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Dupas T, Vergnaud A, Pelé T, Blangy-Letheule A, Aillerie V, Bouaud M, Erraud A, Maillard A, Hassoun D, Persello A, Lecomte J, Rivière M, Tessier A, Leroux AA, Rozec B, Denis M, Lauzier B. O-GlcNAcylation levels remain stable regardless of the anaesthesia in healthy rats. Sci Rep 2024; 14:10669. [PMID: 38724577 PMCID: PMC11082205 DOI: 10.1038/s41598-024-61445-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
Anaesthetics are used daily in human and veterinary medicine as well as in scientific research. Anaesthetics have an impact on cell homeostasis especially through modulation of protein post-translational modifications. O-GlcNAcylation, a ubiquitous post-translational modification, plays a role in many biological processes. The aims of this study were to evaluate whether (1) anaesthesia influences O-GlcNAcylation and (2) its stimulation affects physiological parameters. Male Wistar rats (n = 38) were anaesthetized with ketamine-xylazine or isoflurane. They randomly received either an intravenous injection of Ringer's lactate or NButGT (10mg/kg) in order to increase O-GlcNAcylation levels. One hour after induction of anaesthesia, haemodynamic parameters and plasmatic markers were evaluated. Heart, brain and lungs were harvested and O-GlcNAcylation levels and O-GlcNAc-related enzymes were evaluated by western blot. Cardiac and pulmonary O-GlcNAcylation levels and cardiac, cerebral and pulmonary O-GlcNAc associated enzyme expression were not impacted with anaesthesia. Compared with ketamine-xylazine, isoflurane had a lower impact on blood pressure, heart rate and glycaemia. Pharmacological stimulation of O-GlcNAcylation by NButGT did not affect the physiological parameters. This study offers unprecedented insights into the regulation of O-GlcNAcylation and O-GlcNAc related enzymes during anaesthesia. Pharmacological stimulation of O-GlcNAcylation over a 1-h period did not disrupt the physiological balance in healthy anaesthetized rats.
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Affiliation(s)
- Thomas Dupas
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France.
| | - Amandine Vergnaud
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
| | - Thomas Pelé
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
| | | | - Virginie Aillerie
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
| | - Martin Bouaud
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
| | - Angélique Erraud
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
| | - Anaïs Maillard
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
| | - Dorian Hassoun
- INSERM, L'institut du thorax, CHU Nantes, CNRS, Nantes Université, 44000, Nantes, France
| | - Antoine Persello
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
| | - Jules Lecomte
- INSERM, L'institut du thorax, CHU Nantes, CNRS, Nantes Université, 44000, Nantes, France
| | - Matthieu Rivière
- Faculté des Sciences et des Techniques, Chimie et Interdisciplinarité: Synthèse, Analyse, Modélisation (CEISAM), UMR CNRS 6230, CNRS, Université de Nantes, Nantes, France
| | - Arnaud Tessier
- Faculté des Sciences et des Techniques, Chimie et Interdisciplinarité: Synthèse, Analyse, Modélisation (CEISAM), UMR CNRS 6230, CNRS, Université de Nantes, Nantes, France
| | - Aurélia A Leroux
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
- Oniris, 44300, Nantes, France
| | - Bertrand Rozec
- INSERM, L'institut du thorax, CHU Nantes, CNRS, Nantes Université, 44000, Nantes, France
| | - Manon Denis
- INSERM, L'institut du thorax, CHU Nantes, CNRS, Nantes Université, 44000, Nantes, France
| | - Benjamin Lauzier
- INSERM, L'institut du thorax, CNRS, Nantes Université, 8 Quai Moncousu, 44007, Nantes, France
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Dijoux E, Klein M, Misme-Aucouturier B, Cheminant MA, de Carvalho M, Collin L, Hassoun D, Delage E, Gourdel M, Loirand G, Sauzeau V, Magnan A, Bouchaud G. Allergic Sensitization Driving Immune Phenotyping and Disease Severity in a Mouse Model of Asthma. Allergy Asthma Immunol Res 2023; 15:246-261. [PMID: 37021509 PMCID: PMC10079520 DOI: 10.4168/aair.2023.15.2.246] [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] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/30/2022] [Accepted: 10/17/2022] [Indexed: 04/07/2023]
Abstract
PURPOSE Asthma is a frequent chronic inflammatory bronchial disease affecting more than 300 million patients worldwide, 70% of whom are secondary to allergy. The diversity of asthmatic endotypes contributes to their complexity. The inter-relationship between allergen and other exposure and the airway microbiome adds to the phenotypic diversity and defines the natural course of asthma. Here, we compared the mouse models of house dust mite (HDM)-induced allergic asthma. Allergic sensitization was performed via various routes and associated with outcomes. METHODS Mice were sensitized with HDM via the oral, nasal or percutaneous routes. Lung function, barrier integrity, immune response and microbiota composition were analyzed. RESULTS Severe impairment of respiratory function was observed in the mice sensitized by the nasal and cutaneous paths. It was associated with epithelial dysfunction characterized by an increased permeability secondary to junction protein disruption. Such sensitization paths induced a mixed eosinophilic and neutrophilic inflammatory response with high interleukin (IL)-17 airway secretion. In contrast, orally sensitized mice showed a mild impairment of respiratory function. Epithelial dysfunction was mild with increased mucus production, but preserved epithelial junctions. Regarding lung microbiota, sensitization provoked a significant loss of diversity. At the genus level, Cutibacterium, Acinetobacter, Streptococcus and Lactobacillus were found to be modulated according to the sensitization pathway. An increase in theanti-inflammatory microbiota metabolites was observed in the oral-sensitization group. CONCLUSIONS Our study highlights the strong impact of the sensitization route on the pathophysiology and the critical phenotypic diversity of allergic asthma in a mouse model.
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Affiliation(s)
- Eléonore Dijoux
- Nantes Université, CNRS, INSERM, L'institut du Thorax, Nantes, France
| | - Martin Klein
- Nantes Université, CNRS, INSERM, L'institut du Thorax, Nantes, France
| | | | | | | | - Louise Collin
- Nantes Université, CNRS, INSERM, L'institut du Thorax, Nantes, France
| | - Dorian Hassoun
- Nantes Université, CNRS, INSERM, L'institut du Thorax, Nantes, France
| | - Erwan Delage
- Université de Nantes, CNRS UMR 6004, LS2N, Nantes, France
| | - Mathilde Gourdel
- Nantes Université, CNRS, INSERM, L'institut du Thorax, Nantes, France
- CRNH-Ouest Mass Spectrometry Core Facility, Nantes, France
| | - Gervaise Loirand
- Nantes Université, CNRS, INSERM, L'institut du Thorax, Nantes, France
| | - Vincent Sauzeau
- Nantes Université, CNRS, INSERM, L'institut du Thorax, Nantes, France
| | - Antoine Magnan
- Hôpital Foch, Suresnes, France
- UMR 0892 Virologie et Immunologie Moléculaire, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris-Saclay INRAE, Paris, France
| | - Grégory Bouchaud
- Nantes Université, CNRS, INSERM, L'institut du Thorax, Nantes, France
- INRAe, Biopolymères Interactions Assemblages (BIA), Nantes, France.
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Bergereau H, Hassoun D, Rose L, Rousselle M, Blanc FX, Loirand G, Sauzeau V. Impact de l’activation de la GTPase Rac dans la maturation et les fonctions de l’éosinophile dans l’asthme sévère. Rev Mal Respir 2023. [DOI: 10.1016/j.rmr.2022.11.010] [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: 02/18/2023]
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Menigoz C, Dirou S, Chambellan A, Hassoun D, Moui A, Magnan A, Blanc F. Use of FeNO to predict anti-IL-5 and IL-5R biologics efficacy in a real-world cohort of adults with severe eosinophilic asthma. J Asthma 2022; 60:1162-1170. [PMID: 36301080 DOI: 10.1080/02770903.2022.2136526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Severe eosinophilic asthma (SEA) is associated with multiple exacerbations. Fractional exhaled nitric oxide (FeNO), a biomarker of airway T2 inflammation, is known to be correlated with the risk of exacerbations. While the use of FeNO is well established to predict the therapeutic response to dupilumab (anti-IL-4/IL-13), it remains uncertain for biologics targeting the IL-5 pathway. METHODS We conducted an observational, retrospective, monocentric analysis of adults with SEA who started mepolizumab (anti-IL-5) or benralizumab (anti-IL-5R) between January 1, 2016 and December 31, 2020. RESULTS Data were collected for 109 patients. All participants reported uncontrolled asthma with a median of 3 annual exacerbations and a median Asthma Control Test score of 12. They all had an initial blood eosinophilia >300/mm3, with a median at 610/mm3 (IQR 420-856). Patients with a baseline FeNO ≥50 ppb reported more exacerbations in the previous year than those with a FeNO <50 ppb (p = 0.02). After initiation of treatment, change in FeNO was not associated with therapeutic response. However, decrease in the annual number of exacerbations was significantly greater in patients with a baseline FeNO ≥50 ppb than in those with a baseline FeNO <50 ppb (-3.3 ± 2.7 vs -0.9 ± 2.4, respectively; p = 0.01). There was no association between baseline FeNO values and subsequent lung function, asthma control or reduction of oral corticosteroids use. CONCLUSION In this real-world cohort, adults with SEA who had a baseline FeNO ≥50 ppb experienced a greater decrease in exacerbations after 12 months of anti-IL-5 or IL-5R biologics than those with a FeNO <50 ppb.
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Affiliation(s)
- C. Menigoz
- Nantes Université, CHU Nantes, Service de Pneumologie, L’institut du thorax, Nantes, France.
| | - S. Dirou
- Nantes Université, CHU Nantes, Service de Pneumologie, L’institut du thorax, Nantes, France.
| | - A. Chambellan
- Nantes Université, CHU Nantes, Service d’Explorations Fonctionnelles, L’institut du thorax, Nantes, France.
| | - D. Hassoun
- Nantes Université, CHU Nantes, CNRS, INSERM, L’institut du Thorax, Nantes, France.
| | - A. Moui
- Nantes Université, CHU Nantes, Service de Pneumologie, L’institut du thorax, Nantes, France.
| | - A. Magnan
- Université de Versailles Saint-Quentin Paris-Saclay, Hôpital Foch, INRAe UMR 0892, Suresnes, France
| | - F.X. Blanc
- Nantes Université, CHU Nantes, Service de Pneumologie, L’institut du thorax, Nantes, France.
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Hassoun D, Rose L, Blanc FX, Magnan A, Loirand G, Sauzeau V. Bronchial smooth muscle cell in asthma: where does it fit? BMJ Open Respir Res 2022; 9:9/1/e001351. [PMID: 36109087 PMCID: PMC9478857 DOI: 10.1136/bmjresp-2022-001351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/04/2022] [Indexed: 11/04/2022] Open
Abstract
Asthma is a frequent respiratory condition whose pathophysiology relies on altered interactions between bronchial epithelium, smooth muscle cells (SMC) and immune responses. Those leads to classical hallmarks of asthma: airway hyper-responsiveness, bronchial remodelling and chronic inflammation. Airway smooth muscle biology and pathophysiological implication in asthma are now better understood. Precise deciphering of intracellular signalling pathways regulating smooth muscle contraction highlighted the critical roles played by small GTPases of Rho superfamily. Beyond contractile considerations, active involvement of airway smooth muscle in bronchial remodelling mechanisms is now established. Not only cytokines and growth factors, such as fibroblats growth factor or transforming growth factor-β, but also extracellular matrix composition have been demonstrated as potent phenotype modifiers for airway SMC. Although basic science knowledge has grown significantly, little of it has translated into improvement in asthma clinical practice. Evaluation of airway smooth muscle function is still limited to its contractile activity. Moreover, it relies on tools, such as spirometry, that give only an overall assessment and not a specific one. Interesting technics such as forced oscillometry or specific imagery (CT and MRI) give new perspectives to evaluate other aspects of airway muscle such as bronchial remodelling. Finally, except for the refinement of conventional bronchodilators, no new drug therapy directly targeting airway smooth muscle proved its efficacy. Bronchial thermoplasty is an innovative and efficient therapeutic strategy but is only restricted to a small proportion of severe asthmatic patients. New diagnostic and therapeutic strategies specifically oriented toward airway smooth muscle are needed to improve global asthma care.
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Affiliation(s)
- Dorian Hassoun
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, F-44000 Nantes, France
| | - Lindsay Rose
- Nantes Université, CNRS, INSERM, l'institut du thorax, F-44000 Nantes, Pays de la Loire, France
| | - François-Xavier Blanc
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, F-44000 Nantes, France
| | - Antoine Magnan
- INRAe, UMR 0892, Hôpital Foch, Suresnes, France.,Université Versailles-Saint-Quentin-en-Yvelines Paris-Saclay, Versailles, France
| | - Gervaise Loirand
- Nantes Université, CNRS, INSERM, l'institut du thorax, F-44000 Nantes, Pays de la Loire, France
| | - Vincent Sauzeau
- Nantes Université, CNRS, INSERM, l'institut du thorax, F-44000 Nantes, Pays de la Loire, France
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Hassoun D, Loirand G, Sauzeau V. Un nouvel acteur physiopathologique dans l’asthme sévère : la GTPase Rac. Rev Mal Respir 2022; 39:100-103. [DOI: 10.1016/j.rmr.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
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7
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Hassoun D, Rose L, Rousselle M, Magnan A, Blanc FX, Loirand G, Sauzeau V. Rôle de la GTPase Rac dans les mécanismes inflammatoires dans l’asthme sévère. Rev Mal Respir 2022. [DOI: 10.1016/j.rmr.2022.02.011] [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: 11/25/2022]
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8
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Hassoun D, Malard O, Barbarot S, Magnan A, Colas L. Type 2 immunity-driven diseases: Towards a multidisciplinary approach. Clin Exp Allergy 2021; 51:1538-1552. [PMID: 34617355 PMCID: PMC9292742 DOI: 10.1111/cea.14029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/23/2021] [Accepted: 09/08/2021] [Indexed: 12/31/2022]
Abstract
Asthma, atopic dermatitis and chronic rhinoconjunctivitis are highly heterogeneous. However, epidemiologic associations exist between phenotypic groups of patients. Atopic march is one such association but is not the only common point. Indeed, beyond such phenotypes, hallmarks of type 2 immunity have been found in these diseases involving immune dysregulation as well as environmental triggers and epithelial dysfunction. From the canonical Th2 cytokines (IL-4, IL-5, IL-13), new cellular and molecular actors arise, from the epithelium's alarmins to new innate immune cells. Their interactions are now better understood across the different environmental barriers, and slight differences appeared. In parallel, the development of type 2-targeting biotherapies not only raised hope to treat those diseases but also raised new questions regarding their true pathophysiological involvement. Here, we review the place of type 2 immunity in the different phenotypes of asthma, chronic rhinitis, chronic rhinosinusitis and atopic dermatitis, highlighting nuances between them. New hypotheses rising from the use of biotherapies will be discussed along with the uncertainties and unmet needs of this field.
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Affiliation(s)
- Dorian Hassoun
- CHU Nantes, CNRS, INSERM, l'institut du Thorax, Université de Nantes, Nantes, France
| | - Olivier Malard
- Department of Otorhinolaryngology and Head and Neck Surgery, Nantes University Hospital, Nantes, France
| | - Sébastien Barbarot
- Department of Dermatology, CHU Nantes, UMR 1280 PhAN, INRA, Nantes Université, Nantes, France
| | - Antoine Magnan
- INRAe UMR_S 0892, Hôpital Foch, Université de Versailles Saint-Quentin, Paris Saclay, France
| | - Luc Colas
- Plateforme Transversale d'Allergologie et d'Immunologie Clinique, Institut du Thorax, CHU de Nantes, Nantes, France.,INSERM, CHU Nantes, Centre de Recherche en Transplantation et Immunologie UMR1064, Nantes Université, ITUN, Nantes, France
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9
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Rose L, Hassoun D, Dilasser F, Taille C, Dombret MC, Di-Candia L, Heddebaut N, Pretolani M, Magnan A, Loirand G, Sauzeau V. Essential role of smooth muscle Rac1 in severe asthma associated-airway remodelling. Rev Mal Respir 2021. [DOI: 10.1016/j.rmr.2021.02.010] [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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10
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Dilasser F, Rose L, Hassoun D, Klein M, Rousselle M, Brosseau C, Guignabert C, Taillé C, Dombret MC, Di Candia L, Heddebaut N, Bouchaud G, Pretolani M, Magnan A, Loirand G, Sauzeau V. Essential role of smooth muscle Rac1 in severe asthma-associated airway remodelling. Thorax 2021; 76:326-334. [PMID: 33542087 PMCID: PMC7982925 DOI: 10.1136/thoraxjnl-2020-216271] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 09/28/2020] [Revised: 11/20/2020] [Accepted: 12/02/2020] [Indexed: 12/15/2022]
Abstract
Background Severe asthma is a chronic lung disease characterised by inflammation, airway hyperresponsiveness (AHR) and airway remodelling. The molecular mechanisms underlying uncontrolled airway smooth muscle cell (aSMC) proliferation involved in pulmonary remodelling are still largely unknown. Small G proteins of the Rho family (RhoA, Rac1 and Cdc42) are key regulators of smooth muscle functions and we recently demonstrated that Rac1 is activated in aSMC from allergic mice. The objective of this study was to assess the role of Rac1 in severe asthma-associated airway remodelling. Methods and results Immunofluorescence analysis in human bronchial biopsies revealed an increased Rac1 activity in aSMC from patients with severe asthma compared with control subjects. Inhibition of Rac1 by EHT1864 showed that Rac1 signalling controlled human aSMC proliferation induced by mitogenic stimuli through the signal transducer and activator of transcription 3 (STAT3) signalling pathway. In vivo, specific deletion of Rac1 in SMC or pharmacological inhibition of Rac1 by nebulisation of NSC23766 prevented AHR and aSMC hyperplasia in a mouse model of severe asthma. Moreover, the Rac1 inhibitor prevented goblet cell hyperplasia and epithelial cell hypertrophy whereas treatment with corticosteroids had less effect. Nebulisation of NSC23766 also decreased eosinophil accumulation in the bronchoalveolar lavage of asthmatic mice. Conclusion This study demonstrates that Rac1 is overactive in the airways of patients with severe asthma and is essential for aSMC proliferation. It also provides evidence that Rac1 is causally involved in AHR and airway remodelling. Rac1 may represent as an interesting target for treating both AHR and airway remodelling of patients with severe asthma.
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Affiliation(s)
| | | | | | | | | | - Carole Brosseau
- Centre de recherche en transplantation, Inserm 1064, Nantes, France
| | | | - Camille Taillé
- Service de Pneumologie et Centre de Référence des Maladies Pulmonaires Rares, Hôpital Bichat - Claude-Bernard, Paris, France
| | | | - Leonarda Di Candia
- Service de Pneumologie et Centre de Référence des Maladies Pulmonaires Rares, Hôpital Bichat - Claude-Bernard, Paris, France
| | | | | | | | - Antoine Magnan
- Institut du Thorax UMR1087 CNRS 6291, INSERM, Université de Nantes, CHU de Nantes, DHU2020, Nantes, France
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11
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Colas L, Hassoun D, Magnan A. Needs for Systems Approaches to Better Treat Individuals With Severe Asthma: Predicting Phenotypes and Responses to Treatments. Front Med (Lausanne) 2020; 7:98. [PMID: 32296705 PMCID: PMC7137032 DOI: 10.3389/fmed.2020.00098] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 12/10/2018] [Accepted: 03/05/2020] [Indexed: 01/19/2023] Open
Abstract
Asthma is a frequent heterogeneous multifactorial chronic disease whose severe forms remain largely uncontrolled despite the availability of many drugs and educational therapy. Several phenotypes and endotypes of severe asthma have been described over the last two decades. Typical type-2-immunity-driven asthma remains the most frequent phenotype, and several targeted therapies have been developed and are now available. On the contrary, non-type-2 immunity-driven severe asthma is less understood and still requires efficient innovative therapies. A personalized approach would allow improving asthma control with the help of robust biomarkers able to predict phenotypes/endotypes, exacerbations, response to targeted treatments and, in the future, possible curative options. Some data from large multicenter cohorts have emerged in recent years, especially in transcriptomics. These data have to be integrated and reproduced longitudinally to provide a systems approach for asthma care. In this focused review, the needs for such an approach and the available data will be reviewed as well as the next steps for achieving personalized medicine in asthma.
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Affiliation(s)
- Luc Colas
- Nantes Université, CHU de Nantes, Plateforme Transversale d'Allergologie, Nantes, France.,Nantes Université, INSERM UMR 1087, CNRS UMR 6291, Nantes, France.,Nantes Université, Centre de Recherche en Transplantation et Immunologie UMR1064, INSERM, Nantes, France
| | - Dorian Hassoun
- Nantes Université, INSERM UMR 1087, CNRS UMR 6291, Nantes, France.,Nantes Université, CHU de Nantes, Service de Pneumologie, Nantes, France
| | - Antoine Magnan
- Nantes Université, INSERM UMR 1087, CNRS UMR 6291, Nantes, France.,Nantes Université, CHU de Nantes, Service de Pneumologie, Nantes, France
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12
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Moui A, Klein M, Hassoun D, Dijoux E, Cheminant MA, Magnan A, Bouchaud G. The IL-15 / sIL-15Rα complex modulates immunity without effect on asthma features in mouse. Respir Res 2020; 21:33. [PMID: 31996218 PMCID: PMC6988344 DOI: 10.1186/s12931-020-1301-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/20/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Interleukin 15 (IL-15) is a growth and modulating factor for B, T lymphocytes and natural killer cells (NK). Its action on innate and adaptive immunity is modulated by its alpha chain receptor (IL-15Rα). The IL-15/sIL-15Rα complex (IL-15Cx) increases the bioavailability and activity of the cytokine in vivo. IL-15Cx has been used in diseases to dampen IL-15 inflammation by the use of soluble IL-15Ralpha specificity. Here, we aim to evaluate the interest of IL-15Cx in a mouse model of asthma. METHODS Using a mouse model of asthma consisting in percutaneous sensitization and intranasal challenge with total house dust mite extract, we evaluated the effect of IL-15Cx injected intraperitoneally four times after a first nasal challenge. Respiratory function was assessed by the technique of forced oscillations (Flexivent®). The effect on bronchial remodeling was evaluated by lung histology. The inflammatory status was analyzed by flow cytometry. RESULTS We observed that the IL-15Cx modulates lung and systemic inflammation by increasing NK cells, CD8+ memory T cells and regulatory cells. However, IL-15Cx displays no effect on bronchial hyperreactivity, bronchial remodeling nor cellular bronchial infiltrate, but limits the secretion of bronchial mucus and modulates only inflammatory response in a HDM-allergic asthma murine model. CONCLUSIONS IL-15Cx has a limited effect on immune response in asthma and has no effect on lung function in mice. Thus, it limits its therapeutic potential but might suggest a combinatory potential with other therapeutics.
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Affiliation(s)
- Antoine Moui
- L'institut du thorax, Inserm, CNRS, Université́ de Nantes, Nantes, France.,L'institut du thorax, CHU de Nantes, service de pneumologie, Nantes, France
| | - Martin Klein
- L'institut du thorax, Inserm, CNRS, Université́ de Nantes, Nantes, France
| | - Dorian Hassoun
- L'institut du thorax, Inserm, CNRS, Université́ de Nantes, Nantes, France.,L'institut du thorax, CHU de Nantes, service de pneumologie, Nantes, France
| | - Eléonore Dijoux
- L'institut du thorax, Inserm, CNRS, Université́ de Nantes, Nantes, France
| | | | - Antoine Magnan
- L'institut du thorax, Inserm, CNRS, Université́ de Nantes, Nantes, France.,L'institut du thorax, CHU de Nantes, service de pneumologie, Nantes, France
| | - Grégory Bouchaud
- INRA, UR1268 BIA, rue de la Géraudière, F-44316, Nantes, France.
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13
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Hassoun D, Moui A, Colas L, Blanc FX, Magnan A. [Update in severe asthma physiopathology and treatments]. Rev Med Interne 2019; 40:508-516. [PMID: 31128859 DOI: 10.1016/j.revmed.2019.04.007] [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: 12/07/2018] [Revised: 03/26/2019] [Accepted: 04/12/2019] [Indexed: 11/17/2022]
Abstract
Asthma is an inflammatory airway disease which presentation is highly heterogeneous. Last two decades provided new clinical and basic data concerning asthma physiopathology that make global understanding much complex. Phenotypes based on clinical settings and paraclinical investigations from large cohorts confirm old paradigm (eosinophilic vs. non-eosinophilic asthma) but also introduce new concepts (obesity-related asthma, late onset asthma, etc.). Conversely, improvement of big data analytics allows to initiate new cohorts aiming at better understanding the pathophysiology underlying those phenotypes and unraveling new ones. However, clinical and therapeutic impacts of those big data need to be further detailed. In parallel, biotherapies and innovative techniques as bronchial thermoplasty become available for severe asthmatic patients who did not respond to specific treatment in the past. Development of a personalized medicine in severe asthma becomes an important challenge for tomorrow. This review will focus on new pathophysiological concepts arisen from large cohorts and new therapeutic strategies available and in progress for severe asthma.
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Affiliation(s)
- D Hassoun
- Service de pneumologie, l'institut du thorax, hôpital Guillaume et René LAENNEC, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France; Inserm UMR 1087, CNRS UMR 6291, l'institut du thorax, université de Nantes, 8, quai Moncousu, 44007 Nantes, France.
| | - A Moui
- Service de pneumologie, l'institut du thorax, hôpital Guillaume et René LAENNEC, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France; Inserm UMR 1087, CNRS UMR 6291, l'institut du thorax, université de Nantes, 8, quai Moncousu, 44007 Nantes, France
| | - L Colas
- Inserm UMR 1087, CNRS UMR 6291, l'institut du thorax, université de Nantes, 8, quai Moncousu, 44007 Nantes, France; Plate-forme transversale d'allergologie, l'institut du thorax, Hôpital Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France; Centre de recherche en transplantation et immunologie UMR1064, Inserm, université de Nantes, 30, boulevard Jean-Monnet, 44093 Nantes cedex 1, France
| | - F X Blanc
- Service de pneumologie, l'institut du thorax, hôpital Guillaume et René LAENNEC, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France; Inserm UMR 1087, CNRS UMR 6291, l'institut du thorax, université de Nantes, 8, quai Moncousu, 44007 Nantes, France
| | - A Magnan
- Service de pneumologie, l'institut du thorax, hôpital Guillaume et René LAENNEC, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France; Inserm UMR 1087, CNRS UMR 6291, l'institut du thorax, université de Nantes, 8, quai Moncousu, 44007 Nantes, France
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Hassoun D, Moui A, Colas L, Blanc FX, Magnan A. Instantané de la prise en charge des patients asthmatiques sévères en 2018 : expérience du CHU de Nantes. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2019.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hassoun D, Dirou S, Sagan C, Liberge R, Peuvrel L, Quereux G, Magnan A, Blanc F. Un kyste peut en cacher un autre. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2019.05.032] [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: 10/26/2022]
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Klein M, Dijoux E, Dilasser F, Hassoun D, Moui A, Loirand G, Colas L, Magnan A, Sauzeau V, Bouchaud G. [New protagonists in asthma pathophysiology]. Presse Med 2019; 48:255-261. [PMID: 30857807 DOI: 10.1016/j.lpm.2019.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/14/2018] [Accepted: 01/31/2019] [Indexed: 12/21/2022] Open
Abstract
Asthma is often associated with a Th2-type immune response with well-known cellular and molecular actors such as eosinophils, Th2 lymphocytes and associated cytokines such as interleukin-5 or IL-4. Nevertheless, some of the asthmatic patients show clinical manifestations and characteristics that do not correspond to the current pattern of the pathophysiology of asthma. Thus, recently new cellular and molecular actors in the development of asthma have been demonstrated in animal models and in humans. Among these are components of the innate immune system such as type 2 innate lymphoid cells or adaptive immune system such as Th9 lymphocytes. At the cellular level, the role of small G proteins in asthma is also highlighted as well as the role of major cytokines like IL-17 or those derived from the epithelium. A better knowledge of the physiopathology of asthma and the taking into account of these new actors allows the identification of new therapeutic targets for different endotypes of patients.
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Affiliation(s)
- Martin Klein
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France
| | - Eléonore Dijoux
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France
| | - Florian Dilasser
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France
| | - Dorian Hassoun
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France; L'institut du thorax, CHU de Nantes, service de pneumologie, 44000 Nantes, France
| | - Antoine Moui
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France; L'institut du thorax, CHU de Nantes, service de pneumologie, 44000 Nantes, France
| | - Gervaise Loirand
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France
| | - Luc Colas
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France; L'institut du thorax, CHU de Nantes, service de pneumologie, 44000 Nantes, France
| | - Antoine Magnan
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France; L'institut du thorax, CHU de Nantes, service de pneumologie, 44000 Nantes, France
| | - Vincent Sauzeau
- L'institut du thorax, Inserm, CNRS, université de Nantes, 44000 Nantes, France
| | - Grégory Bouchaud
- INRA, UR1268 BIA, rue de la Géraudière, BP 71627, 44316 Nantes, France.
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Chabbert-Buffet N, Marret H, Agostini A, Cardinale C, Hamdaoui N, Hassoun D, Jonville-Bera AP, Lambert M, Linet T, Pienkowski C, Plu-Bureau G, Pragout D, Robin G, Rousset-Jablonski C, Scheffler M, Vidal F, Vigoureux S, Hédon B. [Contraception: CNGOF Guidelines for Clinical Practice (Short Version)]. ACTA ACUST UNITED AC 2018; 46:760-776. [PMID: 30416023 DOI: 10.1016/j.gofs.2018.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 12/26/2022]
Abstract
The French College of Obstetrics and Gynecology (CNGOF) releases its first global recommendations for clinical practice in contraception, to provide physicians with an updated synthesis of available data as a basis for their practice. The French Health Authority (HAS) methodology was used. Twelve practical issues were selected by the organizing committee and the task force members. The available literature was screened until December 2017, and allowed the release of evidence-based, graded recommendations. This synthesis is issued from 12 developed texts, previously reviewed by experts and physicians from public and private practices, with an experience in the contraceptive field. Male and female sterilization, as well as the use of hormonal treatments without contraceptive label were excluded from the field of this analysis. Specific practical recommendations on the management of contraception prescription, patient information including efficacy, risks, and benefits of the different contraception methods, follow up, intrauterine contraception, emergency contraception, local and natural methods, contraception in teenagers and after 40, contraception in vascular high-risk situations, and in case of cancer risk are provided. The short/mid-term future of contraception mostly relies on improving the use of currently available methods. This includes reinforced information for users and increased access to contraception for women, whatever the social and clinical context. That is the goal of these recommendations.
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Affiliation(s)
- N Chabbert-Buffet
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpitaux universitaires Est parisien, hôpital Tenon, Assistance publique des hôpitaux de Paris (AP-HP), 4, rue de la Chine, 75020 Paris, France; UMRS_938, Inserm Sorbonne université, 75012 Paris, France.
| | - H Marret
- Service de chirurgie pelvienne gynécologique et oncologique, centre hospitalier universitaire de Bretonneau, pôle de gynécologie-obstétrique, 2, boulevard Tonnellé, 37044 Tours cedex 1, France
| | - A Agostini
- Service de gynécologie-obstétrique, hôpital de la Conception, boulevard Baille, 13005 Marseille, France
| | - C Cardinale
- Service de gynécologie-obstétrique, hôpital de la Conception, boulevard Baille, 13005 Marseille, France
| | - N Hamdaoui
- Service de gynécologie-obstétrique, hôpital de la Conception, boulevard Baille, 13005 Marseille, France
| | - D Hassoun
- 38, rue Turenne, 75003 Paris, France
| | - A P Jonville-Bera
- Centre régional de pharmacovigilance, centre Val-de-Loire, CHRU de Tours, 37044 Tours cedex, France
| | - M Lambert
- Service de gynécologie et de médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie Raba-Léon, 33076 Bordeaux cedex, France
| | - T Linet
- Service de gynécologie-obstétrique, centre hospitalier de Loire-Vendée-Océan, 85302 Challans, France
| | - C Pienkowski
- Unité d'endocrinologie et de gynécologie médicale, TSA 70034, centre de référence de pathologies gynécologiques rares (PGR Toulouse), hôpital des Enfants, CHU de Toulouse, 31000 Toulouse, France
| | - G Plu-Bureau
- Unité de gynécologie endocrinienne, hôpital Port-Royal, 53, avenue de l'Observatoire, 75679 Paris, France; Université Paris Descartes, 75005 Paris, France; Inserm UMR 1153, Obstetrical, perinatal and paediatric epidemiology research team (Épopé), Centre for epidemiology and statistics Sorbonne Paris Cité (CRESS), 75005 Paris, France
| | - D Pragout
- Unité d'orthogénie, service de gynécologie-obstétrique, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - G Robin
- Centre d'assistance médicale à la procréation et de préservation de la fertilité, centre hospitalier universitaire de Lille, hôpital Jeanne de Flandre, 59000 Lille, France; EA 4308, gamétogenèse et qualité du gamète, centre hospitalier universitaire de Lille, 59000 Lille, France
| | - C Rousset-Jablonski
- Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France; Centre hospitalier de Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - M Scheffler
- Service de gynécologie, CHU, 10, rue du Dr-Heydenreich, 54000 Nancy, France
| | - F Vidal
- CHU de Purpan, hôpital Paule-de-Viguier, pôle femme-mère-couple, 330, avenue Grande-Bretagne, 31059 Toulouse, France
| | - S Vigoureux
- Service de gynécologie-obstétrique, hôpital Bicêtre, Assistance publique des Hôpitaux de Paris (AP-HP), 94276 Le Kremlin-Bicêtre, France; Faculté de médecine Paris-Sud, université Paris-Sud, 94276 Le Kremlin-Bicêtre, France; U1018, Inserm, reproduction and child development, Centre for research in epidemiology and population health (CESP), 94805 Villejuif, France
| | - B Hédon
- Département de gynécologie-obstétrique, faculté de médecine université de Montpellier (France), centre hospitalier universitaire Arnaud-de-Villeneuve, 34000 Montpellier, France
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Abstract
OBJECTIVE To develop clinical practice recommendations for the use of natural contraception and female and male barrier methods. MATERIALS AND METHODS A systematic review of English and French literatures related to the safety and effectiveness of natural contraceptive methods based on PubMed, Cochrane Library, practice recommendations issued by international scientific societies and guidelines provided by the World Health Organization (WHO) as well as updates from the Center for Disease Control and Prevention (CDC). RESULTS Natural contraceptives methods include fertility awareness-based methods, lactational amenorrhea method (LAM) and withdrawal method. The prevalence is low (4.6% of users) and remains stable over the years. Identification of the fertile period can be symptom-based cervical mucus (Billings), two-day method, basal body temperature, symptom-thermal method or based on calendar calculation (Ogino-Knauss, standard day method). Pregnancy rate after one-year utilization varies from 0.4% to 5% in perfect use but 8% in common practice. Effectiveness increases with absence of vaginal sex and decreases when combined to barriers method inadequately implemented. Data is scarce on reliability and effectiveness of ovulation predictor kits readily available on internet. Lactational amenorrhea method (LAM) can be very effective (98%) provided three conditions are fulfilled: within 6 months after birth, amenorrhea is effective, and breastfeeding is exclusive or quasi exclusive (day/night). Withdrawal method is constraining and of limited effectiveness. Male and female condom, diaphragm, cervical cap and spermicides are mechanical and chemical barrier methods, preventing spermatozoids from passing through the cervix into the uterus and therefore preventing fecundation. Female and male condoms offer a double protection to avoid pregnancy and prevent STD's. They are effective provided strict conditions of use are fulfilled. Male condom is favored by teenagers (45.6% among 15 to 19 years old), sometimes in combination with contraceptive pill (16% of cases). Women on the pill decreases according to their age. Pregnancy rates within the first year of consistent and correct use of these methods vary between 5 to 26% and reach 20 to 32% in practical use. Diaphragm and cervical cap need to be used in combination with spermicides. Spermicides have limited effectiveness when used alone. CONCLUSION In common practice, natural and barrier contraceptive methods are more constraining and less effective than modern contraceptive method. They can be an alternative at given time and/or in situations where the women or the couple accept the possibility of an unexpected pregnancy which might be terminated or not. Women/couples need to be properly informed on how to use such methods, on their disadvantages and possible failures in common practice. Reminders are to be given on emergency contraceptive methods (IUD, hormonal) after unprotected sex.
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Affiliation(s)
- D Hassoun
- 38, rue de Turenne, 75003 Paris, France.
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Hassoun D, Lecouffe-Desprets M, Néel A, Durant C, Dirou S, Arrigoni P, Sagan C, Hamidou M, Agard C. Atteinte pulmonaire exceptionnelle au cours d’une sclérodermie systémique cutanée limitée : la fibroélastose pleuro-parenchymateuse. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Bettahar K, Pinton A, Boisramé T, Cavillon V, Wylomanski S, Nisand I, Hassoun D. Interruption volontaire de grossesse par voie médicamenteuse. ACTA ACUST UNITED AC 2016; 45:1490-1514. [DOI: 10.1016/j.jgyn.2016.09.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
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21
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Braza F, Dirou S, Forest V, Sauzeau V, Hassoun D, Chesné J, Cheminant-Muller MA, Sagan C, Magnan A, Lemarchand P. Mesenchymal Stem Cells Induce Suppressive Macrophages Through Phagocytosis in a Mouse Model of Asthma. Stem Cells 2016; 34:1836-45. [PMID: 26891455 DOI: 10.1002/stem.2344] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 12/13/2022]
Abstract
Mesenchymal stem cell (MSC) immunosuppressive functions make them attractive candidates for anti-inflammatory therapy in allergic asthma. However, the mechanisms by which they ensure therapeutic effects remain to be elucidated. In an acute mouse model of house dust mite (Der f)-induced asthma, one i.v. MSC injection was sufficient to normalize and stabilize lung function in Der f-sensitized mice as compared to control mice. MSC injection decreased in vivo airway responsiveness and decreased ex vivo carbachol-induced bronchial contraction, maintaining bronchial expression of the inhibitory type 2 muscarinic receptor. To evaluate in vivo MSC survival, MSCs were labeled with PKH26 fluorescent marker prior to i.v. injection, and 1 to 10 days later total lungs were digested to obtain single-cell suspensions. 91.5 ± 2.3% and 86.6 ± 6.3% of the recovered PKH26(+) lung cells expressed specific macrophage markers in control and Der f mice, respectively, suggesting that macrophages had phagocyted in vivo the injected MSCs. Interestingly, only PKH26(+) macrophages expressed M2 phenotype, while the innate PKH26(-) macrophages expressed M1 phenotype. Finally, the remaining 0.5% PKH26(+) MSCs expressed 10- to 100-fold more COX-2 than before injection, suggesting in vivo MSC phenotype modification. Together, the results of this study indicate that MSCs attenuate asthma by being phagocyted by lung macrophages, which in turn acquire a M2 suppressive phenotype. Stem Cells 2016;34:1836-1845.
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Affiliation(s)
- Faouzi Braza
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France
| | - Stéphanie Dirou
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France.,CHU de Nantes, Nantes, F-44000, France
| | - Virginie Forest
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France
| | - Vincent Sauzeau
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France
| | - Dorian Hassoun
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France
| | - Julie Chesné
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France
| | - Marie-Aude Cheminant-Muller
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France
| | - Christine Sagan
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France.,CHU de Nantes, Nantes, F-44000, France
| | - Antoine Magnan
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France.,CHU de Nantes, Nantes, F-44000, France
| | - Patricia Lemarchand
- INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.,CNRS, UMR 6291, Nantes, F-44000, France.,Université de Nantes, Nantes, F-44000, France.,CHU de Nantes, Nantes, F-44000, France
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Dubot C, Donnadieu A, Houzard S, Fridmann S, Dehghani C, Dagousset I, Missey-Kolb H, Hassoun D. [Good reasons to develop the out-of-hospital follow-up after breast cancer]. J Gynecol Obstet Hum Reprod 2016; 45:98-99. [PMID: 26705607 DOI: 10.1016/j.jgyn.2015.09.007] [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: 06/16/2015] [Accepted: 08/24/2015] [Indexed: 06/05/2023]
Affiliation(s)
- C Dubot
- Service d'oncologie médicale, institut Curie/Site Paris, 5, rue Dailly, 92210 Saint-Cloud, France
| | - A Donnadieu
- Service de radiothérapie, institut Curie/Site Paris, 26, rue d'Ulm, 75005 Paris, France
| | - S Houzard
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France.
| | - S Fridmann
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France
| | - C Dehghani
- Service de chirurgie gynécologique, groupe hospitalier Diaconesses - Croix-Saint-Simon, 18, rue du Sergent-Bauchat, 75012 Paris, France
| | - I Dagousset
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France
| | - H Missey-Kolb
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France
| | - D Hassoun
- Réseau Gynécomed IdF, 103, rue Legendre, 75017 Paris, France
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Jamin C, Agostini A, Asselin I, Ben M'barek I, Bettahar K, Carbonne B, David P, Faucher P, Fernandez H, Fournet P, Goffinet F, Guilbaud L, Hassoun D, Lachowsky M, Letombe B, Levy G, Trignol-Viguier N, Vayssiere C, Vigoureux S. [Emergency contraceptions: Propositions of the Orthogenics Commission of the French National College of Gynecology and Obstetrics]. Gynecol Obstet Fertil 2015; 43:571-4. [PMID: 26298815 DOI: 10.1016/j.gyobfe.2015.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 07/07/2015] [Indexed: 12/30/2022]
Affiliation(s)
- C Jamin
- 169, boulevard Haussmann, 75008 Paris, France.
| | - A Agostini
- 169, boulevard Haussmann, 75008 Paris, France
| | - I Asselin
- 169, boulevard Haussmann, 75008 Paris, France
| | | | - K Bettahar
- 169, boulevard Haussmann, 75008 Paris, France
| | - B Carbonne
- 169, boulevard Haussmann, 75008 Paris, France
| | - P David
- 169, boulevard Haussmann, 75008 Paris, France
| | - P Faucher
- 169, boulevard Haussmann, 75008 Paris, France
| | - H Fernandez
- 169, boulevard Haussmann, 75008 Paris, France
| | - P Fournet
- 169, boulevard Haussmann, 75008 Paris, France
| | - F Goffinet
- 169, boulevard Haussmann, 75008 Paris, France
| | - L Guilbaud
- 169, boulevard Haussmann, 75008 Paris, France
| | - D Hassoun
- 169, boulevard Haussmann, 75008 Paris, France
| | - M Lachowsky
- 169, boulevard Haussmann, 75008 Paris, France
| | - B Letombe
- 169, boulevard Haussmann, 75008 Paris, France
| | - G Levy
- 169, boulevard Haussmann, 75008 Paris, France
| | | | - C Vayssiere
- 169, boulevard Haussmann, 75008 Paris, France
| | - S Vigoureux
- 169, boulevard Haussmann, 75008 Paris, France
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Rolland-Debord C, Roussey-Bihouee T, Lair D, Chesné J, Mahay G, Hassoun D, Pitard B, Magnan A. Évaluation de la vaccination par ADN dans l’asthme allergique induit par les acariens. Rev Mal Respir 2013. [DOI: 10.1016/j.rmr.2012.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Botturi K, Langelot M, Lair D, Pipet A, Pain M, Chesne J, Hassoun D, Lacoeuille Y, Cavaillès A, Magnan A. Preventing asthma exacerbations: what are the targets? Pharmacol Ther 2011; 131:114-29. [PMID: 21440000 DOI: 10.1016/j.pharmthera.2011.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Accepted: 03/07/2011] [Indexed: 12/22/2022]
Abstract
Exacerbations of asthma are the main cause of asthma morbidity. They induce acute respiratory failure, and sometimes death. Two immunological signals acting in synergy are necessary for inducing asthma exacerbations. The first, triggered by allergens and/or unknown agents leads to the chronic Th2 inflammation characteristic of asthma. The second, caused by either viral infection, allergens, pollutants or a combination of these, results in an acute Th1 and Th2 inflammation precipitating symptoms. In both, innate and adaptive immunities are involved, providing a series of potential targets for therapy. Molecules associated to the first, chronic inflammation constitute targets for preventing therapies, when these related to the second, acute signal provide the rationale for curative treatments. Toll like receptors and bronchial epithelial cell-derived cytokines, engaged upstream of inflammation constitute interesting candidates for future treatments. The great heterogeneity of asthma has to be taken into account when considering targets for therapy to identify clusters of responders and nonresponders, and an integrative system biology approach will be necessary to go further.
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Clark WH, Hassoun D, Gemzell-Danielsson K, Fiala C, Winikoff B. Home use of two doses of misoprostol after mifepristone for medical abortion: A pilot study in Sweden and France. EUR J CONTRACEP REPR 2009; 10:184-91. [PMID: 16318966 DOI: 10.1080/13625180500284581] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To test the feasibility, safety, and efficacy of home use of two doses of misoprostol for medical abortion (MA) in European settings. METHODS One hundred thirty women (100 in Sweden, 30 in France) presenting for first-trimester MA were administered oral mifepristone in the clinic and sent home with two 400 microg doses of misoprostol, along with instructions to take the misoprostol at 24 h intervals. Women were also asked to complete a daily symptom diary. Outcomes of interest included effectiveness, side-effects, and adherence to and acceptability of the home-use regimen. RESULTS Three women (all in France) were lost to follow-up. Of the remaining 127 women, 124 (98%) had a successful MA. All women adhered successfully to the home-use regimen, and satisfaction with home use was high (98%). Most women experienced noticeable, if transitory, side effects after both the first and second doses of misoprostol (97% and 94%, respectively). CONCLUSIONS Misoprostol may successfully and satisfactorily be used at home as part of a MA regimen in European settings as it has been for years in the US. Further research to determine if two doses of misoprostol are more effective than a single dose would be useful.
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Affiliation(s)
- W H Clark
- Gynuity Health Projects, New York, USA
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Abstract
In France, since 2001, medical abortion can be performed in ambulatory conditions, provided an agreement is signed with a hospital serving as referral for complications or failures of the method. This study, reports on the experience of a family planning center (NGO MFPF, Mouvement français de planning familial) in partnership with Delafontaine Hospital in Saint-Denis. In 2004, the MFPF has managed 161 cases of ambulatory medical abortion using a protocol of 200mg of mifepristone on day 1 and 400 to 800 microg of misoprostol on day 3, with possibility for the women to stay at home or go to the hospital for the expulsion. The average age of the women was 24 years and the proportion of young and vulnerable women quite high. The rate of success, defined as the absence or surgical intervention, approached 94.5% and only one case of severe complication was reported, massive hemorrhage 40 days after the initial intake of misoprostol. 75% of women chose to stay home. Acceptance of the method was very good with minimal request for more consultations than the three visits proposed in the protocol. The quality of the follow-up was high with 82% of women attending the medical check, with no difference being observed with regard to age, obstetrical history or socio-economic groups. Ambulatory medical abortion was successful and safe even among vulnerable women. NGOs with multidisciplinary staff involving counsellors, nurses and doctors can offer high quality preparation and follow-up.
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Affiliation(s)
- D Hassoun
- Service de Gynécologie-Obstétrique, Centre d'IVG et de Contraception, Hôpital Delafontaine, rue du Docteur-Delafontaine, 93260 Saint-Denis
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Lelong N, Moreau C, Kaminski M, Bajos N, Bouyer J, Ducot B, Ferrand M, Goulard H, Hassoun D, Job-Spira N, Kaminski M, Lelong N, Leridon H, Moreau C, Oustry P, Razafindratsima N, Rossier C, Warszawski J. Prise en charge de l’IVG en France : résultats de l’enquête COCON. ACTA ACUST UNITED AC 2005; 34:53-61. [PMID: 15767918 DOI: 10.1016/s0368-2315(05)82671-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this article is to describe conditions of abortions practices in France. MATERIALS AND METHODS The study was based on the COCON survey. This survey was carried out among a representative sample of 2863 women aged 18 to 44 living in metropolitan France. Women were interviewed by telephone. The analysis was performed among a sub-sample of 320 women who had had an abortion between 1996 and 2000. Results were compared with those of the national notification of induced abortions. RESULTS Altogether, the way in which abortions were carried out was appropriate, but differences were observed according to the type of hospital: access to care was easier in the private sector; however a pre-abortion interview was less often carried out and a post-abortion interview less often proposed in the private sector. Besides, in both sectors, women were rarely allowed to choose the abortion technique, or the type of anesthesia in the case of a surgical abortion. CONCLUSION The COCON study is the first population based survey describing the characteristics of care regarding voluntary abortion. It shows the persistence of differences in practices between the public and the private sectors.
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Affiliation(s)
- N Lelong
- INSERM U149-IFR69, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif Cedex.
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Houzard S, Bajos N, Warszwawski J, de Guibert-Lantoine C, Kaminski M, Leridon H, Lelong N, Ducot B, Hassoun D, Ferrand M. Analysis of the underestimation of induced abortions in a survey of the general population in France. EUR J CONTRACEP REPR 2000; 5:52-60. [PMID: 10836663 DOI: 10.1080/13625180008500370] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION A pilot study has been conducted in France to estimate the extent of underreporting of induced abortion and the factors linked to underreporting. METHODS A representative random sample of 300 women aged between 18 and 44 years of age who had been pregnant during the previous 2 years and 100 women who had not was selected from the telephone directory. Interviews were conducted by telephone. RESULTS The annual incidence of induced abortion for the 18-44-year-old age group was 6.9 per 1000 (95% confidence interval 2.2-11.6), while the rate derived from national statistics was 15 per 1000. Five women who reported a therapeutic abortion in their lifetime had confused induced abortion and therapeutic abortion. There was no significant difference in the proportion of women reporting induced abortion in their lifetime between those answering with another adult present and those who were alone when answering (13.1% versus 11.1%, p = 0.8). There was also no significant difference according to the sex of the interviewer (10.0% for men versus 12.2% for women, p = 0.6). CONCLUSION The results suggest that the context in which the questions were asked does not affect the validity of the answers and that there is a problem in the comprehension of the terminology used. Extensive rewriting and reformulation of the questions is required to minimize the underreporting of induced abortion.
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Affiliation(s)
- S Houzard
- Institut National de la Santé et de la Recherche Médical U292, Le Kremlin-Bicêtre, France
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Hassoun D. [Conditions of induced abortion in France]. Contracept Fertil Sex 1997; 25:915-20. [PMID: 9497604] [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] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In France, each woman will have an average of one unintended pregnancy in her life and she'll decide to abort once out of two. 21 years after the vote of the law which authorized the abortion, according to certains conditions, the abortion rate decreases slightly. The socioeconomics characteristics of women requesting an abortion are very similar to those found in 1976. The medical and psychological complications are very low. The law is applied except that some difficulties persist: to recruit professionals becomes more difficult, inadequate solutions of public hospitals, inappropriate and not always comprehensive towards the clients, no possibility to choose the methods. The law is limited for the minors, the foreigners and the pregnancies up to 10 weeks which increases the social inegalities. It is a major public health concern to make abortion as safe as possible because it gives accessibility to choose freely motherhood which is the best way for safe pregnancy, birth and parent and child relationship.
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Affiliation(s)
- D Hassoun
- Hôpital Delafontaine, Service de Gynécologie-Obstétrique, Saint-Denis
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Hassoun D, Jourdain A. [Contraception and abortion in the countries of eastern Europe]. Cah Sociol Demogr Med 1995; 35:99-123. [PMID: 7497025] [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: 01/25/2023]
Abstract
For various reasons, including the population policies of the former Socialist countries, abortion is much more frequent than contraception in Central and Eastern Europe. The contrary occurs in Western countries. In the current context, countries in Central and Eastern Europe should improve abortion services and this should be a priority target in their health policy. The study does not detect a clear-cut advantage as concerns substituting contraception to abortion in these countries in terms for instance of reducing maternal mortality. In fact a health policy favouring contraception instead of abortion is firstly inspired by political or ethical reasons. If implemented in Central and Eastern Europe, it would require several decades to bear evident results.
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Affiliation(s)
- D Hassoun
- ANCIC, Centre d'Orthogénie Hôpital Delafontaine Saint-Denis, Hôpital A. Béclère, Clamart
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