Publications by authors named "Robert Bals"

Epigenetics regulates gene expression and thus cellular processes that underlie the pathogenesis of chronic lung diseases such as chronic obstructive pulmonary disease (COPD), asthma, and idiopathic pulmonary fibrosis (IPF). Environmental factors (e.g.

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Chronic Obstructive Pulmonary Disease (COPD) is closely linked to cardiovascular disease (CVD), with up to 70% of COPD patients experiencing cardiovascular comorbidities. The coexistence of COPD and CVD significantly increases hospitalization rates, symptom burden, and mortality, particularly during acute exacerbations of COPD (AECOPD), which impose an increased risk of cardiovascular events - both during and shortly after these episodes. Mechanistic links between COPD and CVD include systemic inflammation, oxidative stress, endothelial dysfunction, and hypoxemia, all of which contribute to the progression of both conditions.

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Background: Lung transplantation is the ultimate treatment option for patients with advanced cystic fibrosis. Chronic colonization of these recipients with multidrug-resistant (MDR) pathogens may constitute a risk factor for an adverse outcome. We sought to analyze whether colonization with MDR pathogens, as outlined in the German classification of multiresistant Gram-negative bacteria (MRGN), was associated with the success of lung transplantation.

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Viremia defined as detectable SARS-CoV-2 RNA in the blood is a potential marker of disease severity and prognosis in COVID-19 patients. Here, we determined the frequency of viremia in serum of two independent COVID-19 patient cohorts within the German National Pandemic Cohort Network (German: tionales andemie horten etzwerk, NAPKON) with diagnostic RT-PCR against SARS-CoV-2. A cross-sectional cohort with 1122 COVID-19 patients (German: , SUEP) and 299 patients recruited in a high-resolution platform with patients at high risk to develop severe courses (German: , HAP) were tested for viremia.

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Tracheal tuft cells shape immune responses in the airways. While some of these effects have been attributed to differential release of either acetylcholine, leukotriene C4 and/or interleukin-25 depending on the activating stimuli, tuft cell-dependent mechanisms underlying the recruitment and activation of immune cells are incompletely understood. Here we show that Pseudomonas aeruginosa infection activates mouse tuft cells, which release ATP via pannexin 1 channels.

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Courses of SARS-CoV-2 infections are highly variable, ranging from asymptomatic to lethal COVID-19. Though research has shown that host genetic factors contribute to this variability, cohort-based joint analyses of variants from the entire allelic spectrum in individuals with confirmed SARS-CoV-2 infections are still lacking. Here, we present the results of whole genome sequencing in 1,220 mainly vaccine-naïve individuals with confirmed SARS-CoV-2 infection, including 827 hospitalized COVID-19 cases.

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Importance: Previous exacerbations of chronic obstructive pulmonary disease (ECOPD) are associated with future events. For more than a decade, patients at high risk have been defined as individuals with a history of 2 or more moderate ECOPD, 1 or more severe ECOPD, or both within 12 months, and treatments have been allocated accordingly, but these cutoffs lack validation.

Objectives: To validate ECOPD history categories by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and explore alternative cutoffs to estimate moderate and severe ECOPD and all-cause mortality in COPD.

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Background: The COPD Assessment Test (CAT) comprises eight questions. We evaluated the information that each of the questions and the total score contributed to outcomes and characteristics of chronic obstructive lung disease (COPD), including their dependence on smoking status.

Methods: Patients with COPD of the COSYCONET cohort with Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 and the former grade 0 were included.

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Background: In patients with chronic diseases, including those with chronic obstructive pulmonary disease (COPD), knowledge on the disease and its self-management is considered as relevant for improving disease control and long-term outcome. We studied to which extent components of knowledge depended on potential predictors, such as participation in educational programs and disease severity. For example, the perception of exacerbations or GOLD grade might modulate the content and reliability of COPD understanding.

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Chronic obstructive pulmonary disease (COPD) is commonly associated with ageing, with the prevalence and severity increasing by age. Smoking-induced premature ageing is thought to contribute to COPD, particularly lung emphysema. This study aimed to explore the relationship between lung function impairment and skin texture, as a marker of biological or premature ageing, in COPD patients.

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Article Synopsis
  • Impaired interaction between fibroblasts and AT2 pneumocytes contributes to chronic lung diseases like idiopathic pulmonary fibrosis (IPF), with Mucin 5B (MUC5B) being associated with the condition.
  • Research using an organoid model showed that fibroblasts with high fibrosis markers can alter STAT3 signaling in AT2 cells, leading to cystic growth and increased MUC5B expression, influenced by the cytokine IL-6.
  • The study also demonstrated that the drug dasatinib can block the formation of these cystic organoids, suggesting a potential avenue for drug development to address these interactions in IPF.
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  • The text discusses a severe infection caused by a bacteria usually found in the mouths of cats and dogs, which can lead to sepsis, particularly in immunocompromised patients, with a high mortality rate of 10% to 30%.
  • An 81-year-old woman developed sepsis after a dog bite and presented with serious symptoms, including thrombopenia and schistocytes, leading to her admission to the intensive care unit.
  • Despite her recovery through plasmapheresis, antibiotics, and dialysis, she required amputation of her affected fingertip and was diagnosed with a rare case of mitral valve endocarditis, which was effectively treated with antibiotics.
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The human microbiome emerges as a promising reservoir for diagnostic markers and therapeutics. Since host-associated microbiomes at various body sites differ and diseases do not occur in isolation, a comprehensive analysis strategy highlighting the full potential of microbiomes should include diverse specimen types and various diseases. To ensure robust data quality and comparability across specimen types and diseases, we employ standardized protocols to generate sequencing data from 1931 prospectively collected specimens, including from saliva, plaque, skin, throat, eye, and stool, with an average sequencing depth of 5.

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  • Pulmonary sequestration (PS) is a birth defect where nonfunctional lung tissue develops without being linked to the airways, leading to complications like repeated pneumonia.
  • A patient diagnosed with PS during pneumonia treatment experienced complications, including chronic obstructive pulmonary disease (COPD) and emphysema, due to late diagnosis and infections.
  • The case highlights that while smoking is a key COPD risk factor, chronic lung infections, often from congenital issues, can also play a significant role, especially in adults with a history of pneumonia since childhood.
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Background: Patients with COPD are often affected by loss of bone mineral density (BMD) and osteoporotic fractures. Natriuretic peptides (NP) are known as cardiac markers, but have also been linked to fragility-associated fractures in the elderly. As their functions include regulation of fluid and mineral balance, they also might affect bone metabolism, particularly in systemic disorders such as COPD.

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  • In patients with COPD, impaired left ventricular (LV) filling can be categorized into two patterns: small LV size and heart failure with preserved ejection fraction (HFpEF), both linked to increased all-cause mortality.
  • A study involving 1,752 COPD patients found that 8% had small LV, 16% had HFpEF features, and 45% had normal cardiac function, with those having small LV or HFpEF showing significantly higher mortality rates.
  • Small LV is an independent predictor of mortality, contrasting with HFpEF as patients with small LV exhibit reduced LV filling but normal filling pressure and lower biomarker levels.
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  • This study explored how CT imaging of pulmonary vessels relates to lung function, disease severity, and mortality risk in patients with chronic obstructive pulmonary disease (COPD).
  • Researchers used automatic software to analyze CT scans from a nationwide cohort, focusing on the features of arterial and venous vessels during breathing.
  • Findings revealed that certain expiratory vessel characteristics, particularly venous volume, are significant predictors of lung function and mortality in COPD patients.
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Cancer research involves significant animal consumption and suffering. Tumor cells can be differentiated in vitro into three-dimensional organoids that resemble the primary tumor. In basic cancer research, however, tumor organoids are usually only used alongside animal experiments.

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Target values for arterial carbon dioxide tension (PaCO 2 ) in extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) are unknown. We hypothesized that lower PaCO 2 values on ECMO would be associated with lighter sedation. We used data from two independent patient cohorts with ARDS spending 1,177 days (discovery cohort, 69 patients) and 516 days (validation cohort, 70 patients) on ECMO and evaluated the associations between daily PaCO 2 , pH, and bicarbonate (HCO 3 ) with sedation.

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Alpha 1‑antitrypsin (AAT) deficiency represents a complex genetic disorder and necessitates an interdisciplinary approach in the clinical practice. This article provides an overview of the epidemiology, genetics, symptoms, diagnostics and treatment of AAT deficiency. Knowledge and an in-depth understanding of AAT deficiency are indispensable to improve the early recognition of AAT, to optimize the quality of life of those affected and to enable targeted treatment interventions.

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Article Synopsis
  • ARDS is a serious condition, impacting over 10% of ICU patients globally with a high mortality rate, making ECMO a potentially vital, but complex, treatment option.
  • Recent research analyzed 283 ARDS patients treated with V-V ECMO in Germany, revealing a median age of 56 and an in-hospital mortality rate of about 50.9%.
  • While various scoring systems were evaluated for predicting patient outcomes, the study concluded that none, including the Simplified Acute Physiology Score-II, demonstrated strong predictive value for selecting patients suitable for ECMO.
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  • The study investigates the prevalence and predictors of post-COVID-19 condition (PCC) symptoms in patients infected with SARS-CoV-2 variants delta and omicron.
  • A total of 758 patients were analyzed, revealing that fatigue was the most common PCC symptom, with no significant difference in prevalence between delta and omicron infections at the three-month follow-up.
  • Most patients reported stable health-related quality of life, with over two-thirds experiencing no decline, indicating that PCC is a common issue for both variants in the German population.
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Objectives: The implementation of the Lung Allocation Score (LAS) in the Eurotransplant international collaborative framework decreased waiting list mortality, but organ shortage remains a significant problem. Transplantation of two single lungs from one donor into two recipients (lung twinning) may decrease waiting list mortality. We sought to analyze if this strategy can lead to an acceptable intermediate-term outcome.

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Background: Randomized controlled trials described beneficial effects of inhaled triple therapy (LABA/LAMA/ICS) in patients with chronic obstructive pulmonary disease (COPD) and high risk of exacerbations. We studied whether such effects were also detectable under continuous treatment in a retrospective observational setting.

Methods: Data from baseline and 18-month follow-up of the COPD cohort COSYCONET were used, including patients categorized as GOLD groups C/D at both visits (n = 258).

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