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Lévesque H, Viallard JF, Houivet E, Bonnotte B, Voisin S, Le Cam-Duchez V, Maillot F, Lambert M, Liozon E, Hervier B, Fain O, Guillet B, Schmidt J, Luca LE, Ebbo M, Ferreira-Maldent N, Babuty A, Sailler L, Duffau P, Barbay V, Audia S, Benichou J, Graveleau J, Benhamou Y. Cyclophosphamide vs rituximab for eradicating inhibitors in acquired hemophilia A: A randomized trial in 108 patients. Thromb Res 2024; 237:79-87. [PMID: 38555718 DOI: 10.1016/j.thromres.2024.03.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Acquired hemophilia A (AHA) is a rare autoimmune disorder due to autoantibodies against Factor VIII, with a high mortality risk. Treatments aim to control bleeding and eradicate antibodies by immunosuppression. International recommendations rely on registers and international expert panels. METHODS CREHA, an open-label randomized trial, compared the efficacy and safety of cyclophosphamide and rituximab in association with steroids in patients with newly diagnosed AHA. Participants were treated with 1 mg/kg prednisone daily and randomly assigned to receive either 1.5-2 mg/kg/day cyclophosphamide orally for 6 weeks, or 375 mg/m2 rituximab once weekly for 4 weeks. The primary endpoint was complete remission over 18 months. Secondary endpoints included time to achieve complete remission, relapse occurrence, mortality, infections and bleeding, and severe adverse events. RESULTS Recruitment was interrupted because of new treatment recommendations after 108 patients included (58 cyclophosphamide, 50 rituximab). After 18 months, 39 cyclophosphamide patients (67.2 %) and 31 rituximab patients (62.0 %) were in complete remission (OR 1.26; 95 % CI, 0.57 to 2.78). In the poor prognosis group (FVIII < 1 IU/dL, inhibitor titer > 20 BU mL-1), significantly more remissions were observed with cyclophosphamide (22 patients, 78.6 %) than with rituximab (12 patients, 48.0 %; p = 0.02). Relapse rates, deaths, severe infections, and bleeding were similar in the 2 groups. In patients with severe infection, cumulative doses of steroids were significantly higher than in patients without infection (p = 0.03). CONCLUSION Cyclophosphamide and rituximab showed similar efficacy and safety. As first line, cyclophosphamide seems preferable, especially in poor prognosis patients, as administered orally and less expensive. FUNDING French Ministry of Health. CLINICALTRIALS gov number: NCT01808911.
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Affiliation(s)
- H Lévesque
- Normandie Univ, UNIROUEN, U 1096, CHU Rouen, Department of Internal Medicine, F-76000 Rouen, France.
| | - J F Viallard
- Service de Médecine Interne et Maladies Infectieuses Hôpital Haut-Lévêque, CHU Bordeaux, 5 avenue de Magellan, 33604 Pessac, France
| | - E Houivet
- Department of Biostatistics, CHU Rouen, F-76031 Rouen, France
| | - B Bonnotte
- Service de médecine interne et immunologie clinique, CHU Dijon-Bourgogne, Université de Dijon, F-21079 Dijon, France
| | - S Voisin
- Department of Internal Medicine, CHU Toulouse, F-31059 Toulouse. France
| | - V Le Cam-Duchez
- Normandie Univ, UNIROUEN, Hématologie biologique, F-76031 Rouen, France
| | - F Maillot
- Département de Médecine Interne et immunologie clinique, CHRU Tours, Université de Tours, F-37044 Tours, France
| | - M Lambert
- CHU Lille, Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reerence Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), F-59000 Lille, France
| | - E Liozon
- Department of Internal Medicine, Dupuytren Hospital, F-87000 Limoges, France
| | - B Hervier
- Service de Médecine Interne, Hôpital Saint-Louis, APHP, 75010 Paris & INSERM UMR-S 976, Human Immunology, Pathophysiology, Immunotherapy, Saint-Louis Research Institute, F-75000 Paris, France
| | - O Fain
- Sorbonne Université, APHP, Service de Médecine Interne-DMU i3, Hôpital Saint-Antoine, Paris F-75000, France
| | - B Guillet
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR-S 1085, F-35000 Rennes, France
| | - J Schmidt
- Department of Internal Medicine, Amiens University Hospital, F-80000 Amiens, France
| | - L E Luca
- Department of Internal Medicine, Poitiers University Hospital, F-86000 Poitiers, France
| | - M Ebbo
- Service de Médecine Interne, Hôpital La Timone, CHU Marseille, Aix-Marseille Université, F-13000 Marseille, France
| | - N Ferreira-Maldent
- Département de Médecine Interne et immunologie clinique, CHRU Tours, Université de Tours, F-37044 Tours, France
| | - A Babuty
- Service d'Hématologie Biologique, CRC-MHC, CHU de Nantes, Nantes Cedex 1, France
| | - L Sailler
- Department of Internal Medicine, CHU Toulouse, F-31059 Toulouse. France
| | - P Duffau
- Service de Médecine Interne-Immunologie Clinique Hôpital Saint-André, CHU Bordeaux, 1 rue Jean Burguet, 33075 Bordeaux, France
| | - V Barbay
- Normandie Univ, UNIROUEN, Hématologie biologique, F-76031 Rouen, France
| | - S Audia
- Service de médecine interne et immunologie clinique, CHU Dijon-Bourgogne, Université de Dijon, F-21079 Dijon, France
| | - J Benichou
- Department of Biostatistics, CHU Rouen and CESP UMR 1018, University of Rouen and University Paris-Saclay, F-76031 Rouen, France
| | - J Graveleau
- Nantes Université, CHU Nantes, Service de Médecine Interne, Nantes, France
| | - Y Benhamou
- Normandie Univ, UNIROUEN, U 1096, CHU Rouen, Department of Internal Medicine, F-76000 Rouen, France
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Horvais V, Beurrier P, Cussac V, Pan-Petesch B, Schirr-Bonnans S, Rose J, Bayart S, Ternisien C, Fouassier M, Sigaud M, Babuty A, Drillaud N, Guillet B, Trossaërt M. Key Drivers of Coagulation Factor Use in Von Willebrand Disease During Hospitalization: An Overview of the French BERHLINGO Cohort. Clin Drug Investig 2024; 44:35-49. [PMID: 38036930 DOI: 10.1007/s40261-023-01323-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Von Willebrand disease (VWD) is the most common inherited bleeding disorder. However, studies of hospitalisation patterns with replacement treatment are scarce. OBJECTIVES The aim of this study was to investigate the current therapeutic management of VWD and determine the key drivers of coagulation factor uses in patients during hospitalisation. METHODS Hopscotch-WILL was a multi-centric retrospective study conducted over a 48-month period in any patients with VWD. The data were collected from the BERHLINGO Research Database and the French Hospital database. RESULTS A total of 988 patients were included; 153 patients (15%) were hospitalised during 293 stays requiring treatment with von Willebrand factor (VWF) concentrates-pure or in association with Factor VIII (FVIII). Their median basal concentrations of VWF and FVIII were significantly lower than in untreated patients: VWF antigen < 30 IU/dL, VWF activity < 20 IU/dL and FVIII:C < 40 IU/dL. The median (interquartile range) concentrate consumption was similar between highly purified VWF or VWF combined with FVIII (72 [110] vs 57 [89] IU/kg/stay, p = 0.154). The use of VWF was highly heterogeneous by VWD type; type 3 had a particularly high impact on VWF consumption in non-surgical situations. The main admissions were for ear/nose/throat, hepato-gastroenterology, and trauma/orthopaedic conditions, besides gynaecological-obstetric causes in women. CONCLUSIONS The use of VWF concentrates is mostly influenced by low basal levels of VWF and FVIII, but also by VWD type or the cause for hospitalisation. These results could inform future studies of newly released recombinant VWF.
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Affiliation(s)
- Valérie Horvais
- Nantes Université, CHU Nantes, Unité d'Investigation Clinique 17, 44000, Nantes, France.
- Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 44000, Nantes, France.
| | - Philippe Beurrier
- CHU Angers, Centre de Traitement des Maladies Hémorragiques Constitutionnelles, 49000, Angers, France
| | - Vincent Cussac
- CH Le Mans, Centre de Traitement des Maladies Hémorragiques Constitutionnelles, 72000, Le Mans, France
| | | | - Solène Schirr-Bonnans
- Nantes Université, CHU Nantes, Service Evaluation Economique et Développement des Produits de Santé, 44000, Nantes, France
| | - Johann Rose
- CH Le Mans, Centre de Traitement des Maladies Hémorragiques Constitutionnelles, 72000, Le Mans, France
| | - Sophie Bayart
- Rennes Université, CHU Rennes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 35000, Rennes, France
| | - Catherine Ternisien
- Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 44000, Nantes, France
| | - Marc Fouassier
- Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 44000, Nantes, France
| | - Marianne Sigaud
- Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 44000, Nantes, France
| | - Antoine Babuty
- Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 44000, Nantes, France
| | - Nicolas Drillaud
- Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 44000, Nantes, France
| | - Benoît Guillet
- Rennes Université, CHU Rennes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 35000, Rennes, France
- Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail)-UMR_S 1085, F-35000, Rennes, France
| | - Marc Trossaërt
- Nantes Université, CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, 44000, Nantes, France
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3
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Drillaud N, Cussac V, Bertho PO, Horvais V, Beurrier P, Ternisien C, Rose J, Fouassier M, Babuty A, Trossaërt M. Efficacy and safety of turoctocog alfa in patients with hemophilia A requiring surgical procedures: A multicentre retrospective study. Transfusion 2023; 63:2321-2327. [PMID: 37850587 DOI: 10.1111/trf.17576] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 07/24/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Turoctocog alfa is a recombinant Factor VIII used in patients with hemophilia A. The aim is to assess the real-life evidence of turoctocog alfa in surgery. STUDY DESIGN AND METHODS Data were extracted from a national database. RESULTS Turoctocog alfa was used for 86 surgeries (49 major and 37 minor) in 56 patients. The results are expressed as medians (interquartile range). Six (10.7%) patients had severe hemophilia A, four (7.1%) moderate, and 46 (82.2%) mild. For patients who underwent major surgeries, basal plasma FVIII coagulant activity (FVIII:C) levels were 15 IU.dL-1 (8-22). Eight (5-14) infusions were given, at a preoperative loading dose of 40.0 (35.0-45.5) IU.kg-1 and a total dose of 253.3 (125.0-507.0) IU.kg-1 . In patients who underwent minor surgeries, basal FVIII:C levels were 18 IU.dL-1 (9-31). Two (1-3) infusions were required, at a preoperative loading dose of 34.0 (28.8-38.5) IU.kg-1 and a total dose of 73.7 (37.6-122.1) IU.kg-1 . The overall clinical efficacy was judged excellent/good in 77 procedures (89.5%) and fair/poor in nine (10.5%). The fair/poor efficacy concerned seven patients (six mild hemophilia and one severe), for four urological surgeries, two dermatological procedures, one heart surgery, one ear-nose-throat procedure, and one dental avulsion in the patient with severe hemophilia. Three out of those seven patients received antiplatelet therapy. No thromboembolic events, anti-FVIII antibodies, or adverse events were reported. DISCUSSION The efficacy and safety of turoctocog alfa were confirmed for the management of surgery in patients with hemophilia A. No adverse events were observed and overall efficacy was good.
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Affiliation(s)
- Nicolas Drillaud
- CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes Université, Nantes, France
| | - Vincent Cussac
- Centre de Traitement des Maladies Hémorragiques Constitutionnelles, CH Le Mans, Le Mans, France
| | - Pierre-Olivier Bertho
- CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes Université, Nantes, France
| | - Valérie Horvais
- CHU Nantes, Unité d'Investigation Clinique 17, Nantes Université, Nantes, France
| | - Philippe Beurrier
- Centre de Traitement des Maladies Hémorragiques Constitutionnelles, CHU Angers, Angers, France
| | - Catherine Ternisien
- CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes Université, Nantes, France
| | - Johann Rose
- Centre de Traitement des Maladies Hémorragiques Constitutionnelles, CH Le Mans, Le Mans, France
| | - Marc Fouassier
- CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes Université, Nantes, France
| | - Antoine Babuty
- CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes Université, Nantes, France
| | - Marc Trossaërt
- CHU Nantes, Centre de Ressources et de Compétences des Maladies Hémorragiques Constitutionnelles, Nantes Université, Nantes, France
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4
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Babuty A, Debord C, Drillaud N, Eveillard M, Trossaert M, Ternisien C, Sigaud M, Cador E, Béné MC, Fouassier M. Prothrombin consumption as an indicator of hemorrhagic phenotype in mild platelet function disorders. Eur J Haematol 2023; 111:787-795. [PMID: 37553915 DOI: 10.1111/ejh.14079] [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: 05/17/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND The bleeding risk of patients with mild platelet function disorders is difficult to assess and their phenotype remains ill-explored. AIM This study was designed to establish a comprehensive biological phenotype of patients with mild platelet function disorders. METHODS Twenty patients were included with persistent abnormal light transmission aggregometry (LTA). The ISTH bleeding assessment tool (ISTH-BAT) was assessed to identify laboratory analyses associated with an abnormal hemorrhagic score. RESULTS The majority of patients had defects that might affect Gαi protein signaling pathways or minor abnormalities. No LTA nor flow cytometry parameters were associated with an above-normal hemorrhagic score. However, prothrombin consumption, which corresponds to the ratio of serum residual factor II to plasma residual factor II, was significantly higher (p = .006) in the abnormal ISTH-BAT group (mean = 14%, SD = 6) compared with the normal ISTH-BAT group (mean = 8%, SD 4). Prothrombin consumption was significantly associated with ISTH-BAT score (r = .5287, IC 95% 0.0986-0.7924, p = .0165). CONCLUSION In this group of patients, there was an association between a pathological bleeding score and increased prothrombin consumption. This test could be used as an additional indicator of platelet function abnormality liable to be related to bleeding risk.
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Affiliation(s)
- Antoine Babuty
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
- Nantes Université, CHU Nantes, Centre de Ressource et de Compétence-Maladies Hémorragiques Constitutionnelles, Nantes, France
| | - Camille Debord
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
| | - Nicolas Drillaud
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
- Nantes Université, CHU Nantes, Centre de Ressource et de Compétence-Maladies Hémorragiques Constitutionnelles, Nantes, France
| | - Marion Eveillard
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
| | - Marc Trossaert
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
- Nantes Université, CHU Nantes, Centre de Ressource et de Compétence-Maladies Hémorragiques Constitutionnelles, Nantes, France
| | - Catherine Ternisien
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
- Nantes Université, CHU Nantes, Centre de Ressource et de Compétence-Maladies Hémorragiques Constitutionnelles, Nantes, France
| | - Marianne Sigaud
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
- Nantes Université, CHU Nantes, Centre de Ressource et de Compétence-Maladies Hémorragiques Constitutionnelles, Nantes, France
| | - Emmanuelle Cador
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
| | - Marie C Béné
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
| | - Marc Fouassier
- Nantes Université, CHU Nantes, Service d'Hématologie Biologique, Nantes, France
- Nantes Université, CHU Nantes, Centre de Ressource et de Compétence-Maladies Hémorragiques Constitutionnelles, Nantes, France
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5
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Dib F, Quéméner A, Bayart S, Boisseau P, Babuty A, Trossaërt M, Sigaud M, Ternisien C, Drillaud N, Eveillard M, Guillet B, Béné MC, Fouassier M. Biological, clinical features and modelling of heterozygous variants of glycoprotein Ib platelet subunit alpha (GP1BA) and glycoprotein Ib platelet subunit beta (GP1BB) genes responsible for constitutional thrombocytopenia. Br J Haematol 2022; 199:744-753. [PMID: 36173017 DOI: 10.1111/bjh.18462] [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: 03/04/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022]
Abstract
Constitutional thrombocytopenias are rare disorders, often difficult to discriminate from acquired thrombocytopenias. More than 80 genes have been described as being at the origin of these diseases. Among them, several variants of the glycoprotein Ib platelet subunit alpha (GP1BA) and glycoprotein Ib platelet subunit beta (GP1BB) genes, coding for the GpIb-IX-V glycoprotein complex, have been reported in the literature. The study reported here aimed at describing newly identified monoallelic anomalies affecting the GP1BA and GP1BB genes on a clinical, biological and molecular level. In a cohort of nine patients with macrothrombocytopenia, eight heterozygous variants of the GP1BA or GP1BB genes were identified. Five of them had never been described in the heterozygous state. Computer modelling disclosed structure/function relationships of these five variants.
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Affiliation(s)
- Fatema Dib
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France
| | - Agnès Quéméner
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
| | | | - Pierre Boisseau
- Service de Génétique Médicale, CHU de Nantes, Nantes, France
| | - Antoine Babuty
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France.,CRC-MH, CHU de Nantes, Nantes, France
| | - Marc Trossaërt
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France.,CRC-MH, CHU de Nantes, Nantes, France
| | - Marianne Sigaud
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France.,CRC-MH, CHU de Nantes, Nantes, France
| | - Catherine Ternisien
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France.,CRC-MH, CHU de Nantes, Nantes, France
| | - Nicolas Drillaud
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France.,CRC-MH, CHU de Nantes, Nantes, France
| | - Marion Eveillard
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France.,Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
| | - Benoit Guillet
- CRC-MH, CHU de Rennes, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Marie C Béné
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France.,Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
| | - Marc Fouassier
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France.,CRC-MH, CHU de Nantes, Nantes, France
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Cadé M, Muñoz-Garcia J, Babuty A, Paré L, Cochonneau D, Fekir K, Chatelais M, Heymann MF, Lokajczyk A, Boisson-Vidal C, Heymann D. FVIII regulates the molecular profile of endothelial cells: functional impact on the blood barrier and macrophage behavior. Cell Mol Life Sci 2022; 79:145. [PMID: 35190870 DOI: 10.1007/s00018-022-04178-5] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/10/2022] [Accepted: 01/28/2022] [Indexed: 12/20/2022]
Abstract
Hemophilia A is an inherited X-linked recessive bleeding disorder caused by deficient activity of blood coagulation factor VIII (FVIII). In addition, hemophilia patients show associated diseases including osteopenia, altered inflammation and vascular fragility which may represent the consequence of recurrent bleeding or may be related to the direct FVIII deficiency. Nowadays, recombinant FVIII is proposed to treat hemophilia patients with no circulating FVIII inhibitor. Initially described as a coenzyme to factor IXa for initiating thrombin generation, there is emerging evidence that FVIII is involved in multiple biological systems, including bone, vascular and immune systems. The present study investigated: (i) the functional activities of recombinant human FVIII (rFVIII) on endothelial cells, and (ii) the impact of rFVIII activities on the functional interactions of human monocytes and endothelial cells. We then investigated whether rFVIII had a direct effect on the adhesion of monocytes to the endothelium under physiological flow conditions. We observed that direct biological activities for rFVIII in endothelial cells were characterized by: (i) a decrease in endothelial cell adhesion to the underlying extracellular matrix; (ii) regulation of the transcriptomic and protein profiles of endothelial cells; (iii) an increase in the vascular tubes formed and vascular permeability in vitro; and (iv) an increase in monocyte adhesion activated endothelium and transendothelial migration. By regulating vascular permeability plus leukocyte adhesion and transendothelial migration, the present work highlights new biological functions for FVIII.
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Affiliation(s)
- Marie Cadé
- Nantes Université, CNRS, US2B, UMR 6286, 44000, Nantes, France.,Institut de Cancérologie de l'Ouest, "Tumor Heterogeneity and Precision Medicine" Laboratory, Blvd Jacques Monod, 44805, Saint-Herblain cedex, France
| | - Javier Muñoz-Garcia
- Institut de Cancérologie de l'Ouest, "Tumor Heterogeneity and Precision Medicine" Laboratory, Blvd Jacques Monod, 44805, Saint-Herblain cedex, France
| | - Antoine Babuty
- Nantes Université, CNRS, US2B, UMR 6286, 44000, Nantes, France.,Department of Hemostasis, CHU de Nantes, Nantes, France
| | - Louis Paré
- Université de Paris, CNRS, Institut Jacques Monod, UMR 7592, Paris, France
| | - Denis Cochonneau
- Institut de Cancérologie de l'Ouest, "Tumor Heterogeneity and Precision Medicine" Laboratory, Blvd Jacques Monod, 44805, Saint-Herblain cedex, France
| | | | | | - Marie-Françoise Heymann
- Institut de Cancérologie de l'Ouest, "Tumor Heterogeneity and Precision Medicine" Laboratory, Blvd Jacques Monod, 44805, Saint-Herblain cedex, France
| | | | | | - Dominique Heymann
- Nantes Université, CNRS, US2B, UMR 6286, 44000, Nantes, France. .,Institut de Cancérologie de l'Ouest, "Tumor Heterogeneity and Precision Medicine" Laboratory, Blvd Jacques Monod, 44805, Saint-Herblain cedex, France. .,Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
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7
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Bonnard G, Babuty A, Collot R, Costes D, Drillaud N, Eveillard M, Néel A, Espitia A, Masseau A, Wahbi A, Hamidou M, Béné MC, Fouassier M. Platelet features allow to differentiate immune thrombocytopenia from inherited thrombocytopenia. Ann Hematol 2021; 100:2677-2682. [PMID: 34519886 DOI: 10.1007/s00277-021-04651-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/18/2021] [Indexed: 11/26/2022]
Abstract
Immune thrombocytopenia (ITP) is an acquired bleeding disorder, for which no specific diagnostic test exists. Inherited thrombocytopenia (IT) can mimic ITP and lead to unappropriated management with significant morbidity. Here, in small cohorts of these two disorders, we explored whether platelet sialylation and platelet activation could allow to discriminate the two conditions. We also aimed to confirm the value of immature platelet counts in this discrimination. Platelet sialylation and the expression level of P-selectin were assessed by multiparameter flow cytometry. Immature platelets were estimated on a Sysmex XN 9000 analyzer. No significant difference in platelet sialylation was observed between ITP and IT. Contrarily, platelet activation was significantly higher in ITP patients (p = 0.008). The immature platelet fraction, as previously demonstrated, was significantly lower in the ITP group compared to the IT group (p = 0.014). That statistical significance was achieved in this small pilot study suggests that the two easily available assays of immature platelet count and P-selectin expression could help physicians to reach the proper diagnosis in complex cases of thrombocytopenia.
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Affiliation(s)
- Guillaume Bonnard
- Service d'Hématologie Biologique, Hôtel Dieu, CHU de Nantes, Nantes, France.
- Centre de ressources et de compétences-Maladies hémorragiques constitutionnelles, CHU de Nantes, Nantes, France.
- Service de Médecine Interne, Hôtel Dieu, CHU de Nantes, Nantes, France.
| | - Antoine Babuty
- Service d'Hématologie Biologique, Hôtel Dieu, CHU de Nantes, Nantes, France
- Centre de ressources et de compétences-Maladies hémorragiques constitutionnelles, CHU de Nantes, Nantes, France
| | - Romain Collot
- Service D'Hématologie Clinique, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Domitille Costes
- Service D'Hématologie Clinique, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Nicolas Drillaud
- Service d'Hématologie Biologique, Hôtel Dieu, CHU de Nantes, Nantes, France
- Centre de ressources et de compétences-Maladies hémorragiques constitutionnelles, CHU de Nantes, Nantes, France
| | - Marion Eveillard
- Service d'Hématologie Biologique, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Antoine Néel
- Service de Médecine Interne, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Alexandra Espitia
- Service de Médecine Interne, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Agathe Masseau
- Service de Médecine Interne, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Anaïs Wahbi
- Service de Médecine Interne, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Mohamed Hamidou
- Service de Médecine Interne, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Marie C Béné
- Service d'Hématologie Biologique, Hôtel Dieu, CHU de Nantes, Nantes, France
- Centre de ressources et de compétences-Maladies hémorragiques constitutionnelles, CHU de Nantes, Nantes, France
| | - Marc Fouassier
- Service d'Hématologie Biologique, Hôtel Dieu, CHU de Nantes, Nantes, France
- Centre de ressources et de compétences-Maladies hémorragiques constitutionnelles, CHU de Nantes, Nantes, France
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8
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Cadé M, Muñoz-Garcia J, Babuty A, Fouassier M, Heymann MF, Monahan PE, Heymann D. FVIII at the crossroad of coagulation, bone and immune biology: Emerging evidence of biological activities beyond hemostasis. Drug Discov Today 2021; 27:102-116. [PMID: 34311113 DOI: 10.1016/j.drudis.2021.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/27/2021] [Accepted: 07/19/2021] [Indexed: 12/19/2022]
Abstract
Hemophilia A is an X-linked hereditary disorder that results from deficient coagulation factor VIII (FVIII) activity, leading to spontaneous bleeding episodes, particularly in joints and muscles. FVIII deficiency has been associated with altered bone remodeling, dysregulated macrophage polarization, and inflammatory processes that are associated with the neoformation of abnormal blood vessels. Treatment based on FVIII replacement can lead to the development of inhibitors that render FVIII concentrate infusion ineffective. In this context, hemophilia has entered a new therapeutic era with the development of new drugs, such as emicizumab, that seek to restore the hemostatic balance by bypassing pathologically acquired antibodies. We discuss the potential extrahemostatic functions of FVIII that may be crucial for defining future therapies in hemophilia.
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Affiliation(s)
- Marie Cadé
- Université de Nantes, INSERM, Institut de Cancérologie de l'Ouest, Saint-Herblain 44805, France
| | - Javier Muñoz-Garcia
- Université de Nantes, INSERM, Institut de Cancérologie de l'Ouest, Saint-Herblain 44805, France
| | - Antoine Babuty
- Université de Nantes, INSERM, Institut de Cancérologie de l'Ouest, Saint-Herblain 44805, France; Department of Haemostasis, CHU de Nantes, France
| | | | - Marie-Francoise Heymann
- Université de Nantes, INSERM, Institut de Cancérologie de l'Ouest, Saint-Herblain 44805, France
| | - Paul E Monahan
- Gene Therapy Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Dominique Heymann
- Université de Nantes, INSERM, Institut de Cancérologie de l'Ouest, Saint-Herblain 44805, France; University of Sheffield, Department of Oncology and Metabolism, Sheffield, UK.
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9
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Babuty A, Debord C, Béné MC, Fouassier M. Flow cytometry for platelets, EDTA or not EDTA: what is the answer? Platelets 2020; 32:144-145. [PMID: 32951494 DOI: 10.1080/09537104.2020.1823361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Antoine Babuty
- Service d'Hématologie Biologique, CHU de Nantes , Nantes, France.,CRC-MH, CHU de Nantes , Nantes, France
| | - Camille Debord
- Service d'Hématologie Biologique, CHU de Nantes , Nantes, France
| | - Marie C Béné
- Service d'Hématologie Biologique, CHU de Nantes , Nantes, France
| | - Marc Fouassier
- Service d'Hématologie Biologique, CHU de Nantes , Nantes, France.,CRC-MH, CHU de Nantes , Nantes, France
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10
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Drillaud N, Babuty A, Rugeri L, Fouassier M, Lienhart A, Béné M, Lefranc C, Ternisien C, Chamouard V, Sigaud M, Pennetier M, Trossaërt M, Meunier S. Management of previously untreated patients with severe haemophilia A preferentially treated with recombinant factor VIII products: Two French centres' real‐life experience. Haemophilia 2020; 26:e349-e352. [DOI: 10.1111/hae.14132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Antoine Babuty
- Haemophilia Treatment Center University Hospital Nantes France
| | - Lucia Rugeri
- Haemophilia Treatment Center University Hospital Lyon France
| | - Marc Fouassier
- Haemophilia Treatment Center University Hospital Nantes France
| | - Anne Lienhart
- Haemophilia Treatment Center University Hospital Lyon France
| | - Marie‐C Béné
- Haemophilia Treatment Center University Hospital Nantes France
| | - Carole Lefranc
- Haemophilia Treatment Center University Hospital Lyon France
| | | | | | - Marianne Sigaud
- Haemophilia Treatment Center University Hospital Nantes France
| | | | - Marc Trossaërt
- Haemophilia Treatment Center University Hospital Nantes France
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11
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Fouassier M, Babuty A, Debord C, Béné MC. Platelet immunophenotyping in health and inherited bleeding disorders, a review and practical hints. Cytometry B Clin Cytom 2020; 98:464-475. [PMID: 32516490 DOI: 10.1002/cyto.b.21892] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/16/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022]
Abstract
Inherited platelet function disorders are rare hemorrhagic diseases. The gold standard for their exploration is optical aggregometry; however, investigations by flow cytometry (FCM) are being increasingly used. In this review, the physiology of platelets is first recalled, setting the stage for the compartments of platelets that can be apprehended by specific and appropriate labeling. As this requires some pre-analytical precautions and specific analytical settings, a second part focuses on these characteristic aspects, based on literature and on the authors' experience in the field, for qualitative or quantitative explorations. Membrane labeling with antibodies to CD42a or CD41, respectively, useful to assess the genetic-related defects of Glanzmann thrombocytopenia and Bernard Soulier syndrome are then described. Platelet degranulation disorders are detailed in the next section, as they can be explored, upon platelet activation, by measuring the expression of surface P-Selectin (CD62P) or CD63. Mepacrin uptake and release after activation is another test allowing to explore the function of dense granules. Finally, the flip-flop anomaly related to Scott syndrome is depicted. Tables summarizing possible FCM assays, and characteristic histograms are provided as reference for flow laboratories interested in developing platelet exploration.
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Affiliation(s)
- Marc Fouassier
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Antoine Babuty
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Camille Debord
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Marie C Béné
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
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12
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Babuty A, Boisseau P, Eveillard M, Ternisien C, Debord C, Sigaud M, Giraud M, Gillet B, Trossaert M, Béné M, Fouassier M. A new case of heterozygous variant of the
GP
1
BB
gene responsible for macrothrombocytopenia. Br J Haematol 2019; 186:157-159. [DOI: 10.1111/bjh.15739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Antoine Babuty
- Centre de Traitement de l'Hémophilie CHU de Nantes – Hôtel DieuNantesCedex 1France
| | - Pierre Boisseau
- Service de Génétique Médicale CHU de Nantes – Hôtel DieuNantesCedex 1France
| | - Marion Eveillard
- Service d'Hématologie Biologique CHU de Nantes – Hôtel Dieu Nantes Cedex 1 France
| | - Catherine Ternisien
- Centre de Traitement de l'Hémophilie CHU de Nantes – Hôtel DieuNantesCedex 1France
| | - Camille Debord
- Service d'Hématologie Biologique CHU de Nantes – Hôtel Dieu Nantes Cedex 1 France
| | - Marianne Sigaud
- Centre de Traitement de l'Hémophilie CHU de Nantes – Hôtel DieuNantesCedex 1France
| | - Mathilde Giraud
- Service de Génétique Médicale CHU de Nantes – Hôtel DieuNantesCedex 1France
| | - Benjamin Gillet
- Centre de Traitement de l'Hémophilie CHU de Nantes – Hôtel DieuNantesCedex 1France
| | - Marc Trossaert
- Centre de Traitement de l'Hémophilie CHU de Nantes – Hôtel DieuNantesCedex 1France
| | - Marie‐Christine Béné
- Service d'Hématologie Biologique CHU de Nantes – Hôtel Dieu Nantes Cedex 1 France
| | - Marc Fouassier
- Centre de Traitement de l'Hémophilie CHU de Nantes – Hôtel DieuNantesCedex 1France
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13
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Bousseksou A, Babuty A, Tetienne JP, Moldovan-Doyen I, Braive R, Beaudoin G, Sagnes I, De Wilde Y, Colombelli R. Sub-wavelength energy concentration with electrically generated mid-infrared surface plasmons. Opt Express 2012; 20:13738-13747. [PMID: 22714439 DOI: 10.1364/oe.20.013738] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
While freely propagating photons cannot be focused below their diffraction limit, surface-plasmon polaritons follow the metallic surface to which they are bound, and can lead to extremely sub-wavelength energy volumes. These properties are lost at long mid-infrared and THz wavelengths where metals behave as quasi-perfect conductors, but can in principle be recovered by artificially tailoring the surface-plasmon dispersion. We demonstrate - in the important mid-infrared range of the electromagnetic spectrum - the generation onto a semiconductor chip of plasmonic excitations which can travel along long distances, on bent paths, to be finally focused into a sub-wavelength volume. The demonstration of these advanced functionalities is supported by full near-field characterizations of the electromagnetic field distribution on the surface of the active plasmonic device.
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Affiliation(s)
- A Bousseksou
- Institut d’Electronique Fondamentale, Univ. Paris Sud, UMR8622 CNRS, 91405 Orsay, France.
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14
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Babuty A, Bousseksou A, Tetienne JP, Doyen IM, Sirtori C, Beaudoin G, Sagnes I, De Wilde Y, Colombelli R. Semiconductor surface plasmon sources. Phys Rev Lett 2010; 104:226806. [PMID: 20867196 DOI: 10.1103/physrevlett.104.226806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 05/10/2010] [Indexed: 05/29/2023]
Abstract
Surface-plasmon polaritons (SPPs) are propagating electromagnetic modes bound at a metal-dielectric interface. We report on electrical generation of SPPs by reproducing the analogue in the near field of the slit-doublet experiment, in a device which includes all the building blocks required for a fully integrated plasmonic active source: an electrical generator of SPPs, a coupler, and a passive metallic waveguide. SPPs are generated upon injection of electrical current, and they are then launched at the edges of a passive metallic strip. The interference fringes arising from the plasmonic standing wave on the surface of the metallic strip are unambiguously detected with apertureless near-field scanning optical microscopy.
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Affiliation(s)
- A Babuty
- Institut Langevin, ESPCI ParisTech, CNRS UMR 7587, LOP, 75005 Paris, France
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15
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Bousseksou A, Colombelli R, Babuty A, De Wilde Y, Chassagneux Y, Sirtori C, Patriarche G, Beaudoin G, Sagnes I. A semiconductor laser device for the generation of surface-plasmons upon electrical injection. Opt Express 2009; 17:9391-9400. [PMID: 19466191 DOI: 10.1364/oe.17.009391] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Surface plasmons are electromagnetic waves originating from electrons and light oscillations at metallic surfaces. Since freely propagating light cannot be coupled directly into surface-plasmon modes, a compact, semiconductor electrical device capable of generating SPs on the device top metallic surface would represent an advantage: not only SP manipulation would become easier, but Au-metalized surfaces can be easily functionalized for applications. Here, we report a demonstration of such a device. The direct proof of surface-plasmon generation is obtained with apertureless near-field scanning optical microscopy, which detects the presence of an intense, evanescent electric field above the device metallic surface upon electrical injection.
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Affiliation(s)
- A Bousseksou
- Institut d'Electronique Fondamentale, Université Paris-Sud and CNRS, UMR8622, 91405 Orsay, France
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