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Gerdin, Bengt
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Publications (10 of 135) Show all publications
Kiwanuka, E., Lee, C. C. .., Hackl, F., Caterson, E. J., Junker, J., Gerdin, B. & Eriksson, E. (2016). Cdc42 and p190RhoGAP activation by CCN2 regulates cell spreading and polarity and induces actin disassembly in migrating keratinocytes. International Wound Journal, 13(3), 372-381
Open this publication in new window or tab >>Cdc42 and p190RhoGAP activation by CCN2 regulates cell spreading and polarity and induces actin disassembly in migrating keratinocytes
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2016 (English)In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 13, no 3, p. 372-381Article in journal (Refereed) Published
Abstract [en]

Cell migration requires spatiotemporal integration of signals that regulate cytoskeletal dynamics. In response to a migration-promoting agent, cells begin to polarise and extend protrusions in the direction of migration. These cytoskeletal rearrangements are orchestrated by a variety of proteins, including focal adhesion kinase (FAK) and the Rho family of GTPases. CCN2, also known as connective tissue growth factor, has emerged as a regulator of cell migration but the mechanism by which CCN2 regulates keratinocyte function is not well understood. In this article, we sought to elucidate the basicmechanism of CCN2-induced cellmigration in human keratinocytes. Immunohistochemical staining was used to demonstrate that treatment with CCN2 induces a migratory phenotype through actin disassembly, spreading of lamellipodia and re-orientation of the Golgi. In vitro assays were used to show that CCN2-induced cell migration is dependent on FAK, RhoA and Cdc42, but independent of Rac1. CCN2-treated keratinocytes displayed increased Cdc42 activity and decreased RhoA activity up to 12 hours post-treatment, with upregulation of p190RhoGAP. An improved understanding of how CCN2 regulates cell migration may establish the foundation for future therapeutics in fibrotic and neoplastic diseases.

Keywords
RhoGTPase, Actin, CCN2, CTGF, Keratinocyte migration
National Category
Medical and Health Sciences
Research subject
Plastic Surgery
Identifiers
urn:nbn:se:uu:diva-213565 (URN)10.1111/iwj.12315 (DOI)000379940300011 ()25185742 (PubMedID)
External cooperation:
Available from: 2013-12-28 Created: 2013-12-28 Last updated: 2017-12-06Bibliographically approved
Gauffin, E., Öster, C., Sjöberg, F., Gerdin, B. & Ekselius, L. (2016). Health-related quality of life (EQ-5D) early after injury predicts long-term pain after burn. Burns, 42(8), 1781-1788
Open this publication in new window or tab >>Health-related quality of life (EQ-5D) early after injury predicts long-term pain after burn
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2016 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 8, p. 1781-1788Article in journal (Refereed) Published
Abstract [en]

Background: Chronic pain after burn can have severe physical and psychological effects on former patients years after the initial injury. Although the issue of pain after burn has gained increased attention over the past years, prospective, longitudinal studies are scarce. Our aim was to prospectively investigate consecutive burn patients for pain severity over time and to evaluate the prevalence and characteristics of post-burn pain to 2-7 years after the burn. As an additional aim, the effects of burn and individual-related factors, especially health related Quality of Life (HRQoL), were investigated.

Method: Sixty-seven consecutive burn patients were assessed during acute care at 3, 6, 12 and 24 months, as well as at 2-7 years post-burn. HRQoL, symptoms of post-traumatic stress disorder (PTSD) and other psychiatric disorders were investigated. During the interviews that took place 2-7 years after the injury (mean 4.6 1.9 years), current chronic post-burn pain was assessed using the Brief Pain Inventory-Short Form (BPI-SF).

Results: One-third of the patients still reported pain 2-7 years after the injury. Pain severity and interference with daily life were mainly mild to moderate though they were found to be associated with significantly lower HRQoL. Chronic pain after bum was associated with both burn- and individual-related factors. In logistic regression analysis HRQoL at 3 and 12 months and symptoms of PTSD at 12 months were independent factors in predicting chronic pain after burn.

Conclusion: Pain after burn becomes a chronic burden for many former burn patients and decreases HRQoL. A novel finding in this study was that HRQoL assessed early after burn was a predictor for the development of chronic pain. This finding may help to predict future pain problems and serve as an indicator for pain preventive measures.

Keywords
Burns, Pain, Brief Pain Inventory-Short Form, Health-related quality of life, Post-traumatic stress disorder
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-314419 (URN)10.1016/j.burns.2016.05.016 (DOI)000391073900021 ()
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2017-02-06 Created: 2017-02-02 Last updated: 2019-04-12Bibliographically approved
Hakelius, M., Reyhani, V., Rubin, K., Gerdin, B. & Nowinski, D. (2016). Normal oral keratinocytes and head and neck squamous carcinoma cells induce an innate response in fibroblasts. Anticancer Research, 36(5), 2131-2137
Open this publication in new window or tab >>Normal oral keratinocytes and head and neck squamous carcinoma cells induce an innate response in fibroblasts
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2016 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 36, no 5, p. 2131-2137Article in journal (Other academic) Published
Abstract [en]

Background: Tumor stroma is similar to the connective tissue of chronic inflammation. The extracellular matrix of tumors is formed by cancer-associated fibroblasts that also modulate the inflammatory response. Materials and Methods: We studied the ability of oral keratinocytes (NOK) and oral squamous cell carcinoma cells (SCC) to induce an innate immune response in fibroblasts. Co-cultures with fibroblasts in collagen gels and keratinocytes in inserts were used. Pentraxin 3 (PTX3) was used as an indicator of an innate immune response. Results: SCC and NOK up-regulated fibroblast mRNA expression and protein release of PTX3. mRNA levels were more pronounced in cultures with malignant cells. The induction of PTX3 was abrogated by an interleukin-1 receptor antagonist Conclusion: Keratinocytes have the capacity to induce an interleukin-1-dependent innate immune response by fibroblasts in vitro. This could be important for subsequent fibroblast modulation of the inflammatory reaction in non-malignant and malignant disease processes.

Keywords
co-culture, pentraxin-3, extracellular matrix, interleukin-1 alpha, tumor stroma
National Category
Surgery Cancer and Oncology
Research subject
Plastic Surgery
Identifiers
urn:nbn:se:uu:diva-221123 (URN)000375456200010 ()27127114 (PubMedID)
Available from: 2014-03-26 Created: 2014-03-25 Last updated: 2017-12-05Bibliographically approved
Björkenstam, C., Ekselius, L., Berlin, M., Gerdin, B. & Björkenstam, E. (2016). Suicide risk and suicide method in patients with personality disorders. Journal of Psychiatric Research, 83, 29-36
Open this publication in new window or tab >>Suicide risk and suicide method in patients with personality disorders
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2016 (English)In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 83, p. 29-36Article in journal (Refereed) Published
Abstract [en]

Objective: The influence of psychopathology on suicide method has revealed different distributions among different psychiatric disorders. However, evidence is still scarce. We hypothesized that having a diagnosis of personality disorder (PD) affect the suicide method, and that different PD clusters would influence the suicide method in different ways. In addition, we hypothesized that the presence of psychiatric and somatic co-morbidity also affects the suicide method. Method: We examined 25,217 individuals aged 15-64 who had been hospitalized in Sweden with a main diagnosis of PD the years 1987-2013 (N = 25,217). The patients were followed from the date of first discharge until death or until the end of the follow-up period, i.e. December 31, 2013, for a total of 323,508.8 person-years, with a mean follow up time of 11.7 years. The SMR, i.e. the ratio between the observed number of suicides and the expected number of suicides, was used as a measure of risk. Results: Overall PD, different PD-clusters, and comorbidity influenced the suicide method. Hanging evidenced highest SMR in female PD patients (SMR 34.2 (95% CI: 29.3-39.8)), as compared to non-PD patients and jumping among male PD patients (SMR 24.8 (95% CI: 18.3-33.6)), as compared to non PD-patients. Furthermore, the elevated suicide risk was related to both psychiatric and somatic comorbidity. Conclusion: The increased suicide risk was unevenly distributed with respect to suicide method and type of PD. However, these differences were only moderate and greatly overshadowed by the overall excess suicide risk in having PD. Any attempt from society to decrease the suicide rate in persons with PD must take these characteristics into account.

Keywords
Personality disorder, Suicide, Suicide method, Register, Sweden
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-312057 (URN)10.1016/j.jpsychires.2016.08.008 (DOI)000389100600005 ()27552531 (PubMedID)
Funder
Swedish Society of MedicineSwedish Research CouncilForte, Swedish Research Council for Health, Working Life and Welfare, 2013-2729
Available from: 2017-01-04 Created: 2017-01-04 Last updated: 2017-11-29Bibliographically approved
Hakelius, M., Saiepour, D., Göransson, H. K., Rubin, K., Gerdin, B. & Nowinski, D. (2015). Differential Gene Regulation in Fibroblasts in Co-culture with Keratinocytes and Head and Neck SCC Cells. Anticancer Research, 35(6), 3253-3265
Open this publication in new window or tab >>Differential Gene Regulation in Fibroblasts in Co-culture with Keratinocytes and Head and Neck SCC Cells
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2015 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 35, no 6, p. 3253-3265Article in journal (Refereed) Published
Abstract [en]

Background: While carcinoma-associated fibroblasts (CAFs) support tumorigenesis, normal tissue fibroblasts suppress tumor progression. Mechanisms behind conversion of fibroblasts into a CAF phenotype are largely unrevealed. Materials and Methods: Transwell co-cultures with fibroblasts in collagen gels and squamous-cell carcinoma (SCC) cells or normal oral keratinocytes (NOKs) in inserts. Differences in fibroblast global gene expression were analyzed using Affymetrix arrays and subsequent functional annotation and cluster analysis, as well as gene set enrichment analysis were performed. Results: There were 52 up-regulated and 30 down-regulated transcript IDs (>2-fold, p<0.05) in fibroblasts co-cultured with SCC compared to NOKs. Functional analysis demonstrated an enrichment of collagen-related genes. There were similarities with gene sets reflecting a non-specific, innate-type response with activation of both interferon pathways and connective tissue turnover. Conclusion: There were distinct differences in fibroblast gene expression between the co-culture types. Many were in genes related to an innate-type of response and to connective tissue turnover.

Keywords
Head and neck cancer, keratinocytes, differential gene regulation, array
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-256809 (URN)000355273800015 ()26026085 (PubMedID)
Available from: 2015-06-29 Created: 2015-06-26 Last updated: 2017-12-04Bibliographically approved
Björkenstam, E., Björkenstam, C., Holm, H., Gerdin, B. & Ekselius, L. (2015). Excess cause-specific mortality in in-patient-treated individuals with personality disorder: 25-year nationwide population-based study.. British Journal of Psychiatry, 207(4), 339-345
Open this publication in new window or tab >>Excess cause-specific mortality in in-patient-treated individuals with personality disorder: 25-year nationwide population-based study.
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2015 (English)In: British Journal of Psychiatry, ISSN 0007-1250, E-ISSN 1472-1465, Vol. 207, no 4, p. 339-345Article in journal (Refereed) Published
Abstract [en]

BackgroundAlthough personality disorders are associated with increased overall mortality, less is known about cause of death and personality type.AimsTo determine causes of mortality in ICD personality disorders.MethodBased on data from Swedish nationwide registers, individuals admitted to hospital with a primary diagnosis of personality disorder between 1987 and 2011 were followed with respect to mortality until 31 December 2011. Standardised mortality ratios (SMRs) with 95% confidence intervals and underlying causes of death were calculated.ResultsAll-cause SMRs were increased, overall and in all clusters, for natural as well as unnatural causes of death. The overall SMR was 6.1 in women and 5.0 in men, as high as previously reported for anorexia nervosa, with higher rates in cluster B and mixed/other personality disorders. The SMR for suicide was 34.5 in women and 16.0 in men for cluster B disorders. Somatic and psychiatric comorbidity increased SMRs.ConclusionsThe SMR was substantially increased for all personality disorder clusters. Thus, there was an increased premature mortality risk for all personality disorders, irrespective of category.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-266749 (URN)10.1192/bjp.bp.114.149583 (DOI)000363222900014 ()26159601 (PubMedID)
Funder
Swedish Research Council
Available from: 2015-11-10 Created: 2015-11-10 Last updated: 2017-12-01Bibliographically approved
Björkenstam, C., Björkenstam, E., Gerdin, B. & Ekselius, L. (2015). Excess cause-specific mortality in out-patients with personality disorder. British Journal of Psychiatry Open, 1(1), 54-55
Open this publication in new window or tab >>Excess cause-specific mortality in out-patients with personality disorder
2015 (English)In: British Journal of Psychiatry Open, ISSN 2056-4724, Vol. 1, no 1, p. 54-55Article in journal (Refereed) Published
Abstract [en]

Personality disorders (PDs) are associated with increased overall mortality. In patients hospitalised with a principal diagnosis of PD, this is observed for all clusters and for natural as well as unnatural causes of death. Data from Swedish nationwide registers were used to assess whether this was also true for the majority of patients diagnosed with PDs not severe enough to lead to hospitalisation. There was an increased mortality in all clusters, and for natural as well as unnatural death, also in patients treated as out-patients only, although not to the same extent as in those hospitalised.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-269418 (URN)10.1192/bjpo.bp.115.000356 (DOI)
Available from: 2015-12-16 Created: 2015-12-16 Last updated: 2016-03-01Bibliographically approved
Ekeblad, F., Gerdin, B. & Öster, C. (2015). Impact of personality disorders on health-related quality of life one year after burn injury. Disability and Rehabilitation, 37(6), 534-540
Open this publication in new window or tab >>Impact of personality disorders on health-related quality of life one year after burn injury
2015 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 6, p. 534-540Article in journal (Refereed) Published
Abstract [en]

Purpose: Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. Methods: One burn-specific instrument (Burn Specific Health Scale-Brief (BSHS-B)) and two generic instruments (EuroQol Five Dimensions and Short Form 36 Health Survey) were used, and Psychiatric Axis I and II disorders were assessed one year post burn. Results: This study identified an above normal prevalence of PDs among individuals afflicted by burn, and participants with PD had a significantly larger lifetime burden of Axis I disorders compared to participants without PD. Participants with PDs scored significantly lower than those without PD in the BSHS-B domain Skin involvement, and the effect of having a PD was related to the subscale Treatment regimens. There was no relationship between the presence of PD and generic HRQoL. Conclusions: An implication of these observations is that special rehabilitation efforts including more tailored interventions must be offered to these patients to ensure that the obstacles they perceive to caring for themselves in this respect are eliminated.

National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-244770 (URN)10.3109/09638288.2014.933898 (DOI)000351007500008 ()24963942 (PubMedID)
Available from: 2015-02-20 Created: 2015-02-20 Last updated: 2017-12-04Bibliographically approved
Gauffin, E., Öster, C., Gerdin, B. & Ekselius, L. (2015). Prevalence and prediction of prolonged pruritus after severe burns. Journal of Burn Care & Research, 36(3), 405-413
Open this publication in new window or tab >>Prevalence and prediction of prolonged pruritus after severe burns
2015 (English)In: Journal of Burn Care & Research, ISSN 1559-047X, E-ISSN 1559-0488, Vol. 36, no 3, p. 405-413Article in journal (Refereed) Published
Abstract [en]

Years after injury, pruritus is a common and severe problem for many burn patients. However, its characteristics and consequences are often only partially described. The authors therefore performed a prospective detailed examination of burn- and individual-related factors and considered those in relation to pruritus severity. Sixty-seven consecutive burn patients were assessed during acute care, and at 3 and 12 months postburn regarding preburn psychiatric disorders, health-related quality of life, post traumatic stress disorder, and personality traits. Postburn pruritus was subsequently assessed 2 to 7 years postburn using the Questionnaire for Pruritus Assessment. Fifty-one individuals, 76% of the participants, reported burn pruritus any time after the burn. Thirty-three individuals, 49% of the participants, reported ongoing pruritus the last 2 months. Information on the characteristics of pruritus was obtained from 32 of these individuals. Most perceived pruritus as bothersome or annoying and as present every day, 16 (50 %) were considered to have severe pruritus, and 11 (34 %) scratched themselves to the point of bleeding. In logistic regressions, this was independently related to TBSA full-thickness burn and health-related quality of life at 3 months, and to TBSA full thickness burn and the personality trait impulsiveness, respectively. About half of the previous burn patients experienced ongoing pruritus on an average of 4.5 years after injury, and half of them had severe pruritus. Scratching oneself to the point of bleeding is linked both to a certain personality and to pruritus. It is suspected that many patients are left without access to the best available treatment.

National Category
Dermatology and Venereal Diseases Surgery
Identifiers
urn:nbn:se:uu:diva-244772 (URN)10.1097/BCR.0000000000000152 (DOI)000369707000022 ()25162945 (PubMedID)
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2015-02-20 Created: 2015-02-20 Last updated: 2019-04-12Bibliographically approved
Bäckström, J., Öster, C., Gerdin, B., Ekselius, L. & Willebrand, M. (2014). Health-related quality of life in family members of patients with burns. Journal of Burn Care & Research, 35(3), 243-250
Open this publication in new window or tab >>Health-related quality of life in family members of patients with burns
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2014 (English)In: Journal of Burn Care & Research, ISSN 1559-047X, E-ISSN 1559-0488, Vol. 35, no 3, p. 243-250Article in journal (Refereed) Published
Abstract [en]

A severe burn not only affects the patients, but may also have a great impact on the lives of family members. It is known that family members of patients with burns experience psychological distress, but health-related quality of life (HRQoL) has not been studied in this group. The aim was to study predictors of HRQoL in family members of patients with burns. Forty-four family members of adult patients treated in a burn center, between 2000 and 2007, completed questionnaires during care, and at 3, 6, and 12 months after injury. HRQoL was assessed with the EuroQol 5D (EQ-5D), which consists of the dimensions: mobility, self-care, usual activities, pain, and anxiety/depression. The questionnaire generates an EQ-5D index and a visual analog scale (VAS) score. Overall, the EQ-5D index was similar to that of the general population. A slight improvement in HRQoL was found in the VAS scores and in the anxiety/depression dimension over time. In regression models, HRQoL was primarily predicted by earlier life events, symptoms of post-traumatic stress disorder, and HRQoL, assessed during the patients’ hospitalization. In summary, HRQoL assessed with VAS scores increased slightly during the first year postburn, and early screening for life events and psychological symptoms, and HRQoL might be useful in identifying family members in need of support.

Keywords
burns, family members, injury, health related quality of life, rehabilitation
National Category
Psychiatry Surgery Nursing
Research subject
Psychiatry; Caring Sciences in Medical Sciences
Identifiers
urn:nbn:se:uu:diva-208623 (URN)10.1097/BCR.0b013e318295744e (DOI)000335394600015 ()
Available from: 2013-10-06 Created: 2013-10-06 Last updated: 2017-12-06Bibliographically approved
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