1
|
Moraly J, Rossignol J, Rouzaud C, Gabas T, Bouktit H, Lhermitte L, Canioni D, Fraitag S, Bruneau J, Barete S, Suarez F, Ballul T, Meni C, Polivka L, Terriou L, Launay D, Bouillet L, Gaudy-Marqueste C, Gousseff M, Le Mouel E, Neel A, Ranta D, Jaussaud R, Guilpain P, Frenzel L, Agopian J, Dubreuil P, Greco C, Dimicoli-Salazar S, Heiblig M, Gourguechon C, Tournilhac O, Javier RM, Castelain F, Cabrera Q, Gourin MP, Wierzbicka-Hainaut E, Torregrosa-Diaz JM, Bulai C, Lavigne C, Hoarau C, Arock M, Damaj G, Lortholary O, Hermine O. Efficacy and safety of mammalian target of rapamycin inhibitors in systemic mastocytosis: A nationwide French pilot study. Am J Hematol 2024; 99:1095-1102. [PMID: 38581211 DOI: 10.1002/ajh.27323] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 04/08/2024]
Abstract
Systemic mastocytosis (SM) corresponds to a rare and heterogeneous spectrum of diseases characterized by the accumulation of atypical mast cells (MCs). Advanced mastocytosis (Adv-SM) is associated with poor survival; in contrast, patients with non-advanced SM (non-Adv-SM) usually have a normal life expectancy but may experience poor quality of life. Despite recent therapeutic progress including tyrosine kinase inhibitors, new treatment options are needed for refractory and/or intolerant patients with both severely symptomatic and Adv-SM. In vitro, the mTOR pathway is activated in MCs from patients bearing the KIT D816V mutation. Furthermore, rapamycin induces the apoptosis of KIT D816V MCs selectively. In this nationwide study, we report the outcomes of patients diagnosed with SM and treated with a mammalian target of rapamycin inhibitor (imTOR) within the French National Reference Center for mastocytosis (CEREMAST). All patients registered were relapsing, treatment-refractory, or ineligible for other cytoreductive therapy. Non-Adv-SM patients received imTOR as a monotherapy (rapamycin/everolimus), and Adv-SM patients received imTOR as a monotherapy or in combination with cytarabine. The objective response rate (ORR) in non-Adv-SM was 60% (partial response in 40% and major response in 20%), including reductions in skin involvement, mediator release symptoms, and serum tryptase. In the Adv-SM group, the ORR was 20% (including one major response and one partial response, both in patients with a KIT D816V mutation), which enabled a successful bridge to allogeneic stem cell transplantation in one patient. Our results suggest that imTOR treatment has potential benefits in patients with SM harboring a KIT D816V mutation.
Collapse
Affiliation(s)
- Josquin Moraly
- Infectious and Tropical Diseases Department, Necker-Pasteur Infectiology Center, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Julien Rossignol
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- INSERM U1163, Imagine Institute, Paris-Cite University, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Hematology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Claire Rouzaud
- Infectious and Tropical Diseases Department, Necker-Pasteur Infectiology Center, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Thomas Gabas
- Infectious and Tropical Diseases Department, Necker-Pasteur Infectiology Center, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Hassiba Bouktit
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Ludovic Lhermitte
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Laboratory of Onco-Hematology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Danielle Canioni
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Pathology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Sylvie Fraitag
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Pathology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Julie Bruneau
- Department of Pathology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Stéphane Barete
- Department of Dermatology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Felipe Suarez
- Department of Hematology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Thomas Ballul
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- INSERM U1163, Imagine Institute, Paris-Cite University, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Hematology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Cécile Meni
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Dermatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Laura Polivka
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- INSERM U1163, Imagine Institute, Paris-Cite University, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Dermatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Louis Terriou
- Department of Internal Medicine and Clinical Immunology, Claude Huriez Hospital, CHRU Lille, Lille, France
| | - David Launay
- Department of Internal Medicine and Clinical Immunology, Claude Huriez Hospital, CHRU Lille, Lille, France
| | - Laurence Bouillet
- Clinical Immunology/Internal Medicine Department, National Reference Center for Angioedema, Grenoble University Hospital, Grenoble, France
| | | | - Marie Gousseff
- Department of Internal Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Edwige Le Mouel
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
| | - Antoine Neel
- Department of Internal Medicine, Hôtel-Dieu University Hospital, Nantes, France
| | - Dana Ranta
- Department of Hematology, Nancy University Hospital, Nancy, France
| | - Roland Jaussaud
- Department of Internal Medicine and Clinical Immunology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Philippe Guilpain
- Department of Internal Medicine-Multi-Organ Diseases, Saint-Eloi University Hospital, Montpellier University, Montpellier, France
| | - Laurent Frenzel
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- INSERM U1163, Imagine Institute, Paris-Cite University, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Hematology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Julie Agopian
- INSERM, U1068, Centre de Recherche en Cancerologie de Marseille (CRCM), Paoli-Calmettes Institute, Marseille, France
| | - Patrice Dubreuil
- INSERM, U1068, Centre de Recherche en Cancerologie de Marseille (CRCM), Paoli-Calmettes Institute, Marseille, France
| | - Céline Greco
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Pain and Palliative Care Unit, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | | | - Mael Heiblig
- Department of Hematology, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
| | | | - Olivier Tournilhac
- Adult Clinical Hematology, CHU Clermont-Ferrand, INSERM CIC501, EA 7453 - Clermont Auvergne University, Clermont-Ferrand, France
| | - Rose-Marie Javier
- Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | - Florence Castelain
- Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France
| | - Quentin Cabrera
- Department of Hematology, Sud Reunion University Hospital, Saint Pierre, La Réunion, France
| | | | | | | | - Cristina Bulai
- Department of Dermatology, Hôpital Larrey, CHU Toulouse, Toulouse, France
| | - Christian Lavigne
- Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France
| | - Cyrille Hoarau
- Department of Clinical Immunology and Allergology, Centre Hospitalier Régional Universitaire, Tours, France
| | - Michel Arock
- Laboratory of Hematology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Gandhi Damaj
- Hematology Institute, Normandy University School of Medicine, Caen, France
| | - Olivier Lortholary
- Infectious and Tropical Diseases Department, Necker-Pasteur Infectiology Center, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Olivier Hermine
- Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades Hospital, AP-HP, Paris, France
- INSERM U1163, Imagine Institute, Paris-Cite University, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- Department of Hematology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| |
Collapse
|
2
|
Reshef A, Buttgereit T, Betschel SD, Caballero T, Farkas H, Grumach AS, Hide M, Jindal AK, Longhurst H, Peter J, Riedl MA, Zhi Y, Aberer W, Abuzakouk M, Al Farsi T, Al Sukaiti N, Al-Ahmad M, Altrichter S, Aygören-Pürsün E, Baeza ML, Bara NA, Bauer A, Bernstein JA, Boccon-Gibod I, Bonnekoh H, Bouillet L, Brzoza Z, Bygum A, Calderon O, de Albuquerque Campos R, Campos Romero FH, Cancian M, Chong-Neto HJ, Christoff G, Cimbollek S, Cohn DM, Craig T, Danilycheva I, Darlenski R, Du-Thanh A, Ensina LF, Fomina D, Fonacier L, Fukunaga A, Gelincik A, Giavina-Bianchi P, Godse K, Gompels M, Goncalo M, Gotua M, Guidos-Fogelbach G, Guilarte M, Kasperska-Zajac A, Katelaris CH, Kinaciyan T, Kolkhir P, Kulthanan K, Kurowski M, Latysheva E, Lauerma A, Launay D, Lleonart R, Lumry W, Malbran A, Ali RM, Nasr I, Nieto-Martinez S, Parisi C, Pawankar R, Piñero-Saavedra M, Popov TA, Porebski G, Prieto Garcia A, Pyatilova P, Rudenko M, Sekerel BE, Serpa FS, Sheikh F, Siebenhaar F, Soria A, Staevska M, Staubach P, Stobiecki M, Thomsen SF, Triggiani M, Valerieva A, Valle S, Van Dinh N, Vera Ayala CE, Zalewska-Janowska A, Zanichelli A, Magerl M, Maurer M. Definition, acronyms, nomenclature, and classification of angioedema (DANCE): AAAAI, ACAAI, ACARE, and APAAACI DANCE consensus. J Allergy Clin Immunol 2024:S0091-6749(24)00407-X. [PMID: 38670233 DOI: 10.1016/j.jaci.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/24/2024] [Accepted: 03/04/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Angioedema (AE) manifests with intermittent, localized, self-limiting swelling of the subcutaneous and/or submucosal tissue. AE is heterogeneous, can be hereditary or acquired, may occur only once or be recurrent, may exhibit wheals or not, and may be due to mast cell mediators, bradykinin, or other mechanisms. Several different taxonomic systems are currently used, making it difficult to compare the results of studies, develop multicenter collaboration, and harmonize AE treatment. OBJECTIVE We developed a consensus on the definition, acronyms, nomenclature, and classification of AE (DANCE). METHODS The initiative involved 91 experts from 35 countries and was endorsed by 53 scientific and medical societies, and patient organizations. A consensus was reached by online discussion and voting using the Delphi process over a period of 16 months (June 2021 to November 2022). RESULTS The DANCE initiative resulted in an international consensus on the definition, classification, and terminology of AE. The new consensus classification features 5 types and endotypes of AE and a harmonized vocabulary of abbreviations/acronyms. CONCLUSION The DANCE classification complements current clinical guidelines and expert consensus recommendations on the diagnostic assessment and treatment of AE. DANCE does not replace current clinical guidelines, and expert consensus algorithms and should not be misconstrued in a way that affects reimbursement of medicines prescribed by physicians using sound clinical judgment. We anticipate that this new AE taxonomy and nomenclature will harmonize and facilitate AE research and clinical studies, thereby improving patient care.
Collapse
Affiliation(s)
- Avner Reshef
- Angioedema Research Center, Barzilai University Medical Center, Ashkelon, Israel.
| | - Thomas Buttgereit
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Stephen D Betschel
- Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Teresa Caballero
- Department of Allergy, La Paz University Hospital, Hospital La Paz Institute for Health Research (IdiPAZ-Group 44), Biomedical Research Network on Rare Diseases (CIBERER U754), Madrid, Spain; NRC Institute of Immunology FMBA of Russia, Moscow, Russia
| | - Henriette Farkas
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Anete S Grumach
- Department of Clinical Immunology, University Center Faculdade de Medicina do ABC, Santo André, Brazil
| | - Michihiro Hide
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ankur K Jindal
- Department of Pediatrics, Allergy Immunology Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Hilary Longhurst
- Department of Medicine, University of Auckland and Department of Immunology, Auckland City Hospital, Auckland, New Zealand
| | - Jonathan Peter
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Cape Town, and the Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - Marc A Riedl
- Division of Rheumatology, Allergy, and Immunology, University of California San Diego, La Jolla, Calif
| | - Yuxiang Zhi
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Werner Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Mohamed Abuzakouk
- Allergy and Immunology, Respiratory Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Tariq Al Farsi
- Department of Pediatric Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman
| | - Nashat Al Sukaiti
- Department of Pediatric Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Sabine Altrichter
- Klinik für Dermatologie und Venerologie, Kepler Uniklinikum, Linz, Austria
| | - Emel Aygören-Pürsün
- Department of Pediatrics, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Maria Luisa Baeza
- Allergy Department, Hospital General Universitario Gregorio Marañón, Biomedical Research Network on Rare Diseases-U761, Gregorio Marañón Health Research Institute (IiSGM), Gregorio Marañón, Madrid, Spain
| | - Noemi Anna Bara
- Romanian Hereditary Angioedema Expertise Centre, Centrul Clinic Mediquest, Sângeorgiu de Mure, Romania
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Jonathan A Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Rheumatology, Allergy and Immunology, Cincinnati, Ohio
| | | | - Hanna Bonnekoh
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Laurence Bouillet
- National Reference Center of Angioedema CREAK, Grenoble, France; Internal medicine department, Grenoble University Hospital, Grenoble, France
| | - Zenon Brzoza
- Department of Internal Diseases with Division of Allergology, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Anette Bygum
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Clinical Institute, University of Southern Denmark, Odense, Denmark
| | | | | | - Freya Helena Campos Romero
- Department of Allergy and Clinical Immunology, Hospital Central Sur Alta Especialidad, Mexico City, Mexico City, Mexico
| | - Mauro Cancian
- Departmental Unit of Allergology, University Hospital of Padua, Padua, Italy
| | - Herberto Jose Chong-Neto
- Serviço de Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - George Christoff
- Excelsior Medical Centre, Sofia, Bulgaria; Medical University-Sofia, Sofia, Bulgaria
| | | | - Danny M Cohn
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Timothy Craig
- Department of Pediatrics, Pennsylvania State University, Hershey, Pa
| | | | - Razvigor Darlenski
- Department of Dermatovenereology, Trakia University, Stara Zagora, Bulgaria
| | - Aurélie Du-Thanh
- Département de dermatologie, ACARE, Centre Hospitalier Universitaire de Montpellier Montpellier, France
| | | | - Daria Fomina
- Moscow City Research and Practical Center of Allergoloy and Immunology, Clinical Hospital No. 52, Moscow Healthcare Department, Moscow, Russia
| | - Luz Fonacier
- New York University-Long Island School of Medicine, Mineola, NY
| | - Atsushi Fukunaga
- Department of Dermatology, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Asli Gelincik
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Pedro Giavina-Bianchi
- Division of Clinical lmmunology and Allergy, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Kiran Godse
- Dr D. Y. Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India
| | - Mark Gompels
- Department of Immunology, ACARE, North Bristol NHS Trust, Bristol, United Kingdom
| | - Margarida Goncalo
- Department of Dermatology, Coimbra Hospital and University Center, and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maia Gotua
- Center of Allergy and Immunology and David Tvildiani Medical University, Tbilisi, Georgia
| | | | - Mar Guilarte
- Allergy Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Alicja Kasperska-Zajac
- European Center for Diagnosis and Treatment of Urticaria and Angioedema and Department of Clinical Allergology and Urticaria, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Tamar Kinaciyan
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Pavel Kolkhir
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Marcin Kurowski
- Department of Immunology and Allergy, Medical University of Lodz, Lodz, Poland
| | - Elena Latysheva
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - Antti Lauerma
- Department of Dermatology, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - David Launay
- University Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Angioedemes à Kinine (CREAK), U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
| | - Ramon Lleonart
- Allergology Department, Hospital Universitari Bellvitge, IDIBILL Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Alejandro Malbran
- Unidad de Alergia, Asma e Inmunología Clínica, Buenos Aires, Argentina
| | - Ramzy Mohammed Ali
- Department of Medicine, Allergy and Immunology Division, Hamad Medical Corporation, Doha, Qatar
| | - Iman Nasr
- Immunology and Allergy Department, The Royal Hospital, Muscat, Oman
| | - Sandra Nieto-Martinez
- Unidad de Genética de la Nutrición, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Claudio Parisi
- Pediatric and Adult Allergy sections of the Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | | | | | | | - Grzegorz Porebski
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland
| | - Alicia Prieto Garcia
- Department of Allergy, Gregorio Marañón Health Research Institute (IiSGM), Gregorio Marañón University Hospital, Madrid, Spain
| | - Polina Pyatilova
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Michael Rudenko
- The London Allergy and Immunology Centre, London, United Kingdom
| | | | - Faradiba Sarquis Serpa
- Angioedema and Urticaria Reference Center, Hospital Santa Casa de Misericórdia de Vitória, Vitória, Espirito Santo, Brazil
| | | | - Frank Siebenhaar
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Angèle Soria
- Médecine Sorbonne Université, Service de Dermatologie et Allergologie, hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Maria Staevska
- Department of Allergology, Medical University of Sofia, Clinic of Allergology, University Hospital "Alexandrovska" Sofia, Bulgaria
| | - Petra Staubach
- Department of Dermatology, ACARE, University Medical Center Mainz, Mainz, Germany
| | - Marcin Stobiecki
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Massimo Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - Anna Valerieva
- Department of Allergology, Medical University of Sofia, Clinic of Allergology, University Hospital "Alexandrovska" Sofia, Bulgaria
| | - Solange Valle
- Department of Internal Medicine, Immunology Service, Hospital Universitario Clementino Fraga Filho, Rio De Janiero, Brazil
| | - Nguyen Van Dinh
- Department of General Internal Medicine, Respiratory-Allergy and Clinical Immunology Unit, Vinmec Healthcare System, Hanoi, Vietnam
| | - Carolina Elisa Vera Ayala
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | | | - Andrea Zanichelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; Operative Unit of Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Markus Magerl
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Marcus Maurer
- Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| |
Collapse
|
3
|
Sanges S, Tian W, Dubucquoi S, Chang JL, Collet A, Launay D, Nicolls MR. B-cells in pulmonary arterial hypertension: friend, foe or bystander? Eur Respir J 2024; 63:2301949. [PMID: 38485150 PMCID: PMC11043614 DOI: 10.1183/13993003.01949-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/01/2024] [Indexed: 04/22/2024]
Abstract
There is an unmet need for new therapeutic strategies that target alternative pathways to improve the prognosis of patients with pulmonary arterial hypertension (PAH). As immunity has been involved in the development and progression of vascular lesions in PAH, we review the potential contribution of B-cells in its pathogenesis and evaluate the relevance of B-cell-targeted therapies. Circulating B-cell homeostasis is altered in PAH patients, with total B-cell lymphopenia, abnormal subset distribution (expansion of naïve and antibody-secreting cells, reduction of memory B-cells) and chronic activation. B-cells are recruited to the lungs through local chemokine secretion, and activated by several mechanisms: 1) interaction with lung vascular autoantigens through cognate B-cell receptors; 2) costimulatory signals provided by T follicular helper cells (interleukin (IL)-21), type 2 T helper cells and mast cells (IL-4, IL-6 and IL-13); and 3) increased survival signals provided by B-cell activating factor pathways. This activity results in the formation of germinal centres within perivascular tertiary lymphoid organs and in the local production of pathogenic autoantibodies that target the pulmonary vasculature and vascular stabilisation factors (including angiotensin-II/endothelin-1 receptors and bone morphogenetic protein receptors). B-cells also mediate their effects through enhanced production of pro-inflammatory cytokines, reduced anti-inflammatory properties by regulatory B-cells, immunoglobulin (Ig)G-induced complement activation, and IgE-induced mast cell activation. Precision-medicine approaches targeting B-cell immunity are a promising direction for select PAH conditions, as suggested by the efficacy of anti-CD20 therapy in experimental models and a trial of rituximab in systemic sclerosis-associated PAH.
Collapse
Affiliation(s)
- Sébastien Sanges
- Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
- INSERM, F-59000 Lille, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord, Nord-Ouest, Méditerranée et Guadeloupe (CeRAINOM), F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
- Veteran Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, School of Medicine, Stanford, CA, USA
- Both authors contributed equally and share co-first authorship
| | - Wen Tian
- Veteran Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, School of Medicine, Stanford, CA, USA
- Both authors contributed equally and share co-first authorship
| | - Sylvain Dubucquoi
- Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
- INSERM, F-59000 Lille, France
- CHU Lille, Institut d'Immunologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France
| | - Jason L Chang
- Veteran Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, School of Medicine, Stanford, CA, USA
| | - Aurore Collet
- Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
- INSERM, F-59000 Lille, France
- CHU Lille, Institut d'Immunologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France
| | - David Launay
- Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
- INSERM, F-59000 Lille, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord, Nord-Ouest, Méditerranée et Guadeloupe (CeRAINOM), F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
- Veteran Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, School of Medicine, Stanford, CA, USA
- Both authors contributed equally and share co-last authorship
| | - Mark R Nicolls
- Veteran Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, School of Medicine, Stanford, CA, USA
- Both authors contributed equally and share co-last authorship
| |
Collapse
|
4
|
Rossignol J, Canioni D, Aouba A, Bulai-Livideanu C, Barete S, Lancesseur C, Polivka L, Madrange M, Ballul T, Neuraz A, Greco C, Agopian J, Brenet F, Dubreuil P, Lemal R, Tournilhac O, Terriou L, Launay D, Bouillet L, Gourguechon C, Frenzel L, Meni C, Gaudy-Marqueste C, Gousseff M, Le Mouel E, Hamidou M, Neel A, Ranta D, Jaussaud R, Guilpain P, Molina TJ, Bruneau J, Lhermitte L, Garcelon N, Javier RM, Pelletier F, Castelain F, Retornaz F, Cabrera Q, Zunic P, Gourin MP, Wierzbicka-Hainaut E, Viallard JF, Lavigne C, Hoarau C, Durieu I, Heiblig M, Dimicoli-Salazar S, Torregrosa-Diaz JM, Soria A, Arock M, Lortholary O, Bodemer C, Pol S, Mallet V, Hermine O, Damaj G. Histological characterization of liver involvement in systemic mastocytosis. Liver Int 2024. [PMID: 38554045 DOI: 10.1111/liv.15913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND AND AIMS Systemic mastocytosis (SM) is characterized by the accumulation of atypical mast cells (MCs) in organs. Liver histology of SM has been marginally described and accurate histological classification is critical, given the consequences of aggressive SM diagnosis. We aimed to describe the histological features associated with liver SM using updated tools. METHODS Using the database of the French Reference Centre for Mastocytosis, we retrospectively identified patients with a liver biopsy (LB) and a diagnosis of SM. All LB procedures were performed according to the local physician in charge and centrally reviewed by an expert pathologist. RESULTS A total of 28 patients were included: 6 had indolent SM, 9 had aggressive SM, and 13 had SM with an associated hematologic neoplasm. Twenty-five (89%) patients presented hepatomegaly, and 19 (68%) had portal hypertension. The LB frequently showed slight sinusoid dilatation (82%). Fibrosis was observed in 3/6 indolent SM and in almost all advanced SM cases (21/22), but none of them showed cirrhosis. A high MC burden (>50 MCs/high-power field) was correlated with elevated blood alkaline phosphatase levels (p = .030). The presence of portal hypertension was associated with a higher mean fibrosis grade (1.6 vs. 0.8 in its absence; p = .026). In advanced SM, the presence of nodular regenerative hyperplasia (NRH) was associated with decreased overall survival (9.5 vs. 46.3 months, p = .002). CONCLUSIONS MC infiltration induced polymorphic hepatic lesions and the degree of fibrosis is associated with portal hypertension. NRH identifies a poor prognosis subgroup of patients with advanced SM. Assessing liver histology can aid in SM prognostic evaluation.
Collapse
Affiliation(s)
- Julien Rossignol
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Danielle Canioni
- CEREMAST, Department of Pathology, Necker Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Achille Aouba
- Department of Internal Medicine, Normandy University School of Medicine, Caen, France
| | | | - Stéphane Barete
- CEREMAST, Dermatology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Charles Lancesseur
- CEREMAST, Hematology Institute, Normandy University School of Medicine, Caen, France
| | - Laura Polivka
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Marine Madrange
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Thomas Ballul
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Antoine Neuraz
- Department of Bioinformatics, Necker Children's Hospital, AP-HP, Paris Centre University, Imagine Institute, INSERM U1163, Paris, France
| | - Celine Greco
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Julie Agopian
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France
- Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Fabienne Brenet
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France
- Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Patrice Dubreuil
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France
- Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Richard Lemal
- Histocompatibility Laboratory, EA 7453-Université Clermont Auvergne, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Olivier Tournilhac
- CEREMAST, Adult Clinical Hematology, CHU Clermont-Ferrand, INSERM CIC501, EA 7453 - Clermont Auvergne University, Clermont-Ferrand, France
| | - Louis Terriou
- CEREMAST, Department of Internal Medicine and Clinical Immunology, CHU Lille, Lille, France
| | - David Launay
- CEREMAST, Department of Internal Medicine and Clinical Immunology, CHU Lille, Lille, France
- Lille University, INSERM U1286 INFINITE, CHU Lille, Lille, France
| | - Laurence Bouillet
- CEREMAST, Clinical Immunology/Internal Medicine Department, National Reference Center for Angioedema, Grenoble University Hospital, Grenoble, France
| | | | - Laurent Frenzel
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Cécile Meni
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | | | - Marie Gousseff
- Department of Internal Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Edwige Le Mouel
- CEREMAST, Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
| | - Mohamed Hamidou
- CEREMAST, Department of Internal Medicine, Hôtel-Dieu University Hospital, Nantes, France
| | - Antoine Neel
- CEREMAST, Department of Internal Medicine, Hôtel-Dieu University Hospital, Nantes, France
| | - Dana Ranta
- Department of Hematology, Nancy University Hospital, Nancy, France
| | - Roland Jaussaud
- Department of Internal Medicine and Clinical Immunology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Philippe Guilpain
- CEREMAST, Department of Internal Medicine-Multi-organ Diseases, Saint-Eloi University Hospital, Montpellier University, Montpellier, France
| | - Thierry J Molina
- CEREMAST, Department of Pathology, Necker Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Julie Bruneau
- CEREMAST, Department of Pathology, Necker Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Ludovic Lhermitte
- CEREMAST, Laboratory of Onco-Hematology, Necker Children's Hospital, APHP, Paris, France
| | - Nicolas Garcelon
- Paris Centre University, Imagine Institute, Data Science Platform, INSERM UMR 1163, Paris, France
| | - Rose-Marie Javier
- CEREMAST, Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | - Fabien Pelletier
- CEREMAST, Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France
| | - Florence Castelain
- CEREMAST, Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France
| | - Frederique Retornaz
- Unité de soins et de recherche en médecine interne et maladies infectieuses, European Hospital, Marseille, France
| | - Quentin Cabrera
- Department of Haematology, Sud Reunion University Hospital, Saint Pierre, La Réunion, France
| | - Patricia Zunic
- Department of Haematology, Sud Reunion University Hospital, Saint Pierre, La Réunion, France
| | | | | | - Jean François Viallard
- Department of Internal Medicine and Infectious Diseases, Haut-Lévêque Hospital, CHRU Bordeaux, Bordeaux University, Bordeaux, France
| | - Christian Lavigne
- CEREMAST, Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France
| | - Cyrille Hoarau
- CEREMAST, Service d'Immunologie Clinique et d'Allergologie, Centre Hospitalier Régional Universitaire, Tours, France
| | - Isabelle Durieu
- CEREMAST, Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France
| | - Maël Heiblig
- CEREMAST, Department of Hematology, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
| | | | | | - Angèle Soria
- CEREMAST, Department of Dermatology and Allergy, Tenon Hospital, Sorbonne University, Paris, France
| | - Michel Arock
- CEREMAST, Laboratory of Hematology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Olivier Lortholary
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
- Infectious and Tropical Diseases Department, Necker-Pasteur Infectiology Center, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Christine Bodemer
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Stanislas Pol
- AP-HP.Centre Université Paris Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et spécialités médico-chirurgicales, Service d'Hépatologie, Paris, France
| | - Vincent Mallet
- AP-HP.Centre Université Paris Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et spécialités médico-chirurgicales, Service d'Hépatologie, Paris, France
| | - Olivier Hermine
- CEREMAST, Imagine Institute, INSERM U1163, AP-HP, Necker Children's Hospital, Paris Centre University, Paris, France
| | - Ghandi Damaj
- CEREMAST, Hematology Institute, Normandy University School of Medicine, Caen, France
| |
Collapse
|
5
|
Martel ME, Leurs A, Launay D, Behal H, Chepy A, Collet A, Sanges S, Hachulla E, Dubucquoi S, Dauchet L, Sobanski V. Prevalence of anti-Ro52-kDa/SSA (TRIM21) antibodies and associated clinical phenotype in systemic sclerosis: Data from a French cohort, a systematic review and meta-analysis. Autoimmun Rev 2024; 23:103536. [PMID: 38555075 DOI: 10.1016/j.autrev.2024.103536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES Estimate the global prevalence of anti-Ro52-kDa/SSA (TRIM21) autoantibodies in systemic sclerosis (SSc), and describe the associated clinical phenotype, through a systematic review and meta-analysis of published reports and new data from our French cohort. METHODS Anti-TRIM21 seropositivity and associated SSc characteristics were assessed in a cross-sectional study including 300 patients of Lille University Hospital. A systematic review of the literature was performed in Pubmed and Embase, followed by a meta-analysis, using data on prevalence, clinical/demographical/biological characteristics of SSc patients and the type of assay used for anti-TRIM21 antibodies detection (PROSPERO n° CRD42021223719). FINDINGS In the cross-sectional study, anti-TRIM21 antibodies prevalence was 26% [95%CI: 21; 31]. Anti-centromere antibodies were the most frequent SSc specific autoantibodies coexisting with anti-TRIM21. Patients with anti-TRIM21 antibodies were more frequently women (91% vs 77%, p = 0.006), more likely to present an associated Sjögren's syndrome (19% vs 7%, p < 0.001), had a higher rate of pulmonary arterial hypertension (PAH) (15% vs 6%, p = 0.017) and a greater frequency of digestive complications such as dysphagia (12% vs 5%, p = 0.038) or nausea/vomiting (10% vs 3%, p = 0.009) than anti-TRIM21 negative patients. Thirty-five articles corresponding to a total of 11,751 SSc patients were included in the meta-analysis. In this population, the overall seroprevalence of anti-TRIM21 antibodies was 23% [95%CI: 21; 27] with a high degree of heterogeneity (I2: 93% Phet: <0.0001), partly explained by the methods of detection. Anti-TRIM21 seropositivity was positively associated with female sex (OR: 1.60 [95%CI: 1.25, 2.06]), limited cutaneous subset (OR: 1.29 [1.04, 1.61]), joint manifestations (OR: 1.33 [1.05, 1.68]), pulmonary hypertension (PH) (OR: 1.82 [1.42, 2.33]), and interstitial lung disease (ILD) (OR: 1.31 [1.07, 1.60]). INTERPRETATION Anti-TRIM21 antibodies frequently co-exist with usual SSc antibodies, but are independently associated to a higher risk of cardio-pulmonary complications. The presence of these autoantibodies should therefore be considered when assessing the risk of developing PH and ILD, and deserves further studies on appropriate screening and follow-up of patients.
Collapse
Affiliation(s)
- Marie-Elise Martel
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Amélie Leurs
- CH Dunkerque, Département de Médecine interne et Maladies infectieuses, F-59240 Dunkerque, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Hélène Behal
- CHU Lille, SEED: Statistique, évaluation, économique, data-management - Maison Régionale de la Recherche Clinique, F-59000 Lille, France
| | - Aurélien Chepy
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Aurore Collet
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Sébastien Sanges
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Eric Hachulla
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Sylvain Dubucquoi
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Luc Dauchet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France
| | - Vincent Sobanski
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France; Institut Universitaire de France (IUF), Paris, France.
| |
Collapse
|
6
|
Midol C, Wiebe E, Siegert E, Huscher D, Béhal H, Launay D, Hachulla E, Matteson EL, Buttgereit F, Sobanski V. Osteoporosis is associated with anti-topoisomerase I positivity and glucocorticoids use in patients with systemic sclerosis. Rheumatology (Oxford) 2024:keae142. [PMID: 38452356 DOI: 10.1093/rheumatology/keae142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVES Patients with systemic sclerosis (SSc) are at increased risk for osteoporosis (OP) and associated fragility fractures. This study aimed to identify underlying risk factors for these conditions in patients with SSc. METHODS This cross-sectional study was based on a large prospective cohort of patients with SSc using retrospectively collected bone health data. OP was defined as the presence of a T-score below -2.5 at the femoral neck or lumbar spine, a previous major osteoporotic fracture, or the prescription of anti-osteoporotic therapy. RESULTS A total of 485 patients fulfilling the ACR/EULAR 2013 diagnostic criteria for SSc, followed in the Lille University Hospital, were included in the study. The prevalence of OP was 23%; fragility fractures occurred in 18% of patients. OP was associated with higher age, diffuse cutaneous subset, interstitial lung disease (ILD), anti-topoisomerase I positivity, treatment with glucocorticoids (GC) and DMARDs in univariable analysis. Multivariable analysis indicated that higher age (OR 1.06 [95%CI 1.04-1.08]), anti-topoisomerase I antibody positivity (OR 2.22 [1.18-4.16]) and treatment with GC (OR 4.48 [2.42-8.26]) were significantly and independently associated with OP. CONCLUSION Our study shows that OP risk in patients with SSc is determined by age, disease-related factors such as diffuse cutaneous subset, ILD and anti-topoisomerase I antibody positivity, but also treatment with GC independently of other factors.
Collapse
Affiliation(s)
- Charles Midol
- Service de Médecine Interne, U1286 - INFINITE-Institute for Translational Research in Inflammation CHU Lille, Univ. Lille, Inserm, Lille, France
| | - Edgar Wiebe
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Elise Siegert
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dörte Huscher
- Institute of Biometry and Clinical Epidemiology, and Berlin Institute of Health Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hélène Béhal
- Biostatistics Department, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, CHU Lille, Univ. Lille, Lille, France
| | - David Launay
- Service de Médecine Interne, U1286 - INFINITE-Institute for Translational Research in Inflammation CHU Lille, Univ. Lille, Inserm, Lille, France
| | - Eric Hachulla
- Service de Médecine Interne, U1286 - INFINITE-Institute for Translational Research in Inflammation CHU Lille, Univ. Lille, Inserm, Lille, France
| | - Eric L Matteson
- Division of Rheumatology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Vincent Sobanski
- Service de Médecine Interne, U1286 - INFINITE-Institute for Translational Research in Inflammation CHU Lille, Univ. Lille, Inserm, Lille, France
- Institut Universitaire de France (IUF), Paris, France
| |
Collapse
|
7
|
Astouati Q, Machet T, Houssais C, Noury JB, Allenbach Y, Gallay L, Quere B, Assan F, Benveniste O, Broner J, Duffau P, Espitia A, Grasland A, Hayem G, Guern VL, Martis N, Mariampillai K, Nocturne G, Mariette X, Meyer A, Mulleman D, Devauchelle-Pensec V, Collet A, Launay D, Hachulla E, Cornec D, Guellec D, Sanges S. Inclusion-body myositis associated with Sjögren's disease: clinical characteristics and comparison with other Sjögren-associated myositis. Rheumatology (Oxford) 2024:keae129. [PMID: 38430004 DOI: 10.1093/rheumatology/keae129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES To describe the characteristics of patients with Sjögren's disease (SjD) and inclusion-body myositis (IBM), and how they compare to SjD patients with other inflammatory myopathies (IM). METHODS Patients were retrospectively recruited from 13 French centers and included if they met the ACR/EULAR criteria for SjD and for IM. They were categorized as SjD-IBM if sub-criteria for IBM were met, or as SjD-other IM if not. RESULTS SjD-IBM patients (n = 22) were mostly females (86%), with a median [Q1; Q3] age of 54 [38.5; 64] years at SjD diagnosis, and 62 [46.5; 70] years at first IBM symptoms. Although most patients displayed glandular and immunological abnormalities, additional extra-glandular manifestations were uncommon, resulting in moderate disease activity at SjD diagnosis (ESSDAI 5.5 [1; 7.8]). Classic IBM features were frequent, such as progressive symptom onset (59%), asymmetrical (27%) and distal (32%) involvements, dysphagia (41%), low CPK (386.5 [221.8; 670.5] UI/l) and CRP (3.0 [3; 8.5] mg/l) levels. Immunosuppressants were reported as efficient in 55% of cases.Compared with SjD-IBM patients, SjD patients with other IM (n = 50) were significantly younger, displayed more frequent additional extra-glandular disease, higher ESSDAI score (11 [3; 30]), shorter delay between SjD diagnosis and myositis onset (0 [-0.5; 26]), more frequent CPK values over 1000 UI/l (36%), and less frequent classic IBM features. CONCLUSION IBM can occur in SjD patients, with muscle features reminiscent of classic sporadic IBM characteristics, but mostly affecting women. In SjD patients with muscle involvement, extra-glandular manifestations, high ESSDAI score, elevated CPK values, and shorter delay after SjD diagnosis plead against IBM.
Collapse
Affiliation(s)
- Quentin Astouati
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord, Nord-Ouest, Méditerranée et Guadeloupe (CeRAINOM), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
| | - Thomas Machet
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord, Nord-Ouest, Méditerranée et Guadeloupe (CeRAINOM), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
| | - Camille Houssais
- Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU de Brest, Brest, France
| | - Jean-Baptiste Noury
- Reference Centre for Neuromuscular Diseases AOC, University of Brest, Brest, France
- LBAI, UMR1227, Univ Brest, Inserm, Brest, France
| | - Yves Allenbach
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière University Hospital, APHP, Centre de Référence Maladies Neuro-Musculaires, Sorbonne University, France, Centre de Recherche en Myologie INSERM-Association Institut de Myologie, UMRS 974, Paris, France
| | - Laure Gallay
- Department of Internal Medicine and Clinical Immunology, Edouard Herriot University Hospital, Hospices Civils de Lyon, University Claude Bernard, Lyon, France
| | - Baptiste Quere
- Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU de Brest, Brest, France
- LBAI, UMR1227, Univ Brest, Inserm, Brest, France
| | - Florence Assan
- Laboratory of Genetic Skin Diseases, Institut Imagine, INSERM UMR 1163, Paris
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière University Hospital, APHP, Centre de Référence Maladies Neuro-Musculaires, Sorbonne University, France, Centre de Recherche en Myologie INSERM-Association Institut de Myologie, UMRS 974, Paris, France
| | - Jonathan Broner
- Department of Internal Medicine, University Hospital of Nîmes, France
| | - Pierre Duffau
- Internal Medicine Department, Bordeaux University Hospital, FHU ACRONIM, Bordeaux, France. CNRS-UMR 5164 Immuno ConcEpT, Bordeaux University, Bordeaux, France
| | | | - Anne Grasland
- Department of Internal Medicine, Hôpital Louis Mourier, Université Paris Cité, AP-HP, Colombes, France
| | - Gilles Hayem
- Rheumatology Department, Paris Saint-Joseph Hospital, Paris, France
| | - Véronique Le Guern
- AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares d'île de France, Paris, France
| | - Nihal Martis
- Department of Internal Medicine, CHU Nice, France. Côte d'Azur University. Mediterranean Centre for Molecular Medicine, Control of gene expression (COdEX), INSERM U1065
| | - Kuberaka Mariampillai
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière University Hospital, APHP, Centre de Référence Maladies Neuro-Musculaires, Sorbonne University, France, Centre de Recherche en Myologie INSERM-Association Institut de Myologie, UMRS 974, Paris, France
| | - Gaëtane Nocturne
- Department of Rheumatology, Université Paris-Saclay, AP-HP, Hôpitaux Universitaires Paris-Saclay, Centre for Immunology of Viral Infections and Autoimmune Diseases, INSERM UMR1184, Le Kremlin Bicêtre, France
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, AP-HP, Hôpitaux Universitaires Paris-Saclay, Centre for Immunology of Viral Infections and Autoimmune Diseases, INSERM UMR1184, Le Kremlin Bicêtre, France
| | - Alain Meyer
- Department of Rheumatology, Strasbourg University Hospital, Centre de Référence des Maladies Auto-immunes Rares, Strasbourg, France
| | - Denis Mulleman
- University of Tours, EA6295 NMNS, Tours, France Department of Rheumatology, CHRU de Tours, Tours, France
| | - Valérie Devauchelle-Pensec
- Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU de Brest, Brest, France
- LBAI, UMR1227, Univ Brest, Inserm, Brest, France
| | - Aurore Collet
- Univ. Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, F-59000, France
- INSERM, Lille, F-59000, France
- CHU Lille, Institut d'Immunologie, Pôle de Biologie Pathologie Génétique, Lille, F-59000, France
| | - David Launay
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord, Nord-Ouest, Méditerranée et Guadeloupe (CeRAINOM), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
- Univ. Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, F-59000, France
- INSERM, Lille, F-59000, France
| | - Eric Hachulla
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord, Nord-Ouest, Méditerranée et Guadeloupe (CeRAINOM), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
| | - Divi Cornec
- Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU de Brest, Brest, France
- LBAI, UMR1227, Univ Brest, Inserm, Brest, France
| | - Dewi Guellec
- Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU de Brest, Brest, France
- LBAI, UMR1227, Univ Brest, Inserm, Brest, France
| | - Sébastien Sanges
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord, Nord-Ouest, Méditerranée et Guadeloupe (CeRAINOM), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
- Univ. Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, F-59000, France
- INSERM, Lille, F-59000, France
| |
Collapse
|
8
|
Ledoult E, Groh M, Meresse B, Dubois R, Trauet J, Toussaint E, Delbeke M, Hachulla E, Terriou L, De Masson A, Vasseur M, Labalette M, Launay D, Kahn JE, Lefevre G. Targeting CCR4 with mogamulizumab in refractory CD3-CD4 + lymphocytic-variant hypereosinophilic syndrome. Haematologica 2024. [PMID: 38328856 DOI: 10.3324/haematol.2023.284429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Indexed: 02/09/2024] Open
Abstract
Not available.
Collapse
Affiliation(s)
- Emmanuel Ledoult
- Service de médecine interne et d'immunologie clinique, Centre de Référence des Syndromes Hyperéosinophiliques (CEREO), CHU Lille, Lille, France; INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille.
| | - Matthieu Groh
- INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille, France; Service de médecine interne, Centre de Référence des Syndromes Hyperéosinophiliques (CEREO), Hôpital Foch, Suresnes
| | - Bertrand Meresse
- INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille
| | | | - Jacques Trauet
- INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille, France; Laboratoire d'immunologie, CHU Lille, Lille
| | - Elise Toussaint
- Service d'hématologie, Institut de Cancérologie Strasbourg Europe, Strasbourg
| | - Marie Delbeke
- INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille
| | - Eric Hachulla
- Service de médecine interne et d'immunologie clinique, Centre de Référence des Syndromes Hyperéosinophiliques (CEREO), CHU Lille, Lille, France; INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille
| | - Louis Terriou
- Service de médecine interne et d'immunologie clinique, Centre de Référence des Syndromes Hyperéosinophiliques (CEREO), CHU Lille, Lille
| | - Adèle De Masson
- INSERM U976 ; Service de dermatologie, Hôpital Saint-Louis, Paris
| | | | - Myriam Labalette
- INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille, France; Laboratoire d'immunologie, CHU Lille, Lille
| | - David Launay
- Service de médecine interne et d'immunologie clinique, Centre de Référence des Syndromes Hyperéosinophiliques (CEREO), CHU Lille, Lille, France; INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille
| | - Jean-Emmanuel Kahn
- Université Paris Saclay ; Service de médecine interne, Hôpital Ambroise Paré, APHP, Boulogne Billancourt
| | - Guillaume Lefevre
- Service de médecine interne et d'immunologie clinique, Centre de Référence des Syndromes Hyperéosinophiliques (CEREO), CHU Lille, Lille, France; INFINITE - Institute for Translational Research in Inflammation, Université de Lille, Lille, France; Laboratoire d'immunologie, CHU Lille, Lille
| |
Collapse
|
9
|
Kalmi G, Nguyen Y, Amarger S, Aubineau M, Bibes B, Blanchard-Delaunay C, Boccon-Gibod I, Bouillet L, Coppo P, Dalmas MC, Debord-Peguet S, Defendi F, Demoreuil C, Du-Thanh A, Gayet S, Hadjadj J, Jeandel PY, Launay D, Ly KH, Avoy CM, Niault M, Ollivier Y, Pelletier F, Porneuf M, Roos-Weil D, Fain O, Gobert D. Efficacy and Safety of Rituximab-Based Treatments in Angioedema With Acquired C1-Inhibitor Deficiency. J Allergy Clin Immunol Pract 2024; 12:212-222. [PMID: 37844846 DOI: 10.1016/j.jaip.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Angioedema (AE) due to acquired C1-inhibitor (C1-INH) deficiency (AAE-C1-INH) is related to excessive consumption of C1-INH or to anti-C1-INH antibodies, and is frequently associated with lymphoproliferative syndromes or monoclonal gammopathies. Standard of care for prophylactic treatment in this condition is not established. Rituximab may be effective to prevent attacks, especially if the lymphoid hemopathy is controlled, but data are scarce. OBJECTIVE To evaluate efficacy of rituximab in AAE-C1-INH. METHODS A retrospective multicenter study was carried out in France, including patients with AAE-C1-INH treated with rituximab between April 2005 and July 2019. RESULTS Fifty-five patients with AAE-C1-INH were included in the study, and 23 of them had an anti-C1-INH antibody. A lymphoid malignancy was identified in 39 patients, and a monoclonal gammopathy in 9. There was no associated condition in 7 cases. Thirty patients received rituximab alone or in association with chemotherapy (n = 25). Among 51 patients with available follow-up, 34 patients were in clinical remission and 17 patients had active AE after a median follow-up of 3.9 years (interquartile range, 1.5-7.7). Three patients died. The presence of anti-C1-INH antibodies was associated with a lower probability of AE remission (hazard ratio, 0.29 [95% CI, 0.12-0.67]; P = .004). Relapse was less frequent in patients with lymphoma (risk ratio, 0.27 [95% CI, 0.09-0.80]; P = .019) and in patients treated with rituximab and chemotherapy (risk ratio, 0.31 [95% CI, 0.12-0.79]; P = .014). CONCLUSIONS Rituximab is an efficient and well-tolerated therapeutic option in AE, especially in lymphoid malignancies and in the absence of detectable anti-C1-INH antibodies.
Collapse
Affiliation(s)
- Galith Kalmi
- Internal Medicine Department, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France.
| | - Yann Nguyen
- Internal Medicine Department, Nord-Université Paris Cité, AP-HP, Hôpital Beaujon, Clichy-sous-Bois, France
| | - Stephanie Amarger
- Dermatology Department, University Hospital, Clermont-Ferrand, France
| | - Magali Aubineau
- Internal Medicine Department, Hospices Civils de Lyon, Lyon, France
| | - Beatrice Bibes
- Internal Medicine Department, Saint Grégoire Hospital, Rennes, France
| | | | - Isabelle Boccon-Gibod
- Internal Medicine Department, French National Reference Center for Angioedema (CREAK), Grenoble University Hospital, Grenoble, France
| | - Laurence Bouillet
- Internal Medicine Department, French National Reference Center for Angioedema (CREAK), Grenoble University Hospital, Grenoble, France; University Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France; Internal Medicine Department, University Hospital La Tronche, Grenoble, France
| | - Paul Coppo
- Hematology Department, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | | | | | - Federica Defendi
- Immunology Department, Grenoble University Hospital, Grenoble, France
| | - Claire Demoreuil
- Internal Medicine Department, La Cavale Blanche University Hospital, Brest, France
| | - Aurélie Du-Thanh
- Dermatology Department, Montpellier University Hospital, Montpellier, France
| | - Stephane Gayet
- Internal Medicine Department, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Jerôme Hadjadj
- Internal Medicine Department, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | | | - David Launay
- Internal and Immunological Medicine Department, Lille Hospital, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille University, INSERM F-59000, Lille, France
| | - Kim Heang Ly
- Internal Medicine Department, Dupuytren University Hospital, Limoges, France
| | - Chloé Mc Avoy
- Internal Medicine Department, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Mathilde Niault
- Hematology Department, Hôpital du Scorff-Lorient, Groupe Hospitalier Bretagne Sud, Lorient, France
| | - Yann Ollivier
- Medicine Department, Cote de Nacre University Hospital, Caen, France
| | - Fabien Pelletier
- Dermatology Department, Allergology Center, Besançon University Hospital, Besançon, France
| | - Marc Porneuf
- Hematology Department, Centre Hospitalier Yves le Foll, Saint-Brieuc, France (x)Hematology Department, Sorbonne Université, AP-HP, Pitié Salpêtrière Hospital, Paris, France
| | - Damien Roos-Weil
- Hematology Department, Centre Hospitalier Yves le Foll, Saint-Brieuc, France (x)Hematology Department, Sorbonne Université, AP-HP, Pitié Salpêtrière Hospital, Paris, France
| | - Olivier Fain
- Internal Medicine Department, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Delphine Gobert
- Internal Medicine Department, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| |
Collapse
|
10
|
Polivka L, Madrange M, Bulai-Livideanu C, Barete S, Ballul T, Neuraz A, Greco C, Agopian J, Brenet F, Dubreuil P, Burdet C, Lemal R, Tournilhac O, Terriou L, Launay D, Bouillet L, Gourguechon C, Damaj G, Frenzel L, Meni C, Bouktit H, Collange AF, Gaudy-Marqueste C, Gousseff M, Le Mouel E, Hamidou M, Neel A, Ranta D, Jaussaud R, Guilpain P, Canioni D, Molina TJ, Bruneau J, Lhermitte L, Garcelon N, Javier RM, Pelletier F, Castelain F, Retornaz F, Cabrera Q, Zunic P, Gourin MP, Wierzbicka-Hainaut E, Viallard JF, Lavigne C, Hoarau C, Durieu I, Heiblig M, Dimicoli-Salazar S, Torregrosa-Diaz JM, Soria A, Arock M, Lortholary O, Bodemer C, Hermine O, Rossignol J. Pathophysiologic implications of elevated prevalence of hereditary alpha-tryptasemia in all mastocytosis subtypes. J Allergy Clin Immunol 2024; 153:349-353.e4. [PMID: 37633651 DOI: 10.1016/j.jaci.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/22/2023] [Accepted: 08/08/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Mastocytosis and monoclonal mast cell (MC) activation syndrome (MMAS) are heterogeneous conditions characterized by the accumulation of atypical MCs. Despite the recurrent involvement of KIT mutations, the pathophysiologic origin of mastocytosis and MMAS is unclear. Although hereditary α-tryptasemia (HαT, related to TPSAB1 gene duplication) is abnormally frequent in these diseases, it is not known whether the association is coincidental or causal. OBJECTIVE We evaluated the prevalence of HαT in all mastocytosis subtypes and MMAS and assessed the pathophysiologic association with HαT. METHODS Clinical data, laboratory data, KIT mutations, TPSAB1 duplication (assessed by droplet digital PCR), and HαT prevalence were retrospectively recorded for all patients with mastocytosis and MMAS registered in the French national referral center database and compared to a control cohort. To increase the power of our analysis for advanced systemic mastocytosis (advSM), we pooled our cohort with literature cases. RESULTS We included 583 patients (27 with MMAS and 556 with mastocytosis). The prevalence of HαT in mastocytosis was 12.6%, significantly higher than in the general population (5.7%, P = .002) and lower than in MMAS (33.3%, P = .02). HαT+ patients were more likely to have anaphylactic reactions and less likely to have cutaneous lesions than HαT- patients (43.0% vs 24.4%, P = .006; 57.7% vs 75.6%, respectively, P = .006). In the pooled analysis, the prevalence of HαT was higher in advSM (11.5%) than in control cohorts (5.2%, P = .01). CONCLUSION Here we confirm the increase incidence of anaphylaxis in HαT+ mastocytosis patients. The increased prevalence of HαT in all subtypes of systemic mastocytosis (including advSM) is suggestive of pathophysiologic involvement.
Collapse
Affiliation(s)
- Laura Polivka
- Department of Dermatology, Reference Center for Genodermatoses (MAGEC), AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Marine Madrange
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | | | - Stéphane Barete
- CEREMAST, the Department of Dermatology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Thomas Ballul
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Hematology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Antoine Neuraz
- Department of Bioinformatics, Necker-Children's Hospital, AP-HP, Paris Centre University, Imagine Institute, INSERM U1163, Paris, France
| | - Celine Greco
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Pain and Palliative Care Unit, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Julie Agopian
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France; Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Fabienne Brenet
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France; Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Patrice Dubreuil
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France; Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Charles Burdet
- Centre d'Investigation Clinique, INSERM CIC 1425, AP-HP, Bichat Hospital, Paris Centre University, Paris, France
| | - Richard Lemal
- Histocompatibility Laboratory, EA 7453, Université Clermont Auvergne, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Olivier Tournilhac
- CEREMAST, the Adult Clinical Hematology, CHU Clermont-Ferrand, INSERM CIC501, EA 7453, Clermont Auvergne University, Clermont-Ferrand, France
| | - Louis Terriou
- CEREMAST, the Department of Internal Medicine and Clinical Immunology, Claude Huriez Hospital, CHRU Lille, Lille, France
| | - David Launay
- CEREMAST, the Department of Internal Medicine and Clinical Immunology, Claude Huriez Hospital, CHRU Lille, Lille, France; Lille University, INSERM U995 LIRIC, CHU Lille, and Referral Center for Rare Systemic Autoimmune Diseases North and North-west of France, Lille, France
| | - Laurence Bouillet
- CEREMAST, the Clinical Immunology/Internal Medicine Department, National Reference Center for Angioedema, Grenoble University Hospital, Grenoble, France
| | | | - Ghandi Damaj
- CEREMAST, the Haematology Institute, Normandy University School of Medicine, Caen, France
| | - Laurent Frenzel
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Hematology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Cécile Meni
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Hassiba Bouktit
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Anne Florence Collange
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Caroline Gaudy-Marqueste
- CEREMAST, the Department of Dermatology, Aix-Marseille University, CHU Timone, Marseille, France
| | - Marie Gousseff
- Department of Internal Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Edwige Le Mouel
- CEREMAST, the Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
| | - Mohamed Hamidou
- CEREMAST, the Department of Internal Medicine, Hôtel-Dieu University Hospital, Nantes, France
| | - Antoine Neel
- CEREMAST, the Department of Internal Medicine, Hôtel-Dieu University Hospital, Nantes, France
| | - Dana Ranta
- Department of Haematology, Nancy University Hospital, Nancy, France
| | - Roland Jaussaud
- Department of Internal Medicine and Clinical Immunology, Vandoeuvre-lès-Nancy, France
| | - Philippe Guilpain
- CEREMAST, the Department of Internal Medicine-Multi-organ Diseases, Saint-Eloi University Hospital, Montpellier University, Montpellier, France
| | - Danielle Canioni
- CEREMAST, the Department of Pathology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Thierry Jo Molina
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Pathology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Julie Bruneau
- CEREMAST, the Department of Pathology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Ludovic Lhermitte
- CEREMAST, the Laboratory of Onco-hematology, Necker Children's Hospital, AP-HP, Paris, France
| | - Nicolas Garcelon
- Paris Centre University, Imagine Institute, Data Science Platform, INSERM UMR 1163, F-75015, Paris, France
| | - Rose-Marie Javier
- CEREMAST, the Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | - Fabien Pelletier
- CEREMAST, the Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France
| | - Florence Castelain
- CEREMAST, the Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France
| | - Frederique Retornaz
- Unité de soins et de recherche en médecine interne et maladies infectieuses, European Hospital, Marseille, France
| | - Quentin Cabrera
- Department of Haematology, Sud Reunion University Hospital, Saint Pierre, La Réunion, France
| | - Patricia Zunic
- Department of Haematology, Sud Reunion University Hospital, Saint Pierre, La Réunion, France
| | | | | | - Jean François Viallard
- Department of Internal Medicine and Infectious Diseases, Haut-Lévêque Hospital, CHRU Bordeaux, Bordeaux University, Bordeaux, France
| | - Christian Lavigne
- CEREMAST, the Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France
| | - Cyrille Hoarau
- CEREMAST, the Service d'Immunologie Clinique et d'Allergologie, Centre Hospitalier Régional Universitaire, Tours, France
| | - Isabelle Durieu
- CEREMAST, the Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France
| | - Maël Heiblig
- CEREMAST, the Department of Hematology, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
| | | | | | - Angèle Soria
- CEREMAST, the Department of Dermatology and Allergy, Tenon Hospital, Sorbonne University, Paris, France
| | - Michel Arock
- CEREMAST, the Laboratory of Hematology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Olivier Lortholary
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Christine Bodemer
- Department of Dermatology, Reference Center for Genodermatoses (MAGEC), AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Olivier Hermine
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Hematology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France.
| | - Julien Rossignol
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Hematology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| |
Collapse
|
11
|
Sanges S, Sobanski V, Lamblin N, Hachulla E, Savale L, Montani D, Launay D. Pulmonary hypertension in connective tissue diseases: What every CTD specialist should know - but is afraid to ask! Rev Med Interne 2024; 45:26-40. [PMID: 37925256 DOI: 10.1016/j.revmed.2023.10.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 11/06/2023]
Abstract
Pulmonary hypertension (PH) is a possible complication of connective tissue diseases (CTDs), especially systemic sclerosis (SSc), systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD). It is defined by an elevation of the mean pulmonary arterial pressure above 20mmHg documented during a right heart catheterization (RHC). Due to their multiorgan involvement, CTDs can induce PH by several mechanisms, that are sometimes intricated: pulmonary vasculopathy (group 1) affecting arterioles (pulmonary arterial hypertension, PAH) and possibly venules (pulmonary veno-occlusive-like disease), left-heart disease (group 2), chronic lung disease (group 3) and/or chronic thromboembolic PH (group 4). PH suspicion is often raised by clinical manifestations (dyspnea, fatigue), echocardiographic data (increased peak tricuspid regurgitation velocity), isolated decrease in DLCO in pulmonary function tests, and/or unexplained elevation of BNP/NT-proBNP. Its formal diagnosis always requires a hemodynamic confirmation by RHC. Strategies for PH screening and RHC referral have been extensively investigated for SSc-PAH but data are lacking in other CTDs. Therapeutic management of PH depends of the underlying mechanism(s): PAH-approved therapies in group 1 PH (with possible use of immunosuppressants, especially in case of SLE or MCTD); management of an underlying left-heart disease in group 2 PH; management of an underlying chronic lung disease in group 3 PH; anticoagulation, pulmonary endartectomy, PAH-approved therapies and/or balloon pulmonary angioplasty in group 4 PH. Regular follow-up is mandatory in all CTD-PH patients.
Collapse
Affiliation(s)
- S Sanges
- Université de Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; CHU de Lille, Département de Médecine Interne et Immunologie Clinique, 59000 Lille, France; Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000 Lille, France.
| | - V Sobanski
- Université de Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; CHU de Lille, Département de Médecine Interne et Immunologie Clinique, 59000 Lille, France; Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000 Lille, France
| | - N Lamblin
- CHU de Lille, Service de Cardiologie, 59000 Lille, France; Institut Pasteur de Lille, Inserm U1167, 59000 Lille, France
| | - E Hachulla
- Université de Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; CHU de Lille, Département de Médecine Interne et Immunologie Clinique, 59000 Lille, France; Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000 Lille, France
| | - L Savale
- Université Paris Saclay, School of Medicine, Le Kremlin-Bicêtre, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Inserm UMR_S 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - D Montani
- Université Paris Saclay, School of Medicine, Le Kremlin-Bicêtre, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Inserm UMR_S 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - D Launay
- Université de Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; CHU de Lille, Département de Médecine Interne et Immunologie Clinique, 59000 Lille, France; Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000 Lille, France
| |
Collapse
|
12
|
Bloch C, Jais JP, Gil M, Boubaya M, Lepelletier Y, Bader-Meunier B, Mahlaoui N, Garcelon N, Lambotte O, Launay D, Larroche C, Lazaro E, Liffermann F, Lortholary O, Michel M, Michot JM, Morel P, Cheminant M, Suarez F, Terriou L, Urbanski G, Viallard JF, Alcais A, Fischer A, de Saint Basile G, Hermine O. Severe adult hemophagocytic lymphohistiocytosis (HLHa) correlates with HLH-related gene variants. J Allergy Clin Immunol 2024; 153:256-264. [PMID: 37678575 DOI: 10.1016/j.jaci.2023.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/14/2023] [Accepted: 07/14/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND The contribution of genetic factors to the severity of adult hemophagocytic lymphohistiocytosis (HLHa) remains unclear. OBJECTIVE We sought to assess a potential link between HLHa outcomes and HLH-related gene variants. METHODS Clinical characteristics of 130 HLHa patients (age ≥ 18 years and HScore ≥ 169) and genotype of 8 HLH-related genes (LYST, PRF1, UNC13-D, STX11, STXBP2, RAB27A, XIAP, and SAP) were collected. A total of 34 variants found in only 6 genes were selected on the basis of their frequency and criteria predicted to impair protein function. Severity was defined by refractory disease to HLH treatment, death, or transfer to an intensive care unit. RESULTS HLHa-associated diseases (ADs) were neoplasia (n = 49 [37.7%]), autoimmune/inflammatory disease (n = 33 [25.4%]), or idiopathic when no AD was identified (n = 48 [36.9%]). Infectious events occurred in 76 (58.5%) patients and were equally distributed in all ADs. Severe and refractory HLHa were observed in 80 (61.5%) and 64 (49.2%) patients, respectively. HScore, age, sex ratio, AD, and infectious events showed no significant association with HLHa severity. Variants were identified in 71 alleles and were present in 56 (43.1%) patients. They were distributed as follows: 44 (34.4%), 9 (6.9%), and 3 (2.3%) patients carrying 1, 2, and 3 variant alleles, respectively. In a logistic regression model, only the number of variants was significantly associated with HLHa severity (1 vs 0: 3.86 [1.73-9.14], P = .0008; 2-3 vs 0: 29.4 [3.62-3810], P = .0002) and refractoriness (1 vs 0: 2.47 [1.17-5.34], P = .018; 2-3 vs 0: 13.2 [2.91-126.8], P = .0003). CONCLUSIONS HLH-related gene variants may be key components to the severity and refractoriness of HLHa.
Collapse
Affiliation(s)
- Coralie Bloch
- Clinical Research Unit, Avicenne University Hospital, AP-HP, Bobigny, France; Paris 13 University, Sorbonne Paris Cité, Paris, France; Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM UMR1163/CNRS URL 8254, Paris, France; French National Center for Primary Immunodeficiencies, Necker University Hospital, AP-HP, Paris, France; Imagine Institute, Université Paris Cité, Paris, France.
| | - Jean Philippe Jais
- Imagine Institute, Université Paris Cité, Paris, France; Biostatistic Unit, Necker University Hospital, AP-HP, Paris, France; Human Genetics of Infectious Diseases: Complex Predisposition, INSERM UMR1163, Paris, France
| | - Marine Gil
- Imagine Institute, Université Paris Cité, Paris, France
| | - Marouane Boubaya
- Clinical Research Unit, Avicenne University Hospital, AP-HP, Bobigny, France
| | - Yves Lepelletier
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM UMR1163/CNRS URL 8254, Paris, France; Imagine Institute, Université Paris Cité, Paris, France
| | - Brigitte Bader-Meunier
- Imagine Institute, Université Paris Cité, Paris, France; Department of Pediatric Immunology and Rheumatology, Necker University Hospital, AP-HP, Paris, France
| | - Nizar Mahlaoui
- French National Center for Primary Immunodeficiencies, Necker University Hospital, AP-HP, Paris, France; Imagine Institute, Université Paris Cité, Paris, France; Department of Pediatric Immunology and Rheumatology, Necker University Hospital, AP-HP, Paris, France
| | | | - Olivier Lambotte
- University Paris Saclay, AP-HP, Hôpital Bicêtre, IMVAHB UMR1184, INSERM, CEA, Le Kremlin Bicêtre, France
| | - David Launay
- Université de Lille, CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France, Lille, France; INSERM INFINITE U1286, Lille, France
| | - Claire Larroche
- Internal Medicine Unit, Avicenne Hospital, AP-HP, Bobigny, France
| | - Estibaliz Lazaro
- Internal Medicine Department, Bordeaux Hospital University, Bordeaux, France; CNRS-UMR 5164 Immuno ConcEpT, Bordeaux, France
| | - Francois Liffermann
- Service de medecine interne-hematologie, Centre hospitalier de Dax, Dax, France
| | - Olivier Lortholary
- French National Center for Primary Immunodeficiencies, Necker University Hospital, AP-HP, Paris, France; Imagine Institute, Université Paris Cité, Paris, France; Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker Pasteur, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Marc Michel
- Department of Internal Medicine, Centre de Référence maladies rares sur les Cytopénies Auto-Immunes de l'adulte, Hôpitaux Universitaires Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France
| | - Jean-Marie Michot
- Gustave Roussy, University Paris Saclay, Drug Development Department, Villejuif, France
| | - Pierre Morel
- Service d'Hématologie Clinique, Hôpital Schaffner de Lens, Lens Cedex, France
| | - Morgane Cheminant
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM UMR1163/CNRS URL 8254, Paris, France; French National Center for Primary Immunodeficiencies, Necker University Hospital, AP-HP, Paris, France; Imagine Institute, Université Paris Cité, Paris, France; Clinical Hematology, Necker University Hospital, AP-HP, Paris, France
| | - Felipe Suarez
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM UMR1163/CNRS URL 8254, Paris, France; French National Center for Primary Immunodeficiencies, Necker University Hospital, AP-HP, Paris, France; Imagine Institute, Université Paris Cité, Paris, France; Clinical Hematology, Necker University Hospital, AP-HP, Paris, France
| | - Louis Terriou
- Université de Lille, CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France, Lille, France; INSERM INFINITE U1286, Lille, France
| | - Geoffrey Urbanski
- Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France; MitoLab Team, MITOVASC Institute, UMR CNRS 6015, INSERM U1083, University of Angers, Angers, France
| | | | - Alexandre Alcais
- Imagine Institute, Université Paris Cité, Paris, France; Biostatistic Unit, Necker University Hospital, AP-HP, Paris, France; Human Genetics of Infectious Diseases: Complex Predisposition, INSERM UMR1163, Paris, France
| | - Alain Fischer
- French National Center for Primary Immunodeficiencies, Necker University Hospital, AP-HP, Paris, France; Imagine Institute, Université Paris Cité, Paris, France; Department of Pediatric Immunology and Rheumatology, Necker University Hospital, AP-HP, Paris, France; Laboratory of Normal and Pathological Homeostasis of the Immune System, INSERM UMR1163, Paris, France; Necker University Hospital, AP-HP, Paris, France; College de France, Paris, France
| | - Geneviève de Saint Basile
- French National Center for Primary Immunodeficiencies, Necker University Hospital, AP-HP, Paris, France; Imagine Institute, Université Paris Cité, Paris, France; Laboratory of Normal and Pathological Homeostasis of the Immune System, INSERM UMR1163, Paris, France
| | - Olivier Hermine
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM UMR1163/CNRS URL 8254, Paris, France; French National Center for Primary Immunodeficiencies, Necker University Hospital, AP-HP, Paris, France; Imagine Institute, Université Paris Cité, Paris, France; Clinical Hematology, Necker University Hospital, AP-HP, Paris, France.
| |
Collapse
|
13
|
Collet A, Sanges S, Ghulam A, Genin M, Soudan B, Sobanski V, Hachulla E, Dubucquoi S, Djobo B, Espiard S, Douillard C, Launay D. Steroid hormones in systemic sclerosis: associations with disease characteristics and modifications during scleroderma renal crisis. Rheumatology (Oxford) 2023:kead699. [PMID: 38141209 DOI: 10.1093/rheumatology/kead699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/16/2023] [Accepted: 12/06/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVE The renin-angiotensin-aldosterone system (RAAS) and glucocorticoids (GCs) are involved in vascular remodeling and fibrosis, but have not been extensively studied in systemic sclerosis (SSc). Our aim was to investigate the RAAS and GC hormones in SSc patients. METHODS Serum levels of renin (dosage and activity), aldosterone and its precursors (DOC, B, 18-OH-DOC, 18-OH-B), and GCs (cortisol, cortisone, 11-deoxycortisol, 18-OH-F) were assessed in 122 SSc patients and 52 healthy controls. After applying stringent inclusion criteria aimed at ensuring accurate hormone assessments (exclusion of interfering drugs, strict sampling conditions), we analyzed RAAS hormones in 61 patients, and GCs in 96 patients. Hormone levels were compared between patients and controls; and associations with disease characteristics were assessed in patients. RESULTS Regarding RAAS hormones, SSc patients displayed significantly lower aldosterone levels (although within normal range), similar renin levels, and higher B levels than controls. Abnormal RAAS hormone levels were associated with a more severe SSc phenotype (lung and skin fibrosis, heart and pulmonary vascular involvements, inflammation). Regarding GC hormones, SSc patients had higher levels of cortisol, 11-desoxycortisol (precursor) and 18-OH-F (metabolite) but lower levels of cortisone (inactive counterpart) than controls.RAAS hormone levels were assessed in 5 SSc patients before and during scleroderma renal crisis (SRC): concentrations varied considerably between patients, but consistently included normal/increased aldosterone levels and elevated renin levels. CONCLUSION RAAS and GC hormones are abnormally produced in SSc patients, especially in patients with severe SSc and during SRC. This could suggest a participation of these hormonal systems in SSc pathogenesis.
Collapse
Affiliation(s)
- A Collet
- Univ. Lille, Lille, F-59000, France, U1286-INFINITE-Institute for Translational Research in Inflammation
- INSERM, Lille, F-59000, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
- CHU Lille, Institut d'Immunologie, Pôle de Biologie Pathologie Génétique, Lille, F-59000, France
| | - S Sanges
- Univ. Lille, Lille, F-59000, France, U1286-INFINITE-Institute for Translational Research in Inflammation
- INSERM, Lille, F-59000, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
- CHU Lille, Institut d'Immunologie, Pôle de Biologie Pathologie Génétique, Lille, F-59000, France
| | - A Ghulam
- CHU Lille, Pôle de Biologie Pathologie Génétique, Service Hormonologie, Métabolisme, Nutrition, Oncologie, F59000 Lille, France
| | - M Genin
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, F-59000, France
| | - B Soudan
- CHU Lille, Pôle de Biologie Pathologie Génétique, Service Hormonologie, Métabolisme, Nutrition, Oncologie, F59000 Lille, France
| | - V Sobanski
- Univ. Lille, Lille, F-59000, France, U1286-INFINITE-Institute for Translational Research in Inflammation
- INSERM, Lille, F-59000, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
| | - E Hachulla
- Univ. Lille, Lille, F-59000, France, U1286-INFINITE-Institute for Translational Research in Inflammation
- INSERM, Lille, F-59000, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
| | - S Dubucquoi
- Univ. Lille, Lille, F-59000, France, U1286-INFINITE-Institute for Translational Research in Inflammation
- INSERM, Lille, F-59000, France
- CHU Lille, Institut d'Immunologie, Pôle de Biologie Pathologie Génétique, Lille, F-59000, France
| | - B Djobo
- CHU Lille, Pôle de Biologie Pathologie Génétique, Service Hormonologie, Métabolisme, Nutrition, Oncologie, F59000 Lille, France
| | - S Espiard
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, F-59000, France
| | - C Douillard
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, F-59000, France
| | - D Launay
- Univ. Lille, Lille, F-59000, France, U1286-INFINITE-Institute for Translational Research in Inflammation
- INSERM, Lille, F-59000, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, F-59000, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, F-59000, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, F-59000, France
| |
Collapse
|
14
|
Antoine P, Morell-Dubois S, Maillard H, Wojtasik G, Sanges S, Launay D, Sobanski V, Saraux A, Devauchelle V, Hachulla E, Farhat MM. Six medico-psycho-social dimensions of a pedagogical model used to define clusters of patients with Sjögren's syndrome and intentionality to participate in a patient education programme. Clin Exp Rheumatol 2023; 41:2379-2388. [PMID: 37389544 DOI: 10.55563/clinexprheumatol/f5r0oe] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/22/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES Sjögren's syndrome (SS) is an autoimmune disease with an impact on quality of life (QoL). The aim of patient education (PE) is to improve patients' QoL. The main objective of this study was to describe the medico-psycho-social characteristics defining the six spheres of an allosteric educational model in order to characterise clusters of patients with SS and intentionality for patients to participate in a programme of patient education. METHODS A self-administered questionnaire was proposed to 408 patients with SS followed in the Department of Internal Medicine of the University Hospital of Lille, France with the aim of assessing the six spheres of the allosteric model: intentional, perceptual, affective, cognitive, infra-cognitive and meta-cognitive. Sub objectives were to determine factors that can influence intentionality to participate in a PE programme and to determine, using cluster analysis, similar characteristics of patients with SS. RESULTS 127 patients (31%) agreed to participate and were included in the study; 96% were women and the median age was 51 years (±14.5). They mostly reported dry syndrome and fatigue, had a good knowledge of SS, and presented anxiety symptoms. They mainly had problem-centred coping strategies, internal locus of control and low self-esteem. SS had an impact on their social interactions. Considering intentionality to participate in a PE programme, the patients were significantly younger, had a shorter duration of the disease, more frequently had disabled status, reported more fatigue, more self-reported symptoms and a poorer QoL. Two clusters of patients could be individualised, with one group including 75 (59%) patients presenting a higher global impact of the disease, including a more severe impairment for the scores of the perceptual, emotional and infra-cognitive spheres, worse physical QoL, and a higher intentionality to participate in a PE programme. CONCLUSIONS Our study described an SS population in terms of the different spheres of an allosteric model applicable to the practice of PE. A cluster of patients appeared to present more impact of the disease and more intentionality to participate in a programme of PE. There was no difference between the two groups in terms of the cognitive sphere (i.e. knowledge of the disease), thus indicating that motivation to participate in a PE programme is influenced by non-cognitive factors. Considering intentionality to participate in a PE programme, duration disease, age of the patient and QoL should be more considered to propose to patients to participate in a PE programme. Use of the allosteric model appears promising for future research in PE.
Collapse
Affiliation(s)
- Pascale Antoine
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Sandrine Morell-Dubois
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Hélène Maillard
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Geraldine Wojtasik
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Sebastien Sanges
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - David Launay
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Vincent Sobanski
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Alain Saraux
- EA2216, ESPRI 29, IFR148, Département de Rhumatologie et de Pédiatrie, Hôpital de la Cavale-Blanche, Brest, and Université de Bretagne occidentale, Brest, France
| | - Valerie Devauchelle
- EA2216, ESPRI 29, IFR148, Département de Rhumatologie et de Pédiatrie, Hôpital de la Cavale-Blanche, Brest, and Université de Bretagne occidentale, Brest, France
| | - Eric Hachulla
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Méryem-Maud Farhat
- University Lille, Inserm, CHU de Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Rférence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.
| |
Collapse
|
15
|
Djouina M, Waxin C, Caboche S, Lecointe K, Steimle A, Beury D, Desai MS, Hot D, Dubuquoy L, Launay D, Vignal C, Body-Malapel M. Low dose dietary contamination with deoxynivalenol mycotoxin exacerbates enteritis and colorectal cancer in mice. Sci Total Environ 2023; 900:165722. [PMID: 37482350 DOI: 10.1016/j.scitotenv.2023.165722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The mycotoxin deoxynivalenol (DON) is a frequent contaminant of grain and cereal products worldwide. Exposure to DON can cause gastrointestinal inflammation, disturb gut barrier function, and induce gut dysbiosis in vivo under basal conditions, but little is known about the effects of DON ingestion in individuals with pre-existing gastrointestinal disease. OBJECTIVES Mice were orally exposed to 10 and 100 μg/kg bw/day of DON, corresponding to 10 to 100-fold human tolerable daily intake concentrations, and to the translation in mice of current human daily intake. The effects of DON exposure were explored under steady-state conditions, and in murine models of enteritis and colorectal cancer (CRC). RESULTS After 8 days of DON exposure, an increase of histomorphological and molecular parameters of epithelial proliferation were observed in normal mice, from the duodenum to the colon. The same exposure in a murine model of indomethacin-induced enteritis led to exacerbation of lesion development and induction of ileal cytokines. DON exposure also worsened the development of colitis-associated CRC in mice as shown by increases in endoscopic and histological colitis scores, tumor grades, and histological hyperplasia. In colon of DON-exposed mice, upstream and downstream ERK signaling genes were upregulated including Mapk1, Mapk3, Map 2k1, Map2k2 core ERK pathway effectors, and Bcl2 and Bcl2l1 antiapoptotic genes. The effects observed in the CRC model were associated with alterations in cecal microbiota taxonomic composition and metabolism of bacterial fucose and rhamnose. Strong Spearman's correlations were revealed between the relative abundance of the changed bacterial genera and CRC-related variables. DISCUSSION Ingestion of DON mycotoxin at concentrations representative of human real-world exposure worsened the development of indomethacin-induced enteritis and colitis-associated CRC in mice. Our results suggest that even at low doses, which are currently tolerated in the human diet, DON could promote the development of intestinal inflammatory diseases and CRC.
Collapse
Affiliation(s)
- Madjid Djouina
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Christophe Waxin
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Ségolène Caboche
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US41-UAR 2014-PLBS, F-59000 Lille, France
| | - Karine Lecointe
- Inserm U1285, Univ. Lille, CHU de Lille, UMR CNRS 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - Alexander Steimle
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Delphine Beury
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US41-UAR 2014-PLBS, F-59000 Lille, France
| | - Mahesh S Desai
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - David Hot
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US41-UAR 2014-PLBS, F-59000 Lille, France
| | - Laurent Dubuquoy
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Cécile Vignal
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Mathilde Body-Malapel
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France.
| |
Collapse
|
16
|
Guédon AF, Carrat F, Mouthon L, Launay D, Chaigne B, Pugnet G, Lega JC, Hot A, Cottin V, Agard C, Allanore Y, Fauchais AL, Jego P, Dhote R, Papo T, Chatelus E, Bonnotte B, Khan JE, Diot E, Bienvenu B, Magy-Bertrand N, Queyrel V, Le Quellec A, Kieffer P, Amoura Z, Harlé JR, Gaultier JB, Balquet MH, Wahl D, Lidove O, Fain O, Mékinian A, Hachulla E, Rivière S. Heart and systemic sclerosis-findings from a national cohort study. Rheumatology (Oxford) 2023:kead599. [PMID: 37944039 DOI: 10.1093/rheumatology/kead599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/03/2023] [Accepted: 10/14/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVES Heart involvement is one of the leading causes of death in systemic sclerosis (SSc). The prevalence of SSc-related cardiac involvement is poorly known. Our objective was to investigate the prevalence and prognosis burden of different heart diseases in a nationwide cohort of patients with SSc. METHODS We used data from a multicentric prospective study using the French SSc national database. Focusing on SSc-related cardiac involvement, we aimed to determine its incidence and risk factors. RESULTS Over the 3528 patients with SSc 312 (10.9%) had SSc-related cardiac involvement at baseline. They tended to have a diffuse SSc subtype more frequently, more severe clinical features, and presented more cardiovascular risk factors. From the 1646 patients available for follow-up analysis, SSc-related cardiac involvement was associated with an increased risk of death. There was no significant difference in overall survival between SSc-related cardiac involvement, ischaemic heart disease or pulmonary arterial hypertension. Regarding survival analysis, 98 patients developed SSc-related cardiac involvement at five years (5-year event rate: 11.15%). Regarding reduced LVEF < 50% and left ventricular diastolic dysfunction, the 5-year event rate was 2.49% and 5.84% respectively. Pericarditis cumulative incidence at five years was 3%. Diffuse SSc subtype was a risk factor for SSc-related cardiac involvement and pericarditis. Female sex was associated with less left ventricular diastolic dysfunction incidence. CONCLUSIONS Our results describe the incidence and prognostic burden of SSc-related cardiac involvement at a large scale, with gender and diffuse SSc subtype as risk factors. Further analyses should assess the potential impact of treatment on these various cardiac outcomes.
Collapse
Affiliation(s)
- Alexis F Guédon
- Sorbonne Université, APHP, Service de Médecine Interne, Département Hospitalo-Universitaire Inflammation-Immunopathologie-Biotherapie (DMU i3), Paris, France
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Unité de Santé Publique, Paris, France
| | - Luc Mouthon
- Department of Internal Medicine, Université Paris Descartes, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - David Launay
- Department of Internal Medicine and Clinical Immunology, Center de Référence des maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), CHU Lille, University of Lille, Lille, France, University of Lille, U1286 - INFINITE-Institute for Translational Research in Inflammation, Lille F-59000, France; INSERM, Lille, France
| | - Benjamin Chaigne
- Department of Internal Medicine, Université Paris Descartes, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Grégory Pugnet
- Department of Internal Medicine and Clinical Immunology, Centre for Clinical Investigation (CIC BT 1436), University Hospital of Toulouse, Toulouse, France
| | - Jean-Christophe Lega
- Service de médecine interne et vasculaire, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université de Lyon, Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Evolutive UMR 5558, Villeurbanne, France; Lyon immunopathology FEderation (LIFE), Hospices Civils de Lyon, Lyon, France
| | - Arnaud Hot
- Department of Internal Medicine, Edouard Herriot University Hospital, Hospices Civils de Lyon, Université Claude, Bernard-Lyon 1, Lyon, France
| | - Vincent Cottin
- National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, UMR 754, INRAE, Claude Bernard University, Lyon 1, Lyon, France
| | - Christian Agard
- Internal Medicine Department, Nantes Université, CHU Nantes, 1 place Alexis Ricordeau, Nantes, France
| | - Yannick Allanore
- Department of Rheumatology, Université de Paris, Cochin Hospital, Paris, France, INSERM U1016, Institut Cochin, CNRS UMR8104, Paris, France
| | - Anne-Laure Fauchais
- Department of Internal Medicine, Limoges University Hospital, CEDEX, Limoges, France
| | - Patrick Jego
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France, Univ Rennes, Rennes University Hospital, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | - Robin Dhote
- Sorbonne Paris Nord University, Service de Médecine Interne, Hôpital Avicenne, Bobigny, France
| | - Thomas Papo
- Department of Internal Medicine, Université de Paris, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
| | - Emmanuel Chatelus
- Rheumatology Department, Strasbourg University Hospital, East and South-West national reference center for auto-immune diseases, Strasbourg, France
| | - Bernard Bonnotte
- Department of Internal Medicine, Centre Hospitalier Universitaire Dijon-Bourgogne, Dijon, France
| | - Jean-Emmanuel Khan
- Department of Internal Medicine, Hôpital Ambroise Paré, Université Versailles-Saint Quentin-en-Yvelines, Boulogne-Billancourt, France
| | - Elisabeth Diot
- Department of Internal Medicine and Clinical Immunology, Regional Competence Center for Systemic and Autoimmune Rare Diseases, Bretonneau Hospital, Tours, Tours, France
| | - Boris Bienvenu
- Department of Internal Medicine, Caen University Hospital, CEDEX 9, Caen, France
| | | | - Viviane Queyrel
- Pasteur 2 Hospital, Department of Rheumatology, Cote d'Azur University, Nice University Hospital, Nice, France
| | - Alain Le Quellec
- Department of Internal Medicine, CHU Saint-Eloi, Montpellier, France
| | | | - Zahir Amoura
- Département d'Immunologie, Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Assistance Publique-Hôpitaux de Paris, Groupement Hospitalier Pitié-Salpêtrière, Paris, France
| | - Jean-Robert Harlé
- Internal Medicine Department, Assistance Publique Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jean-Baptiste Gaultier
- Service de Médecine Interne, Hôpital Nord, Centre Hospitalier universitaire de St Etienne, saint Etienne, France
| | | | - Denis Wahl
- Department of Vascular Medicine, Referral Center for Rare Vascular Diseases, Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Olivier Lidove
- Department of Internal Medicine, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Fain
- Sorbonne Université, APHP, Service de Médecine Interne, Département Hospitalo-Universitaire Inflammation-Immunopathologie-Biotherapie (DMU i3), Paris, France
| | - Arsène Mékinian
- Sorbonne Université, APHP, Service de Médecine Interne, Département Hospitalo-Universitaire Inflammation-Immunopathologie-Biotherapie (DMU i3), Paris, France
| | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, Center de Référence des maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), CHU Lille, University of Lille, Lille, France; University of Lille, U1286 - INFINITE-Institute for Translational Research in Inflammation, Lille F-59000, France; INSERM, Lille, France
| | - Sebastien Rivière
- Sorbonne Université, APHP, Service de Médecine Interne, Département Hospitalo-Universitaire Inflammation-Immunopathologie-Biotherapie (DMU i3), Paris, France
| |
Collapse
|
17
|
Mismetti V, Delavenne X, Montani D, Bezzeghoud S, Delezay O, Hodin S, Launay D, Marchand-Adam S, Nunes H, Ollier E, Reynaud-Gaubert M, Pastre J, Traclet J, Quetant S, Zeghmar S, Bertoletti L, Cottin V. Proteomic biomarkers for survival in systemic sclerosis-associated pulmonary hypertension. Respir Res 2023; 24:273. [PMID: 37936223 PMCID: PMC10629050 DOI: 10.1186/s12931-023-02578-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Interstitial lung disease (ILD) and pulmonary hypertension (PH) represent the major causes of mortality in systemic sclerosis (SSc). Patients with systemic sclerosis and combined PH and ILD (SSc-PH-ILD) generally have a poor prognosis. Predictors of survival and of potential benefit of treatment are lacking in patients with SSc-PH-ILD. OBJECTIVE To identify specific plasma protein expression patterns associated with survival in patients with SSc-PH-ILD. MATERIALS AND METHODS Post-hoc analysis of a prospective multicenter French study in patients with PH-ILD. An untargeted proteomic analysis using mass spectrometry was performed to identify plasma protein changes associated with long-term overall survival in patients with SSc-PH-ILD. RESULTS Thirty two patients were included in the analysis, of whom 13 died during follow-up (median survival: 76.5 months). At baseline, survivors had less severe hemodynamic impairment [pulmonary vascular resistance of 4.4 Wood Units (IQR 3-5.2) vs. 6.2 Wood Units (IQR 4.2-10.7)] and higher carbon monoxide diffusing capacity [median 39% (IQR 35-44%) vs. 25% (IQR 22-30.5%)], than the 13 patients who died. Seven proteins, associated with haemostasis and fibrosis, were differentially expressed according to patients' survival. In the survivor group, two proteins were increased (ADAMTS13, SERPIND1) and five were decreased (PTGDS, OLFM1, C7, IGFBP7, FBN1) compared to the non-survivor groups. CONCLUSION The prognosis of SSc-PH-ILD patients is poor. This proteomic approach found 7 plasma proteins (involved in haemostasis and fibrosis pathways) associated with survival. These potential biomarkers may be good candidates to prognostic enrichment.
Collapse
Affiliation(s)
- Valentine Mismetti
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - Xavier Delavenne
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - David Montani
- Service de Pneumologie et Soins Intensifs Thoraciques, Centre de Référence de L'Hypertension Pulmonaire, INSERM U999 Centre de Compétence Maladies Pulmonaires Rares-OrphaLung Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France
| | - Souad Bezzeghoud
- Service de Médecine Vasculaire et Thérapeutique, INSERM, CIC-1408, CHU de Saint-Etienne, Saint-Etienne, France
| | - Olivier Delezay
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - Sophie Hodin
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - David Launay
- Service de Médecine Interne et d'Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO) CHU Lille, Lille, France
| | | | - Hilario Nunes
- Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, Hôpital Avicenne, INSERM U1272, Université Sorbonne Paris Nord, Bobigny, France
| | - Edouard Ollier
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - Martine Reynaud-Gaubert
- Centre de Compétence des Maladies Pulmonaires Rares (OrphaLung), Service de Pneumologie et Transplantation Pulmonaire, CHU Nord, AP-HM, Aix Marseille Université, Marseille, France
| | - Jean Pastre
- Service de Pneumologie et Soins Intensifs Centre de Compétence Maladie Pulmonaire Rare (OrphaLung) Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Julie Traclet
- National Reference Center for Rare Pulmonary Diseases, Department of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, 69677, Lyon, France
| | | | - Sabrina Zeghmar
- National Reference Center for Rare Pulmonary Diseases, Department of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, 69677, Lyon, France
| | - Laurent Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, INSERM, UMR1059, Université Jean-Monnet, INSERM, CIC-1408, CHU de Saint-Etienne, INNOVTE, 42055, Saint-Etienne, France.
| | - Vincent Cottin
- National Reference Center for Rare Pulmonary Diseases, Department of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, 69677, Lyon, France
- Univ Lyon, INRA, UMR754, 69008, Lyon, France
| |
Collapse
|
18
|
Chaigne B, Chevalier K, Boucly A, Agard C, Baudet A, Bourdin A, Chabanne C, Cottin V, Fesler P, Goupil F, Jego P, Launay D, Lévesque H, Maurac A, Mohamed S, Tromeur C, Rottat L, Sitbon O, Humbert M, Mouthon L. In-depth characterization of pulmonary arterial hypertension in mixed connective tissue disease: a French national multicentre study. Rheumatology (Oxford) 2023; 62:3261-3267. [PMID: 36727465 DOI: 10.1093/rheumatology/kead055] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Pulmonary arterial hypertension (PAH) is a leading cause of death in MCTD. We aimed to describe PAH in well-characterized MCTD patients. METHODS MCTD patients enrolled in the French Pulmonary Hypertension Registry with a PAH diagnosis confirmed by right heart catheterization were included in the study and compared with matched controls: MCTD patients without PAH, SLE patients with PAH and SSc patients with PAH. Survival rates were estimated by the Kaplan-Meier method and risk factors for PAH in MCTD patients and risk factors for mortality in MCTD-PAH were sought using multivariate analyses. RESULTS Thirty-six patients with MCTD-PAH were included in the study. Comparison with MCTD patients without PAH and multivariate analysis revealed that pericarditis, polyarthritis, thrombocytopenia, interstitial lung disease (ILD) and anti-Sm antibodies were independent predictive factors of PAH/PH in MCTD. Estimated survival rates at 1, 5 and 10 years following PAH diagnosis were 83%, 67% and 56%, respectively. MCTD-PAH presentation and survival did not differ from SLE-PAH and SSc-PAH. Multivariate analysis revealed that tobacco exposure was an independent factor predictive of mortality in MCTD-PAH. CONCLUSION PAH is a rare and severe complication of MCTD associated with a 56% 10-year survival. We identified ILD, pericarditis, thrombocytopenia and anti-Sm antibodies as risk factors for PAH in MCTD and tobacco exposure as a predictor of mortality in MCTD-PAH.
Collapse
Affiliation(s)
- Benjamin Chaigne
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Kevin Chevalier
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Athenaïs Boucly
- Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Christian Agard
- Service de Médecine Interne, Nantes Université, CHU Nantes, Nantes, France
| | - Antoine Baudet
- Department of Internal Medicine, Centre de Compétence Maladies Auto-Immunes Systémiques Rares Annecy, CHR Annecy-Genevois, Annecy, France
| | - Arnaud Bourdin
- Physiologie et Médecine Expérimentale du Cœur et des Muscles, Université de Montpellier, Centre National de la Recherche Scientifique, INSERM, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Céline Chabanne
- Service de Cardiologie et Maladies Vasculaires, Centre Hospitalier Universitaire de Rennes, Université de Rennes-Institut National de la Santé et de la Recherche Médicale, Rennes, France
| | - Vincent Cottin
- Unité Mixte de Recherche 754: Infections Virales et Pathologie Comparée, Hospices Civils de Lyon, Université Lyon 1-Institut National de la Recherche Agronomique-Centre National de Référence des Maladies Pulmonaires Rares, Lyon, France
| | - Pierre Fesler
- Service de Médecine Interne, Hôpital Lapeyronie, Montpellier, France
| | | | - Patrick Jego
- Internal Medicine and Clinical Immunology Unit, CHU Rennes, Rennes, France
| | - David Launay
- Service de Médecine Interne et Immunologie Clinique, Centre de Référence Des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France, Université of Lille, Inserm, CHU Lille, U1286 - Institute for Translational Research in Inflammation, Lille, France
| | - Hervé Lévesque
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
- INSERM U 905, University of Rouen IFRMP, Institute for Biochemical Research, Rouen University Hospital, Rouen, France
| | - Arnaud Maurac
- Département de Pneumologie, Hôpital Haut Lévèque, CHU de Bordeaux, Pessac, France
| | - Shirine Mohamed
- Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Centre Hospitalier Universitaire Nancy, Nancy, France
| | - Cécile Tromeur
- Internal and Vascular Medicine and Pulmonology Department, CHU Brest, Brest, France
- INSERM U1304 Groupe d'Etude de la Thrombose de Bretagne Occidentale, University Brest, Brest, France
- F-CRIN INNOVTE, Saint-Etienne, France
| | - Laurence Rottat
- Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
| |
Collapse
|
19
|
Djouina M, Waxin C, Dubuquoy L, Launay D, Vignal C, Body-Malapel M. Oral exposure to polyethylene microplastics induces inflammatory and metabolic changes and promotes fibrosis in mouse liver. Ecotoxicol Environ Saf 2023; 264:115417. [PMID: 37651791 DOI: 10.1016/j.ecoenv.2023.115417] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/02/2023]
Abstract
Accumulating evidence shows widespread contamination of water sources and food with microplastics. Although the liver is one of the main sites of bioaccumulation within the human body, it is still unclear whether microplastics produce damaging effects. In particular, the hepatic consequences of ingesting polyethylene (PE) microplastics in mammals are unknown. In this study, female mice were fed with food contaminated with 36 and 116 µm diameter PE microbeads at a dosage of 100 µg/g of food for 6 and 9 weeks. Mice were exposed to each type of microbead, or co-exposed to the 2 types of microbeads. Mouse liver showed altered levels of genes involved in uptake, synthesis, and β-oxidation of fatty acids. Ingestion of PE microbeads disturbed the detoxification response, promoted oxidative imbalance, increased inflammatory foci and cytokine expression, and enhanced proliferation in liver. Since relative expression of the hepatic stellate cell marker Pdgfa and collagen deposition were increased following PE exposure, we assessed the effect of PE ingestion in a mouse model of CCl4-induced fibrosis and showed that PE dietary exposure exacerbated liver fibrogenesis. These findings provide the first demonstration of the adverse hepatic effects of PE ingestion in mammals and highlight the need for further health risk assessment in humans.
Collapse
Affiliation(s)
- Madjid Djouina
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Christophe Waxin
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Laurent Dubuquoy
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Cécile Vignal
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Mathilde Body-Malapel
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France.
| |
Collapse
|
20
|
Speca S, Farhat MM, Jendoubi M, Guerrier T, Sanges S, Staumont-Sallé D, Hachulla E, Dubucquoi S, Sobanski V, Collet A, Launay D. Intravenous immunoglobulins improve skin fibrosis in experimental models of systemic sclerosis. Sci Rep 2023; 13:15102. [PMID: 37700078 PMCID: PMC10497569 DOI: 10.1038/s41598-023-42464-9] [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: 07/03/2023] [Accepted: 09/11/2023] [Indexed: 09/14/2023] Open
Abstract
Systemic sclerosis (SSc) is the most severe systemic autoimmune disease with currently no cure. Intravenous immunoglobulins (IVIg) are an attractive candidate in this disease to counteract inflammation and fibrosis but data are scarce and conflicting. This study, assessed the effects of IVIg in a murine HOCl-induced model of SSc. We showed that IVIg prevented skin inflammation and fibrosis, by mitigating the immune cell infiltration (p = 0.04), proinflammatory cytokines gene overexpression (IL1β, p = 0.04; TNFα, p = 0.04; IL6, p = 0.05), skin and dermal thickening (p = 0.003 at d21 and p = 0.0003 at d42), the expression markers of fibrosis, such as αSMA (p = 0.031 for mRNA and p = 0.05 for protein), collagen (p = 0.05 for mRNA and p = 0.04 for protein, p = 0.05 for the hydroxyproline content) and fibronectin (p = 0.033 for mRNA). Moreover, IVIg prevented HOCl-induced alterations in splenic cell homeostasis. When administered in curative mode, despite their ability to reduce skin and dermal thickness (p < 0.0001 and p = 0.0002), IVIg showed partial or more mixed effects on skin inflammation and established fibrosis. These data favor further clinical trials in SSc patients on the potential efficiency of early and/or repeated IVIg administration.
Collapse
Affiliation(s)
- Silvia Speca
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
| | - Meryem-Maud Farhat
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
- Département de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), CHU Lille, Lille, France
| | - Manel Jendoubi
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
| | - Thomas Guerrier
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
| | - Sébastien Sanges
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
- Département de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), CHU Lille, Lille, France
| | - Delphine Staumont-Sallé
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
- Service de Dermatologie, CHU Lille, Lille, France
| | - Eric Hachulla
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
- Département de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), CHU Lille, Lille, France
| | - Sylvain Dubucquoi
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
- Institut d'Immunologie, Centre de Biologie Pathologie, CHU Lille, Lille, France
| | - Vincent Sobanski
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
- Département de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), CHU Lille, Lille, France
| | - Aurore Collet
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France
- Institut d'Immunologie, Centre de Biologie Pathologie, CHU Lille, Lille, France
| | - David Launay
- University of Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, France.
- Département de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), CHU Lille, Lille, France.
| |
Collapse
|
21
|
Yelnik CM, Lambert M, Drumez E, Martin C, Grolaux G, Launay D, Hachulla E, Rogeau S, Dubucquoi S, Boulanger E, Lancel S, Frimat M. Relevance of inflammatory and complement activation biomarkers profiling in antiphospholipid syndrome patients outside acute thrombosis. Clin Exp Rheumatol 2023; 41:1875-1881. [PMID: 37279145 DOI: 10.55563/clinexprheumatol/ric86c] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/26/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To evaluate whether inflammatory and complement biomarkers are associated with specific characteristics of antiphospholipid syndrome (APS). METHODS Serum levels of interleukin (IL)-1β (IL-1β), IL-6, IL-8, IL-10, tumour necrosis factor (TNF)-α, interferon-α (IFN)-α, IFN-γ, vascular endothelial growth factor (VEGF), intercellular adhesion molecule 1 (ICAM-1), E-selectin, and vascular cell adhesion molecule (VCAM)-1, and plasma levels of soluble C5b-9 (sC5b-9), C3a, C4a, Bb fragment were measured in unselected APS patients. Twenty-five healthy blood donors were included as controls. RESULTS Between January 2020 and April 2021, 98 APS patients were included outside acute thrombosis (median time from the last APS manifestation: 60 (23;132) months). Levels of IL6, VCAM-1, sC5b-9, C3a, C4a, and Bb were significantly increased in APS patients compared to controls. A cluster analysis allowed to divide patients into two clusters: "inflammatory" (higher levels of IL-6 and VCAM-1) and "complement". In APS, elevated IL-6 was associated with hypertension, diabetes, BMI, and hypertriglyceridaemia. 85% of our APS patients had elevated levels of at least one complement biomarker. Elevated Bb (34%) was associated with aPL positivities, especially with triple aPL positivity (50% vs. 18%, p<0.001). 7/8 patients with history of catastrophic APS had elevated levels of complement biomarkers. CONCLUSIONS Our findings suggested that APS patients outside acute thrombosis might be divided into two clusters: "inflammatory" and "complement". Elevated IL-6 was associated with cardiovascular risk factors and metabolic parameters, whereas Bb fragments, a marker of alternative pathway complement activation, was strongly associated with aPL profile at highest risk of severe disease.
Collapse
Affiliation(s)
- Cecile M Yelnik
- Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), Université de Lille, CHU Lille; and INSERM, UMR 1167, RID-AGE, Lille, France.
| | - Marc Lambert
- Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), Université de Lille, CHU Lille; and INSERM, UMR 1167, RID-AGE, Lille, France
| | - Elodie Drumez
- Université de Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille; and Département de Biostatistiques, CHU Lille, France
| | - Claire Martin
- Université de Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille; and Département de Biostatistiques, CHU Lille, France
| | | | - David Launay
- Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), Université de Lille, CHU Lille, France
| | - Eric Hachulla
- Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), Université de Lille, CHU Lille, France
| | - Stephanie Rogeau
- Immunologie, Centre de Biologie Pathologie, Université de Lille, CHU Lille, France
| | - Sylvain Dubucquoi
- Immunologie, Centre de Biologie Pathologie, Université de Lille, CHU Lille, France
| | | | | | - Marie Frimat
- INSERM, UMR 1167, RID-AGE, Lille, and Département de Néphrologie, Université de Lille, CHU Lille, France
| |
Collapse
|
22
|
Ducrocq Q, Guédon-Moreau L, Launay D, Terriou L, Morell-Dubois S, Maillard H, Lefèvre G, Sobanski V, Lambert M, Yelnik C, Farhat MM, Garcia Fernandez MJ, Hachulla E, Sanges S. Activities of Clinical Expertise and Research in a Rare Disease Referral Centre: A Place for Telemedicine beyond the COVID-19 Pandemic? Healthcare (Basel) 2023; 11:2447. [PMID: 37685481 PMCID: PMC10487162 DOI: 10.3390/healthcare11172447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Rare disease referral centres are entrusted with missions of clinical expertise and research, two activities that have to contend with numerous obstacles. Providing specialist opinions is time-consuming, uncompensated and limited by difficulties in exchanging medical data. Clinical research is constrained by the need for frequent research protocol visits. Our objective was to determine whether telemedicine (TLM) can overcome these difficulties. METHODS To better characterise the activity of clinical expertise provided by our French centre, each opinion delivered by our team was reported on a standardised form. To investigate our clinical research activity, investigators and patients were asked to complete a questionnaire on the acceptability of research protocol teleconsultations. RESULTS Regarding clinical expertise, our team delivered 120 opinions per week (representing a total of 21 h), of which 29% were delivered to patients and 69% to medical practitioners. If these were delivered using TLM, it would represent a potential weekly income of EUR 500 (tele-expertise) and EUR 775 (teleconsultations). Regarding the research activity, 70% of investigators considered the frequency of visits to be a limiting factor for patient inclusions; nearly half of the patients surveyed would be in favour of having teleconsultations in place of (40%) or in addition to (56%) in-person visits. CONCLUSION Whereas TLM has become widely used as a back-up procedure to in-person consultations during the COVID-19 pandemic, the solutions it provides to the problems encountered in performing expertise and research activities have made it a new conventional follow-up modality for patients with rare diseases.
Collapse
Affiliation(s)
- Quentin Ducrocq
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
| | - Laurence Guédon-Moreau
- Université de Lille, Faculté de Médecine et CHU de Lille, Clinique de Cardiologie et Maladies Vasculaires, F-59000 Lille, France;
| | - David Launay
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Louis Terriou
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
| | - Sandrine Morell-Dubois
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Hélène Maillard
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Guillaume Lefèvre
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- CHU Lille, Laboratoire d’Immunologie, F-59000 Lille, France
| | - Vincent Sobanski
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Marc Lambert
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
- CHU Lille, Département de Médecine Polyvalente Post-Urgences, F-59000 Lille, France
- Univ. Lille, U1167—RIDAGE—Risk Factors and Molecular Determinants of Aging-Related Diseases, F-59000 Lille, France
| | - Cécile Yelnik
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
- CHU Lille, Département de Médecine Polyvalente Post-Urgences, F-59000 Lille, France
- Univ. Lille, U1167—RIDAGE—Risk Factors and Molecular Determinants of Aging-Related Diseases, F-59000 Lille, France
| | - Meryem-Maud Farhat
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Maria José Garcia Fernandez
- Unité Matériaux et Transformations (UMET) UMR CNRS 8207, Université Lille 1, F-59655 Villeneuve d’Ascq, France;
- Inserm, CHU Lille, U1008—Controlled Drug Delivery System and Biomaterials, University Lille, F-59000 Lille, France
| | - Eric Hachulla
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Sébastien Sanges
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| |
Collapse
|
23
|
Ortega-Ferreira C, Soret P, Robin G, Speca S, Hubert S, Le Gall M, Desvaux E, Jendoubi M, Saint-Paul J, Chadli L, Chomel A, Berger S, Nony E, Neau B, Fould B, Licznar A, Levasseur F, Guerrier T, Elouej S, Courtade-Gaïani S, Provost N, Nguyen TQ, Verdier J, Launay D, De Ceuninck F. Antibody-mediated neutralization of galectin-3 as a strategy for the treatment of systemic sclerosis. Nat Commun 2023; 14:5291. [PMID: 37652913 PMCID: PMC10471779 DOI: 10.1038/s41467-023-41117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 08/22/2023] [Indexed: 09/02/2023] Open
Abstract
Systemic sclerosis (SSc) is an autoimmune, inflammatory and fibrotic disease with limited treatment options. Developing new therapies is therefore crucial to address patient needs. To this end, we focused on galectin-3 (Gal-3), a lectin known to be associated with several pathological processes seen in SSc. Using RNA sequencing of whole-blood samples in a cross-sectional cohort of 249 patients with SSc, Gal-3 and its interactants defined a strong transcriptomic fingerprint associated with disease severity, pulmonary and cardiac malfunctions, neutrophilia and lymphopenia. We developed new Gal-3 neutralizing monoclonal antibodies (mAb), which were then evaluated in a mouse model of hypochlorous acid (HOCl)-induced SSc. We show that two of these antibodies, D11 and E07, reduced pathological skin thickening, lung and skin collagen deposition, pulmonary macrophage content, and plasma interleukin-5 and -6 levels. Moreover, E07 changed the transcriptional profiles of HOCl-treated mice, resulting in a gene expression pattern that resembled that of control mice. Similarly, pathological pathways engaged in patients with SSc were counteracted by E07 in mice. Collectively, these findings demonstrate the translational potential of Gal-3 blockade as a therapeutic option for SSc.
Collapse
Affiliation(s)
- Céline Ortega-Ferreira
- Servier R&D Center, Biomarker Assay Development, Translational Medicine, Gif-sur-Yvette, France
| | - Perrine Soret
- Servier R&D Center, Biomarker Biostatistics, Gif-sur-Yvette, France
| | | | - Silvia Speca
- U1286 INFINITE, Institute for Translational Research in Inflammation, Lille University, Gif-sur-Yvette, France
- Inserm, Lille, France
| | - Sandra Hubert
- Servier R&D Center, Neurosciences and Immuno-inflammation Therapeutic Area, Gif-sur-Yvette, France
| | | | - Emiko Desvaux
- Servier R&D Center, Neurosciences and Immuno-inflammation Therapeutic Area, Gif-sur-Yvette, France
| | - Manel Jendoubi
- U1286 INFINITE, Institute for Translational Research in Inflammation, Lille University, Gif-sur-Yvette, France
- Inserm, Lille, France
| | | | - Loubna Chadli
- Servier R&D Center, Clinical Biomarker Development, Translational Medicine, Gif-sur-Yvette, France
| | - Agnès Chomel
- Servier R&D Center, Protein Sciences, Gif-sur-Yvette, France
| | - Sylvie Berger
- Servier R&D Center, Structural Sciences, Gif-sur-Yvette, France
| | - Emmanuel Nony
- Servier R&D Center, Protein Sciences, Gif-sur-Yvette, France
| | - Béatrice Neau
- Servier R&D Center, Preclinical Biostatistics, Quantitative Pharmacology, Gif-sur-Yvette, France
| | - Benjamin Fould
- Servier R&D Center, Protein Sciences, Gif-sur-Yvette, France
| | - Anne Licznar
- Servier R&D Center, DMPK Department, Translational Medicine, Gif-sur-Yvette, France
| | - Franck Levasseur
- Servier R&D Center, DMPK Department, Translational Medicine, Gif-sur-Yvette, France
| | - Thomas Guerrier
- U1286 INFINITE, Institute for Translational Research in Inflammation, Lille University, Gif-sur-Yvette, France
- Inserm, Lille, France
| | - Sahar Elouej
- Servier R&D Center, Computational Medicine, Gif-sur-Yvette, France
| | | | - Nicolas Provost
- Servier R&D Center, Molecular Genomics, Gif-sur-Yvette, France
| | | | - Julien Verdier
- Servier R&D Center, Neurosciences and Immuno-inflammation Therapeutic Area, Gif-sur-Yvette, France
| | - David Launay
- U1286 INFINITE, Institute for Translational Research in Inflammation, Lille University, Gif-sur-Yvette, France
- Inserm, Lille, France
- Lille University Hospital, Department of Internal Medicine and Clinical Immunology, Reference Center for Rare Systemic Autoimmune Diseases, North and North-West France (CeRAINO), Lille, France
| | - Frédéric De Ceuninck
- Servier R&D Center, Neurosciences and Immuno-inflammation Therapeutic Area, Gif-sur-Yvette, France.
| |
Collapse
|
24
|
Penet T, Pokeerbux MR, Morell-Dubois S, Sanges S, Maillard H, Ledoult E, Lambert M, Yelnik C, Sobanski V, Launay D, Hachulla E, Farhat MM. Atteintes coronariennes et artérite a cellules géantes : à propos de 2 cas et revue de la littérature. Rev Med Interne 2023; 44:394-401. [PMID: 37088663 DOI: 10.1016/j.revmed.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Coronaritis is a rare but serious complication of giant-cell arteritis (GCA), with an estimated prevalence of less than 1%, however difficult to establish, and of early onset. METHODS We describe 2 cases of GCA presenting with coronaritis and present a review of the literature on this complication. RESULTS The first patient presented with stable angina on common trunk coronaritis with ostial stenosis. Corticosteroid combined with tocilizumab from the outset resulted in improvement. Angioplasty was performed at 6months with good outcome. The second patient presented with asymptomatic tritruncular ostial coronaritis. Corticosteroid allowed clinic-biological improvement of GCA. Two years later, he presented relapse with an acute coronary syndrome, with favorable evolution after angioplasty, increase of corticosteroids and addition of tocilizumab. CONCLUSION Patients presented were successfully treated with corticosteroids combined with tocilizumab and angioplasty of their coronary stenoses. Efficacy of tocilizumab in GCA has not been evaluated especially on coronaritis due to the rarity of this complication. Our experience and the cases reported in the literature suggest good results of angioplasty in this indication. Studies with long-term follow-up will be necessary to evaluate the risk of restenosis.
Collapse
Affiliation(s)
- T Penet
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - M R Pokeerbux
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - S Morell-Dubois
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - S Sanges
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - H Maillard
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - E Ledoult
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - M Lambert
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - C Yelnik
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - V Sobanski
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - D Launay
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - E Hachulla
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - M M Farhat
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France.
| |
Collapse
|
25
|
Chaba A, Devresse A, Audard V, Boffa JJ, Karras A, Cartery C, Deltombe C, Chemouny J, Contamin C, Courivaud C, Duquennoy S, Garcia H, Joly D, Goumri N, Hanouna G, Halimi JM, Plaisier E, Hamidou M, Landron C, Launay D, Lebas C, Legendre M, Masseau A, Mathian A, Mercadal L, Morel N, Mutinelli-Szymanski P, Palat S, Pennaforte JL, Peraldi MN, Pozdzik A, Schleinitz N, Thaunat O, Titeca-Beauport D, Mussini C, Touati S, Prinz E, Faller AL, Richter S, Vilaine E, Ferlicot S, Von-Kotze C, Belliere J, Olagne J, Mesbah R, Snanoudj R, Nouvier M, Ebbo M, Zaidan M. Clinical and Prognostic Factors in Patients with IgG4-Related Kidney Disease. Clin J Am Soc Nephrol 2023; 18:1031-1040. [PMID: 37283461 PMCID: PMC10564355 DOI: 10.2215/cjn.0000000000000193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/31/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND IgG4-related kidney disease is a major manifestation of IgG4-related disease, a systemic fibroinflammatory disorder. However, the clinical and prognostic kidney-related factors in patients with IgG4-related kidney disease are insufficiently defined. METHODS We conducted an observational cohort study using data from 35 sites in two European countries. Clinical, biologic, imaging, and histopathologic data; treatment modalities; and outcomes were collected from medical records. Logistic regression was performed to identify the possible factors related to an eGFR ≤30 ml/min per 1.73 m 2 at the last follow-up. Cox proportional hazards model was performed to assess the factors associated with the risk of relapse. RESULTS We studied 101 adult patients with IgG4-related disease with a median follow-up of 24 (11-58) months. Of these, 87 (86%) patients were male, and the median age was 68 (57-76) years. Eighty-three (82%) patients had IgG4-related kidney disease confirmed by kidney biopsy, with all biopsies showing tubulointerstitial involvement and 16 showing glomerular lesions. Ninety (89%) patients were treated with corticosteroids, and 18 (18%) patients received rituximab as first-line therapy. At the last follow-up, the eGFR was below 30 ml/min per 1.73 m 2 in 32% of patients; 34 (34%) patients experienced a relapse, while 12 (13%) patients had died. By Cox survival analysis, the number of organs involved (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.01 to 1.55) and low C3 and C4 concentrations (HR, 2.31; 95% CI, 1.10 to 4.85) were independently associated with a higher risk of relapse, whereas first-line therapy with rituximab was protective (HR, 0.22; 95% CI, 0.06 to 0.78). At their last follow-up, 19 (19%) patients had an eGFR ≤30 ml/min per 1.73 m 2 . Age (odd ratio [OR], 1.11; 95% CI, 1.03 to 1.20), peak serum creatinine (OR, 2.74; 95% CI, 1.71 to 5.47), and serum IgG4 level ≥5 g/L (OR, 4.46; 95% CI, 1.23 to 19.40) were independently predictive for severe CKD. CONCLUSIONS IgG4-related kidney disease predominantly affected middle-aged men and manifested as tubulointerstitial nephritis with potential glomerular involvement. Complement consumption and the number of organs involved were associated with a higher relapse rate, whereas first-line therapy with rituximab was associated with lower relapse rate. Patients with high serum IgG4 concentrations (≥5 g/L) had more severe kidney disease.
Collapse
Affiliation(s)
- Anis Chaba
- Departement of Nephrology-Dialysis-Transplantation, Assistance Publique des Hôpitaux de Paris (AP-HP), Bicêtre University Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - Arnaud Devresse
- Department of Nephrology, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Vincent Audard
- Nephrology and Renal Transplantation Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Henri Mondor Hospital University, Rare Disease Center « Idiopathic Nephrotic syndrome », Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders, Créteil, France
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | | | | | - Claire Cartery
- Department of Nephrology, CH Valenciennes, Valenciennes, France
| | - Clément Deltombe
- Institute for Transplantation, Urology and Nephrology (ITUN) Nantes University Hospital, Nantes, France
| | | | | | | | - Simon Duquennoy
- Department of Nephrology, Fondation AUB Santé Avranches, France
| | - Hugo Garcia
- Department of Nephrology, Hôpitaux Sorbonne Université, Paris, France
| | | | - Nabila Goumri
- Department of Nephrology, CH Chartres, Chartres, France
| | | | | | | | | | - Cédric Landron
- Department of Internal Medicine, CHU Poitier, Poitier, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286—INFINITE—Institute for Translational Research in Inflammation, Lille, France
| | - Celine Lebas
- Department of Nephrology, CHU Valenciennes, Valenciennes, France
| | | | - Agathe Masseau
- Department of Internal Medicine, CHU Nantes, Nantes, France
| | - Alexis Mathian
- Department of Internal Medicine, Hôpital Cochin, APHP, Paris, France
| | - Lucile Mercadal
- Department of Nephrology, Hôpitaux Sorbonne Université, Paris, France
| | - Nathalie Morel
- Department of Internal Medicine, Hôpital Cochin, APHP, Paris, France
| | | | - Sylvain Palat
- Department of Internal Medicine, CHU Limoges, Limoges, France
| | | | | | | | | | | | | | - Charlotte Mussini
- Departement of Pathology, Assistance Publique des Hôpitaux de Paris (AP-HP), Bicêtre University Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - Sonia Touati
- Department of Nephrology, CH Pontoise, Pontoise, France
| | - Eric Prinz
- Department of Nephrology, NHC Strasbourg, France
| | | | - Sarah Richter
- Department of Nephrology, Clinique Sainte Anne, Strasbourg, France
| | - Eve Vilaine
- Department of Nephrology, CHU Ambroise Paré, France
| | - Sophie Ferlicot
- Departement of Pathology, Assistance Publique des Hôpitaux de Paris (AP-HP), Bicêtre University Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | | | - Julie Belliere
- Departement of Nephrology, CHU Toulouse, Toulouse, France
| | | | - Rafik Mesbah
- Department of Nephrology, Hopital Boulogne-sur-mer, Boulogne-sur-mer, France
| | - Renaud Snanoudj
- Departement of Nephrology-Dialysis-Transplantation, Assistance Publique des Hôpitaux de Paris (AP-HP), Bicêtre University Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | | | - Mikael Ebbo
- Department of Internal Medicine, CHU Timone, Marseille, France
| | - Mohamad Zaidan
- Departement of Nephrology-Dialysis-Transplantation, Assistance Publique des Hôpitaux de Paris (AP-HP), Bicêtre University Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| |
Collapse
|
26
|
Penet T, Lambert M, Baillet C, Outteryck O, Hénon H, Morell-Dubois S, Hachulla E, Launay D, Pokeerbux MR. Giant cell arteritis-related cerebrovascular ischemic events: a French retrospective study of 271 patients, systematic review of the literature and meta-analysis. Arthritis Res Ther 2023; 25:116. [PMID: 37420252 PMCID: PMC10326952 DOI: 10.1186/s13075-023-03091-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/10/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Cerebrovascular ischemic events (CIE) are among the most severe complications of giant cell arteritis (GCA). Heterogeneity between different studies in the definition of GCA-related CIE leads to uncertainty regarding their real prevalence. The aim of our study was to evaluate the prevalence and describe the characteristics of GCA-related CIE in a well-phenotyped cohort completed by a meta-analysis of the existing literature. METHODS In this retrospective study performed in the Lille University Hospital, all consecutive patients with GCA according to American College of Rheumatology (ACR) diagnostic criteria were included from January 1, 2010, to December 31, 2020. A systematic review of the literature using MEDLINE and EMBASE was performed. Cohort studies of unselected GCA patients reporting CIE were included in the meta-analysis. We calculated the pooled summary estimate of GCA-related CIE prevalence. RESULTS A total of 271 GCA patients (89 males, mean age 72 ± 9 years) were included in the study. Among them, 14 (5.2%) presented with GCA-related CIE including 8 in the vertebrobasilar territory, 5 in the carotid territory, and 1 patient having multifocal ischemic and hemorrhagic strokes related to intra-cranial vasculitis. Fourteen studies were included in the meta-analysis, representing a total population of 3553 patients. The pooled prevalence of GCA-related CIE was 4% (95% CI 3-6, I2 = 68%). Lower body mass index (BMI), vertebral artery thrombosis on Doppler US (17% vs 0.8%, p = 0.012), vertebral arteries involvement (50% vs 3.4%, p < 0.001) and intracranial arteries involvement (50% vs 1.8%, p < 0.001) on computed tomography angiography (CTA) and/or magnetic resonance angiography (MRA), and axillary arteries involvement on positron emission computed tomography (PET/CT) (55% vs 20%, p = 0.016) were more frequent in GCA patients with CIE in our population. CONCLUSIONS The pooled prevalence of GCA-related CIE was 4%. Our cohort identified an association between GCA-related CIE, lower BMI, and vertebral, intracranial, and axillary arteries involvement on various imaging modalities.
Collapse
Affiliation(s)
- Thomas Penet
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Autoimmunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
- Service de Médecine Interne et Immunologie Clinique, CHU Lille, Rue Michel Polonovski, F-59037 Lille Cedex, France
| | - Marc Lambert
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Autoimmunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
| | - Clio Baillet
- Nuclear Medicine Department, CHU Lille, Lille, France
| | - Olivier Outteryck
- Department of Neuroradiology, Univ. Lille, INSERM, CHU Lille, U1172 – Lille Neurosciences Institute, 59000 Lille, France
| | - Hilde Hénon
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog-Lille Neuroscience & Cognition, Lille, France
| | - Sandrine Morell-Dubois
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Autoimmunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
| | - Eric Hachulla
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Autoimmunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Autoimmunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
| | - Mohammad Ryadh Pokeerbux
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Autoimmunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
| |
Collapse
|
27
|
Stabler S, Lamblin C, Gaillard S, Just N, Mihailescu M, Viget N, Sy Ndiaye T, Dzeing Ella A, Brunin G, Weyrich P, Prevotat A, Chenivesse C, Le Rouzic O, Mortuaire G, Vuotto F, Faure K, Leurs A, Wallet F, Loiez C, Titecat M, Le Guern R, Hachulla E, Sanges S, Etienne N, Terriou L, Launay D, Lopez B, Bahuaud M, Batteux F, Dubucquoi S, Gesquière-Lasselin C, Labalette M, Lefèvre G. High Frequency of Specific Polysaccharide Antibody Deficiency in Adults With Unexplained, Recurrent and/or Severe Infections With Encapsulated Bacteria. Clin Infect Dis 2023; 76:800-808. [PMID: 36285530 DOI: 10.1093/cid/ciac842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/08/2022] [Accepted: 10/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Primary immunodeficiencies (PIDs) in adults are mainly revealed by recurrent and/or severe bacterial infections. The objective of this study was to evaluate a systematic research strategy of PIDs in adults with unexplained bacterial infections, with a special focus on specific polysaccharide antibody deficiency (SPAD). METHODS In this prospective multicenter study, inclusion criteria were recurrent benign upper and lower respiratory tract infections (RTIs) for at least two years (group 1), at least one upper or lower RTI requiring hospitalization (group 2), and/or at least one invasive infection documented with encapsulated bacteria (group 3). Main exclusion criteria were all local and general conditions that could explain infections. If no PID diagnosis was made, response to polysaccharide antigens was assessed using a pneumococcal polysaccharide vaccine. RESULTS From March 2015 to March 2020, 118 patients were included (37 males, median age of 41 years): 73, 17, and 28 in groups 1, 2, and 3, respectively. Forty-seven PIDs were diagnosed, giving an estimated frequency of 39.8% (95% confidence interval [CI] [30.4, 48.8]). SPAD was the most frequent diagnosis by far (n = 37/47, 78.7%), and was made in 23, 5, and 9 patients from groups 1 to 3, respectively. All SPAD patients received conjugate vaccines and, according to their infectious history, were on surveillance or treated with preventive antibiotics (n = 6) and/or with immunoglobulins replacement therapy (n = 10), the latter being dramatically efficient in all cases. CONCLUSIONS Considering its high prevalence among adults with unexplained recurrent and/or severe bacterial infections, SPAD should be screened in those patients. CLINICAL TRIALS REGISTRATION NCT02972281.
Collapse
Affiliation(s)
- Sarah Stabler
- Département de médecine interne et immunologie clinique, CHU Lille, Lille, France
- Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
- Département de maladies infectieuses et tropicales, CHU Lille, Lille, France
- Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, Lille, France
| | - Catherine Lamblin
- Département de pneumologie, Hôpital privé La Louvière, Lille, France
| | - Sacha Gaillard
- Département de pneumologie, Clinique Tessier, Valenciennes, France
| | - Nicolas Just
- Département de pneumologie, CH Roubaix, Roubaix, France
| | | | - Nathalie Viget
- Département de maladies infectieuses et tropicales, CH Tourcoing, Tourcoing, France
| | - Thierno Sy Ndiaye
- Département de médecine interne, CH d'Armentières, Armentières, France
| | - Arnaud Dzeing Ella
- Département de maladies infectieuses et tropicales, médecine interne et polyvalente, CH Denain, Denain, France
| | - Guillaume Brunin
- Département de réanimation, CH Boulogne, Boulogne Sur Mer, France
| | - Pierre Weyrich
- Département de maladies infectieuses, Groupement Hospitalier de l'Institut Catholique de Lille, Lille, France
| | - Anne Prevotat
- Département de pneumologie, CHU Lille, Lille, France
| | | | - Olivier Le Rouzic
- Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, Lille, France
- Département de pneumologie, CHU Lille, Lille, France
| | | | - Fanny Vuotto
- Département de maladies infectieuses et tropicales, CHU Lille, Lille, France
| | - Karine Faure
- Département de maladies infectieuses et tropicales, CHU Lille, Lille, France
- Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, Lille, France
| | - Amélie Leurs
- Département de médecine interne et maladies infectieuses, CH Dunkerque, Dunkerque, France
| | | | | | - Marie Titecat
- Laboratoire de Bactériologie, CHU Lille, Lille, France
- Université de Lille, U1286 INFINITE, Institut de recherche translationnelle sur l'inflammation, Lille, France
| | - Rémi Le Guern
- Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, Lille, France
- Laboratoire de Bactériologie, CHU Lille, Lille, France
| | - Eric Hachulla
- Département de médecine interne et immunologie clinique, CHU Lille, Lille, France
- Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
| | - Sébastien Sanges
- Département de médecine interne et immunologie clinique, CHU Lille, Lille, France
- Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
| | - Nicolas Etienne
- Département de médecine interne et immunologie clinique, CHU Lille, Lille, France
- Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
| | - Louis Terriou
- Département de médecine interne et immunologie clinique, CHU Lille, Lille, France
- Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
| | - David Launay
- Département de médecine interne et immunologie clinique, CHU Lille, Lille, France
- Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
- Université de Lille, U1286 INFINITE, Institut de recherche translationnelle sur l'inflammation, Lille, France
| | | | - Mathilde Bahuaud
- Laboratoire d'immunologie, CHU Cochin-Hôtel Dieu-Broca, Paris, France
| | - Frédéric Batteux
- Laboratoire d'immunologie, CHU Cochin-Hôtel Dieu-Broca, Paris, France
| | - Sylvain Dubucquoi
- Université de Lille, U1286 INFINITE, Institut de recherche translationnelle sur l'inflammation, Lille, France
- Institut d'Immunologie, CHU Lille, Lille, France
| | | | - Myriam Labalette
- Université de Lille, U1286 INFINITE, Institut de recherche translationnelle sur l'inflammation, Lille, France
- Institut d'Immunologie, CHU Lille, Lille, France
| | - Guillaume Lefèvre
- Département de médecine interne et immunologie clinique, CHU Lille, Lille, France
- Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
- Université de Lille, U1286 INFINITE, Institut de recherche translationnelle sur l'inflammation, Lille, France
- Institut d'Immunologie, CHU Lille, Lille, France
| |
Collapse
|
28
|
Launay D, Bouillet L, Boccon-Gibod I, Trumbic B, Gobert D, Fain O. [Hereditary angioedema and its new treatments: An update]. Rev Med Interne 2023:S0248-8663(23)00061-9. [PMID: 36872215 DOI: 10.1016/j.revmed.2023.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 03/06/2023]
Abstract
Hereditary angioedema, with or without deficient C1 inhibitor level or function, is a rare disease characterized by recurrent attacks of noninflammatory subcutaneous and/or submucosal edema. It may be life-threatening and substantially affects quality of life. Attacks may be spontaneous or induced, in a setting of emotional stress, by infections or physical trauma, in particular. As the key mediator is bradykinin, this angioedema does not respond to the usual treatments of mast cell-mediated angioedema (antihistamines, corticosteroids, adrenaline), which is much more frequent. Therapeutic management of hereditary angioedema first consists in treating severe attacks with a selective B2 bradykinin receptor antagonist or a C1 inhibitor concentrate. The latter or an attenuated androgen (danazol) can be used for short-term prophylaxis. Therapeutic solutions conventionally proposed for long-term prophylaxis (danazol, antifibrinolytics [tranexamic acid], C1 inhibitor concentrate) vary in efficacy and/or pose problems of safety or ease of use. Kallikrein inhibitors (subcutaneous lanadelumab, oral berotralstat) recently made available as disease-modifying treatment constitute an important advance in long-term prophylaxis of hereditary angioedema attacks. The advent of these new drugs is accompanied by a new ambition for patients: optimize control of the disease and thereby minimize its impact on quality of life.
Collapse
Affiliation(s)
- D Launay
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; CHU de Lille, service de médecine interne et immunologie clinique, centre de référence angioedèmes à kinine (CREAK), 59000 Lille, France.
| | - L Bouillet
- CHU Grenoble Alpes, service de médecine interne, centre de référence des angioedèmes (CREAK), 38000 Grenoble, France; University Grenoble Alpes, UMR 5525 TIMC-IMAG, laboratoire T-Raig, 38000 Grenoble, France
| | - I Boccon-Gibod
- Service de médecine interne et immunologie clinique, centre hospitalo-universitaire de Grenoble, CHUGA, centre de référence des angioedèmes national (CREAK) et international (ACARE), Grenoble, France
| | | | - D Gobert
- Sorbonne université, AP-HP, service de médecine interne, hôpital Saint-Antoine, 75012 Paris, France
| | - O Fain
- Sorbonne université, AP-HP, service de médecine interne, hôpital Saint-Antoine, 75012 Paris, France
| |
Collapse
|
29
|
Astouati Q, Provot F, Farhat MM, Launay D, Sanges S. Use of avacopan in severe forms of ANCA-associated vasculitis. Comment on "Inhibiting C5a/C5aR to treat ANCA-associated vasculitides" by Terrier et al. Joint Bone Spine 2023;90:105472. Joint Bone Spine 2023; 90:105522. [PMID: 36623800 DOI: 10.1016/j.jbspin.2023.105522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Quentin Astouati
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France; Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - François Provot
- CHU de Lille, Nephrology, Dialysis and Transplantation Department, 59000 Lille, France
| | - Meryem-Maud Farhat
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France; Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - David Launay
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France; Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France; Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France; INSERM, F-59000 Lille, France
| | - Sébastien Sanges
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France; Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France; Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France; INSERM, F-59000 Lille, France.
| |
Collapse
|
30
|
Le Pavec J, Launay D, Cottin V, Reynaud-Gaubert M. [Lung transplantation for systemic sclerosis-associated interstitial lung disease]. Rev Mal Respir 2023; 40 Suppl 1:e73-e79. [PMID: 36725441 DOI: 10.1016/j.rmr.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- J Le Pavec
- Service de Pneumologie et de Transplantation Pulmonaire, Groupe Hospitalier Marie-Lannelongue-Paris Saint Joseph, Le Plessis-Robinson, France; Université Paris-Saclay, Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Sud, Inserm, Groupe hospitalier Marie-Lannelongue-Saint Joseph, Le Plessis-Robinson, France.
| | - D Launay
- University Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France
| | - V Cottin
- Université de Lyon, INRA, IVPC, Lyon, Centre national de référence des maladies pulmonaires rares, hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - M Reynaud-Gaubert
- Service de Pneumologie et Equipe de Transplantation Pulmonaire, Centre Hospitalo-Universitaire Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| |
Collapse
|
31
|
Nicolas A, Leroy S, Mouthon L, Uzunhan Y, Cottin V, Mekinian A, Queyrel V, Hachulla E, Gachet B, Launay D, Martis N. Systemic sclerosis associated interstitial lung disease: a survey of current practices in France. Ther Adv Musculoskelet Dis 2023; 15:1759720X231159712. [PMID: 37187855 PMCID: PMC10176589 DOI: 10.1177/1759720x231159712] [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: 06/29/2022] [Accepted: 02/07/2023] [Indexed: 05/17/2023] Open
Abstract
Background Interstitial lung disease (ILD) is the leading cause of mortality in systemic sclerosis (SSc). Objective We performed an overview of the diagnostic approaches, follow-up and treatment strategies used in France for the management of SSc-associated ILD (SSc-ILD). Design Structured nationwide online surveyMethods A structured nationwide online survey was submitted to participants via the French Medical Societies for Internal Medicine and Pneumology, and research groups on SSc-ILD from May 2018 to June 2020. The 79 multiple-choice and 9 open-ended questions covered the screening of ILD at baseline, monitoring of patients with established SSc-ILD and its management. Fourteen optional vignettes exploring different clinical phenotypes of SSc-ILD were submitted to evaluate therapeutic decisions. Results All of the 93 participants screened SSc patients for ILD at baseline with 83 (89%) participants relying on a systematic chest computed tomography (CT) scan. Pulmonary function tests (PFT) were prescribed by 87 (94%) participants at baseline and during follow-up. Treatment was started based on abnormal PFT (95%), chest CT scan characteristics (89%), worsening dyspnoea (72%) and drop in SpO2 during 6-min walk tests (66%). First-line therapy was cyclophosphamide (CYC) (89%), mycophenolate mofetil (MMF) (83%) and prednisone (73%). Rituximab as second-line immunosuppressive therapy (41%) was preferred to antifibrotic agents (18%), and a median daily prednisone dose of 10 mg (interquartile range, 10-15) was prescribed by 73% participants. Extensive SSc-ILD with worsening PFT (95%), regardless of diffusing capacity for carbon monoxide values and skin extension, were more likely to be treated, and CYC was favoured over MMF (p < 0.01). Extensive SSc-ILD with disease duration of less than 5 years was also a criterium for treatment initiation. Conclusion This overview of practices in diagnosis, follow-up and treatment of SSc-ILD in France describes real-life management of patients. It highlights heterogeneity in this management and gaps in current strategies that should be addressed to improve and harmonize clinical practices in SSc-ILD.
Collapse
Affiliation(s)
| | - Sylvie Leroy
- Department of Respiratory Diseases, University
Hospital of Nice, Nice, France
- Côte d’Azur University, Nice, France
| | - Luc Mouthon
- Reference Centre for Systemic Autoimmune
Diseases, Cochin Hospital, Paris, France
| | - Yurdagul Uzunhan
- Department of Respiratory Diseases, Avicenne
Hospital, Bobigny, France
| | - Vincent Cottin
- Department of Respiratory Diseases, Louis
Pradel Hospital, Bron, France
| | - Arsene Mekinian
- Department of Internal Medicine and Clinical
Immunology, Saint-Antoine Hospital, Paris, France
| | - Viviane Queyrel
- Department of Internal Medicine and Clinical
Immunology, University Hospital of Nice, Nice, France
- Côte d’Azur University, Nice, France
| | - Eric Hachulla
- Univ. Lille, U1286 – INFINITE – Institute for
Translational Research in Inflammation, Lille, France
- INSERM, Paris, France
- CHU Lille, Département de Médecine Interne et
Immunologie Clinique, Centre de Référence des Maladies Auto-immunes
- Systémiques Rares du Nord et Nord-Ouest de
France (CeRAINO), Lille, France
| | - Benoit Gachet
- Infectious Diseases Department, Gustave Dron
Hospital, Tourcoing, France
| | - David Launay
- Department of Internal Medicine and Clinical
Immunology, Centre de Référence des Maladies Auto-immunes Systémiques Rares
du Nord et Nord-Ouest de France (CeRAINO), University Hospital of Lille, Rue
Michel Polonovski, Hôpital Huriez, CHU Lille, F-59000 Lille, France
- Univ. Lille, U1286 – INFINITE – Institute for
Translational Research in Inflammation, Lille, France
- INSERM, Paris, France
| | - Nihal Martis
- Department of Internal Medicine and Clinical
Immunology, University Hospital of Nice, Nice, France
- Côte d’Azur University, Nice, France
- INSERM U1065 – Mediterranean Centre for
Molecular Medicine, Control of gene expression (COdEX), Paris, France
| | | |
Collapse
|
32
|
Nasseh J, Podevin C, Ternynck C, Zephir H, Letarouilly JG, Flipo RM, Nachury M, Chenivesse C, Hachulla E, Launay D, Staumont-Salle D, Dezoteux F. Self-reported Impact of the Early 2020 COVID-19 Crisis on the
Healthcare Pathway During and After Lockdown in Patients With Chronic
Immune-Mediated Inflammatory Diseases: A Practical Survey. J Patient Exp 2022; 9:23743735221143736. [PMCID: PMC9742925 DOI: 10.1177/23743735221143736] [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] [Indexed: 12/14/2022] Open
Abstract
Introduction: Global lockdown in the context of the coronavirus
disease 2019 (COVID-19) pandemic is an unprecedented experience. We report here
the results of an anonymous questionnaire-based survey on the healthcare and
control of chronic IMIDs (chronic immune-mediated inflammatory diseases) within
the IMMINENT network during the French lockdown (March 17, 2020-May 11, 2020)
and the 2-month period following the end of the lockdown (July 11, 2020).
Methods: Two anonymous questionnaires were sent by email to
4500 patients who were followed in a university hospital for an IMID in the
departments of gastroenterology, rheumatology, dermatology, pneumology,
neurology, and internal medicine. Results: A total of 921/4500
(20.46%) responded to the first survey (impact of the lockdown), and 553/4500
(12.28%) to the second (impact at 2-months post-lockdown). Concerning the impact
of the lockdown, 420/915 (45.9%) reported affected follow-up. Similarly, after
the lockdown, 248/544 (45.6%) declared a negative impact on their follow-up. The
repartition by departments of patients’ perception of an altered follow-up
during (P = .72) and at the end of the lockdown
(P = .77) was not statistically different. Our study
highlighted the effects of the COVID-19 pandemic and the restriction measures
implemented on the self-reported impact felt by patients on the follow-up of
their chronic IMIDs without significant differences among all departments.
Conclusion: Our study is original by showing that patients,
whatever the type of IMID, shared this same negative perception. This
transdisciplinary study demonstrated the importance of a collaborative network
among all departments.
Collapse
Affiliation(s)
| | - Céline Podevin
- CHU Lille, FHU IMMINENT (Immune-Mediated Inflammatory Diseases and
Targeted Therapies), Lille, France
| | | | - Hélène Zephir
- CHU de Lille, Univ Lille, U1172, Unité de neurologie inflammatoire,
CRC-SEP, FHU IMMINENT, Lille, France
| | | | - René-Marc Flipo
- CHU Lille, Univ. Lille, Service de rhumatologie, Lille, France
| | - Maria Nachury
- Univ. Lille, Inserm, CHU Lille, Service de Gastro-entérologie, U1286
- INFINITE - Institute for Translational Research in Inflammation, Lille,
France
| | - Cécile Chenivesse
- Univ. Lille, CHU Lille, Inserm, CNRS, Institut Pasteur de Lille,
Service de Pneumologie et Immuno-allergologie, U1019, UMR 9017, Center for Infection
and Immunity of Lille (CIIL), CRISALIS, F-CRIN Inserm Network, Lille, France
| | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, Referral
Centre for Centre for Rare Systemic Autoimmune Diseases North and North-West of
France (CeRAINO), CHU Lille, Univ. Lille, Inserm, U1286 - INFINITE - Institute for
Translational Research in Inflammation, Lille, France
| | - David Launay
- Department of Internal Medicine and Clinical Immunology, Referral
Centre for Centre for Rare Systemic Autoimmune Diseases North and North-West of
France (CeRAINO), CHU Lille, Univ. Lille, Inserm, U1286 - INFINITE - Institute for
Translational Research in Inflammation, Lille, France
| | - Delphine Staumont-Salle
- CHU Lille, Univ. Lille, Service de dermatologie, U1286 Inserm
INFINITE Institute for Translational Research in Inflammation, Lille, France
| | - Frédéric Dezoteux
- CHU Lille, Univ. Lille, Service de dermatologie, U1286 Inserm
INFINITE Institute for Translational Research in Inflammation, Lille, France,Frédéric Dezoteux, CHU Lille, Univ. Lille,
Service de Dermatologie, U1286 Inserm INFINITE Institute for Translational
Research in Inflammation, Hôpital Claude Huriez, Rue Michel Polonovski, F-59000
Lille, France.
| |
Collapse
|
33
|
Sanges S, Rice L, Tu L, Valenzi E, Cracowski JL, Montani D, Mantero J, Ternynck C, Marot G, Bujor AM, Hachulla É, Launay D, Humbert M, Guignabert C, Lafyatis R. Biomarkers of haemodynamic severity of systemic sclerosis-associated pulmonary arterial hypertension by serum proteome analysis. Ann Rheum Dis 2022; 82:365-373. [PMID: 36600187 PMCID: PMC9918672 DOI: 10.1136/ard-2022-223237] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 08/16/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To mine the serum proteome of patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH) and to detect biomarkers that may assist in earlier and more effective diagnosis and treatment. METHODS Patients with limited cutaneous SSc, no extensive interstitial lung disease and no PAH-specific therapy were included. They were classified as cases if they had PAH confirmed by right heart catheterisation (RHC) and serum collected on the same day as RHC; and as controls if they had no clinical evidence of PAH. RESULTS Patients were mostly middle-aged females with anticentromere-associated SSc. Among 1129 proteins assessed by a high-throughput proteomic assay (SOMAscan), only 2 were differentially expressed and correlated significantly with pulmonary vascular resistance (PVR) in SSc-PAH patients (n=15): chemerin (ρ=0.62, p=0.01) and SET (ρ=0.62, p=0.01). To validate these results, serum levels of chemerin were measured by ELISA in an independent cohort. Chemerin levels were confirmed to be significantly higher (p=0.01) and correlate with PVR (ρ=0.42, p=0.04) in SSc-PAH patients (n=24). Chemerin mRNA expression was detected in fibroblasts, pulmonary artery smooth muscle cells (PA-SMCs)/pericytes and mesothelial cells in SSc-PAH lungs by single-cell RNA-sequencing. Confocal immunofluorescence revealed increased expression of a chemerin receptor, CMKLR1, on SSc-PAH PA-SMCs. SSc-PAH serum seemed to induce higher PA-SMC proliferation than serum from SSc patients without PAH. This difference appeared neutralised when adding the CMKLR1 inhibitor α-NETA. CONCLUSION Chemerin seems an interesting surrogate biomarker for PVR in SSc-PAH. Increased chemerin serum levels and CMKLR1 expression by PA-SMCs may contribute to SSc-PAH pathogenesis by inducing PA-SMC proliferation.
Collapse
Affiliation(s)
- Sébastien Sanges
- Boston University School of Medicine, E5 Arthritis Center, Boston, Massachusetts, USA .,Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,INSERM, Lille, France.,CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, France.,Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - Lisa Rice
- Boston University School of Medicine, E5 Arthritis Center, Boston, MA, USA
| | - Ly Tu
- Université Paris Saclay, School of Medicine, Le Kremlin-Bicêtre, France,INSERM UMR_S 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - Eleanor Valenzi
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - David Montani
- Université Paris Saclay, School of Medicine, Le Kremlin-Bicêtre, France,INSERM UMR_S 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France,AP-HP, Department of Respiratory and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Julio Mantero
- Boston University School of Medicine, E5 Arthritis Center, Boston, MA, USA
| | - Camille Ternynck
- Univ. Lille, CHU Lille, ULR2694 – METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - Guillemette Marot
- Univ. Lille, CHU Lille, ULR2694 – METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France,Inria ,MODAL: MOdels for Data Analysis and Learning, F-59000 Lille, France,Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UAR 2014 - US 41 -PLBS, bilille, F-59000 Lille, France
| | - Andreea M. Bujor
- Boston University School of Medicine, E5 Arthritis Center, Boston, MA, USA
| | - Éric Hachulla
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, F-59000 Lille, France,INSERM, F-59000 Lille, France,CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France,Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - David Launay
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, F-59000 Lille, France,INSERM, F-59000 Lille, France,CHU Lille, Département de Médecine Interne et Immunologie Clinique, F-59000 Lille, France,Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Marc Humbert
- Université Paris Saclay, School of Medicine, Le Kremlin-Bicêtre, France,INSERM UMR_S 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France,AP-HP, Department of Respiratory and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Christophe Guignabert
- Université Paris Saclay, School of Medicine, Le Kremlin-Bicêtre, France,INSERM UMR_S 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - Robert Lafyatis
- Division of Rheumatology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| |
Collapse
|
34
|
Gobert D, Launay D, Boccon-Gibod I, De Moreuil C, Bourgoin-Heck M, Aubineau M, Debord-Peguet S, Jeandel P, Jaussaud R, Du-Thanh A, Armengol G, Hoarau C, Ollivier Y, Pontille F, Guez S, Villedieu M, Crave J, Fain O, Bouillet L. Efficacité et tolérance du bérotralstat dans la prévention des crises récurrentes d’angiœdème héréditaire : analyse intermédiaire de l’étude observationnelle en vie réelle « BEROLIFE ». Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.032] [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: 12/12/2022]
|
35
|
Laurent C, Lefèvre G, Kahn JE, Staumont-Salle D, Felten R, Puget M, Moulinet T, Machelart I, Launay D, Charvet E, Bouaziz JD, Jachiet M, Espitia A, Mahr A, Le Clech C, Malphettes M, Morice C, Mourah S, Moins-Teisserenc H, Lifermann F, Soulier-Guérin K, Villate A, Baillou C, Grados A, Robbins A, Abisror N, Bagot M, Boutboul D, Panel K, Vignon-Pennamen MD, Rivet J, Battistella M, Groh M, de Masson A. Cutaneous manifestations of lymphoid-variant hypereosinophilic syndrome. Br J Dermatol 2022; 187:1011-1013. [PMID: 35862277 PMCID: PMC10087750 DOI: 10.1111/bjd.21782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Claire Laurent
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Guillaume Lefèvre
- CHU Lille, Institut d'Immunologie, National Reference Centers for Hypereosinophilic syndromes, U1286 - INFINITE - Institute for Translational Research in Inflammation Inserm Univ. Lille, Lille, F-59000, Lille, France
| | - Jean-Emmanuel Kahn
- Department of Internal Medicine, Ambroise-Paré Hospital, Boulogne-Billancourt, France
| | - Delphine Staumont-Salle
- CHU Lille, Univ. Lille, Service de Dermatologie, U1286 Inserm INFINITE Institute for Translational Research in Inflammation, F-59000, Lille
| | - Renaud Felten
- Service de Rhumatologie, Centre de Référence National des Maladies Auto-Immunes Systémiques Rares, CNR RESO, Hôpitaux universitaire de Strasbourg, Strasbourg, France
| | - Marie Puget
- Department of Internal Medicine, CHU de Valence, Valence, France
| | - Thomas Moulinet
- Department of Internal Medicine and Clinical Immunology, CHRU de Nancy, Université de Lorraine, CNRS UMR 7365, IMoPA, Nancy, France
| | - Irène Machelart
- Department of Internal Medicine, CH de Bayonne, Bayonne, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | | | - Jean David Bouaziz
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France.,INSERM U976, Paris, France.,Université Paris Cité, Paris, France
| | - Marie Jachiet
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Alexandra Espitia
- Department of Internal Medicine, CHU Nantes Hôtel Dieu, Nantes, France
| | - Alfred Mahr
- Rheumatology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | - Marion Malphettes
- Department of Clinical Immunology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Cécile Morice
- Department of Dermatology, CHU de Caen, Caen, France
| | - Samia Mourah
- Department of Internal Medicine, CHU Nantes Hôtel Dieu, Nantes, France.,Pharmacogenomics and Oncogenetics, Saint-Louis Hospital, AP-HP, Paris, France
| | - Hélène Moins-Teisserenc
- Université Paris Cité, Paris, France.,Hematology Laboratory and Saint-Louis Hospital, AP-HP, Paris, France
| | | | - Karine Soulier-Guérin
- Department of Internal Medicine and Clinical Immunology, Centre Hospitalier de Vichy, Vichy, France
| | - Alban Villate
- Department of Hematology, CHRU Bretonneau, Tours, France
| | - Chloé Baillou
- Department of Clinical Immunology, CHU Poitiers, Poitiers, France
| | - Aurélie Grados
- Department of Clinical Immunology, CH Niort, Niort, France
| | - Ailsa Robbins
- Department of Internal Medicine, CHU de Reims, Reims, France
| | - Noemie Abisror
- Department of Internal Medicine, CHU Tenon, Paris, France
| | - Martine Bagot
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France.,INSERM U976, Paris, France.,Université Paris Cité, Paris, France
| | - David Boutboul
- Department of Clinical Immunology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Kewin Panel
- Department of Internal Medicine, Hôpital Foch, Suresnes, France
| | | | - Jacqueline Rivet
- Department of Pathology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Maxime Battistella
- INSERM U976, Paris, France.,Université Paris Cité, Paris, France.,Department of Pathology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Matthieu Groh
- Department of Internal Medicine, Hôpital Foch, Suresnes, France
| | - Adèle de Masson
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France.,INSERM U976, Paris, France.,Université Paris Cité, Paris, France
| | | |
Collapse
|
36
|
Lahuna C, Defendi F, Bouillet L, Boccon-Gibod I, Leblond V, Launay D, Cathébras P, Brihaye B, Armengol G, Aubineau M, Gondran G, Ly K, Gayet S, Desblache J, Martin L, Arsène M, Olivier F, Delphine G. Angiœdèmes bradykiniques par déficit acquis en C1-inhibiteur, associés aux gammapathies monoclonales de signification indéterminée : caractéristiques d’une cohorte nationale française. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.031] [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: 12/12/2022]
|
37
|
Djouina M, Waxin C, Leprêtre F, Tardivel M, Tillement O, Vasseur F, Figeac M, Bongiovanni A, Sebda S, Desreumaux P, Launay D, Dubuquoy L, Body-Malapel M, Vignal C. Gene/environment interaction in the susceptibility of Crohn's disease patients to aluminum. Sci Total Environ 2022; 850:158017. [PMID: 35973536 DOI: 10.1016/j.scitotenv.2022.158017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND & AIM The key role of environmental factors in the pathogenesis of Inflammatory Bowel Diseases (IBD) is recognized. Aluminum is suspected to be a risk factor for IBD. However, mechanisms linking aluminum exposure to disease development are unknown. We examined the role of aluminum transport and subcellular localisation on human colon susceptibility to aluminum-induced inflammation. METHODS Human colon biopsies isolated from Crohn's disease (CD) or control patients and Caco-2 cells were incubated with aluminum. The effects of aluminum were evaluated on cytokine secretion and transporter expression. The role of aluminum kinetics parameters was studied in Caco-2 using transport inhibitors and in human colon biopsies by assessing genetic polymorphisms of transporters. RESULTS Aluminum exposure was shown to induce cytokine secretion in colon of CD but not healthy patients. In Caco-2 cells, aluminum internalisation was correlated with inflammatory status. In human colon, analysis of genetic polymorphisms and expression of ABCB1 and SLC26A3 transporters showed that their decreased activity was involved in aluminum-induced inflammation. CONCLUSIONS We hypothesize that alteration in detoxifying response would lead to a deregulation of intestinal homeostasis and to the expression of IBD. Our study emphasizes the complexity of gene/environment interaction for aluminum adverse health effect, highlighting at risk populations or subtypes of patients. A better understanding of correlations between gene expression or SNP and xenobiotic kinetics parameters would shift the medical paradigm to more personalized disease management and treatment.
Collapse
Affiliation(s)
- Madjid Djouina
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for translational research in inflammation, F-59000 Lille, France
| | - Christophe Waxin
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for translational research in inflammation, F-59000 Lille, France
| | - Frédéric Leprêtre
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UAR 2014 - PLBS, F-59000 Lille, France
| | - Meryem Tardivel
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UAR 2014 - PLBS, F-59000 Lille, France
| | - Olivier Tillement
- Institut Lumière Matière, Université Claude Bernard Lyon 1, CNRS UMR 5306, 69622 Villeurbanne, France
| | - Francis Vasseur
- Univ. Lille, CHU Lille, ULR 2694-METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - Martin Figeac
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UAR 2014 - PLBS, F-59000 Lille, France
| | - Antonino Bongiovanni
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UAR 2014 - PLBS, F-59000 Lille, France
| | - Shéhérazade Sebda
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UAR 2014 - PLBS, F-59000 Lille, France
| | - Pierre Desreumaux
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for translational research in inflammation, F-59000 Lille, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for translational research in inflammation, F-59000 Lille, France
| | - Laurent Dubuquoy
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for translational research in inflammation, F-59000 Lille, France
| | - Mathilde Body-Malapel
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for translational research in inflammation, F-59000 Lille, France
| | - Cécile Vignal
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for translational research in inflammation, F-59000 Lille, France.
| |
Collapse
|
38
|
Launay D, Boccon-Gibod I, Gobert D, Citerne I, Tolba A, Raguet M. Amélioration de l’observance thérapeutique de la prophylaxie à long terme dans l’angiœdème héréditaire : résultats préliminaires du programme d’accompagnement patients AngiOH. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.033] [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: 12/12/2022]
|
39
|
Chepy A, Benarab S, Dezoteux F, Azib S, Launay D, Sanges S, Staumont-Sallé D, Crinquette M. Profil clinique des vascularites urticariennes anatomopathologiques : étude rétrospective. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.027] [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: 12/12/2022]
|
40
|
Koether V, Launay D, Reynaud-Gaubert M, Prevot G, Mouthon L, Borie R, El Husseini K, Decker P, Dirou S, Blanchart E, Leurs A, Berthier S, Delbrel X, Durel M, Agard C, Nieves A, Hachulla E, Aydindag D, Cottin V, Uzunhan Y. Étude nationale multicentrique sur l’utilisation du nintedanib en vie réelle dans la pneumopathie interstitielle diffuse liée à la sclérodermie systémique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.124] [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: 12/12/2022]
|
41
|
Laurence B, Boccon-Gibod I, Launay D, Hennaoui M, Duthanh A, Rachline A, Pagnier A, Aubineau M, Gobert D, Fain O. Efficacité en vie réelle du lanadelumab chez les patients atteints d’un angiœdème héréditaire : résultats intermédiaires de l’étude observationnelle SERENITI. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.230] [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: 12/12/2022]
|
42
|
Le Pavec J, Pison C, Hirschi S, Bunel V, Mordant P, Brugière O, Guen ML, Olland A, Coiffard B, Renaud-Picard B, Tissot A, Brioude G, Borie R, Crestani B, Deslée G, Stelianides S, Mal H, Schuller A, Falque L, Lorillon G, Tazi A, Burgel PR, Grenet D, De Miranda S, Bergeron A, Launay D, Cottin V, Nunes H, Valeyre D, Uzunhan Y, Prévot G, Sitbon O, Montani D, Savale L, Humbert M, Fadel E, Mercier O, Mornex JF, Dauriat G, Reynaud-Gaubert M. 2022 Update of indications and contraindications for lung transplantation in France. Respir Med Res 2022; 83:100981. [PMID: 36565563 DOI: 10.1016/j.resmer.2022.100981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022]
Abstract
Lung transplantation (LTx) is a steadily expanding field. The considerable developments have been driven over the years by indefatigable work conducted at LTx centers to improve donor and recipient selection, combined with multifaceted efforts to overcome challenges raised by the surgical procedure, perioperative care, and long-term medical complications. One consequence has been a pruning away of contraindications over time, which has, in some ways, complicated the patient selection process. The Francophone Pulmonology Society (Société de Pneumology de Langue Française, SPLF) set up a task force to produce up-to-date working guidelines designed to assist pulmonologists in managing end-stage respiratory insufficiency, determining which patients may be eligible for LTx, and appropriately timing LTx-center referral. The task force examined the most recent literature and evaluated the risk factors that limit patient survival after LTx. Ideally, the objectives of LTx are to prolong life while also improving quality of life. The guidelines developed by the task force apply to a limited resource and are consistent with the ethical principles described below.
Collapse
Affiliation(s)
- Jérôme Le Pavec
- Service de Pneumologie et Transplantation Pulmonaire, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France.
| | - Christophe Pison
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Av. des Maquis du Grésivaudan, 38700 La Tronche, France; INSERM 1055, Laboratoire de Bioénergétique Fondamentale et Appliquée, Bâtiment B Biologie, 2280 Rue de la piscine 38400 Saint Martin d'Hères, France; Université Grenoble Alpes, Av. des Maquis du Grésivaudan, 38700 La Tronche, France
| | - Sandrine Hirschi
- Service de Pneumologie et Transplantation Pulmonaire, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Hôpital Civil, 1 place de l'hôpital BP 426, 67091 Strasbourg, France
| | - Vincent Bunel
- Service de Pneumologie B et Transplantation pulmonaire, Hôpital Bichat, APHP, Inserm U1152, Université de Paris, 46 Rue Henri Huchard, 75018 Paris, France
| | - Pierre Mordant
- Service de chirurgie vasculaire, thoracique, et de transplantation pulmonaire, Hôpital Bichat, Assistance Publique - Hôpitaux de Paris, Université de Paris, 46 Rue Henri Huchard, 75018, Paris, France
| | - Olivier Brugière
- Centre de Transplantation Pulmonaire et CRCM, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Morgan Le Guen
- Département d'Anesthésie, Hôpital Foch, 40 Rue Worth, 92150 Suresnes, France; INRA UMR 892 VIM, équipe Vaccins Immunopathologie Immunomodulation, Domaine de Vilvert, 78350, Jouy-en-Josas, France; Université Versailles Saint Quentin, 45 Av. des États Unis, 78000 Versailles France
| | - Anne Olland
- Lung Transplantation Group, University Hospital Strasbourg, Strasbourg, France; INSERM (French institute for health and medical research) 1260 Regenerative, University Hospital Strasbourg, 1 place de l'hôpital, BP 426, 67091 Strasbourg, France
| | - Benjamin Coiffard
- Service de Pneumologie et Equipe de Transplantation Pulmonaire, Centre Hospitalo-Universitaire Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Chemin des Bourrely, 13915 Marseille cedex 20, France
| | - Benjamin Renaud-Picard
- Service de Pneumologie et Transplantation Pulmonaire, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Hôpital Civil, 1 place de l'hôpital BP 426, 67091 Strasbourg, France; INSERM (French institute for health and medical research) 1260 Regenerative, University Hospital Strasbourg, 1 place de l'hôpital, BP 426, 67091 Strasbourg, France
| | - Adrien Tissot
- Nantes Université, CHU Nantes, Service de Pneumologie, l'institut du thorax, F-44000 Nantes, France; Nantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, 8 Quai Moncousu, 44007, Nantes, France
| | - Geoffrey Brioude
- Service de Chirurgie Thoracique, Centre Hospitalo-Universitaire Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Chemin des Bourrely, 13915 Marseille cedex 20, France
| | - Raphaël Borie
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Bruno Crestani
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Gaétan Deslée
- Service de Pneumologie, Inserm U1250, CHU Reims, Université Reims Champagne Ardenne, 45 Rue Cognacq-Jay, 51092, Reims, France
| | - Sandrine Stelianides
- Institut de réadaptation d'Achères, 7, place Simone-Veil, 78260, Achères, France
| | - Hervé Mal
- Service de Pneumologie B et Transplantation pulmonaire, Hôpital Bichat, APHP, Inserm U1152, Université de Paris, 46 Rue Henri Huchard, 75018 Paris, France
| | - Armelle Schuller
- Service de Pneumologie et Transplantation Pulmonaire, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Hôpital Civil, 1 place de l'hôpital BP 426, 67091 Strasbourg, France
| | - Loïc Falque
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Av. des Maquis du Grésivaudan, 38700 La Tronche, France
| | - Gwenaëlle Lorillon
- Université de Paris, INSERM UMR 976 HIPI, F-75006; Centre national de référence des histiocytoses, Service de Pneumologie, Hôpital Saint Louis, 1 Av. Claude Vellefaux, 75010, Paris, AP-HP, France
| | - Abdellatif Tazi
- Université de Paris, INSERM UMR 976 HIPI, F-75006; Centre national de référence des histiocytoses, Service de Pneumologie, Hôpital Saint Louis, 1 Av. Claude Vellefaux, 75010, Paris, AP-HP, France
| | - Pierre Regis Burgel
- Université Paris Cité, Inserm U1016, Institut Cochin, Paris, France; Pulmonary Department and National Cystic Fibrosis Reference Centre, Cochin Hospital; Assistance Publique Hôpitaux de Paris, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Dominique Grenet
- Centre de Transplantation Pulmonaire et CRCM, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Sandra De Miranda
- Centre de Transplantation Pulmonaire et CRCM, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland; Université de Paris, UMR 1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Parvis Notre-Dame - Pl. Jean-Paul II, 75004, Paris, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, rue Michel Polonowski, 5900, Lille, France; Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, rue Michel Polonowski, 5900, Lille France; Inserm, rue Michel Polonowski, 5900, Lille, France
| | - Vincent Cottin
- Université de Lyon, INRA, IVPC, Lyon; Centre national de référence des maladies pulmonaires rares, hôpital Louis Pradel, Hospices Civils de Lyon, 59 Bd Pinel, 69500, Bron, France
| | - Hilario Nunes
- INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne Service de Pneumologie, 125 Rue de Stalingrad, 93000, Bobigny, France; Service de Pneumologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - Dominique Valeyre
- INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne Service de Pneumologie, 125 Rue de Stalingrad, 93000, Bobigny, France; Hôpital Saint Joseph, Groupe Hospitalier Paris Saint Joseph, 185 Rue Raymond Losserand, 75014, Paris, France
| | - Yurdagul Uzunhan
- INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne Service de Pneumologie, 125 Rue de Stalingrad, 93000, Bobigny, France; Service de Pneumologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - Grégoire Prévot
- Pôle des voies respiratoires-Hôpital Larrey, Centre Hopitalo-Universitaire, 24 Chem. de Pouvourville, 31400, Toulouse, France
| | - Olivier Sitbon
- AP-HP, Service de Pneumologie, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - David Montani
- AP-HP, Service de Pneumologie, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Laurent Savale
- AP-HP, Service de Pneumologie, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Marc Humbert
- AP-HP, Service de Pneumologie, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Elie Fadel
- Service de Chirurgie Thoracique et Transplantation Cardio-pulmonaire, Groupe Hospitalier Marie-Lannelongue -Paris Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Olaf Mercier
- Service de Chirurgie Thoracique et Transplantation Cardio-pulmonaire, Groupe Hospitalier Marie-Lannelongue -Paris Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Jean François Mornex
- Université de Lyon, université Lyon 1; PSL, EPHE; INRAE; IVPC; 69007, Lyon, France; Hospices civils de Lyon, GHE, service de pneumologie; RESPIFIL, Orphalung; Inserm, CIC1407, 59 Bd Pinel, 69500 Bron, France
| | - Gaëlle Dauriat
- Service de Pneumologie et Transplantation Pulmonaire, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie et Equipe de Transplantation Pulmonaire, Centre Hospitalo-Universitaire Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Chemin des Bourrely, 13915 Marseille cedex 20, France
| |
Collapse
|
43
|
Le Pavec J, Pison C, Hirschi S, Bunel V, Mordant P, Brugière O, Le Guen M, Olland A, Coiffard B, Renaud-Picard B, Tissot A, Brioude G, Borie R, Crestani B, Deslée G, Stelianides S, Mal H, Schuller A, Falque L, Lorillon G, Tazi A, Burgel P, Grenet D, De Miranda S, Bergeron A, Launay D, Cottin V, Nunes H, Valeyre D, Uzunhan Y, Prévot G, Sitbon O, Montani D, Savale L, Humbert M, Fadel E, Mercier O, Mornex J, Dauriat G, Reynaud-Gaubert M. Transplantation pulmonaire en France : actualisation des indications et contre-indications en 2022. Rev Mal Respir 2022; 39:855-872. [DOI: 10.1016/j.rmr.2022.10.005] [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: 09/16/2022] [Accepted: 10/18/2022] [Indexed: 11/11/2022]
|
44
|
Puigrenier S, Giovannelli J, Lamblin N, De Groote P, Fertin M, Bervar JF, Lamer A, Edmé JL, Balquet MH, Sobanski V, Launay D, Hachulla É, Sanges S. Mild pulmonary hemodynamic alterations in patients with systemic sclerosis: relevance of the new 2022 ESC/ERS definition of pulmonary hypertension and impact on mortality. Respir Res 2022; 23:284. [PMID: 36243869 PMCID: PMC9571468 DOI: 10.1186/s12931-022-02205-4] [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: 06/09/2022] [Accepted: 09/29/2022] [Indexed: 11/22/2022] Open
Abstract
Background and objective The definition of pre-capillary pulmonary hypertension (PH) has been modified, with lowering of the mean pulmonary arterial pressure (mPAP) threshold from 25 to 20 mmHg and addition of a mandatory criterion of pulmonary vascular resistance (PVR) ≥ 2 Wood units (WU). Our objectives were: 1/ to estimate the proportion of patients reclassified as having pre-capillary PH when using the new 2022 ESC/ERS hemodynamic criteria (i.e. mPAP 21-24 mmHg and PVR ≥ 2 WU), and to describe their clinical characteristics and outcome; and 2/ to study the relationship between PVR and survival in patients with mPAP > 20 mmHg. Methods We retrospectively analyzed consecutive SSc patients included in our National Reference Center for a first right-heart catheterization between 2003 and 2018. The association between survival and PVR was studied using smoothing splines. Results We included 126 SSc patients with mPAP > 20 mmHg. Among them, 16 (13%) had a baseline mPAP value between 21 and 24 mmHg and PVR ≥ 2 mmHg and were reclassified as pre-capillary PH; 10 of which (62%) raised their mPAP ≥ 25 mmHg during follow-up. In patients with mPAP > 20 mmHg, we observed a linear relation between PVR and mortality for values < 6 WU. Conclusion A significant proportion of SSc patients is reclassified as having pre-capillary PH with the new 2022 ESC/ERS hemodynamic definition. Lowering the PVR threshold from 3 to 2 WU captures patients at risk of raising their mPAP > 25 mmHg, with a possibly less severe disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02205-4.
Collapse
Affiliation(s)
- Sébastien Puigrenier
- CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), 59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000, Lille, France.,CH Boulogne-Sur-Mer, Service de Médecine Et Néphrologie, 62200, Boulogne-Sur-Mer, France
| | | | - Nicolas Lamblin
- CHU Lille, Service de Cardiologie, 59000, Lille, France.,Institut Pasteur de Lille, Inserm U1167, 59000, Lille, France
| | - Pascal De Groote
- CHU Lille, Service de Cardiologie, 59000, Lille, France.,Institut Pasteur de Lille, Inserm U1167, 59000, Lille, France
| | - Marie Fertin
- CHU Lille, Service de Cardiologie, 59000, Lille, France.,Institut Pasteur de Lille, Inserm U1167, 59000, Lille, France
| | | | - Antoine Lamer
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation Des Technologies de Santé Et Des Pratiques Médicales, 59000, Lille, France
| | - Jean-Louis Edmé
- Service Des Explorations Fonctionnelles Respiratoires, CHU Lille, 59000, Lille, France.,EA 4483-IMPECS-IMPact de L'Environnement Chimique Sur La Santé Humaine, Univ. Lille, 59000, Lille, France
| | | | - Vincent Sobanski
- CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), 59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000, Lille, France.,Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,, 59000, Lille, France
| | - David Launay
- CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), 59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000, Lille, France.,Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,, 59000, Lille, France
| | - Éric Hachulla
- CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), 59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000, Lille, France.,Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,, 59000, Lille, France
| | - Sébastien Sanges
- CHU Lille, Service de Médecine Interne Et Immunologie Clinique, Centre de Référence Des Maladies Auto-Immunes Systémiques Rares du Nord Et Nord-Ouest de France (CeRAINO), 59000, Lille, France. .,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), 59000, Lille, France. .,Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France. .,, 59000, Lille, France.
| |
Collapse
|
45
|
Nguyen Y, Yelnik CM, Morel N, Paule R, Stammler R, Plaçais L, Sacré K, Godeau B, Maillard H, Launay D, Morell-Dubois S, Dupré A, Lefèvre G, Devloo C, Dufrost V, Benhamou Y, Levesque H, Leroux G, Piette JC, Mouthon L, Hachulla É, Lambert M, Guern VL, Costedoat-Chalumeau N. Determination of four homogeneous subgroups of patients with antiphospholipid syndrome: a cluster analysis based on 509 cases. Rheumatology (Oxford) 2022:6747168. [PMID: 36190346 DOI: 10.1093/rheumatology/keac548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 08/11/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Antiphospholipid syndrome (APS) is a heterogeneous disease with different phenotypes. Using an unsupervised hierarchical cluster analysis, we aimed to determine distinct homogeneous phenotypes among APS patients. METHODS We performed an observational, retrospective study of APS patients enrolled in the French multicentre 'APS and SLE' registry who meet the Sydney classification criteria. The clustering process involved an unsupervised multiple correspondence analysis followed by a hierarchical ascendant clustering analysis; it used 27 variables selected to cover a broad range of APS clinical and laboratory manifestations. RESULTS These analyses included 509 patients, mainly women (77.8%). Mean (± SD) age at APS diagnosis was 36.2 ± 14.6 years, and mean follow-up since diagnosis 10.3 ± 8.5 years. This hierarchical classification cluster analysis yielded four homogeneous groups of patients: cluster 1, mostly with venous thromboembolism without any associated autoimmune disease; cluster 2, older, lowest proportion of women, history of arterial events, and/or with migraines, arterial hypertension, diabetes mellitus, or dyslipidaemia; cluster 3, younger, highest proportion of women, associated SLE or other autoimmune diseases, and a history of venous thromboembolism or pregnancy morbidity; and cluster 4, mainly with a history of catastrophic antiphospholipid syndrome, aPL-associated nephropathy, and pregnancy morbidity, with frequent triple positivity and more deaths (16.7%). CONCLUSIONS Our study applied an unsupervised clustering method to distinguish four homogeneous APS patient subgroups that were predominantly venous; arterial; associated with SLE or another autoimmune disease; and arterial microthrombotic. Heterogeneous pathophysiological mechanisms may explain these findings.
Collapse
Affiliation(s)
- Yann Nguyen
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hôpital Cochin, AP-HP Centre; Université de Paris, Paris, France.,Centre de Recherche en Epidémiologie et Statistiques (CRESS), Unité Inserm 1153, Université de Paris, Paris, France
| | - Cécile M Yelnik
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO, ), CHU Lille, Univ. Lille, Inserm, U1286, - INFINITE-Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Nathalie Morel
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hôpital Cochin, AP-HP Centre; Université de Paris, Paris, France
| | - Romain Paule
- Department of Internal Medicine, Hôpital Foch, Suresnes, France
| | - Romain Stammler
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hôpital Cochin, AP-HP Centre; Université de Paris, Paris, France
| | - Léo Plaçais
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hôpital Cochin, AP-HP Centre; Université de Paris, Paris, France
| | - Karim Sacré
- Department of Internal Medicine, Hôpital Bichat, AP-HP Nord, Université de Paris, Paris, France
| | - Bertrand Godeau
- Department of Internal Medicine, Hôpital Mondor, AP-HP, Université de Paris-Est Créteil, Créteil, France
| | - Hélène Maillard
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO, ), CHU Lille, Univ. Lille, Inserm, U1286, - INFINITE-Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - David Launay
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO, ), CHU Lille, Univ. Lille, Inserm, U1286, - INFINITE-Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Sandrine Morell-Dubois
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO, ), CHU Lille, Univ. Lille, Inserm, U1286, - INFINITE-Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Anastasia Dupré
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hôpital Cochin, AP-HP Centre; Université de Paris, Paris, France
| | - Guillaume Lefèvre
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO, ), CHU Lille, Univ. Lille, Inserm, U1286, - INFINITE-Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Cécile Devloo
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO, ), CHU Lille, Univ. Lille, Inserm, U1286, - INFINITE-Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Virginie Dufrost
- Department of Internal Medicine, CHU de Rouen, UniRouen, Inserm, U1096, Rouen, France
| | - Ygal Benhamou
- Department of Internal Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Hervé Levesque
- Department of Internal Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Gaëlle Leroux
- Department of Internal Medicine, Hôpital Pitié-Salpêtrière, Paris, France
| | | | - Luc Mouthon
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hôpital Cochin, AP-HP Centre; Université de Paris, Paris, France
| | - Éric Hachulla
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO, ), CHU Lille, Univ. Lille, Inserm, U1286, - INFINITE-Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Marc Lambert
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO, ), CHU Lille, Univ. Lille, Inserm, U1286, - INFINITE-Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Véronique Le Guern
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hôpital Cochin, AP-HP Centre; Université de Paris, Paris, France
| | - Nathalie Costedoat-Chalumeau
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Department of Internal Medicine, Hôpital Cochin, AP-HP Centre; Université de Paris, Paris, France.,Centre de Recherche en Epidémiologie et Statistiques (CRESS), Unité Inserm 1153, Université de Paris, Paris, France
| |
Collapse
|
46
|
Bouillet L, Fain O, Armengol G, Aubineau M, Blanchard-Delaunay C, Dalmas MC, De Moreuil C, Du Thanh A, Gobert D, Guez S, Hoarau C, Jaussaud R, Jeandel PY, Maillard H, Marmion N, Masseau A, Menetrey C, Ollivier Y, Pelletier F, Plu-Bureau G, Sailler L, Vincent D, Bouquillon B, Verdier E, Clerson P, Boccon-Gibod I, Launay D. Long-term prophylaxis in hereditary angioedema management: Current practices in France and unmet needs. Allergy Asthma Proc 2022; 43:406-412. [PMID: 35868842 DOI: 10.2500/aap.2022.43.220046] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Hereditary angioedema (HAE) is characterized by unpredictable and potentially life-threatening attacks of cutaneous and submucosal swelling. Over the past decade, new agents, based on a better understanding of the underlying biologic mechanisms of HAE, have changed the face of long-term prophylaxis (LTP). Objective: The objective was to describe current practices and unmet needs with regard to LTP for HAE in expert centers in France. Methods: The study was conducted in France in 2020. Based on their experience with patients with HAE who had visited their center at least once in the past 3 years, physicians from 25 centers who are expert in the management of HAE were requested to fill in a questionnaire that encapsulated their active patient list, criteria for prescribing LTP, and medications used. They were asked about potential unmet needs with currently available therapies. They were asked to express their expectations with regard to the future of HAE management. Results: Analysis was restricted to 20 centers that had an active patient file and agreed to participate. There were 714 patients with C1 inhibitor (C1-INH) deficiency, of whom 423 (59.2%) were treated with LTP. Altered quality of life triggered the decision to start LTP, as did the frequency and severity of attacks. Ongoing LTP included androgens (28.4%), progestins (25.8%), lanadelumab (25.3%), tranexamic acid (14.2%), intravenous C1-INHs (5.6%), and recombinant C1-INH (0.7%). Twenty-nine percent of the patents with LTP were considered to still have unmet needs. Physicians' concerns varied among therapies: poor tolerability for androgens and progestins, a lack of efficacy for tranexamic acid and progestins, dosage form, and high costs for C1-INHs and lanadelumab. Physicians' expectations encompassed more-efficacious and better-tolerated medications, easier treatment administration for the sake of improved quality of life of patients, and less-expensive therapies. Conclusion: Despite the recent enrichment of the therapeutic armamentarium for LTP, physicians still expressed unmet needs with currently available therapies.
Collapse
Affiliation(s)
- Laurence Bouillet
- From the National Reference Center for Angioedema (CREAK), Department of Internal Medicine, Grenoble Alpes University, Laboratoire T-RAIG, UMR 5525 TIMC-IMAG (UGA-CNRS), Grenoble, France
| | - Olivier Fain
- Department of Internal Medicine, Sorbonne University, AP-HP, Saint Antoine Hospital, Paris, France
| | - Guillaume Armengol
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
| | - Magali Aubineau
- Department of Internal Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, France
| | | | - Marie-Caroline Dalmas
- Department of Internal Medicine, Hautepierre Hospital, Strasbourg University Hospital, France
| | - Claire De Moreuil
- Department of Internal Medicine, La Cavale Blanche University Hospital, Brest, France
| | - Aurélie Du Thanh
- Department of Dermatology, University Montpellier, Montpellier, France
| | - Delphine Gobert
- Department of Internal Medicine, Sorbonne University, AP-HP, Saint Antoine Hospital, Paris, France
| | - Stéphane Guez
- Allergy Diseases Unit, Internal Medicine and Post-Emergency, GH Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - Cyrille Hoarau
- Transversal Unit of Allergology and Clinical Immunology, Medicine Department, Tours Regional University Hospital, Tours University, France
| | - Roland Jaussaud
- Department of Internal Medicine and Clinical Immunology, Lorraine University, CHRU-Nancy, Nancy, France
| | - Pierre-Yves Jeandel
- Department of Internal Medicine, Nice University Hospital Center, Côte d'Azur University, Nice, France
| | - Hervé Maillard
- Dermatology Department, Le Mans Regional Hospital, Le Mans, France
| | - Nicolas Marmion
- Department of Medicine, Saint Louis University Hospital, Saint Pierre, Réunion
| | - Agathe Masseau
- Department of Internal Medicine, Nantes University Hospital, Nantes, France
| | | | - Yann Ollivier
- Department of Immuno-Allergology, Caen University Hospital, Caen, France
| | - Fabien Pelletier
- Department of Internal Medicine, Besancon University Hospital, Besancon, France
| | - Geneviève Plu-Bureau
- Department of Gynecology Obstetrics and Reproductive Medicine, Cochin University Hospital, Paris, France
| | - Laurent Sailler
- Internal Medicine, University Hospital Center Toulouse, Toulouse, France
| | - Denis Vincent
- Department of Internal Medicine, Nîmes University Hospital, Nîmes, France
| | | | | | | | - Isabelle Boccon-Gibod
- Department of Internal Medicine, CREAK, ACARE Center of Excellence, Grenoble Alpes University Hospital, France, and
| | - David Launay
- Department of Internal Medicine and Clinical Immunology, Lille University, Inserm, Lille University Hospital, CREAK, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| |
Collapse
|
47
|
Djouina M, Vignal C, Dehaut A, Caboche S, Hirt N, Waxin C, Himber C, Beury D, Hot D, Dubuquoy L, Launay D, Duflos G, Body-Malapel M. Oral exposure to polyethylene microplastics alters gut morphology, immune response, and microbiota composition in mice. Environ Res 2022; 212:113230. [PMID: 35398082 DOI: 10.1016/j.envres.2022.113230] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
The ubiquitous and growing presence of microplastics (MPs) in all compartments of the environment raises concerns about their possible harmful effects on human health. Human exposure to MPs occurs largely through ingestion. Polyethylene (PE) is widely employed for reusable bags and food packaging and found to be present in drinking water and food. It is also one of the major polymers detected in human stool. The aim of this study was to characterize the effects of intestinal exposure to PE MPs on gut homeostasis. Mice were orally exposed for 6 weeks to PE microbeads of 2 different sizes, 36 and 116 μm, that correspond to those found in human stool. They were administrated either individually or as a mixture at a dose of 100 μg/g of food. Both PE microbead sizes were detected in mouse stool. Different parameters related to major intestinal functions were compared between control mice, mice exposed to each type of microbead, or co-exposed to the 2 types of microbeads. Intestinal disturbances were observed after individual exposure to each size of PE microbead, and the most marked deleterious effects were found in co-exposed mice. At the histomorphological level, crypt depth was increased throughout the intestinal tissues. Significant variations of gene expression related to epithelial, permeability, and inflammatory biomarkers were quantified. Defective recruitment of some intestinal immune cells was observed from the proximal portion of the small intestine to the colon. Several bacterial taxa at the order level were found to be affected by exposure to the MPs by metagenomic analysis of cecal microbiota. These results show that ingestion of PE microbeads induces significant alterations of crucial intestinal markers in mice and underscores the need to further study the health impact of MP exposure in humans.
Collapse
Affiliation(s)
- Madjid Djouina
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Cécile Vignal
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Alexandre Dehaut
- ANSES - Laboratoire de Sécurité des Aliments, 6 Boulevard Du Bassin Napoléon, 62200, Boulogne-sur-Mer, France
| | - Ségolène Caboche
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR2014 - US41 - PLBS-Plateformes Lilloises de Biologie & Santé, F-59000, Lille, France
| | - Nell Hirt
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Christophe Waxin
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Charlotte Himber
- ANSES - Laboratoire de Sécurité des Aliments, 6 Boulevard Du Bassin Napoléon, 62200, Boulogne-sur-Mer, France
| | - Delphine Beury
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR2014 - US41 - PLBS-Plateformes Lilloises de Biologie & Santé, F-59000, Lille, France
| | - David Hot
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR2014 - US41 - PLBS-Plateformes Lilloises de Biologie & Santé, F-59000, Lille, France
| | - Laurent Dubuquoy
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, U1286- INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Guillaume Duflos
- ANSES - Laboratoire de Sécurité des Aliments, 6 Boulevard Du Bassin Napoléon, 62200, Boulogne-sur-Mer, France
| | - Mathilde Body-Malapel
- ANSES - Laboratoire de Sécurité des Aliments, 6 Boulevard Du Bassin Napoléon, 62200, Boulogne-sur-Mer, France.
| |
Collapse
|
48
|
Chikhoune L, Brousseau T, Morell-Dubois S, Farhat MM, Maillard H, Ledoult E, Lambert M, Yelnik C, Sanges S, Sobanski V, Hachulla E, Launay D. Association between Routine Laboratory Parameters and the Severity and Progression of Systemic Sclerosis. J Clin Med 2022; 11:jcm11175087. [PMID: 36079017 PMCID: PMC9457158 DOI: 10.3390/jcm11175087] [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: 07/04/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Systemic sclerosis (SSc) is a heterogeneous connective tissue disease with a high mortality and morbidity rate. Identification of biomarkers that can predict the evolution of SSc is a key factor in the management of patients. The aim of this study was to assess the association of routine laboratory parameters, widely used in practice and easily available, with the severity and progression of SSc. (2) Methods: In this retrospective monocentric cohort study, 372 SSc patients were included. We gathered clinical and laboratory data including routine laboratory parameters: C-reactive-protein (CRP), erythrocyte sedimentation rate (ESR), complete blood count, serum sodium and potassium levels, creatinin, urea, ferritin, albumin, uric acid, N-terminal pro-brain natriuretic peptide (NTproBNP), serum protein electrophoresis, and liver enzymes. Associations between these routine laboratory parameters and clinical presentation and outcome were assessed. (3) Results: Median (interquartile range) age was 59.0 (50.0; 68.0) years. White blood cell, monocyte, and neutrophil absolute counts were significantly higher in patients with diffuse cutaneous SSc and with interstitial lung disease (ILD) (p < 0.001). CRP was significantly higher in patients with ILD (p < 0.001). Hemoglobin and ferritin were significantly lower in patients with pulmonary hypertension (PH) including pulmonary arterial hypertension and ILD associated PH (p = 0.016 and 0.046, respectively). Uric acid and NT pro BNP were significantly higher in patients with PH (<0.001). Monocyte count was associated with ILD progression over time. (4) Conclusions: Overall, our study highlights the association of routine laboratory parameters used in current practice with the severity and progression of SSc.
Collapse
Affiliation(s)
- Liticia Chikhoune
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
| | - Thierry Brousseau
- CHU Lille, Service de Biochimie Automatisée Protéines, F-59000 Lille, France
| | - Sandrine Morell-Dubois
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
| | - Meryem Maud Farhat
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
- U1286—INFINITE—Institute for Translational Research in Inflammation, Université de Lille, F-59000 Lille, France
- Inserm, F-59000 Lille, France
| | - Helene Maillard
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
| | - Emmanuel Ledoult
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
- U1286—INFINITE—Institute for Translational Research in Inflammation, Université de Lille, F-59000 Lille, France
- Inserm, F-59000 Lille, France
| | - Marc Lambert
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
| | - Cecile Yelnik
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
| | - Sebastien Sanges
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
- U1286—INFINITE—Institute for Translational Research in Inflammation, Université de Lille, F-59000 Lille, France
- Inserm, F-59000 Lille, France
| | - Vincent Sobanski
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
- U1286—INFINITE—Institute for Translational Research in Inflammation, Université de Lille, F-59000 Lille, France
- Inserm, F-59000 Lille, France
| | - Eric Hachulla
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
- U1286—INFINITE—Institute for Translational Research in Inflammation, Université de Lille, F-59000 Lille, France
- Inserm, F-59000 Lille, France
| | - David Launay
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France
- U1286—INFINITE—Institute for Translational Research in Inflammation, Université de Lille, F-59000 Lille, France
- Inserm, F-59000 Lille, France
- Correspondence: ; Tel.: +33-3-2044-4433
| |
Collapse
|
49
|
Perrard N, Pokeerbux MR, Quesnel B, Duployez N, Fenwarth L, Preudhomme C, Lefèvre G, Baillet C, Launay D, Terriou L. [GATA2 gene mutations: 3 cases]. Rev Med Interne 2022; 43:677-682. [PMID: 36041908 DOI: 10.1016/j.revmed.2022.08.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Heterozygous germline mutations of GATA2 gene (guanine-adenine-thymine-adenine binding protein 2) are hereditary mutations that can be pathogenic, sometimes occurring sporadically, responsible for a florid clinical-biological picture, sometimes serious and quickly leading to the death. CASE REPORTS We reported two women and one man with germline mutations in the GATA2 gene. The first patient, aged 19, initially presented with monocytopenia and chronic lymphedema of the four limbs, suggestive of Emberger syndrome. The second patient, 28-years-old, presented with a disseminated atypical mycobacterium (Mycobacterium kansasii) infection, raising suspicion of an immune deficiency such as MonoMAC syndrome (deficiency syndrome of dendritic cells, monocytes, B lymphocytes and NK cells). The last patient, 30-years-old, presented with pancytopenia, leading to the diagnosis of a family form of myelodysplastic syndromes and acute myeloid leukemia characterized by a mutation of the GATA2 gene. CONCLUSIONS Each case illustrates a typical clinical presentation of GATA2 deficiency, although the evolution of these syndromes ultimately reveals a complex, heterogeneous and intricate picture of hematological, dermatological, infectious, pulmonary, ENT or oncological symptoms. Mutations in the GATA2 gene remain a diagnostic and therapeutic challenge for the internist, and require multidisciplinary management given the florid picture that can be of interest to all specialties. The clinical spectrum of these GATA2 mutations as well as the latest management recommendations from the recent litterature and the "GATA2 club" are described in this article.
Collapse
Affiliation(s)
- N Perrard
- U1286 - INFINITE - Institute for translational research in inflammation, university Lille, 59000 Lille, France; Inserm, 59000 Lille, France; Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des maladies autoimmunes et autoinflammatoires rares (CERAINO), 59000 Lille, France.
| | - M R Pokeerbux
- Service de médecine, clinique Sainte-Clotilde, 97400 Saint-Denis, Réunion
| | - B Quesnel
- Service des maladies du sang, CHU de Lille, Lille, France; U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, University Lille, 59000 Lille, France
| | - N Duployez
- U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, University Lille, 59000 Lille, France; Laboratoire d'hématologie, CHU Lille, 59000 Lille, France
| | - L Fenwarth
- U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, University Lille, 59000 Lille, France; Laboratoire d'hématologie, CHU Lille, 59000 Lille, France
| | - C Preudhomme
- U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, University Lille, 59000 Lille, France; Laboratoire d'hématologie, CHU Lille, 59000 Lille, France
| | - G Lefèvre
- U1286 - INFINITE - Institute for translational research in inflammation, university Lille, 59000 Lille, France; Inserm, 59000 Lille, France; Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des maladies autoimmunes et autoinflammatoires rares (CERAINO), 59000 Lille, France; Pôle de biologie-pathologie-génétique - institut d'immunologie, CHU de Lille, Lille, France
| | - C Baillet
- Médecine nucléaire et imagerie fonctionnelle, CHU de Lille, Lille, France
| | - D Launay
- U1286 - INFINITE - Institute for translational research in inflammation, university Lille, 59000 Lille, France; Inserm, 59000 Lille, France; Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des maladies autoimmunes et autoinflammatoires rares (CERAINO), 59000 Lille, France
| | - L Terriou
- U1286 - INFINITE - Institute for translational research in inflammation, university Lille, 59000 Lille, France; Inserm, 59000 Lille, France; Département de médecine interne et immunologie clinique, CHU Lille, 59000 Lille, France; Centre de référence des maladies autoimmunes et autoinflammatoires rares (CERAINO), 59000 Lille, France
| |
Collapse
|
50
|
Sanges S, Guerrier T, Duhamel A, Guilbert L, Hauspie C, Largy A, Balden M, Podevin C, Lefèvre G, Jendoubi M, Speca S, Hachulla É, Sobanski V, Dubucquoi S, Launay D. Soluble markers of B cell activation suggest a role of B cells in the pathogenesis of systemic sclerosis-associated pulmonary arterial hypertension. Front Immunol 2022; 13:954007. [PMID: 35967377 PMCID: PMC9374103 DOI: 10.3389/fimmu.2022.954007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Soluble markers of B cell activation are interesting diagnostic and prognostic tools in autoimmune diseases. Data in systemic sclerosis (SSc) are scarce and few studies focused on their association with disease characteristics. Methods 1. Serum levels of 14 B cell biomarkers (β2-microglobulin, rheumatoid factor (RF), immunoglobulins (Ig) G, IgA, IgM, BAFF, APRIL, soluble (s)TACI, sBCMA sCD21, sCD23, sCD25, sCD27, CXCL13) were measured in SSc patients and healthy controls (HC). 2. Associations between these biomarkers and SSc characteristics were assessed. 3. The pathophysiological relevance of identified associations was explored by studying protein production in B cell culture supernatant. Results In a discovery panel of 80 SSc patients encompassing the broad spectrum of disease manifestations, we observed a higher frequency of RF positivity, and increased levels of β2-microglobulin, IgG and CXCL13 compared with HC. We found significant associations between several biomarkers and SSc characteristics related to disease phenotype, activity and severity. Especially, serum IgG levels were associated with pulmonary hypertension (PH); β2-microglobulin with Nt-pro-BNP and DLCO; and BAFF with peak tricuspid regurgitation velocity (TRV). In a validation cohort of limited cutaneous SSc patients without extensive ILD, we observed lower serum IgG levels, and higher β2-microglobulin, sBCMA, sCD23 and sCD27 levels in patients with pulmonary arterial hypertension (PAH). BAFF levels strongly correlated with Nt-pro-BNP levels, FVC/DLCO ratio and peak TRV in SSc-PAH patients. Cultured SSc B cells showed increased production of various angiogenic factors (angiogenin, angiopoietin-1, VEGFR-1, PDGF-AA, MMP-8, TIMP-1, L-selectin) and decreased production of angiopoietin-2 compared to HC. Conclusion Soluble markers of B cell activation could be relevant tools to assess organ involvements, activity and severity in SSc. Their associations with PAH could plead for a role of B cell activation in the pathogenesis of pulmonary microangiopathy. B cells may contribute to SSc vasculopathy through production of angiogenic mediators.
Collapse
Affiliation(s)
- Sébastien Sanges
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - Thomas Guerrier
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Institut d’Immunologie, Lille, France
| | - Alain Duhamel
- Univ. Lille, CHU Lille, ULR2694 – METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Lucile Guilbert
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Institut d’Immunologie, Lille, France
| | - Carine Hauspie
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Institut d’Immunologie, Lille, France
| | - Alexis Largy
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
| | - Maïté Balden
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Institut d’Immunologie, Lille, France
| | - Céline Podevin
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, France
| | - Guillaume Lefèvre
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Institut d’Immunologie, Lille, France
| | - Manel Jendoubi
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
| | - Silvia Speca
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
| | - Éric Hachulla
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - Vincent Sobanski
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - Sylvain Dubucquoi
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Institut d’Immunologie, Lille, France
| | - David Launay
- Univ. Lille, U1286 – INFINITE – Institute for Translational Research in Inflammation, Lille, France
- INSERM, Lille, France
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, France
- Centre National de Référence Maladies Auto-immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| |
Collapse
|