{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T01:22:01Z","timestamp":1790904121881,"version":"4.1.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Freiburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Sarcoidosis is granulomatous disease of unknown origin affecting organ function and quality of life. The King\u2019s Sarcoidosis Questionnaire (KSQ) serves as a tool to assess quality of life in sarcoidosis patients with general health and organ specific domains. A German translation has been validated in a German cohort. In this study we assessed, whether clinical parameters influence KSQ scores.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Clinical data (e.g. lung function, organ impairment, serological parameters) for the German validation cohort were extracted from clinical charts and investigated by correlation and linear regression analyses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>KSQ subdomain scores were generally lower in patients with respective organ manifestation or on current therapy. LUNG subdomain was significantly predicted by lung functional parameters, however for general health status, only FeV1 exerted significant influence. GHS was not influenced by serological parameters, but was significantly negatively correlated with body mass index (BMI). KSQ provides additional information beyond lung function, clinical or serological parameters in sarcoidosis patients. Notably, high BMI is significantly negatively associated with patients\u2019 well-being as measured by KSQ-GHS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This observation may direct further studies investigating the effect of obesity on sarcoidosis-related quality of life and strategies to intervene with steroid-sparing therapies and measures of life style modifications.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic> This study was registered in the German Clinical Trials Register (reference number\u00a0DRKS00010072). Registered January 2016.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12890-021-01761-7","type":"journal-article","created":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T19:02:42Z","timestamp":1638558162000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["FeV1 and BMI influence King\u2019s Sarcoidosis Questionnaire score in sarcoidosis patients"],"prefix":"10.1186","volume":"21","author":[{"given":"Bj\u00f6rn Christian","family":"Frye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Potasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Farin-Glattacker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surrinder","family":"Birring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"M\u00fcller-Quernheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Christian","family":"Schupp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,3]]},"reference":[{"issue":"1","key":"1761_CR1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41572-019-0096-x","volume":"5","author":"J Grunewald","year":"2019","unstructured":"Grunewald J, Grutters JC, Arkema EV, Saketkoo LA, Moller DR, Muller-Quernheim J. Sarcoidosis. Nat Rev Dis Primers. 2019;5(1):45.","journal-title":"Nat Rev Dis Primers"},{"issue":"9923","key":"1761_CR2","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1016\/S0140-6736(13)60680-7","volume":"383","author":"D Valeyre","year":"2014","unstructured":"Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Muller-Quernheim J. Sarcoidosis. Lancet. 2014;383(9923):1155\u201367.","journal-title":"Lancet"},{"issue":"4","key":"1761_CR3","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1055\/s-0037-1602589","volume":"38","author":"MA Judson","year":"2017","unstructured":"Judson MA. Quality of life in sarcoidosis. Semin Respir Crit Care Med. 2017;38(4):546\u201358.","journal-title":"Semin Respir Crit Care Med"},{"issue":"5","key":"1761_CR4","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1097\/MCP.0000000000000079","volume":"20","author":"IH Korenromp","year":"2014","unstructured":"Korenromp IH, van de Laar MA. Health-related quality of life in sarcoidosis. Curr Opin Pulm Med. 2014;20(5):503\u20137.","journal-title":"Curr Opin Pulm Med"},{"issue":"7","key":"1761_CR5","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1164\/rccm.200603-402OC","volume":"174","author":"RP Baughman","year":"2006","unstructured":"Baughman RP, Drent M, Kavuru M, Judson MA, Costabel U, du Bois R, et al. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med. 2006;174(7):795\u2013802.","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"1761_CR6","first-page":"90","volume":"29","author":"RP Baughman","year":"2012","unstructured":"Baughman RP, Drent M, Culver DA, Grutters JC, Handa T, Humbert M, et al. Endpoints for clinical trials of sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2012;29(2):90\u20138.","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"issue":"1","key":"1761_CR7","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1136\/thoraxjnl-2012-201962","volume":"68","author":"AS Patel","year":"2013","unstructured":"Patel AS, Siegert RJ, Creamer D, Larkin G, Maher TM, Renzoni EA, et al. The development and validation of the King\u2019s Sarcoidosis Questionnaire for the assessment of health status. Thorax. 2013;68(1):57\u201365.","journal-title":"Thorax"},{"issue":"1","key":"1761_CR8","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s12955-019-1131-z","volume":"17","author":"E Farin","year":"2019","unstructured":"Farin E, Heyduck K, Frye BC, Birring SS, Muller-Quernheim J, Schupp JC. Translation and psychometric properties of the King\u2019s Sarcoidosis Questionnaire (KSQ) in German language. Health Qual Life Outcomes. 2019;17(1):62.","journal-title":"Health Qual Life Outcomes"},{"issue":"1","key":"1761_CR9","first-page":"75","volume":"33","author":"MJ Van Manen","year":"2016","unstructured":"Van Manen MJ, Wapenaar M, Strookappe B, Drent M, Elfferich M, de Vries J, et al. Validation of the King\u2019s Sarcoidosis Questionnaire (KSQ) in a Dutch sarcoidosis population. Sarcoidosis Vasc Diffuse Lung Dis. 2016;33(1):75\u201382.","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"issue":"10","key":"1761_CR10","doi-asserted-by":"publisher","first-page":"e0205308","DOI":"10.1371\/journal.pone.0205308","volume":"13","author":"JC Schupp","year":"2018","unstructured":"Schupp JC, Fichtner UA, Frye BC, Heyduck-Weides K, Birring SS, Windisch W, et al. Psychometric properties of the German version of the Leicester Cough Questionnaire in sarcoidosis. PLoS ONE. 2018;13(10):e0205308.","journal-title":"PLoS ONE"},{"key":"1761_CR11","unstructured":"R Core Development Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria 2019."},{"key":"1761_CR12","unstructured":"Hair JFj, Anderson RE, Tatham RL, Black WC. Multivariate data analysis (3rd Edition). New York: MacMillan. 1995."},{"key":"1761_CR13","unstructured":"Schupp JC, Freitag-Wolf S, Bargagli E, Mihailovic-Vucinic V, Rottoli P, Grubanovic A, et al. Phenotypes of organ involvement in sarcoidosis. Eur Respir J. 2018;51(1)."},{"issue":"5","key":"1761_CR14","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/S2213-2600(18)30064-X","volume":"6","author":"P Spagnolo","year":"2018","unstructured":"Spagnolo P, Rossi G, Trisolini R, Sverzellati N, Baughman RP, Wells AU. Pulmonary sarcoidosis. Lancet Respir Med. 2018;6(5):389\u2013402.","journal-title":"Lancet Respir Med"},{"issue":"1","key":"1761_CR15","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1183\/09031936.00002512","volume":"40","author":"M Drent","year":"2012","unstructured":"Drent M, Lower EE, De Vries J. Sarcoidosis-associated fatigue. Eur Respir J. 2012;40(1):255\u201363.","journal-title":"Eur Respir J"},{"issue":"5","key":"1761_CR16","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1097\/MCP.0000000000000496","volume":"24","author":"C Hendriks","year":"2018","unstructured":"Hendriks C, Drent M, Elfferich M, De Vries J. The Fatigue Assessment Scale: quality and availability in sarcoidosis and other diseases. Curr Opin Pulm Med. 2018;24(5):495\u2013503.","journal-title":"Curr Opin Pulm Med"},{"issue":"1","key":"1761_CR17","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.semarthrit.2017.02.004","volume":"47","author":"Y Zhou","year":"2017","unstructured":"Zhou Y, Lower EE, Li H, Farhey Y, Baughman RP. Clinical characteristics of patients with bone sarcoidosis. Semin Arthritis Rheum. 2017;47(1):143\u20138.","journal-title":"Semin Arthritis Rheum"},{"issue":"2","key":"1761_CR18","first-page":"139","volume":"26","author":"H Biller","year":"2009","unstructured":"Biller H, Ruprecht B, Gaede KI, Muller-Quernheim J, Zissel G. Gene polymorphisms of ACE and the angiotensin receptor AT2R1 influence serum ACE levels in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2009;26(2):139\u201346.","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"issue":"7","key":"1761_CR19","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1055\/s-2001-15616","volume":"55","author":"B Ruprecht","year":"2001","unstructured":"Ruprecht B, Schurmann M, Ziegenhagen MW, vom Bauer E, Meier D, Schlaak M, et al. Corrected normal values for serum ACE by genotyping the deletion-\/insertion-polymorphism of the ACE gene. Pneumologie. 2001;55(7):326\u201332.","journal-title":"Pneumologie"},{"issue":"3","key":"1761_CR20","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1016\/j.rmed.2006.06.025","volume":"101","author":"A Kruit","year":"2007","unstructured":"Kruit A, Grutters JC, Gerritsen WB, Kos S, Wodzig WK, van den Bosch JM, et al. ACE I\/D-corrected Z-scores to identify normal and elevated ACE activity in sarcoidosis. Respir Med. 2007;101(3):510\u20135.","journal-title":"Respir Med"},{"issue":"3","key":"1761_CR21","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1183\/09031936.03.00010403","volume":"21","author":"MW Ziegenhagen","year":"2003","unstructured":"Ziegenhagen MW, Rothe ME, Schlaak M, Muller-Quernheim J. Bronchoalveolar and serological parameters reflecting the severity of sarcoidosis. Eur Respir J. 2003;21(3):407\u201313.","journal-title":"Eur Respir J"},{"issue":"3","key":"1761_CR22","first-page":"185","volume":"19","author":"MW Ziegenhagen","year":"2002","unstructured":"Ziegenhagen MW, Rothe ME, Zissel G, Muller-Quernheim J. Exaggerated TNFalpha release of alveolar macrophages in corticosteroid resistant sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2002;19(3):185\u201390.","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"issue":"7","key":"1761_CR23","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1007\/s00259-009-1097-x","volume":"36","author":"RG Keijsers","year":"2009","unstructured":"Keijsers RG, Verzijlbergen FJ, Oyen WJ, van den Bosch JM, Ruven HJ, van Velzen-Blad H, et al. 18F-FDG PET, genotype-corrected ACE and sIL-2R in newly diagnosed sarcoidosis. Eur J Nucl Med Mol Imaging. 2009;36(7):1131\u20137.","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"2","key":"1761_CR24","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.rmed.2014.11.009","volume":"109","author":"AD Vorselaars","year":"2015","unstructured":"Vorselaars AD, van Moorsel CH, Zanen P, Ruven HJ, Claessen AM, van Velzen-Blad H, et al. ACE and sIL-2R correlate with lung function improvement in sarcoidosis during methotrexate therapy. Respir Med. 2015;109(2):279\u201385.","journal-title":"Respir Med"},{"issue":"1","key":"1761_CR25","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1097\/RLU.0b013e3182335f9b","volume":"37","author":"RL Mostard","year":"2012","unstructured":"Mostard RL, Prompers L, Weijers RE, van Kroonenburgh MJ, Wijnen PA, Geusens PP, et al. F-18 FDG PET\/CT for detecting bone and bone marrow involvement in sarcoidosis patients. Clin Nucl Med. 2012;37(1):21\u20135.","journal-title":"Clin Nucl Med"},{"issue":"2","key":"1761_CR26","first-page":"47","volume":"48","author":"J Muller-Quernheim","year":"1994","unstructured":"Muller-Quernheim J. Monitoring sarcoidosis therapy with immunopathologic parameters. Pneumologie. 1994;48(2):47\u20139.","journal-title":"Pneumologie"},{"issue":"5","key":"1761_CR27","doi-asserted-by":"publisher","first-page":"2007","DOI":"10.1016\/j.chest.2020.04.074","volume":"158","author":"V Kouranos","year":"2020","unstructured":"Kouranos V, Ward S, Kokosi MA, Castillo D, Chua F, Judge EP, et al. Mixed ventilatory defects in pulmonary sarcoidosis: prevalence and clinical features. Chest. 2020;158(5):2007\u201314.","journal-title":"Chest"},{"issue":"3","key":"1761_CR28","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1513\/AnnalsATS.202006-607OC","volume":"18","author":"RP Baughman","year":"2021","unstructured":"Baughman RP, Judson MA, Beaumont JL, Maier LA, Sweiss NJ, Culver DA, et al. Evaluating the minimal clinically important difference of the King\u2019s Sarcoidosis Questionnaire in a Multicenter Prospective Study. Ann Am Thorac Soc. 2021;18(3):477\u201385.","journal-title":"Ann Am Thorac Soc"},{"issue":"4","key":"1761_CR29","first-page":"289","volume":"30","author":"JP Cremers","year":"2013","unstructured":"Cremers JP, Drent M, Elfferich MD, Nelemans PJ, Wijnen PA, Witteman BJ, et al. Body composition profiling in a Dutch sarcoidosis population. Sarcoidosis Vasc Diffuse Lung Dis. 2013;30(4):289\u201399.","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"issue":"4","key":"1761_CR30","doi-asserted-by":"publisher","first-page":"559","DOI":"10.5588\/ijtld.12.0665","volume":"17","author":"BS Gvozdenovic","year":"2013","unstructured":"Gvozdenovic BS, Mihailovic-Vucinic V, Vukovic M, Lower EE, Baughman RP, Dudvarski-Ilic A, et al. Effect of obesity on patient-reported outcomes in sarcoidosis. Int J Tuberc Lung Dis. 2013;17(4):559\u201364.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"15\u201316","key":"1761_CR31","doi-asserted-by":"publisher","first-page":"2376","DOI":"10.1111\/jocn.12490","volume":"23","author":"LN Saligan","year":"2014","unstructured":"Saligan LN. The relationship between physical activity, functional performance and fatigue in sarcoidosis. J Clin Nurs. 2014;23(15\u201316):2376\u20138.","journal-title":"J Clin Nurs"},{"issue":"5","key":"1761_CR32","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1177\/2047487313492631","volume":"20","author":"D Canoy","year":"2013","unstructured":"Canoy D, Cairns BJ, Balkwill A, Wright FL, Green J, Reeves G, et al. Coronary heart disease incidence in women by waist circumference within categories of body mass index. Eur J Prev Cardiol. 2013;20(5):759\u201362.","journal-title":"Eur J Prev Cardiol"},{"issue":"6","key":"1761_CR33","doi-asserted-by":"publisher","first-page":"3870","DOI":"10.1378\/chest.128.6.3870","volume":"128","author":"H El-Gamal","year":"2005","unstructured":"El-Gamal H, Khayat A, Shikora S, Unterborn JN. Relationship of dyspnea to respiratory drive and pulmonary function tests in obese patients before and after weight loss. Chest. 2005;128(6):3870\u20134.","journal-title":"Chest"},{"key":"1761_CR34","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.rmed.2017.09.003","volume":"132","author":"NA Khan","year":"2017","unstructured":"Khan NA, Donatelli CV, Tonelli AR, Wiesen J, Ribeiro Neto ML, Sahoo D, et al. Toxicity risk from glucocorticoids in sarcoidosis patients. Respir Med. 2017;132:9\u201314.","journal-title":"Respir Med"},{"key":"1761_CR35","doi-asserted-by":"publisher","first-page":"2509","DOI":"10.3389\/fimmu.2018.02509","volume":"9","author":"Q Wang","year":"2018","unstructured":"Wang Q, Wu H. T cells in adipose tissue: critical players in immunometabolism. Front Immunol. 2018;9:2509.","journal-title":"Front Immunol"},{"issue":"8","key":"1761_CR36","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.tem.2012.05.011","volume":"23","author":"HS Schipper","year":"2012","unstructured":"Schipper HS, Prakken B, Kalkhoven E, Boes M. Adipose tissue-resident immune cells: key players in immunometabolism. Trends Endocrinol Metab. 2012;23(8):407\u201315.","journal-title":"Trends Endocrinol Metab"},{"issue":"12","key":"1761_CR37","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1038\/s41591-019-0675-0","volume":"25","author":"D Furman","year":"2019","unstructured":"Furman D, Campisi J, Verdin E, Carrera-Bastos P, Targ S, Franceschi C, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822\u201332.","journal-title":"Nat Med"},{"issue":"3","key":"1761_CR38","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1093\/ije\/dyu045","volume":"43","author":"MC Harpsoe","year":"2014","unstructured":"Harpsoe MC, Basit S, Andersson M, Nielsen NM, Frisch M, Wohlfahrt J, et al. Body mass index and risk of autoimmune diseases: a study within the Danish National Birth Cohort. Int J Epidemiol. 2014;43(3):843\u201355.","journal-title":"Int J Epidemiol"},{"key":"1761_CR39","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.rmed.2016.10.003","volume":"120","author":"P Ungprasert","year":"2016","unstructured":"Ungprasert P, Crowson CS, Matteson EL. Smoking, obesity and risk of sarcoidosis: a population-based nested case-control study. Respir Med. 2016;120:87\u201390.","journal-title":"Respir Med"},{"issue":"26","key":"1761_CR40","doi-asserted-by":"publisher","first-page":"2541","DOI":"10.1056\/NEJMra1905136","volume":"381","author":"R de Cabo","year":"2019","unstructured":"de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med. 2019;381(26):2541\u201351.","journal-title":"N Engl J Med"},{"key":"1761_CR41","doi-asserted-by":"crossref","unstructured":"Weindruch R, Sohal RS. Seminars in medicine of the Beth Israel Deaconess Medical Center. Caloric intake and aging. N Engl J Med. 1997;337(14):986\u201394.","DOI":"10.1056\/NEJM199710023371407"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-021-01761-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-021-01761-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-021-01761-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T19:02:53Z","timestamp":1638558173000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/s12890-021-01761-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1761"],"URL":"https:\/\/doi.org\/10.1186\/s12890-021-01761-7","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"17 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the local Ethics Committee of the University of Freiburg and data collection and handling followed the rules of \u201cGood clinical Practice\u201d according to the declaration of Helsinki and regulations concerning data handling.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Institutional review board"}},{"value":"All patients gave informed consent to participation at this study and to data handling and data analysis including publication. All authors approved the final version of the manuscript and agreed to publishing.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent\/consent for publication"}},{"value":"BCF indicates personal fees (speaking and consulting fees) within the last three years from Actelion, AdVita, Astra Zeneca, Boehringer Ingelheim, Novartis and Roche. BCF is co-founder of Advita Lifescience GmbH. LP has nothing to disclose. EF has nothing to disclose.SB indicates fees to King\u2019s Colleges Hospital from Atyr and Actelion for use of KS . JMQ has nothing to disclose. JCS has nothing to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"395"}}