1
|
Banerji A, Bernstein JA, Johnston DT, Lumry WR, Magerl M, Maurer M, Martinez‐Saguer I, Zanichelli A, Hao J, Inhaber N, Yu M, Riedl MA, Hébert J, Ritchie B, Sussman G, Yang W, Aygören‐Pürsün E, Magerl M, Martinez‐Saguer I, Staubach P, Cicardi M, Shennak M, Zaragoza‐Urdaz R, Kiani‐Alikhan S, Anderson J, Banerji A, Baptist A, Bernstein J, Busse P, Craig T, Davis‐Lorton M, Gierer S, Gower R, Harris D, Jacobs J, Johnston D, Li H, Lockey R, Lugar P, Lumry W, Manning M, McNeil D, Melamed I, Otto W, Rehman S, Riedl M, Schwartz L, Shapiro R, Sher E, Smith A, Soteres D, Tachdjian R, Wedner H, Weinstein M, Zafra H. Long-term prevention of hereditary angioedema attacks with lanadelumab: The HELP OLE Study. Allergy 2022; 77:979-990. [PMID: 34287942 PMCID: PMC9292251 DOI: 10.1111/all.15011] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/06/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
Background The aim was to evaluate long‐term effectiveness and safety of lanadelumab in patients ≥12 y old with hereditary angioedema (HAE) 1/2 (NCT02741596). Methods Rollover patients completing the HELP Study and continuing into HELP OLE received one lanadelumab 300 mg dose until first attack (dose‐and‐wait period), then 300 mg q2wks (regular dosing stage). Nonrollovers (newly enrolled) received lanadelumab 300 mg q2wks from day 0. Baseline attack rate for rollovers: ≥1 attack/4 weeks (based on run‐in period attack rate during HELP Study); for nonrollovers: historical attack rate ≥1 attack/12 weeks. The planned treatment period was 33 months. Results 212 patients participated (109 rollovers, 103 nonrollovers); 81.6% completed ≥30 months on study (mean [SD], 29.6 [8.2] months). Lanadelumab markedly reduced mean HAE attack rate (reduction vs baseline: 87.4% overall). Patients were attack free for a mean of 97.7% of days during treatment; 81.8% and 68.9% of patients were attack free for ≥6 and ≥12 months, respectively. Angioedema Quality‐of‐Life total and domain scores improved from day 0 to end of study. Treatment‐emergent adverse events (TEAEs) (excluding HAE attacks) were reported by 97.2% of patients; most commonly injection site pain (47.2%) and viral upper respiratory tract infection (42.0%). Treatment‐related TEAEs were reported by 54.7% of patients. Most injection site reactions resolved within 1 hour (70.2%) or 1 day (92.6%). Six (2.8%) patients discontinued due to TEAEs. No treatment‐related serious TEAEs or deaths were reported. Eleven treatment‐related TEAEs of special interest were reported by seven (3.3%) patients. Conclusion Lanadelumab demonstrated sustained efficacy and acceptable tolerability with long‐term use in HAE patients.
Collapse
Affiliation(s)
- Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Department of Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Jonathan A. Bernstein
- Division of Immunology/Allergy Section Department of Internal Medicine University of Cincinnati, and Bernstein Clinical Research Center Cincinnati Ohio USA
| | | | | | - Markus Magerl
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité–Universitätsmedizin Berlin Berlin Germany
| | - Marcus Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité–Universitätsmedizin Berlin Berlin Germany
| | | | - Andrea Zanichelli
- Department of Internal Medicine ASST Fatebenefratelli Sacco, Ospedale Luigi Sacco‐University of Milan Milan Italy
| | - James Hao
- Takeda Development Center Americas, Inc. Lexington Massachusetts USA
| | - Neil Inhaber
- Takeda Development Center Americas, Inc. Lexington Massachusetts USA
| | - Ming Yu
- Takeda Development Center Americas, Inc. Lexington Massachusetts USA
| | - Marc A. Riedl
- Division of Rheumatology, Allergy and Immunology University of California San Diego La Jolla California USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Lumry WR, Weller K, Magerl M, Banerji A, Longhurst HJ, Riedl MA, Lewis HB, Lu P, Devercelli G, Jain G, Maurer M, Hébert J, Ritchie B, Sussman G, Yang WH, Martinez‐Saguer I, Staubach P, Cicardi M, Shennak M, Zaragoza‐Urdaz RH, Anderson J, Baptist AP, Bernstein JA, Boggs PB, Busse PJ, Craig T, Davis‐Lorton M, Gierer S, Gower RG, Harris D, Hong DI, Jacobs J, Johnston DT, Li HH, Lockey RF, Lugar P, Manning ME, McNeil DL, Melamed I, Mostofi T, Nickel T, Otto WR, Petrov AA, Radojicic C, Rehman SM, Schwartz LB, Shapiro R, Sher E, Smith AM, Soteres D, Tachdjian R, Wedner HJ, Weinstein ME, Zafra H. Impact of lanadelumab on health-related quality of life in patients with hereditary angioedema in the HELP study. Allergy 2021; 76:1188-1198. [PMID: 33258114 PMCID: PMC8247292 DOI: 10.1111/all.14680] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/01/2020] [Accepted: 11/14/2020] [Indexed: 01/20/2023]
Abstract
Background An objective of the phase 3 HELP Study was to investigate the effect of lanadelumab on health‐related quality of life (HRQoL) in patients with hereditary angioedema (HAE). Methods Patients with HAE‐1/2 received either lanadelumab 150 mg every 4 weeks (q4wks; n = 28), 300 mg q4wks (n = 29), 300 mg every 2 weeks (q2wks; n = 27), or placebo (n = 41) for 26 weeks (days 0–182). The Angioedema Quality of Life Questionnaire (AE‐QoL) was administered monthly, consisting of four domain (functioning, fatigue/mood, fears/shame, nutrition) and total scores. The generic EQ‐5D‐5L questionnaire was administered on days 0, 98, and 182. Comparisons were made between placebo and (a) all lanadelumab‐treated patients and (b) individual lanadelumab groups for changes in scores (day 0–182) and proportions achieving the minimal clinically important difference (MCID, −6) in AE‐QoL total score. Results Compared with the placebo group, the lanadelumab total group demonstrated significantly greater improvements in AE‐QoL total and domain scores (mean change, −13.0 to −29.3; p < 0.05 for all); the largest improvement was in functioning. A significantly greater proportion of the lanadelumab total group achieved the MCID (70% vs 37%; p = 0.001). The lanadelumab 300 mg q2wks group had the highest proportion (81%; p = 0.001) and was 7.2 times more likely to achieve the MCID than the placebo group. Mean EQ‐5D‐5L scores at day 0 were high in all groups, indicating low impairment, with no significant changes at day 182. Conclusion Patients with HAE‐1/2 experienced significant and clinically meaningful improvements in HRQoL measured by AE‐QoL following lanadelumab treatment in the HELP Study.
Collapse
Affiliation(s)
- William R. Lumry
- Allergy Asthma Research Associates Research Center Dallas TX USA
| | - Karsten Weller
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Markus Magerl
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Massachusetts General HospitalHarvard Medical School Boston MA USA
| | - Hilary J. Longhurst
- Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation TrustCambridge, and University College London Hospitals London UK
| | - Marc A. Riedl
- Division of Rheumatology Allergy & Immunology University of California San Diego La Jolla CA USA
| | | | - Peng Lu
- Takeda Pharmaceutical Company Limited Lexington MA USA
| | | | - Gagan Jain
- Takeda Pharmaceutical Company Limited Lexington MA USA
| | - Marcus Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Riedl MA, Maurer M, Bernstein JA, Banerji A, Longhurst HJ, Li HH, Lu P, Hao J, Juethner S, Lumry WR, Hébert J, Ritchie B, Sussman G, Yang WH, Escuriola Ettingshausen C, Magerl M, Martinez‐Saguer I, Maurer M, Staubach P, Zimmer S, Cicardi M, Perego F, Wu MA, Zanichelli A, Al‐Ghazawi A, Shennak M, Zaragoza‐Urdaz RH, Ghurye R, Longhurst HJ, Zinser E, Anderson J, Banerji A, Baptist AP, Bernstein JA, Boggs PB, Busse PJ, Christiansen S, Craig T, Davis‐Lorton M, Gierer S, Gower RG, Harris D, Hong DI, Jacobs J, Johnston DT, Levitch ES, Li HH, Lockey RF, Lugar P, Lumry WR, Manning ME, McNeil DL, Melamed I, Mostofi T, Nickel T, Otto WR, Petrov AA, Poarch K, Radojicic C, Rehman SM, Riedl MA, Schwartz LB, Shapiro R, Sher E, Smith AM, Smith TD, Soteres D, Tachdjian R, Wedner HJ, Weinstein ME, Zafra H, Zuraw BL. Lanadelumab demonstrates rapid and sustained prevention of hereditary angioedema attacks. Allergy 2020; 75:2879-2887. [PMID: 32452549 PMCID: PMC7689768 DOI: 10.1111/all.14416] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023]
Abstract
Background Lanadelumab demonstrated efficacy in preventing hereditary angioedema (HAE) attacks in the phase 3 HELP Study. Objective To assess time to onset of effect and long‐term efficacy of lanadelumab, based on exploratory findings from the HELP Study. Methods Eligible patients with HAE type I/II received lanadelumab 150 mg every 4 weeks (q4wks), 300 mg q4wks, 300 mg q2wks, or placebo. Ad hoc analyses evaluated day 0‐69 findings using a Poisson regression model accounting for overdispersion. Least‐squares mean monthly HAE attack rate for lanadelumab was compared with placebo. Intrapatient comparisons for days 0‐69 versus steady state (days 70‐182) used a paired t test for continuous endpoints or Kappa statistics for categorical endpoints. Results One hundred twenty‐five patients were randomized and treated. During days 0‐69, mean monthly attack rate was significantly lower with lanadelumab (0.41‐0.76) vs placebo (2.04), including attacks requiring acute treatment (0.33‐0.61 vs 1.66) and moderate/severe attacks (0.31‐0.48 vs 1.33, all P ≤ .001). More patients receiving lanadelumab vs placebo were attack free (37.9%‐48.1% vs 7.3%) and responders (85.7%‐100% vs 26.8%). During steady state, the efficacy of lanadelumab vs placebo was similar or improved vs days 0‐69. Intrapatient differences were significant with lanadelumab 300 mg q4wks for select outcomes. Lanadelumab efficacy was durable—HAE attack rate was consistently lower vs placebo, from the first 2 weeks of treatment through study end. Treatment emergent adverse events were comparable during days 0‐69 and 70‐182. Conclusion Protection with lanadelumab started from the first dose and continued throughout the entire study period.
Collapse
Affiliation(s)
- Marc A. Riedl
- Division of Rheumatology, Allergy and Immunology University of California, San Diego San Diego CA USA
| | - Marcus Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Jonathan A. Bernstein
- Division of Immunology/Allergy Section Department of Internal Medicine University of Cincinnati Cincinnati OH USA
- Bernstein Clinical Research Center Cincinnati OH USA
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Department of Medicine Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Hilary J. Longhurst
- Addenbrooke's Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge and University College London Hospitals London UK
| | - H. Henry Li
- Institute for Asthma and Allergy, P.C. Chevy Chase MD USA
| | - Peng Lu
- Shire, a Takeda company Lexington MA USA
| | - James Hao
- Shire, a Takeda company Lexington MA USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Maurer M, Gierer S, Hébert J, Hao J, Boudjemia K, Lu P, Banerji A. Le lanadelumab est très efficace à l’état d’équilibre pour l’angio-œdème héréditaire (AOH) : résultats de l’étude de phase 3 HELP. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
5
|
Gravot F, Hébert J, Robert-Dehault A, Bouttier R, Le Gall F, Blondin G, Vic P. Pyomyosite de l’enfant : deux cas d’infection à Staphylococcus aureus. Arch Pediatr 2017; 24:995-999. [DOI: 10.1016/j.arcped.2017.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/11/2017] [Accepted: 07/06/2017] [Indexed: 10/18/2022]
|
6
|
Baccelli I, Krosl J, Boucher G, Boivin I, Lavallée VP, Hébert J, Lemieux S, Marinier A, Sauvageau G. A novel approach for the identification of efficient combination therapies in primary human acute myeloid leukemia specimens. Blood Cancer J 2017; 7:e529. [PMID: 28211886 PMCID: PMC5386329 DOI: 10.1038/bcj.2017.10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 01/05/2017] [Indexed: 12/12/2022] Open
Abstract
Appropriate culture methods for the interrogation of primary leukemic samples were hitherto lacking and current assays for compound screening are not adapted for large-scale investigation of synergistic combinations. In this study, we report a novel approach that efficiently distills synthetic lethal interactions between small molecules active on primary human acute myeloid leukemia (AML) specimens. In single-dose experiments and under culture conditions preserving leukemia stem cell activity, our strategy considerably reduces the number of tests needed for the identification of promising compound combinations. Initially conducted with a selected library of 5000 small molecules and 20 primary AML specimens, it reveals 5 broad classes of sensitized therapeutic target pathways along with their synergistic patient-specific fingerprints. This novel method opens new avenues for the development of AML personalized therapeutics and may be generalized to other tumor types, for which in vitro cancer stem cell cultures have been developed.
Collapse
Affiliation(s)
- I Baccelli
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada
| | - J Krosl
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada
| | - G Boucher
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada
| | - I Boivin
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada
| | - V-P Lavallée
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada.,Division of Hematology, Maisonneuve-Rosemont Hospital, Montréal, Québec, Canada
| | - J Hébert
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada.,Division of Hematology, Maisonneuve-Rosemont Hospital, Montréal, Québec, Canada.,Leukemia Cell Bank of Quebec, Maisonneuve-Rosemont Hospital, Montréal, Québec, Canada.,Faculty of Medicine, Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - S Lemieux
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada.,Department of Computer Science and Operations Research, Université de Montréal, Montréal, Québec, Canada
| | - A Marinier
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada.,Department of Chemistry, Université de Montréal, Montréal, Québec, Canada
| | - G Sauvageau
- The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, Québec, Canada.,Division of Hematology, Maisonneuve-Rosemont Hospital, Montréal, Québec, Canada.,Leukemia Cell Bank of Quebec, Maisonneuve-Rosemont Hospital, Montréal, Québec, Canada.,Faculty of Medicine, Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| |
Collapse
|
7
|
Neufcourt L, Assmann K, Fézeu L, Touvier M, Graffouillère L, Shivappa N, Hébert J, Wirth M, Hercberg S, Galan P, Julia C, Kesse-Guyot E. Association prospective entre le Dietary Inflammatory Index et les maladies cardiovasculaires dans la cohorte SU.VI.MAX. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2016.10.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
8
|
Graffouillère L, Deschasaux M, Mariotti F, Neufcourt L, Shivappa N, Hébert J, Wirth M, Latino-Martel P, Hercberg S, Galan P, Julia C, Kesse-Guyot E, Touvier M. Association entre un score mesurant le potentiel pro/anti-inflammatoire de l’alimentation (le DII) et la mortalité : modulation par une supplémentation en antioxydants dans l’essai randomisé SU.VI.MAX. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2016.10.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Barabé F, Gil L, Celton M, Bergeron A, Lamontagne V, Roques É, Lagacé K, Forest A, Johnson R, Pécheux L, Simard J, Pelloux J, Bellemare-Pelletier A, Gagnon E, Hébert J, Cellot S, Wilhelm BT. Modeling human MLL-AF9 translocated acute myeloid leukemia from single donors reveals RET as a potential therapeutic target. Leukemia 2016; 31:1166-1176. [DOI: 10.1038/leu.2016.302] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/16/2016] [Accepted: 09/26/2016] [Indexed: 12/19/2022]
|
10
|
McCulloch L, Hébert J, Tcholakov Y, Ashorn M, Blair K, Byrne M, Connolly E, Evert J, Goodman L, Liu T, LoPiccolo M, Perez W, Rhee J, Shen J, Tran T, Wiley E. CUGH Trainee Advisory Committee (TAC) survey: the trainee perspectives in
global health. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
11
|
Lavallée VP, Lemieux S, Boucher G, Gendron P, Boivin I, Girard S, Hébert J, Sauvageau G. Identification of MYC mutations in acute myeloid leukemias with NUP98–NSD1 translocations. Leukemia 2016; 30:1621-4. [DOI: 10.1038/leu.2016.19] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
12
|
Vic P, Pouliquen-Coquet M, Hébert J, Le Moigno L, Robert-Dehault A. Diarrhée aiguë du nourrisson : évaluation des pratiques des médecins généralistes. Arch Pediatr 2016; 23:110-1. [DOI: 10.1016/j.arcped.2015.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/24/2015] [Accepted: 10/08/2015] [Indexed: 11/24/2022]
|
13
|
Vic P, Ramé E, Robert-Dehault A, Henry S, Le Moigno L, Hébert J. Repérage des conduites à risque et des symptômes dépressifs chez les adolescents admis en service d’accueil des urgences. Arch Pediatr 2015; 22:580-94. [DOI: 10.1016/j.arcped.2015.03.004] [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: 09/26/2014] [Revised: 01/26/2015] [Accepted: 03/02/2015] [Indexed: 11/25/2022]
|
14
|
Buhl R, Abrahams R, Bjermer L, Derom E, Fležar M, Hébert J, Veale A, Groenke L, Hamilton A, Tetzlaff K, Korducki L, Huisman H, Waitere-Wijker S, McGarvey L. Safety of once-daily tiotropium and olodaterol fixed-dose combination via the Respimat in chronic obstructive pulmonary disease in two 1-year studies. Pneumologie 2015. [DOI: 10.1055/s-0035-1544638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
15
|
Kleiderman E, Avard D, Besso A, Ali-Khan S, Sauvageau G, Hébert J. Disclosure of incidental findings in cancer genomic research: investigators' perceptions on obligations and barriers. Clin Genet 2014; 88:320-6. [PMID: 25492269 DOI: 10.1111/cge.12540] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 11/10/2014] [Accepted: 11/12/2014] [Indexed: 01/24/2023]
Abstract
Although there has been significant research surrounding incidental findings (IFs), the guidelines and information provided to investigators remain unspecific, unclear, and often generalize the course of action to everyone in the field. We explored the perceptions and experiences of investigators regarding the return of IFs in genetic research. Researchers and clinician-researchers were invited to participate in semi-structured telephone interviews in Quebec and Ontario. Twenty professionals participated, and thematic analysis was used to analyze the transcriptions. Four contextual elements emerged: (i) degree of significance of results, (ii) respect for persons, (iii) infrastructure implications, and (iv) professional responsibilities. Our findings demonstrate that all investigators raised similar contextual elements surrounding the return of IFs. However, some nuances in participants' experiences of the understanding of professional responsibilities also emerged. Because of the existing nuances, a one-size-fits-all approach is inappropriate, suggesting that context ought to be considered in decisions about IFs.
Collapse
Affiliation(s)
- E Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - D Avard
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - A Besso
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - S Ali-Khan
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - G Sauvageau
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, Quebec, Canada.,Leukemia Cell Bank of Quebec and Division of Hematology-Oncology, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada.,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - J Hébert
- Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, Quebec, Canada.,Leukemia Cell Bank of Quebec and Division of Hematology-Oncology, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada.,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| |
Collapse
|
16
|
Malbrán A, Riedl M, Ritchie B, Smith WB, Yang W, Banerji A, Hébert J, Gleich GJ, Hurewitz D, Jacobson KW, Bernstein JA, Khan DA, Kirkpatrick CH, Resnick D, Li H, Fernández Romero DS, Lumry W. Repeat treatment of acute hereditary angioedema attacks with open-label icatibant in the FAST-1 trial. Clin Exp Immunol 2014; 177:544-53. [PMID: 24749847 DOI: 10.1111/cei.12358] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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: 03/15/2014] [Indexed: 11/30/2022] Open
Abstract
Hereditary angioedema (HAE) is characterized by potentially life-threatening recurrent episodes of oedema. The open-label extension (OLE) phase of the For Angioedema Subcutaneous Treatment (FAST)-1 trial (NCT00097695) evaluated the efficacy and safety of repeated icatibant exposure in adults with multiple HAE attacks. Following completion of the randomized, controlled phase, patients could receive open-label icatibant (30 mg subcutaneously) for subsequent attacks. The primary end-point was time to onset of primary symptom relief, as assessed by visual analogue scale (VAS). Descriptive statistics were reported for cutaneous/abdominal attacks 1-10 treated in the OLE phase and individual laryngeal attacks. Post-hoc analyses were conducted in patients with ≥ 5 attacks across the controlled and OLE phases. Safety was evaluated throughout. During the OLE phase, 72 patients received icatibant for 340 attacks. For cutaneous/abdominal attacks 1-10, the median time to onset of primary symptom relief was 1·0-2·0 h. For laryngeal attacks 1-12, patient-assessed median time to initial symptom improvement was 0·3-1·2 h. Post-hoc analyses showed the time to onset of symptom relief based on composite VAS was consistent across repeated treatments with icatibant. One injection of icatibant was sufficient to treat 88·2% of attacks; rescue medication was required in 5·3% of attacks. No icatibant-related serious adverse events were reported. Icatibant provided consistent efficacy and was well tolerated for repeated treatment of HAE attacks.
Collapse
Affiliation(s)
- A Malbrán
- Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Kornmann O, Mailänder C, D'Urzo A, Hébert J, Chen H, Banerji D, Goyal P. Glycopyrronium einmal täglich zeigt anhaltende Bronchodilatation und verbessert Symptome in verschiedenen Subgruppen von Patienten mit COPD. Pneumologie 2014. [DOI: 10.1055/s-0034-1368051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
18
|
Black L, Avard D, Zawati MH, Knoppers BM, Hébert J, Sauvageau G. Funding considerations for the disclosure of genetic incidental findings in biobank research. Clin Genet 2013; 84:397-406. [PMID: 23662709 PMCID: PMC4670700 DOI: 10.1111/cge.12190] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/08/2013] [Accepted: 05/08/2013] [Indexed: 12/19/2022]
Abstract
The use of biobanks in biomedical research has grown considerably in recent years. As a result of the increasing analysis of tissue samples stored in biobanks, there has also been an increase in the probability of discovering-in addition to the research target-incidental findings (IF). We identified 23 laws, policies and guidelines from international, regional and national organizations that provide guidance or identify the need for the disclosure of IF to research participants. We analyzed these instruments to determine their contemplation of the funding considerations for the disclosure of IF, examining their guidance for who discloses and the extent of researcher responsibilities. We found that the available normative documents provide little guidance to researchers and biobanks for how they should address cost and funding concerns associated with IF disclosure. It is therefore essential that the research and policy communities think through the financial implications of imposing an ethical responsibility to disclose IF. Concerted efforts should be made by policymakers, ethicists, researchers, clinicians and research institutions to develop detailed funding recommendations, potentially universal in application, to aid in the disclosure of IF, and we provide recommendations on steps that can be taken to ensure full consideration of these issues.
Collapse
Affiliation(s)
- L Black
- Department of Human Genetics, Faculty of Medicine, Centre of Genomics and Policy, McGill UniversityMontreal, Quebec, Canada
| | - D Avard
- Department of Human Genetics, Faculty of Medicine, Centre of Genomics and Policy, McGill UniversityMontreal, Quebec, Canada
| | - MH Zawati
- Department of Human Genetics, Faculty of Medicine, Centre of Genomics and Policy, McGill UniversityMontreal, Quebec, Canada
| | - BM Knoppers
- Department of Human Genetics, Faculty of Medicine, Centre of Genomics and Policy, McGill UniversityMontreal, Quebec, Canada
| | - J Hébert
- Institute for Research in Immunology and Cancer, Université de MontréalMontreal, Quebec, Canada
- Leukemia Cell Bank of Quebec and Division of Hematology-Oncology, Maisonneuve-Rosemont HospitalMontreal, Quebec, Canada
| | - G Sauvageau
- Institute for Research in Immunology and Cancer, Université de MontréalMontreal, Quebec, Canada
- Leukemia Cell Bank of Quebec and Division of Hematology-Oncology, Maisonneuve-Rosemont HospitalMontreal, Quebec, Canada
| |
Collapse
|
19
|
Cicardi M, Craig TJ, Martinez-Saguer I, Hébert J, Longhurst HJ. Review of recent guidelines and consensus statements on hereditary angioedema therapy with focus on self-administration. Int Arch Allergy Immunol 2013; 161 Suppl 1:3-9. [PMID: 23689238 DOI: 10.1159/000351232] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Consensus meetings and the resulting recommendations shape treatment choices in rare diseases such as hereditary angioedema (HAE) because they combine the experience of prescribing physicians and the patients who are receiving therapy. Self-administration of HAE therapy was recognised as a potential treatment option in the first consensus publication in 2003. Recent studies have confirmed that self-administration of therapy resolves attacks quickly, safely and minimises burden of disease; however, the discovery of inconsistent treatment approaches is a concern and warrants investigation into the barriers that prevent adherence with current recommendations.
Collapse
Affiliation(s)
- M Cicardi
- Department of Biomedical and Clinical Sciences, University of Milan and Luigi Sacco Hospital, Milan, Italy.
| | | | | | | | | |
Collapse
|
20
|
Greulich T, Korenblat PE, Hébert J, Gallagher N, Martin C, Banerji D, Lu Y. NVA237 einmal täglich verbessert die Atemnot und die gesundheitsbezogene Lebensqualität bei Patienten mit COPD: die GLOW2 Studie. Pneumologie 2013. [DOI: 10.1055/s-0033-1334774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
21
|
Kornmann O, Kerwin EM, Hébert J, Pedinoff A, Gallagher N, Martin C, Banerji D, Lu Y, Overend T. NVA237 einmal täglich erzielt eine schnelle und anhaltende Bronchodilatation bei COPD Patienten, mit vergleichbarer Wirksamkeit zu open-label Tiotropium: die GLOW2 Studie. Pneumologie 2013. [DOI: 10.1055/s-0033-1334776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
22
|
Guérin L, Collet E, Hébert J, Buron-Le Cointe M, Adachi S, Koshihara S, Cailleau H. Evidence of one-dimensional precursors in the photoinduced transformation in TTF-CA. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311086788] [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: 11/10/2022] Open
|
23
|
Kulus M, Hébert J, Garcia E, Fowler Taylor A, Fernandez Vidaurre C, Blogg M. Omalizumab in children with inadequately controlled severe allergic (IgE-mediated) asthma. Curr Med Res Opin 2010; 26:1285-93. [PMID: 20377320 DOI: 10.1185/03007991003771338] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many children with severe persistent allergic (IgE-mediated) asthma remain inadequately controlled despite treatment with high-dose inhaled corticosteroids (ICS) plus a long-acting beta(2)-agonist (LABA). RESEARCH AND DESIGN METHODS This pre-specified analysis of a randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of omalizumab in children (6-<12 years) with perennial allergen sensitivity, and history of asthma exacerbations and symptoms despite treatment with ICS (fluticasone >or=500 microg x day(-1) or equivalent) plus a LABA. Patients received omalizumab (75-375 mg once or twice a month by subcutaneous injection, as determined from dosing tables) or placebo over 52 weeks (24-week fixed-steroid then 28-week adjustable-steroid phases). RESULTS Out of 246 randomized patients (omalizumab, n = 166; placebo, n = 80), efficacy was analysed in 235 (omalizumab, n = 159; placebo, n = 76). Over the 24-week fixed-steroid phase, omalizumab reduced the rate of clinically significant asthma exacerbations (worsening symptoms requiring doubling of baseline ICS dose and/or systemic steroids) by 34% versus placebo (0.42 vs 0.63, rate ratio 0.662; P = 0.047). Over 52 weeks, the exacerbation rate was reduced by 50% (P < 0.001). Omalizumab had an acceptable safety profile, with no statistically significant (P < 0.05) differences in adverse events observed between omalizumab and placebo. CONCLUSION Add-on omalizumab is well-tolerated and reduces exacerbations in children (6-<12 years) with severe persistent allergic asthma, inadequately controlled despite high-dose ICS plus a LABA. It should be noted that the sample size was not based on providing statistical power in the severe subgroup, and no corrections were made for multiple comparisons; however, outcomes consistently favoured omalizumab.
Collapse
Affiliation(s)
- M Kulus
- Medical University of Warsaw, Warsaw, Poland.
| | | | | | | | | | | |
Collapse
|
24
|
Lorenc M, Hébert J, Moisan N, Trzop E, Servol M, Buron-Le Cointe M, Cailleau H, Boillot ML, Pontecorvo E, Wulff M, Koshihara S, Collet E. Successive dynamical steps of photoinduced switching of a molecular Fe(III) spin-crossover material by time-resolved x-ray diffraction. Phys Rev Lett 2009; 103:028301. [PMID: 19659251 DOI: 10.1103/physrevlett.103.028301] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Indexed: 05/28/2023]
Abstract
We investigate the out-of-equilibrium switching dynamics of a molecular Fe(III) spin-crossover solid triggered by a femtosecond laser flash. The time-resolved x-ray diffraction and optical results show that the dynamics span from subpicosecond local photoswitching followed by volume expansion (nanosecond) and thermal switching (microsecond). We present a physical picture of the consecutive steps in the photoswitching of molecular materials.
Collapse
Affiliation(s)
- M Lorenc
- Institut de Physique de Rennes, Université de Rennes 1-CNRS, UMR 6251, 35042 Rennes, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Hébert J, Lust A, Fuller A, Maloney SK, Mitchell D, Mitchell G. Thermoregulation in pronghorn antelope (Antilocapra americana, Ord) in winter. ACTA ACUST UNITED AC 2008; 211:749-56. [PMID: 18281337 DOI: 10.1242/jeb.013946] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Conservation of energy is a prerequisite thermoregulatory strategy for survival in northern hemisphere winters. We have used thermistor/data logger assemblies to measure temperatures in the brain, carotid artery, jugular vein and abdominal cavity, in pronghorn antelope to determine their winter body temperature and to investigate whether the carotid rete has a survival role. Over the study period mean black globe and air temperature were -0.5+/-3.2 degrees C and -2.0+/-3.4 degrees C, respectively, and mean daytime solar radiation was approximately 186 W m(-2). Brain temperature (T(brain), 39.3+/-0.3 degrees C) was higher than carotid blood temperature (T(carotid), 38.5+/-0.4 degrees C), and higher than jugular temperature (T(jugular), 37.9+/-0.7 degrees C). Minimum T(brain) (38.5+/-0.4 degrees C) and T(carotid) (37.8+/-0.2 degrees C) in winter were higher than the minimum T(brain) (37.7+/-0.5 degrees C) and T(carotid) (36.4+/-0.8 degrees C) in summer that we have reported previously. Compared with summer, winter body temperature patterns were characterized by an absence of selective brain cooling (SBC), a higher range of T(brain), a range of T(carotid) that was significantly narrower (1.8 degrees C) than in summer (3.1 degrees C), and changes in T(carotid) and T(brain) that were more highly correlated (r=0.99 in winter vs r=0.83 in summer). These findings suggest that in winter the effects of the carotid rete are reduced, which eliminates SBC and prevents independent regulation of T(brain), thus coupling T(brain) to T(carotid). The net effect is that T(carotid) varies little. A possible consequence is depression of metabolism, with the survival advantage of conservation of energy. These findings also suggest that the carotid rete has wider thermoregulatory effects than its traditional SBC function.
Collapse
Affiliation(s)
- J Hébert
- Department of Zoology and Physiology, University of Wyoming, Laramie, WY 82071, USA
| | | | | | | | | | | |
Collapse
|
26
|
Jamal R, Bélisle C, Lessard MC, Hébert J, Roy DC, Levine R, Busque L. Evidence suggesting the presence of a stem cell clone anteceding the acquisition of the JAK2-V617F mutation. Leukemia 2008; 22:1472-4. [PMID: 18239619 DOI: 10.1038/leu.2008.6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
|
27
|
Collet E, Buron M, Guérin L, Hébert J, Cailleau H, Adachi S, Koshihara S. Photoinduced transition of TTF-CA: picosecond diffuse scattering investigations. Acta Crystallogr A 2007. [DOI: 10.1107/s0108767307097747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
28
|
|
29
|
Hébert J, Rolli M, Gao J, Reisner C. Omalizumab, an Anti-IgE Monoclonal Antibody, Demonstrates Long-Term Asthma Control, Safety and Tolerability in Patients with Severe Allergic Asthma. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
30
|
Humbert M, Beasley R, Ayres J, Slavin R, Hébert J, Bousquet J, Beeh KM, Ramos S, Canonica GW, Hedgecock S, Fox H, Blogg M, Surrey K. Benefits of omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE. Allergy 2005; 60:309-16. [PMID: 15679715 DOI: 10.1111/j.1398-9995.2004.00772.x] [Citation(s) in RCA: 744] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with severe persistent asthma who are inadequately controlled despite Global Initiative for Asthma (GINA) 2002 step 4 therapy are a challenging population with significant unmet medical need. We determined the effect of omalizumab on clinically significant asthma exacerbations (requiring systemic corticosteroids) in the first omalizumab study to exclusively enrol patients from this difficult-to-treat patient population. METHODS Following a run-in phase, patients (12-75 years) inadequately controlled despite therapy with high-dose inhaled corticosteroids (ICS) and long-acting beta(2)-agonists (LABA) with reduced lung function and a recent history of clinically significant exacerbations were randomized to receive omalizumab or placebo for 28 weeks in a double-blind, parallel-group, multicentre study. RESULTS A total of 419 patients were included in the efficacy analyses. The clinically significant asthma exacerbation rate (primary efficacy variable), adjusted for an observed relevant imbalance in history of clinically significant asthma exacerbations, was 0.68 with omalizumab and 0.91 with placebo (26% reduction) during the 28-week treatment phase (P = 0.042). Without adjustment, a similar magnitude of effect was seen (19% reduction), but this did not reach statistical significance. Omalizumab significantly reduced severe asthma exacerbation rate (0.24 vs 0.48, P = 0.002) and emergency visit rate (0.24 vs 0.43, P = 0.038). Omalizumab significantly improved asthma-related quality of life, morning peak expiratory flow and asthma symptom scores. The incidence of adverse events was similar between treatment groups. CONCLUSIONS In patients with inadequately controlled severe persistent asthma, despite high-dose ICS and LABA therapy, and often additional therapy, omalizumab significantly reduced the rate of clinically significant asthma exacerbations, severe exacerbations and emergency visits. Omalizumab is effective and should be considered as add-on therapy for patients with inadequately controlled severe persistent asthma who have a significant unmet need despite best available therapy.
Collapse
MESH Headings
- Administration, Inhalation
- Adolescent
- Adrenal Cortex Hormones/administration & dosage
- Adrenal Cortex Hormones/therapeutic use
- Adrenergic beta-Agonists/therapeutic use
- Adult
- Aged
- Anti-Asthmatic Agents/adverse effects
- Anti-Asthmatic Agents/therapeutic use
- Antibodies, Anti-Idiotypic
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Asthma/drug therapy
- Asthma/physiopathology
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Therapy, Combination
- Female
- Forced Expiratory Volume
- Humans
- Male
- Middle Aged
- Omalizumab
- Patient Admission/statistics & numerical data
- Quality of Life
- Receptors, Adrenergic, beta-2/drug effects
- Retreatment
- Severity of Illness Index
- Treatment Outcome
Collapse
Affiliation(s)
- M Humbert
- Hôpital Antoine Beclere, Clamart, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Gübeli AO, Hébert J, Taillon R, Côté PA. L'action de l'ammoniac sur l'hydroxyde de cobalt(II) et la stabilité des complexes en milieu aqueux. Helv Chim Acta 2004. [DOI: 10.1002/hlca.19700530542] [Citation(s) in RCA: 9] [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] [Indexed: 11/10/2022]
|
32
|
|
33
|
Holgate ST, Chuchalin AG, Hébert J, Lötvall J, Persson GB, Chung KF, Bousquet J, Kerstjens HA, Fox H, Thirlwell J, Cioppa GD. Efficacy and safety of a recombinant anti-immunoglobulin E antibody (omalizumab) in severe allergic asthma. Clin Exp Allergy 2004; 34:632-8. [PMID: 15080818 DOI: 10.1111/j.1365-2222.2004.1916.x] [Citation(s) in RCA: 374] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patients with severe asthma are often inadequately controlled on existing anti-asthma therapy, constituting an unmet clinical need. OBJECTIVE This randomized, double-blind, placebo-controlled trial evaluated the ability of omalizumab, a humanized monoclonal anti-IgE antibody, to improve disease control sufficiently to enable inhaled corticosteroid reduction in patients with severe allergic asthma. METHODS After a run-in period when an optimized fluticasone dose (> or =1000 microg/day) was received for 4 weeks, patients were randomized to receive subcutaneous omalizumab [minimum 0.016 mg/kg/IgE (IU/mL) per 4 weeks; n=126] or matching placebo (n=120) at intervals of 2 or 4 weeks. The study comprised a 16-week add-on phase of treatment followed by a 16-week fluticasone-reduction phase. Short-/long-acting beta(2)-agonists were allowed as needed. RESULTS Median reductions in fluticasone dose were significantly greater with omalizumab than placebo: 60% vs. 50% (P=0.003). Some 73.8% and 50.8% of patients, respectively, achieved a > or =50% dose reduction (P=0.001). Fluticasone dose reduction to < or =500 microg/day occurred in 60.3% of omalizumab recipients vs. 45.8% of placebo-treated patients (P=0.026). Through both phases, omalizumab reduced rescue medication requirements, improved asthma symptoms and asthma-related quality of life compared to placebo. CONCLUSION Omalizumab treatment improves asthma control in severely allergic asthmatics, reducing inhaled corticosteroid requirements without worsening of symptom control or increase in rescue medication use.
Collapse
Affiliation(s)
- S T Holgate
- RCMB Research Division, Southampton General Hospital, Southampton, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Verreault N, Lavoie A, Bédard PM, Côté L, Hébert J. ImmunodéFiciences Primaires Et Mortalité : Est-Il Possible De PréVenir? Paediatr Child Health 2003. [DOI: 10.1093/pch/8.suppl_b.35bb] [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
|
35
|
Le Blanc R, Montminy-Métivier S, Bélanger R, Busque L, Fish D, Roy DC, Kassis J, Boileau J, Lavallée R, Bélanger D, Letendre F, Hébert J, Sauvageau G, Perreault C, Roy J. Allogeneic transplantation for multiple myeloma: further evidence for a GVHD-associated graft-versus-myeloma effect. Bone Marrow Transplant 2001; 28:841-8. [PMID: 11781644 DOI: 10.1038/sj.bmt.1703253] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2001] [Accepted: 08/02/2001] [Indexed: 11/09/2022]
Abstract
We report a series of 37 consecutive patients with multiple myeloma (MM) who received an allograft between 1990 and 2000 at our institution. Median age was 47 years, and nearly 70% of patients were Durie-Salmon stage III. A median of five cycles of chemotherapy were given before transplant, with a median interval between diagnosis and transplant of 9.3 months. We report a nonrelapse mortality rate of 22% with a median follow-up period of 40 months, whereas complete remission (CR) rate at 12 months is estimated at 57%. Treatment failure rate and overall survival at 40 months are estimated at 52% and 32%, respectively. The number of chemotherapy cycles prior to allotransplantation achieved borderline statistical significance as a poor prognosis factor for overall survival (P = 0.05), while the presence of chronic graft-versus-host disease (cGVHD) was significantly correlated with CR achievement (P = 0.036). Our study confirms that early allografting in MM can yield toxicity rates significantly lower than those associated with historical cohorts, and supports the hypothesis that cumulative chemotoxicity has a negative influence on mortality and survival rates. More importantly, our study clearly demonstrates an association between cGVHD and CR and brings further evidence in favor of a graft-versus-myeloma effect.
Collapse
Affiliation(s)
- R Le Blanc
- Division of Hematology-Immunology, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Minegishi Y, Lavoie A, Cunningham-Rundles C, Bédard PM, Hébert J, Côté L, Dan K, Sedlak D, Buckley RH, Fischer A, Durandy A, Conley ME. Mutations in activation-induced cytidine deaminase in patients with hyper IgM syndrome. Clin Immunol 2000; 97:203-10. [PMID: 11112359 DOI: 10.1006/clim.2000.4956] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Recent studies have shown that mutations in a newly described RNA editing enzyme, activation-induced cytidine deaminase (AID), can cause an autosomal recessive form of hyper IgM syndrome. To determine the relative frequency of mutations in AID, we evaluated a group of 27 patients with hyper IgM syndrome who did not have defects in CD40 ligand and 23 patients with common variable immunodeficiency. Three different mutations in AID were identified in 18 patients with hyper IgM syndrome, including 14 French Canadians, 2 Lumbee Indians, and a brother and sister from Okinawa. No mutations were found in the remaining 32 patients. In the group of patients with hyper IgM syndrome, the patients with mutations in AID were older at the age of diagnosis, were more likely to have positive isohemagglutinins, and were less likely to have anemia, neutropenia, or thrombocytopenia. Lymphoid hyperplasia was seen in patients with hyper IgM syndrome and normal AID as well as the patients with hyper IgM syndrome and defects in AID.
Collapse
Affiliation(s)
- Y Minegishi
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101-0318, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Hébert J, Boucher JP. Effect of manual segmental vibration on neuromuscular excitability. J Manipulative Physiol Ther 1998; 21:528-33. [PMID: 9798181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To measure the effects of manual segmental vibration (MSV) on motoneuron pool excitability. METHODS Seven healthy subjects were tested under five conditions: pretest, upholding static knee position (USKP), MSV, posttest 1 and posttest 2. Each test lasted 2 min, and a 2-min rest was given between pretest, USKP and MSV, whereas the last two tests were consecutive. Cutaneous pressure and vibration frequency were stabilized through training periods. The effects of MSV on motoneuron excitability were investigated by measuring the H-reflex peak-to-peak amplitude. MEASURES The H-reflex and M response were taken from the medial gastrocnemius electromyogram and elicited every 7 sec by a 1 ms square wave pulses to the tibial nerve. Fifteen trials were recorded for each condition. Stimulation intensity was set at 10% (+/- 2.5%) of Mmax stimulus. RESULTS Repeated-measures analysis of variance comparing conditions revealed no significant differences in M response [F(4,24) = 2.37, p > .05, beta = .35]. H-reflex comparisons revealed significant differences [F(4,24) = 30.39, p < .05, beta = .01] between conditions. Duncan post hoc analysis showed that MSV produced the greatest inhibition (decreases 95%) and USKP also elicited a significant inhibition (decreases 41%). CONCLUSIONS The inhibition may be the result of the following mechanisms: the reflex inhibition, the implication of cutaneous afferences and the higher control mechanism. Because MSV produces a reduction in neuromuscular excitability, it could also play a role in predisposing the system for changes to occur and therefore be used as an adjunct for other therapeutic applications.
Collapse
Affiliation(s)
- J Hébert
- Department of Kinanthropology, University of Quebec at Montreal, Canada
| | | |
Collapse
|
38
|
Wolfgang M, Lauer P, Park HS, Brossay L, Hébert J, Koomey M. PilT mutations lead to simultaneous defects in competence for natural transformation and twitching motility in piliated Neisseria gonorrhoeae. Mol Microbiol 1998; 29:321-30. [PMID: 9701824 DOI: 10.1046/j.1365-2958.1998.00935.x] [Citation(s) in RCA: 262] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neisseria gonorrhoeae, the Gram-negative aetiological agent of gonorrhoeae, is one of many mucosal pathogens of man that expresses competence for natural transformation. Expression of this phenotype by gonococci appears to rely on the expression of type IV pili (Tfp), but the mechanistic basis for this relationship remains unknown. During studies of gonococcal pilus biogenesis, a homologue of the PilT family of proteins, required for Tfp-dependent twitching motility in Pseudomonas aeruginosa and social gliding motility in Myxococcus xanthus, was discovered. Like the findings in these other species, we show here that gonococcal PilT mutants constructed in vitro no longer display twitching motility. In addition, we demonstrate that they have concurrently lost the ability to undergo natural transformation, despite the expression of structurally and morphologically normal Tpf. These results were confirmed by the findings that two classes of spontaneous mutants that failed to express twitching motility and transformability carried mutations in PilT. Piliated PilT mutants and a panel of pilus assembly mutants were found to be deficient in sequence-specific DNA uptake into the cell, the earliest demonstrable step in neisserial competence. The PilT-deficient strains represent the first genetically defined mutants that are defective in DNA uptake but retain Tfp expression.
Collapse
Affiliation(s)
- M Wolfgang
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor 48109-0620, USA
| | | | | | | | | | | |
Collapse
|
39
|
Tkaczyk C, Viguier M, Boutin Y, Frandji P, David B, Hébert J, Mécheri S. Specific antigen targeting to surface IgE and IgG on mouse bone marrow-derived mast cells enhances efficiency of antigen presentation. Immunology 1998; 94:318-24. [PMID: 9767412 PMCID: PMC1364248 DOI: 10.1046/j.1365-2567.1998.00525.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The discovery that bone marrow-derived mast cells can express major histocompatibility complex class II molecules and act as antigen-presenting cells prompted us to evaluate this function when antigen is internalized through fluid-phase endocytosis or via specific uptake by using IgG and IgE antibodies. This study was performed using a specific T-cell hybridoma developed against Lol p 1, the major allergen of grass pollen Lolium perenne. Expression of Fc gamma R and Fc epsilon RI by mast cells led us to investigate the influence of IgG- and IgE-targeted antigen on the antigen-presenting function of mast cells. Internalization of Lol p 1 through different specific IgG monoclonal antibodies (mAb) resulted in the activation of Lol p 1-specific T-cell hybridoma at concentrations about 100-fold less than that required for T-cell stimulation by uncomplexed antigen. IgE-complexed Lol p 1, which facilitates trapping of antigen by mast cells, induced an accelerated and more efficient antigen-presenting capacity of mast cells than that obtained with uncomplexed antigen. However, aggregation of anti-dinitrophenyl (DNP) IgE mAb by the irrelevant antigen DNP-human serum albumin did not substantially increase the capacity of mast cells to present Lol p 1 to T cells. This suggests that the mere aggregation of Fc epsilon RI is not sufficient for enhanced antigen presentation mediated by IgE. Tissue distribution and strategic location of mast cells at the mucosal barriers and their capacity to process the antigen through efficient fluid-phase pinocytosis as well as IgG- and IgE-dependent targeting of antigens provide mast cells with a prominent role in immune surveillance.
Collapse
Affiliation(s)
- C Tkaczyk
- Unité d'Immunoallergie, Institut Pasteur, Paris, France
| | | | | | | | | | | | | |
Collapse
|
40
|
Perfetti L, Hébert J, Lapalme Y, Ghezzo H, Gautrin D, Malo JL. Changes in IgE-mediated allergy to ubiquitous inhalants after removal from or diminution of exposure to the agent causing occupational asthma. Clin Exp Allergy 1998; 28:66-73. [PMID: 9537782 DOI: 10.1046/j.1365-2222.1998.00193.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND One possibility, among others, for explaining the persistence of asthma symptoms in occupational asthma (OA) after the cessation of exposure to the causal agents may be that subjects become sensitized to ubiquitous inhalants. OBJECTIVE The aim of this study was to evaluate the development or increase of IgE-mediated sensitization to ubiquitous allergens, both to high- and low-molecular-weight agents, in 100 subjects with OA after cessation of exposure. METHODS Subjects were evaluated on a first visit, at the time of diagnosis of OA, coinciding with the cessation or diminution of exposure to the causal agent, and on a second visit, 5.8+/-3.3 years afterwards. At each visit, a history of ocular, nasal and asthmatic symptoms related to exposure to common allergens was obtained together with spirometry and assessment of bronchial responsiveness to methacholine. We analysed total IgE and specific IgE to Dermatophagoides farinae, D. pteronyssinus, birch, ragweed and timothy grass pollens, cat and dog danders, and Alternaria, using enzyme allergosorbent test (EAST) from blood samples taken on each visit. RESULTS Total IgE levels showed a tendency to diminish. No changes were found in the number of positive EAST (presence of detectable levels of specific IgE) or in the levels of specific IgE. Although significantly more symptoms of rhinoconjunctivitis and asthma in contact with house dust (P < 0.05) and pets (P < 0.01) were reported on the second visit than on the first, no significant changes in the frequency of symptomatic sensitized subjects were found. CONCLUSION Subjects with OA are unlikely to develop IgE-dependent sensitization to common inhalants after removal from exposure to occupational agents.
Collapse
Affiliation(s)
- L Perfetti
- Department of Chest Medicine, Sacré-Coeur Hospital, Montreal, Québec, Canada
| | | | | | | | | | | |
Collapse
|
41
|
Abstract
BACKGROUND Current forms of allergy diagnosis and therapies are based on the use of natural allergenic extracts. Despite strong evidence that higher therapeutic efficacy may be achieved with purified allergens, the purification of multiple allergic components from extracts is a fastidious and sometimes an impossible task. However, the use of recombinant allergens may be an alternative to overcome this problem. OBJECTIVE In this study, we compared the immunological properties of recombinant (r) Lol p 1 with those of the natural protein. METHOD We cloned directly the gene encoding Lol p 1 from genomic DNA of ryegrass pollen. This gene was subcloned into the expression vector pMAL-c and expressed as fusion protein. Subsequently, rLol p 1 was cleaved from maltose-binding protein using factor Xa. Using binding inhibition and proliferative assays, we assessed the immunological properties of the recombinant allergens. The capacity of rLol p 1 to trigger basophil histamine release and to elicit a skin reaction was also assessed and compared to those of its natural counterpart. RESULTS We found that the Lol p 1 gene has no introns since we amplified this gene directly from genomic DNA. We demonstrated that the binding sites of anti-Lol p 1 monoclonal antibody, specific human IgG and IgE antibody are well conserved on rLol p 1 as no difference in the binding inhibition profile was observed when using either natural or recombinant protein. At the T-cell level, rLol p 1 elicited a T-cell response in mice comparable to that observed with the natural protein. In addition, we demonstrated that the biological characteristics of rLol p 1 were comparable to those of the natural counterpart, in that rLol p 1 elicited a skin wheal reaction and induced basophil histamine release in grass-allergic patients only. CONCLUSION The data indicate that natural Lol p 1 and rLol p 1 shared identical immunological and biological properties.
Collapse
Affiliation(s)
- Y Boutin
- Centre de Recherche en Immunologie et Rhumatologie, Centre Hospitalier de l'Université Laval and Immunova Ltd., Sainte-Foy, Québec, Canada
| | | | | | | | | |
Collapse
|
42
|
Boulet LP, Turcotte H, Laprise C, Lavertu C, Bédard PM, Lavoie A, Hébert J. Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma. Clin Exp Allergy 1997; 27:52-9. [PMID: 9117881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES The determinants of variability in the clinical expression of atopy are still to be documented. The goals of this study were to determine, in subjects with a clinical diagnosis of symptomatic asthma or rhinitis, what is the possible contribution of different types of indoor and outdoor allergens to the development of their disease, by looking at the prevalence and degree of sensitization to these allergens according to age and gender. SUBJECTS AND METHODS We analysed allergy skin prick tests to common airborne indoor and outdoor allergens in 3371 consecutive patients, grouped according to diagnosis of allergic asthma, rhinitis, or both. For each of these three groups, we calculated the prevalence of sensitization to indoor/outdoor allergens, the atopic index (AI), the number of positive responses to allergy skin prick test and the mean wheal diameter (MWD) of these responses. RESULTS The prevalence of atopy and the values of AI and MWD peaked in subjects aged 16 to 25 years, declining afterwards; in subjects > or = 18 years old, atopic indices were slightly higher in men than in women. In atopic subjects, the prevalence of sensitization was, in decreasing order, housedust (84.2%), cat hair-epithelium (76.5%), dog hair-dander (63.0%), house dust mite (54.2%), grasses (51.9%), trees (47.2%) and ragweed pollens (44.9%) and finally, moulds (25.4%). Among subjects sensitized only to outdoor allergens (n = 195). 73.8% had a rhinitis, 11.8% had asthma and 14.4% had both diagnoses; for those sensitized only to indoor allergens (n = 710), these values were respectively 48.6, 24.5 and 26.9%, and for those sensitized to both indoor and outdoor allergens (n = 1793), the comparable values were 55.5, 14.6 and 29.9%. CONCLUSION These data show that in our population of subjects with respiratory allergic symptoms, indoor allergen sensitization is strongly associated with asthma, while exclusive sensitization to pollens is associated primarily with rhinitis. Sensitization was more prevalent for indoor allergens than for outdoor allergens in all groups determined according to diagnosis or age. Indices of atopy were higher in men in the group > or = 18 years old. Prevalence and degree of sensitization were shown to peak in young adults, regardless of the allergen, and to diminish with age. This study stresses the role of indoor allergens in the development of asthma and shows the variability of allergic manifestations according to the type of sensitization.
Collapse
Affiliation(s)
- L P Boulet
- Unité de Recherche en Pneumologie, Hôpital Laval, Université Laval, Sainte-Foy, Québec, Canada
| | | | | | | | | | | | | |
Collapse
|
43
|
Boulet LP, Laviolette M, Boucher S, Knight A, Hébert J, Chapman KR. A twelve-week comparison of salmeterol and salbutamol in the treatment of mild-to-moderate asthma: a Canadian multicenter study. J Allergy Clin Immunol 1997; 99:13-21. [PMID: 9003206 DOI: 10.1016/s0091-6749(97)70295-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND A long-acting inhaled bronchodilator that is both well tolerated and effective could allow for improved control of both daytime and nighttime symptoms in patients with asthma who use frequent as-needed short-acting bronchodilators despite antiinflammatory treatment. OBJECTIVE AND METHODS We compared the efficacy and safety of inhaled salmeterol, 50 micrograms twice daily, with inhaled salbutamol, 200 micrograms four times daily, delivered through a metered-dose inhaler for 3 months in a multicenter, randomized, double-blind, parallel-group study of 228 patients (aged 12 to 76 years) with mild-to-moderate asthma. RESULTS A single morning dose of salmeterol produced improvement in FEV1 that was significantly greater (p < or = 0.012) than that produced by two doses of salbutamol (taken 6 hours apart) when patients were assessed 3 to 6 hours and 10 to 12 hours after the dose. This greater bronchodilation was present on day 1 of the study and after 4, 8, and 12 weeks of regular treatment. Over the 12 weeks, compared with salbutamol, salmeterol treatment was associated with a greater mean improvement in morning peak expiratory flow (35 L/min vs -3 L/min, p < 0.001), a higher percentage of days with no symptoms (29% vs 15%; p = 0.012), and a higher percentage of nights with no awakenings (14% vs -1%; p < 0.001). Adverse events were similar for both treatments. CONCLUSIONS In this study salmeterol, 50 micrograms twice daily, was well tolerated and more effective than salbutamol, 200 micrograms four times daily, in improving symptoms and lung function in patients with mild-to-moderate asthma.
Collapse
Affiliation(s)
- L P Boulet
- Centre de Pneumologie, Hôpital Laval, Sainte-Foy, Québec, Canada
| | | | | | | | | | | |
Collapse
|
44
|
Claveau J, Lavoie A, Brunet C, Bédard PM, Hébert J. Comparison of histamine-releasing factor recovered from skin and peripheral blood mononuclear cells of patients with chronic idiopathic urticaria. Ann Allergy Asthma Immunol 1996; 77:475-9. [PMID: 8970437 DOI: 10.1016/s1081-1206(10)63353-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The pathogenesis of chronic idiopathic urticaria is characterized by defective histamine release. Skin mast cells show an increased release of histamine while circulating basophils are less responsive to immunologic stimulus. OBJECTIVE The purpose of the study was to examine and compare the production of the histamine-releasing factor in the skin and within the peripheral blood of patients with chronic idiopathic urticaria and normal control subjects, as a possible factor responsible for the difference observed in the releasability of both skin mast cells and basophils. METHODS Using the skin chamber technique, histamine-releasing factor production and histamine concentration were assessed in normal-appearing skin of patients with chronic idiopathic urticaria (n = 12) and normal controls (n = 5) over a 2-hour observation period. In both groups, histamine-releasing factor production by peripheral blood mononuclear cells was also measured. RESULTS The weighted average of histamine-releasing factor production during the 2-hour observation period was higher in the non-lesional skin of patients with chronic idiopathic urticaria as compared with normal controls (5.6 +/- 1.4% versus 0.7 +/- 0.6%, P < .01). In contrast, less histamine-releasing factor was produced by peripheral blood mononuclear cells in chronic urticaria as opposed to normal controls (17.2 +/- 2.1% versus 25.7 +/- 2.8%, P < .03). Spontaneous histamine concentration was not significantly different in patients with chronic urticaria than in normal controls. CONCLUSION Histamine-releasing factor production is increased in the skin, and decreased in the peripheral blood of patients with chronic idiopathic urticaria when compared with nonatopic controls. The lower production of histamine releasing factor in the blood could be explained by the migration of activated T-lymphocytes in the skin.
Collapse
Affiliation(s)
- J Claveau
- Division de dermatologie, Université Laval, Sainte-Foy, Québec, Canada
| | | | | | | | | |
Collapse
|
45
|
Drouin M, Yang WH, Bertrand B, Van Cauwenberge P, Clement P, Dalby K, Darnell R, Ernst TM, Hébert J, Karlsson G, Luciuk G, Mazza J, Roovers M, Ruoppi P, Seppey M, Stern M, Suonpää J, Sussman G, Tan KY, Tse K, Widjaja P, Jensen P, Nolop K, Lutsky BN. Once daily mometasone furoate aqueous nasal spray is as effective as twice daily beclomethasone dipropionate for treating perennial allergic rhinitis patients. Ann Allergy Asthma Immunol 1996; 77:153-60. [PMID: 8760782 DOI: 10.1016/s1081-1206(10)63502-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Perennial allergic rhinitis is chronic and persistent, may lead to a constellation of secondary complaints including sinusitis, mouth-breathing, and some symptoms resembling a permanent cold, and often requires constant medical intervention. Well-tolerated nasal corticosteroids, alone or in combination with antihistamines, have been found to be very effective in treating this condition. OBJECTIVE To compare the effectiveness and tolerability of mometasone furoate aqueous suspension, a new once daily nasal spray, to placebo vehicle and to beclomethasone dipropionate, administered twice daily, in patients with perennial allergic rhinitis. METHODS This was a randomized, double-blind, placebo-controlled, double-dummy, parallel group study, in 427 patients age 12 years and older at 24 centers in Canada and Europe. Patients allergic to at least one perennial allergen, confirmed by medical history, skin testing, and adequate symptomatology were eligible to receive one of the following regimens for 3 months: mometasone furoate, 200 micrograms only daily; beclomethasone dipropionate, 200 micrograms twice daily (400 micrograms total dose); or placebo vehicle control. The primary efficacy variable was the change from baseline in total AM plus PM diary nasal symptom score over the first 15 days of treatment. RESULTS Three hundred eighty-seven patients were valid for efficacy. For the primary efficacy variable, mometasone furoate was significantly (P < or = .01) more effective than placebo and was indistinguishable from beclomethasone dipropionate. Similar trends were seen among individual symptoms, physician symptom evaluations, and therapeutic response. There was no evidence of tachyphylaxis. All treatments were well tolerated. CONCLUSIONS Mometasone furoate nasal spray adequately controls symptoms of perennial allergic rhinitis, offers the advantage of once daily treatment, and is well tolerated.
Collapse
Affiliation(s)
- M Drouin
- Allergy and Asthma Research Centre, Ottawa, Ontario, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Paradis L, Lavoie A, Brunet C, Bédard PM, Hébert J. Effects of systemic corticosteroids on cutaneous histamine secretion and histamine-releasing factor in patients with chronic idiopathic urticaria. Clin Exp Allergy 1996; 26:815-20. [PMID: 8842556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Enhanced skin mast cell releasability of histamine, increased production of histamine releasing factor (HRF), and cutaneous inflammatory process are the hallmarks of chronic idiopathic urticaria (CU). Although H1-antihistamines are known to alleviate the symptoms effectively in most cases, systemic corticosteroids (CS) are given in more resistant patients. Their mode of action remains a matter of controversy. OBJECTIVES In the present study, the effects of a 7-day course of CS or placebo on histamine content and HRF production in non-lesional skin of 19 CU patients were examined. METHODS Using the skin chamber technique, HRF production and histamine content were assessed in normal-appearing skin of patients with CU over a 2-h observation period. Those two parameters were measured before and after treatment, in a double-blind fashion. RESULTS No significant changes occurred in any parameters after placebo treatment. In contrast with this, significant decrease of HRF activity was observed after 1 week of oral methylprednisolone while no change was documented for histamine secretion. CONCLUSION These data suggest that CS therapy improves symptoms of CU in association with a decreased production of HRF in uninvolved skin.
Collapse
Affiliation(s)
- L Paradis
- Centre de Recherche en Immunologie-Rhumatologie, Le Centre Hospitalier de l'Université Laval, Sainte-Foy, Québec, Canada
| | | | | | | | | |
Collapse
|
47
|
Lamontagne P, Boutin Y, Brunét C, Boulanger J, Berton J, Hébert J. Characterization of allergenic determinants on the C-terminal region of the r-Lol p 1. Adv Exp Med Biol 1996; 409:425-9. [PMID: 9095277 DOI: 10.1007/978-1-4615-5855-2_62] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- P Lamontagne
- Centre de Recherche en Immunologie et Rhumatologie, Le Centre de Recherche du Centre Hospitalier de l'Université Laval Sainte-Foy, Québec, Canada
| | | | | | | | | | | |
Collapse
|
48
|
Affiliation(s)
- J Hébert
- Centre de Recherche en Immunologie et Rhumatologie, Le Centre de Recherche du Centre Hospitalier de l'Université Laval, Sainte-Foy, Québec, Canada
| | | |
Collapse
|
49
|
Deperthes D, Chapdelaine P, Tremblay RR, Brunet C, Berton J, Hébert J, Lazure C, Dubé JY. Isolation of prostatic kallikrein hK2, also known as hGK-1, in human seminal plasma. Biochim Biophys Acta 1995; 1245:311-6. [PMID: 8541306 DOI: 10.1016/0304-4165(95)00118-2] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
To demonstrate the presence of kallikrein hK2 in the human prostate and seminal plasma, we used mouse monoclonal antibodies (MAb) against a recombinant hK2-fusion protein. Using one of these MAb 9D5, we detected the presence of several major immunoreactive spots of 22 kDa and minor ones of 31 and 55 kDa in prostate cytosol and seminal plasma. After ion exchange and immunoaffinity chromatography of seminal plasma proteins, the 22-kDa immunoreactive proteins were isolated along with 55- and 75-kDa proteins. The NH2-terminal amino acid sequencing permitted identification of fragments of hK2 and protein C inhibitor, respectively, in the 22- ad 55-kDa bands. Furthermore, immunoblotting experiments in one and two-D gels with two different anti-hK2 MAbs and one polyclonal anti-PCI antibody suggested that the major 55- and 75-kDa bands were covalent hK2-PCI complexes containing either the full-length hK2 chain or only its carboxyterminal fragment in the presence of mercaptoethanol. These results demonstrate for the first time the existence of kallikrein hK2 and suggest that PCI may regulate its activity in seminal plasma.
Collapse
Affiliation(s)
- D Deperthes
- Laboratory of Hormonal Bioregulation, CHUL Research Center, Sainte-Foy, Quebec, Canada
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Mahana W, al-Daccak R, Lévéillé C, Valet JP, Hébert J, Ouellette M, Mourad W. A natural mutation of the amino acid residue at position 60 destroys staphylococcal enterotoxin A murine T-cell mitogenicity. Infect Immun 1995; 63:2826-32. [PMID: 7622202 PMCID: PMC173383 DOI: 10.1128/iai.63.8.2826-2832.1995] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
A variety of techniques have been used to identify the amino acid residues of bacterial superantigens involved in their interactions with major histocompatibility complex (MHC) class II and T-cell receptor (TCR). In this study, we isolated a naturally mutated staphylococcal enterotoxin A (SEA) from three different Staphylococcus aureus strains, in which the amino acid at position 60 has been changed from aspartic acid (D) to asparagine (N). We then studied the influence of this change on the immunological activities of SEA. Our results demonstrated that this mutation does not affect the capacity of SEA to bind MHC class II molecules and consequently activates human monocytes and peripheral blood lymphocytes. In contrast, mutated SEA failed to stimulate the proliferation of murine splenic lymphocytes of two different strains, and when presented by human MHC class II molecules, it also failed to activate murine cell line 3DT, which expresses the SEA-specific TCR V beta element (V beta 1). These results indicate that this mutation alters the interaction between SEA and murine TCR. The reactivity patterns of the mutated SEA with two specific anti-SEA monoclonal antibodies suggested that the observed effect of the isolated mutation in the murine system might be due to certain conformational changes in the SEA molecule introduced upon changing the D at position 60 to N. Site-directed mutagenesis of the N residue to D or to glycine reconstituted the ability of SEA to stimulate murine splenic lymphocytes. The different effects of this natural mutation at position 60 on the immunological activities of SEA with murine and human cells highlight the relevance of the affinity and avidity in SEA-TCR interactions in the function of different species or may reflect a difference in epitope specificity.
Collapse
Affiliation(s)
- W Mahana
- Centre de Recherche en Rhumatologie et Immunologie, Centre Hospitalier de l'Université Laval, Ste. Foy, Québec, Canada
| | | | | | | | | | | | | |
Collapse
|