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Potier L, Julla JB, Roussel R, Boudou P, Gauthier DC, Ketfi C, Gautier JF. COVID-19 symptoms masking inaugural ketoacidosis of type 1 diabetes. Diabetes Metab 2020; 47:101162. [PMID: 32447100 PMCID: PMC7240273 DOI: 10.1016/j.diabet.2020.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/16/2022]
Affiliation(s)
- L Potier
- Bichat Hospital, AP-HP, Université de Paris, Paris, France.
| | - J B Julla
- Lariboisière Hospital, AP-HP, Université de Paris, Paris, France
| | - R Roussel
- Bichat Hospital, AP-HP, Université de Paris, Paris, France
| | - P Boudou
- Saint-Louis Hospital, AP-HP, Université de Paris, Paris, France
| | - D C Gauthier
- Lariboisière Hospital, AP-HP, Université de Paris, Paris, France
| | - C Ketfi
- Lariboisière Hospital, AP-HP, Université de Paris, Paris, France
| | - J F Gautier
- Lariboisière Hospital, AP-HP, Université de Paris, Paris, France
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Matar O, Potier L, Abouleka Y, Hallot-Feron M, Fumeron F, Mohammedi K, Hadjadj S, Roussel R, Velho G, Marre M. Relationship between renal capacity to reabsorb glucose and renal status in patients with diabetes. Diabetes Metab 2020; 46:488-495. [PMID: 32259661 DOI: 10.1016/j.diabet.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/04/2020] [Accepted: 03/19/2020] [Indexed: 10/24/2022]
Abstract
AIMS Interindividual variability in capacity to reabsorb glucose at the proximal renal tubule could contribute to risk of diabetic kidney disease. Our present study investigated, in patients with diabetes, the association between fractional reabsorption of glucose (FRGLU) and degree of renal disease as assessed by urinary albumin excretion (UAE) and estimated glomerular filtration rate (eGFR). METHODS FRGLU [1-(glucose clearance/creatinine clearance)] was assessed in 637 diabetes patients attending our tertiary referral centre, looking for correlations between FRGLU and UAE (normo-, micro-, macro-albuminuria) and Kidney Disease: Improving Global Outcomes (KDIGO) eGFR categories: >90 (G1); 90-60 (G2); 59-30 (G3); and<30-16 (G4) mL/min/1.73 m2. Patients were stratified by admission fasting plasma glucose (FPG) into three groups: low (<6mmol/L); intermediate (6-11mmol/L); and high (>11mmol/L). RESULTS Median (interquartile range, IQR) FRGLU levels were blood glucose-dependent: 99.90% (0.05) for low (n=106); 99.90% (0.41) for intermediate (n=288); and 96.36% (12.57) for high (n=243) blood glucose categories (P<0.0001). Also, FRGLU increased with renal disease severity in patients in the high FPG group: normoalbuminuria, 93.50% (17.74) (n=135); microalbuminuria, 96.56% (5.94) (n=77); macroalbuminuria, 99.12% (5.44) (n=31; P<0.001); eGFR G1, 94.13% (16.24) (n=111); G2, 96.35% (11.94) (n=72); G3 98.88% (7.59) (n=46); and G4, 99.11% (2.20) (n=14; P<0.01). On multiple regression analyses, FRGLU remained significantly and independently associated with UAE and eGFR in patients in the high blood glucose group. CONCLUSION High glucose reabsorption capacity in renal proximal tubules is associated with high UAE and low eGFR in patients with diabetes and blood glucose levels>11mmol/L.
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Affiliation(s)
- O Matar
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - L Potier
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - Y Abouleka
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - M Hallot-Feron
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France
| | - F Fumeron
- UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - K Mohammedi
- Faculté de médecine Paul-Broca, université de Bordeaux, Bordeaux, France
| | - S Hadjadj
- Inserm, CNRS, Institut du thorax, université de Nantes, Nantes, France
| | - R Roussel
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - G Velho
- Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - M Marre
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France; CMC Ambroise-Paré, Neuilly-sur-Seine, France.
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Waeckel L, Potier L, Richer C, Roussel R, Bouby N, Alhenc-Gelas F. Pathophysiology of genetic deficiency in tissue kallikrein activity in mouse and man. Thromb Haemost 2013; 110:476-83. [PMID: 23572029 DOI: 10.1160/th12-12-0937] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 03/14/2013] [Indexed: 12/30/2022]
Abstract
Study of mice rendered deficient in tissue kallikrein (TK) by gene inactivation and human subjects partially deficient in TK activity as consequence of an active site mutation has allowed recognising the physiological role of TK and its peptide products kinins in arterial function and in vasodilatation, in both species. TK appears as the major kinin forming enzyme in arteries, heart and kidney. Non-kinin mediated actions of TK may occur in epithelial cells in the renal tubule. In basal condition, TK deficiency induces mild defective phenotypes in the cardiovascular system and the kidney. However, in pathological situations where TK synthesis is typically increased and kinins are produced, TK deficiency has major, deleterious consequences. This has been well documented experimentally for cardiac ischaemia, diabetes renal disease, peripheral ischaemia and aldosterone-salt induced hypertension. These conditions are all aggravated by TK deficiency. The beneficial effect of ACE/kininase II inhibitors or angiotensin II AT1 receptor antagonists in cardiac ischaemia is abolished in TK-deficient mice, suggesting a prominent role for TK and kinins in the cardioprotective action of these drugs. Based on findings made in TK-deficient mice and additional evidence obtained by pharmacological or genetic inactivation of kinin receptors, development of novel therapeutic approaches relying on kinin receptor agonism may be warranted.
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Affiliation(s)
- L Waeckel
- Francois Alhenc-Gelas, INSERM U872, Centre de Recherche des Cordeliers, 15 rue de l'Ecole de Médecine 75006 Paris, France, E-mail:
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Potier L, Abi Khalil C, Mohammedi K, Roussel R. Use and utility of ankle brachial index in patients with diabetes. Eur J Vasc Endovasc Surg 2010; 41:110-6. [PMID: 21095144 DOI: 10.1016/j.ejvs.2010.09.020] [Citation(s) in RCA: 171] [Impact Index Per Article: 12.2] [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: 05/10/2010] [Accepted: 09/16/2010] [Indexed: 01/25/2023]
Abstract
Ankle brachial index (ABI) is a simple method to screen peripheral arterial disease (PAD) and to evaluate cardiovascular (CV) prognosis in the general population. Measuring it requires a hand-held Doppler probe but it can be done also with an automatic device. ABI is an effective tool for clinical practice or clinical studies. However, in diabetic patients, it has some specific caveats. Sensitivity of the standard threshold of 0.9 appears to be lower in diabetic patients with complications. Moreover, highly frequent arterial medial calcifications in diabetes increase ABI. It has been demonstrated that measurements >1.3 are well correlated with both an increased prevalence of PAD and CV risk. Therefore, ABI thresholds of less than 0.9 and more than 1.3 are highly suspicious for PAD and high CV risk in diabetic patients. However, when there is concomitant clinical peripheral neuropathy or high risk of arterial calcification, the efficiency of ABI seems to be limited. In this case, other methods should be applied, toe pressure, in particular. Thus, the ABI could be used in patients with diabetes, but values should be interpreted with precision, according to the clinical situation.
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Affiliation(s)
- L Potier
- Hôpital Bichat, AP-HP, Paris, France.
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Ould-Ahmed M, Choplain JN, Andre M, Mondine P, Potier L. Rupture diaphragmatique droite, de découverte tardive et fortuite à la consultation d'anesthésie. ACTA ACUST UNITED AC 2005; 24:416-20. [PMID: 15826792 DOI: 10.1016/j.annfar.2005.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Accepted: 01/05/2005] [Indexed: 11/16/2022]
Abstract
Although diaphragmatic rupture occurs after violent blunt trauma, its diagnosis is often delayed. The intra-thoracic displacement of abdominal organs through diaphragmatic rupture may lead to early or delayed complications because of compression of heart and lungs or strangulation of the abdominal viscera. A 49-year-old woman was scheduled to undergo elective lumbar disc surgery in prone position. The preoperative chest radiograph revealed an abnormally elevated right hemi diaphragm with loops of colon filling the right costophrenic angle. The CT-scan confirmed right chronic diaphragmatic rupture with colon and liver herniations. Fifteen months previously, this woman had been involved in a traffic accident, with blunt right trauma resulting in right pelvic fractures. Perianaesthetic course increase the pre-existing mechanical risk of complications of chronic diaphragmatic rupture. Primary repair of right chronic diaphragmatic rupture through thoracotomy must be recommended. When another surgery must be done in emergency, the feasibility of regional anaesthesia should be considered.
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Affiliation(s)
- M Ould-Ahmed
- Service d'anesthésie, HIA Clermont-Tonnerre, 29240 Brest-Armées, France.
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Delneste Y, Jeannin P, Potier L, Romero P, Bonnefoy JY. N-acetyl-L-cysteine exhibits antitumoral activity by increasing tumor necrosis factor alpha-dependent T-cell cytotoxicity. Blood 1997; 90:1124-32. [PMID: 9242544] [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: 02/04/2023] Open
Abstract
Because of its anticarcinogenic and antimutagenic properties, N-acetyl-L-cysteine (NAC) has been proposed for cancer treatment. Here we present a mechanism of action for NAC in cancer. Our data show that NAC (1) induces an early and sustained increase of membrane tumor necrosis factor alpha (TNF alpha) expression on human stimulated-peripheral blood (PB) T cells and (2) increases membrane TNF-RI and TNF-RII on tumoral cell lines and on T cells after stimulation. These effects result from an early inhibition of both TNF alpha and TNF-R shedding, as well as a later increase of the respective mRNA expression. Consequently, NAC confers cytotoxic properties to human PB T cells through a membrane TNF alpha-dependent pathway. In vivo, NAC given orally inhibits tumor appearance in more than a third (18 out of 50) B6D2F1 mice injected with L1210 lymphoma cells. Spleen cells from protected mice killed L1210 lymphoma cells in vitro in a membrane TNF alpha-dependent manner. Furthermore these mice were resistant to a second inoculation of L1210 cells without further treatment with NAC. Thus, NAC exhibits a potent antitumoral activity by modulating TNF alpha and TNF-R processing without showing any in vitro and in vivo toxicity.
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MESH Headings
- Acetylcysteine/pharmacology
- Acetylcysteine/therapeutic use
- Adjuvants, Immunologic/pharmacology
- Adjuvants, Immunologic/therapeutic use
- Animals
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Cells, Cultured
- Cytotoxicity, Immunologic/drug effects
- Gene Expression Regulation/drug effects
- Gene Expression Regulation, Leukemic/drug effects
- Humans
- Leukemia L1210/drug therapy
- Leukemia L1210/immunology
- Leukemia L1210/pathology
- Mice
- Mice, Inbred BALB C
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Neoplasm Transplantation
- Receptors, Tumor Necrosis Factor/biosynthesis
- Receptors, Tumor Necrosis Factor/genetics
- T-Lymphocytes, Cytotoxic/drug effects
- T-Lymphocytes, Cytotoxic/immunology
- Tumor Necrosis Factor-alpha/biosynthesis
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/physiology
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Affiliation(s)
- Y Delneste
- Geneva Biomedical Research Institute, Glaxo Wellcome Research and Development SA, Immunology Department, Switzerland
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