Andreas G Nerlich

Hannover Medical School, Hannover, Lower Saxony, Germany

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Publications (173)610.72 Total impact

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    ABSTRACT: Chronic inflammation is a major risk factor for the development and metastatic progression of cancer. We have previously reported that the chemopreventive polyphenol Curcumin inhibits the expression of the proinflammatory cytokines CXCL1 and -2 leading to diminished formation of breast and prostate cancer metastases. In the present study, we have analyzed the effects of Curcumin on miRNA expression and its correlation to the anti-tumorigenic properties of this natural occurring polyphenol. Using microarray miRNA expression analyses, we show here that Curcumin modulates the expression of a series of miRNAs, including miR181b, in metastatic breast cancer cells. Interestingly, we found that miR181b down-modulates CXCL1 and -2 through a direct binding to their 3'-UTR. Overexpression or inhibition of miR181b in metastatic breast cancer cells has a significant impact on CXCL1 and -2 and is required for the effect of Curcumin on these two cytokines. miR181b also mediates the effects of Curcumin on inhibition of proliferation and invasion as well as induction of apoptosis. Importantly, over-expression of miR181b in metastatic breast cancer cells inhibits metastasis formation in vivo in immunodeficient mice. Finally, we demonstrated that Curcumin up-regulates miR181b and down-regulates CXCL1 and -2 in cells isolated from several primary human breast cancers. Taken together, these data show that Curcumin provides a simple bridge to bring metastamir modulation into the clinic, placing it in a primary and tertiary preventive, as well as a therapeutic, setting.
    Molecular oncology 01/2014; · 6.70 Impact Factor
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    ABSTRACT: The paleopathological, paleoradiological, histological, molecular and forensic investigation of a female mummy (radiocarbon dated 1451-1642 AD) provides circumstantial evidence for massive skull trauma affecting a young adult female individual shortly before death along with chronic infection by Trypanosoma cruzi (Chagas disease). The mummy (initially assumed to be a German bog body) was localized by stable isotope analysis to South America at/near the Peruvian/Northern Chilean coast line. This is further supported by New World camelid fibers attached to her plaits, typical Inca-type skull deformation and the type of Wormian bone at her occiput. Despite an only small transverse wound of the supraorbital region computed tomography scans show an almost complete destruction of face and frontal skull bones with terrace-like margins, but without evidence for tissue reaction. The type of destruction indicates massive blunt force applied to the center of the face. Stable isotope analysis indicates South American origin: Nitrogen and hydrogen isotope patterns indicate an extraordinarily high marine diet along with C4-plant alimentation which fits best to the coastal area of Pacific South America. A hair strand over the last ten months of her life indicates a shift to a more "terrestric" nutrition pattern suggesting either a move from the coast or a change in her nutrition. Paleoradiology further shows extensive hypertrophy of the heart muscle and a distended large bowel/rectum. Histologically, in the rectum wall massive fibrosis alternates with residual smooth muscle. The latter contains multiple inclusions of small intracellular parasites as confirmed by immunohistochemical and molecular ancient DNA analysis to represent a chronic Trypanosoma cruzi infection. This case shows a unique paleopathological setting with massive blunt force trauma to the skull nurturing the hypothesis of a ritual homicide as previously described in South American mummies in an individual that suffered from severe chronic Chagas disease.
    PLoS ONE 01/2014; 9(2):e89528. · 3.73 Impact Factor
  • Kais Hussein, Ekatrina Matin, Andreas G Nerlich
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    ABSTRACT: Modern paleopathology is a multidisciplinary field of research which involves archaeology, medicine and biology. The most common diseases of Ancient Egypt were traumatic injuries, malaria and tuberculosis. Exemplarily, an internistic and trauma surgery case of that time is reviewed: Pharaoh Tutankhamun (ca. 1330-1324 B.C.). Summarising all findings which have been collected between 1922 and 2010, including computed tomography and molecular pathology, a diversity of disease is verifiable: (1) chronic/degenerative diseases (mild kyphoscoliosis, pes planus and hypophalangism of the right foot, bone necrosis of metatarsal bones II-III of the left foot); (2) inflammatory disease (malaria tropica, verified by PCR analysis) and (3) acute trauma (complex fracture of the right knee shortly before death). The most likely cause of death is the severe acute knee fracture and/or the malaria, while a suspected eighteenth dynasty syndrome cannot be proven.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 06/2013; · 2.68 Impact Factor
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    ABSTRACT: We applied, for the first time, next-generation sequencing (NGS) technology on Egyptian mummies. Seven NGS datasets obtained from five randomly selected Third Intermediate to Graeco-Roman Egyptian mummies (806 BC-124AD) and two unearthed pre-contact Bolivian lowland skeletons were generated and characterised. The datasets were contrasted to three recently published NGS datasets obtained from cold-climate regions, i.e. the Saqqaq, the Denisova hominid and the Alpine Iceman. Analysis was done using one million reads of each newly generated or published dataset. Blastn and megablast results were analysed using MEGAN software. Distinct NGS results were replicated by specific and sensitive polymerase chain reaction (PCR) protocols in ancient DNA dedicated laboratories. Here, we provide unambiguous identification of authentic DNA in Egyptian mummies. The NGS datasets showed variable contents of endogenous DNA harboured in tissues. Three of five mummies displayed a human DNA proportion comparable to the human read count of the Saqqaq permafrost-preserved specimen. Furthermore, a metagenomic signature unique to mummies was displayed. By applying a "bacterial fingerprint", discrimination among mummies and other remains from warm areas outside Egypt was possible. Due to the absence of an adequate environment monitoring, a bacterial bloom was identified when analysing different biopsies from the same mummies taken after a lapse of time of 1.5 years. Plant kingdom representation in all mummy datasets was unique and could be partially associated with their use in embalming materials. Finally, NGS data showed the presence of Plasmodium falciparum and Toxoplasma gondii DNA sequences, indicating malaria and toxoplasmosis in these mummies. We demonstrate that endogenous ancient DNA can be extracted from mummies and serve as a proper template for the NGS technique, thus, opening new pathways of investigation for future genome sequencing of ancient Egyptian individuals.
    Journal of applied genetics 04/2013; · 1.85 Impact Factor
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    Andreas G Nerlich, Beatrice E Bachmeier
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    ABSTRACT: The use of cell lines in cancer research is strongly dependent on the avoidance of contaminations, the correct attribution of a cell line to the initial primary tumor and stability. Previous studies have identified expression of melanocytic molecular markers in the widely used breast cancer cell line, MDA-MB-435. In the present study the three breast cancer cell lines, MCF-7, MDA-MB-231 and MDA-MB-435, were systematically analyzed for mRNA and protein expression of major epithelial (cytokeratin isoforms), mammary (mammaglobin) and melanocytic (melan A and S100-protein) markers. Protein expression was identified by immunocytochemistry and quantitative RT-PCR was used to determine mRNA levels. While MCF-7 and MDA-MB-231 cells unambiguously revealed an epithelial/mammary phenotype, MDA-MB-435 cells were found to exhibit epithelial/mammary and melanocytic features dependent on cell density. Subconfluent cells demonstrated epithelial characteristics only, however, densely growing, confluent cells also expressed melanocytic markers. Consistent with gain of melanocytic features, the expression levels of mammaglobin mRNA decreased in these cells. These results indicate that the three cell lines are primarily of epithelial phenotype, however, MDA-MB-435 cells revealed lineage infidelity in dense cultures with a gain in melanocytic phenotype. These characteristics must be taken into consideration when analyzing cancer-relevant genes and their expression profiles in vitro.
    Oncology letters 04/2013; 5(4):1370-1374. · 0.24 Impact Factor
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    ABSTRACT: Due to the presence of the lake Quarun and to the particular nature of its irrigation system, it has been speculated that the Fayum, a large depression 80 kilometers south- west of modern Cairo, was exposed to the hazards of malaria in historic times. Similarly, it has been speculated that, in the same area, also human tuberculosis might have been far more widespread in the antiquity than in its recent past. If these hypotheses were confirmed, it would imply that frequent cases of co-infection between the two pathogens might have occurred in ancient populations. To substantiate those speculations, molecular analyses were carried out on sixteen mummified heads recovered from the necropolis of Abusir el Meleq (Fayum) dating from the 3(rd) Intermediate Period (1064- 656 BC) to the Roman Period (30 BC- 300 AD). Soft tissue biopsies were used for DNA extractions and PCR amplifications using well-suited protocols. A partial 196-bp fragment of Plasmodium falciparum apical membrane antigen 1 gene and a 123-bp fragment of the Mycobacterium tuberculosis complex insertion sequence IS6110 were amplified and sequenced in six and five of the sixteen specimens, respectively. A 100% concordance rates between our sequences and those of P. falciparum and M. tuberculosis complex ones were obtained. Lastly, concomitant PCR amplification of P. falciparum and M. tuberculosis complex DNA specific fragments was obtained in four mummies, three of which are (14) C dated to the Late and Graeco-Roman Periods. Our data confirm that the hydrography of Fayum was extremely conducive to the spread of malaria. They also support the notion that the agricultural boom and dense crowding occurred in this region, especially under the Ptolemies, highly increased the probability for the manifestation and spread of tuberculosis. Here we extend back-wards to ca. 800 BC new evidence for malaria tropica and human tuberculosis co-occurrence in ancient Lower Egypt.
    PLoS ONE 01/2013; 8(4):e60307. · 3.73 Impact Factor
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    ABSTRACT: Clinical reports imply that, from the age of 28, Eleonora of Toledo (1522- 17th December 1562), the wife of Cosimo I de’Medici, developed pulmonary tuberculosis, which together with an outbreak of pernicious malaria, killed her at the age of 40. Eleonora’s autopsy indicated that she had severe lung lesions consistent with chronic pulmonary infection. In order to clarify the disease status, we performed paleomolecular investigations. Our results identified ancient DNA of the Mycobacterium tuberculosis complex together with an infection by Leishmania infantum. Our data are of particular interest since in Tuscany the endemic foci of L. infantum are widely distributed and overlapped with those of malaria prior to its eradication. Although we can only speculate on Eleonora’s true state of health, our clear evidence of long- term co-infections with MTB and VL are major medical and biological interest since the co-evolution of the two pathogens and the host- pathogen interactions in co-infected individuals are still not fully understood.
    International Journal of Paleopathology. 12/2012; accepted for publication(in press).
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    ABSTRACT: Common variable immunodeficiency (CVID) is the most common primary antibody deficient syndrome in adults. Among the broad spectrum of clinical manifestations are recurrent infections, allergies, autoimmune, tumour, pulmonary, liver and gastrointestinal diseases. Here we report the case of a 45-year-old male patient, who has been suffering from ulcerative colitis - likewise recognised as a CVID-associated disease - for many years. He was admitted to our clinic with a rapid progressive reduction of his general condition and a loss of weight. Diagnostic work-up revealed adenocarcinoma of the stomach as well as an undifferentiated neuroendocrine carinoma of the colorectum at the rectosigmoidal junction. Curative resection of the distal stomach and proctolcolectomy were performed. To date, the pathogenesis of the association of many diseases with CVID is still ambiguous. Yet, there is no doubt about the significantly higher incidence of e. g., inflammatory bowel disease or gastric cancer in patients with CVID. Our case highlights that in patients with CVID and obscure deterioration of their general health condition a careful search for especially malignant complications is mandatory although to date there are no precise recommendations for screening.
    Zeitschrift für Gastroenterologie 12/2012; 50(12):1292-5. · 1.41 Impact Factor
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    ABSTRACT: In America and Western Europe prostate cancer is the second leading cause of death in men. Emerging evidence suggests that chronic inflammation is a major risk factor for the development and metastatic progression of prostate cancer.We previously reported that the chemopreventive polyphenol Curcumin inhibits the expression of the pro-inflammatory cytokines CXCL1 and -2 leading to diminished formation of breast cancer metastases. Here we analyse the effects of Curcumin on prostate carcinoma growth, apoptosis and metastasis. We show that Curcumin inhibits translocation of NFκB to the nucleus through the inhibition of the IκB-kinase, IKKβ, leading to stabilization of the inhibitor of NFκB, IκBα, in PC3 prostate carcinoma cells. Inhibition of NFκB activity reduces expression of CXCL1 and -2 and abolishes the autocrine/paracrine loop that links the two chemokines to NFκB. The combination of Curcumin with the synthetic IKKβ inhibitor, SC-541, shows no additive or synergistic effects indicating that the two compounds share the target. Treatment of the cells with Curcumin as wells as siRNA based knock-down of CXCL1 and -2 induce apoptosis, inhibit proliferation, and down-regulate several important metastasis-promoting factors like COX2, SPARC, and EFEMP. In an orthotopic mouse model of haematogenous metastasis, treatment with Curcumin inhibits statistically significantly formation of lung metastases.In conclusion, chronic inflammation can induce a metastasis prone phenotype in prostate cancer cells by maintaining a positive pro-inflammatory and pro-metastatic feed-back loop between NFκB and CXCL1/-2. Curcumin disrupts this feed-back loop by the inhibition of NFκB signalling leading to reduced metastasis formation in vivo.
    Carcinogenesis 10/2012; · 5.64 Impact Factor
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    ABSTRACT: The role of fusion of lumbar motion segments for the treatment of axial low back pain (LBP) from lumbar degenerative disc disease (DDD) without any true deformities or instabilities remains controversially debated. In an attempt to avoid previously published and fusion-related negative side effects, motion preserving technologies such as total lumbar disc replacement (TDR) have been introduced. The adequate extent of preoperative DDD for TDR remains unknown, the number of previously published studies is scarce and the limited data available reveal contradictory results. The goal of this current analysis was to perform a prospective histological, X-ray and MRI investigation of the index-segment's degree of DDD and to correlate these data with each patient's pre- and postoperative clinical outcome parameters from an ongoing prospective clinical trial with ProDisc II (Synthes, Paoli, USA). Nucleus pulposus (NP) and annulus fibrosus (AF) changes were evaluated according to a previously validated quantitative histological degeneration score (HDS). X-ray evaluation included assessment of the mean, anterior and posterior disc space height (DSH). MRI investigation of DDD was performed on a 5-scale grading system. The prospective clinical outcome assessment included Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) scores as well as the patient's subjective satisfaction rates. Data from 51 patients with an average follow-up of 50.5 months (range 6.1-91.9 months) were included in the study. Postoperative VAS and ODI scores improved significantly in comparison to preoperative levels (p < 0.002). A significant correlation and interdependence was established between various parameters of DDD preoperatively (p < 0.05). Degenerative changes of NP tissue samples were significantly more pronounced in comparison to those of AF material (p < 0.001) with no significant correlation between each other (p > 0.05). Preoperatively, the extent of DDD was not significantly correlated with the patient's symptomatology (p > 0.05). No negative influence was associated with increasing stages of DDD on the postoperative clinical outcome parameters following TDR (p > 0.05). Increasing stages of DDD in terms of lower DSH scores were not associated with inferior clinical results as outlined by postoperative VAS or ODI scores or the patient's subjective outcome evaluation at the last FU examination (p > 0.05). Conversely, some potential positive effects on the postoperative outcome were observed in patients with advanced stages of preoperative DDD. Patients with more severe preoperative HDS scores of NP samples demonstrated significantly lower VAS scores during the early postoperative course (p = 0.02). Increasing stages of DDD did not negatively impact on the outcome following TDR in a highly selected patient population. In particular, no preoperative DDD threshold value was identified from which an inferior postoperative outcome could have been deduced. Conversely, some positive effects on the postoperative outcome were detected in patients with advanced stages of DDD. Combined advantageous effects of progressive morphological structural rigidity of the index segment and restabilizing effects from larger distraction in degenerated segments may compensate for increasing axial rotational instability, one of TDR's perceived disadvantages. Our data reveal a "therapeutic window" for TDR in a cohort of patients with various stages of DDD as long as preoperative facet joint complaints or degenerative facet arthropathies can be excluded and stringent preoperative decision making criteria are adhered to. Previously published absolute DSH values as contraindication against TDR should be reconsidered.
    European Spine Journal 05/2012; 21(11):2287-99. · 2.47 Impact Factor
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    Sandra Lösch, Stefanie Panzer, Andreas Nerlich
    05/2012: pages 37-40;
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    ABSTRACT: Disc degeneration and re-herniation after nucleotomy procedures are common problems. Simultaneous application of hyaluronic acid (HA)-based matrix has been proposed to limit disc degeneration. This, however, is hampered by loss of the substituted matrix out of the disc. Hence, in situ polymerization of the injected matrix with ultraviolet light (UVL) directly used after injection may be useful. Therefore, this study evaluates a new HA/collagen hydrogel matrix with in situ polymerization after implantation in an established porcine nucleotomy model. 12 mature minipigs were used. A total of 60 lumbar discs were analyzed. 36 discs underwent partial nucleotomy with a 16G biopsy needle. Of those, 24 discs received matrix (porcine nucleus pulposus collagenous scaffold component and chemically modified HA) which was in situ polymerized using UVL immediately after transplantation. 12 nucleotomized discs and 24 non-nucleotomized discs served as controls. After 24 weeks, animals were killed. X-rays, MRIs, histology, and gene expression analysis were done. Disc height was reduced equally after sole nucleotomy and nucleotomy with HA treatment and in MRIs signal intensity decreased. For both nucleotomy groups, the nucleus histo-degeneration score showed a significant increase compared to controls. In histology, HA treatment resulted in more scarring and inflammation in the annulus. Gene expression of catabolic MMPs was up-regulated, whereas IFN-gamma, IL-6, and IL-1b were unchanged. Although nucleotomy and administration of the implant material did not cause generalized inflammation of the disc, localized annular damage with annulus inflammation and scarring resulted in detrimental degenerative disc changes. As a result, therapeutic strategies should strongly focus on the prevention of annular damage or techniques for annular repair to remain disc integrity.
    European Spine Journal 04/2012; 21(9):1700-8. · 2.47 Impact Factor
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    ABSTRACT: Egyptology relies on traditional descriptive methods. Here we show that modern, Internet-based science and statistical methods can be applied to Egyptology. Two four-thousand-year-old sarcophagi in one tomb, one within the other, with skeletal remains of a woman, gave us the opportunity to diagnose a congenital nervous system disorder in the absence of a living nervous system. The sarcophagi were discovered near Thebes, Egypt. They were well preserved and meticulously restored. The skeletal remains suggested that the woman, aged between 50 and 60 years, was Black, possibly of Nubian descent and suffered from syringobulbia, a congenital cyst in the brain stem and upper spinal cord. We employed crowd sourcing, the anonymous responses of 204 Facebook users who performed a matching task of living persons' iris color with iris color of the Udjat eyes, a decoration found on Egyptian sarcophagi, to confirm the ethnicities of the sarcophagus occupants. We used modern fMRI techniques to illustrate the putative extent of her lesion in the brain stem and upper spinal cord deduced from her skeletal remains. We compared, statistically, the right/left ratios, a non-dimensional number, of the orbit height, orbit width, malar height and the infraorbital foramena with the same measures obtained from 32 ancient skulls excavated from the Fayum, North of Thebes. We found that these ratios were significantly different in this skull indicating atrophy of cranial bones on the left. In this instance, Internet science and the use of modern neurologic research tools showed that ancient sarcophagus makers shaped and decorated their wares to fit the ethnicity of the prospective occupants of the sarcophagi. We also showed that, occasionally, human nervous system disease may be recognizable in the absence of a living nervous system.
    PLoS ONE 01/2012; 7(11):e50382. · 3.73 Impact Factor
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    Emerging Infectious Diseases 01/2012; 18(1):184-6. · 6.79 Impact Factor
  • Zentralblatt für Chirurgie 12/2011; 137(1):65-8. · 0.69 Impact Factor
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    ABSTRACT: Destruction of cancer cells by cytotoxic T lymphocytes depends on immunogenic tumor peptides generated by proteasomes and presented by human leukocyte antigen (HLA) molecules. Functional differences arising from alleles of immunoproteasome subunits have not been recognized so far. We analyzed the genetic polymorphism of the immunoproteasome subunits LMP2 and LMP7 and of the transporters associated with antigen processing (TAP1 and TAP2) in two independently collected panels of colorectal carcinoma patients (N(1) = 112, N(2) = 62; controls, N = 165). High risk of colon cancer was associated with the LMP7-K/Q genotype (OR = 8.10, P = 1.10 × 10(-11)) and low risk with the LMP7-Q/Q genotype (OR = 0.10, P = 5.97 × 10(-13)). The basis for these distinct associations of LMP7 genotypes was functionally assessed by IFN-γ stimulation of colon carcinoma cell lines (N = 10), followed by analyses of mRNA expression of HLA class I, TAP1, TAP2, and LMP7, with real-time PCR. Whereas induction of HLA-B, TAP1, and TAP2 was comparable in all cell lines, transcript amounts of LMP7-Q increased 10-fold, but of LMP7-K only 3.8-fold. This correlated with a reduced transcript stability of LMP7-K (t(1/2) ≈ 7 minutes) compared with LMP7-Q (t(1/2) ≈ 33 minutes). In addition, LMP7-Q/Q colon carcinoma cells increased (the peptide based) HLA class I surface expression significantly after IFN-γ stimulation, whereas LMP7-Q/K and LMP7-K/K carcinoma cells showed minimal (<20%) changes. These results suggest that the presence of LMP7-K can reduce the formation of immunoproteasomes and thus peptide processing, followed by reduced peptide-HLA presentation, a crucial factor in the immune response against cancer.
    Cancer Research 12/2011; 71(23):7145-54. · 8.65 Impact Factor
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    ABSTRACT: Although histopathological grading systems for disc degeneration are frequently used in research, they are not yet integrated into daily care routine pathology of surgical samples. Therefore, data on histopathological changes in surgically excised disc material and their correlation to clinical parameters such as age, gender or body mass index (BMI) is limited to date. The current study was designed to correlate major physico-clinical parameters from a population of orthopaedic spine center patients (gender, age and BMI) with a quantitative histologic degeneration score (HDS). Excised lumbar disc material from 854 patients (529 men/325 women/mean age 56 (15-96) yrs.) was graded based on a previously validated histologic degeneration score (HDS) in a cohort of surgical disc samples that had been obtained for the treatment of either disc herniation or discogenic back pain. Cases with obvious inflammation, tumor formation or congenital disc pathology were excluded. The degree of histological changes was correlated with sex, age and BMI. The HDS (0-15 points) showed significantly higher values in the nucleus pulposus (NP) than in the annulus fibrosus (AF) (Mean: NP 11.45/AF 7.87), with a significantly higher frequency of histomorphological alterations in men in comparison to women. Furthermore, the HDS revealed a positive significant correlation between the BMI and the extent of histological changes. No statistical age relation of the degenerative lesions was seen. This study demonstrated that histological disc alterations in surgical specimens can be graded in a reliable manner based on a quantitative histologic degeneration score (HDS). Increased BMI was identified as a positive risk factor for the development of symptomatic, clinically significant disc degeneration.
    BMC Research Notes 11/2011; 4:497.
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    Acta Neurochirurgica 11/2011; · 1.55 Impact Factor
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    ABSTRACT: Intervertebral disc (IVD) degeneration is characterized as a multifactorial disease, in which the hereditary background is thought to be of high importance. Accordingly, one would expect all spinal levels (lumbar/cervical/thoracal) to be affected by above-average disc degeneration in genetically predisposed individuals. The aim of this study, therefore, was to analyze the amount of degenerative changes in different spine levels in humans from different ages. In detail, the presence, localization and abundance of histomorphological changes in the annulus fibrosus (AF) and nucleus pulposus (NP) in the cervical (C5/C6), thoracic (T2/T3) and lumbar (L2/L3) spine were investigated in complete autopsy IVD specimens (47 individuals) covering a complete age range (0-95 years). Results indicate that the highest degree of histo-degenerative changes were observed in the NP in all spine levels and showed an age-related expression pattern. With regard to the different spine levels, lumbar disc specimen showed significantly more degenerative changes compared to cervical and thoracic discs, whereas no statistical difference was observed between cervical and thoracic discs. In summary, highest grades of degeneration were observed in lumbar discs (especially in the NP). Intra-individual correlations between the degeneration score in the different levels showed a significant individual concordance. The intra-individual correlation of degenerative changes in all three examined spine regions further supports the notion that individual, i.e. genetic factors are strong predisposing factor for the development of age-related disc alterations.
    European Spine Journal 08/2011; 21 Suppl 6:S810-8. · 2.47 Impact Factor

Publication Stats

3k Citations
610.72 Total Impact Points

Institutions

  • 2013
    • Hannover Medical School
      • Institute for Pathology
      Hannover, Lower Saxony, Germany
  • 2012
    • Städtisches Klinikum Solingen Gmbh
      Solingen, North Rhine-Westphalia, Germany
  • 1997–2012
    • Ludwig-Maximilian-University of Munich
      • Institute of Pathology
      München, Bavaria, Germany
    • Universitätsklinikum Tübingen
      Tübingen, Baden-Württemberg, Germany
  • 2010–2011
    • Universität Ulm
      • Clinic for Neurosurgery
      Ulm, Baden-Wuerttemberg, Germany
    • Klinikum Bogenhausen
      Münchenbernsdorf, Thuringia, Germany
    • Deutsches Herzzentrum München
      München, Bavaria, Germany
  • 2007–2011
    • University of Zurich
      • Center for Applied Biotechnology and Molecular Medicine - CABMM
      Zürich, Zurich, Switzerland
  • 1998–2011
    • Technische Universität München
      • Abteilung für Gastroenterologische Onkologie
      München, Bavaria, Germany
  • 2009
    • CRO Centro di Riferimento Oncologico di Aviano
      Aviano, Friuli Venezia Giulia, Italy
  • 2008
    • University of Minnesota Duluth
      Duluth, Minnesota, United States
  • 2003
    • Uniklinik Balgrist
      Zürich, Zurich, Switzerland
  • 2001
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 2000
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      Erlangen, Bavaria, Germany
  • 1992–1998
    • University Hospital München
      München, Bavaria, Germany
  • 1995
    • Pathologisches Institut Bremerhaven
      Bremerhaven, Bremen, Germany