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Böck A, Urner K, Eckert JK, Salvermoser M, Laubhahn K, Kunze S, Kumbrink J, Hoeppner MP, Kalkbrenner K, Kreimeier S, Beyer K, Hamelmann E, Kabesch M, Depner M, Hansen G, Riedler J, Roponen M, Schmausser-Hechfellner E, Barnig C, Divaret-Chauveau A, Karvonen AM, Pekkanen J, Frei R, Roduit C, Lauener R, Schaub B. An integrated molecular risk score early in life for subsequent childhood asthma risk. Clin Exp Allergy 2024; 54:314-328. [PMID: 38556721 DOI: 10.1111/cea.14475] [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: 08/30/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Numerous children present with early wheeze symptoms, yet solely a subgroup develops childhood asthma. Early identification of children at risk is key for clinical monitoring, timely patient-tailored treatment, and preventing chronic, severe sequelae. For early prediction of childhood asthma, we aimed to define an integrated risk score combining established risk factors with genome-wide molecular markers at birth, complemented by subsequent clinical symptoms/diagnoses (wheezing, atopic dermatitis, food allergy). METHODS Three longitudinal birth cohorts (PAULINA/PAULCHEN, n = 190 + 93 = 283, PASTURE, n = 1133) were used to predict childhood asthma (age 5-11) including epidemiological characteristics and molecular markers: genotype, DNA methylation and mRNA expression (RNASeq/NanoString). Apparent (ap) and optimism-corrected (oc) performance (AUC/R2) was assessed leveraging evidence from independent studies (Naïve-Bayes approach) combined with high-dimensional logistic regression models (LASSO). RESULTS Asthma prediction with epidemiological characteristics at birth (maternal asthma, sex, farm environment) yielded an ocAUC = 0.65. Inclusion of molecular markers as predictors resulted in an improvement in apparent prediction performance, however, for optimism-corrected performance only a moderate increase was observed (upto ocAUC = 0.68). The greatest discriminate power was reached by adding the first symptoms/diagnosis (up to ocAUC = 0.76; increase of 0.08, p = .002). Longitudinal analysis of selected mRNA expression in PASTURE (cord blood, 1, 4.5, 6 years) showed that expression at age six had the strongest association with asthma and correlation of genes getting larger over time (r = .59, p < .001, 4.5-6 years). CONCLUSION Applying epidemiological predictors alone showed moderate predictive abilities. Molecular markers from birth modestly improved prediction. Allergic symptoms/diagnoses enhanced the power of prediction, which is important for clinical practice and for the design of future studies with molecular markers.
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Affiliation(s)
- Andreas Böck
- Pediatric Allergology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
| | - Kathrin Urner
- Pediatric Allergology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
| | - Jana Kristin Eckert
- Pediatric Allergology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
| | - Michael Salvermoser
- Pediatric Allergology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
| | - Kristina Laubhahn
- Pediatric Allergology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center - Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Sonja Kunze
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Jörg Kumbrink
- Institute of Pathology, Medical Faculty, LMU Munich, Munich, Germany
| | - Marc P Hoeppner
- Institute of Clinical Molecular Biology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Kathrin Kalkbrenner
- Pediatric Allergology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
| | - Simone Kreimeier
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Kirsten Beyer
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Eckard Hamelmann
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
- Department for Pediatrics, Children's Center Bethel, University Hospital OWL, Bielefeld University, Bielefeld, Germany
| | - Michael Kabesch
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
- University Children's Hospital Regensburg (KUNO), St. Hedwig's Hospital of the Order of St. John and the University of Regensburg, Regensburg, Germany
| | - Martin Depner
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany
| | - Gesine Hansen
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
- Excellence Cluster Resolving Infection Susceptibility RESIST (EXC 2155), Deutsche Forschungsgemeinschaft, Hannover Medical School, Hannover, Germany
| | | | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Elisabeth Schmausser-Hechfellner
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany
| | - Cindy Barnig
- Department of Respiratory Disease, University Hospital, Besanҫon, France
- INSERM, EFS BFC, LabEx LipSTIC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, Besançon, France
| | - Amandine Divaret-Chauveau
- Pediatric Allergy Department, Children's Hospital, University Hospital of Nancy, Vandoeuvre les Nancy, France
- EA3450 Development, Adaptation and Handicap (devah), Pediatric Allergy Department, University of Lorraine, Nancy, France
- UMR/CNRS 6249 Chrono-environment, University of Franche Comté, Besançon, France
| | - Anne M Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Remo Frei
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
- Division of Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Caroline Roduit
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
- Division of Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
- Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
- Children's Hospital, University of Zürich, Zürich, Switzerland
| | - Roger Lauener
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
- Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Bianca Schaub
- Pediatric Allergology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
- Member of the CHildhood Allergy and Tolerance Consortium (CHAMP), LMU Munich, Munich, Germany
- Comprehensive Pneumology Center - Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
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Poisson C, Chenivesse C, Cuvillon E, Barnig C, Clarot C, Dupin C, Mangiapan G, Rolland-Debord C, Bonniaud P, Taillé C. Asthma loss of control after switch from anti-IL-5/5R drugs to dupilumab in severe eosinophilic asthma: A case series. J Allergy Clin Immunol Pract 2024:S2213-2198(24)00330-1. [PMID: 38553004 DOI: 10.1016/j.jaip.2024.03.037] [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] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/14/2024] [Accepted: 03/15/2024] [Indexed: 04/23/2024]
Affiliation(s)
- Camille Poisson
- Service de Pneumologie et Soins Intensifs Respiratoire, Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adultes de Dijon, Réseau OrphaLung, Filière RespiFil, Centre Hospitalier Universitaire de Bourgogne, Dijon, France; Inserm U1231, Equipe HSP-pathies, Faculty of Medicine and Pharmacy, University of Bourgogne-Franche Comté, Dijon, France
| | - Cécile Chenivesse
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, Lille, France; Inserm, F-CRIN, Clinical Research Initiative in Severe Asthma: a Lever for Innovation and Science, Toulouse, France
| | - Edouard Cuvillon
- Université de Lille, CHU Lille, Lille, France, Groupe AHNAC-Clinique Teissier, Valenciennes, France
| | - Cindy Barnig
- Inserm, F-CRIN, Clinical Research Initiative in Severe Asthma: a Lever for Innovation and Science, Toulouse, France; Université de Franche-Comté, EFS, Inserm, UMR RIGHT, Besançon, France; Department of Chest Disease, University Hospital of Besançon, Besançon, France
| | - Caroline Clarot
- Department of Pulmonology, Centre Hospitalier d'Abbeville, Abbeville, France
| | - Clairelyne Dupin
- Service de Pneumologie et Centre de Référence des Maladies Pulmonaires Rares, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gilles Mangiapan
- Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, Créteil, France
| | - Camille Rolland-Debord
- Service de Pneumologie, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Philippe Bonniaud
- Service de Pneumologie et Soins Intensifs Respiratoire, Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adultes de Dijon, Réseau OrphaLung, Filière RespiFil, Centre Hospitalier Universitaire de Bourgogne, Dijon, France; Inserm U1231, Equipe HSP-pathies, Faculty of Medicine and Pharmacy, University of Bourgogne-Franche Comté, Dijon, France; Inserm, F-CRIN, Clinical Research Initiative in Severe Asthma: a Lever for Innovation and Science, Toulouse, France.
| | - Camille Taillé
- Inserm, F-CRIN, Clinical Research Initiative in Severe Asthma: a Lever for Innovation and Science, Toulouse, France; Service de Pneumologie et Centre de Référence des Maladies Pulmonaires Rares, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France; UMR 1152, Université Paris Cité, Paris, France
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Perotin JM, Gauquelin L, Just N, Devouassoux G, Chenivesse C, Bourdin A, Garcia G, Saint Raymond C, Boudjemaa A, Bonniaud P, Chanez P, Barnig C, Beurnier A, Maurer C, Freymond N, Didi T, Tcherakian C, Russier M, Drucbert M, Guillo S, Estellat C, Taillé C. Severe asthma care trajectories: the French RAMSES cohort. ERJ Open Res 2024; 10:00837-2023. [PMID: 38651091 PMCID: PMC11033728 DOI: 10.1183/23120541.00837-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/05/2024] [Indexed: 04/25/2024] Open
Abstract
Background The French RAMSES study is an observational prospective multicentre real-life cohort including severe asthmatic subjects. The objective of the study was to compare the characteristics of patients, in terms of phenotype and asthma care trajectories, between those managed by tertiary referral centres (TRCs) or secondary care centres (SCCs). Methods Patients were prospectively recruited and enrolled for a 5-year follow-up. Patients' characteristics were analysed at inclusion and compared between TRCs and SCCs. Results 52 centres (24 TRCs and 28 SCCs) included 2046 patients: 1502 (73.4%) were included by a TRC and 544 (26.6%) by a SCC. Patients were mainly women (62%), 53±15 years old, 67% with Asthma Control Test <20; at inclusion, 14% received oral corticosteroids (OCS) and 66% biologics. Compared with the SCC group, the TRC group had more frequent comorbidities and lower blood eosinophil counts (262 versus 340 mm-3; p=0.0036). OCS and biologics use did not differ between groups, but patients in the TRC group benefited more frequently from an educational programme (26% versus 18%; p=0.0008) and received more frequently two or more sequential lines of biologics (33% versus 24%; p=0.0105). In-depth investigations were more frequently performed in the TRC group (allergy tests: 74% versus 62%; p<0.0001; exhaled nitric oxide fraction: 56% versus 21%; p<0.0001; induced sputum: 6% versus 3%; p=0.0390). Conclusions Phenotypes and care trajectories differed in the RAMSES cohort between SCCs and TRCs, probably related to different levels of asthma severity and differences in medical resources and practices among centres. This highlights the need for standardisation of severe asthma care.
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Affiliation(s)
- Jeanne-Marie Perotin
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- University of Reims Champagne-Ardenne, Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
- CRISALIS/F-CRIN INSERM Network, France
| | - Lisa Gauquelin
- AP-HP, Centre de Pharmacoépidémiologie (Cephepi), Paris, France
| | - Nicolas Just
- Respiratory Diseases Department, Victor Provo Hospital, Roubaix, France
| | - Gilles Devouassoux
- CRISALIS/F-CRIN INSERM Network, France
- Service de Pneumologie, CIERA, Hôpital de la Croix Rousse, GHN, HCL, VIRPATH, Université Claude Bernard Lyon 1, Lyon, France
| | - Cécile Chenivesse
- University of Reims Champagne-Ardenne, Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
- Université de Lille, CNRS, Inserm, CHU Lille, U1019 – UMR 9017 – Center for Infection and Immunity of Lille, Lille, France
| | - Arnaud Bourdin
- Université de Montpellier, PhyMedExp, INSERM, CNRS, Montpellier, France
| | - Gilles Garcia
- Service de Pneumologie, Hôpital Privé d'Antony, Antony, France
| | | | | | - Philippe Bonniaud
- University of Reims Champagne-Ardenne, Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
- Department of Respiratory Diseases and Intensive Care, Dijon-Bourgogne University Hospital, Dijon, France
- University of Burgundy, Inserm UMR1231, Dijon, France
| | - Pascal Chanez
- Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
- AP-HM, Hôpital Nord, Clinique des Bronches, de l'Allergie et du Sommeil, Marseille, France
| | - Cindy Barnig
- University of Reims Champagne-Ardenne, Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
- Université de Franche-Comté, CHU Besançon, EFS, INSERM, UMR RIGHT, Besançon, France
| | - Antoine Beurnier
- Department of Physiology – Functional Explorations, bi-site Hôpital Bicêtre (Le Kremlin-Bicêtre) and Ambroise Paré (Boulogne-Billancourt), DMU 5 Thorinno, AP-HP, Université Paris-Saclay, INSERM UMR_S 999, Paris, France
| | - Cyril Maurer
- Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France
| | - Nathalie Freymond
- Respiratory Diseases and Thoracic Oncology Department, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon, France
| | - Toufik Didi
- Service de Pneumologie, CH Annecy Genevois, Metz-Tessy, France
| | - Colas Tcherakian
- Department of Respiratory Diseases, Foch Hospital, Suresnes, France
| | - Maud Russier
- Pneumo-allergology Department, Orléans Regional Hospital Center, Orléans, France
| | - Mélanie Drucbert
- Department of Respiratory Disease, University Hospital of Amiens, Amiens, France
- University of Picardie Jules Verne, Amiens, France
| | - Sylvie Guillo
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique – IPLESP, AP-HP, Hôpital Pitié Salpêtrière, Cephepi, Paris, France
| | - Candice Estellat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique – IPLESP, AP-HP, Hôpital Pitié Salpêtrière, Cephepi, Paris, France
| | - Camille Taillé
- Department of Respiratory Diseases, Reference Center for Rare Pulmonary Diseases, Bichat Hospital, AP-HP, Paris, France
- INSERM UMR 1152, University of Paris Cité, Paris, France
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Ecrement A, Barnig C. Unlocking the potential of NK cells: NgR1-mediated modulation of immunological synapse stability. Allergy 2023; 78:3285-3286. [PMID: 37661661 DOI: 10.1111/all.15873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/10/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Affiliation(s)
| | - Cindy Barnig
- Université de Franche-Comté, EFS, INSERM, UMR RIGHT, Besançon, France
- CHU Besançon, Department of Chest Disease, Besançon, France
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Zysman M, Mahay G, Guibert N, Barnig C, Leroy S, Guilleminault L. Impact of pharmacological and non-pharmacological interventions on mortality in chronic obstructive pulmonary disease (COPD) patients. Respir Med Res 2023; 84:101035. [PMID: 37651981 DOI: 10.1016/j.resmer.2023.101035] [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: 03/02/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE This review aimed to summarise evidence about the impact of pharmacological and non-pharmacological interventions on survival in COPD patients. METHODS We performed a narrative literature review on the effect of pharmacological and non-pharmacological interventions on survival in COPD patients. RESULTS Inhaled therapies are central to reduce symptoms in COPD. In particular, inhaled steroids seem to have the greatest effect on mortality. Despite the anti-inflammatory effects attributed to statins, their benefit in COPD has been shown only in cases of combined cardiovascular diseases. The use of beta-blockers in COPD has not been associated with increased COPD-related mortality and a beneficial effect on all-cause mortality has even been shown in COPD patients with cardiovascular diseases. Influenza and pneumococcal vaccination reduced the occurrence of exacerbations and mortality due to COPD. In addition, long-term oxygen therapy (LTOT) (≥15h/day) in COPD patients with severe hypoxemia had a positive effect on survival. Regarding non-pharmacological interventions, it has been demonstrated that smoking cessation, treatment compliance and nutritional supplementation for underweight patients also have a positive effect on survival. Non-invasive ventilation results were dependent on patient PaCO2 levels. In patients with advanced COPD, further prospective studies are needed to know the effect of bronchoscopic lung volume reduction and lung transplant on COPD survival. Regarding lung transplant, a survival benefit in patients with a pre-transplant BODE score of ≥7 has been shown in retrospective studies. CONCLUSION Most of the studies did not evaluate survival as the main criteria and further long-term studies on the global management of COPD are required.
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Affiliation(s)
- Maeva Zysman
- Service de Pneumologie, CHU Haut-Lévèque, Bordeaux, France; Univ. Bordeaux, Centre de Recherche cardio-thoracique, INSERM U1045, CIC 1401, Pessac, France
| | - Guillaume Mahay
- Service de Pneumologie, Oncologie thoracique et soins intensifs respiratoires, CHU Rouen, Rouen, France
| | - Nicolas Guibert
- Pôle des voies respiratoires, CHU de Toulouse, Toulouse, France
| | - Cindy Barnig
- INSERM, EFS BFC, LabEx LipSTIC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, Besançon, France; Service de Pneumologie, Oncologie thoracique et allergologie respiratoire, CHRU Besançon, Besançon, France
| | - Sylvie Leroy
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, CNRS UMR 7275 - FHU OncoAge, Service de Pneumologie Oncologie Thoracique et Soins Intensifs Respiratoires, CHU de Nice, Hôpital Pasteur, Nice, France
| | - Laurent Guilleminault
- Pôle des voies respiratoires, CHU de Toulouse, Toulouse, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM UMR1291 - CNRS UMR5051 - Université Toulouse III, CRISALIS F-CRIN, Toulouse, France.
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Noureddine S, Roux-Claudé P, Eberst G, Westeel V, Barnig C, Claudé F. [The role of the cardiopulmonary exercise test and pulmonary rehabilitation in long COVID-19]. Rev Mal Respir 2023; 40:604-622. [PMID: 37357041 PMCID: PMC10289121 DOI: 10.1016/j.rmr.2023.05.003] [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: 03/21/2023] [Accepted: 05/12/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Long COVID refers to persistent symptoms, lasting more than 4 weeks after acute SARS-CoV-2 infection, even though the infection itself has been successfully controlled and remedied. Patient complaints are diverse, and the underlying physiopathological mechanisms are not well understood. Dyspnea and muscle fatigue are among the most commonly reported symptoms. STATE OF THE ART Cardiopulmonary exercise test (CPET) has been recognized as a useful tool in investigation of unexplained dyspnea. In patients with chronic lung disease, pulmonary rehabilitation is a program designed to counteract dyspnea, to increase exercise capacity and to improve quality of life. PERSPECTIVES Publications on CPET and pulmonary rehabilitation are needed in order to deepen comprehension and enhance management of long-COVID-19. CONCLUSIONS CPET reports have shown that symptoms persisting in the aftermath of acute SARS-CoV-2 infection may be related to deconditioning, a common occurrence after ICU stay, to cardiac dysautonomia subsequent to critical infections and, finally, to dysfunctional breathing subsequent to mild infections. These findings justify pulmonary rehabilitation, which has proven to be effective regardless of the severity of the initial infection, not only immediately after hospital discharge, but also at later points in time.
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Affiliation(s)
- S Noureddine
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.
| | - P Roux-Claudé
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - G Eberst
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - V Westeel
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - C Barnig
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; UMR1098 Inserm, établissement français du sang de Bourgogne-Franche-Comté, 8, rue du Docteur-Jean-François-Xavier-Girod, 25000 Besançon, France
| | - F Claudé
- Service de pneumologie, d'oncologie thoracique et d'allergologie respiratoire, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
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Hordequin L, Eberst G, Guion-Dusserre M, Gondouin A, Barnig C, Westeel V. Immunoglobulins as a treatment modality for corticosteroid-refractory pemetrexed-induced interstitial lung disease, case report. Respir Med Res 2023; 83:101000. [PMID: 36812771 DOI: 10.1016/j.resmer.2023.101000] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 02/22/2023]
Affiliation(s)
- Lucie Hordequin
- Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, 3 Boulevard Fleming, Besançon 25030 CEDEX, France.
| | - Guillaume Eberst
- Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, 3 Boulevard Fleming, Besançon 25030 CEDEX, France; UMR 1098, Université de Franche-Comté, Besançon, France
| | - Marc Guion-Dusserre
- Service de Pneumologie, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Anne Gondouin
- Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, 3 Boulevard Fleming, Besançon 25030 CEDEX, France
| | - Cindy Barnig
- Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, 3 Boulevard Fleming, Besançon 25030 CEDEX, France; UMR 1098, Université de Franche-Comté, Besançon, France
| | - Virginie Westeel
- Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, 3 Boulevard Fleming, Besançon 25030 CEDEX, France; UMR 1098, Université de Franche-Comté, Besançon, France
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Soumagne T, Barnig C, Perotin-Collard JM, Taillé C. [An action plan for everyone !]. Rev Mal Respir 2023; 40:306-307. [PMID: 36746702 DOI: 10.1016/j.rmr.2023.01.012] [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: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 02/05/2023]
Affiliation(s)
- T Soumagne
- Service de pneumologie et de soins intensifs, hôpital européen Georges Pompidou, AP-HP, 20, rue Leblanc, Paris, France.
| | - C Barnig
- Service de pneumologie, oncologie thoracique et allergologie respiratoire, CHU de Besançon, Besançon, France; CRISALIS, F-CRIN Inserm network, France
| | - J-M Perotin-Collard
- CRISALIS, F-CRIN Inserm network, France; Service des maladies respiratoires et allergiques, CHU de Reims, Reims, France
| | - C Taillé
- CRISALIS, F-CRIN Inserm network, France; Service de pneumologie, groupe hospitalier universitaire, AP-HP Nord-Université Paris Cité, Hôpital Bichat, Inserm UMR1152, Paris, France
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Laplaza C, Barnig C, Westeel V, Eberst G. [A rare and atypical form of tularemia in a context of immunodepression]. Rev Mal Respir 2023; 40:188-192. [PMID: 36681600 DOI: 10.1016/j.rmr.2022.12.015] [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: 04/21/2022] [Accepted: 12/04/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION We present an original severe case of tularemia with cutaneous damage, lymphadenopathy and pericarditis ; pathology of increasing incidence in Europe due to global warming. OBSERVATION A 33-years-old women consulted emergency unit for altered general condition, anorexia, hyperthermia at 38,3°C, dyspnea and dry cough evolving for few days. Her only history was Crohn's disease with introduction of an anti-TNF alpha for 3 months. The interrogation found regular forest walks ». Treatment with Amoxicillin/clavulanic acid 1g 3 times daily and curative anticoagulation was started after the initial diagnosis of infectious pneumonia associated with pulmonary embolism. The patient reconsulted 2 weeks later for clinical deterioration associated with skin lesions. The chest CT scan showed increased mediastinal lymphadenopathy and a circumferential pericardial effusion ; quantified at 5mm on transthoracic ultrasound. Tularemia serology was positive in IgG at 400IU/mL. Despite an adapted antibiotic therapy with Ciprofloxacin, the patient presented a new brutal clinical deterioration. A pericardiocentesis was performed and the analysis revealed a predominantly neutrophilic exudate and a strongly positive PCR Francisella tularensis. Gentamicin 5mg/kg was associated allowing a resolution of the symptoms. CONCLUSION Tularemia is one of the pathologies whose atypical presentation with pericarditis (favored by a certain immunodepression) worsens the prognosis. Global warming influences the epidemiology of inoculation diseases, including tularemia, making it more frequent.
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Affiliation(s)
- C Laplaza
- Service de pneumologie, oncologie thoracique et allergologie respiratoire, CHU Jean Minjoz, 25030 Besançon, France.
| | - C Barnig
- Service de pneumologie, oncologie thoracique et allergologie respiratoire, CHU Jean Minjoz, 25030 Besançon, France
| | - V Westeel
- Service de pneumologie, oncologie thoracique et allergologie respiratoire, CHU Jean Minjoz, 25030 Besançon, France; Inserm, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, université Bourgogne Franche-Comté, Besançon, France
| | - G Eberst
- Service de pneumologie, oncologie thoracique et allergologie respiratoire, CHU Jean Minjoz, 25030 Besançon, France; Inserm, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, université Bourgogne Franche-Comté, Besançon, France
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10
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Pechlivanis S, Depner M, Kirjavainen PV, Roduit C, Täubel M, Frei R, Skevaki C, Hose A, Barnig C, Schmausser-Hechfellner E, Ege MJ, Schaub B, Divaret-Chauveau A, Lauener R, Karvonen AM, Pekkanen J, Riedler J, Illi S, von Mutius E. Continuous Rather Than Solely Early Farm Exposure Protects From Hay Fever Development. J Allergy Clin Immunol Pract 2023; 11:591-601. [PMID: 36356926 PMCID: PMC9907754 DOI: 10.1016/j.jaip.2022.10.035] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/12/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND An important window of opportunity for early-life exposures has been proposed for the development of atopic eczema and asthma. OBJECTIVE However, it is unknown whether hay fever with a peak incidence around late school age to adolescence is similarly determined very early in life. METHODS In the Protection against Allergy-Study in Rural Environments (PASTURE) birth cohort potentially relevant exposures such as farm milk consumption and exposure to animal sheds were assessed at multiple time points from infancy to age 10.5 years and classified by repeated measure latent class analyses (n = 769). Fecal samples at ages 2 and 12 months were sequenced by 16S rRNA. Hay fever was defined by parent-reported symptoms and/or physician's diagnosis of hay fever in the last 12 months using questionnaires at 10.5 years. RESULTS Farm children had half the risk of hay fever at 10.5 years (adjusted odds ratio [aOR] 0.50; 95% CI 0.31-0.79) than that of nonfarm children. Whereas early life events such as gut microbiome richness at 12 months (aOR 0.66; 95% CI 0.46-0.96) and exposure to animal sheds in the first 3 years of life (aOR 0.26; 95% CI 0.06-1.15) were determinants of hay fever, the continuous consumption of farm milk from infancy up to school age was necessary to exert the protective effect (aOR 0.35; 95% CI 0.17-0.72). CONCLUSIONS While early life events determine the risk of subsequent hay fever, continuous exposure is necessary to achieve protection. These findings argue against the notion that only early life exposures set long-lasting trajectories.
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Affiliation(s)
- Sonali Pechlivanis
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
| | - Martin Depner
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Pirkka V. Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Caroline Roduit
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland,Children's Hospital, University of Zurich, Zurich, Switzerland,Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Martin Täubel
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Remo Frei
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland,Division of Respiratory Medicine, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, Marburg, Germany,Member of the German Center for Lung Research, Gießen, Germany
| | - Alexander Hose
- Dr. von Hauner Children’s Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Cindy Barnig
- Institut national de la santé et de la recherche médicale, Établissement français du sang Bourgogne-Franche-Comté, LabEx LipSTIC, Unité Mixte de recherche 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, Besançon, France,Department of Chest Disease, University Hospital of Besançon, Besançon, France
| | - Elisabeth Schmausser-Hechfellner
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Markus J. Ege
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany,Member of the German Center for Lung Research, Gießen, Germany,Dr. von Hauner Children’s Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Bianca Schaub
- Member of the German Center for Lung Research, Gießen, Germany,Dr. von Hauner Children’s Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Amandine Divaret-Chauveau
- Pediatric Allergy Department, Children’s Hospital, University Hospital of Nancy, Vandoeuvre les Nancy, Nancy, France,UMR 6249 Chrono-environment, Centre National de la Recherche Scientifique and University of Franche-Comté, Besançon, France,EA3450 Development, Adaptation and Handicap, University of Lorraine, Nancy, France
| | - Roger Lauener
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland,Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Anne M. Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland,Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Sabina Illi
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Erika von Mutius
- Institute of Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany,Member of the German Center for Lung Research, Gießen, Germany,Dr. von Hauner Children’s Hospital, Ludwig Maximilians University Munich, Munich, Germany
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11
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Günther S, Gille T, Chenuel B, Aubourg F, Barnig C, Bayat S, Beydon N, Bonay M, Charloux A, Demoulin S, Hulo S, Ioana C, Rannou F, Gauthier R, Edmé JL, Plantier L. [Global Lung Initiative reference values are recommended for pulmonary function testing in France: A statement from the Lung Function Group of the French-Speaking Pulmonology Society]. Rev Mal Respir 2023; 40:198-201. [PMID: 36717334 DOI: 10.1016/j.rmr.2023.01.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/27/2022] [Indexed: 01/30/2023]
Affiliation(s)
- S Günther
- Unité d'explorations fonctionnelles respiratoires et du sommeil, université de Paris Cité, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - T Gille
- Inserm U1272 « Hypoxie et Poumon », service physiologie et explorations fonctionnelles, UFR SMBH Léonard-de-Vinci, université Sorbonne Paris Nord, hôpitaux universitaires de Paris Seine-Saint-Denis, AP-HP, Bobigny, France
| | - B Chenuel
- Exploration fonctionnelle respiratoire, centre universitaire de médecine du sport et activités physiques adaptées, DevAH, CHRU-Nancy, université de Lorraine, Nancy, France
| | - F Aubourg
- Service de physiologie, explorations fonctionnelles, université de Paris Cité, hôpital Cochin, AP-HP, Paris, France
| | - C Barnig
- Service de pneumologie, oncologie thoracique et allergologie respiratoire, CHRU Besançon, Besançon, France; Inserm, EFS BFC, LabEx LipSTIC, UMR1098, interactions hôte-greffon-tumeur/ingénierie cellulaire et génique, université de Bourgogne Franche-Comté, Besançon, France
| | - S Bayat
- STROBE Inserm UA07, laboratoire d'explorations fonctionnelles respiratoires, CHU de Grenoble-Alpes, université Grenoble-Alpes, Grenoble, France
| | - N Beydon
- Inserm U938, unité fonctionnelle de physiologie-explorations fonctionnelles respiratoires et du sommeil, centre de recherche Saint-Antoine, Sorbonne-université, hôpital Armand-Trousseau, hôpital Saint-Antoine, AP-HP, Paris, France
| | - M Bonay
- Service de physiologie - explorations fonctionnelles bi-sites Ambroise-Paré - Bicêtre, université Paris Saclay, hôpital Ambroise-Paré, AP-HP, Boulogne, France
| | - A Charloux
- Faculté de médecine, maïeutique et sciences de la santé de Strasbourg, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg cedex, France
| | - S Demoulin
- Inserm, service d'explorations fonctionnelles respiratoires, CNRS, CHU Lille, université de Lille, U1019-UMR9017-CIIL-centre d'infection et d'immunité de Lille, institut Pasteur de Lille, Lille, France
| | - S Hulo
- CHU de Lille, université de Lille, ULR 4483 - IMPECS - IMPact de l'environnement chimique sur la santé humaine, institut Pasteur Lille, Lille, France
| | - C Ioana
- Service d'explorations fonctionnelles pédiatriques, CHRU de Nancy ; EA DevAH, université de Lorraine, hôpital d'Enfants, Nancy, France
| | - F Rannou
- Équipe ASMS-UNH, service de médecine du sport & explorations fonctionnelles, CHU de Clermont-Ferrand, CRNH Auvergne, Clermont-Ferrand, France
| | - R Gauthier
- Unité d'explorations fonctionnelles respiratoires pédiatriques, CHU de Amiens-Picardie, Amiens, France
| | - J-L Edmé
- CHU de Lille, université de Lille, ULR 4483 - IMPECS - IMPact de l'environnement chimique sur la santé humaine, institut Pasteur Lille, Lille, France
| | - L Plantier
- CEPR/Inserm UMR1100, service de pneumologie et explorations respiratoires, CHRU de Tours, université de Tours, Tours, France.
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12
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Noureddine S, Roux-Claudé P, Laurent L, Ritter O, Dolla P, Karaer S, Claudé F, Eberst G, Westeel V, Barnig C. Evaluation of long-term sequelae by cardiopulmonary exercise testing 12 months after hospitalization for severe COVID-19. BMC Pulm Med 2023; 23:13. [PMID: 36635717 PMCID: PMC9834678 DOI: 10.1186/s12890-023-02313-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cardiopulmonary exercise testing (CPET) is an important clinical tool that provides a global assessment of the respiratory, circulatory and metabolic responses to exercise which are not adequately reflected through the measurement of individual organ system function at rest. In the context of critical COVID-19, CPET is an ideal approach for assessing long term sequelae. METHODS In this prospective single-center study, we performed CPET 12 months after symptom onset in 60 patients that had required intensive care unit treatment for a severe COVID-19 infection. Lung function at rest and chest computed tomography (CT) scan were also performed. RESULTS Twelve months after severe COVID-19 pneumonia, dyspnea was the most frequently reported symptom although only a minority of patients had impaired respiratory function at rest. Mild ground-glass opacities, reticulations and bronchiectasis were the most common CT scan abnormalities. The majority of the patients (80%) had a peak O2 uptake (V'O2) considered within normal limits (median peak predicted O2 uptake (V'O2) of 98% [87.2-106.3]). Length of ICU stay remained an independent predictor of V'O2. More than half of the patients with a normal peak predicted V'O2 showed ventilatory inefficiency during exercise with an abnormal increase of physiological dead space ventilation (VD/Vt) (median VD/VT of 0.27 [0.21-0.32] at anaerobic threshold (AT) and 0.29 [0.25-0.34] at peak) and a widened median peak alveolar-arterial gradient for O2 (35.2 mmHg [31.2-44.8]. Peak PetCO2 was significantly lower in subjects with an abnormal increase of VD/Vt (p = 0.001). Impairments were more pronounced in patients with dyspnea. Peak VD/Vt values were positively correlated with peak D-Dimer plasma concentrations from blood samples collected during ICU stay (r2 = 0.12; p = 0.02) and to predicted diffusion capacity of the lung for carbon monoxide (DLCO) (r2 = - 0.15; p = 0.01). CONCLUSIONS Twelve months after severe COVID-19 pneumonia, most of the patients had a peak V'O2 considered within normal limits but showed ventilatory inefficiency during exercise with increased dead space ventilation that was more pronounced in patients with persistent dyspnea. TRIAL REGISTRATION NCT04519320 (19/08/2020).
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Affiliation(s)
- Sofia Noureddine
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Pauline Roux-Claudé
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Lucie Laurent
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Ophélie Ritter
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Pauline Dolla
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Sinan Karaer
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Frédéric Claudé
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Guillaume Eberst
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France ,grid.7459.f0000 0001 2188 3779Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France and UMR 1098, University of Franche-Comté, Besançon, France
| | - Virginie Westeel
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France ,grid.7459.f0000 0001 2188 3779Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France and UMR 1098, University of Franche-Comté, Besançon, France
| | - Cindy Barnig
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France ,grid.7459.f0000 0001 2188 3779UMR1098, University of Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France
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13
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Divaret‐Chauveau A, Mauny F, Hose A, Depner M, Dalphin M, Kaulek V, Barnig C, Schaub B, Schmausser‐Hechfellner E, Renz H, Riedler J, Pekkanen J, Karvonen AM, Täubel M, Lauener R, Roduit C, Vuitton DA, von Mutius E, Demoulin‐Alexikova S, Kirjavainen P, Roponen M, Laurent L, Theodorou J, Böck A, Pechlivanis S, Ege M, Genuneit J, Illi S, Kabesch M, Pfefferle P, Frei R. Trajectories of cough without a cold in early childhood and associations with atopic diseases. Clin Exp Allergy 2022; 53:429-442. [PMID: 36453463 DOI: 10.1111/cea.14257] [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] [Received: 08/01/2022] [Revised: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Although children can frequently experience a cough that affects their quality of life, few epidemiological studies have explored cough without a cold during childhood. OBJECTIVES The objective of the study was to describe the latent class trajectories of cough from one to 10 years old and analyse their association with wheezing, atopy and allergic diseases. METHODS Questions about cough, wheeze and allergic diseases were asked at 1, 1.5, 2, 3, 4, 5, 6 and 10 years of age in the European prospective cohort of Protection against Allergy: STUdy in Rural Environment (PASTURE). Specific IgE assays were performed at 10 years of age. Questions regarding a cough without a cold were used to build a latent class model of cough over time. RESULTS Among the 961 children included in the study, apart from the never/infrequent trajectory (59.9%), eight trajectories of cough without a cold were identified: five grouped acute transient classes (24.1%), moderate transient (6.8%), late persistent (4.8%) and early persistent (4.4%). Compared with the never/infrequent trajectory, the other trajectories were significantly associated with wheezing, asthma and allergic rhinitis. For asthma, the strongest association was with the early persistent trajectory (ORa = 31.00 [14.03-68.51]), which was inversely associated with farm environment (ORa = 0.39 [0.19-0.77]) and had a high prevalence of cough triggers and unremitting wheeze. Late and early persistent trajectories were also associated with food allergy. Atopic sensitization was only associated with the late persistent trajectory. CONCLUSION Late and early persistent coughs without a cold are positively associated with atopic respiratory diseases and food allergy. Children having recurrent cough without a cold with night cough and triggers would benefit from an asthma and allergy assessment. Growing up on a farm is associated with reduced early persistent cough.
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Affiliation(s)
- Amandine Divaret‐Chauveau
- Paediatric Allergy Department University Hospital of Nancy Vandoeuvre‐les‐Nancy France
- EA3450 Développement Adaptation et Handicap (DevAH) University of Lorraine Nancy France
- UMR 6249 Chrono‐environment, CNRS and University of Franche‐Comté Besançon France
| | - Frederic Mauny
- UMR 6249 Chrono‐environment, CNRS and University of Franche‐Comté Besançon France
- Unité de Méthodologie en Recherche Clinique, Épidémiologie et Santé Publique CIC Inserm 143, University Hospital of Besançon Besançon France
| | - Alexander Hose
- Department of Paediatric Allergology, Dr von Hauner Children's Hospital Ludwig Maximilian University of Munich Munich Germany
| | - Martin Depner
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg Germany
| | | | - Vincent Kaulek
- Respiratory Diseases Department University Hospital of Besançon Besançon France
| | - Cindy Barnig
- Respiratory Diseases Department University Hospital of Besançon Besançon France
- INSERM, EFS BFC, LabEx LipSTIC, UMR1098, Interactions Hôte‐Greffon‐Tumeur, Ingénierie Cellulaire et Génique Bourgogne Franche‐Comté University Besançon France
| | - Bianca Schaub
- Department of Paediatric Allergology, Dr von Hauner Children's Hospital Ludwig Maximilian University of Munich Munich Germany
- Comprehensive Pneumology Center Munich (CPC‐M), Member of the German Centre for Lung Research Neuherberg Germany
| | - Elisabeth Schmausser‐Hechfellner
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg Germany
| | - Harald Renz
- Institute for Medicine Laboratory, Pathobiochemistry and Molecular Diagnostics Philipps‐University Marburg Marburg Germany
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergology Sechenov University Moscow Russia
| | | | - Juha Pekkanen
- Department of Health Security Finnish Institute for Health and Welfare Kuopio Finland
- Department of Public Health University of Helsinki Helsinki Finland
| | - Anne M. Karvonen
- Department of Health Security Finnish Institute for Health and Welfare Kuopio Finland
| | - Martin Täubel
- Department of Health Security Finnish Institute for Health and Welfare Kuopio Finland
| | - Roger Lauener
- Christine Kühne Centre for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Children's Hospital of Eastern Switzerland St Gallen Switzerland
| | - Caroline Roduit
- Christine Kühne Centre for Allergy Research and Education (CK‐CARE) Davos Switzerland
- University Children's Hospital Zurich Zurich Switzerland
| | | | - Erika von Mutius
- Department of Paediatric Allergology, Dr von Hauner Children's Hospital Ludwig Maximilian University of Munich Munich Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg Germany
- Comprehensive Pneumology Center Munich (CPC‐M), Member of the German Centre for Lung Research Neuherberg Germany
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14
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Sesé L, Mahay G, Barnig C, Guibert N, Leroy S, Guilleminault L. [Markers of severity and predictors of response to treatment in severe asthma]. Rev Mal Respir 2022; 39:740-757. [PMID: 36115752 DOI: 10.1016/j.rmr.2022.08.009] [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: 03/28/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Abstract
Asthma is a multifactorial disease with complex pathophysiology. Knowledge of its immunopathology and inflammatory mechanisms is progressing and has led to the development over recent years of increasingly targeted therapeutic strategies. The objective of this review is to pinpoint the different predictive markers of asthma severity and therapeutic response. Obesity, nasal polyposis, gastroesophageal reflux disease and intolerance to aspirin have all been considered as clinical markers associated with asthma severity, as have functional markers such as bronchial obstruction, low FEV1, small daily variations in FEV1, and high FeNO. While sinonasal polyposis and allergic comorbidities are associated with better response to omalizumab, nasal polyposis or long-term systemic steroid use are associated with better response to antibodies targeting the IL5 pathway. Elevated total IgE concentrations and eosinophil counts are classic biological markers regularly found in severe asthma. Blood eosinophils are predictive biomarkers of response to anti-IgE, anti-IL5, anti-IL5R and anti-IL4R biotherapies. Dupilumab is particularly effective in a subgroup of patients with marked type 2 inflammation (long-term systemic corticosteroid therapy, eosinophilia≥150/μl or FENO>20 ppb). Chest imaging may help to identify severe patients by seeking out bronchial wall thickening and bronchial dilation. Study of the patient's environment is crucial insofar as exposure to tobacco, dust mites and molds, as well as outdoor and indoor air pollutants (cleaning products), can trigger asthma exacerbation. Wider and more systematic use of markers of severity or response to treatment could foster increasingly targeted and tailored approaches to severe asthma.
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Affiliation(s)
- L Sesé
- AP-HP, service de physiologie, hôpital Avicenne, Bobigny, France
| | - G Mahay
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, CHU Rouen, Rouen, France
| | - C Barnig
- INSERM, EFS BFC, LabEx LipSTIC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, University Bourgogne Franche-Comté, Besançon, France; Service de pneumologie, oncologie thoracique et allergologie respiratoire, CHRU Besançon, Besançon, France
| | - N Guibert
- AP-HP, service de physiologie, hôpital Avicenne, Bobigny, France
| | - S Leroy
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, CNRS UMR 7275-FHU OncoAge, service de pneumologie oncologie thoracique et soins intensifs respiratoires, CHU de Nice, hôpital Pasteur, Nice, France
| | - L Guilleminault
- AP-HP, service de physiologie, hôpital Avicenne, Bobigny, France; Institut Toulousain des maladies infectieuses et inflammatoires (Infinity) inserm UMR1291-CNRS UMR5051-université Toulouse III, CRISALIS F-CRIN, Toulouse, France.
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15
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Eberst G, Claudé F, Laurent L, Meurisse A, Roux-Claudé P, Barnig C, Vernerey D, Paget-Bailly S, Bouiller K, Chirouze C, Behr J, Grillet F, Ritter O, Karaer S, Pili-Floury S, Winiszewski H, Samain E, Decavel P, Capellier G, Westeel V. Result of one-year, prospective follow-up of intensive care unit survivors after SARS-CoV-2 pneumonia. Ann Intensive Care 2022; 12:23. [PMID: 35262794 PMCID: PMC8905558 DOI: 10.1186/s13613-022-00997-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [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: 09/30/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Survivors of viral ARDS are at risk of long-term physical, functional and neuropsychological complications resulting from the lung injury itself, but also from potential multiorgan dysfunction, and the long stay in the intensive care unit (ICU). Recovery profiles after severe SARS-CoV-2 pneumonia in intensive care unit survivors have yet to be clearly defined. Material and methods The goal of this single-center, prospective, observational study was to systematically evaluate pulmonary and extrapulmonary function at 12 months after a stay in the ICU, in a prospectively identified cohort of patients who survived SARS-CoV-2 pneumonia. Eligible patients were assessed at 3, 6 and 12 months after onset of SARS-CoV-2. Patients underwent physical examination, pulmonary function testing, chest computed tomography (CT) scan, a standardized six-minute walk test with continuous oximetry, overnight home respiratory polygraphy and have completed quality of life questionnaire. The primary endpoint was alteration of the alveolar–capillary barrier compared to reference values as measured by DLCO, at 12 months after onset of SARS-CoV-2 symptoms. Results In total, 85 patients (median age 68.4 years, (interquartile range [IQR] = 60.1–72.9 years), 78.8% male) participated in the trial. The median length of hospital stay was 44 days (IQR: 20–60) including 17 days in ICU (IQR: 11–26). Pulmonary function tests were completed at 3 months (n = 85), 6 months (n = 80), and 12 months (n = 73) after onset of symptoms. Most patients showed an improvement in DLCO at each timepoint (3, 6, and 12 months). All patients who normalized their DLCO did not subsequently deteriorate, except one. Chest CT scans were abnormal in 77 patients (96.3%) at 3 months and although the proportion was the same at 12 months, but patterns have changed. Conclusion We report the results of a comprehensive evaluation of 85 patients admitted to the ICU for SARS-CoV-2, at one-year follow-up after symptom onset. We show that most patients had an improvement in DLCO at each timepoint. Trial registration: Clinical trial registration number: NCT04519320. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-022-00997-8. The most interesting findings were that most patients showed an improvement in their DLCO at 3, 6, and 12 months, and all patients but one who normalized their DLCO did not deteriorate afterwards. Only 11% of patients had persistent impairment of DLCO at 1 year.
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Affiliation(s)
- Guillaume Eberst
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France. .,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France. .,UMR 1098, University of Franche-Comté, Besançon, France.
| | - Fréderic Claudé
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Lucie Laurent
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Aurelia Meurisse
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Pauline Roux-Claudé
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Cindy Barnig
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Dewi Vernerey
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Kevin Bouiller
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Catherine Chirouze
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Julien Behr
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Franck Grillet
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Ophélie Ritter
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Sinan Karaer
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Sébastien Pili-Floury
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Hadrien Winiszewski
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Emmanuel Samain
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France
| | - Pierre Decavel
- Laboratory of Clinical Functional Exploration of Movement, Department of Physical Medicine and Rehabilitation, University Hospital of Besançon, Besançon, France
| | - Gilles Capellier
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France.,Australian and New Zealand Intensive Care Research Center, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Virginie Westeel
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
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16
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Poirot A, Wacht G, Lehalle C, Saas P, Frossard N, Geny B, de Blay F, Barnig C. NK cells and lipoxin A 4 promote resolution of eosinophilic inflammation after nasal allergen challenge. Allergy 2022; 77:309-313. [PMID: 34543440 DOI: 10.1111/all.15103] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/19/2021] [Accepted: 09/11/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Anh Poirot
- Department of Chest Disease University Hospital of Strasbourg Strasbourg France
| | | | - Christine Lehalle
- Laboratoire d’Innovation Thérapeutique and LabEx MEDALIS Faculté de Pharmacie UMR 7200 CNRS / Université de Strasbourg Strasbourg France
| | - Philippe Saas
- INSERM, EFS BFC LabEx LipSTIC UMR1098, Interactions Hôte‐Greffon‐Tumeur/Ingénierie Cellulaire et Génique Univ. Bourgogne Franche‐Comté Besançon France
| | - Nelly Frossard
- Laboratoire d’Innovation Thérapeutique and LabEx MEDALIS Faculté de Pharmacie UMR 7200 CNRS / Université de Strasbourg Strasbourg France
| | - Bernard Geny
- EA 3072 University of Strasbourg Strasbourg France
| | - Fréderic de Blay
- Department of Chest Disease University Hospital of Strasbourg Strasbourg France
- EA 3072 University of Strasbourg Strasbourg France
| | - Cindy Barnig
- INSERM, EFS BFC LabEx LipSTIC UMR1098, Interactions Hôte‐Greffon‐Tumeur/Ingénierie Cellulaire et Génique Univ. Bourgogne Franche‐Comté Besançon France
- Department of Chest Disease University Hospital of Besançon Besançon France
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17
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Traore I, Eberst G, Claudé F, Laurent L, Meurisse A, Paget-Bailly S, Roux-Claudé P, Jacoulet P, Barnig C, Martarello R, Poirson B, Bouiller K, Chirouze C, Behr J, Grillet F, Ritter O, Pili-Floury S, Winiszewski H, Samain E, Capellier G, Westeel V. Prevalence and Characteristics of Sleep Apnea in Intensive Care Unit Survivors After SARS-CoV-2 Pneumonia. Nat Sci Sleep 2022; 14:2213-2225. [PMID: 36578669 PMCID: PMC9791936 DOI: 10.2147/nss.s377946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sleep apnea (SA) was reported as possibly exacerbating symptoms of COVID-19, a disease induced by SARS-CoV-2 virus. The same comorbidities are common with both pathologies. This study aimed to estimate the prevalence, characteristics of SA and variation in AHI three months after severe COVID-19 requiring intensive care unit (ICU) admission. METHODS A prospective cohort of patients admitted to ICU for severe COVID-19 underwent an overnight home polygraphy 3 months after onset of symptoms, as part of a comprehensive follow-up program (pulmonary function tests, 6-minute walk tests and chest CT-scan). Patients with an apnea hypopnea index (AHI) ≥5 were considered as having SA. We performed a comparative descriptive analysis of 2 subgroups according to the existence, severity of SA and indication for effective SA treatment: patients with absent or mild SA (AHI <15) vs patients with moderate to severe SA (AHI ≥15). RESULTS Among 68 patients included, 62 (91%) had known comorbidities (34 hypertension, 21 obesity, 20 dyslipidemia, 16 type 2 diabetes). It has been observed a preexisting SA for 13 patients (19.1%). At 3 months, 62 patients (91%) had SA with 85.5% of obstructive events. Twenty-four patients had no or a mild SA (AHI <15) and 44 had moderate to severe SA (AHI ≥15). Ischemic heart disease exclusively affected the moderate to severe SA group. Except for thoracic CT-scan which revealed less honeycomb lesions, COVID-19 symptoms were more severe in the group with moderate to severe SA, requiring a longer curarization, more prone position sessions and more frequent tracheotomy. CONCLUSION SA involved 91% of patients in our population at 3 months of severe COVID-19 and was mainly obstructive type. Although SA might be a risk factor as well as consequences of ICU care in severe COVID-19 infection, our results underline the importance of sleep explorations after an ICU stay for this disease.
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Affiliation(s)
- Ibrahim Traore
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Guillaume Eberst
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Fréderic Claudé
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Lucie Laurent
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Aurelia Meurisse
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Pauline Roux-Claudé
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Pascale Jacoulet
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Cindy Barnig
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Rachel Martarello
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Bastien Poirson
- Department of Geriatrics, University Hospital of Besançon, Besançon, France
| | - Kevin Bouiller
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Catherine Chirouze
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Julien Behr
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Franck Grillet
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Ophélie Ritter
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Sébastien Pili-Floury
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Hadrien Winiszewski
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Emmanuel Samain
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France
| | - Gilles Capellier
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France.,Australian and New Zealand Intensive Care Research Center, Department of Epidemiology and Preventive Medicine, Monash University, Monash, Australia
| | - Virginie Westeel
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
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18
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Barnig C, Bezema T, Calder PC, Charloux A, Frossard N, Garssen J, Haworth O, Dilevskaya K, Levi-Schaffer F, Lonsdorfer E, Wauben M, Kraneveld AD, Te Velde AA. Activation of Resolution Pathways to Prevent and Fight Chronic Inflammation: Lessons From Asthma and Inflammatory Bowel Disease. Front Immunol 2019; 10:1699. [PMID: 31396220 PMCID: PMC6664683 DOI: 10.3389/fimmu.2019.01699] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [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: 11/06/2018] [Accepted: 07/08/2019] [Indexed: 12/15/2022] Open
Abstract
Formerly considered as a passive process, the resolution of acute inflammation is now recognized as an active host response, with a cascade of coordinated cellular and molecular events that promotes termination of the inflammatory response and initiates tissue repair and healing. In a state of immune fitness, the resolution of inflammation is contained in time and space enabling the restoration of tissue homeostasis. There is increasing evidence that poor and/or inappropriate resolution of inflammation participates in the pathogenesis of chronic inflammatory diseases, extending in time the actions of pro-inflammatory mechanisms, and responsible in the long run for excessive tissue damage and pathology. In this review, we will focus on how resolution can be the target for therapy in "Th1/Th17 cell-driven" immune diseases and "Th2 cell-driven" immune diseases, with inflammatory bowel diseases (IBD) and asthma, as relevant examples. We describe the main cells and mediators stimulating the resolution of inflammation and discuss how pharmacological and dietary interventions but also life style factors, physical and psychological conditions, might influence the resolution phase. A better understanding of the impact of endogenous and exogenous factors on the resolution of inflammation might open a whole area in the development of personalized therapies in non-resolving chronic inflammatory diseases.
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Affiliation(s)
- Cindy Barnig
- Department of Chest Disease, Strasbourg University Hospital, Strasbourg, France.,Equipe d'accueil 3072, University of Strasbourg, Strasbourg, France
| | | | - Philip C Calder
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Anne Charloux
- Department of Chest Disease, Strasbourg University Hospital, Strasbourg, France.,Equipe d'accueil 3072, University of Strasbourg, Strasbourg, France
| | - Nelly Frossard
- UMR 7200 CNRS/Université de Strasbourg, Laboratoire d'Innovation Thérapeutique and LabEx MEDALIS, Faculté de Pharmacie, Strasbourg, France
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.,Nutricia Research, Utrecht, Netherlands
| | - Oliver Haworth
- Biochemical Pharmacology, William Harvey Research Institute, Bart's School of Medicine and Queen Mary University of London, London, United Kingdom
| | - Ksenia Dilevskaya
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Francesca Levi-Schaffer
- Pharmacology and Experimental Therapeutics Unit, Faculty of Medicine, School of Pharmacy, Institute for Drug Research, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Evelyne Lonsdorfer
- Department of Chest Disease, Strasbourg University Hospital, Strasbourg, France.,Equipe d'accueil 3072, University of Strasbourg, Strasbourg, France
| | - Marca Wauben
- Department of Biochemistry & Cell Biology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Aletta D Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.,Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Anje A Te Velde
- Amsterdam UMC, Tytgat Institute for Liver and Intestinal Research, University of Amsterdam, AGEM, Amsterdam, Netherlands
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19
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Wacht G, Poirot A, Charles AL, Radosavljevic M, Uring-Lambert B, de Blay F, Geny B, Bahram S, Barnig C. FACS - based isolation of human eosinophils allows purification of high quality RNA. J Immunol Methods 2018; 463:47-53. [PMID: 30217720 DOI: 10.1016/j.jim.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 06/10/2018] [Revised: 08/18/2018] [Accepted: 09/06/2018] [Indexed: 12/25/2022]
Abstract
Here we extensively describe a FACS-based protocol for isolating intact non-stained human eosinophils from peripheral blood; a stop forward from our recently published initial study. This method of purification could be accomplished in <3 h with only small volumes of whole blood necessary, even in healthy subjects generally exhibiting low levels of circulating eosinophils. Eosinophil activation during the isolation steps appeared to be minimal and this purification procedure yielded high quality RNA. Moreover, these FACS-isolated eosinophils had prolonged viability in culture and were suitable for further activation assays.
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Affiliation(s)
- Guillaume Wacht
- Laboratoire Central d'Immunologie, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Nouvel Hôpital Civil, 67091 Strasbourg Cedex, France; EA 3072, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, 67085 Strasbourg Cedex, France
| | - Anh Poirot
- Pulmonology Unit, Department of Chest Disease, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg University Hospital, 67091 Strasbourg Cedex, France
| | - Anne-Laure Charles
- EA 3072, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, 67085 Strasbourg Cedex, France
| | - Mirjana Radosavljevic
- Laboratoire Central d'Immunologie, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Nouvel Hôpital Civil, 67091 Strasbourg Cedex, France; INSERM UMR S_1109, ImmunoRhumatologie Moléculaire, Labex Transplantex, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, University de Strasbourg, 67085 Strasbourg, France
| | - Béatrice Uring-Lambert
- Laboratoire Central d'Immunologie, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Nouvel Hôpital Civil, 67091 Strasbourg Cedex, France
| | - Frédéric de Blay
- EA 3072, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, 67085 Strasbourg Cedex, France; Pulmonology Unit, Department of Chest Disease, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg University Hospital, 67091 Strasbourg Cedex, France
| | - Bernard Geny
- EA 3072, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, 67085 Strasbourg Cedex, France; Physiology Unit, Department of Chest Disease, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg University Hospital, 67091 Strasbourg Cedex, France
| | - Seiamak Bahram
- Laboratoire Central d'Immunologie, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Nouvel Hôpital Civil, 67091 Strasbourg Cedex, France; INSERM UMR S_1109, ImmunoRhumatologie Moléculaire, Labex Transplantex, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, University de Strasbourg, 67085 Strasbourg, France
| | - Cindy Barnig
- Laboratoire Central d'Immunologie, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Nouvel Hôpital Civil, 67091 Strasbourg Cedex, France; Pulmonology Unit, Department of Chest Disease, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg University Hospital, 67091 Strasbourg Cedex, France; INSERM UMR S_1109, ImmunoRhumatologie Moléculaire, Labex Transplantex, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, University de Strasbourg, 67085 Strasbourg, France.
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20
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Abdulnour REE, Gunderson T, Barkas I, Timmons JY, Barnig C, Gong M, Kor DJ, Gajic O, Talmor D, Carter RE, Levy BD. Early Intravascular Events Are Associated with Development of Acute Respiratory Distress Syndrome. A Substudy of the LIPS-A Clinical Trial. Am J Respir Crit Care Med 2018; 197:1575-1585. [PMID: 29782179 PMCID: PMC6006404 DOI: 10.1164/rccm.201712-2530oc] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 12/15/2017] [Accepted: 05/21/2018] [Indexed: 02/01/2023] Open
Abstract
RATIONALE Acute respiratory distress syndrome (ARDS) is a devastating illness with limited therapeutic options. A better understanding of early biochemical and immunological events in ARDS could inform the development of new preventive and treatment strategies. OBJECTIVES To determine select peripheral blood lipid mediator and leukocyte responses in patients at risk for ARDS. METHODS Patients at risk for ARDS were randomized as part of a multicenter, double-blind clinical trial of aspirin versus placebo (the LIPS-A [Lung Injury Prevention Study with Aspirin] trial; NCT01504867). Plasma thromboxane B2 (TXB2), aspirin-triggered lipoxin A4 (15-epi-LXA4, ATL), and peripheral blood leukocyte number and activation were determined on enrollment and after treatment with either aspirin or placebo. MEASUREMENTS AND MAIN RESULTS Thirty-three of 367 subjects (9.0%) developed ARDS after randomization. Baseline ATL levels, total monocyte counts, intermediate monocyte counts, and monocyte-platelet aggregates were associated with the development of ARDS. Peripheral blood neutrophil count and monocyte-platelet aggregates significantly decreased over time. Of note, nine subjects developed ARDS after randomization yet before study drug initiation, including seven subjects assigned to aspirin treatment. Subjects without ARDS at the time of first dose demonstrated a lower incidence of ARDS with aspirin treatment. Compared with placebo, aspirin significantly decreased TXB2 and increased the ATL/TXB2 ratio. CONCLUSIONS Biomarkers of intravascular monocyte activation in at-risk patients were associated with development of ARDS. The potential clinical benefit of early aspirin for prevention of ARDS remains uncertain. Together, results of the biochemical and immunological analyses provide a window into the early pathogenesis of human ARDS and represent potential vascular biomarkers of ARDS risk. Clinical trial registered with www.clinicaltrials.gov (NCT01504867).
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Affiliation(s)
- Raja-Elie E. Abdulnour
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tina Gunderson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research
| | - Ioanna Barkas
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jack Y. Timmons
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cindy Barnig
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Chest Disease, University Hospital of Strasbourg and Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Michelle Gong
- Department of Medicine and
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Montefiore Healthcare Center, Bronx, New York; and
| | - Daryl J. Kor
- Department of Anesthesiology and Perioperative Medicine, and
| | - Ognjen Gajic
- Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Daniel Talmor
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Rickey E. Carter
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research
| | - Bruce D. Levy
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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21
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Abstract
Asthma is a chronic disorder characterized by persistent inflammation of the airways with mucosal infiltration of eosinophils, T lymphocytes, and mast cells, and release of proinflammatory cytokines and lipid mediators. The natural resolution of airway inflammation is now recognized as an active host response, with highly coordinated cellular events under the control of endogenous pro-resolving mediators that enable the restoration of tissue homeostasis. Lead members of proresolving mediators are enzymatically derived from essential polyunsaturated fatty acids, including arachidonic acid-derived lipoxins, eicosapentaenoic acid-derived E-series resolvins, and docosahexaenoic acid-derived D-series resolvins, protectins, and maresins. Functionally, these specialized pro-resolving mediators can limit further leukocyte recruitment, induce granulocyte apoptosis, and enhance efferocytosis by macrophages. They can also switch macrophages from classical to alternatively activated cells, promote the return of non-apoptotic cells to lymphatics and blood vessels, and help initiate tissue repair and healing. In this review, we highlight cellular and molecular mechanisms for successful resolution of inflammation, and describe the main specialized pro-resolving mediators that drive these processes. Furthermore, we report recent data suggesting that the pathobiology of severe asthma may result in part from impaired resolution of airway inflammation, including defects in the biosynthesis of these specialized pro-resolving mediators. Finally, we discuss resolution-based therapeutic perspectives.
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Affiliation(s)
- Cindy Barnig
- Department of Chest Disease, Strasbourg University Hospital, 1, place de l'Hôpital, 67091 Strasbourg, France; EA 3072, University of Strasbourg, France.
| | - Nelly Frossard
- UMR 7200 CNRS/Université de Strasbourg, Laboratoire d'Innovation Thérapeutique and LabEx MEDALIS, Faculté de Pharmacie, Strasbourg, France
| | - Bruce D Levy
- Pulmonary and Critical Care Medicine, Department of Internal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
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22
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Gantner P, Partisani M, Barnig C, Beck-Wirth G, Faller J, Artinot M, Mohseni-Zadeh M, Cheneau C, Batard M, Fuchs A, Fischer P, Bahram S, Rey D, Fafi-Kremer S. HIV-DNA, CD32a CD4+ T-cells and immune activation on successfull dolutegravir-based regimen. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30621-x] [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: 11/29/2022] Open
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23
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Barnig C. [New inflammatory pathways in asthma: the pathophysiology of asthma revisited]. Rev Prat 2017; 67:962-965. [PMID: 30717579] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the same way, the clinical presentation of asthma may differ from one individual to another, it has been demonstrated that the nature and extent of bronchial inflammation in asthma also varies among subjects. Thus, the composition of the bronchial inflammatory infiltrate makes it possible to distinguish at least two molecular signatures, each with a distinct pathophysiology. A "Th2" profile, the most frequent, with increased total E immunoglobulin levels, the presence of eosinophils and "Th2" cytokines (IL-4, IL-5 and IL-13) in the airways. It includes classical allergic asthma related to an abnormal adaptive immune response but also a subtype of non-allergic asthma where eosinophil accumulation is under the control of the innate immune system via a newly identified cell population, called type 2 innate lymphoid cells (ILC2); type 2-driven asthma is thus an emerging nomenclature for a common subtype of asthma. And a "non-Th2" profile, including the accumulation of neutrophils in the airways, with new pathways beginning to be uncovered.
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Affiliation(s)
- Cindy Barnig
- Service de physiologie et d’explorations fonctionnelles, pôle de pathologie thoracique, Hôpitaux universitaires de Strasbourg, Strasbourg, France
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24
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Barnig C, Baron-Thurotte A, Barbaud A, Beaudouin E, de Blay F, Bonniaud P, Demoly P, Deschildre A, Didier A, Drouet M, Just J, Lavaud F, Mailhol C, Metz-Favre C, Neukirch C, Petit N, Perotin JM, Ponvert C, Sauvage C, Magnan A, Birnbaum J. Recommandations de la Société Française d’Allergologie. Indications des actes allergologiques en Hôpital de Jour. Revue Française d'Allergologie 2017. [DOI: 10.1016/j.reval.2017.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Duvall MG, Barnig C, Cernadas M, Ricklefs I, Krishnamoorthy N, Grossman NL, Bhakta NR, Fahy JV, Bleecker ER, Castro M, Erzurum SC, Gaston BM, Jarjour NN, Mauger DT, Wenzel SE, Comhair SA, Coverstone AM, Fajt ML, Hastie AT, Johansson MW, Peters MC, Phillips BR, Israel E, Levy BD. Natural killer cell-mediated inflammation resolution is disabled in severe asthma. Sci Immunol 2017; 2:2/9/eaam5446. [PMID: 28783702 DOI: 10.1126/sciimmunol.aam5446] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/27/2017] [Indexed: 12/24/2022]
Abstract
Severe asthma is typically characterized by chronic airway inflammation that is refractory to corticosteroids and associated with excess morbidity. Patients were recruited into the National Heart, Lung, and Blood Institute-sponsored Severe Asthma Research Program and comprehensively phenotyped by bronchoscopy. Bronchoalveolar lavage (BAL) cells were analyzed by flow cytometry. Compared with healthy individuals (n = 21), patients with asthma (n = 53) had fewer BAL natural killer (NK) cells. Patients with severe asthma (n = 29) had a marked increase in the ratios of CD4+ T cells to NK cells and neutrophils to NK cells. BAL NK cells in severe asthma were skewed toward the cytotoxic CD56dim subset, with significantly increased BAL fluid levels of the cytotoxic mediator granzyme A. The numbers of BAL CD56dim NK cells and CCR6-CCR4- T helper 1-enriched CD4+ T cells correlated inversely with lung function [forced expiratory volume in 1 s (FEV1) % predicted] in asthma. Relative to cells from healthy controls, peripheral blood NK cells from asthmatic patients had impaired killing of K562 myeloid target cells despite releasing more cytotoxic mediators. Ex vivo exposure to dexamethasone markedly decreased blood NK cell lysis of target cells and cytotoxic mediator release. NK cells expressed airway lipoxin A4/formyl peptide receptor 2 receptors, and in contrast to dexamethasone, lipoxin A4-exposed NK cells had preserved functional responses. Together, our findings indicate that the immunology of the severe asthma airway is characterized by decreased NK cell cytotoxicity with increased numbers of target leukocytes, which is exacerbated by corticosteroids that further disable NK cell function. These failed resolution mechanisms likely contribute to persistent airway inflammation in severe asthma.
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Affiliation(s)
- Melody G Duvall
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Cindy Barnig
- Department of Chest Diseases, University Hospital of Strasbourg, Strasbourg, France
| | - Manuela Cernadas
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Isabell Ricklefs
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Nandini Krishnamoorthy
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Nicole L Grossman
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Nirav R Bhakta
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - John V Fahy
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Eugene R Bleecker
- Center for Genomics and Personalized Medicine Research, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Mario Castro
- Division of Pulmonary and Critical Care Medicine, Departments of Medicine and Pediatrics, Washington University, St. Louis, MO 63110, USA
| | - Serpil C Erzurum
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Benjamin M Gaston
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Nizar N Jarjour
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - David T Mauger
- Division of Statistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University, Hershey, PA 17033, USA
| | - Sally E Wenzel
- Pulmonary, Allergy and Critical Care Medicine Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Suzy A Comhair
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Andrea M Coverstone
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Merritt L Fajt
- Pulmonary, Allergy and Critical Care Medicine Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Annette T Hastie
- Center for Genomics and Personalized Medicine Research, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Mats W Johansson
- Department of Biomolecular Chemistry, University of Wisconsin School of Medicine and Public Health, Madison, WI 53706, USA
| | - Michael C Peters
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Brenda R Phillips
- Division of Statistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University, Hershey, PA 17033, USA
| | - Elliot Israel
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Bruce D Levy
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Abstract
INTRODUCTION Omalizumab is used as a treatment for severe allergic asthma. Its intended mechanism of action is based on its anti-IgE proprieties. However, recent studies have highlighted other mechanisms of action. STATE OF THE ART Omalizumab treatment is associated with a decrease in the number of dendritic cells, T and B lymphocytes and eosinophils. This anti-inflammatory activity is characterized by a decrease in the levels of several cytokines involved in the recruitment, activation and survival of eosinophils and mastocytes, and in a Th2 orientation of the immune response. A modulation of bronchial remodeling by omalizumab has recently been shown. A decrease in the production of extracellular matrix components and in the proliferation of smooth muscle cells could be involved in this modulation. These mechanisms of action could explain in part the clinical efficiency of omalizumab in non-allergic conditions such as non-allergic asthma, non-allergic urticaria or nasal polyposis. CONCLUSION A precise knowledge of the mechanisms of action of omalizumab could allow the identification of biomarkers predictive of efficacy of this treatment. These could be useful tools in the phenotyping of severe asthma.
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Affiliation(s)
- J-M Perotin
- Service des maladies respiratoires, Inserm UMRS 903, centre hospitalier universitaire, 45, rue Cognacq-Jay, 51100 Reims, France.
| | - C Barnig
- Service de physiologie et d'explorations fonctionnelles, pôle de pathologie thoracique, centre hospitalier universitaire, 67000 Strasbourg, France
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Qi S, Barnig C, Charles AL, Poirot A, Meyer A, Clere-Jehl R, de Blay F, Geny B. Effect of nasal allergen challenge in allergic rhinitis on mitochondrial function of peripheral blood mononuclear cells. Ann Allergy Asthma Immunol 2017; 118:367-369. [PMID: 28073613 DOI: 10.1016/j.anai.2016.11.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/24/2016] [Accepted: 11/29/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Shanshan Qi
- Université de Strasbourg, Mitochondrie, Stress Oxydant et Protection Musculaire, Strasbourg, France; Service de Pneumologie, Pôle de Pathologie Thoracique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Fédération de Médecine Translationnelle, Strasbourg, France
| | - Cindy Barnig
- Université de Strasbourg, Mitochondrie, Stress Oxydant et Protection Musculaire, Strasbourg, France; Fédération de Médecine Translationnelle, Strasbourg, France; Service de Physiologie et d'Explorations Fonctionnelles, Pôle de Pathologie Thoracique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
| | - Anne-Laure Charles
- Université de Strasbourg, Mitochondrie, Stress Oxydant et Protection Musculaire, Strasbourg, France
| | - Anh Poirot
- Service de Pneumologie, Pôle de Pathologie Thoracique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Alain Meyer
- Université de Strasbourg, Mitochondrie, Stress Oxydant et Protection Musculaire, Strasbourg, France; Fédération de Médecine Translationnelle, Strasbourg, France; Service de Physiologie et d'Explorations Fonctionnelles, Pôle de Pathologie Thoracique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Raphaël Clere-Jehl
- Université de Strasbourg, Mitochondrie, Stress Oxydant et Protection Musculaire, Strasbourg, France; Fédération de Médecine Translationnelle, Strasbourg, France
| | - Fréderic de Blay
- Université de Strasbourg, Mitochondrie, Stress Oxydant et Protection Musculaire, Strasbourg, France; Service de Pneumologie, Pôle de Pathologie Thoracique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Fédération de Médecine Translationnelle, Strasbourg, France
| | - Bernard Geny
- Université de Strasbourg, Mitochondrie, Stress Oxydant et Protection Musculaire, Strasbourg, France; Fédération de Médecine Translationnelle, Strasbourg, France; Service de Physiologie et d'Explorations Fonctionnelles, Pôle de Pathologie Thoracique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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28
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Barnig C, Veaudor M, Gautier C, Margelidon-Cozzolino V, Pigearias B, Devouassoux G, Raherison C, De Blay F, Chanez P. [How to consider triggers and comorbid conditions in severe asthma in adults]. Presse Med 2016; 45:1030-1042. [PMID: 27544706 DOI: 10.1016/j.lpm.2016.07.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/05/2016] [Accepted: 07/12/2016] [Indexed: 12/16/2022] Open
Abstract
Triggers and precipitating factors as well as comorbid conditions are associated with asthma and severe asthma. They interfere with the potential to control the disease and represent an additional burden for the patients. Allergen exposure is well known to induce loss of control and exacerbations. Comorbid conditions belong to various fields of medicines including cardiovascular diseases, osteoporosis, obesity and sleep apneas and GERD. They should be diagnosed and treated for themselves according to the best state of the art. Their precise role et their contribution to severe asthma pathophysiology is largely unknown and longitudinal cohort studies are needed to better understand and treat the patients with severe asthma.
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Affiliation(s)
- Cindy Barnig
- Hôpitaux universitaires de Strasbourg, département de pneumologie, 67000 Strasbourg, France
| | - Martin Veaudor
- Université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, service de pneumologie, HCL, CIRI Inserm U1111, 69001 Lyon, France
| | - Clarisse Gautier
- AP-HM, Aix-Marseille université, département des maladies respiratoires, UMR 7333 CNRS, Inserm U1067, 13015 Marseille, France
| | - Victor Margelidon-Cozzolino
- Université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, service de pneumologie, HCL, CIRI Inserm U1111, 69001 Lyon, France
| | | | - Gilles Devouassoux
- Université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, service de pneumologie, HCL, CIRI Inserm U1111, 69001 Lyon, France
| | - Chantal Raherison
- CHU de Bordeaux, université de Bordeaux, service des maladies respiratoires, ISPED, U897, 33000 Bordeaux, France
| | - Frederic De Blay
- Hôpitaux universitaires de Strasbourg, département de pneumologie, 67000 Strasbourg, France
| | - Pascal Chanez
- AP-HM, Aix-Marseille université, département des maladies respiratoires, UMR 7333 CNRS, Inserm U1067, 13015 Marseille, France.
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Sylvestre L, Jégu J, Metz-Favre C, Barnig C, Qi S, de Blay F. Component-Based Allergen-Microarray: Der p 2 and Der f 2 Dust Mite Sensitization Is More Common in Patients With Severe Asthma. J Investig Allergol Clin Immunol 2016; 26:141-3. [PMID: 27164641 DOI: 10.18176/jiaci.0035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- L Sylvestre
- Pharmacy-Sterilization Department, University Hospital of Strasbourg, France
| | - J Jégu
- Public Health Department, University Hospital of Strasbourg, France.,Epidemiology Department, EA3430, FMTS, University of Strasbourg, France
| | - C Metz-Favre
- Chest Disease Department, University Hospital of Strasbourg, France
| | - C Barnig
- Chest Disease Department, University Hospital of Strasbourg, France
| | - S Qi
- Chest Disease Department, University Hospital of Strasbourg, France
| | - F de Blay
- Chest Disease Department, University Hospital of Strasbourg, France
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Affiliation(s)
- C Radu
- Department of Chest Disease, University Hospital of Strasbourg, France
| | - C Barnig
- Department of Chest Disease, University Hospital of Strasbourg, France.,Federation of Translational Medicine, EA3072, University of Strasbourg, France
| | - F de Blay
- Department of Chest Disease, University Hospital of Strasbourg, France.,Federation of Translational Medicine, EA3072, University of Strasbourg, France
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31
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Abstract
The resolution of inflammation is an integral and natural part of the physiological response to tissue injury, infection and allergens or other noxious stimuli. Resolution is now recognised as an active process with highly regulated cellular and biochemical events. Recent discoveries have highlighted that innate inflammatory cells have bimodal effector functions during the inflammatory response, including active roles during the resolution process. Several mediators displaying potent pro-resolving actions have recently been uncovered. Lipoxin A4, the lead member of this new class of pro-resolving mediators, has anti-inflammatory actions on type 2 innate lymphoid cells and pro-resolving actions through natural killer cells in asthma immunobiology. Eosinophils are also able to control crucial aspects of resolution through the generation of pro-resolving mediators. Uncontrolled asthma has been associated with a defect in the generation of specialised pro-resolving mediators, including lipoxin A4 and protectin D1. Thus, bioactive stable analogue mimetics of these mediators that can harness endogenous resolution mechanisms for inflammation may offer new therapeutic strategies for asthma and airway inflammation associated diseases.
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Affiliation(s)
- Cindy Barnig
- Dept of Chest Disease, University Hospital of Strasbourg and FMTS (Fédération de Médecine Translationnelle de Strasbourg), Strasbourg, France
| | - Bruce D Levy
- Pulmonary and Critical Care Medicine, Dept of Internal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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de Blay F, Doyen V, Lutz C, Godet J, Barnig C, Qi S, Braun JJ. A new, faster, and safe nasal provocation test method for diagnosing mite allergic rhinitis. Ann Allergy Asthma Immunol 2015; 115:385-390.e1. [PMID: 26265011 DOI: 10.1016/j.anai.2015.07.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/20/2015] [Accepted: 07/22/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND Diagnosing house dust mite (HDM) allergic rhinitis is difficult. The nasal provocation test (NPT) has been shown to be the most pertinent, but several methods are available. According to guidelines, the NPT requires a skin end-point titration and an objective measurement of nasal patency. Hence, NPT is time consuming and its use is limited. OBJECTIVE To evaluate the sensitivity, specificity, and safety of a new, more rapid, and simple alternative NPT (NPT-R) to HDM. METHODS Eighty-eight patients with from rhinitis (49 allergic to HDM and 39 controls with and without atopy) were included. Allergic rhinitis to HDM was confirmed by a "classic" NPT based on the Lebel score and rhinomanometry. After a period of 4 weeks, NPT-R was performed and only the clinical score was measured. RESULTS The study population was young (mean ± SD, 27.7 ± 8.5 years old), composed mostly of women (61 vs 27 men), and 24% reported asthma. The sensitivity and specificity of NPT-R were 83.7% and 100%, respectively. The correlation between the NPTs was statistically significant (0.833, P < .0001, n = 88) and the 2 NPTs were completely safe. Performing NPT-R was more rapid (mean ± SD, 22 ± 8 minutes) than the classic NPT (97 ± 20 minutes). CONCLUSION The NPT-R is safe and easier and faster than the classic NPT. This new method appears to be a very useful tool in the diagnosis of HDM allergic rhinitis when the diagnosis is uncertain or before initiating immunotherapy. TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT01485523.
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Affiliation(s)
- Frédéric de Blay
- Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Virginie Doyen
- Immuno-Allergology Clinic, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
| | - Céline Lutz
- Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Julien Godet
- Statistics Department, Strasbourg University Hospital, Strasbourg, France
| | - Cindy Barnig
- Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Shanshan Qi
- Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Jean-Jacques Braun
- Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
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Bellier M, Barnig C, Renaudin J, Sbinne B, De Blay F. Test de provocation bronchique spécifique : importance dans le diagnostic de l’asthme professionnel. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2014.10.120] [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: 10/24/2022]
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Barnig C, Cernadas M, Dutile S, Liu X, Perrella MA, Kazani S, Wechsler ME, Israel E, Levy BD. Lipoxin A4 regulates natural killer cell and type 2 innate lymphoid cell activation in asthma. Sci Transl Med 2014; 5:174ra26. [PMID: 23447017 DOI: 10.1126/scitranslmed.3004812] [Citation(s) in RCA: 360] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Asthma is a prevalent disease of chronic inflammation in which endogenous counterregulatory signaling pathways are dysregulated. Recent evidence suggests that innate lymphoid cells (ILCs), including natural killer (NK) cells and type 2 ILCs (ILC2s), can participate in the regulation of allergic airway responses, in particular airway mucosal inflammation. We have identified both NK cells and ILC2s in human lung and peripheral blood in healthy and asthmatic subjects. NK cells were highly activated in severe asthma, were linked to eosinophilia, and interacted with autologous eosinophils to promote their apoptosis. ILC2s generated antigen-independent interleukin-13 (IL-13) in response to the mast cell product prostaglandin D2 alone and in a synergistic manner with the airway epithelial cytokines IL-25 and IL-33. Both NK cells and ILC2s expressed the pro-resolving ALX/FPR2 receptors. Lipoxin A4, a natural pro-resolving ligand for ALX/FPR2 receptors, significantly increased NK cell-mediated eosinophil apoptosis and decreased IL-13 release by ILC2s. Together, these findings indicate that ILCs are targets for lipoxin A4 to decrease airway inflammation and mediate the catabasis of eosinophilic inflammation. Because lipoxin A4 generation is decreased in severe asthma, these findings also implicate unrestrained ILC activation in asthma pathobiology.
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Affiliation(s)
- Cindy Barnig
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
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36
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Barnig C, de Blay F. [Pathophysiology of multiple chemical sensitivity]. Rev Mal Respir 2013; 30:446-50. [PMID: 23835316 DOI: 10.1016/j.rmr.2013.02.016] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 02/11/2013] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND BACKGROUND Multiple chemical sensitivity (MCS) is a complex clinical entity that includes a large number of non-specific symptoms, associated in a univocal manner in each patient and triggered by exposure to various chemicals at low concentrations, well below those known to cause toxic effects. However, no objective test exists currently to diagnose this syndrome. One of the main reasons is that the pathophysiology is poorly understood. However, many explanatory hypotheses have been proposed. VIEWPOINTS AND CONCLUSIONS Patients with symptoms of MCS are often encountered by pulmonologists. Their suffering is undeniable but, unfortunately, the lack of understanding of the pathophysiological mechanisms makes treatment difficult and empirical.
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Affiliation(s)
- C Barnig
- Service de pneumologie, d'allergologie et de pathologie respiratoire de l'environnement, pôle de pathologie thoracique, hôpitaux universitaires de Strasbourg, BP 426, 67091 Strasbourg cedex, France.
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Barnig C, Reboux G, Roussel S, Casset A, Sohy C, Dalphin JC, de Blay F. Indoor dust and air concentrations of endotoxin in urban and rural environments. Lett Appl Microbiol 2013; 56:161-7. [PMID: 23121051 DOI: 10.1111/lam.12024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 10/30/2012] [Accepted: 10/30/2012] [Indexed: 11/30/2022]
Abstract
SIGNIFICANCE AND IMPACT OF THE STUDY Rural dairy farming is associated with high exposure to indoor endotoxins as compared to rural nonfarming houses and urban houses. The time spent on the mattress (7 h for an adult) and of the proximity of the contaminated source should be taken into account with the other causes of exposure. Studies in European children from a farming background have shown that these children have a reduced risk of asthma and atopic sensitization compared to their urban counterparts. It has been suggested that this might be due to exposure to high levels of endotoxin in the farming environment. The aim of this study was to compare indoor endotoxin concentrations in air and dust samples from randomly selected urban and rural dwellings. In the rural area, endotoxins were analysed in farmhouses and nonfarmhouses as well as housing characteristics, lifestyle factors and agricultural practices likely to influence air and dust endotoxin levels. Endotoxin levels were significantly higher in floor (6600 ± 6100 vs 3600 ± 5600 and 3800 ± 17,000 ng g⁻¹; P < 0·001) and mattress dust (2900 ± 4100 vs 1100 ± 2400 and 800 ± 2600 ng g⁻¹; P < 0·001) from farmhouses compared to other rural and urban homes. However, no difference was observed between endotoxin concentrations in the air of urban and rural houses, and airborne endotoxin levels did not correlate to dust levels. Lack of ventilation and direct entry into the house were correlated with an increase in dust endotoxin levels. These results confirm that dairy farming is associated with high exposure to endotoxins in indoor dust samples. No difference was observed between indoor airborne concentrations between urban and rural houses. These results suggest that measuring endotoxin in dust is the most relevant method to assess endotoxin exposure.
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Affiliation(s)
- C Barnig
- Department of Chest Disease, University Hospital Strasbourg, Strasbourg, France
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Barnig C, Purohit A, Casset A, Sohy C, Lieutier-Colas F, Sauleau E, de Blay F. Nonallergic airway hyperresponsiveness and allergen-specific IgE levels are the main determinants of the early and late asthmatic response to allergen. J Investig Allergol Clin Immunol 2013; 23:267-274. [PMID: 23964557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Conflicting results have been reported in studies of predictive factors for airway responsiveness to allergens during bronchial challenges. OBJECTIVE The aim of this study was to assess determinants of airway responsiveness to 3 different allergens during standardized bronchial challenges. METHODS Data were collected from asthmatic patients who participated in allergen challenge trials between 2000 and 2006 (cat, n = 37; house dust mite [HDM], n = 35; grass pollen, n = 27). PD20 (provocative dose causing a 20% fall in forced expiratory volume in the first second) methacholine, PD20 allergen, allergen skin test endpoint, allergen-specific immunoglobulin (Ig) E levels, and late asthmatic response were analyzed for each allergen group. RESULTS During the early asthmatic response, a significant relationship was found between PD20 allergen and PD20 methacholine (P < .01 for cat, HDM, and grass pollen), as well as between PD20 allergen and allergen-specific IgE levels (P < .05 for cat and HDM). No relationship was observed between PD20 allergen and allergen skin test endpoint (P > .05). Late asthmatic response was significantly more frequent after HDM challenge than after cat or grass pollen challenges (57.1% vs16.2% and 33.3%, P < .01). Dual responders during HDM challenges had significantly higher allergen-specific IgE levels (P < .05) and higher nonallergic airway responsiveness (P < .05). CONCLUSION Nonallergic airway hyperresponsiveness and allergen-specific IgE levels were the main determinants of early and late asthmatic responses. HDM challenges were the most interesting model with regard to the occurrence of late asthmatic response. In contrast to previous publications and to the official statement on standardized challenge testing with sensitizing stimuli, skin sensitivity appears to be a poor predictor of the early asthmatic response.
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Affiliation(s)
- C Barnig
- Department of Chest Diseases, University Hospital of Strasbourg, Strasbourg, France.
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Moscato G, Pala G, Barnig C, Blay F, Del Giacco SR, Folletti I, Heffler E, Maestrelli P, Pauli G, Perfetti L, Quirce S, Sastre J, Siracusa A, Walusiak-Skorupa J, Wjik RG. EAACI consensus statement for investigation of work-related asthma in non-specialized centres. Allergy 2012; 67:491-501. [PMID: 22257175 DOI: 10.1111/j.1398-9995.2011.02784.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2011] [Indexed: 11/28/2022]
Abstract
Work-related asthma (WRA) is a relevant problem in several countries, is cause of disability and socioeconomic consequences for both the patient and the society and is probably still underdiagnosed. A correct diagnosis is extremely important to reduce or limit the consequences of the disease. This consensus document was prepared by a EAACI Task Force consisting of an expert panel of allergologists, pneumologists and occupational physicians from different European countries. This document is not intended to address in detail the full diagnostic work-up of WRA, nor to be a formal evidence-based guideline. It is written to provide an operative protocol to allergologists and physicians dealing with asthma useful for identifying the subjects suspected of having WRA to address them to in-depth investigations in a specialized centre. No evidence-based system could be used because of the low grade of evidence of published studies in this area, and instead, 'key messages' or 'suggestions' are provided based on consensus of the expert panel members.
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Affiliation(s)
- G. Moscato
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - G. Pala
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - C. Barnig
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - F. Blay
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - S. R. Del Giacco
- Department of Medical Sciences ‘M. Aresu’; University of Cagliari; Cagliari; Italy
| | - I. Folletti
- Department of Clinical and Experimental Medicine; Occupational Allergy Unit; Terni Hospital; University of Perugia; Perugia; Italy
| | - E. Heffler
- Allergy and Clinical Immunology; University of Torino; ASO Mauriziano ‘Umberto I’; Torino; Italy
| | - P. Maestrelli
- Department of Environmental Medicine and Public Health; University of Padova; Padova; Italy
| | - G. Pauli
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - L. Perfetti
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - S. Quirce
- Department of Allergy; Hospital La Paz-IdiPAZ and CIBER de Enfermedades Respiratorias CIBERES; Madrid; Spain
| | - J. Sastre
- CIBER de Enfermedades Respiratorias; Ciberes and Department of Allergy; Fundación Jiménez Díaz; Madrid; Spain
| | - A. Siracusa
- Department of Clinical an Experimental Medicine; University of Perugia; Perugia; Italy
| | - J. Walusiak-Skorupa
- Department of Occupational Diseases; Nofer Institute of Occupational Medicine; Lodz; Poland
| | - R. Gerth Wjik
- Section of Allergology; Department of Internal Medicine; Erasmus MC; Rotterdam; the Netherlands
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Barnig C, Hilger C, Muti D, Blaumeiser M, Purohit A, Hentges F, de Blay F. Anaphylaxis to vapors of roasting chicken controlled by omalizumab. J Investig Allergol Clin Immunol 2012; 22:439-440. [PMID: 23101190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- C Barnig
- Department of Chest Diseases, University Hospital of Strasbourg, Strasbourg, France.
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Bierry G, Boileau J, Barnig C, Gasser B, Korganow AS, Buy X, Jeung MY, Roy C, Gangi A. Thoracic manifestations of primary humoral immunodeficiency: a comprehensive review. Radiographics 2010; 29:1909-20. [PMID: 19926753 DOI: 10.1148/rg.297095717] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Humoral immunodeficiencies, which are characterized by defective production of antibodies, are the most common types of primary immunodeficiency. Pulmonary changes are present in as many as 60% of patients with humoral immunodeficiency. Chronic changes and recurrent infections in the respiratory airways are the main causes of morbidity and mortality in those affected by a humoral immunodeficiency. Medical imaging, especially computed tomography (CT), plays a crucial role in the initial detection and characterization of changes and in monitoring the response to therapy. The spectrum of abnormalities seen at thoracic imaging includes noninfectious airway disorders, infections, chronic lung diseases, chronic inflammatory conditions (granulomatosis, interstitial pneumonias), and benign and malignant neoplasms. Recognition of characteristic CT and radiographic features, and correlation of those features with clinical and laboratory findings, are necessary to differentiate between the many possible causes of parenchymal and mediastinal disease seen in patients with primary humoral immunodeficiencies.
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Affiliation(s)
- Guillaume Bierry
- Department of Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, Strasbourg Cedex, France.
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Barnig C, Purohit A, Casset A, Sohy C, Lieutier-Colas F, de Blay F. Predictor Factors for Airway Responsiveness during Bronchial Allergen Challenge Tests: Role of Allergen-Specific IgE Levels, Cutaneous Allergen Sensitivity and Non-Specific Airway Hyperresponsiveness. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.047] [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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de Blay F, Barnig C, Kanny G, Purohit A, Leynadier F, Tunon de Lara JM, Chabane H, Guérin L. Sublingual-swallow immunotherapy with standardized 3-grass pollen extract: a double-blind, placebo-controlled study. Ann Allergy Asthma Immunol 2007; 99:453-61. [PMID: 18051216 DOI: 10.1016/s1081-1206(10)60571-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sublingual immunotherapy (SLIT) is accepted as a safe and effective route for the treatment of grass pollen allergy, but clarification of its clinical and biological efficacy requires more study. OBJECTIVE To evaluate the efficacy, safety, and compliance of SLIT with a standardized 3-grass pollen extract in patients with grass pollen seasonal allergic rhinoconjunctivitis, with or without mild asthma. METHODS This multicenter, randomized, double-blind study included 127 patients (aged 12-41 years; mean age, 24.9 years) with grass pollen seasonal allergic rhinoconjunctivitis, with or without mild asthma. They received either SLIT with a high-dose, standardized, 3-grass pollen extract or placebo for 10 months before and during the grass pollen season. The efficacy evaluation compared weekly clinical scores (defined as the sum of the symptom score and rescue medication score) to measure rhinoconjunctivitis and asthma for the first 8 weeks of the pollen season. We also evaluated safety and compliance and measured changes in anti-Dactylis specific IgG4 antibody levels. RESULTS There was a trend in favor of the study group in the mean adjusted clinical score. The groups were not comparable on inclusion (P = .02): the SLIT group included more subjects with asthma and had a higher mean IgG4 serum level. Additional exploration according to subgroups with and without asthma found that among the patients without asthma, the SLIT group had a significantly better clinical score (P = .045). Anti-Dactylis specific IgG4 levels increased significantly in the SLIT group. CONCLUSION SLIT with a standardized, high-dose, 3-grass pollen extract is safe and significantly improves the clinical score in patients with hay fever and without asthma during the pollen season.
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Affiliation(s)
- Frédéric de Blay
- Département de Pneumologie, Hôpital Lyautey, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
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Bierry G, Kellner F, Barnig C. Management of Patients with History of Adverse Effects to Contrast Media When Pulmonary Artery CT Angiography Is Required. Radiology 2007; 245:919-21; author reply 919-21. [DOI: 10.1148/radiol.2453070428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Affiliation(s)
- W Chen
- Division of Asthma and Allergy, Department of Chest Diseases, Hòpital Universitaire de Strasburg Université Louis Pasteur, B.P. 426, 67091 Strasbourg cedex, France
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Barnig C, Uring-Lambert B, Purohit A, Donnay C, Casset A, Bahram S, de Blay F. Effect Of Nasal And Bronchial Grass Pollen Challenges On Plasma Cytokine Levels. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.12.061] [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: 10/23/2022]
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Barnig C, Uring-Lambert B, De Blay F. 017 Étude par cytométrie en flux des cytokines sériques après test de provocation nasal et bronchique chez des sujets allergiques au pollen de graminées. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71845-9] [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: 10/22/2022]
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Barnig C, Mennecier B, Bambara M, Sakhri L, Andres E, Pauli G, Quoix E. Thrombophilie, Alimta® et mutation hétérozygote C677T MTHFR. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72127-1] [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: 11/29/2022]
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