Skip to main content
Erschienen in: CME 12/2023

14.12.2023 | Zystische Fibrose | CME Fortbildung

Die Goldenen Zwanziger der Mukoviszidose

verfasst von: Prof. Dr. med. Mirjam Stahl

Erschienen in: CME | Ausgabe 12/2023

zum CME-Kurs Einloggen, um Zugang zu erhalten

Zusammenfassung

Bei der Multiorganerkrankung Mukoviszidose (Cystische Fibrose, CF) beginnt die Prognose-entscheidende CF-Lungenerkrankung früh im Säuglingsalter, genau wie extrapulmonale Manifestationen wie die exokrine Pankreasinsuffizienz oder die kongenitale bilaterale Aplasie des Vas deferens, welche z.T. in utero beginnen. Die CF-Manifestationen schreiten auch bei normaler Spirometrie und normalem Gewicht bereits im Kindesalter fort. Das CF-Neugeborenenscreening ermöglicht eine frühe Diagnosestellung mit frühem Therapiebeginn. Es gibt mit Gasauswaschverfahren und Lungenmagnetresonanztomografie sensitive, nicht-invasive Verfahren, um den Verlauf der frühen CF-Lungenerkrankung verfolgen und Therapieeffekte beurteilen zu können. Effektivere Therapien als symptomatische Ansätze sind notwendig, um den Kurs der (frühen) CF-Lungenerkrankung zu verbessern, jedoch werden symptomatische Therapien weiter eine Rolle spielen. Perspektivisch bietet der Einsatz von CFTR-Modulatoren ab Geburt/Diagnosestellung die Chance, den Krankheitsverlauf substantiell zu beeinflussen, jedoch erfolgt durch diese Therapie weiterhin keine Heilung.
Fußnoten
1
alle Angaben zur Zulassung beziehen sich auf Deutschland, Stand: 03.10.2023
 
Literatur
1.
Zurück zum Zitat Collins FS. Cystic fibrosis: molecular biology and therapeutic implications. Science 1992;256:774-779. Collins FS. Cystic fibrosis: molecular biology and therapeutic implications. Science 1992;256:774-779.
2.
Zurück zum Zitat Kerem B, Rommens JM, Buchanan JA, Markiewicz D, Cox TK, Chakravarti A, Buchwald M, Tsui LC. Identification of the cystic fibrosis gene: genetic analysis. Science 1989;245:1073-1080. Kerem B, Rommens JM, Buchanan JA, Markiewicz D, Cox TK, Chakravarti A, Buchwald M, Tsui LC. Identification of the cystic fibrosis gene: genetic analysis. Science 1989;245:1073-1080.
3.
Zurück zum Zitat Riordan JR, Rommens JM, Kerem B, Alon N, Rozmahel R, Grzelczak Z, Zielenski J, Lok S, Plavsic N, Chou JL, et al. Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA. Science 1989;245:1066-1073. Riordan JR, Rommens JM, Kerem B, Alon N, Rozmahel R, Grzelczak Z, Zielenski J, Lok S, Plavsic N, Chou JL, et al. Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA. Science 1989;245:1066-1073.
4.
Zurück zum Zitat Rommens JM, Iannuzzi MC, Kerem B, Drumm ML, Melmer G, Dean M, Rozmahel R, Cole JL, Kennedy D, Hidaka N, et al. Identification of the cystic fibrosis gene: chromosome walking and jumping. Science 1989;245:1059-1065. Rommens JM, Iannuzzi MC, Kerem B, Drumm ML, Melmer G, Dean M, Rozmahel R, Cole JL, Kennedy D, Hidaka N, et al. Identification of the cystic fibrosis gene: chromosome walking and jumping. Science 1989;245:1059-1065.
5.
6.
Zurück zum Zitat Veit G, Avramescu RG, Chiang AN, Houck SA, Cai Z, Peters KW, Hong JS, Pollard HB, Guggino WB, Balch WE, Skach WR, Cutting GR, Frizzell RA, Sheppard DN, Cyr DM, Sorscher EJ, Brodsky JL, Lukacs GL. From CFTR biology toward combinatorial pharmacotherapy: expanded classification of cystic fibrosis mutations. Mol Biol Cell 2016;27:424-433. Veit G, Avramescu RG, Chiang AN, Houck SA, Cai Z, Peters KW, Hong JS, Pollard HB, Guggino WB, Balch WE, Skach WR, Cutting GR, Frizzell RA, Sheppard DN, Cyr DM, Sorscher EJ, Brodsky JL, Lukacs GL. From CFTR biology toward combinatorial pharmacotherapy: expanded classification of cystic fibrosis mutations. Mol Biol Cell 2016;27:424-433.
7.
Zurück zum Zitat Welsh MJ, Smith AE. Molecular mechanisms of CFTR chloride channel dysfunction in cystic fibrosis. Cell 1993;73:1251-1254. Welsh MJ, Smith AE. Molecular mechanisms of CFTR chloride channel dysfunction in cystic fibrosis. Cell 1993;73:1251-1254.
8.
Zurück zum Zitat Mall MA, Hartl D. CFTR: cystic fibrosis and beyond. Eur Respir J 2014;44:1042-1054. Mall MA, Hartl D. CFTR: cystic fibrosis and beyond. Eur Respir J 2014;44:1042-1054.
9.
Zurück zum Zitat Elborn JS. Cystic fibrosis. Lancet 2016;388:2519-2531. Elborn JS. Cystic fibrosis. Lancet 2016;388:2519-2531.
10.
Zurück zum Zitat Rowe SM, Miller S, Sorscher EJ. Cystic fibrosis. N Engl J Med 2005;352:1992-2001. Rowe SM, Miller S, Sorscher EJ. Cystic fibrosis. N Engl J Med 2005;352:1992-2001.
11.
Zurück zum Zitat Koch C, Cuppens H, Rainisio M, Madessani U, Harms H, Hodson M, Mastella G, Navarro J, Strandvik B, McKenzie S, Investigators of the E. European Epidemiologic Registry of Cystic Fibrosis (ERCF): comparison of major disease manifestations between patients with different classes of mutations. Pediatr Pulmonol 2001;31:1-12. Koch C, Cuppens H, Rainisio M, Madessani U, Harms H, Hodson M, Mastella G, Navarro J, Strandvik B, McKenzie S, Investigators of the E. European Epidemiologic Registry of Cystic Fibrosis (ERCF): comparison of major disease manifestations between patients with different classes of mutations. Pediatr Pulmonol 2001;31:1-12.
12.
Zurück zum Zitat Gibson RL, Burns JL, Ramsey BW. Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med 2003;168:918-951. Gibson RL, Burns JL, Ramsey BW. Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med 2003;168:918-951.
13.
Zurück zum Zitat Mall MA, Boucher RC. Pathophysiology of cystic fibrosis lung disease. In: Mall MA, Elborn JS, editors. Cystic fibrosis. Sheffield: European Respiratory Society; 2014. p. 1-13. Mall MA, Boucher RC. Pathophysiology of cystic fibrosis lung disease. In: Mall MA, Elborn JS, editors. Cystic fibrosis. Sheffield: European Respiratory Society; 2014. p. 1-13.
14.
Zurück zum Zitat Farrell P, Ferec C, Macek M, Frischer T, Renner S, Riss K, Barton D, Repetto T, Tzetis M, Giteau K, Duno M, Rogers M, Levy H, Sahbatou M, Fichou Y, Le Marechal C, Genin E. Estimating the age of p.(Phe508del) with family studies of geographically distinct European populations and the early spread of cystic fibrosis. Eur J Hum Genet 2018;26:1832-1839. Farrell P, Ferec C, Macek M, Frischer T, Renner S, Riss K, Barton D, Repetto T, Tzetis M, Giteau K, Duno M, Rogers M, Levy H, Sahbatou M, Fichou Y, Le Marechal C, Genin E. Estimating the age of p.(Phe508del) with family studies of geographically distinct European populations and the early spread of cystic fibrosis. Eur J Hum Genet 2018;26:1832-1839.
15.
Zurück zum Zitat Farrell PM, Kosorok MR, Laxova A, Shen G, Koscik RE, Bruns WT, Splaingard M, Mischler EH. Nutritional benefits of neonatal screening for cystic fibrosis. Wisconsin Cystic Fibrosis Neonatal Screening Study Group. N Engl J Med 1997;337:963-969. Farrell PM, Kosorok MR, Laxova A, Shen G, Koscik RE, Bruns WT, Splaingard M, Mischler EH. Nutritional benefits of neonatal screening for cystic fibrosis. Wisconsin Cystic Fibrosis Neonatal Screening Study Group. N Engl J Med 1997;337:963-969.
16.
Zurück zum Zitat Grosse SD, Rosenfeld M, Devine OJ, Lai HJ, Farrell PM. Potential impact of newborn screening for cystic fibrosis on child survival: a systematic review and analysis. J Pediatr 2006;149:362-366. Grosse SD, Rosenfeld M, Devine OJ, Lai HJ, Farrell PM. Potential impact of newborn screening for cystic fibrosis on child survival: a systematic review and analysis. J Pediatr 2006;149:362-366.
17.
Zurück zum Zitat Dankert-Roelse JE, Merelle ME. Review of outcomes of neonatal screening for cystic fibrosis versus non-screening in Europe. J Pediatr 2005;147:S15-20. Dankert-Roelse JE, Merelle ME. Review of outcomes of neonatal screening for cystic fibrosis versus non-screening in Europe. J Pediatr 2005;147:S15-20.
18.
Zurück zum Zitat Siret D, Bretaudeau G, Branger B, Dabadie A, Dagorne M, David V, de Braekeleer M, Moisan-Petit V, Picherot G, Rault G, Storni V, Roussey M. Comparing the clinical evolution of cystic fibrosis screened neonatally to that of cystic fibrosis diagnosed from clinical symptoms: a 10-year retrospective study in a French region (Brittany). Pediatr Pulmonol 2003; 35:342-349. Siret D, Bretaudeau G, Branger B, Dabadie A, Dagorne M, David V, de Braekeleer M, Moisan-Petit V, Picherot G, Rault G, Storni V, Roussey M. Comparing the clinical evolution of cystic fibrosis screened neonatally to that of cystic fibrosis diagnosed from clinical symptoms: a 10-year retrospective study in a French region (Brittany). Pediatr Pulmonol 2003; 35:342-349.
19.
Zurück zum Zitat Sims EJ, McCormick J, Mehta G, Mehta A, Steering Committee of the UKCFD. Neonatal screening for cystic fibrosis is beneficial even in the context of modern treatment. J Pediatr 2005;147:S42-46. Sims EJ, McCormick J, Mehta G, Mehta A, Steering Committee of the UKCFD. Neonatal screening for cystic fibrosis is beneficial even in the context of modern treatment. J Pediatr 2005;147:S42-46.
20.
Zurück zum Zitat Accurso FJ, Sontag MK, Wagener JS. Complications associated with symptomatic diagnosis in infants with cystic fibrosis. J Pediatr 2005;147:S37-41. Accurso FJ, Sontag MK, Wagener JS. Complications associated with symptomatic diagnosis in infants with cystic fibrosis. J Pediatr 2005;147:S37-41.
21.
Zurück zum Zitat Sims EJ, Mugford M, Clark A, Aitken D, McCormick J, Mehta G, Mehta A, Committee UKCFDS. Economic implications of newborn screening for cystic fibrosis: a cost of illness retrospective cohort study. Lancet 2007;369:1187-1195. Sims EJ, Mugford M, Clark A, Aitken D, McCormick J, Mehta G, Mehta A, Committee UKCFDS. Economic implications of newborn screening for cystic fibrosis: a cost of illness retrospective cohort study. Lancet 2007;369:1187-1195.
22.
Zurück zum Zitat Hirtz S, Gonska T, Seydewitz HH, Thomas J, Greiner P, Kuehr J, Brandis M, Eichler I, Rocha H, Lopes AI, Barreto C, Ramalho A, Amaral MD, Kunzelmann K, Mall M. CFTR Cl- channel function in native human colon correlates with the genotype and phenotype in cystic fibrosis. Gastroenterology 2004;127:1085-1095. Hirtz S, Gonska T, Seydewitz HH, Thomas J, Greiner P, Kuehr J, Brandis M, Eichler I, Rocha H, Lopes AI, Barreto C, Ramalho A, Amaral MD, Kunzelmann K, Mall M. CFTR Cl- channel function in native human colon correlates with the genotype and phenotype in cystic fibrosis. Gastroenterology 2004;127:1085-1095.
23.
Zurück zum Zitat Montgomery ST, Mall MA, Kicic A, Stick SM, Arest CF. Hypoxia and sterile inflammation in cystic fibrosis airways: mechanisms and potential therapies. Eur Respir J 2017;49. Montgomery ST, Mall MA, Kicic A, Stick SM, Arest CF. Hypoxia and sterile inflammation in cystic fibrosis airways: mechanisms and potential therapies. Eur Respir J 2017;49.
24.
Zurück zum Zitat Balazs A, Mall MA. Mucus obstruction and inflammation in early cystic fibrosis lung disease: Emerging role of the IL-1 signaling pathway. Pediatr Pulmonol 2019;54 Suppl 3:S5-S12. Balazs A, Mall MA. Mucus obstruction and inflammation in early cystic fibrosis lung disease: Emerging role of the IL-1 signaling pathway. Pediatr Pulmonol 2019;54 Suppl 3:S5-S12.
25.
Zurück zum Zitat Zhou-Suckow Z, Duerr J, Hagner M, Agrawal R, Mall MA. Airway mucus, inflammation and remodeling: emerging links in the pathogenesis of chronic lung diseases. Cell Tissue Res 2017;367:537-550. Zhou-Suckow Z, Duerr J, Hagner M, Agrawal R, Mall MA. Airway mucus, inflammation and remodeling: emerging links in the pathogenesis of chronic lung diseases. Cell Tissue Res 2017;367:537-550.
26.
Zurück zum Zitat Ramsey KA, Ranganathan S, Park J, Skoric B, Adams AM, Simpson SJ, Robins-Browne RM, Franklin PJ, de Klerk NH, Sly PD, Stick SM, Hall GL, Arest CF. Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis. Am J Respir Crit Care Med 2014;190:1111-1116. Ramsey KA, Ranganathan S, Park J, Skoric B, Adams AM, Simpson SJ, Robins-Browne RM, Franklin PJ, de Klerk NH, Sly PD, Stick SM, Hall GL, Arest CF. Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis. Am J Respir Crit Care Med 2014;190:1111-1116.
27.
Zurück zum Zitat Frey DL, Boutin S, Dittrich SA, Graeber SY, Stahl M, Wege S, Herth FJF, Sommerburg O, Schultz C, Mall MA, Dalpke AH. Relationship between airway dysbiosis, inflammation and lung function in adults with cystic fibrosis. J Cyst Fibros 2021;[Epub ahead of print]. Frey DL, Boutin S, Dittrich SA, Graeber SY, Stahl M, Wege S, Herth FJF, Sommerburg O, Schultz C, Mall MA, Dalpke AH. Relationship between airway dysbiosis, inflammation and lung function in adults with cystic fibrosis. J Cyst Fibros 2021;[Epub ahead of print].
28.
Zurück zum Zitat Grasemann H, Ratjen F. Early lung disease in cystic fibrosis. Lancet Respir Med 2013;1:148-157. Grasemann H, Ratjen F. Early lung disease in cystic fibrosis. Lancet Respir Med 2013;1:148-157.
29.
Zurück zum Zitat Sly PD, Brennan S, Gangell C, de Klerk N, Murray C, Mott L, Stick SM, Robinson PJ, Robertson CF, Ranganathan SC. Lung disease at diagnosis in infants with cystic fibrosis detected by newborn screening. Am J Respir Crit Care Med 2009;180:146-152. Sly PD, Brennan S, Gangell C, de Klerk N, Murray C, Mott L, Stick SM, Robinson PJ, Robertson CF, Ranganathan SC. Lung disease at diagnosis in infants with cystic fibrosis detected by newborn screening. Am J Respir Crit Care Med 2009;180:146-152.
30.
Zurück zum Zitat Esther CR, Jr., Muhlebach MS, Ehre C, Hill DB, Wolfgang MC, Kesimer M, Ramsey KA, Markovetz MR, Garbarine IC, Forest MG, Seim I, Zorn B, Morrison CB, Delion MF, Thelin WR, Villalon D, Sabater JR, Turkovic L, Ranganathan S, Stick SM, Boucher RC. Mucus accumulation in the lungs precedes structural changes and infection in children with cystic fibrosis. Sci Transl Med 2019;11. Esther CR, Jr., Muhlebach MS, Ehre C, Hill DB, Wolfgang MC, Kesimer M, Ramsey KA, Markovetz MR, Garbarine IC, Forest MG, Seim I, Zorn B, Morrison CB, Delion MF, Thelin WR, Villalon D, Sabater JR, Turkovic L, Ranganathan S, Stick SM, Boucher RC. Mucus accumulation in the lungs precedes structural changes and infection in children with cystic fibrosis. Sci Transl Med 2019;11.
31.
Zurück zum Zitat Muhlebach MS, Zorn BT, Esther CR, Hatch JE, Murray CP, Turkovic L, Ranganathan SC, Boucher RC, Stick SM, Wolfgang MC. Initial acquisition and succession of the cystic fibrosis lung microbiome is associated with disease progression in infants and preschool children. PLoS Pathog 2018;14:e1006798. Muhlebach MS, Zorn BT, Esther CR, Hatch JE, Murray CP, Turkovic L, Ranganathan SC, Boucher RC, Stick SM, Wolfgang MC. Initial acquisition and succession of the cystic fibrosis lung microbiome is associated with disease progression in infants and preschool children. PLoS Pathog 2018;14:e1006798.
32.
Zurück zum Zitat Hoo AF, Thia LP, Nguyen TT, Bush A, Chudleigh J, Lum S, Ahmed D, Lynn IB, Carr SB, Chavasse RJ, Costeloe KL, Price J, Shankar A, Wallis C, Wyatt HA, Wade A, Stocks J. Lung function is abnormal in 3-month-old infants with cystic fibrosis diagnosed by newborn screening. Thorax 2012;67:874-881. Hoo AF, Thia LP, Nguyen TT, Bush A, Chudleigh J, Lum S, Ahmed D, Lynn IB, Carr SB, Chavasse RJ, Costeloe KL, Price J, Shankar A, Wallis C, Wyatt HA, Wade A, Stocks J. Lung function is abnormal in 3-month-old infants with cystic fibrosis diagnosed by newborn screening. Thorax 2012;67:874-881.
33.
Zurück zum Zitat Stahl M, Wielputz MO, Graeber SY, Joachim C, Sommerburg O, Kauczor HU, Puderbach M, Eichinger M, Mall MA. Comparison of Lung Clearance Index and Magnetic Resonance Imaging for Assessment of Lung Disease in Children with Cystic Fibrosis. Am J Respir Crit Care Med 2017;195:349-359. Stahl M, Wielputz MO, Graeber SY, Joachim C, Sommerburg O, Kauczor HU, Puderbach M, Eichinger M, Mall MA. Comparison of Lung Clearance Index and Magnetic Resonance Imaging for Assessment of Lung Disease in Children with Cystic Fibrosis. Am J Respir Crit Care Med 2017;195:349-359.
34.
Zurück zum Zitat Stahl M, Graeber SY, Joachim C, Barth S, Ricklefs I, Diekmann G, Kopp MV, Naehrlich L, Mall MA. Three-center feasibility of lung clearance index in infants and preschool children with cystic fibrosis and other lung diseases. J Cyst Fibros 2018;17:249-255. Stahl M, Graeber SY, Joachim C, Barth S, Ricklefs I, Diekmann G, Kopp MV, Naehrlich L, Mall MA. Three-center feasibility of lung clearance index in infants and preschool children with cystic fibrosis and other lung diseases. J Cyst Fibros 2018;17:249-255.
35.
Zurück zum Zitat Stahl M, Joachim C, Blessing K, Hämmerling S, Sommerburg O, Latzin P, Mall MA. Multiple breath washout is feasible in the clinical setting and detects abnormal lung function in infants and young children with cystic fibrosis. Respiration 2014;87:357-363. Stahl M, Joachim C, Blessing K, Hämmerling S, Sommerburg O, Latzin P, Mall MA. Multiple breath washout is feasible in the clinical setting and detects abnormal lung function in infants and young children with cystic fibrosis. Respiration 2014;87:357-363.
36.
Zurück zum Zitat Amin R, Subbarao P, Jabar A, Balkovec S, Jensen R, Kerrigan S, Gustafsson P, Ratjen F. Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function. Thorax 2010;65:379-383. Amin R, Subbarao P, Jabar A, Balkovec S, Jensen R, Kerrigan S, Gustafsson P, Ratjen F. Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function. Thorax 2010;65:379-383.
37.
Zurück zum Zitat Amin R, Subbarao P, Lou W, Jabar A, Balkovec S, Jensen R, Kerrigan S, Gustafsson P, Ratjen F. The effect of dornase alfa on ventilation inhomogeneity in patients with cystic fibrosis. Eur Respir J 2011;37:806-812. Amin R, Subbarao P, Lou W, Jabar A, Balkovec S, Jensen R, Kerrigan S, Gustafsson P, Ratjen F. The effect of dornase alfa on ventilation inhomogeneity in patients with cystic fibrosis. Eur Respir J 2011;37:806-812.
38.
Zurück zum Zitat Aurora P, Bush A, Gustafsson P, Oliver C, Wallis C, Price J, Stroobant J, Carr S, Stocks J. Multiple-breath washout as a marker of lung disease in preschool children with cystic fibrosis. Am J Respir Crit Care Med 2005;171:249-256. Aurora P, Bush A, Gustafsson P, Oliver C, Wallis C, Price J, Stroobant J, Carr S, Stocks J. Multiple-breath washout as a marker of lung disease in preschool children with cystic fibrosis. Am J Respir Crit Care Med 2005;171:249-256.
39.
Zurück zum Zitat Belessis Y, Dixon B, Hawkins G, Pereira J, Peat J, MacDonald R, Field P, Numa A, Morton J, Lui K, Jaffe A. Early cystic fibrosis lung disease detected by bronchoalveolar lavage and lung clearance index. Am J Respir Crit Care Med 2012;185:862-873. Belessis Y, Dixon B, Hawkins G, Pereira J, Peat J, MacDonald R, Field P, Numa A, Morton J, Lui K, Jaffe A. Early cystic fibrosis lung disease detected by bronchoalveolar lavage and lung clearance index. Am J Respir Crit Care Med 2012;185:862-873.
40.
Zurück zum Zitat Davies J, Sheridan H, Bell N, Cunningham S, Davis SD, Elborn JS, Milla CE, Starner TD, Weiner DJ, Lee PS, Ratjen F. Assessment of clinical response to ivacaftor with lung clearance index in cystic fibrosis patients with a G551D-CFTR mutation and preserved spirometry: a randomised controlled trial. Lancet Respir Med 2013;1:630-638. Davies J, Sheridan H, Bell N, Cunningham S, Davis SD, Elborn JS, Milla CE, Starner TD, Weiner DJ, Lee PS, Ratjen F. Assessment of clinical response to ivacaftor with lung clearance index in cystic fibrosis patients with a G551D-CFTR mutation and preserved spirometry: a randomised controlled trial. Lancet Respir Med 2013;1:630-638.
41.
Zurück zum Zitat Lum S, Gustafsson P, Ljungberg H, Hulskamp G, Bush A, Carr SB, Castle R, Hoo AF, Price J, Ranganathan S, Stroobant J, Wade A, Wallis C, Wyatt H, Stocks J. Early detection of cystic fibrosis lung disease: multiple-breath washout versus raised volume tests. Thorax 2007;62:341-347. Lum S, Gustafsson P, Ljungberg H, Hulskamp G, Bush A, Carr SB, Castle R, Hoo AF, Price J, Ranganathan S, Stroobant J, Wade A, Wallis C, Wyatt H, Stocks J. Early detection of cystic fibrosis lung disease: multiple-breath washout versus raised volume tests. Thorax 2007;62:341-347.
42.
Zurück zum Zitat Ratjen F, Davis SD, Stanojevic S, Kronmal RA, Hinckley Stukovsky KD, Jorgensen N, Rosenfeld M, Group SS. Inhaled hypertonic saline in preschool children with cystic fibrosis (SHIP): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet Respir Med 2019;7:802-809. Ratjen F, Davis SD, Stanojevic S, Kronmal RA, Hinckley Stukovsky KD, Jorgensen N, Rosenfeld M, Group SS. Inhaled hypertonic saline in preschool children with cystic fibrosis (SHIP): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet Respir Med 2019;7:802-809.
43.
Zurück zum Zitat Stahl M, Joachim C, Kirsch I, Uselmann T, Yu Y, Alfeis N, Berger C, Minso R, Rudolf I, Stolpe C, Bovermann X, Liboschik L, Steinmetz A, Tennhardt D, Dörfler F, Röhmel J, Unorji-Frank K, Rückes-Nilges C, von Stoutz B, Naehrlich L, Kopp MV, Dittrich AM, Sommerburg O, Mall MA. Multicentre feasibility of multiple-breath washout in preschool children with cystic fibrosis and other lung diseases. ERJ Open Res 2020;6:00408-02020. Stahl M, Joachim C, Kirsch I, Uselmann T, Yu Y, Alfeis N, Berger C, Minso R, Rudolf I, Stolpe C, Bovermann X, Liboschik L, Steinmetz A, Tennhardt D, Dörfler F, Röhmel J, Unorji-Frank K, Rückes-Nilges C, von Stoutz B, Naehrlich L, Kopp MV, Dittrich AM, Sommerburg O, Mall MA. Multicentre feasibility of multiple-breath washout in preschool children with cystic fibrosis and other lung diseases. ERJ Open Res 2020;6:00408-02020.
44.
Zurück zum Zitat Stahl M, Wielputz MO, Ricklefs I, Dopfer C, Barth S, Schlegtendal A, Graeber SY, Sommerburg O, Diekmann G, Husing J, Koerner-Rettberg C, Nahrlich L, Dittrich AM, Kopp MV, Mall MA. Preventive Inhalation of Hypertonic Saline in Infants with Cystic Fibrosis (PRESIS). A Randomized, Double-Blind, Controlled Study. Am J Respir Crit Care Med 2019;199:1238-1248. Stahl M, Wielputz MO, Ricklefs I, Dopfer C, Barth S, Schlegtendal A, Graeber SY, Sommerburg O, Diekmann G, Husing J, Koerner-Rettberg C, Nahrlich L, Dittrich AM, Kopp MV, Mall MA. Preventive Inhalation of Hypertonic Saline in Infants with Cystic Fibrosis (PRESIS). A Randomized, Double-Blind, Controlled Study. Am J Respir Crit Care Med 2019;199:1238-1248.
45.
Zurück zum Zitat Subbarao P, Stanojevic S, Brown M, Jensen R, Rosenfeld M, Davis S, Brumback L, Gustafsson P, Ratjen F. Lung clearance index as an outcome measure for clinical trials in young children with cystic fibrosis. A pilot study using inhaled hypertonic saline. Am J Respir Crit Care Med 2013;188:456-460. Subbarao P, Stanojevic S, Brown M, Jensen R, Rosenfeld M, Davis S, Brumback L, Gustafsson P, Ratjen F. Lung clearance index as an outcome measure for clinical trials in young children with cystic fibrosis. A pilot study using inhaled hypertonic saline. Am J Respir Crit Care Med 2013;188:456-460.
46.
Zurück zum Zitat Sileo C, Corvol H, Boelle PY, Blondiaux E, Clement A, Ducou Le Pointe H. HRCT and MRI of the lung in children with cystic fibrosis: comparison of different scoring systems. J Cyst Fibros 2014;13:198-204. Sileo C, Corvol H, Boelle PY, Blondiaux E, Clement A, Ducou Le Pointe H. HRCT and MRI of the lung in children with cystic fibrosis: comparison of different scoring systems. J Cyst Fibros 2014;13:198-204.
47.
Zurück zum Zitat Heidenreich JF, Veldhoen S, Metz C, Mendes Pereira L, Benkert T, Pfeuffer J, Bley TA, Kostler H, Weng AM. Functional MRI of the Lungs Using Single Breath-Hold and Self-Navigated Ultrashort Echo Time Sequences. Radiol Cardiothorac Imaging 2020;2:e190162. Heidenreich JF, Veldhoen S, Metz C, Mendes Pereira L, Benkert T, Pfeuffer J, Bley TA, Kostler H, Weng AM. Functional MRI of the Lungs Using Single Breath-Hold and Self-Navigated Ultrashort Echo Time Sequences. Radiol Cardiothorac Imaging 2020;2:e190162.
48.
Zurück zum Zitat Triphan SMF, Stahl M, Jobst BJ, Sommerburg O, Kauczor HU, Schenk JP, Alrajab A, Eichinger M, Mall MA, Wielputz MO. Echo Time-Dependence of Observed Lung T1 in Patients With Cystic Fibrosis and Correlation With Clinical Metrics. J Magn Reson Imaging 2020:e27271. Triphan SMF, Stahl M, Jobst BJ, Sommerburg O, Kauczor HU, Schenk JP, Alrajab A, Eichinger M, Mall MA, Wielputz MO. Echo Time-Dependence of Observed Lung T1 in Patients With Cystic Fibrosis and Correlation With Clinical Metrics. J Magn Reson Imaging 2020:e27271.
49.
Zurück zum Zitat Leutz-Schmidt P, Stahl M, Sommerburg O, Eichinger M, Puderbach MU, Schenk JP, Alrajab A, Triphan SMF, Kauczor HU, Mall MA, Wielputz MO. Non-contrast enhanced magnetic resonance imaging detects mosaic signal intensity in early cystic fibrosis lung disease. Eur J Radiol 2018;101:178-183. Leutz-Schmidt P, Stahl M, Sommerburg O, Eichinger M, Puderbach MU, Schenk JP, Alrajab A, Triphan SMF, Kauczor HU, Mall MA, Wielputz MO. Non-contrast enhanced magnetic resonance imaging detects mosaic signal intensity in early cystic fibrosis lung disease. Eur J Radiol 2018;101:178-183.
50.
Zurück zum Zitat Shammi UA, D‘Alessandro MF, Altes T, Hersman FW, Ruset IC, Mugler J, 3rd, Meyer C, Mata J, Qing K, Thomen R. Comparison of Hyperpolarized (3)He and (129)Xe MR Imaging in Cystic Fibrosis Patients. Acad Radiol 2021. Shammi UA, D‘Alessandro MF, Altes T, Hersman FW, Ruset IC, Mugler J, 3rd, Meyer C, Mata J, Qing K, Thomen R. Comparison of Hyperpolarized (3)He and (129)Xe MR Imaging in Cystic Fibrosis Patients. Acad Radiol 2021.
51.
Zurück zum Zitat Smith LJ, Collier GJ, Marshall H, Hughes PJC, Biancardi AM, Wildman M, Aldag I, West N, Horsley A, Wild JM. Patterns of regional lung physiology in cystic fibrosis using ventilation magnetic resonance imaging and multiple-breath washout. Eur Respir J 2018;52. Smith LJ, Collier GJ, Marshall H, Hughes PJC, Biancardi AM, Wildman M, Aldag I, West N, Horsley A, Wild JM. Patterns of regional lung physiology in cystic fibrosis using ventilation magnetic resonance imaging and multiple-breath washout. Eur Respir J 2018;52.
52.
Zurück zum Zitat Couch MJ, Thomen R, Kanhere N, Hu R, Ratjen F, Woods J, Santyr G. A two-center analysis of hyperpolarized (129)Xe lung MRI in stable pediatric cystic fibrosis: Potential as a biomarker for multi-site trials. J Cyst Fibros 2019;18:728-733. Couch MJ, Thomen R, Kanhere N, Hu R, Ratjen F, Woods J, Santyr G. A two-center analysis of hyperpolarized (129)Xe lung MRI in stable pediatric cystic fibrosis: Potential as a biomarker for multi-site trials. J Cyst Fibros 2019;18:728-733.
53.
Zurück zum Zitat Thomen RP, Walkup LL, Roach DJ, Cleveland ZI, Clancy JP, Woods JC. Hyperpolarized (129)Xe for investigation of mild cystic fibrosis lung disease in pediatric patients. J Cyst Fibros 2017;16:275-282. Thomen RP, Walkup LL, Roach DJ, Cleveland ZI, Clancy JP, Woods JC. Hyperpolarized (129)Xe for investigation of mild cystic fibrosis lung disease in pediatric patients. J Cyst Fibros 2017;16:275-282.
54.
Zurück zum Zitat Thomen RP, Walkup LL, Roach DJ, Higano N, Schapiro A, Brody A, Clancy JP, Cleveland ZI, Woods JC. Regional Structure-Function in Cystic Fibrosis Lung Disease Using Hyperpolarized (129)Xe and Ultrashort Echo Magnetic Resonance Imaging. Am J Respir Crit Care Med 2020;202:290-292. Thomen RP, Walkup LL, Roach DJ, Higano N, Schapiro A, Brody A, Clancy JP, Cleveland ZI, Woods JC. Regional Structure-Function in Cystic Fibrosis Lung Disease Using Hyperpolarized (129)Xe and Ultrashort Echo Magnetic Resonance Imaging. Am J Respir Crit Care Med 2020;202:290-292.
55.
Zurück zum Zitat Mall MA, Mayer-Hamblett N, Rowe SM. Cystic Fibrosis: Emergence of Highly Effective Targeted Therapeutics and Potential Clinical Implications. Am J Respir Crit Care Med 2020;201:1193-1208. Mall MA, Mayer-Hamblett N, Rowe SM. Cystic Fibrosis: Emergence of Highly Effective Targeted Therapeutics and Potential Clinical Implications. Am J Respir Crit Care Med 2020;201:1193-1208.
56.
Zurück zum Zitat Rosenfeld M, Wainwright CE, Higgins M, Wang LT, McKee C, Campbell D, Tian S, Schneider J, Cunningham S, Davies JC, group As. Ivacaftor treatment of cystic fibrosis in children aged 12 to <24 months and with a CFTR gating mutation (ARRIVAL): a phase 3 single-arm study. Lancet Respir Med 2018;6:545-553. Rosenfeld M, Wainwright CE, Higgins M, Wang LT, McKee C, Campbell D, Tian S, Schneider J, Cunningham S, Davies JC, group As. Ivacaftor treatment of cystic fibrosis in children aged 12 to <24 months and with a CFTR gating mutation (ARRIVAL): a phase 3 single-arm study. Lancet Respir Med 2018;6:545-553.
57.
Zurück zum Zitat Davies JC, Wainwright CE, Sawicki GS, Higgins MN, Campbell D, Harris C, Panorchan P, Haseltine E, Tian S, Rosenfeld M. Ivacaftor in Infants Aged 4 to <12 Months with Cystic Fibrosis and a Gating Mutation. Results of a Two-Part Phase 3 Clinical Trial. Am J Respir Crit Care Med 2021;203:585-593. Davies JC, Wainwright CE, Sawicki GS, Higgins MN, Campbell D, Harris C, Panorchan P, Haseltine E, Tian S, Rosenfeld M. Ivacaftor in Infants Aged 4 to <12 Months with Cystic Fibrosis and a Gating Mutation. Results of a Two-Part Phase 3 Clinical Trial. Am J Respir Crit Care Med 2021;203:585-593.
58.
Zurück zum Zitat McNamara JJ, McColley SA, Marigowda G, Liu F, Tian S, Owen CA, Stiles D, Li C, Waltz D, Wang LT, Sawicki GS. Safety, pharmacokinetics, and pharmacodynamics of lumacaftor and ivacaftor combination therapy in children aged 2-5 years with cystic fibrosis homozygous for F508del-CFTR: an open-label phase 3 study. Lancet Respir Med 2019;7:325-335. McNamara JJ, McColley SA, Marigowda G, Liu F, Tian S, Owen CA, Stiles D, Li C, Waltz D, Wang LT, Sawicki GS. Safety, pharmacokinetics, and pharmacodynamics of lumacaftor and ivacaftor combination therapy in children aged 2-5 years with cystic fibrosis homozygous for F508del-CFTR: an open-label phase 3 study. Lancet Respir Med 2019;7:325-335.
59.
Zurück zum Zitat Stahl M, Steinke E, Graeber SY, Joachim C, Seitz C, Kauczor HU, Eichinger M, Hammerling S, Sommerburg O, Wielputz MO, Mall MA. Magnetic Resonance Imaging Detects Progression of Lung Disease and Impact of Newborn Screening in Preschool Children with Cystic Fibrosis. Am J Respir Crit Care Med 2021;204:943-953. Stahl M, Steinke E, Graeber SY, Joachim C, Seitz C, Kauczor HU, Eichinger M, Hammerling S, Sommerburg O, Wielputz MO, Mall MA. Magnetic Resonance Imaging Detects Progression of Lung Disease and Impact of Newborn Screening in Preschool Children with Cystic Fibrosis. Am J Respir Crit Care Med 2021;204:943-953.
60.
Zurück zum Zitat Graeber SY, Vitzthum C, Pallenberg ST, Naehrlich L, Stahl M, Rohrbach A, Drescher M, Minso R, Ringshausen FC, Rueckes-Nilges C, Klajda J, Berges J, Yu Y, Scheuermann H, Hirtz S, Sommerburg O, Dittrich AM, Tummler B, Mall MA. Effects of Elexacaftor/Tezacaftor/Ivacaftor Therapy on CFTR Function in Patients with Cystic Fibrosis and One or Two F508del Alleles. Am J Respir Crit Care Med 2022;205:540-549. Graeber SY, Vitzthum C, Pallenberg ST, Naehrlich L, Stahl M, Rohrbach A, Drescher M, Minso R, Ringshausen FC, Rueckes-Nilges C, Klajda J, Berges J, Yu Y, Scheuermann H, Hirtz S, Sommerburg O, Dittrich AM, Tummler B, Mall MA. Effects of Elexacaftor/Tezacaftor/Ivacaftor Therapy on CFTR Function in Patients with Cystic Fibrosis and One or Two F508del Alleles. Am J Respir Crit Care Med 2022;205:540-549.
61.
Zurück zum Zitat Nichols DP, Paynter AC, Heltshe SL, Donaldson SH, Frederick CA, Freedman SD, Gelfond D, Hoffman LR, Kelly A, Narkewicz MR, Pittman JE, Ratjen F, Rosenfeld M, Sagel SD, Schwarzenberg SJ, Singh PK, Solomon GM, Stalvey MS, Clancy JP, Kirby S, Van Dalfsen JM, Kloster MH, Rowe SM, group PS. Clinical Effectiveness of Elexacaftor/Tezacaftor/Ivacaftor in People with Cystic Fibrosis: A Clinical Trial. Am J Respir Crit Care Med 2022;205:529-539. Nichols DP, Paynter AC, Heltshe SL, Donaldson SH, Frederick CA, Freedman SD, Gelfond D, Hoffman LR, Kelly A, Narkewicz MR, Pittman JE, Ratjen F, Rosenfeld M, Sagel SD, Schwarzenberg SJ, Singh PK, Solomon GM, Stalvey MS, Clancy JP, Kirby S, Van Dalfsen JM, Kloster MH, Rowe SM, group PS. Clinical Effectiveness of Elexacaftor/Tezacaftor/Ivacaftor in People with Cystic Fibrosis: A Clinical Trial. Am J Respir Crit Care Med 2022;205:529-539.
62.
Zurück zum Zitat Mall MA, Brugha R, Gartner S, Legg J, Moeller A, Mondejar-Lopez P, Prais D, Pressler T, Ratjen F, Reix P, Robinson PD, Selvadurai H, Stehling F, Ahluwalia N, Arteaga-Solis E, Bruinsma BG, Jennings M, Moskowitz SM, Noel S, Tian S, Weinstock TG, Wu P, Wainwright CE, Davies JC, Group VXS. Efficacy and Safety of Elexacaftor/Tezacaftor/Ivacaftor in Children 6 Through 11 Years of Age with Cystic Fibrosis Heterozygous for F508del and a Minimal Function Mutation: A Phase 3B, Randomized, Placebo-Controlled Study. Am J Respir Crit Care Med 2022. Mall MA, Brugha R, Gartner S, Legg J, Moeller A, Mondejar-Lopez P, Prais D, Pressler T, Ratjen F, Reix P, Robinson PD, Selvadurai H, Stehling F, Ahluwalia N, Arteaga-Solis E, Bruinsma BG, Jennings M, Moskowitz SM, Noel S, Tian S, Weinstock TG, Wu P, Wainwright CE, Davies JC, Group VXS. Efficacy and Safety of Elexacaftor/Tezacaftor/Ivacaftor in Children 6 Through 11 Years of Age with Cystic Fibrosis Heterozygous for F508del and a Minimal Function Mutation: A Phase 3B, Randomized, Placebo-Controlled Study. Am J Respir Crit Care Med 2022.
63.
Zurück zum Zitat Graeber SY, Renz DM, Stahl M, Pallenberg ST, Sommerburg O, Naehrlich L, Berges J, Dohna M, Ringshausen FC, Doellinger F, Vitzthum C, Rohmel J, Allomba C, Hammerling S, Barth S, Ruckes-Nilges C, Wielputz MO, Hansen G, Vogel-Claussen J, Tummler B, Mall MA, Dittrich AM. Effects of Elexacaftor/Tezacaftor/Ivacaftor Therapy on Lung Clearance Index and Magnetic Resonance Imaging in Patients with Cystic Fibrosis and One or Two F508del Alleles. Am J Respir Crit Care Med 2022;206:311-320. Graeber SY, Renz DM, Stahl M, Pallenberg ST, Sommerburg O, Naehrlich L, Berges J, Dohna M, Ringshausen FC, Doellinger F, Vitzthum C, Rohmel J, Allomba C, Hammerling S, Barth S, Ruckes-Nilges C, Wielputz MO, Hansen G, Vogel-Claussen J, Tummler B, Mall MA, Dittrich AM. Effects of Elexacaftor/Tezacaftor/Ivacaftor Therapy on Lung Clearance Index and Magnetic Resonance Imaging in Patients with Cystic Fibrosis and One or Two F508del Alleles. Am J Respir Crit Care Med 2022;206:311-320.
64.
Zurück zum Zitat Martin C, Legeai C, Regard L, Cantrelle C, Dorent R, Carlier N, Kerbaul F, Burgel PR. Major Decrease in Lung Transplantation for Patients with Cystic Fibrosis in France. Am J Respir Crit Care Med 2022;205:584-586. Martin C, Legeai C, Regard L, Cantrelle C, Dorent R, Carlier N, Kerbaul F, Burgel PR. Major Decrease in Lung Transplantation for Patients with Cystic Fibrosis in France. Am J Respir Crit Care Med 2022;205:584-586.
65.
Zurück zum Zitat Wucherpfennig L, Triphan SMF, Wege S, Kauczor HU, Heussel CP, Schmitt N, Wuennemann F, Mayer VL, Sommerburg O, Mall MA, Eichinger M, Wielputz MO. Magnetic resonance imaging detects improvements of pulmonary and paranasal sinus abnormalities in response to elexacaftor/tezacaftor/ivacaftor therapy in adults with cystic fibrosis. J Cyst Fibros 2022;21:1053-1060. Wucherpfennig L, Triphan SMF, Wege S, Kauczor HU, Heussel CP, Schmitt N, Wuennemann F, Mayer VL, Sommerburg O, Mall MA, Eichinger M, Wielputz MO. Magnetic resonance imaging detects improvements of pulmonary and paranasal sinus abnormalities in response to elexacaftor/tezacaftor/ivacaftor therapy in adults with cystic fibrosis. J Cyst Fibros 2022;21:1053-1060.
66.
Zurück zum Zitat Mainz JG, Zagoya C, Polte L, Naehrlich L, Sasse L, Eickmeier O, Smaczny C, Barucha A, Bechinger L, Duckstein F, Kurzidim L, Eschenhagen P, Caley L, Peckham D, Schwarz C. Elexacaftor-Tezacaftor-Ivacaftor Treatment Reduces Abdominal Symptoms in Cystic Fibrosis-Early results Obtained With the CF-Specific CFAbd-Score. Front Pharmacol 2022;13:877118. Mainz JG, Zagoya C, Polte L, Naehrlich L, Sasse L, Eickmeier O, Smaczny C, Barucha A, Bechinger L, Duckstein F, Kurzidim L, Eschenhagen P, Caley L, Peckham D, Schwarz C. Elexacaftor-Tezacaftor-Ivacaftor Treatment Reduces Abdominal Symptoms in Cystic Fibrosis-Early results Obtained With the CF-Specific CFAbd-Score. Front Pharmacol 2022;13:877118.
67.
Zurück zum Zitat Sutharsan S, McKone EF, Downey DG, Duckers J, MacGregor G, Tullis E, Van Braeckel E, Wainwright CE, Watson D, Ahluwalia N, Bruinsma BG, Harris C, Lam AP, Lou Y, Moskowitz SM, Tian S, Yuan J, Waltz D, Mall MA, group VXs. Efficacy and safety of elexacaftor plus tezacaftor plus ivacaftor versus tezacaftor plus ivacaftor in people with cystic fibrosis homozygous for F508del-CFTR: a 24-week, multicentre, randomised, double-blind, active-controlled, phase 3b trial. Lancet Respir Med 2022;10:267-277. Sutharsan S, McKone EF, Downey DG, Duckers J, MacGregor G, Tullis E, Van Braeckel E, Wainwright CE, Watson D, Ahluwalia N, Bruinsma BG, Harris C, Lam AP, Lou Y, Moskowitz SM, Tian S, Yuan J, Waltz D, Mall MA, group VXs. Efficacy and safety of elexacaftor plus tezacaftor plus ivacaftor versus tezacaftor plus ivacaftor in people with cystic fibrosis homozygous for F508del-CFTR: a 24-week, multicentre, randomised, double-blind, active-controlled, phase 3b trial. Lancet Respir Med 2022;10:267-277.
68.
Zurück zum Zitat Spoletini G, Gillgrass L, Pollard K, Shaw N, Williams E, Etherington C, Clifton IJ, Peckham DG. Dose adjustments of Elexacaftor/Tezacaftor/Ivacaftor in response to mental health side effects in adults with cystic fibrosis. J Cyst Fibros 2022;21:1061-1065. Spoletini G, Gillgrass L, Pollard K, Shaw N, Williams E, Etherington C, Clifton IJ, Peckham DG. Dose adjustments of Elexacaftor/Tezacaftor/Ivacaftor in response to mental health side effects in adults with cystic fibrosis. J Cyst Fibros 2022;21:1061-1065.
69.
Zurück zum Zitat Szentpetery S, Foil K, Hendrix S, Gray S, Mingora C, Head B, Johnson D, Flume PA. A case report of CFTR modulator administration via carrier mother to treat meconium ileus in a F508del homozygous fetus. J Cyst Fibros 2022;21:721-724. Szentpetery S, Foil K, Hendrix S, Gray S, Mingora C, Head B, Johnson D, Flume PA. A case report of CFTR modulator administration via carrier mother to treat meconium ileus in a F508del homozygous fetus. J Cyst Fibros 2022;21:721-724.
70.
Zurück zum Zitat McCormick J, Mehta G, Olesen HV, Viviani L, Macek M, Jr., Mehta A, European Registry Working G. Comparative demographics of the European cystic fibrosis population: a cross-sectional database analysis. Lancet 2010;375:1007-1013. McCormick J, Mehta G, Olesen HV, Viviani L, Macek M, Jr., Mehta A, European Registry Working G. Comparative demographics of the European cystic fibrosis population: a cross-sectional database analysis. Lancet 2010;375:1007-1013.
Metadaten
Titel
Die Goldenen Zwanziger der Mukoviszidose
verfasst von
Prof. Dr. med. Mirjam Stahl
Publikationsdatum
14.12.2023
Verlag
Springer Medizin
Erschienen in
CME / Ausgabe 12/2023
Print ISSN: 1614-371X
Elektronische ISSN: 1614-3744
DOI
https://doi.org/10.1007/s11298-023-3392-4

Weitere Artikel der Ausgabe 12/2023

CME 12/2023 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Deeskalation in der Systemtherapie: Das Ziel muss bekannt sein

21.06.2024 Senologiekongress 2024 Kongressbericht

Anhand des Brustkrebssubtyps und des Risikos kann die Eskalationsstufe der Behandlung beim frühen Mammakarzinom festgelegt werden. Prof. Christian Jackisch, Essen, gab beim 43. Jahreskongress der Deutschen Gesellschaft für Senologie einen Einblick in bestehende Konzepte.

Wie wird Brustkrebs in zehn Jahren behandelt?

21.06.2024 Senologiekongress 2024 Kongressbericht

Beim 43. Jahreskongress der Deutschen Gesellschaft für Senologie haben vier Behandelnde verschiedener Fachrichtungen einen Blick in die Zukunft der Brustkrebstherapie gewagt. Wie könnte sie im Jahr 2034 aussehen?

Cannabis wirkt nicht antientzündlich

Cannabinoide Nachrichten

Die Wirksamkeit von Cannabisprodukten ist in einigen medizinischen Indikationen gesichert. Aber längst nicht alle Effekte, die Cannabis zugesprochen werden, lassen sich in Studien nachvollziehen. In der randomisierten, placebokontrollierten Studie MedCan-1 wurde der antiinflammatorische Effekt von Cannabidiol genauer unter die Lupe genommen.

So beeinflussen Herzinfarkte auf lange Sicht die Sterblichkeit

20.06.2024 ST-Hebungsinfarkt Nachrichten

Wie hoch ist bei Patienten, die nach einem ST-Hebungs-Myokardinfarkt die initiale Hochrisikophase überleben, auf lange Sicht das Sterberisiko? Eine Studie aus Dänemark liefert dazu nun aufschlussreiche Daten.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.