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Southern KW, Addy C, Bell SC, Bevan A, Borawska U, Brown C, Burgel PR, Button B, Castellani C, Chansard A, Chilvers MA, Davies G, Davies JC, De Boeck K, Declercq D, Doumit M, Drevinek P, Fajac I, Gartner S, Georgiopoulos AM, Gursli S, Gramegna A, Hansen CM, Hug MJ, Lammertyn E, Landau EEC, Langley R, Mayer-Hamblett N, Middleton A, Middleton PG, Mielus M, Morrison L, Munck A, Plant B, Ploeger M, Bertrand DP, Pressler T, Quon BS, Radtke T, Saynor ZL, Shufer I, Smyth AR, Smith C, van Koningsbruggen-Rietschel S. Standards for the care of people with cystic fibrosis; establishing and maintaining health. J Cyst Fibros 2024; 23:12-28. [PMID: 38129255 DOI: 10.1016/j.jcf.2023.12.002] [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: 10/06/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
This is the second in a series of four papers updating the European Cystic Fibrosis Society (ECFS) standards for the care of people with CF. This paper focuses on establishing and maintaining health. The guidance is produced using an evidence-based framework and with wide stakeholder engagement, including people from the CF community. Authors provided a narrative description of their topic and statements, which were more directive. These statements were reviewed by a Delphi exercise, achieving good levels of agreement from a wide group for all statements. This guidance reinforces the importance of a multi-disciplinary CF team, but also describes developing models of care including virtual consultations. The framework for health is reinforced, including the need for a physically active lifestyle and the strict avoidance of all recreational inhalations, including e-cigarettes. Progress with cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy is reviewed, including emerging adverse events and advice for dose reduction and interruption. This paper contains guidance that is pertinent to all people with CF regardless of age and eligibility for and access to modulator therapy.
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Affiliation(s)
- Kevin W Southern
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK.
| | - Charlotte Addy
- All Wales Adult Cystic Fibrosis Centre, University Hospital Llandough, Cardiff and Vale University Health Board, Cardiff, UK
| | - Scott C Bell
- Department of Thoracic Medicine and Faculty of Medicine, The University of Queensland, The Prince Charles Hospital, Brisbane, Australia
| | - Amanda Bevan
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Urzula Borawska
- Institute of Mother and Child in Warsaw, Cystic Fibrosis Department and Dziekanow Lesny Hospital, Cystic Fibrosis Center, Dziekanow Lesny, Poland
| | - Catherine Brown
- West Midlands Adult CF Centre, Heartlands Hospital Birmingham, UK
| | - Pierre-Régis Burgel
- Respiratory Medicine and Cystic Fibrosis National Reference Center, Cochin Hospital, Assistance Publique Hôpitaux de Paris (AP-HP) and Université Paris-Cité, Institut Cochin, Inserm U1016, Paris, France
| | - Brenda Button
- Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia 3181, and Department of Respiratory Medicine, Alfred Health, Melbourne 3004, Australia
| | - Carlo Castellani
- IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genova, Italy
| | - Audrey Chansard
- Epigenetics and Cell Fate Centre, UMR7216 CNRS, Université Paris Cité, Paris, France, and Cystic Fibrosis Europe, Brussels, Belgium
| | - Mark A Chilvers
- Divison of Pediatric Respiratroy Medicine, BC Childrens Hospital, Vancouver, Canada
| | - Gwyneth Davies
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jane C Davies
- National Heart & Lung Institute, Imperial College London; Imperial Biomedical Research Centre; Royal Brompton Hospital, Guy's & St Thomas' Trust, London, UK
| | | | - Dimitri Declercq
- Cystic Fibrosis Reference Center, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium; Department of Pediatrics, Center for children and adolescents with diabetes, Ghent University Hospital, Ghent, Belgium; Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Pavel Drevinek
- Department of Medical Microbiology, Second Faculty of Medicine, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Isabelle Fajac
- Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France
| | | | - Anna M Georgiopoulos
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Sandra Gursli
- National Resource Centre for Cystic Fibrosis, Oslo University Hospital, Oslo, Norway
| | - Andrea Gramegna
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Carina Me Hansen
- Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
| | - Martin J Hug
- Medical Center - University of Freiburg, Pharmacy, Hugstetter St. 55, Freiburg, D-79106, Germany
| | - Elise Lammertyn
- Cystic Fibrosis Europe, Brussels, Belgium and the Belgian CF Association, Brussels, Belgium
| | - Edwina Eddie C Landau
- The Graub CF Center, Pulmonary Institute, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Ross Langley
- Department of Paediatric Respiratory & Sleep Medicine, Royal Hospital for Children, Glasgow, UK
| | - Nicole Mayer-Hamblett
- Seattle Children's Research Institute, Seattle, WA and Department of Pediatrics, University of Washington, Seattle, Wa, USA
| | - Anna Middleton
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Peter G Middleton
- Westmead Clinical School, University of Sydney and CITRICA, Dept Respiratory & Sleep Medicine, Westmead Hospital, Westmead, Australia
| | - Monika Mielus
- Cystic Fibrosis Department, Institute of Mother and Child, Warsaw, Poland; Cystic Fibrosis Centre, Pediatric Hospital, Dziekanów Leśny, Poland
| | - Lisa Morrison
- West of Scotland Adult CF Centre, Queen Elizabeth University Hospital, Glasgow, UK
| | - Anne Munck
- Hospital Necker Enfants-Malades, AP-HP, CF centre, Université Paris Descartes, Paris, France
| | - Barry Plant
- Cork Centre for Cystic Fibrosis (3CF), Cork University Hospital, Cork, Ireland
| | | | - Dominique Pougheon Bertrand
- Laboratoire Educations et Promotion de la santé, LEPS, UR 3412, University of Sorbonne Paris Nord, F-93430, Villetaneuse, France
| | | | - Bradley S Quon
- Division of Respiratory Medicine, Department of Medicine. St. Paul's Hospital and the University of British Columbia. Vancouver, British Columbia, Canada
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Zoe L Saynor
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, UK and Wessex Cystic Fibrosis Unit, University Hospitals Southampton NHS Foundation Trust, UK
| | - Ilan Shufer
- CF Patient, Head of Access, Off label and Trials, Computer Science Architecture, Research and Innovation, Cystic Fibrosis Foundation of Israel, Israel
| | - Alan R Smyth
- School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Chris Smith
- Department of Nutrition and Dietetics, Royal Alexandra Children's Hospital, Brighton, UK
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Pougheon Bertrand D, Fanchini A, Lombrail P, Rault G, Chansard A, Le Breton N, Frenod C, Milon F, Royer CH, Segretain D, Silber M, Therouanne S, Haesebaert J, Llerena C, Michel P, Reynaud Q. A conceptual framework to develop a patient-reported experience questionnaire on the cystic fibrosis journey in France: the ExPaParM collaborative study. Orphanet J Rare Dis 2023; 18:31. [PMID: 36805739 PMCID: PMC9938348 DOI: 10.1186/s13023-023-02640-6] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The objective of the study was to elaborate a conceptual framework related to the domains of patient experience along the cystic fibrosis (CF) journey from the patients and parents of children with CF to inform the design of a patient-reported experience questionnaire. METHOD A collaborative research group including patients and parents with clinicians and academic researchers was set up. They identified the situations along the CF care pathway from diagnosis to paediatric care, transition to adult care and adult follow-up, transfer to transplant centres and follow-up after transplantation. Participants were recruited by CF centres in metropolitan France and overseas departments. Semi-structured interviews were conducted, transcribed verbatim and subjected to an inductive analysis conducted in duos of researchers/co-researchers using NVivo®. The conceptual framework was discussed with the research group and presented to the CF centres during two video conferences. The protocol obtained a favourable opinion from the Ethics Evaluation Committee of INSERM (IRB00003888-no. 20-700). RESULTS The analysis led to a conceptual framework composed of domains of the CF journey, each divided into several items. 1. CF care: Management of care by the CF centre team; in-hospital care; quality of care in the community; therapeutic education and self-management support; at-home care; new therapies and research; procreation; 2. Transplant care: management of transplant and CF care; coordination with other specialties; education and self-management support; at-home care; procreation; new therapies and research; 3. Turning points along the journey: diagnosis of CF, transition to adult care, transfer to transplantation; 4. Social life with CF: housing, employment and education, social relations, social welfare and family finances. The number of patients included and the diversity of situations made it possible to achieve a sufficient richness and saturation of codes by domain to develop patient experience questionnaires. CONCLUSION This conceptual framework, resulting from the participants' experience, will inform the design of a patient-reported experience tool, whose construct will be tested during the next phase of the ExPaParM project to assess its fidelity, intelligibility, and ability to report patient experience of the CF journey.
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Affiliation(s)
- D. Pougheon Bertrand
- grid.462844.80000 0001 2308 1657Université Sorbonne Paris Nord (USPN), LEPS, UR 3412, 93430 Villetaneuse, France
| | - A. Fanchini
- grid.462844.80000 0001 2308 1657Université Sorbonne Paris Nord (USPN), LEPS, UR 3412, 93430 Villetaneuse, France
| | - P. Lombrail
- grid.462844.80000 0001 2308 1657Université Sorbonne Paris Nord (USPN), LEPS, UR 3412, 93430 Villetaneuse, France
| | - G. Rault
- grid.462844.80000 0001 2308 1657Université Sorbonne Paris Nord (USPN), LEPS, UR 3412, 93430 Villetaneuse, France
| | - A. Chansard
- Groupe Des Co-Chercheurs Patients et Parents d’enfants Atteints de Mucoviscidose, USPN, LEPS, UR 3412, 93430 Villetaneuse, France
| | - N. Le Breton
- Groupe Des Co-Chercheurs Patients et Parents d’enfants Atteints de Mucoviscidose, USPN, LEPS, UR 3412, 93430 Villetaneuse, France
| | - C. Frenod
- Groupe Des Co-Chercheurs Patients et Parents d’enfants Atteints de Mucoviscidose, USPN, LEPS, UR 3412, 93430 Villetaneuse, France
| | - F. Milon
- Groupe Des Co-Chercheurs Patients et Parents d’enfants Atteints de Mucoviscidose, USPN, LEPS, UR 3412, 93430 Villetaneuse, France
| | - C. Heymes Royer
- Groupe Des Co-Chercheurs Patients et Parents d’enfants Atteints de Mucoviscidose, USPN, LEPS, UR 3412, 93430 Villetaneuse, France
| | - D. Segretain
- Groupe Des Co-Chercheurs Patients et Parents d’enfants Atteints de Mucoviscidose, USPN, LEPS, UR 3412, 93430 Villetaneuse, France
| | - M. Silber
- Groupe Des Co-Chercheurs Patients et Parents d’enfants Atteints de Mucoviscidose, USPN, LEPS, UR 3412, 93430 Villetaneuse, France
| | - S. Therouanne
- grid.410463.40000 0004 0471 8845Centre de Ressources et de Compétences Mucoviscidose, CHU Lille, Lille, France
| | - J. Haesebaert
- grid.7429.80000000121866389Laboratory RESHAPE U. INSERM 1290, Claude Bernard Lyon1 University, Villeurbanne, France
| | - C. Llerena
- Centre de Ressources et de Compétences Mucoviscidose, Hôpital Couple-Enfants, Grenoble, France
| | - P. Michel
- grid.7429.80000000121866389Laboratory RESHAPE U. INSERM 1290, Claude Bernard Lyon1 University, Villeurbanne, France
| | - Q. Reynaud
- grid.7429.80000000121866389Laboratory RESHAPE U. INSERM 1290, Claude Bernard Lyon1 University, Villeurbanne, France ,grid.411430.30000 0001 0288 2594Centre de Ressources et de Compétences Mucoviscidose, Hôpital Lyon Sud, Pierre-Bénite, France
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3
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Chansard A, Pobega E, Caron P, Polo SE. Imaging the Response to DNA Damage in Heterochromatin Domains. Front Cell Dev Biol 2022; 10:920267. [PMID: 35721488 PMCID: PMC9201110 DOI: 10.3389/fcell.2022.920267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
The eukaryotic genome is assembled in a nucleoprotein complex called chromatin, whose organization markedly influences the repair of DNA lesions. For instance, compact chromatin states, broadly categorized as heterochromatin, present a challenging environment for DNA damage repair. Through transcriptional silencing, heterochromatin also plays a vital role in the maintenance of genomic integrity and cellular homeostasis. It is thus of critical importance to decipher whether and how heterochromatin affects the DNA damage response (DDR) to understand how this chromatin state is preserved after DNA damage. Here, we present two laser micro-irradiation-based methods for imaging the DDR in heterochromatin domains in mammalian cells. These methods allow DNA damage targeting to specific subnuclear compartments, direct visualization of the DDR and image-based quantification of the repair response. We apply them to study DNA double-strand break repair pathways in facultative heterochromatin and the repair of UV photoproducts in constitutive heterochromatin. We discuss the advantages and limitations of these methods compared to other targeted approaches for DNA damage induction.
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Pougheon Bertrand D, Fanchini A, Lombrail P, Rault G, Chansard A, Le Breton N, Frenod C, Milon F, Heymes-Royer C, Segretain D, Silber M, Therouanne S, Haesebaert J, Llerena C, Michel P, Reynaud Q. Collaborative research protocol to define patient-reported experience measures of the cystic fibrosis care pathway in France: the ExPaParM study. Orphanet J Rare Dis 2022; 17:73. [PMID: 35193621 PMCID: PMC8861995 DOI: 10.1186/s13023-022-02204-0] [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: 11/06/2021] [Accepted: 02/06/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction In France, the cystic fibrosis (CF) care pathway is coordinated by multidisciplinary teams from specialised CF centres or transplant centres. It includes the care provided at home or out of hospital, risk prevention in daily life and adjustments to social life, which together contribute to the person’s quality of life. Patient experience is used to describe and evaluate the care and life of patients living with the disease. Objectives Our collaborative research aims to identify the most significant areas and criteria that characterise the CF pathway. It will lead to the development of a questionnaire to collect patients' experience, which can be administered to all patients or parents of children registered and followed in the centres. The article describes the protocol developed in partnership with patients and parents of children living with the disease. Method A multidisciplinary research group brings together researchers, patients, parents of children with CF and health care professionals. The patient partnership is involved in the 4 phases of the protocol: (1) setting up the study, recruiting patient and parent co-researchers, training them in qualitative research methods, defining the situations and profiles of patients in the study population, elaborating the protocol; (2) selecting the study sites, recruiting participants, carrying out semi-structured interviews, analysing verbatims using the grounded theory approach; (3) co-elaborating Patient-Reported Experience Measures (PREM) questionnaires adapted to the 4 types of participants: parents, adolescents, non-transplanted adults and transplanted adults; (4) validating the construct with participants and professionals from the study centres. Results The protocol obtained a favourable opinion from the Ethics Evaluation Committee of INSERM (IRB00003888—no. 20-700). Training was provided to the 5 patients and 2 parent co-researchers to enable them to participate effectively in the research. Eleven centres participated in the recruitment of participants in mainland France and Reunion Island. Eighty hours of interviews were conducted. Discussion The PREM questionnaires to be elaborated will have to undergo psychometric validation before being used by the actors of the CF network to assess the impact on the care pathways of quality approaches or new therapies available in cystic fibrosis. Trial Registration Registry: IRB00003888 – no. 20-700. Issue date: 06/09/2020.
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Affiliation(s)
- D Pougheon Bertrand
- Laboratory of Education and Health Practices (LEPS) UR3412, Sorbonne Paris Nord University, Villetaneuse, France.
| | - A Fanchini
- Laboratory of Education and Health Practices (LEPS) UR3412, Sorbonne Paris Nord University, Villetaneuse, France
| | - P Lombrail
- Laboratory of Education and Health Practices (LEPS) UR3412, Sorbonne Paris Nord University, Villetaneuse, France
| | - G Rault
- Laboratory of Education and Health Practices (LEPS) UR3412, Sorbonne Paris Nord University, Villetaneuse, France
| | - A Chansard
- Cystic Fibrosis Patient and Parent Co-Investigators Group, Paris, France
| | - N Le Breton
- Cystic Fibrosis Patient and Parent Co-Investigators Group, Paris, France
| | - C Frenod
- Cystic Fibrosis Patient and Parent Co-Investigators Group, Paris, France
| | - F Milon
- Cystic Fibrosis Patient and Parent Co-Investigators Group, Paris, France
| | - C Heymes-Royer
- Cystic Fibrosis Patient and Parent Co-Investigators Group, Paris, France
| | - D Segretain
- Cystic Fibrosis Patient and Parent Co-Investigators Group, Paris, France
| | - M Silber
- Cystic Fibrosis Patient and Parent Co-Investigators Group, Paris, France
| | - S Therouanne
- Centre de Ressources et de Compétences mucoviscidose, CHU Lille, Lille, France
| | - J Haesebaert
- Laboratory RESHAPE U. INSERM 1290, Claude Bernard Lyon 1 University, Villeurbanne, France
| | - C Llerena
- Centre de Ressources et de Compétences mucoviscidose, Hôpital Couple-Enfants, Grenoble, France
| | - P Michel
- Laboratory RESHAPE U. INSERM 1290, Claude Bernard Lyon 1 University, Villeurbanne, France.,Quality and Security Department, Hospices Civils de Lyon, Lyon, France
| | - Q Reynaud
- Laboratory RESHAPE U. INSERM 1290, Claude Bernard Lyon 1 University, Villeurbanne, France.,Centre de Ressources et de Compétences mucoviscidose, Hôpital Lyon Sud, Pierre-Bénite, France
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5
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Chansard A, Dubrulle N, Poujol de Molliens M, Falanga PB, Stephen T, Hasan M, van Zandbergen G, Aulner N, Shorte SL, David-Watine B. Corrigendum: Unveiling Interindividual Variability of Human Fibroblast Innate Immune Response Using Robust Cell-Based Protocols. Front Immunol 2021; 12:685768. [PMID: 33981321 PMCID: PMC8109174 DOI: 10.3389/fimmu.2021.685768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Audrey Chansard
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France
| | - Nelly Dubrulle
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France
| | | | - Pierre B Falanga
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France
| | - Tharshana Stephen
- UTechS Cytometry and Biomarkers, CRT, Institut Pasteur, Paris, France
| | - Milena Hasan
- UTechS Cytometry and Biomarkers, CRT, Institut Pasteur, Paris, France
| | - Ger van Zandbergen
- Division of Immunology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Nathalie Aulner
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France
| | - Spencer L Shorte
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France.,Pasteur Joint International Research Unit Ai3D, Institut Pasteur Korea, Seongnam-si, South Korea
| | - Brigitte David-Watine
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France.,Unité INSERM U 1223, Institut Pasteur, Paris, France.,Unité Biologie et Génétique de la Paroi Bactérienne, Institut Pasteur, Paris, France.,CNRS UMR2001, Paris, France.,INSERM, Équipe Avenir, Paris, France
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6
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Fortuny A, Chansard A, Caron P, Chevallier O, Leroy O, Renaud O, Polo SE. Imaging the response to DNA damage in heterochromatin domains reveals core principles of heterochromatin maintenance. Nat Commun 2021; 12:2428. [PMID: 33893291 PMCID: PMC8065061 DOI: 10.1038/s41467-021-22575-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 07/27/2020] [Accepted: 03/17/2021] [Indexed: 02/02/2023] Open
Abstract
Heterochromatin is a critical chromatin compartment, whose integrity governs genome stability and cell fate transitions. How heterochromatin features, including higher-order chromatin folding and histone modifications associated with transcriptional silencing, are maintained following a genotoxic stress challenge is unknown. Here, we establish a system for targeting UV damage to pericentric heterochromatin in mammalian cells and for tracking the heterochromatin response to UV in real time. We uncover profound heterochromatin compaction changes during repair, orchestrated by the UV damage sensor DDB2, which stimulates linker histone displacement from chromatin. Despite massive heterochromatin unfolding, heterochromatin-specific histone modifications and transcriptional silencing are maintained. We unveil a central role for the methyltransferase SETDB1 in the maintenance of heterochromatic histone marks after UV. SETDB1 coordinates histone methylation with new histone deposition in damaged heterochromatin, thus protecting cells from genome instability. Our data shed light on fundamental molecular mechanisms safeguarding higher-order chromatin integrity following DNA damage.
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Affiliation(s)
- Anna Fortuny
- Epigenetics and Cell Fate Centre, UMR7216 CNRS, Université de Paris, Paris, France
| | - Audrey Chansard
- Epigenetics and Cell Fate Centre, UMR7216 CNRS, Université de Paris, Paris, France
| | - Pierre Caron
- Epigenetics and Cell Fate Centre, UMR7216 CNRS, Université de Paris, Paris, France
| | - Odile Chevallier
- Epigenetics and Cell Fate Centre, UMR7216 CNRS, Université de Paris, Paris, France
| | - Olivier Leroy
- Cell and Tissue Imaging Facility, UMR3215 PICT-IBiSA, Institut Curie, Paris, France
| | - Olivier Renaud
- Cell and Tissue Imaging Facility, UMR3215 PICT-IBiSA, Institut Curie, Paris, France
| | - Sophie E Polo
- Epigenetics and Cell Fate Centre, UMR7216 CNRS, Université de Paris, Paris, France.
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7
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Coucke R, Chansard A, Bontemps V, Grenet D, Hubert D, Martin C, Lammertyn E, Bardin E, Bulteel V, Chedevergne F, Bourgeois ML, Burgel PR, Honore I, de Keyser H, Kirszenbaum M, de Carli P, Sermet-Gaudelus I, Hayes K. "Il faut continuer à poser des questions" patient reported outcome measures in cystic fibrosis: An anthropological perspective. J Cyst Fibros 2021; 20:e108-e113. [PMID: 33648900 DOI: 10.1016/j.jcf.2021.02.009] [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: 10/20/2020] [Revised: 01/11/2021] [Accepted: 02/17/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND People with cystic fibrosis (pwCF) are central in the development of patient-led assessment tools. Qualitative analysis of a frequently used CF-specific patient-reported outcome measure (PROM) sought patient recommendations for development of a new quality of life (QoL) tool. METHODS We performed an inventory of PROMs, symptom-report and QoL tools used in clinical trials within the European Cystic Fibrosis Society Clinical Trial Network (ECFS-CTN) and in routine clinical practice among Cystic Fibrosis Europe and ECFS members. A qualitative study using cognitive interviews with pwCF and their caregivers reviewed the Cystic Fibrosis Questionnaire (CFQ), the French initial form of the Cystic Fibrosis Questionnaire-Revised (CFQ-R). RESULTS Survey results from 33 countries revealed over 70 tools used in routine clinical practice, utilized by clinical specialists (n=124), pwCF/parents/carers (n=49) and other allied health professionals (n=60). The CFQ-R was the main PROM used in clinical trials. The qualitative study enrolled 99 pwCF, 6 to 11 years (n=31); 12 to 18 years (n=38); >18 years (n=30) and 26 parents. Inductive thematic analysis based on the CFQ, revealed 19 key themes. Themes common across all cohorts included burden of treatment, impact of disease on day-to-day life, relationships/family, stress/mood, and nutrition. Themes unique to individual groups included, treatment when not symptomatic for the paediatric group; education/studies and planning for the future for adolescents, impact of anxiety and depression on day-to-day life for adults, and for parents, questions addressing anxiety and their role as carers. CONCLUSIONS Patient-centeredness is paramount in development of an up-to-date PROM in the era of novel therapies.
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Affiliation(s)
- Rosa Coucke
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | | | - Véronique Bontemps
- Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux, Campus Condorcet, Bâtiment Recherche Sud, 5 cours de Humanitiés, 93322 Aubervillers cedex, France
| | | | - Dominique Hubert
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris and Université de Paris, Institut Cochin, Inserm U1016, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Clémence Martin
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris and Université de Paris, Institut Cochin, Inserm U1016, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | | | | | | | - Frédérique Chedevergne
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | - Muriel Le Bourgeois
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | - Pierre-Régis Burgel
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris and Université de Paris, Institut Cochin, Inserm U1016, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Isabelle Honore
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris and Université de Paris, Institut Cochin, Inserm U1016, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | | | - Maya Kirszenbaum
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | - Paola de Carli
- Association Vaincre la Mucoviscidose, 181 rue de Tolbiac, 75013 Paris, France
| | - Isabelle Sermet-Gaudelus
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | - Kate Hayes
- European Cystic Fibrosis Society, Karup, Denmark; Northern Ireland Clinical Research Facility, The Wellcome-Wolfson Centre for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Ireland.
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Chansard A, Dubrulle N, Poujol de Molliens M, Falanga PB, Stephen T, Hasan M, van Zandbergen G, Aulner N, Shorte SL, David-Watine B. Unveiling Interindividual Variability of Human Fibroblast Innate Immune Response Using Robust Cell-Based Protocols. Front Immunol 2021; 11:569331. [PMID: 33505391 PMCID: PMC7829859 DOI: 10.3389/fimmu.2020.569331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/19/2020] [Indexed: 11/13/2022] Open
Abstract
The LabEx Milieu Interieur (MI) project is a clinical study centered on the detailed characterization of the baseline and induced immune responses in blood samples from 1,000 healthy donors. Analyses of these samples has lay ground for seminal studies on the genetic and environmental determinants of immunologic variance in a healthy cohort population. In the current study we developed in vitro methods enabling standardized quantification of MI-cohort-derived primary fibroblasts responses. Our results show that in vitro human donor cohort fibroblast responses to stimulation by different MAMPs analogs allows to characterize individual donor immune-phenotype variability. The results provide proof-of-concept foundation to a new experimental framework for such studies. A bio-bank of primary fibroblast lines was generated from 323 out of 1,000 healthy individuals selected from the MI-study cohort. To study inter-donor variability of innate immune response in primary human dermal fibroblasts we chose to measure the TLR3 and TLR4 response pathways, both receptors being expressed and previously studied in fibroblasts. We established high-throughput automation compatible methods for standardized primary fibroblast cell activation, using purified MAMPS analogs, poly I:C and LPS that stimulate TLR3 and TLR4 pathways respectively. These results were in turn compared with a stimulation method using infection by HSV-1 virus. Our "Add-only" protocol minimizes high-throughput automation system variability facilitating whole process automation from cell plating through stimulation to recovery of cell supernatants, and fluorescent labeling. Images were acquired automatically by high-throughput acquisition on an automated high-content imaging microscope. Under these methodological conditions standardized image acquisition provided for quantification of cellular responses allowing biological variability to be measured with low system noise and high biological signal fidelity. Optimal for automated analysis of immuno-phenotype of primary human cell responses our method and experimental framework as reported here is highly compatible to high-throughput screening protocols like those necessary for chemo-genomic screening. In context of primary fibroblasts derived from donors enrolled to the MI-clinical-study our results open the way to assert the utility of studying immune-phenotype characteristics relevant to a human clinical cohort.
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Affiliation(s)
- Audrey Chansard
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France
| | - Nelly Dubrulle
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France
| | | | - Pierre B Falanga
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France
| | - Tharshana Stephen
- UTechS Cytometry and Biomarkers, CRT, Institut Pasteur, Paris, France
| | - Milena Hasan
- UTechS Cytometry and Biomarkers, CRT, Institut Pasteur, Paris, France
| | - Ger van Zandbergen
- Division of Immunology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Nathalie Aulner
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France
| | - Spencer L Shorte
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France.,Pasteur Joint International Research Unit Ai3D, Institut Pasteur Korea, Seongnam-si, South Korea
| | - Brigitte David-Watine
- UTechS Photonic BioImaging, C2RT, Institut Pasteur, Paris, France.,Unité INSERM U 1223, Institut Pasteur, Paris, France.,Unité Biologie et Génétique de la Paroi Bactérienne, Institut Pasteur, Paris, France.,CNRS UMR2001, Paris, France.,INSERM, Équipe Avenir, Paris, France
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Hayes K, Lammertyn E, De Keyser H, Havermans T, Chansard A, Sermet I. P205 Patient-reported outcome measures in the current context of new generation modulator therapies in cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01230-3] [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: 11/15/2022]
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Hayes K, Sermet I, Bontemps V, de Carli P, Chansard A, Lammertyn E, de Keyser H, Coucke R. ePS5.08 “Il faut continuer à poser des questions/We must continue to ask questions.” Patient-reported outcomes in cystic fibrosis: a qualitative study of patients with cystic fibrosis and their caregivers. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30327-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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