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Gounelle M, Cousson-Gelie F, Nicolas B, Kerdraon J, Gault D, Tournebise H, Goossens D, Leynaert V, Middleton J, Coffy A, Gelis A. French cross-cultural adaptation and validity of the Moorong Self-Efficacy scale: the MSES-FR, a measure of Self-Efficacy for French people with spinal cord injury. Disabil Rehabil 2022; 44:8066-8074. [PMID: 34802337 DOI: 10.1080/09638288.2021.2003452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To adapt the Moorong Self-Efficacy Scale (MSES) in the French language and determine its psychometric proprieties. MATERIALS AND METHODS After a back-translation process, an expert committee was solicited to develop the French Self Efficacy Scale, thanks to a Delphi method, regarding theoretical framework and concepts explored. A total of 201 patients with SCI were included to explore internal consistency, internal and external structure validity assessed with the General Self-Efficacy scale, MOS Health Survey Short-Form, Hospital Anxiety and Depression Scale, Way of Coping Check-list, Perceived Stress Scale, Social Support Questionnaire, Self-Esteem questionnaire, and Satisfaction With Life Scale. The retest was performed 4 days later with a randomized version of the MSES-Fr. RESULTS The 16 items are distributed in 3 different dimensions: Interpersonal Self-Efficacy (4 items), Instrumental Self-Efficacy (4 items) and Participation Self-Efficacy (6 items). The internal consistency was excellent (Cronbach α = .87). Results evidenced significant correlations with the MSES-Fr and other related psychological constructs (self-esteem, mood, quality of life). Reproducibility was good for the total score of the MSES-Fr (ICC = .74) and for the 3 dimensions of the scale. CONCLUSIONS The MSES-Fr is a valid and reliable tool to assess self-efficacy in persons with spinal cord injury.Implications for rehabilitationThe Moorong Self-Efficacy Scale (MSES) is commonly used in persons with SCI for evaluating the level of perceived effectiveness in living with a disability.Validity and reliability studies of the MSES-Fr show good psychometrics properties in people with SCI.The French version of the MSES has been cross-culturally translated and is ready to be used clinically.
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Affiliation(s)
- Marion Gounelle
- Université Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, Montpellier, France.,Centre Neurologique Mutualiste Propara, Montpellier
| | - Florence Cousson-Gelie
- Université Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, Montpellier, France.,Institut régional du Cancer de Montpellier-ICM, Epidaure, Montpellier, France
| | | | | | - Dominique Gault
- Institut de Réadaptation Fonctionnelle Clémenceau, Strasbourg, France
| | | | | | | | - James Middleton
- University of Sydney, Kolling Institute of Medical Research, Sydney, Australia
| | - Amandine Coffy
- Institut Universitaire de Recherche Clinique (IURC), Laboratoire de Biostatistiques et d'Epidémiologie EA2415, Montpellier, France
| | - Anthony Gelis
- Université Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, Montpellier, France.,Centre Neurologique Mutualiste Propara, Montpellier
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Pujol P, Yauy K, Coffy A, Duforet-Frebourg N, Gabteni S, Daurès JP, Penault-Llorca FM, Collet L, Thomas F, Turnbull C, Galibert V, Rideau C, You B, Geneviève D, Hughes KS, Philippe N. Predominance of BRCA2 mutation and estrogen receptor-positive breast cancer among BRCA1/2 mutation carriers. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
551 Background: PARP inhibitor (PARPi) agents can improve progression-free survival of patients with breast cancer (BC) who carry a germline BRCA1 or BRCA2 pathogenic or likely pathogenic variant (gBRCA1/2) in both the metastatic and adjuvant setting. Therefore, we need to redefine the criteria of women and tumor phenotype that should be tested for gBRCA1/2. Methods: We studied the relative distribution of gBRCA1 and gBRCA2 in unselected populations of women with BC and in unaffected individuals. We also analyzed the proportion of estrogen receptor (ER)-positive (ER+) tumors in unselected BC patients with gBRCA1/2.We performed a meta-analysis of studies of unselected BC that analyzed the relative contribution of gBRCA1 versus gBRCA2 and ER+ tumors among gBRCA1/2 carriers. We then performed a meta-analysis of gBRCA1/2 carriage in unaffected individuals, from genome-wide population studies, the gnomAD databank, and case–control studies. Results: The BRCA2 gene was involved in 54% of BC in unselected patients with gBRCA1/2 (n=108,699) and 59% of unaffected individuals (n=238,973) as compared with 38% of gBRCA1/2 family cohorts (n=29,700). The meta-analysis showed that 1.66% (95% CI 1.08-2.54) and 1.71% (95% CI 1.33-2.2) of unselected BC patients carried a gBRCA1 and gBRCA2, respectively. In unaffected individuals, the frequency of heterozygosity for gBRCA1 and gBRCA2 was estimated at 1/434 and 1/288, respectively. Nearly 0.5% of unaffected individuals in the studied populations carried a gBRCA1/2. Carriage of a gBRCA was 2.5% for patients with ER+ tumors (95% CI 1.5-4.1) and 5.7% (95% CI 5.1-6.2) for those with ER- tumors. Overall, 58% of breast tumors occurring in women carrying a gBRCA1/2 were ER+ (n=86,870). Conclusions: This meta-analysis showed that gBRCA2 carriage is predominant in unselected BC and in unaffected individuals. ER+ tumors among women with gBRCA1/2-related BC is predominant and has been underestimated. Because PARPi agents improve progression-free survival with ER+ gBRCA1/2 BC in both the adjuvant and metastatic setting, BC should be considered regardless of ER status for BRCA1/2 screening for therapeutic purposes.
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Affiliation(s)
- Pascal Pujol
- CREEC, UMR IRD 224-CNRS 5290 Université Montpellier, Montpellier, France
| | | | | | | | | | | | | | | | - Frédéric Thomas
- CREEC, UMR IRD 224-CNRS 5290 Université Montpellier, Montpellier, France
| | - Clare Turnbull
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Benoit You
- Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), Lyon, France
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Revol B, Castelli C, Ben Messaoud R, Coffy A, Bailly S, Jullian-Desayes I, Martinot JB, Martinot P, Joyeux-Faure M, Pépin JL. Deprescribing antihypertensive drugs after starting OSA primary therapy? Sleep 2022; 45:zsac060. [PMID: 35554591 DOI: 10.1093/sleep/zsac060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Affiliation(s)
- Bruno Revol
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Pole Thorax and Vessels, Grenoble Alpes University Hospital, Grenoble, France
- Pharmacovigilance Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Christel Castelli
- UMR 5815, Laboratory of Law and Health Economics, University of Montpellier, Montpellier, France
- Department of Languedoc Mutualité Nouvelles Technologies, Montpellier Beausoleil Clinic, Montpellier, France
| | - Raoua Ben Messaoud
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Pole Thorax and Vessels, Grenoble Alpes University Hospital, Grenoble, France
| | - Amandine Coffy
- Department of Languedoc Mutualité Nouvelles Technologies, Montpellier Beausoleil Clinic, Montpellier, France
| | - Sébastien Bailly
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Pole Thorax and Vessels, Grenoble Alpes University Hospital, Grenoble, France
| | - Ingrid Jullian-Desayes
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Pole Thorax and Vessels, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-Benoît Martinot
- Sleep Laboratory, CHU UCL Namur Site Sainte-Elisabeth, Namur, Belgium
- Institute of Experimental and Clinical Research, UCL, Bruxelles Woluwe, Belgium
| | - Pierre Martinot
- Sleep Laboratory, CHU UCL Namur Site Sainte-Elisabeth, Namur, Belgium
- Institute of Experimental and Clinical Research, UCL, Bruxelles Woluwe, Belgium
| | - Marie Joyeux-Faure
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Pole Thorax and Vessels, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-Louis Pépin
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
- EFCR Laboratory, Pole Thorax and Vessels, Grenoble Alpes University Hospital, Grenoble, France
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Beltai A, Combe B, Coffy A, Gaujoux-Viala C, Lukas C, Saraux A, Dougados M, Daurès JP, Hua C. Impact of multimorbidity on disease modifying anti-rheumatic drug therapy in early rheumatoid arthritis: data from the Espoir cohort. Joint Bone Spine 2021; 89:105326. [PMID: 34906696 DOI: 10.1016/j.jbspin.2021.105326] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/27/2021] [Revised: 11/19/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Multimorbidity is frequent in rheumatoid arthritis (RA) and could interfere with the therapeutic response. The aim of this study was to evaluate multimorbidity in the French cohort of early arthritis, the ESPOIR cohort, and its possible impact on the therapeutic response. METHODS We included patients fulfilling 2010 ACR/EULAR criteria for RA. An adapted MultiMorbidity Index (aMMI) was developed. Each patient was assigned scores of binary aMMI (0= no comorbidity, 1= at least 1 comorbidity) and counted and weighted aMMI. The primary endpoint was achievement of Clinical Disease Activity Index (CDAI) low disease activity after initiation of a first disease-modifying anti-rheumatic drug (DMARD) according to the aMMI. We collected data from the visit preceding the first DMARD initiation and the visit after at least 3 months of treatment. The impact of aMMI on therapeutic maintenance at 1, 3, 5 and 10 years was evaluated. RESULTS Analyses involved 472 patients: 302 (64%) had at least 1 comorbidity. Overall, 45.3% and 44.7% with binary aMMI= 0 or 1, respectively (non significant), achieved CDAI low disease activity. Similar results were found with counted and weighted aMMI. Therapeutic maintenance was significantly better with binary aMMI = 1 than binary aMMI = 0 (OR at 10 years= 14.0 [CI 95% 3.3-59.4]). Increased counted aMMI was associated with increased probability of still being on the first initiated DMARD at each time point. CONCLUSION In the ESPOIR cohort, therapeutic response to a first DMARD was not affected by multimorbidity but therapeutic maintenance was better in multimorbid patients.
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Affiliation(s)
- Aurélie Beltai
- Department of Rheumatology, CHU Montpellier, University of Montpellier, 371 Av. du Doyen Gaston Giraud, 34090 Montpellier, France
| | - Bernard Combe
- Department of Rheumatology, CHU Montpellier, University of Montpellier, 371 Av. du Doyen Gaston Giraud, 34090 Montpellier, France
| | - Amandine Coffy
- Biostatistiques, Nouvelles Technologies, 641 Av. du Doyen Gaston Giraud, 34090 Montpellier, France
| | - Cécile Gaujoux-Viala
- Department of Rheumatology, CHU Nîmes, Place du Professeur Robert Debré, 30000 Nîmes, France; Institut Desbrest d'Epidémiologie et de Santé Publique UMR INSERM - University of Montpellier, 641 Av. du Doyen Gaston Giraud, 34090 Montpellier, France
| | - Cédric Lukas
- Department of Rheumatology, CHU Montpellier, University of Montpellier, 371 Av. du Doyen Gaston Giraud, 34090 Montpellier, France; Institut Desbrest d'Epidémiologie et de Santé Publique UMR INSERM - University of Montpellier, 641 Av. du Doyen Gaston Giraud, 34090 Montpellier, France
| | - Alain Saraux
- Department of Rheumatology, CHU de Brest, INSERM UMR 1227, University of Brest, 2 Avenue Foch, 29200 Brest, France
| | - Maxime Dougados
- Department of Rheumatology, CHU Cochin, University of Paris 5, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Jean Pierre Daurès
- Biostatistiques, Nouvelles Technologies, 641 Av. du Doyen Gaston Giraud, 34090 Montpellier, France
| | - Charlotte Hua
- Department of Rheumatology, CHU Nîmes, Place du Professeur Robert Debré, 30000 Nîmes, France; Institut Desbrest d'Epidémiologie et de Santé Publique UMR INSERM - University of Montpellier, 641 Av. du Doyen Gaston Giraud, 34090 Montpellier, France.
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Roubille C, Coffy A, Rincheval N, Dougados M, Flipo RM, Daurès JP, Combe B. Ten-year analysis of the risk of severe outcomes related to low-dose glucocorticoids in early rheumatoid arthritis. Rheumatology (Oxford) 2021; 60:3738-3746. [PMID: 33320245 DOI: 10.1093/rheumatology/keaa850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 09/20/2020] [Revised: 11/14/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To explore the 10-year tolerability profile of glucocorticoids (GC) use in patients with early RA. METHODS Analysis of 10-year outcome from the early arthritis ESPOIR cohort. Patients were stratified in two groups, without or with GC treatment at least once during their follow-up. The primary outcome was a composite of deaths, cardiovascular diseases (CVD), severe infections and fractures. The weighted Cox time-dependent analysis model was used with inverse probability of treatment weighting (IPTW) propensity score method. RESULTS Among the 608 patients [480 women, mean age of 47.5 (12.1) years], 397 (65%) received low-dose GC [median 1.9 mg/day (IQR 0.6-4.2), mean cumulative prednisone dose 8468 mg (8376), mean duration 44.6 months (40.1)]. In univariate analysis, over 95 total events (10 deaths, 18 CVDs, 32 fractures and 35 severe infections), patients taking GC experienced more events (n = 71) than those without GC (n = 24) (P =0.035). Highest cumulative exposure of GC (≥8.4 g) was associated with highest risk of occurrence of the primary outcome (24.3%, P =0.007), CVDs (7.9%, P =0.001) and severe infections (9.9%, P =0.024). The risk of events over time was significantly associated with GC, age, hypertension and ESR. The risk associated with GC treatment increased between the first follow-up visit [hazard ratio (HR) at 1 year = 0.46, 95% CI: 0.23, 0.90] and 10 years (HR = 6.83, 95% CI: 2.29, 20.35). CONCLUSION The 10-year analysis of this prospective early RA cohort supports a dose and time-dependent impact of low-dose GC treatment, with a long-term high risk of severe outcomes. TRIAL REGISTRATION (ClinicalTrials.gov Identifier: NCT03666091).
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Affiliation(s)
- Camille Roubille
- Department of Internal Medicine, CHU Montpellier, Montpellier University, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Amandine Coffy
- Statistiques, University Institute of Clinical Research EA2415 and Clinique Beausoleil, Montpellier cedex, France
| | - Nathalie Rincheval
- Statistiques, University Institute of Clinical Research EA2415 and Clinique Beausoleil, Montpellier cedex, France.,Rheumatology Department, CHU Montpellier, Montpellier University, Montpellier, France
| | - Maxime Dougados
- Medicine Faculty and Rheumatology B Department, Paris-Descartes University, UPRES-EA 4058; APHP, Cochin Hospital, Paris, France
| | - René-Marc Flipo
- Department of Rheumatology, Roger Salengro Hospital, Lille, France
| | - Jean-Pierre Daurès
- Statistiques, University Institute of Clinical Research EA2415 and Clinique Beausoleil, Montpellier cedex, France
| | - Bernard Combe
- Rheumatology Department, CHU Montpellier, Montpellier University, Montpellier, France
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Beltai A, Combe B, Coffy A, Gaujoux-Viala C, Lukas C, Saraux A, Dougados M, Daures JP, Hua C. POS0306 IMPACT OF MULTIMORBIDITY ON DISEASE MODIFYING ANTI-RHEUMATIC DRUG THERAPY IN EARLY RHEUMATOID ARTHRITIS: DATA FROM THE ESPOIR COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Multimorbidity is frequent in rheumatoid arthritis (RA) and could interfere with the therapeutic response.Objectives:The aim of this study was to evaluate multimorbidity in the French cohort of early arthritis (ESPOIR cohort) and its possible impact on the therapeutic response.Methods:We included patients fulfilling 2010 ACR/EULAR criteria for RA. An adapted MultiMorbidity Index (aMMI) was developed [1]. Each patient was assigned scores of binary aMMI (0= no comorbidity, 1= at least 1 comorbidity) and counted and weighted aMMI. The primary endpoint was achievement of Clinical Disease Activity Index (CDAI) low disease activity after initiation of a first disease-modifying anti-rheumatic drug (DMARD) according to the aMMI. Secondary endpoints were other disease activity scores and response criteria. We collected data from the visit preceding the first DMARD initiation (baseline visit) and the visit after at least 3 months of treatment (follow-up visit). The impact of aMMI on therapeutic maintenance at 1, 3, 5 and 10 years was evaluated.Results:Analyses involved 472 patients: 302 (64%) had at least 1 comorbidity. Overall, 45.3% and 44.7% with binary aMMI= 0 or 1, respectively (p= 0.9), achieved CDAI low disease activity (Table 1). Similar results were found with counted and weighted aMMI. Use of other disease activity scores or response criteria did not show a significant impact of multimorbidity on the therapeutic response. Therapeutic maintenance was significantly better with binary aMMI = 1 than binary aMMI = 0. Increased counted aMMI was associated with increased probability of still being on the first initiated DMARD at each time point (Table 2).Table 1.Impact of aMMIs on CDAI, DAS28 and SDAI low disease activity (LDA) achievement at follow-up visit (univariate analyses)LDA achievementCDAIpDAS28pSDAIpYesNoYesNoYesNoBinary aMMI, n (%)077 (45.3)93 (54.7)0.9*85 (50.0)85 (50.0)0.2*80 (47.1)90 (52.9)0.9*1135 (44.7)167 (55.3)131 (43.4)171 (56.6)141 (46.7)161 (53.3)Counted aMMI, mean (SD)1.0 (1.1)1.1 (1.1)0.71.0 (1.1)1.1 (1.1)0.21.1 (1.1)1.1 (1.1)1.0Weighted aMMI, mean (SD)4.1 (5.2)4.0 (4.7)0.94.0 (5.2)4.1 (4.7)0.34.0 (5.0)4.0 (4.9)1.0aMMI= adapted MultiMorbidity Index; CDAI= Clinical Disease Activity Index; SDAI= Simplified Disease Activity Index* Proportion of patients achieving LDA between patients with binary aMMI= 0 and binary aMMI= 1. Because of no statistically significant results, no multivariate analysis was performed.Table 2.Probability of first DMARD maintenance at 1, 3, 5 and 10 years (multivariate analysis)Time pointFirst DMARD maintained or stoppedBinary aMMI#Counted aMMI§011 year(n= 530)Maintenance (n= 300)22981.71 (0.93)OR [95% CI]*> 999 [286.2->999]221.3 [84.0-583.0]Withdrawal (n= 230)205250.12 (0.37)3 years(n= 493)Maintenance (n= 285)102751.66 (0.94)OR [95% CI]*153.9 [73.0-324.5]26.1 [15.1-45.3]Withdrawal (n= 208)175330.22 (0.64)5 years(n= 459)Maintenance (n= 116)91071.72 (1.05)OR [95% CI]*10.9 [5.1-23.3]2.2 [1.8-2.7]Withdrawal (n= 343)1631800.82 (1.0)10 years(n= 415)Maintenance (n= 40)2381.58 (0.84)OR [95% CI]*14.0 [3.3-59.1]1.6 [1.2-2.0]Withdrawal (n= 375)1582170.99 (1.12)#data are number of patients§ data are mean (standard error)* data are odds ratios (ORs) and 95% confidence intervals (95% CI) of still being on the first initiated DMARD at 1, 3, 5 and 10 years between patients with binary aMMI = 1 and binary aMMI = 0 and according to counted aMMI, per additional point.Conclusion:In the ESPOIR cohort, therapeutic response to a first DMARD was not affected by multimorbidity but therapeutic maintenance was better in multimorbid patients.References:[1]Radner H, Yoshida K, Mjaavatten MD, et al. Development of a multimorbidity index: Impact on quality of life using a rheumatoid arthritis cohort. Semin Arthritis Rheum 2015;45:167–73.The variables included in multivariate analyses were sex, rheumatoid factor and/or anti-citrunillated peptide antibody positivity, age, CDAI at baseline visit, number of treatments at baseline visit.Acknowledgements:We are grateful to Nathalie Rincheval (Montpellier) for expert monitoring and data management and all the investigators who recruited and followed the patients (F. Berenbaum, Paris-Saint Antoine; MC. Boissier, Paris-Bobigny; A. Cantagrel, Toulouse; B. Combe, Montpellier; M. Dougados, Paris-Cochin; P. Fardellone and P. Boumier, Amiens; B. Fautrel, Paris-La Pitié; RM. Flipo, Lille; Ph. Goupille, Tours; F. Liote, Paris- Lariboisière; O. Vittecoq, Rouen; X. Mariette, Paris-Bicêtre; P. Dieude, Paris Bichat; A. Saraux, Brest; T. Schaeverbeke, Bordeaux; and J. Sibilia, Strasbourg).Disclosure of Interests:Aurélie BELTAI: None declared, Bernard Combe Speakers bureau: AbbVie; Bristol-Myers Squibb; Gilead; Janssen; Lilly; Merck; Novartis; Pfizer; Roche-Chugai; and Sanofi, Consultant of: AbbVie; Bristol-Myers Squibb; Gilead; Janssen; Lilly; Merck; Novartis; Pfizer; Roche-Chugai; and Sanofi, Grant/research support from: Novartis, Pfizer, and Roche, Amandine Coffy: None declared, Cécile Gaujoux-Viala: None declared, Cédric Lukas Speakers bureau: Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai and UCB, Consultant of: Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai and UCB, Grant/research support from: Pfizer, Novartis and Roche-Chugai, Alain Saraux Speakers bureau: AbbVie; Bristol-Myers Squibb; Lilly; Nordic; Novartis; Pfizer; Roche-Chugai; Sanofi and UCB, Consultant of: AbbVie; Bristol-Myers Squibb; Lilly; Nordic; Novartis; Pfizer; Roche-Chugai; Sanofi and UCB, Grant/research support from: AbbVie; Bristol-Myers Squibb; Lilly; Nordic; Novartis; Pfizer; Roche-Chugai; Sanofi and UCB, Maxime Dougados Speakers bureau: Pfizer, Abbvie, Lilly, UCB, Merck, BMS, Roche, Biogen, Sanofi, Novartis, Sandoz, Consultant of: Pfizer, Abbvie, Lilly, UCB, Merck, BMS, Roche, Biogen, Sanofi, Novartis, Sandoz, Grant/research support from: Pfizer, Abbvie, Lilly, UCB, Merck, BMS, Roche, Biogen, Sanofi, Novartis, Sandoz, Jean-Pierre DAURES: None declared, Charlotte Hua: None declared
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Bommart S, Pujol JL, Coffy A, Daurès JP, Roch B. Authors reply to letter to the editor by Dr Degens et al. Lung Cancer 2021; 153:185. [PMID: 33461818 DOI: 10.1016/j.lungcan.2020.12.035] [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] [Received: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - A Coffy
- University of Montpellier, France
| | | | - B Roch
- University of Montpellier, France
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Roubille C, Coffy A, Rincheval N, Dougados M, Flipo RM, Daures JP, Combe B. OP0116 TEN-YEAR ANALYSIS OF VERY LOW-DOSE GLUCOCORTICOIDS IN EARLY RA (ESPOIR COHORT) SUPPORTS A TIME-DEPENDENT RISK OF SEVERE OUTCOMES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:We previously failed to find any significant difference with regard to severe outcomes (death, severe infections, fractures, cardiovascular diseases [CVD]) between recent-onset RA patients taking or not low-dose GC treatment in a 7-year analysis of the ESPOIR cohort (1).Objectives:To explore the 10-year tolerability profile of GC use in patients with early RA.Methods:We analysed data from the early arthritis (less than 6 months disease duration) ESPOIR cohort. Patients were stratified in two groups, with or without GC treatment at least once during their follow-up (median 10 years IQR [9-10]). The primary outcome was a composite of death, CVD (including myocardial ischemia, cerebrovascular accident and heart failure), severe infection and fracture. In order to reduce the impact of treatment selection bias and potential confounding factors, the weighted Cox time-dependent analysis model was used with inverse probability of treatment weighting (IPTW) propensity score method.Results:Among the 608 RA patients (480 women, mean age of 47.5 ± 12.1 years), 397 patients (65%) received low-dose prednisone (median 1.9 mg/day [IQR 0.6-4.2], mainly during the first 6 months (70%). The mean duration of GC treatment was 44.6 months ± 40.1. Overall, 95 events were identified during follow-up: 10 deaths, 18 CVD, 32 fractures and 35 severe infections. Based on univariate analysis at 10 years, patients taking GC experienced significantly more events (n=71) than those without GC (n=24) (p=0.035), especially severe infections (n=30 with GC versus 5 without GC, p=0.009) (table 1), with a cumulative dose effect (p=0.007).On weighted Cox time-dependent analysis, using the IPTW propensity score method, the risk of events over time was significantly associated with GC treatment (p <0.001), age, history of hypertension and erythrocyte sedimentation rate. The risk associated with GC treatment, estimated by the hazard ratio (HR), increased between the first follow-up visit (HR at 6 months = 0.39, 95% CI 0.19-0.82) and 10 years (HR=6.83, 95% CI 2.29-20.35) (figure 1 and table 2).Table 1.Primary outcome and events at 10 years: univariate analysisTotal study population (n=608)Without GCWith CGP ValuePrimary outcome95 (15.6%)24 (11.4%)71 (17.9%)0.035Death10 (1.6%)1 (0.5%)9 (2.3%)0.103Cardiovascular diseases18 (3%)3 (1.4%)15 (3.8%)0.177Severe infections35 (5.8%)5 (2.4%)30 (7.6%)0.009Fractures32 (5.3%)15 (7.1%)17 (4.3%)0.137Table 2.Time-dependent relationship between glucocorticoids treatment and risk of eventsestimated by hazard ratioTime (Months)Hazard Ratio (95% CI)120.46 (0.23 - 0.90)240.62 (0.36 - 1.08)360.83 (0.52 - 1.33)481.12 (0.73 - 1.72)601.52 (0.96 - 2.40)722.05 (1.19 - 3.52)842.77 (1.44 - 5.34)963.74 (1.69 - 8.26)1085.05 (1.98 - 12.91)1206.83 (2.29 - 20.35)Figure 1.Time-dependent relationship between glucocorticoids treatment and risk of eventsestimated by hazard ratio (HR)Conclusion:This 10-year analysis of the ESPOIR cohort supports a dose and time-dependent impact of very low-dose GC treatment in early RA, with a long-term high risk of severe outcomes.Disclosure of Interests:Camille Roubille Consultant of: Servier, Pfizer, Novartis, Amandine Coffy: None declared, Nathalie Rincheval: None declared, Maxime Dougados Grant/research support from: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Consultant of: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Speakers bureau: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma, Rene-Marc Flipo Speakers bureau: Novartis, Janssen, Lilly, Jean-Pierre Daures: None declared, Bernard Combe Grant/research support from: Novartis, Pfizer, Roche-Chugai, Consultant of: AbbVie; Gilead Sciences, Inc.; Janssen; Eli Lilly and Company; Pfizer; Roche-Chugai; Sanofi, Speakers bureau: Bristol-Myers Squibb; Gilead Sciences, Inc.; Eli Lilly and Company; Merck Sharp & Dohme; Pfizer; Roche-Chugai; UCB
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Roch B, Coffy A, Jean-Baptiste S, Palaysi E, Daures JP, Pujol JL, Bommart S. Cachexia - sarcopenia as a determinant of disease control rate and survival in non-small lung cancer patients receiving immune-checkpoint inhibitors. Lung Cancer 2020; 143:19-26. [PMID: 32200137 DOI: 10.1016/j.lungcan.2020.03.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/26/2020] [Accepted: 03/03/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE The metabolic changes associated with cachexia - sarcopenia syndrome might down-regulate antitumor immunity. We hypothesized that this syndrome reduces efficiency of immune checkpoint inhibitors (ICPI) in non-small cell lung cancer (NSCLC). METHODS The records of 142 consecutive NSCLC patients receiving first- or second-line anti-Programmed cell death protein 1) ICPI were reviewed. Response evaluation according to Response Evaluation Criteria in Solid Tumors 1.1 was performed at the eighth week of immunotherapy. Pretreatment cachexia was defined as a body-weight loss of 5% or more in the previous 6 months. Sarcopenia was estimated with the third lumbar skeletal muscle mass index (mSMI) and was evaluated before immunotherapy and at the eighth week. A decrease by 5% or more of the mSMI was considered as an evolving sarcopenia. The endpoints were disease control rate (DCR), progression-free (PFS) and overall survival (OS).Logistic regression model and Cox model took into account others covariables known to influence ICPI efficiency, particularly Programmed Death -Ligand 1 tumor cell score, Eastern Cooperative Oncology Group performance status and common somatic mutational status. RESULTS In multivariate analysis, cachexia - sarcopenia syndrome reduced the probability of achieving a disease control and were associated with a shorter survival. Patients without cachexia had a better probability to achieve disease control in comparison with those who did not experience cachexia (59.9 % and 41.1 %, respectively; odds ratio 95 % (confidence interval [95 %CI]): 2.60 (1.03-6.58)). Patients with cachexia had a shorter OS when compared with those without cachexia (hazard ratios [HR] (95 %CI): 6.26 (2.23-17.57)). Patients with an evolving sarcopenia had a shorter PFS and OS, with HR (95 %CI): 2.45 (1.09-5.53) and 3.87 (1.60-9.34) respectively. CONCLUSION Cachexia - sarcopenia syndrome negatively influences patients' outcome during anti-PD-1 ICPI therapy.
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Affiliation(s)
- Benoît Roch
- Thoracic Oncology Unit, University Hospital of Montpellier, Arnaud de Villeneuve Hospital, 371 avenue Doyen Gaston Giraud, 34295, Montpellier, France; Cancerology Resarch Institute of Montpellier (IRCM), INSERM unit-U1194, 208 avenue des Apothicaires, 34298, Montpellier, France
| | - Amandine Coffy
- Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France
| | - Sandy Jean-Baptiste
- Thoracic Oncology Unit, University Hospital of Montpellier, Arnaud de Villeneuve Hospital, 371 avenue Doyen Gaston Giraud, 34295, Montpellier, France
| | - Estelle Palaysi
- Department of Medical Imaging, University Hospital of Montpellier, Arnaud de Villeneuve Hospital, 371 avenue Doyen Gaston Giraud, 34295, Montpellier, France
| | - Jean-Pierre Daures
- Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France
| | - Jean-Louis Pujol
- Thoracic Oncology Unit, University Hospital of Montpellier, Arnaud de Villeneuve Hospital, 371 avenue Doyen Gaston Giraud, 34295, Montpellier, France; Cancerology Resarch Institute of Montpellier (IRCM), INSERM unit-U1194, 208 avenue des Apothicaires, 34298, Montpellier, France.
| | - Sébastien Bommart
- Department of Medical Imaging, University Hospital of Montpellier, Arnaud de Villeneuve Hospital, 371 avenue Doyen Gaston Giraud, 34295, Montpellier, France; PhyMedExp University of Montpellier, INSERM U 1046, CNRS UMR, 9214, France
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10
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Negre E, Coffy A, Langlais A, Daures JP, Lavole A, Quoix E, Molinier O, Greillier L, Audigier-Valette C, Moro-Sibilot D, Westeel V, Morin F, Roch B, Pujol JL. Development and Validation of a Simplified Prognostic Score in SCLC. JTO Clin Res Rep 2020; 1:100016. [PMID: 34589918 PMCID: PMC8474253 DOI: 10.1016/j.jtocrr.2020.100016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 01/16/2023] Open
Abstract
Introduction This study aimed at generating a new simplified prognostic score (SPS) using common clinical and biological variables to discriminate a limited number of subgroups of patients with SCLC differing by their overall survival (OS). Methods The SPS was developed exploring the Montpellier University Hospital retrospective database of 401 patients over a 16-year period. All patients had received etoposide - platinum-based chemotherapy as first-line treatment. The SPS development took into account significant determinants of OS in the Cox model, weighted by their regression β coefficients. Validation of the consequent SPS has been done separately in a combined population of 213 patients accrued from two different published trials (NCT03059667 and NCT00930891). Results The significant independent determinants of OS included the following: (1) American Joint Committee on Cancer TNM stage IV (hazard ratio [HR]: 2.52; 95% confidence interval [CI]: 1.91–3.33); (2) Eastern Cooperative Oncology Group performance status greater than 1 (HR: 2.27; 95% CI: 1.79–2.87); (3) the presence of liver metastases (HR: 1.66; 95% CI: 1.29–2.15); and (4) neutrophil-to-lymphocyte ratio greater than 4 (HR: 1.39; 95% CI: 1.11–1.92). The SPS generated with these four variables, segregated three groups (good, intermediate, and poor prognosis) with respective median OS of 26.9 months (95% CI: 20.1–38.9), 11.5 months (95% CI: 9.8–13.0), and 6.8 months (95% CI: 5.8–8.3; log-rank p < 10–4). Harrell's C statistic estimate was 0.68 ± 0.012, suggesting goodness of calibration. In the validation cohort, the SPS segregated the aforementioned three subgroups in a nearly similar manner, with respective median OS: 27.2, 12.3, and 8.6 months (log-rank p < 10–3; Harrell’s C statistic: 0.58 ± 0.02). Conclusions The SPS is easy to calculate in real-life practice and efficiently discriminates three populations with different prognoses. This study deserves further validation of this score in patients with SCLC receiving immunochemotherapy.
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Affiliation(s)
- Elodie Negre
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France
| | - Amandine Coffy
- Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier University, Montpellier, France
| | | | - Jean-Pierre Daures
- Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier University, Montpellier, France
| | | | - Elisabeth Quoix
- Department of Pneumology, University Hospital, Strasbourg, France
| | - Olivier Molinier
- Department of Pneumology, Centre Hospitalier Le Mans, Le Mans, France
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique-Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | | | | | - Virginie Westeel
- Department of pneumology, Hopital Universitaire, Besançon, France
| | - Franck Morin
- French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | - Benoît Roch
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France.,Montpellier Cancer Research Institute, INSERM U1194, Montpellier, France
| | - Jean-Louis Pujol
- Department of Thoracic Oncology, Montpellier Regional University Hospital, Montpellier, France.,Montpellier Cancer Research Institute, INSERM U1194, Montpellier, France
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Maris E, Ferrieres-Hoa A, Gala A, Coffy A, Vintejoux E, Ranisavljevic N, Hamamah S. [Comparison of birth weights of children born after slow frozen embryo replacement versus fresh embryo transfer]. ACTA ACUST UNITED AC 2019; 47:305-310. [PMID: 30745159 DOI: 10.1016/j.gofs.2019.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE It is already known that children born after slow frozen embryo replacement have a significantly higher birth weight compared to children born after fresh embryo transfer. Similar data have been reported related to frozen embryo transfer using an open vitrification system. However, few data relative to birth weight using a complete embryo closed vitrification system has been reported. The purpose of this study was to know if frozen embryo in closed vitrification system is associated with a higher birth weight compared to fresh embryo replacement. DESIGN This was a monocentric retrospective cohort study, 371 children were issued from fresh embryo replacement and 127 from vitrified embryo transfer. MATERIALS AND METHODS All singletons born after fresh or vitrified embryo transfer between January 2011 and April 2015 were included. Births from the vitrified or fresh transfers of egg or sperm donation, and preimplantation genetic diagnosis were excluded. In addition, pregnancies with more than one gestational sac at the first ultrasound were excluded. An analysis of covariance (ANCOVA) was used for multivariate analysis. RESULTS Mean birth weight was 205g higher in the frozen embryo compared with fresh embryos transfer groups (3368g vs. 3163g respectively, P<0.001). This difference remained after multivariate analysis adjusted on confounding factors such as gestational age, maternal age, maternal body mass index (BMI), tobacco exposure, number of embryo transferred and birth order (P<0.001).. CONCLUSIONS Embryo frozen in closed vitrification system is associated with a higher birth weight compared to fresh embryo replacement. Our findings are consistent with the previous studies related to slow freezing and open vitrification systems data. The effects of controlled ovarian stimulation (COS), ex vivo culture conditions and cryopreservation systems on birth weight of children born should be further explored.
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Affiliation(s)
- E Maris
- Département de médecine de la reproduction, CHU de Montpellier, 34000 Montpellier France; Département de gynécologie obstétrique, CHU de Nîmes, 30000 Nîmes, France.
| | - A Ferrieres-Hoa
- Département de biologie de la reproduction, CHU de Montpellier, 34000 Montpellier, France; Inserm, U1203, institut de médecine régénératrice et de biothérapie, CHU de Montpellier, 34000 Montpellier, France
| | - A Gala
- Département de biologie de la reproduction, CHU de Montpellier, 34000 Montpellier, France; Inserm, U1203, institut de médecine régénératrice et de biothérapie, CHU de Montpellier, 34000 Montpellier, France
| | - A Coffy
- Laboratoire de biostatistiques et d'épidémiologie, institut universitaire de recherche clinique, 34000 Montpellier, France
| | - E Vintejoux
- Département de médecine de la reproduction, CHU de Montpellier, 34000 Montpellier France
| | - N Ranisavljevic
- Département de médecine de la reproduction, CHU de Montpellier, 34000 Montpellier France
| | - S Hamamah
- Département de biologie de la reproduction, CHU de Montpellier, 34000 Montpellier, France; Inserm, U1203, institut de médecine régénératrice et de biothérapie, CHU de Montpellier, 34000 Montpellier, France
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Batt M, Camou F, Coffy A, Feugier P, Senneville E, Caillon J, Calvet B, Chidiac C, Laurent F, Revest M, Daures JP. A meta-analysis of outcomes of in-situ reconstruction after total or partial removal of infected abdominal aortic graft. J Cardiovasc Surg (Torino) 2019; 61:171-182. [PMID: 30698369 DOI: 10.23736/s0021-9509.19.10669-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION There is currently a lack of evidence for the relative effectiveness of partial resection (PR) and total resection (TR) before managing abdominal aortic graft infection (AGI). Most authorities agree that TR is mandatory for intracavitary AGI in patients with favorable conditions but there is an increasing number of patients with severe comorbidities for whom this approach is not suitable, resulting in a prohibitive mortality rate. The purpose of this study was to determine the most appropriate indication for TR or PR. EVIDENCE ACQUISITION A meta-analysis was conducted on the rates of early/late mortality, amputations and reinfection. A meta-regression was performed with eight variables: patient age, male prevalence, presence of virulent or nonvirulent organisms, urgency, omentoplasty and follow-up. EVIDENCE SYNTHESIS Twenty-one studies and 1052 patients were included. For TR and PR, the rates of early mortality and reinfection were 16.8% and 10.5%, 11% and 27%, respectively. For TR urgency and male gender were associated with increased rate of early mortality and male gender, PDF and virulent organisms were associated with increased risk of reinfection. For PR no statistical correlation was analyzable except for PDF with increased risk of reinfection. CONCLUSIONS Early mortality rates are higher for TR and reinfection rates are higher for PR. For TR early mortality increases in urgent cases and it is suggested that alternative option must be discussed, reinfection decreases in the presence of nonvirulent organisms and TR seems optimal. For TR and PR reinfection increases in presence of PDF and alternative technique may be more appropriate.
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Affiliation(s)
- Michel Batt
- Department of Vascular Surgery, University Nice-Sophia Antipolis, Nice, France -
| | - Fabrice Camou
- Intensive Care Unit, Saint-Andre University Hospital, Bordeaux, France
| | - Amandine Coffy
- Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France
| | - Patrick Feugier
- Department of Vascular Surgery, University Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon, France
| | - Eric Senneville
- Infectious Diseases Department, Gustave Dron Hospital, Lille 2 University, Tourcoing, France
| | | | - Brigitte Calvet
- Anesthosiology Department, Béziers Hospital, Béziers, France
| | - Christian Chidiac
- Infectious Deseases Department, Hospices Civils de Lyon and International Center for Infectiology Research (CIRI), INSERM U1111, Lyon 1 University, Lyon, France.,Bacteriology Department, International Center for Infectiology Research (CIRI), INSERM U1111, Lyon 1 University, Lyon, France
| | - Frederic Laurent
- Infectious Diseases, and Intensive Care Unit, Pontchaillou University Hospital, CIC-INSERM 1414, Rennes 1 University, France
| | | | - Jean Pierre Daures
- Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France
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Pujol JL, Roch B, Coffy A, Mérel JP, Daurès JP. [What do chemotherapy specialists expect of lung cancer?]. Rev Mal Respir 2018; 35:919-928. [PMID: 30174238 DOI: 10.1016/j.rmr.2018.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/31/2017] [Accepted: 12/21/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In an attempt to understand physicians' expectations of chemotherapy, a group of lung cancer specialists was involved in an online survey investigating their opinions by a self-questionnaire. The questionnaire described five different chemotherapy prescription situations for lung cancer patients (stages IIIB or IV). METHOD A total of 30 expert specialists were invited; 22 responded (73%). For each of the clinical situations, the expert was asked for his opinion on 3 items: cure, prolongation of survival and alleviation of symptoms. Each item was judged on a Likert scale with categories between -2 "not at all probable" and +2 "quite likely". RESULTS For "cure", the percentage of -2 responses differed significantly according to the clinical situation (Fisher test: P<0.00001). The trend test showed a relationship between the percentage of -2 responses and the suspected order of the clinical situations (Cochran-Armitage trend test: P<0.0001). For symptom alleviation, the percentage of responses +2 and +1 differed significantly according to the clinical situation (Fisher test: P=0.00013, trend test: P<0.0001). CONCLUSION What specialist physicians expect of chemotherapy in terms of curability and symptom relief differs according to the actual statistical prognosis of each situation as presented in the literature. The worst prognostic situation leads to the strongest expectation in terms of symptom relief and, conversely, the lowest for curability.
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Affiliation(s)
- J-L Pujol
- Laboratoire Epsylon EA 4556 dynamique des capacités humaines et des conduites de sante, UFR médecine, sciences du sujet et de la société, STAPS universités Montpellier et St-Etienne, université Paul-Valéry Montpellier III, route de Mende, 34199 Montpellier cedex 5, France; Hôpital Arnaud-de-Villeneuve, centre hospitalier universitaire de Montpellier, avenue du Doyen-Giraud, 34295 Montpellier cedex, France.
| | - B Roch
- Hôpital Arnaud-de-Villeneuve, centre hospitalier universitaire de Montpellier, avenue du Doyen-Giraud, 34295 Montpellier cedex, France
| | - A Coffy
- Unité de biostatistiques et d'épidémiologie, institut universitaire de la recherche clinique, université de Montpellier 1, 34000 Montpellier, France
| | - J-P Mérel
- Hôpital Arnaud-de-Villeneuve, centre hospitalier universitaire de Montpellier, avenue du Doyen-Giraud, 34295 Montpellier cedex, France
| | - J-P Daurès
- Unité de biostatistiques et d'épidémiologie, institut universitaire de la recherche clinique, université de Montpellier 1, 34000 Montpellier, France
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Ollivier M, Paris F, Philibert P, Garnier S, Coffy A, Fauconnet-Servant N, Haddad M, Guys JM, Reynaud R, Faure A, Merrot T, Wagner K, Bréaud J, Valla JS, Dobremez E, Gaspari L, Daures JP, Sultan C, Kalfa N. Family History is Underestimated in Children with Isolated Hypospadias: A French Multicenter Report of 88 Families. J Urol 2018; 200:890-894. [PMID: 29723568 DOI: 10.1016/j.juro.2018.04.072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE While familial forms of complex disorders/differences of sex development have been widely reported, data regarding isolated hypospadias are sparse and a family history is thought to be less frequent. We aimed to determine the frequency of hypospadias in families of boys with hypospadias, to establish whether these familial forms exhibit a particular phenotype and to evaluate the prevalence of genetic defects of the main candidate genes. MATERIALS AND METHODS A total of 395 boys with hypospadias were prospectively screened for a family history with a standardized questionnaire, extensive clinical description, family tree and sequencing of AR, SF1, SRD5A2 and MAMLD1. RESULTS Family history of hypospadias was more frequent than expected (88 patients, 22.3%). In 17 instances (19.3%) familial hypospadias cases were multiple. Familial hypospadias was related to the paternal side in 59.1% of cases, consisting of the father himself (30.7%) as well as paternal uncles and cousins. Premature birth, assisted reproductive techniques, other congenital abnormalities and growth retardation were not more frequent in familial hypospadias than in sporadic cases. The severity of phenotype was similar in both groups. The results of genetic analysis combined with previous data on androgen receptor sequencing revealed that familial cases more frequently tend to demonstrate genetic defects than sporadic cases (5.68% vs 1.63%, p = 0.048). CONCLUSIONS Familial forms of hypospadias are far more frequent than previously reported. Even minor and isolated forms justify a full clinical investigation of the family history. Detecting these hereditary forms may help to determine the underlying genetic defects, and may improve followup and counseling of these patients.
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Affiliation(s)
- Margot Ollivier
- Department of Pediatric Surgery and Urology, Lapeyronie Hospital, CHU Montpellier, Montpellier University, Montpellier, France
| | - Francoise Paris
- National Reference Center of Genital Development (Constitutive South), Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier University, Montpellier, France; Pediatric Endocrinology and Gynecology Unit, Department of Pediatrics, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier University, Montpellier, France; Genetic Genital Development Unit, University Institute of Clinical Research, CHU Montpellier, Montpellier University, Montpellier, France
| | - Pascal Philibert
- National Reference Center of Genital Development (Constitutive South), Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier University, Montpellier, France; Genetic Genital Development Unit, University Institute of Clinical Research, CHU Montpellier, Montpellier University, Montpellier, France
| | - Sarah Garnier
- Department of Pediatric Surgery and Urology, Lapeyronie Hospital, CHU Montpellier, Montpellier University, Montpellier, France
| | - Amandine Coffy
- Laboratory of Biostatistics and Epidemiology, University Institute of Clinical Research, Montpellier University, Montpellier, France
| | - Nadège Fauconnet-Servant
- National Reference Center of Genital Development (Constitutive South), Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier University, Montpellier, France; Genetic Genital Development Unit, University Institute of Clinical Research, CHU Montpellier, Montpellier University, Montpellier, France
| | - Mirna Haddad
- Department of Pediatric Surgery and Urology, Timone Hospital, AP-HM, Marseille, France
| | - Jean Michel Guys
- Department of Pediatric Surgery and Urology, Timone Hospital, AP-HM, Marseille, France
| | - Rachel Reynaud
- Pediatric Endocrinology and Diabetology Unit, Timone Hospital, AP-HM, Marseille, France
| | - Alice Faure
- Department of Pediatric Surgery and Urology, Nord Hospital, AP-HM, Marseille, France
| | - Thierry Merrot
- Department of Pediatric Surgery and Urology, Nord Hospital, AP-HM, Marseille, France
| | - Kathy Wagner
- Pediatric Service, Lenval Hospital, CHU de Nice, Nice, France
| | - Jean Bréaud
- Department of Pediatric Surgery and Urology, Lenval Hospital, CHU de Nice, Nice, France
| | - Jean Stéphane Valla
- Department of Pediatric Surgery and Urology, Lenval Hospital, CHU de Nice, Nice, France
| | - Eric Dobremez
- Department of Pediatric Surgery, Pellegrin Children's Hospital, Bordeaux, France
| | - Laura Gaspari
- Pediatric Endocrinology and Gynecology Unit, Department of Pediatrics, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier University, Montpellier, France
| | - Jean-Pierre Daures
- Laboratory of Biostatistics and Epidemiology, University Institute of Clinical Research, Montpellier University, Montpellier, France
| | - Charles Sultan
- Pediatric Endocrinology and Gynecology Unit, Department of Pediatrics, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier University, Montpellier, France
| | - Nicolas Kalfa
- Department of Pediatric Surgery and Urology, Lapeyronie Hospital, CHU Montpellier, Montpellier University, Montpellier, France; National Reference Center of Genital Development (Constitutive South), Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier University, Montpellier, France; Pediatric Endocrinology and Gynecology Unit, Department of Pediatrics, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier University, Montpellier, France; Genetic Genital Development Unit, University Institute of Clinical Research, CHU Montpellier, Montpellier University, Montpellier, France.
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Batt M, Feugier P, Camou F, Coffy A, Senneville E, Caillon J, Calvet B, Chidiac C, Laurent F, Revest M, Daures JP. A Meta-Analysis of Outcomes After In Situ Reconstructions for Aortic Graft Infection. Angiology 2017; 69:370-379. [PMID: 28578619 DOI: 10.1177/0003319717710114] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To confirm the advantage of in situ reconstruction (ISR) over extra-anatomic reconstruction (EAR) for aortic graft infection and determine the most appropriate conduit including autogenous veins, cryopreserved allografts, and synthetic prosthesis (standard, rifampicin of silver polyesters). METHODS A meta-analysis was conducted with rate of mortality, graft occlusion, amputation, and reinfection. A meta-regression was performed with 4 factors: patients' age, presence of prosthetic-duodenal fistula (PDF), virulent organisms, or nonvirulent organisms. RESULTS In situ reconstruction over EAR seems to favor all events. For the 5 conduits used for ISR, according to operative mortality, age of the patients looks to have a positive correlation only for silver polyester and no conduit present any advantage in the presence of PDF. Reinfection seems to be not significantly different for the 5 conduits, and only autogenous veins appear to have a positive correlation with infecting organisms. CONCLUSION In situ reconstruction may be considered as first-line treatment. Our results suggest that silver polyesters appear to be most appropriate for older patients, and in order to limit reinfection, autogenous veins are probably the most suitable conduit.
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Affiliation(s)
- Michel Batt
- 1 Department of Vascular Surgery, University Nice-Sophia Antipolis, Nice, France.,2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France
| | - Patrick Feugier
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France.,3 Department of Vascular Surgery, University Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon, France
| | - Fabrice Camou
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France.,4 Intensive Care Unit, Saint-Andre University Hospital, Bordeaux, France
| | - Amandine Coffy
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France
| | - Eric Senneville
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France.,5 Infectious Diseases Department, Gustave Dron Hospital, Lille 2 University, Tourcoing, France
| | - Jocelyne Caillon
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France.,6 Bactériology Department, Nantes University Hospital, Nantes, France
| | - Brigitte Calvet
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France.,7 Anesthesiology Département, Béziers Hospital, Béziers, France
| | - Christian Chidiac
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France.,8 Infectious Diseases Department, Hospices Civils de Lyon and Center for Infectiology Research (CIRI), INSERM U1111, Lyon 1 University, Lyon, France
| | - Frederic Laurent
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France.,9 Bacteriology Department, International Center for Infectiology Research (CIRI), INSERM U1111, Lyon I University, Lyon, France
| | - Matthieu Revest
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France.,10 Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, CIC-INSERM 1414, Rennes 1 University Rennes, France
| | - Jean Pierre Daures
- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France
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- 2 Laboratory of Biostatistics and Epidemiology, University Institute for Clinical Research, Montpellier, France
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Garnier S, Maillet O, Cereda B, Ollivier M, Jeandel C, Broussous S, Lopez C, Paris F, Philibert P, Amouroux C, Jeandel C, Coffy A, Gaspari L, Daures JP, Sultan C, Kalfa N. Late surgical correction of hypospadias increases the risk of complications: a series of 501 consecutive patients. BJU Int 2017; 119:942-947. [DOI: 10.1111/bju.13771] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Sarah Garnier
- Department of Paediatric Surgery and Urology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Olivier Maillet
- Department of Paediatric Surgery and Urology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Barbara Cereda
- Department of Paediatric Surgery and Urology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Margot Ollivier
- Department of Paediatric Surgery and Urology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Clement Jeandel
- Department of Paediatric Surgery and Urology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Sylvie Broussous
- Department of Paediatric Surgery and Urology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Christophe Lopez
- Department of Paediatric Surgery and Urology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Francoise Paris
- Department of Paediatric Endocrinology; Arnaud de Villeneuve Hospital; CHU Montpellier; Montpellier France
- Department of Endocrinology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Pascal Philibert
- Department of Endocrinology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Cyril Amouroux
- Department of Paediatric Endocrinology; Arnaud de Villeneuve Hospital; CHU Montpellier; Montpellier France
| | - Claire Jeandel
- Department of Paediatric Endocrinology; Arnaud de Villeneuve Hospital; CHU Montpellier; Montpellier France
| | - Amandine Coffy
- Institute of Clinical Research; University of Montpellier; Montpellier France
| | - Laura Gaspari
- Department of Endocrinology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Jean Pierre Daures
- Institute of Clinical Research; University of Montpellier; Montpellier France
| | - Charles Sultan
- Department of Paediatric Endocrinology; Arnaud de Villeneuve Hospital; CHU Montpellier; Montpellier France
- Department of Endocrinology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
| | - Nicolas Kalfa
- Department of Paediatric Surgery and Urology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
- Department of Endocrinology; Lapeyronie Hospital; CHU Montpellier; Montpellier France
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Pujol J, Coffy A, Mérel J, Daurès J. Qu’attendent les médecins spécialistes de la chimiothérapie des cancers bronchiques ? Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2014.10.552] [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: 10/24/2022]
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18
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Brun-Micaleff E, Coffy A, Rey V, Didelot MN, Combecal J, Doutre S, Daurès JP, Segondy M, Boulle N. Cervical cancer screening by cytology and human papillomavirus testing during pregnancy in French women with poor adhesion to regular cervical screening. J Med Virol 2013; 86:536-45. [PMID: 24114972 DOI: 10.1002/jmv.23764] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2013] [Indexed: 11/08/2022]
Abstract
In France, cervical screening is opportunistic and approximately 40% of women do not attend regular screening programs. The aim of this study was (1) to assess the prevalence of human papillomavirus (HPV) cervical infection and of cytological abnormalities in a population of young pregnant women with poor adherence to cervical cancer screening and (2) to evaluate the adherence to a screening strategy combining HPV testing and cytology during pregnancy. For this purpose, pregnant women benefited from a cervical smear associated with HPV DNA detection. High-risk HPV types were detected and identified using the HC2 assay and the INNO-LiPA HPV genotyping Extra assay. Two hundred forty-seven women (mean age 26.6 ± 5.1 years) were enrolled. Among them, 76.8% did not attend regular cervical cancer screening programs. High-risk HPV types were detected in 50 (20.2%) samples, HPV 16 being the most frequent (N = 12; 14.5%), with multiple HPV infection in 17 samples (27%). Nine (3.6%) abnormal cervical smears were diagnosed. Follow-up of women with abnormal cytology and/or infection with high-risk HPV was obtained in 29 cases (55.8%), showing 12 persistent high-risk HPV infections. Nine women had colposcopy with a final diagnosis of four normal cervixes, three cervical intraepithelial neoplasia grade 1 and two cervical intraepithelial neoplasia grade 2. Overall, women adherence to the free post-partum follow-up visit was 53.5%. This study suggests that a screening program combining HPV testing with cervical cytology during pregnancy may be one option to target young women with poor adhesion to regular cervical cancer screening.
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Affiliation(s)
- Elisabeth Brun-Micaleff
- Prenatal Care Center (PMI), Montpellier, France; Department of Gynecology and Obstetrics, CHRU de Montpellier, Montpellier, France
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Denève E, Riethdorf S, Ramos J, Nocca D, Coffy A, Daurès JP, Maudelonde T, Fabre JM, Pantel K, Alix-Panabières C. Capture of viable circulating tumor cells in the liver of colorectal cancer patients. Clin Chem 2013; 59:1384-92. [PMID: 23695297 DOI: 10.1373/clinchem.2013.202846] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The incidence and number of circulating tumor cells (CTCs) in the peripheral blood of colorectal cancer patients are lower than in other cancer types, which may point to a particular biology of colorectal cancer affecting CTC detection. METHODS We detected CTCs in the peripheral and mesenteric blood of colorectal cancer patients by use of 2 independent technologies on the basis of different biological properties of colon cancer cells. Seventy-five patients diagnosed with localized (M0, n = 60) and metastatic (M1, n = 15) colorectal cancer were included. Peripheral and mesenteric blood samples were collected before tumor resection. We performed CTC enumeration with an EpCAM-independent enrichment method followed by the Epispot assay that detected only viable CK19-releasing CTCs. In parallel, we used the FDA-cleared EpCAM-dependent CellSearch® as the reference method. RESULTS The enumeration of CK19-releasing cells by the CK19-Epispot assay revealed viable CTCs in 27 of 41 (65.9%) and 41 of 74 (55.4%) (P = 0.04) patients in mesenteric and peripheral blood, respectively, whereas CellSearch detected CTCs in 19 of 34 (55.9%) and 20 of 69 (29.0%) (P = 0.0046) patients. In mesenteric blood, medians of 4 (range 0-247) and 2.7 CTCs (range 0-286) were found with Epispot and CellSearch (P = 0.2), respectively, whereas in peripheral blood, Epispot and CellSearch detected a median of 1.2 (range 0-92) and 0 CTCs (range 0-147) (P = 0.002). CONCLUSIONS A considerable portion of viable CTCs detectable by the Epispot assay are trapped in the liver as the first filter organ in CRC patients.
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Affiliation(s)
- Eric Denève
- Department of Digestive Surgery, Saint-Eloi Hospital, Montpellier, France
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Pantel K, Denève E, Nocca D, Coffy A, Vendrell JP, Maudelonde T, Riethdorf S, Alix-Panabières C. Circulating epithelial cells in patients with benign colon diseases. Clin Chem 2011; 58:936-40. [PMID: 22205690 DOI: 10.1373/clinchem.2011.175570] [Citation(s) in RCA: 201] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Detection of circulating tumor cells (CTCs) in the peripheral blood is a rapidly developing research field with clear clinical implications for the staging and monitoring of cancer patients. Current CTC assays, including the US Food and Drug Administration-cleared CellSearch® system, typically use markers [e.g., cytokeratins (CKs), the transmembrane protein EpCAM (epithelial cell adhesion molecule)] that are expressed on normal and malignant epithelial cells but not on the surrounding normal leukocytes. METHODS We enrolled 53 patients with benign colon diseases (e.g., diverticulosis, benign polyps, Crohn disease, ulcerative rectocolitis, colonic endometriosis) and analyzed their peripheral blood with 2 previously validated CTC assays: the epithelial immunospot (EPISPOT) assay and the CellSearch system. The EPISPOT assay detects only viable, CK19-releasing CTCs that were enriched by depletion of CD45(+) leukocytes, whereas the CellSearch system detects CK-positive CTCs after positive EpCAM-based immunomagnetic enrichment. RESULTS In patients with benign colon diseases, positive events that met the criteria for "tumor cells" were detected with both the CellSearch system (11.3%) and the CK19-EPISPOT assay (18.9%), whereas no positive events were detected in samples from healthy volunteers. Positive events were detected most frequently in patients with diverticulosis and Crohn disease. All positive events lacked expression of CD45, a common leukocyte antigen. CONCLUSIONS These results indicate that patients with benign inflammatory colon diseases in particular can harbor viable circulating epithelial cells that are detectable with current CTC assays. This finding points to the need for further molecular characterization of circulating epithelial cells and has important implications for the use of CTC testing.
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Affiliation(s)
- Klaus Pantel
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Mrugala D, Dossat N, Ringe J, Delorme B, Coffy A, Bony C, Charbord P, Häupl T, Daures JP, Noël D, Jorgensen C. Gene expression profile of multipotent mesenchymal stromal cells: Identification of pathways common to TGFbeta3/BMP2-induced chondrogenesis. Cloning Stem Cells 2009; 11:61-76. [PMID: 19196040 DOI: 10.1089/clo.2008.0070] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Multipotent mesenchymal stromal cells (MSC) display a high potential for the development of novel treatment strategies for cartilage repair. However, the pathways involved in their differentiation to functional non hypertrophic chondrocytes remain largely unknown, despite the work on embryologic development and the identification of key growth factors including TGFbeta, Hh, Wnt and FGF. In this study, we asked if we could identify specific biological networks common to the growth factors used (TGFbeta3 or BMP-2). To address this question, we used DNA microarrays and performed large-scale expression profiling of MSC at different time points during their chondrogenic differentiation. By comparing these data with those obtained during the differentiation of MSC into osteoblasts and adipocytes, we identified 318 genes specific for chondrogenesis and developed a new algorithm to classify the genes according to their kinetic profile. We distributed the selected genes in five classes according to their kinetic of expression. We could reconstruct three phases characterized by functional pathways. The first phase corresponds to cell attachment and apoptosis induction; the second phase is characterized by a proliferation/differentiation step, and the third phase is characterized by a differentiation/hypertrophy pathway. Indeed, these data propose new pathways to understand the complexity of MSC differentiation to chondrocytes.
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