Dr. Anne-Kathrin Tausche

Focus on interdisciplinary questions of Internal medicine – from the theory to the practical use

Previous and current research

1. Chronic ulceration of the legs is a common problem in modern health care. In western societies the prevalence of leg ulcers reaches 1% whereas the prevalence of venous leg ulcers ranges from 0,1 to 2%. For recalcitrant ulcers the current invasive treatment of choice is meshed split-thickness skin auto graft (mesh graft). This procedure usually requires hospitalization and has the disadvantage of morbidity at the donor sites. Therefore we desperately search for effective alternatives. In this context tissue engineering methods offer promising perspectives. The outer root sheath (ORS) of hair follicles plays an important role in epidermal regeneration in vivo. Keratinocytes isolated by explantation of ORS-tissue have extensive proliferative capacity irrespective of donor age, which probably depends on pluripotent epithelial stem cells residing in the ORS. These keratinocytes can be organotypically grown to epidermal equivalents in vitro. In a multicenter, randomizid phase II study we have recently demonstrated, that a fully differentiated autologous epidermal equivalent derived from this keratinocytes is as effective as split-thickness skin autografting in the promotion of healing and complete closure of recalcitrant vascular leg ulcers.

2. In our modern affluent society hyperuricemia is one of the most frequent metabolic disturbances. So far, every fourth man and every tenth woman suffer from an asymptomatic or a symptomatic hyperuricemia named gout. Mostly, overnutrition and malnutrition together with other secondary factors such as a genetically determined renal secretion disturbance of uric acid lead to an increase of serum uric acid. The deposition of uric acid crystals in tissues with intermittent immunologic activation of inflammatory cells favour an acute manifestation of gout. The clinical image of this disease varies widely. It may manifest as acute or chronic arthritis, tophi on the skin, subcutaneous tissue and the skeletal system as well as urate nephropathy. To eliminate the consequences of chronic hyperuricemia (apart from a thorough anamnesis of nutritional habits) a examination of general metabolic parameters is of paramount interest. In this scenario one should consider a metabolic syndrome and additional causes for a secondary hyperuricemia. Nevertheless gout is very often primarily caused by a renal secretion disturbance of the uric acid we recommend a special focusing diagnostics.

Future prospects and goals

• Based on our previous experiences we are seeking to expand the indications of tissue engineering products, especially in the demanding clinical context of chronic ulcerations (diabetes and other conditions as in autoimmune diseases, e.g. systemic sclerosis). These conditions carry inherent limitations for invasive operative procedures, such as mesh grafting, because of the problems of donor sites (skin sclerosis in scleroderma, infections in diabetes).

• As gout is very often primarily caused by a renal secretion disturbance of uric acid special diagnostics should be advocated. We are interested in the molecular mechanism of urate excretion and because of our existing register with more than 700 patients with primary gout and well defined “gout-families” we hopefully will be able to analyse defects in genes.

Selected publications

1. Tausche AK, Meurer M (2001): Mycophenolate Mofetil for Dermatomyositis. Dermatology 202:341-343.
2. Tausche AK, Skaria M, Böhlen L, Liebold K, Hafner J, Friedlein H, Meurer M, Goedkoop RJ, Wollina U, Salomon D, Hunziker T (2003): An autologous epidermal equivalent tissue-engineered from follicular outer root sheath keratinocytes is as effective as split-thickness skin autograft in recalcitrant vascular leg ulcers. Wound Repair Regen. 11:248-52.
3. Tausche AK, Richter-Huhn G, Sebastian G (2004): Treatment of recalcitrant wounds with autologous epidermal equivalents. After excision of multiple cylindromas of the scalp. Hautarzt. 55:296-300.
4. Tausche AK, Richter K, Grässler A, Hänsel S, Roch B, Schröder HE (2004): Severe gouty arthritis
   

Curriculum vitae

1996: MD at the University of Dresden

1997-1998: Resident at the Clinic of Dermatology, Ludwig Maximilian University Munich

1998-2002: Resident at the Clinic of Dermatology, University Clinic of Dresden

2002: Specialization as Dermatologist

Since 2002: Resident of the Clinic for Internal Medicine, Medical Clinic III, Department of Rheumatology