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Maisons V, Lanot A, Luque Y, Sautenet B, Esteve E, Guillouet E, François H, Bobot M. Simulation-based learning in nephrology. Clin Kidney J 2024; 17:sfae059. [PMID: 38680455 PMCID: PMC11053359 DOI: 10.1093/ckj/sfae059] [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: 01/16/2024] [Indexed: 05/01/2024] Open
Abstract
Simulation is a technique to replace and amplify real experiences with guided ones that evoke or replicate substantial aspects of the real world in a fully interactive fashion. In nephrology (a particularly complex specialty), simulation can be used by patients, nurses, residents, and attending physicians alike. It allows one to learn techniques outside the stressful environment of care such as central venous catheter placement, arteriovenous fistula management, learning about peritoneal dialysis, or performing a kidney biopsy. Serious games and virtual reality are emerging methods that show promise. Simulation could also be important in relational aspects of working in a team or with the patient. The development of simulation as a teaching tool in nephrology allows for maintaining high-quality training for residents, tailored to their future practice, and minimizing risks for patients. Additionally, this education helps nephrologists maintain mastery of technical procedures, making the specialty attractive to younger generations. Unfortunately, the inclusion of simulation training programmes faces occasional logistical or funding limitations that universities must overcome with the assistance and innovation of teaching nephrologists. The impact of simulation-based teaching on clinical outcomes needs to be investigated in clinical studies.
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Affiliation(s)
- Valentin Maisons
- Service de Néphrologie, CHU de Tours, Tours, France
- U1246, INSERM, SPHERE, Université de Tours, Université de Nantes, Tours, Nantes, France, INI-CRCT, France
| | - Antoine Lanot
- Normandie University, Unicaen, CHU de Caen Normandie, Nephrology, Côte de Nacre Caen, France
- “ANTICIPE” U1086 INSERM-UCN, Centre Francois Baclesse, 3 Av. du General Harris, Caen, France
| | - Yosu Luque
- Soins Intensifs Néphrologiques Rein Aigu, Hôpital Tenon, APHP, Paris, France
- Sorbonne Université, INSERM UMR_S1155, CORAKID, Hôpital Tenon, Paris, France
| | - Benedicte Sautenet
- Service de Néphrologie, CHU de Tours, Tours, France
- U1246, INSERM, SPHERE, Université de Tours, Université de Nantes, Tours, Nantes, France, INI-CRCT, France
| | - Emmanuel Esteve
- Sorbonne Université, INSERM UMR_S1155, CORAKID, Hôpital Tenon, Paris, France
- Service Néphrologie et Dialyses, Département de Néphrologie, Hôpital Tenon, APHP, Paris, France
| | - Erwan Guillouet
- Normandie University, Unicaen, CHU de Caen Normandie, Nephrology, Côte de Nacre Caen, France
- NorSimS Simulation Center, Caen University Hospital, Caen, France
| | - Hélène François
- Sorbonne Université, INSERM UMR_S1155, CORAKID, Hôpital Tenon, Paris, France
- Service de Transplantation rénale-Néphrologie, Département de néphrologie, Hôpital Pitié Salpétrière, APHP, Paris, France
| | - Mickaël Bobot
- Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, AP-HM, Marseille, France
- Aix Marseille Univ, INSERM 1263, INRAE 1260, C2VN, Marseille, France
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Schwarz C, Georgin-Lavialle S, Lombardi Y, Marion O, Jambon F, Legendre C, Marx D, Levi C, Toure F, Le Quintrec M, Bobot M, Matignon M, Dujardin A, Maanaoui M, Cuozzo S, Jalal-Eddine A, Louis K, Mohamadou I, Brazier F, De Nattes T, Geneste C, Thervet E, Ducloux D, Mayet V, Kormann R, Lanot A, Duveau A, Zaidan M, Mesnard L, Ouali N, Rondeau E, Petit-Hoang C, Audard V, Deshayes A, Moktefi A, Rabant M, Buob D, François H, Luque Y. Kidney Transplantation in Patients With AA Amyloidosis: Outcomes in a French Multicenter Cohort. Am J Kidney Dis 2024; 83:329-339. [PMID: 37741608 DOI: 10.1053/j.ajkd.2023.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 09/25/2023]
Abstract
RATIONALE & OBJECTIVE Outcomes of kidney transplantation for patients with renal AA amyloidosis are uncertain, with reports of poor survival and high rates of disease recurrence. However, the data are inconclusive and mostly based on studies from the early 2000s and earlier. STUDY DESIGN Retrospective multicenter cohort study. SETTING & PARTICIPANTS We searched the French national transplant database to identify all patients with renal AA amyloidosis who underwent kidney transplantation between 2008 and 2018. EXPOSURES Age, cause of amyloidosis, use of biotherapies, and C-reactive protein levels. OUTCOMES Outcomes were all-cause mortality and allograft loss. We also reported amyloidosis allograft recurrence, occurrence of acute rejection episodes, as well as infectious, cardiovascular, and neoplastic disease events. ANALYTICAL APPROACH Kaplan-Meier estimator for mortality and cumulative incidence function method for allograft loss. Factors associated with patient and allograft survival were investigated using a Cox proportional hazards model and a cause-specific hazards model, respectively. RESULTS 86 patients who received kidney transplants for AA amyloidosis at 26 French centers were included. The median age was 49.4 years (IQR, 39.7-61.1). The main cause of amyloidosis was familial Mediterranean fever (37 cases; 43%). 16 (18.6%) patients received biotherapy after transplantation. Patient survival rates were 94.0% (95% CI, 89.1-99.2) at 1 year and 85.5% (77.8-94.0) at 5 years after transplantation. Cumulative incidences of allograft loss were 10.5% (4.0-17.0) at 1 year and 13.0% (5.8-20.1) at 5 years after transplantation. Histologically proven AA amyloidosis recurrence occurred in 5 transplants (5.8%). An infection requiring hospitalization developed in 55.8% of cases, and there was a 27.9% incidence of acute allograft rejection. Multivariable analysis showed that C-reactive protein concentration at the time of transplantation was associated with patient survival (HR, 1.01; 95% CI, 1.00-1.02; P=0.01) and allograft survival (HR, 1.68; 95% CI, 1.10-2.57; P=0.02). LIMITATIONS The study lacked a control group, and the effect of biotherapies on transplantation outcomes could not be explored. CONCLUSIONS This relatively contemporary cohort of patients who received a kidney transplant for AA amyloidosis experienced favorable rates of survival and lower recurrence rates than previously reported. These data support the practice of treating these patients with kidney transplantation for end-stage kidney disease. PLAIN-LANGUAGE SUMMARY AA amyloidosis is a severe and rare disease. Kidney involvement is frequent and leads to end-stage kidney disease. Because of the involvement of other organs, these patients are often frail, which has raised concerns about their suitability for kidney transplantation. We reviewed all patients with AA amyloidosis nephropathy who underwent kidney transplantation in France in the recent era (2008-2018) and found that the outcomes after kidney transplantation were favorable, with 85.5% of patients still alive 5 years after transplantation, a survival rate that is comparable to the outcomes of patients receiving a transplant for other forms of kidney diseases. Recurrence of amyloidosis in the transplanted kidney was infrequent (5.8%). These data support the practice of kidney transplantation for patients with AA amyloidosis who experience kidney failure.
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Affiliation(s)
- Chloë Schwarz
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France; Université de Paris, Service de Néphrologie-Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sophie Georgin-Lavialle
- Sorbonne Université, Internal Medicine Department, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, National Reference Center for Autoinflammatory Diseases and Inflammatory Amyloidosis, Groupe de recherche clinique Amylose AA Sorbonne Université (GRAASU), Paris, France
| | - Yannis Lombardi
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Olivier Marion
- Department of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, Toulouse, France
| | - Frédéric Jambon
- Centre Hospitalier Universitaire de Bordeaux, Service de Néphrologie, Transplantation Dialyse, Aphérèses, Hôpital Pellegrin, Place Amélie Raba Léon, Bordeaux, France
| | | | - David Marx
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Charlène Levi
- Service de Transplantation Rénale, Hôpitaux Civils, Lyon, France
| | - Fatouma Toure
- Department of Nephrology, Dialysis and Transplantation, Hospital University of Limoges, Limoges, France
| | - Moglie Le Quintrec
- Service de Transplantation Rénale, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Mickael Bobot
- Centre de Néphrologie et Transplantation Rénale, Assistance Publique-Hôpitaux de Marseille, Hôpital de la Conception, Centre Hospitalier Universitaire de la Conception, Marseille, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Creteil, France
| | - Amaury Dujardin
- Service de Néphrologie et Immunologie Clinique, Nantes Université, Centre Hospitalier Universitaire Nantes, Institut National de la Santé et de la Recherche Médicale, Centre de Recherche en Transplantation et Immunologie, Unité Mixte de Recherche 1064, Institut de Transplantation Urologie Néphrologie, Nantes, France
| | - Mehdi Maanaoui
- Nephrology Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Sébastien Cuozzo
- Department of Nephrology Dialysis and Transplantation, Pasteur 2 Hospital, Nice University Hospital, Nice, France
| | | | - Kévin Louis
- Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Nephrology and Transplantation Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Inna Mohamadou
- Kidney Transplantation Department, Hôpital Pitié-Salpétriêre, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Brazier
- Nephrology, Internal Medicine, Dialysis and Transplantation Department, Centre Hospitalier Universitaire Amiens, Amiens, France
| | - Tristan De Nattes
- Nephrology-Hemodialysis Department, Centre Hospitalier Universitaire Rouen, Rouen, France
| | - Claire Geneste
- Nephrology Department, Centre Hospitalier Universitaire Tours, Tours, France
| | - Eric Thervet
- Nephrology Department, European Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Didier Ducloux
- Nephrology Department, Centre Hospitalier Universitaire Besançon, Besançon, France
| | - Valentin Mayet
- Nephrology-Hemodialysis Department, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Raphaël Kormann
- Nephrology Department, Centre Hospitalier Universitaire Nancy, Nancy, France
| | - Antoine Lanot
- Nephrology-Dialysis-Kidney Transplantation Department, Centre Hospitalier Universitaire Caen, Caen, France
| | - Agnès Duveau
- Nephrology Department, Centre Hospitalier Universitaire Angers, Angers, France
| | - Mohamad Zaidan
- Université de Paris, Service de Néphrologie-Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Laurent Mesnard
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Nacera Ouali
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Eric Rondeau
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Camille Petit-Hoang
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Vincent Audard
- Nephrology and Renal Transplantation Department, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Creteil, France
| | | | - Anissa Moktefi
- Pathology Department, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | | | - David Buob
- Pathology Department, Sorbonne Université, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Hélène François
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Yosu Luque
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France.
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Bureau C, Rafat C, Taupin JL, Malard S, Mesnard L, François H, Petit-Hoang C, Ouali N, Hertig A, Jamme M, Buob D, Rondeau E, Galichon P, Luque Y. Immunoadsorption-Based HLA Desensitization in Patients Awaiting Deceased Donor Kidney Transplantation: An Interventional, Non-Randomised, Single Cohort Study. Transpl Int 2023; 36:11212. [PMID: 37680645 PMCID: PMC10481532 DOI: 10.3389/ti.2023.11212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/01/2023] [Indexed: 09/09/2023]
Abstract
Whether immunoadsorption (IADS) as part of desensitization protocols could facilitate deceased donor kidney transplantation (KT) in highly sensitized (HS) patients remains to be proven. We retrospectively analyzed our IADS based desensitization protocol for deceased donor KTs between 2013 and 2018. Fifteen HS patients (age 52 years [40-56]) were included. Waiting time before IADS was 6 years [5-10] and the interval between IADS initiation and KT was 5 months [1-12] for the 14 transplanted patients. Nine patients had prior KT. Calculated panel reactive antibody decreased significantly during the protocol (99.3% [92.5-99.9] vs. 79.4% [56.7-81.9]; p = 0.004). Death-censored graft survival was 85.7% at 1 and 2 years post-transplantation. One-year median plasma creatinine level was 135 µmol/L [111-202]. Six developed active antibody mediated rejection (ABMR) at 1 year, with a median delay of 13 days [11-26]. Eight patients developed severe infections, including two fatal outcomes. Finally, compared to 93% of patients who received desensitization receiving a KT, only 43% of a control with similar characteristics underwent transplantation. However, no difference was found in overall probability of being alive with a functioning graft at the end of follow-up. The results indicate that our IADS-based desensitization strategy was not effective due to a high rate of ABMR and severe infectious complications which pose a challenge to its universalization.
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Affiliation(s)
- Côme Bureau
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
| | - Cédric Rafat
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
| | - Jean Luc Taupin
- Assistance Publique-Hôpitaux de Paris, Laboratoire Régional d’Histocompatibilité, Hôpital Saint Louis, Paris, France
| | - Stéphanie Malard
- Assistance Publique-Hôpitaux de Paris, Laboratoire Régional d’Histocompatibilité, Hôpital Saint Louis, Paris, France
| | - Laurent Mesnard
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
- Sorbonne Université, CoRaKid Inserm UMR_S1155, Paris, France
| | - Hélène François
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
- Sorbonne Université, CoRaKid Inserm UMR_S1155, Paris, France
| | - Camille Petit-Hoang
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
| | - Nacera Ouali
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
| | - Alexandre Hertig
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
- Sorbonne Université, CoRaKid Inserm UMR_S1155, Paris, France
| | - Matthieu Jamme
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
| | - David Buob
- Sorbonne Université, CoRaKid Inserm UMR_S1155, Paris, France
- Assistance Publique-Hôpitaux de Paris, Service d’Anatomie et Cytologie Pathologiques, Hôpital Tenon, Paris, France
| | - Eric Rondeau
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
- Sorbonne Université, CoRaKid Inserm UMR_S1155, Paris, France
| | - Pierre Galichon
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
- Sorbonne Université, CoRaKid Inserm UMR_S1155, Paris, France
| | - Yosu Luque
- Assistance Publique – Hôpitaux de Paris, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Paris, France
- Sorbonne Université, CoRaKid Inserm UMR_S1155, Paris, France
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Schwarz C, Morel A, Matignon M, Grimbert P, Rondeau E, Ouali N, François H, Mesnard L, Petit-Hoang C, Rafat C, Dahan K, Luque Y. Hepatitis B Virus Reactivation in Kidney Transplant Recipients Treated With Belatacept. Kidney Int Rep 2023; 8:1531-1541. [PMID: 37547512 PMCID: PMC10403656 DOI: 10.1016/j.ekir.2023.05.005] [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: 12/28/2022] [Revised: 04/30/2023] [Accepted: 05/08/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Hepatitis B virus (HBV) reactivation in kidney transplant recipients has been reported in 3% to 9% of anti-HBc antibody (HBcAb)-positive HBs antigen (HBsAg)-negative patients. It has not been studied in patients receiving belatacept, a selective costimulation blocker. Methods We performed a retrospective study of all transplant recipients receiving belatacept in 2 kidney transplantation centers in France. Among HBcAb-positive patients, we analyzed HBV reactivation rate, outcomes, and risk factors. Results A total of 135 patients treated with belatacept were included: 32 were HBcAb-positive and 2 were HBsAg-positive. Seven patients reactivated HBV (21.9% of HBcAb-positive patients), including 5 HBsAg-negative patients (16.7% of HBcAb-positive HBsAg-negative patients). Reactivation occurred 54.8 (± 70.9) months after transplantation. One patient presented with severe hepatitis and 1 patient developed cirrhosis. There was no significant difference in survival between patients that reactivated HBV and patients that did not: 5-year patient survival of 100% (28.6; 100) and 83.4% (67.6; 100), respectively (P = 0.363); and 5-year graft survival of 100% (28.6; 100) and 79.8% (61.7; 100), respectively (P = 0.335). No factor, including HBsAb positivity and antiviral prophylaxis, was statistically associated with the risk of HBV reactivation. Conclusion HBV reactivation rate was high in patients treated with belatacept when compared with previous transplantation studies. HBV reactivation did not impact survival. Further studies are needed to confirm these results. A systematic antiviral prophylaxis for these patients should be considered and evaluated.
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Affiliation(s)
- Chloë Schwarz
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Antoine Morel
- Service de Néphrologie, Hôpital Henri Mondor, Assistance Publique–Hôpitaux de Paris, Créteil, France
| | - Marie Matignon
- Service de Néphrologie, Hôpital Henri Mondor, Assistance Publique–Hôpitaux de Paris, Créteil, France
| | - Philippe Grimbert
- Service de Néphrologie, Hôpital Henri Mondor, Assistance Publique–Hôpitaux de Paris, Créteil, France
| | - Eric Rondeau
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Sorbonne Université, Unité CoRaKid, Inserm, UMR_S1155, Paris, France
| | - Nacera Ouali
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Hélène François
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Sorbonne Université, Unité CoRaKid, Inserm, UMR_S1155, Paris, France
| | - Laurent Mesnard
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Sorbonne Université, Unité CoRaKid, Inserm, UMR_S1155, Paris, France
| | - Camille Petit-Hoang
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Cédric Rafat
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Karine Dahan
- Néphrologie et Dialyses, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Yosu Luque
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Sorbonne Université, Unité CoRaKid, Inserm, UMR_S1155, Paris, France
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Tamzali Y, Bigot J, Senghor Y, Hennequin C, François H. Uncommon fungal pyomyositis in a kidney transplant recipient. Transpl Infect Dis 2023; 25:e14060. [PMID: 37014782 DOI: 10.1111/tid.14060] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/15/2023] [Accepted: 03/18/2023] [Indexed: 04/05/2023]
Affiliation(s)
- Yanis Tamzali
- Sorbonne Université, APHP, Hôpital Pitié-Salpétrière, Service Médico-chirugical de Transplantation Rénale, Hôpital Tenon, Départment de Néphrologie, Unité SINRA, Paris, France
| | - Jeanne Bigot
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Paris, France
| | - Yaye Senghor
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Paris, France
| | - Christophe Hennequin
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Paris, France
| | - Hélène François
- Sorbonne Université, INSERM Unité Mixte de Recherche 1155, APHP, Tenon Hospital, Nephrology Department, SINRA Unit, Paris, France
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Mohamadou I, Matignon M, Malard S, Lombardi Y, Buob D, Moktefi A, Jamme M, Ouali N, Rafat C, François H, Petit-Hoang C, Rondeau E, Mesnard L, Grimbert P, Taupin JL, Luque Y. Additional Benefits of Rituximab and Plasma Exchange on Top of Standard Induction Therapy in Kidney Transplant Recipients With a Negative CDC Crossmatch but High Preformed Donor Specific Antibody Titer. Transpl Int 2023; 36:10844. [PMID: 37056357 PMCID: PMC10088221 DOI: 10.3389/ti.2023.10844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 02/28/2023] [Indexed: 03/30/2023]
Abstract
Optimal induction strategy in highly sensitized kidney transplant recipients (KTRs) is still a matter of debate. The place of therapies, such as plasma exchange and rituximab, with potential side effects and high cost, is not clearly established. We compared two induction strategies with (intensive) or without (standard) rituximab and plasma exchange in KTRs with high levels of preformed DSA transplanted between 2012 and 2019. Sixty KTRs with a mean age of 52.2 ± 12.2 years were included, 36 receiving standard and 24 intensive induction. Mean fluorescence intensity of immunodominant DSA in the cohort was 8,903 ± 5,469 pre-transplantation and similar in both groups. DSA level decrease was similar at 3 and 12 months after transplantation in the two groups. An intensive induction strategy was not associated with better graft or patient survival, nor more infectious complications. The proportion of patients with rejection during the first year was similar (33% in each group), but rejection occurred later in the intensive group (211 ± 188 days, vs. 79 ± 158 days in the standard group, p < 0.01). Our study suggests that an intensive induction therapy including rituximab and plasma exchanges in highly sensitized kidney recipients is not associated with better graft survival but may delay biopsy-proven rejection.
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Affiliation(s)
- Inna Mohamadou
- Service de Transplantation Rénale, Hôpital Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Paris, France
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- *Correspondence: Inna Mohamadou,
| | - Marie Matignon
- Service de Néphrologie, Hôpitaux Universitaires Henri Mondor, Créteil, France
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Stéphanie Malard
- Laboratoire d’Immunologie et d’Histocompatibilité, Hôpital Saint-Louis, Paris, France
| | - Yannis Lombardi
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - David Buob
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Anatomie Pathologique, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Pairs, France
| | - Anissa Moktefi
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Département de Pathologie, Hôpitaux Universitaires Henri Mondor, Assistance Publique – Hôpitaux de Paris, Créteil, France
| | - Matthieu Jamme
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Nacera Ouali
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Cedric Rafat
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Hélène François
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Camille Petit-Hoang
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Eric Rondeau
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Laurent Mesnard
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Philippe Grimbert
- Service de Néphrologie, Hôpitaux Universitaires Henri Mondor, Créteil, France
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Jean-Luc Taupin
- Laboratoire d’Immunologie et d’Histocompatibilité, Hôpital Saint-Louis, Paris, France
| | - Yosu Luque
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
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Doreille A, Lombardi Y, Dancer M, Lamri R, Testard Q, Vanhoye X, Lebre AS, Garcia H, Rafat C, Ouali N, Luque Y, Izzedine H, Esteve E, Cez A, Petit-Hoang C, François H, Marchal A, Letavernier E, Frémeaux-Bacchi V, Boffa JJ, Rondeau E, Raymond L, Mesnard L. Exome-First Strategy in Adult Patients With CKD: A Cohort Study. Kidney Int Rep 2023; 8:596-605. [PMID: 36938085 PMCID: PMC10014383 DOI: 10.1016/j.ekir.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Exome sequencing (ES) has widened the field of nephrogenomics in adult nephrology. In addition to reporting the diagnostic yield of ES in an adult cohort study, we investigated the clinical implications of molecular diagnosis and developed a clinical score to predict the probability of obtaining positive result. Methods From September 2018 we have used ES to prospectively perform a first-tier liberal exploration of adult nephropathies of unknown origin and/or when a genetic kidney disease was clinically suggested. We also analyzed copy number variant using the same assay. Results Molecular diagnosis was made in 127 of 538 patients sequenced (diagnostic yield: 24%), comprising 47 distinct monogenic disorders. Eight of these monogenic disorders (17% [8/47]) accounted for 52% of genetic diagnoses. In 98% (n = 125/127) of the patients, the genetic information was reported to have major clinical implications. We developed a 4-value clinical score to predict the probability of obtaining a molecular diagnosis (area under the receiver operating characteristics curve [AUC] 0.726 [95% confidence interval: 0.670-0.782]) (available at http://allogenomics.com/score). Conclusion This study reinforces the role of ES as a first-tier exploration for adult chronic kidney disease patients in whom phenotypes are often poor and atypical. Although external validation is required, our clinical score could be a useful tool for the implementation of nephrogenomics in adults.
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Affiliation(s)
- Alice Doreille
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
- Faculté de médecine, Sorbonne Université, Paris, France
| | - Yannis Lombardi
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
- Faculté de médecine, Sorbonne Université, Paris, France
| | | | | | | | | | - Anne-Sophie Lebre
- Service de génétique, Pole de biologie, Hôpital Maison Blanche, CHU Reims, Reims, France
- Département de Génétique, hôpital Pité Salpétrière, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Hugo Garcia
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Cédric Rafat
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Nacera Ouali
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Yosu Luque
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
- Faculté de médecine, Sorbonne Université, Paris, France
| | - Hassan Izzedine
- Department of Nephrology, Peupliers Private Hospital, Ramsay Générale de Santé, Paris, France
| | - Emmanuel Esteve
- Faculté de médecine, Sorbonne Université, Paris, France
- Department of Nephrology, hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Alexandre Cez
- Department of Nephrology, hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Camille Petit-Hoang
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Hélène François
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
- Faculté de médecine, Sorbonne Université, Paris, France
- Inserm UMR_S1155, Paris, France
| | - Armance Marchal
- Faculté de médecine, Sorbonne Université, Paris, France
- Department of Nephrology, hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Emmanuel Letavernier
- Faculté de médecine, Sorbonne Université, Paris, France
- Department of Nephrology, hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Inserm UMR_S1155, Paris, France
| | - Véronique Frémeaux-Bacchi
- Immunology Department, Hôpital Européen Georges Pompidou, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Jean-Jacques Boffa
- Faculté de médecine, Sorbonne Université, Paris, France
- Department of Nephrology, hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Inserm UMR_S1155, Paris, France
| | - Eric Rondeau
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
- Faculté de médecine, Sorbonne Université, Paris, France
- Inserm UMR_S1155, Paris, France
| | | | - Laurent Mesnard
- Soins Intensifs Néphrologiques et Rein Aigu, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
- Faculté de médecine, Sorbonne Université, Paris, France
- Inserm UMR_S1155, Paris, France
- Institut des Sciences du Calcul et des Données, Sorbonne Université, Paris, France
- Centre Maladie Rare MAHREA, hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
- Correspondence: Laurent Mesnard, Soins Intensifs Néphrologiques et Rein Aigu (SINRA), Département de Néphrologie, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France.
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Buob D, Scarton M, Brocheriou I, Karras A, Belenfant X, Rabant M, Caudwell V, Georgin-Lavialle S, François H. Amylose AA rénale : étude rétrospective de corrélation anatomoclinique menée chez 74 patients avec diagnostic fait sur biopsie rénale entre 2010 et 2021. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.257] [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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Ruiz P, Gabarre P, Chenevier-Gobeaux C, François H, Kerneis M, Cidlowski JA, Oakley RH, Lefèvre G, Boissan M. Case report: Changes in the levels of stress hormones during Takotsubo syndrome. Front Cardiovasc Med 2022; 9:931054. [PMID: 35935637 PMCID: PMC9354975 DOI: 10.3389/fcvm.2022.931054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/04/2022] [Indexed: 12/02/2022] Open
Abstract
Background Takotsubo syndrome is an acute cardiac condition usually involving abnormal regional left ventricular wall motion and impaired left ventricular contractility. It is due mainly to hyper-stimulation of the sympathetic nerve system, inducing an excess of catecholamines, usually triggered by intense psychological or physiological stress. The relationship between Takotsubo syndrome and the circulating stress hormones cortisol and copeptin (a surrogate marker of arginine vasopressin) has not been well documented. Case summary Here, we describe the dynamic changes in circulating cortisol and copeptin during an entire episode of Takotsubo syndrome in a post-partum woman after spontaneous vaginal delivery. The patient was diagnosed with inverted Takotsubo syndrome accompanied by HELLP syndrome. We found qualitative and quantitative changes in cortisol: a loss of circadian rhythm and a three-fold elevation in the plasma concentration of the hormone with a peak appearing several hours before circulating cardiac biomarkers began to rise. By contrast, levels of copeptin remained normal during the entire episode. Discussion Our findings indicate that the levels of cortisol change during Takotsubo syndrome whereas those of copeptin do not. This association between elevated cortisol and Takotsubo syndrome suggests that aberrant levels of this stress hormone may contribute to the observed cardiac pathology. We conclude that biochemical assays of circulating cortisol and cardiac biomarkers may be a useful complement to the diagnosis of Takotsubo syndrome by non-invasive cardiac imaging.
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Affiliation(s)
- Pablo Ruiz
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Tenon, Laboratoire de Biochimie, Paris, France
| | - Paul Gabarre
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Tenon, Soins Intensifs Néphrologiques et Rein Aigu (SINRA), Paris, France
| | - Camille Chenevier-Gobeaux
- Assistance Publique-Hôpitaux de Paris (AP-HP)-Centre Université de Paris, Hôpital Cochin, Department of Automated Biological Diagnostic, Paris, France
| | - Hélène François
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Tenon, Soins Intensifs Néphrologiques et Rein Aigu (SINRA), Paris, France
- Sorbonne Université, Inserm, UMR_S1155, Paris, France
| | - Mathieu Kerneis
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie (AP-HP), Paris, France
| | - John A. Cidlowski
- Signal Transduction Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States
| | - Robert H. Oakley
- Signal Transduction Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States
| | - Guillaume Lefèvre
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Tenon, Laboratoire de Biochimie, Paris, France
| | - Mathieu Boissan
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Tenon, Laboratoire de Biochimie, Paris, France
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine (CRSA), Paris, France
- *Correspondence: Mathieu Boissan
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Lombardi Y, François H. Belatacept in Kidney Transplantation: What Are the True Benefits? A Systematic Review. Front Med (Lausanne) 2022; 9:942665. [PMID: 35911396 PMCID: PMC9329606 DOI: 10.3389/fmed.2022.942665] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/20/2022] [Indexed: 12/05/2022] Open
Abstract
The current gold standard to prevent allograft rejection for maintenance immunosuppression in kidney transplantation currently consists in glucocorticoids, an antiproliferative agent and a calcineurin inhibitor (CNI), with better outcome for tacrolimus than cyclosporin. Although, CNI drastically improved early graft survival, so far, CNI have failed to significantly improve long-term survival mainly because of nephrotoxicity. In addition, CNI carry several other side effects such as an increased risk for cardiovascular events and for diabetes mellitus. Therefore, seeking alternatives to CNI remains of paramount importance in kidney transplantation. Belatacept is a fusion protein composed of the human IgG1 Fc fragment linked to the modified extracellular domain of cytotoxic T lymphocyte–associated antigen 4. In kidney transplant recipients, pivotal phase III randomized studies suggested clinical benefits of belatacept as an initial maintenance regimen, as compared with cyclosporine, mainly on kidney function. Recently, a randomized study also suggested a clinical benefit on renal function of a conversion from a CNI-based to a belatacept-based maintenance regimen in patients. However, conversion from CNIs to belatacept is probably associated with an increased risk of biopsy-proven acute rejection and should prompt close clinical surveillance. On the other hand, other studies suggest a decrease in de novo humoral transplant immunization. Belatacept is probably associated with an increase in both risk and severity of some infectious diseases, including EBV-linked post-transplantation lymphoproliferative disorders, and with a decreased response to vaccines. Most studies on belatacept are observational, retrospective, and non-comparative. Consequently, high-quality data about the safety and efficacy profile of belatacept, as compared with the current gold standard for maintenance regimens (tacrolimus-based), is uncertain. Our review will therefore focus on the most recent published data aiming at evaluating the evidence-based or the “true” benefits and risks of belatacept-based regimens in kidney transplantation.
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Affiliation(s)
- Yannis Lombardi
- Soins Intensifs Néphrologiques et Rein Aigu, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine, Paris, France
- Sorbonne Université, Paris, France
| | - Hélène François
- Soins Intensifs Néphrologiques et Rein Aigu, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine, Paris, France
- Sorbonne Université, Paris, France
- INSERM UMR_S 1155, Paris, France
- *Correspondence: Hélène François
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Gabarre P, Ruiz P, Chenevier-Gobeaux C, Charpentier E, Soulat-Dufour L, Cohen A, Monnier-Cholley L, Chemali L, François H, Kerneis M, Lefèvre G, Boissan M. Inverted Takotsubo Syndrome With HELLP Syndrome: A Case Report. Front Cardiovasc Med 2022; 9:832098. [PMID: 35433851 PMCID: PMC9008274 DOI: 10.3389/fcvm.2022.832098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTakotsubo syndrome is an acute cardiac condition involving sudden, transient apical ballooning of the left ventricle of the heart that may be triggered by emotional stress and some non-cardiac conditions. Its diagnosis is based on clinical presentation, electrocardiogram, cardiac imaging and biomarkers.Case SummaryHere, we present a novel and original case report of a patient presenting very soon in the post-partum period with an unusual form of Takotsubo syndrome without clinical symptoms of cardiac disease and accompanied by HELLP syndrome. The overall dynamics of the changes in troponin I, troponin T and NT-proBNP levels after delivery were generally similar, but the amount of troponin I was much greater than that of troponin T and troponin I was already elevated before delivery. NT-proBNP levels peaked around the same time as the troponins and the peak concentration was within the same range as that of troponin I.DiscussionOur findings indicate that assaying circulating cardiac biomarkers, especially troponin I and NT-proBNP, may be a useful complement to non-invasive cardiac imaging including transthoracic echocardiography and cardiovascular magnetic resonance imaging, in the diagnosis of Takotsubo syndrome. They illustrate the importance of cardiac biomarkers in assisting diagnosis of this disease.
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Affiliation(s)
- Paul Gabarre
- AP-HP, Hôpital Tenon, Soins Intensifs Néphrologiques et Rein Aigu (SINRA), Paris, France
| | - Pablo Ruiz
- AP-HP, Hôpital Tenon, Laboratoire de Biochimie, Paris, France
| | - Camille Chenevier-Gobeaux
- AP-HP-Centre Université de Paris, Hôpital Cochin, Department of Automated Biological Diagnostic, Paris, France
| | - Etienne Charpentier
- AP-HP, Groupe Hospitalier Pitié Salpêtrière, Unité d'Imagerie Cardiovasculaire et Thoracique ICT, Institut de Cardiologie, Paris, France
| | - Laurie Soulat-Dufour
- AP-HP, Hôpital Saint-Antoine-Tenon, Service de Cardiologie, Paris, France
- Sorbonne Université, Inserm, Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Paris, France
| | - Ariel Cohen
- AP-HP, Hôpital Saint-Antoine-Tenon, Service de Cardiologie, Paris, France
- Sorbonne Université, Inserm, Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Paris, France
| | | | - Lotfi Chemali
- AP-HP, Hôpital Tenon, Laboratoire de Biochimie, Paris, France
| | - Hélène François
- AP-HP, Hôpital Tenon, Soins Intensifs Néphrologiques et Rein Aigu (SINRA), Paris, France
- Sorbonne Université, Inserm, UMR_S1155, Paris, France
| | - Mathieu Kerneis
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie (AP-HP), Paris, France
| | | | - Mathieu Boissan
- AP-HP, Hôpital Tenon, Laboratoire de Biochimie, Paris, France
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Paris, France
- *Correspondence: Mathieu Boissan
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SCARTON M, Buob D, Brochériou I, Bruneval P, Karras A, Boffa J, Georgin-Lavialle S, Belenfant X, Caudwell V, Massy Z, Isnard-Bagnis C, François H. POS-212 RENAL AA AMYLOIDOSIS: A RETROSPECTIVE CLINICOPATHOLOGIC STUDY WITH EMPHASIS ON PROGNOSIS CONDUCTED IN 74 FRENCH PATIENTS DIAGNOSED BETWEEN 2010 AND 2021. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.230] [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: 10/19/2022] Open
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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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Devocelle A, Lecru L, Ferlicot S, Bessede T, Candelier JJ, Giron-Michel J, François H. IL-15 Prevents Renal Fibrosis by Inhibiting Collagen Synthesis: A New Pathway in Chronic Kidney Disease? Int J Mol Sci 2021; 22:11698. [PMID: 34769128 PMCID: PMC8583733 DOI: 10.3390/ijms222111698] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 12/24/2022] Open
Abstract
Chronic kidney disease (CKD), secondary to renal fibrogenesis, is a public health burden. The activation of interstitial myofibroblasts and excessive production of extracellular matrix (ECM) proteins are major events leading to end-stage kidney disease. Recently, interleukin-15 (IL-15) has been implicated in fibrosis protection in several organs, with little evidence in the kidney. Since endogenous IL-15 expression decreased in nephrectomized human allografts evolving toward fibrosis and kidneys in the unilateral ureteral obstruction (UUO) model, we explored IL-15's renoprotective role by pharmologically delivering IL-15 coupled or not with its soluble receptor IL-15Rα. Despite the lack of effects on myofibroblast accumulation, both IL-15 treatments prevented tubulointerstitial fibrosis (TIF) in UUO as characterized by reduced collagen and fibronectin deposition. Moreover, IL-15 treatments inhibited collagen and fibronectin secretion by transforming growth factor-β (TGF-β)-treated primary myofibroblast cultures, demonstrating that the antifibrotic effect of IL-15 in UUO acts, in part, through a direct inhibition of ECM synthesis by myofibroblasts. In addition, IL-15 treatments resulted in decreased expression of monocyte chemoattractant protein 1 (MCP-1) and subsequent macrophage infiltration in UUO. Taken together, our study highlights a major role of IL-15 on myofibroblasts and macrophages, two main effector cells in renal fibrosis, demonstrating that IL-15 may represent a new therapeutic option for CKD.
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Affiliation(s)
- Aurore Devocelle
- INSERM UMR-S-MD 1197/Ministry of the Armed Forces, Biomedical Research Institute of the Armed Forces (IRBA), Paul-Brousse Hospital Villejuif and CTSA Clamart, 94807 Villejuif, France; (A.D.); (L.L.); (J.-J.C.)
- Orsay-Vallée Campus, Paris-Saclay University, 91190 Gif-sur-Yvette, France
| | - Lola Lecru
- INSERM UMR-S-MD 1197/Ministry of the Armed Forces, Biomedical Research Institute of the Armed Forces (IRBA), Paul-Brousse Hospital Villejuif and CTSA Clamart, 94807 Villejuif, France; (A.D.); (L.L.); (J.-J.C.)
- Orsay-Vallée Campus, Paris-Saclay University, 91190 Gif-sur-Yvette, France
| | - Sophie Ferlicot
- Service d’Anatomopathologie, Hôpital Bicêtre, AP-HP, 94270 Le Kremlin-Bicêtre, France;
| | - Thomas Bessede
- Service d’Urologie, Hôpital Bicêtre, AP-HP, 94270 Le Kremlin-Bicêtre, France;
| | - Jean-Jacques Candelier
- INSERM UMR-S-MD 1197/Ministry of the Armed Forces, Biomedical Research Institute of the Armed Forces (IRBA), Paul-Brousse Hospital Villejuif and CTSA Clamart, 94807 Villejuif, France; (A.D.); (L.L.); (J.-J.C.)
- Orsay-Vallée Campus, Paris-Saclay University, 91190 Gif-sur-Yvette, France
| | - Julien Giron-Michel
- INSERM UMR-S-MD 1197/Ministry of the Armed Forces, Biomedical Research Institute of the Armed Forces (IRBA), Paul-Brousse Hospital Villejuif and CTSA Clamart, 94807 Villejuif, France; (A.D.); (L.L.); (J.-J.C.)
- Orsay-Vallée Campus, Paris-Saclay University, 91190 Gif-sur-Yvette, France
| | - Hélène François
- INSERM UMR_S1155, Tenon Hospital, 75020 Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu (SINRA), Hôpital Tenon, AP-HP, Sorbonne University, 75020 Paris, France
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Abegg B, Morin S, Demiroglu OC, François H, Rothleitner M, Strasser U. Overloaded! Critical revision and a new conceptual approach for snow indicators in ski tourism. Int J Biometeorol 2021; 65:691-701. [PMID: 32020306 PMCID: PMC8116232 DOI: 10.1007/s00484-020-01867-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 11/12/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
Indicators are widely used in climate variability and climate change assessments to simplify the tracking of complex processes and phenomena in the state of the environment. Apart from the climatic criteria, the snow indicators in ski tourism have been increasingly extended with elements that relate to the technical, operational, and commercial aspects of ski tourism. These non-natural influencing factors have gained in importance in comparison with the natural environmental conditions but are more difficult to comprehend in time and space, resulting in limited explanatory power of the related indicators when applied for larger/longer scale assessments. We review the existing indicator approaches to derive quantitative measures for the snow conditions in ski areas, to formulate the criteria that the indicators should fulfill, and to provide a list of indicators with their technical specifications which can be used in snow condition assessments for ski tourism. For the use of these indicators, a three-step procedure consisting of definition, application, and interpretation is suggested. We also provide recommendations for the design of indicator-based assessments of climate change effects on ski tourism. Thereby, we highlight the importance of extensive stakeholder involvement to allow for real-world relevance of the achieved results.
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Affiliation(s)
- B Abegg
- Institute for Systemic Management and Public Governance, University of St. Gallen, 9000, St. Gallen, Switzerland.
- Department of Geography, University of Innsbruck, 6020, Innsbruck, Austria.
| | - S Morin
- Univ. Grenoble Alpes, Université de Toulouse, Météo-France Grenoble, CNRS, CNRM, Centre d'Etudes de la Neige, 38000 Grenoble, France
| | - O C Demiroglu
- Department of Geography and Arctic Research Centre, Umeå University (ARCUM), 901 87, Umeå, Sweden
| | - H François
- Univ. Grenoble Alpes, INRAE, LESSEM, 38000, Grenoble, France
| | - M Rothleitner
- Schneezentrum Tirol am MCI, The Entrepreneurial School, 6020, Innsbruck, Austria
| | - U Strasser
- Department of Geography, University of Innsbruck, 6020, Innsbruck, Austria
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Ferlicot S, Jamme M, Gaillard F, Oniszczuk J, Couturier A, May O, Grünenwald A, Sannier A, Moktefi A, Le Monnier O, Petit-Hoang C, Maroun N, Brodin-Sartorius A, Michon A, Dobosziewicz H, Andreelli F, Guillet M, Izzedine H, Richard C, Dekeyser M, Arrestier R, Sthelé T, Lefèvre E, Mathian A, Legendre C, Mussini C, Verpont MC, Pallet N, Amoura Z, Essig M, Snanoudj R, Brocheriou-Spelle I, François H, Belenfant X, Geri G, Daugas E, Audard V, Buob D, Massy ZA, Zaidan M. The spectrum of kidney biopsies in hospitalized patients with COVID-19, acute kidney injury, and/or proteinuria. Nephrol Dial Transplant 2021; 36:gfab042. [PMID: 33576823 PMCID: PMC7928708 DOI: 10.1093/ndt/gfab042] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [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: 11/19/2020] [Revised: 01/27/2021] [Indexed: 01/08/2023] Open
Abstract
We report a multicentric retrospective case series of patients with COVID-19 who developed acute kidney injury and/or proteinuria and underwent a kidney biopsy in the Paris and its metropolitan area. Forty-seven patients (80.9% men) with COVID-19 who underwent a kidney biopsy between March 08 and May 19, 2020 were included. Median age was 63 years IQR [52-69]. Comorbidities included hypertension (66.0%), diabetes mellitus (27.7%), obesity (27.7%), history of chronic kidney (25.5%), cardiac (38.6%) and respiratory (27.3%) diseases. Initial symptoms were fever (85.1%), cough (63.8%), shortness of breath (55.3%), and diarrhea (23.4%). Almost all patients developed acute kidney injury (97.9%) and 63.8% required renal replacement therapy. Kidney biopsy showed two main histopathological patterns, including acute tubular injury in 20 (42.6%) patients, and glomerular injury consisting of collapsing glomerulopathy and focal segmental glomerulosclerosis in 17 (36.2%) patients. Two (4.3%) patients had acute vascular nephropathy, while eight (17%) had alternative diagnosis most likely unrelated to COVID-19. Acute tubular injury occurred almost invariably in the setting of severe forms of COVID-19, whereas patients with glomerular injury had various profiles of COVID-19 severity and collapsing glomerulopathy was only observed in patients harboring a combination of APOL1 risk variants. At last follow-up, 16 of the 30 patients who initially required dialysis were still on dialysis, and 9 died. The present study describes the spectrum of kidney lesions in patients with COVID-19. While acute tubular injury is correlated with COVID-19 severity, the pattern of glomerular injury is intimately associated with the expression of APOL1 risk variants.
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Affiliation(s)
- Sophie Ferlicot
- Service d’Anatomie Pathologique, Assistance Publique-Hôpitaux de Paris (APHP) Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Club Francophone de Pathologie Rénale (CFPR) group
| | - Matthieu Jamme
- Service de Réanimation polyvalente, CH Intercommunal de Poissy Saint Germain en Laye, Poissy, France
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
| | - François Gaillard
- Service de Néphrologie, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, INSERM U1149, Paris, France
| | - Julie Oniszczuk
- Service de Néphrologie et Transplantation, Centre de Référence Maladies Rares « Syndrome Néphrotique Idiopathique », Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Créteil, France
| | - Aymeric Couturier
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
- Service de Néphrologie et Dialyse, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Universitaire Ambroise Paré, Boulogne Billancourt, France
| | - Olivia May
- Service de néphrologie-dialyse, GHT Grand Paris Nord Est, Hôpital André Grégoire, Montreuil sous Bois
| | - Anne Grünenwald
- Service de médecine intensive-réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Aurélie Sannier
- Club Francophone de Pathologie Rénale (CFPR) group
- Université de Paris, Assistance Publique-Hôpitaux de Paris (APHP), Service d’Anatomie et Cytologie Pathologiques, Hôpital Bichat, F-75018, Paris, France
| | - Anissa Moktefi
- Club Francophone de Pathologie Rénale (CFPR) group
- Service d’Anatomie Pathologique, Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Créteil, France
| | - Ophélie Le Monnier
- Sorbonne Université, Assistance Publique–Hôpitaux de Paris, Groupement Hospitalier Pitié–Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Camille Petit-Hoang
- Service UNTR, Assistance Publique-Hôpitaux de Paris (APHP), INSERM 1155, Sorbonne Université, Hôpital Tenon, Paris, France
| | - Nadine Maroun
- Service de Néphrologie et Dialyse, CH Intercommunal de Poissy Saint-Germain-en-Laye, Poissy, France
| | | | - Arthur Michon
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Hélène Dobosziewicz
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Fabrizio Andreelli
- Service de Diabétologie-Métabolismes, Assistance Publique-Hôpitaux de Paris (APHP), CHU Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Matthieu Guillet
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Hassane Izzedine
- Service de Néphrologie, Hôpital Privé des Peupliers, Ramsay Générale de Santé, Paris, France
| | - Christian Richard
- Service de médecine intensive-réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Manon Dekeyser
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Romain Arrestier
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, Assistance Publique-Hôpitaux de Paris (APHP), Univ Paris Est Créteil, Créteil, France
| | - Thomas Sthelé
- Service de Néphrologie et Transplantation, Centre de Référence Maladies Rares « Syndrome Néphrotique Idiopathique », Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Créteil, France
| | - Edouard Lefèvre
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Alexis Mathian
- Sorbonne Université, Assistance Publique–Hôpitaux de Paris, Groupement Hospitalier Pitié–Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Christophe Legendre
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Charlotte Mussini
- Service d’Anatomie Pathologique, Assistance Publique-Hôpitaux de Paris (APHP) Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Club Francophone de Pathologie Rénale (CFPR) group
| | - Marie-Christine Verpont
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, and Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1155, plate-forme d'Imagerie et de Cytométrie de Tenon, F-75020, Paris, France
| | - Nicolas Pallet
- Service de Biochimie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Européen Georges Pompidou, Paris, France
| | - Zahir Amoura
- Sorbonne Université, Assistance Publique–Hôpitaux de Paris, Groupement Hospitalier Pitié–Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Marie Essig
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
- Service de Néphrologie et Dialyse, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Universitaire Ambroise Paré, Boulogne Billancourt, France
| | - Renaud Snanoudj
- Service de Néphrologie-Dialyse-Transplantation, Hôpital Foch, Suresnes, France
| | - Isabelle Brocheriou-Spelle
- Club Francophone de Pathologie Rénale (CFPR) group
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1155, Assistance Publique-Hôpitaux de Paris, Pathology department, Hôpital de la Pitié-Salpêtrière
| | - Hélène François
- Service UNTR, Assistance Publique-Hôpitaux de Paris (APHP), INSERM 1155, Sorbonne Université, Hôpital Tenon, Paris, France
| | - Xavier Belenfant
- Service de néphrologie-dialyse, GHT Grand Paris Nord Est, Hôpital André Grégoire, Montreuil sous Bois
| | - Guillaume Geri
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
- Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Universitaire Ambroise Paré, Boulogne Billancourt, France
| | - Eric Daugas
- Service de Néphrologie, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, INSERM U1149, Paris, France
| | - Vincent Audard
- Service de Néphrologie et Transplantation, Centre de Référence Maladies Rares « Syndrome Néphrotique Idiopathique », Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Créteil, France
| | - David Buob
- Club Francophone de Pathologie Rénale (CFPR) group
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Service d’Anatomie et Cytologie Pathologiques, Hôpital Tenon, F-75020, Paris, France
| | - Ziad A Massy
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
- Service de Néphrologie et Dialyse, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Universitaire Ambroise Paré, Boulogne Billancourt, France
| | - Mohamad Zaidan
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
- INSERM U1163, Institut IMAGINE, Hôpital Necker-Enfants malades, 75005 Paris, France
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Mayet V, Mousseaux C, Petit-Hoang C, Ouali N, Rafat C, Mesnard L, Luque Y, Rondeau E, Buob D, François H. COVID-19-associated acute kidney injury: after the tubule and the glomerulus, now the vessel? Clin Kidney J 2020; 13:1105-1106. [PMID: 33391756 PMCID: PMC7769511 DOI: 10.1093/ckj/sfaa210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Valentin Mayet
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France
| | - Cyril Mousseaux
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France.,INSERM UMR-S 1155, Hospital Tenon, Paris, France.,Urgences Néphrologiques et Transplantation rénale, Sorbonne Université, Paris, France
| | - Camille Petit-Hoang
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France
| | - Nacera Ouali
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France
| | - Cedric Rafat
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France
| | - Laurent Mesnard
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France.,INSERM UMR-S 1155, Hospital Tenon, Paris, France.,Urgences Néphrologiques et Transplantation rénale, Sorbonne Université, Paris, France
| | - Yosu Luque
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France.,INSERM UMR-S 1155, Hospital Tenon, Paris, France.,Urgences Néphrologiques et Transplantation rénale, Sorbonne Université, Paris, France
| | - Eric Rondeau
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France.,INSERM UMR-S 1155, Hospital Tenon, Paris, France.,Urgences Néphrologiques et Transplantation rénale, Sorbonne Université, Paris, France
| | - David Buob
- INSERM UMR-S 1155, Hospital Tenon, Paris, France.,Urgences Néphrologiques et Transplantation rénale, Sorbonne Université, Paris, France.,Department of Anatomopathology, AP-HP, Hôpital Tenon, Paris, France
| | - Hélène François
- Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France.,INSERM UMR-S 1155, Hospital Tenon, Paris, France.,Urgences Néphrologiques et Transplantation rénale, Sorbonne Université, Paris, France
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18
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Abstract
Primary Sjögren syndrome is an autoimmune disorder characterized by lymphoplasmacytic infiltration of the exocrine (salivary and lachrymal) glands resulting in sicca symptoms (dryness). Systemic complications can occur in primary Sjögren syndrome, but renal involvement is rare, affecting<10% patients. The most frequent form of nephropathy in primary Sjögren syndrome is tubulointerstitial nephritis, where infiltration of the kidney by plasma cells is a key feature and shows similarity to the lymphoplasmacytic infiltration of the salivary glands. Electrolyte disturbances may occur in primary Sjögren syndrome, such as renal distal tubular acidosis, diabetes insipidus, Gitelman syndrome, or Fanconi syndrome. Glomerular involvement is less frequently detected in patients with primary Sjögren syndrome, but can take the form of membranoproliferative glomerulonephritis secondary to cryoglobulinaemia. The renal prognosis in patients with primary Sjögren syndrome and TIN or glomerular disease is usually good, but the risk of chronic kidney disease remains significant for some patients. Appropriate screening must be performed at least once a year in patients with systemic primary Sjögren syndrome in order to facilitate the early detection of renal complications. In this Review, we discuss the epidemiology, pathophysiology, differential diagnosis, and treatment of renal disease in primary Sjögren syndrome.
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Affiliation(s)
- Hélène François
- Département d'Urgences Néphrologiques et Transplantation Rénale, INSERM UMR_S 1155, Hôpital Tenon, Sorbonne université, AP-HP, Paris, France.
| | - Xavier Mariette
- Inserm, CEA, rheumatology department, centre de recherche en immunologie des infections virales et des maladies auto-immunes, université Paris-Saclay, hôpital Bicêtre, AP-HP, 94270 Le Kremlin-Bicêtre, France
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19
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Forté V, Alaoui Mdaghri A, Lamzawak A, Michel P, Boffa J, Petit-Hoang C, François H, Fessi H. Facteurs pronostiques de forme grave d’infection à SARS-CoV2 chez les hémodialysés : l’expérience d’un centre lourd. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.056] [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: 10/23/2022]
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20
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Lombardi Y, Fessi H, François H, Michel P, Ouali N, Petit-Hoang C, Rondeau E. Impact de la modalité du traitement de suppléance rénale sur le pronostic de l’infection à SARS-CoV2. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.202] [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: 10/23/2022]
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21
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Meyer L, Ulrich M, Ducloux D, Garrigue V, Vigneau C, Nochy D, Bobrie G, Ferlicot S, Colombat M, Boffa JJ, Clabault K, Mansour J, Mousson C, Azar R, Bacri JL, Dürrbach A, Duvic C, El Karoui K, Hoffmann M, Lionet A, Panescu V, Plaisier E, Ratsimbazafy A, Guerrot D, Vrigneaud L, Valleix S, François H. Organ Transplantation in Hereditary Fibrinogen A α-Chain Amyloidosis: A Case Series of French Patients. Am J Kidney Dis 2020; 76:384-391. [PMID: 32660897 DOI: 10.1053/j.ajkd.2020.02.445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 02/04/2020] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Fibrinogen A α-chain amyloidosis (AFib amyloidosis) is a form of amyloidosis resulting from mutations in the fibrinogen A α-chain gene (FGA), causing progressive kidney disease leading to kidney failure. Treatment may include kidney transplantation (KT) or liver-kidney transplantation (LKT), but it is not clear what factors should guide this decision. The aim of this study was to characterize the natural history and long-term outcomes of this disease, with and without organ transplantation, among patients with AFib amyloidosis and various FGA variants. STUDY DESIGN Case series. SETTING & PARTICIPANTS 32 patients with AFib amyloidosis diagnosed by genetic testing in France between 1983 and 2014, with a median follow-up of 93 (range, 4-192) months, were included. RESULTS Median age at diagnosis was 51.5 (range, 12-77) years. Clinical presentation consisted of proteinuria (93%), hypertension (83%), and kidney failure (68%). Manifestations of kidney disease appeared on average at age 57 (range, 36-77) years in patients with the E526V variant, at age 45 (range, 12-59) years in those with the R554L variant (P<0.001), and at age 24.5 (range, 12-31) years in those with frameshift variants (P<0.001). KT was performed in 15 patients and LKT was performed in 4. In KT patients with the E526V variant, recurrence of AFib amyloidosis in the kidney graft was less common than with a non-E526V (R554L or frameshift) variant (22% vs 83%; P=0.03) and led to graft loss less frequently (33% vs 100%). Amyloid recurrence was not observed in patients after LKT. LIMITATIONS Analyses were based on clinically available historical data. Small number of patients with non-E526V and frameshift variants. CONCLUSIONS Our study suggests phenotypic variability in the natural history of AFib amyloidosis, depending on the FGA mutation type. KT appears to be a viable option for patients with the most common E526V variant, whereas LKT may be a preferred option for patients with frameshift variants.
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Affiliation(s)
- Lara Meyer
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Nephrology, Université Paris Descartes, Paris
| | - Marc Ulrich
- Department of Nephrology, Hôpital Jean Bernard, Valenciennes, France
| | - Didier Ducloux
- Department of Nephrology, Centre Hospitalier Universitaire de Besançon, France
| | - Valérie Garrigue
- Department of Nephrology, Hôpital Lapeyronie, Montpellier, France
| | - Cécile Vigneau
- Department of Nephrology, Centre Hospitalier Universitaire de Rennes, France
| | - Dominique Nochy
- Departments of Pathology, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, Paris, France
| | - Guillaume Bobrie
- Departments of Hypertension, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, France
| | - Sophie Ferlicot
- Hôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, Paris, Department of Pathology, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Le Kremlin-Bicêtre, France
| | - Magalie Colombat
- Department of Pathology, Centre Hospitalier Universitaire de Toulouse, France
| | - Jean-Jacques Boffa
- Department of Nephrology and Dialysis, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France
| | | | | | - Christiane Mousson
- Department of Nephrology, Centre Hospitalier Unversitaire de Dijon, France
| | - Raymond Azar
- Department of Nephrology, Centre Hospitalier de Dunkerque, France
| | - Jean-Louis Bacri
- Department of Nephrology, Hôpital Jean Bernard, Valenciennes, France
| | - Antoine Dürrbach
- Department of Nephrology, Dialysis and Transplantation, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Le Kremlin-Bicêtre
| | - Christian Duvic
- Department of Hemodialysis Clinique de Choisy, Le Gosier, Guadeloupe
| | | | - Maxime Hoffmann
- Department of Nephrology and Dialysis, Hôpital Privé La Louvière, Groupe Ramsay Générale de Santé, Lille
| | - Arnaud Lionet
- Department of Nephrology, and Transplantation, Centre Hospitalier Régional et Universitaire de Lille, France
| | - Victor Panescu
- Department of Nephrology and Hemodialysis, Polyclinique de Gentilly, Gentilly, France
| | - Emmanuelle Plaisier
- Department of Nephrology and Dialysis, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France
| | | | - Dominique Guerrot
- Department of Nephrology and Dialysis, Centre Hospitalier Bois Guillaume, Rouen
| | - Laurence Vrigneaud
- Department of Nephrology and Dialysis, Hôpital Privé La Louvière, Groupe Ramsay Générale de Santé, Lille
| | - Sophie Valleix
- Department of Genetic Necker Hospital, AP-HP, Université Paris Descartes, Paris AP-HP, France.
| | - Hélène François
- Department of Nephrology and Transplantation, Hôpital Tenon, Sorbonne Université, Paris, France.
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22
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Dao M, Pouliquen C, Duquesne A, Posseme K, Mussini C, Durrbach A, Guettier C, François H, Ferlicot S. Usefulness of morphometric image analysis with Sirius Red to assess interstitial fibrosis after renal transplantation from uncontrolled circulatory death donors. Sci Rep 2020; 10:6894. [PMID: 32327683 PMCID: PMC7181605 DOI: 10.1038/s41598-020-63749-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 03/19/2020] [Indexed: 11/12/2022] Open
Abstract
Early interstitial fibrosis (IF) correlates with long-term renal graft dysfunction, highlighting the need for accurate quantification of IF. However, the currently used Banff classification exhibits some limitations. The aim of our study was to precisely describe the progression of IF after renal transplantation using a new morphometric image analysis method relying of Sirius Red staining. The morphometric analysis we developed showed high inter-observer and intra-observer reproducibility, with ICC [95% IC] of respectively 0.75 [0.67–0.81] (n = 151) and 0.88 [0.72–0.95] (n = 21). We used this method to assess IF (mIF) during the first year after the kidney transplantation from 66 uncontrolled donors after circulatory death (uDCD). Both mIF and interstitial fibrosis (ci) according to the Banff classification significantly increased the first three months after transplantation. From M3 to M12, mIF significantly increased whereas Banff classification failed to highlight increase of ci. Moreover, mIF at M12 (p = 0.005) correlated with mean time to graft function recovery and was significantly associated with increase of creatininemia at M12 and at last follow-up. To conclude, the new morphometric image analysis method we developed, using a routine and cheap staining, may provide valuable tool to assess IF and thus to evaluate new sources of grafts.
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Affiliation(s)
- Myriam Dao
- AP-HP, Service de Néphrologie adulte, Hôpital Necker, 75015, Paris, France.,Inserm UMR_S 1155, Hôpital Tenon, 75020, Paris, France
| | | | - Alyette Duquesne
- Service de Néphrologie, CHI André Grégoire, 93100, Montreuil, France
| | - Katia Posseme
- AP-HP, Service d'Anatomie et de Cytologie Pathologiques, Hôpital de Bicêtre, 94270 Le Kremlin Bicêtre, France, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Charlotte Mussini
- AP-HP, Service d'Anatomie et de Cytologie Pathologiques, Hôpital de Bicêtre, 94270 Le Kremlin Bicêtre, France, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Antoine Durrbach
- AP-HP, Service de Néphrologie, Hôpital de Bicêtre, 94270 Le Kremlin Bicêtre, France, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Catherine Guettier
- AP-HP, Service d'Anatomie et de Cytologie Pathologiques, Hôpital de Bicêtre, 94270 Le Kremlin Bicêtre, France, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Hélène François
- Inserm UMR_S 1155, Hôpital Tenon, 75020, Paris, France. .,AP-HP, Unité de Néphrologie et de Transplantation rénale, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, Sorbonne Université, Paris, France.
| | - Sophie Ferlicot
- AP-HP, Service d'Anatomie et de Cytologie Pathologiques, Hôpital de Bicêtre, 94270 Le Kremlin Bicêtre, France, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
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23
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Doreille A, Vilaine E, Belenfant X, Massy Z, Luque Y, Rondeau E, Benhamou D, François H. Peut-on apprendre l’empathie ? Retour d’expérience sur l’enseignement de la consultation d’annonce de la maladie rénale chronique en Île-de-France. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.248] [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: 10/26/2022]
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24
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Doreille A, Raymond L, Yosu L, Xu X, Homs S, François H, Rafat C, Ouali N, Rondeau E, Mesnard L. Séquençage complet de l’exome dans les néphropathies indéterminées des jeunes adultes : séquençage d’abord et rétrophénotypage ensuite ? Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Dao M, Lecru L, Vandermeersch S, Ferreira M, Ferlicot S, Posseme K, Dürrbach A, Hermeziu B, Mussini C, Chatziantoniou C, François H. The cannabinoid receptor 1 is involved in renal fibrosis during chronic allograft dysfunction: Proof of concept. J Cell Mol Med 2019; 23:7279-7288. [PMID: 31469511 PMCID: PMC6815790 DOI: 10.1111/jcmm.14570] [Citation(s) in RCA: 10] [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: 01/18/2019] [Revised: 05/14/2019] [Accepted: 06/28/2019] [Indexed: 12/22/2022] Open
Abstract
Chronic allograft dysfunction (CAD), defined as the replacement of functional renal tissue by extracellular matrix proteins, remains the first cause of graft loss. The aim of our study was to explore the potential role of the cannabinoid receptor 1 (CB1) during CAD. We retrospectively quantified CB1 expression and correlated it with renal fibrosis in 26 kidney‐transplanted patients who underwent serial routine kidney biopsies. Whereas CB1 expression was low in normal kidney grafts, it was highly expressed during CAD, especially in tubular cells. CB1 expression significantly increased early on after transplantation, from day 0 (D0) to month 3 post‐transplant (M3) (22.5% ± 15.4% vs 33.4% ± 13.8%, P < .01), and it remained stable thereafter. CB1 expression correlated with renal fibrosis at M3 (P = .04). In an in vitro model of tacrolimus‐mediated fibrogenesis by tubular cells, we found that tacrolimus treatment significantly induced mRNA and protein expression of CB1 concomitantly to col3a1 and col4a3 up regulation. Administration of rimonabant, a CB1 antagonist, blunted collagen synthesis by tubular cells (P < .05). Overall, our study strongly suggests an involvement of the cannabinoid system in the progression of fibrosis during CAD and indicates the therapeutic potential of CB1 antagonists in this pathology.
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Affiliation(s)
- Myriam Dao
- Inserm UMR_S 1155, Hôpital Tenon, Paris, France.,APHP, Service de Néphrologie Adulte, Hôpital Necker, Paris, France
| | | | | | | | - Sophie Ferlicot
- AP-HP, Service d'Anatomie et de Cytologie Pathologiques, Hôpital Bicêtre, Université Paris Sud, Le Kremlin Bicêtre, France
| | - Katia Posseme
- AP-HP, Service d'Anatomie et de Cytologie Pathologiques, Hôpital Bicêtre, Université Paris Sud, Le Kremlin Bicêtre, France
| | - Antoine Dürrbach
- AP-HP, Service de Néphrologie, Hôpital Bicêtre, Université Paris Sud, Le Kremlin Bicêtre, France
| | - Bogdan Hermeziu
- AP-HP, Service d'Hépatologie Pédiatrique, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Charlotte Mussini
- AP-HP, Service d'Anatomie et de Cytologie Pathologiques, Hôpital Bicêtre, Université Paris Sud, Le Kremlin Bicêtre, France
| | | | - Hélène François
- Inserm UMR_S 1155, Hôpital Tenon, Paris, France.,AP-HP, Unité de Néphrologie et de Transplantation rénale, Hôpital Tenon, Sorbonne Université, Paris, France
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26
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Dao M, Lecru L, Ferlicot S, Vandermeersch S, Durrbach A, Chatziantoniou C, François H. Le rôle des récepteurs cannabinoïdes dans la dysfonction chronique de l’allogreffe. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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27
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Dao M, Reimbold P, François H, Mussini C, Guettier C, Durrbach A, Posseme K, Bessede T, Ferlicot S. Tumeurs de vessie chez les transplantés rénaux : vers un rôle oncogène du BK virus. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.395] [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: 11/15/2022]
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28
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Touzot M, Terrier CSP, Faguer S, Masson I, François H, Couzi L, Hummel A, Quellard N, Touchard G, Jourde-Chiche N, Goujon JM, Daugas E. Proliferative lupus nephritis in the absence of overt systemic lupus erythematosus: A historical study of 12 adult patients. Medicine (Baltimore) 2017; 96:e9017. [PMID: 29310419 PMCID: PMC5728820 DOI: 10.1097/md.0000000000009017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Severe lupus nephritis in the absence of systemic lupus erythematosus (SLE) is a rare condition with an unclear clinical presentation and outcome.We conducted a historical observational study of 12 adult (age >18 years) patients with biopsy-proven severe lupus nephritis or lupus-like nephritis without SLE immunological markers at diagnosis or during follow-up. Excluded were patients with chronic infections with HIV or hepatitis B or C; patients with a bacterial infectious disease; and patients with pure membranous nephropathy. Electron microscopy was retrospectively performed when the material was available. End points were the proportion of patients with a complete response (urine protein to creatinine ratio <0.5 g/day and a normal or near-normal eGFR), partial response (≥50% reduction in proteinuria to subnephrotic levels and a normal or near-normal eGFR), or nonresponse at 12 months or later after the initiation of the treatment.The study included 12 patients (66% female) with a median age of 36.5 years. At diagnosis, median creatinine and proteinuria levels were 1.21 mg/dL (range 0.5-11.6) and 7.5 g/day (1.4-26.7), respectively. Six patients had nephrotic syndrome and acute kidney injury. Renal biopsy examinations revealed class III or class IV A/C lupus nephritis in all cases. Electron microscopy was performed on samples from 5 patients. The results showed mesangial and subendothelial dense deposits consistent with LN in 4 cases, and a retrospective diagnosis of pseudo-amyloid fibrillary glomerulonephritis was made in 1 patient.Patients received immunosuppressive therapy consisting of induction therapy followed by maintenance therapy, similar to treatment for severe lupus nephritis. Remission was recorded in 10 patients at 12 months after the initiation of treatment. One patient reached end-stage renal disease. After a median follow-up of 24 months, 2 patients relapsed.Lupus nephritis in the absence of overt SLE is a nosological entity requiring careful etiological investigation, including systematic electron microscopy examination of renal biopsies to rule out fibrillary glomerulonephritis. In this series, most patients presented with severe glomerulonephritis, which was highly similar to lupus nephritis at presentation and in terms of response to immunosuppressive therapy.
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Affiliation(s)
| | | | - Stanislas Faguer
- Département de Néphrologie et Transplantation d’organes, Hôpital Rangueil, CHU de Toulouse
| | - Ingrid Masson
- Service de néphrologie, Service de néphrologie, CHU Saint-Etienne
| | - Hélène François
- Service de Médecine interne et immunologie clinique, CHU Bicêtre, Kremlin-Bicêtre
| | - Lionel Couzi
- Service de néphrologie-transplantation, CHU de Bordeaux, FHU ACRONYM, CNRS-UMR 5164 Immuno Concept
| | | | | | | | | | | | - Eric Daugas
- Service de néphrologie, CHU Bichat, AP-HP, INSERM U1199, Paris Diderot University and DHU FIRE, Paris, France
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Kofman T, Pourcine F, Canoui-Poitrine F, Kamar N, Malvezzi P, François H, Boutin E, Audard V, Lang P, Martinez F, Legendre C, Matignon M, Grimbert P. Safety of renal transplantation in patients with bipolar or psychotic disorders: a retrospective study. Transpl Int 2017; 31:377-385. [PMID: 28945291 DOI: 10.1111/tri.13078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 04/11/2017] [Accepted: 09/18/2017] [Indexed: 02/05/2023]
Abstract
Solid organ transplantation societies recommend a relative contraindication of transplantation for people with bipolar or psychotic disorders. Very few data are available on the outcome of kidney transplantation and the increased risk of kidney disease in those patients. We conducted a retrospective multicenter cohort study (1979-2014) including kidney allograft recipients with either bipolar (BD) or psychotic disorders prior to transplant. Objectives were kidney allograft and patient outcomes compared to a matched control group without psychiatric disorders and the evolution of psychiatric disorder at 60 months after transplantation. Forty-seven patients including 25 women were identified, 34 with BD and 13 with psychotic disorder. Patients' overall cumulative death rates at 60 months were not significantly different in both groups [12.2%; 95% confidence interval: (4.5-24.1) in the group with psychiatric disorder versus 5.2%; (1.7-11.7) in control group P = 0.11] as for cumulative allograft loss rates [11.7% (3.5-25.2) vs. 9.4% (4.4-16.8) in control group (P = 0.91)]. Twenty-three patients (16 with BD and seven with psychotic disorder) experienced at least one psychiatric relapse [incidence rate: 1.8/100 persons- months; 95% CI; (1.2-2.7)] totaling 13 hospitalizations within 60 months of follow-up. Four patients stopped immunosuppressive therapy leading to allograft loss in three. Our study suggests that patients with BD or psychotic disorders have to be considered for renal transplantation with close psychiatric follow-up after transplant.
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Affiliation(s)
- Tomek Kofman
- Nephrology and Renal Transplantation Department, AP-HP, Hôpital Henri Mondor, Créteil, France.,UPEC, Université Paris-Est, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Néphrologie, Centre Hospitalier Annecy Genevois, Metz Tessy, France
| | - Franck Pourcine
- Nephrology and Renal Transplantation Department, AP-HP, Hôpital Henri Mondor, Créteil, France.,UPEC, Université Paris-Est, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Department of Nephrology and Adult Transplantation, AP-HP, Hôpital Necker, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Florence Canoui-Poitrine
- Public Health Department, AP-HP, Henri-Mondor Hospital, Créteil, France.,UPEC, DHU A-TVB, IMRB-EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Université Paris-Est, Créteil, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,Université Paul Sabatier, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France
| | - Paolo Malvezzi
- Clinique de Néphrologie, University Hospital, Grenoble, France
| | - Hélène François
- Department of Nephrology, Dialysis, and Transplantation, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Paris, France
| | - Emmanuelle Boutin
- Public Health Department, AP-HP, Henri-Mondor Hospital, Créteil, France.,UPEC, DHU A-TVB, IMRB-EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Université Paris-Est, Créteil, France
| | - Vincent Audard
- Nephrology and Renal Transplantation Department, AP-HP, Hôpital Henri Mondor, Créteil, France.,UPEC, Université Paris-Est, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Philippe Lang
- Nephrology and Renal Transplantation Department, AP-HP, Hôpital Henri Mondor, Créteil, France.,UPEC, Université Paris-Est, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Frank Martinez
- Department of Nephrology and Adult Transplantation, AP-HP, Hôpital Necker, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Christophe Legendre
- Department of Nephrology and Adult Transplantation, AP-HP, Hôpital Necker, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, AP-HP, Hôpital Henri Mondor, Créteil, France.,UPEC, Université Paris-Est, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Philippe Grimbert
- Nephrology and Renal Transplantation Department, AP-HP, Hôpital Henri Mondor, Créteil, France.,UPEC, Université Paris-Est, Créteil, France.,INSERM U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,AP-HP, CIC-BT 504, Créteil, France
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30
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Romain A, Sahali D, Isnard-Bagnis C, Gatault P, Raimbourg Q, Buob D, Heng A, François H, Matignon M, Brochériou I, Plaisier E, Audard V. Syndrome néphrotique à lésions glomérulaires minimes associé à l’infection par le VIH : à propos de huit cas. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.204] [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: 11/26/2022]
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31
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Kormann R, François H, Moles T, Dantal J, Kamar N, Moreau K, Bachelet T, Heng AE, Garstka A, Colosio C, Ducloux D, Sayegh J, Savenkoff B, Viglietti D, Sberro R, Rondeau E, Peltier J. Plasma cell neoplasia after kidney transplantation: French cohort series and review of the literature. PLoS One 2017; 12:e0179406. [PMID: 28636627 PMCID: PMC5479561 DOI: 10.1371/journal.pone.0179406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/30/2017] [Indexed: 12/30/2022] Open
Abstract
Although post-transplant lymphoproliferative disorder (PTLD) is the second most common type of cancer in kidney transplantation (KT), plasma cell neoplasia (PCN) occurs only rarely after KT, and little is known about its characteristics and evolution. We included twenty-two cases of post-transplant PCN occurring between 1991 and 2013. These included 12 symptomatic multiple myeloma, eight indolent myeloma and two plasmacytomas. The median age at diagnosis was 56.5 years and the median onset after transplantation was 66.7 months (2-252). Four of the eight indolent myelomas evolved into symptomatic myeloma after a median time of 33 months (6-72). PCN-related kidney graft dysfunction was observed in nine patients, including six cast nephropathies, two light chain deposition disease and one amyloidosis. Serum creatinine was higher at the time of PCN diagnosis than before, increasing from 135.7 (±71.6) to 195.9 (±123.7) μmol/l (p = 0.008). Following transplantation, the annual rate of bacterial infections was significantly higher after the diagnosis of PCN, increasing from 0.16 (±0.37) to 1.09 (±1.30) (p = 0.0005). No difference was found regarding viral infections before and after PCN. Acute rejection risk was decreased after the diagnosis of PCN (36% before versus 0% after, p = 0.004), suggesting a decreased allogeneic response. Thirteen patients (59%) died, including twelve directly related to the hematologic disease. Median graft and patient survival was 31.7 and 49.4 months, respectively. PCN after KT occurs in younger patients compared to the general population, shares the same clinical characteristics, but is associated with frequent bacterial infections and relapses of the hematologic disease that severely impact the survival of grafts and patients.
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Affiliation(s)
- Raphaël Kormann
- Service d'Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, APHP, Université Pierre et Marie Curie, Paris, France
| | - Hélène François
- Service de Néphrologie, Hôpital Bicêtre, APHP, Université Paris Sud, Paris, France
| | - Thibault Moles
- Service de Néphrologie et d'Immunologie Clinique, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Jacques Dantal
- Service de Néphrologie et d'Immunologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Nassim Kamar
- Service de Néphrologie et Transplantation, CHU Rangueil, Toulouse, Toulouse, France
| | - Karine Moreau
- Service de Néphrologie et Transplantation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Thomas Bachelet
- Centre de Traitement des Maladies Rénales-Clinique Saint Augustin, 96 avenue d’Arès, Bordeaux, France
| | - Anne-Elisabeth Heng
- Service de Néphrologie—Hémodialyses, Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand, France
| | - Antoine Garstka
- Service de Néphrologie, Centre Hospitalier Regional Universitaire de Lille, Lille, France
| | - Charlotte Colosio
- Service de Néphrologie—Hypertension artérielle—Hémodialyse—Transplantation, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Didier Ducloux
- Service de Néphrologie-Dialyse, Centre Hospitalier Régional Universitaire, Hôpital Jean Minjoz, Besançon, France
| | - Johnny Sayegh
- Service de Néphrologie—Dialyse—Transplantation, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Benjamin Savenkoff
- Service de Néphrologie et Transplantation, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-Les-Nancy, France
| | - Denis Viglietti
- Service de Néphrologie, Hôpital Saint Louis, Université Denis Diderot-Paris VII AP-HP, Paris, France
| | - Rebecca Sberro
- Service de Transplantation, Hôpital Necker, Université Paris Descartes AP-HP, Paris, France
| | - Eric Rondeau
- Service d'Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, APHP, Université Pierre et Marie Curie, Paris, France
| | - Julie Peltier
- Service d'Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, APHP, Université Pierre et Marie Curie, Paris, France
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Jasiek M, Karras A, Le Guern V, Krastinova E, Mesbah R, Faguer S, Jourde-Chiche N, Fauchais AL, Chiche L, Dernis E, Moulis G, Fraison JB, Lazaro E, Jullien P, Hachulla E, Le Quellec A, Rémy P, Hummel A, Costedoat-Chalumeau N, Ronco P, Vanhille P, Meas-Yedid V, Cordonnier C, Ferlicot S, Daniel L, Seror R, Mariette X, Thervet E, François H, Terrier B. A multicentre study of 95 biopsy-proven cases of renal disease in primary Sjögren's syndrome. Rheumatology (Oxford) 2017; 56:362-370. [PMID: 27940588 DOI: 10.1093/rheumatology/kew376] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Indexed: 12/24/2022] Open
Abstract
Objective. Renal involvement is a rare event during primary SS (pSS). We aimed to describe the clinico-biological and histopathological characteristics of pSS-related nephropathy and its response to treatment. Methods. We conducted a French nationwide, retrospective, multicentre study including pSS patients fulfilling American-European Consensus Group criteria or enlarged American-European Consensus Group criteria, and with biopsy-proven renal involvement. Results. A total of 95 patients were included (median age 49 years). An estimated glomerular filtration rate (eGFR) of <60 ml/min was found in 82/95 patients (86.3%). Renal biopsy demonstrated tubulointerstitial nephritis (TIN) in 93 patients (97.9%), and frequent (75%) plasma cell infiltrates. Glomerular lesions were found in 22 patients (23.2%), mainly related to cryoglobulin. The presence of anti-SSA (76.8%) and anti-SSB (53.8%) antibodies was particularly frequent among patients with TIN and was associated with a worse renal prognosis. Eighty-one patients (85.3%) were treated, with CSs in 80 (98.8%) and immunosuppressive agents (mostly rituximab) in 21 cases (25.9%). Despite marked interstitial fibrosis at initial biopsy, kidney function improved significantly during the 12-month period following diagnosis (final eGFR 49.9 vs 39.8 ml/min/1.73 m 2 at baseline, P < 0.001). No proven benefit of immunosuppressive agents over steroid therapy alone was found in this study. Conclusion. Renal involvement of pSS is mostly due to TIN with marked T, B and especially plasma cell infiltration. Renal dysfunction is usually isolated but can be severe. Use of CSs can improve the eGFR, but further studies are needed to define the best therapeutic strategy in this disease.
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Affiliation(s)
- Magali Jasiek
- Department of Nephrology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Le Kremlin-Bicêtre
| | - Alexandre Karras
- Department of Nephrology, Hôpital Européen Georges Pompidou, AP-HP
| | - Véronique Le Guern
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris
| | - Evguenia Krastinova
- Department of Epidemiology and Statistics, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Le Kremlin-Bicêtre
| | - Rafik Mesbah
- Department of Nephrology, Centre Hospitalier, Boulogne-Sur-Mer
| | - Stanislas Faguer
- Department of Nephrology and Organ Transplantation, Hôpital Rangueil, Toulouse
| | | | | | - Laurent Chiche
- Department of Internal Medicine, Hôpital Européen, Marseille
| | | | | | | | | | - Perrine Jullien
- Department of Internal Medicine, CHU Saint-Étienne, Saint-Étienne
| | - Eric Hachulla
- Department of Internal Medicine, Hôpital Claude Huriez, Université Lille 2, Lille
| | - Alain Le Quellec
- Department of Internal Medicine, Hôpital Saint-Eloi, Montpellier
| | - Philippe Rémy
- Department of Nephrology, Hôpital Henri Mondor, Créteil
| | | | - Nathalie Costedoat-Chalumeau
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris
| | | | | | | | | | - Sophie Ferlicot
- Department of Pathology, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Le Kremlin-Bicêtre
| | | | - Raphaele Seror
- Department of Rheumatology, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Le Kremlin-Bicêtre.,Center of Immunology of Viral and Autoimmune Diseases (IMVA), INSRM U1184, Le Kremlin-Bicêtre, France
| | - Xavier Mariette
- Department of Rheumatology, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Le Kremlin-Bicêtre.,Center of Immunology of Viral and Autoimmune Diseases (IMVA), INSRM U1184, Le Kremlin-Bicêtre, France
| | - Eric Thervet
- Department of Nephrology, Hôpital Européen Georges Pompidou, AP-HP
| | - Hélène François
- Department of Nephrology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Le Kremlin-Bicêtre
| | - Benjamin Terrier
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris
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da Silva JP, Prola A, Guilbert A, Lecru L, Piquereau J, Ribeiro M, Mateo P, Gressette M, Gallerne C, François H, Eid P, Ventura-Clapier R, Garnier A, Lemaire C. SIRT1 protects the heart from endoplasmic reticulum stress-induced apoptosis through eIF2α deacetylation. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30429-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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34
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Meyer L, Ulrich M, Ducloux D, Garrigue V, Vigneau C, Boffa J, Clabault K, Mousson C, Nochy D, Vrigneaud L, François H, Valleix S. Caractéristiques génétiques, phénotypiques et évolutives de l’amylose à fibrinogène : une série française. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.321] [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: 11/29/2022]
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35
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Touzot M, Saint Pastou Terrier C, Faguer S, Masson I, Pons A, Saadoun D, François H, Couzi L, Jourde-Chiche N, Goujon J, Daugas E. Glomérulonéphrites lupiques séronégatives : étude rétrospective multicentrique de 12 cas par le Groupe coopératif sur le lupus rénal. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.351] [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: 11/26/2022]
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36
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Quirins M, Labeyrie C, Dekeyser M, François H, Gasnault J, Durrbach A, Adams D. Survenue d’un cas de LEMP chez un patient greffé rénal traité par bélatacept. Rev Neurol (Paris) 2016. [DOI: 10.1016/j.neurol.2016.01.311] [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: 11/26/2022]
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37
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Danlos FX, Daoued-Keffi F, Rohmer J, Cluzel G, Blanc-Autran E, François H, Lazure T, Seror R, Mariette X. IgG4-related disease associated with renal microaneurysms and polycythaemia. Rheumatology (Oxford) 2016; 55:380-2. [PMID: 26464522 PMCID: PMC5854041 DOI: 10.1093/rheumatology/kev365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/02/2015] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | | | - Estelle Blanc-Autran
- Service de médecine nucléaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson
| | | | - Thierry Lazure
- Service d'anatomopathologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France
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38
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Champiat S, Lambotte O, Barreau E, Belkhir R, Berdelou A, Carbonnel F, Cauquil C, Chanson P, Collins M, Durrbach A, Ederhy S, Feuillet S, François H, Lazarovici J, Le Pavec J, De Martin E, Mateus C, Michot JM, Samuel D, Soria JC, Robert C, Eggermont A, Marabelle A. Management of immune checkpoint blockade dysimmune toxicities: a collaborative position paper. Ann Oncol 2015; 27:559-74. [PMID: 26715621 DOI: 10.1093/annonc/mdv623] [Citation(s) in RCA: 600] [Impact Index Per Article: 66.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 12/18/2015] [Indexed: 12/13/2022] Open
Abstract
Monoclonal antibodies targeted against the immune checkpoint molecules CTLA-4 and PD-1 have recently obtained approval for the treatment of metastatic melanoma and advanced/refractory non small-cell lung cancers. Therefore, their use will not be limited anymore to selected hospitals involved in clinical trials. Indeed, they will be routinely prescribed in many cancer centers across the world. Besides their efficacy profile, these immune targeted agents also generate immune-related adverse events (irAEs). This new family of dysimmune toxicities remains largely unknown to the broad oncology community. Although severe irAEs remain rare (∼10% of cases under monotherapy), they can become life-threatening if not anticipated and managed appropriately. Over the last 5 years, Gustave Roussy has accumulated a significant experience in the prescription of immune checkpoint blockade (ICB) antibodies and the management of their toxicities. Together with the collaboration of Gustave Roussy's network of organ specialists with expertise in irAEs, we propose here some practical guidelines for the oncologist to help in the clinical care of patients under ICB immunotherapy.
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Affiliation(s)
- S Champiat
- Department of Drug Development (DITEP), Gustave Roussy Inserm U981, Univ. Paris-Sud, Université Paris-Saclay, Villejuif
| | - O Lambotte
- Department of Internal Medicine and Clinical Immunology, Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Bicêtre, Le Kremlin Bicêtre Université Paris Sud 11, Le Kremlin-Bicêtre CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Fontenay-aux-Roses INSERM, U1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Le Kremlin-Bicêtre
| | - E Barreau
- Department of Ophthalmology, Hôpital Universitaire Bicêtre, Le Kremlin Bicêtre
| | - R Belkhir
- Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre
| | - A Berdelou
- Department of Nuclear Medicine and Endocrine Tumors, Gustave Roussy, Univ. Paris-Sud, Université Paris-Saclay, Villejuif
| | - F Carbonnel
- Gastroenterology Unit, Université Paris-Sud, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre
| | - C Cauquil
- Division of Adult Neurology, Hôpital Universitaire Bicêtre, Le Kremlin Bicêtre
| | - P Chanson
- Faculty of Medicine, Université Paris-Saclay, Univ Paris-Sud, Paris-Sud, UMR-S1185, Le Kremlin Bicêtre Unit of Endocrinology and reproductive Health, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre Unit of Gastroenterology, Institut National de la Santé et de la Recherche Médicale U1185 (P.C.), Le Kremlin Bicêtre
| | - M Collins
- Gastroenterology Unit, Université Paris-Sud, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre
| | - A Durrbach
- Department of Nephrology and Transplantation, Bicêtre Hospital, Paris Saclay University, INSERM 1197, Le Kremlin Bicêtre
| | - S Ederhy
- Department of Cardiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie University [UPMC], Paris-Sorbonne, Paris
| | - S Feuillet
- Department of Thoracic and cardiovascular, and transplantation cardio-pulmonary, Hôpital Marie-Lannelongue, Le Plessis-Robinson Univ. Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre
| | - H François
- Department of Nephrology and Transplantation, Bicêtre Hospital, Paris Saclay University, INSERM 1197, Le Kremlin Bicêtre
| | - J Lazarovici
- Hematology Unit, Department of Medical Oncology, Gustave Roussy, Univ. Paris-Sud, Université Paris-Saclay, Villejuif
| | - J Le Pavec
- Department of Thoracic and cardiovascular, and transplantation cardio-pulmonary, Hôpital Marie-Lannelongue, Le Plessis-Robinson Univ. Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre UMR_S 999, Univ. Paris-Sud; INSERM; Hôpital Marie Lannelongue, Le Plessis Robinson
| | - E De Martin
- Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse Inserm U1193
| | - C Mateus
- Dermatology Unit, Department of Medical Oncology, Gustave Roussy, Univ. Paris-Sud, Université Paris-Saclay, Villejuif
| | - J-M Michot
- Department of Drug Development (DITEP), Gustave Roussy
| | - D Samuel
- Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse Inserm U1193
| | - J-C Soria
- Department of Drug Development (DITEP), Gustave Roussy Inserm U981, Univ. Paris-Sud, Université Paris-Saclay, Villejuif
| | - C Robert
- Inserm U981, Univ. Paris-Sud, Université Paris-Saclay, Villejuif Dermatology Unit, Department of Medical Oncology, Gustave Roussy, Univ. Paris-Sud, Université Paris-Saclay, Villejuif
| | | | - A Marabelle
- Department of Drug Development (DITEP), Gustave Roussy Gustave Roussy Cancer Campus, Villejuif Inserm 1015, Univ. Paris-Sud, Université Paris-Saclay, Villejuif, France
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Abstract
Primary Sjögren syndrome (pSS) is an autoimmune disorder characterized by lymphoplasmacytic infiltration of the exocrine (salivary and lachrymal) glands that results in sicca symptoms (dryness of the eyes and mouth). Systemic complications can occur in pSS, but renal involvement is rare, affecting <10% patients. The most frequent form of nephropathy in pSS is tubulointerstitial nephritis (TIN), in which infiltration of the kidney by plasma cells is a key feature and shows similarity to the lymphoplasmacytic infiltration of the salivary glands. Electrolyte disturbances may occur in pSS, such as renal distal tubular acidosis, diabetes insipidus, Gitelman syndrome or Fanconi syndrome. Glomerular involvement is less frequently detected in patients with pSS, but usually takes the form of membranoproliferative glomerulonephritis secondary to cryoglobulinaemia. The renal prognosis in patients with pSS and TIN or glomerular disease is usually favourable, but the risk of chronic kidney disease remains high in patients with TIN. Appropriate screening must be performed at least once a year in patients with systemic pSS in order to facilitate the early detection of renal complications. In this Review we discuss the epidemiology, pathophysiology, differential diagnosis and treatment of renal disease in pSS.
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Affiliation(s)
- Hélène François
- Department of Nephrology, Dialysis, and Transplantation, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Saclay, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, Paris, France
| | - Xavier Mariette
- Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Saclay, IMVA Centre of Immunology of Viral Infections and Autoimmune Diseases, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, Paris, France
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40
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Calle P, Hautekiet A, François H, Sundahl N, Cornelis C, Calle S, Damen J, Vanbrabant P, De Turck B, De Graeve K, Mpotos N, De Paepe P. Alcohol-related emergency department admissions among adolescents in the Ghent and Sint-Niklaas areas. Acta Clin Belg 2015; 70:345-9. [PMID: 25984783 DOI: 10.1179/2295333715y.0000000031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Alcohol abuse is a major health concern. The aim of this retrospective study was to analyse the alcohol-related emergency department (ED) admissions among adolescents in all hospitals of distinct areas during a 1-year period. In each hospital, all ED patients with a blood alcohol concentration (BAC) of at least 0.5 g/l were surveyed in a standardised way. Of the 3918 included patients, only 146 (3.7%) were < 18 years. The male-to-female ratio was 1.5:1. There was a strong preponderance of weekend and night time admissions. Most of the patients were transported by ambulance (77% of 138 patients with information on this item). The main reason for ED admittance was depressed level of consciousness (64%), trauma (12%), vomiting and/or abdominal pain (12%), agitation or aggression (4%), syncope (4%) and psychological problems (4%). The context of the alcohol intoxication was related to some kind of festivity in 85%, mental problems in 14% and chronic abuse in 1%. Median BAC values (and range) were 2.08 g/l (0.73-3.70 g/l) for boys and 1.51 g/l (0.73-2.90 g/l) for girls. Most patients (87%) could be discharged home within 24 hours. Our study confirms that problematic alcohol use leading to ED admissions starts in adolescence. Although the numbers of cases below 18 years are low when compared to adults, the phenomenon is alarming as it is associated with substantial health problems. Therefore, Belgium urgently needs a global national alcohol plan, with youngsters being one of the target groups.
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Affiliation(s)
- P Calle
- Emergency Department, Maria Middelares General Hospital , Ghent, Belgium
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41
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Dekeyser M, François H, Beaudreuil S, Durrbach A. Polyomavirus-Specific Cellular Immunity: From BK-Virus-Specific Cellular Immunity to BK-Virus-Associated Nephropathy? Front Immunol 2015; 6:307. [PMID: 26136745 PMCID: PMC4468917 DOI: 10.3389/fimmu.2015.00307] [Citation(s) in RCA: 22] [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: 11/04/2014] [Accepted: 05/29/2015] [Indexed: 12/29/2022] Open
Abstract
In renal transplantation, BK-virus (BKV)-associated nephropathy has emerged as a major complication, with a prevalence of 1-10% and graft loss in >50% of cases. BKV is a member of the polyomavirus family and rarely induces apparent clinical disease in the general population. However, replication of polyomaviruses, associated with significant organ disease, is observed in patients with acquired immunosuppression. Monitoring of specific immunity combined with viral load could be used to individually assess the risk of viral reactivation and virus control. We review the current knowledge on BKV-specific cellular immunity and, more specifically, in immunocompromised patients. In the future, immune-based therapies could allow us to treat and prevent BKV-associated nephropathy.
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Affiliation(s)
- Manon Dekeyser
- Nephrology Department, IFRNT, Bicêtre Hospital , Le Kremlin Bicêtre , France ; UMRS1197, INSERM , Villejuif , France ; University Paris South , Orsay , France
| | - Hélène François
- Nephrology Department, IFRNT, Bicêtre Hospital , Le Kremlin Bicêtre , France ; UMRS1197, INSERM , Villejuif , France ; University Paris South , Orsay , France
| | - Séverine Beaudreuil
- Nephrology Department, IFRNT, Bicêtre Hospital , Le Kremlin Bicêtre , France ; UMRS1197, INSERM , Villejuif , France ; University Paris South , Orsay , France
| | - Antoine Durrbach
- Nephrology Department, IFRNT, Bicêtre Hospital , Le Kremlin Bicêtre , France ; UMRS1197, INSERM , Villejuif , France ; University Paris South , Orsay , France
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42
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Mansour-Hendili L, Blanchard A, Le Pottier N, Roncelin I, Lourdel S, Treard C, González W, Vergara-Jaque A, Morin G, Colin E, Holder-Espinasse M, Bacchetta J, Baudouin V, Benoit S, Bérard E, Bourdat-Michel G, Bouchireb K, Burtey S, Cailliez M, Cardon G, Cartery C, Champion G, Chauveau D, Cochat P, Dahan K, De la Faille R, Debray FG, Dehoux L, Deschenes G, Desport E, Devuyst O, Dieguez S, Emma F, Fischbach M, Fouque D, Fourcade J, François H, Gilbert-Dussardier B, Hannedouche T, Houillier P, Izzedine H, Janner M, Karras A, Knebelmann B, Lavocat MP, Lemoine S, Leroy V, Loirat C, Macher MA, Martin-Coignard D, Morin D, Niaudet P, Nivet H, Nobili F, Novo R, Faivre L, Rigothier C, Roussey-Kesler G, Salomon R, Schleich A, Sellier-Leclerc AL, Soulami K, Tiple A, Ulinski T, Vanhille P, Van Regemorter N, Jeunemaître X, Vargas-Poussou R. Mutation Update of the CLCN5 Gene Responsible for Dent Disease 1. Hum Mutat 2015; 36:743-52. [PMID: 25907713 DOI: 10.1002/humu.22804] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [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: 02/11/2015] [Accepted: 04/08/2015] [Indexed: 02/06/2023]
Abstract
Dent disease is a rare X-linked tubulopathy characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis and/or nephrolithiasis, progressive renal failure, and variable manifestations of other proximal tubule dysfunctions. It often progresses over a few decades to chronic renal insufficiency, and therefore molecular characterization is important to allow appropriate genetic counseling. Two genetic subtypes have been described to date: Dent disease 1 is caused by mutations of the CLCN5 gene, coding for the chloride/proton exchanger ClC-5; and Dent disease 2 by mutations of the OCRL gene, coding for the inositol polyphosphate 5-phosphatase OCRL-1. Herein, we review previously reported mutations (n = 192) and their associated phenotype in 377 male patients with Dent disease 1 and describe phenotype and novel (n = 42) and recurrent mutations (n = 24) in a large cohort of 117 Dent disease 1 patients belonging to 90 families. The novel missense and in-frame mutations described were mapped onto a three-dimensional homology model of the ClC-5 protein. This analysis suggests that these mutations affect the dimerization process, helix stability, or transport. The phenotype of our cohort patients supports and extends the phenotype that has been reported in smaller studies.
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Affiliation(s)
- Lamisse Mansour-Hendili
- Faculté de Médecine, Université Paris Descartes, Paris, France.,Assistance Publique-Hôpitaux de Paris, Service de Génétique, Hôpital Européen Georges Pompidou, Paris, France
| | - Anne Blanchard
- Faculté de Médecine, Université Paris Descartes, Paris, France.,INSERM, UMR970, Paris-Cardiovascular Research Center, Paris, France.,Assistance Publique-Hôpitaux de Paris, Centre d'investigation clinique, Hôpital Européen Georges Pompidou, Paris, France.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France
| | - Nelly Le Pottier
- Assistance Publique-Hôpitaux de Paris, Service de Génétique, Hôpital Européen Georges Pompidou, Paris, France
| | - Isabelle Roncelin
- Assistance Publique-Hôpitaux de Paris, Service de Génétique, Hôpital Européen Georges Pompidou, Paris, France
| | - Stéphane Lourdel
- Sorbonne Universités, UPMC Université, Paris, France.,INSERM, Université Paris Descartes, Sorbonne Paris Cité, UMR S1138, Centre de Recherche des Cordeliers, CNRS ERL 8228, Paris, F-75006, France
| | - Cyrielle Treard
- Assistance Publique-Hôpitaux de Paris, Service de Génétique, Hôpital Européen Georges Pompidou, Paris, France.,INSERM, UMR970, Paris-Cardiovascular Research Center, Paris, France
| | - Wendy González
- Centro de Bioinformática y Simulación Molecular, Universidad de Talca, Talca, Chile
| | - Ariela Vergara-Jaque
- Centro de Bioinformática y Simulación Molecular, Universidad de Talca, Talca, Chile
| | - Gilles Morin
- Service de Génétique et Oncogénétique, Centre Hospitalier Universitaire Amiens Picardie, Amiens, France
| | - Estelle Colin
- Département de Biochimie et Génétique, LUNAM Angers, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Muriel Holder-Espinasse
- Département de Génétique, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Clinical Genetics, Guy's Hospital, London, United Kingdom
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares. Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France
| | - Véronique Baudouin
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Service de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Stéphane Benoit
- Service de Néphrologie, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Etienne Bérard
- Service de Néphrologie pédiatrique, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | - Karim Bouchireb
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Necker-Enfants-malades, Service de Néphrologie Pédiatrique, Paris, France
| | - Stéphane Burtey
- VRCM, centre de néphrologie et transplantation rénale, Aix-Marseille Université, Marseille, France
| | - Mathilde Cailliez
- Assistance Publique Hôpitaux de Marseille, Unité de Néphrologie Pédiatrique, Hôpital La Timone, Marseille, France
| | - Gérard Cardon
- Service de Néphrologie, Centre Hospitalier de Douai, Douai, France
| | - Claire Cartery
- Assistance Publique-Hôpitaux de Paris, Service de Néphrologie et dialyse, Hôpital Tenon, Paris, France
| | - Gerard Champion
- Département de Pédiatrie, LUNAM Angers, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Dominique Chauveau
- Centre Hospitalier Universitaire de Toulouse, Département de Néphrologie et Transplantation d'organes, Hôpital Rangueil, Toulouse, France
| | - Pierre Cochat
- Centre de Référence des Maladies Rénales Rares. Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France
| | - Karin Dahan
- Département de Génétique Humaine, Institut de Pathologie et de Génétique, Gosselies, Belgium
| | - Renaud De la Faille
- Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Laurenne Dehoux
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Service de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Georges Deschenes
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Service de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Estelle Desport
- Service de Néphrologie, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Olivier Devuyst
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.,Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Stella Dieguez
- Nefrologia Infantil, Hospital General de Agudos Dr. Teodoro Álvarez, Buenos Aires, Argentina
| | - Francesco Emma
- Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - Michel Fischbach
- Service de Pédiatrie, Centre Hospitalier Universitaire Hautepierre, Strasbourg, France
| | - Denis Fouque
- Departement de Néphrology, Centre Hospitalier Universitaire Lyon Sud, Lyon, France
| | - Jacques Fourcade
- Service de Néphrology, Centre Hospitalier de Chambery, Chambery, France
| | - Hélène François
- Assistance Publique-Hôpitaux de Paris, Hôpital Kremlin Bicêtre, Service de Néphrologie, Le Kremlin-Bicêtre, France
| | - Brigitte Gilbert-Dussardier
- Centre Hospitalier Universitaire de Poitiers, Service de Génétique, EA 3808, Université de Poitiers, Poitiers, France
| | - Thierry Hannedouche
- Hôpitaux Universitaires de Strasbourg, Service de Néphrologie et Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | - Pascal Houillier
- Faculté de Médecine, Université Paris Descartes, Paris, France.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,INSERM, Université Paris Descartes, Sorbonne Paris Cité, UMR S1138, Centre de Recherche des Cordeliers, CNRS ERL 8228, Paris, F-75006, France.,Assistance Publique Hôpitaux de Paris, Département de Physiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Hassan Izzedine
- Assistance Publique-Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Service de Néphrologie, Paris, France
| | - Marco Janner
- Department of Paediatric Endocrinology, Diabetology and Metabolism, University of Berne Children's Hospital, Berne, Switzerland
| | - Alexandre Karras
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Néphrologie, Paris, France
| | - Bertrand Knebelmann
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Necker-Enfants-malades, Service de Néphrologie adulte, Paris, France
| | - Marie-Pierre Lavocat
- Département de Pédiatrie, Centre Hospitalier Universitaire de Saint Etienne, Hôpital Nord, Saint Etienne, France
| | - Sandrine Lemoine
- Hospices Civils de Lyon, Service d'Exploration Fonctionnelle Rénale, Hôpital Edouard-Herriot, Lyon, France
| | - Valérie Leroy
- Hôpital Jeanne de Flandre, Service de Néphrologie Pédiatrique, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Chantal Loirat
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Service de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Marie-Alice Macher
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Service de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | | | - Denis Morin
- Unité de Néphrologie Pédiatrique, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Patrick Niaudet
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Necker-Enfants-malades, Service de Néphrologie Pédiatrique, Paris, France
| | - Hubert Nivet
- Service de Néphrologie, Centre Hospitalier Universitaire de Tours, Tours, France
| | - François Nobili
- Unité de Néphrologie Pédiatrie, Besançon, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Robert Novo
- Hôpital Jeanne de Flandre, Service de Néphrologie Pédiatrique, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Laurence Faivre
- Centre de Génétique, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Claire Rigothier
- Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Remi Salomon
- Faculté de Médecine, Université Paris Descartes, Paris, France.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Necker-Enfants-malades, Service de Néphrologie Pédiatrique, Paris, France
| | - Andreas Schleich
- Institute of Nephrology Statspital Waid Zuerich, Zuerich, Switzerland
| | - Anne-Laure Sellier-Leclerc
- Centre de Référence des Maladies Rénales Rares. Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Hospices Civils de Lyon, Lyon, France
| | | | - Aurélien Tiple
- Centre Hospitalier Universitaire Gabriel-Montpied Service de Néphrologie, Clermont-Ferrand, France
| | - Tim Ulinski
- Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Assistance Publique-Hôpitaux de Paris, Service de Néphrologie et Transplantation Rénale, Hôpital Trousseau, Paris, France
| | - Philippe Vanhille
- Centre Hospitalier de Valenciennes, Service de Néphrologie et Médecine Interne, Valenciennes, France
| | - Nicole Van Regemorter
- Université Libre de Bruxelles, Hôpital Erasme Département de Génétique Médicale, Brussels, Belgium
| | - Xavier Jeunemaître
- Faculté de Médecine, Université Paris Descartes, Paris, France.,Assistance Publique-Hôpitaux de Paris, Service de Génétique, Hôpital Européen Georges Pompidou, Paris, France.,INSERM, UMR970, Paris-Cardiovascular Research Center, Paris, France.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France
| | - Rosa Vargas-Poussou
- Assistance Publique-Hôpitaux de Paris, Service de Génétique, Hôpital Européen Georges Pompidou, Paris, France.,INSERM, UMR970, Paris-Cardiovascular Research Center, Paris, France.,Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France
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Dahane N, François H, Anguel N, Hamoudi Y, Durrbach A, Angoulvant A. Épidémiologie des infections fongiques invasives chez les patients transplantés d’organes solides au CHU de Bicêtre. J Mycol Med 2015. [DOI: 10.1016/j.mycmed.2015.02.035] [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: 12/01/2022]
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Hebibi H, Weclawiak H, Rostaing L, Beaudreuil S, Allal A, François H, Durrbach A, Kamar N. Non-tolerability of double-filtration plasmapheresis in antibody-incompatible kidney transplant candidates. Saudi J Kidney Dis Transpl 2015; 26:297-301. [PMID: 25758878 DOI: 10.4103/1319-2442.152435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Few studies have reported the use of double-filtration plasmapheresis (DFPP) in antibody-incompatible kidney transplantation. To assess the efficiency and tolerability of DFPP, we prospectively studied four chronic hemodialysis patients from two centers undergoing antibody-incompatible kidney transplantation. DFPP was used for ABO-incompatible transplantation (n = 1), for high human leukocyte antigen (HLA) immunization levels (n = 2) or for the presence of a donor-specific antibody (DSA) against a potential living donor (n = 1). In all the patients, the DFPP program was discontinued because of the adverse effects. Low blood pressure occurred during the first hour of the session in all the patients. A significant loss of plasma proteins, clotting factors and immunoglobulins also occurred during this treatment. In addition, fistula thrombosis was diagnosed in two patients. Three patients experienced gastrointestinal symptoms. The DFPP reduced the titers of the anti-B antibodies and reduced the levels of DSA in one patient, but had no effect on anti-HLA antibodies in the remaining two patients. Our study highlights the non-tolerability and poor efficacy of DFPP prior to antibody-incompatible kidney transplantation that limit its extensive use in the desensitization protocols.
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Affiliation(s)
| | | | | | | | | | | | | | - Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil; INSERM U1043, IFR-BMT, CHU Purpan Toulouse, France
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45
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Lecru L, Desterke C, Grassin-Delyle S, Chatziantoniou C, Vandermeersch S, Devocelle A, Vernochet A, Ivanovski N, Ledent C, Ferlicot S, Dalia M, Saïd M, Beaudreuil S, Charpentier B, Vazquez A, Giron-Michel J, Azzarone B, Durrbach A, François H. Cannabinoid receptor 1 is a major mediator of renal fibrosis. Kidney Int 2015; 88:72-84. [PMID: 25760323 DOI: 10.1038/ki.2015.63] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 01/13/2015] [Accepted: 01/22/2015] [Indexed: 12/12/2022]
Abstract
Chronic kidney disease, secondary to renal fibrogenesis, is a burden on public health. There is a need to explore new therapeutic pathways to reduce renal fibrogenesis. To study this, we used unilateral ureteral obstruction (UUO) in mice as an experimental model of renal fibrosis and microarray analysis to compare gene expression in fibrotic and normal kidneys. The cannabinoid receptor 1 (CB1) was among the most upregulated genes in mice, and the main endogenous CB1 ligand (2-arachidonoylglycerol) was significantly increased in the fibrotic kidney. Interestingly, CB1 expression was highly increased in kidney biopsies of patients with IgA nephropathy, diabetes, and acute interstitial nephritis. Both genetic and pharmacological knockout of CB1 induced a profound reduction in renal fibrosis during UUO. While CB2 is also involved in renal fibrogenesis, it did not potentiate the role of CB1. CB1 expression was significantly increased in myofibroblasts, the main effector cells in renal fibrogenesis, upon TGF-β1 stimulation. The decrease in renal fibrosis during CB1 blockade could be explained by a direct action on myofibroblasts. CB1 blockade reduced collagen expression in vitro. Rimonabant, a selective CB1 endocannabinoid receptor antagonist, modulated the macrophage infiltrate responsible for renal fibrosis in UUO through a decrease in monocyte chemoattractant protein-1 synthesis. Thus, CB1 has a major role in the activation of myofibroblasts and may be a new target for treating chronic kidney disease.
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Affiliation(s)
- Lola Lecru
- INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Christophe Desterke
- INSERM Unité 972, Transfert des gènes dans le foie: Applications Thérapeutiques, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Stanislas Grassin-Delyle
- Université de Versailles Saint-Quentin, Mass Spectrometry Facility, MasSpecLab, Versailles, France
| | | | | | - Aurore Devocelle
- INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Amelia Vernochet
- INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Ninoslav Ivanovski
- INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Catherine Ledent
- Institut de la Recherche Interdisciplinaire en Biologie Humaine Et Moléculaire, Bruxelles, Belgium
| | | | - Meriem Dalia
- INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Myriam Saïd
- INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Séverine Beaudreuil
- 1] INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France [2] AP-HP Hôpital Bicêtre, le Kremlin-Bicêtre, France
| | - Bernard Charpentier
- 1] INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France [2] AP-HP Hôpital Bicêtre, le Kremlin-Bicêtre, France
| | - Aimé Vazquez
- INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Julien Giron-Michel
- INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France
| | - Bruno Azzarone
- Immunology Department, Istituto Giannina Gaslini, Genova, Italy
| | - Antoine Durrbach
- 1] INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France [2] AP-HP Hôpital Bicêtre, le Kremlin-Bicêtre, France [3] Institut Francilien de Recherche en Néphrologie et Transplantation, le Kremlin-Bicêtre, France
| | - Hélène François
- 1] INSERM Unité 1014, Régulation de la survie et des Allogreffes, Institut André Lwoff, Hôpital Paul Brousse, Villejuif, France [2] AP-HP Hôpital Bicêtre, le Kremlin-Bicêtre, France [3] Institut Francilien de Recherche en Néphrologie et Transplantation, le Kremlin-Bicêtre, France
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Wyplosz B, Derradji O, Hong E, François H, Durrbach A, Duclos-Vallée JC, Samuel D, Escaut L, Launay O, Vittecoq D, Taha M. Low immunogenicity of quadrivalent meningococcal vaccines in solid organ transplant recipients. Transpl Infect Dis 2015; 17:322-7. [DOI: 10.1111/tid.12359] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 05/27/2014] [Accepted: 01/18/2015] [Indexed: 11/29/2022]
Affiliation(s)
- B. Wyplosz
- Assistance Publique-Hôpitaux de Paris; CHU Bicêtre; Centre de Vaccinations Internationales; Service de Maladies Infectieuses et Tropicales; Le Kremlin-Bicêtre France
| | - O. Derradji
- Assistance Publique-Hôpitaux de Paris; CHU Bicêtre; Centre de Vaccinations Internationales; Service de Maladies Infectieuses et Tropicales; Le Kremlin-Bicêtre France
| | - E. Hong
- Institut Pasteur; Invasive Bacterial Infections Unit; Paris France
| | - H. François
- Assistance Publique-Hôpitaux de Paris; CHU Bicêtre; Néphrologie; Le Kremlin-Bicêtre France
- Faculté de Médecine; Université Paris Sud; Paris France
| | - A. Durrbach
- Assistance Publique-Hôpitaux de Paris; CHU Bicêtre; Néphrologie; Le Kremlin-Bicêtre France
- Faculté de Médecine; Université Paris Sud; Paris France
| | - J.-C. Duclos-Vallée
- Faculté de Médecine; Université Paris Sud; Paris France
- Assistance Publique-Hôpitaux de Paris; Hôpital Universitaire Paul Brousse; Centre Hépatobiliaire; Villejuif France
| | - D. Samuel
- Faculté de Médecine; Université Paris Sud; Paris France
- Assistance Publique-Hôpitaux de Paris; Hôpital Universitaire Paul Brousse; Centre Hépatobiliaire; Villejuif France
| | - L. Escaut
- Assistance Publique-Hôpitaux de Paris; CHU Bicêtre; Centre de Vaccinations Internationales; Service de Maladies Infectieuses et Tropicales; Le Kremlin-Bicêtre France
| | - O. Launay
- INSERM, CIC BT505, and AP-HP; Paris Descartes University; Cochin Hospital; Paris France
| | - D. Vittecoq
- Assistance Publique-Hôpitaux de Paris; CHU Bicêtre; Centre de Vaccinations Internationales; Service de Maladies Infectieuses et Tropicales; Le Kremlin-Bicêtre France
- Assistance Publique-Hôpitaux de Paris; CHU Bicêtre; Néphrologie; Le Kremlin-Bicêtre France
| | - M.K. Taha
- Institut Pasteur; Invasive Bacterial Infections Unit; Paris France
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47
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Touzot M, Poisson J, Faguer S, Ribes D, Geffray L, François H, Karras A, Cacoub P, Durrbach A, Saadoun D. Efficacité et tolérance au long cours d’un traitement par rituximab dans la maladie des anticorps anti-membrane basale glomérulaire. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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48
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Danlos F, Daoued F, Rohmer J, Cluzel G, François H, Lazure T, Seror R, Mariette X. Une première observation de périartérite rénale typique associée à une polyglobulie secondaire compliquant une maladie associée aux IgG4 (IgG4-RD). Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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49
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Beaudreuil S, Igliqui F, Ledoux S, François H, Tsafack Obada E, Lorenzo HK, Coffin B, Durrbach A. Étude de l’efficacité et de la tolérance d’un ballon intra-gastrique chez des patients obèses en attente de transplantation rénale. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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50
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Touzot M, Obada EN, Beaudreuil S, François H, Durrbach A. Complement modulation in solid-organ transplantation. Transplant Rev (Orlando) 2014; 28:119-25. [PMID: 24996770 DOI: 10.1016/j.trre.2014.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 03/08/2014] [Indexed: 01/18/2023]
Abstract
The complement system is a major constituent of the innate immune system. It has a critical role in defense against pathogens but dysregulation of complement activation may lead to tissue injury and modulate the adaptive immune response. In organ transplantation, local complement activation is involved in hyper-acute rejection and antibody-mediated rejection. This last decade, interest in complement activation has increased due to new insights into the pathophysiology of antibody-mediated rejection, but also since the availability of news drugs that target terminal complement activation. In this review, we discuss our current understanding of how local complement activation induces acute and chronic graft injury, and review recent advances in clinical trials that block complement activation using the anti-C5 monoclonal antibody, eculizumab. Finally, we discuss how complement-targeted therapy may be integrated into our current immunosuppressive regimen and what type of patient will benefit most from this therapy.
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Affiliation(s)
- Maxime Touzot
- Nephrology Department, IFRNT, Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale INSERM U1014, Villejuif, France
| | | | - Severine Beaudreuil
- Nephrology Department, IFRNT, Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale INSERM U1014, Villejuif, France
| | - Hélène François
- Nephrology Department, IFRNT, Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale INSERM U1014, Villejuif, France
| | - Antoine Durrbach
- Nephrology Department, IFRNT, Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale INSERM U1014, Villejuif, France.
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