C Witt

Charité Universitätsmedizin Berlin, Berlín, Berlin, Germany

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Publications (140)394.73 Total impact

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    ABSTRACT: Ziel der Studie: Die Metropolregion Berlin verzeichnet ca. 1600 Todesfälle/Jahr in folge urbanen Hitzstresses. Zusätzlich, nimmt die Morbidität bei chronischen Lungenkrankheiten durch Hitzestress zu, die zur Hospitalisierung via Notaufnahme führen kann. Folglich wurde geprüft, ob Innenraumklimatisierung den Hospitalisierungsverlauf vulnerabler Patienten beeinflusst in Hinblick auf den Flüssigkeitshaushalt und CAT score. Methoden: Prospektiv-randomisiert wurden 33 Patienten (Durchschnittsalter 69,52 Jahre, BMI 24,61, COPD IV 33,33%) mit Verlausfsverschlechterung chronischer Lungenkrankheit (zumeist COPD) in einer Pilotauswertung untersucht. Studieneinschluss erfolgte im Verhältnis 1:1 in klimatisierte oder unklimatisierte Krankenzimmer. Die Innenraumtemperatur wurde konstant bei 23 °C mittels Kältemittel-führenden Kapillarrohrmatten unter Zimmerdecken- Oberfläche gehalten (Fa. CLINA Heiz-& Kühlelemente GmbH, Berlin), betrug hingegen in nicht-klimatisierten Zimmern im Sommer 2014: 24,2 °C- 28,2 °C. Gemessene Innenraum- sowie meteorologische Außenparameter erlauben, die Hitzebelastung auf Patienten zu beurteilen. Vegetative und funktionelle Parameter, u.a. Trinkmenge und Fragebögen (CAT, HADS-S, SGRQ, MMRC) waren Bewertungsgrundlage. Ergebnisse und Ausblick: Die erste Auswertung zeigt, dass die Patienten in klimatisierten Zimmern, im Unterscheid zu den Patienten in unklimatisierten Krankenzimmern eine geringere Trinkmenge zuführten (1,62 l versus 2,17 l, p < 0,05). Der CAT Score sank in klimatisierten Zimmern mehr (1,25 Punkte) als bei Patienten im unklimatisierten Setting (0,857 Punkte, p < 0,05). Folglich hat die Krankenzimmer-Klimatisierung unterstützenden Einfluss auf vulnerable chronisch-kranke Lungenpatienten während der Hospitalisierung. In Hinblick auf den Klimawandel und die damit verbundene weitere Erwärmung könnte Klimatisierung eine Adaptationsstrategie im Krankenzimmer der Zukunft für Lungenkranke sein. Förderung: DFG FOR 1736 (UCaHS)
    Pneumologie 02/2015; 69(S 01). DOI:10.1055/s-0035-1544786
  • Pneumologie 02/2015; 69(S 01). DOI:10.1055/s-0035-1544724
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    ABSTRACT: Summer heat waves with temperature extremes are becoming more frequent with growing numbers in morbidity and mortality in patients with respiratory diseases. The aim of this study was to evaluate the ramifications of heat stress (temperature >25 °C) on the health status of patients with pulmonary arterial hypertension (PAH). Fifteen patients with PAH (mean age = 66.7 ± 5.2 years) continuously wore an accelerometer from April 1 to September 30, 2011, and their daily step count was recorded. In addition, patients kept a diary to record data on seven standardized questions regarding their daily symptoms. Echocardiography, 6-minute walk test, NTproBNP, and Modified Medical Research Council Scale (MMRC) were assessed at baseline and at the end of the study after 6 months. On heat-stress days, patients showed significantly more symptoms and lower total steps/day compared to thermal comfort days (3,995 ± 2,013 steps/day vs. 5,567 ± 2,434 steps/day, respectively; P < 0.001). There was a significant negative correlation between total steps/day and Tempmax (R = -0.47; P < 0.001) and humidity (R = -0.34; P < 0.001). A significant positive correlation was found between daily symptoms and Tempmax (R = +0.79; P < 0.001) and humidity (R = +0.23; P < 0.001). Heat stress is associated with a compromised clinical status in patients with PAH. Adaptation strategies must be implemented to prevent heart-related morbidity, including therapeutic adjustments and adequate room cooling in the patient's home and at the hospital.
    Beiträge zur Klinik der Tuberkulose 05/2014; DOI:10.1007/s00408-014-9587-4 · 2.17 Impact Factor
  • M. Jehn · C. Witt
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    ABSTRACT: Hintergrund Der Klimawandel führt zu einer Zunahme von Temperaturextremen, indem es mehr heiße und mehr kalte Rekordtage geben wird. Patienten mit chronisch obstruktiver Bronchitis sind demnach einem erhöhten Morbiditäts- und Mortalitätsrisiko ausgesetzt. Fragestellung Ein telemedizinisches Monitoringsystem wurde entwickelt, um die Auswirkungen von Hitzestress (Tage > 25 °C) auf den klinischen Zustand zu evaluieren. Methoden Es wurden 62 Patienten in die Studie eingeschlossen und entweder in eine Telemedizingruppe (n = 32) oder Kontrollgruppe (n = 30) randomisiert. Das Telemonitoring beinhaltete die Erfassung des klinischen Zustands (COPD-Assessment-Test, CAT), eine tägliche Lungenfunktionsmessung (FEV1) und einen wöchentlichen 6-Minuten-Gehtest (6MWT). Die Beobachtungsdauer betrug insgesamt 9 Monate. Ergebnisse Im Zeitraum vom 1. Juni bis 31. August 2012 wurden insgesamt 32 Tage mit Hitzestress gezählt (mittlere Lufttemperatur 29 ± 2,5 °C) und mit 32 Tagen ohne Hitzestress aus dem gleichen Zeitraum verglichen (mittlere Lufttemperatur 21 ± 2,9 °C). An Tagen mit Hitzestress zeigten die Patienten in der Telemedizingruppe eine signifikante Verschlechterung der Lungenfunktion, der körperlichen Leistungsfähigkeit im 6MWT und ihres klinischen Zustands gemessen am CAT-Fragebogen. In den Sommermonaten erlitten 3 Patienten der Telemedizingruppe einen durch akute Luftnot bedingten Anfall (Exazerbation) im Vergleich zu 14 Kontrollpatienten. Über die gesamte 9-monatige Beobachtungsdauer zeigten die Patienten in der Telemedizingruppe insgesamt weniger Exazerbationen im Vergleich zur Kontrollgruppe, eine kürzere Krankenhausliegedauer und weniger Konsultationen beim Lungenarzt. Schlussfolgerungen Patienten mit COPD sind vom Hitzestress stark betroffen. Sowohl der klinische als auch der funktionelle Zustand sind durch Hitzestress eingeschränkt. Ein telemedizinisches Patientenmonitoring senkt das Exazerbationsrisiko und den Bedarf an Krankenversorgung und sollte für das Management von chronischen Erkrankungen während Hitzeperioden zusätzlich zur Grundversorgung bedacht werden.
    Der Pneumologe 05/2014; 11(3):204-213. DOI:10.1007/s10405-013-0727-y
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    ABSTRACT: A home based tele-monitoring system was developed to assess the effects of heat stress (days > 25[degree sign]C) on clinical and functional status in patients with chronic obstructive pulmonary disease (COPD). Sixty-two COPD patients (GOLD II--IV) were randomized into a tele-monitoring Group (TG, N = 32) or Control Group (CG, N = 30). Tele-monitoring included 1) daily clinical status (COPD Assessment Test-CAT), 2) daily lung function and 3) weekly 6-minute walk test (6MWT). Duration of monitoring lasted a total of nine months (9 M). From June 1st--August 31st 2012, 32 days with heat stress (29.0 +/- 2.5[degree sign]C) were recorded and matched with 32 thermal comfort days (21.0 +/- 2.9[degree sign]C). During heat stress, the TG showed a significant reduction in lung function and exercise capacity (FEV1% predicted: 51.1 +/- 7.2 vs. 57.7 +/- 5.0%; P <0.001 and 6MWT performance: 452 +/- 85 vs. 600 +/- 76 steps; P <0.001) and increase in CAT scores (19.2 +/- 7.9 vs. 16.2 +/- 7.2; P <0.001).Over summer, significantly fewer TG patients suffered exacerbation of COPD compared to CG patients (3 vs. 14; P = 0.006). Over entire 9 M follow-up, the TG group had fewer exacerbations compared to CG (7 vs. 22; P = 0.012), shorter cumulative hospital stay (34 vs. 97 days) and 43% fewer specialist consultations (24. vs. 42; P = 0.04). Heat stress affects clinical and functional status in COPD. Tele-monitoring reduces exacerbation frequency and health care utilization during heat stress and other periods of the year.Trial registration: DRKS-ID: DRK00000705.
    Environmental Health 11/2013; 12(1):99. DOI:10.1186/1476-069X-12-99 · 2.71 Impact Factor
  • Pneumologie 02/2013; 67(S 01). DOI:10.1055/s-0033-1334696
  • Pneumologie 02/2013; 67(S 01). DOI:10.1055/s-0033-1334742
  • Pneumologie 02/2013; 67(S 01). DOI:10.1055/s-0033-1334800
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    ABSTRACT: Background: The prevalence of cardiovascular mortality is high in Chronic Obstructive Pulmonary Disease (COPD) and the identification of clinical parameters to improve risk stratification is of great interest. Objectives: This study aims to assess the predictive strength of daily walking activity on expression of cardiac biomarkers in patients with COPD. Methods: One hundred and five patients with COPD (66.1 ± 8.7 years of age) were prospectively analyzed. Daily walking activity was measured by means of accelerometry. Stepwise multivariate regression analyses were employed with either midregional proatrial natriuretic peptide (MRproANP) or plasma proadrenomedullin (MRproADM) as dependent variables, and age, age-adjusted Charlson score, Modified Medical Research Council Dyspnea Scale (MMRC), Saint Georges Respiratory Questionnaire total score and either total walk, steps per day or fast walk as covariates. Results: Independent predictors of MRproANP included age (p = 0.015) and either total walk or steps per day (both p < 0.0001). Total walk or steps per day were the only independent predictors of MRproADM (p < 0.0001). There was a significant negative correlation between fast walk and MMRC (R = -0.70; p < 0.001) and fast walk was only independently predictive of MRproANP but not MRproADM once MMRC was excluded from the list of covariates (p = 0.023 and p = 0.057, respectively). Conclusions: Daily walking activity independently predicts levels of circulating MRproANP and MRproADM in stable COPD patients, two prognostic biomarkers of cardiac distress associated with long-term survival upon exacerbation of COPD. Employing activity monitors in the stable state might simplify risk stratification in daily living.
    Respiration 12/2012; 85(3). DOI:10.1159/000345218 · 2.92 Impact Factor
  • Pneumologie 03/2012; 66(S 01). DOI:10.1055/s-0032-1302712
  • Pneumologie 03/2012; 66(S 01). DOI:10.1055/s-0032-1302714
  • Christian Witt
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 08/2011; 6(8):1451. DOI:10.1097/JTO.0b013e318224643b · 5.80 Impact Factor
  • Pneumologie 03/2011; 65(S 01). DOI:10.1055/s-0031-1272326
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    ABSTRACT: This study aimed to show that SHOX2 DNA methylation is a tumor marker in patients with suspected lung cancer by using bronchial fluid aspirated during bronchoscopy. Such a biomarker would be clinically valuable, especially when, following the first bronchoscopy, a final diagnosis cannot be established by histology or cytology. A test with a low false positive rate can reduce the need for further invasive and costly procedures and ensure early treatment. Marker discovery was carried out by differential methylation hybridization (DMH) and real-time PCR. The real-time PCR based HeavyMethyl technology was used for quantitative analysis of DNA methylation of SHOX2 using bronchial aspirates from two clinical centres in a case-control study. Fresh-frozen and Saccomanno-fixed samples were used to show the tumor marker performance in different sample types of clinical relevance. Valid measurements were obtained from a total of 523 patient samples (242 controls, 281 cases). DNA methylation of SHOX2 allowed to distinguish between malignant and benign lung disease, i.e. abscesses, infections, obstructive lung diseases, sarcoidosis, scleroderma, stenoses, at high specificity (68% sensitivity [95% CI 62-73%], 95% specificity [95% CI 91-97%]). Hypermethylation of SHOX2 in bronchial aspirates appears to be a clinically useful tumor marker for identifying subjects with lung carcinoma, especially if histological and cytological findings after bronchoscopy are ambiguous.
    BMC Cancer 11/2010; 10:600. DOI:10.1186/1471-2407-10-600 · 3.32 Impact Factor
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    ABSTRACT: Cytologic examination of specimens obtained from the respiratory tract is a lung cancer diagnostic procedure with high specificity but moderate sensitivity. The use of molecular biomarkers may enhance the sensitivity of cytologic examination in the detection of lung cancer. Complement factor H, a protein secreted by lung cancer cells, was quantified in a series of bronchoalveolar lavage supernatants from lung cancer patients and patients with nonmalignant respiratory diseases. Albumin, total protein content, and hemoglobin were also analyzed. Results were validated in independent sets of bronchoalveolar lavage and sputum supernatants. There was a significantly higher concentration of factor H in bronchoalveolar lavage samples from lung cancer patients. The sensitivity and specificity of the factor H test was 82% and 77%, respectively. These results were validated in an independent set of patients with nearly identical results. Furthermore, 70% and 45% of bronchoalveolar lavage fluids from central and peripheral tumors, respectively, reported as cytologically negative, were classified as positive using this marker. Finally, the test was evaluated in a series of sputum supernatants from lung cancer patients and controls. The sensitivity and specificity of the factor H test in this series was 80% and 88%, respectively. Factor H is elevated in bronchoalveolar lavage and sputum from lung cancer patients. Measurement of molecular biomarkers, such as complement factor H, may be used in the future as an adjunct to cytology in the diagnosis of malignant pulmonary diseases.
    Cancer Epidemiology Biomarkers & Prevention 10/2010; 19(10):2665-72. DOI:10.1158/1055-9965.EPI-10-0467 · 4.32 Impact Factor
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    ABSTRACT: Due to an increasing awareness of the potential hazardousness of air pollutants, new laws, rules and guidelines have recently been implemented globally. In this respect, numerous studies have addressed traffic-related exposure to particulate matter using stationary technology so far. By contrast, only few studies used the advanced technology of mobile exposure analysis. The Mobile Air Quality Study (MAQS) addresses the issue of air pollutant exposure by combining advanced high-granularity spatial-temporal analysis with vehicle-mounted, person-mounted and roadside sensors. The MAQS-platform will be used by international collaborators in order 1) to assess air pollutant exposure in relation to road structure, 2) to assess air pollutant exposure in relation to traffic density, 3) to assess air pollutant exposure in relation to weather conditions, 4) to compare exposure within vehicles between front and back seat (children) positions, and 5) to evaluate "traffic zone"-exposure in relation to non-"traffic zone"-exposure.Primarily, the MAQS-platform will focus on particulate matter. With the establishment of advanced mobile analysis tools, it is planed to extend the analysis to other pollutants including NO2, SO2, nanoparticles and ozone.
    Journal of Occupational Medicine and Toxicology 04/2010; 5:8. DOI:10.1186/1745-6673-5-8 · 1.23 Impact Factor
  • Pneumologie 03/2010; 64. DOI:10.1055/s-0030-1251121
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    ABSTRACT: DNA methylation is an important epigenetic mechanism involved in fundamental biological processes such as development, imprinting, and carcino-genesis. For these reasons, DNA methylation represents a valuable source for cancer biomarkers. Methods for the sensitive and specific detection of methylated DNA are a prerequisite for the implementation of DNA biomarkers into clinical routine when early detection based on the analysis of body fluids is desired. Here, a novel technique is presented for the detection of DNA methylation biomarkers, based on real-time PCR of bisulfite-treated template with enzymatic digestion of background DNA during amplification using the heat-stable enzyme Tsp509I. An assay for the lung cancer methylation biomarker BARHL2 was used to show clinical and analytical performance of the method in comparison with methylation-specific PCR technology. Both technologies showed comparable performance when analyzing technical DNA mixtures and bronchial lavage samples from 75 patients suspected of having lung cancer. The results demonstrate that the approach is useful for sensitive and specific detection of a few copies of methylated DNA in samples with a high background of unmethylated DNA, such as in clinical samples from body fluids.
    BioTechniques 09/2009; 47(3):737-44. DOI:10.2144/000113208 · 2.75 Impact Factor
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    ABSTRACT: Interstitial lung disease (ILD) is a frequent manifestation of systemic sclerosis (SSc), and cytokines can contribute to the disease pathology. The aim of the current study was to identify specific changes in cytokine levels that may serve as disease markers and possible targets for therapy. Cytokines were measured with bioplex analysis in 38 bronchoalveolar fluids (BALFs) from 32 SSc patients (27 with alveolitis and 11 without alveolitis) and 26 control patients. In the case of SSc patients, cytokines were correlated with the respective bronchoalveolar lavage (BAL) cell differentiation, lung function, and thoracic HR-CT score. For 35 BALF samples derived from 29 SSc patients, follow-up investigations of clinical data, lung-function parameter, or thoracic HR-CT scans were available to evaluate the predictive capacity of BALF cytokines and chemokines. High IL-7 levels were characteristic of SSc-associated interstitial lung disease (ILD) and, in addition, when compared with ILD-negative SSc patients, ILD-positive SSc patients revealed higher IL-4, IL-6, IL-8, and CCL2 (MCP-1) BALF levels. High CCL2 and IL-8 BALF concentrations were associated with neutrophilic and mixed alveolitis. Cytokine levels of IL-4, IL-8, and CCL2 correlated negatively with lung-function parameters; CCL2 concentrations also correlated with HR-CT scores. High concentrations of several cytokines were associated with the progress of ILD and end-stage ILD. Univariate analyses revealed high IL-2 and tumor necrosis factor-alpha (TNF-alpha) levels as the best predictors for progressive disease, together with lung-function parameters, young age, and neutrophilic alveolitis. Multivariate analyses partially confirmed these results but did not sufficiently converge because of the limited number of patients. The association of BALF cytokines with lung fibrosis and its progress suggests that cytokines contribute to the pathogenesis of ILD and hence could be regarded as potential therapeutic targets.
    Arthritis research & therapy 08/2009; 11(4):R111. DOI:10.1186/ar2766 · 3.75 Impact Factor
  • Matthias John · Ute Oltmanns · Ingo Fietze · Christian Witt · Klaus Jung
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    ABSTRACT: Matrix metalloproteinases (MMPs) and cathepsins have been implicated in the pathogenesis of several interstitial lung diseases by their effects on inflammatory processes and extracellular matrix remodelling. The aim of this study was to investigate whether macrophage-derived MMPs and cathepsins are involved in the pathogenesis of sarcoidosis. Therefore the release of MMP-2, MMP-9, and cathepsins B and L from alveolar macrophages (AM) in active pulmonary sarcoidosis was studied and compared to normal controls and patients with pneumonia and fibrosis. Patients with sarcoidosis (n = 11), pulmonary fibrosis (n = 7), and pneumonia (n = 9) and normal controls (n = 10) were enrolled in the study. AM were obtained by bronchoalveolar lavage and cultured without stimulation and in presence of tumor necrosis factor alpha (TNFα) and interleukin-10 (IL-10). The release of cathepsins and MMPs as well as IL-10 and TNFα was measured in the supernatant of cultured AM by fluorimetric assays and zymography. AM of patients with sarcoidosis and pneumonia spontaneously released more MMP-2 than normal controls. Stimulation with TNFα showed no effects on MMP-2 and MMP-9 production. Exogenous IL-10 led partially to an inhibition of the MMP-2 and MMP-9 release. Patients with sarcoidosis produced significantly more IL-10 and TNFα than normal controls. This was not observed in patients with fibrosis and pneumonia. The spontaneous release of cathepsins B and L did not differ between the patient groups and normal controls and was not affected by TNFα and IL-10. The data show that AM of patients with sarcoidosis and pneumonia release significant amounts of MMP-2. The endogenous production of IL-10 in AM of patients with sarcoidosis and the MMP downregulation by exogenous IL-10 suggest an involvement of IL-10 in MMP regulation. Furthermore the results suggest that the production of MMP-2 is more specific for acute lung injury, rather than for a single lung disease such as sarcoidosis.
    Experimental Lung Research 07/2009; 28(1):55-68. DOI:10.1080/019021402753355535 · 1.75 Impact Factor

Publication Stats

2k Citations
394.73 Total Impact Points

Institutions

  • 2003–2014
    • Charité Universitätsmedizin Berlin
      • • Medical Department, Division of Rheumatology and Clinical Immunology
      • • Department of Cardiology and Pulmonology
      Berlín, Berlin, Germany
  • 1997–2010
    • Humboldt-Universität zu Berlin
      • • Department of Biology
      • • Clinical Psychology Research Unit
      Berlín, Berlin, Germany
  • 2005
    • Hannover Medical School
      • Centre for Internal Medicine
      Hannover, Lower Saxony, Germany
    • Freie Universität Berlin
      Berlín, Berlin, Germany
  • 2004
    • Humboldt State University
      Arcata, California, United States
  • 2002–2003
    • University of Freiburg
      Freiburg, Baden-Württemberg, Germany
    • University of Leipzig
      Leipzig, Saxony, Germany