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Sansen PY, Coche E, Hainaut P, Froidure A, Scohy A, Ghaye B, Belkhir L, De Greef J. Secondary organizing pneumonia associated with protracted COVID: A case series. Infect Dis Now 2024; 54:104888. [PMID: 38494118 DOI: 10.1016/j.idnow.2024.104888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/01/2024] [Accepted: 03/13/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES Immunocompromised B-cell-depleted patients are at risk of developing protracted COVID-19, a clinical syndrome characterized by prolonged viral shedding and respiratory symptoms that can lead to hypoxemic pneumonia. Our aim is to describe this unusual condition and its treatment. PATIENTS AND METHODS This monocentric retrospective study reports six cases of severe organizing pneumonia that developed during the clinical course of protracted COVID-19. RESULTS All patients developed organizing pneumonia (OP) in the setting of protracted COVID. Clinical improvement was obtained after several treatment lines including specific antiviral agents and occurred simultaneously with control of the viral load. CONCLUSION As it was the most frequent presentation of protracted COVID-19 in our survey, we believe that this specific form of organizing pneumonia warrants increased awareness. Furthermore, specific antiviral therapy seems to control this condition.
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Affiliation(s)
- P-Y Sansen
- Service de Médecine interne et Maladies Infectieuses, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.
| | - E Coche
- Service de Radiologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - P Hainaut
- Service de Médecine interne et Maladies Infectieuses, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Froidure
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Scohy
- Service de Microbiologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - B Ghaye
- Service de Radiologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - L Belkhir
- Service de Médecine interne et Maladies Infectieuses, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - J De Greef
- Service de Médecine interne et Maladies Infectieuses, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Froidure A, Bondue B, Dahlqvist C, Guiot J, Gusbin N, Wirtz G, Brusselle G, Strens D, Slabbynck H, Wuyts WA. Clinical course of suspected familial and sporadic idiopathic pulmonary fibrosis: Data from the PROOF-Next registry. Respirology 2024; 29:304-311. [PMID: 38123492 DOI: 10.1111/resp.14650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND OBJECTIVE Real-life data on suspected familial fibrosis, defined as the occurrence of the disease in a patient younger than 50 and/or having at least one relative affected by pulmonary fibrosis remain scarce. METHODS The Belgian and Luxembourg IPF registry (PROOF-Next) is a multicentric prospective longitudinal and observational study set in Belgium and Luxembourg. We compared characteristics and clinical course of patients with suspected familial pulmonary fibrosis (FPF) and sporadic IPF. RESULTS We included 618 patients in the analysis, of whom 76 (12%) fulfilled criteria for FPF. They were significantly younger than sIPF (median age (range) 65 (43-87), vs. 72 (51-98), p = 0.0001). Male gender proportion and smoking status did not differ between groups, but the number of pack-year among current and former smokers was lower in FPF (20 vs. 25, p = 0.02). Besides, 87% of FPF and 76% of sIPF were treated with antifibrotic (p = 0.047). Baseline pulmonary function tests were similar in both groups, as well as median time before progression and transplant-free survival. Finally, genetic testing, performed in a minority, led to the identification of 10 telomerase-related gene variants. CONCLUSION Although younger and exposed to less tobacco, patients with FPF show an equally aggressive progression as observed in sporadic IPF patients. These results warrant early referral of FPF patients to expert centres for optimal management.
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Affiliation(s)
- Antoine Froidure
- Pulmonology Department, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
- European Reference Network for Rare Pulmonary Diseases (ERN-LUNG)
| | - Benjamin Bondue
- European Reference Network for Rare Pulmonary Diseases (ERN-LUNG)
- Pulmonology Department, Hôpital Erasme, Bruxelles, Belgium
| | | | - Julien Guiot
- Pulmonology Department, CHU Liège, Liège, Belgium
| | | | - Gil Wirtz
- Pulmonology Department, CHL Luxembourg, Luxembourg, Luxembourg
| | - Guy Brusselle
- European Reference Network for Rare Pulmonary Diseases (ERN-LUNG)
- Pulmonology Department, Ghent University Hospital, Gent, Belgium
| | | | - Hans Slabbynck
- Pulmonology Department, ZNA Middelheim, Antwerpen, Belgium
| | - Wim A Wuyts
- European Reference Network for Rare Pulmonary Diseases (ERN-LUNG)
- Pulmonology Department, UZ Leuven, Leuven, Belgium
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Sánchez-Montalvo A, Lecocq M, Bouillet E, Steelant B, Gohy S, Froidure A, Bullens D, Pilette C, Hox V. Validation and shortcomings of the most common mouse model of chronic rhinosinusitis with nasal polyps. Rhinology 2024; 0:3167. [PMID: 38497676 DOI: 10.4193/rhin23.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a highly prevalent airway disease worldwide. Whereas eosinophilic CRS with nasal polyps (eCRSwNP) represents its most severe phenotype, pathogenic mechanisms remain poorly understood despite a wide spectrum of in vitro and in vivo experimental models. A mouse model of experimental ovalbumin (OVA)-induced airway allergy with coadministration of Staphylococcus aureus enterotoxin B (SEB) has been widely used to study eosinophilic eCRSwNP. This study revisits the features of this model and its suitability for studying eCRS. METHODOLOGY We implemented the most used eCRSwNP mouse model based on OVA+SEB intranasal challenges. Readouts including inflammatory features by (immuno)histology of the sinonasal epithelium (NP formation, eosinophils, epithelial and basement membrane thickness, fibrosis, goblet cells, Charcot-Leyden crystals (CLC)-like, tight junctions) and IgE production by enzyme-linked immunosorbent assay (ELISA), were compared to features of the corresponding human disease. RESULTS The OVA+SEB model induced eosinophilic inflammation of upper and lower airways, with epithelial and basement membrane thickening, goblet cell hyperplasia and subepithelial fibrosis in the sinuses, along increased IgE production. Except local IgE in nasal lavage (NL), which was only increased in OVA+SEB group, all other features did not differ between OVA and OVA+SEB groups. Macro- or microscopic NP were not detected. CONCLUSIONS With the notable exception of local IgE production, the addition of SEB did not induce additional inflammatory or structural change in the sinuses from mice exposed to and challenged with OVA. This model might represent a model for severe upper airway allergy rather than a specific model of human eCRSwNP.
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Affiliation(s)
- A Sánchez-Montalvo
- Pole of Pneumology, ORL (airways) and Dermatology (skin) (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
- Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KULeuven, Leuven, Belgium
| | - M Lecocq
- Pole of Pneumology, ORL (airways) and Dermatology (skin) (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - E Bouillet
- Pole of Pneumology, ORL (airways) and Dermatology (skin) (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - B Steelant
- Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KULeuven, Leuven, Belgium
| | - S Gohy
- Pole of Pneumology, ORL (airways) and Dermatology (skin) (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
- Department of Pneumology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Cystic Fibrosis Reference Centre, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - A Froidure
- Pole of Pneumology, ORL (airways) and Dermatology (skin) (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
- Department of Pneumology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - D Bullens
- Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KULeuven, Leuven, Belgium
- Clinical Division of Paediatrics, UZ Leuven, Leuven, Belgium
| | - C Pilette
- Pole of Pneumology, ORL (airways) and Dermatology (skin) (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
- Department of Pneumology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - V Hox
- Pole of Pneumology, ORL (airways) and Dermatology (skin) (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Fabbri L, Guiot J, Vermant M, Miądlikowska E, Estrella D, Wijsenbeek MS, Wuyts W, Bargagli E, Froidure A, Spagnolo P, Veltkamp M, Molina-Molina M, McCarthy C, Antoniou K, Kreuter M, Moor CC. ERS International Congress 2023: highlights from the Interstitial Lung Diseases Assembly. ERJ Open Res 2024; 10:00839-2023. [PMID: 38529351 PMCID: PMC10962449 DOI: 10.1183/23120541.00839-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 03/27/2024] Open
Abstract
This article summarises a selection of scientific highlights in the field of interstitial lung diseases (ILDs) presented at the International Congress of the European Respiratory Society in 2023. Translational and clinical studies focused on the whole spectrum of ILDs, from (ultra)rare ILDs to sarcoidosis, ILDs associated with connective tissue disease and idiopathic pulmonary fibrosis. The main topics of the 2023 Congress presentations were improving the diagnostic process of ILDs, better prediction of disease course and investigation of novel treatment options.
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Affiliation(s)
- Laura Fabbri
- Margaret Turner Warwick Centre for Fibrosing Lung Diseases, NHLI, Imperial College, London, UK
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
| | - Julien Guiot
- Department of Respiratory Medicine, University Hospital of Liège, Liège, Belgium
- GIGA I3 Research Group, Laboratory of Respiratory Medicine, Vascular and Interstitial Lung Disease Unit and Fibropole Research Group, University of Liège, Liège, Belgium
| | - Marie Vermant
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Ewa Miądlikowska
- Department of Pneumology, Medical University of Lodz, Lodz, Poland
| | - Deborah Estrella
- Hospital das Clínicas, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Marlies S. Wijsenbeek
- Centre for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Wim Wuyts
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Elena Bargagli
- Respiratory Diseases Unit, Department Medical Sciences, Surgery and Neurological Sciences, Siena University, Siena, Italy
| | - Antoine Froidure
- Pulmonology Department, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Marcel Veltkamp
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
- Division of Heart and Lungs, University Medical Center, Utrecht, The Netherlands
| | - Maria Molina-Molina
- ILD Unit, Respiratory Department, University Hospital of Bellvitge, IDIBELL, CIBERES, Barcelona, Spain
| | - Cormac McCarthy
- UCD School of Medicine, Education and Research Centre, St Vincent's University Hospital, Dublin, Ireland
| | - Katerina Antoniou
- Laboratory of Molecular and Cellular Pneumonology, Dept of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Michael Kreuter
- Mainz Center for Pulmonary Medicine, Department of Pneumology, ZfT, Mainz University Medical Center and Department of Pulmonary, Critical Care and Sleep Medicine, Marienhaus Clinic Mainz, Mainz, Germany
| | - Catharina C. Moor
- Centre for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Hollmen M, Wijsenbeek M, Bromilow T, Smith AB, Mealing S, Lewis D, Galvin L, Jones S, Asijee G, Soulard S, Froidure A. I-PreFer Study: A Discrete Choice Experiment to Explore Patient, Caregiver and Pulmonologist Preferences of Idiopathic Pulmonary Fibrosis Pharmacological Treatment Options. Patient Prefer Adherence 2023; 17:1895-1906. [PMID: 37560147 PMCID: PMC10408660 DOI: 10.2147/ppa.s409767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/05/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and ultimately fatal lung disease that, while rare, has seen incidence rise over time. There is no cure for IPF other than a lung transplant, though two antifibrotic (AF) drugs do exist to slow disease progression. While these drugs are efficacious, they are both associated with differing profiles of adverse events. This study aimed to elicit patient, caregiver and pulmonologist preferences on the treatment profiles of AFs via a discrete choice experiment (DCE). PATIENTS AND METHODS The DCE and associated survey were distributed across 7 European countries, and bespoke DCEs were developed for patients/caregivers and pulmonologists. After collaboration with European Pulmonary Fibrosis & Related Disorders Federation (EU-PFF) and expert pulmonologists, respectively, a patient/caregiver DCE with 5 attributes and a pulmonologist DCE with 6 attributes were finalized. The DCEs had a blocked approach to reduce participant burden and were distributed on an online survey platform. Preferences were estimated through conditional multinomial logit regression analysis. RESULTS Ninety-five patients, 22 caregivers and 115 pulmonologists fully completed their respective DCEs. Overall, patients and caregivers preferred management of treatment-related adverse events over both survival benefits and disease progression. Nearly all preference levels were found to be significantly different from their reference level. In contrast, pulmonologists showed a greater preference for control of lung function and exacerbations over adverse events. Although there were relative differences between the univariate subgroups in terms of the preference weights, most of these were not statistically significant. CONCLUSION The outcomes from this study suggest that while patients and caregivers had similar preferences for characteristics of IPF treatments, pulmonologists did not share those same preferences. Patients and caregivers preferred safety, while pulmonologists preferred efficacy. These differences should be considered by clinicians to better involve the patient in treatment decision-making for IPF.
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Affiliation(s)
- Maria Hollmen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marlies Wijsenbeek
- Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Tom Bromilow
- York Health Economics Consortium (YHEC), York, UK
| | - Adam B Smith
- York Health Economics Consortium (YHEC), York, UK
| | | | - Damian Lewis
- York Health Economics Consortium (YHEC), York, UK
| | - Liam Galvin
- European Pulmonary Fibrosis & Related Disorders Federation, Overijse, Belgium
| | - Steve Jones
- European Pulmonary Fibrosis & Related Disorders Federation, Overijse, Belgium
| | - Guus Asijee
- Boehringer Ingelheim, Amsterdam, the Netherlands
| | | | - Antoine Froidure
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Belgium
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Hollmen M, Bromilow T, Smith AB, Mealing S, Lewis D, Galvin L, Jones S, Pacheco L, Soulard S, Froidure A. I-PreFer Study: A Questionnaire to Explore Patient, Caregiver and Pulmonologist Preferences of Idiopathic Pulmonary Fibrosis Treatment Options. Patient Prefer Adherence 2023; 17:1621-1639. [PMID: 37560148 PMCID: PMC10408661 DOI: 10.2147/ppa.s408857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/19/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Idiopathic Pulmonary Fibrosis (IPF) is a rare disease that causes shortness of breath, dry cough, and tiredness. While there is no cure for IPF, current therapeutic treatments aim to slow lung degeneration while managing side effects. There is little known about patient experience and attitude with regards to their disease and medication. PURPOSE To understand the perceptions, behaviors and drivers of treatment decision-making among patients, caregivers and pulmonologists in IPF. PATIENTS AND METHODS Online surveys to patients with IPF, caregivers and pulmonologists were developed and administered in Belgium, Finland, France, Greece (pulmonologists only), the Netherlands, Ireland and the United Kingdom between November 2021 and January 2022. RESULTS A total of 111 patients, 22 caregivers and 140 pulmonologists participated. Half (47%) of patients rated their disease as "severe", while pulmonologists reported that a quarter of their patients had a low Forced Vital Capacity (FVC) (below 50% of the predicted value). Between 21% and 42% of the patients do not take an IPF medication (patients' perception) or antifibrotic (physicians' perception). Pulmonologists reported that a total of 58% of their patients were receiving antifibrotic medication, any IPF medication, while around 53%, 55%, 35% and 73% of the patients limited their exposure (sometimes or often) to the sun due to IPF, considered taking medication against diarrhea, nausea/vomiting and heartburn, respectively. Treatment adherence was relatively high (81%), in line with the caregivers' view and the pulmonologists' expectations. Overall, cultural, clinical or socio-demographic factors impacted patients' perceptions or behaviors. CONCLUSION This study shows there is a significant proportion of IPF patients who remain untreated, a misalignment of disease severity between patients and their physicians and patient background impacts behavior. Overall, more in-depth patient-physician communication is needed to improve treatment experience.
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Affiliation(s)
- Maria Hollmen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tom Bromilow
- York Health Economics Consortium (YHEC), York, UK
| | - Adam B Smith
- York Health Economics Consortium (YHEC), York, UK
| | | | - Damian Lewis
- York Health Economics Consortium (YHEC), York, UK
| | - Liam Galvin
- European Pulmonary Fibrosis & Related Disorders Federation, Overijse, Belgium
| | - Steve Jones
- European Pulmonary Fibrosis & Related Disorders Federation, Overijse, Belgium
| | - Luís Pacheco
- Boehringer Ingelheim, Amsterdam, the Netherlands
| | | | - Antoine Froidure
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
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Mauclet C, Dupont MV, Roelandt K, Regnier M, Delos M, Pirard L, Vander Borght T, Dahlqvist C, Froidure A, Rondelet B, Vanderick J, Remouchamps V, Duplaquet F, Ocak S. Treatment and Prognosis of Patients with Lung Cancer and Combined Interstitial Lung Disease. Cancers (Basel) 2023; 15:3876. [PMID: 37568692 PMCID: PMC10417812 DOI: 10.3390/cancers15153876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Interstitial lung disease (ILD) is associated with a higher lung cancer (LC) risk and may impact cancer's clinical characteristics, treatment strategies, and outcomes. This impact's extent is unclear, particularly in Caucasians. METHODS In this retrospective observational study, we reviewed the files of all LC patients diagnosed in a 38-month period. Expert radiologists reviewed the computed tomography scans performed at diagnosis. Patients with LC and ILD (n = 29, 7%) were compared to those without ILD (n = 363, 93%) for population and cancer characteristics, treatments, and clinical outcomes. RESULTS Patients with LC and ILD were older (73 ± 8 vs. 65 ± 11 years; p < 0.001). There was no significant difference in LC histology, localization, stage, or treatment modalities. The respiratory complication rate after cancer treatment was significantly higher in the ILD group (39% vs. 6%; p < 0.01). Overall survival rates were similar at 12 (52% vs. 59%; p = 0.48) and 24 months (41% vs. 45%; p = 0.64) but poorer in the ILD group at 36 months, although not statistically significant (9% vs. 39%; p = 0.06). The ILD group had a higher probability of death (hazard ratio (HR) = 1.49 [0.96;2.27]), but this was not statistically significant (p = 0.06). In a Cox regression model, patients with ILD treated surgically had a significantly higher mortality risk (HR = 2.37 [1.1;5.09]; p = 0.03). CONCLUSIONS Patients with combined LC and ILD have worse clinical outcomes even when similar treatment modalities are offered.
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Affiliation(s)
- Charlotte Mauclet
- Division of Pulmonology, Clinique Saint-Luc Bouge, Rue Saint-Luc, 8, 5004 Namur, Belgium
| | - Michaël V. Dupont
- Division of Radiology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (M.V.D.); (K.R.)
| | - Kerwin Roelandt
- Division of Radiology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (M.V.D.); (K.R.)
| | - Maxime Regnier
- Scientific Support Unit, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium;
| | - Monique Delos
- Division of Pathology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium;
| | - Lionel Pirard
- Division of Pulmonology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (L.P.); (C.D.); (F.D.); (S.O.)
| | - Thierry Vander Borght
- Division of Nuclear Medicine, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium;
| | - Caroline Dahlqvist
- Division of Pulmonology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (L.P.); (C.D.); (F.D.); (S.O.)
| | - Antoine Froidure
- Division of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 10, 1200 Bruxelles, Belgium;
- Pole of Pulmonology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 55/B1.55.02, 1200 Bruxelles, Belgium
| | - Benoît Rondelet
- Division of Thoracic Surgery, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium;
| | - Jean Vanderick
- Division of Radiation Therapy, CHU UCL Namur (Sainte-Elisabeth Site), Université Catholique de Louvain (UCLouvain), Place Louise Godin, 15, 5000 Namur, Belgium; (J.V.); (V.R.)
| | - Vincent Remouchamps
- Division of Radiation Therapy, CHU UCL Namur (Sainte-Elisabeth Site), Université Catholique de Louvain (UCLouvain), Place Louise Godin, 15, 5000 Namur, Belgium; (J.V.); (V.R.)
| | - Fabrice Duplaquet
- Division of Pulmonology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (L.P.); (C.D.); (F.D.); (S.O.)
| | - Sebahat Ocak
- Division of Pulmonology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (L.P.); (C.D.); (F.D.); (S.O.)
- Pole of Pulmonology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 55/B1.55.02, 1200 Bruxelles, Belgium
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8
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Marchal-Duval E, Homps-Legrand M, Froidure A, Jaillet M, Ghanem M, Lou D, Justet A, Maurac A, Vadel A, Fortas E, Cazes A, Joannes A, Giersh L, Mal H, Mordant P, Piolot T, Truchin M, Mounier CM, Schirduan K, Korfei M, Gunther A, Mari B, Jaschinski F, Crestani B, Mailleux AA. Identification of paired-related Homeobox Protein 1 as a key mesenchymal transcription factor in pulmonary fibrosis. eLife 2023; 12:79840. [PMID: 37261432 DOI: 10.7554/elife.79840] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/31/2023] [Indexed: 06/02/2023] Open
Abstract
Matrix remodeling is a salient feature of idiopathic pulmonary fibrosis (IPF). Targeting cells driving matrix remodeling could be a promising avenue for IPF treatment. Analysis of transcriptomic database identified the mesenchymal transcription factor PRRX1 as upregulated in IPF. PRRX1, strongly expressed by lung fibroblasts, was regulated by a TGF-b/PGE2 balance in vitro in control and IPF human lung fibroblasts, while IPF fibroblast-derived matrix increased PRRX1 expression in a PDGFR dependent manner in control ones. PRRX1 inhibition decreased human lung fibroblast proliferation by downregulating the expression of S phase cyclins. PRRX1 inhibition also impacted TGF-β driven myofibroblastic differentiation by inhibiting SMAD2/3 phosphorylation through phosphatase PPM1A upregulation and TGFBR2 downregulation, leading to TGF-β response global decrease. Finally, targeted inhibition of Prrx1 attenuated fibrotic remodeling in vivo with intra-tracheal antisense oligonucleotides in bleomycin mouse model of lung fibrosis and ex vivo using human and mouse precision-cut lung slices. Our results identified PRRX1 as a key mesenchymal transcription factor during lung fibrogenesis.
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Affiliation(s)
- Emmeline Marchal-Duval
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Méline Homps-Legrand
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Antoine Froidure
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Madeleine Jaillet
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Mada Ghanem
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Deneuville Lou
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Aurélien Justet
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Arnaud Maurac
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Aurelie Vadel
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Emilie Fortas
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Aurelie Cazes
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Audrey Joannes
- Institut de recherche en santé, environnement et travail, Univ Rennes, Inserm, EHESP, Rennes, France
| | - Laura Giersh
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Herve Mal
- Service de Pneumologie et Transplantation, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Pierre Mordant
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
| | - Tristan Piolot
- Collège de France, CNRS-UMR7241, INSERM-U1050, PSL Research University,, Paris, France
| | | | | | | | - Martina Korfei
- Department of Internal Medicine II, University of Giessen, Gießen, Germany
| | - Andreas Gunther
- Department of Internal Medicine, University of Giessen, Gießen, Germany
| | | | | | - Bruno Crestani
- Service de Pneumologie, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Arnaud A Mailleux
- Physiopathologie et épidémiologie des maladies respiratoires, Université Paris Cité, Inserm, Paris, France
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9
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Borie R, Kannengiesser C, Antoniou K, Bonella F, Crestani B, Fabre A, Froidure A, Galvin L, Griese M, Grutters JC, Molina-Molina M, Poletti V, Prasse A, Renzoni E, van der Smagt J, van Moorsel CHM. European Respiratory Society statement on familial pulmonary fibrosis. Eur Respir J 2023; 61:13993003.01383-2022. [PMID: 36549714 DOI: 10.1183/13993003.01383-2022] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/26/2022] [Indexed: 12/24/2022]
Abstract
Genetic predisposition to pulmonary fibrosis has been confirmed by the discovery of several gene mutations that cause pulmonary fibrosis. Although genetic sequencing of familial pulmonary fibrosis (FPF) cases is embedded in routine clinical practice in several countries, many centres have yet to incorporate genetic sequencing within interstitial lung disease (ILD) services and proper international consensus has not yet been established. An international and multidisciplinary expert Task Force (pulmonologists, geneticists, paediatrician, pathologist, genetic counsellor, patient representative and librarian) reviewed the literature between 1945 and 2022, and reached consensus for all of the following questions: 1) Which patients may benefit from genetic sequencing and clinical counselling? 2) What is known of the natural history of FPF? 3) Which genes are usually tested? 4) What is the evidence for telomere length measurement? 5) What is the role of common genetic variants (polymorphisms) in the diagnostic workup? 6) What are the optimal treatment options for FPF? 7) Which family members are eligible for genetic sequencing? 8) Which clinical screening and follow-up parameters may be considered in family members? Through a robust review of the literature, the Task Force offers a statement on genetic sequencing, clinical management and screening of patients with FPF and their relatives. This proposal may serve as a basis for a prospective evaluation and future international recommendations.
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Affiliation(s)
- Raphael Borie
- Université Paris Cité, Inserm, PHERE, Hôpital Bichat, AP-HP, Service de Pneumologie A, Centre Constitutif du Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Paris, France
| | | | - Katerina Antoniou
- Laboratory of Molecular and Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Francesco Bonella
- Center for Interstitial and Rare Lung Diseases, Pneumology Department, Ruhrlandklinik, University Hospital, University of Essen, European Reference Network (ERN)-LUNG, ILD Core Network, Essen, Germany
| | - Bruno Crestani
- Université Paris Cité, Inserm, PHERE, Hôpital Bichat, AP-HP, Service de Pneumologie A, Centre Constitutif du Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Paris, France
| | - Aurélie Fabre
- Department of Histopathology, St Vincent's University Hospital and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Antoine Froidure
- Pulmonology Department, Cliniques Universitaires Saint-Luc and Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Liam Galvin
- European Pulmonary Fibrosis Federation, Blackrock, Ireland
| | - Matthias Griese
- Dr von Haunersches Kinderspital, University of Munich, German Center for Lung Research (DZL), Munich, Germany
| | - Jan C Grutters
- ILD Center of Excellence, St Antonius Hospital, Nieuwegein, The Netherlands
- Division of Heart and Lungs, UMC Utrecht, Utrecht, The Netherlands
| | - Maria Molina-Molina
- Interstitial Lung Disease Unit, Respiratory Department, University Hospital of Bellvitge, IDIBELL, Hospitalet de Llobregat (Barcelona), CIBERES, Barcelona, Spain
| | - Venerino Poletti
- Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy
- Department of Experimental, Diagnostics and Speciality Medicine, University of Bologna, Bologna, Italy
| | - Antje Prasse
- Department of Pulmonology, Hannover Medical School, German Center for Lung Research (DZL), BREATH, Hannover, Germany
- Fraunhofer ITEM, Hannover, Germany
| | - Elisabetta Renzoni
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jasper van der Smagt
- Division of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
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10
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Froidure A, Bondue B, Dahlqvist C, Guiot J, Gusbin N, Wirtz G, Joos G, Cataldo D, Strens D, Slabbynck H, Wuyts WA. Correlation of BAL Cell Count and Pulmonary Function Tests in the Era of Antifibrotics: Data From the Belgium-Luxembourg Idiopathic Pulmonary Fibrosis Registry. Chest 2023; 163:358-361. [PMID: 36183786 DOI: 10.1016/j.chest.2022.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Antoine Froidure
- Pulmonology Department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium.
| | | | | | - Julien Guiot
- Pulmonology Department, CHU Liège, Liège, Belgium
| | | | - Gil Wirtz
- Pulmonology Department, CHL, Luxembourg, Luxembourg
| | - Guy Joos
- Pulmonology Department, Ghent University Hospital, Gent, Belgium
| | | | | | - Hans Slabbynck
- Pulmonology Department, ZNA Middelheim, Antwerpen, Belgium
| | - Wim A Wuyts
- Pulmonology Department, UZ Leuven, Leuven, Belgium
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11
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Karampitsakos T, Phuong Diep P, Loth DW, Nadeem I, Khurtsidze E, Wijsenbeek MS, Wuyts WA, Bargagli E, Froidure A, Spagnolo P, Veltkamp M, Molina-Molina M, McCarthy C, Antoniou KM, Kreuter M, Moor CC. ERS International Congress 2022: highlights from the Interstitial Lung Diseases Assembly. ERJ Open Res 2023; 9:00584-2022. [PMID: 37077550 PMCID: PMC10107062 DOI: 10.1183/23120541.00584-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/01/2022] [Indexed: 01/07/2023] Open
Abstract
This article contains a selection of scientific highlights in the field of interstitial lung diseases (ILDs) presented at the hybrid European Respiratory Society (ERS) congress 2022. Early Career Members of Assembly 12 summarize recent advances in translational and clinical research in idiopathic interstitial pneumonias, ILDs of known origin, sarcoidosis and other granulomatous diseases, and rare ILDs. Many studies focused on evaluation of diagnostic and prognostic (bio)markers, and novel pharmacological and non-pharmacological treatment options for different ILDs. Besides, new insights in clinical, physiological, and radiological features of various rare ILDs were presented.
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12
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Bertrand Y, Sánchez-Montalvo A, Hox V, Froidure A, Pilette C. IgA-producing B cells in lung homeostasis and disease. Front Immunol 2023; 14:1117749. [PMID: 36936934 PMCID: PMC10014553 DOI: 10.3389/fimmu.2023.1117749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/14/2023] [Indexed: 03/05/2023] Open
Abstract
Immunoglobulin A (IgA) is the most abundant Ig in mucosae where it plays key roles in host defense against pathogens and in mucosal immunoregulation. Whereas intense research has established the different roles of secretory IgA in the gut, its function has been much less studied in the lung. This review will first summarize the state-of-the-art knowledge on the distribution and phenotype of IgA+ B cells in the human lung in both homeostasis and disease. Second, it will analyze the studies looking at cellular and molecular mechanisms of homing and priming of IgA+ B cells in the lung, notably following immunization. Lastly, published data on observations related to IgA and IgA+ B cells in lung and airway disease such as asthma, cystic fibrosis, idiopathic pulmonary fibrosis, or chronic rhinosinusitis, will be discussed. Collectively it provides the state-of-the-art of our current understanding of the biology of IgA-producing cells in the airways and identifies gaps that future research should address in order to improve mucosal protection against lung infections and chronic inflammatory diseases.
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Affiliation(s)
- Youri Bertrand
- Centre de Pneumologie, Otorhinolaryngologie (ORL) et Dermatologie, Institut de Recherche Expérimentale et Clinique, Faculté de Pharmacie et des Sciences Biomédicales, Université Catholique de Louvain, Brussels, Belgium
| | - Alba Sánchez-Montalvo
- Centre de Pneumologie, Otorhinolaryngologie (ORL) et Dermatologie, Institut de Recherche Expérimentale et Clinique, Faculté de Pharmacie et des Sciences Biomédicales, Université Catholique de Louvain, Brussels, Belgium
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, Katholieke universiteit (KU) Leuven, Leuven, Belgium
| | - Valérie Hox
- Centre de Pneumologie, Otorhinolaryngologie (ORL) et Dermatologie, Institut de Recherche Expérimentale et Clinique, Faculté de Pharmacie et des Sciences Biomédicales, Université Catholique de Louvain, Brussels, Belgium
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Antoine Froidure
- Centre de Pneumologie, Otorhinolaryngologie (ORL) et Dermatologie, Institut de Recherche Expérimentale et Clinique, Faculté de Pharmacie et des Sciences Biomédicales, Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Charles Pilette
- Centre de Pneumologie, Otorhinolaryngologie (ORL) et Dermatologie, Institut de Recherche Expérimentale et Clinique, Faculté de Pharmacie et des Sciences Biomédicales, Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- *Correspondence: Charles Pilette,
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13
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Pinto Pereira J, Hantson P, Pieters T, Apraxine M, Froidure A. A breath of not so fresh air…. Breathe (Sheff) 2022; 18:220026. [PMID: 36340827 PMCID: PMC9584560 DOI: 10.1183/20734735.0026-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/03/2022] [Indexed: 11/06/2022] Open
Abstract
Despite being widely used as a recreational drug, "poppers" lack a legal framework for their delivery. Their composition may vary largely. This report describes a case of severe bronchiolitis following amyl nitrite mixture inhalation. https://bit.ly/3p3S7LM.
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Affiliation(s)
- João Pinto Pereira
- Pulmonology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium,Corresponding author: João Pinto Pereira ()
| | - Philippe Hantson
- Department of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, Brussels, Belgium,Louvain Centre for Toxicology and Applied Pharmacology, Cliniques St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Thierry Pieters
- Pulmonology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Matveï Apraxine
- Pulmonology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Antoine Froidure
- Pulmonology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium,Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
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14
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Terwiel M, Borie R, Crestani B, Galvin L, Bonella F, Fabre A, Froidure A, Griese M, Grutters JC, Johannson K, Kannengiesser C, Kawano-Dourado L, Molina-Molina M, Prasse A, Renzoni EA, van der Smagt J, Poletti V, Antoniou K, van Moorsel CHM. Genetic testing in interstitial lung disease: An international survey. Respirology 2022; 27:747-757. [PMID: 35652243 DOI: 10.1111/resp.14303] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/05/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Genetic analysis is emerging for interstitial lung diseases (ILDs); however, ILD practices are not yet standardized. We surveyed patients', relatives' and pulmonologists' experiences and needs on genetic testing in ILD to evaluate the current situation and identify future needs. METHODS A clinical epidemiologist (MT) together with members of the ERS taskforce and representatives of the European Idiopathic Pulmonary Fibrosis and related disorders Federation (EU-IPFF) patient organisation developed a survey for patients, relatives and pulmonologists. Online surveys consisted of questions on five main topics: awareness of hereditary ILD, the provision of information, genetic testing, screening of asymptomatic relatives and clinical impact of genetic analysis in ILD. RESULTS Survey respondents consisted of 458 patients with ILD, 181 patients' relatives and 352 pulmonologists. Most respondents think genetic testing can be useful, particularly for explaining the cause of disease, predicting its course, determining risk for developing disease and the need to test relatives. Informing patients and relatives on genetic analysis is primarily performed by the pulmonologist, but 88% (218) of pulmonologists identify a need for more information and 96% (240) ask for guidelines on genetic testing in ILD. A third of the pulmonologists who would offer genetic testing currently do not offer a genetic test, primarily because they have limited access to genetic tests. Following genetic testing, 72% (171) of pulmonologists may change the diagnostic work-up and 57% (137) may change the therapeutic approach. CONCLUSION This survey shows that there is wide support for implementation of genetic testing in ILD and a high need for information, guidelines and access to testing among patients, their relatives and pulmonologists.
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Affiliation(s)
- Michelle Terwiel
- ILD Center of Excellence, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Raphael Borie
- Service de Pneumologie A, Hôpital Bichat, APHP, Paris, France.,INSERM, Unité 1152, Université de Paris, Paris, France
| | - Bruno Crestani
- Service de Pneumologie A, Hôpital Bichat, APHP, Paris, France.,INSERM, Unité 1152, Université de Paris, Paris, France
| | - Liam Galvin
- European Idiopathic Pulmonary Fibrosis and Related Disorders Federation, Overijse, Belgium
| | - Francesco Bonella
- Center for Interstitial and Rare Lung Diseases, Ruhrlandklinik University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital & School of Medicine, University College Dublin, Dublin, Ireland
| | - Antoine Froidure
- Service de Pneumologie, Cliniques universitaires Saint-Luc and Institut de Recherche Expérimentale et Clinique, UC Louvain, Bruxelles, Belgium
| | - Matthias Griese
- Dr. von Hauner Children's Hospital, Ludwig-Maximilians University Munich, German Center for Lung Research (DZL), Munich, Germany
| | - Jan C Grutters
- ILD Center of Excellence, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Kerri Johannson
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Caroline Kannengiesser
- INSERM, Unité 1152, Université de Paris, Paris, France.,Laboratoire de Génétique, Hôpital Bichat, APHP, Paris, France
| | - Leticia Kawano-Dourado
- INSERM, Unité 1152, Université de Paris, Paris, France.,Pneumologie, Hôpital Bichat, APHP, Paris, France.,HCOR Research Institute, Hospital do Coracao, Sao Paulo, Brazil
| | - Maria Molina-Molina
- ILD Unit, Respiratory Department, Bellvitge University Hospital-IDIBELL, CIBERES, Barcelona, Spain
| | - Antje Prasse
- Pneumologie, Hannover Hochschule, Hannover, Germany
| | - Elisabetta A Renzoni
- Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Margaret Turner Warwick Centre for Fibrosing Lung Diseases, NHLI, Imperial College, London, UK
| | - Jasper van der Smagt
- Klinische Genetica, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Venerino Poletti
- Department of Diseases of the Thorax, University of Bologna/GB Morgagni Hospital, Forli, Italy
| | - Katerina Antoniou
- Department of Thoracic Medicine, University of Crete, Heraklion, Greece
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15
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Tuyls S, Van Der Brempt X, Faber M, Gadisseur R, Dezfoulian B, Schrijvers R, Froidure A. Allergic reactions to COVID-19 vaccines: statement of the Belgian Society for Allergy and Clinical Immunology (BelSACI). Acta Clin Belg 2022; 77:552-557. [PMID: 33792500 DOI: 10.1080/17843286.2021.1909447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Vaccination against COVID-19 constitutes a huge hope and a major challenge. For the first time in modern history, a global vaccination campaign has started worldwide in a short period of time and with products that were recently developed. Consequently, legitimate concerns regarding the safety and tolerability of COVID-19 vaccines arise.In line with international allergy societies, the Belgian Society for Allergy and Clinical Immunology (BelSACI) provides this statement to guide health care providers (general practitioners, specialists including allergists) and stakeholders.In this statement, we first review current evidence on allergic reactions to vaccines and the potential risk factors that have been identified.Second, we provide a risk stratification method that may be used as a worksheet during the vaccination campaign.Finally, we discuss the management of suspected or confirmed allergic reactions following vaccination.
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Affiliation(s)
- Sebastiaan Tuyls
- Pulmonology Department, Sint Augustinus Ziekenhuis GZA, Antwerpen and UZ Leuven, Leuven, Belgium
| | | | - Margaretha Faber
- Allergology and Immunology Department, World Allergy Organization (WAO) Center of Excellence, Universitaire Ziekenhuizen Antwerpen and Universiteit Antwerpen, Antwerpen, Belgium
| | - Romy Gadisseur
- Clinical Biology Department, CHU Liège and Université de Liège, Liège, Belgium
| | - Bita Dezfoulian
- Dermatology Department, CHU Liège and Université de Liège, Liège, Belgium
| | - Rik Schrijvers
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
| | - Antoine Froidure
- Pulmonology Department, WAO Center of Excellence, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Bruxelles, Belgium
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16
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Phillips-Houlbracq M, Mal H, Cottin V, Gauvain C, Beier F, Sicre de Fontbrune F, Sidali S, Mornex JF, Hirschi S, Roux A, Weisenburger G, Roussel A, Wémeau-Stervinou L, Le Pavec J, Pison C, Marchand Adam S, Froidure A, Lazor R, Naccache JM, Jouneau S, Nunes H, Reynaud-Gaubert M, Le Borgne A, Boutboul D, Ba I, Boileau C, Crestani B, Kannengiesser C, Borie R. Determinants of survival after lung transplantation in telomerase-related gene mutation carriers: A retrospective cohort. Am J Transplant 2022; 22:1236-1244. [PMID: 34854205 DOI: 10.1111/ajt.16893] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 10/01/2021] [Accepted: 10/20/2021] [Indexed: 01/25/2023]
Abstract
Carriers of germline telomerase-related gene (TRG) mutations can show poor prognosis, with an increase in common hematological complications after lung transplantation (LT) for pulmonary fibrosis. The aim of this study was to describe the outcomes after LT in recipients carrying a germline TRG mutation and to identify the predictors of survival. In a multicenter cohort of LT patients, we retrospectively reviewed those carrying pathogenic TRG variations (n = 38; TERT, n = 23, TERC, n = 9, RTEL1, n = 6) between 2009 and 2018. The median age at LT was 54 years (interquartile range [IQR] 46-59); 68% were male and 71% had idiopathic pulmonary fibrosis. During the diagnosis of pulmonary fibrosis, 28 (74%) had a hematological disease, including eight with myelodysplasia. After a median follow-up of 26 months (IQR 15-46), 38 patients received LT. The overall post-LT median survival was 3.75 years (IQR 1.8-NA). The risk of death after LT was increased for patients with myelodysplasia (HR 4.1 [95% CI 1.5-11.5]) or short telomere (HR 2.2 [1.0-5.0]) before LT. After LT, all patients had anemia, 66% had thrombocytopenia, and 39% had neutropenia. Chronic lung allograft dysfunction frequency was 29% at 4 years. The present findings support the use of LT in TRG mutation carriers without myelodysplasia. Hematological evaluation should be systematically performed before LT.
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Affiliation(s)
- Mathilde Phillips-Houlbracq
- Service de Pneumologie A, Centre de référence des maladies pulmonaires rares (site constitutif), APHP, Hôpital Bichat, Paris, France
| | - Hervé Mal
- Université de Paris and INSERM U1152, Paris, France.,Service de Pneumologie B, APHP, Hôpital Bichat, Paris, France
| | - Vincent Cottin
- Service de Pneumologie, Centre coordonnateur national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Université de Lyon, INRAE, ERN-LUNG, Lyon, France
| | - Clément Gauvain
- Service d'oncologie, Hôpital Calmette, CHU de Lille, Lille, France
| | - Fabian Beier
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | | | - Sabrina Sidali
- Service d'hépatologie, Hôpital Beaujon, APHP, Clichy, France
| | - Jean François Mornex
- Service de Pneumologie, Centre coordonnateur national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Université de Lyon, INRAE, ERN-LUNG, Lyon, France
| | - Sandrine Hirschi
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Antoine Roux
- Service de Pneumologie, Hôpital Foch, Suresnes, France
| | - Gaelle Weisenburger
- Université de Paris and INSERM U1152, Paris, France.,Service de Pneumologie B, APHP, Hôpital Bichat, Paris, France
| | - Arnaud Roussel
- Service de chirurgie vasculaire et thoracique, Hopital Bichat, Paris, France
| | - Lidwine Wémeau-Stervinou
- Service de Pneumologie, Centre de référence des maladies pulmonaires rares (site constitutif), CHU de Lille, Lille, France
| | - Jérôme Le Pavec
- Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Groupe Hospitalier Saint Joseph/Marie-Lannelongue, Le Plessis-Robinson, France.,Faculté de Médecine, Université Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France.,UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Christophe Pison
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | | | - Antoine Froidure
- Service de pneumologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
| | - Romain Lazor
- Service de Pneumologie, Centre hospitalier universitaire vaudois, Lausanne, Suisse
| | - Jean-Marc Naccache
- Service de Pneumologie, Centre de référence des maladies pulmonaires rares (site constitutif), Hôpital Tenon, Paris, France
| | - Stéphane Jouneau
- Service de Pneumologie, Centre de compétences des maladies rares pulmonaires, Hôpital Pontchaillou, IRSET UMR 1085, Université de Rennes 1, Rennes, France
| | - Hilario Nunes
- Service de Pneumologie Centre de référence des maladies pulmonaires rares (site constitutif), Hôpital Avicenne, Bobigny, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre de compétences des maladies pulmonaires rares, CHU Nord, AP-HM, Marseille, France.,Aix-Marseille Université, IHU Méditerranée Infection, MEPHI, Marseille, France
| | - Aurélie Le Borgne
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares Hôpital Larrey CHU Toulouse, Toulouse, France
| | - David Boutboul
- Service d'Immunopathologie Clinique, Hôpital St Louis, APHP, Paris, France
| | - Ibrahima Ba
- Laboratoire de Génétique, APHP, Hôpital Bichat, Paris, France
| | | | - Bruno Crestani
- Service de Pneumologie A, Centre de référence des maladies pulmonaires rares (site constitutif), APHP, Hôpital Bichat, Paris, France
| | | | - Raphaël Borie
- Service de Pneumologie A, Centre de référence des maladies pulmonaires rares (site constitutif), APHP, Hôpital Bichat, Paris, France
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Froidure A, Antoniou K, Bocchino M, Conte E. Editorial: Mechanisms of Lung Fibrosis: Is Immunity Back in the Game? Front Immunol 2022; 13:882979. [PMID: 35371029 PMCID: PMC8968066 DOI: 10.3389/fimmu.2022.882979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Antoine Froidure
- Service de pneumologie, Cliniques Universitaires Saint-Luc, Bruxelles et Institut de Recherche Expérimentale et Clinique, UCLouvain, Bruxelles, Belgium
- *Correspondence: Antoine Froidure,
| | - Katerina Antoniou
- Laboratory of Molecular & Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Marialuisa Bocchino
- Respiratory Medicine Section, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Enrico Conte
- Laboratory of Molecular Surfaces and Nanotechnologies (LAMSUN), University of Catania, Catania, Italy
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18
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Planté-Bordeneuve T, Bertrand Y, Pilette C, Froidure A. Implications potentielles du système IgA-pIgR dans la fibrose pulmonaire idiopathique. Rev Mal Respir 2022; 39:75-78. [DOI: 10.1016/j.rmr.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
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19
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Planté-Bordeneuve T, Pilette C, Lecocq M, Huaux F, Froidure A. Le rôle de l’IgA et du pIgR dans la fibrose pulmonaire. Rev Mal Respir 2022. [DOI: 10.1016/j.rmr.2022.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Planté-Bordeneuve T, Pilette C, Lecocq M, Huaux F, Froidure A. Le rôle de l’IgA et du pIgR dans la fibrose pulmonaire. Rev Mal Respir 2022. [DOI: 10.1016/j.rmr.2022.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Guler SA, Cuevas-Ocaña S, Nasser M, Wuyts WA, Wijsenbeek MS, Froidure A, Bargagli E, Renzoni EA, Veltkamp M, Spagnolo P, Nunes H, McCarthy C, Molina-Molina M, Bonella F, Poletti V, Kreuter M, Antoniou KM, Moor CC. ERS International Congress 2021: highlights from the Interstitial Lung Diseases Assembly. ERJ Open Res 2022; 8:00640-2021. [PMID: 35615418 PMCID: PMC9124869 DOI: 10.1183/23120541.00640-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/04/2021] [Indexed: 11/05/2022] Open
Abstract
This article provides an overview of scientific highlights in the field of interstitial lung disease (ILD), presented at the virtual European Respiratory Society Congress 2021. A broad range of topics was discussed this year, ranging from translational and genetic aspects to novel innovations with the potential to improve the patient pathway. Early Career Members summarize a selection of interesting findings from different congress sessions, together with the leadership of Assembly 12 – Interstitial Lung Disease.
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22
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Gagliardi M, Berg DV, Heylen CE, Koenig S, Hoton D, Tamirou F, Pieters T, Ghaye B, Froidure A. Real-life prevalence of progressive fibrosing interstitial lung diseases. Sci Rep 2021; 11:23988. [PMID: 34907290 PMCID: PMC8671400 DOI: 10.1038/s41598-021-03481-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/23/2021] [Indexed: 12/27/2022] Open
Abstract
The concept of progressive fibrosing interstitial lung disease (PF-ILD) has recently emerged. However, real-life proportion of PF-ILDs outside IPF is still hard to evaluate. Therefore, we sought to estimate the proportion of PF-ILD in our ILD cohort. We also determined the proportion of ILD subtypes within PF-ILD and investigated factors associated with PF-ILDs. Finally, we quantified interobserver agreement between radiologists for the assessment of fibrosis. We reviewed the files of ILD patients discussed in multidisciplinary discussion between January 1st 2017 and December 31st 2019. Clinical data, pulmonary function tests (PFTs) and high-resolution computed tomography (HRCTs) were centrally reviewed. Fibrosis was defined as the presence of traction bronchiectasis, reticulations with/out honeycombing. Progression was defined as a relative forced vital capacity (FVC) decline of ≥ 10% in ≤ 24 months or 5% < FVC decline < 10% and progression of fibrosis on HRCT in ≤ 24 months. 464 consecutive ILD patients were included. 105 had a diagnosis of IPF (23%). Most frequent non-IPF ILD were connective tissue disease (CTD)-associated ILD (22%), hypersensitivity pneumonitis (13%), unclassifiable ILD (10%) and sarcoidosis (8%). Features of fibrosis were common (82% of CTD-ILD, 81% of HP, 95% of uILD). After review of HRCTs and PFTs, 68 patients (19% of non-IPF ILD) had a PF-ILD according to our criteria. Interobserver agreement for fibrosis between radiologists was excellent (Cohen’s kappa 0.86). The main diagnosis among PF-ILD were CTD-ILD (36%), HP (22%) and uILD (20%). PF-ILD patients were significantly older than non-F-ILD (P = 0.0005). PF-ILDs represent about 20% of ILDs outside IPF. This provides an estimation of the proportion of patients who might benefit from antifibrotics. Interobserver agreement between radiologists for the diagnosis of fibrotic ILD is excellent.
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Affiliation(s)
- Maureen Gagliardi
- Department of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate, 10, 1200, Bruxelles, Belgium
| | - Damienne Vande Berg
- Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium
| | - Charles-Edouard Heylen
- Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium
| | - Sandra Koenig
- Department of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate, 10, 1200, Bruxelles, Belgium
| | - Delphine Hoton
- Department of Pathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium
| | - Farah Tamirou
- Department of Rheumatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium
| | - Thierry Pieters
- Department of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate, 10, 1200, Bruxelles, Belgium
| | - Benoit Ghaye
- Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium
| | - Antoine Froidure
- Department of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate, 10, 1200, Bruxelles, Belgium.
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23
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Choi B, Messika J, Courtwright A, Mornex JF, Hirschi S, Roux A, Le Pavec J, Quêtant S, Froidure A, Lazor R, Reynaud-Gaubert M, Borgne AL, Houlbracq MP, Goldberg H, El-Chemaly S, Borie R. Airway complications in lung transplant recipients with telomere-related interstitial lung disease. Clin Transplant 2021; 36:e14552. [PMID: 34856024 DOI: 10.1111/ctr.14552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/03/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Patients with short telomere-related interstitial lung disease (ILD) have worse outcomes after lung transplantation. We hypothesized that post-transplant airway complications, including dehiscence and bronchial stenosis, would be more common in the short telomere ILD lung transplant population. METHODS We conducted a multi-institutional (Brigham and Women's Hospital, Groupe de Transplantation de la SPLF) retrospective cohort study of 63 recipients between 2009 and 2019 with ILD and short telomeres, compared to 4359 recipients from the Scientific Registry of Transplant Recipients with ILD and no known telomeropathy. RESULTS In the short telomere cohort, six recipients (9.5%) developed dehiscence and nine recipients (14.3%) developed stenosis, compared to 60 (1.4%) and 149 (3.4%) in the control, respectively. After adjusting for age, sex, and bilaterality, the presence of short telomeres was associated with higher odds of dehiscence (odds ratio (OR) = 8.24, 95% confidence interval (CI) = 3.34 20.29, p < .001) and stenosis (OR = 4.63, 95% CI 2.21 9.69, p < .001). CONCLUSION The association between the presence of short telomeres and post-transplant dehiscence and stenosis suggest that airway complications may be a contributor to increased morbidity and mortality in patients with telomere-related ILD.
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Affiliation(s)
- Bina Choi
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jonathan Messika
- Physiopathology and Epidemiology of Respiratory Diseases, UMR1152 INSERM and Université de Paris, Paris, France
| | - Andrew Courtwright
- Department of Pulmonary and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jean François Mornex
- Université de Lyon, Université Lyon 1, INRAE, EPHE, IVPC, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,Centre de Référence des Maladies Pulmonaires Rares, France
| | - Sandrine Hirschi
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Antoine Roux
- Service de Pneumologie, Hôpital Foch, UVSQ, France
| | - Jérôme Le Pavec
- Service de chirurgie thoracique et de transplantation pulmonaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France
| | - Sébastien Quêtant
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm1055, Grenoble, France
| | - Antoine Froidure
- Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Romain Lazor
- Respiratory Medicine Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre de compétences des maladies pulmonaires rares, CHU Nord, AP-HM, Marseille, Aix- Marseille Université, IHU Méditerranée Infection, MEPHI, Marseille, France
| | - Aurélie Le Borgne
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares Hôpital Larrey CHU Toulouse, Toulouse, France
| | - Mathilde Phillips Houlbracq
- Physiopathology and Epidemiology of Respiratory Diseases, UMR1152 INSERM and Université de Paris, Paris, France.,Hôpital Bichat-Claude Bernard, Service de Pneumologie et Transplantation Pulmonaire, APHP.Nord-Université de Paris, Paris, France
| | - Hilary Goldberg
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Souheil El-Chemaly
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Raphael Borie
- Physiopathology and Epidemiology of Respiratory Diseases, UMR1152 INSERM and Université de Paris, Paris, France.,Hôpital Bichat-Claude Bernard, Service de Pneumologie et Transplantation Pulmonaire, APHP.Nord-Université de Paris, Paris, France
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24
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Collin AM, Lecocq M, Detry B, Carlier FM, Bouzin C, de Sany P, Hoton D, Verleden S, Froidure A, Pilette C, Gohy S. Loss of ciliated cells and altered airway epithelial integrity in cystic fibrosis. J Cyst Fibros 2021; 20:e129-e139. [PMID: 34657818 DOI: 10.1016/j.jcf.2021.09.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 06/28/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In cystic fibrosis, the respiratory epithelium is the target tissue of both the genetic abnormality of the disease and of external aggressions, notably by pathogens (Pseudomonas aeruginosa). A detailed characterisation of the cystic fibrosis bronchial epithelium is however lacking, as most previous studies focused on the nasal epithelium or on cell lines. This study aimed to characterise the abnormal phenotype and epithelial-to-mesenchymal transition in cystic fibrosis bronchial epithelium and to evaluate in cell cultures whether abnormalities persist ex vivo. METHODS Explant lung tissues (n = 44) were assessed for bronchial epithelial cell phenotyping by immunostaining. Human bronchial epithelial cells were derived from basal cells isolated from cystic fibrosis patients or control donors and cultured in air-liquid interface for 2, 4 or 6 weeks. RESULTS Enhanced mucin 5AC and decreased β-tubulin expression were observed in cystic fibrosis airways reflecting a decreased ciliated/goblet cell ratio, associated with increased number of vimentin-positive cells, indicating epithelial-to-mesenchymal transition process. These features were recapitulated in vitro, in cystic fibrosis-derived reconstituted epithelium. However, they were not induced by CFTR inhibition or Pseudomonas infection, and most abnormalities tended to disappear in long-term culture (6 weeks) except for increased fibronectin release, an epithelial-to-mesenchymal transition marker. CONCLUSIONS This study provides new insights into airway epithelial changes in cystic fibrosis, which are imprinted through an acquired mechanism that we could not relate to CFTR function.
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Affiliation(s)
- Amandine M Collin
- Pole of Pneumology, ENT and Dermatology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Marylène Lecocq
- Pole of Pneumology, ENT and Dermatology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Bruno Detry
- Pole of Pneumology, ENT and Dermatology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - François M Carlier
- Pole of Pneumology, ENT and Dermatology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Caroline Bouzin
- IREC Imaging Platform, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Philippe de Sany
- Pole of Microbiology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Delphine Hoton
- Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Stijn Verleden
- Lung Transplant Unit, Division of Respiratory Disease, Department of chronic disease, metabolism and aging, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Antoine Froidure
- Pole of Pneumology, ENT and Dermatology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium; Department of Pneumology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Charles Pilette
- Pole of Pneumology, ENT and Dermatology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium; Department of Pneumology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Sophie Gohy
- Pole of Pneumology, ENT and Dermatology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium; Department of Pneumology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Centre de référence pour la mucoviscidose, Cliniques universitaires Saint-Luc, Brussels, Belgium.
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25
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Lecoq N, Godefroid N, Berardis S, Froidure A, Poncelet A, Goubau C. Epstein-Barr Virus-associated Pulmonary Tumor: A Pediatric Case and Discussion of the Literature. J Pediatr Hematol Oncol 2021; 43:e957-e961. [PMID: 34133382 DOI: 10.1097/mph.0000000000002228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/30/2021] [Indexed: 11/26/2022]
Abstract
Epstein-Barr virus-associated smooth pulmonary tumor is a rare condition that mostly affects immunosuppressed patients. This case describes a young boy with a history of kidney transplantation who presented recurrent pneumonia. Multiple endobronchial soft tissue tumors affecting both right and left bronchial tree were found and partially removed by bronchoscopy. Immunohistologic analysis demonstrated Epstein-Barr virus-associated smooth pulmonary tumor. Immunosuppressive therapy was changed from tacrolimus to sirolimus. A few months later, new right upper lobe and inferior left lobe tumors were found. Recurrent left lower lobe pneumonia prompted lobectomy. In the present case, complete resection and change of immunosuppressive treatment were effective.
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Affiliation(s)
| | | | | | - Antoine Froidure
- Department of Pulmonology and Respiratory Medicine, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Alain Poncelet
- Cardio-vascular and Thoracic Surgery, Cliniques Universitaires Saint Luc, Bruxelles
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26
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Abstract
Interactions between the lung epithelium and the immune system involve a tight regulation to prevent inappropriate reactions and have been connected to several pulmonary diseases. Although the distal lung epithelium and local immunity have been implicated in the pathogenesis and disease course of idiopathic pulmonary fibrosis (IPF), consequences of their abnormal interplay remain less well known. Recent data suggests a two-way process, as illustrated by the influence of epithelial-derived periplakin on the immune landscape or the effect of macrophage-derived IL-17B on epithelial cells. Additionally, damage associated molecular patterns (DAMPs), released by damaged or dying (epithelial) cells, are augmented in IPF. Next to “sterile inflammation”, pathogen-associated molecular patterns (PAMPs) are increased in IPF and have been linked with lung fibrosis, while outer membrane vesicles from bacteria are able to influence epithelial-macrophage crosstalk. Finally, the advent of high-throughput technologies such as microbiome-sequencing has allowed for the identification of a disease-specific microbial environment. In this review, we propose to discuss how the interplays between the altered distal airway and alveolar epithelium, the lung microbiome and immune cells may shape a pro-fibrotic environment. More specifically, it will highlight DAMPs-PAMPs pathways and the specificities of the IPF lung microbiome while discussing recent elements suggesting abnormal mucosal immunity in pulmonary fibrosis.
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Affiliation(s)
- Thomas Planté-Bordeneuve
- Pôle de pneumologie, O.R.L. et dermatologie, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Bruxelles, Belgium
| | - Charles Pilette
- Pôle de pneumologie, O.R.L. et dermatologie, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Bruxelles, Belgium.,Service de pneumologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Antoine Froidure
- Pôle de pneumologie, O.R.L. et dermatologie, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Bruxelles, Belgium.,Service de pneumologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
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27
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Martin I, Braem F, Baudet L, Poncin W, Fizaine S, Aboubakar F, Froidure A, Pilette C, Liistro G, De Greef J, Yildiz H, Pothen L, Yombi JC, Belkhir L, Reychler G. Follow-up of functional exercise capacity in patients with COVID-19: It is improved by telerehabilitation. Respir Med 2021; 183:106438. [PMID: 33964817 PMCID: PMC8084600 DOI: 10.1016/j.rmed.2021.106438] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The impact of the COVID-19 pandemic on functional exercise capacity seemed quickly clinically evident. The objective of this study was to assess the functional exercise capacity of patients with severe COVID-19 and to evaluate the effect of a telerehabilitation program in the specific context of the COVID-19 pandemic. METHOD Patients hospitalized for severe or critical COVID-19 were recruited. The functional exercise capacity (1-min sit-to-stand test (STST)) was prospectively quantified at discharge. A telerehabilitation program was then proposed. A control group was composed with the patients refusing the program. RESULTS At discharge, none of the 48 recruited patients had a STST higher than the 50th percentile and 77% of them were below the 2.5th percentile. SpO2 was 92.6 ± 3.0% after STST and 15 patients had oxygen desaturation. After 3-months of follow-up, the number of repetitions during STST significantly increased either in telerehabilitation (n = 14) (p < 0.001) or in control groups (n = 13) (p = 0.002) but only one patient had a result higher than the 50th percentile (in Telerehabilitation group) and 37% of them were still under the 2.5th percentile for this result. The improvement was significantly and clinically greater after the telerehabilitation program (p = 0.005). No adverse events were reported by the patients during the program. CONCLUSIONS Patients hospitalized for COVID-19 have a low functional exercise capacity at discharge and the recovery after three months is poor. The feasibility and the effect of a simple telerehabilitation program were verified, this program being able to substantially improve the functional recovery after three months.
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Affiliation(s)
- Ines Martin
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Fred Braem
- Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Lia Baudet
- Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - William Poncin
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Stéphane Fizaine
- Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Frank Aboubakar
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Antoine Froidure
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Charles Pilette
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Giuseppe Liistro
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Julien De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Halil Yildiz
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Lucie Pothen
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jean-Cyr Yombi
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Leïla Belkhir
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Gregory Reychler
- Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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28
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Choi B, Messika J, Courtwright A, Mornex J, Hirschi S, Roux A, Le Pavec J, Quêtant S, Froidure A, Lazor R, Reynaud-Gaubert M, Le Borgne A, Goldberg H, El-Chemaly S, Borie R. Airway Complications in Lung Transplant Recipients with Telomere-Related Interstitial Lung Disease. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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29
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Froidure A, Crestani B. Regulation of immune cells in lung fibrosis: the reign of regnase-1? Eur Respir J 2021; 57:57/3/2004029. [PMID: 33707169 DOI: 10.1183/13993003.04029-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 11/01/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Antoine Froidure
- Service de pneumologie, Cliniques universitaires Saint-Luc et Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Bruno Crestani
- Université de Paris, Inserm U1152, Labex Inflamex, Paris, France.,APHP, Service de Pneumologie A, Reference center for rare pulmonary diseases, DHU APOLLO, Hôpital Bichat, Paris, France
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30
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Justet A, Klay D, Porcher R, Cottin V, Ahmad K, Molina Molina M, Nunes H, Reynaud-Gaubert M, Naccache JM, Manali E, Froidure A, Jouneau S, Wemeau L, Andrejak C, Gondouin A, Hirschi S, Blanchard E, Bondue B, Bonniaud P, Tromeur C, Prévot G, Marchand-Adam S, Funke-Chambour M, Gamez AS, Ba I, Papiris S, Grutters J, Crestani B, van Moorsel C, Kannengiesser C, Borie R. Safety and efficacy of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis and carrying a telomere-related gene mutation. Eur Respir J 2021; 57:13993003.03198-2020. [PMID: 33214205 DOI: 10.1183/13993003.03198-2020] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 09/09/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Aurélien Justet
- Université de Paris, Reference center for rare pulmonary diseases, Service de Pneumologie A, Bichat Hospital, DHU APOLLO, APHP - Paris (France) - INSERM UMR 1152, Paris, France.,OrphaLung Network, Paris, France.,Center for rare pulmonary disease, Service de Pneumologie, CHU de Caen - ISTCT, UMR6030-CNRS-CEA-Université de Caen, Caen, France
| | - Dymph Klay
- Interstitial Lung Diseases Center of Excellence, Dept of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Raphaël Porcher
- Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité -CRESS-UMR1153, Paris, France
| | - Vincent Cottin
- OrphaLung Network, Paris, France.,National reference center for rare pulmonary diseases (OrphaLung), Dept of Respiratory Medicine, Louis Pradel Hospital; UMR754, Claude Bernard Lyon 1 University; Lyon, France
| | - Kais Ahmad
- OrphaLung Network, Paris, France.,National reference center for rare pulmonary diseases (OrphaLung), Dept of Respiratory Medicine, Louis Pradel Hospital; UMR754, Claude Bernard Lyon 1 University; Lyon, France
| | - Maria Molina Molina
- Unit of Interstitial Lung Diseases, Dept of Pneumology, University Hospital of Bellvitge, Barcelona, Spain
| | - Hilario Nunes
- OrphaLung Network, Paris, France.,Reference center for rare pulmonary diseases APHP, Service de Pneumologie, Hôpital Avicenne, Bobigny, France
| | - Martine Reynaud-Gaubert
- OrphaLung Network, Paris, France.,Center for rare pulmonary disease, Service de Pneumologie, Hôpital Nord, Marseille, France
| | - Jean Marc Naccache
- OrphaLung Network, Paris, France.,Reference center for rare pulmonary diseases, APHP, Service de Pneumologie, Hôpital Tenon, Paris, France
| | - Effrosyni Manali
- Respiratory Medicine Dept, 'Attikon' University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Antoine Froidure
- Cliniques Universitaires Saint-Luc, Service de Pneumologie, Bruxelles, France
| | - Stéphane Jouneau
- OrphaLung Network, Paris, France.,Center for rare pulmonary disease, Centre Hospitalier Universitaire de Rennes, Service de Pneumologie, - IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Université de Rennes 1, Rennes, France
| | - Lidwine Wemeau
- OrphaLung Network, Paris, France.,Reference center for rare pulmonary diseases, Service de Pneumologie, CHRU de Lille, Lille, France
| | - Claire Andrejak
- OrphaLung Network, Paris, France.,Center for rare pulmonary disease, Service de Pneumologie, Hôpital d'Amiens, Université de Picardie Jules Verne, Amiens, France
| | - Anne Gondouin
- OrphaLung Network, Paris, France.,Center for rare pulmonary disease CHU de Besançon, Service de Pneumologie, Besançon, France
| | - Sandrine Hirschi
- OrphaLung Network, Paris, France.,Center for rare pulmonary disease, Service de Pneumologie, Groupe de Transplantation Pulmonaire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Elodie Blanchard
- OrphaLung Network, Paris, France.,Center for rare pulmonary disease, CHU de Bordeaux, Service de Pneumologie, Pessac, France
| | | | - Philippe Bonniaud
- OrphaLung Network, Paris, France.,Reference center for rare pulmonary diseases, Service de Pneumologie, Dijon, France
| | - Cécile Tromeur
- OrphaLung Network, Paris, France.,CHU de la Cavale Blanche, Département de médecine interne et de pneumologie, Brest, France
| | - Grégoire Prévot
- OrphaLung Network, Paris, France.,Center for rare pulmonary diseases, Service de Pneumologie, Hôpital Larrey, Toulouse, France
| | - Sylvain Marchand-Adam
- OrphaLung Network, Paris, France.,Center for rare pulmonary diseases, CHU de Tours, Service de Pneumologie et Explorations Fonctionnelles Respiratoires, Tours, France
| | | | - Anne Sophie Gamez
- OrphaLung Network, Paris, France.,Center for rare pulmonary diseases, Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve, CHU Montpellier, Montpellier, France
| | - Ibrahima Ba
- OrphaLung Network, Paris, France.,Dept of Genetics, APHP, Hôpital Bichat, Paris, France
| | - Spyridon Papiris
- Respiratory Medicine Dept, 'Attikon' University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jan Grutters
- Interstitial Lung Diseases Center of Excellence, Dept of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Bruno Crestani
- Université de Paris, Reference center for rare pulmonary diseases, Service de Pneumologie A, Bichat Hospital, DHU APOLLO, APHP - Paris (France) - INSERM UMR 1152, Paris, France.,OrphaLung Network, Paris, France
| | - Coline van Moorsel
- Interstitial Lung Diseases Center of Excellence, Dept of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Raphaël Borie
- Université de Paris, Reference center for rare pulmonary diseases, Service de Pneumologie A, Bichat Hospital, DHU APOLLO, APHP - Paris (France) - INSERM UMR 1152, Paris, France.,OrphaLung Network, Paris, France
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31
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Courtoy GE, Leclercq I, Froidure A, Schiano G, Morelle J, Devuyst O, Huaux F, Bouzin C. Digital Image Analysis of Picrosirius Red Staining: A Robust Method for Multi-Organ Fibrosis Quantification and Characterization. Biomolecules 2020; 10:biom10111585. [PMID: 33266431 PMCID: PMC7709042 DOI: 10.3390/biom10111585] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 02/06/2023] Open
Abstract
Current understanding of fibrosis remains incomplete despite the increasing burden of related diseases. Preclinical models are used to dissect the pathogenesis and dynamics of fibrosis, and to evaluate anti-fibrotic therapies. These studies require objective and accurate measurements of fibrosis. Existing histological quantification methods are operator-dependent, organ-specific, and/or need advanced equipment. Therefore, we developed a robust, minimally operator-dependent, and tissue-transposable digital method for fibrosis quantification. The proposed method involves a novel algorithm for more specific and more sensitive detection of collagen fibers stained by picrosirius red (PSR), a computer-assisted segmentation of histological structures, and a new automated morphological classification of fibers according to their compactness. The new algorithm proved more accurate than classical filtering using principal color component (red-green-blue; RGB) for PSR detection. We applied this new method on established mouse models of liver, lung, and kidney fibrosis and demonstrated its validity by evidencing topological collagen accumulation in relevant histological compartments. Our data also showed an overall accumulation of compact fibers concomitant with worsening fibrosis and evidenced topological changes in fiber compactness proper to each model. In conclusion, we describe here a robust digital method for fibrosis analysis allowing accurate quantification, pattern recognition, and multi-organ comparisons useful to understand fibrosis dynamics.
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Affiliation(s)
- Guillaume E. Courtoy
- IREC Imaging Platform (2IP), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Isabelle Leclercq
- Laboratory of Hepato-Gastroenterology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, 1200 Brussels, Belgium
- Correspondence: (I.L.); (C.B.)
| | - Antoine Froidure
- Pole of Pneumology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Guglielmo Schiano
- Mechanisms of Inherited Kidney Diseases Group, University of Zurich, 8057 Zurich, Switzerland; (G.S.); (O.D.)
| | - Johann Morelle
- Pole of Nephrology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Olivier Devuyst
- Mechanisms of Inherited Kidney Diseases Group, University of Zurich, 8057 Zurich, Switzerland; (G.S.); (O.D.)
- Pole of Nephrology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - François Huaux
- Louvain Centre for Toxicology and Applied Pharmacology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Caroline Bouzin
- IREC Imaging Platform (2IP), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, 1200 Brussels, Belgium;
- Correspondence: (I.L.); (C.B.)
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32
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Froidure A, Marchal-Duval E, Homps-Legrand M, Ghanem M, Justet A, Crestani B, Mailleux A. Chaotic activation of developmental signalling pathways drives idiopathic pulmonary fibrosis. Eur Respir Rev 2020; 29:29/158/190140. [PMID: 33208483 DOI: 10.1183/16000617.0140-2019] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/25/2020] [Indexed: 12/28/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is characterised by an important remodelling of lung parenchyma. Current evidence indicates that the disease is triggered by alveolar epithelium activation following chronic lung injury, resulting in alveolar epithelial type 2 cell hyperplasia and bronchiolisation of alveoli. Signals are then delivered to fibroblasts that undergo differentiation into myofibroblasts. These changes in lung architecture require the activation of developmental pathways that are important regulators of cell transformation, growth and migration. Among others, aberrant expression of profibrotic Wnt-β-catenin, transforming growth factor-β and Sonic hedgehog pathways in IPF fibroblasts has been assessed. In the present review, we will discuss the transcriptional integration of these different pathways during IPF as compared with lung early ontogeny. We will challenge the hypothesis that aberrant transcriptional integration of these pathways might be under the control of a chaotic dynamic, meaning that a small change in baseline conditions could be sufficient to trigger fibrosis rather than repair in a chronically injured lung. Finally, we will discuss some potential opportunities for treatment, either by suppressing deleterious mechanisms or by enhancing the expression of pathways involved in lung repair. Whether developmental mechanisms are involved in repair processes induced by stem cell therapy will also be discussed.
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Affiliation(s)
- Antoine Froidure
- Institut National de la Santé et de la Recherche Médical, UMR1152, Labex Inflamex, DHU FIRE, Université de Paris, Faculté de médecine Xavier Bichat, Paris, France.,Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, Université catholique de Louvain, Belgium Service de pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Emmeline Marchal-Duval
- Institut National de la Santé et de la Recherche Médical, UMR1152, Labex Inflamex, DHU FIRE, Université de Paris, Faculté de médecine Xavier Bichat, Paris, France
| | - Meline Homps-Legrand
- Institut National de la Santé et de la Recherche Médical, UMR1152, Labex Inflamex, DHU FIRE, Université de Paris, Faculté de médecine Xavier Bichat, Paris, France
| | - Mada Ghanem
- Institut National de la Santé et de la Recherche Médical, UMR1152, Labex Inflamex, DHU FIRE, Université de Paris, Faculté de médecine Xavier Bichat, Paris, France.,Assistance Publique des Hôpitaux de Paris, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Paris, France
| | - Aurélien Justet
- Institut National de la Santé et de la Recherche Médical, UMR1152, Labex Inflamex, DHU FIRE, Université de Paris, Faculté de médecine Xavier Bichat, Paris, France.,Assistance Publique des Hôpitaux de Paris, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Paris, France.,Service de pneumologie, CHU de Caen, Caen, France
| | - Bruno Crestani
- Institut National de la Santé et de la Recherche Médical, UMR1152, Labex Inflamex, DHU FIRE, Université de Paris, Faculté de médecine Xavier Bichat, Paris, France.,Assistance Publique des Hôpitaux de Paris, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Paris, France
| | - Arnaud Mailleux
- Institut National de la Santé et de la Recherche Médical, UMR1152, Labex Inflamex, DHU FIRE, Université de Paris, Faculté de médecine Xavier Bichat, Paris, France
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33
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Froidure A, Mahieu M, Hoton D, Laterre PF, Yombi JC, Koenig S, Ghaye B, Defour JP, Decottignies A. Short telomeres increase the risk of severe COVID-19. Aging (Albany NY) 2020; 12:19911-19922. [PMID: 33104521 PMCID: PMC7655194 DOI: 10.18632/aging.104097] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/08/2020] [Indexed: 12/23/2022]
Abstract
Telomeres are non-coding DNA sequences that protect chromosome ends and shorten with age. Short telomere length (TL) is associated with chronic diseases and immunosenescence. The main risk factor for mortality of coronavirus disease 2019 (COVID-19) is older age, but outcome is very heterogeneous among individuals of the same age group. Therefore, we hypothesized that TL influences COVID-19-related outcomes. In a prospective study, we measured TL by Flow-FISH in 70 hospitalized COVID-19 patients and compared TL distribution with our reference cohort of 491 healthy volunteers. We also correlated TL with baseline clinical and biological parameters. We stained autopsy lung tissue from six non-survivor COVID-19 patients to detect senescence-associated β-galactosidase activity, a marker of cellular aging. We found a significantly higher proportion of patients with short telomeres (<10th percentile) in the COVID-19 patients as compared to the reference cohort (P<0.001). Short telomeres were associated with a higher risk of critical disease, defined as admission to intensive care unit (ICU) or death without ICU. TL was negatively correlated with C-reactive protein and neutrophil-to-lymphocyte ratio. Finally, lung tissue from patients with very short telomeres exhibit signs of senescence in structural and immune cells. Our results suggest that TL influences the severity of the disease.
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Affiliation(s)
- Antoine Froidure
- Department of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Manon Mahieu
- de Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Delphine Hoton
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Department of Pathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre-François Laterre
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Department of Intensive Care, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jean Cyr Yombi
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Sandra Koenig
- Department of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Benoit Ghaye
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jean-Philippe Defour
- de Duve Institute, Université Catholique de Louvain, Brussels, Belgium.,Department of Laboratory Hematology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Bondue B, Leduc D, Froidure A, Pieters T, Taton O, Heinen V, Alexander P, Hoton D, Dome F, Remmelink M. Usefulness of surgical lung biopsies after cryobiopsies when pathological results are inconclusive or show a pattern suggestive of a nonspecific interstitial pneumonia. Respir Res 2020; 21:231. [PMID: 32887582 PMCID: PMC7487918 DOI: 10.1186/s12931-020-01487-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background Although increasing data supports the use of transbronchial lung cryobiopsies (TBLCs) for the diagnosis of diffuse parenchymal lung diseases (DPLDs), its role as an alternative to surgical lung biopsy (SLB) is still under debate. The aim of this study was to assess the benefit of additional SLBs performed in selected patients after TBLCs. Method We conducted a multicentric Belgian prospective trial in which SLBs were performed after TBLCs when the pathological diagnosis was uncertain or if a nonspecific interstitial pneumonia (NSIP) pattern was observed hypothesizing that SLB could provide additional information and that a co-existent UIP pattern could be missed. Results Eighty-one patients with TBLCs performed for a DPLD were included in the study between April 2015 and December 2019. A specific histological diagnosis was obtained in 52 patients (64%) whereas no pathological diagnosis following TBLCs was obtained in 13 patients (16%) and a pattern suggestive of a NSIP was observed in 16 patients (20%). Fourteen out of these 29 patients had SLBs after TBLCs. SLBs showed a UIP pattern in 11 (79%), a pattern suggestive of a hypersensitivity pneumonitis in two (14%) and a NSIP pattern in one patient (7%). Among the 16 patients with pathological NSIP following TBLCs, six underwent a SLBs showing a UIP in five and confirming a NSIP in one patient only. A retrospective pathological analysis of patients having both procedures showed a lower diagnostic confidence and agreement among pathologists for TBLCs compared to SLBs. Major factors underlying the added value of SLBs were the bigger size of the sample as well as the subpleural localization of the biopsies. Conclusions TBLCs are useful in the setting of DPLDs with a good diagnostic yield. However, our study suggests that SLB provides critical additional information in case TBLCs are inconclusive or show a pattern suggestive of a NSIP, questioning the accuracy of TBLC to adequately identify this histological pattern.
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Affiliation(s)
- Benjamin Bondue
- Department of Pneumology, Hôpital Erasme, Université libre de Bruxelles, 808 route de Lennik, 1070, Brussels, Belgium.
| | - Dimitri Leduc
- Department of Pneumology, Hôpital Erasme, Université libre de Bruxelles, 808 route de Lennik, 1070, Brussels, Belgium
| | - Antoine Froidure
- Department of Pneumology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Thierry Pieters
- Department of Pneumology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Olivier Taton
- Department of Pneumology, Hôpital Erasme, Université libre de Bruxelles, 808 route de Lennik, 1070, Brussels, Belgium
| | - Vincent Heinen
- Department of Pneumology, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | | | - Delphine Hoton
- Department of Pathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Florence Dome
- Department of Pathology, Centre Universitaire de Liège, Liège, Belgium
| | - Myriam Remmelink
- Department of Pathology, Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium
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35
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Rinciog C, Diamantopoulos A, Gentilini A, Bondue B, Dahlqvist C, Froidure A, Wuyts WA, Soulard S. Cost-Effectiveness Analysis of Nintedanib Versus Pirfenidone in Idiopathic Pulmonary Fibrosis in Belgium. Pharmacoecon Open 2020; 4:449-458. [PMID: 31939146 PMCID: PMC7426351 DOI: 10.1007/s41669-019-00191-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Nintedanib (Ofev®) and pirfenidone (Esbriet®) are recommended by international guidelines as treatment options for idiopathic pulmonary fibrosis (IPF). OBJECTIVES To compare the cost-effectiveness of nintedanib with that of pirfenidone for the treatment of IPF from a Belgian healthcare payer perspective. METHODS The economic analysis used a Markov model that calculated outcomes over patient lifetime. Overall survival was assumed to be the same for the two comparators. Data from a network meta-analysis were used for loss of lung function, acute exacerbation events, safety and treatment discontinuation (for any reason). The health-state utility estimates in the model were calculated from EQ-5D scores collected in nintedanib studies. The assumed resource use for background care was also based on patient-level data that were categorised to fit the health states in the model and synthesised with costs and tariffs from Belgian national databases. RESULTS Treatment with nintedanib resulted in an estimated total cost of €102,315, which was less than the total cost of treatment with pirfenidone (€113,313). Given the similarities in the survival and progression outcomes obtained with nintedanib and pirfenidone, the model predicted near equivalence in total QALYs (3.353 QALYs for the nintedanib arm and 3.318 for the pirfenidone arm). Results were largely driven by model assumptions underlying mortality, acute exacerbations and treatment discontinuation. CONCLUSIONS After performing a synthesis of the most recently published evidence for IPF patients and assuming a Belgian healthcare payer perspective, we found nintedanib to be more cost-saving than pirfenidone.
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Affiliation(s)
- C Rinciog
- Symmetron Limited, 8 Devonshire Square, London, UK.
| | | | - A Gentilini
- Symmetron Limited, 8 Devonshire Square, London, UK
| | - B Bondue
- Department of Respiratory Medicine, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - C Dahlqvist
- Department of Pneumology, CHU UCL Namur Site Godinne, Yvoir, Belgium
| | - A Froidure
- Department of Pneumology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - W A Wuyts
- Unit for Interstitial Lung Diseases, Department of Respiratory Medicine, University Hospitals Leuven, Louvain, Belgium
| | - S Soulard
- Boehringer Ingelheim, Amsterdam, The Netherlands
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36
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Planté-Bordeneuve T, Gilbert O, Latinne D, Bruffaerts N, Ghaye B, Froidure A. Familial hypersensitivity pneumonitis triggered by Cladosporium herbarum exposure during carpooling. ERJ Open Res 2020; 6:00233-2020. [PMID: 32832522 PMCID: PMC7430138 DOI: 10.1183/23120541.00233-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/10/2020] [Indexed: 11/24/2022] Open
Abstract
Hypersensitivity pneumonitis (HP) is a respiratory disease caused by an inappropriate immune response to environmental antigens affecting the small airways and lung parenchyma. With an incidence of 0.3–1.94 cases per 100 000 per year [1, 2], HP is the third cause of interstitial lung disease (ILD) [3]. Seven to 17% of patients with HP report a positive family history for ILD [4, 5], suggesting predisposing genetic factors. This series reports cases of Cladosporium herbarum-related HP due to an uncommon exposure source, illustrating the genetic background underlying HP, and highlighting the role of environmental home inquiry and serum precipitins in diagnosis and follow-uphttps://bit.ly/3hzvE4w
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Affiliation(s)
| | - Olivier Gilbert
- Pneumology Dept, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Dominique Latinne
- Dept of Clinical Biology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | | | - Benoit Ghaye
- Radiology Dept, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Antoine Froidure
- Pneumology Dept, Cliniques universitaires Saint-Luc, Brussels, Belgium
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37
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Froidure A, Pieters T, Leduc D, Bondue B. Bad Performance of Lung Cryobiopsy in the Diagnosis of Interstitial Lung Diseases: Don't Throw the Baby Out with the Bathwater. Am J Respir Crit Care Med 2020; 200:938-939. [PMID: 31442077 PMCID: PMC6812443 DOI: 10.1164/rccm.201903-0701le] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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38
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Planté-Bordeneuve T, Haouas H, Vanderheyde K, Froidure A. Telomerase-related monogenic lung fibrosis presenting with subacute onset: a case report and review of literature. Acta Clin Belg 2019; 74:445-450. [PMID: 30451599 DOI: 10.1080/17843286.2018.1545375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Monogenic pulmonary fibrosis related to telomerase mutations is characterized by a large spectrum of clinical presentations. The disease may affect several organs including bone marrow, liver and skin. This case illustrates some of the most salient features of telomere-related Interstitial Lung Disease(ILD). Methods: Single case study and review of the litterature. Results: We report the case of a 44-year-old man admitted to our unit for subacute pulmonary fibrosis. No underlying cause could be identified. Personal and familial history was highly suggestive of monogenic telomere related lung fibrosis. Genetic investigation confirmed a mutation in the TERT gene, coding for one of the components of telomerase. Given the severe hypoxemia unresponsive to supportive treatment, he was referred for urgent lung transplantation, with a favourable outcome. Genetic counselling was proposed to his family. Conclusions: Telomerase-related monogenic lung fibrosis may present with a subacute onset, requiring urgent lung transplantation. Extra-thoracic clinical manifestations and familial history are key elements pointing towards the diagnosis.
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Affiliation(s)
| | - Hanae Haouas
- Service de pneumologie, Hopital Notre-Dame de Grâce, Gosselies, Belgium
| | - Kim Vanderheyde
- Service de pneumologie, Hopital Notre-Dame de Grâce, Gosselies, Belgium
| | - Antoine Froidure
- Service de pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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39
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Gohy S, Hoton D, Froidure A. Therapeutic endobronchial resection of a benign tumor in a patient with cystic fibrosis. Clin Case Rep 2019; 7:1900-1902. [PMID: 31632673 PMCID: PMC6787941 DOI: 10.1002/ccr3.2325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/19/2019] [Accepted: 06/23/2019] [Indexed: 11/28/2022] Open
Abstract
This report highlights the usefulness of bronchoscopy in case of recurrent pneumonia with the same localization even in CF patients where the presence of bronchiectasis as promoting factor of infections could delay the diagnosis.
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Affiliation(s)
- Sophie Gohy
- Department of PulmonologyCliniques Universitaires Saint‐Luc, UCLBrusselsBelgium
- Cystic Fibrosis Reference CenterCliniques Universitaires Saint‐Luc, UCLBrusselsBelgium
| | - Delphine Hoton
- Department of PathologyCliniques Universitaires Saint‐Luc, UCLBrusselsBelgium
| | - Antoine Froidure
- Department of PulmonologyCliniques Universitaires Saint‐Luc, UCLBrusselsBelgium
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Phillips Houlbracq M, Mal H, Cottin V, Philit F, Hirschi S, Roux A, Wémeau-Stervinou L, Le Pavec J, Pison C, Marchand Adam S, Froidure A, Lazor R, Naccache JM, Jouneau S, Nunes H, Reynaud-Gaubert M, Le Borgne A, Crestani B, Kannengiesser C, Borie R. Clinical outcomes after lung transplantation for fibrosis in telomerase related genes mutation carriers. Transplantation 2019. [DOI: 10.1183/13993003.congress-2019.pa3365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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41
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Biglia C, Ghaye B, Reychler G, Koenig S, Yildiz H, Lacroix V, Tamirou F, Hoton D, Pieters T, Froidure A. Multidisciplinary management of interstitial lung diseases: A real-life study. Sarcoidosis Vasc Diffuse Lung Dis 2019; 36:108-115. [PMID: 32476943 DOI: 10.36141/svdld.v36i2.8107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/11/2019] [Indexed: 02/01/2023]
Abstract
Background The guidelines on idiopathic pulmonary fibrosis (IPF) diagnosis established the crucial role of multidisciplinary discussion (MDD) in the diagnosis of interstitial lung diseases (ILD). However, real-life evaluation of MDD remains scarce. Our aim was to study the impact of a well-structured MDD on etiological assessment, diagnosis, and management of ILD. Methods We collected and analysed all relevant data on patients concerning diagnosis and treatment before and after MDD during the year 2017. Results One hundred fifty patients were included in the analysis. MDD had a significant impact on management: 42% of diagnoses were revised and the number of unclassifiable ILD was significantly reduced. Lung biopsy was performed in 26 patients (12 cryobiopsies and 14 surgical biopsies). The most prevalent diagnoses were connective-tissue disease associated ILD (32%), idiopathic pulmonary fibrosis (23%), hypersensitivity pneumonitis (13%) and granulomatous ILD (7%). MDD led to a change or initiation of treatment in 55% of cases. Nine patients were evaluated for transplantation, 23 patients were screened for academic or sponsored clinical trials and an 8-fold increase in rehabilitation inclusion was observed. Conclusion Our results confirm the benefits of MDD on ILD management and diagnosis. MDD also facilitates access to non-pharmacological therapies and clinical trials.
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Affiliation(s)
- Caroline Biglia
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Benoît Ghaye
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Gregory Reychler
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium.,Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Belgium
| | - Sandra Koenig
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Halil Yildiz
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Valérie Lacroix
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Farah Tamirou
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Delphine Hoton
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Thierry Pieters
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Antoine Froidure
- Pneumology department, Cliniques universitaires Saint-Luc, Bruxelles, Belgium.,Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Belgium
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Justet A, Klay D, Cottin V, Nunes H, Molina Molina M, Reynaud-Gaubert M, Naccache J, Manali E, Froidure A, Wemeau L, Gondouin A, Bonniaud P, Andrejak C, Hirschi S, Stéphane J, Tromeur C, Prevost G, Marchand-Adam S, Gamez A, Kannengiesser C, Van Moorsel C, Crestani B, Borie R. Efficacité et tolérance des traitements anti-fibrosants chez les patients porteurs d’une mutation du complexe telomèrase. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Phillips Houlbracq M, Mal H, Cottin V, Hirschi S, Roux A, Wémeau-Stervinou L, Le Pavec J, Claustre J, Park S, Marchand-Adam S, Froidure A, Lazor R, Naccache J, Jouneau S, Nunes H, Reynaud-Gaubert M, Prevot G, Crestani B, Kannengiesser C, Borie R. Évolution après transplantation pulmonaire pour fibrose chez les patients porteurs d’une mutation du complexe télomérase. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Froidure A, Ladjemi MZ, Pilette C. Interleukin-1α: a key player for epithelial-to-mesenchymal signalling in COPD? Eur Respir J 2018; 48:301-4. [PMID: 27478185 DOI: 10.1183/13993003.01180-2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 06/15/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Antoine Froidure
- Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium Cliniques Universitaires Saint-Luc, Service de Pneumologie, Brussels, Belgium UMR Inserm U1152, Labex Inflammex, Université Paris 7, Paris, France These authors contributed equally to this manuscript
| | - Maha Zohra Ladjemi
- UMR Inserm U1152, Labex Inflammex, Université Paris 7, Paris, France These authors contributed equally to this manuscript
| | - Charles Pilette
- Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium Cliniques Universitaires Saint-Luc, Service de Pneumologie, Brussels, Belgium
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45
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Gohy S, Froidure A, Lebecque P. DRESS syndrome in a patient with cystic fibrosis: A case report. Pediatr Pulmonol 2017; 52:E18-E21. [PMID: 27740720 DOI: 10.1002/ppul.23567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 08/15/2016] [Accepted: 08/19/2016] [Indexed: 11/06/2022]
Abstract
Drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a rare and severe side-effect, mainly described after intake of anticonvulsants, allopurinol, or antibiotics. It usually begins within 2 months after drug introduction. Symptoms include cutaneous rash, hematologic abnormalities, and internal organ involvement and the diagnosis might be challenging. This case report illustrates for the first time this life-threatening complication in a patient with cystic fibrosis (CF). In this case, withdrawal of the offending drug was sufficient for full recovery. Clinicians involved in CF care should be aware of DRESS syndrome, as they commonly prescribe several potentially culprit drugs. Pediatr Pulmonol. 2017;52:E18-E21. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sophie Gohy
- Department of Pulmonology, Cliniques Universitaires St-Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium.,Pediatric Pulmonology and Cystic Fibrosis Unit, Cliniques Universitaires St-Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium
| | - Antoine Froidure
- Department of Pulmonology, Cliniques Universitaires St-Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium
| | - Patrick Lebecque
- Pediatric Pulmonology and Cystic Fibrosis Unit, Cliniques Universitaires St-Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium
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46
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Froidure A, Pilette C. From the hygiene hypothesis to A20: the protective effect of endotoxins against asthma development. Clin Exp Allergy 2016; 46:192-3. [PMID: 26817857 DOI: 10.1111/cea.12651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- A Froidure
- Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium.,Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - C Pilette
- Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium.,Cliniques universitaires Saint-Luc, Brussels, Belgium
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47
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Vandenplas O, Froidure A, Meurer U, Rihs HP, Rifflart C, Soetaert S, Jamart J, Pilette C, Raulf M. The role of allergen components for the diagnosis of latex-induced occupational asthma. Allergy 2016; 71:840-9. [PMID: 26940537 DOI: 10.1111/all.12872] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recombinant Hevea brasiliensis (rHev b) natural rubber latex (NRL) allergen components have been developed to assess the patients' allergen sensitization profile and to improve the diagnosis of NRL allergy. OBJECTIVE To examine whether the determination of specific IgE (sIgE) reactivity to a panel of recombinant allergen components would be helpful for diagnosing NRL-induced occupational asthma (OA) in predicting the outcome of a specific inhalation test. METHODS sIgE levels to NRL extract and 12 recombinant NRL allergen components were assessed in 82 subjects with OA ascertained by a positive specific inhalation challenge (SIC) with NRL gloves and in 25 symptomatic subjects with a negative challenge. RESULTS The sensitivity, specificity, positive predictive value, and negative predictive value of a NRL-sIgE level ≥0.35 kUA /l as compared to the result of SICs were 94%, 48%, 86%, and 71%, respectively. The positive predictive value increased above 95% when increasing the cutoff value to 5.41 kUA /l. Subjects with a positive SIC showed a significantly higher rate of sIgE reactivity to rHev b 5, 6.01, 6.02, and 11 than those with a negative SIC. A sIgE sum score against rHev b 5 plus 6.01/6.02 ≥ 1.46 kUA /l provided a positive predictive value >95% with a higher sensitivity (79%) and diagnostic efficiency (Youden index: 0.67) as compared with a NRL-sIgE ≥5.41 kUA /l (49% and 0.41, respectively). CONCLUSION In suspected OA, high levels of sIgE against rHev b 5 combined with rHev b 6.01 or 6.02 are the most efficient predictors of a bronchial response to NRL.
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Affiliation(s)
- O. Vandenplas
- Department of Chest Medicine; Centre Hospitalier Universitaire de Dinant-Godinne; Université catholique de Louvain; Yvoir Belgium
- Institut de Recherche Expérimentale et Clinique; Pôle de Pneumologie; Université catholique de Louvain; Brussels Belgium
- Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO); Brussels Belgium
| | - A. Froidure
- Institut de Recherche Expérimentale et Clinique; Pôle de Pneumologie; Université catholique de Louvain; Brussels Belgium
- Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO); Brussels Belgium
- Department of Chest Medicine; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - U. Meurer
- IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance; Institute of the Ruhr-Universität Bochum; Bochum Germany
| | - H.-P. Rihs
- IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance; Institute of the Ruhr-Universität Bochum; Bochum Germany
| | - C. Rifflart
- Department of Chest Medicine; Centre Hospitalier Universitaire de Dinant-Godinne; Université catholique de Louvain; Yvoir Belgium
| | - S. Soetaert
- Prévention et Protection au Travail - Centre de Service Interentreprises (CESI); Brussels Belgium
| | - J. Jamart
- Scientific Support Unit; Centre Hospitalier Universitaire de Dinant-Godinne; Université catholique de Louvain; Yvoir Belgium
| | - C. Pilette
- Institut de Recherche Expérimentale et Clinique; Pôle de Pneumologie; Université catholique de Louvain; Brussels Belgium
- Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO); Brussels Belgium
- Department of Chest Medicine; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - M. Raulf
- IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance; Institute of the Ruhr-Universität Bochum; Bochum Germany
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48
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Froidure A, Joannes A, Mailleux AA, Crestani B. New targets in idiopathic pulmonary fibrosis: from inflammation and immunity to remodeling and repair. Expert Opin Orphan Drugs 2016. [DOI: 10.1517/21678707.2016.1171140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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49
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Coussement J, Steensels D, Nollevaux MC, Bogaerts P, Dumonceaux M, Delaere B, Froidure A. When polymerase chain reaction does not help: cytomegalovirus pneumonitis associated with very low or undetectable viral load in both blood and bronchoalveolar lavage samples after lung transplantation. Transpl Infect Dis 2016; 18:284-7. [PMID: 26910136 PMCID: PMC7169703 DOI: 10.1111/tid.12515] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 12/21/2015] [Accepted: 12/30/2015] [Indexed: 12/19/2022]
Abstract
Cytomegalovirus (CMV) pneumonitis occurs frequently among solid organ transplant recipients and is classically associated with significant viral replication in both blood and bronchoalveolar lavage (BAL) samples. We present a case of a 64‐year‐old lung transplant recipient who presented with CMV pneumonitis that was diagnosed based on the association of viral inclusion in the BAL sample, rapid response to ganciclovir, and absence of other infectious etiology. Surprisingly, we observed very low or undetectable viral load both in blood and BAL samples. Diagnosis of CMV pneumonitis should rely on the association of clinical, pathological, radiological, and microbiological signs, while quantitative nucleic acid amplification testing should be interpreted with caution.
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Affiliation(s)
- J Coussement
- Department of Infectious Diseases, CHU UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - D Steensels
- Department of Clinical Microbiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - M-C Nollevaux
- Department of Pathology, CHU UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - P Bogaerts
- Department of Microbiology, CHU UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - M Dumonceaux
- Department of Pneumology and Lung Transplantation, CHU UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - B Delaere
- Department of Infectious Diseases, CHU UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - A Froidure
- Department of Pneumology and Lung Transplantation, CHU UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
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Abstract
The role of dendritic cells (DCs) in airway allergy has been studied for 15 years; recent data has highlighted the cross talk with airway epithelial cells and environmental factors (allergens, virus) during the inception and exacerbation of allergic asthma. Although murine models have provided key information, it remains uncertain to what extent these basic mechanisms take place in human allergic disease, notably with regard to different clinical phenotypes. In the present review, we discuss new evidence regarding mechanisms of DC regulation in the mouse which could be important in human asthma. Finally, after discussing the effects of current therapies on DC biology, we focus on pathways that could represent targets for future therapies.
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Affiliation(s)
- A. Froidure
- Institut de Recherche Expérimentale et Clinique; Université Catholique de Louvain and Walloon Institute for Excellence in Lifesciences and Biotechnology; Brussels Belgium
- Cliniques Universitaires Saint-Luc, service de pneumologie; Brussels Belgium
| | - C. Shen
- Institut de Recherche Expérimentale et Clinique; Université Catholique de Louvain and Walloon Institute for Excellence in Lifesciences and Biotechnology; Brussels Belgium
| | - C. Pilette
- Institut de Recherche Expérimentale et Clinique; Université Catholique de Louvain and Walloon Institute for Excellence in Lifesciences and Biotechnology; Brussels Belgium
- Cliniques Universitaires Saint-Luc, service de pneumologie; Brussels Belgium
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