1,910 results on '"A Kleger"'
Search Results
52. Human stem cell-based retina on chip as new translational model for validation of AAV retinal gene therapy vectors
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Achberger, Kevin, Cipriano, Madalena, Düchs, Matthias J., Schön, Christian, Michelfelder, Stefan, Stierstorfer, Birgit, Lamla, Thorsten, Kauschke, Stefan G., Chuchuy, Johanna, Roosz, Julia, Mesch, Lena, Cora, Virginia, Pars, Selin, Pashkovskaia, Natalia, Corti, Serena, Hartmann, Sophia-Marie, Kleger, Alexander, Kreuz, Sebastian, Maier, Udo, Liebau, Stefan, and Loskill, Peter
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- 2021
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53. Organoid‐based precision medicine in pancreatic cancer
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Beutel, Alica K., Ekizce, Menar, Ettrich, Thomas J., Seufferlein, Thomas, Lindenmayer, Jessica, Gout, Johann, and Kleger, Alexander
- Abstract
Pancreatic ductal adenocarcinoma (PDAC) ranks among the leading causes of cancer‐related deaths worldwide. Despite advances in precision oncology in other malignancies, treatment of PDAC still largely relies on conventional chemotherapy. Given the dismal prognosis and heterogeneity in PDAC, there is an urgent need for personalized therapeutic strategies to improve treatment response. Organoids, generated from patients' tumor tissue, have emerged as a powerful tool in cancer research. These three‐dimensional models faithfully recapitulate the morphological and genetic features of the parental tumor and retain patient‐specific heterogeneity. This review summarizes existing precision oncology approaches in PDAC, explores current applications and limitations of organoid cultures in personalized medicine, details preclinical studies correlating in vitro organoid prediction and patient treatment response, and provides an overview of ongoing organoid‐based clinical trials.
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- 2025
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54. European guidelines for the diagnosis and treatment of pancreatic exocrine insufficiency: UEG, EPC, EDS, ESPEN, ESPGHAN, ESDO, and ESPCG evidence‐based recommendations
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Dominguez‐Muñoz, J. Enrique, Vujasinovic, Miroslav, Iglesia, Daniel, Cahen, Djuna, Capurso, Gabriele, Gubergrits, Natalya, Hegyi, Peter, Hungin, Pali, Ockenga, Johann, Paiella, Salvatore, Perkhofer, Lukas, Rebours, Vinciane, Rosendahl, Jonas, Salvia, Roberto, Scheers, Isabelle, Szentesi, Andrea, Bonovas, Stefanos, Piovani, Daniele, Löhr, J. Matthias, Algül, Hana, Archibugi, Livia, Arvanitakis, Marianna, Barbu, Sorin, Beyer, Georg, Bezmarevic, Mihailo, Bodewes, Frank, Boermeester, Marja A., Bordin, Dmitry, Bruno, Marco, Ceyhan, Güralp, Czako, Laszlo, D'Amico, Ferdinando, Madaria, Enrique, De Martino, Julian, Deprez, Pierre H., Dervenis, Christos, Dité, Petr, Drewes, Asbjørn, Duggan, Sinead N., Duman, Deniz, Engjom, Trond, Ewald, Nils, Fabian, Ovidiu, Fracasso, Pierluigi, Friess, Helmut, Frøkjær, Jens Brøndum, Frulloni, Luca, Gaujoux, Sebastien, Gheorghe, Cristian, Gohy, Sophie, Hardt, Philip, Hauge, Truls, Hopper, Andrew, Iglesias‐Garcia, Julio, Keller, Jutta, Kiriukova, Mariia, Kleeff, Jörg, Kleger, Alexander, Laghi, Andrea, Larino‐Noia, José, Laukkarinen, Johanna, Leeds, John, Lindkvist, Björn, Masip, Etna, Marchegiani, Giovanni, Mari, Amir, Martinez‐Moneo, Emma, Mayerle, Julia, Molven, Anders, Okhlobystin, Alexey, Panic, Nikola, Parniczky, Andrea, Pezzilli, Raffaele, Phillips, Mary, Poropat, Goran, Matic, Jelena Rakic, Roberts, Keith, Robinson, Stuart, Sandru, Vasile, Sauvanet, Alain, Schneider, Alexander, Shvets, Oleg, Stigliano, Serena, Stimac, Davor, Strobel, Oliver, Timmerhuis, Hester, Udrescu, Mihaela, Vancsa, Szilard, Veness, Vicki, Wilschanski, Michael, and Witt, Heiko
- Abstract
Pancreatic exocrine insufficiency (PEI) is defined as a reduction in pancreatic exocrine secretion below the level that allows the normal digestion of nutrients. Pancreatic disease and surgery are the main causes of PEI. However, other conditions and upper gastrointestinal surgery can also affect the digestive function of the pancreas. PEI can cause symptoms of nutritional malabsorption and deficiencies, which affect the quality of life and increase morbidity and mortality. These guidelines were developed following the United European Gastroenterology framework for the development of high‐quality clinical guidelines. After a systematic literature review, the evidence was evaluated according to the Oxford Center for Evidence‐Based Medicine and the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted on using the Delphi method. The diagnosis of PEI should be based on a global assessment of symptoms, nutritional status, and a pancreatic secretion test. Pancreatic enzyme replacement therapy (PERT), together with dietary advice and support, are the cornerstones of PEI therapy. PERT is indicated in patients with PEI that is secondary to pancreatic disease, pancreatic surgery, or other metabolic or gastroenterological conditions. Specific recommendations concerning the management of PEI under various clinical conditions are provided based on evidence and expert opinions. This evidence‐based guideline summarizes the prevalence, clinical impact, and general diagnostic and therapeutic approaches for PEI, as well as the specifics of PEI in different clinical conditions. Finally, the unmet needs for future research are discussed.
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- 2025
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55. Modellsysteme in der gastroenterologischen Forschung: Vom Tiermodell über humane Organoide in die Klinik
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Arnold, Frank and Kleger, Alexander
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- 2021
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56. Modeling plasticity and dysplasia of pancreatic ductal organoids derived from human pluripotent stem cells
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Breunig, Markus, Merkle, Jessica, Wagner, Martin, Melzer, Michael K., Barth, Thomas F.E., Engleitner, Thomas, Krumm, Johannes, Wiedenmann, Sandra, Cohrs, Christian M., Perkhofer, Lukas, Jain, Gaurav, Krüger, Jana, Hermann, Patrick C., Schmid, Maximilian, Madácsy, Tamara, Varga, Árpád, Griger, Joscha, Azoitei, Ninel, Müller, Martin, Wessely, Oliver, Robey, Pamela G., Heller, Sandra, Dantes, Zahra, Reichert, Maximilian, Günes, Cagatay, Bolenz, Christian, Kuhn, Florian, Maléth, József, Speier, Stephan, Liebau, Stefan, Sipos, Bence, Kuster, Bernhard, Seufferlein, Thomas, Rad, Roland, Meier, Matthias, Hohwieler, Meike, and Kleger, Alexander
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- 2021
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57. Prevalence of hypophosphatemia in the ICU – Results of an international one-day point prevalence survey
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Abel, Arroyo, Erna, Alberts, Berger Mette, M., Guillaume, Besch, Costel, Besançon Bodolea, Michael, Casaer, Pérez, Cheng Meisy, Jean-Michel, Constantin, Swarna, Deepak, de Man Angelique, M.E., Frantisek, Duska, Patricia, Fodor, Kristina, Fuest, Thierry, Fumeaux, Hubert, Grand, Gundogan, K., Jan, Gunst, Mohan, Gurjar, Laurent, Heyer, Shihan, Huq, Carole, Ichai, Motiul, Islam, Samir, Jaber, Nikilesh, Jain, Matthieu, Jamme, Ib, Jammer, Olivier, Joannes-Boyau, Veronika, Jung, Inga, Karu, Kamal Habeeb, Keryakos Hesham, Gian-Reto, Kleger, Tim, Krol, Friedrich, Kuhn Karl, Marcus, Laube, Yoann, Launey, Manu, Malbrain, Manrique Ezequiel, Julien, Marrel, Roberto, Martinez-Alejos, Mongardon, Nicolas, Conway, Morris Andrew, Madhu, Pahuja, Fernando, Pereira, Gema, Pérez, Marie-Helene, Perez, Carmen, Pfortmuller, Annika, Reintam Blaser, Ricardo, Rosenfeld, Noryani, Samat, Schaller Stefan, J., Shannon, Simpson, Kelly, Straka, Tamas, Szakmany, Kadri, Tamme, Arthur, Van Zanten, Verçoza, Viana Marina, Berger, M.M., Appelberg, O., Reintam-Blaser, A., Ichai, C., Joannes-Boyau, O., Casaer, M., Schaller, S.J., Gunst, J., and Starkopf, J.
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- 2021
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58. SARS-CoV-2 variants B.1.351 and P.1 escape from neutralizing antibodies
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Hoffmann, Markus, Arora, Prerna, Groß, Rüdiger, Seidel, Alina, Hörnich, Bojan F., Hahn, Alexander S., Krüger, Nadine, Graichen, Luise, Hofmann-Winkler, Heike, Kempf, Amy, Winkler, Martin S., Schulz, Sebastian, Jäck, Hans-Martin, Jahrsdörfer, Bernd, Schrezenmeier, Hubert, Müller, Martin, Kleger, Alexander, Münch, Jan, and Pöhlmann, Stefan
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- 2021
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59. A high-risk gut microbiota configuration associates with fatal hyperinflammatory immune and metabolic responses to SARS-CoV-2
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Werner C. Albrich, Tarini Shankar Ghosh, Sinead Ahearn-Ford, Flora Mikaeloff, Nonhlanhla Lunjani, Brian Forde, Noémie Suh, Gian-Reto Kleger, Urs Pietsch, Manuel Frischknecht, Christian Garzoni, Rossella Forlenza, Mary Horgan, Corinna Sadlier, Tommaso Rochat Negro, Jérôme Pugin, Hannah Wozniak, Andreas Cerny, Ujjwal Neogi, Paul W. O’Toole, and Liam O’Mahony
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Microbiota ,COVID-19 ,cytokines ,inflammation ,metabolites ,tryptophan ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and associated clinical sequelae requires well-coordinated metabolic and immune responses that limit viral spread and promote recovery of damaged systems. However, the role of the gut microbiota in regulating these responses has not been thoroughly investigated. In order to identify mechanisms underpinning microbiota interactions with host immune and metabolic systems that influence coronavirus disease 2019 (COVID-19) outcomes, we performed a multi-omics analysis on hospitalized COVID-19 patients and compared those with the most severe outcome (i.e. death, n = 41) to those with severe non-fatal disease (n = 89), or mild/moderate disease (n = 42), that recovered. A distinct subset of 8 cytokines (e.g. TSLP) and 140 metabolites (e.g. quinolinate) in sera identified those with a fatal outcome to infection. In addition, elevated levels of multiple pathobionts and lower levels of protective or anti-inflammatory microbes were observed in the fecal microbiome of those with the poorest clinical outcomes. Weighted gene correlation network analysis (WGCNA) identified modules that associated severity-associated cytokines with tryptophan metabolism, coagulation-linked fibrinopeptides, and bile acids with multiple pathobionts, such as Enterococcus. In contrast, less severe clinical outcomes are associated with clusters of anti-inflammatory microbes such as Bifidobacterium or Ruminococcus, short chain fatty acids (SCFAs) and IL-17A. Our study uncovered distinct mechanistic modules that link host and microbiome processes with fatal outcomes to SARS-CoV-2 infection. These features may be useful to identify at risk individuals, but also highlight a role for the microbiome in modifying hyperinflammatory responses to SARS-CoV-2 and other infectious agents.
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- 2022
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60. Protocol to use de-epithelialized porcine urinary bladder as a tissue scaffold for propagation of pancreatic cells
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Michael Karl Melzer, Markus Breunig, Paul Lopatta, Meike Hohwieler, Sarah Merz, Anca Azoitei, Cagatay Günes, Christian Bolenz, and Alexander Kleger
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Cell culture ,Stem Cells ,Cell Differentiation ,Tissue Engineering ,Material sciences ,Science (General) ,Q1-390 - Abstract
Summary: Ex vivo organ culture can be a useful alternative to in vivo models, which can be time-, labor-, and cost-intensive. Here we describe a step-by-step protocol to use de-epithelialized porcine urinary bladders as scaffolds in air-liquid interface in vitro culture systems for a variety of pluripotent stem-cell-derived and patient-derived pancreatic cells and organoids. The scaffold can trigger cell maturation and enable cell-cell interaction and invasion capacity studies. However, this model is limited by the lack of functional vasculature.For complete details on the use and execution of this protocol, please refer to Melzer et al. (2022),1 Breunig et al. (2021),2 and Breunig et al. (2021).3 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.
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- 2022
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61. IFITM proteins promote SARS-CoV-2 infection and are targets for virus inhibition in vitro
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Caterina Prelli Bozzo, Rayhane Nchioua, Meta Volcic, Lennart Koepke, Jana Krüger, Desiree Schütz, Sandra Heller, Christina M. Stürzel, Dorota Kmiec, Carina Conzelmann, Janis Müller, Fabian Zech, Elisabeth Braun, Rüdiger Groß, Lukas Wettstein, Tatjana Weil, Johanna Weiß, Federica Diofano, Armando A. Rodríguez Alfonso, Sebastian Wiese, Daniel Sauter, Jan Münch, Christine Goffinet, Alberto Catanese, Michael Schön, Tobias M. Boeckers, Steffen Stenger, Kei Sato, Steffen Just, Alexander Kleger, Konstantin M. J. Sparrer, and Frank Kirchhoff
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Science - Abstract
IFITM proteins can inhibit several viruses, but effects on SARS-CoV-2 infection are not well understood. Here, the authors show that endogenous IFITMs support SARS-CoV-2 infection in different in vitro models by binding spike and enhancing virus entry.
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- 2021
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62. Drug Inhibition of SARS-CoV-2 Replication in Human Pluripotent Stem Cell–Derived Intestinal Organoids
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Krüger, Jana, Groß, Rüdiger, Conzelmann, Carina, Müller, Janis A., Koepke, Lennart, Sparrer, Konstantin M.J., Weil, Tatjana, Schütz, Desiree, Seufferlein, Thomas, Barth, Thomas F.E., Stenger, Steffen, Heller, Sandra, Münch, Jan, and Kleger, Alexander
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- 2021
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63. A Methodological Workflow to Analyze Synthetic Lethality and Drug Synergism in Cancer Cells
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Gout, Johann, primary, Roger, Elodie, additional, Kleger, Alexander, additional, and Perkhofer, Lukas, additional
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- 2022
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64. The Effects of Hospitalisation on the Serum Metabolome in COVID-19 Patients
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Tim Hensen, Daniel Fässler, Liam O’Mahony, Werner C. Albrich, Beatrice Barda, Christian Garzoni, Gian-Reto Kleger, Urs Pietsch, Noémie Suh, Johannes Hertel, and Ines Thiele
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COVID-19 ,hospitalisation ,metabolomics ,serum ,disease progression ,multi-centre ,Microbiology ,QR1-502 - Abstract
COVID-19, a systemic multi-organ disease resulting from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is known to result in a wide array of disease outcomes, ranging from asymptomatic to fatal. Despite persistent progress, there is a continued need for more accurate determinants of disease outcomes, including post-acute symptoms after COVID-19. In this study, we characterised the serum metabolomic changes due to hospitalisation and COVID-19 disease progression by mapping the serum metabolomic trajectories of 71 newly hospitalised moderate and severe patients in their first week after hospitalisation. These 71 patients were spread out over three hospitals in Switzerland, enabling us to meta-analyse the metabolomic trajectories and filter consistently changing metabolites. Additionally, we investigated differential metabolite–metabolite trajectories between fatal, severe, and moderate disease outcomes to find prognostic markers of disease severity. We found drastic changes in serum metabolite concentrations for 448 out of the 901 metabolites. These results included markers of hospitalisation, such as environmental exposures, dietary changes, and altered drug administration, but also possible markers of physiological functioning, including carboxyethyl-GABA and fibrinopeptides, which might be prognostic for worsening lung injury. Possible markers of disease progression included altered urea cycle metabolites and metabolites of the tricarboxylic acid (TCA) cycle, indicating a SARS-CoV-2-induced reprogramming of the host metabolism. Glycerophosphorylcholine was identified as a potential marker of disease severity. Taken together, this study describes the metabolome-wide changes due to hospitalisation and COVID-19 disease progression. Moreover, we propose a wide range of novel potential biomarkers for monitoring COVID-19 disease course, both dependent and independent of the severity.
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- 2023
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65. Circulating Tumor DNA as a Novel Biomarker for Pancreatic Cancer
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Berger, Andreas W., Kleger, Alexander, Coleman, William B., Series Editor, Tsongalis, Gregory J., Series Editor, Michalski, Christoph W., editor, Rosendahl, Jonas, editor, Michl, Patrick, editor, and Kleeff, Jörg, editor
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- 2020
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66. Single-cell-resolved differentiation of human induced pluripotent stem cells into pancreatic duct-like organoids on a microwell chip
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Wiedenmann, Sandra, Breunig, Markus, Merkle, Jessica, von Toerne, Christine, Georgiev, Tihomir, Moussus, Michel, Schulte, Lucas, Seufferlein, Thomas, Sterr, Michael, Lickert, Heiko, Weissinger, Stephanie Ellen, Möller, Peter, Hauck, Stefanie M., Hohwieler, Meike, Kleger, Alexander, and Meier, Matthias
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- 2021
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67. Prospective pharmacotyping of urothelial carcinoma organoids for drug sensitivity prediction – feasibility and real world experience.
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Melzer, Michael Karl, Ma, Yanchun, Lindenmayer, Jessica, Morgenstern, Clara, Wezel, Felix, Zengerling, Friedemann, Günes, Cagatay, Gaisa, Nadine Therese, Kleger, Alexander, and Bolenz, Christian
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NON-muscle invasive bladder cancer ,TRANSITIONAL cell carcinoma ,BLADDER ,CELL culture ,TRANSLATIONAL research ,BLADDER cancer - Abstract
Urothelial carcinoma (UC) of the urinary bladder has significant challenges in treatment due to its diverse genetic landscape and variable response to systemic therapy. In recent years, patient-derived organoids (PDOs) emerged as a novel tool to model primary tumors with higher resemblance than conventional 2D cell culture approaches. However, the potential of organoids to predict therapy response in a clinical setting remains to be evaluated. This study explores the clinical feasibility of PDOs for pharmacotyping in UC. Initially, we subjected tumor tissue specimens from 50 patients undergoing transurethral resection or radical cystectomy to organoid propagation, of whom 19 (38%) yielded PDOs suitable for drug sensitivity assessment. Notably, whole transcriptome-based analysis indicated that PDOs may show phenotypes distinct from their parental tumor tissue. Pharmacotyping within a clinically relevant timeframe [mean of 35.44 and 55 days for non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC), respectively] was achieved. Drug sensitivity analyses revealed marked differences between NMIBC and MIBC, with MIBC-derived organoids demonstrating higher chemosensitivity toward clinically relevant drugs. A case study correlating organoid response with patient treatment outcome illustrated the complexity of predicting chemotherapy efficacy, especially considering the rapid acquisition of drug resistance. We propose a workflow of prospective organoid-based pharmacotyping in UC, enabling further translational research and integration of this approach into clinical practice. [ABSTRACT FROM AUTHOR]
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- 2024
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68. Implications of early respiratory support strategies on disease progression in critical COVID-19: a matched subanalysis of the prospective RISC-19-ICU cohort
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Pedro D. Wendel Garcia, Hernán Aguirre-Bermeo, Philipp K. Buehler, Mario Alfaro-Farias, Bernd Yuen, Sascha David, Thomas Tschoellitsch, Tobias Wengenmayer, Anita Korsos, Alberto Fogagnolo, Gian-Reto Kleger, Maddalena A. Wu, Riccardo Colombo, Fabrizio Turrini, Antonella Potalivo, Emanuele Rezoagli, Raquel Rodríguez-García, Pedro Castro, Arantxa Lander-Azcona, Maria C. Martín-Delgado, Herminia Lozano-Gómez, Rolf Ensner, Marc P. Michot, Nadine Gehring, Peter Schott, Martin Siegemund, Lukas Merki, Jan Wiegand, Marie M. Jeitziner, Marcus Laube, Petra Salomon, Frank Hillgaertner, Alexander Dullenkopf, Hatem Ksouri, Sara Cereghetti, Serge Grazioli, Christian Bürkle, Julien Marrel, Isabelle Fleisch, Marie-Helene Perez, Anja Baltussen Weber, Samuele Ceruti, Katharina Marquardt, Tobias Hübner, Hermann Redecker, Michael Studhalter, Michael Stephan, Daniela Selz, Urs Pietsch, Anette Ristic, Antje Heise, Friederike Meyer zu Bentrup, Marilene Franchitti Laurent, Patricia Fodor, Tomislav Gaspert, Christoph Haberthuer, Elif Colak, Dorothea M. Heuberger, Thierry Fumeaux, Jonathan Montomoli, Philippe Guerci, Reto A. Schuepbach, Matthias P. Hilty, Ferran Roche-Campo, and RISC-19-ICU Investigators
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COVID-19 ,ARDS ,Respiratory support ,Noninvasive mechanical ventilation ,High flow oxygen therapy ,Invasive mechanical ventilation ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Uncertainty about the optimal respiratory support strategies in critically ill COVID-19 patients is widespread. While the risks and benefits of noninvasive techniques versus early invasive mechanical ventilation (IMV) are intensely debated, actual evidence is lacking. We sought to assess the risks and benefits of different respiratory support strategies, employed in intensive care units during the first months of the COVID-19 pandemic on intubation and intensive care unit (ICU) mortality rates. Methods Subanalysis of a prospective, multinational registry of critically ill COVID-19 patients. Patients were subclassified into standard oxygen therapy ≥10 L/min (SOT), high-flow oxygen therapy (HFNC), noninvasive positive-pressure ventilation (NIV), and early IMV, according to the respiratory support strategy employed at the day of admission to ICU. Propensity score matching was performed to ensure comparability between groups. Results Initially, 1421 patients were assessed for possible study inclusion. Of these, 351 patients (85 SOT, 87 HFNC, 87 NIV, and 92 IMV) remained eligible for full analysis after propensity score matching. 55% of patients initially receiving noninvasive respiratory support required IMV. The intubation rate was lower in patients initially ventilated with HFNC and NIV compared to those who received SOT (SOT: 64%, HFNC: 52%, NIV: 49%, p = 0.025). Compared to the other respiratory support strategies, NIV was associated with a higher overall ICU mortality (SOT: 18%, HFNC: 20%, NIV: 37%, IMV: 25%, p = 0.016). Conclusion In this cohort of critically ill patients with COVID-19, a trial of HFNC appeared to be the most balanced initial respiratory support strategy, given the reduced intubation rate and comparable ICU mortality rate. Nonetheless, considering the uncertainty and stress associated with the COVID-19 pandemic, SOT and early IMV represented safe initial respiratory support strategies. The presented findings, in agreement with classic ARDS literature, suggest that NIV should be avoided whenever possible due to the elevated ICU mortality risk.
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- 2021
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69. Prognostic factors associated with mortality risk and disease progression in 639 critically ill patients with COVID-19 in Europe: Initial report of the international RISC-19-ICU prospective observational cohort
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Alfaro Farias, Mario, Margarit, Antoni, Vizmanos-Lamotte, Gerardo, Tschoellitsch, Thomas, Meier, Jens, Cardona, Francesco S., Skola, Josef, Horakova, Lenka, Aguirre-Bermeo, Hernan, Apolo, Janina, Novy, Emmanuel, Losser, Marie-Reine, Jurkolow, Geoffrey, Delahaye, Gauthier, David, Sascha, Welte, Tobias, Wengenmayer, Tobias, Staudacher, Dawid L., Aslanidis, Theodoros, Babik, Barna, Korsos, Anita, Gal, Janos, Csaba, Hermann, Donati, Abele, Carsetti, Andrea, Turrini, Fabrizio, Simonini, Maria Sole, Ceriani, Roberto, Murrone, Martina, Rezoagli, Emanuele, Vitale, Giovanni, Fogagnolo, Alberto, Spadaro, Savino, Wu, Maddalena Alessandra, Cogliati, Chiara, Colombo, Riccardo, Catena, Emanuele, Facondini, Francesca, Potalivo, Antonella, Gangitano, Gianfilippo, Perin, Tiziana, Bocci, Maria Grazia, Antonelli, Massimo, Gommers, Diederik, Ince, Can, Mayor-Vázquez, Eric, Cruz, Maria, Delgado, Martin, Garcia, Raquel Rodriguez, Gamez Zapata, Jorge, Zalba-Etayo, Begoña, Lozano-Gomez, Herminia, Castro, Pedro, Tellez, Adrian, Jacas, Adriana, Muñoz, Guido, Andrea, Rut, Ortiz, Jose, Quintana, Eduard, Rovira, Irene, Reverter, Enric, Fernandez, Javier, Ferrer, Miquel, Badia, Joan R., Lander Azcona, Arantxa, Orta, Jesus Escos, Bühler, Philipp, Brugger, Silvio, Hofmaenner, Daniel, Unseld, Simone, Ruschitzka, Frank, Moret-Bochatay, Mallory, Yuen, Bernd, Hillermann, Thomas, Ksouri, Hatem, Sridharan, Govind Oliver, Ristic, Anette, Sepulcri, Michael, Filipovic, Miodrag, Pietsch, Urs, Salomon, Petra, Drvaric, Iris, Schott, Peter, Urech, Severin, Lambert, Adriana, Merki, Lukas, Laube, Marcus, Hillgaertner, Frank, Sieber, Marianne, Dullenkopf, Alexander, Petersen, Lina, Grazioli, Serge, Rimensberger, Peter C., Fleisch, Isabelle, Lavanchy, Jerome, Marquardt, Katharina, Shaikh, Karim, Redecker, Hermann, Stephan, Michael, Brem, Jan, Rogdo, Bjarte, Birkenmaier, Andre, Meyer zu Bentrup, Friederike, Fodor, Patricia, Locher, Pascal, Camen, Giovanni, Siegemund, Martin, Zellweger, Nuria, Jeitziner, Marie-Madlen, Jenni-Moser, Beatrice, Bürkle, Christian, Kleger, Gian-Reto, Franchitti Laurent, Marilene, Laurent, Jean-Christophe, Gaspert, Tomislav, Jovic, Marija, Studhalter, Michael, Haberthuer, Christoph, Lussman, Roger F., Selz, Daniela, Naon, Didier, Mauri, Romano, Ceruti, Samuele, Marrel, Julien, Brenni, Mirko, Ensner, Rolf, Gehring, Nadine, Heise, Antje, Huebner, Tobias, Neff, Thomas A., Cereghetti, Sara, Boroli, Filippo, Pugin, Jerome, Marczin, Nandor, Wong, Joyce, Wendel Garcia, Pedro David, Fumeaux, Thierry, Guerci, Philippe, Heuberger, Dorothea Monika, Montomoli, Jonathan, Roche-Campo, Ferran, Schuepbach, Reto Andreas, and Hilty, Matthias Peter
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- 2020
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70. SARS‐Cov‐2 vaccination is safe in autoimmune pancreatitis patients
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Perkhofer, Lukas, primary, Kilani, Katja, additional, Wieser, Ägädius, additional, Seufferlein, Thomas, additional, Kleger, Pauline, additional, Mueller, Martin, additional, and Kleger, Alexander, additional
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- 2024
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71. Type 1 Autoimmune Pancreatitis in Europe: Clinical Profile and Response to Treatment
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Overbeek, Kasper A., primary, Poulsen, Jakob L., additional, Lanzillotta, Marco, additional, Vinge-Holmquist, Olof, additional, Macinga, Peter, additional, Demirci, A. Fatih, additional, Sindhunata, Daniko P., additional, Backhus, Johanna, additional, Algül, Hana, additional, Buijs, Jorie, additional, Levy, Philippe, additional, Kiriukova, Mariia, additional, Goni, Elisabetta, additional, Hollenbach, Marcus, additional, Miksch, Rainer C., additional, Kunovsky, Lumir, additional, Vujasinovic, Miroslav, additional, Nikolic, Sara, additional, Dickerson, Luke, additional, Hirth, Michael, additional, Neurath, Markus F., additional, Zumblick, Malte, additional, Vila, Josephine, additional, Jalal, Mustafa, additional, Beyer, Georg, additional, Frost, Fabian, additional, Carrara, Silvia, additional, Kala, Zdenek, additional, Jabandziev, Petr, additional, Sisman, Gurhan, additional, Akyuz, Filiz, additional, Capurso, Gabriele, additional, Falconi, Massimo, additional, Arlt, Alexander, additional, Vleggaar, Frank P., additional, Barresi, Luca, additional, Greenhalf, Bill, additional, Czakó, László, additional, Hegyi, Peter, additional, Hopper, Andrew, additional, Nayar, Manu K., additional, Gress, Thomas M., additional, Vitali, Francesco, additional, Schneider, Alexander, additional, Halloran, Chris M., additional, Trna, Jan, additional, Okhlobystin, Alexey V., additional, Dagna, Lorenzo, additional, Cahen, Djuna L., additional, Bordin, Dmitry, additional, Rebours, Vinciane, additional, Mayerle, Julia, additional, Kahraman, Alisan, additional, Rasch, Sebastian, additional, Culver, Emma, additional, Kleger, Alexander, additional, Martínez-Moneo, Emma, additional, Røkke, Ola, additional, Hucl, Tomas, additional, Olesen, Søren S., additional, Bruno, Marco J., additional, Della-Torre, Emanuel, additional, Beuers, Ulrich, additional, Löhr, J.-Matthias, additional, Rosendahl, Jonas, additional, Drewes, A. Mohr, additional, Haas, S.L., additional, Hoyer, B.F., additional, Hampe, J., additional, Hinrichs, C. Noreen, additional, Lerch, M.M., additional, Aghdassi, A.A., additional, Grote, T., additional, Heuser, D.J., additional, Ignatavicius, P., additional, Malecka-Panas, E., additional, Domínguez-Muñoz, J.E., additional, López-Serrano, A., additional, Auriemma, F., additional, Oracz, G., additional, Duman, D., additional, and Gubergrits, N., additional
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- 2024
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72. Alpha-1 antitrypsin inhibits TMPRSS2 protease activity and SARS-CoV-2 infection
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Lukas Wettstein, Tatjana Weil, Carina Conzelmann, Janis A. Müller, Rüdiger Groß, Maximilian Hirschenberger, Alina Seidel, Susanne Klute, Fabian Zech, Caterina Prelli Bozzo, Nico Preising, Giorgio Fois, Robin Lochbaum, Philip Maximilian Knaff, Volker Mailänder, Ludger Ständker, Dietmar Rudolf Thal, Christian Schumann, Steffen Stenger, Alexander Kleger, Günter Lochnit, Benjamin Mayer, Yasser B. Ruiz-Blanco, Markus Hoffmann, Konstantin M. J. Sparrer, Stefan Pöhlmann, Elsa Sanchez-Garcia, Frank Kirchhoff, Manfred Frick, and Jan Münch
- Subjects
Science - Abstract
Here, via screening of a polypeptide library from bronchoalveolar lavage, the authors identify and characterize α1-antitrypsin (α1AT) as SARS-CoV-2 inhibitor and show that α1AT binds and inactivates the serine protease TMPRSS2, which enzymatically primes the SARS-CoV-2 spike protein for membrane fusion.
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- 2021
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73. Impaired regulation of PMCA activity by defective CFTR expression promotes epithelial cell damage in alcoholic pancreatitis and hepatitis
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Madácsy, Tamara, Varga, Árpád, Papp, Noémi, Tél, Bálint, Pallagi, Petra, Szabó, Viktória, Kiss, Aletta, Fanczal, Júlia, Rakonczay, Jr., Zoltan, Tiszlavicz, László, Rázga, Zsolt, Hohwieler, Meike, Kleger, Alexander, Gray, Mike, Hegyi, Péter, and Maléth, József
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- 2022
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74. SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas
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Müller, Janis A., Groß, Rüdiger, Conzelmann, Carina, Krüger, Jana, Merle, Uta, Steinhart, Johannes, Weil, Tatjana, Koepke, Lennart, Bozzo, Caterina Prelli, Read, Clarissa, Fois, Giorgio, Eiseler, Tim, Gehrmann, Julia, van Vuuren, Joanne, Wessbecher, Isabel M., Frick, Manfred, Costa, Ivan G., Breunig, Markus, Grüner, Beate, Peters, Lynn, Schuster, Michael, Liebau, Stefan, Seufferlein, Thomas, Stenger, Steffen, Stenzinger, Albrecht, MacDonald, Patrick E., Kirchhoff, Frank, Sparrer, Konstantin M. J., Walther, Paul, Lickert, Heiko, Barth, Thomas F. E., Wagner, Martin, Münch, Jan, Heller, Sandra, and Kleger, Alexander
- Published
- 2021
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75. Influenza-associated aspergillosis in critically-ill patients—a retrospective bicentric cohort study
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Waldeck, Frederike, Boroli, Filippo, Suh, Noémie, Wendel Garcia, Pedro David, Flury, Domenica, Notter, Julia, Iten, Anne, Kaiser, Laurent, Schrenzel, Jacques, Boggian, Katia, Maggiorini, Marco, Pugin, Jérôme, Kleger, Gian-Reto, and Albrich, Werner Christian
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- 2020
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76. Aufklärung über Demokratie : Populismus, Aufklärung und die Krise der Öffentlichkeit
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Kleger, Heinz, Eisenegger, Mark, editor, Udris, Linards, editor, and Ettinger, Patrik, editor
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- 2019
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77. Toward a Physiologically Relevant 3D Helicoidal-Oriented Cardiac Model: Simultaneous Application of Mechanical Stimulation and Surface Topography
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Fatemeh Navaee, Philippe Renaud, Niccolò Piacentini, Mathilde Durand, Dara Zaman Bayat, Diane Ledroit, Sarah Heub, Stephanie Boder-Pasche, Alexander Kleger, Thomas Braschler, and Gilles Weder
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cardiac model ,helicoidal orientation ,3D cell orientation ,mechanical stimulation ,surface topography ,Technology ,Biology (General) ,QH301-705.5 - Abstract
Myocardium consists of cardiac cells that interact with their environment through physical, biochemical, and electrical stimulations. The physiology, function, and metabolism of cardiac tissue are affected by this dynamic structure. Within the myocardium, cardiomyocytes’ orientations are parallel, creating a dominant orientation. Additionally, local alignments of fibers, along with a helical organization, become evident at the macroscopic level. For the successful development of a reliable in vitro cardiac model, evaluation of cardiac cells’ behavior in a dynamic microenvironment, as well as their spatial architecture, is mandatory. In this study, we hypothesize that complex interactions between long-term contraction boundary conditions and cyclic mechanical stimulation may provide a physiological mechanism to generate off-axis alignments in the preferred mechanical stretch direction. This off-axis alignment can be engineered in vitro and, most importantly, mirrors the helical arrangements observed in vivo. For this purpose, uniaxial mechanical stretching of dECM-fibrin hydrogels was performed on pre-aligned 3D cultures of cardiac cells. In view of the potential development of helical structures similar to those in native hearts, the possibility of generating oblique alignments ranging between 0° and 90° was explored. Indeed, our investigations of cell alignment in 3D, employing both mechanical stimulation and groove constraint, provide a reliable mechanism for the generation of helicoidal structures in the myocardium. By combining cyclic stretch and geometric alignment in grooves, an intermediate angle toward favored direction can be achieved experimentally: while cyclic stretch produces a perpendicular orientation, geometric alignment is associated with a parallel one. In our 2D and 3D culture conditions, nonlinear cellular addition of the strains and strain avoidance concept reliably predicted the preferred cellular alignment. The 3D dECM-fibrin model system in this study shows that cyclical stretching supports cell survival and development. Using mechanical stimulation of pre-aligned heart cells, maturation markers are augmented in neonatal cardiomyocytes, while the beating culture period is prolonged, indicating an improved model function. We propose a simplified theoretical model based on numerical simulation and nonlinear strain avoidance by cells to explain oblique alignment angles. Thus, this work lays a possible rational basis for understanding and engineering oblique cellular alignments, such as the helicoidal layout of the heart, using approaches that simultaneously enhance maturation and function.
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- 2023
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78. A Three-Dimensional Engineered Cardiac In Vitro Model: Controlled Alignment of Cardiomyocytes in 3D Microphysiological Systems
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Fatemeh Navaee, Niloofar Khornian, David Longet, Sarah Heub, Stephanie Boder-Pasche, Gilles Weder, Alexander Kleger, Philippe Renaud, and Thomas Braschler
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3D cell culture ,in vitro cardiac model ,cardiac cell alignment ,3D hydrogel ,decellularized extracellular matrix (ECM) ,microfabricated grooves ,Cytology ,QH573-671 - Abstract
Cardiomyocyte alignment in myocardium tissue plays a significant role in the physiological, electrical, and mechanical functions of the myocardium. It remains, however, difficult to align cardiac cells in a 3D in vitro heart model. This paper proposes a simple method to align cells using microfabricated Polydimethylsiloxane (PDMS) grooves with large dimensions (of up to 350 µm in width), similar to the dimensions of trabeculae carneae, the smallest functional unit of the myocardium. Two cell groups were used in this work; first, H9c2 cells in combination with Nor10 cells for proof of concept, and second, neonatal cardiac cells to investigate the functionality of the 3D model. This model compared the patterned and nonpatterned 3D constructs, as well as the 2D cell cultures, with and without patterns. In addition to alignment, we assessed the functionality of our proposed 3D model by comparing beating rates between aligned and non-aligned structures. In order to assess the practicality of the model, the 3D aligned structures should be demonstrated to be detachable and alignable. This evaluation is crucial to the use of this 3D functional model in future studies related to drug screening, building blocks for tissue engineering, and as a heart-on-chip by integrating microfluidics.
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- 2023
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79. Differentiation of human pluripotent stem cells into pancreatic duct-like organoids
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Markus Breunig, Jessica Merkle, Michael Karl Melzer, Sandra Heller, Thomas Seufferlein, Matthias Meier, Meike Hohwieler, and Alexander Kleger
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Cell culture ,Developmental biology ,Stem Cells ,Cell Differentiation ,Organoids ,Science (General) ,Q1-390 - Abstract
Summary: The recapitulation of human developmental processes and pathological manifestations requires access to specific cell types and precursor stages during embryogenesis and disease. Here, we describe a scalable in vitro differentiation protocol to guide human pluripotent stem cells stepwise into pancreatic duct-like organoids. The protocol mimics pancreatic duct development and was successfully used to model the onset and progression of pancreatic ductal adenocarcinoma; the approach is suitable for multiple downstream applications. However, the protocol is cost- and time-intensive.For complete details on the use and execution of this protocol, please refer to Breunig et al. (2021).
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- 2021
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80. Prospective standardization of organoid-based pharmacotyping in urothelial carcinoma
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Melzer, M.K., primary, Ma, Y., additional, Lindenmayer, J., additional, Zengerling, F., additional, Wezel, F., additional, Günes, C., additional, Kleger, A., additional, and Bolenz, C., additional
- Published
- 2024
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81. Abstract C028: DKK3 in pancreatic cancer – Elucidating the roles of a double-edged sword
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Srinivasan, Dharini, primary, Arnold, Frank, additional, Roger, Elodie, additional, Härle, Anna, additional, Melzer, Michael, additional, Hermann, Patrick, additional, Perkhofer, Lukas, additional, Gout, Johann, additional, and Kleger, Alexander, additional
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- 2024
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82. Abstract A056: Targeting the mevalonate biosynthesis pathway in gemcitabine resistant pancreatic cancer
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Beutel, Alica K., primary, Calderon, Sabrina, additional, Nghiem, Ethan, additional, Singh, Rima, additional, Anaraki, Cecily, additional, Gulay, Kevin, additional, Tiriac, Herve, additional, Kleger, Alexander, additional, Seufferlein, Thomas, additional, Muir, Alexander, additional, Jang, Cholsoon, additional, Juarez, Dennis, additional, Fruman, David, additional, and Halbrook, Christopher, additional
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- 2024
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83. Abstract C061: Therapeutic profiling, patient response prediction, and tumor evolution in pancreatic cancer organoids
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Gout, Johann, primary, Resheq, Yazid J., additional, Lindenmayer, Jessica, additional, Ettrich, Thomas, additional, Perkhofer, Lukas, additional, Seufferlein, Thomas, additional, and Kleger, Alexander, additional
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- 2024
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84. Evaluation of Psychosomatic, Respiratory, and Neurocognitive Health in COVID-19 Survivors 12 Months after ICU Discharge.
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Germann, Nicolas, Amozova, Daria, Göhl-Freyn, Kristina, Fischer, Tim, Frischknecht, Manuel, Kleger, Gian-Reto, Pietsch, Urs, Filipovic, Miodrag, Brutsche, Martin H., Frauenfelder, Thomas, Kahlert, Christian R., Schmid, Dagmar A., and Albrich, Werner C.
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COVID-19 ,SLEEP ,INTENSIVE care units ,PSYCHOSOMATIC medicine ,CANCER fatigue ,FATIGUE (Physiology) ,BIOMARKERS ,PSYCHOSOMATIC disorders - Abstract
Patients who survive critical COVID-19 frequently report post-acute sequelae of COVID-19 (PASC) such as psychosomatic and neurocognitive health problems. The goal of this study was to identify clinical risk factors and other predictors for such long-term consequences in severely ill COVID-19 patients. Adult COVID-19 intensive care unit (ICU) survivors from August 2020 to May 2021 were enrolled. A broad range of clinical, laboratory and chest computed tomography (CT) data was collected during their ICU stays. The association between ICU predictors and psychosomatic, respiratory, and neurocognitive assessments 12 months after ICU discharge was analyzed using univariate regression analysis. In 17 patients (mean age 58.9 ± 11.4 years), laboratory markers (CRP, lymphocytes, hemoglobin), ICU severity (SOFA, SAPS II, need for mechanical ventilation), complications (ARDS), and lung CT data (ground-glass opacity) were promising predictors of depressive and anxiety symptoms, fatigue, and sleep problems. Recovery of psychosomatic health such as fatigue, depression, and anxiety correlated with lower levels of inflammation and high hemoglobin levels. ARDS, mechanical ventilation, and worse SOFA and SAPS II scores were further risk factors for depressive and anxiety symptoms. Our study identified novel associations such as pulmonary ground-glass opacity being positively associated with depression, anxiety, fatigue, and insomnia levels. [ABSTRACT FROM AUTHOR]
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- 2024
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85. Human Serum Albumin Is an Essential Component of the Host Defense Mechanism Against Clostridium difficile Intoxication
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di Masi, Alessandra, Leboffe, Loris, Polticelli, Fabio, Tonon, Federica, Zennaro, Cristina, Caterino, Marianna, Stano, Pasquale, Fischer, Stephan, Hägele, Marlen, Müller, Martin, Kleger, Alexander, Papatheodorou, Panagiotis, Nocca, Giuseppina, Arcovito, Alessandro, Gori, Andrea, Ruoppolo, Margherita, Barth, Holger, Petrosillo, Nicola, Ascenzi, Paolo, and Di Bella, Stefano
- Published
- 2018
86. Functional Genomic Screening During Somatic Cell Reprogramming Identifies DKK3 as a Roadblock of Organ Regeneration
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Frank Arnold, Pallavi U Mahaddalkar, Johann M. Kraus, Xiaowei Zhong, Wendy Bergmann, Dharini Srinivasan, Johann Gout, Elodie Roger, Alica K. Beutel, Eugen Zizer, Umesh Tharehalli, Nora Daiss, Ronan Russell, Lukas Perkhofer, Rupert Oellinger, Qiong Lin, Ninel Azoitei, Frank‐Ulrich Weiss, Markus M. Lerch, Stefan Liebau, Sarah‐Fee Katz, André Lechel, Roland Rad, Thomas Seufferlein, Hans A. Kestler, Michael Ott, Amar Deep Sharma, Patrick C. Hermann, and Alexander Kleger
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functional shRNA screen ,regeneration ,reprogramming ,Wnt‐/Hedgehog‐signaling ,Science - Abstract
Abstract Somatic cell reprogramming and tissue repair share relevant factors and molecular programs. Here, Dickkopf‐3 (DKK3) is identified as novel factor for organ regeneration using combined transcription‐factor‐induced reprogramming and RNA‐interference techniques. Loss of Dkk3 enhances the generation of induced pluripotent stem cells but does not affect de novo derivation of embryonic stem cells, three‐germ‐layer differentiation or colony formation capacity of liver and pancreatic organoids. However, DKK3 expression levels in wildtype animals and serum levels in human patients are elevated upon injury. Accordingly, Dkk3‐null mice display less liver damage upon acute and chronic failure mediated by increased proliferation in hepatocytes and LGR5+ liver progenitor cell population, respectively. Similarly, recovery from experimental pancreatitis is accelerated. Regeneration onset occurs in the acinar compartment accompanied by virtually abolished canonical‐Wnt‐signaling in Dkk3‐null animals. This results in reduced expression of the Hedgehog repressor Gli3 and increased Hedgehog‐signaling activity upon Dkk3 loss. Collectively, these data reveal Dkk3 as a key regulator of organ regeneration via a direct, previously unacknowledged link between DKK3, canonical‐Wnt‐, and Hedgehog‐signaling.
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- 2021
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87. Human Pluripotent Stem Cells Go Diabetic: A Glimpse on Monogenic Variants
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Sandra Heller, Michael Karl Melzer, Ninel Azoitei, Cécile Julier, and Alexander Kleger
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pluripotent stem cells ,diabetes ,monogenic variants ,Maturity Onset of Diabetes in the Young ,type 2 diabetes ,type 1 diabetes ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Diabetes, as one of the major diseases in industrial countries, affects over 350 million people worldwide. Type 1 (T1D) and type 2 diabetes (T2D) are the most common forms with both types having invariable genetic influence. It is accepted that a subset of all diabetes patients, generally estimated to account for 1–2% of all diabetic cases, is attributed to mutations in single genes. As only a subset of these genes has been identified and fully characterized, there is a dramatic need to understand the pathophysiological impact of genetic determinants on β-cell function and pancreatic development but also on cell replacement therapies. Pluripotent stem cells differentiated along the pancreatic lineage provide a valuable research platform to study such genes. This review summarizes current perspectives in applying this platform to study monogenic diabetes variants.
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- 2021
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88. TBX3 Directs Cell-Fate Decision toward Mesendoderm
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Weidgang, Clair E, Russell, Ronan, Tata, Purushothama R, Kühl, Susanne J, Illing, Anett, Müller, Martin, Lin, Qiong, Brunner, Cornelia, Boeckers, Tobias M, Bauer, Kerstin, Kartikasari, Apriliana ER, Guo, Yanchun, Radenz, Melanie, Bernemann, Christof, Weiß, Matthias, Seufferlein, Thomas, Zenke, Martin, Iacovino, Michelina, Kyba, Michael, Schöler, Hans R, Kühl, Michael, Liebau, Stefan, and Kleger, Alexander
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Stem Cell Research ,Stem Cell Research - Nonembryonic - Non-Human ,Stem Cell Research - Embryonic - Non-Human ,1.1 Normal biological development and functioning ,Underpinning research ,Generic health relevance ,Animals ,Cell Differentiation ,Cell Lineage ,Embryonic Stem Cells ,Gastrulation ,Gene Expression Regulation ,Developmental ,Mesoderm ,Mice ,Nodal Protein ,Smad2 Protein ,T-Box Domain Proteins ,Xenopus ,Biochemistry and Cell Biology ,Clinical Sciences - Abstract
Cell-fate decisions and pluripotency are dependent on networks of key transcriptional regulators. Recent reports demonstrated additional functions of pluripotency-associated factors during early lineage commitment. The T-box transcription factor TBX3 has been implicated in regulating embryonic stem cell self-renewal and cardiogenesis. Here, we show that TBX3 is dynamically expressed during specification of the mesendoderm lineages in differentiating embryonic stem cells (ESCs) in vitro and in developing mouse and Xenopus embryos in vivo. Forced TBX3 expression in ESCs promotes mesendoderm specification by directly activating key lineage specification factors and indirectly by enhancing paracrine Nodal/Smad2 signaling. TBX3 loss-of-function analyses in the Xenopus underline its requirement for mesendoderm lineage commitment. Moreover, we uncovered a functional redundancy between TBX3 and Tbx2 during Xenopus gastrulation. Taken together, we define further facets of TBX3 actions and map TBX3 as an upstream regulator of the mesendoderm transcriptional program during gastrulation.
- Published
- 2013
89. Acute respiratory distress syndrome during the COVID-19 pandemic: not only SARS-CoV-2
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P.M. Meyer Sauteur, G.-R. Kleger, and W.C. Albrich
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Acute respiratory distress syndrome ,extracorporeal membrane oxygenation ,Mycoplasma pneumoniae ,pneumonia ,sepsis ,Infectious and parasitic diseases ,RC109-216 - Abstract
A previously healthy 30-year-old woman developed severe ARDS at the beginning of the COVID-19 pandemic. SARS-CoV-2 infection was suspected, but testing was negative. Mycoplasma pneumoniae was detected by PCR in bronchoalveolar lavage fluid and blood. This case illustrates that M. pneumoniae infection can progress to septicemia and ARDS with severe respiratory failure in young healthy adults.
- Published
- 2021
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90. Probabilistic analysis of COVID-19 patients' individual length of stay in Swiss intensive care units.
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Alexander Henzi, Gian-Reto Kleger, Matthias P Hilty, Pedro D Wendel Garcia, Johanna F Ziegel, and RISC-19-ICU Investigators for Switzerland
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Medicine ,Science - Abstract
RationaleThe COVID-19 pandemic induces considerable strain on intensive care unit resources.ObjectivesWe aim to provide early predictions of individual patients' intensive care unit length of stay, which might improve resource allocation and patient care during the on-going pandemic.MethodsWe developed a new semiparametric distributional index model depending on covariates which are available within 24h after intensive care unit admission. The model was trained on a large cohort of acute respiratory distress syndrome patients out of the Minimal Dataset of the Swiss Society of Intensive Care Medicine. Then, we predict individual length of stay of patients in the RISC-19-ICU registry.MeasurementsThe RISC-19-ICU Investigators for Switzerland collected data of 557 critically ill patients with COVID-19.Main resultsThe model gives probabilistically and marginally calibrated predictions which are more informative than the empirical length of stay distribution of the training data. However, marginal calibration was worse after approximately 20 days in the whole cohort and in different subgroups. Long staying COVID-19 patients have shorter length of stay than regular acute respiratory distress syndrome patients. We found differences in LoS with respect to age categories and gender but not in regions of Switzerland with different stress of intensive care unit resources.ConclusionA new probabilistic model permits calibrated and informative probabilistic prediction of LoS of individual patients with COVID-19. Long staying patients could be discovered early. The model may be the basis to simulate stochastic models for bed occupation in intensive care units under different casemix scenarios.
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- 2021
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91. Enteropathogenic Infections: Organoids Go Bacterial
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Viktoria Hentschel, Frank Arnold, Thomas Seufferlein, Ninel Azoitei, Alexander Kleger, and Martin Müller
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Internal medicine ,RC31-1245 - Abstract
Enteric infections represent a major health care challenge which is particularly prevalent in countries with restricted access to clean water and sanitation and lacking personal hygiene precautions, altogether facilitating fecal-oral transmission of a heterogeneous spectrum of enteropathogenic microorganisms. Among these, bacterial species are responsible for a considerable proportion of illnesses, hospitalizations, and fatal cases, all of which have been continuously contributing to ignite researchers’ interest in further exploring their individual pathogenicity. Beyond the universally accepted animal models, intestinal organoids are increasingly valued for their ability to mimic key architectural and physiologic features of the native intestinal mucosa. As a consequence, they are regarded as the most versatile and naturalistic in vitro model of the gut, allowing monitoring of adherence, invasion, intracellular trafficking, and propagation as well as repurposing components of the host cell equipment. At the same time, infected intestinal organoids allow close characterization of the host epithelium’s immune response to enteropathogens. In this review, (i) we provide a profound update on intestinal organoid-based tissue engineering, (ii) we report the latest pathophysiological findings defining the infected intestinal organoids, and (iii) we discuss the advantages and limitations of this in vitro model.
- Published
- 2021
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92. PDX-derived organoids model in vivo drug response and secrete biomarkers
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Ling Huang, Bruno Bockorny, Indranil Paul, Dipikaa Akshinthala, Pierre-Oliver Frappart, Omar Gandarilla, Arindam Bose, Veronica Sanchez-Gonzalez, Emily E. Rouse, Sylvain D. Lehoux, Nicole Pandell, Christine M. Lim, John G. Clohessy, Joseph Grossman, Raul Gonzalez, Sofia Perea Del Pino, George Daaboul, Mandeep S. Sawhney, Steven D. Freedman, Alexander Kleger, Richard D. Cummings, Andrew Emili, Lakshmi B. Muthuswamy, Manuel Hidalgo, and Senthil K. Muthuswamy
- Subjects
Oncology ,Medicine - Abstract
Patient-derived organoid models are proving to be a powerful platform for both basic and translational studies. Here we conduct a methodical analysis of pancreatic ductal adenocarcinoma (PDAC) tumor organoid drug response in paired patient-derived xenograft (PDX) and PDX-derived organoid (PXO) models grown under WNT-free culture conditions. We report a specific relationship between area under the curve value of organoid drug dose response and in vivo tumor growth, irrespective of the drug treatment. In addition, we analyzed the glycome of PDX and PXO models and demonstrate that PXOs recapitulate the in vivo glycan landscape. In addition, we identify a core set of 57 N-glycans detected in all 10 models that represent 50%–94% of the relative abundance of all N-glycans detected in each of the models. Last, we developed a secreted biomarker discovery pipeline using media supernatant of organoid cultures and identified potentially new extracellular vesicle (EV) protein markers. We validated our findings using plasma samples from patients with PDAC, benign gastrointestinal diseases, and chronic pancreatitis and discovered that 4 EV proteins are potential circulating biomarkers for PDAC. Thus, we demonstrate the utility of organoid cultures to not only model in vivo drug responses but also serve as a powerful platform for discovering clinically actionable serologic biomarkers.
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- 2020
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93. IFN-γ treatment protocol for MHC-Ilo/PD-L1+ pancreatic tumor cells selectively restores their TAP-mediated presentation competence and CD8 T-cell priming potential
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Johann Gout, Thomas Seufferlein, Alexander Kleger, Katja Stifter, Jana Krieger, Leonie Ruths, Medhanie Mulaw, Andre Lechel, Martin Wagner, and Reinhold Schirmbeck
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background Many cancer cells express a major histocompatibility complex class I low/ programmed cell death 1 ligand 1 positive (MHC-Ilo/PD-L1+) cell surface profile. For immunotherapy, there is, thus, an urgent need to restore presentation competence of cancer cells with defects in MHC-I processing/presentation combined with immune interventions that tackle the tumor-initiated PD-L1/PD-1 signaling axis. Using pancreatic ductal adenocarcinoma cells (PDACCs) as a model, we here explored if (and how) expression/processing of tumor antigens via transporters associated with antigen processing (TAP) affects priming of CD8 T cells in PD-1/PD-L1-competent/-deficient mice.Methods We generated tumor antigen-expressing vectors, immunized TAP-competent/-deficient mice and determined de novo primed CD8 T-cell frequencies by flow cytometry. Similarly, we explored the antigenicity and PD-L1/PD-1 sensitivity of PDACCs versus interferon-γ (IFN-γ)-treated PDACCs in PD-1/PD-L1-competent/deficient mice. The IFN-γ-induced effects on gene and cell surface expression profiles were determined by microarrays and flow cytometry.Results We identified two antigens (cripto-1 and an endogenous leukemia virus-derived gp70) that were expressed in the Endoplasmic Reticulum (ER) of PDACCs and induced CD8 T-cell responses either independent (Cripto-1:Kb/Cr16-24) or dependent (gp70:Kb/p15E) on TAP by DNA immunization. IFN-γ-treatment of PDACCs in vitro upregulated MHC-I- and TAP- but also PD-L1-expression. Mechanistically, PD-L1/PD-1 signaling was superior to the reconstitution of MHC-I presentation competence, as subcutaneously transplanted IFN-γ-treated PDACCs developed tumors in C57BL/6J and PD-L1-/- but not in PD-1-/- mice. Using PDACCs, irradiated at day 3 post-IFN-γ-treatment or PD-L1 knockout PDACCs as vaccines, we could selectively bypass upregulation of PD-L1, preferentially induce TAP-dependent gp70:Kb/p15E-specific CD8 T cells associated with a weakened PD-1+ exhaustion phenotype and reject consecutively injected tumor transplants in C57BL/6J mice.Conclusions The IFN-γ-treatment protocol is attractive for cell-based immunotherapies, because it restores TAP-dependent antigen processing in cancer cells, facilitates priming of TAP-dependent effector CD8 T-cell responses without additional check point inhibitors and could be combined with genetic vaccines that complement priming of TAP-independent CD8 T cells.
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- 2020
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94. Serum IgG4 levels outperform IgG4/IgG RNA ratio in differential diagnosis of IgG4-related disease
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Lucas A. Schulte, Frank Arnold, Florian Siegel, Johanna Backhus, Georg Beyer, Frank Ulrich Weiss, Lukas Perkhofer, Alica Beutel, Thomas Seufferlein, Martin Müller, and Alexander Kleger
- Subjects
Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2020
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95. Thirty-Eight-Negative Kinase 1 Is a Mediator of Acute Kidney Injury in Experimental and Clinical Traumatic Hemorrhagic Shock
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Rebecca Halbgebauer, Ebru Karasu, Christian K. Braun, Annette Palmer, Sonja Braumüller, Anke Schultze, Fabian Schäfer, Sarah Bückle, Alica Eigner, Ulrich Wachter, Peter Radermacher, Ranillo R. G. Resuello, Joel V. Tuplano, Kristina Nilsson Ekdahl, Bo Nilsson, Milena Armacki, Alexander Kleger, Thomas Seufferlein, Miriam Kalbitz, Florian Gebhard, John D. Lambris, Martijn van Griensven, and Markus Huber-Lang
- Subjects
trauma ,injury ,TNK1 ,AKI ,complement ,inflammation ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Trauma represents a major socioeconomic burden worldwide. After a severe injury, hemorrhagic shock (HS) as a frequent concomitant aspect is a central driver of systemic inflammation and organ damage. The kidney is often strongly affected by traumatic-HS, and acute kidney injury (AKI) poses the patient at great risk for adverse outcome. Recently, thirty-eight-negative kinase 1 (TNK1) was proposed to play a detrimental role in organ damage after trauma/HS. Therefore, we aimed to assess the role of TNK1 in HS-induced kidney injury in a murine and a post hoc analysis of a non-human primate model of HS comparable to the clinical situation. Mice and non-human primates underwent resuscitated HS at 30 mmHg for 60 min. 5 h after the induction of shock, animals were assessed for systemic inflammation and TNK1 expression in the kidney. In vitro, murine distal convoluted tubule cells were stimulated with inflammatory mediators to gain mechanistic insights into the role of TNK1 in kidney dysfunction. In a translational approach, we investigated blood drawn from either healthy volunteers or severely injured patients at different time points after trauma (from arrival at the emergency room and at fixed time intervals until 10 days post injury; identifier: NCT02682550, https://clinicaltrials.gov/ct2/show/NCT02682550). A pronounced inflammatory response, as seen by increased IL-6 plasma levels as well as early signs of AKI, were observed in mice, non-human primates, and humans after trauma/HS. TNK1 was found in the plasma early after trauma-HS in trauma patients. Renal TNK1 expression was significantly increased in mice and non-human primates after HS, and these effects with concomitant induction of apoptosis were blocked by therapeutic inhibition of complement C3 activation in non-human primates. Mechanistically, in vitro data suggested that IL-6 rather than C3 cleavage products induced upregulation of TNK1 and impaired barrier function in renal epithelial cells. In conclusion, these data indicate that C3 inhibition in vivo may inhibit an excessive inflammatory response and mediator release, thereby indirectly neutralizing TNK1 as a potent driver of organ damage. In future studies, we will address the therapeutic potential of direct TNK1 inhibition in the context of severe tissue trauma with different degrees of additional HS.
- Published
- 2020
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96. An Inducible Expression System of the Calcium-Activated Potassium Channel 4 to Study the Differential Impact on Embryonic Stem Cells
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Liebau, Stefan, Tischendorf, Michael, Ansorge, Daniel, Linta, Leonhard, Stockmann, Marianne, Weidgang, Clair, Iacovino, Michelina, Boeckers, Tobias, von Wichert, Götz, Kyba, Michael, and Kleger, Alexander
- Subjects
Cardiovascular ,Stem Cell Research - Embryonic - Non-Human ,Stem Cell Research ,Regenerative Medicine ,Stem Cell Research - Embryonic - Human ,1.1 Normal biological development and functioning ,2.1 Biological and endogenous factors ,Underpinning research ,Aetiology ,Biochemistry and Cell Biology ,Clinical Sciences - Abstract
Rationale. The family of calcium-activated potassium channels consists of four members with varying biological functions and conductances. Besides membrane potential modulation, SK channels have been found to be involved in cardiac pacemaker cell development from ES cells and morphological shaping of neural stem cells. Objective. Distinct SK channel subtype expression in ES cells might elucidate their precise impact during cardiac development. We chose SK channel subtype 4 as a potential candidate influencing embryonic stem cell differentiation. Methods. We generated a doxycycline inducible mouse ES cell line via targeted homologous recombination of a cassette expressing a bicistronic construct encoding SK4 and a fluorophore from the murine HPRT locus. Conclusion. We characterized the mouse ES cell line iSK4-AcGFP. The cassette is readily expressed under the control of doxycycline, and the overexpression of SK4 led to an increase in cardiac and pacemaker cell differentiation thereby serving as a unique tool to characterize the cell biological variances due to specific SK channel overexpression.
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- 2011
97. Generating iPSCs with a High-Efficient, Non-Invasive Method—An Improved Way to Cultivate Keratinocytes from Plucked Hair for Reprogramming
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Lisa S. Wüstner, Moritz Klingenstein, Karl G. Frey, Mohammad R. Nikbin, Alfio Milazzo, Alexander Kleger, Stefan Liebau, and Stefanie Klingenstein
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plucked human hair ,hair follicle (HF) ,keratinocytes ,induced pluripotent stem cells (iPSCs) ,Cytology ,QH573-671 - Abstract
Various somatic cell types are suitable for induced pluripotency reprogramming, such as dermal fibroblasts, mesenchymal stem cells or hair keratinocytes. Harvesting primary epithelial keratinocytes from plucked human hair follicles (HFs) represents an easy and non-invasive alternative to a fibroblast culture from invasive skin biopsies. Nevertheless, to facilitate and simplify the process, which can be divided into three main steps (collecting, culturing and reprogramming), the whole procedure of generating hair keratinocytes has to be revised and upgraded continuously. In this study, we address advancements and approaches which improve the generation and handling of primary HF-derived keratinocytes tremendously, e.g., for iPSCs reprogramming. We not only evaluated different serum- and animal-origin-free media, but also supplements and coating solutions for an enhanced protocol. Here, we demonstrate the importance of speed and accuracy in the collecting step, as well as the choice of the right transportation medium. Our results lead to a more defined approach that further increases the reliability of downstream experiments and inter-laboratory reproducibility. These improvements will make it possible to obtain keratinocytes from plucked human hair for the generation of donor-specific iPSCs easier and more efficient than ever before, whilst preserving a non-invasive capability.
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- 2022
- Full Text
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98. Clinical and Imaging Features of COVID-19-Associated Pulmonary Aspergillosis
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Tim Fischer, Yassir El Baz, Nicole Graf, Simon Wildermuth, Sebastian Leschka, Gian-Reto Kleger, Urs Pietsch, Manuel Frischknecht, Giulia Scanferla, Carol Strahm, Stephan Wälti, Tobias Johannes Dietrich, and Werner C. Albrich
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COVID-19 ,COVID-19-associated pulmonary aspergillosis ,chest CT ,Medicine (General) ,R5-920 - Abstract
Background: COVID-19 superinfection by Aspergillus (COVID-19-associated aspergillosis, CAPA) is increasingly observed due to increased awareness and use of corticosteroids. The aim of this study is to compare clinical and imaging features between COVID-19 patients with and without associated pulmonary aspergillosis. Material and Methods: In this case–control study, hospitalized patients between March 2020 and March 2021 were evaluated. Two observers independently compared 105 chest CTs of 52 COVID-19 patients without pulmonary aspergillosis to 40 chest CTs of 13 CAPA patients. The following features were evaluated: lung involvement, predominant main pattern (ground glass opacity, crazy paving, consolidation) and additional lung and chest findings. Chronological changes in the abnormal extent upon CT and chronological changes in the main patterns were compared with mixed models. Patient-wise comparisons of additional features and demographic and clinical data were performed using Student’s t-test, Chi-squared test, Fisher’s exact tests and Wilcoxon rank-sum tests. Results: Compared to COVID-19 patients without pulmonary aspergillosis, CAPA patients were older (mean age (±SD): 70.3 (±7.8) versus 63.5 (±9.5) years (p = 0.01). The time-dependent evolution rates for consolidation (p = 0.02) and ground glass (p = 0.006) differed. In early COVID-19 disease, consolidation was associated with CAPA, whereas ground glass was less common. Chronological changes in the abnormal extent upon CT did not differ (p = 0.29). Regardless of the time point, bronchial wall thickening was observed more frequently in CAPA patients (p = 0.03). Conclusions: CAPA patients showed a tendency for consolidation in early COVID-19 disease. Bronchial wall thickening and higher patient age were associated with CAPA. The overall lung involvement was similar between both groups.
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- 2022
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99. Protestantismus und die Tradition des zivilen Ungehorsams
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Kleger, Heinz, Klein, Ansgar, Series editor, Kleinfeld, Ralf, Series editor, Krimmer, Holger, Series editor, Rehder, Britta, Series editor, Teune, Simon, Series editor, Walk, Heike, Series editor, Zimmer, Annette, Series editor, and Zimmermann, Olaf, editor
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- 2017
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100. Twelve-Month Outcomes after Metabolic and Bariatric Surgery among Youths Participating in a Structured Preparation and Follow-Up Program: Results of the Youth with Extreme Obesity Study
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Brandt, Stephanie, primary, Lennerz, Belinda S., additional, Wiegand, Susanna, additional, Schirmer, Melanie, additional, Kleger, Pauline, additional, Weyhreter, Helmut, additional, Holle, Rolf, additional, Hüttl, Thomas P., additional, Dietl, Otto, additional, von Schnurbein, Julia, additional, Holl, Reinhard W., additional, and Wabitsch, Martin, additional
- Published
- 2023
- Full Text
- View/download PDF
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