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Feugray G, Grall M, Dumesnil C, Brunel V, Benhamou Y, Quillard Muraine M, Billoir P. Lipid and hemolysis parameters predicting acute chest syndrome in adulthood with sickle cell disease. Lipids Health Dis 2024; 23:140. [PMID: 38755670 PMCID: PMC11100209 DOI: 10.1186/s12944-024-02135-8] [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: 02/15/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
Sickle cell disease (SCD) is a lifelong blood disorder affecting approximately 100,000 people in the United States and is one of the most common monogenic diseases. A serious complication of SCD is acute chest syndrome (ACS). ACS is a condition with a high rate of morbidity and mortality. The aim of the study was to assess hemolysis and lipid parameters in a cohort of confirmed SCD patients to predict ACS development in the following year.Standard lipid were performed (triglycerides, total cholesterol, high-density cholesterol, low-density cholesterol) panel to calculate of non-HDL-C, large buoyant LDL cholesterol (lbLDL-C) and small dense LDL cholesterol (sdLDL-C) with Sampson equation. Hemolysis and hematologic parameters were also evaluated.Among 91 patients included between September 2018 and June 2021, thirty-seven patients had history of ACS and 6 patients developed ACS during following year. In unadjusted logistic regression, total bilirubin was associated with ACS occurrence (RR: 1.2 [1.05-1.51] p = 0.013). Concerning lipid profile, non-HDL-C (RR: 0.87 [0.0.67-0.99] p = 0.04) and sdLDL-C (RR: 0.78 [0.49-0.96] p = 0.03) were associated with ACS occurrence decrease. C-reactive protein was associated with ACS occurrence (RR: 1.27 [1.065-1.85] p = 0.011).Based on these findings, this study demonstrated that several biomarker easily available can be used at steady state to predict ACS in the following year. The validation of these results are required to ensure the reproducibility of the findings.
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Affiliation(s)
- Guillaume Feugray
- Department of General Biochemistry, Normandie Univ, UNIROUEN, INSERM U1096 EnVI, CHU Rouen, Rouen, F-76000, France.
- Service de Biochimie, Centre hospitalier Universitaire Charles Nicolle, 1 rue de Germont, Rouen, 76031, France.
| | - Maximilien Grall
- Department of Internal Medicine, CHU Rouen, Rouen, F-76000, France
| | - Cécile Dumesnil
- Department of Pediatric Onco-Hematology, CHU Rouen, Rouen, F-76000, France
| | - Valéry Brunel
- Department of General Biochemistry, CHU Rouen, Rouen, F-76000, France
| | - Ygal Benhamou
- Department of Internal Medicine, Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Rouen, F-76000, France
| | - Muriel Quillard Muraine
- Department of General Biochemistry, Normandie Univ, UNIROUEN, INSERM U1404 INSERMU1073 ADEN, CHU Rouen, CIC-CRB, Rouen, F-76000, France
| | - Paul Billoir
- Normandie Univ, UNIROUEN, INSERM U1096 EnVI, CHU Rouen, Vascular Hemostasis Unit, Rouen, F-76000, France
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Engin KN, Harmancı Karagülle D, Durmaz Engin C, Kant M, Yaman A, Akış M, Özel Yıldız S, İşlekel H, Güner Akdoğan G, Söylev Bajin M. Is the clinical course of non-arteritic ischemic optic neuropathy associated with oxidative damage and the dynamics of the antioxidant response? Int Ophthalmol 2023; 43:2935-2945. [PMID: 37029212 DOI: 10.1007/s10792-023-02699-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/24/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE Oxidative stress is known to be a decisive factor in the wide etiopathogenesis of optic neuropathy. This study aimed to comprehensively evaluate the interaction of optic neuropathy's clinical course with systemic oxidative damage and antioxidant response dynamics in a large series. METHODS This case-controlled clinical study included 33 non-arteritic anterior ischemic optic neuropathy (NAION) patients and 32 healthy individuals. Extensive systemic oxidation profiles were statistically compared between the two groups, and correlations between the clinical and biochemical data in the study group were analyzed. RESULTS Vitamin E and malondialdehyde (MDA) levels were significantly higher in the study group. Significant correlations were observed in the analyses between clinical findings and oxidative stress parameters. Correlations between vitamin E and intraocular pressure (IOP), between B12 and cup-to-disk ratio (c/d), between antioxidant glutathione and superoxide dismutase (SOD) enzyme systems, and between uric acid (UA) and age were found to be very significant. As significant correlations were found in either clinical and biochemical data or in oxidative stress parameters, correlations between vitamin E and cholesterol, MDA were found to be very significant. CONCLUSIONS This study not only supplies significant information regarding oxidative damage and antioxidant response in NAION, but also points out the specific interactions of neuromodulators, like vitamin E, in intracellular signaling pathways and regulation mechanisms. A better reading of these connections may help improve diagnosis, follow-ups and treatment criteria and strategies.
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Affiliation(s)
- Kaya Nusret Engin
- Department of Ophthalmology, Ümraniyemraniye Education and Research Hospital, Sağlık University, Elmalıkent Mh. Ümraniye, 34764, Istanbul, Turkey.
| | - Duygu Harmancı Karagülle
- Graduate School of Health Science, Department of Molecular Genetics, Dokuz Eylül University, Izmir, Turkey
| | - Ceren Durmaz Engin
- Faculty of Medicine, Department of Ophthalmology, Dokuz Eylül University, Izmir, Turkey
| | - Melis Kant
- Faculty of Medicine, Department of Biochemistry, Dokuz Eylül University, Izmir, Turkey
| | - Aylin Yaman
- Faculty of Medicine, Department of Ophthalmology, Dokuz Eylül University, Izmir, Turkey
| | - Merve Akış
- Faculty of Medicine, Department of Biochemistry, Dokuz Eylül University, Izmir, Turkey
| | - Sevda Özel Yıldız
- Istanbul Faculty of Medicine, Department of Biostatistics, Istanbul University, Istanbul, Turkey
| | - Hüray İşlekel
- Graduate School of Health Science, Department of Molecular Genetics, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Biochemistry, Dokuz Eylül University, Izmir, Turkey
| | - Gül Güner Akdoğan
- Department of Medical Biochemistry, School of Medicine, Izmir University of Economics, Izmir, Turkey
| | - Meltem Söylev Bajin
- Faculty of Medicine, Department of Ophthalmology, Dokuz Eylül University, Izmir, Turkey
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Ulloque-Badaracco JR, Hernandez-Bustamante EA, Alarcon-Braga EA, Mosquera-Rojas MD, Campos-Aspajo A, Salazar-Valdivia FE, Valdez-Cornejo VA, Benites-Zapata VA, Herrera-Añazco P, Valenzuela-Rodríguez G, Hernandez AV. Atherogenic index of plasma and coronary artery disease: A systematic review. Open Med (Wars) 2022; 17:1915-1926. [PMID: 36561845 PMCID: PMC9730543 DOI: 10.1515/med-2022-0590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 10/06/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022] Open
Abstract
Various studies suggest that the atherogenic index of plasma (AIP) is associated with the risk of coronary artery disease (CAD) in different clinical scenarios. This review aimed to synthesize evidence of the association between AIP values and CAD. A literature search was carried out on four databases, namely, PubMed, Scopus, Web of Science, and Ovid-Medline. A handsearch was performed on preprint repositories (MedRxiv and Research Square). The effect measurements were expressed as odds ratios (OR) with their corresponding 95% confidence intervals (CI). For the quantitative synthesis, we employed a random-effects model. We analyzed 14 articles (with 40,902 participants) from seven different countries. The quantitative analysis revealed that an increase in one unit of AIP was associated with higher odds of developing CAD (OR 2.11; 95% CI 1.65-2.69; P < 0.001; I 2 = 98%). We conducted subgroup analyses of Chinese (OR 1.89; 95% CI 1.40-2.56; P < 0.001) and non-Chinese studies (OR 2.51; 95% CI 1.42-4.42; P < 0.001). The sensitivity analysis by risk of bias continued to demonstrate an association, and the heterogeneity remained unchanged (OR 1.75; 95% CI 1.33-2.31; P < 0.001; I 2 = 98%). Higher AIP values were associated with higher odds of developing CAD.
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Affiliation(s)
- Juan R. Ulloque-Badaracco
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Enrique A. Hernandez-Bustamante
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Perú,Grupo Peruano de Investigación Epidemiológica, Unidad Para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Perú
| | - Esteban A. Alarcon-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Melany D. Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Alvaro Campos-Aspajo
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Farley E. Salazar-Valdivia
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Valeria A. Valdez-Cornejo
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Vicente A. Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Avenida La Fontana #750 La Molina, Lima, Perú
| | - Percy Herrera-Añazco
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Trujillo, Perú,Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru
| | - Germán Valenzuela-Rodríguez
- Clínica Delgado, Servicio de Medicina Interna y Cardiología, Lima, Perú,Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima, Perú
| | - Adrian V. Hernandez
- Unidad de Revisiones Sistemáticas y Meta- análisis, Guías de Práctica Clínica y Evaluaciones de Tecnología Sanitaria, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú,Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, United States of America
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Jakubiak GK, Osadnik K, Lejawa M, Osadnik T, Goławski M, Lewandowski P, Pawlas N. "Obesity and Insulin Resistance" Is the Component of the Metabolic Syndrome Most Strongly Associated with Oxidative Stress. Antioxidants (Basel) 2021; 11:79. [PMID: 35052583 PMCID: PMC8773170 DOI: 10.3390/antiox11010079] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome (MS) is not a homogeneous entity, but this term refers to the coexistence of factors that increase the risk for the development of type 2 diabetes and cardiovascular disease. There are different versions of the criteria for the diagnosis of MS, which makes the population of patients diagnosed with MS heterogeneous. Research to date shows that MS is associated with oxidative stress (OS), but it is unclear which MS component is most strongly associated with OS. The purpose of the study was to investigate the relationship between the parameters of OS and the presence of individual elements of MS in young adults, as well as to identify the components of MS by means of principal components analysis (PCA) and to investigate how the parameters of OS correlate with the presence of individual components. The study included 724 young adults with or without a family history of coronary heart disease (population of the MAGNETIC study). Blood samples were taken from the participants of the study to determine peripheral blood counts, biochemical parameters, and selected parameters of OS. In addition, blood pressure and anthropometric parameters were measured. In subjects with MS, significantly lower activity of superoxide dismutase (SOD), copper- and zinc-containing SOD (CuZnSOD), and manganese-containing SOD (MnSOD) were found, along with significantly higher total antioxidant capacity (TAC) and significantly lower concentration of thiol groups per gram of protein (PSH). We identified three components of MS by means of PCA: "Obesity and insulin resistance", "Dyslipidemia", and "Blood pressure", and showed the component "Obesity and insulin resistance" to have the strongest relationship with OS. In conclusion, we documented significant differences in some parameters of OS between young adults with and without MS. We showed that "Obesity and insulin resistance" is the most important component of MS in terms of relationship with OS.
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Affiliation(s)
- Grzegorz K. Jakubiak
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 38 Street, 41-808 Zabrze, Poland; (K.O.); (M.L.); (T.O.); (N.P.)
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 Street, 41-902 Bytom, Poland
| | - Kamila Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 38 Street, 41-808 Zabrze, Poland; (K.O.); (M.L.); (T.O.); (N.P.)
| | - Mateusz Lejawa
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 38 Street, 41-808 Zabrze, Poland; (K.O.); (M.L.); (T.O.); (N.P.)
| | - Tadeusz Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 38 Street, 41-808 Zabrze, Poland; (K.O.); (M.L.); (T.O.); (N.P.)
| | - Marcin Goławski
- Student Research Group, Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 38 Street, 41-808 Zabrze, Poland; (M.G.); (P.L.)
| | - Piotr Lewandowski
- Student Research Group, Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 38 Street, 41-808 Zabrze, Poland; (M.G.); (P.L.)
| | - Natalia Pawlas
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 38 Street, 41-808 Zabrze, Poland; (K.O.); (M.L.); (T.O.); (N.P.)
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5
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Gueye Tall F, Martin C, Ndour EHM, Faes C, Déme Ly I, Pialoux V, Connes P, Gueye PM, Ndiaye Diallo R, Renoux C, Diagne I, Diop PA, Cissé A, Sall PL, Joly P. Influence of Oxidative Stress Biomarkers and Genetic Polymorphisms on the Clinical Severity of Hydroxyurea-Free Senegalese Children with Sickle Cell Anemia. Antioxidants (Basel) 2020; 9:antiox9090863. [PMID: 32937882 PMCID: PMC7555380 DOI: 10.3390/antiox9090863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/16/2022] Open
Abstract
Oxidative stress would play a role in the pathophysiology of sickle cell anemia (SCA). We tested the impact of common SCA genetic modifiers (alpha-thalassemia, G6PD deficiency, HbF quantitative trait loci; QTL) and pro/antioxidant genes polymorphisms (SOD2 rs4880, XO rs207454, MPO rs233322) on oxidative stress biomarkers (AOPP, MDA, MPO, XO, MnSOD, CAT, GPx) and clinical severity in 301 Senegalese SCA hydroxyurea-free children at steady-state (median age 9.1 years, sex ratio H/F = 1.3). Plasma oxidative stress biomarkers were compared with those of a control group (AA). CAT activity, AOPP, and MDA levels were higher in SCA than in AA individuals while XO, GPX, and MnSOD activities were lower. The presence of alpha-thalassemia decreased MDA level and MPO activity but no effect of the HbF QTL or G6PD deficiency was observed. SCA children who experienced their first hospitalized complication before 3 years old had higher MnSOD and CAT activities than the other children while those with no hospitalized VOC in the previous 2 years presented higher GPX activity. Age of the first hospitalized complication and AOPP levels were affected by the MPO rs2333227 SNP. Our results suggest that alpha-thalassemia modulates oxidative stress in SCA, presumably because of a reduction in the MPO activity.
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Affiliation(s)
- Fatou Gueye Tall
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Cyril Martin
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
| | - El hadji Malick Ndour
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Camille Faes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
| | - Indou Déme Ly
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
- Service Universitaire de Pédiatrie-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal;
| | - Vincent Pialoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
| | - Papa Madieye Gueye
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Rokhaya Ndiaye Diallo
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- UF Biochimie des Pathologies Erythrocytaires, Laboratoire de Biochimie et Biologie Moleculaire Grand-Est, Groupement Hospitalier Est, Hospices Civils de Lyon, 69500 Bron, France
| | - Ibrahima Diagne
- Service Universitaire de Pédiatrie-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal;
- UFR des Sciences de la Santé–Universite Gaston Berger, Saint-Louis 32002, Senegal
| | - Pape Amadou Diop
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Aynina Cissé
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
| | - Philomène Lopez Sall
- Laboratoire de Biochimie Pharmaceutique-FMPO, Universite Cheikh Anta Diop, Dakar BP 5005, Senegal; (F.G.T.); (E.h.M.N.); (P.M.G.); (R.N.D.); (P.A.D.); (A.C.); (P.L.S.)
- Centre Hospitalier National d’Enfants Albert Royer-Dakar, Dakar BP 5005, Senegal; (C.M.); (I.D.L.)
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe Biologie Vasculaire et du Globule Rouge, Universite Claude Bernard Lyon 1, COMUE Lyon, 69100 Villeurbanne, France; (C.F.); (V.P.); (P.C.); (C.R.)
- Laboratoire d’Excellence sur le Globule Rouge (Labex GR-Ex), 75000 Paris, France
- UF Biochimie des Pathologies Erythrocytaires, Laboratoire de Biochimie et Biologie Moleculaire Grand-Est, Groupement Hospitalier Est, Hospices Civils de Lyon, 69500 Bron, France
- Correspondence:
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