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Dreux S, Rosenblatt J, Massardier J, Benachi A, Voirin-Mathieu E, Muller F. Very elevated hCGβ (≥10 multiple of the median) in maternal marker screening for Down syndrome: Frequency, etiologies, outcomes, and guidelines. Prenat Diagn 2024. [PMID: 38757850 DOI: 10.1002/pd.6588] [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: 02/06/2024] [Revised: 04/04/2024] [Accepted: 05/05/2024] [Indexed: 05/18/2024]
Abstract
AIM This aim of this study was to detail maternal and fetal anomalies observed on a national scale in a large French cohort of patients presenting high hCG values (≥10 multiple of the median [MoM]) at Down syndrome screening in order to define clear and optimal guidelines. METHODS This is a retrospective multicenter study based on a French annual database of all trisomy 21 screenings. Our study targeted and studied cases with hCG or hCGβ values ≥10 MoM. Complementary exams and outcomes were analyzed. RESULTS The calculated frequency was 0.05% for hCGβ ≥10 MoM in unselected patients. For this series of 289 cases, a complication of the pregnancy or a poor outcome was observed in 145 cases (51%) as follows: 96 (66%) cases of fetal disease, 23 (16%) of maternal disease, 5 (3.5%) of placental anomalies and 21 (14.5%) of systemic disease concerning mother, fetus and placenta. CONCLUSION This study establishes the frequency of hCG or hCGβ values ≥10 MoM, presents a flow chart that optimizes follow-up, and gives clear information for patients presenting with such abnormal values at trisomy 21 screening.
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Affiliation(s)
- Sophie Dreux
- Biochimie-Hormonologie, Hôpital R. Debré, DMU Biogem AP-HP, Paris, France
- Fédération des CPDPN, Paris, France
| | - Jonathan Rosenblatt
- Fédération des CPDPN, Paris, France
- Gynécologie-Obstétrique, Hôpital Robert Debré, AP-HP, Paris, France
| | - Jérôme Massardier
- Fédération des CPDPN, Paris, France
- Gynécologie-Obstétrique, HFME, Hospices Civils de Lyon, Lyon, France
- Centre Français de Référence des Maladies Trophoblastiques, Pierre Bénite, France
| | - Alexandra Benachi
- Fédération des CPDPN, Paris, France
- Gynécologie-Obstétrique, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay Clamart, Paris, France
| | | | - Françoise Muller
- Biochimie-Hormonologie, Hôpital R. Debré, DMU Biogem AP-HP, Paris, France
- Fédération des CPDPN, Paris, France
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2
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Mangione R, Voirin-Mathieu E, Yvert M, Fries N, Mousty E, Castaigne V, Muller F, Dreux S. Fetal intestinal loop dilatation: Follow-up and outcome of a series of 133 consecutive cases (the DILDIG study). Prenat Diagn 2023; 43:328-338. [PMID: 36604769 DOI: 10.1002/pd.6300] [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: 07/26/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To define the prognostic markers of fetal dilated bowel loops. METHODS National non-interventional study of 133 consecutive prenatal observations of dilated loops including ultrasound examinations, complementary laboratory tests, magnetic resonance imaging (MRI), outcomes, and postnatal diagnosis. RESULTS One hundred twenty seven cases were classified according to outcome: Group 1, very severe (n = 43), Group 2, children needing specific care (n = 39), and Group 3, healthy children (n = 45). Prenatal ultrasound scan suggested duodenal obstruction in 30 cases, small bowel obstruction in 81, colonic obstruction in 11, and diffuse dilatation in 5. Diameter of dilated loops did not significantly differ between the groups. A poor prognosis was significantly associated with duodenal obstruction, genetic anomalies (53% vs. 21.8%), including aneuploidies or CFTR gene mutations and abnormal amniotic fluid biochemistry (86.4% vs. 38.7%). A good prognosis was associated with regression of dilatation and normal MRI. CONCLUSION In this study, postnatal outcomes for fetuses with intestinal dilatation were best predicted by assessing the level of obstruction with prenatal ultrasound and MRI, determining the presence of associated malformations, amniotic fluid biochemical and genetic testing, and monitoring for regression of bowel dilatation. These results should help inform future guidelines on the prenatal and neonatal management of congenital intestinal obstruction.
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Affiliation(s)
- Raphaële Mangione
- Collège Français d'Echographie Fœtale, CFEF, Paris, France.,Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France.,Imagerie de la Femme, Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France
| | | | - Marianne Yvert
- Collège Français d'Echographie Fœtale, CFEF, Paris, France.,Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France.,Diagnostic Prénatal, Maison de Santé Protestante Bagatelle, Talence, France
| | - Nicolas Fries
- Collège Français d'Echographie Fœtale, CFEF, Paris, France
| | - Eve Mousty
- Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France.,Gynécologie Obstétrique, CPDPN, CHU Nimes, Nimes, France
| | - Vanina Castaigne
- Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France.,Gynécologie Obstétrique, Hôpital Intercommunal de Créteil, Créteil, France
| | - Françoise Muller
- Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France.,Biochimie Foetale, Hôpital Robert Debré, DMU BioGeM, AP-HP, Paris, France
| | - Sophie Dreux
- Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France.,Biochimie Foetale, Hôpital Robert Debré, DMU BioGeM, AP-HP, Paris, France
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Muller F, Warshaviak D, Gyuris J, Nir R, Baloglu E, Shacham S, Morley A, Depinho R. A family of novel TEAD palmitoylation site inhibitors with exceptional pre-clinical anti-neoplastic activity as a monotherapy and in combination with MAPK inhibitors. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00907-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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4
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Hoel H, Heggelund L, Reikvam DH, Stiksrud B, Ueland T, Michelsen AE, Otterdal K, Muller KE, Lind A, Muller F, Dudman S, Aukrust P, Dyrhol-Riise AM, Holter JC, Trøseid M. Elevated markers of gut leakage and inflammasome activation in COVID-19 patients with cardiac involvement. J Intern Med 2021; 289:523-531. [PMID: 32976665 PMCID: PMC7536991 DOI: 10.1111/joim.13178] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND A high proportion of COVID-19 patients have cardiac involvement, even those without known cardiac disease. Downregulation of angiotensin converting enzyme 2 (ACE2), a receptor for SARS-CoV-2 and the renin-angiotensin system, as well as inflammatory mechanisms have been suggested to play a role. ACE2 is abundant in the gut and associated with gut microbiota composition. We hypothesized that gut leakage of microbial products, and subsequent inflammasome activation could contribute to cardiac involvement in COVID-19 patients. METHODS Plasma levels of a gut leakage marker (LPS-binding protein, LBP), a marker of enterocyte damage (intestinal fatty acid binding protein, IFABP), a gut homing marker (CCL25, ligand for chemokine receptor CCR9) and markers of inflammasome activation (IL-1β, IL-18 and their regulatory proteins) were measured at three time points (day 1, 3-5 and 7-10) in 39 hospitalized COVID-19 patients and related to cardiac involvement. RESULTS Compared to controls, COVID-19 patients had elevated plasma levels of LBP and CCL25 but not IFABP, suggesting impaired gut barrier function and accentuated gut homing of T cells without excessive enterocyte damage. Levels of LBP were twice as high at baseline in patients with elevated cardiac markers compared with those without and remained elevated during hospitalization. Also, markers of inflammasome activation were moderately elevated in patients with cardiac involvement. LBP was associated with higher NT-pro-BNP levels, whereas IL-18, IL-18BP and IL-1Ra were associated with higher troponin levels. CONCLUSION Patients with cardiac involvement had elevated markers of gut leakage and inflammasome activation, suggestive of a potential gut-heart axis in COVID-19.
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Affiliation(s)
- H Hoel
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Lovisenberg Diaconal Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - L Heggelund
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - D H Reikvam
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - B Stiksrud
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - T Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway
| | - A E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - K Otterdal
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - K E Muller
- Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - A Lind
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - F Muller
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - S Dudman
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - P Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - A M Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - J C Holter
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - M Trøseid
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
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5
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Koch A, Favre R, Weingertner AS, Zaloszyc A, Kohler M, Guerra F, Rosenblatt J, Muller F, Dreux S, Sananès N. Evaluation of Sequential Urine Analysis when Selecting Candidates for Vesicoamniotic Shunting in Lower Urinary Tract Obstruction. Fetal Diagn Ther 2021; 48:265-271. [PMID: 33756463 DOI: 10.1159/000514911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/31/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of our study was to assess the utility of sequential fetal urine analysis in severe lower urinary tract obstruction (LUTO) when selecting cases suitable for vesicoamniotic shunting. MATERIAL AND METHODS This was a retrospective cohort study of cases of severe LUTO treated in our fetal medicine center from 1994 to 2013. Two fetal bladder samples were taken 24-48 h apart to assess renal function. A vesicoamniotic shunt was inserted in case of improvement in urinary biochemistry between the 2 samples. We assessed perinatal morbidity and mortality and renal function at 5 years. RESULTS Among a total of 26 LUTO cases with sequential urine analysis, 5 showed normal urinary biochemistry, 13 were abnormal, and 8 improved between the 2 samples. These 8 cases underwent vesicoamniotic shunt placement, leading to the birth of 6/8 (75%) live infants, 5/6 (83%) of whom had normal renal function at 5 years. The 5 cases with normal biochemistry occasioned 2 neonatal deaths and 3 children with normal renal function at 5 years. Elective termination of pregnancy was requested by parents for the fetuses exhibiting abnormal biochemistry. CONCLUSION An improvement in urinary biochemistry between 2 sequential fetal bladder punctures in severe LUTO could be an effective criterion in the selection of candidates for vesicoamniotic shunting. However, the benefit of a shunt in fetuses with normal amniotic fluid remains to be evaluated in clinical trials.
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Affiliation(s)
- Antoine Koch
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France,
| | - Romain Favre
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | | | - Ariane Zaloszyc
- Pediatric Nephrology Department, Strasbourg University Hospital, Strasbourg, France
| | - Monique Kohler
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | - Fernando Guerra
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | - Jonathan Rosenblatt
- Maternal Fetal Medicine Department, Robert Debré Hospital, AP-HP, Paris, France
| | - Françoise Muller
- Biochemistry-Hormonology Department, Robert Debré Hospital, AP-HP, Paris, France
| | - Sophie Dreux
- Biochemistry-Hormonology Department, Robert Debré Hospital, AP-HP, Paris, France
| | - Nicolas Sananès
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France.,INSERM, UMR-S 1121, "Biomatériaux et Bioingénierie", Strasbourg, France
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6
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Rabialahy A, Muller L, Gendarme S, Minary L, Berndt N, Muller F, Vaillant S, Eby E, Rotonda C. Comment accompagner les étudiants fumeurs dans leur projet d’arrêt du tabac ? Une étude par méthode mixte. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2020.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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7
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Coudert M, Pépin M, de Thezy A, Fercot E, Laycuras M, Coudert AL, Duran C, Bouchand F, Davido B, Le Crane M, Denis B, Muller F, Gourdon M, Peng CL, Mahamdia R, Mekerta Z, Seridi Z, Gaillard JL, Leichowski L, Moulias S, Rottman M, Sivadon-Tardy V, Teillet L, Dinh A. Présentation clinique et performance de la bandelette urinaire pour le diagnostic d’infection urinaire en population gériatrique. Rev Med Interne 2019; 40:714-721. [DOI: 10.1016/j.revmed.2019.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 06/12/2019] [Accepted: 06/17/2019] [Indexed: 11/30/2022]
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8
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Luton D, Mitanchez D, Winer N, Muller F, Gallot D, Perrotin F, Jouannic JM, Bretelle F, de Lagausie P, Ville Y, Guibourdenche J, Oury JF, Alberti C, Benachi A. A randomised controlled trial of amnioexchange for fetal gastroschisis. BJOG 2019; 126:1233-1241. [PMID: 31033140 DOI: 10.1111/1471-0528.15804] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Morbidity in fetuses affected by gastroschisis is mainly the result of bowel ischaemic and inflammatory processes. Experimental studies on animal models show that clearing amniotic fluid from the digestive secretions by amnioexchange procedures reduces the inflammatory process. We evaluated the benefit of the amnioexchange procedure for fetal gastroschisis in humans. DESIGN Prospective, interventional, randomised study. SETTING Eight referral centres for fetal medicine. POPULATION Pregnant women carrying a fetus with gastroschisis. METHODS We compared, in utero, amnioexchange with a sham procedure. The protocol included, in both arms, steroid injections at 30 weeks of gestation and the use of postnatal minimal enteral feeding. MAIN OUTCOME MEASURES The primary outcome was a composite variable based on the duration of ventilation and parenteral nutrition. Secondary outcomes were the effectiveness and safety of the amnioexchange procedure, including the rate of perinatal death, time to full enteral feeding, primary closure, and late feeding disorders. RESULTS Sixty-four patients were randomised. There was no difference in the composite criteria between the amnioexchange and control groups. Based on an intention-to-treat analysis, there were no significant between-group differences in pregnancy outcome or complications. When studying the relationship between digestive compounds and amniotic fluid inflammatory markers, a clear correlation was found between bile acid and both ferritin and interleukin 1β (IL1β). CONCLUSIONS In humans, amnioexchange, as described in our protocol, is not an option for fetal care; however, we provide supplementary proof of the involvement of inflammation in the pathogenicity of gastroschisis and suggest that future research should aim at reducing inflammation. ClinicalTrials.gov: NCT00127946. TWEETABLE ABSTRACT A prospective, interventional, randomised study shows no benefit of amnioexchange for fetal gastroschisis in humans.
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Affiliation(s)
- D Luton
- Department of Obstetrics and Gynaecology, AP-HP, Bichat Hospital, Paris, France.,DHU Risks in Pregnancy, Paris, France.,Department of Obstetrics and Gynaecology, AP-HP, Bichat-Claude Bernard Hospital, Paris, France.,Université Paris VII, Paris Diderot, Sorbonne Paris Cité, Paris, France.,INSERM U1141, Robert-Debré Hospital, Paris, France
| | - D Mitanchez
- Department of Neonatal Pediatrics, AP-HP, GHUEP, Armand Trousseau Hospital, Paris, France.,Faculty of Medicine, Sorbonne University, Paris, France
| | - N Winer
- Department of Obstetrics and Gynaecology, University Hospital of Nantes, CIC Mère enfant Nantes, UMR 1280 INRA Physiologie des Adaptations Nutritionnelles, Nantes, France
| | - F Muller
- INSERM U1141, Robert-Debré Hospital, Paris, France.,Department of Biochemistry and Hormonology, AP-HP, Robert Debré Hospital, Paris, France
| | - D Gallot
- Department of Obstetrics and Gynaecology, CHU de Clermont-Ferrand - Hôpital d'Estaing, Auvergne University, Clermont-Ferrand, France
| | - F Perrotin
- Department of Obstetrics and Gynaecology, CHRU de Tours, François Rabelais University, Tours, France
| | - J-M Jouannic
- Department of Obstetrics and Gynaecology, Faculty of Medicine, AP-HP, Armand Trousseau Hospital, Sorbonne University, Paris, France
| | - F Bretelle
- Department of Obstetrics and Gynaecology, CHU de Marseille, APHM, Aix Marseille University, Marseille, France
| | - P de Lagausie
- INSERM U1141, Robert-Debré Hospital, Paris, France.,Department of Paediatrics Surgery, AP-HP, Robert Debré Hospital, Paris, France
| | - Y Ville
- Department of Obstetrics and Gynaecology, AP-HP, Necker-Enfants Malades, Paris Descartes University, Paris, France
| | - J Guibourdenche
- Department of Biochemistry and Hormonology, AP-HP, Robert Debré Hospital, Paris, France
| | - J-F Oury
- Department of Obstetrics and Gynaecology, AP-HP, Robert Debré Hospital, Paris, France
| | - C Alberti
- INSERM U1141, Robert-Debré Hospital, Paris, France.,AP-HP, Inserm, Univ. Paris Diderot, Univ. Sorbonne Paris Cité, Robert Debré Hospital, CIC 1426, UMR-S 1123, Paris, France
| | - A Benachi
- Department of Obstetrics and Gynaecology, AP-HP, Antoine Béclère Hospital, Paris-Sud University, Clamart, France
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Muller F, Burbeau A, Gréa BJ, Sagaut P. Minimum enstrophy principle for two-dimensional inviscid flows around obstacles. Phys Rev E 2019; 99:023105. [PMID: 30934294 DOI: 10.1103/physreve.99.023105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Indexed: 11/07/2022]
Abstract
Large-scale coherent structures emerging in two-dimensional flows can be predicted from statistical physics inspired methods consisting in minimizing the global enstrophy while conserving the total energy and circulation in the Euler equations. In many situations, solid obstacles inside the domain may also constrain the flow and have to be accounted for via a minimum enstrophy principle. In this work, we detail this extended variational formulation and its numerical resolution. It is shown from applications to complex geometries containing multiple circular obstacles that the number of solutions is enhanced, allowing many possibilities of bifurcations for the large-scale structures. These phase change phenomena can explain the downstream recombinations of the flow in rod-bundle experiments and simulations.
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Affiliation(s)
- F Muller
- CEA Saclay, DEN, DM2S/STMF, F-91191 Gif/Yvette, France
| | - A Burbeau
- CEA Saclay, DEN, DM2S/STMF, F-91191 Gif/Yvette, France
| | - B-J Gréa
- CEA, DAM, DIF, F-91297 Arpajon, France
| | - P Sagaut
- Aix Marseille Univ, CNRS, Centrale Marseille, M2P2 UMR 7340, 13451 Marseille, France
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Buffin-Meyer B, Klein J, Breuil B, Muller F, Moulos P, Groussolles M, Bouali O, Bascands J, Decramer S, Schanstra J. Combinaison des métabolome et peptidome urinaires fœtaux pour prédire in utero la fonction rénale postnatale des fœtus porteurs de valves de l’urètre postérieure. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Buffin-Meyer B, Klein J, Breuil B, Muller F, Moulos P, Groussolles M, Bouali O, Bascands JL, Decramer S, Schanstra JP. Combination of the fetal urinary metabolome and peptidome for the prediction of postnatal renal outcome in fetuses with PUV. J Proteomics 2018; 184:1-9. [PMID: 29929039 DOI: 10.1016/j.jprot.2018.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 04/26/2018] [Revised: 06/11/2018] [Accepted: 06/16/2018] [Indexed: 01/15/2023]
Abstract
Most of biomarker panels, extracted from single omics traits, still need improvement since they display a gray zone where prediction is uncertain. Here we verified whether a combination of omics traits, fetal urinary metabolites and peptides analyzed in the same sample, improved prediction of postnatal renal function in fetuses with posterior urethral valves (PUV) compared to individual omics traits. Using CE-MS, we explored the urinary metabolome of 13 PUV fetuses with end stage renal disease (ESRD) and 12 PUV fetuses without postnatal ESRD at 2 years postnatally. This allowed the selection of 24 differentially abundant metabolite features which were modelled into predictive classifiers, alone or in combination with 12 peptides previously identified as predictive of ESRD. Validation in 35 new fetuses showed that the combination of peptides and metabolites significantly outperformed the 24 metabolite features with increased AUC (0.987 vs 0.905), net reclassification improvement (36%) and better sensitivity accuracy (86% vs 60%). In addition, the two trait combination tended to improve, but without reaching statistical significance, the already high performances of the 12 peptide biomarkers (AUC 0.967, accuracy 80%). In conclusion, this study demonstrates the potential of cumulating different omics traits in biomarker research where single omics traits fall short. SIGNIFICANCE Although increasingly proposed in disease-diagnosis and -prognosis because of their improved efficacy over single markers, panels of body fluid biomarkers based on single omics analysis still fail to display perfect accuracy, probably due to biological variability. Here, we hypothesized that combination of different omics traits allowed to better capture this biological variability. As proof of concept, we studied the added value of fetal urine metabolites and peptides using CE-MS, starting from the same urine sample, to predict postnatal renal outcome in fetuses with posterior urethral valves. We observed that the prognostic power of combined metabolite and peptide markers was clearly higher than that of metabolites alone and slightly, but non-significantly, improved compared to the peptides alone. To our knowledge, this report is the first to demonstrate that combining multiomics traits extracted from (fetal) urine samples displays clear promise for kidney disease stratification.
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Affiliation(s)
- Bénédicte Buffin-Meyer
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France; Université Toulouse III Paul-Sabatier, Toulouse, France.
| | - Julie Klein
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Benjamin Breuil
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Françoise Muller
- CHU Paris, Hôpital Robert Debré, Laboratoire de Biochimie-Hormonologie, Paris, France
| | | | - Marion Groussolles
- CHU Toulouse, Hôpital Paule de Viguier, Service d'Echographie et Diagnostic prénatal, Toulouse, France; INSERM, U1027, Toulouse, France
| | - Ourdia Bouali
- CHU Toulouse, Hôpital des Enfants, Service de Chirurgie viscérale, Toulouse, France
| | - Jean-Loup Bascands
- INSERM, U1188, Sainte Clotilde/La Réunion, France; Université de La Réunion, Sainte Clotilde/La Réunion, France
| | - Stéphane Decramer
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France; Université Toulouse III Paul-Sabatier, Toulouse, France; CHU Toulouse, Hôpital des Enfants, Service de Néphrologie - Médecine Interne - Hypertension Pédiatrique, Toulouse, France
| | - Joost P Schanstra
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France; Université Toulouse III Paul-Sabatier, Toulouse, France.
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12
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Rosenblatt J, Dreux S, Spaggiari E, Morin C, Allaf B, Valat AS, Halim D, Oury JF, Muller F. Prenatal diagnosis of megacystis microcolon intestinal hypoperistalsis syndrome by biochemical analysis of fetal urine. Prenat Diagn 2018; 38:585-590. [PMID: 29752823 DOI: 10.1002/pd.5283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/18/2018] [Accepted: 05/01/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The objective of the study is to determine a model of fetal urine biochemical markers to differentiate megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) from other megacystis. METHOD This is a retrospective study of biochemical analysis of fetal urine in patients who presented prenatally with megacystis. We studied β2-microglobulin, sodium, calcium, and phosphorus. Twenty-six patients subsequently diagnosed with MMIHS were compared with 2 control groups: one of end-stage renal failure (64 fetuses) and the second of "good" postnatal renal function (control group, 64 fetuses). RESULTS Mean fetal urine β2-microglobulin was significantly higher (P < .001) in end-stage renal failure (15.7 mg/L) than in MMIHS (2.2 mg/L) and the control group (3.2 mg/L). Fetal urine profiles differed significantly (P < .001) between MMIHS and the control group: median sodium 46.5 and 51 mmol/L, median calcium 1.12 and 0.73 mmol/L, and median phosphorus 0.03 and 0.15 mmol/L respectively. Fetal urinary ionic index [ratio: calcium / (phosphorus × sodium)] gave an area under the ROC curve of 0.86, at 54% sensitivity and 97% specificity, with correct classification in 84% of cases. We defined a nomogram to obtain a probability for MMIHS. CONCLUSION Fetal urinalysis can be helpful in prenatal differentiation of MMIHS from posterior urethral valves with good postnatal renal function.
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Affiliation(s)
- Jonathan Rosenblatt
- Gynecologie-Obstétrique, Hôpital Universitaire Robert Debré, APHP, Paris, France
| | - Sophie Dreux
- Biochimie-Hormonologie, Hôpital Universitaire Robert Debré, APHP, Paris, France
| | | | - Cécile Morin
- Gynecologie-Obstétrique, Hôpital Universitaire Robert Debré, APHP, Paris, France
| | - Bichr Allaf
- Biochimie-Hormonologie, Hôpital Universitaire Robert Debré, APHP, Paris, France
| | - Anne Sylvie Valat
- Gynécologie-Obstétrique, Centre Hospitalier Lens, CPDPN, Lille, France
| | - Danny Halim
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jean-François Oury
- Gynecologie-Obstétrique, Hôpital Universitaire Robert Debré, APHP, Paris, France
| | - Françoise Muller
- Biochimie-Hormonologie, Hôpital Universitaire Robert Debré, APHP, Paris, France
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Spaggiari E, Stirnemann JJ, Benedetti S, Dreux S, Salomon LJ, Blanc T, Rosenblatt J, Favre R, Ville Y, Muller F. Comparison of biochemical analysis of fetal serum and fetal urine in the prediction of postnatal renal outcome in lower urinary tract obstruction. Prenat Diagn 2018; 38:555-560. [PMID: 29644715 DOI: 10.1002/pd.5263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 02/18/2018] [Accepted: 04/02/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To compare the prognostic value of fetal serum biochemistry and fetal urine biochemistry in predicting renal outcome in lower urinary tract obstruction (LUTO). METHODS We retrospectively studied renal outcome following a prenatal diagnosis of LUTO in cases for which both fetal blood and fetal urine were sampled. We classified the renal outcome as either "favorable," when postnatal renal function was normal, or "adverse," in the case of postnatal chronic renal failure or when renal histological lesions were present at autopsy in the case of termination of pregnancy. A prognostic model was constructed for urine and serum separately. β2-Microglobulin was the only remaining independent predictor in fetal urine. β2-Microglobulin in serum and urine were compared by using receiver operating characteristic curves. RESULTS In the 50 cases included, the rate of adverse outcome was 34 of 50(68%): autopsy confirmed severity of renal disease in all 27 cases who underwent termination of pregnancy, and among the 23 live born children, 7 developed renal failure. Fetal serum and urine markers were all significantly associated with renal outcome (P < .01). The receiver operating characteristic curves for fetal serum and fetal urinary β2-microglobulin were similar (area under the curve = 0.908 versus 0.909, P = .96). CONCLUSION Fetal serum biochemistry and fetal urine biochemistry are of similar prognostic value in predicting postnatal renal outcome in fetuses with LUTO.
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Affiliation(s)
- Emmanuel Spaggiari
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Julien J Stirnemann
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - Sara Benedetti
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Sophie Dreux
- Department of Biochemistry and Hormonology, Robert Debré Hospital, AP-HP, Paris, France
| | - Laurent J Salomon
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - Thomas Blanc
- Department of Pediatric Surgery and Urology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - Jonathan Rosenblatt
- Department of Obstetrics and Gynecology, Robert Debré Hospital, AP-HP, Paris, France
| | - Romain Favre
- Obstetrics and Gynecology Department, Hautepierre and CMCO Hospital, Strasbourg, France
| | - Yves Ville
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - Françoise Muller
- Department of Biochemistry and Hormonology, Robert Debré Hospital, AP-HP, Paris, France
- University Versailles Saint-Quentin, Versailles, France
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Fries N, Salomon LJ, Muller F, Dreux S, Houfflin-Debarge V, Coquel P, Kleinfinger P, Dommergues M. Impact of a shift in nuchal translucency measurements on the detection rate of first-trimester Down syndrome screening: A population-based study. Prenat Diagn 2018; 38:106-109. [PMID: 29231978 DOI: 10.1002/pd.5193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/29/2017] [Accepted: 12/04/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the distribution of nuchal translucency (NT) measurements following a national policy without credentialing and its impact on first-trimester Down syndrome screening (DSS) detection rate. METHOD All first-trimester DSS data recorded in France (2010-2014) were collected by the laboratories in charge via an Internet database (https://www.bionuqual.org/echo.php). There was no minimal requirement for image quality to allow sonographers to enter the screening process. A subgroup of DSS with complete DS follow-up corresponded to 1614 sonographers. Based on the distribution of maternal age, DS detection rate was calculated and split as a function of the distribution of NT multiple of the median (MoM). RESULTS Four thousand nine hundred forty-three sonographers performed 2,337,372 NT measurements. Median NT expressed in MoM was 0.83. Screenings with complete follow-up consisted of 197,417 screenings, in which DSS detection rates were respectively 70.4%, 70.9%, 79.4%, 87.7%, and 79.5% for the following median NT MoM ranges: <0.7, 0.70 to 0.79, 0.80 to 0.89, 0.90 to 0.99, and >0.99 (trend χ = 12.21; P = .0158). CONCLUSION In France, following a policy of quality assessment without standardized credentialing, the distribution of NT measurements did not fit the expected distribution. Down syndrome detection rate was 10% lower in screenings by sonographers with a median NT < 0.80 MoM.
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Affiliation(s)
- Nicolas Fries
- Collège Français d'Echographie Foetale (CFEF), Montpellier, France
| | - Laurent J Salomon
- Maternité, Hôpital Necker-Enfants Malades, AP-HP, Université Paris-Descartes, Paris, France.,Collège d'Evaluation des Pratiques Professionnelles en Imagerie Médicale (CEPPIM), Paris, France
| | - Françoise Muller
- Biochimie-Hormonologie, Hôpital Robert Debré, AP-HP, Paris, France.,Association des Biologistes Agréés (ABA), Paris, France
| | - Sophie Dreux
- Biochimie-Hormonologie, Hôpital Robert Debré, AP-HP, Paris, France.,Association des Biologistes Agréés (ABA), Paris, France
| | - Véronique Houfflin-Debarge
- Département d'Obstétrique, CHU Lille, Lille, France.,Collège National des Gynécologues Obstétriciens Français (CNGOF), Paris, France
| | - Philippe Coquel
- Collège d'Evaluation des Pratiques Professionnelles en Imagerie Médicale (CEPPIM), Paris, France
| | | | - Marc Dommergues
- Gynécologie-Obstétrique, Hôpital Pitié-Salpétrière AP-HP, Paris, France.,Université Pierre et Marie Curie Paris 6, Paris, France
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15
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Bonnin A, Muller F, Senat MV, Sault C, Galland A, Taieb J, Dreux S, Bouyer J, Benachi A. Down syndrome maternal serum markers in oocyte donation and other assisted reproductive technologies. Prenat Diagn 2017; 37:1155-1159. [DOI: 10.1002/pd.5157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/06/2017] [Accepted: 09/11/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Aurore Bonnin
- Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, AP-HP; Université Paris Sud; 92140 Clamart France
| | - Françoise Muller
- Biochimie-Hormonologie; Hôpital Robert Debré, AP-HP; 75019 Paris France
| | - Marie-Victoire Senat
- Gynécologie-Obstétrique; Hôpital Bicêtre, AP-HP; 94270 Le Kremlin-Bicêtre France
| | | | | | - Joëlle Taieb
- Biochimie; Hôpital Antoine Béclère, AP-HP; 92140 Clamart France
| | - Sophie Dreux
- Biochimie-Hormonologie; Hôpital Robert Debré, AP-HP; 75019 Paris France
| | - Jean Bouyer
- Center for Research in Epidemiology and Population Health (CESP), Inserm, Univ Paris-Sud, UVSQ; Université Paris Saclay; F-94276 Le Kremlin Bicêtre France
| | - Alexandra Benachi
- Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, AP-HP; Université Paris Sud; 92140 Clamart France
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16
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Tostivint I, Royer N, Nicolas M, Bourillon A, Czerkiewicz I, Becker PH, Muller F, Benoist JF. Spectrum of mutations in cystinuria patients presenting with prenatal hyperechoic colon. Clin Genet 2017. [PMID: 28646536 DOI: 10.1111/cge.13079] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cystinuria is a heterogeneous, rare but important cause of inherited kidney stone disease due to mutations in 2 genes: SLC3A1 and SLC7A9. Antenatal hyperechoic colon (HEC) has been reported in some patients as a non-pathological consequence of the intestinal transport defect. We report 83 patients affected by cystinuria: 44 presented prenatally with a HEC (HEC group) and 39 with a classical postnatal form (CC group). SLC3A1 and SLC7A9 were sequenced. All patients were fully genotyped, and the relationship between the genotype and clinical features was analyzed. We identified mutations in SLC3A1 in 80% of the HEC group and in only 49% of the CC group. The SLC3A1 p.Thr216Met mutation was found in 21% of the alleles in the HEC group but was never found in the CC group. Most of the mutations found in the HEC group were considered severe mutations in contrast with the CC group. Twenty-five novel mutations were reported. This study shows a relationship between genotype and the clinical form of cystinuria, suggesting that only the patients with the most severe mutations presented with an HEC. These results emphasized the need for prenatal cystinuria screening using classical third-trimester ultrasound scan and the early management of suspected newborns.
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Affiliation(s)
- I Tostivint
- Department of Urology and Nephrology, Interdisciplinary Urolithiasis Center, Pitié-Salpêtrière Universitary Teaching Hospital, Paris, France
| | - N Royer
- Service de Biochimie Hormonologie, APHP, Paris, France
| | - M Nicolas
- Service de Biochimie Hormonologie, APHP, Paris, France
| | - A Bourillon
- Service de Biochimie Hormonologie, APHP, Paris, France
| | - I Czerkiewicz
- Service de Biochimie Hormonologie, APHP, Paris, France
| | - P-H Becker
- Service de Biochimie Hormonologie, APHP, Paris, France
| | - F Muller
- Service de Biochimie Hormonologie, APHP, Paris, France
| | - J-F Benoist
- Service de Biochimie Hormonologie, APHP, Paris, France
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17
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Halim D, Brosens E, Muller F, Wangler MF, Beaudet AL, Lupski JR, Akdemir ZHC, Doukas M, Stoop HJ, de Graaf BM, Brouwer RWW, van Ijcken WFJ, Oury JF, Rosenblatt J, Burns AJ, Tibboel D, Hofstra RMW, Alves MM. Loss-of-Function Variants in MYLK Cause Recessive Megacystis Microcolon Intestinal Hypoperistalsis Syndrome. Am J Hum Genet 2017; 101:123-129. [PMID: 28602422 PMCID: PMC5501771 DOI: 10.1016/j.ajhg.2017.05.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [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: 04/10/2017] [Accepted: 05/11/2017] [Indexed: 12/11/2022] Open
Abstract
Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is a congenital disorder characterized by loss of smooth muscle contraction in the bladder and intestine. To date, three genes are known to be involved in MMIHS pathogenesis: ACTG2, MYH11, and LMOD1. However, for approximately 10% of affected individuals, the genetic cause of the disease is unknown, suggesting that other loci are most likely involved. Here, we report on three MMIHS-affected subjects from two consanguineous families with no variants in the known MMIHS-associated genes. By performing homozygosity mapping and whole-exome sequencing, we found homozygous variants in myosin light chain kinase (MYLK) in both families. We identified a 7 bp duplication (c.3838_3844dupGAAAGCG [p.Glu1282_Glyfs∗51]) in one family and a putative splice-site variant (c.3985+5C>A) in the other. Expression studies and splicing assays indicated that both variants affect normal MYLK expression. Because MYLK encodes an important kinase required for myosin activation and subsequent interaction with actin filaments, it is likely that in its absence, contraction of smooth muscle cells is impaired. The existence of a conditional-Mylk-knockout mouse model with severe gut dysmotility and abnormal function of the bladder supports the involvement of this gene in MMIHS pathogenesis. In aggregate, our findings implicate MYLK as a gene involved in the recessive form of MMIHS, confirming that this disease of the visceral organs is heterogeneous with a myopathic origin.
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Affiliation(s)
- Danny Halim
- Department of Clinical Genetics, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - Françoise Muller
- Biochimie Prenatale, Hôpital Universitaire Robert Debré, 75019 Paris, France
| | - Michael F Wangler
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Childen's Hospital, Houston, TX 77030, USA
| | - Arthur L Beaudet
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Childen's Hospital, Houston, TX 77030, USA
| | - James R Lupski
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Childen's Hospital, Houston, TX 77030, USA; Baylor-Hopkins Center for Mendelian Genomics, Baylor College of Medicine, Houston, TX 77030, USA; Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Zeynep H Coban Akdemir
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Baylor-Hopkins Center for Mendelian Genomics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michael Doukas
- Department of Pathology, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - Hans J Stoop
- Department of Pathology, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - Bianca M de Graaf
- Department of Clinical Genetics, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - Rutger W W Brouwer
- Erasmus Center for Biomics, Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands
| | | | - Jean-François Oury
- Department of Obstetrics and Gynecology, Hôpital Universitaire Robert Debré, 75019 Paris, France
| | - Jonathan Rosenblatt
- Department of Obstetrics and Gynecology, Hôpital Universitaire Robert Debré, 75019 Paris, France
| | - Alan J Burns
- Department of Clinical Genetics, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands; Stem Cells and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, University College London, WC1N 1EH London, UK
| | - Dick Tibboel
- Department of Pediatric Surgery, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - Robert M W Hofstra
- Department of Clinical Genetics, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands; Stem Cells and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, University College London, WC1N 1EH London, UK.
| | - Maria M Alves
- Department of Clinical Genetics, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands.
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Vermeil C, Matheson M, Leach S, Muller F. Photo-conductivité électrique et photo-ionisation dans les diélectriques liquides. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1964610596] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Schaub B, Vouga M, Najioullah F, Gueneret M, Monthieux A, Harte C, Muller F, Jolivet E, Adenet C, Dreux S, Leparc-Goffart I, Cesaire R, Volumenie JL, Baud D. Analysis of blood from Zika virus-infected fetuses: a prospective case series. The Lancet Infectious Diseases 2017; 17:520-527. [DOI: 10.1016/s1473-3099(17)30102-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 01/22/2023]
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20
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Spaggiari E, Faure G, Dreux S, Czerkiewicz I, Stirnemann JJ, Guimiot F, Heidet L, Favre R, Salomon LJ, Oury JF, Ville Y, Muller F. Sequential fetal serum β2-microglobulin to predict postnatal renal function in bilateral or low urinary tract obstruction. Ultrasound Obstet Gynecol 2017; 49:617-622. [PMID: 27197901 DOI: 10.1002/uog.15968] [Citation(s) in RCA: 14] [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: 01/21/2016] [Revised: 05/03/2016] [Accepted: 05/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Fetal serum β2-microglobulin has been shown to predict postnatal renal outcome in cases of fetal obstructive uropathy. We assessed the value of serial measurements of fetal serum β2-microglobulin in the prediction of postnatal renal outcome. METHODS We retrospectively studied renal outcome in 42 fetuses with bilateral or low urinary tract obstruction that had fetal blood sampling on at least two occasions to assay serum levels of β2-microglobulin. Amniotic fluid volume at the time of each sampling was recorded. We classified renal outcome as either favorable (when postnatal renal function was normal) or adverse (when postnatal chronic renal failure occurred or when renal dysplasia at autopsy was noted). A β2-microglobulin cut-off of 5 mg/L and amniotic fluid index of 5 cm were used to predict postnatal renal outcome. RESULTS Renal outcome was adverse in 28 cases and favorable in 14. In 12 (28.6%) cases, fetal serum β2-microglobulin concentration differed between the first and last measurement. Prediction of postnatal renal outcome was correct in 11 of these cases based on the last β2-microglobulin measurement. The sensitivity of β2-microglobulin in predicting renal outcome was significantly higher (P = 0.005) when using the last rather than the first measurement (96.4% vs 64.3%), with similar specificity for both measurements (85.7% vs 78.6%, non-significant). The sensitivity of amniotic fluid volume was also significantly higher (P = 0.005) when using the last rather than the first measurement (75.0% vs 35.7%), with similar specificity for both measurements (64.3% vs 71.4%, non-significant). CONCLUSION Sequential measurement of serum β2-microglobulin, performed for adverse ultrasound findings, such as renal parenchymal abnormality or decreasing amniotic fluid volume, predicts postnatal renal outcome more accurately than does a single assay. This may be due to possible worsening of renal injury with increasing duration of urinary tract obstruction. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- E Spaggiari
- Department of Obstetrics and Gynecology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - G Faure
- Department of Obstetrics and Gynecology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - S Dreux
- Department of Biochemistry and Hormonology, Robert Debré Hospital, AP-HP, Paris, France
| | - I Czerkiewicz
- Department of Biochemistry and Hormonology, Robert Debré Hospital, AP-HP, Paris, France
| | - J J Stirnemann
- Department of Obstetrics and Gynecology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - F Guimiot
- Department of Developmental Biology, Robert Debré Hospital, AP-HP, Paris, France
- University Paris Diderot and Sorbonne Paris-Cité, Paris, France
| | - L Heidet
- Department of Pediatric Nephrology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - R Favre
- Department of Obstetrics and Gynecology, Hautepierre and CMCO Hospital, Strasbourg, France
| | - L J Salomon
- Department of Obstetrics and Gynecology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - J F Oury
- University Paris Diderot and Sorbonne Paris-Cité, Paris, France
- Department of Obstetrics and Gynecology, Robert Debré Hospital, AP-HP, Paris, France
| | - Y Ville
- Department of Obstetrics and Gynecology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - F Muller
- Department of Biochemistry and Hormonology, Robert Debré Hospital, AP-HP, Paris, France
- University Versailles Saint-Quentin, Versailles, France
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Schaub B, Monthieux A, Najioullah F, Adenet C, Muller F, Césaire R. Persistent maternal Zika viremia: a marker of fetal infection. Ultrasound Obstet Gynecol 2017; 49:658-660. [PMID: 27485955 DOI: 10.1002/uog.17210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/08/2016] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Affiliation(s)
- B Schaub
- Centre Pluridisciplinaire de Diagnostic Prénatal de Martinique, Maison de la Femme de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, BP 632, 97261, Fort-de-France, French West Indies
| | - A Monthieux
- Centre Pluridisciplinaire de Diagnostic Prénatal de Martinique, Maison de la Femme de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, BP 632, 97261, Fort-de-France, French West Indies
| | - F Najioullah
- Service de Virologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, French West Indies
| | - C Adenet
- Centre Pluridisciplinaire de Diagnostic Prénatal de Martinique, Maison de la Femme de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, BP 632, 97261, Fort-de-France, French West Indies
| | - F Muller
- Laboratoire de Biochimie, Hôpital Robert-Debré, Paris, France
| | - R Césaire
- Service de Virologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, French West Indies
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Gondra L, Décramer S, Chalouhi GE, Muller F, Salomon R, Heidet L. Hyperechogenic kidneys and polyhydramnios associated with HNF1B gene mutation. Pediatr Nephrol 2016; 31:1705-8. [PMID: 27286685 DOI: 10.1007/s00467-016-3421-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 04/07/2016] [Revised: 05/08/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND HNF1B mutation is the leading cause of isolated hyperechogenic fetal kidneys with normal or moderately large size. Although most cases have normal amniotic fluid volume, some cases present with early oligohydramnios and renal failure associated with high perinatal mortality. CASE DIAGNOSIS/TREATMENT Here we report on seven fetuses from six unrelated families, carrying an HNF1B mutation, and presenting with polyhydramnios during the second or third trimester of pregnancy. Polyhydramnios was transitory in two cases. None of the mothers was presenting gestational diabetes. Bilateral hyperechogenic kidneys with size between -2.5 and +2 SD was the most common renal phenotype at prenatal US. Two patients were born prematurely at 28 and 32 weeks of gestation, respectively. Both presented high urine output the first days of life with urinary salt and potassium loss requiring hydro-electrolytic compensation. All mutations were large deletions removing the whole HNF1B gene. CONCLUSIONS In the absence of maternal diabetes, HNF1B mutation can be associated with polyhydramnios, probably due to fetal polyuria. Thus, HNF1B mutation represents a differential diagnosis of polyhydramnios associated with hyperechogenic (and sometimes enlarged) kidneys.
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Affiliation(s)
- Leire Gondra
- Service de Néphrologie Pédiatrique, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Hôpital Necker-Enfants Malades, Assistance Publique- Hôpitaux de Paris, 149 rue de Sèvres, Paris Cedex 15, 75743, France
| | - Stéphane Décramer
- Service de Néphrologie Pédiatrique, Centre de Référence du Sud Ouest des Maladies Rénales Rares (SORARE), Hôpital Purpan, Toulouse, France.,Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Cardiovascular and Metabolic Diseases, Toulouse, France.,Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Gihad E Chalouhi
- Obstetrics and Foetal Medicine Department, Necker-Enfants-Malades Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Françoise Muller
- Biochimie-Hormonologie, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Rémi Salomon
- Service de Néphrologie Pédiatrique, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Hôpital Necker-Enfants Malades, Assistance Publique- Hôpitaux de Paris, 149 rue de Sèvres, Paris Cedex 15, 75743, France.,Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Laurence Heidet
- Service de Néphrologie Pédiatrique, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Hôpital Necker-Enfants Malades, Assistance Publique- Hôpitaux de Paris, 149 rue de Sèvres, Paris Cedex 15, 75743, France.
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Rachid ML, Dreux S, Czerkiewicz I, Deschênes G, Vargas‐Poussou R, Mahieu‐Caputo D, Oury J, Muller F. Fetal urine biochemistry in antenatal Bartter syndrome: a case report. Clin Case Rep 2016; 4:876-8. [PMID: 27648267 PMCID: PMC5018593 DOI: 10.1002/ccr3.471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 09/09/2015] [Accepted: 11/05/2015] [Indexed: 11/19/2022] Open
Abstract
Bartter syndrome is a severe inherited tubulopathy responsible for renal salt wasting, and hence electrolyte disorders and dehydration. Prenatally, it is characterized by severe polyhydramnios caused by fetal polyuria. We studied for the first time fetal urine in a Bartter syndrome case and demonstrated that the tubulopathy is already present at 24 weeks of gestation.
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Affiliation(s)
| | - Sophie Dreux
- Biochimie‐HormonologieHôpital Robert DebréAPHPParisFrance
| | | | | | | | | | | | - Françoise Muller
- Biochimie‐HormonologieHôpital Robert DebréAPHPParisFrance
- Université Versailles Saint Quentin en YvelinesVersaillesFrance
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Chougrani I, Muller F, Marcelin L, Tsatsaris V, Abric J, Luton D, Guibourdenche J, Azria E. Combined first-trimester Down syndrome screening in HIV-infected women. Eur J Obstet Gynecol Reprod Biol 2016; 203:274-8. [PMID: 27391901 DOI: 10.1016/j.ejogrb.2016.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/26/2016] [Revised: 06/16/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine if human immunodeficiency virus (HIV) infection or antiretroviral therapy interferes with maternal levels of free human β-chorionic gonadotrophin (hCGβ) and pregnancy-associated plasma protein-A (PAPP-A) and whether any such influence alters first-trimester Down syndrome (DS) screening in HIV-infected women. STUDY DESIGN We performed a multicenter 1:2 matched case-control study comparing 84 HIV-infected women with singleton pregnancies with controls randomly selected among uninfected women, delivered and screened in the same center and matched for maternal age, geographical origin and fetal sex. RESULTS Groups did not differ significantly in screening results, although case women showed a slightly lower median free hCGβ multiple of the median (MoM) (1.11 versus 1.24 MoM, p=0.32) and higher median PAPP-A MoM (1.45 versus 1.32 MoM, p=0.23) than control women. The false-positive rate was similar in the case and control groups (5% versus 6.5%, p=0.5). Biomarker levels did not differ when comparing treated and untreated patients with their respective controls, and with one another. CONCLUSION First-trimester DS combined screening biomarker levels and calculated risk do not seem to be significantly altered by HIV infection or antiretroviral treatment. This screening strategy appears to be suitable for HIV-infected women.
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Affiliation(s)
- Imène Chougrani
- Department of Obstetrics and Gynecology, Hopital Bichat Claude Bernard, DHU Risks in Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris Diderot University, Paris, France
| | - Françoise Muller
- Department of Biochemistry, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Louis Marcelin
- Centre Hospitalier Universitaire Cochin Broca Hôtel Dieu, Port Royal Maternity, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Vassilis Tsatsaris
- Centre Hospitalier Universitaire Cochin Broca Hôtel Dieu, Port Royal Maternity, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Judith Abric
- Centre Hospitalier Universitaire Cochin Broca Hôtel Dieu, Port Royal Maternity, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Dominique Luton
- Department of Obstetrics and Gynecology, Hopital Bichat Claude Bernard, DHU Risks in Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris Diderot University, Paris, France
| | - Jean Guibourdenche
- Hormonology Department, Centre Hospitalier Universitaire Cochin Broca Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Elie Azria
- Maternity Unit, Groupe Hospitalier Paris Saint Joseph, DHU Risks in Pregnancy, Paris Descartes University, Paris, France; Inserm U1153 - Obstetrical, Perinatal and Pediatric Epidemiology (EPOPé Research Team), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité, DHU Risk in Pregnancy, Paris Descartes University, Paris, France.
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25
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Cassoudesalle H, Nozères A, Petit H, Cressot V, Muller F, Rouanet F, Sibon I, Joseph PA, Dehail P. Post-acute referral of stroke victims in a French urban area: Results of a specific program. Ann Phys Rehabil Med 2016; 59:248-54. [PMID: 27009910 DOI: 10.1016/j.rehab.2016.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 02/18/2016] [Accepted: 02/19/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The main objective of this study was to describe the distribution of referrals offered to patients assessed in the "Post-Acute Stroke program" of Bordeaux University Hospital (France). This program was developed in 2008 to organize the dispensation of care in rehabilitation units specialized in neurological diseases. MATERIAL AND METHODS This was a single-centre observational study. Between July 2008 and December 2012, data on the number of stroke patients hospitalized at the Bordeaux University Hospital and their post-acute referral were collected from the local hospital discharge database. Some of these patients were assessed by Physical Rehabilitation and Medicine physicians participating in the program. Proposed and actual referrals, time from admission to assessment and functional status were also collected. RESULTS Among 4189 stroke patients, 1465 (35%) survivors were assessed, of whom 932 (22.2%) were discharged to inpatient rehabilitation facilities. There were no patients discharged to this type of unit without an assessment. Among the 1465 patients who were assessed, 57.2% were referred to specialized rehabilitation units, 6.3% were discharged to non-specialized rehabilitation units and 26% returned home directly. The median total length of stay in acute units varied from 10 to 15days depending on referral orientation. CONCLUSION Patients that were assessed were more likely to be transferred to specialized rehabilitation units than to non-specialized rehabilitation units. The Post-Acute Stroke program has the particularity of combining private and public specialized rehabilitation units in a common collaborative referral system while retaining the control and flexibility of personalised referral for each patient in the light of local care availability.
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Affiliation(s)
- H Cassoudesalle
- Physical and rehabilitation medicine Unit, Clinical Neuroscience, EA4136 University of Bordeaux, University Hospital of Bordeaux, 33000 Bordeaux, France
| | - A Nozères
- Physical and rehabilitation medicine Unit "La Tour de Gassies", Bruges, France
| | - H Petit
- Physical and rehabilitation medicine Unit "Korian - Les Grands Chênes", Bordeaux, France
| | - V Cressot
- Physical and rehabilitation medicine Unit, Clinical Gerontology, University Hospital of Bordeaux, Bordeaux, France
| | - F Muller
- C Physical and rehabilitation medicine Unit "Les Embruns", Bidart, France
| | - F Rouanet
- Stroke Unit, Clinical Neuroscience, University Hospital of Bordeaux, Bordeaux, France
| | - I Sibon
- Stroke Unit, Clinical Neuroscience, University Hospital of Bordeaux, Bordeaux, France
| | - P-A Joseph
- Physical and rehabilitation medicine Unit, Clinical Neuroscience, EA4136 University of Bordeaux, University Hospital of Bordeaux, 33000 Bordeaux, France
| | - P Dehail
- Physical and rehabilitation medicine Unit, Clinical Neuroscience, EA4136 University of Bordeaux, University Hospital of Bordeaux, 33000 Bordeaux, France.
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26
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Spaggiari E, Czerkiewicz I, Sault C, Dreux S, Galland A, Salomon LJ, Ville Y, Muller F. Impact of Including or Removing Nuchal Translucency Measurement on the Detection and False-Positive Rates of First-Trimester Down Syndrome Screening. Fetal Diagn Ther 2015; 40:214-218. [PMID: 26656919 DOI: 10.1159/000442198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/26/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION First-trimester Down syndrome (DS) screening combining maternal age, serum markers (pregnancy-associated plasma protein-A and beta-human chorionic gonadotropin) and nuchal translucency (NT) gives an 85% detection rate for a 5% false-positive rate. These results largely depend on quality assessment of biochemical markers and of NT. In routine practice, despite an ultrasound quality control organization, NT images can be considered inadequate. The aim of the study was to evaluate the consequences for risk calculation when NT measurement is not taken into account. MATERIAL AND METHOD Comparison of detection and false-positive rates of first-trimester DS screening (PerkinElmer, Turku, Finland), with and without NT, based on a retrospective study of 117,126 patients including 274 trisomy 21-affected fetuses. NT was measured by more than 3,000 certified sonographers. RESULTS There was no significant difference in detection rates between the two strategies including or excluding NT measurement (86.7 vs. 81.8%). However, there was a significant difference in the false-positive rates (2.23 vs. 9.97%, p < 0.001). DISCUSSION Sonographers should be aware that removing NT from combined first-trimester screening would result in a 5-fold increase in false-positive rate to maintain the expected detection rates. This should be an incentive for maintaining quality in NT measurement.
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Affiliation(s)
- Emmanuel Spaggiari
- Department of Obstetrics and Maternal Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
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27
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Halim D, Hofstra RMW, Signorile L, Verdijk RM, van der Werf CS, Sribudiani Y, Brouwer RWW, van IJcken WFJ, Dahl N, Verheij JBGM, Baumann C, Kerner J, van Bever Y, Galjart N, Wijnen RMH, Tibboel D, Burns AJ, Muller F, Brooks AS, Alves MM. ACTG2 variants impair actin polymerization in sporadic Megacystis Microcolon Intestinal Hypoperistalsis Syndrome. Hum Mol Genet 2015; 25:571-83. [PMID: 26647307 DOI: 10.1093/hmg/ddv497] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 11/30/2015] [Indexed: 12/13/2022] Open
Abstract
Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS) is a rare congenital disorder, in which heterozygous missense variants in the Enteric Smooth Muscle actin γ-2 (ACTG2) gene have been recently identified. To investigate the mechanism by which ACTG2 variants lead to MMIHS, we screened a cohort of eleven MMIHS patients, eight sporadic and three familial cases, and performed immunohistochemistry, molecular modeling and molecular dynamics (MD) simulations, and in vitro assays. In all sporadic cases, a heterozygous missense variant in ACTG2 was identified. ACTG2 expression was detected in all intestinal layers where smooth muscle cells are present in different stages of human development. No histopathological abnormalities were found in the patients. Using molecular modeling and MD simulations, we predicted that ACTG2 variants lead to significant changes to the protein function. This was confirmed by in vitro studies, which showed that the identified variants not only impair ACTG2 polymerization, but also contribute to reduced cell contractility. Taken together, our results confirm the involvement of ACTG2 in sporadic MMIHS, and bring new insights to MMIHS pathogenesis.
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Affiliation(s)
| | - Robert M W Hofstra
- Department of Clinical Genetics, Birth Defects Research Centre, UCL Institute of Child Health, London, UK
| | | | | | | | | | - Rutger W W Brouwer
- Erasmus Center for Biomics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Wilfred F J van IJcken
- Erasmus Center for Biomics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niklas Dahl
- Department of Immunology, Genetics and Pathology, Medical Genetics and Genomics, Uppsala University, Uppsala, Sweden
| | - Joke B G M Verheij
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | | | - John Kerner
- Lucile Salter Packard Children's Hospital, Stanford University, Palo Alto, CA, USA and
| | | | | | - Rene M H Wijnen
- Department of Pediatric Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dick Tibboel
- Department of Pediatric Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alan J Burns
- Department of Clinical Genetics, Birth Defects Research Centre, UCL Institute of Child Health, London, UK
| | - Françoise Muller
- Biochimie Prenatalé, Hôpital Universitaire Robert Debré, Paris, France
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28
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Rachid ML, Dreux S, Pean de Ponfilly G, Vargas-Poussou R, Czerkiewicz I, Chevenne D, Oury JF, Deschênes G, Muller F. Prenatal diagnosis of Bartter syndrome: amniotic fluid aldosterone. Prenat Diagn 2015; 36:88-91. [PMID: 26528764 DOI: 10.1002/pd.4717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Bartter syndrome is a severe inherited tubulopathy characterized by postnatal salt wasting, severe polyuria, dehydration, failure to thrive and secondary hyperaldosteronism. Prenatally, the disease is usually discovered following the onset of severe polyhydramnios in the second trimester. We studied amniotic fluid aldosterone concentration in Bartter syndrome and in controls. METHODS Amniotic fluid aldosterone was assayed by radioimmunoassay. We undertook a retrospective case-control study based on 36 cases of prenatally suspected and postnatally confirmed Bartter syndrome (22 with identified mutations): and 72 gestational age matched controls presenting with polyhydramnios and 72 without polyhydramnios. Amniotic fluid aldosterone was compared between the three groups. RESULTS The median amniotic fluid aldosterone concentration in the Bartter syndrome group (90 pg/mL) was not different from that in the controls with polyhydramnios (90 pg/mL, P = 0.33) or without polyhydramnios (87 pg/mL, P = 0.41). CONCLUSION Amniotic fluid aldosterone assay cannot be used for prenatal diagnosis of Bartter syndrome. © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Myriam L Rachid
- Biochimie-Hormonologie, Hôpital Robert Debré, APHP, Paris, France
| | - Sophie Dreux
- Biochimie-Hormonologie, Hôpital Robert Debré, APHP, Paris, France
| | | | - Rosa Vargas-Poussou
- Département de Génétique, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | | | - Didier Chevenne
- Biochimie-Hormonologie, Hôpital Robert Debré, APHP, Paris, France
| | | | | | - Françoise Muller
- Biochimie-Hormonologie, Hôpital Robert Debré, APHP, Paris, France.,Université Versailles Saint Quentin en Yvelines, Paris, France
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Muller F, Bernard P, Salomon LJ, Dreux S, Allaf B, Czerkiewicz I, Ville Y. Role of fetal blood sampling in cases of non-visualization of fetal gallbladder. Ultrasound Obstet Gynecol 2015; 46:743-744. [PMID: 25914176 DOI: 10.1002/uog.14888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 04/20/2015] [Accepted: 04/22/2015] [Indexed: 06/04/2023]
Affiliation(s)
- F Muller
- Department of Biochemistry-Hormonology, Robert Debré Hospital, AP-HP, 48 Boulevard Sérurier, 75019, Paris, France
- University Paris Ile de France Ouest, Versailles Saint-Quentin, France
| | - P Bernard
- Department of Obstetrics and Maternal Fetal Medicine, Saint Luc Academic Hospital, Brussels, Belgium
| | - L J Salomon
- Department of Obstetrics and Maternal Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
| | - S Dreux
- Department of Biochemistry-Hormonology, Robert Debré Hospital, AP-HP, 48 Boulevard Sérurier, 75019, Paris, France
| | - B Allaf
- Department of Biochemistry-Hormonology, Robert Debré Hospital, AP-HP, 48 Boulevard Sérurier, 75019, Paris, France
| | - I Czerkiewicz
- Department of Biochemistry-Hormonology, Robert Debré Hospital, AP-HP, 48 Boulevard Sérurier, 75019, Paris, France
| | - Y Ville
- Department of Obstetrics and Maternal Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes and Sorbonne Paris-Cité, Paris, France
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30
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Allaf B, Dreux S, Schmitz T, Czerkiewicz I, Le Vaillant C, Benachi A, Houfflin-Debarge V, Maréchaud M, Oury JF, Muller F. Amniotic fluid biochemistry in isolated polyhydramnios: a series of 464 cases. Prenat Diagn 2015; 35:1331-5. [DOI: 10.1002/pd.4700] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/22/2015] [Accepted: 09/24/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Bichr Allaf
- Biochimie-Hormonologie; Hôpital Robert Debré, APHP; Paris France
| | - Sophie Dreux
- Biochimie-Hormonologie; Hôpital Robert Debré, APHP; Paris France
| | - Thomas Schmitz
- Gynécologie-Obstétrique; Hôpital Robert Debré, APHP; Paris France
| | | | | | - Alexandra Benachi
- Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, AP-HP; Université Paris Sud; Clamart France
| | | | | | | | - Françoise Muller
- Biochimie-Hormonologie; Hôpital Robert Debré, APHP; Paris France
- Université Versailles Saint Quentin en Yvelines; Versailles France
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31
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Abdennadher W, Chalouhi G, Dreux S, Rosenblatt J, Favre R, Guimiot F, Salomon LJ, Oury JF, Ville Y, Muller F. Fetal urine biochemistry at 13-23 weeks of gestation in lower urinary tract obstruction: criteria for in-utero treatment. Ultrasound Obstet Gynecol 2015; 46:306-311. [PMID: 25412852 DOI: 10.1002/uog.14734] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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: 08/13/2014] [Revised: 11/12/2014] [Accepted: 11/12/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To assess the value of fetal urine biochemistry before 23 weeks of gestation in cases of lower urinary tract obstruction (LUTO) to refine prognosis and to select potential candidates for in-utero intervention. METHODS This was a retrospective study including 72 cases of LUTO with fetal urine sampled before 23 weeks and assayed for total protein, β-2-microglobulin, sodium, chloride, calcium, phosphorus, glucose and gamma-glutamyl transpeptidase (GGTP). Two groups were defined according to renal outcome: 1) bilateral renal dysplasia on histological examination or renal failure at birth; 2) normal postnatal renal function or histologically normal appearance of the kidneys. Correlations between fetal urinary biochemical markers and postnatal renal function were studied. RESULTS LUTO was isolated in 56/72 (77.8%) cases and was associated with other malformations in 16/72 (22.2%) cases. High GGTP levels (236 IU/L vs 5 IU/L; P < 0.0001) were observed in fetal urine in the five cases of urodigestive fistula. A significant difference between outcome groups was observed for β-2-microglobulin (P = 0.0017), sodium (P = 0.0008), chloride (P = 0.0028) and calcium (P = 0.0092) but not for protein, glucose or phosphorus. Sensitivity and specificity in defining a poor renal prognosis were 80.6% and 89% for β-2-microglobulin, 61.3% and 100% for sodium and 64.5% and 100% for calcium, respectively. CONCLUSIONS Fetal urinalysis before 23 weeks of gestation allowed distinction between three groups: 1) fetuses with normal urine biochemistry for which fetal therapy should be discussed; 2) fetuses with abnormal urine biochemistry for which prognosis for renal outcome is poor and for which the benefit of fetal therapy is likely to be compromised; 3) fetuses with urodigestive fistula.
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Affiliation(s)
- W Abdennadher
- Department of Obstetrics and Gynaecology, Hôpital Necker Enfants Malades, APHP, Paris, France
| | - G Chalouhi
- Department of Obstetrics and Gynaecology, Hôpital Necker Enfants Malades, APHP, Paris, France
| | - S Dreux
- Department of Biochemistry, Hôpital Robert Debré, APHP, Paris, France
| | - J Rosenblatt
- Department of Obstetrics and Gynaecology, Hôpital Robert Debré, APHP, Paris, France
| | - R Favre
- Department of Obstetrics and Gynaecology, CMCO, Schiltigheim, France
| | - F Guimiot
- Department of Developmental Biology, Hôpital Robert Debré, APHP, Paris, France
| | - L J Salomon
- Department of Obstetrics and Gynaecology, Hôpital Necker Enfants Malades, APHP, Paris, France
| | - J F Oury
- Department of Obstetrics and Gynaecology, Hôpital Robert Debré, APHP, Paris, France
| | - Y Ville
- Department of Obstetrics and Gynaecology, Hôpital Necker Enfants Malades, APHP, Paris, France
| | - F Muller
- Department of Biochemistry, Hôpital Robert Debré, APHP, Paris, France
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32
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Desseauve D, Voluménie JL, Gueneret M, Colombani JF, Schaub B, Muller F. [Contribution of the biochemical study of amniotic and cystic fluids for prenatal diagnosis of urogenital sinus]. Gynecol Obstet Fertil 2015; 43:398-400. [PMID: 25890506 DOI: 10.1016/j.gyobfe.2015.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 03/11/2015] [Indexed: 11/25/2022]
Affiliation(s)
- D Desseauve
- Université de Poitiers, CHU de Poitiers, 86021 Poitiers cedex, France; Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Poitiers, 86021 Poitiers cedex, France.
| | - J-L Voluménie
- Service de gynécologie-obstétrique, maison de la femme, de la mère et de l'enfant, CHU de Fort-de-France, 97261 Fort-de-France cedex, Martinique
| | - M Gueneret
- Service de gynécologie-obstétrique, maison de la femme, de la mère et de l'enfant, CHU de Fort-de-France, 97261 Fort-de-France cedex, Martinique
| | - J-F Colombani
- Service de chirurgie pédiatrique, maison de la femme, de la mère et de l'enfant, CHU de Fort-de-France, 97261 Fort-de-France cedex, Martinique
| | - B Schaub
- Service de gynécologie-obstétrique, maison de la femme, de la mère et de l'enfant, CHU de Fort-de-France, 97261 Fort-de-France cedex, Martinique
| | - F Muller
- Biochimie hormonologie, hôpital Robert-Debré, AP-HP, 75019 Paris, France
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Valentin M, Muller F, Beaujard MP, Dreux S, Czerkiewicz I, Meyer V, Leruez M, Ville Y, Salomon LJ. First-trimester combined screening for trisomy 21 in women with renal disease. Prenat Diagn 2015; 35:244-8. [PMID: 25395363 DOI: 10.1002/pd.4528] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 11/06/2014] [Accepted: 11/06/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate the results of first-trimester combined screening for Down syndrome in women with chronic renal disease. METHOD Fifty-five pregnant women with renal disease were compared with 110 patients matched for maternal age, maternal weight, smoking status, and gestational age. Maternal renal function was assayed at the time of the combined screening, and renal insufficiency was defined by serum creatinine >90 µmol/L and renal clearance <80 mL/min. We defined three groups: kidney disease and normal renal function (group 1), kidney disease and renal insufficiency (group 2), and a control group (group 3). The values of nuchal translucency, pregnancy-associated plasma protein A, human β-chorionic gonadotrophin (hCGβ), and false-positive rates for Down syndrome screening were compared. RESULTS There were 39 (71%) and 16 (29%) cases in groups 1 and 2, respectively. Nuchal translucency and multiple of the median (MoM) pregnancy-associated plasma protein A were similar in the three groups. However, MoM hCGβ levels were higher in group 2 than in groups 1 and 3 (5.37 vs 1.1 vs 0.98 MoM, p = 0.0001). The resulting screen-positive rate was also higher in group 2 than in groups 1 and 3 (43.7% vs 10.2% vs 5.5%, p = 0.0001). CONCLUSION Trisomy 21 first-trimester screening using hCGβ is not suitable in the case of maternal renal failure. © 2014 John Wiley & Sons, Ltd.
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Affiliation(s)
- Morgane Valentin
- Department of Obstetrics and Maternal-Fetal Medicine, Necker Enfants Malades Hospital, AP-HP, Paris, France
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Khanolkar R, Rajpara S, Muller F, Depasquale I, Lawson L, Barker RN, Nicolson M, Ormerod AD, Ward FJ. TGF-β2 mediated secretion of sCTLA-4 from regulatory T cells. J Inflamm (Lond) 2015. [PMCID: PMC4416152 DOI: 10.1186/1476-9255-12-s1-p6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Dreux S, Salomon LJ, Rosenblatt J, Favre R, Houfflin-Debarge V, Broussin B, Guimiot F, Fenaux H, Delezoide AL, Muller F. Biochemical analysis of ascites fluid as an aid to etiological diagnosis: a series of 100 cases of nonimmune fetal ascites. Prenat Diagn 2014; 35:214-20. [PMID: 25346315 DOI: 10.1002/pd.4522] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/30/2014] [Accepted: 10/20/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The aim of this study is to analyze the contribution of biochemistry and cytology of fetal ascites fluid to the etiological diagnosis of ascites after ultrasonographic scan, maternal blood sampling, and fetal karyotyping. METHOD This is a retrospective study of 100 consecutive cases of nonimmune fetal ascites in which ascites fluid was sampled. All women underwent referral ultrasound scan and fetal karyotyping. All cases of fetal ascites were studied by biochemistry (total protein, β2 -microglobulin, IgM, gamma-glutamyl transpeptidase, aspartate aminotransferase, aminopeptidase M, and intestinal isoform of alkaline phosphatase) and cytology (lymphocyte count and vacuolated cells). RESULTS The etiology of ascites was diagnosed at ultrasound scan in only 50% of cases. We observed significantly (P < 0.001) low levels of total protein in ascites of urinary origin, high levels of digestive enzymes in ascites of digestive origin, and high β2 -microglobulin in infectious ascites. Vacuolated cells were observed in all ten storage metabolic diseases. CONCLUSION Sampling of fetal ascites fluid for biochemical and cytological examination provides important additional information. We propose a two-step management: (1) detailed ultrasound scan examination, maternal blood analysis, and fetal karyotyping and (2) biochemical and cytological analyses. On the basis of such an approach, 63% and 96% of etiologies would have been identified in our series after the first and second steps, respectively. © 2014 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sophie Dreux
- Biochimie-Hormonologie, CHU Robert Debré AP-HP, Paris, France
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Muller F, Dreux S, Czerkiewicz I, Bernard M, Guibourdenche J, Lacroix I, Moineau MP, Read MH, Sault C, Thibaud D, Veyrat B, Bidat L. Dépistage de la trisomie 21 par les marqueurs sériques maternels : justification des commentaires appliqués par les biologistes. ACTA ACUST UNITED AC 2014; 43:671-9. [DOI: 10.1016/j.jgyn.2014.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 04/30/2014] [Accepted: 05/14/2014] [Indexed: 10/24/2022]
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Kim H, Zheng S, Amini S, Virk S, Mikkelsen T, Brat D, Sougnez C, Muller F, Hu J, Sloan A, Cohen M, Van Meir E, Scarpace L, Lander E, Gabriel S, Getz G, Meyerson M, Chin L, Barnholtz-Sloan J, Verhaak R. GE-17 * ALTERATION OF THE p53 PATHWAY AND ANCESTRAL PROGENITORS ARE ASSOCIATED WITH TUMOR RECURRENCE IN GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou256.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Huguet S, Leheup B, Aslan M, Muller F, Dautel G, Journeau P. Radiological and clinical analysis of Madelung's deformity in children. Orthop Traumatol Surg Res 2014; 100:S349-52. [PMID: 25217032 DOI: 10.1016/j.otsr.2014.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/13/2014] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Madelung's deformity is a bone dysplasia that occurs predominantly in adolescent females, characterized by early epiphyseal growth arrest in the medial part of the distal radius. This leads to an upward and medial displacement of the radial joint surface, restricting range of motion. OBJECTIVES The objective of this study was to determine whether there was a link between clinical and radiological data in children with Madelung's deformity and to test the hypothesis of a relation between the deformity and a genetic mutation. METHODS A retrospective study recruited 13 patients with Madelung's deformity, with a mean age of 13.2 years (range, 8-18 years). Assessment comprised level of pain, range of motion and grip force, with standard AP and lateral wrist X-rays. Every patient except one underwent molecular genetic screening, adhering to current recommendations. RESULTS Pronation-supination, radial inclination and grip force were significantly impaired compared to normal results. All X-ray measurements were significantly abnormal, except for the lunate-covering ratio. Genetic mutation (SHOX) was systematic in the 12 patients screened. DISCUSSION Radiological deformity did not correlate with functional disturbance or pain. Non-acquired Madelung's deformity requires molecular screening for SHOX or XO mutation, which definitively diagnoses Léri-Weill dyschondrosteosis or Turner syndrome. CONCLUSION A larger series is necessary to confirm these preliminary results, which nevertheless suggest that non-acquired Madelung's deformity is not isolated but syndromic. Early detection of Léri-Weill or Turner syndrome is essential, due to their therapeutic specificities. LEVEL: IV.
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Affiliation(s)
- S Huguet
- Service de chirurgie d'orthopédie pédiatrique, hôpital d'Enfants, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - B Leheup
- Service de génétique clinique pédiatrique, hôpital d'Enfants, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - M Aslan
- Service de chirurgie d'orthopédie pédiatrique, hôpital d'Enfants, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - F Muller
- Service de chirurgie d'orthopédie pédiatrique, hôpital d'Enfants, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - G Dautel
- Service de chirurgie d'orthopédie pédiatrique, hôpital d'Enfants, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - P Journeau
- Service de chirurgie d'orthopédie pédiatrique, hôpital d'Enfants, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France.
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Muller F, Taverne B. [Representations of therapeutic failure of ARV treatment among patients and health care professionals in Dakar]. ACTA ACUST UNITED AC 2014; 107:281-5. [PMID: 25204574 DOI: 10.1007/s13149-014-0394-1] [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: 02/26/2014] [Accepted: 06/08/2014] [Indexed: 11/28/2022]
Abstract
The aim of this qualitative study was to describe and analyze representations of therapeutic failure and the medical and social responses proposed by health care professionals and patients receiving follow-up in the ANRS cohort 1215 in Senegal from 1999 to 2010. Patients' medical histories show that therapeutic failures are related to complex multifactorial situations, resulting from factors attributable to patients (adherence failure related to various psychosocial problems) but also to health care structures (organization of the health system, training for health care professionals and availability of biological exams and appropriate drugs). Both patients and health care staff recognize these causes. The incidence of the onset of therapeutic failures should be regarded as an indicator of the quality of care provided. Further thought should be given to how well health care systems function when changes occur in these rates.
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Affiliation(s)
- F Muller
- Centre régional de recherche et de formation à la prise en charge clinique, CHU de Fann à Dakar, Sénégal (CRCF) ; UMI 233 de l'IRD TransVIHMI, BP 1386, CP 18524, Dakar, Sénégal
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Verhaak RGW, Kim H, Zheng S, Amini SS, Virk SM, Mikkelsen T, Brat DJ, Grimsby J, Sougnez C, Muller F, Hu J, Sloan AE, Cohen ML, Van Meir EG, Scarpace L, Laird PW, Weinstein JN, Lander E, Gabriel S, Getz G, Meyerson M, Chin L, Barnholtz-Sloan JS. THE P53 PATHWAY AND ANCESTRAL PROGENITORS ARE ASSOCIATED WITH TUMOR RECURRENCE IN GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou206.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Garabedian C, Verpillat P, Czerkiewicz I, Langlois C, Muller F, Avni F, Bigot J, Sfeir R, Vaast P, Coulon C, Subtil D, Houfflin-Debarge V. Does a combination of ultrasound, MRI, and biochemical amniotic fluid analysis improve prenatal diagnosis of esophageal atresia? Prenat Diagn 2014; 34:839-42. [DOI: 10.1002/pd.4376] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 03/31/2014] [Accepted: 03/31/2014] [Indexed: 11/10/2022]
Affiliation(s)
- C. Garabedian
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - P. Verpillat
- Department of Pediatric Radiology; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - I. Czerkiewicz
- Biochemistry-Hormonology Department, Robert Debré Hospital, AP-HP; University Paris Ile de France Ouest; Paris France
| | - C. Langlois
- Department of Biostatistics, EA2694, UDSL; University of Lille Nord de France, CHRU de Lille; Lille France
| | - F. Muller
- Biochemistry-Hormonology Department, Robert Debré Hospital, AP-HP; University Paris Ile de France Ouest; Paris France
| | - F. Avni
- Department of Pediatric Radiology; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - J. Bigot
- Department of Pediatric Radiology; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - R. Sfeir
- Reference Center for Congenital Esophageal Abnormalities (CRACMO); Lille France
| | - P. Vaast
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - C. Coulon
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
| | - D. Subtil
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
- University of Lille Nord de France; Lille France
| | - V. Houfflin-Debarge
- Department of Obstetrics; Jeanne de Flandre Hospital, CHRU de Lille; Lille France
- University of Lille Nord de France; Lille France
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Bornes M, Spaggiari E, Schmitz T, Dreux S, Czerkiewicz I, Delezoide AL, El-Ghoneimi A, Oury JF, Muller F. Outcome and etiologies of fetal megacystis according to the gestational age at diagnosis. Prenat Diagn 2013; 33:1162-6. [PMID: 23939878 DOI: 10.1002/pd.4215] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 07/28/2013] [Accepted: 08/09/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the gestational age-specific outcomes and the different etiologies of megacystis diagnosed at screening ultrasound. METHODS A retrospective single-center study was conducted between 1989 and 2009. We identified all consecutive cases of megacystis prenatally diagnosed during routine ultrasound screening. Outcome, final diagnosis, and renal function were recorded. RESULTS Eighty-four patients were included. An isolated lower urinary tract obstruction was observed in 38/84 (45.2%), ureterovesical reflux in 9/84 (10.7%), an associated congenital abnormality in 32/84 (38.1%) and a normal bladder in 5/84 (6%). Increased gestational age at diagnosis was correlated with an increased rate of live born children (P < 0.01). No cases of megacystis diagnosed in the first trimester were born alive. When diagnosis of posterior urethral valves (PUV) was made in the third trimester, the ultimate survival rate was 11/13 (84.6%) compared with 3/12 (25%) for a diagnosis made in the second trimester (P = 0.02). CONCLUSION Lower urinary tract obstruction is the main etiology of megacystis. Megacystis can also be part of more complex malformations. Outcome of megacystis detected in the first trimester is poor. PUV detected in the third trimester had a better overall survival rate than PUV detected in the second trimester.
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Affiliation(s)
- Marie Bornes
- Gynecology and Obstetrics, AP-HP, Robert Debré Hospital, Paris, France; Gynecology and Obstetrics, AP-HP, Tenon Hospital, Paris, France
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Spaggiari E, Stirnemann JJ, Heidet L, Dreux S, Ville Y, Oury JF, Delezoide AL, Muller F. Outcome following prenatal diagnosis of severe bilateral renal hypoplasia. Prenat Diagn 2013; 33:1167-72. [PMID: 23943585 DOI: 10.1002/pd.4217] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 07/28/2013] [Accepted: 08/09/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this research was to evaluate the outcome and prognostic value of fetal serum β2-microglobulin in case of prenatal diagnosis of severe bilateral renal hypoplasia. METHODS Cases of hypoplastic kidneys were detected on ultrasound and referred to our laboratory for determination of fetal blood β2-microglobulin, over a 12-year period. Prenatal prognostic assessment was based upon amniotic fluid volume and fetal serum β2-microglobulin (cut-off: 5 mg/L). Outcome measures were postnatal renal function or renal pathological features when termination of pregnancy (TOP) and genetic studies were performed. RESULTS A total of 34 cases were identified; 13 (38%) were liveborn and 21 (62%) underwent TOP. Renal hypoplasia was confirmed postnatally in all cases. Oligohydramnios/anhydramnios was observed in 30/34 (88%) cases. Associated genetic or anatomical anomalies were found in 8/34 (24%) cases. Renal function of liveborn infants was normal in 4/13 cases. Renal lesions were observed in all TOPs (21/21 cases). Overall, 30/34 (88.2%) cases had a poor outcome. β2-microglobulin accurately predicts poor renal outcome in 27/31 (87.1%) cases. β2-microglobulin was not interpretable in three cases due to amniotic fluid contamination. The prognostic value of β2-microglobulin was similar to that of amniotic fluid volume assessment. CONCLUSION Hypoplastic kidneys complicated by oligohydramnios/anhydramnios are associated with poor outcome. Fetal serum β2-microglobulin and oligohydramnios both predicted poor outcome.
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Klein J, Lacroix C, Caubet C, Siwy J, Zurbig P, Dakna M, Muller F, Breuil B, Stalmach A, Mullen W, Mischak H, Bandin F, Monsarrat B, Bascands JL, Decramer S, Schanstra JP. Fetal Urinary Peptides to Predict Postnatal Outcome of Renal Disease in Fetuses with Posterior Urethral Valves (PUV). Sci Transl Med 2013; 5:198ra106. [DOI: 10.1126/scitranslmed.3005807] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Wernet A, Luton D, Muller F, Ducarme G. Use of insulin-like growth factor binding protein-1 for retrospective diagnosis of amniotic fluid embolism in first trimester. Arch Gynecol Obstet 2013; 289:461-2. [DOI: 10.1007/s00404-013-2970-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 07/11/2013] [Indexed: 11/24/2022]
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Imbard A, Blom HJ, Schlemmer D, Barto R, Czerkiewicz I, Rigal O, Muller F, Benoist JF. Methylation metabolites in amniotic fluid depend on gestational age. Prenat Diagn 2013; 33:848-55. [PMID: 23613283 DOI: 10.1002/pd.4142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Methylation metabolism is essential for fetus development. However, normative data for amniotic fluid (AF) concentrations of methylation metabolites at different gestational ages are lacking. We aimed to determine in AF reference values of 14 intermediates involved in methylation. METHODS Two hundred sixty-eight AFs sampled between 14 and 39 weeks of gestation were retrospectively selected in our AF bank. Next, we measured methionine (Met)-cycle intermediates [S-adenosyl Met (AdoMet), S-adenosyl-l-homocysteine (AdoHcy), total Hcy, Met, and methyl malonic acid] and methyl donors and methyl acceptors (betaine, dimethylglycine, sarcosine, free and total choline, free and total ethanolamine, creatine, and guanidinoacetate) by liquid chromatography coupled with tandem mass spectrometry. RESULTS Reference ranges according to gestational age were determined for each parameter. Strong correlations between metabolites directly connected in their metabolic pathway and between total Hcy and betaine were observed. CONCLUSION Methionine, an essential amino acid required for protein synthesis, is the only parameter that dramatically decreases with gestational age. The AdoMet/AdoHcy ratio exponentially increases from 25 weeks of gestation, which could reflect increasing methylation capacities. The negative correlation between betaine and total Hcy together with a constant betaine to dimethylglycine ratio during gestation suggests that betaine may be used as a methyl donor during fetal life.
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Affiliation(s)
- Apolline Imbard
- Biochemistry Hormonology Laboratory, AP-HP Hôpital Robert Debré, Paris, France.
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Maurice P, Eyrolle-Guignot D, Dhombres F, Garel C, Gonzales M, Muller F, Jouannic JM. The key role of ultrasound examination in the prenatal diagnosis of epidermolysis bullosa with pyloric atresia. Prenat Diagn 2013; 33:908-9. [DOI: 10.1002/pd.4137] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/13/2013] [Accepted: 04/14/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Paul Maurice
- Service de Gynécologie-Obstétrique et Centre Pluridisciplinaire de Diagnostic Prénatal de l’ Est Parisien; Hôpital Armand Trousseau, APHP; Paris France
| | | | - Ferdinand Dhombres
- Service de Gynécologie-Obstétrique et Centre Pluridisciplinaire de Diagnostic Prénatal de l’ Est Parisien; Hôpital Armand Trousseau, APHP; Paris France
| | - Catherine Garel
- Service de Radiopédiatrie, et Centre Pluridisciplinaire de Diagnostic Prénatal de l’ Est Parisien; Hôpital Armand Trousseau, APHP; Paris France
| | - Marie Gonzales
- Unité de foetopathologie et Centre Pluridisciplinaire de Diagnostic Prénatal de l’ Est Parisien; Hôpital Armand Trousseau, APHP; Paris France
| | | | - Jean-Marie Jouannic
- Service de Gynécologie-Obstétrique et Centre Pluridisciplinaire de Diagnostic Prénatal de l’ Est Parisien; Hôpital Armand Trousseau, APHP; Paris France
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Nguyen C, Dreux S, Heidet L, Czerkiewicz I, Salomon LJ, Guimiot F, Schmitz T, Tsatsaris V, Boulot P, Rousseau T, Muller F. Fetal serum α
-1 microglobulin for renal function assessment: comparison with β
2-microglobulin and cystatin C. Prenat Diagn 2013; 33:775-81. [DOI: 10.1002/pd.4128] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 03/26/2013] [Accepted: 03/26/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Claire Nguyen
- Biochimie-Hormonologie; Hôpital Robert Debré AP-HP; Paris France
| | - Sophie Dreux
- Biochimie-Hormonologie; Hôpital Robert Debré AP-HP; Paris France
| | - Laurence Heidet
- Nephrologie Pédiatrique, Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte; Hôpital Necker Enfants-Malades AP-HP; Paris France
| | | | - Laurent J. Salomon
- Gynécologie-Obstétrique, Hôpital Necker Enfants-Malades AP-HP; Université Paris-René Descartes; Paris France
| | - Fabien Guimiot
- Biologie de la Reproduction, Foetopathologie; Hôpital Robert Debré AP-HP; Paris France
| | - Thomas Schmitz
- Gynécologie Obstétrique, Hôpital Robert Debré, AP-HP; Université Paris Diderot; Paris France
| | - Vassilis Tsatsaris
- Gynécologie Obstétrique, Hôpital Cochin, AP-HP; Université Paris Descartes; Paris France
| | - Pierre Boulot
- Gynécologie Obstétrique, Hôpital Arnaud de Villeneuve; Université de Montpellier; Montpellier France
| | - Thierry Rousseau
- Gynécologie Obstétrique, Hôpital du Bocage; Université de Dijon; Dijon France
| | - Françoise Muller
- Biochimie-Hormonologie; Hôpital Robert Debré AP-HP; Paris France
- Université Paris Versailles-Saint Quentin; Paris France
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Dreux S, Nguyen C, Czerkiewicz I, Schmitz T, Azria E, Fouré MA, Muller F. Down syndrome maternal serum marker screening after 18 weeks of gestation: a countrywide study. Am J Obstet Gynecol 2013; 208:397.e1-5. [PMID: 23353023 DOI: 10.1016/j.ajog.2013.01.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 01/08/2013] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The objective of the study was to evaluate the efficacy of maternal serum markers in detecting Down syndrome after 18 weeks of gestation in women who book late for maternity care in a large national retrospective study. STUDY DESIGN During the period 2007-2012, 27,648 women, regardless of maternal age (17.4% were 35 years old and over), were included in a late Down syndrome screening program (18(+0) to 35(+6) weeks) using the maternal serum markers alpha-fetoprotein and human chorionic gonadotrophin-beta. Samples were assayed in a single laboratory. A dataset of median markers previously established in our laboratory was used for risk calculation. The control group consisted of 27,648 women (14(+0) to 17(+6) weeks) randomly selected from the routine database. RESULTS When the later screening group was compared with the standard second-trimester control group, the median multiples of medians (1.01 vs 0.98 for alpha-fetoprotein, 1.03 vs 0.98 for human chorionic gonadotrophin-beta), median risks (1 of 2414 vs 1 of 2720), false-positive rates (11.1% vs 11.6%), and trisomy 21 detection rates (83.3% vs 85.7%) did not differ significantly. CONCLUSION Late Down syndrome maternal serum screening is feasible with a good sensitivity/specificity compromise throughout gestation and is of clinical value in late-booking women.
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Abstract
Most biogerontologists agree that oxygen (and nitrogen) free radicals play a major role in the process of aging. The evidence strongly suggests that the electron transport chain, located in the inner mitochondrial membrane, is the major source of reactive oxygen species in animal cells. It has been reported that there exists an inverse correlation between the rate of superoxide/hydrogen peroxide production by mitochondria and the maximum longevity of mammalian species. However, no correlation or most frequently an inverse correlation exists between the amount of antioxidant enzymes and maximum longevity. Although overexpression of the antioxidant enzymes SOD1 and CAT (as well as SOD1 alone) have been successful at extending maximum lifespan in Drosophila, this has not been the case in mice. Several labs have overexpressed SOD1 and failed to see a positive effect on longevity. An explanation for this failure is that there is some level of superoxide damage that is not preventable by SOD, such as that initiated by the hydroperoxyl radical inside the lipid bilayer, and that accumulation of this damage is responsible for aging. I therefore suggest an alternative approach to testing the free radical theory of aging in mammals. Instead of trying to increase the amount of antioxidant enzymes, I suggest using molecular biology/transgenics to decrease the rate of superoxide production, which in the context of the free radical theory of aging would be expected to increase longevity. This paper aims to summarize what is known about the nature and mechanisms of superoxide production and what genes are involved in controlling the rate of superoxide production.
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Affiliation(s)
- F Muller
- Laboratory of David M. Kramer, Institute of Biological Chemistry, Washington State University, Pullman, WA 99164 USA
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