Tom Eirik Mollnes

Oslo University Hospital, Kristiania (historical), Oslo, Norway

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Publications (509)1794.59 Total impact

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    ABSTRACT: Introduction: Sepsis is an exaggerated and dysfunctional immune response to infection. Activation of innate immunity recognition systems including complement and the Toll-like receptor family initiate this disproportionate inflammatory response. The aim of this study was to explore the effect of combined inhibition of the complement component C5 and the Toll-like receptor co-factor CD14 on survival, hemodynamic parameters and systemic inflammation including complement activation in a clinically relevant porcine model of polymicrobial sepsis. Methods: Norwegian landrace piglets (4 ± 0.5 kg) were blindly randomized to a treatment group (n = 12) receiving the C5 inhibitor coversin (OmCI) and anti-CD14 or to a positive control group (n = 12) receiving saline. Under anesthesia, sepsis was induced by a 2 cm cecal incision and the piglets were monitored in standard intensive care for 8 hours. Three sham piglets had a laparotomy without cecal incision or treatment. Complement activation was measured as sC5b-9 using enzyme immunoassay. Cytokines were measured with multiplex technology. Results: Combined C5 and CD14 inhibition significantly improved survival (p = 0.03). Nine piglets survived in the treatment group and four in the control group. The treatment group had significantly lower pulmonary artery pressure (p = 0.04) and ratio of pulmonary artery pressure to systemic artery pressure (p < 0.001). Plasma sC5b-9 levels were significantly lower in the treatment group (p < 0.001) and correlated significantly with mortality (p = 0.006). IL-8 and IL-10 were significantly (p < 0.05) lower in the treatment group. Conclusions: Combined inhibition of C5 and CD14 significantly improved survival, hemodynamic parameters and inflammation in a blinded, randomized trial of porcine polymicrobial sepsis.
    Critical Care 12/2015; 19(1). DOI:10.1186/s13054-015-1129-9 · 4.48 Impact Factor
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    ABSTRACT: Background: Inappropriate and uncontrolled activation of the cascade systems in the blood is a driving force in adverse inflammatory and thrombotic reactions elicited by biomaterials, but limited data are available on the activation of the contact system by polymers and the present study was undertaken to investigate these mechanisms in established models. Methods: Polymer particles were incubated in (1) EDTA-plasma (10 mM) to monitor the adsorption of 20 selected proteins; (2) lepirudin-anticoagulated plasma to evaluate contact system activation, monitored by the formation of complexes between the generated proteases factor[F]XIIa, FXIa and kallikrein and the serpins C1-inhibitor [C1INH] and antithrombin [AT]; (3) lepirudin-anticoagulated whole blood to determine cytokine release. Results: Strong negative correlations were found between 10 cytokines and the ratio of deposited FXII/C1INH, generated FXIIa-C1INH complexes, and kallikrein-C1INH complexes. Formation of FXIIa-C1INH complexes correlated negatively with the amount of C3a and positively with deposited IgG. Conclusions: A reciprocal relationship was found between activation of the contact system and the complement system induced by the polymers studied here. The ratios of FXII/C1INH or C4/C4BP, adsorbed from EDTA-plasma are useful surrogate markers for cytokine release and inflammatory response to materials intended for blood contact.
    Biomaterials 11/2015; 77. DOI:10.1016/j.biomaterials.2015.10.067 · 8.56 Impact Factor
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    ABSTRACT: Laparoscopic and open liver resection have not been compared in randomized trials. The aim of the current study was to compare the inflammatory response after laparoscopic and open resection of colorectal liver metastases (CLM) in a randomized controlled trial.This was a predefined exploratory substudy within the Oslo CoMet-study. Forty-five patients with CLM were randomized to laparoscopic (n = 23) or open (n = 22) resection. Ethylenediaminetetraacetic acid-plasma samples were collected preoperatively and at defined time points during and after surgery and snap frozen at -80 C. A total of 25 markers were examined using luminex and enzyme-linked immunosorbent assay techniques: high-mobility box group 1(HMGB-1), cell-free DNA (cfDNA), cytokines, and terminal C5b-9 complement complex complement activation.Eight inflammatory markers increased significantly from baseline: HMGB-1, cfDNA, interleukin (IL)-6, C-reactive protein, macrophage inflammatory protein -1β, monocyte chemotactic protein -1, IL-10, and terminal C5b-9 complement complex. Peak levels were reached at the end of or shortly after surgery. Five markers, HMGB-1, cfDNA, IL-6, C-reactive protein, and macrophage inflammatory protein -1β, showed significantly higher levels in the open surgery group compared with the laparoscopic surgery group.Laparoscopic resection of CLM reduced the inflammatory response compared with open resection. The lower level of HMGB-1 is interesting because of the known association with oncogenesis.
    Medicine 10/2015; 94(42):e1786. DOI:10.1097/MD.0000000000001786 · 5.72 Impact Factor
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    ABSTRACT: Objective: To explore immune mechanisms and identify possible biomarkers associated with an inadequate immune recovery in HIV patients with efficient antiretroviral therapy (ART). Design. A cross sectional study of 67 HIV-infected patients on ART for ≥ 24 months with HIV RNA < 20 copies/mL; 41 were defined as immunological non-responders (INR) (CD4 count < 400 cells/µL) and 26 as immune responders (IR) (CD4 count > 600 cells/µL). Methods: Seventeen different interleukins and chemokines, soluble markers of microbial translocation, monocyte activation, Trimethylamine N oxide and tryptophan catabolites were measured in plasma by multiplex cytokine assay, ELISA or spectrometry. T-cell activation, differentiation and regulation were analyzed by flow cytometry in two subgroups with comparable age, nadir CD4 count and duration of HIV infection. Non-parametric statistics were applied. Results: The INR had significantly higher levels of interferon-inducible protein-10 (IP-10) compared to IR (p=0.03). IP-10 levels were also elevated in patients with cardiovascular disease (n=6, p=0.03) or previous cancer (n=9, p=0.02). The CD4+ and CD8+ T-cells were significantly more activated and the naïve/effector memory T-cell ratio was lower in INR than in IR patients (all p<0.05). The proportion of resting Tregs (CD4+CD45RA+Foxp3+) was reduced among INR (p<0.01) and an INR subgroup with CD4 count ≤ 300 demonstrated a higher fraction of activated Tregs (CD4+CD147++CD25++) compared to INR with CD4 count 301-400 (p=0.03) or IR (p=0.02). In INR, the percentages of activated Tregs correlated with the IP-10 levels (r=0.59, p<0.01) and inversely with the CD4 count (r= 0.61, p<0.01). There were no differences between INR and IR in the other measured markers. Conclusion: HIV patients with inadequate CD4 responses have higher levels of immune activation, T cell turnover and regulation compared to patients with satisfactory CD4 T-cell gain and comparable CD4 nadir count. Plasma IP-10 might be a convenient biomarker to predict incomplete immune recovery in HIV patients.
    15th European Aids Conference, Barcelona, Spain; 10/2015

  • Tidsskrift for den Norske laegeforening 10/2015; 135(19):1745-1749. DOI:10.4045/tidsskr.15.0049
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    ABSTRACT: Fulminant meningococcal sepsis is characterized by a massive growth of bacteria in the circulation, regarded as the primary inflammatory site, with no specific solid organ focus. Here we aimed to study the local inflammatory response in organs using a porcine model of fulminant meningococcal septic shock challenged with exponentially increasing doses of heat inactivated Neisseria meningitidis. The results were compared with those obtained in organs post mortem from three patients with lethal meningococcal septic shock. Nine patients with lethal pneumococcal disease and 14 patients with sudden infant death syndrome served as controls. Frozen tissue were thawed, homogenized and prepared for quantification of bacterial DNA by real-time polymerase chain reaction, and key inflammatory mediators were measured by ELISA in the pig material and by multiplex in the human material. In addition, gene expression assayed by Affymetrix gene expression profiling was performed in the pig study. The porcine model revealed a major influx of N. meningitidis in lungs, liver, spleen, and kidneys accompanied with major production of cardinal inflammatory mediators including tumor necrosis factor, interleukin (IL)-1β, IL-6, and IL-8, far exceeding the amount detected in blood. Genes encoding for these mediators revealed a similar profile. By comparing the wild-type with a lipopolysaccharide (LPS) deficient meningococcal strain, we documented that LPS was the dominant group of molecules inducing organ inflammation and was required for IL-8 production. IL-10 production was predominantly stimulated by non-LPS molecules. The massive organ inflammation in the porcine model was present in the three patients dying of meningococcal shock and differed markedly from the patients with lethal pneumococcal infections and sudden infant death syndrome. In conclusion, in meningococcal sepsis, a massive local inflammatory response occurs in specific organs.
    Shock (Augusta, Ga.) 10/2015; 44(5):458-469. DOI:10.1097/SHK.0000000000000441 · 3.05 Impact Factor
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    ABSTRACT: Complement C5 inhibitor eculizumab treatment in atypical hemolytic uremic syndrome is effective, but associated with high costs. Complement inhibition monitoring in these patients has not been standardized. In this study we evaluated novel functional assays for application in routine follow-up. We documented that the Wieslab® complement screen assay showed a sensitivity of 1-2% of C5 activity by adding purified C5 or normal human serum to a C5 deficient serum. All the patient samples obtained during the treatment course, were completely blocked for terminal complement pathway activity for up to four weeks after the eculizumab infusion. Levels of complexes between eculizumab and C5 were inversely correlated to the complement activity (p=0.01). Moreover, titrating serum from eculizumab-treated patients into normal serum revealed that eculizumab was present in excess up to four weeks after infusion. Thus, we demonstrate sensitive, reliable and easy-performed assays which can be used to design individual eculizumab dosage regimens.
    Clinical Immunology 09/2015; 160(2):237-243. DOI:10.1016/j.clim.2015.05.018 · 3.67 Impact Factor
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    Blood 07/2015; 126(2):278-279. DOI:10.1182/blood-2015-03-637645 · 10.45 Impact Factor
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    ABSTRACT: Congestive heart failure is associated with increased levels of several inflammatory mediators, and animal studies have shown that infusion of a number of cytokines can induce heart failure. However, several drugs with proven efficacy in heart failure have failed to affect inflammatory mediators, and anti-inflammatory therapy in heart failure patients has thus far been disappointing. Hence, to what extent heart failure is caused by or responsible for the increased inflammatory burden in the patient is still unclear. Over the past couple of decades resynchronization therapy with a biventricular pacemaker has emerged as an effective treatment in a subset of heart failure patients, reducing both morbidity and mortality. Such treatment has also been shown to affect the inflammation associated with heart failure. In this paper we review recent data on the association between heart failure and inflammation, and in particular how resynchronization therapy can affect the inflammatory process. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Scandinavian Journal of Immunology 06/2015; 82(3). DOI:10.1111/sji.12328 · 1.74 Impact Factor
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    ABSTRACT: Microdialysis is an excellent tool to assess tissue inflammation in patients, but in vitro systems to evaluate recovery of inflammatory mediators have not been standardized. We aimed to develop a reference plasma preparation and evaluate different perfusion fluids with respect to recovery of metabolic and inflammatory markers. The reference preparation was produced by incubation of human blood with lipopolysaccharide and cobra venom factor to generate cytokines and activate complement, respectively. Microdialysis with 100 kDa catheters was performed using different colloid and crystalloid perfusion fluids (hydroxylethyl starch (HES) 130/0.4, HES 200/0.5, hyperosmolar HES 200/0.5, albumin 200g/l, T1-Perfusionfluid, and Ringer's acetate) compared to todays recommended dextran-60 solution. Recovery of glucose, glycerol and pyruvate were not significantly different between the perfusion fluids, whereas lactate had lower recovery in HES 200/0.5 and albumin perfusion fluids. Recovery rates for the inflammatory proteins in comparison to the concentration in the reference preparation differed substantially: IL-6=9%, IL-1β=18%, TNF=0.3%, MCP-1=45%, IL-8=48%, MIG=48%, IP-10=25%, C3a=53%, and C5a=12%. IL-10 was not detectable in microdialysis dialysate. HES 130/0.4 and HES 200/0.5 yielded a recovery not significantly different from dextran-60. Hyperosmolar HES 200/0.5 and albumin showed significantly different pattern of recovery with increased concentration of MIG, IP-10, C3a, C5a, and decreased concentration of IL-1β, TNF, MCP-1, IL-8 in comparison to dextran-60. In conclusion, microdialysis perfusion fluid dextran-60 can be replaced by the commonly used HES 130/0.4, whereas albumin might be used if specific immunological variables are in focus. The present reference plasma preparation is suitable for in vitro evaluation of microdialysis systems. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Scandinavian Journal of Immunology 06/2015; 82(5). DOI:10.1111/sji.12332 · 1.74 Impact Factor
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    ABSTRACT: Staphylococcus aureus may cause serious infections and is one of the most lethal and common causes of sepsis. TLR2 has been described as the main pattern recognition receptor that senses S. aureus and elicits production of proinflammatory cytokines via MyD88 -: NF-κB signaling. S. aureus can also induce the production of IFN-β, a cytokine that requires IFN regulatory factors (IRFs) for its transcription, but the signaling mechanism for IFN-β induction by S. aureus are unclear. Surprisingly, we demonstrate that activation of TLR2 by lipoproteins does not contribute to IFN-β production but instead can suppress the induction of IFN-β in human primary monocytes and monocyte-derived macrophages. The production of IFN-β was induced by TLR8-mediated sensing of S. aureus RNA, which triggered IRF5 nuclear accumulation, and this could be antagonized by concomitant TLR2 signaling. The TLR8-mediated activation of IRF5 was dependent on TAK1 and IκB kinase (IKK)β, which thus reveals a physiological role of the recently described IRF5-activating function of IKKβ. TLR8 -: IRF5 signaling was necessary for induction of IFN-β and IL-12 by S. aureus, and it also contributed to the induction of TNF. In conclusion, our study demonstrates a physiological role of TLR8 in the sensing of entire S. aureus in human primary phagocytes, including the induction of IFN-β and IL-12 production via a TAK1 -: IKKβ -: IRF5 pathway that can be inhibited by TLR2 signaling. Copyright © 2015 by The American Association of Immunologists, Inc.
    The Journal of Immunology 06/2015; 195(3). DOI:10.4049/jimmunol.1403176 · 4.92 Impact Factor
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    ABSTRACT: Despite recent medical advances, atherosclerosis is a global burden accounting for numerous deaths and hospital admissions. Immune-mediated inflammation is a major component of the atherosclerotic process, but earlier research focus on adaptive immunity has gradually switched towards the role of innate immunity. The complement system and toll-like receptors (TLRs), and the crosstalk between them, may be of particular interest both with respect to pathogenesis and as therapeutic targets in atherosclerosis. Animal studies indicate that inhibition of C3a and C5a reduces atherosclerosis. In humans modified LDL-cholesterol activate complement and TLRs leading to downstream inflammation, and histopathological studies indicate that the innate immune system is present in atherosclerotic lesions. Moreover, clinical studies have demonstrated that both complement and TLRs are upregulated in atherosclerotic diseases, although interventional trials have this far been disappointing. However, based on recent research showing an intimate interplay between complement and TLRs we propose a model in which combined inhibition of both complement and TLRs may represent a potent anti-inflammatory therapeutic approach to reduce atherosclerosis. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
    Atherosclerosis 06/2015; 123(2). DOI:10.1016/j.atherosclerosis.2015.05.038 · 3.99 Impact Factor
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    ABSTRACT: The complement system and the Toll-like (TLR) co-receptor CD14 play important roles in innate immunity and sepsis. Tissue factor (TF) is a key initiating component in intravascular coagulation in sepsis, and long pentraxin 3 (PTX3) enhances the lipopolysaccharide (LPS)-induced transcription of TF. The aim of this study was to study the mechanism by which complement and CD14 affects LPS- and Escherichia coli (E. coli)-induced coagulation in human blood. Fresh whole blood was anti-coagulated with lepirudin, and incubated with ultra-purified LPS (100 ng/ml) or with E. coli (1 × 10(7)/ml). Inhibitors and controls included the C3 blocking peptide compstatin, an anti-CD14 F(ab')2 antibody and a control F(ab')2. TF mRNA was measured using quantitative polymerase chain reaction (qPCR) and monocyte TF surface expression by flow cytometry. TF functional activity in plasma microparticles was measured using an amidolytic assay. Prothrombin fragment F 1+2 (PTF1.2) and PTX3 were measured by enzyme-linked immunosorbent assay (ELISA). The effect of TF was examined using an anti-TF blocking antibody. E. coli increased plasma PTF1.2 and PTX3 levels markedly. This increase was reduced by 84->99% with compstatin, 55-97% with anti-CD14 and > 99% with combined inhibition (P < 0·05 for all). The combined inhibition was significantly (P < 0·05) more efficient than compstatin and anti-CD14 alone. The LPS- and E. coli-induced TF mRNA levels, monocyte TF surface expression and TF functional activity were reduced by > 99% (P < 0·05) with combined C3 and CD14 inhibition. LPS- and E. coli-induced PTF1.2 was reduced by 76-81% (P < 0·05) with anti-TF antibody. LPS and E. coli activated the coagulation system by a complement- and CD14-dependent up-regulation of TF, leading subsequently to prothrombin activation. © 2015 British Society for Immunology.
    Clinical & Experimental Immunology 06/2015; 182(1). DOI:10.1111/cei.12663 · 3.04 Impact Factor
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    ABSTRACT: Chronic inflammation of the arterial wall is a key element in the development of atherosclerosis, and cholesterol crystals (CC) that accumulate in plaques are associated with initiation and progression of the disease. We recently revealed a link between the complement system and CC-induced inflammasome caspase-1 activation, showing that the complement system is a key trigger in CC-induced inflammation. HDL exhibits cardioprotective and anti-inflammatory properties thought to explain its inverse correlation to cardiovascular risk. In this study, we sought to determine the effect of reconstituted HDL (rHDL) on CC-induced inflammation in a human whole blood model. rHDL bound to CC and inhibited the CC-induced complement activation as measured by soluble terminal C5b-9 formation and C3c deposition on the CC surface. rHDL attenuated the amount of CC-induced complement receptor 3 (CD11b/CD18) expression on monocytes and granulocytes, as well as reactive oxygen species generation. Moreover, addition of CC to whole blood resulted in release of proinflammatory cytokines that were inhibited by rHDL. Our results support and extend the notion that CC are potent triggers of inflammation, and that rHDL may have a beneficial role in controlling the CC-induced inflammatory responses by inhibiting complement deposition on the crystals. Copyright © 2015 by The American Association of Immunologists, Inc.
    The Journal of Immunology 05/2015; 195(1). DOI:10.4049/jimmunol.1403044 · 4.92 Impact Factor
  • Bo Nilsson · Kristina Nilsson Ekdahl · Claudia Kemper · Tom Eirik Mollnes ·

    Molecular Immunology 05/2015; 67(1):1-2. DOI:10.1016/j.molimm.2015.04.006 · 2.97 Impact Factor
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    ABSTRACT: A whole complement ELISA-based assay kit, primarily designed to screen for deficiencies in components of the complement system was developed during a European Union grant involving more than a dozen European scientists and a small-medium enterprise company (Wieslab, which later merged into Eurodiagnostica). The consortium was led by Prof. Mohamed R. Daha who had already guided a preceding European grant which prepared the ground for this endeavor to create a novel and sophisticated complement measurement tool. The final result of the grant was a scientific publication (Seelen et al., 2005, J. Immunol. Methods 296, 187-198) and a commercially available complement deficiency screening kit, WIESLAB(®) Complement system Screen. Thereafter, the group decided to carry on with a grant, located at Innsbruck Medical University, and supported by royalties and unrestricted educational grants from Eurodiagnostica, Malmö, entitled "Search for Applications for WIESLAB(®) Complement system Screen (SAW)" with the aim to look for further applications of this assay. During the latter project the group organized several scientific meetings aimed at evaluating the use of the assay as well as developing further branches of its platform. A look back over almost two decades reveals a great story of excellent research which was also commercially successful, fulfilling the aims of European Union grants. It is also a story of ageless friendship, only possible due to the vision and guidance of an exceptional manager: Moh Daha. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Molecular Immunology 05/2015; 68. DOI:10.1016/j.molimm.2015.05.003 · 2.97 Impact Factor
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    ABSTRACT: The impact of complement activation and its possible relation to cytokine responses in malaria pathology was investigated in plasma samples from patients with confirmed Plasmodium falciparum malaria, and in human whole blood stimulated with malaria relevant agents ex vivo. Complement was significantly activated in the malaria cohort as compared to healthy controls, positively correlated to disease severity, and with certain cytokines, in particular IL-8/CXCL8. This was confirmed in ex vivo-stimulated blood where complement inhibition significantly reduced IL-8/CXCL8 release. Plasmodium falciparum malaria is associated with a systemic complement activation and complement-dependent release of inflammatory cytokines, of which IL-8/CXCL8 is particularly prominent. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:
    The Journal of Infectious Diseases 05/2015; DOI:10.1093/infdis/jiv283 · 6.00 Impact Factor
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    ABSTRACT: Non-sterile pathogen-induced sepsis and sterile inflammation like in trauma or ischemia-reperfusion injury may both coincide with the life threatening systemic inflammatory response syndrome and multi-organ failure. Consequently, there is an urgent need for specific biomarkers in order to distinguish sepsis from sterile conditions. The overall aim of this study was to uncover putative sepsis biomarkers and biomarker pathways, as well as to test the efficacy of combined inhibition of innate immunity key players complement and Toll-like receptor co-receptor CD14 as a possible therapeutic regimen for sepsis. We performed whole blood gene expression analyses using microarray in order to profile Gram-negative bacteria-induced inflammatory responses in an ex vivo human whole blood model. The experiments were performed in the presence or absence of inhibitors of complement proteins (C3 and CD88 (C5a receptor 1)) and CD14, alone or in combination. In addition, we used blood from a C5-deficient donor. Anti-coagulated whole blood was challenged with heat-inactivated Escherichia coli for 2 h, total RNA was isolated and microarray analyses were performed on the Affymetrix GeneChip Gene 1.0 ST Array platform. The initial experiments were performed in duplicates using blood from two healthy donors. C5-deficiency is very rare, and only one donor could be recruited. In order to increase statistical power, a technical replicate of the C5-deficient samples was run. Subsequently, log2-transformed intensities were processed by robust multichip analysis and filtered using a threshold of four. In total, 73 microarray chips were run and analyzed. The normalized and filtered raw data have been deposited in NCBI's Gene Expression Omnibus (GEO) and are accessible with GEO Series accession number GSE55537. Linear models for microarray data were applied to estimate fold changes between data sets and the respective multiple testing adjusted p-values (FDR q-values). The interpretation of the data has been published by Lau et al. in an open access article entitled “CD14 and Complement Crosstalk and Largely Mediate the Transcriptional Response to Escherichia coli in Human Whole Blood as revealed by DNA Microarray” (Lau et al., 2015).
    Genomics Data 05/2015; 5. DOI:10.1016/j.gdata.2015.05.019
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    ABSTRACT: Combined inhibition of complement and CD14 is known to attenuate bacterial-induced inflammation, but the dependency of the bacterial load on this effect is unknown. Thus, we investigated whether the effect of such combined inhibition on Escherichia coli- and Staphylococcus aureus-induced inflammation was preserved during increasing bacterial concentrations. Human whole blood was preincubated with anti-CD14, eculizumab (C5-inhibitor) or compstatin (C3-inhibitor), or combinations thereof. Then heat-inactivated bacteria were added at final concentrations of 5x10(4) -1x10(8) /mL (E. coli) or 5x10(7) -4x10(8) /mL (S. aureus). Inflammatory markers were measured using ELISA, multiplex technology and flow cytometry. Combined inhibition of complement and CD14 significantly (P<0.05) reduced E. coli-induced IL-6 by 40-92% at all bacterial concentrations. IL-1β, IL-8 and MIP-1α were significantly (P<0.05) inhibited by 53-100%, and the effect was lost only at the highest bacterial concentration. TNF and MIP-1β were significantly (P<0.05) reduced by 80-97% at the lowest bacterial concentration. Monocyte and granulocyte CD11b were significantly (P<0.05) reduced by 63-91% at all bacterial doses. Lactoferrin was significantly (P<0.05) attenuated to the level of background activity at the lowest bacterial concentration. For S. aureus similar effects were observed, but the attenuation was in general less pronounced. Compared to E. coli, much higher concentrations of S. aureus were required to induce the same cytokine responses. This study demonstrates generally preserved effects of combined complement and CD14 inhibition on Gram-negative and Gram-positive bacterial-induced inflammation during escalating bacterial load. The implications of these findings for future therapy of sepsis are discussed. This article is protected by copyright. All rights reserved. © 2015 British Society for Immunology.
    Clinical & Experimental Immunology 04/2015; 181(3). DOI:10.1111/cei.12645 · 3.04 Impact Factor
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    ABSTRACT: Neurodegenerative and inflammatory processes are involved separately in major depression (MD) and alcohol-use disorders (AUD). Little is known about the nature of this relationship in the context of comorbid AUD and depression disorders. In this study, we determined brain-derived neurotrophic factor (BDNF) serum levels in patients with AUD and tested whether BDNF levels were related to history of major depression, recent depressive symptoms, AUD severity, and TNF-α and IL-6 levels. Nepalese male AUD inpatients (N = 152) abstinent from alcohol for an average of 34 days were administered structured interviews to assess depression symptoms and pattern and extent of alcohol use, and to generate research diagnoses for AUD and MD. AUD severity was assessed by scores on the Alcohol Use Disorder Identification Test. Serum BDNF and cytokines were measured using ELISA and multiplex technology, respectively. Although serum BDNF levels were unrelated to MD history, patients with recent depressive symptoms (n = 42) had lower (mean ± SD) BDNF serum levels compared to those without (n = 110) (21.6 ± 8.1 ng/mL vs. 26.0 ± 9.6 ng/mL; p = 0.010), and patients with higher AUD severity and binge-drinking patterns had higher mean serum BDNF levels compared to lower AUD severity and non-binging (25.9 ± 9.7 ng/mL vs. 22.1 ± 8.7 ng/mL; p = 0.022 and 25.7 ± 9.3 vs. 21.8 ± 9.7 ng/mL; p = 0.029, respectively). Positive correlations were present between BDNF and TNF-α (r = 0.39, p < 0.001) and IL-6 (r = 0.2, p = 0.027). In particular, TNF-α levels were predictive of BDNF levels after controlling for confounders (B = 0.3 [95% CI = 0.2-0.5], p < 0.001). These findings show that in alcohol-using populations, peripheral BDNF levels are related to severity of AUD as well as presence of depressive symptoms. The significant associations between inflammatory and neurotrophic factors may have implications for neuroadaptive changes during recovery from AUD.
    Alcohol (Fayetteville, N.Y.) 03/2015; 49(5). DOI:10.1016/j.alcohol.2015.01.012 · 2.01 Impact Factor

Publication Stats

10k Citations
1,794.59 Total Impact Points


  • 1996-2015
    • Oslo University Hospital
      • • Department of Immunology
      • • Department of Cardiothoracic Surgery
      Kristiania (historical), Oslo, Norway
  • 1995-2015
    • Universitetet i Tromsø
      • • Faculty of Health Sciences
      • • Department of Clinical Medicine (IKM)
      • • Department of Medical Biology(IMB)
      Tromsø, Troms, Norway
    • Folktandvården Stockholm AB
      Tukholma, Stockholm, Sweden
  • 1993-2015
    • Nordlandssykehuset Bodoe
      Bodø, Nordland, Norway
  • 1987-2015
    • University of Oslo
      • • Department of Immunology (IMM)
      • • Department of Cardiology
      • • Division of Surgery
      • • Department of Physiology
      Kristiania (historical), Oslo, Norway
  • 2013
    • IT University of Copenhagen
      København, Capital Region, Denmark
  • 2008-2013
    • Norwegian University of Science and Technology
      • Department of Cancer Research and Molecular Medicine
      Nidaros, Sør-Trøndelag, Norway
  • 2011
    • Centre for Ecology & Hydrology
      Wallingford, England, United Kingdom
  • 2009
    • Norwegian Institute of Public Health
      • Division of Infectious Disease Control
      Kristiania (historical), Oslo, Norway
    • University of Bristol
      • School of Veterinary Sciences
      Bristol, England, United Kingdom
  • 2007
    • University of Helsinki
      • Department of Bacteriology and Immunology
      Helsinki, Uusimaa, Finland
  • 2001-2003
    • Universität Heidelberg
      • Institute of Immunology and Serology
      Heidelberg, Baden-Wuerttemberg, Germany
    • Diakonhjemmet Hospital (Norway)
      Kristiania (historical), Oslo, Norway
    • Haukeland University Hospital
      Bergen, Hordaland, Norway
  • 1999
    • Nordlandssykehuset HF
      Bodø, Nordland, Norway
  • 1992
    • The Scripps Research Institute
      لا هویا, California, United States
  • 1989
    • Glostrup Hospital
      • Department of Urology
      København, Capital Region, Denmark
  • 1988
    • Medical Research Council (UK)
      Londinium, England, United Kingdom
  • 1985-1988
    • University of Lausanne
      • Department of Medicine
      Lausanne, Vaud, Switzerland