J O Schroeder

Universitätsklinikum Schleswig - Holstein, Kiel, Schleswig-Holstein, Germany

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Publications (35)187.56 Total impact

  • R. A. Zeuner · K. Kay · S. Boettcher · J. O. Schroeder
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    ABSTRACT: Objectives Dendritic cells play a pivotal role in the initiation of innate and adaptive immune responses in host reaction to microbial infection as well as in autoimmune pathology. DC subsets in peripheral blood consist of myeloid DC 1 (MDC1), plasmocytoid DC (PDC), and myeloid DC2 (MDC2) that differ in their expression of Toll-like receptor repertoire and cytocine expression upon stimulation. Several inflammatory diseases have been reported to have altered DC subsets distribution such as Sjögren’s, Lupus erythematosus, Hepatitis and HIV Infection. Little data exist about the impact of TNF-blocking agents on peripheral blood DC subsets. Methods 38 patients with active rheumatic disease (16 rheumatoid arthritis (RA), 14 spondylarthritis (SPA), 8 psoriatic arthritis (PSA)) requiring TNF-blocking therapy due to insuffient disease control under DMARD therapy were prospectively followed for 12 weeks after initiation of etanercept treatment (timepoints: 0,week 2, 6,and 12). Peripheral blood dc subsets were evaluated by flow cytometry using the different expression of BDCA antigens (Milthenyi KIT). Prednisolon dose was <10mg and the individual Prednisolon dose was not altered during the observation period. A historic group of 29 healthy individuals served as controls. Results Independent from the underlying rheumatic disease all patients showed significantly reduced numbers of peripheral blood MDC1 prior to initiation of Etanercept therapy. The numbers of MDC1 negatively correlated with values of CRP (CC -0,36, p<0,05). MDC2 were significantly reduced in patients with rheumatoid arthritis but not in patients with spondylarthritis or psoriatic arthritis. MDC2 where reduced in RA patients and SPA patients but not in patients with PSA. During Etanercept therapy numbers of MDC1 significantly increased within 2 weeks and further increased by week 12 (from 6791±747/ml to 16170±2327/ml). While PDC numbers showed the same pattern (from 5523±461/ml to 8329±935/m), the numbers of MDC2 were not significantly changed (1011±121/ml to 1352±219/ml). Parallel to the changes in MDC and PDC numbers Etanercept therapy induced a rapid decline in CRP-values (14,7mg/l±2,2 to 5,9mg/l+1,1) in DAS28 (from 4,14±0,45 to 2,48±0,31) and BASDAI (4,4±0,86 to 2,33±0,33) at week 2 (all data mean±SEM). By week 12 DAS28 and BASDAI had further declined. Conclusions Active disease in rheumatoid arthritis, spondylarthritis or psoriatic arthritis is associated with reduced numbers of peripheral blood dendritic cells especially MDC1. This effect seems to be non-specifically related to the inflammatory response and independent of the type of rheumatic disease. MDC1 and PDC did not further decrease but increased during 12 week Etanercept therapy. Therefore the observed changes in peripheral blood DC subsets do not to contribute to the immunosuppressive effects of a TNF blocking therapy. Disclosure of Interest R. Zeuner Grant/Research support from: Investigator originated study, that has been supported by a peer reviewed grant of Pfizer, K. Kay: None Declared, S. Boettcher: None Declared, J. Schroeder Speakers Bureau: Speakers fee’s from Pfizer & MSD
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases

  • No preview · Article · Mar 2013 · Experimental and Clinical Endocrinology & Diabetes
  • J O Schröder · R A Zeuner · B Bewig · M Both
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    ABSTRACT: Pulmonary emergencies in rheumatic diseases are rare, potentially life-threatening conditions that occur either as a manifestation of the disease itself or as an adverse event of immunosuppressive treatment. Diffuse alveolar hemorrhage, tracheal stenosis, acute pneumonitis and drug-induced lung injury belong to this category. The management of these emergencies requires intensive cooperation between rheumatology and pulmonology. The latter contributes its experience in the care of related conditions, specific endoscopic techniques and local interventions as well as the indispensable and life-supporting forms of assisted ventilation. The present article summarizes the current knowledge on diagnostic and therapeutic procedures including the newly available B-cell directed treatments.
    No preview · Article · Jun 2012 · Zeitschrift für Rheumatologie
  • R.-H. Hübner · R.A. Zeuner · J.O. Schröder
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    ABSTRACT: Eine 60-jährige Patientin wurde wegen einer zervikalen Schwellung und einer Leistungsminderung mit B-Symptomatik stationär aufgenommen. Bei der körperlichen Untersuchung zeigten die Haut und die Halsmuskulatur oberhalb des Jugulums eine handflächengroße, nahezu brettharte Konsistenzvermehrung. Eine Beteiligung der Schilddrüse konnte durch die bildgebende Diagnostik ausgeschlossen werden. Ätiologisch wurden zunächst eine extramedulläre Manifestation eines bekannten, nicht therapiebedürftigen multiplen Myeloms (IgG, Typ κ) oder eine infektiöse Komplikation desselben vermutet. Beides ließ sich bei histologischer Untersuchung nicht bestätigen. Das Stanzpräparat zeigte reichlich dichtes Bindegewebe aus überwiegend kollagenen Fasern mit perivaskulären, lymphozytären Infiltraten entsprechend dem Bild einer Fibrosklerose. Da die Patientin 5 Jahre zuvor an einem fibrotischen Pseudotumor orbitae mit identischer Histologie erkrankt war, und darüber hinaus CT-morphologisch Korrelate einer mesenterialen Fibrose bestanden, stellten wir die Diagnose einer idiopathischen multifokalen Fibrosklerose. Unter einer Therapie mit Prednisolon kam es innerhalb weniger Tage zu einer vollständigen Rückbildung sowohl der zervikalen Schwellung als auch der Allgemeinsymptome. Ein 8 Monate später auftretendes Rezidiv der Erkrankung sprach gut auf Prednisolon und Azathioprin an.
    No preview · Article · Apr 2012 · Der Internist
  • Schröder J O · Zeuner RA · Specker C
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    ABSTRACT: Emergencies are rare in systemic lupus erythematosus (SLE). Catastrophic antiphospholipid syndrome (APS), acute and severe CNS involvement, alveolar haemorrhage, thrombotic thrombocytopenic purpura (TTP), transverse myelitis and pericardial tamponade are the main manifestations of SLE-related emergencies, each of them occuring in about 1% of a given lupus population. The mortality of these manifestations, however, is considerable and may amount to 40-50% in APS, 50-60% in alveolar haemorrhage or even 90% in TTP. Timely recognition of these emergencies requires specific evaluations such as extensive clotting tests in APS, the search for schistocytes and analysis of ADAMTS13 activity in TTP, bronchoalveolar lavage in alveolar haemorrhage, echocardiography in pericardial tamponade and magnetic resonance imaging in neurological disease. Likewise, management of these emergencies demands specific therapies such as infusion of fresh frozen plasma or large-volume plasma exchange in TTP, adequate anticoagulation in APS and pericardiocenthesis in pericardial tamponade. High-dose corticosteroids and pulse cyclophosphamide are the most promising measures to intensify the immunosuppressive therapy and to block the SLE-related inflammation within a time-frame appropriate to the given clinical situation.
    No preview · Article · Feb 2010 · Aktuelle Rheumatologie
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    ABSTRACT: No abstract available
    No preview · Article · Jan 2010 · Transplantation Proceedings
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    F Moosig · F Damm · A Knorr-Spahr · M Ritgen · R.A. Zeuner · M Kneba · M Ernst · J O Schröder
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    ABSTRACT: Inherited C1q deficiency is associated strongly with the development of systemic lupus erythematosus (SLE). The aim of our study was to evaluate the ability of monocytes from SLE patients without inherited C1q deficiency to up-regulate C1q-mRNA upon stimulation. Furthermore, we wanted to elucidate the physiological stimulus for up-regulation of C1q-mRNA. Peripheral blood mononuclear cell (PBMC)-derived monocytes from 10 SLE patients, 10 patients with rheumatoid arthritis (RA) and 10 healthy controls (HC) were stimulated with dexamethasone (DXM), interferon-gamma or both. Additionally, purified monocytes from HC were stimulated with interleukin (IL)-10. C1q-mRNA expression was measured by quantitative reverse transcription-polymerase chain reaction (RT-PCR). C1q protein was detected using the standard alkaline phosphatase/anti-alkaline phosphatase (APAAP) technique. SLE monocytes were significantly less able to up-regulate C1q-mRNA when compared to RA or HC. IL-10 was identified as an important stimulus for C1q synthesis. In SLE patients there is a significant functional impairment of monocytes to synthesize C1q upon stimulation. As C1q is linked to the process of recognition and removal of apoptotic cells, this relative C1q deficiency is likely to contribute to the reduced phagocytosis of apoptotic material observed in SLE and thereby might be a central pathogenetic factor.
    Full-text · Article · Jan 2007 · Clinical & Experimental Immunology
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    W Klapper · F Moosig · A Sotnikova · W Qian · J O Schröder · R Parwaresch
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    ABSTRACT: To evaluate telomerase activity as a marker of lymphocyte proliferation in systemic lupus erythematosus (SLE). CD19+, CD4+, and CD8+ lymphocytes were isolated from the peripheral blood of nine patients with SLE and nine healthy controls by means of magnetic bead-coupled antibodies and tested for telomerase activity with the TRAP assay. Telomerase activity was significantly increased in CD19+ B cells from patients with SLE. CD4+ and CD8+ T cells from lupus patients displayed increased mean telomerase activity, although the difference from normal controls did not reach statistical significance. Increased telomerase activity in the B and the T cell lineage might indicate activation and proliferation of these lymphocytes.
    Full-text · Article · Jan 2005 · Annals of the Rheumatic Diseases
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    F Moosig · N Czech · C Mehl · E Henze · RA Zeuner · M Kneba · J O Schröder
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    ABSTRACT: To quantify 18-fluorodeoxyglucose (FDG) accumulation in large vessels in patients with polymyalgia rheumatica by positron emission tomography (PET), and to compare these data with serological markers of inflammation. 13 untreated patients with active polymyalgia rheumatica underwent FDG positron emission tomography; eight were analysed in a second PET when in clinical remission. Six patients with other highly inflammatory conditions served as controls. For quantitative analysis, FDG uptake over nine defined vascular regions, divided by an individual background value, was expressed as a region of interest (ROI) index. These data were compared with the clinical status of the patient and with erythrocyte sedimentation rate (ESR), C reactive protein, haemoglobin, and platelet and leucocyte counts. By visual evaluation, 12 of the 13 patients showed an increased tracer uptake of the aorta or its major branches. By quantitative analysis, FDG uptake was significantly increased in polymyalgia rheumatica. In patients with active disease, the mean ROI index for all vascular regions exceeded that of controls by 70% (mean (SD): 1.58 (0.37) v 0.93 (0.12); p<0.001). In the eight patients who underwent follow up PET, the index declined substantially. In active polymyalgia rheumatica, FDG uptake was significantly correlated with C reactive protein (r = 0.8), ESR (r = 0.79), and platelet counts (r = 0.68). The observed FDG accumulation in the aorta and its branches and a strong correlation between tracer uptake and markers of inflammation is suggestive of large vessel arteritis. Quantitative ROI analysis appears to be a sensitive tool for detecting such inflammation.
    Full-text · Article · Jul 2004 · Annals of the Rheumatic Diseases
  • F Moosig · R Zeuner · C Renk · J O Schröder
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    ABSTRACT: There is evidence from animal and human studies that IL-1 might play an important role in the development and maintainence of inflammation in systemic lupus erythemathosus (SLE). We hypothesized that, in SLE, there might be a relative deficiency in the physiologic antagonist of IL-1, IL-1 receptor antagonist (IL-1RA). We therefore treated three patients with active SLE in whom conventional therapy has failed with the human IL-1RA, Anakinra. In two of the three patients there was a transient effect on muscle pain and/or polyarthritis. In one patient with lupus myositis there was no effect at all. The therapy was well tolerated and the only significant side effect was a transient drop in complement levels (C3 and C4) without clinical or laboratory signs of increased SLE activity in all three patients.
    No preview · Article · Feb 2004 · Lupus
  • R H Hübner · R A Zeuner · J O Schröder

    No preview · Article · Jan 2001 · Der Internist
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    ABSTRACT: For nine years a 54-year-old woman had been suffering from worsening treatment-resistant cold-dependent purpura of the limbs as well as cutaneous ulcerations and arthralgia, which recently had occurred even at a even slight decrease in room temperature. A special form of cryofibrinogenemia was identified by affinity-chromatographic separation of a plasma cryoprecipitate. From this cryoprecipitate a monoclonal antifibrinogen antibody (IgG-kappa) was isolated which, in the cold, formed a precipitating complex with fibrinogen. Paraproteinaemia was not demonstrated by conventional serum and plasma electrophoresis. There was no evidence of neoplasma. Attempted treatment with steroids, fibrinolytic agents and intravenous cyclophosphamide was unsuccessful. But long-term repeated plasmaphereses and anti-immunoglobulin adsorption improved the symptoms. After 5 years of this treatment-14 years after onset of symptoms-the patient died of the consequences of fulminant pulmonary embolism. To establish the diagnosis of monoclonal cryofibrinogenemia it is necessary, first, to identify the cryoprecipitate in plasma; secondly, to undertake affinity-chromatographic separation of the cryoprecipitate with subsequent analysis of its components.
    No preview · Article · Oct 1996 · DMW - Deutsche Medizinische Wochenschrift
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    ABSTRACT: We report on a 54-year-old female patient with arthritis and a severe cold-induced leukocytoclastic vasculitis of the skin caused by a rare form of cryofibrinogenemia ("type II" cryofibrinogen). Affinity chromatography of cryoprecipitates from the patient's plasma revealed reversible cryoprecipitability of complexes composed of fibrinogen and a monoclonal antifibrinogen antibody (IgG3 kappa). Conventional serum and plasma electrophoresis did not detect the paraprotein. Control of symptoms was achieved by long-term plasmapheresis.
    No preview · Article · Jul 1996 · Arthritis & Rheumatology
  • H H Euler · U M Schwab · J O Schroeder · J Hasford

    No preview · Article · May 1996 · Artificial Organs
  • J O Schroeder · RA Zeuner · H H Euler · H Löffler
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    ABSTRACT: To investigate the effect of high dose intravenous immunoglobulins (IVIG) in systemic lupus erythematosus (SLE). Twelve patients with mildly to moderately active disease were given 30 g of sulfonated IVIG preparation on each of Days 1-4 and 21-24. Within 6 weeks the mean disease activity score, the Systemic Lupus Activity Measure (SLAM), declined from 7.33 (range 3-15) to 5.25 (range 0-10) (p < 0.01). In 9/12 patients the SLAM dropped by at least 2 points. In 3/12 patients the improvement lasted 5 to 12 months. Within 1 week after initiation of therapy most patients showed a decline in ds-DNA antibodies, whereas titers of antinuclear antibodies and complement proteins were not affected. The treatment was well tolerated, with the exception of transient hypotension in one patient. In this uncontrolled study, IVIG had temporary beneficial effects in mildly to moderately active SLE.
    No preview · Article · Jan 1996 · The Journal of Rheumatology
  • H H Euler · J O Schröder

    No preview · Article · Jan 1996 · DMW - Deutsche Medizinische Wochenschrift
  • M. Corzillius · P. Harten · U.M. Schwab · J.O. Schröder · H.H. Euler
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    ABSTRACT: Intravenous pulse cyclophosphamide (Cy) is an established treatment for severe SLE and other autoimmune diseases. Peroral application on an outpatient basis would be easier, less costly, and impose less of a burden on patients. We studied the feasibility of peroral pulse Cy in 16 patients with SLE (n = 12), pemphigus (n = 2), glomerulonephritis and cerebral vaculitis (n = 1 each). 195 oral Cy pulses (ranging from 285 mg/m 2 up to the intravenous dosage of 1000 mg/m 2) were applied (mean dosage: 480 mg/m 2), 95% on an outpatient basis. 77% of the pulses induced no side effects. Nausea or vomiting were observed in 22%, oral candidiasis and pneumonia once each. In 12 patients disease activity declined, with a mean drop in the SLE activity index (SLAM) of 30.5%. Neurological deficits in the cerebral vasculitis improved and one of the pemphigus patients experienced remission of cutaneous blistering. Provided there is good patient compliance and if frequent laboratory controls are carried out, peroral pulse Cy is a feasible option.
    No preview · Article · Jan 1996 · Aktuelle Rheumatologie
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    R A Zeuner · J O Schroeder · F Schröder · H H Euler

    Preview · Article · Dec 1995 · Annals of the Rheumatic Diseases
  • H.H. Euler · U.M. Schwab · J.O. Schroeder

    No preview · Article · Dec 1994 · The Lancet
  • J O Schröder · H H Euler

    No preview · Article · May 1993 · Der Internist

Publication Stats

398 Citations
187.56 Total Impact Points


  • 2010-2012
    • Universitätsklinikum Schleswig - Holstein
      • Klinik für Diagnostische Radiologie (Kiel)
      Kiel, Schleswig-Holstein, Germany
  • 1987-2012
    • Christian-Albrechts-Universität zu Kiel
      • UKSH II. Medizinische Klinik und Poliklinik
      Kiel, Schleswig-Holstein, Germany
  • 2007
    • University Medical Center Schleswig-Holstein
      • Department of Pediatrics
      Kiel, Schleswig-Holstein, Germany
  • 1996
    • HELIOS Klinik Kiel
      Kiel, Schleswig-Holstein, Germany
  • 1990
    • Universitätsklinikum Jena
      Jena, Thuringia, Germany