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Melo SF, Nondonfaz A, Aqil A, Pierrard A, Hulin A, Delierneux C, Ditkowski B, Gustin M, Legrand M, Tullemans BME, Brouns SLN, Nchimi A, Carrus R, Dejosé A, Heemskerk JWM, Kuijpers MJE, Ritter J, Steinseifer U, Clauser JC, Jérôme C, Lancellotti P, Oury C. Design, manufacturing and testing of a green non-isocyanate polyurethane prosthetic heart valve. Biomater Sci 2024; 12:2149-2164. [PMID: 38487997 DOI: 10.1039/d3bm01911j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The sole effective treatment for most patients with heart valve disease is valve replacement by implantation of mechanical or biological prostheses. However, mechanical valves represent high risk of thromboembolism, and biological prostheses are prone to early degeneration. In this work, we aim to determine the potential of novel environmentally-friendly non-isocyanate polyurethanes (NIPUs) for manufacturing synthetic prosthetic heart valves. Polyhydroxyurethane (PHU) NIPUs are synthesized via an isocyanate-free route, tested in vitro, and used to produce aortic valves. PHU elastomers reinforced with a polyester mesh show mechanical properties similar to native valve leaflets. These NIPUs do not cause hemolysis. Interestingly, both platelet adhesion and contact activation-induced coagulation are strongly reduced on NIPU surfaces, indicating low thrombogenicity. Fibroblasts and endothelial cells maintain normal growth and shape after indirect contact with NIPUs. Fluid-structure interaction (FSI) allows modeling of the ideal valve design, with minimal shear stress on the leaflets. Injection-molded valves are tested in a pulse duplicator and show ISO-compliant hydrodynamic performance, comparable to clinically-used bioprostheses. Poly(tetrahydrofuran) (PTHF)-NIPU patches do not show any evidence of calcification over a period of 8 weeks. NIPUs are promising sustainable biomaterials for the manufacturing of improved prosthetic valves with low thrombogenicity.
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Affiliation(s)
- Sofia F Melo
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Alicia Nondonfaz
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Abdelhafid Aqil
- Center for Education and Research on Macromolecules (CERM), CESAM Research Unit, Department of Chemistry, University of Liège, Allée du 6 août 13, B6a, 4000 Liège, Belgium
| | - Anna Pierrard
- Center for Education and Research on Macromolecules (CERM), CESAM Research Unit, Department of Chemistry, University of Liège, Allée du 6 août 13, B6a, 4000 Liège, Belgium
| | - Alexia Hulin
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Céline Delierneux
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Bartosz Ditkowski
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Maxime Gustin
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Maxime Legrand
- Sirris, Liège Science Park, Rue du Bois Saint-Jean 12, 4102 Seraing, Belgium
| | - Bibian M E Tullemans
- Cardiovascular Research Institute Maastricht (CARIM), Department of Biochemistry, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Sanne L N Brouns
- Cardiovascular Research Institute Maastricht (CARIM), Department of Biochemistry, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Alain Nchimi
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Raoul Carrus
- Sirris, Liège Science Park, Rue du Bois Saint-Jean 12, 4102 Seraing, Belgium
| | - Astrid Dejosé
- Sirris, Liège Science Park, Rue du Bois Saint-Jean 12, 4102 Seraing, Belgium
| | - Johan W M Heemskerk
- Cardiovascular Research Institute Maastricht (CARIM), Department of Biochemistry, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Marijke J E Kuijpers
- Cardiovascular Research Institute Maastricht (CARIM), Department of Biochemistry, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Jan Ritter
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Johanna C Clauser
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Christine Jérôme
- Center for Education and Research on Macromolecules (CERM), CESAM Research Unit, Department of Chemistry, University of Liège, Allée du 6 août 13, B6a, 4000 Liège, Belgium
| | - Patrizio Lancellotti
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Cécile Oury
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
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Tron C, Lemaitre F, Locher C, Lecomte T, Tournigand C, Bouhier Leporrier K, Le Sourd S, Metges JP, Tougeron D, Di Fiore F, Hervé C, Heran M, Touchefeu Y, Rousseau BC, Hulin A, Lievre A. 449TiP Evaluation of regorafenib treatment PERSOnalization based on therapeutic drug monitoring in patients with metastatic colorectal cancer (mCRC): RePERSO study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1870] [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: 11/16/2022] Open
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3
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Huriez P, Ourghanlian C, Razazi K, Vindrios W, Hulin A, Lepeule R, Habibi A, Gallien S. Probenecid, an old β-lactams pharmacokinetic enhancer for a renewed use: a retrospective study. Infect Dis Now 2022; 52:273-279. [DOI: 10.1016/j.idnow.2022.05.006] [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: 12/16/2021] [Revised: 04/13/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
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Donis N, Jiang Z, D'Emal C, Hulin A, Debuisson M, Dulgheru R, Nguyen ML, Postolache A, Lallemand F, Coucke P, Martinive P, Herzog M, Pamart D, Terrell J, Pincemail J, Drion P, Delvenne P, Nchimi A, Lancellotti P, Oury C. Differential Biological Effects of Dietary Lipids and Irradiation on the Aorta, Aortic Valve, and the Mitral Valve. Front Cardiovasc Med 2022; 9:839720. [PMID: 35295264 PMCID: PMC8918952 DOI: 10.3389/fcvm.2022.839720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/20/2021] [Accepted: 01/24/2022] [Indexed: 01/12/2023] Open
Abstract
Aims Dietary cholesterol and palmitic acid are risk factors for cardiovascular diseases (CVDs) affecting the arteries and the heart valves. The ionizing radiation that is frequently used as an anticancer treatment promotes CVD. The specific pathophysiology of these distinct disease manifestations is poorly understood. We, therefore, studied the biological effects of these dietary lipids and their cardiac irradiation on the arteries and the heart valves in the rabbit models of CVD. Methods and Results Cholesterol-enriched diet led to the thickening of the aortic wall and the aortic valve leaflets, immune cell infiltration in the aorta, mitral and aortic valves, as well as aortic valve calcification. Numerous cells expressing α-smooth muscle actin were detected in both the mitral and aortic valves. Lard-enriched diet induced massive aorta and aortic valve calcification, with no detectable immune cell infiltration. The addition of cardiac irradiation to the cholesterol diet yielded more calcification and more immune cell infiltrates in the atheroma and the aortic valve than cholesterol alone. RNA sequencing (RNAseq) analyses of aorta and heart valves revealed that a cholesterol-enriched diet mainly triggered inflammation-related biological processes in the aorta, aortic and mitral valves, which was further enhanced by cardiac irradiation. Lard-enriched diet rather affected calcification- and muscle-related processes in the aorta and aortic valve, respectively. Neutrophil count and systemic levels of platelet factor 4 and ent-8-iso-15(S)-PGF2α were identified as early biomarkers of cholesterol-induced tissue alterations, while cardiac irradiation resulted in elevated levels of circulating nucleosomes. Conclusion Dietary cholesterol, palmitic acid, and cardiac irradiation combined with a cholesterol-rich diet led to the development of distinct vascular and valvular lesions and changes in the circulating biomarkers. Hence, our study highlights unprecedented specificities related to common risk factors that underlie CVD.
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Affiliation(s)
- Nathalie Donis
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Zheshen Jiang
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Céline D'Emal
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Alexia Hulin
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Margaux Debuisson
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Raluca Dulgheru
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Mai-Linh Nguyen
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Adriana Postolache
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | | | | | - Philippe Martinive
- Department Radiation Oncology, Institut Jules Bordet, Université Libre Bruxelles, Brussels, Belgium
| | - Marielle Herzog
- Belgian Volition Société à Responsabilité Limitée, Gembloux, Belgium
| | - Dorian Pamart
- Belgian Volition Société à Responsabilité Limitée, Gembloux, Belgium
| | - Jason Terrell
- Department of Oncology and Livestrong Cancer Institutes, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Volition America, Austin, TX, United States
| | | | - Pierre Drion
- Experimental Surgery Unit, Centre de Recherche du Département de Chrirurgie, Groupe Interdisciplinaire de Géno-Protéomique Appliquée Institute, University of Liège, Liège, Belgium
| | - Philippe Delvenne
- Department of Pathology, Centre Hospitalier Universitaire of Liège, Liège, Belgium
- Laboratory of Experimental Pathology, GIGA Institute, University of Liège, Liège, Belgium
| | - Alain Nchimi
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy
- Anthea Hospital, Bari, Italy
| | - Cécile Oury
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
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Huriez P, Ourghanlian C, Razazi K, Vindrios W, Hulin A, Lepeule R, Habibi A, Wemmert C, Gallien S. Probénécide, ancien potentialisateur des β-lactamines pour un usage renouvelé ? Une étude rétrospective. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.110] [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: 11/25/2022]
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Dousset B, Magne J, Cassat C, Feuillade R, Hulin A, Lion M, Virot P, Aboyans V. Short-term air pollution concentration variations and ST-elevation myocardial infarction: A case-crossover study from the SCALIM registry. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.009] [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: 10/22/2022]
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7
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Donis N, D’emal C, Hulin A, Gustin M, Dulgheru R, Lancellotti P, Oury C. Effect of cholesterol- and palm oil-enriched diets on rabbit aorta and aortic valve calcification. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2020.03.124] [Citation(s) in RCA: 1] [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] [Indexed: 11/25/2022]
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Kim AJ, Xu N, Umeyama K, Hulin A, Ponny SR, Vagnozzi RJ, Green EA, Hanson P, McManus BM, Nagashima H, Yutzey KE. Deficiency of Circulating Monocytes Ameliorates the Progression of Myxomatous Valve Degeneration in Marfan Syndrome. Circulation 2020; 141:132-146. [PMID: 31928435 DOI: 10.1161/circulationaha.119.042391] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Myxomatous valve degeneration (MVD) involves the progressive thickening and degeneration of the heart valves, leading to valve prolapse, regurgitant blood flow, and impaired cardiac function. Leukocytes composed primarily of macrophages have recently been detected in myxomatous valves, but the timing of the presence and the contributions of these cells in MVD progression are not known. METHODS We examined MVD progression, macrophages, and the valve microenvironment in the context of Marfan syndrome (MFS) using mitral valves from MFS mice (Fbn1C1039G/+), gene-edited MFS pigs (FBN1Glu433AsnfsX98/+), and patients with MFS. Additional histological and transcriptomic evaluation was performed by using nonsyndromic human and canine myxomatous valves, respectively. Macrophage ontogeny was determined using MFS mice transplanted with mTomato+ bone marrow or MFS mice harboring RFP (red fluorescent protein)-tagged C-C chemokine receptor type 2 (CCR2) monocytes. Mice deficient in recruited macrophages (Fbn1C1039G/+;Ccr2RFP/RFP) were generated to determine the requirements of recruited macrophages to MVD progression. RESULTS MFS mice recapitulated histopathological features of myxomatous valve disease by 2 months of age, including mitral valve thickening, increased leaflet cellularity, and extracellular matrix abnormalities characterized by proteoglycan accumulation and collagen fragmentation. Diseased mitral valves of MFS mice concurrently exhibited a marked increase of infiltrating (MHCII+, CCR2+) and resident macrophages (CD206+, CCR2-), along with increased chemokine activity and inflammatory extracellular matrix modification. Likewise, mitral valve specimens obtained from gene-edited MFS pigs and human patients with MFS exhibited increased monocytes and macrophages (CD14+, CD64+, CD68+, CD163+) detected by immunofluorescence. In addition, comparative transcriptomic evaluation of both genetic (MFS mice) and acquired forms of MVD (humans and dogs) unveiled a shared upregulated inflammatory response in diseased valves. Remarkably, the deficiency of monocytes was protective against MVD progression, resulting in a significant reduction of MHCII macrophages, minimal leaflet thickening, and preserved mitral valve integrity. CONCLUSIONS All together, our results suggest sterile inflammation as a novel paradigm to disease progression, and we identify, for the first time, monocytes as a viable candidate for targeted therapy in MVD.
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Affiliation(s)
- Andrew J Kim
- The Heart Institute, Division of Molecular Cardiovascular Biology (A.J.K., N.X., R.J.V., E.A.G., K.E.Y.), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH
| | - Na Xu
- The Heart Institute, Division of Molecular Cardiovascular Biology (A.J.K., N.X., R.J.V., E.A.G., K.E.Y.), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH
| | - Kazuhiro Umeyama
- Meiji University International Institute for Bio-Resource Research, Kawasaki, Japan (K.U.)
| | - Alexia Hulin
- Laboratory of Cardiology, GIGA Cardiovascular Sciences, University of Liège, CHU Sart Tilman, Belgium (A.H.)
| | - Sithara Raju Ponny
- Division of Human Genetics (S.R.P.), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH
| | - Ronald J Vagnozzi
- The Heart Institute, Division of Molecular Cardiovascular Biology (A.J.K., N.X., R.J.V., E.A.G., K.E.Y.), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH
| | - Ellis A Green
- The Heart Institute, Division of Molecular Cardiovascular Biology (A.J.K., N.X., R.J.V., E.A.G., K.E.Y.), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH
| | - Paul Hanson
- Center for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada (P.H., B.M.M.)
| | - Bruce M McManus
- Center for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada (P.H., B.M.M.)
| | | | - Katherine E Yutzey
- The Heart Institute, Division of Molecular Cardiovascular Biology (A.J.K., N.X., R.J.V., E.A.G., K.E.Y.), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH
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9
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Blomme B, Deroanne C, Hulin A, Lambert C, Defraigne JO, Nusgens B, Radermecker M, Colige A. Mechanical strain induces a pro-fibrotic phenotype in human mitral valvular interstitial cells through RhoC/ROCK/MRTF-A and Erk1/2 signaling pathways. J Mol Cell Cardiol 2019; 135:149-159. [PMID: 31442470 DOI: 10.1016/j.yjmcc.2019.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/13/2019] [Accepted: 08/19/2019] [Indexed: 01/16/2023]
Abstract
The mitral valve is a complex multilayered structure populated by fibroblast-like cells, valvular interstitial cells (VIC) which are embedded in an extracellular matrix (ECM) scaffold and are submitted to the mechanical deformations affecting valve at each heartbeat, for an average of 40 million times per year. Myxomatous mitral valve (MMV) is the most frequent heart valve disease characterized by disruption of several valvular structures due to alterations of their ECM preventing the complete closure of the valve resulting in symptoms of prolapse and regurgitation. VIC and their ECM exhibit reciprocal dynamic processes between the mechanical signals issued from the ECM and the modulation of VIC phenotype responsible for ECM homeostasis of the valve. Abnormal perception and responsiveness of VIC to mechanical stress may induce an inappropriate adaptative remodeling of the valve progressively leading to MMV. To investigate the response of human VIC to mechanical strain and identify the molecular mechanisms of mechano-transduction in these cells, a cyclic equibiaxial elongation of 14% at the cardiac frequency of 1.16 Hz was applied to VIC by using a Flexercell-4000 T™ apparatus for increasing time (from 1 h to 8 h). We showed that cyclic stretch induces an early (1 h) and transient over-expression of TGFβ2 and αSMA. CTGF, a profibrotic growth factor promoting the synthesis of ECM components, was strongly induced after 1 and 2 h of stretching and still upregulated at 8 h. The mechanical stress-induced CTGF up-regulation was dependent on RhoC, but not RhoA, as demonstrated by siRNA-mediated silencing approaches, and further supported by evidencing RhoC activation upon cell stretching and suppression of cell response by pharmacological inhibition of the effector ROCK1/2. It was also dependent on the MEK/Erk1/2 pathway which was activated by mechanical stress independently of RhoC and ROCK. Finally, mechanical stretching induced the nuclear translocation of myocardin related transcription factor-A (MRTF-A) which forms a transcriptional complex with SRF to promote the expression of target genes, notably CTGF. Treatment of stretched cultures with inhibitors of the identified pathways (ROCK1/2, MEK/Erk1/2, MRTF-A translocation) blocked CTGF overexpression and abrogated the increased MRTF-A nuclear translocation. CTGF is up-regulated in many pathological processes involving mechanically challenged organs, promotes ECM accumulation and is considered as a hallmark of fibrotic diseases. Pharmacological targeting of MRTF-A by newly developed inhibitors may represent a relevant therapy for MMV.
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Affiliation(s)
- Benoit Blomme
- Laboratory of Connective Tissues Biology, GIGA-Research, University of Liège, Tour de Pathologie, B23, 4000 Sart-Tilman, Belgium; Department of Cardiovascular and Thoracic Surgery, B35, University of Liège, CHU Sart-Tilman, 4000 Sart Tilman, Belgium
| | - Christophe Deroanne
- Laboratory of Connective Tissues Biology, GIGA-Research, University of Liège, Tour de Pathologie, B23, 4000 Sart-Tilman, Belgium
| | - Alexia Hulin
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, B34, University of Liège, 4000 Sart- Tilman, Belgium
| | - Charles Lambert
- Laboratory of Connective Tissues Biology, GIGA-Research, University of Liège, Tour de Pathologie, B23, 4000 Sart-Tilman, Belgium
| | - Jean-Olivier Defraigne
- Department of Cardiovascular and Thoracic Surgery, B35, University of Liège, CHU Sart-Tilman, 4000 Sart Tilman, Belgium
| | - Betty Nusgens
- Laboratory of Connective Tissues Biology, GIGA-Research, University of Liège, Tour de Pathologie, B23, 4000 Sart-Tilman, Belgium
| | - Marc Radermecker
- Department of Cardiovascular and Thoracic Surgery, B35, University of Liège, CHU Sart-Tilman, 4000 Sart Tilman, Belgium; Department of Human Anatomy, B23, University of Liège, CHU Sart-Tilman, 4000 Sart Tilman, Belgium
| | - Alain Colige
- Laboratory of Connective Tissues Biology, GIGA-Research, University of Liège, Tour de Pathologie, B23, 4000 Sart-Tilman, Belgium.
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10
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Hulin A, Hortells L, Gomez-Stallons MV, O'Donnell A, Chetal K, Adam M, Lancellotti P, Oury C, Potter SS, Salomonis N, Yutzey KE. Maturation of heart valve cell populations during postnatal remodeling. Development 2019; 146:dev.173047. [PMID: 30796046 DOI: 10.1242/dev.173047] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/07/2019] [Indexed: 01/23/2023]
Abstract
Heart valve cells mediate extracellular matrix (ECM) remodeling during postnatal valve leaflet stratification, but phenotypic and transcriptional diversity of valve cells in development is largely unknown. Single cell analysis of mouse heart valve cells was used to evaluate cell heterogeneity during postnatal ECM remodeling and leaflet morphogenesis. The transcriptomic analysis of single cells from postnatal day (P)7 and P30 murine aortic (AoV) and mitral (MV) heart valves uncovered distinct subsets of melanocytes, immune and endothelial cells present at P7 and P30. By contrast, interstitial cell populations are different from P7 to P30. P7 valve leaflets exhibit two distinct collagen- and glycosaminoglycan-expressing interstitial cell clusters, and prevalent ECM gene expression. At P30, four interstitial cell clusters are apparent with leaflet specificity and differential expression of complement factors, ECM proteins and osteogenic genes. This initial transcriptomic analysis of postnatal heart valves at single cell resolution demonstrates that subpopulations of endothelial and immune cells are relatively constant throughout postnatal development, but interstitial cell subpopulations undergo changes in gene expression and cellular functions in primordial and mature valves.
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Affiliation(s)
- Alexia Hulin
- The Heart Institute, Division of Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA.,Laboratory of Cardiology, GIGA Cardiovascular Sciences, University of Liège, CHU Sart Tilman, Liège 4000, Belgium
| | - Luis Hortells
- The Heart Institute, Division of Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA
| | - M Victoria Gomez-Stallons
- The Heart Institute, Division of Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA
| | - Anna O'Donnell
- The Heart Institute, Division of Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA
| | - Kashish Chetal
- Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA
| | - Mike Adam
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA
| | - Patrizio Lancellotti
- Laboratory of Cardiology, GIGA Cardiovascular Sciences, University of Liège, CHU Sart Tilman, Liège 4000, Belgium.,University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liège 4000, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari 70124, Italy
| | - Cecile Oury
- Laboratory of Cardiology, GIGA Cardiovascular Sciences, University of Liège, CHU Sart Tilman, Liège 4000, Belgium
| | - S Steven Potter
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH45229, USA
| | - Nathan Salomonis
- Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH45229, USA
| | - Katherine E Yutzey
- The Heart Institute, Division of Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH45229, USA .,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH45229, USA
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Beinse G, Hulin A, Rousseau B. Axitinib pharmacologic therapeutic monitoring reveals severe under-exposure despite titration in patients with metastatic renal cell carcinoma. Invest New Drugs 2019; 37:1289-1291. [DOI: 10.1007/s10637-019-00743-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/06/2019] [Indexed: 11/24/2022]
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12
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Hulin A, Hego A, Lancellotti P, Oury C. Advances in Pathophysiology of Calcific Aortic Valve Disease Propose Novel Molecular Therapeutic Targets. Front Cardiovasc Med 2018; 5:21. [PMID: 29594151 PMCID: PMC5862098 DOI: 10.3389/fcvm.2018.00021] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 01/31/2018] [Accepted: 02/26/2018] [Indexed: 01/17/2023] Open
Abstract
Calcific Aortic Valve Disease (CAVD) is the most common heart valve disease and its incidence is expected to rise with aging population. No medical treatment so far has shown slowing progression of CAVD progression. Surgery remains to this day the only way to treat it. Effective drug therapy can only be achieved through a better insight into the pathogenic mechanisms underlying CAVD. The cellular and molecular events leading to leaflets calcification are complex. Upon endothelium cell damage, oxidized LDLs trigger a proinflammatory response disrupting healthy cross-talk between valve endothelial and interstitial cells. Therefore, valve interstitial cells transform into osteoblasts and mineralize the leaflets. Studies have investigated signaling pathways driving and connecting lipid metabolism, inflammation and osteogenesis. This review draws a summary of the recent advances and discusses their exploitation as promising therapeutic targets to treat CAVD and reduce valve replacement.
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Affiliation(s)
- Alexia Hulin
- GIGA Cardiovascular Sciences, Laboratory of Thrombosis and Hemostasis and Valvular Heart Disease, University of Liège, CHU Sart Tilman, Liège, Belgium
| | - Alexandre Hego
- GIGA Cardiovascular Sciences, Laboratory of Thrombosis and Hemostasis and Valvular Heart Disease, University of Liège, CHU Sart Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Laboratory of Thrombosis and Hemostasis and Valvular Heart Disease, University of Liège, CHU Sart Tilman, Liège, Belgium.,GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Cécile Oury
- GIGA Cardiovascular Sciences, Laboratory of Thrombosis and Hemostasis and Valvular Heart Disease, University of Liège, CHU Sart Tilman, Liège, Belgium
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Hulin A, Anstine LJ, Kim AJ, Potter SJ, DeFalco T, Lincoln J, Yutzey KE. Macrophage Transitions in Heart Valve Development and Myxomatous Valve Disease. Arterioscler Thromb Vasc Biol 2018; 38:636-644. [PMID: 29348122 DOI: 10.1161/atvbaha.117.310667] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 12/29/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Hematopoietic-derived cells have been reported in heart valves but remain poorly characterized. Interestingly, recent studies reveal infiltration of leukocytes and increased macrophages in human myxomatous mitral valves. Nevertheless, timing and contribution of macrophages in normal valves and myxomatous valve disease are still unknown. The objective is to characterize leukocytes during postnatal heart valve maturation and identify macrophage subsets in myxomatous valve disease. APPROACH AND RESULTS Leukocytes are detected in heart valves after birth, and their numbers increase during postnatal valve development. Flow cytometry and immunostaining analysis indicate that almost all valve leukocytes are myeloid cells, consisting of at least 2 differentially localized macrophage subsets and dendritic cells. Beginning a week after birth, increased numbers of CCR2+ (C-C chemokine receptor type 2) macrophages are present, consistent with infiltrating populations of monocytes, and macrophages are localized in regions of biomechanical stress in the valve leaflets. Valve leukocytes maintain expression of CD (cluster of differentiation) 45 and do not contribute to significant numbers of endothelial or interstitial cells. Macrophage lineages were examined in aortic and mitral valves of Axin2 KO (knockout) mice that exhibit myxomatous features. Infiltrating CCR2+ monocytes and expansion of CD206-expressing macrophages are localized in regions where modified heavy chain hyaluronan is observed in myxomatous valve leaflets. Similar colocalization of modified hyaluronan and increased numbers of macrophages were observed in human myxomatous valve disease. CONCLUSIONS Our study demonstrates the heterogeneity of myeloid cells in heart valves and highlights an alteration of macrophage subpopulations, notably an increased presence of infiltrating CCR2+ monocytes and CD206+ macrophages, in myxomatous valve disease.
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Affiliation(s)
- Alexia Hulin
- From the Division of Molecular Cardiovascular Biology, Heart Institute (A.H., A.J.K., K.E.Y.) and Division of Reproductive Sciences (S.J.P., T.D.), Cincinnati Children's Hospital Medical Center, OH; Center for Cardiovascular Research, Columbus, OH (L.J.A., J.L.); and Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (L.J.A., J.L.)
| | - Lindsey J Anstine
- From the Division of Molecular Cardiovascular Biology, Heart Institute (A.H., A.J.K., K.E.Y.) and Division of Reproductive Sciences (S.J.P., T.D.), Cincinnati Children's Hospital Medical Center, OH; Center for Cardiovascular Research, Columbus, OH (L.J.A., J.L.); and Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (L.J.A., J.L.)
| | - Andrew J Kim
- From the Division of Molecular Cardiovascular Biology, Heart Institute (A.H., A.J.K., K.E.Y.) and Division of Reproductive Sciences (S.J.P., T.D.), Cincinnati Children's Hospital Medical Center, OH; Center for Cardiovascular Research, Columbus, OH (L.J.A., J.L.); and Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (L.J.A., J.L.)
| | - Sarah J Potter
- From the Division of Molecular Cardiovascular Biology, Heart Institute (A.H., A.J.K., K.E.Y.) and Division of Reproductive Sciences (S.J.P., T.D.), Cincinnati Children's Hospital Medical Center, OH; Center for Cardiovascular Research, Columbus, OH (L.J.A., J.L.); and Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (L.J.A., J.L.)
| | - Tony DeFalco
- From the Division of Molecular Cardiovascular Biology, Heart Institute (A.H., A.J.K., K.E.Y.) and Division of Reproductive Sciences (S.J.P., T.D.), Cincinnati Children's Hospital Medical Center, OH; Center for Cardiovascular Research, Columbus, OH (L.J.A., J.L.); and Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (L.J.A., J.L.)
| | - Joy Lincoln
- From the Division of Molecular Cardiovascular Biology, Heart Institute (A.H., A.J.K., K.E.Y.) and Division of Reproductive Sciences (S.J.P., T.D.), Cincinnati Children's Hospital Medical Center, OH; Center for Cardiovascular Research, Columbus, OH (L.J.A., J.L.); and Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (L.J.A., J.L.)
| | - Katherine E Yutzey
- From the Division of Molecular Cardiovascular Biology, Heart Institute (A.H., A.J.K., K.E.Y.) and Division of Reproductive Sciences (S.J.P., T.D.), Cincinnati Children's Hospital Medical Center, OH; Center for Cardiovascular Research, Columbus, OH (L.J.A., J.L.); and Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (L.J.A., J.L.).
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Amofa D, Hulin A, Nakada Y, Sadek HA, Yutzey KE. Hypoxia promotes primitive glycosaminoglycan-rich extracellular matrix composition in developing heart valves. Am J Physiol Heart Circ Physiol 2017; 313:H1143-H1154. [PMID: 28842437 PMCID: PMC5814654 DOI: 10.1152/ajpheart.00209.2017] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/16/2017] [Accepted: 08/17/2017] [Indexed: 12/21/2022]
Abstract
During postnatal heart valve development, glycosaminoglycan (GAG)-rich valve primordia transform into stratified valve leaflets composed of GAGs, fibrillar collagen, and elastin layers accompanied by decreased cell proliferation as well as thinning and elongation. The neonatal period is characterized by the transition from a uterine environment to atmospheric O2, but the role of changing O2 levels in valve extracellular matrix (ECM) composition or morphogenesis is not well characterized. Here, we show that tissue hypoxia decreases in mouse aortic valves in the days after birth, concomitant with ECM remodeling and cell cycle arrest of valve interstitial cells. The effects of hypoxia on late embryonic valve ECM composition, Sox9 expression, and cell proliferation were examined in chicken embryo aortic valve organ cultures. Maintenance of late embryonic chicken aortic valve organ cultures in a hypoxic environment promotes GAG expression, Sox9 nuclear localization, and indicators of hyaluronan remodeling but does not affect fibrillar collagen content or cell proliferation. Chronic hypoxia also promotes GAG accumulation in murine adult heart valves in vivo. Together, these results support a role for hypoxia in maintaining a primitive GAG-rich matrix in developing heart valves before birth and also in the induction of hyaluronan remodeling in adults.NEW & NOTEWORTHY Tissue hypoxia decreases in mouse aortic valves after birth, and exposure to hypoxia promotes glycosaminoglycan accumulation in cultured chicken embryo valves and adult murine heart valves. Thus, hypoxia maintains a primitive extracellular matrix during heart valve development and promotes extracellular matrix remodeling in adult mice, as occurs in myxomatous disease.
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Affiliation(s)
- Dorothy Amofa
- Division of Molecular Cardiovascular Biology, Heart Institute, Cincinnati Children's Medical Center, Cincinnati Ohio; and
| | - Alexia Hulin
- Division of Molecular Cardiovascular Biology, Heart Institute, Cincinnati Children's Medical Center, Cincinnati Ohio; and
| | - Yuji Nakada
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Hesham A Sadek
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Katherine E Yutzey
- Division of Molecular Cardiovascular Biology, Heart Institute, Cincinnati Children's Medical Center, Cincinnati Ohio; and
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Coutte L, Hulin A, Vodovar D, Oliver L, Fiore A, Ternacle J, Gallien S, Lepeule R. Dosage des bêtalactamines au cours de l’endocardite infectieuse : un outil d’optimisation de la prise en charge ? Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.163] [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: 11/24/2022]
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Hulin A, Moore V, James JM, Yutzey KE. Loss of Axin2 results in impaired heart valve maturation and subsequent myxomatous valve disease. Cardiovasc Res 2016; 113:40-51. [PMID: 28069701 DOI: 10.1093/cvr/cvw229] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/09/2016] [Accepted: 10/28/2016] [Indexed: 11/12/2022] Open
Abstract
AIMS Myxomatous valve disease (MVD) is the most common aetiology of primary mitral regurgitation. Recent studies suggest that defects in heart valve development can lead to heart valve disease in adults. Wnt/β-catenin signalling is active during heart valve development and has been reported in human MVD. The consequences of increased Wnt/β-catenin signalling due to Axin2 deficiency in postnatal valve remodelling and pathogenesis of MVD were determined. METHODS AND RESULTS To investigate the role of Wnt/β-catenin signalling, we analysed heart valves from mice deficient in Axin2 (KO), a negative regulator of Wnt/β-catenin signalling. Axin2 KO mice display enlarged mitral and aortic valves (AoV) after birth with increased Wnt/β-catenin signalling and cell proliferation, whereas Sox9 expression and collagen deposition are decreased. At 2 months in Axin2 KO mice, the valve extracellular matrix (ECM) is stratified but distal AoV leaflets remain thickened and develop aortic insufficiency. Progressive myxomatous degeneration is apparent at 4 months with extensive ECM remodelling and focal aggrecan-rich areas, along with increased BMP signalling. Infiltration of inflammatory cells is also observed in Axin2 KO AoV prior to ECM remodelling. Overall, these features are consistent with the progression of human MVD. Finally, Axin2 expression is decreased and Wnt/β-catenin signalling is increased in myxomatous mitral valves in a murine model of Marfan syndrome, supporting the importance of Wnt/β-catenin signalling in the development of MVD. CONCLUSIONS Altogether, these data indicate that Axin2 limits Wnt/β-catenin signalling after birth and allows proper heart valve maturation. Moreover, dysregulation of Wnt/β-catenin signalling resulting from loss of Axin2 leads to progressive MVD.
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Affiliation(s)
- Alexia Hulin
- Division of Molecular Cardiovascular Biology, The Heart Institute, Cincinnati Children's Hospital Medical Center, ML7020, 240 Albert Sabin Way, Cincinnati, OH 45229, USA
| | - Vicky Moore
- Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jeanne M James
- Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Katherine E Yutzey
- Division of Molecular Cardiovascular Biology, The Heart Institute, Cincinnati Children's Hospital Medical Center, ML7020, 240 Albert Sabin Way, Cincinnati, OH 45229, USA;
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Sear DA, Jones JI, Collins AL, Hulin A, Burke N, Bateman S, Pattison I, Naden PS. Does fine sediment source as well as quantity affect salmonid embryo mortality and development? Sci Total Environ 2016; 541:957-968. [PMID: 26473698 DOI: 10.1016/j.scitotenv.2015.09.155] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 09/29/2015] [Accepted: 09/30/2015] [Indexed: 06/05/2023]
Abstract
Fine sediments are known to be an important cause of increased mortality in benthic spawning fish. To date, most of the research has focussed on the relationship between embryo mortality and the quantity of fine sediment accumulated in the egg pocket. However, recent evidence suggests a) that the source of fine sediment might also be important, and b) that fitness of surviving embryos post-hatch might also be impacted by the accumulation of fine sediments. In this paper, we report an experiment designed to simulate the incubation environment of brown trout (Salmo trutta) and Atlantic salmon (Salmo salar). During the experiment, the incubating embryos were exposed to different quantities of fine (<63 μm) sediment derived from four different sources; agricultural topsoils, damaged road verges, eroding river channel banks and tertiary level treated sewage. Results showed that mass and source are independently important for determining the mortality and fitness of alevin. Differences between species were observed, such that brown trout are less sensitive to mass and source of accumulated sediment. We demonstrate for the first time that sediment source is an additional control on the impact of fine sediment, and that this is primarily controlled by the organic matter content and oxygen consumption of the catchment source material.
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Affiliation(s)
- D A Sear
- Geography and Environment, University of Southampton, Highfield, Southampton S017 1BJ, UK
| | - J I Jones
- School of Biological and Chemical Sciences, Queen Mary University of London, Mile End Road, London E1 4NS, UK
| | - A L Collins
- Sustainable Soils and Grassland Systems Department, Rothamsted Research, North Wyke, Okehampton, Devon EX20 2SB, UK
| | - A Hulin
- Soils, Agriculture and Water, ADAS, Pendeford House, Wobaston Road, Wolverhampton WV9 5AP, West Midlands, UK
| | - N Burke
- Geography and Environment, University of Southampton, Highfield, Southampton S017 1BJ, UK
| | - S Bateman
- Geography and Environment, University of Southampton, Highfield, Southampton S017 1BJ, UK
| | - I Pattison
- School of Civil and Building Engineering, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - P S Naden
- Centre for Ecology and Hydrology, Crowmarsh Gifford, Wallingford, Oxon OX10 8BB, UK
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Servy A, Gerschenfeld G, Karkouche R, de Prost N, Cecchini J, Barbaud A, Hulin A, Wolkenstein P, Chosidow O, Valeyrie-Allanore L. Premier cas de nécrolyse épidermique toxique au tériflunomide. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.556] [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: 11/24/2022]
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Deroyer C, Magne J, Moonen M, Le Goff C, Dupont L, Hulin A, Radermecker M, Colige A, Cavalier E, Kolh P, Pierard L, Lancellotti P, Merville MP, Fillet M. New biomarkers for primary mitral regurgitation. Clin Proteomics 2015; 12:25. [PMID: 26405438 PMCID: PMC4581160 DOI: 10.1186/s12014-015-9097-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/14/2015] [Indexed: 12/24/2022] Open
Abstract
Background Mitral regurgitation is a frequent valvular heart disease affecting around 2.5 % of the population with prevalence directly related to aging. Degeneration of mitral valve is broadly considered as a passive ongoing pathophysiological process and little is known about its physiological deregulation. The purpose of this study was to highlight new biomarkers of mitral regurgitation in order to decipher the underlying pathological mechanism as well as to allow the diagnosis and the monitoring of the disease. Results Modulation of various blood proteins expression was examined in patients suffering from different grades of mitral regurgitation (mild, moderate and severe) compared to healthy controls. To this end, several routine clinical assays and the multi analyte profile technology targeting 184 proteins were used. High-density lipoprotein, apolipoprotein-A1, haptoglobin and haptoglobin-α2 chain levels significantly decreased proportionally to the degree of mitral regurgitation when compared to controls. High-density lipoprotein and apolipoprotein-A1 levels were associated with effective regurgitant orifice area and regurgitant volume. Apolipoprotein-A1 was an independent predictor of severe mitral regurgitation. Moreover, with ordinal logistic regression, apolipoprotein-A1 remained the only independent factor associated with mitral regurgitation. In addition, myxomatous mitral valves were studied by immunocytochemistry. We observed an increase of LC3, the marker of autophagy, in myxomatous mitral valves compared with healthy mitral valves. Conclusion These potential biomarkers of mitral regurgitation highlighted different cellular processes that could be modified in myxomatous degenerescence: reverse cholesterol transport, antioxidant properties and autophagy. Electronic supplementary material The online version of this article (doi:10.1186/s12014-015-9097-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Céline Deroyer
- GIGA Proteomic Unit, Clinical Chemistry Laboratory, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Julien Magne
- GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Marie Moonen
- GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Caroline Le Goff
- Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Laura Dupont
- GIGA-Cancer, Laboratory of Connective Tissues Biology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Alexia Hulin
- GIGA-Cancer, Laboratory of Connective Tissues Biology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Marc Radermecker
- Department of Cardiovascular and Thoracic Surgery and Human Anatomy, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Alain Colige
- GIGA-Cancer, Laboratory of Connective Tissues Biology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Philippe Kolh
- Department of Biomedical and Preclinical Sciences, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Luc Pierard
- GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Marie-Paule Merville
- Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
| | - Marianne Fillet
- GIGA Proteomic Unit, Clinical Chemistry Laboratory, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium ; Laboratory for the Analysis of Medicines, CIRM, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium
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Hulin A, Alfieri C, Yutzey K. Loss of axin2 in murine aortic valves leads to myxomatous disease. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.553.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alexia Hulin
- The Heart Institute Cincinnati Children's Hospital Medical CenterCincinnatiOhioUnited States
| | - Christina Alfieri
- The Heart Institute Cincinnati Children's Hospital Medical CenterCincinnatiOhioUnited States
| | - Katherine Yutzey
- The Heart Institute Cincinnati Children's Hospital Medical CenterCincinnatiOhioUnited States
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Fang M, Alfieri CM, Hulin A, Conway SJ, Yutzey KE. Loss of β-catenin promotes chondrogenic differentiation of aortic valve interstitial cells. Arterioscler Thromb Vasc Biol 2014; 34:2601-8. [PMID: 25341799 DOI: 10.1161/atvbaha.114.304579] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The Wnt/β-catenin signaling pathway has been implicated in human heart valve disease and is required for early heart valve formation in mouse and zebrafish. However, the specific functions of Wnt/β-catenin signaling activity in heart valve maturation and maintenance in adults have not been determined previously. APPROACH AND RESULTS Here, we show that Wnt/β-catenin signaling inhibits Sox9 nuclear localization and proteoglycan expression in cultured chicken embryo aortic valves. Loss of β-catenin in vivo in mice, using Periostin(Postn)Cre-mediated tissue-restricted loss of β-catenin (Ctnnb1) in valvular interstitial cells, leads to the formation of aberrant chondrogenic nodules and induction of chondrogenic gene expression in adult aortic valves. These nodular cells strongly express nuclear Sox9 and Sox9 downstream chondrogenic extracellular matrix genes, including Aggrecan, Col2a1, and Col10a1. Excessive chondrogenic proteoglycan accumulation and disruption of stratified extracellular matrix maintenance in the aortic valve leaflets are characteristics of myxomatous valve disease. Both in vitro and in vivo data demonstrate that the loss of Wnt/β-catenin signaling leads to increased nuclear expression of Sox9 concomitant with induced expression of chondrogenic extracellular matrix proteins. CONCLUSIONS β-Catenin limits Sox9 nuclear localization and inhibits chondrogenic differentiation during valve development and in adult aortic valve homeostasis.
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Affiliation(s)
- Ming Fang
- From the Heart Institute, Division of Molecular Cardiovascular Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, OH (M.F., C.M.A., A.H., K.E.Y.); and Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.J.C.)
| | - Christina M Alfieri
- From the Heart Institute, Division of Molecular Cardiovascular Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, OH (M.F., C.M.A., A.H., K.E.Y.); and Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.J.C.)
| | - Alexia Hulin
- From the Heart Institute, Division of Molecular Cardiovascular Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, OH (M.F., C.M.A., A.H., K.E.Y.); and Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.J.C.)
| | - Simon J Conway
- From the Heart Institute, Division of Molecular Cardiovascular Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, OH (M.F., C.M.A., A.H., K.E.Y.); and Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.J.C.)
| | - Katherine E Yutzey
- From the Heart Institute, Division of Molecular Cardiovascular Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, OH (M.F., C.M.A., A.H., K.E.Y.); and Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.J.C.).
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Barnette DN, Hulin A, Ahmed ASI, Colige AC, Azhar M, Lincoln J. Tgfβ-Smad and MAPK signaling mediate scleraxis and proteoglycan expression in heart valves. J Mol Cell Cardiol 2013; 65:137-46. [PMID: 24157418 DOI: 10.1016/j.yjmcc.2013.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 09/10/2013] [Accepted: 10/09/2013] [Indexed: 11/17/2022]
Abstract
Mature heart valves are complex structures consisting of three highly organized extracellular matrix layers primarily composed of collagens, proteoglycans and elastin. Collectively, these diverse matrix components provide all the necessary biomechanical properties for valve function throughout life. In contrast to healthy valves, myxomatous valve disease is the most common cause of mitral valve prolapse in the human population and is characterized by an abnormal abundance of proteoglycans within the valve tri-laminar structure. Despite the clinical significance, the etiology of this phenotype is not known. Scleraxis (Scx) is a basic-helix-loop-helix transcription factor that we previously showed to be required for establishing heart valve structure during remodeling stages of valvulogenesis. In this study, we report that remodeling heart valves from Scx null mice express decreased levels of proteoglycans, particularly chondroitin sulfate proteoglycans (CSPGs), while overexpression in embryonic avian valve precursor cells and adult porcine valve interstitial cells increases CSPGs. Using these systems we further identify that Scx is positively regulated by canonical Tgfβ2 signaling during this process and this is attenuated by MAPK activity. Finally, we show that Scx is increased in myxomatous valves from human patients and mouse models, and overexpression in human mitral valve interstitial cells modestly increases proteoglycan expression consistent with myxomatous mitral valve phenotypes. Together, these studies identify an important role for Scx in regulating proteoglycans in embryonic and mature valve cells and suggest that imbalanced regulation could influence myxomatous pathogenesis.
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Affiliation(s)
- Damien N Barnette
- Molecular and Cellular Pharmacology Graduate Program, Leonard M. Miller School of Medicine, P.O. Box 016189 (R-189), Miami, FL, USA; Center for Cardiovascular and Pulmonary Research at Nationwide Children's Hospital Research Institute, 700 Children's Drive, Columbus, OH 43205, USA; The Heart Center at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
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Hulin A, Deroanne C, Lambert C, Defraigne JO, Nusgens B, Radermecker M, Colige A. Emerging pathogenic mechanisms in human myxomatous mitral valve: lessons from past and novel data. Cardiovasc Pathol 2012; 22:245-50. [PMID: 23261354 DOI: 10.1016/j.carpath.2012.11.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/11/2012] [Accepted: 11/07/2012] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Myxomatous mitral valve is one of the most common heart valves diseases in human and has been well characterized at a functional and morphological level. Diseased valves are thickened as a result of extracellular matrix remodeling and proteoglycans accumulation accompanied by the disruption of the stratified structures of the leaflets. METHODS Global transcriptomic analysis was used as a start-up to investigate potential pathogenic mechanisms involved in the development of the human idiopathic myxomatous mitral valve, which have been elusive for many years. RESULTS These prospective analyses have highlighted the potential role of apparently unrelated molecules in myxomatous mitral valve such as members of the transforming growth factor-β superfamily, aggrecanases of the "a disintegrin and metalloprotease with thrombospondin repeats I" family, and a weakening of the protection against oxidative stress. We have integrated, in this review, recent transcriptomic data from our laboratory [A. Hulin, C.F. Deroanne, C.A. Lambert, B. Dumont, V. Castronovo, J.O. Defraigne, et al. Metallothionein-dependent up-regulation of TGF-beta2 participates in the remodelling of the myxomatous mitral valve. Cardiovasc Res 2012;93:480-489] and from the publication of Sainger et al. [R. Sainger, J.B. Grau, E. Branchetti, P. Poggio, W.F. Seefried, B.C. Field, et al. Human myxomatous mitral valve prolapse: role of bone morphogenetic protein 4 in valvular interstitial cell activation. J Cell Physiol 2012;227:2595-2604] with existing literature and information issued from the study of monogenic syndromes and animal models. CONCLUSION Understanding cellular alterations and molecular mechanisms involved in myxomatous mitral valve should help at identifying relevant targets for future effective pharmacological therapy to prevent or reduce its progression.
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Affiliation(s)
- Alexia Hulin
- Laboratory of Connective Tissues Biology, GIGA, University of Liège, Liège, Belgium
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Chubilleau C, Comte J, Ben-Brik E, Pubert M, Hulin A, Leonard S, Giraud J, Ingrand P. Étude écologique du lien entre pesticides et mortalité en Poitou-Charentes entre 2003 et 2007. ARCH MAL PROF ENVIRO 2012. [DOI: 10.1016/j.admp.2012.03.338] [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: 10/28/2022]
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Hulin A, Deroanne CF, Lambert CA, Dumont B, Castronovo V, Defraigne JO, Nusgens BV, Radermecker MA, Colige AC. Metallothionein-dependent up-regulation of TGF-β2 participates in the remodelling of the myxomatous mitral valve. Cardiovasc Res 2011; 93:480-9. [PMID: 22180604 DOI: 10.1093/cvr/cvr337] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
AIMS Although an excessive extracellular matrix remodelling has been well described in myxomatous mitral valve (MMV), the underlying pathogenic mechanisms remain largely unknown. Our goal was to identify dysregulated genes in human MMV and then to evaluate their functional role in the progression of the disease. METHODS AND RESULTS Dysregulated genes were investigated by transcriptomic, immunohistochemistry, and western blot analyses of the P2 segment collected from human idiopathic MMV during valvuloplasty (n = 23) and from healthy control valves (n = 17). The most striking results showed a decreased expression of two families of genes: the metallothioneins-1 and -2 (MT1/2) and members of the ADAMTS. The mechanistic consequences of the reduced level of MT1/2 were evaluated by silencing their expression in normal valvular interstitial cells (VICs) cultures. The knock-down of MT1/2 resulted in the up-regulation of transforming growth factor-beta 2 (TGF-β2). Most importantly, TGF-β2 was also found significantly increased in MMV tissues. The activation of VICs in vitro by TGF-β2 induced a down-regulation of ADAMTS-1 and an accumulation of versican as observed in human MMV. CONCLUSION Our studies demonstrate for the first time that MMV are characterized by reduced levels of MT1/2 accompanied by an up-regulation of TGF-β2. In turn, increased TGF-β2 signalling induces down-regulation of aggrecanases and up-regulation of versican, two co-operating processes that potentially participate in the development of the pathology.
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Affiliation(s)
- Alexia Hulin
- Laboratory of Connective Tissues Biology, GIGA-Cancer, University of Liège, Tour de Pathologie, B23/3, B-4000 Sart-Tilman, Belgium.
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26
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Dharancy S, Iannelli A, Hulin A, Declerck N, Schneck AS, Mathurin P, Boleslawski E, Gugenheim J, Pruvot FR. Mycophenolate mofetil monotherapy for severe side effects of calcineurin inhibitors following liver transplantation. Am J Transplant 2009; 9:610-3. [PMID: 19260838 DOI: 10.1111/j.1600-6143.2008.02529.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Withdrawal of calcineurin inhibitors (CNI) followed by mycophenolate mofetil (MMF) monotherapy after liver transplantation (LT) remains controversial due to the increased risk of acute rejection and graft loss. The aim of the present study, performed in a large cohort of liver-transplanted patients with severe CNI-induced side effects, was to assess renal function recovery, and safety in terms of liver function, of complete CNI withdrawal and replacement by MMF monotherapy. Fifty-two patients treated with MMF monotherapy for CNI-induced toxicity were analyzed. Mean estimated glomerular filtration rate (eGFR) increased significantly during the period of MMF monotherapy, from 37 +/- 10 to 44.7 +/- 15 mL/min/1.73 m(2) at 6 months (p = 0.001) corresponding to a benefit of +17.4% in renal function. eGFR stabilized or improved in 86.5%, 81% and 79% of cases, and chronic renal dysfunction worsened in 13.5%, 19% and 21% of cases, at 6, 12 and 24 months after CNI withdrawal, respectively. Only two patients experienced acute rejection. MMF monotherapy may be efficient at reversing/stabilizing CRD, and appears relatively safe in terms of liver graft function in long-term liver-transplanted patients. However, clinicians must bear in mind the potential risk of rejection and graft loss, and should be very cautious in the management of such 'difficult-to-treat patients'.
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Affiliation(s)
- S Dharancy
- Maladies de l'Appareil digestif et de la Nutrition, Hôpital Claude Huriez, CHRU Lille, France.
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27
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Radermecker MA, Boulanger K, Hulin A, Lambert C, Limet R, Ch L, Nusgens B. [Myxomatous mitral valve degeneration: biochemical aspects and physiopathological considerations]. Rev Med Liege 2008; 63:187-192. [PMID: 18575073] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Mitral valve is a complex structure which is submitted to repeated mechanical constraints. In clinical practice, an increasing incidence of mitral insufficiency resulting from myxomatous degeneration is observed. Since myxomatous degeneration is also observed in defined genetic diseases of connective tissues, we propose the hypothesis that idiopathic mitral insufficiency might result from a minor alteration of the interstitial valvular cells and/or their interactions with their support. After a brief review of the role of the extracellular matrix in the heart, some histopathological and biochemical aspects of myxomatous degeneration are presented. Our data and those of the literature will be summarized and a physiopathological hypothesis proposed for myxomatous mitral valve degeneration.
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Affiliation(s)
- M A Radermecker
- Service de Chirurgie Cardio-Vasculaire et Thoracique, CHU Sart Tilman, Liège, Belgique.
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Hulin A. Mécanismes moléculaires de l’activité des immunosuppresseurs actuels en transplantation : rôles du pharmacien. Annales Pharmaceutiques Françaises 2008; 66:102-14. [DOI: 10.1016/j.pharma.2008.03.005] [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] [Received: 01/24/2008] [Accepted: 03/26/2008] [Indexed: 11/24/2022]
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N'dri K, Kouame KE, Sahari R, Hommel D, Hulin A. [Strongyloides stercoralis hyperinfection syndrome with acute meningoencephalitis associated to HTLV-1 and HTLV-2 virus co-infection]. Med Mal Infect 2008; 38:162-4. [PMID: 18191522 DOI: 10.1016/j.medmal.2007.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Accepted: 11/11/2007] [Indexed: 11/29/2022]
Affiliation(s)
- K N'dri
- Service de Réanimation Polyvalente, Centre Hospitalier de Cayenne, Cayenne, French Guiana.
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Huet E, Morand K, Blanchet B, Astier A, Hulin A. Evaluation of the new heterogeneous ACMIA immunoassay for the determination of whole-blood cyclosporine concentrations in bone marrow, kidney, heart, and liver transplant recipients. Transplant Proc 2005; 36:1317-20. [PMID: 15251322 DOI: 10.1016/j.transproceed.2004.05.062] [Citation(s) in RCA: 5] [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: 11/16/2022]
Abstract
Cyclosporine (CyA) has a narrow therapeutic index. Determination of CyA concentrations correlate with rejection or adverse effects like nephropathy. Cyclosporine is assayed based on either chromatographic or many different immunoenzymologic techniques. The investigators evaluated a new heterogeneous immunoassay of CyA on RxL Dimension. The pretreatment step is automatically performed in the apparatus. Linearity, intra- and interday precision, limit of quantification, dilutions, and stability of the equipment were compared with the EMIT method for patient determinations. The heterogeneous immunoassay showed a good linearity between 0 and 500 ng/mL, and intra- and inter-day precision with a coefficient of variation below 9.2%. The investigators observed reproducible and accurate dilutions of high concentrations (500 to 2000 ng/mL). The correlation with the EMIT technique was valid: ACMIA = 0.964 EMIT + 0.156 (r = .96) for different types of transplant (n = 116). Finally, this new system improves the determination of CyA concentrations.
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Affiliation(s)
- E Huet
- Laboratory of Pharmacology and Toxicology, CHU Henri Mondor, 51 ave du mal de Lattre de Tassigny, 94010 Creteil Cédex, France
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Morand K, Huet E, Blanchet B, Astier A, Hulin A. [Evaluation of the heterogeneous immunoassay (ACMIA) for the measurement of blood cyclosporin on the Behring dimension RXL clinical chemistry analyzer]. Ann Biol Clin (Paris) 2003; 61:713-8. [PMID: 14711615] [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: 04/27/2023]
Abstract
We propose an evaluation of a new heterogeneous immunoassay of cyclosporin on RXL HM Dimension (Dade Behring) for therapeutic cyclosporin monitoring in whole-blood patients transplant. The pretreatment step is performed automatically into the apparatus while it is a manual step with EMIT. Linearity, intra- and inter-day precision, limit of quantification, precision and accuracy of dilution steps and stability into the equipment were studied. We realized the comparison between ACMIA and EMIT methods on whole-blood patients transplant recipients. Heterogeneous immunoassay showed a good linearity between 0 and 500 ng/mL, intra- and inter-day precision with coefficient of variation inferior to 7.2%. We observed reproducible and accurate dilutions of high concentrations (500 to 2,000 ng/mL). The correlation with EMIT technique was correct for different type of transplant (n=55).
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Affiliation(s)
- K Morand
- Laboratoire de pharmacologie et toxicologie, CHU Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil
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32
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Gardon J, Héraud JM, Laventure S, Ladam A, Capot P, Fouquet E, Favre J, Weber S, Hommel D, Hulin A, Couratte Y, Talarmin A. Suburban transmission of Q fever in French Guiana: evidence of a wild reservoir. J Infect Dis 2001; 184:278-84. [PMID: 11443552 DOI: 10.1086/322034] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [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: 01/26/2001] [Revised: 04/02/2001] [Indexed: 11/03/2022] Open
Abstract
The annual incidence of Q fever in French Guiana was found to have increased in 1996 and was 37/100,000 population over the last 4 years. Subsequent investigations in Cayenne and its suburbs indicated that a wild reservoir of the bacteria was responsible for the epidemiologic pattern. A case-control study showed that residence near a forest and occupations and activities that result in exposure to aerosols of dusts from the soil are risk factors for Q fever. By means of time-series analysis, a strong positive correlation between rainfall and the incidence of Q fever with a time lag of 1-3 months was found. The spatial distribution of the cases showed that transmission occurs widely throughout greater Cayenne, which is incompatible with a pinpoint source of contamination. Transmission from livestock and dissemination of the bacteria by the wind appeared to be unlikely, which strengthens the hypothesis that a wild reservoir is responsible for transmission.
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Affiliation(s)
- J Gardon
- Laboratoire d'Epidémiologie, Institut Pasteur de la Guyane, 97306 Cayenne cedex, France.
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33
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Ariey F, Hommel D, Le Scanf C, Duchemin JB, Peneau C, Hulin A, Sarthou JL, Reynes JM, Fandeur T, Mercereau-Puijalon O. Association of severe malaria with a specific Plasmodium falciparum genotype in French Guiana. J Infect Dis 2001; 184:237-41. [PMID: 11424024 DOI: 10.1086/322012] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2001] [Revised: 04/03/2001] [Indexed: 11/03/2022] Open
Abstract
Why severe Plasmodium falciparum malaria occurs in only a small percentage of patients is unclear. The possibility that specific parasite characteristics contribute to severity has been investigated in French Guiana, a hypoendemic area, where parasite diversity is low and all patients with severe cases are referred to a single intensive care unit. Parasite genotyping in geographically and temporally matched patients with mild and severe disease showed that the association of a specific msp-1 allele (B-K1) with a specific var gene (var-D) was overrepresented among patients with severe versus mild disease (47% vs. 3%, respectively; P<.001). Moreover, this genotype combination was consistently observed in the most severe clinical cases. Reverse-transcription polymerase chain reaction demonstrated programmed expression of var-D in vivo, which is consistent with its potential implication in severe disease. These results provide field evidence of an association of severe malaria with specific genetic characteristics of parasites and open the way for intervention strategies targeting key virulence factors of parasites.
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Affiliation(s)
- F Ariey
- Laboratoire de Parasitologie Moléculaire et Centre National de Référence de la Chimiorésistance du Paludisme, Institut Pasteur de la Guyane, French Guiana.
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Talarmin A, Trochu J, Gardon J, Laventure S, Hommel D, Lelarge J, Labeau B, Digoutte JP, Hulin A, Sarthou JL. Tonate virus infection in French Guiana: clinical aspects and seroepidemiologic study. Am J Trop Med Hyg 2001; 64:274-9. [PMID: 11463116 DOI: 10.4269/ajtmh.2001.64.274] [Citation(s) in RCA: 6] [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: 11/07/2022] Open
Abstract
Two recent cases of human infection with Tonate virus, one of which was a fatal case of encephalitis, have renewed interest in these viruses in French Guiana. The clinical aspects of confirmed and probable cases of infection with this virus indicate that it has pathogenic properties in humans similar to those of other viruses of the Venezuelan equine encephalitis complex. To determine the prevalence of antibodies to Tonate virus in the various ethnic groups and areas of French Guiana, 3,516 human sera were tested with a hemagglutination inhibition test. Of these, 11.9% were positive for the virus, but significant differences in seroprevalence were found by age, with an increase with age. After adjustment for age, significant differences were found between places of residence. The prevalence of antibody to Tonate virus was higher in savannah areas, especially in the Bas Maroni (odds ratio [OR] = 22.2, 95% confidence interval [CI] = 15.2-32.4) and Bas Oyapock areas (OR = 13.4; 95% CI = 9.8-18.4). The ethnic differences observed in this study were due mainly to differences in place of residence, except that whites were significantly less frequently infected than other ethnic groups. This study indicates that Tonate virus infection is highly prevalent in French Guiana, especially in savannah areas.
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Affiliation(s)
- A Talarmin
- Centre National de Référence pour la Surveillance des Arboviroses pour la Region Antilles, Cayenne, French Guiana
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35
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Gardon J, Héraud J, Laventure S, Ladam A, Capot P, Fouquet E, Favre J, Weber S, Hommel D, Hulin A, Couratte Y, Talarmin A. Épidémiologie de la fièvre Q en Guyane. Med Mal Infect 2001. [DOI: 10.1016/s0399-077x(01)80077-9] [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: 11/28/2022]
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Abstract
In 1956, the Brazilian government brought honeybees <i>(Apis mellifera andansonii)</i> from South Africa. A group of these bees crossed the Amazon and reached Venezuela where they have killed between 30 and 50 people in the last 4 years [1]. In 1993, we observed the first case of rhabdomyolysis, hepatic dysfunction and acute renal failure (ARF) following multiple stings by African bees <i>(A. mellifera andansonii)</i> in French Guiana.
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Proust V, Toth K, Hulin A, Taburet AM, Gimenez F, Singlas E. Simultaneous high-performance liquid chromatographic determination of the antiretroviral agents amprenavir, nelfinavir, ritonavir, saquinavir, delavirdine and efavirenz in human plasma. J Chromatogr B Biomed Sci Appl 2000; 742:453-8. [PMID: 10901152 DOI: 10.1016/s0378-4347(00)00208-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This article describes a method for the simultaneous determination of four licensed HIV protease inhibitors (amprenavir, nelfinavir, saquinavir and ritonavir) and two novel non-nucleoside reverse transcriptase inhibitors (efavirenz and delavirdine) in human plasma in a single run. Plasma samples (500 microl) were treated by liquid-liquid extraction with methyl tert.-butyl ether. The compounds were separated by reversed-phase liquid chromatography on a C(18) column with spectrophotometric detection at 260 nm. The method is linear over the specific ranges investigated, accurate (inaccuracy <11.7%) and showed intra-day and inter-day precision within the ranges of 0.9-7.0 and 1.9-8.8%, respectively. The six compounds were stable in plasma after 6 months of storage at -20 degrees C and after five freeze-thaw cycles.
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Affiliation(s)
- V Proust
- Hôpital Necker Enfants Malades, Service Pharmacie, Paris, France
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38
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Sermet-Gaudelus I, Hulin A, Ferroni A, Silly C, Gaillard JL, Berche P, Lenoir G. [Antibiotic therapy in cystic fibrosis. I. Pharmacologic specifics of antibiotics]. Arch Pediatr 2000; 7:519-28. [PMID: 10855392 DOI: 10.1016/s0929-693x(00)89009-0] [Citation(s) in RCA: 6] [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: 11/29/2022]
Abstract
Antibiotherapy is one of the main treatment in cystic fibrosis. Antibiotic administration schedules are different from normal patients because of pharmacokinetic and pharmacodynamic particularities. In moderate disease, the digestive resorption of antibiotics is delayed and their half-life is reduced due to an increase in total clearance. In severe disease, the volume of distribution of antibiotics is increased due to the higher proportion of lean mass in these malnourished patients. Other particularities limit the action of antibiotics such as thick sputum, which limits drug penetration; the property of Pseudomonas aeruginosa to be surrounded by a biofilm; alteration of local antibacterial defense; and inhibition of antibiotics by local factors. Systematic prescription of a biotherapy beta-lactam-aminoglycoside and obtaining high antibiotic concentration in situ might limit this antagonism. In spite of particular therapeutic schedules such as single daily dose for aminoglycoside and continuous infusion for beta-lactams, the intervals between administrations must be narrowed for time-dependent antibiotics, and the total daily dose increased by 20 to 30% for concentration-dependent antibiotics.
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Affiliation(s)
- I Sermet-Gaudelus
- Service de pédiatrie générale, hôpital Necker-Enfants-malades, Paris, France
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Hommel D, Heraud JM, Hulin A, Talarmin A. Association of Tonate virus (subtype IIIB of the Venezuelan equine encephalitis complex) with encephalitis in a human. Clin Infect Dis 2000; 30:188-90. [PMID: 10619752 DOI: 10.1086/313611] [Citation(s) in RCA: 12] [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: 11/03/2022] Open
Abstract
Tonate virus, subtype IIIB of the Venezuelan equine encephalitis (VEE) complex, was first isolated in 1973 in French Guiana, South America. However, very little is known about its pathogenicity; it was considered to be responsible for only mild dengue-like syndromes. In 1998, a 2-month-old boy living along the Oyapock river in French Guiana was hospitalized for fever and generalized status myoclonus, and despite treatment the patient died 72 h after admission. Testing showed the presence of IgM specific for viruses of the VEE complex. A sensitive seminested polymerase chain reaction derived from a previous study was developed to detect viruses from the VEE complex, since no virus could be recovered from clinical specimens cultured on mosquito cells or from intracerebral inoculation into newborn mice. The genome of a virus from the VEE complex was detected in postmortem brain biopsies, and Tonate virus was identified by direct sequencing. This is the first reported case of human encephalitis due to Tonate virus.
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Affiliation(s)
- D Hommel
- Intensive Care Unit, General Hospital, Institut Pasteur de la Guyane, Cayenne, French Guiana
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40
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Ariey F, Chalvet W, Hommel D, Peneau C, Hulin A, Mercereau-Puijalon O, Duchemin JB, Sarthou JL, Reynes JM, Fandeur T. Plasmodium falciparum parasites in French Guiana: limited genetic diversity and high selfing rate. Am J Trop Med Hyg 1999; 61:978-85. [PMID: 10674682 DOI: 10.4269/ajtmh.1999.61.978] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [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: 11/07/2022] Open
Abstract
The genetic characteristics of Plasmodium falciparum isolates collected in French Guiana, where malaria transmission is low and occurs in isolated foci, were studied. Blood samples were collected from 142 patients with symptomatic malaria and typed using a polymerase chain reaction-based strategy for merozoite surface protein-(MSP-1) block 2, the MSP-2 central domain, and glutamate-rich protein (GLURP) repeat domain polymorphism. This showed that the parasite population circulating in French Guiana presented a limited number of allelic forms (4, 2, and 3 for MSP-1 block 2, MSP-1, and GLURP, respectively) and a small number of mixed infections, contrasting with the large genetic diversity of parasite populations and infection complexity reported for Africa, Asia, and other parts of South America. Two groups of isolates displaying identical 3 loci allele combinations were further studied for the Pf332 antigen, histidine-rich protein-1, thrombospondin-related anonymous protein, and Pf60 multigene family polymorphism. Within each group, most isolates were identical for all markers tested. This suggests a high rate of self-fertilization of P. falciparum parasites in French Guiana, resulting in homogenization of the population. The implications of these findings for malaria control in areas of low endemicity are discussed.
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Affiliation(s)
- F Ariey
- Laboratoire de Parasitologie Moléculaire, Centre National de Référence de la Chimiorésistance du Paludisme, Institut Pasteur de la Guyane, Cayenne, French Guiana
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41
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Abstract
The first case of yellow fever in French Guiana since 1902 was reported in March 1998. The yellow fever virus genome was detected in postmortem liver biopsies by seminested polymerase chain reaction. Sequence analysis showed that this strain was most closely related to strains from Brazil and Ecuador.
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Affiliation(s)
- J M Heraud
- Institut Pasteur de la Guyane, Cayenne, French Guiana
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Couppié P, Hommel D, Prévost G, Godart MC, Moreau B, Sainte-Marie D, Peneau C, Hulin A, Monteil H, Pradinaud R. [Staphylococcus aureus septicemia producing Panton-Valentine leukocidin. 3 cases]. Ann Dermatol Venereol 1998; 124:684-6. [PMID: 9740863] [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: 02/08/2023]
Abstract
BACKGROUND A strong association has been observed between furuncles and Panton-Valentine leukocidin-producing Staphylococcus aureus. CASE REPORTS Within one year, we cared for three men at the Cayenne hospital who had Staphylococcus aureus septicemia with severe pleuropulmonary involvement originating from furuncular lesions. The Staphylococcus aureus strains isolated from the skin lesions and from blood cultures produced Panton-Valentine leukocidin. CONCLUSION These cases demonstrate the gravity of S. aureus septicemia in young patients with furunculosis. These cases are the first reported with severe S. aureus infections associated with Panton-Valentine leukocidin producing strains.
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Affiliation(s)
- P Couppié
- Service de Dermatologie, Centre Hospitalier de Cayenne
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Abstract
Thousands of cases of dengue fever (DF) and several cases of dengue haemorrhagic fever were recorded in French Guiana during the recent outbreak of dengue-2 virus (1991-1992) and in subsequent years. One case with clinical signs typical of classical DF with neurological complications is reported in this study. The neurological features (encephalitis) appeared during the acute phase, 2 days after the onset of fever. Dengue-2 virus was detected in both the cerebrospinal fluid and blood sample. This case was fatal. This first reported case of classical DF with encephalitis in French Guiana is a new demonstration of the potential neurovirulence of dengue viruses.
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Affiliation(s)
- D Hommel
- Intensive Care Unit, General Hospital, Cayenne, French Guiana
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45
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Pfaff F, François A, Hommel D, Jeanne I, Margery J, Guillot G, Couratte-Arnaude Y, Hulin A, Talarmin A. Q fever in French Guiana: new trends. Emerg Infect Dis 1998; 4:131-2. [PMID: 9454566 PMCID: PMC2627661 DOI: 10.3201/eid0401.980124] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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46
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Hommel D, Bollandard F, Hulin A. [Re-emergence of Venezuelan equine encephalitis virus in French Guiana. Apropos of 1 confirmed case]. Bull Soc Pathol Exot 1997; 90:153-5. [PMID: 9410246] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Venezuelan equine encephalitis (VEE) is a mosquito-borne viral disease that occurs in equine species and in man. The strains can be grouped epidemiologically into two major categories: enzootic and epizootic. Enzootic strains cause sporadic human disease and are not associated with disease among equines. These strains are found throughout Florida. Central America, northern South America and Brazil. Epizootic strains are associated with enormous morbidity and mortality in equine species. In man, VEE virus infections are largely asymptomatic and in children and young adults there is an increased risk of encephalitis and dead. We report the first case in French Guiana of Venezuelan equine encephalitis. Clinical examination and biological studies showed encephalitis, interstitial pneumonia and acute liver failure. Despite an adequate symptomatic treatment, the young patient died five days after her admission in multiple organ dysfunction syndrome. Diagnosis is establishing by virologic test: VEE virus is isolated from the blood. These example of re-emerging infectious disease vividly illustrate that we remains vulnerable and emphasizes the need for an active surveillance system.
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Affiliation(s)
- D Hommel
- Unité de réanimation polyvalente, Centre hospitalier de Cayenne, Guyane française
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47
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Michel P, Hulin A, Bourlaud G, Pagliano G. [Post-traumatic gastric rupture]. J Chir (Paris) 1987; 124:138-9. [PMID: 3571346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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48
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Michel P, Hulin A, Desbordes JM. [Post-traumatic intramural hematoma of the duodenum]. J Chir (Paris) 1986; 123:484-9. [PMID: 3805195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A post-traumatic intramural hematoma of duodenum in a 9 year old child was detected during exploratory laparotomy but left undisturbed. Postoperative follow up during parenteral feeding included surveillance by repeated gastrografin follow through examinations, normal transit being restored by the 12th day. Intramural hematoma of duodenum is usually due to injury and often affects male children. Symptomatology is that of upper digestive occlusion. The principal investigation should be gastro-duodenal follow through examinations with gastrografin, because of the risk of an associated perforation, to reveal possible partial or total duodenal obstruction. Conservative treatment is possible, but in case of failure or in adults surgery is indicated with evacuation of the hematoma and in some cases a gastro-jejunostomy.
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49
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Desbordes JM, Maissin F, Bernard P, Herpin D, Hulin A. [An apparatus for the noninvasive automatic measurement of arterial pressure]. Cah Anesthesiol 1984; 32:119-21. [PMID: 6529643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
An automatic apparatus for the measurement of arterial pressure by a non-invasive technique is compared with direct intra-arterial measurement in patients admitted to a neurosurgical intensive care unit. A good correlation is found between the results of the two methods for the systolic and diastolic pressure.
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50
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Desbordes JM, Deglaire B, Hulin A, Desplat A, Roualdes G. [Intracranial and intraspinal hemorrhage during anticoagulant therapy. Analysis of 52 cases]. Cah Anesthesiol 1984; 32:209-12. [PMID: 6529657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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