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Casco N, Jorge AL, Palmero DJ, Alffenaar JW, Fox GJ, Ezz W, Cho JG, Denholm J, Skrahina A, Solodovnikova V, Arbex MA, Alves T, Rabahi MF, Pereira GR, Sales R, Silva DR, Saffie MM, Salinas NE, Miranda RC, Cisterna C, Concha C, Fernandez I, Villalón C, Vera CG, Tapia PG, Cancino V, Carbonell M, Cruz A, Muñoz E, Muñoz C, Navarro I, Pizarro R, Cristina Sánchez GP, Vergara Riquelme MS, Vilca E, Soto A, Flores X, Garavagno A, Bahamondes MH, Merino LM, Pradenas AM, Revillot ME, Rodriguez P, Salinas AS, Taiba C, Valdés JF, Subiabre JN, Ortega C, Palma S, Castillo PP, Pinto M, Bidegain FR, Venegas M, Yucra E, Li Y, Cruz A, Guelvez B, Victoria Plaza R, Tello Hoyos KY, Cardoso-Landivar J, Van Den Boom M, Andréjak C, Blanc FX, Dourmane S, Froissart A, Izadifar A, Rivière F, Schlemmer F, Manika K, Diallo BD, Hassane-Harouna S, Artiles N, Mejia LA, Gupta N, Ish P, Mishra G, Patel JM, Singla R, Udwadia ZF, Alladio F, Angeli F, Calcagno A, Centis R, Codecasa LR, De Lauretis A, Esposito SMR, Formenti B, Gaviraghi A, Giacomet V, Goletti D, Gualano G, Matteelli A, Migliori GB, Motta I, Palmieri F, Pontali E, Prestileo T, Riccardi N, Saderi L, Saporiti M, Sotgiu G, Spanevello A, Stochino C, Tadolini M, Torre A, Villa S, Visca D, Kurhasani X, Furjani M, Rasheed N, Danila E, Diktanas S, Ridaura RL, Luna López FL, Torrico MM, Rendon A, Akkerman OW, Chizaram O, Al-Abri S, Alyaquobi F, Althohli K, Aguirre S, Teixeira RC, De Egea V, Irala S, Medina A, Sequera G, Sosa N, Vázquez F, Llanos-Tejada FK, Manga S, Villanueva-Villegas R, Araujo D, Sales Marques RD, Socaci A, Barkanova O, Bogorodskaya M, Borisov S, Mariandyshev A, Kaluzhenina A, Vukicevic TA, Stosic M, Beh D, Ng D, Ong CWM, Solovic I, Dheda K, Gina P, Caminero JA, De Souza Galvão ML, Dominguez-Castellano A, García-García JM, Pinargote IM, Fernandez SQ, Sánchez-Montalvá A, Huguet ET, Murguiondo MZ, Bart PA, Mazza-Stalder J, D'Ambrosio L, Kamolwat P, Bakko F, Barnacle J, Bird S, Brown A, Chandran S, Killington K, Man K, Papineni P, Ritchie F, Tiberi S, Utjesanovic N, Zenner D, Hearn JL, Heysell S, Young L. Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort. Eur Respir J 2023; 62:2300925. [PMID: 37827576 PMCID: PMC10627308 DOI: 10.1183/13993003.00925-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. METHODS We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. RESULTS Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03-1.07), HIV infection (HR 2.29, 95% CI 1.02-5.16) and invasive ventilation (HR 4.28, 95% CI 2.34-7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02-1.04), male sex (HR 2.21, 95% CI 1.24-3.91), oxygen requirement (HR 7.93, 95% CI 3.44-18.26) and invasive ventilation (HR 2.19, 95% CI 1.36-3.53). CONCLUSIONS In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.
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Schlemmer F, Valentin S, Boyer L, Guillaumot A, Chabot F, Dupin C, Le Guen P, Lorillon G, Bergeron A, Basille D, Delomez J, Andrejak C, Bonnefoy V, Goussault H, Assié JB, Choinier P, Ruppert AM, Cadranel J, Mennitti MC, Roumila M, Colin C, Günther S, Sanchez O, Gille T, Sésé L, Uzunhan Y, Faure M, Patout M, Morelot-Panzini C, Laveneziana P, Zysman M, Blanchard E, Raherison-Semjen C, Giraud V, Giroux-Leprieur E, Habib S, Roche N, Dinh-Xuan AT, Sifaoui I, Brillet PY, Jung C, Boutin E, Layese R, Canoui-Poitrine F, Maitre B. Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study. Eur Respir J 2023; 61:13993003.01532-2022. [PMID: 36669777 PMCID: PMC10066566 DOI: 10.1183/13993003.01532-2022] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/20/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Survivors of severe-to-critical COVID-19 may have functional impairment, radiological sequelae and persistent symptoms requiring prolonged follow-up. This pragmatic study aimed to describe their clinical follow-up and determine their respiratory recovery trajectories, and factors that could influence them and their health-related quality of life. METHODS Adults hospitalised for severe-to-critical COVID-19 were evaluated at 3 months and up to 12 months post-hospital discharge in this prospective, multicentre, cohort study. RESULTS Among 485 enrolled participants, 293 (60%) were reassessed at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 ones initially managed with standard oxygen were reassessed at 6 and 12 months, respectively. At 3 months, 34%, 70% and 56% of the participants had a restrictive lung defect, impaired DLCO and significant radiological sequelae, respectively. During extended follow-up, DLCO and FVC (% of predicted value) increased by means of +4 points at 6 months, and +6 points at 12 months. Sex, body mass index, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19 and prolonged invasive mechanical ventilation (IMV) were associated with DLCO at month 3, but not its trajectory thereafter. Among 475 (98%) patients with at least one chest computed-tomography scan during follow-up, 196 (41%) had significant sequelae on their last images. CONCLUSION Although pulmonary function and radiological abnormalities improved up to 1 year post-acute-COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.
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Affiliation(s)
- Frédéric Schlemmer
- Unité de Pneumologie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Créteil, France .,Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France
| | - Simon Valentin
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, INSERM UMR_S 1116, Vandœuvre-lès-Nancy, France
| | - Laurent Boyer
- Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France.,APHP, Hôpitaux Universitaires Henri-Mondor, Service des Explorations Fonctionnelles, Créteil, France
| | - Anne Guillaumot
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France
| | - François Chabot
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, INSERM UMR_S 1116, Vandœuvre-lès-Nancy, France
| | - Clairelyne Dupin
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Pierre Le Guen
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Gwenael Lorillon
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève, Service de Pneumologie, Genève, Switzerland
| | - Damien Basille
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Julia Delomez
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Claire Andrejak
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Valentine Bonnefoy
- Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France
| | - Hélène Goussault
- Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France
| | - Jean-Baptiste Assié
- Unité de Pneumologie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Pascaline Choinier
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Anne-Marie Ruppert
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Jacques Cadranel
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | | | - Mehdi Roumila
- Département de Pneumologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Charlotte Colin
- Département de Pneumologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Sven Günther
- APHP, Hôpital Européen Georges-Pompidou, Service de Physiologie, Université de Paris, Paris, France
| | - Olivier Sanchez
- APHP, Hôpital Européen Georges-Pompidou, Service de Pneumologie, Université de Paris, Paris, France
| | - Thomas Gille
- APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Physiologie et Explorations Fonctionnelles, Bobigny, France.,Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France
| | - Lucile Sésé
- APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Physiologie et Explorations Fonctionnelles, Bobigny, France.,Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France
| | - Yurdagul Uzunhan
- Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France.,APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Pneumologie, Centre de Reference Maladies Pulmonaires Rares de l'Adulte (site constitutif), Bobigny, France
| | - Morgane Faure
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Maxime Patout
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Capucine Morelot-Panzini
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Pierantonio Laveneziana
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, hôpitaux Pitié-Salpêtrière, Saint-Antoine et Tenon, Paris, France
| | - Maeva Zysman
- Département de Pneumologie, CHU Haut-Lévèque, Bordeaux, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM U1045, Pessac, France
| | - Elodie Blanchard
- Département de Pneumologie, CHU Haut-Lévèque, Bordeaux, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM U1045, Pessac, France
| | - Chantal Raherison-Semjen
- Département de Pneumologie, CHU Guadeloupe, Guadeloupe, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM 1219 Epicene Team, Pessac, France
| | - Violaine Giraud
- APHP, Hôpital Ambroise-Paré, Service de Pneumologie et Oncologie thoracique, Boulogne, France
| | - Etienne Giroux-Leprieur
- APHP, Hôpital Ambroise-Paré, Service de Pneumologie et Oncologie thoracique, Boulogne, France.,Univ Paris-Saclay, Université de Versailles-Saint-Quentin (UVSQ), Boulogne, France
| | - Stéfanie Habib
- APHP, Hôpital Cochin, Service de Pneumologie, Université Paris Cité, Institut Cochin (UMR1016), Paris, France
| | - Nicolas Roche
- APHP, Hôpital Cochin, Service de Pneumologie, Université Paris Cité, Institut Cochin (UMR1016), Paris, France
| | - Anh Tuan Dinh-Xuan
- APHP, Hôpital Cochin, Service de Physiologie et Explorations Fonctionnelles, Université de Paris, Paris, France
| | - Islem Sifaoui
- Département d'Imagerie Médicale, APHP, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | | | - Camille Jung
- Centre Hospitalier Intercommunal, CRC, Créteil, France
| | - Emmanuelle Boutin
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France
| | - Richard Layese
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France
| | - Florence Canoui-Poitrine
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France.,APHP, Hôpitaux Universitaires Henri-Mondor, Unité de Recherche Clinique (URC Mondor), Créteil, France.,These two authors contributed equally to this work
| | - Bernard Maitre
- Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France.,Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France.,These two authors contributed equally to this work
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Tiendrébéogo AJF, Soumagne T, Pellegrin F, Dagouassat M, Tran Van Nhieu J, Caramelle P, Paul EN, Even B, Zysman M, Julé Y, Samb A, Boczkowski J, Lanone S, Schlemmer F. The telomerase activator TA-65 protects from cigarette smoke-induced small airway remodeling in mice through extra-telomeric effects. Sci Rep 2023; 13:25. [PMID: 36646720 PMCID: PMC9842758 DOI: 10.1038/s41598-022-25993-7] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/07/2022] [Indexed: 01/18/2023] Open
Abstract
Small airway remodeling (SAR) is a key phenomenon of airflow obstruction in smokers, leading to chronic obstructive pulmonary disease (COPD). SAR results in an increased thickness of small airway walls, with a combination of peribronchiolar fibrosis with increased fibrous tissue and accumulation of mesenchymal and epithelial cells. SAR pathogenesis is still unclear but recent data suggest that alterations in telomerase activity could represent a possible underlying mechanism of SAR. Our study was dedicated to identify a potential protective role of TA-65, a pharmacological telomerase activator, in a cigarette smoke (CS) model of SAR in mice, and to further precise if extra-telomeric effects of telomerase, involving oxidative stress modulation, could explain it. C57BL/6J mice were daily exposed to air or CS during 4 weeks with or without a concomitant administration of TA-65 starting 7 days before CS exposure. Morphological analyses were performed, and mucus production, myofibroblast differentiation, collagen deposition, as well as transforming growth factor-β1 (TGF-β1) expression in the small airway walls were examined. In addition, the effects of TA-65 treatment on TGF-β expression, fibroblast-to-myofibroblast differentiation, reactive oxygen species (ROS) production and catalase expression and activity were evaluated in primary cultures of pulmonary fibroblasts and/or mouse embryonic fibroblasts in vitro. Exposure to CS during 4 weeks induced SAR in mice, characterized by small airway walls thickening and peribronchiolar fibrosis (increased deposition of collagen, expression of α-SMA in small airway walls), without mucus overproduction. Treatment of mice with TA-65 protected them from CS-induced SAR. This effect was associated with the prevention of CS-induced TGF-β expression in vivo, the blockade of TGF-β-induced myofibroblast differentiation, and the reduction of TGF-β-induced ROS production that correlates with an increase of catalase expression and activity. Our findings demonstrate that telomerase is a critical player of SAR, probably through extra-telomeric anti-oxidant effects, and therefore provide new insights in the understanding and treatment of COPD pathogenesis.
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Affiliation(s)
- Arnaud Jean Florent Tiendrébéogo
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France ,Laboratoire de physiologie et d’explorations fonctionnelles physiologiques, Université Cheik Anta Diop, Dakar, Senegal
| | - Thibaud Soumagne
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France
| | - François Pellegrin
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France
| | - Maylis Dagouassat
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France
| | - Jeanne Tran Van Nhieu
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France ,grid.412116.10000 0004 1799 3934Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Département de Pathologie, 94000 Créteil, France
| | - Philippe Caramelle
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France
| | - Emmanuel N. Paul
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France
| | - Benjamin Even
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France
| | - Maeva Zysman
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France
| | | | - Abdoulaye Samb
- Laboratoire de physiologie et d’explorations fonctionnelles physiologiques, Université Cheik Anta Diop, Dakar, Senegal
| | - Jorge Boczkowski
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France ,grid.412116.10000 0004 1799 3934Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service d’explorations fonctionnelles respiratoires, DHU A-TVB, FHU Senec, 94000 Créteil, France
| | - Sophie Lanone
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France
| | - Frédéric Schlemmer
- grid.462410.50000 0004 0386 3258IMRB, INSERM U955, 94000 Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est-Créteil, Faculté de Santé, 94000 Créteil, France ,grid.412116.10000 0004 1799 3934Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Unité de Pneumologie, DHU A-TVB, FHU Senec, 94000 Créteil, France
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Hermine O, Mariette X, Porcher R, Djossou F, Nguyen Y, Arlet JB, Savale L, Diehl JL, Georgin-Lavialle S, Cadranel J, Pialoux G, Lacombe K, Mekinian A, Gros H, Lescure X, Ghosn J, Coupez E, Grapin K, Rapp C, Michel M, Lecapitaine AL, Michot JM, Costedoat-Chalumeau N, Nguyen LBL, Semerano L, Raffi F, Aguillar C, Rouzaud C, Gottenberg JE, Hansmann Y, Bienvenu B, London J, Fantchou FS, Ackermann F, Gros A, Morel A, Gambier N, Sène D, Mégarbane B, Azoulay E, Bureau S, Dougados M, Emmerich J, Fartoukh M, Guidet B, Humbert M, Mahevas M, Pène F, Schlemmer F, Pourcher-Martinez V, Tibi A, Baron G, Perrodeau E, Baron S, Steg G, Yazdapanah Y, Simon T, Resche-Rigon M, Tharaux PL, Ravaud P. Tocilizumab plus dexamethasone versus dexamethasone in patients with moderate-to-severe COVID-19 pneumonia: A randomised clinical trial from the CORIMUNO-19 study group. EClinicalMedicine 2022; 46:101362. [PMID: 35350097 PMCID: PMC8949640 DOI: 10.1016/j.eclinm.2022.101362] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 02/07/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In moderate-to-severe COVID-19 pneumonia, dexamethasone (DEX) and tocilizumab (TCZ) reduce the occurrence of death and ventilatory support. We investigated the efficacy and safety of DEX+TCZ in an open randomized clinical trial. METHODS From July 24, 2020, through May 18, 2021, patients with moderate-to-severe COVID-19 pneumonia requiring oxygen (>3 L/min) were randomly assigned to receive DEX (10 mg/d 5 days tapering up to 10 days) alone or combined with TCZ (8 mg/kg IV) at day 1, possibly repeated with a fixed dose of 400 mg i.v. at day 3. The primary outcome was time from randomization to mechanical ventilation support or death up to day 14, analysed on an intent-to-treat basis using a Bayesian approach. ClinicalTrials.gov number, NCT04476979. FINDINGS A total of 453 patients were randomized, 3 withdrew consent, 450 were analysed, of whom 226 and 224 patients were assigned to receive DEX or TCZ+DEX, respectively. At day 14, mechanical ventilation or death occurred in 32/226 (14%) and 27/224 (12%) in the DEX and TCZ+DEX arms, respectively (hazard ratio [HR] 0·85, 90% credible interval [CrI] 0·55 to 1·31). At day 14, the World health Organization (WHO) clinical progression scale (CPS) was significantly improved in the TCZ+DEX arm (OR 0·69, 95% CrI, 0·49 to 0.97). At day 28, the cumulative incidence of oxygen supply independency was 82% in the TCZ+DEX arms and 72% in the DEX arm (HR 1·36, 95% CI 1·11 to 1·67). On day 90, 24 deaths (11%) were observed in the DEX arm and 18 (8%) in the TCZ+DEX arm (HR 0·77, 95% CI 0·42-1·41). Serious adverse events were observed in 25% and 21% in DEX and TCZ+DEX arms, respectively. INTERPRETATION Mechanical ventilation need and mortality were not improved with TCZ+DEX compared with DEX alone. The safety of both treatments was similar. However, given the wide confidence intervals for the estimate of effect, definitive interpretation cannot be drawn. FUNDING Programme Hospitalier de Recherche Clinique [PHRC COVID-19-20-0151, PHRC COVID-19-20-0029], Fondation de l'Assistance Publique - Hôpitaux de Paris (Alliance Tous Unis Contre le Virus) and from Fédération pour la Recherche Médicale" (FRM). Tocilizumab was provided by Roche.
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Affiliation(s)
- Olivier Hermine
- Département d'hématologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, 149 rue de Sèvres, Paris 75015, France
- Laboratory of physiopathology and treatment of Hematological malignancies, Institut imagine, INSERM U1153, Université de Paris, Paris, France
- Corresponding author at: Département d'hématologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, 149 rue de Sèvres, Paris 75015, France.
| | - Xavier Mariette
- Département de Rhumatologie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Raphael Porcher
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Felix Djossou
- Service de maladies infectieuses et tropicales (UMIT), TBIP, Univ. de Guyane, Cayenne 97300, French Guiana
- Univ. de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille 59000, France
| | - Yann Nguyen
- Département de Médecine interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Jean-Benoît Arlet
- Département de Médecine interne, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Laurent Savale
- Université Paris–Saclay, INSERM UMR_S999, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Jean Luc Diehl
- Département de Réanimation, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Sophie Georgin-Lavialle
- Département de Médecine Interne, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Jacques Cadranel
- Département de Pneumologie, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Gilles Pialoux
- Département de Maladies Infectieuses, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Karine Lacombe
- Département de Maladies Infectieuses, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Arsène Mekinian
- Département de Médecine Interne, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Hélène Gros
- Service de Médecine Interne et Maladies Infectieuses, CHI Robert Ballanger, Aulnay sous Bois 93600, France
| | - Xavier Lescure
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Jade Ghosn
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, and INSERM UMRS 1137 IAME, Université de Paris, Paris France
| | - Elisabeth Coupez
- Département de Réanimation, Hôpital Gabriel Montpied, CHU de Clermont Ferrand Université de Clermont Ferrand, France
| | - Kevin Grapin
- Département de Pneumologie, Hôpital Gabriel Montpied, CHU de Clermont Ferrand, Université de Clermont Ferrand, France
| | - Christophe Rapp
- Service de Médecine Interne, Hôpital Américain, Neuilly, France
| | - Marc Michel
- Département de Médecine interne, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université de Paris Est Créteil, Créteil France
| | | | - Jean Marie Michot
- Service d'hématologie, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Nathalie Costedoat-Chalumeau
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Luca Semerano
- Service de Rhumatologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Université de Paris Nord Sorbonne, Bobigny, France
| | - François Raffi
- Department of Infectious Diseases, Hotel-Dieu Hospital and INSERM CIC 1413, Nantes University Hospital, Nantes, France
| | - Claire Aguillar
- Département de maladies Infectieuses, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Claire Rouzaud
- Département de maladies Infectieuses, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
- Département de maladies Infectieuses, Hôpital Saint Joseph, University of Paris, Paris France
| | - Jacques Eric Gottenberg
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Service de maladies infectieuses, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Boris Bienvenu
- Département de médecine Interne, Hôpital Saint Joseph, Marseille, France
| | - Jonathan London
- Service de Médecine interne, Hôpital des Diaconesse-Croix saint Simon, Paris, France
| | - Franklin Samou Fantchou
- Service de Maladies Infectieuses, Centre hospitalier du centre Hospitalier de l'ouest Guyanais, Saint Laurent du Maroni, France
| | | | - Antoine Gros
- Service de Réanimation Médico-chirurgicale, Hôpital André Mignot, Versailles, France
| | - Alexandre Morel
- Service d'Hématologie, Hôpital Privé d'Antony, Antony, France
| | - Nicolas Gambier
- Service de Maladies Infectieuses, Centre Hospitalier Saint Denis, Hôpital Delafontaine, Saint Denis, France
| | - Damien Sène
- Service de Médecine Interne, Hôpital de Lariboisière, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Bruno Mégarbane
- Réanimation Médicale et Toxicologique, Hôpital de Lariboisière, Assistance Publique Hôpitaux de Paris, Université de Paris, INSERM UMRS-1144, Paris France
| | - Elie Azoulay
- Département de Réanimation, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Serge Bureau
- Direction de la recherche clinique, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Maxime Dougados
- Département de Rhumatologie, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Joseph Emmerich
- Département de médecine vasculaire, Hôpital Saint Joseph, Université de Paris, Paris France
| | - Muriel Fartoukh
- Département de Réanimation, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Bertrand Guidet
- Département de Réanimation, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Marc Humbert
- Université Paris–Saclay, INSERM UMR_S999, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Mathieu Mahevas
- Département de Médecine interne, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université de Paris Est Créteil, Créteil France
| | - Frédéric Pène
- Service de Médecine Intensive et Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris. Centre, Université de Paris, Paris France
| | - Frédéric Schlemmer
- Université de Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Unité de Pneumologie - Service de Médecine Intensive et Réanimation, Hôpitaux Universitaires Henri Mondor, Créteil France
| | - Valérie Pourcher-Martinez
- Département de Maladies Infectieuses, Hôpital de la Pitié Salpétrière, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Annick Tibi
- Agence Générale des Equipements et Produits de Santé, Assistance Publique des hôpitaux de Paris, Paris, France
| | - Gabriel Baron
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Elodie Perrodeau
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Stéphanie Baron
- Département de physiologie et explorations fonctionelles, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Gabriel Steg
- Département de cardiologie, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Yazdan Yazdapanah
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Tabassome Simon
- Service de pharmacologie clinique, centre de recherche clinique de Paris Est, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Matthieu Resche-Rigon
- Service de biostatistique et information médicale, INSERM U153, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Pierre-Louis Tharaux
- INSERM U970 Paris Cardiovascular Centre (PARCC), Université de Paris, Paris, France
| | - Philippe Ravaud
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
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5
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Ribeiro Baptista B, d'Humières T, Schlemmer F, Bendib I, Justeau G, Al-Assaad L, Hachem M, Codiat R, Bardel B, Abou Chakra L, Belmondo T, Audureau E, Hue S, Mekontso-Dessap A, Derumeaux G, Boyer L. Identification of factors impairing exercise capacity after severe COVID-19 pulmonary infection: a 3-month follow-up of prospective COVulnerability cohort. Respir Res 2022; 23:68. [PMID: 35317815 PMCID: PMC8938727 DOI: 10.1186/s12931-022-01977-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/06/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patient hospitalized for coronavirus disease 2019 (COVID-19) pulmonary infection can have sequelae such as impaired exercise capacity. We aimed to determine the frequency of long-term exercise capacity limitation in survivors of severe COVID-19 pulmonary infection and the factors associated with this limitation. METHODS Patients with severe COVID-19 pulmonary infection were enrolled 3 months after hospital discharge in COVulnerability, a prospective cohort. They underwent cardiopulmonary exercise testing, pulmonary function test, echocardiography, and skeletal muscle mass evaluation. RESULTS Among 105 patients included, 35% had a reduced exercise capacity (VO2peak < 80% of predicted). Compared to patients with a normal exercise capacity, patients with reduced exercise capacity were more often men (89.2% vs. 67.6%, p = 0.015), with diabetes (45.9% vs. 17.6%, p = 0.002) and renal dysfunction (21.6% vs. 17.6%, p = 0.006), but did not differ in terms of initial acute disease severity. An altered exercise capacity was associated with an impaired respiratory function as assessed by a decrease in forced vital capacity (p < 0.0001), FEV1 (p < 0.0001), total lung capacity (p < 0.0001) and DLCO (p = 0.015). Moreover, we uncovered a decrease of muscular mass index and grip test in the reduced exercise capacity group (p = 0.001 and p = 0.047 respectively), whilst 38.9% of patients with low exercise capacity had a sarcopenia, compared to 10.9% in those with normal exercise capacity (p = 0.001). Myocardial function was normal with similar systolic and diastolic parameters between groups whilst reduced exercise capacity was associated with a slightly shorter pulmonary acceleration time, despite no pulmonary hypertension. CONCLUSION Three months after a severe COVID-19 pulmonary infection, more than one third of patients had an impairment of exercise capacity which was associated with a reduced pulmonary function, a reduced skeletal muscle mass and function but without any significant impairment in cardiac function.
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Affiliation(s)
| | - Thomas d'Humières
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Frédéric Schlemmer
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Unité de Pneumologie, Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Inès Bendib
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France.,Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
| | - Grégoire Justeau
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France
| | - Lara Al-Assaad
- Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Mouna Hachem
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Unité de Pneumologie, Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Rebecca Codiat
- Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Benjamin Bardel
- Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Laure Abou Chakra
- Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Thibaut Belmondo
- Département d'Hématologie et d'Immunologie Biologiques, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Etienne Audureau
- Biostatistics Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.,CEpiA IMRB U955, FHU SENEC, Université Paris Est (UPEC), Créteil, France
| | - Sophie Hue
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Département d'Hématologie et d'Immunologie Biologiques, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Armand Mekontso-Dessap
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
| | - Geneviève Derumeaux
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Laurent Boyer
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France. .,Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France.
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6
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Fadel M, Van Nhieu JT, Grall P, Beugnon K, Boudet P, Schlemmer F, Mangiapan G, Maitre B, Boczkowski J, Martinon L, Pairon JC. Determinants of a bronchoalveolar lavage of good quality for mineralogical analyses in adults: Experience from the Asbestos Fibers and Particles Laboratory of Paris City. Respir Med Res 2022; 81:100885. [DOI: 10.1016/j.resmer.2022.100885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 10/19/2022]
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7
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Philippot Q, Kannengiesser C, Debray MP, Gauvain C, Ba I, Vieri M, Gondouin A, Naccache JM, Reynaud-Gaubert M, Uzunhan Y, Bondue B, Israël-Biet D, Dieudé P, Fourrage C, Lainey E, Manali E, Papiris S, Wemeau L, Hirschi S, Mal H, Nunes H, Schlemmer F, Blanchard E, Beier F, Cottin V, Crestani B, Borie R. Interstitial lung diseases associated with mutations of poly(A)-specific ribonuclease: A multicentre retrospective study. Respirology 2022; 27:226-235. [PMID: 34981600 DOI: 10.1111/resp.14195] [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] [Received: 09/04/2021] [Revised: 10/21/2021] [Accepted: 11/29/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Poly(A)-specific ribonuclease (PARN) mutations have been associated with familial pulmonary fibrosis. This study aims to describe the phenotype of patients with interstitial lung disease (ILD) and heterozygous PARN mutations. METHODS We performed a retrospective, observational, non-interventional study of patients with an ILD diagnosis and a pathogenic heterozygous PARN mutation followed up in a centre of the OrphaLung network. RESULTS We included 31 patients (29 from 16 kindreds and two sporadic patients). The median age at ILD diagnosis was 59 years (range 54 to 63). In total, 23 (74%) patients had a smoking history and/or fibrogenic exposure. The pulmonary phenotypes were heterogenous, but the most frequent diagnosis was idiopathic pulmonary fibrosis (n = 12, 39%). Haematological abnormalities were identified in three patients and liver disease in two. In total, 21 patients received a specific treatment for ILD: steroids (n = 13), antifibrotic agents (n = 11), immunosuppressants (n = 5) and N-acetyl cysteine (n = 2). The median forced vital capacity decline for the whole sample was 256 ml/year (range -363 to -148). After a median follow-up of 32 months (range 18 to 66), 10 patients had died and six had undergone lung transplantation. The median transplantation-free survival was 54 months (95% CI 29 to ∞). Extra-pulmonary features were less frequent with PARN mutation than telomerase reverse transcriptase (TERT) or telomerase RNA component (TERC) mutation. CONCLUSION IPF is common among individuals with PARN mutation, but other ILD subtypes may be observed.
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Affiliation(s)
| | - Caroline Kannengiesser
- INSERM, Unité 1152, Université de Paris, Paris, France.,Laboratoire de Génétique, Hôpital Bichat, APHP, Paris, France
| | - Marie Pierre Debray
- INSERM, Unité 1152, Université de Paris, Paris, France.,Service de Radiologie, Hôpital Bichat, APHP, Paris, France
| | | | - Ibrahima Ba
- Laboratoire de Génétique, Hôpital Bichat, APHP, Paris, France
| | - Margherita Vieri
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Anne Gondouin
- Service de Pneumologie, CHU de Besançon, Besancon, France
| | | | | | | | | | | | - Philippe Dieudé
- INSERM, Unité 1152, Université de Paris, Paris, France.,Service de Rhumatologie, Hôpital Bichat, APHP, Paris, France
| | - Cécile Fourrage
- Service de Génétique Hôpital Necker Enfants Malades, APHP, Paris, France.,Plateforme de Bio-informatique, Institut Imagine, Université de Paris, Paris, France
| | - Elodie Lainey
- Laboratoire d'Hématologie Hôpital Robert Debré, APHP, Paris, France
| | - Effrosyne Manali
- 2nd Pulmonary department, Attikon University Hospital, Athens, Greece
| | - Spyros Papiris
- 2nd Pulmonary department, Attikon University Hospital, Athens, Greece
| | | | | | - Hervé Mal
- INSERM, Unité 1152, Université de Paris, Paris, France.,Service de Pneumologie B, Hôpital Bichat, APHP, Paris, France
| | - Hilario Nunes
- Service de Pneumologie, Hôpital Avicenne, APHP, Bobigny, France
| | - Frédéric Schlemmer
- Unité de Pneumologie, Université Paris-Est Créteil, APHP, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | | | - Fabian Beier
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Vincent Cottin
- Coordonnateur OrphaLung, Centre coordonnateur national de référence des maladies pulmonaires rares, Service de Pneumologie, Hôpital Louis Pradel, Université de Lyon, INRAE, member of Radico-ILD, Lyon, France.,RespiFil, ERN-LUNG, Lyon, France
| | - Bruno Crestani
- Service de Pneumologie A, Hôpital Bichat, APHP, Paris, France.,INSERM, Unité 1152, Université de Paris, Paris, France
| | - Raphaël Borie
- Service de Pneumologie A, Hôpital Bichat, APHP, Paris, France.,INSERM, Unité 1152, Université de Paris, Paris, France
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Mariette X, Hermine O, Tharaux PL, Resche-Rigon M, Porcher R, Ravaud P, Bureau S, Dougados M, Tibi A, Azoulay E, Cadranel J, Emmerich J, Fartoukh M, Guidet B, Humbert M, Lacombe K, Mahevas M, Pene F, Pourchet-Martinez V, Schlemmer F, Yazdanpanah Y, Baron G, Perrodeau E, Vanhoye D, Kedzia C, Demerville L, Gysembergh-Houal A, Bourgoin A, Dalibey S, Raked N, Mameri L, Alary S, Hamiria S, Bariz T, Semri H, Hai DM, Benafla M, Belloul M, Vauboin P, Flamand S, Pacheco C, Walter-Petrich A, Stan E, Benarab S, Nyanou C, Montlahuc C, Biard L, Charreteur R, Dupré C, Cardet K, Lehmann B, Baghli K, Madelaine C, D'Ortenzio E, Puéchal O, Semaille C, Savale L, Harrois A, Figueiredo S, Duranteau J, Anguel N, Pavot A, Monnet X, Richard C, Teboul JL, Durand P, Tissieres P, Jevnikar M, Montani D, Bulifon S, Jaïs X, Sitbon O, Pavy S, Noel N, Lambotte O, Escaut L, Jauréguiberry S, Baudry E, Verny C, Noaillon M, Lefèvre E, Zaidan M, Le Tiec CLT, Verstuyft C, Roques AM, Grimaldi L, Molinari D, Leprun G, Fourreau A, Cylly L, Virlouvet M, Meftali R, Fabre S, Licois M, Mamoune A, Boudali Y, Georgin-Lavialle S, Senet P, Pialoux G, Soria A, Parrot A, François H, Rozensztajn N, Blin E, Choinier P, Camuset J, Rech JS, Canellas A, Rolland-Debord C, Lemarié N, Belaube N, Nadal M, Siguier M, Petit-Hoang C, Chas J, Drouet E, Lemoine M, Phibel A, Aunay L, Bertrand E, Ravato S, Vayssettes M, Adda A, Wilpotte C, Thibaut P, Fillon J, Debrix I, Fellahi S, Bastard JP, Lefèvre G, Fallet V, Gottenberg JE, Hansmann Y, Andres E, Bayer S, Becker G, Blanc F, Brin S, Castelain V, Chatelus E, Chatron E, Collange O, Danion F, De Blay F, Demonsant E, Diemunsch P, Diemunsch S, Felten R, Goichot B, Greigert V, Guffroy A, Heger B, Hutt A, Kaeuffer C, Kassegne L, Korganow AS, Le Borgne P, Lefebvre N, Martin T, Mertes PM, Metzger C, Meyer N, Nisand G, Noll E, Oberlin M, Ohlmann-Caillard S, Poindron V, Pottecher J, Ruch Y, Sublon C, Tayebi H, Weill F, Mekinian A, Abisror N, Jachiet V, Chopin D, Fain O, Garnier M, Krause le Garrec J, Morgand M, Pacanowski J, Urbina T, McAvoy C, Pereira M, Aratus G, Berard L, Simon T, Daguenel-Nguyen A, Antignac M, Leplay C, Arlet JB, Diehl JL, Bellenfant F, Blanchard A, Buffet A, Cholley B, Fayol A, Flamarion E, Godier A, Gorget T, Hamada SR, Hauw-Berlemont C, Hulot JS, Lebeaux D, Livrozet M, Michon A, Neuschwander A, Penet MA, Planquette B, Ranque B, Sanchez O, Volle G, Briois S, Cornic M, Elisee V, Jesuthasan D, Djadi-Prat J, Jouany P, Junquera R, Henriques M, Kebir A, Lehir I, Meunier J, Patin F, Paquet V, Tréhan A, Vigna V, Sabatier B, Bergerot D, Jouve C, Knosp C, Lenoir O, Mahtal N, Resmini L, Lescure FX, Ghosn J, BACHELARD A, BIRONNE T, BORIE R, BOUNHIOL A, BOUSSARD C, CHAUFFiER J, CHALAL S, CHALAL L, CHANSOMBAT M, CRESPIN P, CRESTANI B, DACONCEICAO O, DECONINCK L, DIEUDE P, DOSSIER A, DUBERT M, DUCROCQ G, FUENTES A, GERVAIS A, GILBERT M, ISERNIA V, ISMAEL S, JOLY V, JULIA Z, LARIVEN S, LE GAC S, LE PLUART D, LOUNI F, NDIAYE A, PAPO T, PARISEY M, PHUNG B, POURBAIX A, RACHLINE A, RIOUX C, SAUTEREAU A, STEG G, TARHINI H, VALAYER S, VALLOIS D, VERMES P, VOLPE T, Nguyen Y, Honsel V, Weiss E, Codorniu A, Zarrouk V, De Lastours V, Uzzan M, Olivier O, Rossi G, Gamany N, Rahli R, Louis Z, Boutboul D, Galicier L, Amara Y, Archer G, Benattia A, Bergeron A, Bondeelle L, De Castro N, Clément M, Darmont M, Denis B, Dupin C, Feredj E, Feyeux D, Joseph A, Lengliné E, Le Guen P, Liégeon G, Lorillon G, Mabrouki A, Mariotte E, Martin de Frémont G, Mirouse A, Molina JM, Peffault de Latour R, Oksenhendler E, Saussereau J, Tazi A, Tudesq JJ, Zafrani L, Brindele I, Bugnet E, Celli Lebras K, Chabert J, Djaghout L, Fauvaux C, Jegu AL, Kozaliewicz E, Meunier M, Tremorin MT, Davoine C, Madeleine I, Caillat-Zucman S, Delaugerre C, Morin F, SENE D, BURLACU R, CHOUSTERMAN B, MEGARBANE B, RICHETTE P, RIVELINE JP, FRAZIER A, VICAUT E, BERTON L, HADJAM T, VASQUEZ-IBARRA MA, JOURDAINE C, JACOB A, SMATI J, RENAUD S, MANIVET P, PERNIN C, SUAREZ L, Semerano L, ABAD S, Benainous R, Bloch Queyrat C, Bonnet N, Brahmi S, Cailhol J, Cohen Y, Comparon C, Cordel H, Dhote R, Dournon N, Duchemann B, Ebstein N, Giroux-Leprieur B, Goupil de Bouille J, Jacolot A, Nunes H, Oziel J, Rathouin V, Rigal M, Roulot D, Tantet C, Uzunhan Y, COSTEDOAT-CHALUMEAU N, Ait Hamou Z, Benghanem S, BLANCHE P, CANOUI E, CARLIER N, CHAIGNE B, CONTEJEAN A, DUNOGUE B, DUPLAND P, DUREL - MAURISSE A, GAUZIT R, JAUBERT P, Joumaa H, Jozwiak M, KERNEIS S, LACHATRE M, Lafoeste H, LEGENDRE P, LUONG NGUYEN LB, MAREY J, MORBIEU C, MOUTHON L, NGUYEN L, Palmieri LJ, REGENT A, SZWEBEL TA, TERRIER B, GUERIN C, ZERBIT J, CHEREF K, CHITOUR K, CISSE MS, CLARKE A, CLAVERE G, DUSANTER I, GAUDEFROY C, JALLOULI M, KOLTA S, LE BOURLOUT C, MARIN N, MENAGE N, MOORES A, PEIGNEY I, PIERRON C, SALEH-MGHIR S, VALLET M, MICHEL M, MELICA G, LELIEVRE JD, FOIS E, LIM P, MATIGNON M, GUILLAUD C, THIEMELE A, SCHMITZ D, BOUHRIS M, BELAZOUZ S, LANGUILLE L, MEKONTSO-DESSAPS A, SADAOUI T, Mayaux J, Cacoub P, Corvol JC, Louapre C, Sambin S, Mariani LL, Karachi C, Tubach F, Estellat C, Gimeno L, Martin K, Bah A, Keo V, Ouamri S, Messaoudi Y, Yelles N, Faye P, Cavelot S, Larcheveque C, Annonay L, Benhida J, Zahrate-Ghoul A, Hammal S, Belilita R, Lecronier M, Beurton A, Haudebourg L, Deleris R, Le Marec J, Virolle S, Nemlaghi S, Bureau C, Mora P, De Sarcus M, Clovet O, Duceau B, Grisot PH, Pari MH, Arzoine J, Clarac U, Faure M, Delemazure J, Decavele M, Morawiec E, Demoule A, Dres M, Vautier M, Allenbach Y, Benveniste O, Leroux G, Rigolet A, Guillaume-Jugnot P, Domont F, Desbois AC, Comarmond C, Champtiaux N, Toquet S, Ghembaza A, Vieira M, Maalouf G, Boleto G, Ferfar Y, Charbonnier F, AGUILAR C, ALBY-LAURENT F, ALYANAKIAN MA, BAKOUBOULA P, BROISSAND C, BURGER C, CAMPOS-VEGA C, CHAVAROT N, CHOUPEAUX L, FOURNIER B, GRANVILLE S, ISSORAT E, ROUZAUD C, VIMPERE D, Geri G, Derridj N, Sguiouar N, Meddah H, Djadel M, Chambrin-Lauvray H, Duclos-Vallée JC, Saliba F, Sacleux SC, Koumis I, Michot JM, Stoclin A, Colomba E, Pommeret F, Willekens C, Sakkal M, Da Silva R, Dejean V, Mekid Y, Ben-Mabrouk I, Pradon C, Drouard L, Camara-Clayette V, Morel A, Garcia G, Mohebbi A, Berbour F, Dehais M, Pouliquen AL, Klasen A, Soyez-Herkert L, London J, Keroumi Y, Guillot E, Grailles G, El Amine Y, Defrancq F, Fodil H, Bouras C, Dautel D, Gambier N, Dieye T, Razurel A, Bienvenu B, Lancon V, Lecomte L, Beziriganyan K, Asselate B, Allanic L, Kiouris E, Legros MH, Lemagner C, Martel P, Provitolo V, Ackermann F, Le Marchand M, Clan Hew Wai A, Fremont D, Coupez E, Adda M, Duée F, Bernard L, Gros A, Henry E, Courtin C, Pattyn A, Guinot PG, Bardou M, Maurer A, Jambon J, Cransac A, Pernot C, Mourvillier B, Servettaz A, Deslée G, Wynckel A, Benoit P, Marquis E, Roux D, Gernez C, Yelnik C, Poissy J, Nizard M, Denies F, Gros H, Mourad JJ, Sacco E, Renet S. Sarilumab in adults hospitalised with moderate-to-severe COVID-19 pneumonia (CORIMUNO-SARI-1): An open-label randomised controlled trial. The Lancet Rheumatology 2022; 4:e24-e32. [PMID: 34812424 PMCID: PMC8598187 DOI: 10.1016/s2665-9913(21)00315-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Patients with COVID-19 pneumonia can have increased inflammation and elevated cytokines, including interleukin (IL)-6, which might be deleterious. Thus, sarilumab, a high-affinity anti-IL-6 receptor antibody, might improve the outcome of patients with moderate-to-severe COVID-19 pneumonia. Methods We did a multicentric, open-label, Bayesian randomised, adaptive, phase 2/3 clinical trial, nested within the CORIMUNO-19 cohort, to test a superiority hypothesis. Patients 18 years or older hospitalised with COVID-19 in six French centres, requiring at least 3L/min of oxygen but without ventilation assistance and a WHO Clinical Progression Scale [CPS] score of 5 were enrolled. Patients were randomly assigned (1:1) via a web-based system, according to a randomisation list stratified on centre and with blocks randomly selected among 2 and 4, to receive usual care plus 400 mg of sarilumab intravenously on day 1 and on day 3 if clinically indicated (sarilumab group) or usual care alone (usual care group). Primary outcomes were the proportion of patients with WHO-CPS scores greater than 5 on the 10-point scale on day 4 and survival without invasive or non-invasive ventilation at day 14. This completed trial is closed to new participants and is registered with ClinicalTrials.gov, NCT04324073. Findings 165 patients were recruited from March 27 to April 6, 2020, and 148 patients were randomised (68 patients to the sarilumab group and 80 to the usual care group) and followed up for 90 days. Median age was 61·7 years [IQR 53·0–71·1] in the sarilumab group and 62·8 years [56·0–71·7] in the usual care group. In the sarilumab group 49 (72%) of 68 were men and in the usual care group 59 (78%) of 76 were men. Four patients in the usual care group withdrew consent and were not analysed. 18 (26%) of 68 patients in the sarilumab group had a WHO-CPS score greater than 5 at day 4 versus 20 (26%) of 76 in the usual care group (median posterior absolute risk difference 0·2%; 90% credible interval [CrI] −11·7 to 12·2), with a posterior probability of absolute risk difference greater than 0 of 48·9%. At day 14, 25 (37%) patients in the sarilumab and 26 (34%) patients in the usual care group needed ventilation or died, (median posterior hazard ratio [HR] 1·10; 90% CrI 0·69–1·74) with a posterior probability HR greater than 1 of 37·4%. Serious adverse events occurred in 27 (40%) patients in the sarilumab group and 28 (37%) patients in the usual care group (p=0·73). Interpretation Sarilumab treatment did not improve early outcomes in patients with moderate-to-severe COVID-19 pneumonia. Further studies are warranted to evaluate the effect of sarilumab on long-term survival. Funding Assistance publique—Hôpitaux de Paris
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Epaud S, Epaud R, Salaün-Penquer N, Belozertseva E, Remus N, Douvry B, Bequignon E, Coste A, Prulière-Escabasse V, Schlemmer F, Jung C, Ortala M, Maitre B, Delestrain C. Impact of a rare respiratory diseases reference centre set-up on primary ciliary dyskinesia care pathway. Eur Respir J 2021; 59:13993003.02413-2021. [PMID: 34711540 DOI: 10.1183/13993003.02413-2021] [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: 09/04/2021] [Accepted: 10/14/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Salome Epaud
- Kaduceo SAS, Toulouse, France.,equal contributors
| | - Ralph Epaud
- Centre Hospitalier Intercommunal de Créteil, Service de Pédiatrie Générale, Créteil, , France .,University Paris Est Créteil, INSERM, IMRB, Créteil, France.,Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,FHU SENEC, Créteil, France.,equal contributors
| | | | - Ekaterina Belozertseva
- Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,Clinical Research Centre, Intercommunal Hospital of Créteil, Créteil, France
| | - Natascha Remus
- Centre Hospitalier Intercommunal de Créteil, Service de Pédiatrie Générale, Créteil, , France.,Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France
| | - Benoit Douvry
- Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, Créteil, , France
| | - Emilie Bequignon
- Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,Centre Hospitalier Intercommunal de Créteil, Service d'ORL, Créteil, , France
| | - Andre Coste
- University Paris Est Créteil, INSERM, IMRB, Créteil, France.,Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,Centre Hospitalier Intercommunal de Créteil, Service d'ORL, Créteil, , France
| | - Virginie Prulière-Escabasse
- University Paris Est Créteil, INSERM, IMRB, Créteil, France.,Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, Créteil, , France
| | - Frédéric Schlemmer
- University Paris Est Créteil, INSERM, IMRB, Créteil, France.,Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,FHU SENEC, Créteil, France.,Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, Créteil, , France
| | - Camille Jung
- Clinical Research Centre, Intercommunal Hospital of Créteil, Créteil, France
| | | | - Bernard Maitre
- University Paris Est Créteil, INSERM, IMRB, Créteil, France.,Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,FHU SENEC, Créteil, France.,Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, Créteil, , France.,equal contributors
| | - Céline Delestrain
- Centre Hospitalier Intercommunal de Créteil, Service de Pédiatrie Générale, Créteil, , France .,University Paris Est Créteil, INSERM, IMRB, Créteil, France.,Centre des Maladies Respiratoires Rares (RESPIRARE®), Créteil, France.,FHU SENEC, Créteil, France
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Schlemmer F, Murris-Espin M, Douvry B, Bergeron A, Burgel PR, Andrejak C, Maitre B. Management of early infection with Pseudomonas aeruginosa in adults with bronchiectasis: A survey of French pulmonologist's practices. Respir Med Res 2021; 80:100859. [PMID: 34563790 DOI: 10.1016/j.resmer.2021.100859] [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] [Received: 06/03/2021] [Revised: 08/23/2021] [Accepted: 08/31/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Frédéric Schlemmer
- Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil F-94010 France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Unité de Pneumologie, Créteil F-94010 France.
| | - Marlene Murris-Espin
- Service de Pneumologie, Pôle des Voies Respiratoires, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Benoit Douvry
- Hôpital Intercommunal de Créteil, Service de Pneumologie, Créteil F-94000 France
| | - Anne Bergeron
- Université de Paris, Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie, Hôpital Saint-Louis, Paris, France
| | - Pierre-Régis Burgel
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de Pneumologie, France; Université de Paris, Institut Cochin, Inserm U1016, Paris, France
| | - Claire Andrejak
- Service de pneumologie, CHU Amiens-Picardie, Université Picardie Jules-Verne, 80054 Amiens, France
| | - Bernard Maitre
- Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil F-94010 France; Hôpital Intercommunal de Créteil, Service de Pneumologie, Créteil F-94000 France
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Schlemmer F. [Not Available]. Rev Malad Respir Actual 2021; 13:1S61-1S62. [PMID: 34188722 PMCID: PMC8227340 DOI: 10.1016/s1877-1203(21)00058-6] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- F. Schlemmer
- Unité de Pneumologie, Hôpitaux Universitaires Henri Mondor, Assistance Publique – Hôpitaux de Paris, Créteil, France
- Groupe pour la Recherche et l’Enseignement en Pneumo-Infectiologie (GREPI), Société de Pneumologie de Langue Française, France
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12
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Schlemmer F, Zysman M, Ribeiro Baptista B, Audureau E, Covali Noroc A, Ridoux A, Derumeaux G, Adnot S, Maitre B, le Corvoisier P, Lanone S, Boczkowski J, Boyer L. Beclin-1 increases with obstructive sleep apnea severity. Sleep Med 2021; 81:474-476. [PMID: 33872948 DOI: 10.1016/j.sleep.2021.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/16/2021] [Accepted: 03/10/2021] [Indexed: 01/04/2023]
Abstract
Obstructive sleep apnea is a common chronic disorder that leads to chronic intermittent hypoxia described as an important factor contributing to the pathogenesis of OSA-related comorbidities. Besides, recent data suggest that intermittent hypoxia can induce adaptative cardiovascular pathways inducing a relative resistance to ischemic insults. Adaptative pathways induced by hypoxia could implicate autophagic processes and Beclin-1, one of the first mammalian autophagy effectors. Thus, activation of autophagy could protect against cardiovascular events in patients with OSA and could be considered as biomarker of a better prognosis.
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Affiliation(s)
- Frédéric Schlemmer
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France; AP-HP, Hôpital Henri Mondor, Unité de Pneumologie, F-94010, Créteil, France
| | - Maéva Zysman
- Univ-Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, INSERM U1045, Team 2, F-33604, Pessac, France; CHU de Bordeaux, Département de Pneumologie, F-33604, Pessac, France
| | - Bruno Ribeiro Baptista
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France; CHU de Nancy, Département de Pneumologie, F-54500, Vandoeuvre-lès-Nancy, France
| | - Etienne Audureau
- AP-HP, Hôpital Henri Mondor, Département de Santé Publique, Unité de Recherche Clinique (URC-Mondor), IMRB EA7376, Clinical Epidemiology and Aging (CEpiA), F-94010, Créteil, France
| | - Ala Covali Noroc
- AP-HP, Hôpital Henri Mondor, Département de Physiologie-Explorations Fonctionnelles, F-94010, Créteil, France
| | - Audrey Ridoux
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France
| | - Geneviève Derumeaux
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France; AP-HP, Hôpital Henri Mondor, Département de Physiologie-Explorations Fonctionnelles, F-94010, Créteil, France
| | - Serge Adnot
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France; AP-HP, Hôpital Henri Mondor, Département de Physiologie-Explorations Fonctionnelles, F-94010, Créteil, France
| | - Bernard Maitre
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France; Centre Hospitalier Intercommunal, Département de Pneumologie et Pathologie Professionnelle, Créteil, France
| | - Philippe le Corvoisier
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France; AP-HP, Hôpital Henri Mondor, Unité de Pneumologie, F-94010, Créteil, France; Univ-Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, INSERM U1045, Team 2, F-33604, Pessac, France; CHU de Bordeaux, Département de Pneumologie, F-33604, Pessac, France; CHU de Nancy, Département de Pneumologie, F-54500, Vandoeuvre-lès-Nancy, France; AP-HP, Hôpital Henri Mondor, Département de Santé Publique, Unité de Recherche Clinique (URC-Mondor), IMRB EA7376, Clinical Epidemiology and Aging (CEpiA), F-94010, Créteil, France; AP-HP, Hôpital Henri Mondor, Département de Physiologie-Explorations Fonctionnelles, F-94010, Créteil, France; Centre Hospitalier Intercommunal, Département de Pneumologie et Pathologie Professionnelle, Créteil, France; Department VERDI, Inserm, CIC1430, AP-HP, Henri Mondor Hospital, F-94000, Creteil, France
| | - Sophie Lanone
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France
| | - Jorge Boczkowski
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France
| | - Laurent Boyer
- Univ Paris Est Créteil, INSERM, IMRB, FHU Senec, F-94010, Créteil, France; AP-HP, Hôpital Henri Mondor, Département de Physiologie-Explorations Fonctionnelles, F-94010, Créteil, France.
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Carteaux G, Pons M, Morin F, Tuffet S, Lesimple A, Badat B, Haudebourg AF, Perier F, Deplante Y, Guillaud C, Schlemmer F, Fois E, Mongardon N, Khellaf M, Jaffal K, Deguillard C, Grimbert P, Huguet R, Razazi K, de Prost N, Templier F, Beloncle F, Mercat A, Brochard L, Audard V, Lim P, Richard JC, Savary D, Mekontso Dessap A. Continuous positive airway pressure for respiratory support during COVID-19 pandemic: a frugal approach from bench to bedside. Ann Intensive Care 2021; 11:38. [PMID: 33655452 PMCID: PMC7924341 DOI: 10.1186/s13613-021-00828-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/07/2020] [Accepted: 02/18/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND We describe a frugal approach (focusing on needs, performance, and costs) to manage a massive influx of COVID-19 patients with acute hypoxemic respiratory failure (AHRF) using the Boussignac valve protected by a filter ("Filter Frugal CPAP", FF-CPAP) in and out the ICU. METHODS (1) A bench study measured the impact of two filters with different mechanical properties on CPAP performances, and pressures were also measured in patients. (2) Non-ICU healthcare staff working in COVID-19 intermediate care units were trained with a video tutorial posted on a massive open online course. (3) A clinical study assessed the feasibility and safety of using FF-CPAP to maintain oxygenation and manage patients out of the ICU during a massive outbreak. RESULTS Bench assessments showed that adding a filter did not affect the effective pressure delivered to the patient. The resistive load induced by the filter variably increased the simulated patient's work of breathing (6-34%) needed to sustain the tidal volume, depending on the filter's resistance, respiratory mechanics and basal inspiratory effort. In patients, FF-CPAP achieved pressures similar to those obtained on the bench. The massive training tool provided precious information on the use of Boussignac FF-CPAP on COVID-19 patients. Then 85 COVID-19 patients with ICU admission criteria over a 1-month period were studied upon FF-CPAP initiation for AHRF. FF-CPAP significantly decreased respiratory rate and increased SpO2. Thirty-six (43%) patients presented with respiratory indications for intubation prior to FF-CPAP initiation, and 13 (36%) of them improved without intubation. Overall, 31 patients (36%) improved with FF-CPAP alone and 17 patients (20%) did not require ICU admission. Patients with a respiratory rate > 32 breaths/min upon FF-CPAP initiation had a higher cumulative probability of intubation (p < 0.001 by log-rank test). CONCLUSION Adding a filter to the Boussignac valve does not affect the delivered pressure but may variably increase the resistive load depending on the filter used. Clinical assessment suggests that FF-CPAP is a frugal solution to provide a ventilatory support and improve oxygenation to numerous patients suffering from AHRF in the context of a massive outbreak.
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Affiliation(s)
- Guillaume Carteaux
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor-Albert Chenevier, Service de Médecine Intensive Réanimation, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France. .,Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France. .,INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France.
| | - Manuella Pons
- Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France.,Médecine Intensive Réanimation, CHU Grenoble Alpes, Grenoble, France
| | - François Morin
- Département de Médecine d'Urgence, Faculté de Santé, Centre Hospitalier Universitaire d'Angers, Université d'Angers, Angers, France
| | - Samuel Tuffet
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor-Albert Chenevier, Service de Médecine Intensive Réanimation, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France
| | - Arnaud Lesimple
- CNRS, INSERM 1083, MITOVASC, Université d'Angers, Angers, France.,Laboratoire Med2Lab ALMS, Antony, France
| | | | - Anne-Fleur Haudebourg
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor-Albert Chenevier, Service de Médecine Intensive Réanimation, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France
| | - François Perier
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor-Albert Chenevier, Service de Médecine Intensive Réanimation, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France
| | - Yvon Deplante
- Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France
| | - Constance Guillaud
- Département d'Aval des Urgences, Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, 94010, Créteil, France
| | - Frédéric Schlemmer
- INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France.,Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, Unité de Pneumologie, 94010, Créteil, France
| | - Elena Fois
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, Unité des Maladies Génétiques du Globule Rouge, 94010, Créteil, France
| | - Nicolas Mongardon
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, Service d'Anesthésie-Réanimation Chirurgicale, 94010, Créteil, France
| | - Mehdi Khellaf
- Emergency Department, Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, 94010, Créteil, France
| | - Karim Jaffal
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, Service d'immunologie Clinique Et Maladies Infectieuses, 94010, Créteil, France
| | - Camille Deguillard
- Department of Cardiovascular Medicine, Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, 94010, Créteil, France
| | - Philippe Grimbert
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », 94010, Créteil, France
| | - Raphaëlle Huguet
- Department of Cardiovascular Medicine, Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, 94010, Créteil, France
| | - Keyvan Razazi
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor-Albert Chenevier, Service de Médecine Intensive Réanimation, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France
| | - Nicolas de Prost
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor-Albert Chenevier, Service de Médecine Intensive Réanimation, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France
| | - François Templier
- Département de Médecine d'Urgence, Faculté de Santé, Centre Hospitalier Universitaire d'Angers, Université d'Angers, Angers, France
| | - François Beloncle
- CNRS, INSERM 1083, MITOVASC, Université d'Angers, Angers, France.,Département de Médecine Intensive-Réanimation et Médecine Hyperbare, Faculté de Santé, Centre Hospitalier Universitaire d'Angers, Vent' Lab, Université d'Angers, Angers, France
| | - Alain Mercat
- CNRS, INSERM 1083, MITOVASC, Université d'Angers, Angers, France.,Département de Médecine Intensive-Réanimation et Médecine Hyperbare, Faculté de Santé, Centre Hospitalier Universitaire d'Angers, Vent' Lab, Université d'Angers, Angers, France
| | - Laurent Brochard
- Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Vincent Audard
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », 94010, Créteil, France.,Université Paris Est-Créteil, INSERM, IMRB, Equipe 21, 94010, Créteil, France
| | - Pascal Lim
- INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France.,Department of Cardiovascular Medicine, Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, 94010, Créteil, France
| | - Jean-Christophe Richard
- Département de Médecine Intensive-Réanimation et Médecine Hyperbare, Faculté de Santé, Centre Hospitalier Universitaire d'Angers, Vent' Lab, Université d'Angers, Angers, France.,INSERM, UMR 1066, Créteil, France
| | - Dominique Savary
- Département de Médecine d'Urgence, Faculté de Santé, Centre Hospitalier Universitaire d'Angers, Université d'Angers, Angers, France.,IRSET (Institut de Recherche en Santé, environnement et travail)-UMR_S 1085, 49000, Angers, France
| | - Armand Mekontso Dessap
- Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor-Albert Chenevier, Service de Médecine Intensive Réanimation, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, 94010, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France
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Casco N, Jorge AL, Palmero D, Alffenaar JW, Fox G, Ezz W, Cho JG, Skrahina A, Solodovnikova V, Bachez P, Arbex MA, Galvão T, Rabahi M, Pereira GR, Sales R, Silva DR, Saffie MM, Miranda RC, Cancino V, Carbonell M, Cisterna C, Concha C, Cruz A, Salinas NE, Revillot ME, Farias J, Fernandez I, Flores X, Gallegos P, Garavagno A, Guajardo C, Bahamondes MH, Merino LM, Muñoz E, Muñoz C, Navarro I, Navarro J, Ortega C, Palma S, Pardenas AM, Pereira G, Castillo PP, Pinto M, Pizarro R, Rivas F, Rodriguez P, Sánchez C, Serrano A, Soto A, Taiba C, Venegas M, Vergara MS, Vilca E, Villalon C, Yucra E, Li Y, Cruz A, Guelvez B, Plaza R, Tello K, Andréjak C, Blanc FX, Dourmane S, Froissart A, Izadifar A, Rivière F, Schlemmer F, Gupta N, Ish P, Mishra G, Sharma S, Singla R, Udwadia ZF, Manika K, Diallo BD, Hassane-Harouna S, Artiles N, Mejia LA, Alladio F, Calcagno A, Centis R, Codecasa LR, D Ambrosio L, Formenti B, Gaviraghi A, Giacomet V, Goletti D, Gualano G, Kuksa L, Danila E, Diktanas S, Miliauskas S, Ridaura RL, López F, Torrico MM, Rendon A, Akkerman OW, Piubello A, Souleymane MB, Aizpurua E, Gonzales R, Jurado J, Loban A, Aguirre S, de Egea V, Irala S, Medina A, Sequera G, Sosa N, Vázquez F, Manga S, Villanueva R, Araujo D, Duarte R, Marques TS, Grecu VI, Socaci A, Barkanova O, Bogorodskaya M, Borisov S, Mariandyshev A, Kaluzhenina A, Stosic M, Beh D, Ng D, Ong C, Solovic I, Dheda D, Gina P, Caminero JA, Cardoso-Landivar J, de Souza Galvão ML, Dominguez-Castellano A, García-García JM, Pinargote IM, Fernandez SQ, Sánchez-Montalvá A, Huguet ET, Murguiondo MZ, Bruchfeld J, Bart PA, Mazza-Stalder J, Tiberi S, Arrieta F, Heysell S, Logsdon J, Young L. TB and COVID-19 co-infection: rationale and aims of a global study. Int J Tuberc Lung Dis 2021; 25:78-80. [PMID: 33384052 DOI: 10.5588/ijtld.20.0786] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | | | | | | | - G Fox
- New South Wales, Australia
| | - W Ezz
- New South Wales, Australia
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15
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Bendib I, Beldi-Ferchiou A, Schlemmer F, Surenaud M, Maitre B, Plonquet A, Carteaux G, Razazi K, Godot V, Hüe S, Mekontso Dessap A, de Prost N. Alveolar compartmentalization of inflammatory and immune cell biomarkers in pneumonia-related ARDS. Crit Care 2021; 25:23. [PMID: 33422148 PMCID: PMC7794625 DOI: 10.1186/s13054-020-03427-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/07/2020] [Indexed: 12/23/2022]
Abstract
Background Biomarkers of disease severity might help individualizing the management of patients with the acute respiratory distress syndrome (ARDS). Whether the alveolar compartmentalization of biomarkers has a clinical significance in patients with pneumonia-related ARDS is unknown. This study aimed at assessing the interrelation of ARDS/sepsis biomarkers in the alveolar and blood compartments and explored their association with clinical outcomes. Methods Immunocompetent patients with pneumonia-related ARDS admitted between 2014 and 2018 were included in a prospective monocentric study. Bronchoalveolar lavage (BAL) fluid and blood samples were obtained within 48 h of admission. Twenty-two biomarkers were quantified in BAL fluid and serum. HLA-DR+ monocytes and CD8+ PD-1+ lymphocytes were quantified using flow cytometry. The primary clinical endpoint of the study was hospital mortality. Patients undergoing a bronchoscopy as part of routine care were included as controls. Results Seventy ARDS patients were included. Hospital mortality was 21.4%. The BAL fluid-to-serum ratio of IL-8 was 20 times higher in ARDS patients than in controls (p < 0.0001). ARDS patients with shock had lower BAL fluid-to-serum ratio of IL-1Ra (p = 0.026), IL-6 (p = 0.002), IP-10/CXCL10 (p = 0.024) and IL-10 (p = 0.023) than others. The BAL fluid-to-serum ratio of IL-1Ra was more elevated in hospital survivors than decedents (p = 0.006), even after adjusting for SOFA and driving pressure (p = 0.036). There was no significant association between alveolar or alveolar/blood monocytic HLA-DR or CD8+ lymphocytes PD-1 expression and hospital mortality. Conclusions IL-8 was the most compartmentalized cytokine and lower BAL fluid-to-serum concentration ratios of IL-1Ra were associated with hospital mortality in patients with pneumonia-associated ARDS.
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Affiliation(s)
- Inès Bendib
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, 94010, Créteil Cedex, France.,INSERM U955, Equipe 16, 94 000, Créteil, France
| | - Asma Beldi-Ferchiou
- Université Paris Est Créteil, INSERM, IMRB, 94010, Créteil, France.,Département d'Hématologie et d'Immunologie biologiques, AP-HP, Groupe Hospitalo-Universitaire Chenevier Mondor, 94010, Créteil, France
| | - Frédéric Schlemmer
- Unité de Pneumologie, Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Cedex 94010, Créteil, France
| | - Mathieu Surenaud
- Université Paris Est Créteil, INSERM, IMRB, 94010, Créteil, France
| | - Bernard Maitre
- Unité de Pneumologie, Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Cedex 94010, Créteil, France
| | - Anne Plonquet
- Département d'Hématologie et d'Immunologie biologiques, AP-HP, Groupe Hospitalo-Universitaire Chenevier Mondor, 94010, Créteil, France
| | - Guillaume Carteaux
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, 94010, Créteil Cedex, France
| | - Keyvan Razazi
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, 94010, Créteil Cedex, France
| | - Veronique Godot
- INSERM U955, Equipe 16, 94 000, Créteil, France.,Vaccine Research Institute, 94 000, Créteil, France.,Faculté de Médecine, Université Paris Est, 94 000, Créteil, France
| | - Sophie Hüe
- Université Paris Est Créteil, INSERM, IMRB, 94010, Créteil, France.,Département d'Hématologie et d'Immunologie biologiques, AP-HP, Groupe Hospitalo-Universitaire Chenevier Mondor, 94010, Créteil, France
| | - Armand Mekontso Dessap
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, 94010, Créteil Cedex, France.,INSERM U955, 94 000, Créteil, France
| | - Nicolas de Prost
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France. .,Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, 94010, Créteil Cedex, France.
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16
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Lalevee S, Catano J, Oro S, Surenaud M, Schlemmer F, Bendib I, Mekontso-Dessap A, Hue S, De Prost N. Atteinte bronchopulmonaire sévère au cours de la nécrolyse épidermique (syndromes de Stevens–Johnson et nécrolyse épidermique toxique). Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Georges O, Risso K, Lemiale V, Schlemmer F. [The place of bronchoalveolar lavage in the diagnosis of pneumonia in the immunocompromised patient]. Rev Mal Respir 2020; 37:652-661. [PMID: 32888730 DOI: 10.1016/j.rmr.2020.06.016] [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: 02/16/2020] [Accepted: 06/05/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Bronchoalveolar lavage (BAL) was previously considered as the standard diagnostic procedure to investigate pneumonia occurring in immunocompromised patients, and it is probably still widely used. However, the development of new microbiological diagnostic tools, applicable to samples obtained non-invasively, leads to questioning of the predominant place of BAL in this situation. BACKGROUND The available studies agree on the acceptable tolerance of BAL performed in immunocompromised patients. Although imperfect, the diagnostic yield of BAL in immunocompromised patients is well established, but it may vary between studies depending on the underlying disease. However, it must also be compared to the yield of non-invasive microbiological tools, now widely available and effective. The position of BAL remains important both for the diagnosis of fungal infections (invasive aspergillosis, pneumocystis pneumonia) and non-infectious lung diseases both of which occur frequently in immunocompromised patients. CONCLUSION The place of BAL in the diagnostic work-up of pneumonia occurring in immunocompromised patients must be considered in the framework of a structured consideration, taking into account the diagnostic performance of non invasive microbiological tests and the broad spectrum of lung diseases occurring in this context.
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Affiliation(s)
- O Georges
- Service de Pneumologie et Réanimation Respiratoire, CHU de Amiens - Picardie, 80000 Amiens, France
| | - K Risso
- Service de Maladies Infectieuses et Tropicales, hôpital l'Archet, centre hospitalier universitaire de Nice, 06200 Nice, France
| | - V Lemiale
- Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), hôpital Saint-Louis, université Paris-Diderot, 75010 Paris, France
| | - F Schlemmer
- Unité de Pneumologie, Assistance Publique - Hôpitaux de Paris (AP-HP), hôpitaux universitaires Henri-Mondor, DHU A-TVB, université Paris-Est-Créteil, 94010 Créteil, France; Inserm U955-Institut Mondor de Recherche Biomédicale, université Paris-Est-Créteil, 94010 Créteil, France.
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De Luna G, Habibi A, Deux J, Colard M, Pham Hung d'Alexandry d'Orengiani A, Schlemmer F, Joher N, Kassasseya C, Pawlotsky JM, Ourghanlian C, Michel M, Mekontso‐Dessap A, Bartolucci P. Rapid and severe Covid-19 pneumonia with severe acute chest syndrome in a sickle cell patient successfully treated with tocilizumab. Am J Hematol 2020; 95:876-878. [PMID: 32282956 PMCID: PMC7262334 DOI: 10.1002/ajh.25833] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 02/02/2023]
Affiliation(s)
- Gonzalo De Luna
- Sickle Cell Referral Center, Department of Internal MedicineHenri‐Mondor University Hospital‐ UPEC, AP‐HP Créteil France
| | - Anoosha Habibi
- Sickle Cell Referral Center, Department of Internal MedicineHenri‐Mondor University Hospital‐ UPEC, AP‐HP Créteil France
| | | | - Martin Colard
- Sickle Cell Referral Center, Department of Internal MedicineHenri‐Mondor University Hospital‐ UPEC, AP‐HP Créteil France
| | | | - Frédéric Schlemmer
- Service de Pneumologie, DHU A‐TVB, APHP, CHU Henri Mondor Créteil France
| | - Nizar Joher
- Nephrology and Renal Transplantation DepartmentInstitut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri‐Mondor/Albert‐Chenevier Créteil France
| | | | - Jean Michel Pawlotsky
- National Reference Center for Viral Hepatitis B, C and D, Department of VirologyHôpital Henri Mondor, Université Paris‐Est Créteil France
| | | | - Marc Michel
- Department of Internal Medicine, National Referral Center for Adult Immune Cytopenias, Henri Mondor University Hospital, Assistance Publique Hôpitaux de ParisUniversité Paris‐Est Créteil Paris France
| | - Armand Mekontso‐Dessap
- Department of Intensive Care, Henri Mondor University HospitalAssistance Publique Hôpitaux de Paris, Université Paris‐Est Créteil Paris France
| | - Pablo Bartolucci
- Sickle Cell Referral Center, Department of Internal MedicineHenri‐Mondor University Hospital‐ UPEC, AP‐HP Créteil France
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Tadolini M, Codecasa LR, García-García JM, Blanc FX, Borisov S, Alffenaar JW, Andréjak C, Bachez P, Bart PA, Belilovski E, Cardoso-Landivar J, Centis R, D'Ambrosio L, Luiza De Souza-Galvão M, Dominguez-Castellano A, Dourmane S, Fréchet Jachym M, Froissart A, Giacomet V, Goletti D, Grard S, Gualano G, Izadifar A, Le Du D, Marín Royo M, Mazza-Stalder J, Motta I, Ong CWM, Palmieri F, Rivière F, Rodrigo T, Silva DR, Sánchez-Montalvá A, Saporiti M, Scarpellini P, Schlemmer F, Spanevello A, Sumarokova E, Tabernero E, Tambyah PA, Tiberi S, Torre A, Visca D, Zabaleta Murguiondo M, Sotgiu G, Migliori GB. Active tuberculosis, sequelae and COVID-19 co-infection: first cohort of 49 cases. Eur Respir J 2020; 56:2001398. [PMID: 32457198 PMCID: PMC7251245 DOI: 10.1183/13993003.01398-2020] [Citation(s) in RCA: 212] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/10/2020] [Indexed: 01/08/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) pandemic has attracted interest because of its global rapid spread, clinical severity, high mortality rate and capacity to overwhelm healthcare systems [1, 2]. SARS-CoV-2 transmission occurs mainly through droplets, although surface contamination contributes and debate continues on aerosol transmission [3–5]. Diagnostic, treatment and outcome details of 49 COVID-19 patients with concurrent or previous tuberculosis from 8 countries show varied clinical profiles https://bit.ly/369ZGGu
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Affiliation(s)
- Marina Tadolini
- Unit of Infectious Diseases, Dept of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Co-first authors
| | - Luigi Ruffo Codecasa
- TB Reference Centre, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
- Co-first authors
| | | | | | - Sergey Borisov
- Moscow Research and Clinical Center for TB Control, Moscow, Russian Federation
| | - Jan-Willem Alffenaar
- The University of Sydney, Sydney Pharmacy School, Sydney, Australia
- Westmead Hospital, Sydney, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Claire Andréjak
- Service de Pneumologie CHU AMIENS PICARDIE, France AND UR Université de Picardie Jules Verne, Amiens, France
| | - Pierre Bachez
- Service de Pneumologie, Clinique Saint Luc, Bouge, Belgium
| | | | - Evgeny Belilovski
- Moscow Research and Clinical Center for TB Control, Moscow, Russian Federation
| | | | - Rosella Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | | | | | | | - Samir Dourmane
- Service de Pneumologie, Groupe hospitalier sud île de France (GHSIF), Melun, France
| | | | | | - Vania Giacomet
- Pediatric Infectious Diseases Unit, Dept of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases 'L. Spallanzani', IRCCS, Rome, Italy
| | - Soazic Grard
- Centre de Lutte Antituberculeuse (CLAT 38), Grenoble, France
| | - Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', IRCCS, Rome, Italy
| | - Armine Izadifar
- Hôpital Européen de Paris La Roseraie, Aubervilliers, France
| | - Damien Le Du
- Centre Hospitalier de Bligny, Briis Sous Forges, France
| | - Margarita Marín Royo
- Servicio Neumología, Hospital General Universitario de Castellón, Castelló, Spain
| | - Jesica Mazza-Stalder
- Pulmonary Division, Lausanne University Hospital CHUV, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Ilaria Motta
- Dipartimento di Scienze Mediche, Clinica Universitaria Malattie Infettive, Ospedale Amedeo di Savoia, Torino, Italia
| | - Catherine Wei Min Ong
- Dept of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', IRCCS, Rome, Italy
| | | | - Teresa Rodrigo
- Tuberculosis Research Programme (PII-TB), SEPAR, Barcelona, Spain
| | - Denise Rossato Silva
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - Adrián Sánchez-Montalvá
- Infectious Diseases Dept, International Health and Tuberculosis Unit, Vall d'Hebron University Hospital, Barcelona, Spain
- Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
- Grupo de Estudio de Infecciones por Micobacterias (GEIM), Spanish Society of Infectious Diseases (SEIMC), Spain
| | - Matteo Saporiti
- TB Reference Centre, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
| | - Paolo Scarpellini
- Unit of Infectious Diseases, Università Vita e Salute, San Raffaele Hospital, Milan, Italy
| | | | - Antonio Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
- Dept of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Italy
| | - Elena Sumarokova
- Moscow Research and Clinical Center for TB Control, Moscow, Russian Federation
| | - Eva Tabernero
- Servicio Neumología, Hospital de Cruces, Bilbao, Spain
| | - Paul Anantharajah Tambyah
- Dept of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Simon Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Alessandro Torre
- Dept of Infectious Diseases, University of Milan, L. Sacco Hospital, Milan, Italy
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
- Dept of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Italy
| | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Battista Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
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Mahévas M, Tran VT, Roumier M, Chabrol A, Paule R, Guillaud C, Fois E, Lepeule R, Szwebel TA, Lescure FX, Schlemmer F, Matignon M, Khellaf M, Crickx E, Terrier B, Morbieu C, Legendre P, Dang J, Schoindre Y, Pawlotsky JM, Michel M, Perrodeau E, Carlier N, Roche N, de Lastours V, Ourghanlian C, Kerneis S, Ménager P, Mouthon L, Audureau E, Ravaud P, Godeau B, Gallien S, Costedoat-Chalumeau N. Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data. BMJ 2020; 369:m1844. [PMID: 32409486 PMCID: PMC7221472 DOI: 10.1136/bmj.m1844] [Citation(s) in RCA: 268] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To assess the effectiveness of hydroxychloroquine in patients admitted to hospital with coronavirus disease 2019 (covid-19) pneumonia who require oxygen. DESIGN Comparative observational study using data collected from routine care. SETTING Four French tertiary care centres providing care to patients with covid-19 pneumonia between 12 March and 31 March 2020. PARTICIPANTS 181 patients aged 18-80 years with documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who required oxygen but not intensive care. INTERVENTIONS Hydroxychloroquine at a dose of 600 mg/day within 48 hours of admission to hospital (treatment group) versus standard care without hydroxychloroquine (control group). MAIN OUTCOME MEASURES The primary outcome was survival without transfer to the intensive care unit at day 21. Secondary outcomes were overall survival, survival without acute respiratory distress syndrome, weaning from oxygen, and discharge from hospital to home or rehabilitation (all at day 21). Analyses were adjusted for confounding factors by inverse probability of treatment weighting. RESULTS In the main analysis, 84 patients who received hydroxychloroquine within 48 hours of admission to hospital (treatment group) were compared with 89 patients who did not receive hydroxychloroquine (control group). Eight additional patients received hydroxychloroquine more than 48 hours after admission. In the weighted analyses, the survival rate without transfer to the intensive care unit at day 21 was 76% in the treatment group and 75% in the control group (weighted hazard ratio 0.9, 95% confidence interval 0.4 to 2.1). Overall survival at day 21 was 89% in the treatment group and 91% in the control group (1.2, 0.4 to 3.3). Survival without acute respiratory distress syndrome at day 21 was 69% in the treatment group compared with 74% in the control group (1.3, 0.7 to 2.6). At day 21, 82% of patients in the treatment group had been weaned from oxygen compared with 76% in the control group (weighted risk ratio 1.1, 95% confidence interval 0.9 to 1.3). Eight patients in the treatment group (10%) experienced electrocardiographic modifications that required discontinuation of treatment. CONCLUSIONS Hydroxychloroquine has received worldwide attention as a potential treatment for covid-19 because of positive results from small studies. However, the results of this study do not support its use in patients admitted to hospital with covid-19 who require oxygen.
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Affiliation(s)
- Matthieu Mahévas
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Viet-Thi Tran
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Mathilde Roumier
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Amélie Chabrol
- Department of Infectious Diseases, Sud Francilien Hospital, Corbeil-Essonnes, France
| | - Romain Paule
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Constance Guillaud
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Elena Fois
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Raphael Lepeule
- Transversal Infections Treatment Unit, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Tali-Anne Szwebel
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | | | - Frédéric Schlemmer
- Pulmonology Unit, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Marie Matignon
- Department of Nephrology, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Mehdi Khellaf
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Etienne Crickx
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Benjamin Terrier
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Caroline Morbieu
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Paul Legendre
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Julien Dang
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Yoland Schoindre
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Jean-Michel Pawlotsky
- Department of Virology, Bacteriology-Hygiene, and Mycology-Parasitology Centre, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marc Michel
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Elodie Perrodeau
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Nicolas Carlier
- Department of Pulmonology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Nicolas Roche
- Department of Pulmonology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Victoire de Lastours
- Department of Internal Medicine, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Clément Ourghanlian
- Pharmacy, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Solen Kerneis
- Mobile Infectious Disease Team, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Philippe Ménager
- Pulmonology Unit, Sud Francilien Hospital, Corbeil-Essonnes, France
| | - Luc Mouthon
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Etienne Audureau
- Clinical Epidemiology and Aging Team, Mondor Institute for Biomedical Research (INSERM U955), Public Health Services, Henri-Mondor Hosptial, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Philippe Ravaud
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Bertrand Godeau
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Sébastien Gallien
- Department of Infectious Diseases, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Pari, Paris-Est Créteil University, Créteil, France
| | - Nathalie Costedoat-Chalumeau
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
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Schlemmer F, Gellen-Dautremer J, Carette MF, de Prost N, Spagnolo S, Deux JF, Fartoukh M, Naccache JM, Habibi A, Mahevas M, Bartolucci P, Mekontso Dessap A, Maitre B. Systemo-pulmonary shunting and acute chest syndrome in a patient with SC sickle-cell disease. Respir Med Res 2020; 77:21-23. [PMID: 32036282 DOI: 10.1016/j.resmer.2019.11.001] [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] [Received: 08/05/2019] [Revised: 11/10/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
Affiliation(s)
- F Schlemmer
- Pneumology, DHU A-TVB, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Université Paris Est Créteil, 94010 Créteil, France.
| | - J Gellen-Dautremer
- Unité des maladies génétiques du globule rouge, Sickle cell center, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - M F Carette
- Radiology, hôpital Tenon, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75970 Paris, France; Université Pierre et Marie Curie Paris, 75252 Paris, France
| | - N de Prost
- Université Paris Est Créteil, 94010 Créteil, France; Intensive Care Unit, DHU A-TVB, CHU Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - S Spagnolo
- Intensive Care Unit, DHU A-TVB, CHU Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - J F Deux
- Université Paris Est Créteil, 94010 Créteil, France; Radiology, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75970 Paris, France
| | - M Fartoukh
- Intensive Care Unit, hôpital Tenon, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75970 Paris, France; Université Pierre et Marie Curie Paris, 75252 Paris, France
| | - J M Naccache
- Université Pierre et Marie Curie Paris, 75252 Paris, France; Pneumology, hôpital Tenon, Assistance publique-hôpitaux de Paris, 4, rue de la Chine, 75970 Paris, France
| | - A Habibi
- Unité des maladies génétiques du globule rouge, Sickle cell center, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - M Mahevas
- Université Paris Est Créteil, 94010 Créteil, France; Centre de référence des cytopénies auto-immunes de l'adulte, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - P Bartolucci
- Université Paris Est Créteil, 94010 Créteil, France; Unité des maladies génétiques du globule rouge, Sickle cell center, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - A Mekontso Dessap
- Université Paris Est Créteil, 94010 Créteil, France; Intensive Care Unit, DHU A-TVB, CHU Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - B Maitre
- Pneumology, DHU A-TVB, CHU Henri Mondor, Assistance publique-hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Université Paris Est Créteil, 94010 Créteil, France
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22
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Dellière S, Angebault C, Fihman V, Foulet F, Lepeule R, Maitre B, Schlemmer F, Botterel F. Concomitant Presence of Aspergillus Species and Mycobacterium Species in the Respiratory Tract of Patients: Underestimated Co-occurrence? Front Microbiol 2020; 10:2980. [PMID: 31998267 PMCID: PMC6967598 DOI: 10.3389/fmicb.2019.02980] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/10/2019] [Indexed: 01/26/2023] Open
Abstract
Objectives Aspergillus and Mycobacterium are opportunistic pathogens that can cause severe pulmonary diseases. To date, the clinical significance of their concomitant isolation and potential interactions in the lung remains poorly understood. The aim of this study was to assess the prevalence of their concomitant isolation from respiratory samples, and to depict the related clinical and microbiological characteristics. Methods A retrospective monocentric study was conducted from January 2011 to December 2017, including all in-patients from whom positive cultures of Aspergillus and Mycobacterium were obtained on respiratory samples within a 3-month period. Clinical, radiological and laboratory data were analyzed. Patients were categorized by a clinical and microbiological committee as "infected" or "colonized" by both pathogens according to current guidelines. Results Overall, 140 patients had ≥1 respiratory samples positive for Mycobacterium and concomitantly sent for fungal culture, and 708 were positive for Aspergillus, concomitantly sent for mycobacterial culture. Only 50 had at least one positive culture for both Mycobacterium sp. and Aspergillus sp. Men represented 63% of patients, mean age was 61 years. A third of patients were immunocompromised and 92% had underlying lung diseases. Aspergillus was primarily found as a colonizing agent. Proportion of Mycobacterium Avium Complex (p = 0.02) was higher in patients co-carrying Aspergillus spp. Conclusion In this first study focusing on co-isolation of Mycobacteria and Aspergillus in patient's respiratory samples, co-infection remains rare. Further studies are warranted in order to precise the exact relationship between these opportunistic pathogens and the clinical impact of co-isolations.
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Affiliation(s)
- Sarah Dellière
- Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France
| | - Cécile Angebault
- Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France.,Dynamyc, UPEC, EnVA, ANSES, Créteil, France
| | - Vincent Fihman
- Dynamyc, UPEC, EnVA, ANSES, Créteil, France.,Unité de Bactériologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France
| | - Françoise Foulet
- Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France.,Dynamyc, UPEC, EnVA, ANSES, Créteil, France
| | - Raphaël Lepeule
- Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France
| | - Bernard Maitre
- Service de Pneumologie, DHU A-TVB, APHP, CHU Henri Mondor, Créteil, France
| | - Frédéric Schlemmer
- Service de Pneumologie, DHU A-TVB, APHP, CHU Henri Mondor, Créteil, France
| | - Françoise Botterel
- Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France.,Dynamyc, UPEC, EnVA, ANSES, Créteil, France
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23
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Lalevée S, Catano J, Ingen-Housz-Oro S, Surenaud M, Tran Van Nhieu J, Schlemmer F, Bendib I, Mekontso-Dessap A, Hue S, de Prost N. Acute lung injury in mechanically ventilated patients with epidermal necrolysis: an exposed-unexposed retrospective cohort study. Burns & Trauma 2020; 8:tkaa041. [PMID: 33324706 PMCID: PMC7723417 DOI: 10.1093/burnst/tkaa041] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022]
Affiliation(s)
- S Lalevée
- Service de dermatologie, AP-HP, hôpital Henri Mondor, Créteil, France
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
| | - J Catano
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France
| | - S Ingen-Housz-Oro
- Service de dermatologie, AP-HP, hôpital Henri Mondor, Créteil, France
- EA7379 EpidermE, UPEC, Créteil, France
- Centre de référence des dermatoses bulleuses toxiques et toxidermies graves TOXIBUL, Créteil, France
| | - M Surenaud
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
| | - J Tran Van Nhieu
- Service d’Anatomopathologie, AP-HP, hôpital Henri Mondor, Créteil, France
| | - F Schlemmer
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Unité de Pneumologie, Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France
| | - I Bendib
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France
- Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, Créteil Cedex 94010, France
| | - A Mekontso-Dessap
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, Créteil Cedex 94010, France
| | - S Hue
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Centre de référence des dermatoses bulleuses toxiques et toxidermies graves TOXIBUL, Créteil, France
- AP-HP, Département d'Hématologie et d'Immunologie biologiques, Groupe hospitalo-universitaire Chenevier Mondor, Assistance Publique-Hôpitaux de Paris F-94010 Créteil, France
| | - N de Prost
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France
- Centre de référence des dermatoses bulleuses toxiques et toxidermies graves TOXIBUL, Créteil, France
- Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, Créteil Cedex 94010, France
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24
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Levi LI, Schlemmer F, de Castro N, Brun O, Veziris N, Argemi X, Roupret M, Launay O, Bergeron A, Groh M. Bacillus Calmette-Guerin infection following intravesical instillation: Does the strain matter? Med Mal Infect 2018; 49:350-355. [PMID: 30583869 DOI: 10.1016/j.medmal.2018.11.014] [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: 11/27/2017] [Revised: 04/02/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Intravesical BCG is the standard treatment of non-muscle invasive bladder cancer. No difference has yet been reported in the safety profiles of the various BCG strains. METHODS A nationwide multidisciplinary retrospective survey was conducted between January 2013 and December 2016 to identify cases of BCG infection and differentiate them based on the type of BCG strain used. RESULTS Forty patients were identified (BCG RIVM 28; other strains 8; unknown 4). Patients treated with BCG RIVM were less severely ill, with fewer occurrences of septic shock (3.6% vs. 50%, P=0.003) and ICU admission (7.1% vs. 62.5%, P=0.003). A higher frequency of pulmonary miliaries (71.4% vs. 12.5%, P=0.005) but lower transaminase levels (mean AST 65 vs. 264 U/L, P=0.001) were observed in these patients. No difference in terms of recovery was reported. CONCLUSION The type of BCG strain could correlate with the frequency and severity of subsequent BCG infections.
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Affiliation(s)
- L I Levi
- Fédération d'infectiologie, hôpital Cochin, université Paris-Descartes, Sorbonne Paris Santé, Assistance publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France.
| | - F Schlemmer
- Unité de pneumologie, hôpitaux universitaires Henri Mondor, DHU A-TVB, université Paris-Est Créteil (UPEC), Assistance publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
| | - N de Castro
- Service de maladies infectieuses et tropicales, hôpital Saint-Louis, université Diderot, Assistance publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France
| | - O Brun
- Service de pneumologie, clinique medipôle Saint-Roch, Perpignan Cabestany, 66330 Cabestany, France
| | - N Veziris
- Laboratoire de bactériologie-hygiène, Centre national de référence des mycobactéries et de la résistance aux antituberculeux, hôpital de la Pitié-Salpêtrière, Sorbonne université, UPMC University Paris 06, Assistance publique-Hôpitaux de Paris (AP-HP), 75013 Paris, France; Inserm, CR7, centre d'immunologie et des maladies infectieuses, Team 13, U1135, 75013 Paris, France
| | - X Argemi
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, université de Strasbourg, 67091 Strasbourg, France
| | - M Roupret
- Service d'urologie, hôpital de la Pitié-Salpêtrière, Sorbonne université, Assistance publique-Hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - O Launay
- Fédération d'infectiologie, hôpital Cochin, université Paris-Descartes, Sorbonne Paris Santé, Assistance publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France
| | - A Bergeron
- Service de pneumologie, hôpital Saint-Louis, universite Diderot, Assistance publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France
| | - M Groh
- Fédération d'infectiologie, hôpital Cochin, université Paris-Descartes, Sorbonne Paris Santé, Assistance publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France; Service de médecine interne, hôpital Foch, 92150 Suresnes, France
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25
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Amode R, Ingen-Housz-Oro S, Ortonne N, Bounfour T, Pereyre S, Schlemmer F, Bequignon E, Royer G, Wolkenstein P, Chosidow O. Clinical and histologic features of Mycoplasma pneumoniae-related erythema multiforme: A single-center series of 33 cases compared with 100 cases induced by other causes. J Am Acad Dermatol 2018; 79:110-117. [PMID: 29559400 DOI: 10.1016/j.jaad.2018.03.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 03/03/2018] [Accepted: 03/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mycoplasma pneumoniae infection has been documented in erythema multiforme (EM) and Stevens-Johnson syndrome-toxic epidermal necrosis (SJS-TEN). Clinical aspects of M pneumoniae-related EM have been poorly described in the literature. OBJECTIVE To highlight differences between M pneumoniae EM and non-M pneumoniae EM. METHODS This single-center, retrospective cohort study included all patients admitted to our dermatology department for EM during 2000-2015. We compared epidemiologic, clinical, and histologic data and follow-up for M pneumoniae EM and non-M pneumoniae EM cases. RESULTS Thirty-three patients with M pneumoniae EM were compared with 100 patients with non-M pneumoniae EM. Disease onset in winter was more frequent with M pneumoniae EM (P = .003). Acrally distributed lesions (32% vs 88%, P < .0001) and typical targets (45% vs 74%, P = .01) were less common in M pneumoniae EM than non-M pneumoniae EM. Multiple (≥2) mucousal membrane involvement was more frequent in M pneumoniae EM than non-M pneumoniae EM (97% vs 60%; P < .0001), as were mucosal and respiratory tract sequelae (P < .05). The mean hospital stay was longer with M pneumoniae EM patients: 9.5 days versus 5.1 days (P = .0002). A TEN-like pattern was observed in all 14 (100%) M pneumoniae EM skin biopsies versus 10 of 27 (48%) non-M pneumoniae EM biopsies (P < .001). LIMITATIONS The retrospective design. CONCLUSION M pneumoniae EM has a distinctive presentation compared with non-M pneumoniae EM, with more diffuse and atypical targets, more mucositis and respiratory tract sequelae. Histologic data show a TEN-like pattern in all M pneumoniae EM skin samples.
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Affiliation(s)
- Reyhan Amode
- Dermatology Department, Assistance Publique Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
| | - Saskia Ingen-Housz-Oro
- Dermatology Department, Assistance Publique Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France; Epidémiologie en Dermatologie et Evaluation des Thérapeutiques, Université Paris-Est Créteil (UPEC) Val de Marne, Créteil, France; Referral Center for Toxic Bullous Diseases, AP-HP, Henri Mondor Hospital, Créteil, France.
| | - Nicolas Ortonne
- Pathology Department, AP-HP, Henri Mondor Hospital, Créteil, France; UPEC, Créteil, France
| | - Touda Bounfour
- Dermatology Department, Assistance Publique Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
| | - Sabine Pereyre
- Université Bordeaux, National Institute for Agricultural Research, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France; Bacteriology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Frédéric Schlemmer
- Pneumology Department, AP-HP, Henri Mondor Hospital, Créteil and Département Hospitalo-Universitaire A-TVB (Ageing-Thorax-Vessel-Blood), UPEC, Créteil, France
| | - Emilie Bequignon
- Ear-Nose-Throat - Head and Neck Surgery Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Gérard Royer
- Ophthalmology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Pierre Wolkenstein
- Dermatology Department, Assistance Publique Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France; Epidémiologie en Dermatologie et Evaluation des Thérapeutiques, Université Paris-Est Créteil (UPEC) Val de Marne, Créteil, France; Referral Center for Toxic Bullous Diseases, AP-HP, Henri Mondor Hospital, Créteil, France; UPEC, Créteil, France
| | - Olivier Chosidow
- Dermatology Department, Assistance Publique Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France; Epidémiologie en Dermatologie et Evaluation des Thérapeutiques, Université Paris-Est Créteil (UPEC) Val de Marne, Créteil, France; Referral Center for Toxic Bullous Diseases, AP-HP, Henri Mondor Hospital, Créteil, France; UPEC, Créteil, France
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26
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Schlemmer F, Boyer L, Soumagne T, Ridoux A, Chouaid C, Maitre B, Lanone S, Adnot S, Audureau E, Boczkowski J. Beclin1 circulating levels and accelerated aging markers in COPD. Cell Death Dis 2018; 9:156. [PMID: 29402890 PMCID: PMC5833829 DOI: 10.1038/s41419-017-0178-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Frédéric Schlemmer
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France ,0000 0001 2292 1474grid.412116.1Unité de Pneumologie, APHP, Hôpital Henri Mondor, DHU-ATVB, Créteil, France
| | - Laurent Boyer
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France ,0000 0001 2292 1474grid.412116.1Département de Physiologie-Explorations Fonctionnelles, APHP, Hôpital Henri Mondor, DHU-ATVB, Créteil, France
| | - Thibaud Soumagne
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France
| | - Audrey Ridoux
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France
| | - Christos Chouaid
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France ,0000 0004 1765 2136grid.414145.1Département de Pneumologie et Pathologie Professionnelle, Centre Hospitalier Intercommunal, DHU-ATVB, Créteil, France
| | - Bernard Maitre
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France ,0000 0001 2292 1474grid.412116.1Unité de Pneumologie, APHP, Hôpital Henri Mondor, DHU-ATVB, Créteil, France ,0000 0004 1765 2136grid.414145.1Département de Pneumologie et Pathologie Professionnelle, Centre Hospitalier Intercommunal, DHU-ATVB, Créteil, France
| | - Sophie Lanone
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France
| | - Serge Adnot
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France ,0000 0001 2292 1474grid.412116.1Département de Physiologie-Explorations Fonctionnelles, APHP, Hôpital Henri Mondor, DHU-ATVB, Créteil, France
| | - Etienne Audureau
- 0000 0001 2292 1474grid.412116.1Département de Santé Publique, Unité de Recherche Clinique (URC-Mondor), APHP, Hôpital Henri Mondor, IMRB EA7376, Clinical Epidemiology and Aging (CEpiA), Créteil, France
| | - Jorge Boczkowski
- 0000 0004 0386 3258grid.462410.5INSERM U955, Institut Mondor de Recherche Biomédicale and Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France ,0000 0001 2292 1474grid.412116.1Unité de Pneumologie, APHP, Hôpital Henri Mondor, DHU-ATVB, Créteil, France
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27
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Bendib I, Schlemmer F, Maitre B, Carteaux G, Razazi K, Mekontso Dessap A, de Prost N. Insuffisance respiratoire aiguë : l’ARDS et au-delà. Méd Intensive Réa 2018. [DOI: 10.3166/rea-2018-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Viarnaud A, Ingen-Housz-Oro S, Marque M, Valeyrie-Allanore L, Ortonne N, Gueudry J, Grootenboer-Mignot S, Muraine M, Bequignon E, Gagnière C, Schlemmer F, Wolkenstein P, Chosidow O. Severe sequelae of erythema multiforme: three cases. J Eur Acad Dermatol Venereol 2017; 32:e34-e36. [DOI: 10.1111/jdv.14478] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A. Viarnaud
- Dermatology; AP-HP, Henri Mondor hospital; Créteil France
| | - S. Ingen-Housz-Oro
- Dermatology; AP-HP, Henri Mondor hospital; Créteil France
- EA 7379 EpiDermE (Epidemiologie en Dermatologie et Evaluation des Thérapeutiques); Université Paris-Est Creteil Val de Marne (UPEC); Creteil France
- Referral center for toxic bullous diseases; Créteil France
| | - M. Marque
- Dermatology; Caremeau hospital; Nîmes France
| | - L. Valeyrie-Allanore
- Dermatology; AP-HP, Henri Mondor hospital; Créteil France
- Referral center for toxic bullous diseases; Créteil France
| | - N. Ortonne
- Department of Pathology; AP-HP, Henri Mondor hospital; Créteil France
| | - J. Gueudry
- Referral center for toxic bullous diseases; Créteil France
- Ophtalmology; Charles Nicolle hospital; Rouen France
| | | | - M. Muraine
- Referral center for toxic bullous diseases; Créteil France
- Ophtalmology; Charles Nicolle hospital; Rouen France
| | - E. Bequignon
- Otorhinolaryngology and Facial Cervical Surgery; Intercommunal Hospital; Intercommunal hospital; Créteil France
| | - C. Gagnière
- Gastro-enterology; AP-HP, Henri-Mondor hospital; Créteil France
| | - F. Schlemmer
- Pneumology; AP-HP, Henri Mondor hospital; Créteil France
| | - P. Wolkenstein
- Dermatology; AP-HP, Henri Mondor hospital; Créteil France
- EA 7379 EpiDermE (Epidemiologie en Dermatologie et Evaluation des Thérapeutiques); Université Paris-Est Creteil Val de Marne (UPEC); Creteil France
- Referral center for toxic bullous diseases; Créteil France
| | - O. Chosidow
- Dermatology; AP-HP, Henri Mondor hospital; Créteil France
- EA 7379 EpiDermE (Epidemiologie en Dermatologie et Evaluation des Thérapeutiques); Université Paris-Est Creteil Val de Marne (UPEC); Creteil France
- Referral center for toxic bullous diseases; Créteil France
- INSERM CIC 1430; Créteil France
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29
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Robin C, Alanio A, Gits-Muselli M, la Martire G, Schlemmer F, Botterel F, Angebault C, Leclerc M, Beckerich F, Redjoul R, Pautas C, Toma A, Maury S, Bretagne S, Cordonnier C. Molecular Demonstration of a Pneumocystis Outbreak in Stem Cell Transplant Patients: Evidence for Transmission in the Daycare Center. Front Microbiol 2017; 8:700. [PMID: 28484441 PMCID: PMC5401873 DOI: 10.3389/fmicb.2017.00700] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 04/05/2017] [Indexed: 12/24/2022] Open
Abstract
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening infection in hematology. Although occasionally reported, the role of interhuman transmission of P. jirovecii in PCP, compared to that of reactivation, remains an unresolved question; the recommendation to isolate PCP patients in the hematology ward are not well evidence-based. Following an unexpected increase in the number of febrile pneumonia patients with P. jirovecii DNA detected in respiratory samples in our hematology ward, we explored 12 consecutive patients from November 2015 to May 2016. Genotyping of P jirovecii was performed using microsatellite markers. The frequency of simultaneous occupancy of these 12 patients in the same unit on the same day from 4 months prior to the first diagnosis was recorded. In three patients, the P. jirovecii genotype could not be determined because DNA was insufficient. One rare single genotype (Gt2) was found in four of the other nine, all allogeneic stem cell transplant recipients. The transmission map showed that these 4 patients had multiple opportunities to meet on the same day (median, 6.5; range, 4–10) at the daycare center. It was much less among the eight non-Gt2 patients (median, 1; range, 0–9; P = 0.048). This study, based on modern molecular technics, strongly suggests that interhuman transmission of P. jirovecii between allogeneic stem cell transplant recipients is possible. P. jirovecii DNA detected in respiratory specimens supports that isolation and respiratory precautions be recommended in such cases in the hematology ward.
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Affiliation(s)
- Christine Robin
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Alexandre Alanio
- Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Lariboisière Saint-Louis Fernand Widal HospitalParis, France.,Paris-Diderot, Sorbonne Paris Cité UniversityParis, France.,Molecular Mycology Unit, National Reference Center of Invasive Mycosis and Antifungals, Centre National de la Recherche Scientifique, Institut Pasteur, URA3012Paris, France
| | - Maud Gits-Muselli
- Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Lariboisière Saint-Louis Fernand Widal HospitalParis, France.,Paris-Diderot, Sorbonne Paris Cité UniversityParis, France
| | - Giulia la Martire
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Frédéric Schlemmer
- Paris-Est Créteil UniversityCréteil, France.,Unit of Pneumology, Intensive Care Department, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching Hospital, DHU A-TVBCréteil, France
| | - Françoise Botterel
- Paris-Est Créteil UniversityCréteil, France.,Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Cécile Angebault
- Paris-Est Créteil UniversityCréteil, France.,Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Mathieu Leclerc
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Florence Beckerich
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Rabah Redjoul
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Cécile Pautas
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Andrea Toma
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Sébastien Maury
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Stéphane Bretagne
- Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Lariboisière Saint-Louis Fernand Widal HospitalParis, France.,Paris-Diderot, Sorbonne Paris Cité UniversityParis, France.,Molecular Mycology Unit, National Reference Center of Invasive Mycosis and Antifungals, Centre National de la Recherche Scientifique, Institut Pasteur, URA3012Paris, France
| | - Catherine Cordonnier
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
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30
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Contou D, Dorison M, Rosman J, Schlemmer F, Gibelin A, Foulet F, Botterel F, Carteaux G, Razazi K, Brun-Buisson C, Mekontso Dessap A, de Prost N. Aspergillus-positive lower respiratory tract samples in patients with the acute respiratory distress syndrome: a 10-year retrospective study. Ann Intensive Care 2016; 6:52. [PMID: 27294891 PMCID: PMC4906097 DOI: 10.1186/s13613-016-0156-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 04/25/2016] [Accepted: 06/05/2016] [Indexed: 12/24/2022] Open
Abstract
Background The detection of Aspergillus spp. in endotracheal aspirate cultures of mechanically ventilated patients may reflect either colonization or infection. However, little is known about the prevalence and the impact on outcome of respiratory tract sample positive for Aspergillus during the acute respiratory distress syndrome (ARDS). Methods We conducted a monocentric, retrospective study over a 10-year period (January 2006–December 2015) in the ICU of a university hospital. All consecutive adult patients with ARDS were included, and the diagnosis of invasive pulmonary aspergillosis was assessed using a previously validated algorithm. Results In total, 423 ARDS patients were included with 35 patients [8.3 %, 95 % CI (5.4–10.6)] having at least one respiratory tract sample positive for Aspergillus (Aspergillus+ patients) after a median delay of 3 days (1–11) following ICU admission. Comorbidities did not differ between Aspergillus+ and Aspergillus− patients except for more frequent immunosuppression in Aspergillus+ patients (40 vs. 22 %; p = 0.02). There was no difference between Aspergillus− and Aspergillus+ patients regarding in-ICU mortality, ventilator-free days at day 28, and incidence of ventilator-associated pneumonia, but need for renal replacement therapy was higher in Aspergillus+ patients than in others (49 vs. 27 %; p = 0.01). Seventeen [4.0 %, 95 % CI (2.1–5.9)] patients had putative/proven aspergillosis. After adjusting on covariates associated with ICU mortality, putative/proven aspergillosis was associated with in-ICU mortality [aOR = 9.58 (1.97–46.52); p = 0.005], while Aspergillus colonization was not [aOR = 0.64 (0.21–1.99); p = 0.44]. Conclusions Eight percent of ARDS patients had Aspergillus spp.-positive respiratory tract cultures. These had a higher risk of mortality only when categorized as having putative or proven invasive pulmonary aspergillosis.
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Affiliation(s)
- Damien Contou
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010, Créteil, France
| | - Matthieu Dorison
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Jérémy Rosman
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Frédéric Schlemmer
- Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Antenne de Pneumologie, Assistance Publique-Hôpitaux de Paris, 94010, Créteil, France
| | - Aude Gibelin
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Françoise Foulet
- Unité de Mycologie, Département de Biologie-Pathologie, Centre Hospitalier Universitaire Henri Mondor, DHU VIC, Assistance Publique-Hôpitaux de Paris, 94010, Créteil, France
| | - Françoise Botterel
- Unité de Mycologie, Département de Biologie-Pathologie, Centre Hospitalier Universitaire Henri Mondor, DHU VIC, Assistance Publique-Hôpitaux de Paris, 94010, Créteil, France
| | - Guillaume Carteaux
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010, Créteil, France
| | - Keyvan Razazi
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010, Créteil, France
| | - Christian Brun-Buisson
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010, Créteil, France
| | - Armand Mekontso Dessap
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.,Groupe de Recherche CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010, Créteil, France
| | - Nicolas de Prost
- Groupe Henri Mondor-Albert Chenevier, Centre Hospitalier Universitaire Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, Assistance Publique-Hôpitaux de Paris, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France. .,Groupe de Recherche CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010, Créteil, France.
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Macovei L, Boudjemaa A, Ben Hassen I, Mangiapan G, Saakashvili Z, Jérome S, Samé V, Boyer L, Schlemmer F, Maitre B, Housset B. Performance médiocre de trois questionnaires de repérage de la BPCO. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Schlemmer F, Chevret S, Lorillon G, De Bazelaire C, Peffault de Latour R, Meignin V, Michallet M, Hermet E, Wyplosz B, Houdouin V, Marchand-Adam S, Socié G, Tazi A, Bergeron A. Late-onset noninfectious interstitial lung disease after allogeneic hematopoietic stem cell transplantation. Respir Med 2014; 108:1525-33. [DOI: 10.1016/j.rmed.2014.09.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/28/2014] [Accepted: 09/08/2014] [Indexed: 12/31/2022]
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33
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Sukkurwala AQ, Martins I, Wang Y, Schlemmer F, Ruckenstuhl C, Durchschlag M, Michaud M, Senovilla L, Sistigu A, Ma Y, Vacchelli E, Sulpice E, Gidrol X, Zitvogel L, Madeo F, Galluzzi L, Kepp O, Kroemer G. Immunogenic calreticulin exposure occurs through a phylogenetically conserved stress pathway involving the chemokine CXCL8. Cell Death Differ 2014; 21:59-68. [PMID: 23787997 PMCID: PMC3857625 DOI: 10.1038/cdd.2013.73] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [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: 01/29/2013] [Revised: 05/17/2013] [Accepted: 05/28/2013] [Indexed: 12/20/2022] Open
Abstract
The exposure of calreticulin (CRT) on the surface of stressed and dying cancer cells facilitates their uptake by dendritic cells and the subsequent presentation of tumor-associated antigens to T lymphocytes, hence stimulating an anticancer immune response. The chemotherapeutic agent mitoxantrone (MTX) can stimulate the peripheral relocation of CRT in both human and yeast cells, suggesting that the CRT exposure pathway is phylogenetically conserved. Here, we show that pheromones can act as physiological inducers of CRT exposure in yeast cells, thereby facilitating the formation of mating conjugates, and that a large-spectrum inhibitor of G protein-coupled receptors (which resemble the yeast pheromone receptor) prevents CRT exposure in human cancer cells exposed to MTX. An RNA interference screen as well as transcriptome analyses revealed that chemokines, in particular human CXCL8 (best known as interleukin-8) and its mouse ortholog Cxcl2, are involved in the immunogenic translocation of CRT to the outer leaflet of the plasma membrane. MTX stimulated the production of CXCL8 by human cancer cells in vitro and that of Cxcl2 by murine tumors in vivo. The knockdown of CXCL8/Cxcl2 receptors (CXCR1/Cxcr1 and Cxcr2) reduced MTX-induced CRT exposure in both human and murine cancer cells, as well as the capacity of the latter-on exposure to MTX-to elicit an anticancer immune response in vivo. Conversely, the addition of exogenous Cxcl2 increased the immunogenicity of dying cells in a CRT-dependent manner. Altogether, these results identify autocrine and paracrine chemokine signaling circuitries that modulate CRT exposure and the immunogenicity of cell death.
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Affiliation(s)
- A Q Sukkurwala
- INSERM, U848, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
| | - I Martins
- INSERM, U848, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
| | - Y Wang
- INSERM, U848, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
| | - F Schlemmer
- INSERM, U848, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
| | - C Ruckenstuhl
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - M Durchschlag
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - M Michaud
- INSERM, U848, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
| | - L Senovilla
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
- INSERM, U1015 Labellisée par la Ligue Nationale Contre le Cancer, Villejuif, France
| | - A Sistigu
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
- INSERM, U1015 Labellisée par la Ligue Nationale Contre le Cancer, Villejuif, France
| | - Y Ma
- INSERM, U848, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
| | - E Vacchelli
- INSERM, U848, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
| | - E Sulpice
- Laboratoire Biologie à Grande Echelle, CEA, Grenoble, France
- INSERM, U1038, Université Joseph Fourier, Grenoble, France
| | - X Gidrol
- Laboratoire Biologie à Grande Echelle, CEA, Grenoble, France
- INSERM, U1038, Université Joseph Fourier, Grenoble, France
| | - L Zitvogel
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
- INSERM, U1015 Labellisée par la Ligue Nationale Contre le Cancer, Villejuif, France
- Centre d'Investigation Clinique Biothérapie CICBT507, Institut Gustave Roussy, Villejuif, France
| | - F Madeo
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - L Galluzzi
- INSERM, U848, Villejuif, France
- Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France
| | - O Kepp
- INSERM, U848, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris Sud/Paris XI, Le Kremlin Bicêtre, France
| | - G Kroemer
- INSERM, U848, Villejuif, France
- Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France
- Metabolomics Platform, Institut Gustave Roussy, Villejuif, France
- Equipe 11 Labellisée par la Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
- Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
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Dietzel R, Schlemmer F. Über die Desinfektionswirkung von p-Toluolsulfonchloramidnatrium, insbesondere von “Chloramin-Heyden”. Arch Pharm (Weinheim) 2013. [DOI: 10.1002/ardp.192800055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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35
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Menger L, Vacchelli E, Adjemian S, Martins I, Ma Y, Shen S, Yamazaki T, Sukkurwala AQ, Michaud M, Mignot G, Schlemmer F, Sulpice E, Locher C, Gidrol X, Ghiringhelli F, Modjtahedi N, Galluzzi L, Andre F, Zitvogel L, Kepp O, Kroemer G. Cardiac Glycosides Exert Anticancer Effects by Inducing Immunogenic Cell Death. Sci Transl Med 2012; 4:143ra99. [DOI: 10.1126/scitranslmed.3003807] [Citation(s) in RCA: 288] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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36
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Schlemmer F, Lorillon G, Bergeron A. Les complications pulmonaires non infectieuses de l’allogreffe de cellules souches hématopoïétiques. Réanimation 2012. [DOI: 10.1007/s13546-011-0333-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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37
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Tesniere A, Schlemmer F, Boige V, Kepp O, Martins I, Ghiringhelli F, Aymeric L, Michaud M, Apetoh L, Barault L, Mendiboure J, Pignon JP, Jooste V, van Endert P, Ducreux M, Zitvogel L, Piard F, Kroemer G. Immunogenic death of colon cancer cells treated with oxaliplatin. Oncogene 2009; 29:482-91. [PMID: 19881547 DOI: 10.1038/onc.2009.356] [Citation(s) in RCA: 822] [Impact Index Per Article: 54.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Both the pre-apoptotic exposure of calreticulin (CRT) and the post-apoptotic release of high-mobility group box 1 protein (HMGB1) are required for immunogenic cell death elicited by anthracyclins. Here, we show that both oxaliplatin (OXP) and cisplatin (CDDP) were equally efficient in triggering HMGB1 release. However, OXP, but not CDDP, stimulates pre-apoptotic CRT exposure in a series of murine and human colon cancer cell lines. Subcutaneous injection of OXP-treated colorectal cancer (CRC), CT26, cells induced an anticancer immune response that was reduced by short interfering RNA-mediated depletion of CRT or HMGB1. In contrast, CDDP-treated CT26 cells failed to induce anticancer immunity, unless recombinant CRT protein was absorbed into the cells. CT26 tumors implanted in immunocompetent mice responded to OXP treatment in vivo, and this therapeutic response was lost when CRT exposure by CT26 cells was inhibited or when CT26 cells were implanted in immunodeficient mice. The knockout of toll-like receptor 4 (TLR4), the receptor for HMGB1, also resulted in a deficient immune response against OXP-treated CT26 cells. In patients with advanced (stage IV, Duke D) CRC, who received an OXP-based chemotherapeutic regimen, the loss-of-function allele of TLR4 (Asp299Gly in linkage disequilibrium with Thr399Ile, reducing its affinity for HMGB1) was as prevalent as in the general population. However, patients carrying the TLR4 loss-of-function allele exhibited reduced progression-free and overall survival, as compared with patients carrying the normal TLR4 allele. In conclusion, OXP induces immunogenic death of CRC cells, and this effect determines its therapeutic efficacy in CRC patients.
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Lagrange-Xélot M, Schlemmer F, Gallien S, Lacroix C, Molina J. Trichoderma fungaemia in a neutropenic patient with pulmonary cancer and human immunodeficiency virus infection. Clin Microbiol Infect 2008; 14:1190-2. [DOI: 10.1111/j.1469-0691.2008.02111.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Schlemmer F, Lagrange-Xélot M, Lacroix C, de La Tour R, Socié G, Molina JM. Breakthrough Rhizopus infection on posaconazole prophylaxis following allogeneic stem cell transplantation. Bone Marrow Transplant 2008; 42:551-2. [PMID: 18622416 DOI: 10.1038/bmt.2008.199] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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40
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Gallien S, Taieb F, Schlemmer F, Lagrange-Xelot M, Atlan A, Sarfati C, Molina JM. Failure of atovaquone/proguanil to prevent Plasmodium ovale malaria in traveler returning from Cameroon. Travel Med Infect Dis 2008; 6:128-9. [PMID: 18486067 DOI: 10.1016/j.tmaid.2008.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Revised: 12/02/2007] [Accepted: 01/24/2008] [Indexed: 11/27/2022]
Abstract
We report a case of a patient returning from Cameroon who developed Plasmodium ovale malaria, despite atovaquone/proguanil (AP, Malarone) prophylaxis, which is widely used for the prevention of chloroquine-resistant malaria. AP is indeed active only on schizont blood forms of P. ovale but not against liver-stage hypnozoites and does not realize effective prophylaxis against delayed onset of P. ovale malaria. Hence, this case illustrates the risk of failure with Malarone for the prophylaxis of P. ovale infection for travelers in endemic regions. Travelers returned from risk areas with symptoms suggestive of malaria, should not have the diagnosis of P. ovale (or P. vivax) infection discounted, despite a history of compliance with a standard chemoprophylactic regimen.
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Affiliation(s)
- Sébastien Gallien
- Department of Tropical and Infectious Diseases, Saint-Louis University Hospital, 75475 Paris Cedex 10, France.
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41
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Schlemmer F, Rivaud E, Bart-Delabesse E, Honderlick P, Couderc L, Philippe B. Aspergillose pulmonaire du malade non neutropénique et antigénémie aspergillaire. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72214-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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42
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Rab M, Schrögendorfer KF, Girsch W, Kamolz LP, Beck H, Wagner G, Schlemmer F, Högler R, Aszmann O, Frey M. [Value of several examination systems in patients with carpal tunnel syndrome. Comparison of Dellon computer-assisted sensation test with Mellesi hand status and Levine examination scheme]. HANDCHIR MIKROCHIR P 2001; 33:121-8. [PMID: 11329890 DOI: 10.1055/s-2001-12291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
The goal of the presented carpal tunnel syndrome (CTS) follow-up study was to compare the clinical value of the Millesi hand function score with the "Pressure Specifying Sensory Device" (PSSD) introduced by A. L. Dellon using self-administered patient questionnaires. 25 patients (10 male, 15 female) with an electrodiagnostically confirmed CTS were enrolled in this study, performing one preoperative and five postoperative examinations over 24 weeks. 12 of the 25 patients underwent an "open" two-portal carpal tunnel release with two minimal incisions (group OT); the other 13 patients were treated with a two-portal endoscopic carpal tunnel release (group ET). Additionally, in eleven out of the twelve patients of group OT, an epineuriotomy of the median nerve was performed during the same session. Concerning preoperative data of the Millesi score and the PSSD, no statistically significant differences were found between group OT and ET. However, preoperative comparison with the contralateral hand demonstrated a reduction in hand function of 15% and an increase in the pressure perception threshold of 41% compared to normative data could be measured with the PSSD. The subjective functional value of the hand was objectively evacuated using the Levine score. In the second postoperative week, a significant decrease in hand function could be obtained with the Millesi score in group OT. In group ET, the decrease in hand function representing the operative trauma was significantly lower than in group OT. Data of the static one- and two-point pressure perception threshold revealed a statistically significant improvement of the sensibility in both groups. The results of the Millesi score recorded at the last examination in the 24th postoperative week showed an improvement in hand function in both groups compared to preoperative data. Concerning static one- and two-point measurements with the PSSD, distinct improvements compared to the preoperative data could also be detected in both groups although significant differences between group OT and ET were evident: Data of group OT regarding the whole postoperative course demonstrate a continuous improvement in sensibility of the index finger. In contrast, the analysis of the PSSD measurements in group ET revealed an increase in all the parameters starting in the sixth postoperative week and ending with significantly worse static one- and two-point threshold measurements than in group OT. On the other hand, data of self-administered patient questionnaires using the Levine Score revealed significant improvements in hand function and reduction in pain intensity in both groups compared to preoperative results. Differences between both groups at the end of the examination course were not evident. In conclusion, the Millesi hand score with its emphasis on the motor function proved to be a reliable method to record the severity of CTS preoperatively, the severity of the surgical trauma and changes in the course of rehabilitation of the affected hand. A good correlation was found between data obtained with the Millesi Score and the self-administered patient questionnaires according to Levine. But when compared with the PSSD, both methods could not directly document the preoperative status and postoperative changes of the median nerve. Preoperative static two-point pressure threshold measurements with the PSSD confirmed their status as a screening parameter as published by A. L. Dellon. In the postoperative course of group ET, a distinct worsening in the sensibility of the index and little finger could only be detected with the PSSD before the patients noticed the onset of related symptoms.
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Affiliation(s)
- M Rab
- Klinische Abteilung für Wiederherstellungs- und Plastische Chirurgie, Universitätsklinik für Chirurgie, Wien
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Wessler I, Dooley DJ, Werhand J, Schlemmer F. Differential effects of calcium channel antagonists (omega-conotoxin GVIA, nifedipine, verapamil) on the electrically-evoked release of [3H]acetylcholine from the myenteric plexus, phrenic nerve and neocortex of rats. Naunyn Schmiedebergs Arch Pharmacol 1990; 341:288-94. [PMID: 2333100 DOI: 10.1007/bf00180653] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Electrically-evoked release of [3H]acetylcholine from autonomic neurons (myenteric plexus), motoneurons (phrenic nerve) and the central nervous system (neocortex) was investigated in the presence and absence of the calcium channel antagonists omega-conotoxin GVIA, nifedipine and verapamil, whereby the same species (rat) was used in all experiments. Release of [3H]acetylcholine was measured after incubation of the tissue with [3H]choline. omega-Conotoxin GVIA markedly reduced (70%) the evoked release of [3H]acetylcholine from the myenteric plexus of the small intestine (IC50: 0.7 nmol/l) with a similar potency at 3 and 10 Hz stimulation. An increase in the extracellular calcium concentration attenuated the inhibitory effect of omega-conotoxin GVIA. Release of [3H]acetylcholine from the rat neocortex was also inhibited (90%) by omega-conotoxin GVIA, but the potency was 19-fold lower (IC50: 13 nmol/l). However, the release of [3H]acetylcholine from the phrenic nerve was not reduced by omega-conotoxin GVIA (100 nmol/l) at 1.8 mmol/l calcium (normal concentration), whereas omega-conotoxin GVIA inhibited evoked [3H]acetylcholine release by 47% at 0.9 mmol/l calcium. Neither nifedipine (0.1 and 1 mumol/l) nor verapamil (0.1, 1 and 10 mumol/l) modified the evoked release of [3H]acetylcholine from the myenteric plexus and the phrenic nerve. Acetylcholine release from different neurons appears to be regulated by different types of calcium channels. N-type channels play the dominant role in regulating acetylcholine release from both the myenteric plexus and the neocortex, whereas acetylcholine release from motor nerves is regulated by calcium channel(s) not yet characterized.
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Affiliation(s)
- I Wessler
- Department of Pharmacology, University of Mainz, Federal Republic of Germany
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Wessler I, Dooley DJ, Osswald H, Schlemmer F. Differential blockade by nifedipine and omega-conotoxin GVIA of alpha 1- and beta 1-adrenoceptor-controlled calcium channels on motor nerve terminals of the rat. Neurosci Lett 1990; 108:173-8. [PMID: 2154721 DOI: 10.1016/0304-3940(90)90726-p] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Electrically evoked release of [3H]acetylcholine ([3H]ACh) from the rat phrenic nerve and its facilitation by stimulation of presynaptic alpha 1- and beta 1-adrenoceptors were investigated in the absence and presence of nifedipine and omega-conotoxin GVIA. Both calcium channel antagonists did not modify electrically evoked [3H]ACh release, but selectively blocked the effect triggered by both facilitatory adrenergic receptors. The increase in [3H]ACh release mediated via beta 1-adrenoceptor activation was abolished by low concentrations (1 nM) of omega-conotoxin GVIA, whereas nifedipine (100 nM) abolished the facilitatory effect mediated via alpha 1-adrenoceptor stimulation. Therefore, the beta 1-adrenoceptor is apparently coupled to a calcium channel that can be regarded as of the N-type, and the alpha 1-adrenoceptor is apparently coupled to a calcium channel that appears as a subtype of the L-type which is not sensitive to omega-conotoxin GVIA.
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Affiliation(s)
- I Wessler
- Department of Pharmacology, University of Mainz, F.R.G
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Schlemmer F. [Faith. "The calling" or the helping relationship in the health professions: an ambiguous story]. Krankenpfl Soins Infirm 1983:37-40. [PMID: 6302377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Narasimhachari N, Friedel RO, Schlemmer F, Davis JM. Quantitation of amphetamine in plasma and cerebrospinal fluid by gas chromatography-mass spectrometry-selected ion monitoring, using beta-methylphenethylamine as in internal standard. J Chromatogr 1979; 164:386-93. [PMID: 120872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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47
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Narasimhachari N, Friedel R, Schlemmer F, Davis J. Quantitation of amphetamine in plasma and cerebrospinal fluid by gas chromatography—mass spectrometry—selected ion monitoring, using β-methylphenethylamine as an internal standard. ACTA ACUST UNITED AC 1979. [DOI: 10.1016/s0378-4347(00)81240-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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48
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Schlemmer F. [Drugs in "sugar teas"]. Dtsch Apoth Ztg 1965; 105:1205-11. [PMID: 5858573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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49
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Schlemmer F. [Pharmaceutical training for specialists in control laboratories]. Dtsch Apoth Ztg 1965; 105:1169-71. [PMID: 5858157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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50
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Schlemmer F, Beck L. Zur Pharmakognosie von Rhizoma Sanguinariae. Arch Pharm (Weinheim) 1939. [DOI: 10.1002/ardp.19392770804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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