5 results on '"Lukas Schuierer"'
Search Results
2. Comparison of the Development of SARS-Coronavirus-2-Specific Cellular Immunity, and Central Memory CD4+ T-Cell Responses Following Infection versus Vaccination
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Kevin M. Dennehy, Eva Löll, Christine Dhillon, Johanna-Maria Classen, Tobias D. Warm, Lukas Schuierer, Alexander Hyhlik-Dürr, Christoph Römmele, Yvonne Gosslau, Elisabeth Kling, and Reinhard Hoffmann
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Pharmacology ,SARS-CoV-2 ,Immunology ,COVID-19 ,memory T-cells ,cellular immunity ,vaccination ,Article ,Infectious Diseases ,Drug Discovery ,Medicine ,Pharmacology (medical) ,ddc:610 - Abstract
Memory T-cell responses following infection with coronaviruses are reportedly long-lived and provide long-term protection against severe disease. Whether vaccination induces similar long-lived responses is not yet clear since, to date, there are limited data comparing memory CD4+ T-cell responses induced after SARS-CoV-2 infection versus following vaccination with BioNTech/Pfizer BNT162b2. We compared T-cell immune responses over time after infection or vaccination using ELISpot, and memory CD4+ T-cell responses three months after infection/vaccination using activation-induced marker flow cytometric assays. Levels of cytokine-producing T-cells were remarkably stable between three and twelve months after infection, and were comparable to IFNγ+ and IFNγ+IL-2+ T-cell responses but lower than IL-2+ T-cell responses at three months after vaccination. Consistent with this finding, vaccination and infection elicited comparable levels of SARS-CoV-2 specific CD4+ T-cells after three months in addition to comparable proportions of specific central memory CD4+ T-cells. By contrast, the proportions of specific effector memory CD4+ T-cells were significantly lower, whereas specific effector CD4+ T-cells were higher after infection than after vaccination. Our results suggest that T-cell responses—as measured by cytokine expression—and the frequencies of SARS-CoV-2-specific central memory CD4+T-cells—indicative of the formation of the long-lived memory T-cell compartment—are comparably induced after infection and vaccination.
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- 2021
3. Performance of antigen testing for diagnosis of COVID-19: a direct comparison of a lateral flow device to nucleic acid amplification based tests
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Christina C. Bartenschlager, Lukas Schuierer, Christine Dhillon, Ramona Frey, Marie Freitag, Margit Heier, Stephan Zellmer, Christoph Römmele, Elisabeth Kling, Markus Wehler, Alanna Ebigbo, Reinhard Hoffmann, Maria Kahn, Helmut Messmann, Christian Denzel, and Selin Temizel
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medicine.medical_specialty ,Point-of-care testing ,Infectious and parasitic diseases ,RC109-216 ,COVID-19 testing ,Sensitivity and Specificity ,Gastroenterology ,Asymptomatic ,Medical microbiology ,Antigen ,(3–10): SARS-CoV-2 ,Internal medicine ,medicine ,Humans ,ddc:610 ,SARS-COV-2 antigen testing ,Retrospective Studies ,SARS-CoV-2 ,business.industry ,Research ,COVID-19 ,Retrospective cohort study ,Gold standard (test) ,Nucleic acid amplification technique ,Infectious Diseases ,Parasitology ,RNA, Viral ,medicine.symptom ,business ,Nucleic Acid Amplification Techniques - Abstract
Objectives The gold standard for diagnosing an infection with SARS-CoV-2 is detection of viral RNA by nucleic acid amplification techniques. Test capacities, however, are limited. Therefore, numerous easy-to-use rapid antigen tests based on lateral flow technology have been developed. Manufacturer-reported performance data seem convincing, but real-world data are missing. Methods We retrospectively analysed all prospectively collected antigen tests results performed between 23.06.2020 and 26.11.2020, generated by non-laboratory personnel at the point-of-care from oro- or nasopharyngeal swab samples at the University Hospital Augsburg and compared them to concomitantly (within 24 h.) generated results from molecular tests. Results For a total of 3630 antigen tests, 3110 NAAT results were available. Overall, sensitivity, specificity, NPV and PPV of antigen testing were 59.4%, 99.0%, 98.7% and 64.8%, respectively. Sensitivity and PPV were lower in asymptomatic patients (47.6% and 44.4%, respectively) and only slightly higher in patients with clinical symptoms (66.7% and 85.0%, respectively). Some samples with very low Ct-values (minimum Ct 13) were not detected by antigen testing. 31 false positive results occurred. ROC curve analysis showed that reducing the COI cut-off from 1, as suggested by the manufacturer, to 0.9 is optimal, albeit with an AUC of only 0.66. Conclusion In real life, performance of lateral-flow-based antigen tests are well below the manufacturer's specifications, irrespective of patient’s symptoms. Their use for detection of individual patients infected with SARS-CoV2 should be discouraged. This does not preclude their usefulness in large-scale screening programs to reduce transmission events on a population-wide scale.
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- 2021
4. Effect of antiviral therapy on the outcomes of mechanically ventilated patients with herpes simplex virus detected in the respiratory tract: a systematic review and meta-analysis
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Stefan Hagel, André Scherag, Lukas Schuierer, Reinhard Hoffmann, Charles-Edouard Luyt, Mathias W. Pletz, Miriam Kesselmeier, Sebastian Weis, Gestionnaire, Hal Sorbonne Université, Jena University Hospital [Jena], Friedrich-Schiller-Universität = Friedrich Schiller University Jena [Jena, Germany], Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Universität Augsburg [Augsburg], Institut de cardiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Réanimation Médicale [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP]
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Herpes simplex ,Research ,[SDV]Life Sciences [q-bio] ,Respiratory System ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,lcsh:RC86-88.9 ,Length of Stay ,Antiviral therapy ,Antiviral Agents ,Respiration, Artificial ,[SDV] Life Sciences [q-bio] ,Mechanical ventilation ,Humans ,Simplexvirus ,Hospital Mortality ,ddc:610 ,Critically ill - Abstract
Background Herpes simplex virus (HSV) is frequently detected in the respiratory tract of mechanically ventilated patients. The aim of this study was to assess current evidence to determine whether antiviral therapy is associated with better outcomes in these patients. Methods MEDLINE, ISI Web of Science, Cochrane Database and ClinicalTrials.gov were searched from inception to 25 May 2020. All clinical studies investigating the effects of antiviral therapy on the outcome of mechanically ventilated ICU patients in whom HSV was detected in the respiratory tract were eligible for inclusion, regardless of study design, publication status or language. Titles and abstracts were reviewed independently by two authors. If the articles seemed eligible, full-text articles were reviewed and data extracted. We performed a random-effects meta-analysis to estimate relative risks (RRs) with corresponding 95% confidence intervals (CIs). The primary endpoint was hospital all-cause mortality. Results Nine studies were included in the meta-analysis (one randomized controlled trial, eight cohort studies). Antiviral treatment was associated with lower hospital mortality (with antiviral treatment, 40.6% (189 out of 465 patients); without, 52.7% (193 out of 366 patients); RR 0.74 [0.64, 0.85]; eight studies, low quality of evidence). Furthermore, antiviral treatment was associated with lower 30-day mortality (RR 0.75 [0.59, 0.94]; three studies, very low quality of evidence). We did not observe evidence for differences in ICU mortality (RR 0.73 [0.51, 1.05]; three studies, very low quality of evidence). Conclusions This meta-analysis of the available data shows that antiviral therapy might result in lower hospital and 30-day all-cause mortality in mechanically ventilated ICU patients who are positive for HSV in the respiratory tract. However, this result must be interpreted with great caution due to the high risk of bias and limited number of patients. Large, well-designed randomized controlled clinical trials are urgently needed. Trial registration The study was registered in advance on International Prospective Register of Systematic Reviews (CRD42020180053) .
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- 2020
5. Impact of acyclovir use on survival of patients with ventilator-associated pneumonia and high load herpes simplex virus replication
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Georg Braun, Michael Wittmann, Ulrich Jaschinski, Reinhard Hoffmann, Michael Gebhard, Dirk H. Busch, Thomas M. Berghaus, Hans-Georg Ruf, and Lukas Schuierer
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Male ,medicine.medical_specialty ,Letter ,Acyclovir ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Antiviral Agents ,Real-time polymerase chain reaction ,Statistics, Nonparametric ,law.invention ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal medicine ,medicine ,Ventilator-associated pneumonia ,Humans ,Simplexvirus ,Clinical significance ,030212 general & internal medicine ,ddc:610 ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Research ,Bronchoalveolar lavage fluid ,Hazard ratio ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Pneumonia, Ventilator-Associated ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,Middle Aged ,medicine.disease ,Intensive care unit ,Survival Analysis ,Radiography ,Pneumonia ,Bronchoalveolar lavage ,Female ,business ,Tomography, X-Ray Computed ,Viral load - Abstract
Background Herpes simplex virus (HSV) replication can be detected in the respiratory secretions of a high proportion of ventilated intensive care unit (ICU) patients. However, the clinical significance remains poorly defined. We investigated whether patients with ventilator-associated pneumonia not responding to antibiotics and in whom high levels of HSV could be detected in respiratory secretions benefit from acyclovir treatment. Methods Respiratory secretions (bronchoalveolar lavage fluid or tracheal aspirates) were tested for HSV replication by quantitative real-time PCR. ICU survival times, clinical parameters, and radiographic findings were retrospectively compared between untreated and acyclovir treated patients with high (> 105 HSV copies/mL) and low (103–105 HSV copies/mL) viral load. Results Fifty-seven low and 69 high viral load patients were identified. Fewer patients with high viral load responded to antibiotic treatment (12% compared to 40% of low load patients, p = 0.001). Acyclovir improved median ICU survival (8 vs 22 days, p = 0.014) and was associated with a significantly reduced hazard ratio for ICU death (HR = 0.31, 95% CI 0.11–0.92, p = 0.035) in high load patients only. Moreover, circulatory and pulmonary oxygenation function of high load patients improved significantly over the course of acyclovir treatment: mean norepinephrine doses decreased from 0.05 to 0.02 μg/kg body weight/min between days 0 and 6 of treatment (p = 0.049), and median PaO2/FiO2 ratio increased from 187 to 241 between day 3 and day 7 of treatment (p = 0.02). Chest radiographic findings also improved significantly (p Conclusions In patients with ventilator-associated pneumonia, antibiotic treatment failure, and high levels of HSV replication, acyclovir treatment was associated with a significantly longer time to death in the ICU and improved circulatory and pulmonary function. This suggests a causative role for HSV in this highly selected group of patients.
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- 2020
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