoma, Oana-Maria; Neurath, Markus; Waldner, Maximilian (Cancers, 2021)
Colorectal cancer (CRC) continues to be one of the most frequently diagnosed types of cancers in the world. CRC is considered to affect mostly elderly patients, and the number of diagnosed cases increases with age. Even though general screening improves outcomes, the overall survival and recurrence-free CRC rates in aged individuals are highly dependent on their history of comorbidities. Furthermore, aging is also known to alter the immune system, and especially the adaptive immune T cells. Many studies have emphasized the importance of T cell responses to CRC. Therefore, understanding how age-related changes affect the outcome in CRC patients is crucial. This review focuses on what is so far known about age-related T cell dysfunction in elderly patients with colorectal cancer and how aged T cells can mediate its development. Last, this study describes the advances in basic animal models that have potential to be used to elucidate the role of aged T cells in CRC.
CRIS-Team Scopus Importer:2021-12-31
Keywords: Aging; Colorectal cancer; CRC; Exhaustion; Senescence; T cell aging

Technical success, resection status, and procedural complication rate of colonoscopic full-wall resection: a pooled analysis from 7 hospitals of different care levels - Krutzenbichler, Irmengard; Dollhopf, Markus; Diepolder, Helmut; Eigler, Andreas; Fuchs, Martin; Herrmann, Simon; Kleber, Gerhard; Lewerenz, Bjoern; Kaiser, Christoph; Lilje, Tilman; Rath, Timo; Agha, Ayman; et al. (Surgical Endoscopy, 2020)
Introduction: Endoscopic full-thickness resection (eFTR) using the full-thickness resection device (FTRD®) is a novel minimally invasive procedure that allows the resection of various lesions in the gastrointestinal tract including the colorectum. Real-world data outside of published studies are limited. The aim of this study was a detailed analysis of the outcomes of colonoscopic eFTR in different hospitals from different care levels in correlation with the number of endoscopists performing eFTR. Material and methods: In this case series, the data of all patients who underwent eFTR between November 2014 and June 2019 (performed by a total of 22 endoscopists) in 7 hospitals were analyzed retrospectively regarding rates of technical success, R0 resection, and procedure-related complications. Results: Colonoscopic eFTR was performed in 229 patients (64.6% men; average age 69.3 ± 10.3 years) mainly on the basis of the following indication: 69.9% difficult adenomas, 21.0% gastrointestinal adenocarcinomas, and 7.9% subepithelial tumors. The average size of the lesions was 16.3 mm. Technical success rate of eFTR was achieved in 83.8% (binominal confidence interval 78.4–88.4%). Overall, histologically complete resection (R0) was achieved in 77.2% (CI 69.8–83.6%) while histologically proven full-wall excidate was confirmed in 90.0% (CI 85.1–93.7%). Of the resectates obtained (n = 210), 190 were resected en bloc (90.5%). We did not observe a clear improvement of technical success and R0 resection rate over time by the performing endoscopists. Altogether, procedure-related complications were observed in 17.5% (mostly moderate) including 2 cases of acute gangrenous appendicitis requiring operation. Discussion: In this pooled analysis, eFTR represents a feasible, effective, and safe minimally invasive endoscopic technique.
CRIS-Team Scopus Importer:2020-07-24
Keywords: Endoscopic full-thickness resection (eFTR); Endoscopic resection; Full-thickness resection device (FTRD®); Polypectomy; ‘WALL RESECT’

Tele-Endoscopy: Influence of Data Compression, Bandwidth and Simulated Impairments on the Usability of Real-Time Digital Video Endoscopy Transmissions for Medical Diagnoses - Rabenstein, Thomas; Maiß, Jürgen; Naegele-Jackson, Susanne; Liebl, Kersten; Hengstenberg, Thomas; Radespiel-Tröger, Martin; Holleczek, Peter; Hahn, Eckhart Georg; Sackmann, Michael (Endoscopy, 2002)
Background and study aims: Real-time digital video transmission (rtDVT) at an acceptable quality through networks has been possible for several years. This technique can be used for telemedical applications, such as tele-endoscopy. The hypotheses of the present study were that the quality of real-time DVT depends on the technical equipment used, and that the resulting image quality influences the usability of the system for diagnostic purposes. Materials and methods: An experimental network was established between two German referral endoscopy centers, using the Asynchronous Transfer Mode (ATM) protocol. At first, rtDVTs of routine gastrointestinal video endoscopies were transferred through the network for prospective evaluation of the feasibility of the technical equipment and its usability for diagnostic tele-endoscopy, based on the video image quality. Secondly, the image quality and usability for correct telemedical diagnosis were evaluated prospectively in a double-blind experimental setting in relation to variations in the methods of data compression used, transmission bandwidths, and simulated transmission errors. Fourteen endoscopists evaluated 27 variations of an endoscopic video sequence. Results: Compression with the Moving Picture Expert Group 2 (MPEG2 [4:2:2]) standard, the ATM protocol, and a bandwidth of 40 megabits per second (Mb/s) were used successfully in 40 routine tele-endoscopies for practical evaluation. Doctors were able to handle the system with ease, and its availability was 100%. There were no detectable differences between the original video image and the transferred image, and the images were usable for diagnosis in all cases. The set-up used clinically was therefore considered to provide the optimal conditions for comparisons in the experimental part of the study. Experimentally, any technical variation was found to cause a reduction in the overall image quality and hence a reduction in diagnostic usability: compression algorithm (MPEG2 [4:2:2] vs. others: P = 0.001), bandwidth (≥ 8 vs. < 8 Mb/s: P = 0.001), and error rate (10-8 vs. 10-7: P = 0.001). Conclusions: rtDVT using MPEG2 [4:2:2] compression and a bandwidth of 40 Mb/s did not effectively differ from the original video images in routine tele-endoscopy. The qualitative requirements in diagnostic video endoscopy, however, are obviously much higher than previously assumed, since experienced endoscopists detected a loss of image quality and a reduction in diagnostic usability with any reduction in the technical specification. Modern methods of data compression, broadband networks and a network protocol with good quality-of-service guarantees are therefore prerequisites for diagnostic rtDVT.
UnivIS-Import:2015-03-09:Pub.2002.zwiss.rrze.ksys.teleen