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122 results on '"Loebermann M"'

1. Rare HCV subtypes and retreatment outcomes in a cohort of European DAA-experienced patients

Author

Antoni, C., Teufel, A., Vogelmann, R., Ebert, M., Balavoine, J., Giostra, E., Berning, M., Hampe, J., Boettler, T., Neumann-Haefelin, C., Thimme, R., De Gottardi, A., Rauch, A., Semmo, N., Ellenrieder, V., Gress, M., Herrmann, A., Stallmach, A., Hoffmann, D., Protzer, U., Kodal, A., Löbermann, M., Götze, T., Keitel-Anselmino, V., Lange, C.M., Zachoval, R., Mayerle, J., Maieron, A., Michl, P., Merle, U., Moradpour, D., Chave, J.-P., Muche, M., Epple, H.-J., Müller-Schilling, M., Kocheise, F., Müller, T., Tacke, F., Roeb, E., Rissland, J., Krawczyk, M., Schulze, P., Semela, D., Spengler, U., Rockstroh, J., Strassburg, C.P., Siebler, J., Schulze zur Wiesch, J., Piecha, F., von Felden, J., Jordan, S., Lohse, A., Sprinzl, M., Galle, P., Stauber, R., Strey, B., Steckstor, W., Schmiegel, W., Brockmeyer, N.H., Canbay, A., Trautwein, C., Uschner, F., Trebicka, J., Weber, T., Wedemeyer, H., Cornberg, M., Manns, M., Wietzke-Braun, P., Günther, R., Willuweit, K., Hilgard, G., Schmidt, H., Zizer, E., Backhus, J., Seufferlein, T., Al-Taie, O., Angeli, W., Beckebaum, S., Erhardt, A., Garrido-Lüneburg, A., Gattringer, H., Genné, D., Gschwantler, M., Gundling, F., Hametner, S., Schöfl, R., Haag, S., Heinzow, H., Heyer, T., Hirschi, C., Jussios, A., Kanzler, S., Kordecki, N., Kraus, M., Kullig, U., Wollschläger, S., Magenta, L., Beretta-Piccoli, B. Terziroli, Menges, M., Mohr, L., Muehlenberg, K., Niederau, C., Paulweber, B., Petrides, A., Pinkernell, M., Piso, R., Rambach, W., Reinhardt, L., Reiser, M., Riecken, B., Rieke, A., Roth, J., Schelling, M., Schlee, P., Schneider, A., Scholz, D., Schott, E., Schuchmann, M., Schulten-Baumer, U., Seelhoff, A., Stich, A., Stickel, F., Ungemach, J., Walter, E., Weber, A., Wege, H., Winzer, T., Abels, W., Adler, M., Audebert, F., Baermann, C., Bästlein, E., Barth, R., Barthel, K., Becker, W., Behrends, J., Benninger, J., Berger, F., Berzow, D., Beyer, T., Bierbaum, M., Blaukat, O., Bodtländer, A., Böhm, G., Börner, N., Bohr, U., Bokemeyer, B., Bruch, H.R., Bucholz, D., Buggisch, P., Matschenz, K., Petersen, J., Burkhard, O., Busch, N., Chirca, C., Delker, R., Diedrich, J., Frank, M., Diehl, M., Tal, A.O., Schneider, M., Dienethal, A., Dietel, P., Dikopoulos, N., Dreck, M., Dreher, F., Drude, L., Ende, K., Ehrle, U., Baumgartl, K., Emke, F., Glosemeyer, R., Felten, G., Hüppe, D., Fischer, J., Fischer, U., Frederking, D., Frick, B., Friese, G., Gantke, B., Geyer, P., Schwind, H.R., Glas, M., Glaunsinger, T., Goebel, F., Göbel, U., Görlitz, B., Graf, R., Gruber, H., Hartmann, C., Klag, C., Härter, G., Herder, M., Heuchel, T., Heuer, S., Hinrichsen, H., Seegers, B., Höffl, K.-H., Hörster, H., Sonne, J.-U., Hofmann, W.P., Holst, F., Hunstiger, M., Hurst, A., Jägel-Guedes, E., John, C., Jung, M., Kallinowski, B., Kapzan, B., Kerzel, W., Khaykin, P., Klarhof, M., Klüppelberg, U., Wolfratshausen, Klugewitz, K., Knapp, B., Knevels, U., Kochsiek, T., Körfer, A., Köster, A., Kuhn, M., Langekamp, A., Künzig, B., Link, R., Littman, M., Löhr, H., Lutz, T., Gute, P., Knecht, G., Lutz, U., Mainz, D., Mahle, I., Maurer, P., Mauss, S., Mayer, C., Möller, H., Heyne, R., Moritzen, D., Mroß, M., Mundlos, M., Naumann, U., Nehls, O., K, Ningel, R., Oelmann, A., Olejnik, H., Gadow, K., Pascher, E., Philipp, A., Pichler, M., Polzien, F., Raddant, R., Riedel, M., Rietzler, S., Rössle, M., Rufle, W., Rump, A., Schewe, C., Hoffmann, C., Schleehauf, D., Schmidt, W., Schmidt-Heinevetter, G., Fabris, J. Schmidtler-von, Schneider, L., Schober, A., Niehaus-Hahn, S., Schwenzer, J., Seidel, T., Seitel, G., Sick, C., Simon, K., Stähler, D., Stenschke, F., Steffens, H., Stein, K., Steinmüller, M., Sternfeld, T., Svensson, K., Tacke, W., Teuber, G., Teubner, K., Thieringer, J., Tomesch, A., Trappe, U., Ullrich, J., Urban, G., Usadel, S., von Lucadou, A., Weinberger, F., Werheid-Dobers, M., Werner, P., Winter, T., Zehnter, E., Zipf, A., Dietz, Julia, Graf, Christiana, Berg, Christoph P., Port, Kerstin, Deterding, Katja, Buggisch, Peter, Peiffer, Kai-Henrik, Vermehren, Johannes, Dultz, Georg, Geier, Andreas, Reiter, Florian P., Bruns, Tony, Schattenberg, Jörn M., Durmashkina, Elena, Gustot, Thierry, Moreno, Christophe, Trauth, Janina, Discher, Thomas, Fischer, Janett, Berg, Thomas, Kremer, Andreas E., Müllhaupt, Beat, Zeuzem, Stefan, and Sarrazin, Christoph

Published
2024
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2. Long-term persistence of HCV resistance-associated substitutions after DAA treatment failure

Author

Balavoine, J., Giostra, E., Berning, M., Hampe, J., Canbay, A., Steckstor, W., Schmiegel, W., Brockmeyer, N.H., De Gottardi, A., Rauch, A., Semmo, N., Fischer, J., Gress, M., Heinzow, H., Hilgard, G., Schmidt, H., Herrmann, A., Stallmach, A., Hoffmann, D., Protzer, U., Klinker, H., Schulze, P., Kodal, A., Kremer, A., Siebler, J., Löbermann, M., Götze, T., Weigt, J., Lohse, A., Von Felden, J., Jordan, S., Lange, C.M., Zachoval, R., Mayerle, J., Maieron, A., Moradpour, D., Chave, J.-P., Moreno, C., Muche, M., Epple, H.-J., Müller-Schilling, M., Kocheise, F., Müllhaupt, B., Port, K., Deterding, K., Wedemeyer, H., Cornberg, M., Manns, M., Reinhardt, L., Ellenrieder, V., Rissland, J., Semela, D., Spengler, U., Rockstroh, J., Roeb, E., Sprinzl, M., Galle, P., Stauber, R., Stremmel, W., Strey, B., Thimme, R., Boettler, T., Tacke, F., Teufel, A., Vogelmann, R., Ebert, M., Tomasiewicz, K., Trautwein, C., Koenen, T., Weber, T., Wietzke-Braun, P., Günther, R., Zizer, E., Backhus, J., Seufferlein, T., Angeli, W., Beckebaum, S., Doberauer, C., Durmashkina, E., Hackelsberger, A., Erhardt, A., Garrido-Lüneburg, A., Gattringer, H., Genné, D., Gschwantler, M., Gundling, F., Hametner, S., Schöfl, R., Hartmann, C., Heyer, T., Hirschi, C., Jussios, A., Kanzler, S., Kordecki, N., Kraus, M., Kullig, U., Wollschläger, S., Magenta, L., Terziroli Beretta-Piccoli, B., Menges, M., Mohr, L., Muehlenberg, K., Niederau, C., Paulweber, B., Petrides, A., Pinkernell, M., Piso, R., Rambach, W., Reiser, M., Riecken, B., Rieke, A., Roth, J., Schelling, M., Schlee, P., Schneider, A., Scholz, D., Schott, E., Schuchmann, M., Schulten-Baumer, U., Seelhoff, A., Stich, A., Stickel, F., Ungemach, J., Walter, E., Weber, A., Winzer, T., Abels, W., Adler, M., Audebert, F., Baermann, C., Bästlein, E., Barth, R., Barthel, K., Becker, W., Behrends, J., Benninger, J., Berger, F., Berzow, D., Beyer, T., Bierbaum, M., Blaukat, O., Bodtländer, A., Böhm, G., Börner, N., Bohr, U., Bokemeyer, B., Bruch, H.R., Bucholz, D., Burkhard, O., Busch, N., Chirca, C., Delker, R., Diedrich, J., Frank, M., Diehl, M., Dienethal, A., Dietel, P., Dikopoulos, N., Dreck, M., Dreher, F., Drude, L., Ende, K., Ehrle, U., Baumgartl, K., Emke, F., Glosemeyer, R., Felten, G., Hüppe, D., Fischer, U., Frederking, D., Frick, B., Friese, G., Gantke, B., Geyer, P., Schwind, H.R., Glas, M., Glaunsinger, T., Goebel, F., Göbel, U., Görlitz, B., Graf, R., Gruber, H., Härter, G., Herder, M., Heuchel, T., Heuer, S., Höffl, K.-H., Hörster, H., Sonne, J.-U., Hofmann, W.P., Holst, F., Hunstiger, M., Hurst, A., Jägel-Guedes, E., John, C., Jung, M., Kallinowski, B., Kapzan, B., Kerzel, W., Khaykin, P., Klarhof, M., Klüppelberg, U., Wolfratshausen, Klugewitz, K., Knapp, B., Knevels, U., Kochsiek, T., Körfer, A., Köster, A., Kuhn, M., Langekamp, A., Künzig, B., Link, R., Littman, M., Löhr, H., Lutz, T., Knecht, G., Lutz, U., Mainz, D., Mahle, I., Maurer, P., Mayer, C., Meister, V., Möller, H., Heyne, R., Moritzen, D., Mroß, M., Mundlos, M., Naumann, U., Nehls, O., Ningel, K.R., Oelmann, A., Olejnik, H., Gadow, K., Pascher, E., Petersen, J., Philipp, A., Pichler, M., Polzien, F., Raddant, R., Riedel, M., Rietzler, S., Rössle, M., Rufle, W., Rump, A., Schewe, C., Hoffmann, C., Schleehauf, D., Schmidt, W., Schmidt-Heinevetter, G., Schmidtler-von Fabris, J., Schneider, L., Schober, A., Niehaus-Hahn, S., Schwenzer, J., Seegers, B., Seidel, T., Seitel, G., Sick, C., Simon, K., Stähler, D., Stenschke, F., Steffens, H., Stein, K., Steinmüller, M., Sternfeld, T., Svensson, K., Tacke, W., Teuber, G., Teubner, K., Thieringer, J., Tomesch, A., Trappe, U., Ullrich, J., Urban, G., Usadel, S., Von Lucadou, A., Weinberger, F., Werheid-Dobers, M., Werner, P., Winter, T., Zehnter, E., Zipf, A., Dietz, Julia, Müllhaupt, Beat, Buggisch, Peter, Graf, Christiana, Peiffer, Kai-Henrik, Matschenz, Katrin, Schattenberg, Jörn M., Antoni, Christoph, Mauss, Stefan, Niederau, Claus, Discher, Thomas, Trauth, Janina, Dultz, Georg, Schulze zur Wiesch, Julian, Piecha, Felix, Klinker, Hartwig, Müller, Tobias, Berg, Thomas, Neumann-Haefelin, Christoph, Berg, Christoph P., Zeuzem, Stefan, and Sarrazin, Christoph

Published
2023
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3. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1–3 Infections

Author

Balavoine, J., Giostra, E., Berning, M., Hampe, J., De Gottardi, A., Rauch, A., Semmo, N., Discher, T., Trauth, J., Fischer, J., Gress, M., Günther, R., Heinzow, H., Schmidt, J., Herrmann, A., Stallmach, A., Hilgard, G., Deterding, K., Lange, C.M., Ciesek, S., Wedemeyer, H., Hoffmann, D., Klinker, H., Schulze, P., Kocheise, F., Müller-Schilling, M., Kodal, A., Kremer, A., Ganslmayer, M., Siebler, J., Lammert, F., Rissland, J., Löbermann, M., Götze, T., Canbay, A., Lohse, A., von Felden, J., Jordan, S., Maieron, A., Moradpour, D., Chave, J.-P., Moreno, C., Müller, T., Muche, M., Epple, H.-J., Port, K., von Hahn, T., Cornberg, M., Manns, M., Reinhardt, L., Ellenrieder, V., Rockstroh, J., Schattenberg, J., Sprinzl, M., Galle, P., Roeb, E., Steckstor, M., Schmiegel, W., Brockmeyer, N.H., Seufferlein, T., Stremmel, W., Strey, B., Thimme, R., Teufel, A., Vogelmann, R., Ebert, M., Tomasiewicz, K., Trautwein, C., Tacke, F., Koenen, T., Weber, T., Zachoval, R., Mayerle, J., Raziorrouh, B., Angeli, W., Beckebaum, S., Doberauer, C., Durmashkina, E., Hackelsberger, A., Erhardt, A., Garrido-Lüneburg, A., Gattringer, H., Genné, D., Gschwantler, M., Gundling, F., Hametner, S., Schöfl, R., Hartmann, C., Heyer, T., Hirschi, C., Jussios, A., Kanzler, S., Kordecki, N., Kraus, M., Kullig, U., Wollschläger, S., Magenta, L., Beretta-Piccoli, B. Terziroli, Menges, M., Mohr, L., Muehlenberg, K., Niederau, C., Paulweber, B., Petrides, A., Pinkernell, M., Piso, R., Rambach, W., Reiser, M., Riecken, B., Rieke, A., Roth, J., Schelling, M., Schlee, P., Schneider, A., Scholz, D., Schott, E., Schuchmann, M., Schulten-Baumer, U., Seelhoff, A., Stich, A., Stickel, F., Ungemach, J., Walter, E., Weber, A., Winzer, T., Abels, W., Adler, M., Audebert, F., Baermann, C., Bästlein, E., Barth, R., Barthel, K., Becker, W., Behrends, J., Benninger, J., Berger, F., Berzow, D., Beyer, T., Bierbaum, M., Blaukat, O., Bodtländer, A., Böhm, G., Börner, N., Bohr, U., Bokemeyer, B., Bruch, H.R., Bucholz, D., Burkhard, O., Busch, N., Chirca, C., Delker, R., Diedrich, J., Frank, M., Diehl, M., Dienethal, A., Dietel, P., Dikopoulos, N., Dreck, M., Dreher, F., Drude, L., Ende, K., Ehrle, U., Baumgartl, K., Emke, F., Glosemeyer, R., Felten, G., Hüppe, D., Fischer, U., Frederking, D., Frick, B., Friese, G., Gantke, B., Geyer, P., Schwind, H.R., Glas, M., Glaunsinger, T., Goebel, F., Göbel, U., Görlitz, B., Graf, R., Gruber, H., Härter, G., Herder, M., Heuchel, T., Heuer, S., Höffl, K.-H., Hörster, H., Sonne, J.-U., Hofmann, W.P., Holst, F., Hunstiger, M., Hurst, A., Jägel-Guedes, E., John, C., Jung, M., Kallinowski, B., Kapzan, B., Kerzel, W., Khaykin, P., Klarhof, M., Klüppelberg, U., Klugewitz, K., Knapp, B., Knevels, U., Kochsiek, T., Körfer, A., Köster, A., Kuhn, M., Langekamp, A., Künzig, B., Link, R., Littman, M., Löhr, H., Lutz, T., Knecht, G., Lutz, U., Mainz, D., Mahle, I., Maurer, P., Mayer, C., Meister, V., Möller, H., Heyne, R., Moritzen, D., Mroß, M., Mundlos, M., Naumann, U., Nehls, O., Ningel, K.&R., Oelmann, A., Olejnik, H., Gadow, K., Pascher, E., Petersen, J., Philipp, A., Pichler, M., Polzien, F., Raddant, R., Riedel, M., Rietzler, S., Rössle, M., Rufle, W., Rump, A., Schewe, C., Hoffmann, C., Schleehauf, D., Schmidt, K.J., Schmidt, W., Schmidt-Heinevetter, G., Schmidtler-von Fabris, J., Schnaitmann, E., Schneider, L., Schober, A., Niehaus-Hahn, S., Schwenzer, J., Seidel, T., Seitel, G., Sick, C., Simon, K.G., Stähler, D., Stenschke, F., Steffens, H., Stein, K., Steinmüller, M., Sternfeld, T., Svensson, K., Tacke, W., Teuber, G., Teubner, K., Thieringer, J., Tomesch, A., Trappe, U., Ullrich, J., Urban, G., Usadel, S., von Lucadou, A., Weinberger, F., Werheid-Dobers, M., Werner, P., Winter, T., Zehnter, E., Zipf, A., Dietz, Julia, Spengler, Ulrich, Müllhaupt, Beat, Schulze zur Wiesch, Julian, Piecha, Felix, Mauss, Stefan, Seegers, Barbara, Hinrichsen, Holger, Antoni, Christoph, Wietzke-Braun, Perdita, Peiffer, Kai-Henrik, Berger, Annemarie, Matschenz, Katrin, Buggisch, Peter, Backhus, Johanna, Zizer, Eugen, Boettler, Tobias, Neumann-Haefelin, Christoph, Semela, David, Stauber, Rudolf, Berg, Thomas, Berg, Christoph, Zeuzem, Stefan, Vermehren, Johannes, and Sarrazin, Christoph

Published
2021
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4. Patterns of Resistance-Associated Substitutions in Patients With Chronic HCV Infection Following Treatment With Direct-Acting Antivirals

Author

Antoni, C., Vogelmann, R., Ebert, M., Backhus, J., Seufferlein, T., Balavoine, J., Giostra, E., Berg, C., Cornberg, M., Wedemeyer, H., Manns, M., De Gottardi, A., Esteban, R., Discher, T., Roeb, E., Gress, M., Günther, R., Wietzke-Braun, P., Herrmann, A., Stallmach, A., Hoffmann, D., Klinker, H., Kodal, A., Lammert, F., Löbermann, M., Schulze zur Wiesch, J., von Felden, J., Piecha, F., Lohse, A., Götze, T., Malfertheiner, P., Mayerle, J., Moradpour, D., Moreno, C., Neumann-Haefelin, C., Thimme, R., Reinhardt, L., Ellenrieder, V., Schattenberg, J., Sprinzl, M., Galle, P., Schmidt, J., Schott, E., Epple, H.-J., Siebler, J., Stauber, R., Steckstor, M., Schmiegel, W., Stremmel, W., Strey, B., Tomasiewicz, K., Trautwein, C., Zachoval, R., Angeli, W., Beckebaum, S., Doberauer, C., Ende, K., Erhardt, A., Garrido-Lüneburg, A., Gattringer, H., Genné, D., Gschwantler, M., Gundling, F., Hartmann, C., Heyer, T., Hirschi, C., Kanzler, S., Kordecki, N., Kraus, M., Kullig, U., Magenta, L., Terziroli Beretta-Piccoli, B., Menges, M., Mohr, L., Muehlenberg, K., Niederau, C., Paulweber, B., Petrides, A., Piso, R., Rambach, W., Reiser, M., Riecken, B., Roth, J., Schöfl, R., Maieron, A., Schneider, A., Schuchmann, M., Schulten-Baumer, U., Seelhoff, A., Semela, D., Stich, A., Vollmer, C., Brückner, J., Ungemach, J., Walter, E., Weber, A., Winzer, T., Abels, W., Adler, M., Audebert, F., Baermann, C., Bästlein, E., Barth, R., Barthel, K., Baumgartl, K., Becker, W., Benninger, J., Beyer, T., Bodtländer, A., Böhm, G., Bohr, U., Moll, A., Naumann, U., Börner, N., Bruch, H.R., Busch, N., Burkhard, O., Chirca, C., Dienethal, A., Dietel, P., Dreher, F., Efken, P., Ehrle, U., Emke, F., Fischer, J., Fischer, U., Frederking, D., Frick, B., Gantke B, B., Geyer, P., Glaunsinger, T., Goebel, F., Göbel, U., Graf, R., Herder, M., Heuchel, T., Heuer, S., Heyne, R., Höffl, K.H., Hofmann, W.P., Holst, F., Hörster, H., John, C., Jung, M.C., Kallinowski, B., Kerzel, W., Khaykin, P., Klarhof, M., Knapp, B., Knevels, U., Körfer, A., Köster, A., Künzig, B., Langenkamp, A., Kuhn, M., Littman, M., Löhr, H., Ludwig, L., Lutz, U., Maurer, P., Mayer, C., Meister, V., Moritzen, D., Mroß, M., Mundlos, M., Nehls, O., Ningel, K., Oelmann, A., Olejnik, H., Pascher, E., Philipp, A., Pichler, M., Polzien, F., Raddant, R., Riedel, M., Rietzler, S., Rump, A., Schmidt, W., Schmidtler-von Fabris, J., Schneider, L., Schober, A., Schwenzer, J., Seidel, T., Seitel, G., Sick, C., Simon, K., Stähler, D., Steffens, H., Svensson, K., Tacke, W., Teubner, K., Thieringer, J., Trappe, U., Ullrich, J., Usadel, S., von Lucadou, A., Werheid-Dobers, M., Zehnter, E., Zipf, A., Dietz, Julia, Susser, Simone, Vermehren, Johannes, Peiffer, Kai-Henrik, Grammatikos, Georgios, Berger, Annemarie, Ferenci, Peter, Buti, Maria, Müllhaupt, Beat, Hunyady, Bela, Hinrichsen, Holger, Mauss, Stefan, Petersen, Jörg, Buggisch, Peter, Felten, Gisela, Hüppe, Dietrich, Knecht, Gaby, Lutz, Thomas, Schott, Eckart, Berg, Christoph, Spengler, Ulrich, von Hahn, Thomas, Berg, Thomas, Zeuzem, Stefan, and Sarrazin, Christoph

Published
2018
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13. Long-term safety and efficacy of Eculizumab in Aquaporin-4 IgG-positive NMOSD

Author

Wingerchuk, D.M., Fujihara, K., Palace, J., Berthele, A., Levy, M., Kim, H.J., Nakashima, I., Oreja-Guevara, C., Wang, K.-C., Miller, L., Shang, S., Sabatella, G., Yountz, M., Pittock, S.J., Villa, A., Garcea, O., Manin, A., Melamud, L., Aguirre, F., Fernandez, V., Munoz, D.J., Amor, J., Bocchiardo, C., Obregon, C.D.D., Laffue, A., Paez, M.F., Perez, R.M., Rocchi, V., Teijeiro, L., De Virgiliis, M., Cordoba, M., Ingolotti, M., Lupinacci, A., Ballario, C., Chiesa, A., Gomez, H., Mainella, C., Lattini, H., Barnett, M., Barton, J., Beadnall, H., Garber, J., Hardy, T., Pollard, J., Trewin, B., Shuey, N., Bryson, A., French, A., Laing, J., Law, L.Y., Plummer, C., Sanders, L., Sedal, L., Winkel, A., Neal, A., Habek, M., Adamec, I., Barun, B., Crnosija, L., Gabelic, T., Pitha, J., Nytrova, P., Novakova, I., Tyblova, M., Krasulova, E., Pavlickova, J., Petersen, T., Rasmussen, P., Stilund, M., Svendsen, K., Diem, R., Platten, M., Berberich, A., Jaschonek, H., Wildemann, B., Biberacher, V.M., Brinkhoff, K., Golkowski, D., Kowarik, M., Lehmann-Horn, K., Pongratz, V., Zettl, U., Klinke, J., Loebermann, M., Meister, S., Rimmele, F., Winkelmann, A., Lau, A.Y.L., Au, L.W.C., Fan, S.Y.F., Ip, V.H.L., Ma, S.H., Ma, K.Y.K., Mok, C.T.V., Patti, F., Messina, S., Proietto, M., Filla, A., Morra, V.B., Costabile, T., Nozzolillo, A., Sacc, Sacca, Tackley, George, and MATUR, ZELİHA

Subjects
0301 basic medicine, medicine.medical_specialty, Neuromyelitis optica, business.industry, Maintenance dose, Eculizumab, Placebo, Interim analysis, medicine.disease, Confidence interval, ddc, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Aquaporin 4, Neurology, Internal medicine, Medicine, Neurology (clinical), Adverse effect, business, Research Articles, 030217 neurology & neurosurgery, Research Article, medicine.drug
Abstract

Objective\udDuring PREVENT (NCT01892345), eculizumab significantly reduced relapse risk versus placebo in patients with aquaporin-4 immunoglobulin G-positive neuromyelitis optica spectrum disorder (AQP4-IgG+ NMOSD). We report an interim analysis of PREVENT's ongoing open-label extension (OLE; NCT02003144) evaluating eculizumab's long-term safety and efficacy.\ud\udMethods\udPatients who completed PREVENT could enroll in the OLE to receive eculizumab (maintenance dose = 1,200 mg/2 weeks, after a blinded induction phase). Safety and efficacy data from PREVENT and its OLE (interim data cut, July 31, 2019) were combined for this analysis.\ud\udResults\udAcross PREVENT and the OLE, 137 patients received eculizumab and were monitored for a median (range) of 133.3 weeks (5.1–276.9 weeks), for a combined total of 362.3 patient-years (PY). Treatment-related adverse event (AE) and serious adverse event (SAE) rates were 183.5 in 100 PY and 8.6 in 100 PY, respectively. Serious infection rates were 10.2 in 100 PY in eculizumab-treated patients versus 15.1 in 100 PY in the PREVENT placebo group. No patient developed a meningococcal infection. At 192 weeks (3.7 years), 94.4% (95% confidence interval [CI], 88.6–97.3) of patients remained adjudicated relapse-free. The adjudicated annualized relapse rate was 0.025 (95% CI = 0.013–0.048) in all eculizumab-treated patients versus 0.350 (95% CI = 0.199–0.616) in the PREVENT placebo group. During the OLE, 37% of patients (44 of 119 patients) stopped or decreased background immunosuppressive therapy use.\ud\udInterpretation\udThis analysis demonstrates that eculizumab's long-term safety profile in NMOSD is consistent with its established profile across other indications. This analysis also demonstrated the sustained ability of long-term eculizumab treatment to reduce relapse risk in patients with AQP4-IgG+ NMOSD. ANN NEUROL 2021;89:1088–1098

Published
2021

15. [Fever after travel to tropical regions: Malaria and other emergencies]

Author

Loebermann M, C J Hemmer, and E C Reisinger

Subjects
Gynecology, medicine.medical_specialty, biology, business.industry, Malaria-Schnelltests, Inkubationszeiten, Plasmodium falciparum, Tropical diseases, Rapid diagnostic tests, 030231 tropical medicine, biology.organism_classification, Incubation periods, 03 medical and health sciences, 0302 clinical medicine, Leitthema, Tropenkrankheiten, Emergency Medicine, medicine, Differential diagnosis, 030212 general & internal medicine, business, Differenzialdiagnosen
Abstract

Zusammenfassung Hintergrund Bei Tropenrückkehrern ist Malaria die häufigste Fieberursache. Die häufigste und gleichzeitig gefährlichste Art der Malaria ist die Malaria tropica. Sie wird durch Plasmodium falciparum verursacht. Methode Recherche und Auswertung der aktuellen Literatur. Ergebnisse und Schlussfolgerung Über 90 % der Malariaerkrankungen und der Malariatodesfälle betreffen Afrika. Der Rest verteilt sich auf Indien, Südost-Asien, Ozeanien, und Lateinamerika. In Deutschland wurden in den letzten 10 Jahren laut Robert Koch-Institut (RKI) zwischen 513 und 613 Malariafälle gemeldet, darunter zwischen 389 und 541 Fälle der potenziell tödlichen Malaria tropica (Plasmodium falciparum). Ein Malariaverdacht besteht bei jedem Fieber, das bis zu 4 Monate nach einem Tropenaufenthalt auftritt, bei Einwanderern aus Malariaregionen auch noch Jahre nach dem letzten Tropenaufenthalt. Die sog. Malaria-Schnelltests sind – v. a. im Hinblick auf die durch Plasmodium falciparum hervorgerufene Malaria tropica – inzwischen teilweise brauchbar. Sie ergeben jedoch gelegentlich falsch-negative oder falsch-positive Befunde. Die Therapie der Malaria hängt von der Plasmodien-Art, dem klinischen Schweregrad und der Region, in der die Infektion erworben wurde, und ferner vom Schweregrad der Erkrankung ab.

Published
2020

16. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections

Author

Dietz, Julia, Spengler, Ulrich, Mullhaupt, Beat, zur Wiesch, Julian Schulze, Piecha, Felix, Mauss, Stefan, Seegers, Barbara, Hinrichsen, Holger, Antoni, Christoph, Wietzke-Braun, Perdita, Peiffer, Kai-Henrik, Berger, Annemarie, Matschenz, Katrin, Buggisch, Peter, Backhus, Johanna, Zizer, Eugen, Boettler, Tobias, Neumann-Haefelin, Christoph, Semela, David, Stauber, Rudolf, Berg, Thomas, Berg, Christoph, Zeuzem, Stefan, Vermehren, Johannes, Sarrazin, Christoph, Balavoine, J., Giostra, E., Berning, M., Hampe, J., De Gottardi, A., Rauch, A., Semmo, N., Discher, T., Trauth, J., Fischer, J., Gress, M., Guenther, R., Heinzow, H., Schmidt, J., Herrmann, A., Stallmach, A., Hilgard, G., Deterding, K., Lange, C. M., Ciesek, S., Wedemeyer, H., Hoffmann, D., Klinker, H., Schulze, P., Kocheise, F., Mueller-Schilling, M., Kodal, A., Kremer, A., Ganslmayer, M., Siebler, J., Lammert, F., Rissland, J., Loebermann, M., Goetze, T., Canbay, A., Lohse, A., von Felden, J., Jordan, S., Maieron, A., Moradpour, D., Chave, J. -P., Moreno, C., Mueller, T., Muche, M., Epple, H. -J., Port, K., von Hahn, T., Cornberg, M., Manns, M., Reinhardt, L., Ellenrieder, V., Rockstroh, J., Schattenberg, J., Sprinzl, M., Galle, P., Roeb, E., Steckstor, M., Schmiegel, W., Brockmeyer, N. H., Seufferlein, T., Stremmel, W., Strey, B., Thimme, R., Teufel, A., Vogelmann, R., Ebert, M., Tomasiewicz, K., Trautwein, C., Tacke, F., Koenen, T., Weber, T., Zachoval, R., Mayerle, J., Raziorrouh, B., Angeli, W., Beckebaum, S., Doberauer, C., Durmashkina, E., Hackelsberger, A., Erhardt, A., Garrido-Luneburg, A., Gattringer, H., Genne, D., Gschwantler, M., Gundling, F., Hametner, S., Schofl, R., Hartmann, C., Heyer, T., Hirschi, C., Jussios, A., Kanzler, S., Kordecki, N., Kraus, M., Kullig, U., Wollschlager, S., Magenta, L., Beretta-Piccoli, B. Terziroli, Menges, M., Mohr, L., Muehlenberg, K., Niederau, C., Paulweber, B., Petrides, A., Pinkernell, M., Piso, R., Rambach, W., Reiser, M., Riecken, B., Rieke, A., Roth, J., Schelling, M., Schlee, P., Schneider, A., Scholz, D., Schott, E., Schuchmann, M., Schulten-Baumer, U., Seelhoff, A., Stich, A., Stickel, F., Ungemach, J., Walter, E., Weber, A., Winzer, T., Abels, W., Adler, M., Baermann, C., Bastlein, E., Barth, R., Barthel, K., Becker, W., Behrends, J., Benninger, J., Berger, F., Berzow, D., Beyer, T., Bierbaum, M., Blaukat, O., Bodtlander, A., Bohm, G., Borner, N., Bohr, U., Bokemeyer, B., Bruch, H. R., Bucholz, D., Burkhard, O., Busch, N., Chirca, C., Delker, R., Diedrich, J., Frank, M., Diehl, M., Dienethal, A., Dietel, P., Dikopoulos, N., Dreck, M., Dreher, F., Drude, L., Ende, K., Ehrle, U., Baumgartl, K., Emke, F., Glosemeyer, R., Felten, G., Huppe, D., Fischer, U., Frederking, D., Frick, B., Friese, G., Gantke, B., Geyer, P., Schwind, H. R., Glas, M., Glaunsinger, T., Goebel, F., Gobel, U., Gorlitz, B., Graf, R., Gruber, H., Harter, G., Herder, M., Heuchel, T., Heuer, S., Hoffl, K. -H., Horster, H., Sonne, J. -U., Hofmann, W. P., Holst, F., Hunstiger, M., Hurst, A., Jagel-Guedes, E., John, C., Jung, M., Kallinowski, B., Kapzan, B., Kerzel, W., Khaykin, P., Klarhof, M., Kluppelberg, U., Klugewitz, K., Knapp, B., Knevels, U., Kochsiek, T., Korfer, A., Koster, A., Kuhn, M., Langekamp, A., Kunzig, B., Link, R., Littman, M., Lohr, H., Lutz, T., Knecht, G., Lutz, U., Mainz, D., Mahle, I., Maurer, P., Mayer, C., Meister, V., Moller, H., Heyne, R., Moritzen, D., Mross, M., Mundlos, M., Naumann, U., Nehls, O., Ningel, R., Oelmann, A., Olejnik, H., Gadow, K., Pascher, E., Petersen, J., Philipp, A., Pichler, M., Polzien, F., Raddant, R., Riedel, M., Rietzler, S., Rossle, M., Rufle, W., Rump, A., Schewe, C., Hoffmann, C., Schleehauf, D., Schmidt, K. J., Schmidt, W., Schmidt-Heinevetter, G., Schmidtler-von Fabris, J., Schnaitmann, E., Schneider, L., Schober, A., Niehaus-Hahn, S., Schwenzer, J., Seidel, T., Seitel, G., Sick, C., Simon, K. G., Stahler, D., Stenschke, F., Steffens, H., Stein, K., Steinmuller, M., Sternfeld, T., Svensson, K., Tacke, W., Teuber, G., Teubner, K., Thieringer, J., Tomesch, A., Trappe, U., Ullrich, J., Urban, G., Usadel, S., von Lucadou, A., Weinberger, F., Werheid-Dobers, M., Werner, P., Winter, T., Zehnter, E., Zipf, A., Dietz, Julia, Spengler, Ulrich, Mullhaupt, Beat, zur Wiesch, Julian Schulze, Piecha, Felix, Mauss, Stefan, Seegers, Barbara, Hinrichsen, Holger, Antoni, Christoph, Wietzke-Braun, Perdita, Peiffer, Kai-Henrik, Berger, Annemarie, Matschenz, Katrin, Buggisch, Peter, Backhus, Johanna, Zizer, Eugen, Boettler, Tobias, Neumann-Haefelin, Christoph, Semela, David, Stauber, Rudolf, Berg, Thomas, Berg, Christoph, Zeuzem, Stefan, Vermehren, Johannes, Sarrazin, Christoph, Balavoine, J., Giostra, E., Berning, M., Hampe, J., De Gottardi, A., Rauch, A., Semmo, N., Discher, T., Trauth, J., Fischer, J., Gress, M., Guenther, R., Heinzow, H., Schmidt, J., Herrmann, A., Stallmach, A., Hilgard, G., Deterding, K., Lange, C. M., Ciesek, S., Wedemeyer, H., Hoffmann, D., Klinker, H., Schulze, P., Kocheise, F., Mueller-Schilling, M., Kodal, A., Kremer, A., Ganslmayer, M., Siebler, J., Lammert, F., Rissland, J., Loebermann, M., Goetze, T., Canbay, A., Lohse, A., von Felden, J., Jordan, S., Maieron, A., Moradpour, D., Chave, J. -P., Moreno, C., Mueller, T., Muche, M., Epple, H. -J., Port, K., von Hahn, T., Cornberg, M., Manns, M., Reinhardt, L., Ellenrieder, V., Rockstroh, J., Schattenberg, J., Sprinzl, M., Galle, P., Roeb, E., Steckstor, M., Schmiegel, W., Brockmeyer, N. H., Seufferlein, T., Stremmel, W., Strey, B., Thimme, R., Teufel, A., Vogelmann, R., Ebert, M., Tomasiewicz, K., Trautwein, C., Tacke, F., Koenen, T., Weber, T., Zachoval, R., Mayerle, J., Raziorrouh, B., Angeli, W., Beckebaum, S., Doberauer, C., Durmashkina, E., Hackelsberger, A., Erhardt, A., Garrido-Luneburg, A., Gattringer, H., Genne, D., Gschwantler, M., Gundling, F., Hametner, S., Schofl, R., Hartmann, C., Heyer, T., Hirschi, C., Jussios, A., Kanzler, S., Kordecki, N., Kraus, M., Kullig, U., Wollschlager, S., Magenta, L., Beretta-Piccoli, B. Terziroli, Menges, M., Mohr, L., Muehlenberg, K., Niederau, C., Paulweber, B., Petrides, A., Pinkernell, M., Piso, R., Rambach, W., Reiser, M., Riecken, B., Rieke, A., Roth, J., Schelling, M., Schlee, P., Schneider, A., Scholz, D., Schott, E., Schuchmann, M., Schulten-Baumer, U., Seelhoff, A., Stich, A., Stickel, F., Ungemach, J., Walter, E., Weber, A., Winzer, T., Abels, W., Adler, M., Baermann, C., Bastlein, E., Barth, R., Barthel, K., Becker, W., Behrends, J., Benninger, J., Berger, F., Berzow, D., Beyer, T., Bierbaum, M., Blaukat, O., Bodtlander, A., Bohm, G., Borner, N., Bohr, U., Bokemeyer, B., Bruch, H. R., Bucholz, D., Burkhard, O., Busch, N., Chirca, C., Delker, R., Diedrich, J., Frank, M., Diehl, M., Dienethal, A., Dietel, P., Dikopoulos, N., Dreck, M., Dreher, F., Drude, L., Ende, K., Ehrle, U., Baumgartl, K., Emke, F., Glosemeyer, R., Felten, G., Huppe, D., Fischer, U., Frederking, D., Frick, B., Friese, G., Gantke, B., Geyer, P., Schwind, H. R., Glas, M., Glaunsinger, T., Goebel, F., Gobel, U., Gorlitz, B., Graf, R., Gruber, H., Harter, G., Herder, M., Heuchel, T., Heuer, S., Hoffl, K. -H., Horster, H., Sonne, J. -U., Hofmann, W. P., Holst, F., Hunstiger, M., Hurst, A., Jagel-Guedes, E., John, C., Jung, M., Kallinowski, B., Kapzan, B., Kerzel, W., Khaykin, P., Klarhof, M., Kluppelberg, U., Klugewitz, K., Knapp, B., Knevels, U., Kochsiek, T., Korfer, A., Koster, A., Kuhn, M., Langekamp, A., Kunzig, B., Link, R., Littman, M., Lohr, H., Lutz, T., Knecht, G., Lutz, U., Mainz, D., Mahle, I., Maurer, P., Mayer, C., Meister, V., Moller, H., Heyne, R., Moritzen, D., Mross, M., Mundlos, M., Naumann, U., Nehls, O., Ningel, R., Oelmann, A., Olejnik, H., Gadow, K., Pascher, E., Petersen, J., Philipp, A., Pichler, M., Polzien, F., Raddant, R., Riedel, M., Rietzler, S., Rossle, M., Rufle, W., Rump, A., Schewe, C., Hoffmann, C., Schleehauf, D., Schmidt, K. J., Schmidt, W., Schmidt-Heinevetter, G., Schmidtler-von Fabris, J., Schnaitmann, E., Schneider, L., Schober, A., Niehaus-Hahn, S., Schwenzer, J., Seidel, T., Seitel, G., Sick, C., Simon, K. G., Stahler, D., Stenschke, F., Steffens, H., Stein, K., Steinmuller, M., Sternfeld, T., Svensson, K., Tacke, W., Teuber, G., Teubner, K., Thieringer, J., Tomesch, A., Trappe, U., Ullrich, J., Urban, G., Usadel, S., von Lucadou, A., Weinberger, F., Werheid-Dobers, M., Werner, P., Winter, T., Zehnter, E., and Zipf, A.

Published
2021

21. Focal Myositis in Salmonella paratyphi B Infection: A Case Report

Author

Geerdes-Fenge H, E C Reisinger, Loebermann M, C J Hemmer, and Kolarov C

Subjects
Salmonella, Pathology, medicine.medical_specialty, biology, business.industry, Focal myositis, Salmonella paratyphi B, biology.organism_classification, medicine.disease_cause, medicine.disease, Medius, Bacterial myositis, Medicine, Iliopsoas, business, Myositis
Abstract

Background: We report a case of focal myositis caused by an infection with Salmonella paratyphi B in an 18-year-old immuno-competent woman. Methods: Case report and review of the literature on Salmonella causing (pyo)-myositis. Results: An 18-year-old woman developed a focal myositis of the iliopsoas, gluteus medius and piriformis muscles on the right side occurring 2 days after onset of fever caused by Salmonella paratyphi B infection. Other reasons for focal myositis were excluded. Conclusion: This is the first reported case of focal myositis being caused by an infection with Salmonella paratyphi B in a previously healthy patient.

Published
2019
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22. Host defense versus immunosuppression: Male and female Schistosoma mansoni differentially impact the host’s immune system

Author

Sombetzki, M, Koslowski, N, Rabes, A, Seneberg, S, Winkelmann, F, Fritzsche, C, Loebermann, M, and Reisinger, EC

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Schistosomiasis remains a major cause of morbidity and mortality, and in the tropics and subtropics, in particular, infection rates are high [ref:1]. The efficacy of anthelmintic therapy is limited since it has no effect on immature parasite stages and does not prevent re-infection. The root[for full text, please go to the a.m. URL], Infektiologie Update 2018; 26. Jahrestagung der Paul-Ehrlich-Gesellschaft für Chemotherapie (PEG)

Published
2018
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23. 24-nor-ursodeoxycholic acid impairs inflammatory response and hepatic fibrosis in a murine model of Schistosoma mansoni infection

Author

Sombetzki, M, Loebermann, M, Fickert, P, Fuchsbichler, A, Langner, C, Gumhold, J, Silbert, D, Riebold, D, Holtfreter, MC, Nizze, H, Trauner, M, and Reisinger, EC

Subjects
ddc: 610, parasitic diseases, 610 Medical sciences, Medicine
Abstract

Objectives: Vigorous intrahepatic granuloma formation and fibrosis in response to parasite eggs specify the pathological picture of Schistosoma mansoni infection as one of the worldwide leading causes for liver fibrosis and portal hypertension. Following our previous observations that 24-nor-ursodeoxycholic[for full text, please go to the a.m. URL], 10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Published
2010
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30. Schistosomula, pre-adults and adults of Schistosoma mansoni ingest fluorescence-labelled albumin in vitro and in vivo: implication for a drug-targeting model.

Author

Holtfreter, M. C., Loebermann, M., Frei, E., Riebold, D., Wolff, D., Hartung, G., Kinzelbach, R., and Reisinger, E. C.

Subjects
*SCHISTOSOMA mansoni, *SCHISTOSOMIASIS, *TARGETED drug delivery, *SCHISTOSOMA haematobium, *ERYTHROCYTES, *SERUM albumin, *ANTHELMINTICS, *ALBUMINS
Abstract

Objective. Bilharziosis is one of the most important helminthal infections in humans and is caused by blood flukes of the genus Schistosoma. Three different life stages of the parasite occur within the mammalian host: schistosomula located in the skin, pre-adults located in the lung and adult worms located in the portal venous system. Erythrocytes are a major source of nutrient supply for adults. However, sources of nutrition for the developing stages are still unclear. Methods. To investigate whether schistosomula, pre-adults and adults of Schistosoma mansoni ingest human serum albumin (HSA) in vitro, these life stages were incubated with aminofluorescein-labelled human serum albumin (Afl-HSA) for 5 h. To test the uptake of albumin in vivo, the albumin conjugate was given intravenously to S. mansoni infected NMRI mice 24 h before harvesting the 3 life stages. Results. In comparison to the control group schistosomula, pre-adults, and adults showed an accumulation of Afl-HSA within the oesophagus and intestinal caecum in vitro and in vivo. Conclusion. Our findings suggest that albumin seems to be a major source of energy supply for the early schistosomal life stages and an additive energy support for adult worms. Since albumin has been used successfully as a drug carrier for chemotherapeutic substances against malignant disorders, further studies will focus on albumin as a carrier for anthelminthics in a drug-targeting model. [ABSTRACT FROM AUTHOR]

Published
2010
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32. A randomized, open-label study of the immunogenicity and reactogenicity of three lots of a combined typhoid fever/hepatitis A vaccine in healthy adults.

Author

Loebermann M, Kollaritsch H, Ziegler T, Rendi-Wagner P, Chambonneau L, Dumas R, and Lafrenz M

Abstract

BACKGROUND: Travelers are often advised to receive both the typhoid fever and hepatitis A virus (HAV) vaccines, particularly when going to areas where the 2 diseases are endemic. Thus, combined administration of these vaccines could make immunization more acceptable by reducing the number of injections needed. OBJECTIVE: This study compared the safety profiles and immunogenicity of 3 batches of a combined typhoid fever/HAV vaccine administered using a dual-chamber bypass syringe. METHODS: This randomized, open-label study was conducted at 2 university-based travel clinics in Germany and Austria. Subjects received a single IM injection from 1 of 3 batches of the combined vaccine. Blood samples were drawn immediately before and 28 days after vaccination to evaluate the response to the 2 antigens by assessing geometric mean titers (GMTs) and rates of seroconversion and seroprotection. Subjects recorded all adverse events (AEs) occurring during the study period in a diary. RESULTS: Six hundred ten healthy adults were enrolled in the study. Twenty-eight days after vaccination, 90.6% of the study population had protective typhoid Vi antibody titers (> or = 1 microg/mL) and 100% had protective HAV antibody titers (> or = 20 mIU/mL). Seroconversion rates and GMTs were not significantly different between the 3 batches. There were no differences with regard to local or systemic AEs between the 3 batches of vaccine. There were no immediate adverse reactions (within 30 minutes of vaccination) and no serious AEs related to vaccination. Of 609 evaluable subjects (1 was lost to follow-up after the first visit), 555 (91.1%) experienced > or = 1 local reaction within the first 7 days after vaccination, mainly pain at the injection site (550 [90.3%]), but only 26 (4.3%) described this pain as severe. Vaccine-related headache and mild to moderate asthenia were each reported by 54 subjects (8.9%). Symptoms resolved spontaneously in all cases. CONCLUSIONS: The 3 batches of the combined typhoid fever/HAV vaccine administered by dual-chamber bypass syringe were equally well tolerated and effective in healthy adults, and did not differ significantly in terms of GMTs or seroconversion rates. [ABSTRACT FROM AUTHOR]

Published
2004
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34. Pneumocystispneumonia in an alcoholic patient with prolonged mechanical ventilation.

Author

Riebold, D., Hennig, A., Loebermann, M., Schareck, W., and Reisinger, E.

Subjects
PNEUMOCYSTIS pneumonia, IMMUNOLOGICAL deficiency syndrome complications, PNEUMONIA, B cells, T cells, IMMUNOSUPPRESSION, ADRENAL glands
Abstract

Examines the effect of pneumocystis jirovecii in immunocompromised hosts with impaired T- or B-cell function. Detection of isolated cases of pneumocystis pneumonia (PcP) patients without obvious immunosuppression; Effect on adrenal glands; Occurrence of PcP in an immunocompetent alcoholic patient.

Published
2005
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36. Influenza in Adults Seeking Care at Seven European Emergency Departments: A Prospective Active Surveillance During the 2019-2020 Influenza Season.

Author

Amour S, Rubio AP, Orsi A, Oppert M, Loebermann M, Del Pozo Vegas C, Tazarourte K, Douplat M, Jacquin L, Icardi G, Walker J, Glass A, Nealon J, Chaves SS, Bricout H, and Vanhems P

Subjects
Humans, Female, Male, Middle Aged, Adult, Aged, Prospective Studies, Europe epidemiology, Young Adult, Adolescent, Aged, 80 and over, Patient Acceptance of Health Care statistics & numerical data, Influenza, Human epidemiology, Influenza, Human diagnosis, Emergency Service, Hospital statistics & numerical data, Seasons
Abstract

Background: Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza-like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED-discharge diagnosis., Methods: The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019-20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected., Results: There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory-confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED-discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms., Conclusion: Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization., (© 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Published
2024
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37. No substantial neurocognitive impact of COVID-19 across ages and disease severity: a multicenter biomarker study of SARS-CoV-2 positive and negative adult and pediatric patients with acute respiratory tract infections.

Author

Ehler J, Klawitter F, von Möllendorff F, Zacharias M, Fischer DC, Danckert L, Bajorat R, Hackenberg J, Bertsche A, Loebermann M, Geerdes-Fenge H, Fleischmann R, Klinkmann G, Schramm P, Schober S, Petzold A, Perneczky R, and Saller T

Abstract

Background: Compared to intensive care unit patients with SARS-CoV-2 negative acute respiratory tract infections, patients with SARS-CoV-2 are supposed to develop more frequently and more severely neurologic sequelae. Delirium and subsequent neurocognitive deficits (NCD) have implications for patients' morbidity and mortality. However, the extent of brain injury during acute COVID-19 and subsequent NCD still remain largely unexplored. Body-fluid biomarkers may offer valuable insights into the quantification of acute delirium, brain injury and may help to predict subsequent NCD following COVID-19., Methods: In a multicenter, observational case-control study, conducted across four German University Hospitals, hospitalized adult and pediatric patients with an acute COVID-19 and SARS-CoV-2 negative controls presenting with acute respiratory tract infections were included. Study procedures comprised the assessment of pre-existing neurocognitive function, daily screening for delirium, neurological examination and blood sampling. Fourteen biomarkers indicative of neuroaxonal, glial, neurovascular injury and inflammation were analyzed. Neurocognitive functions were re-evaluated after three months., Results: We enrolled 118 participants (90 adults, 28 children). The incidence of delirium [85 out of 90 patients (94.4%) were assessable for delirium) was comparable between patients with COVID-19 [16 out of 61 patients (26.2%)] and SARS-CoV-2 negative controls [8 out of 24 patients (33.3%); p > 0.05] across adults and children. No differences in outcomes as measured by the modified Rankin Scale, the Short-Blessed Test, the Informant Questionnaire on Cognitive Decline in the Elderly, and the pediatrics cerebral performance category scale were observed after three months. Levels of body-fluid biomarkers were generally elevated in both adult and pediatric cohorts, without significant differences between SARS-CoV-2 negative controls and COVID-19. In COVID-19 patients experiencing delirium, levels of GFAP and MMP-9 were significantly higher compared to those without delirium., Conclusions: Delirium and subsequent NCD are not more frequent in COVID-19 as compared to SARS-CoV-2 negative patients with acute respiratory tract infections. Consistently, biomarker levels of brain injury indicated no differences between COVID-19 cases and SARS-CoV-2 negative controls. Our data suggest that delirium in COVID-19 does not distinctly trigger substantial and persistent subsequent NCD compared to patients with other acute respiratory tract infections., Trial Registration: ClinicalTrials.gov: NCT04359914; date of registration 24-APR 2020., (© 2024. The Author(s).)

Published
2024
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38. Performance Analysis of Serodiagnostic Tests to Characterize the Incline and Decline of the Individual Humoral Immune Response in COVID-19 Patients: Impact on Diagnostic Management.

Author

von Possel R, Menge B, Deschermeier C, Fritzsche C, Hemmer C, Geerdes-Fenge H, Loebermann M, Schulz A, Lattwein E, Steinhagen K, Tönnies R, Ahrendt R, and Emmerich P

Subjects
Humans, Immunity, Humoral, SARS-CoV-2, Serologic Tests, Immunoglobulin G, COVID-19 Testing, COVID-19 diagnosis
Abstract

Serodiagnostic tests for antibody detection to estimate the immunoprotective status regarding SARS-CoV-2 support diagnostic management. This study aimed to investigate the performance of serological assays for COVID-19 and elaborate on test-specific characteristics. Sequential samples ( n = 636) of four panels (acute COVID-19, convalescent COVID-19 (partly vaccinated post-infection), pre-pandemic, and cross-reactive) were tested for IgG by indirect immunofluorescence test (IIFT) and EUROIMMUN EUROLINE Anti-SARS-CoV-2 Profile (IgG). Neutralizing antibodies were determined by a virus neutralization test (VNT) and two surrogate neutralization tests (sVNT, GenScript cPass, and EUROIMMUN SARS-CoV-2 NeutraLISA). Analysis of the acute and convalescent panels revealed high positive (78.3% and 91.6%) and negative (91.6%) agreement between IIFT and Profile IgG. The sVNTs revealed differences in their positive (cPass: 89.4% and 97.0%, NeutraLISA: 71.5% and 72.1%) and negative agreement with VNT (cPass: 92.3% and 50.0%, NeutraLISA: 95.1% and 92.5%) at a diagnostic specificity of 100% for all tests. The cPass showed higher inhibition rates than NeutraLISA at VNT titers below 1:640. Cross-reactivities were only found by cPass (57.1%). Serodiagnostic tests, which showed substantial agreement and fast runtime, could provide alternatives for cell-based assays. The findings of this study suggest that careful interpretation of serodiagnostic results obtained at different times after SARS-CoV-2 antigen exposure is crucial to support decision-making in diagnostic management.

Published
2024
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39. Side effects following vaccination in multiple sclerosis: a prospective, multi-centre cohort study.

Author

Winkelmann A, Metze C, Zettl UK, and Loebermann M

Subjects
Female, Humans, Male, Prospective Studies, Tetanus Toxoid, Vaccination adverse effects, Drug-Related Side Effects and Adverse Reactions, Multiple Sclerosis, Multiple Sclerosis, Relapsing-Remitting
Abstract

Vaccines play a crucial role in preventing infections in patients with multiple sclerosis (MS), although concerns have been raised about potential worsening of the underlying disease. To investigate this, we conducted a prospective, multicentre, non-randomized observational study assessing changes in disease activity, safety, and clinical tolerability of vaccination in 222 MS patients on disease-modifying drugs. The majority of patients were female (76.6%) and 89.6% had relapsing-remitting MS. The vaccines administered were primarily seasonal influenza (56.3%) or tetanus-based vaccines (33.8%). Disease activity, as measured by annualized relapse rate, decreased significantly from 0.64 the year prior to vaccination to 0.38 in the following year. Moreover, the extended disability status scale remained stable within six months after vaccination in comparison to pre-vaccination values. Side effects were reported in 19.2% of vaccinated subjects, most commonly local side effects (65.2%) or flu-like symptoms (34.8%). Our findings suggest that standard non-live vaccines are safe and well-tolerated in MS patients and do not negatively impact disease activity., (© 2023. Springer Nature Limited.)

Published
2023
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40. SARS-CoV-2 vaccination in patients with multiple sclerosis in Germany and the United Kingdom: Gender-specific results from a longitudinal observational study.

Author

Frahm N, Fneish F, Ellenberger D, Haas J, Loebermann M, Parciak T, Peters M, Pöhlau D, Rodgers J, Röper AL, Schilling S, Stahmann A, Temmes H, Zettl UK, and Middleton RM

Abstract

Background: Vaccines offer people with multiple sclerosis (PwMS) an effective protection against severe COVID-19 disease courses. However, representative real-world data on the tolerability of SARS-CoV-2 vaccines in PwMS are limited. We aimed at analysing vaccination reactions (VRs) and MS deterioration following SARS-CoV-2 vaccinations in German and United Kingdom (UK) PwMS, especially regarding gender-specific differences., Methods: The German Multiple Sclerosis Society and the UK MS Registry acquired health data via an online system following the first (X 1 ) and second SARS-CoV-2 vaccination (X 2 ), respectively: sociodemographic and clinical data, vaccines used, VRs, MS deterioration (worsened or new MS symptoms, Germany only) and relapses (Germany only). The frequencies of VRs and MS deterioration were analysed stratified by gender., Findings: Following X 1 (X 2 ), 2346 (1835) German PwMS and 3796 (683) UK PwMS participated in the study. The most frequent vaccination scheme was two-dose tozinameran for Germany (77·1%, 1424/1847) and two-dose AZD1222 for the UK (61·3%, 419/683). The most common VRs were fatigue, headache and pain (at the injection site) and occurred more often in women compared with men. German PwMS reported VRs more frequently after X 2 vs. X 1 (65·4% [1201/1835] vs. 61·2% [1435/2346]), while for UK patients it was the opposite (X 1 vs. X 2 : 48·7% [1849/3796] vs. 30·0% [205/683]). MS deterioration occurred in 19·0% (445/2346) of the German PwMS without resulting in gender-specific differences. Fatigue and gait impairment were the most frequent deteriorated MS symptoms., Interpretation: Female PwMS reported experiencing VRs more often than men. Longitudinal data are needed to enable valid statements regarding long-term MS deterioration and long-lasting VRs., Funding: German Multiple Sclerosis Society (DMSG Bundesverband e.V.), Biogen, Bristol Myers Squibb, Merck Serono, Mylan, Novartis, Roche and Sanofi., Competing Interests: Niklas Frahm is an employee of the MSFP. Moreover, he is an employee of Rostock's University Medical Center and received travel funds for research meetings from Novartis; none resulted in a conflict of interest. Firas Fneish, Melanie Peters, David Ellenberger and Sarah Schilling had no personal financial interests to disclose other than being employees of the German MS Registry; none resulted in a conflict of interest. Tina Parciak had no personal financial interests to disclose. Anna-Lena Röper is employee of the MSFP and Germany MS society, which is funded by many public and corporate sponsors. She received travel funds from Novartis. None resulted in a conflict of interest. Micha Löbermann received speaker honoraria from Sanofi, AbbVie and Pfizer, he served as investigator in vaccine studies sponsored by Janssen, GSK and Novartis; none resulted in a conflict of interest. Herbert Temmes has no personal pecuniary interests to disclose, other than being the Secretary General of the German MS Society, federal association, which receives funding from a range of public and corporate sponsors, recently including Bundesgesundheitsministerium (BMG), The German Innovation Fund (G-BA), The German MS Trust, Biogen, Bristol Myers Squibb, Merck Serono, Novartis, Roche, Sanofi, Viatris (former Mylan); none resulted in a conflict of interest. Judith Haas has no personal pecuniary interests to disclose, other than being the President of the German MS Society, federal association, which receives funding from a range of public and corporate sponsors, recently including BMG, G-BA, The German MS Trust, Biogen, Bristol Myers Squibb, Merck Serono, Novartis, Roche, Sanofi, Viatris (former Mylan); none resulted in a conflict of interest. Dieter Pöhlau received speaking fees, travel support and financial support for research projects from: Allmirall, Bayer, Biogen-Idec, Merck-Serono, Octapharm, Novartis, Roche, Sanofi-Aventis and Teva; none resulted in a conflict of interest. Jeff Rodgers has no personal pecuniary interests to disclose, other than being an employee of the UK MS Register which is funded by the MS Society, travel research and conference costs are also funded by them; none resulted in a conflict of interest. Uwe K. Zettl has received speaking fees, travel support and /or financial support for research activities from Alexion, Almirall, Bayer, Biogen, Bristol-Myers-Squibb, Janssen, Merck Serono, Novartis, Octapharm, Roche, Sanofi Genzyme, Teva as well as EU, BMBF, BMWi and DFG; none resulted in a conflict of interest. Alexander Stahmann has no personal financial interests to disclose, other than being the leader of the German MS Registry, which receives funding from a range of public and corporate sponsors, recently including G-BA, The German MS Trust, German MS Society, Biogen, Bristol Myers Squibb, Merck, Novartis, Roche and Sanofi; none resulted in a conflict of interest. Rod Middleton has no personal pecuniary interests to disclose, other than being the lead of the UK MS Register which is funded by the MS Society, travel research and conference costs are also funded by them; none resulted in a conflict of interest., (© 2022 MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH).)

Published
2022
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41. Vaccination and immunotherapies in neuroimmunological diseases.

Author

Winkelmann A, Loebermann M, Barnett M, Hartung HP, and Zettl UK

Subjects
Humans, Immunologic Factors, Immunotherapy, Pandemics, SARS-CoV-2, Vaccination, COVID-19 prevention & control, COVID-19 Vaccines
Abstract

Neuroimmunological diseases and their treatment compromise the immune system, thereby increasing the risk of infections and serious illness. Consequently, vaccinations to protect against infections are an important part of the clinical management of these diseases. However, the wide variety of immunotherapies that are currently used to treat neuroimmunological disease - particularly multiple sclerosis and neuromyelitis optica spectrum disorders - can also impair immunological responses to vaccinations. In this Review, we discuss what is known about the effects of various immunotherapies on immunological responses to vaccines and what these effects mean for the safe and effective use of vaccines in patients with a neuroimmunological disease. The success of vaccination in patients receiving immunotherapy largely depends on the specific mode of action of the immunotherapy. To minimize the risk of infection when using immunotherapy, assessment of immune status and exclusion of underlying chronic infections before initiation of therapy are essential. Selection of the required vaccinations and leaving appropriate time intervals between vaccination and administration of immunotherapy can help to safeguard patients. We also discuss the rapidly evolving knowledge of how immunotherapies affect responses to SARS-CoV-2 vaccines and how these effects should influence the management of patients on these therapies during the COVID-19 pandemic., (© 2022. Springer Nature Limited.)

Published
2022
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42. First molecular detection of Pneumocystis spp. in red foxes (Vulpes vulpeslinnaeus, 1758) and raccoon dogs (Nyctereutes procyonoidesgray, 1834).

Author

Riebold D, Lubig J, Wolf P, Wolf C, Russow K, Loebermann M, Slevogt H, Mohr E, Feldhusen F, and Reisinger EC

Subjects
Animals, DNA, Fungal isolation & purification, Female, Lung microbiology, Male, Phylogeny, Pneumocystis classification, Pneumocystis genetics, Pneumonia, Pneumocystis diagnosis, Pneumonia, Pneumocystis epidemiology, Polymerase Chain Reaction veterinary, Retrospective Studies, Foxes, Pneumocystis isolation & purification, Pneumonia, Pneumocystis veterinary, Raccoon Dogs
Abstract

Fungal organisms of the genus Pneumocystis may cause Pneumocystis pneumonia (PCP) in humans, but also domestic and wild mammals. Almost every animal species hosts its own genetically distinct Pneumocystis species, however information is sparse. In this study, 62 red foxes (Vulpes vulpes) and 37 raccoon dogs (Nyctereutes procyonoides) were collected in North-East Germany. The lung tissues of the animals were analysed by a new designed specific pan-Pneumocystis mtLSU rRNA gene PCR and sequencing. With this PCR, detection and discrimination of all known Pneumocystis spp. in a single step should be possible. This first detection of Pneumocystis spp. in 29/62 (46.8%) red foxes and 29/37 (78.4%) raccoon dogs indicated, that they harbour two dissimilar strains, as seen by specific single nucleotide position changes (SNPs). Nevertheless, five samples with contrary SNPs showed a probable inter-species transmission., (Copyright © 2020. Published by Elsevier Ltd.)

Published
2020
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43. Occurrence of Gastrointestinal Parasites in Small Mammals from Germany.

Author

Riebold D, Russow K, Schlegel M, Wollny T, Thiel J, Freise J, Hüppop O, Eccard JA, Plenge-Bönig A, Loebermann M, Ulrich RG, Klammt S, Mettenleiter TC, and Reisinger EC

Subjects
Animals, Coccidia isolation & purification, Entamoeba isolation & purification, Feces parasitology, Female, Germany epidemiology, Giardia isolation & purification, Helminths isolation & purification, Male, Pilot Projects, Prevalence, Retortamonadidae isolation & purification, Eulipotyphla parasitology, Intestines parasitology, Rodentia parasitology
Abstract

An increase in zoonotic infections in humans in recent years has led to a high level of public interest. However, the extent of infestation of free-living small mammals with pathogens and especially parasites is not well understood. This pilot study was carried out within the framework of the "Rodent-borne pathogens" network to identify zoonotic parasites in small mammals in Germany. From 2008 to 2009, 111 small mammals of 8 rodent and 5 insectivore species were collected. Feces and intestine samples from every mammal were examined microscopically for the presence of intestinal parasites by using Telemann concentration for worm eggs, Kinyoun staining for coccidia, and Heidenhain staining for other protozoa. Adult helminths were additionally stained with carmine acid for species determination. Eleven different helminth species, five coccidians, and three other protozoa species were detected. Simultaneous infection of one host by different helminths was common. Hymenolepis spp. (20.7%) were the most common zoonotic helminths in the investigated hosts. Coccidia, including Eimeria spp. (30.6%), Cryptosporidium spp. (17.1%), and Sarcocystis spp. (17.1%), were present in 40.5% of the feces samples of small mammals. Protozoa, such as Giardia spp. and amoebae, were rarely detected, most likely because of the repeated freeze-thawing of the samples during preparation. The zoonotic pathogens detected in this pilot study may be potentially transmitted to humans by drinking water, smear infection, and airborne transmission.

Published
2020
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44. Tick-borne encephalitis vaccination in multiple sclerosis: A prospective, multicenter study.

Author

Winkelmann A, Metze C, Frimmel S, Reisinger EC, Zettl UK, and Loebermann M

Subjects
Adult, Female, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome, Vaccination, Viral Vaccines adverse effects, Antibodies, Viral blood, Encephalitis Viruses, Tick-Borne immunology, Encephalitis, Tick-Borne prevention & control, Multiple Sclerosis blood, Multiple Sclerosis drug therapy, Multiple Sclerosis immunology, Neurotransmitter Agents administration & dosage, Viral Vaccines administration & dosage
Abstract

Objective: To assess the changes in disease activity after tick-borne encephalitis (TBE) vaccination in patients with multiple sclerosis (MS) on a variety of disease-modifying drugs and to assess the immunogenicity, safety, and clinical tolerability of the vaccine in this patient group., Methods: We conducted a prospective, multicenter, nonrandomized observational study. We enrolled 20 patients with MS receiving TBE vaccination who had been on disease-modifying treatment (DMT) for at least 6 months. Serum samples were obtained before and after 4 weeks of vaccination to determine the specific TBE antibody response. MS disease activity (Expanded Disability Status Scale and relapse rates) was evaluated for 1 year after immunization. Local and systemic adverse events were registered., Results: In 20 subjects with TBE vaccination, the annualized relapse rate decreased from 0.65 in the year before vaccination to 0.21 in the following year. Expanded Disability Status Scale remained stable during the 2-year period before vaccination and 1 year after vaccination (range: 1.50-1.97). The geometric mean titer (GMT) increased from 169 Vienna units per milliliter (VIEU/mL) to 719 VIEU/mL 4 weeks after vaccination ( p = 0.001), and 77.8% had protective antibody titers after vaccination. In 9 patients treated with beta interferons, GMT increased from 181 VIEU/mL to 690 VIEU/mL ( p = 0.018). Three subjects treated with glatiramer acetate developed a 2- to 9.6-fold increase. Patients treated with fingolimod developed the lowest increase in antibody titer., Conclusion: TBE vaccination showed good tolerability and was safe in patients with MS. MS disease activity was not increased, and annualized relapse rates decreased after vaccination. Vaccine response differs according to the underlying DMT., Trial Registration: ClinicalTrials.gov, clinicaltrials.gov, Identifier: NCT02275741., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)

Published
2020
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45. Immunogenicity, safety, and tolerability of the measles-vectored chikungunya virus vaccine MV-CHIK: a double-blind, randomised, placebo-controlled and active-controlled phase 2 trial.

Author

Reisinger EC, Tschismarov R, Beubler E, Wiedermann U, Firbas C, Loebermann M, Pfeiffer A, Muellner M, Tauber E, and Ramsauer K

Subjects
Adolescent, Adult, Antibodies, Viral biosynthesis, Antibodies, Viral blood, Dose-Response Relationship, Immunologic, Double-Blind Method, Female, Healthy Volunteers, Humans, Male, Measles Vaccine administration & dosage, Measles Vaccine adverse effects, Measles Vaccine immunology, Measles virus immunology, Middle Aged, Vaccines, Attenuated administration & dosage, Vaccines, Attenuated adverse effects, Vaccines, Attenuated immunology, Vaccines, Synthetic administration & dosage, Vaccines, Synthetic adverse effects, Vaccines, Synthetic immunology, Viral Vaccines administration & dosage, Viral Vaccines adverse effects, Young Adult, Chikungunya Fever prevention & control, Chikungunya virus immunology, Viral Vaccines immunology
Abstract

Background: Chikungunya fever is an emerging viral disease and substantial threat to public health. We aimed to assess the safety, tolerability, and immunogenicity of a live-attenuated, measles-vectored chikungunya vaccine (MV-CHIK)., Methods: In this double-blind, randomised, placebo-controlled and active-controlled phase 2 trial, we enrolled healthy volunteers aged 18-55 years at four study sites in Austria and Germany. Participants were randomly assigned to receive intramuscular injections with MV-CHIK (5 × 10 4 or 5 × 10 5 50% tissue culture infectious dose), control vaccine, or measles prime and MV-CHIK, in two different administration regimens. Randomisation was done by use of three-digit randomisation codes in envelopes provided by a data management service. The participants and investigators were masked to treatment assignment, which was maintained by use of sterile saline as a placebo injection. The primary endpoint was immunogenicity, defined as the presence of neutralising antibodies against chikungunya virus, at day 56, which is 28 days after one or two immunisations. The primary endpoint was assessed in all participants who completed the study without major protocol deviations (per-protocol population) and in all randomised participants who received at least one study treatment (modified intention-to-treat population). The safety analysis included all participants who received at least one study treatment. This trial is registered with ClinicalTrials.gov (NCT02861586) and EudraCT (2015-004037-26) and is completed., Findings: Between Aug 17, 2016, and May 31, 2017, we randomly assigned 263 participants to receive control vaccine (n=34), MV-CHIK (n=195), or measles prime and MV-CHIK (n=34). 247 participants were included in the per-protocol population. Neutralising antibodies against chikungunya virus were detected in all MV-CHIK treatment groups after one or two immunisations, with geometric mean titres ranging from 12·87 (95% CI 8·75-18·93) to 174·80 (119·10-256·50) and seroconversion rates ranging from 50·0% to 95·9% depending on the dose and administration schedule. Adverse events were similar between groups, with solicited adverse events reported in 168 (73%) of 229 participants assigned to MV-CHIK and 24 (71%) of 34 assigned to control vaccine (p=0·84) and unsolicited adverse events in 116 (51%) participants assigned to MV-CHIK and 17 (50%) assigned to control vaccine (p=1·00). No serious adverse events related to the vaccine were reported., Interpretation: MV-CHIK showed excellent safety and tolerability and good immunogenicity, independent of pre-existing immunity against the vector. MV-CHIK is a promising candidate vaccine for the prevention of chikungunya fever, an emerging disease of global concern., Funding: Themis., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Published
2019
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46. Vaccination in Multiple Sclerosis: Friend or Foe?

Author

Zrzavy T, Kollaritsch H, Rommer PS, Boxberger N, Loebermann M, Wimmer I, Winkelmann A, and Zettl UK

Subjects
Humans, Multiple Sclerosis immunology, Vaccination adverse effects, Vaccination methods, Vaccines adverse effects, Vaccines immunology
Abstract

Multiple sclerosis (MS) is a debilitating disease of the central nervous systems (CNS). Disease-modifying treatments (including immunosuppressive treatments) have shown positive effects on the disease course, but are associated with systemic consequences on the immune system and may increase the risk of infections and alter vaccine efficiency. Therefore, vaccination of MS patients is of major interest. Over the last years, vaccine hesitancy has steadily grown especially in Western countries, partly due to fear of sequelae arising from vaccination, especially neurological disorders. The interaction of vaccination and MS has been discussed for decades. In this review, we highlight the immunology of vaccination, provide a review of literature and discuss the clinical consideration of MS, vaccination and immunosuppression. In conclusion, there is consensus that MS cannot be caused by vaccines, neither by inactivated nor by live vaccines. However, particular attention should be paid to two aspects: First, in immunocompromised patients, live vaccines may lead to a stronger immune reaction with signs of the disease against which the patients have been vaccinated, albeit in weakened form. Second, protection provided by vaccination should be controlled in patients who have been vaccinated while receiving immunomodulatory or immunosuppressive treatment. In conclusion, there is evidence that systemic infections can worsen MS, thus vaccination will lower the risk of relapses by reducing the risk of infections. Therefore, vaccination should be in general recommended to MS patients.

Published
2019
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47. Immune response to hepatitis A vaccine in patients with HIV.

Author

Fritzsche C, Bergmann L, Loebermann M, Glass A, and Reisinger EC

Subjects
Adult, Aged, CD4 Lymphocyte Count, CD4-CD8 Ratio, Cross-Sectional Studies, Female, Hepatitis A Vaccines administration & dosage, Humans, Male, Middle Aged, Retrospective Studies, Seroconversion, Vaccination, Viral Load, Young Adult, Coinfection, HIV Infections immunology, Hepatitis A immunology, Hepatitis A prevention & control, Hepatitis A Vaccines immunology, Immunity
Abstract

Objectives: The aim of this study was to evaluate the impact of various factors that may influence the immunologic response to hepatitis A mono-vaccine or hepatitis A/B co-vaccine (Twinrix®) in HIV-infected patients., Design: Retrospective cross-sectional study., Methods: HIV positive patients with a full course of hepatitis A vaccine were tested for HAV antibodies. The seroconversion rates were determined, and the influence of several factors including CD4 cell counts, CD4/CD8 ratio, plasma viral load, type of vaccine, and antiretroviral therapy at the time of vaccine, was evaluated., Results: After vaccination, 80.2% of the patients developed anti-HAV antibodies, 81.5% in the mono-vaccine group and 79.2% in the hepatitis A/B co-vaccine group. In the mono-vaccine group, factors significantly associated with a better response to the vaccine were higher CD4 cell count, higher CD4/CD8 ratio, and shorter time interval from vaccine to serological control. In patients who received the hepatitis A/B co-vaccine, younger age and female sex were significantly associated with better vaccine response. Multivariable logistic regression analysis revealed time interval from vaccine to serological control of more than 5 years vs. less than 1 year to be significantly associated with decrease of seroconversion after HAV vaccine., Conclusions: The response to hepatitis A vaccine is impaired in HIV positive patients. HIV patients, at least those older than 30, should be tested for seroconversion after receiving the hepatitis A vaccine. As hepatitis A titers may rapidly decline, control serology during follow-up should be proposed, possibly within two years. However, vaccine type does not play a role in vaccine response., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Published
2019
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48. A phase III, open-label, single-arm, study to evaluate the safety and immunogenicity of a trivalent, surface antigen inactivated subunit influenza virus vaccine produced in mammalian cell culture (Optaflu®) in healthy adults.

Author

Loebermann M, Fritzsche C, Geerdes-Fenge H, Heijnen E, Kirby D, and Reisinger EC

Subjects
Adult, Aged, Female, Germany, Hemagglutination Inhibition Tests, Humans, Male, Middle Aged, Young Adult, Antigens, Viral immunology, Immunogenicity, Vaccine immunology, Influenza A Virus, H1N1 Subtype immunology, Influenza A Virus, H3N2 Subtype immunology, Influenza B virus immunology, Influenza Vaccines adverse effects, Influenza Vaccines immunology
Abstract

Vaccination is an essential tool in reducing the impact of seasonal influenza infections. The viral strains responsible for seasonal outbreaks vary annually, and preventive vaccines have to be adapted accordingly. The aim of this study was to evaluate the safety, clinical tolerability and the antibody response to each of the three influenza vaccine antigens after vaccination with a cell-derived, trivalent, surface antigen, inactivated influenza vaccine (TIVc), as measured by single radial haemolysis (SRH) or haemagglutination inhibition (HI) assay in accordance with European Union licensing guidelines in place for years 2013/2014. This phase 3, open-label, single-arm study enrolled 126 healthy adults divided into two age groups (63 subjects aged 18 to ≤ 60 years and 63 subjects aged ≥ 61 years). Antibody titres were measured before and 21 days after vaccination. Adverse events were determined using diary cards, interviews and reviews of the available medical records. One subject was lost to follow-up and three subjects had protocol deviations. Following vaccination, protective HI antibody titres (≥ 1:40) were detected in 100%, 97%, and 94% of the younger adults (18-≤ 60 years) and in 97%, 95%, and 80% of the older adults (≥ 61 years) against the A (H1N1), A (H3N2), and B influenza strains respectively. The antibody response licensing criteria were met in both age groups. Solicited adverse events were reported by 57% subjects 18 to ≤ 60 years and 35% subjects ≥ 61 years. Among the younger adults 51% had local and 27% had systemic adverse events, whereas of the older subjects 29% had local and 13% had systemic adverse events (mainly injection site pain or headache in both age groups). Unsolicited adverse events at least possibly related to the vaccine were mild and detected in 3% of the younger adults and none of the older adults. Overall, the trivalent, surface antigen, inactivated subunit influenza virus vaccine produced in mammalian cell culture proved to be safe and immunogenic in younger and older healthy adults.

Published
2019
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49. Immunogenicity and predictors of response to a single dose trivalent seasonal influenza vaccine in multiple sclerosis patients receiving disease-modifying therapies.

Author

Metze C, Winkelmann A, Loebermann M, Hecker M, Schweiger B, Reisinger EC, and Zettl UK

Subjects
Adolescent, Adult, Aged, Cohort Studies, Female, Fingolimod Hydrochloride adverse effects, Fingolimod Hydrochloride therapeutic use, Humans, Influenza A Virus, H1N1 Subtype immunology, Influenza A Virus, H3N2 Subtype immunology, Influenza B virus immunology, Influenza Vaccines administration & dosage, Male, Middle Aged, Natalizumab adverse effects, Natalizumab therapeutic use, Prospective Studies, Young Adult, Immunosuppressive Agents adverse effects, Immunosuppressive Agents therapeutic use, Influenza Vaccines immunology, Multiple Sclerosis drug therapy, Multiple Sclerosis immunology
Abstract

Aims: To evaluate the immunogenicity and safety of a seasonal influenza vaccine in a cohort of multiple sclerosis (MS) patients receiving different immunomodulating/immunosuppressive therapies and assess predictors of immune response., Methods: A prospective, multicenter, non-randomized observational study including 108 patients receiving a trivalent seasonal influenza vaccination was conducted. Influenza-specific antibody titers (H1N1, H3N2, and influenza B) were measured to evaluate rates of seroprotection and seroconversion/significant titer increase. Univariable and multivariable analyses were performed to identify prognostic factors of vaccination outcomes., Results: Regarding the whole cohort, seroprotection rates >70% were achieved for each influenza strain. Interferon-treated patients reached high seroprotection rates (>84%). Good seroprotection rates were seen in patients treated with glatiramer acetate. In particular for H3N2, response rates were low in natalizumab-treated patients and in the small subgroup of fingolimod-treated patients. Patients with a previous disease-modifying therapy and a longer disease duration were less likely to respond sufficiently. No severe adverse events were reported. MS disease activity was not increased after a one-year follow-up period., Conclusion: Vaccination led to good immunogenicity, especially in MS patients treated with interferons and glatiramer acetate. At least for the H1N1 strain, rates of seroprotection and seroconversion/significant titer increase were high (>70% and >60%, respectively) for all therapeutic subgroups. Patients with a longer duration of the disease are exposed to an increased risk of insufficient immune response to vaccination., (© 2018 John Wiley & Sons Ltd.)

Published
2019
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50. [Mosquitoes and Ticks: The Influence of Global Warming in the Transmission of Infectious Diseases in Germany].

Author

Hemmer CJ, Emmerich P, Loebermann M, Frimmel S, and Reisinger EC

Subjects
Animals, Humans, Arthropod Vectors, Culicidae, Global Warming, Ticks, Virus Diseases transmission, Virus Diseases virology
Abstract

During the last 135 years, the average temperature in Germany has increased by 1.4 °C. By 2050, a further rise by 1.5 °C is expected. This is associated with an increase of precipitation during the winter months. This climate change probably will improve both the growth conditions for mosquitoes and ticks, as well as their ability to transmit infectious diseases. Today, vectors that have not yet been present are invading into Germany. Among them is Aedes albopictus, which transmits Chikungunya, Zika, and Dengue Fever. Also, spreading of autochthonous malaria and West Nile Fever appear possible in Germany. Because of the increased presence of Phlebotomus species, leishmaniasis should be considered as a potential differential diagnosis in unclear hematologic diseases. Among the tick-borne diseases, climate change has already led to increased case numbers of Borreliosis and Tick Borne Encephalitis (TBE), and Crimean Congo Virus is spreading from the Balkan region towards Central Europe. This requires physicians to consider additional differential diagnoses in febrile illnesses., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

Published
2018
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