Development of a technology for expression of recombinant human erythropoietin in cultured mammalian cells using alphavirus expression system

Currently there are no industrial eukaryotic expression systems other than transient expression from plasmids or expression from genes integrated into host genome. Both approaches (use of eukaryotic plasmids or chromosomal integration) suffer from poor scalability and often from poor yields. Although, in laboratory settings, effective means for transducing of cultured cells to express foreign proteins and for high-level transient expression were developed based on viral genomes. We thought to develop a scalable and suitable for industrial application technology for the production of recombinant human erythropoietin (EPO) in mammalian cell cultures using an expression vector based on the genome of RNA virus

Development of a technology for expression of recombinant human erythropoietin in cultured mammalian cells using alphavirus expression system

Currently there are no industrial eukaryotic expression systems other than transient expression from plasmids or expression from genes integrated into host genome. Both approaches (use of eukaryotic plasmids or chromosomal integration) suffer from poor scalability and often from poor yields. Although, in laboratory settings, effective means for transducing of cultured cells to express foreign proteins and for high-level transient expression were developed based on viral genomes. We thought to develop a scalable and suitable for industrial application technology for the production of recombinant human erythropoietin (EPO) in mammalian cell cultures using an expression vector based on the genome of RNA virus

Mycophenolic acid in the treatment of birdshot chorioretinopathy: long-term follow-up

Aim: To assess the long-term efficacy and tolerability of both derivatives of mycophenolic acid, mycophenolate mofetil (MMF) and mycophenolate sodium (MPS), in the therapy of patients with birdshot chorioretinopathy (BSCR). Methods: Retrospective analysis of 24 patients (48 eyes) with BSCR, treated with MMF or MPS with a follow-up of at least 1 year. The main outcome measures included control of inflammation, steroid-sparing potential and side effects. Secondary outcome measure was the development of retinal function during the therapy measured by best-corrected visual acuity (BCVA), visual field and/or electroretinography (ERG). Results: Twelve patients (50%) were treated with MMF and 12 patients (50%) with MPS. Control of intraocular inflammation, defined as complete lack of clinical and angiographic signs of inflammatory activity, was achieved in 16 of 24 patients (67%). The angiographic signs of activity were significantly reduced during the follow-up (p0.05). In 20 out of 21 patients (95%) who received systemic corticosteroids, the corticosteroids could be tapered to a daily dose of ≤10 mg (rate 0.26/patient-year). Drug-related side effects occurred in 12 patients (50%, rate 0.16/patient-year). In four patients (17%), a therapy switch from MMF to MPS was undertaken due to gastrointestinal discomfort. Conclusions: Derivatives of mycophenolic acid are effective and safe drugs for the treatment of BSCR. In cases with gastrointestinal side effects, a therapy switch from MMF to MPS should be considered

Incidental finding of lamellar calcification of the falx cerebri leading to the diagnosis of gorlin-goltz syndrome

Here, we report the case of an incidental finding of lamellar calcification of the falx cerebri in a routine computed tomography scan of the head after an accidental trauma. This lamellar calcification led to the diagnosis of Gorlin-Goltz syndrome (GGS) in the patient and her daughter. Lamellar calcification of the falx cerebri is a pathognomonic feature of GGS. Our case report highlights the importance of a multidisciplinary diagnostic approach to GGS

New XEN63 Gel Stent Implantation in Open-Angle Glaucoma: A Two-Year Follow-Up Pilot Study

Bogomil Voykov, Emil Nasyrov, Jonas Neubauer, Caroline J Gassel Centre for Ophthalmology, University Hospital Tuebingen, Tuebingen, GermanyCorrespondence: Bogomil Voykov, Centre for Ophthalmology, University Hospital Tuebingen, Elfriede-Aulhorn-Str. 7, Tuebingen, 72076, Germany, Tel +49 7071 2988088, Fax +49 7071 295455, Email [email protected]: The XEN gel stent was developed to reduce the risks of filtration surgery by standardizing the outflow of aqueous humor into the subconjunctival space. Recently, a modified version of the XEN63 gel stent was introduced. The goal of this study was to assess its efficacy and safety.Methods: This is a prospective, nonrandomized, observational, consecutive case series study at a single tertiary centre. Patients with open-angle glaucoma with above target intraocular pressure (IOP) despite maximal tolerated medication were included. The primary outcome was a change of median IOP. Secondary outcomes included a change in the number of medications, complete success, needling and complication rates. Success was defined as a lowering of IOP > 20% from baseline and IOP ≤ 14 mmHg. Complete success indicated that the target IOP was reached without medications.Results: Six patients were included. The median IOP decreased from 35.5 mmHg (25.0– 40.0 mmHg) at baseline to 11.5 mmHg (4.0– 15.0 mmHg, p = 0.03), and median IOP-lowering medication was reduced from 4.0 (3.0– 4.0) at baseline to 0 (0– 1.0, p = 0.03) after two years. Five patients (83.0%) had a complete success after two years. Two patients (33.0%) required a needling procedure. Three patients (50.0%) required an intervention due to symptomatic hypotony within the first three weeks postoperatively. Hypotony resolved completely or was asymptomatic after three months.Conclusion: Our study demonstrated a statistically significant reduction in both IOP and number of IOP-lowering medications. Complications were well manageable and had no long-term sequelae.Keywords: open-angle glaucoma, filtering surgery, minimally invasive surgery, glaucoma gel sten

Tuberöse Sklerose: eine interdisziplinäre Diagnose [Tuberous sclerosis: an interdisciplinary diagnosis]

Tuberous sclerosis is a relatively rare disease, but it often takes a progressive and severe course. We wish to demonstrate the typical changes in a patient with tuberous sclerosis and their relevance for the ophthalmologist. Ophthalmologic evaluation including funduscopy, 30 degree perimetry and fundus photography and clinical course of a 40-year-old man are described. We observed an elevated, multinodular, opaque hamartoma resembling mulberries, approximately (1/3)-(1/2) PD large, at the temporal superior arc with corresponding visual field defects. An ophthalmologist should always think of a tuberous sclerosis as a differential diagnosis when confronted with a retinal hamartoma. Other characteristic ophthalmological findings include facial and eyelid angiofibromas, coloboma of the iris, lens and choroid, strabismus, poliosis of the eyelashes, papilloedema and sector iris depigmentation. Clinical diagnosis of tuberous sclerosis is in most cases relatively easy; however, an interdisciplinary cooperation is needed

Using a slit lamp-mounted digital high-speed camera for dynamic observation of phakic lenses during eye movements: a pilot study

Martin Alexander Leitritz, Focke Ziemssen, Karl Ulrich Bartz-Schmidt, Bogomil Voykov Centre for Ophthalmology, University Eye Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany Purpose: To evaluate a digital high-speed camera combined with digital morphometry software for dynamic measurements of phakic intraocular lens movements to observe kinetic influences, particularly in fast direction changes and at lateral end points. Materials and methods: A high-speed camera taking 300 frames per second observed movements of eight iris-claw intraocular lenses and two angle-supported intraocular lenses. Standardized saccades were performed by the patients to trigger mass inertia with lens position changes. Freeze images with maximum deviation were used for digital software-based morphometry analysis with ImageJ.Results: Two eyes from each of five patients (median age 32 years, range 28–45 years) without findings other than refractive errors were included. The high-speed images showed sufficient usability for further morphometric processing. In the primary eye position, the median decentrations downward and in a lateral direction were -0.32 mm (range -0.69 to 0.024) and 0.175 mm (range -0.37 to 0.45), respectively. Despite the small sample size of asymptomatic patients, we found a considerable amount of lens dislocation. The median distance amplitude during eye movements was 0.158 mm (range 0.02–0.84). There was a slight positive corrlation (r=0.39, P<0.001) between the grade of deviation in the primary position and the distance increase triggered by movements.Conclusion: With the use of a slit lamp-mounted high-speed camera system and morphometry software, observation and objective measurements of iris-claw intraocular lenses and angle-supported intraocular lenses movements seem to be possible. Slight decentration in the primary position might be an indicator of increased lens mobility during kinetic stress during eye movements. Long-term assessment by high-speed analysis with higher case numbers has to clarify the relationship between progressing motility and endothelial cell damage. Keywords: intraocular lens, high-speed camera, phakic len

Alagille syndrome associated with myelinated retinal nerve fibers.

Alagille syndrome is frequently associated with optic disc anomalies. This is the first report of a patient with Alagille syndrome and myelinated retinal nerve fibers. A 5-year-old female patient was referred to the Centre for Ophthalmology before a liver transplantation. Ocular examinations including slit lamp examination and funduscopy as well as anterior segment and fundus images were performed. We observed myelinated retinal nerve fibers in both eyes of a 5-year-old female patient with Alagille syndrome. A broad spectrum of ocular anomalies is associated with Alagille syndrome. To our knowledge, this is the first reported case of myelinated retinal nerve fibers in a patient with Alagille syndrome