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Dreano E, Burgel PR, Hatton A, Bouazza N, Chevalier B, Macey J, Leroy S, Durieu I, Weiss L, Grenet D, Stremler N, Ohlmann C, Reix P, Porzio M, Roux Claude P, Rémus N, Douvry B, Montcouquiol S, Cosson L, Mankikian J, Languepin J, Houdouin V, Le Clainche L, Guillaumot A, Pouradier D, Tissot A, Priou P, Mély L, Chedevergne F, Lebourgeois M, Lebihan J, Martin C, Zavala F, Da Silva J, Lemonnier L, Kelly-Aubert M, Golec A, Foucaud P, Marguet C, Edelman A, Hinzpeter A, de Carli P, Girodon E, Sermet-Gaudelus I, Pranke I. Theratyping cystic fibrosis patients to guide elexacaftor/tezacaftor/ivacaftor out-of-label prescription. Eur Respir J 2023; 62:2300110. [PMID: 37696564 DOI: 10.1183/13993003.00110-2023] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Around 20% of people with cystic fibrosis (pwCF) do not have access to the triple combination elexacaftor/tezacaftor/ivacaftor (ETI) in Europe because they do not carry the F508del allele on the CF transmembrane conductance regulator (CFTR) gene. Considering that pwCF carrying rare variants may benefit from ETI, including variants already validated by the US Food and Drug Administration (FDA), a compassionate use programme was launched in France. PwCF were invited to undergo a nasal brushing to investigate whether the pharmacological rescue of CFTR activity by ETI in human nasal epithelial cell (HNEC) cultures was predictive of the clinical response. METHODS CFTR activity correction was studied by short-circuit current in HNEC cultures at basal state (dimethyl sulfoxide (DMSO)) and after ETI incubation and expressed as percentage of normal (wild-type (WT)) CFTR activity after sequential addition of forskolin and Inh-172 (ΔI ETI/DMSO%WT). RESULTS 11 pwCF carried variants eligible for ETI according to the FDA label and 28 carried variants not listed by the FDA. ETI significantly increased CFTR activity of FDA-approved CFTR variants (I601F, G85E, S492F, M1101K, R347P, R74W;V201M;D1270N and H1085R). We point out ETI correction of non-FDA-approved variants, including N1303K, R334W, R1066C, Q552P and terminal splicing variants (4374+1G>A and 4096-3C>G). ΔI ETI/DMSO%WT was significantly correlated to change in percentage predicted forced expiratory volume in 1 s and sweat chloride concentration (p<0.0001 for both). G85E, R74W;V201M;D1270N, Q552P and M1101K were rescued more efficiently by other CFTR modulator combinations than ETI. CONCLUSIONS Primary nasal epithelial cells hold promise for expanding the prescription of CFTR modulators in pwCF carrying rare mutants. Additional variants should be discussed for ETI indication.
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Affiliation(s)
- Elise Dreano
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
| | - Pierre Régis Burgel
- Université Paris-Cité, Paris, France
- Respiratory Medicine and Cystic Fibrosis National Reference Center, Cochin Hospital, AP-HP, Paris, France
- INSERM U1016, Institut Cochin, Paris, France
- ERN-LUNG CF Network, Frankfurt, Germany
| | - Aurelie Hatton
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
| | - Naim Bouazza
- Université Paris-Cité, Paris, France
- Unité de Recherche Clinique, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Benoit Chevalier
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
| | - Julie Macey
- Centre de Ressources et de Compétence de la Mucoviscidose, CHU Pellegrin, Bordeaux, France
| | - Sylvie Leroy
- Centre de Ressources et de Compétence de la Mucoviscidose, CHU, Nice, France
| | - Isabelle Durieu
- Centre de Référence Adulte de la Mucoviscidose, Hospices Civils de Lyon, Université de Lyon, Équipe d'Accueil Health Services and Performance Research (HESPER) 7425, Lyon, France
| | - Laurence Weiss
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, CHU, Strasbourg, France
| | - Dominique Grenet
- Centre de Ressources et de Compétence de la Mucoviscidose, Hôpital Foch, Suresnes, France
| | - Nathalie Stremler
- Centre de Ressources et de Compétence de la Mucoviscidose, Hôpital de la Timone, Marseille, France
| | - Camille Ohlmann
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, Hospices Civils de Lyon, Bron, France
| | - Philippe Reix
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, Hospices Civils de Lyon, Bron, France
| | - Michele Porzio
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, CHU, Strasbourg, France
| | - Pauline Roux Claude
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, CHU, Besancon, France
| | - Natacha Rémus
- Centre de Ressources et de Compétence de la Mucoviscidose Mixte, CHIC, Créteil, France
| | - Benoit Douvry
- Centre de Ressources et de Compétence de la Mucoviscidose Mixte, CHIC, Créteil, France
| | - Sylvie Montcouquiol
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, CHU, Clermont Ferrand, France
| | - Laure Cosson
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, CHU, Tours, France
| | - Julie Mankikian
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, CHU, Tours, France
| | - Jeanne Languepin
- Centre de Ressources et de Compétence de la Mucoviscidose Mixte, CHU, Limoges, France
| | - Veronique Houdouin
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, Hôpital Robert Debré, Paris, France
| | - Laurence Le Clainche
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, Hôpital Robert Debré, Paris, France
| | - Anne Guillaumot
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, CHU, Nancy, France
| | - Delphine Pouradier
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, Hôpital Mignot, Le Chesnay, France
| | - Adrien Tissot
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, CHU, Nantes, France
| | - Pascaline Priou
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, CHU, Angers, France
| | - Laurent Mély
- Centre de Ressources et de Compétence de la Mucoviscidose, Hôpital René Sabran, Hospices Civils de Lyon, Giens, France
| | - Frederique Chedevergne
- Cystic Fibrosis National Pediatric Reference Center, Pneumo-Allergologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Muriel Lebourgeois
- Cystic Fibrosis National Pediatric Reference Center, Pneumo-Allergologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Jean Lebihan
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, Centre de Perharidy, Roscoff, France
| | - Clémence Martin
- Université Paris-Cité, Paris, France
- Respiratory Medicine and Cystic Fibrosis National Reference Center, Cochin Hospital, AP-HP, Paris, France
| | - Flora Zavala
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
| | - Jennifer Da Silva
- Respiratory Medicine and Cystic Fibrosis National Reference Center, Cochin Hospital, AP-HP, Paris, France
| | | | - Mairead Kelly-Aubert
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
| | - Anita Golec
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
| | | | - Christophe Marguet
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, CHU, Rouen, France
| | - Aleksander Edelman
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
| | - Alexandre Hinzpeter
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
| | | | - Emmanuelle Girodon
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
- Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, Paris, France
- These three authors contributed equally to this work as co-last authors
| | - Isabelle Sermet-Gaudelus
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
- ERN-LUNG CF Network, Frankfurt, Germany
- Centre de Ressources et de Compétence de la Mucoviscidose Pédiatrique, Hôpital Mignot, Le Chesnay, France
- These three authors contributed equally to this work as co-last authors
| | - Iwona Pranke
- INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
- Université Paris-Cité, Paris, France
- These three authors contributed equally to this work as co-last authors
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Pranke I, Hatton A, Masson A, Flament T, Le Bourgeois M, Chedevergne F, Bailly C, Urbach V, Hinzpeter A, Edelman A, Sermet-Gaudelus I. Might Brushed Nasal Cells Be a Surrogate for CFTR Modulator Clinical Response? Am J Respir Crit Care Med 2019; 199:123-126. [PMID: 30326728 DOI: 10.1164/rccm.201808-1436le] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
| | | | - Alexandra Masson
- 2 Hôpital Necker-Enfants Malades Paris, France.,3 Hôpital Dupuytren Limoges, France
| | | | | | | | | | | | | | | | - Isabelle Sermet-Gaudelus
- 1 Institut Necker-Enfants Malades Paris, France.,2 Hôpital Necker-Enfants Malades Paris, France.,5 Université Paris Sorbonne Paris, France
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Masson A, Schneider-Futschik EK, Baatallah N, Nguyen-Khoa T, Girodon E, Hatton A, Flament T, Le Bourgeois M, Chedevergne F, Bailly C, Kyrilli S, Achimastos D, Hinzpeter A, Edelman A, Sermet-Gaudelus I. Predictive factors for lumacaftor/ivacaftor clinical response. J Cyst Fibros 2018; 18:368-374. [PMID: 30595473 DOI: 10.1016/j.jcf.2018.12.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 12/09/2018] [Accepted: 12/22/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Ivacaftor-lumacaftor combination therapy corrects the F508 del-CFTR mutated protein which causes Cystic Fibrosis. The clinical response of the patients treated with the combination therapy is highly variable. This study aimed to determine factors involved in the individual's response to lumacaftor-ivacaftor therapy. METHODS Sweat test was assessed at baseline and after 6 months of ivacaftor-lumacaftor treatment in 41 homozygous F508del children and young adults. β-adrenergic peak sweat secretion, nasal potential difference (NPD) and intestinal current measurements (ICM) were performed in patients accepting these tests. Seric level of lumacaftor and ivacaftor were determined and additional CFTR variant were searched. RESULTS Sweat chloride concentration significantly decreased after treatment, whereas the β-adrenergic peak sweat response did not vary in 9 patients who underwent these tests. The average level of F508del-CFTR activity rescue reached up to 15% of the normal level in intestinal epithelium, as studied by ICM in 12 patients (p = .03) and 20% of normal in the nasal epithelium in NPD tests performed in 21 patients (NS). There was no significant correlation between these changes and improvements in FEV1 at 6 months. Serum drug levels did not correlate with changes in FEV1, BMI-Zscore or other CFTR activity biomarkers. Additional exonic variants were identified in 4 patients. The F87L-I1027T-F508del-CFTR complex allele abolished the lumacaftor corrector effect. CONCLUSION This observational study investigates a number of potential factors linked to the clinical response of F508del homozygous patients treated with lumacaftor-ivacaftor combination therapy. Lumacaftor and ivacaftor blood levels are not associated with the clinical response. Additional exonic variants may influence protein correction.
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Affiliation(s)
- Alexandra Masson
- Centre Maladie Rare Mucoviscidose, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de sèvres, 75015 Paris, France; Centre de Référence et de Compétence de la Mucoviscidose, Hôpital Dupuytren, 8 avenue Dominique Larrey, 87042 Limoges, France
| | - Elena K Schneider-Futschik
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052, Australia; Lung Health Research Center, Department of Pharmacology & Therapeutics, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Nesrine Baatallah
- Institut Necker-Enfants Malades, INSERM U1151, 149 rue de Sèvres, 75015 Paris, France.
| | - Thao Nguyen-Khoa
- Centre Maladie Rare Mucoviscidose, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de sèvres, 75015 Paris, France; Institut Necker-Enfants Malades, INSERM U1151, 149 rue de Sèvres, 75015 Paris, France; Laboratoire de Biochimie Générale, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de Sèvres, 75015 Paris, France.
| | - Emmanuelle Girodon
- Institut Necker-Enfants Malades, INSERM U1151, 149 rue de Sèvres, 75015 Paris, France; Service de Biochimie et Génétique Moléculaire, Hôpital Cochin, Assistance-Publique Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France.
| | - Aurélie Hatton
- Institut Necker-Enfants Malades, INSERM U1151, 149 rue de Sèvres, 75015 Paris, France.
| | - Thomas Flament
- Centre de Ressources et de Compétence de la Mucoviscidose Adulte, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire, 2 boulevard Tonnellé, 37000 Tours, France.
| | - Muriel Le Bourgeois
- Centre Maladie Rare Mucoviscidose, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de sèvres, 75015 Paris, France.
| | - Frederique Chedevergne
- Centre Maladie Rare Mucoviscidose, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de sèvres, 75015 Paris, France.
| | - Céline Bailly
- Centre Maladie Rare Mucoviscidose, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de sèvres, 75015 Paris, France.
| | - Sylvia Kyrilli
- Centre Maladie Rare Mucoviscidose, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de sèvres, 75015 Paris, France
| | - Diane Achimastos
- Centre Maladie Rare Mucoviscidose, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de sèvres, 75015 Paris, France.
| | - Alexandre Hinzpeter
- Institut Necker-Enfants Malades, INSERM U1151, 149 rue de Sèvres, 75015 Paris, France.
| | - Aleksander Edelman
- Institut Necker-Enfants Malades, INSERM U1151, 149 rue de Sèvres, 75015 Paris, France.
| | - Isabelle Sermet-Gaudelus
- Centre Maladie Rare Mucoviscidose, Hôpital Necker-Enfants Malades, Assistance-Publique Hôpitaux de Paris, 149 rue de sèvres, 75015 Paris, France; Institut Necker-Enfants Malades, INSERM U1151, 149 rue de Sèvres, 75015 Paris, France; Université Paris Sorbonne, 75005 Paris, France.
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Charatsi A, Dusser P, Freund R, Maruani G, Rossin H, Boulier A, Le Bourgeois M, Chedevergne F, de Blic J, Letourneur A, Casimir G, Jais J, Sermet-Gaudelus I. Bioelectrical impedance in young patients with cystic fibrosis: Validation of a specific equation and clinical relevance. J Cyst Fibros 2016; 15:825-833. [DOI: 10.1016/j.jcf.2016.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 04/28/2016] [Accepted: 05/07/2016] [Indexed: 01/10/2023]
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Masson A, Launay O, Delaisi B, Bassinet L, Remus N, Lebourgeois M, Chedevergne F, Bailly C, Foucaud P, Corvol H, deBlic J, Sermet-Gaudelus I. Vaccine coverage in CF children: A French multicenter study. J Cyst Fibros 2015; 14:615-20. [DOI: 10.1016/j.jcf.2015.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 04/27/2015] [Accepted: 04/27/2015] [Indexed: 11/30/2022]
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El Khatib N, Ferroni A, Le Bourgeois M, Chedevergne F, Clairicia M, Avril H, Guiso N, Sermet-Gaudelus I. Persistent Bordetella bronchiseptica infection in a child with cystic fibrosis: Relationship to bacterial phenotype. J Cyst Fibros 2015; 14:E13-5. [PMID: 25900817 DOI: 10.1016/j.jcf.2015.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 02/07/2015] [Revised: 03/24/2015] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
Abstract
Bordetella bronchiseptica is an opportunistic bacteria infecting the respiratory tract of patients with cystic fibrosis. We present a case of B. bronchiseptica chronic pulmonary infection and documentation of some phenotypic attributes of the clinical isolates allowing the microorganism to induce progressive respiratory degradation and chronic sputum colonization. We recommend implementing adequate treatment aiming eradication from the first isolation of this bacterium. We advise for practices that minimize opportunities for zoonotic transmission of B. bronchiseptica from family pets.
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Affiliation(s)
- Nevine El Khatib
- Centre de Ressources et de Compétences de la Mucoviscidose, Service de Pneumologie et d'allergologie de l'Enfant, Hôpital Necker-Enfants malades, Paris, France
| | - Agnes Ferroni
- Laboratoire de Microbiologie, Hôpital Necker-Enfants malades, Paris, France
| | - Muriel Le Bourgeois
- Centre de Ressources et de Compétences de la Mucoviscidose, Service de Pneumologie et d'allergologie de l'Enfant, Hôpital Necker-Enfants malades, Paris, France
| | - Frederique Chedevergne
- Centre de Ressources et de Compétences de la Mucoviscidose, Service de Pneumologie et d'allergologie de l'Enfant, Hôpital Necker-Enfants malades, Paris, France
| | - Marlene Clairicia
- Centre de Ressources et de Compétences de la Mucoviscidose, Service de Pneumologie et d'allergologie de l'Enfant, Hôpital Necker-Enfants malades, Paris, France
| | - Helene Avril
- Centre de Ressources et de Compétences de la Mucoviscidose, Service de Pneumologie et d'allergologie de l'Enfant, Hôpital Necker-Enfants malades, Paris, France
| | - Nicole Guiso
- National Centre of Reference of Pertussis and other Bordetelloses, Institut Pasteur., Paris, France
| | - I Sermet-Gaudelus
- Centre de Ressources et de Compétences de la Mucoviscidose, Service de Pneumologie et d'allergologie de l'Enfant, Hôpital Necker-Enfants malades, Paris, France; Université Paris-Sorbonne, Paris, France; INSERM U 1151, Paris, France.
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Launay O, Boelle PY, Krivine A, Grenet D, Boussaud V, Rémus N, Corvol H, Chedevergne F, Hubert D, Sermet-Gaudelus I. Factors associated with humoral immune response to pandemic A/H1N1(v) 2009 influenza vaccine in cystic fibrosis. Vaccine 2014; 32:4515-4521. [PMID: 24950362 DOI: 10.1016/j.vaccine.2014.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 03/09/2014] [Revised: 05/28/2014] [Accepted: 06/06/2014] [Indexed: 11/25/2022]
Abstract
Influenza vaccination is recommended in cystic fibrosis patients. The objective of this study was to assess the immunogenicity of vaccination against 2009 pandemic A/H1N1 influenza and to study the factors associated with the immune response in patients with cystic fibrosis. 122 patients with cystic fibrosis were enrolled in a prospective study and received 1 dose of 2009/H1N1v adjuvanted vaccine, or for children <2 years and lung-transplanted patients, two doses of non-adjuvanted 2009/H1N1v vaccine administered 21 days apart. Hemagglutination inhibition antibodies were assessed before and 21 days after vaccination and at least 6 months after vaccination. After vaccination, 85% of the patients had an influenza antibody titer ≥1:40 and 69% seroconverted. 13% of the transplanted patients seroconverted compared with 72% of the non-transplanted patients. In this latter group, non-adjuvanted vaccine and low body mass index were independently associated with lower response to vaccination. 86% of the non-transplanted patients with normal BMI and receiving adjuvanted vaccine seroconverted. Persistence of seroprotection 10 months after vaccination was found in 50% of the patients. In patients with cystic fibrosis, malnutrition and receipt of non-adjuvanted vaccine were associated with lower immune response to pandemic influenza vaccination. Our data also suggest a potential defect in the immune response to influenza vaccination of patients with cystic fibrosis and raise the question of whether a different immunization strategy is needed.
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Affiliation(s)
- O Launay
- Inserm, CIC 1417, Paris, France; Université Paris Descartes, Paris Sorbonne Cité, Paris, France; Assistance-Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin-Pasteur, Paris, France
| | | | - A Krivine
- Assistance-Publique Hôpitaux de Paris, Hôpital Cochin, Service de Virologie, Paris, France
| | - D Grenet
- Hôpital Foch, Service de Pneumologie, Suresnes, France
| | - V Boussaud
- Assistance-Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Chirurgie Thoracique, Paris, France
| | - N Rémus
- Centre Hospitalier Intercommunal de Créteil, Centre de Ressources et de Compétences en Mucoviscidose, Créteil, France
| | - H Corvol
- Assistance-Publique Hôpitaux de Paris, Hôpital Trousseau, Centre de Ressources et de Compétences en Mucoviscidose, Paris, France
| | - F Chedevergne
- Assistance-Publique Hôpitaux de Paris, Hôpital Necker, Service de Pneumologie- Allergologie Pediatrique et Centre de Ressources et de Compétences en Mucoviscidose, Paris, France
| | - D Hubert
- Assistance-Publique Hôpitaux de Paris, Hôpital Cochin, Service de Pneumologie, Centre de Ressources et de Compétences en Mucoviscidose, Paris, France
| | - I Sermet-Gaudelus
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France; Assistance-Publique Hôpitaux de Paris, Hôpital Necker, Service de Pneumologie- Allergologie Pediatrique et Centre de Ressources et de Compétences en Mucoviscidose, Paris, France; INSERM U 1151, Paris, France.
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Masson A, Launay O, Delaisi B, Remus N, Lebourgeois M, Chedevergne F, Corvol H, Bonnel AS, Bassinet L, Bailly C, de Blic J, Sermet-Gaudelus I. 142 Immunisation coverage in children with cystic fibrosis: a French multicenter survey. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60278-2] [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: 10/25/2022]
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Dubus JC, Bassinet L, Chedevergne F, Delaisi B, Desmazes-Dufeu N, Reychler G, Vecellio L. Mucoviscidose et traitements inhalés : quoi de neuf en 2013 ? Rev Mal Respir 2014; 31:336-46. [DOI: 10.1016/j.rmr.2013.12.001] [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: 07/24/2013] [Accepted: 10/13/2013] [Indexed: 10/25/2022]
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Clairicia M, Fezaa D, Sallort M, Barbosa M, Kirszenbaum M, Chedevergne F, Vrielynck S, Brechu M, Gaudet L, Lindgren A, Sermet-Gaudelus I. Experience of a 1 year therapeutic education program. J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60382-9] [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: 11/25/2022]
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Chedevergne F, Dahan M, Burtheret A, Parratte B. Walking test to validate an equipped slipper for measurement of foot-to-ground pressure distribution. Comput Methods Biomech Biomed Engin 2007. [DOI: 10.1080/10255840701479958] [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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Sermet-Gaudelus I, Ferroni A, Vrielinck S, Lebourgeois M, Chedevergne F, Lenoir G. [Anti Pseudomonas aeruginosa antibiotic therapy in cystic fibrosis (exclusion of macrolides)]. Arch Pediatr 2006; 13 Suppl 1:S30-43. [PMID: 17370394] [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: 05/14/2023]
Abstract
Antibiotherapy is one of the main treatment in cystic fibrosis. Pseudomonas aeruginosa infection is one of the main causes of pulmonary degradation. The chronic sputum colonisation is characterized by the emergence of the mucoid phenotype, the formation of biofilm and the induction of excessive inflammatory response and consecutive tissue lesion. The choice of antibiotics depends on quantitative and qualitative analysis of sputum, bacteria resistance phenotypes and severity of infection. Treatment of P. aeruginosa is different in case of first colonization or chronic infection. In the first case, parenteral antibiotherapy (beta-lactams-aminoglycosids) followed by inhaled antibiotherapy may eradicate the germ. In the other case, superinfections can be treated with parenteral biantibiothérapy (beta-lactams or quinolons and aminoglycosides) during 15 to 21 days. This is associated with a better nutritional and respiratory status and a prolonged survival. Inhaled antibiotics between the courses have decreased the number of superinfections. This prolonged antibiotherapy must be monitored because of possible induction of bacterial resistance, nephrotoxicity and ototoxicity of aminosids and allergy to beta-lactams.
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Affiliation(s)
- I Sermet-Gaudelus
- Centre de ŕeférence et de compétence en mucoviscidose, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris 15, France.
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Paty E, Chedevergne F, Scheinmann P, Wal JM, Bernard H. Allergie au lait de chèvre et de brebis sans allergie associée au lait de vache. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s0335-7457(03)00239-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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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Abstract
The role of inflammation in adult asthma is well known, involving a cascade of immunological stimulation in which mast cells and eosinophils play pivotal roles. However, the assessment of airway inflammation in children is more difficult as the invasive methods used in adults cannot ethically be used for this purpose alone. Nevertheless, limited data from studies using invasive methodology, and studies using novel non-invasive techniques such as sputum induction and nitrous oxide exhalation, are improving knowledge. The immunopathology in childhood asthma appears to mirror that in adult sufferers. The inflammatory processes are evident at an early age in wheezing infants who later develop asthma, and there are different "wheezing phenotypes" in children with atopic asthma or viral associated wheeze. The mechanisms underlying childhood asthma are dependent not only on increased numbers of inflammatory cells in the airways, but also increased activation of these cells. In vitro data have shown that corticosteroids can inhibit the secretion of proinflammatory compounds from alveolar macrophages, suggesting a potential important role for these agents in halting the development of asthma. Techniques for measuring inflammation in infants need to be refined, in order to provide increased knowledge and accurate monitoring of the disease. It is hoped that this will enable the development of early interventions to minimise the impact of asthma in infants who are identified as being susceptible.
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Affiliation(s)
- F Chedevergne
- Service de Pneumologie et d'Allergologie Pediatriques, Hospital Necker Enfants Malades, 149 rue de Sêvres, 75743 Paris, France.
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