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Berrada KR, Belot A, Neven B, Ohlmann C, Tronc F, Rice G, Thouvenin G, Dubus JC, Mazenq J, Frémond ML, Stremler N, Soummer-Feuillet S, Cottin V, Reix P. Lung Transplantation under a Janus Kinase Inhibitor in Three Patients with SAVI Syndrome. J Clin Immunol 2023; 43:2156-2164. [PMID: 37814086 DOI: 10.1007/s10875-023-01595-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023]
Abstract
Stimulator of interferon genes (STING)-associated vasculopathy with onset in infancy (SAVI) is a very rare autoinflammatory disease related to STING1 mutation. SAVI is mainly characterized by fever attacks and skin and respiratory manifestations such as interstitial lung disease or alveolar hemorrhage. Respiratory involvement occurs in 80% of cases and might progress to severe lung fibrosis and require lung transplantation (LT). Three patients with SAVI who underwent LT have been reported to date. Two of the three patients died months or years after LT due to multiple organ failure or sepsis. However, the diagnosis of SAVI was made after LT, thus preventing the use of targeted therapy, such as the Janus kinase 1 and 2 inhibitor (JAK1/2i) ruxolitinib, which might be beneficial for the respiratory status of these patients. We aimed to report our experience in managing three patients who were followed in three large lung transplantation centers in France and who benefited from ruxolitinib before undergoing LT. We describe posttransplant complications that occurred as well as outcomes.
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Affiliation(s)
- Kenza Rhzioual Berrada
- Service de Pneumologie Pédiatrique, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France
| | - Alexandre Belot
- Service de Rhumatologie, Néphrologie Et Dermatologie Pédiatrique, CMR RAISE, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France
- Centre International de Recherche en Infectiologie, Université de Lyon, Institut National de La Santé Et de La Recherche Médicale, U1111, Université Claude Bernard Lyon 1, Lyon, France
- Le Centre National de La Recherche Scientifique, UMR5308, Lyon, France
| | - Bénédicte Neven
- Service d'immunologie-Hématologie Et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris, INSERM, Paris, France
| | - Camille Ohlmann
- Service de Pneumologie Pédiatrique, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France
| | - François Tronc
- Service de Chirurgie Thoracique Et Transplantation Pulmonaire, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Gillian Rice
- School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK
| | - Guillaume Thouvenin
- Service de Pneumologie Pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Armand Trousseau, Paris, France
- Centre de Recherche St Antoine Inserm UMRS.938, UPMC Université Paris Cité 06, Sorbonne Universités, Paris, France
| | - Jean-Christophe Dubus
- Service de Pneumologie Pédiatrique, Centre Hospitalier Universitaire Timone Enfants, Assistance Publique-Hôpitaux de Marseille, Université de La Méditerranée, Marseille, France
| | - Julie Mazenq
- Service de Pneumologie Pédiatrique, Centre Hospitalier Universitaire Timone Enfants, Assistance Publique-Hôpitaux de Marseille, Université de La Méditerranée, Marseille, France
| | - Marie-Louise Frémond
- Service d'immunologie-Hématologie Et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris, INSERM, Paris, France
- Institut Imagine, Laboratoire de Neurogénétique Et de Neuroinflammation, Université de Paris, Paris, France
| | - Nathalie Stremler
- Service de Pneumologie Pédiatrique, Centre Hospitalier Universitaire Timone Enfants, Assistance Publique-Hôpitaux de Marseille, Université de La Méditerranée, Marseille, France
| | - Séverine Soummer-Feuillet
- Service de Chirurgie Thoracique Et Chirurgie Vasculaire, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Plessis-Robinson, France
- UMR-S-99, Inserm, Hôpital Marie Lannelongue, Faculté de Médecine Paris Saclay, Université Paris-Saclay, Plessis-Robinson, France
| | - Vincent Cottin
- Service de Pneumologie, Centre de Référence Des Maladies Pulmonaires Rares, Hôpital Louis Pradel, Hospices Civils de Lyon; UMR754, INRAE, Université Lyon 1, Lyon, France
| | - Philippe Reix
- Service de Pneumologie Pédiatrique, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France.
- CNRS, Laboratoire de Biométrie Et Biologie Evolutive, UMR 5558, Équipe EMET, Université Lyon 1, 69622, Villeurbanne, France.
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Mouren D, Khalil A, Messika J. Haemoptyis in lung transplant recipients: What is the right question? Respir Med Res 2022; 82:100949. [DOI: 10.1016/j.resmer.2022.100949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 07/31/2022] [Indexed: 11/19/2022]
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Trans-arterial embolization for hemoptysis in lung transplant recipients. Respir Med Res 2022; 82:100941. [DOI: 10.1016/j.resmer.2022.100941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/03/2022] [Accepted: 06/16/2022] [Indexed: 11/22/2022]
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Pregnancies and Gynecological Follow-Up after Solid Organ Transplantation: Experience of a Decade. J Clin Med 2022; 11:jcm11164792. [PMID: 36013030 PMCID: PMC9409658 DOI: 10.3390/jcm11164792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
In recent years, solid organ transplantations, such as kidney or lung grafts, have been performed worldwide with an improvement of quality of life under immunosuppressive therapy and an increase in life expectancy, allowing young women to consider childbearing. In the current study, we conduct a retrospective study in two French centers for kidney and lung transplantations to evaluate the rate and outcomes of pregnancies, contraception and gynecological monitoring for women under 40 years old who underwent solid organ transplantation. Among 210 women, progestin was the most widely used contraceptive method. Of the 210 women, 24 (11.4%) conceived 33 pregnancies of which 25 (75.8%) were planned with an immunosuppressant therapy switch. Of the 33 pregnancies, 7 miscarried (21.2%) and 21 (63.7%) resulted in a live birth with a high rate of pre-eclampsia (50%). No graft rejections were observed during pregnancies. Among the deliveries, 19 were premature (90.5%, mostly due to induced delivery) and the C-section rate was high (52.4%). No particular pathology was identified among newborns. We conclude that pregnancies following solid organ transplantation are feasible, and while they are at an increased risk of pre-eclampsia and prematurity, they should still be permitted with close surveillance by a multidisciplinary care team.
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Glorion M, De Wolf J, Zuber B, Cassiano F, Preau S, Brun AL, Cohen J, Tachon G, Neuville M, Brugière O, Picard C, Beaumont-Azuar L, Fessler J, Jacqmin S, Pricopi C, Chapelier A, Cuquemelle E, Parquin F, Magnan A, Roux A, Le Guen M, Sage E, Cerf C. Lung transplantation for COVID-19-associated acute respiratory distress syndrome: The first French patient. Respir Med Res 2021; 80:100851. [PMID: 34433119 PMCID: PMC8349363 DOI: 10.1016/j.resmer.2021.100851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/01/2021] [Accepted: 07/06/2021] [Indexed: 01/08/2023]
Affiliation(s)
- M Glorion
- Department of Thoracic Surgery, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France.
| | - J De Wolf
- Department of Thoracic Surgery, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - B Zuber
- Department of Intensive Care, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - F Cassiano
- Department of Thoracic Surgery, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - S Preau
- Department of Intensive Care, Salengro Hospital Lille CHU Avenue du Professeur Emile Laine, 59037 Lille, France
| | - A L Brun
- Department of radiology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - J Cohen
- Department of Pathology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - G Tachon
- Department of Intensive Care, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - M Neuville
- Department of Intensive Care, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - O Brugière
- Department of Pneumology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - C Picard
- Department of Pneumology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - L Beaumont-Azuar
- Department of Pneumology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - J Fessler
- Department of Anaesthesiology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - S Jacqmin
- Department of Anaesthesiology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - C Pricopi
- Department of Thoracic Surgery, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - A Chapelier
- Department of Thoracic Surgery, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - E Cuquemelle
- Department of Thoracic Surgery, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - F Parquin
- Department of Thoracic Surgery, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - A Magnan
- Department of Pneumology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - A Roux
- Department of Pathology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - M Le Guen
- Department of Anaesthesiology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - E Sage
- Department of Thoracic Surgery, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - C Cerf
- Department of Anaesthesiology, Hôpital Foch, 92150 Suresnes, France and Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
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François S, Helissey C, Cavallero S, Drouet M, Libert N, Cosset JM, Deutsch E, Meziani L, Chargari C. COVID-19-Associated Pneumonia: Radiobiological Insights. Front Pharmacol 2021; 12:640040. [PMID: 34113249 PMCID: PMC8185272 DOI: 10.3389/fphar.2021.640040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/04/2021] [Indexed: 12/15/2022] Open
Abstract
The evolution of SARS-CoV-2 pneumonia to acute respiratory distress syndrome is linked to a virus-induced “cytokine storm”, associated with systemic inflammation, coagulopathies, endothelial damage, thrombo-inflammation, immune system deregulation and disruption of angiotensin converting enzyme signaling pathways. To date, the most promising therapeutic approaches in COVID-19 pandemic are linked to the development of vaccines. However, the fight against COVID-19 pandemic in the short and mid-term cannot only rely on vaccines strategies, in particular given the growing proportion of more contagious and more lethal variants among exposed population (the English, South African and Brazilian variants). As long as collective immunity is still not acquired, some patients will have severe forms of the disease. Therapeutic perspectives also rely on the implementation of strategies for the prevention of secondary complications resulting from vascular endothelial damage and from immune system deregulation, which contributes to acute respiratory distress and potentially to long term irreversible tissue damage. While the anti-inflammatory effects of low dose irradiation have been exploited for a long time in the clinics, few recent physiopathological and experimental data suggested the possibility to modulate the inflammatory storm related to COVID-19 pulmonary infection by exposing patients to ionizing radiation at very low doses. Despite level of evidence is only preliminary, these preclinical findings open therapeutic perspectives and are discussed in this article.
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Affiliation(s)
- Sabine François
- Department of Radiation Biological Effects, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | | | - Sophie Cavallero
- Department of Radiation Biological Effects, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Michel Drouet
- Department of Radiation Biological Effects, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | | | - Jean-Marc Cosset
- Centre de Radiothérapie Charlebourg/La Défense, Groupe Amethyst, La Garenne-Colombes, France
| | - Eric Deutsch
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.,INSERM U1030, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Lydia Meziani
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.,INSERM U1030, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Cyrus Chargari
- Department of Radiation Biological Effects, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France.,Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.,INSERM U1030, Université Paris Saclay, Le Kremlin Bicêtre, France
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