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Hindré R, Besnard V, Kort F, Nunes H, Valeyre D, Jeny F. Complete response to mTOR inhibitor following JAKi failure in severe pulmonary sarcoidosis. Pulmonology 2024:S2531-0437(24)00042-4. [PMID: 38614861 DOI: 10.1016/j.pulmoe.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/15/2024] Open
Affiliation(s)
- R Hindré
- AP-HP, Pulmonology Departement, Avicenne Hospital, Bobigny, France; Inserm UMR 1272, Sorbonne Paris Nord University, Bobigny, France.
| | - V Besnard
- Inserm UMR 1272, Sorbonne Paris Nord University, Bobigny, France
| | - F Kort
- AP-HP, Pulmonology Departement, Avicenne Hospital, Bobigny, France
| | - H Nunes
- AP-HP, Pulmonology Departement, Avicenne Hospital, Bobigny, France; Inserm UMR 1272, Sorbonne Paris Nord University, Bobigny, France
| | - D Valeyre
- Inserm UMR 1272, Sorbonne Paris Nord University, Bobigny, France; Groupe hospitalier Paris Saint Joseph, Pulmonology Departement, Paris, France
| | - F Jeny
- AP-HP, Pulmonology Departement, Avicenne Hospital, Bobigny, France; Inserm UMR 1272, Sorbonne Paris Nord University, Bobigny, France
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2
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Brudon A, Legendre M, Mageau A, Bermudez J, Bonniaud P, Bouvry D, Cadranel J, Cazes A, Crestani B, Dégot T, Delestrain C, Diesler R, Epaud R, Philippot Q, Theou-Anton N, Kannengiesser C, Ba I, Debray MP, Fanen P, Manali E, Papiris S, Nathan N, Amselem S, Gondouin A, Guillaumot A, Andréjak C, Jouneau S, Beltramo G, Uzunhan Y, Galodé F, Westeel V, Mehdaoui A, Hirschi S, Leroy S, Marchand-Adam S, Nunes H, Picard C, Prevot G, Reynaud-Gaubert M, De Vuyst P, Wemeau L, Defossez G, Zalcman G, Cottin V, Borie R. High risk of lung cancer in surfactant-related gene variant carriers. Eur Respir J 2024:2301809. [PMID: 38575158 DOI: 10.1183/13993003.01809-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/19/2024] [Indexed: 04/06/2024]
Abstract
RATIONALE Several rare surfactant-related genes variants associated with interstitial lung disease are suspected to be associated with lung cancer, but data are missing. OBJECTIVES We aimed to study the epidemiology and phenotype of lung cancer in an international cohort of surfactant-related gene (SRG) variant carriers. METHODS We conducted a cross-sectional study of all adults with SRG variants in the OrphaLung network and compared lung cancer risk with telomerase-related gene (TRG) variant carriers. RESULTS We identified 99 SRG adult variant carriers (SFTPA1 [n=18], SFTPA2 [n=31], SFTPC [n=24], ABCA3 [n=14] and NKX2-1 [n=12]), including 20 (20.2%) with lung cancer (SFTPA1 [n=7]; SFTPA2 [n=8], SFTPC [n=3], NKX2-1 [n=2] and ABCA3 [n=0]). Among SRG variant carriers, the odds of lung cancer was associated with age (odds ratio [OR] 1.04 [95% CI 1.01-1.08]), smoking (OR 20.7 [6.60-76.2]) and SFTPA1/SFTPA2 variants (OR 3.97 [1.39-13.2]). Adenocarcinoma was the only histological type reported, with PDL1 expression≥1% of tumor cells in 3 cases. Cancer staging was localized (I/II) in 8 (40%) individuals, locally advanced (III) in 2 (10%) and metastatic (IV) in 10 (50%). We found no somatic variant eligible for targeted therapy. Seven cancers were surgically removed, 10 received systemic therapy, and 3 received the best supportive care according to their stage and performance status. The median overall survival was 24 months, with stage I/II cancers showing better survival. We identified 233 TRG variant carriers. The comparative risk (subdistribution hazard ratio) for lung cancer in SRG patients versus TRG patients was 18.1 [7.1-44.7]. CONCLUSION The high risk of lung cancer among SRG variant carriers suggests specific screening and diagnostic and therapeutic challenges. The benefit of regular CT scan follow-up should be evaluated.
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Affiliation(s)
- Alexandre Brudon
- Service d'oncologie thoracique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- These authors contributed equally to this work
| | - Marie Legendre
- U.F. de Génétique moléculaire, Hôpital Armand Trousseau, AP-HP, Paris, France
- Sorbonne Université, Inserm UMR-S 933, Maladies génétiques d'expression pédiatrique, Paris, France
- These authors contributed equally to this work
| | - Arthur Mageau
- Département de Médecine Interne, Hôpital Bichat, AP-HP, Paris, France
- Université Paris Cité, Inserm IAME UMR 1137 Team Descid, Paris, France
| | - Julien Bermudez
- Service de Pneumologie, Centre de compétences de Maladies Pulmonaires rares et de Transplantation pulmonaire, CHU Nord, APHM, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Philippe Bonniaud
- Department of Respiratory Diseases and Intensive Care, Reference Constitutive Center for Adulte Rare Pulmonary Diseases, Dijon-Bourgogne University Hospital; University of Burgundy, Inserm UMR1231, Dijon, France
| | - Diane Bouvry
- Département de pneumologie, Hôpital Avicenne, APHP, Bobigny, France
- Université Paris 13, Inserm UMR U1272, Bobigny, France
| | - Jacques Cadranel
- Service de pneumologie et oncologie thoracique, DMU APPROCHES, Hôpital Tenon, APHP, Paris, France
- Sorbonne Université, GRC04 Theranoscan, Paris, France
| | - Aurélie Cazes
- Département d'anatomie pathologique, Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, INSERM U1552, Paris, France
| | - Bruno Crestani
- Service de Pneumologie A Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, Inserm UMR-S 1152 PHERE, Paris, France
| | - Tristan Dégot
- Service de pneumologie, Groupe de transplantation pulmonaire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Céline Delestrain
- Centre de référence pour les maladies respiratoires rares RespiRare, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université de Paris Est Creteil, Inserm IMRB F-94010, Creteil, France
| | - Rémi Diesler
- Service de pneumologie, Centre national coordinateur de référence des pathologies pulmonaires rares, ERN-LUNG, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Ralph Epaud
- Centre de référence pour les maladies respiratoires rares RespiRare, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université de Paris Est Creteil, Inserm IMRB F-94010, Creteil, France
| | - Quentin Philippot
- Service de Pneumologie A Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, Inserm UMR-S 1152 PHERE, Paris, France
| | - Nathalie Theou-Anton
- Département de génétique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- Université Paris Cité, Paris, France
| | - Caroline Kannengiesser
- Département de génétique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- Université Paris Cité, Paris, France
| | - Ibrahima Ba
- Département de génétique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- Université Paris Cité, Paris, France
| | - Marie-Pierre Debray
- Service de Radiologie, Hopital Bichat, APHP, Paris, France
- Université Paris Cité, Paris, France
| | - Pascale Fanen
- Service de Radiologie, Hopital Bichat, APHP, Paris, France
- Université de Paris Est Creteil, Inserm IMRB F-94010, Creteil, France
| | - Efrosine Manali
- General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyros Papiris
- General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nadia Nathan
- Sorbonne Université, Inserm UMR-S 933, Maladies génétiques d'expression pédiatrique, Paris, France
- Département de pneumologie pédiatrique, Centre de référence des maladies respiratoires rares RespiRare, Paris, France
| | - Serge Amselem
- U.F. de Génétique moléculaire, Hôpital Armand Trousseau, AP-HP, Paris, France
- Sorbonne Université, Inserm UMR-S 933, Maladies génétiques d'expression pédiatrique, Paris, France
| | - Antoine Gondouin
- Service de pneumologie, Centre des maladies pulmonaires rares, Hôpital de Besançon, Besançon, France
| | - Anne Guillaumot
- Service de pneumologie, Hôpital de Brabois, Vandoeuvre-les-Nancy, France
| | - Claire Andréjak
- Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, France
- EA 4294, AGIR, Jules Verne Picardy University, Amiens, France
| | - Stephane Jouneau
- Service de Pneumologie, Centre de Référence Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Inserm UMR1085 IRSET, Université de Rennes 1, EHESP, Rennes, France
| | - Guillaume Beltramo
- Department of Respiratory Diseases and Intensive Care, Reference Constitutive Center for Adulte Rare Pulmonary Diseases, Dijon-Bourgogne University Hospital; University of Burgundy, Inserm UMR1231, Dijon, France
| | - Yurdagul Uzunhan
- Département de pneumologie, Hôpital Avicenne, APHP, Bobigny, France
| | - François Galodé
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Pediatrics Department, Pediatric Pulmonology, CEDEX, Bordeaux, France
| | - Virginie Westeel
- Service de pneumologie, Centre des maladies pulmonaires rares, Hôpital de Besançon, Besançon, France
| | - Anas Mehdaoui
- Pneumonology and Thoracic Oncology Department, Eure-Seine Hospital Center, Évreux, France
| | - Sandrine Hirschi
- Service de pneumologie, Groupe de transplantation pulmonaire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sylvie Leroy
- Service de pneumologie, FHU Oncoage, Hôpital Pasteur - Centre Hospitalier Universitaire de Nice, Nice, France
- Université Nice Côte d'Azur, Nice, France
| | - Sylvain Marchand-Adam
- Service de pneumologie, Hôpital de Tours, Tours, France
- Université de Tours, Inserm U1100, Tours, France
| | - Hilario Nunes
- Département de pneumologie, Hôpital Avicenne, APHP, Bobigny, France
- Université Paris 13, Inserm UMR U1272, Bobigny, France
| | - Clément Picard
- Service de pneumologie et de transplantation pulmonaire, Hôpital Foch, Suresnes, France
| | | | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre de compétences de Maladies Pulmonaires rares et de Transplantation pulmonaire, CHU Nord, APHM, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Paul De Vuyst
- Service de pneumologie, Hôpital Erasme, Bruxelles, Belgium
| | - Lidwine Wemeau
- Service de pneumologie et immuno-allergie, Institut coeur-poumon, Lille, France
| | | | - Gérard Zalcman
- Service d'oncologie thoracique, Hôpital Bichat, AP-HP, Institut du Cancer AP-HP Nord, Paris, France
- Université Paris Cité, Inserm CIC-EC 1425, Paris, France
| | - Vincent Cottin
- Service de pneumologie, Centre national coordinateur de référence des pathologies pulmonaires rares, ERN-LUNG, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Raphael Borie
- Service de Pneumologie A Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, Inserm UMR-S 1152 PHERE, Paris, France
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Israël-Biet D, Pastré J, Nunes H. Sarcoidosis-Associated Pulmonary Hypertension. J Clin Med 2024; 13:2054. [PMID: 38610818 PMCID: PMC11012707 DOI: 10.3390/jcm13072054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/25/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Sarcoidosis-associated pulmonary hypertension (SAPH) is a very severe complication of the disease, largely impacting its morbidity and being one of its strongest predictors of mortality. With the recent modifications of the hemodynamic definition of pulmonary hypertension (mean arterial pulmonary pressure >20 instead of <25 mmHg,) its prevalence is presently not precisely known, but it affects from 3 to 20% of sarcoid patients; mostly, although not exclusively, those with an advanced, fibrotic pulmonary disease. Its gold-standard diagnostic tool remains right heart catheterization (RHC). The decision to perform it relies on an expert decision after a non-invasive work-up, in which echocardiography remains the screening tool of choice. The mechanisms underlying SAPH, very often entangled, are crucial to define, as appropriate and personalized therapeutic strategies will aim at targeting the most significant ones. There are no recommendations so far as to the indications and modalities of the medical treatment of SAPH, which is based upon the opinion of a multidisciplinary team of sarcoidosis, pulmonary hypertension and sometimes lung transplant experts.
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Affiliation(s)
| | - Jean Pastré
- Service de Pneumologie, Hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France;
| | - Hilario Nunes
- Service de Pneumologie, Hôpital Avivenne, AP-HP, 93000 Bobigny, France;
- Inserm UMR 1272 “Hypoxie et Poumon”, UFR de Santé, Médecine et Biologie Humaine (SMBH), Université Sorbonne Paris-Nord, 93000 Bobigny, France
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Diesler R, Legendre M, Si-Mohamed S, Brillet PY, Wemeau L, Manali ED, Gagnadoux F, Hirschi S, Lorillon G, Reynaud-Gaubert M, Bironneau V, Blanchard E, Bourdin A, Dominique S, Justet A, Macey J, Marchand-Adam S, Morisse-Pradier H, Nunes H, Papiris SA, Traclet J, Traore I, Crestani B, Amselem S, Nathan N, Borie R, Cottin V. Similarities and differences of interstitial lung disease associated with pathogenic variants in SFTPC and ABCA3 in adults. Respirology 2024; 29:312-323. [PMID: 38345107 DOI: 10.1111/resp.14667] [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: 06/18/2023] [Accepted: 01/21/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND AND OBJECTIVE Variants in surfactant genes SFTPC or ABCA3 are responsible for interstitial lung disease (ILD) in children and adults, with few studies in adults. METHODS We conducted a multicentre retrospective study of all consecutive adult patients diagnosed with ILD associated with variants in SFTPC or ABCA3 in the French rare pulmonary diseases network, OrphaLung. Variants and chest computed tomography (CT) features were centrally reviewed. RESULTS We included 36 patients (median age: 34 years, 20 males), 22 in the SFTPC group and 14 in the ABCA3 group. Clinical characteristics were similar between groups. Baseline median FVC was 59% ([52-72]) and DLco was 44% ([35-50]). An unclassifiable pattern of fibrosing ILD was the most frequent on chest CT, found in 85% of patients, however with a distinct phenotype with ground-glass opacities and/or cysts. Nonspecific interstitial pneumonia and usual interstitial pneumonia were the most common histological patterns in the ABCA3 group and in the SFTPC group, respectively. Annually, FVC and DLCO declined by 1.87% and 2.43% in the SFTPC group, respectively, and by 0.72% and 0.95% in the ABCA3 group, respectively (FVC, p = 0.014 and DLCO , p = 0.004 for comparison between groups). Median time to death or lung transplantation was 10 years in the SFTPC group and was not reached at the end of follow-up in the ABCA3 group. CONCLUSION SFTPC and ABCA3-associated ILD present with a distinct phenotype and prognosis. A radiologic pattern of fibrosing ILD with ground-glass opacities and/or cysts is frequently found in these rare conditions.
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Affiliation(s)
- Rémi Diesler
- Department of Respiratory Medicine, National Reference Centre for Rare Pulmonary Diseases, Hospices civils de Lyon, Université Lyon 1, UMR754, INRAE, ERN-LUNG, Lyon, France
| | - Marie Legendre
- U.F. de Génétique moléculaire, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Hôpital Armand Trousseau, Paris, France
- Childhood Genetic Diseases, UMR_S933, Inserm, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Hôpital Armand Trousseau, Paris, France
| | - Salim Si-Mohamed
- Department of Thoracic Imaging, Louis Pradel Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, INSA-Lyon, UJM-Saint-Étienne, CNRS, Inserm, CREATIS UMR 5220, Lyon, France
| | - Pierre-Yves Brillet
- Service de Radiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France
| | - Lidwine Wemeau
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Hôpital Calmette, Lille, France
| | - Effrosyni D Manali
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Frédéric Gagnadoux
- Service de Pneumologie et Allergologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Sandrine Hirschi
- Service de Pneumologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Gwenaël Lorillon
- National Reference Centre for Histiocytoses, Pulmonary Department, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie, Équipe de Transplantation Pulmonaire, Centre de Compétence des Maladies Pulmonaires Rares, Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille, CHU Nord, Marseille, France
| | - Vanessa Bironneau
- Service de Pneumologie CHU de Poitiers, INSERM CIC 1402, IS-ALIVE Research Group, Université de Poitiers, UFR Médecine et Pharmacie, Poitiers, France
| | - Elodie Blanchard
- Service de Pneumologie, Hôpital Haut Lévêque, CHU de Bordeaux, Bordeaux, France
| | - Arnaud Bourdin
- Department of Respiratory Diseases and PhyMedExp, Centre National de la Recherche Scientifique, INSERM, University of Montpellier, CHU Montpellier, Montpellier, France
| | | | - Aurélien Justet
- Service de Pneumologie, CHU de Caen, Centre de compétence des maladies pulmonaires rares, ISTCT, UMR6030-CNRS-CEA-Université de Caen, Caen, France
| | - Julie Macey
- Respiratory Medicine and Cystic Fibrosis Center, University Hospital Center of Bordeaux, Bordeaux, France
| | - Sylvain Marchand-Adam
- Service de Pneumologie et Explorations Fonctionnelles Respiratoires, CHU Tours, Université François Rabelais, Tours, France
| | | | - Hilario Nunes
- Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'Adulte, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Paris, France
| | - Spyros A Papiris
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Julie Traclet
- Department of Respiratory Medicine, National Reference Centre for Rare Pulmonary Diseases, Hospices civils de Lyon, Université Lyon 1, Lyon, France
| | - Ibrahim Traore
- Service de Pneumologie, CHU Jean Minjoz, Besançon, France
| | - Bruno Crestani
- Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Paris, France
| | - Serge Amselem
- U.F. de Génétique moléculaire, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Hôpital Armand Trousseau, Paris, France
- Childhood Genetic Diseases, UMR_S933, Inserm, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Hôpital Armand Trousseau, Paris, France
| | - Nadia Nathan
- Childhood Genetic Diseases, UMR_S933, Inserm, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Hôpital Armand Trousseau, Paris, France
- Pediatric Pulmonology Department and Reference Center for Rare Lung Diseases and Laboratory of Childhood Genetic Diseases Inserm UMR_S933, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Armand Trousseau Hospital, Paris, France
| | - Raphaël Borie
- Université Paris Cité, INSERM U1152, Laboratoire D'Excellence Inflamex, Assistance Publique-Hôpitaux de Paris, Service de Pneumologie A, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Fédération Hospitalo-Universitaire Apollo, Hôpital Bichat, Paris, France
| | - Vincent Cottin
- Department of Respiratory Medicine, National Reference Centre for Rare Pulmonary Diseases, Hospices civils de Lyon, Université Lyon 1, UMR754, INRAE, ERN-LUNG, Lyon, France
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Sesé L, Borie R, Kannengiesser C, Cottin V, Israel-Biet D, Crestani B, Cadranel J, Chenivesse C, Boubaya M, Valeyre D, Annesi-Maesano I, Nunes H. Impact of Air Pollution and MUC5B Genotype on Survival in Idiopathic Pulmonary Fibrosis. Ann Am Thorac Soc 2024; 21:519-523. [PMID: 38096447 DOI: 10.1513/annalsats.202305-495rl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
- Lucile Sesé
- Hôpital Avicenne Bobigny, France
- Université Sorbonne Paris Nord Bobigny, France
| | - Raphaël Borie
- Hôpital Bichat Paris, France
- Université Paris Cité Paris, France
| | | | - Vincent Cottin
- Hôpital Louis Pradel Lyon, France
- Université Claude Bernard Lyon 1 Lyon, France
- Institut National de Recherche pour l'Agriculture et l'Environnement Paris, France
- OrphaLung, member of Respifil, ERN-LUNG Lyon, France
| | | | | | | | | | | | - Dominique Valeyre
- Hôpital Avicenne Bobigny, France
- Université Sorbonne Paris Nord Bobigny, France
| | | | - Hilario Nunes
- Université Sorbonne Paris Nord Bobigny, France
- Hôpital Avicenne Paris, France
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Nunes H, Brillet PY, Bernaudin JF, Gille T, Valeyre D, Jeny F. Fibrotic Pulmonary Sarcoidosis. Clin Chest Med 2024; 45:199-212. [PMID: 38245367 DOI: 10.1016/j.ccm.2023.08.011] [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] [Indexed: 01/22/2024]
Abstract
Fibrotic pulmonary sarcoidosis (fPS) affects about 20% of patients. fPS carries a significant morbidity and mortality. However, its prognosis is highly variable, depending mainly on fibrosis extent, functional impairment severity, and the development of pulmonary hypertension. Moreover, fPS outcomes are also influenced by several other complications, including acute exacerbations, and infections. fPS natural history is unknown, in particular regarding the risk of progressive self-sustaining fibrosis. The management of fPS is challenging, including anti-inflammatory treatment if granulomatous activity persists, rehabilitation, and in highly selected patients antifibrotic treatment and lung transplantation.
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Affiliation(s)
- Hilario Nunes
- AP-HP, Pulmonology Department, Avicenne Hospital, Bobigny, 93009, France; INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, 93009, France.
| | - Pierre-Yves Brillet
- INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, 93009, France; AP-HP, Radiology Department, Avicenne Hospital, Bobigny, 93009, France
| | | | - Thomas Gille
- INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, 93009, France; AP-HP, Physiology Department, Avicenne Hospital, Bobigny, 93009, France
| | - Dominique Valeyre
- INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, 93009, France; Groupe Hospitalier Paris Saint-Joseph, Pulmonology Department, Paris, 75014 France
| | - Florence Jeny
- AP-HP, Pulmonology Department, Avicenne Hospital, Bobigny, 93009, France; INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, 93009, France
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7
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Valeyre D, Bernaudin JF, Brauner M, Nunes H, Jeny F. Infectious Complications of Pulmonary Sarcoidosis. J Clin Med 2024; 13:342. [PMID: 38256476 PMCID: PMC10816300 DOI: 10.3390/jcm13020342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
In this review, the infectious complications observed in sarcoidosis are considered from a practical point of view to help the clinician not to overlook them in a difficult context, as pulmonary sarcoidosis makes the recognition of superinfections more difficult. An increased incidence of community-acquired pneumonia and of opportunistic pneumonia has been reported, especially in immunosuppressed patients. Pulmonary destructive lesions of advanced sarcoidosis increase the incidence of chronic pulmonary aspergillosis and infection by other agents. Screening and treatment of latent tuberculosis infection are crucial to prevent severe tuberculosis. Severity in COVID-19 appears to be increased by comorbidities rather than by sarcoidosis per se. The diagnosis of infectious complications can be challenging and should be considered as a potential differential diagnosis when the exacerbation of sarcoidosis is suspected. These complications not only increase the need for hospitalizations, but also increase the risk of death. This aspect must be carefully considered when assessing the overall health burden associated with sarcoidosis. The impact of immune dysregulation on infectious risk is unclear except in exceptional cases. In the absence of evidence-based studies on immunosuppressants in the specific context of pulmonary sarcoidosis, it is recommended to apply guidelines used in areas outside sarcoidosis. Preventive measures are essential, beginning with an appropriate use of immunosuppressants and the avoidance of unjustified treatments and doses. This approach should take into account the risk of tuberculosis, especially in highly endemic countries. Additionally, parallel emphasis should be placed on vaccinations, especially against COVID-19.
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Affiliation(s)
- Dominique Valeyre
- INSERM-UMR 1272, SMBH Université Sorbonne Paris-Nord, 93009 Bobigny, France; (D.V.); (J.-F.B.); (H.N.)
- Service de Pneumologie, Groupe Hospitalier Paris Saint Joseph, 75014 Paris, France
| | - Jean-François Bernaudin
- INSERM-UMR 1272, SMBH Université Sorbonne Paris-Nord, 93009 Bobigny, France; (D.V.); (J.-F.B.); (H.N.)
- Faculty of Medicine, Sorbonne University, 75013 Paris, France
| | - Michel Brauner
- Service de Radiologie, Hôpital Avicenne, 93009 Bobigny, France;
| | - Hilario Nunes
- INSERM-UMR 1272, SMBH Université Sorbonne Paris-Nord, 93009 Bobigny, France; (D.V.); (J.-F.B.); (H.N.)
- Service de Pneumologie, Hôpital Avicenne, 93009 Bobigny, France
| | - Florence Jeny
- INSERM-UMR 1272, SMBH Université Sorbonne Paris-Nord, 93009 Bobigny, France; (D.V.); (J.-F.B.); (H.N.)
- Service de Pneumologie, Hôpital Avicenne, 93009 Bobigny, France
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8
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Jeny F, Nunes H, Valeyre D. In sarcoidosis trials, time also matters. Eur Respir J 2024; 63:2301629. [PMID: 38237993 DOI: 10.1183/13993003.01629-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/20/2023] [Indexed: 01/23/2024]
Affiliation(s)
- Florence Jeny
- AP-HP, Pulmonology Department, Avicenne Hospital, Bobigny, France
- INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, France
| | - Hilario Nunes
- AP-HP, Pulmonology Department, Avicenne Hospital, Bobigny, France
- INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, France
| | - Dominique Valeyre
- INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, France
- Groupe hospitalier Paris Saint Joseph, Pulmonology Department, Paris, France
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9
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Ford P, Kreuter M, Brown KK, Wuyts WA, Wijsenbeek M, Israël-Biet D, Hubbard R, Nathan SD, Nunes H, Penninckx B, Prasad N, Seghers I, Spagnolo P, Verbruggen N, Hirani N, Behr J, Kaner RJ, Maher TM. An adjudication algorithm for respiratory-related hospitalisation in idiopathic pulmonary fibrosis. ERJ Open Res 2024; 10:00636-2023. [PMID: 38288082 PMCID: PMC10823372 DOI: 10.1183/23120541.00636-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/07/2023] [Indexed: 01/31/2024] Open
Abstract
Background There is no standard definition of respiratory-related hospitalisation, a common end-point in idiopathic pulmonary fibrosis (IPF) clinical trials. As diverse aetiologies and complicating comorbidities can present similarly, external adjudication is sometimes employed to achieve standardisation of these events. Methods An algorithm for respiratory-related hospitalisation was developed through a literature review of IPF clinical trials with respiratory-related hospitalisation as an end-point. Experts reviewed the algorithm until a consensus was reached. The algorithm was validated using data from the phase 3 ISABELA trials (clinicaltrials.gov identifiers NCT03711162 and NCT03733444), by assessing concordance between nonadjudicated, investigator-defined, respiratory-related hospitalisations and those defined by the adjudication committee using the algorithm. Results The algorithm classifies respiratory-related hospitalisation according to cause: extraparenchymal (worsening respiratory symptoms due to left heart failure, volume overload, pulmonary embolism, pneumothorax or trauma); other (respiratory tract infection, right heart failure or exacerbation of COPD); "definite" acute exacerbation of IPF (AEIPF) (worsening respiratory symptoms within 1 month, with radiological or histological evidence of diffuse alveolar damage); or "suspected" AEIPF (as for "definite" AEIPF, but with no radiological or histological evidence of diffuse alveolar damage). Exacerbations ("definite" or "suspected") with identified triggers (infective, post-procedural or traumatic, drug toxicity- or aspiration-related) are classed as "known AEIPF"; "idiopathic AEIPF" refers to exacerbations with no identified trigger. In the ISABELA programme, there was 94% concordance between investigator- and adjudication committee-determined causes of respiratory-related hospitalisation. Conclusion The algorithm could help to ensure consistency in the reporting of respiratory-related hospitalisation in IPF trials, optimising its utility as an end-point.
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Affiliation(s)
| | - Michael Kreuter
- Center for Pulmonary Medicine, Departments of Pneumology, Mainz University Medical Center and of Pulmonary, Critical Care and Sleep Medicine, Marienhaus Clinic Mainz, Mainz, Germany
| | - Kevin K. Brown
- Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Wim A. Wuyts
- Unit for Interstitial Lung Diseases, Department of Respiratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Marlies Wijsenbeek
- Centre for Interstitial Lung Disease and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Richard Hubbard
- Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Steven D. Nathan
- Inova Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, USA
| | - Hilario Nunes
- Department of Pneumology, Centre de Référence des Maladies Pulmonaires Rares, Assistance Publique–Hôpitaux de Paris, Hôpital Avicenne, Université Sorbonne Paris Nord, Bobigny, France
| | | | | | | | - Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | | | - Nik Hirani
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh and Centre for Inflammation Research, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Juergen Behr
- Department of Medicine V, LMU University Hospital, Ludwig Maximilian University Munich, Comprehensive Pneumology Center (member of the German Center for Lung Research), Munich, Germany
| | - Robert J. Kaner
- Division of Pulmonary and Critical Care Medicine and Department of Genetic Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Toby M. Maher
- National Heart and Lung Institute, Imperial College London, London, UK
- Keck Medicine of University of Southern California, Los Angeles, CA, USA
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Mabo A, Borie R, Wemeau-Stervinou L, Uzunhan Y, Gomez E, Prevot G, Reynaud-Gaubert M, Traclet J, Bergot E, Cadranel J, Marchand-Adam S, Bergeron A, Blanchard E, Bondue B, Bonniaud P, Bourdin A, Burgel PR, Hirschi S, Marquette CH, Quétant S, Nunes H, Chenivesse C, Crestani B, Guirriec Y, Monnier D, Ménard C, Tattevin P, Cottin V, Luque Paz D, Jouneau S. Infections in autoimmune pulmonary alveolar proteinosis: a large retrospective cohort. Thorax 2023; 79:68-74. [PMID: 37758458 DOI: 10.1136/thorax-2023-220040] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease, predisposing to an increased risk of infection. A complete picture of these infections is lacking. RESEARCH QUESTION Describe the characteristics and clinical outcomes of patients diagnosed with aPAP, and to identify risk factors associated with opportunistic infections. METHODS We conducted a retrospective cohort including all patients diagnosed with aPAP between 2008 and 2018 in France and Belgium. Data were collected using a standardised questionnaire including demographics, comorbidities, imaging features, outcomes and microbiological data. RESULTS We included 104 patients, 2/3 were men and median age at diagnosis was 45 years. With a median follow-up of 3.4 years (IQR 1.7-6.6 years), 60 patients (58%), developed at least one infection, including 23 (22%) with opportunistic infections. Nocardia spp was the main pathogen identified (n=10). Thirty-five (34%) patients were hospitalised due to infection. In univariate analysis, male gender was associated with opportunistic infections (p=0.04, OR=3.88; 95% CI (1.02 to 22.06)). Anti-granulocyte macrophage colony-stimulating factor antibody titre at diagnosis was significantly higher among patients who developed nocardiosis (1058 (316-1591) vs 580 (200-1190), p=0.01). Nine patients had died (9%), but only one death was related to infection. INTERPRETATION Patients with aPAP often presented with opportunistic infections, especially nocardiosis, which highlights the importance of systematic search for slow-growing bacteria in bronchoalveolar lavage or whole lung lavage.
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Affiliation(s)
- Axelle Mabo
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Raphael Borie
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Service de Pneumologie A, Hopital Bichat, APHP, Paris, France
| | - Lidwine Wemeau-Stervinou
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Institut Cœur-Poumon, Service de Pneumologie et Immuno-Allergologie, CHRU Lille, Lille, France
| | - Yurdagül Uzunhan
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Service de Pneumologie, Hôpital Avicenne, APHP, Bobigny, France
| | - Emmanuel Gomez
- Centre de Compétence pour les Maladies Pulmonaires Rares, Département de Pneumologie, Hôpitaux de Brabois, CHRU de Nancy, Vandoeuvre-les Nancy, France
| | - Gregoire Prevot
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Larry, CHU Toulouse, Toulouse, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie et Transplantation Pulmonaire, Centre de Compétences des Maladies Rares Pulmonaires et de l'Hypertension Pulmonaire, CHU Nord de Marseille, AP-HM, Aix Marseille Université, Marseille, France
| | - Julie Traclet
- Service de Pneumologie, Centre National Coordonnateur de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), UMR754, INRAE, Université Lyon 1, ERN-LUNG, Lyon, France
| | - Emmanuel Bergot
- Centre de Compétence pour les Maladies Pulmonaires Rares de l'Adulte, Service de Pneumologie et Oncologie Thoracique, Hôpital Côte de Nacre, CHU de Caen, Caen, France
| | - Jacques Cadranel
- Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares, Hôpital Tenon, APHP, Sorbonne Université, Paris, France
| | - Sylvain Marchand-Adam
- Service de Pneumologie, CHRU de Tours, Université François Rabelais de Tours, INSERM U1100, Tours, France
| | - Anne Bergeron
- Service de Pneumologie, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - Elodie Blanchard
- Service de Pneumologie, centre de compétence pour les maladies pulmonaires rares, CHU de Bordeaux, Pessac, France
| | - Benjamin Bondue
- Service de Pneumologie, CUB Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Philippe Bonniaud
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adulte, CHU Dijon-Bourgogne, Inserm U123, Université de Bourgogne, Dijon, France
| | - Arnaud Bourdin
- Service de Pneumologie, CHU Montpellier, Université de Montpellier, Inserm U1046, Montpellier, France
| | - Pierre Regis Burgel
- Service de Pneumologie, Hopital Cochin Pneumologie, AP-HP, Université Paris Cité Paris, Paris, France
| | - Sandrine Hirschi
- Service de Pneumologie et Transplantation Pulmonaire, Hopitaux universitaires de Strasbourg, Strasbourg, France
| | - Charles Hugo Marquette
- Service de Pneumologie, CHU Nice, Fédération Hospitalo-Universitaire OncoAge, Nice, France
| | - Sébastien Quétant
- Service Hospitalo-Universitaire de Pneumologie et Physiologie, Pôle Thorax et Vaisseaux, CHU de Grenoble-Alpes, La Tronche, Grenoble, France
| | - Hilario Nunes
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Service de Pneumologie, Hôpital Avicenne, APHP, Bobigny, France
| | - Cécile Chenivesse
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Institut Cœur-Poumon, Service de Pneumologie et Immuno-Allergologie, CHRU Lille, Lille, France
| | - Bruno Crestani
- Centre de Référence Constitutif des Maladies Pulmonaires Rares, Service de Pneumologie A, Hopital Bichat, APHP, Paris, France
| | - Yoann Guirriec
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Delphine Monnier
- Service d'Immunologie, Laboratoire de Biologie Médicale de Référence Lipoprotéinose Alvéolaire, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Cédric Ménard
- Service d'Immunologie, Laboratoire de Biologie Médicale de Référence Lipoprotéinose Alvéolaire, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Pierre Tattevin
- Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Inserm U1230, Université de Rennes, Rennes, France
| | - Vincent Cottin
- Service de Pneumologie, Centre National Coordonnateur de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), UMR754, INRAE, Université Lyon 1, ERN-LUNG, Lyon, France
| | - David Luque Paz
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Rennes, France
- Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Inserm U1230, Université de Rennes, Rennes, France
| | - Stéphane Jouneau
- Service de Pneumologie, Centre de Compétence pour les Maladies Pulmonaires Rares, Hôpital Pontchaillou, CHU Rennes, Rennes, France
- Inserm UMR1085 IRSET, Université de Rennes, EHESP, Rennes, France
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Desai SR, Sivarasan N, Johannson KA, George PM, Culver DA, Devaraj A, Lynch DA, Milne D, Renzoni E, Nunes H, Sverzellati N, Spagnolo P, Baughman RP, Yadav R, Piciucchi S, Walsh SLF, Kouranos V, Wells AU. High-resolution CT phenotypes in pulmonary sarcoidosis: a multinational Delphi consensus study. Lancet Respir Med 2023:S2213-2600(23)00267-9. [PMID: 38104579 DOI: 10.1016/s2213-2600(23)00267-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/23/2023] [Accepted: 07/14/2023] [Indexed: 12/19/2023]
Abstract
One view of sarcoidosis is that the term covers many different diseases. However, no classification framework exists for the future exploration of pathogenetic pathways, genetic or trigger predilections, patterns of lung function impairment, or treatment separations, or for the development of diagnostic algorithms or relevant outcome measures. We aimed to establish agreement on high-resolution CT (HRCT) phenotypic separations in sarcoidosis to anchor future CT research through a multinational two-round Delphi consensus process. Delphi participants included members of the Fleischner Society and the World Association of Sarcoidosis and other Granulomatous Disorders, as well as members' nominees. 146 individuals (98 chest physicians, 48 thoracic radiologists) from 28 countries took part, 144 of whom completed both Delphi rounds. After rating of 35 Delphi statements on a five-point Likert scale, consensus was achieved for 22 (63%) statements. There was 97% agreement on the existence of distinct HRCT phenotypes, with seven HRCT phenotypes that were categorised by participants as non-fibrotic or likely to be fibrotic. The international consensus reached in this Delphi exercise justifies the formulation of a CT classification as a basis for the possible definition of separate diseases. Further refinement of phenotypes with rapidly achievable CT studies is now needed to underpin the development of a formal classification of sarcoidosis.
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Affiliation(s)
- Sujal R Desai
- Department of Radiology, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK; Margaret Turner Warwick Centre for Fibrosing Lung Disease, Imperial College London, London, UK.
| | | | | | - Peter M George
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK; Margaret Turner Warwick Centre for Fibrosing Lung Disease, Imperial College London, London, UK
| | - Daniel A Culver
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Anand Devaraj
- Department of Radiology, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK; Margaret Turner Warwick Centre for Fibrosing Lung Disease, Imperial College London, London, UK
| | - David A Lynch
- Department of Radiology, National Jewish Health, Denver, CO, USA
| | - David Milne
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Elisabetta Renzoni
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK; Margaret Turner Warwick Centre for Fibrosing Lung Disease, Imperial College London, London, UK
| | - Hilario Nunes
- Service de Pneumologie, Hôpital Avicenne, Université Sorbonne Paris Nord, Paris, France
| | | | - Paolo Spagnolo
- Section of Respiratory Diseases, University of Padova, Padova, Italy
| | - Robert P Baughman
- Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Ruchi Yadav
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sara Piciucchi
- Department of Radiology, GB Morgagni Hospital, Forlì, Italy
| | - Simon L F Walsh
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Vasileios Kouranos
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK; Margaret Turner Warwick Centre for Fibrosing Lung Disease, Imperial College London, London, UK
| | - Athol U Wells
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK; Margaret Turner Warwick Centre for Fibrosing Lung Disease, Imperial College London, London, UK
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12
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Mismetti V, Delavenne X, Montani D, Bezzeghoud S, Delezay O, Hodin S, Launay D, Marchand-Adam S, Nunes H, Ollier E, Reynaud-Gaubert M, Pastre J, Traclet J, Quetant S, Zeghmar S, Bertoletti L, Cottin V. Proteomic biomarkers for survival in systemic sclerosis-associated pulmonary hypertension. Respir Res 2023; 24:273. [PMID: 37936223 PMCID: PMC10629050 DOI: 10.1186/s12931-023-02578-0] [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: 07/11/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Interstitial lung disease (ILD) and pulmonary hypertension (PH) represent the major causes of mortality in systemic sclerosis (SSc). Patients with systemic sclerosis and combined PH and ILD (SSc-PH-ILD) generally have a poor prognosis. Predictors of survival and of potential benefit of treatment are lacking in patients with SSc-PH-ILD. OBJECTIVE To identify specific plasma protein expression patterns associated with survival in patients with SSc-PH-ILD. MATERIALS AND METHODS Post-hoc analysis of a prospective multicenter French study in patients with PH-ILD. An untargeted proteomic analysis using mass spectrometry was performed to identify plasma protein changes associated with long-term overall survival in patients with SSc-PH-ILD. RESULTS Thirty two patients were included in the analysis, of whom 13 died during follow-up (median survival: 76.5 months). At baseline, survivors had less severe hemodynamic impairment [pulmonary vascular resistance of 4.4 Wood Units (IQR 3-5.2) vs. 6.2 Wood Units (IQR 4.2-10.7)] and higher carbon monoxide diffusing capacity [median 39% (IQR 35-44%) vs. 25% (IQR 22-30.5%)], than the 13 patients who died. Seven proteins, associated with haemostasis and fibrosis, were differentially expressed according to patients' survival. In the survivor group, two proteins were increased (ADAMTS13, SERPIND1) and five were decreased (PTGDS, OLFM1, C7, IGFBP7, FBN1) compared to the non-survivor groups. CONCLUSION The prognosis of SSc-PH-ILD patients is poor. This proteomic approach found 7 plasma proteins (involved in haemostasis and fibrosis pathways) associated with survival. These potential biomarkers may be good candidates to prognostic enrichment.
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Affiliation(s)
- Valentine Mismetti
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - Xavier Delavenne
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - David Montani
- Service de Pneumologie et Soins Intensifs Thoraciques, Centre de Référence de L'Hypertension Pulmonaire, INSERM U999 Centre de Compétence Maladies Pulmonaires Rares-OrphaLung Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France
| | - Souad Bezzeghoud
- Service de Médecine Vasculaire et Thérapeutique, INSERM, CIC-1408, CHU de Saint-Etienne, Saint-Etienne, France
| | - Olivier Delezay
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - Sophie Hodin
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - David Launay
- Service de Médecine Interne et d'Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO) CHU Lille, Lille, France
| | | | - Hilario Nunes
- Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, Hôpital Avicenne, INSERM U1272, Université Sorbonne Paris Nord, Bobigny, France
| | - Edouard Ollier
- Université Jean Monnet Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, 42023, Saint-Etienne, France
| | - Martine Reynaud-Gaubert
- Centre de Compétence des Maladies Pulmonaires Rares (OrphaLung), Service de Pneumologie et Transplantation Pulmonaire, CHU Nord, AP-HM, Aix Marseille Université, Marseille, France
| | - Jean Pastre
- Service de Pneumologie et Soins Intensifs Centre de Compétence Maladie Pulmonaire Rare (OrphaLung) Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Julie Traclet
- National Reference Center for Rare Pulmonary Diseases, Department of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, 69677, Lyon, France
| | | | - Sabrina Zeghmar
- National Reference Center for Rare Pulmonary Diseases, Department of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, 69677, Lyon, France
| | - Laurent Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, INSERM, UMR1059, Université Jean-Monnet, INSERM, CIC-1408, CHU de Saint-Etienne, INNOVTE, 42055, Saint-Etienne, France.
| | - Vincent Cottin
- National Reference Center for Rare Pulmonary Diseases, Department of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, 69677, Lyon, France
- Univ Lyon, INRA, UMR754, 69008, Lyon, France
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13
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Sidali S, Borie R, Sicre de Fontbrune F, El Husseini K, Rautou PE, Lainey E, Goria O, Crestani B, Cadranel J, Cottin V, Bunel V, Dumortier J, Jacquemin E, Reboux N, Hirschi S, Bourdin A, Meszaros M, Dharancy S, Hilaire S, Mallet V, Reynaud-Gaubert M, Terriou L, Gottrand F, Abou Chahla W, Khan JE, Carrier P, Saliba F, Rubbia-Brandt L, Aubert JD, Elkrief L, de Lédinghen V, Abergel A, Olivier T, Houssel P, Jouneau S, Wemeau L, Bergeron A, Leblanc T, Ollivier-Hourmand I, Nguyen Khac E, Morisse-Pradier H, Ba I, Boileau C, Roudot-Thoraval F, Vilgrain V, Bureau C, Nunes H, Naccache JM, Durand F, Francoz C, Roulot D, Valla D, Paradis V, Kannengiesser C, Plessier A. Liver disease in germline mutations of telomere-related genes: Prevalence, clinical, radiological, pathological features, outcome, and risk factors. Hepatology 2023:01515467-990000000-00633. [PMID: 37934624 DOI: 10.1097/hep.0000000000000667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND AND AIM Germline mutations of telomere-related genes (TRG) induce multiorgan dysfunction, and liver-specific manifestations have not been clearly outlined. We aimed to describe TRG mutations-associated liver diseases. APPROACH AND RESULTS Retrospective multicenter analysis of liver disease (transaminases > 30 IU/L and/or abnormal liver imaging) in patients with TRG mutations. Main measurements were characteristics, outcomes, and risk factors of liver disease in a TRG mutations cohort. The prevalence of liver disease was compared to a community-based control group (n = 1190) stratified for age and matched 1:3 for known risk factors of liver disease. Among 132 patients with TRG mutations, 95 (72%) had liver disease, with associated lung, blood, skin, rheumatological, and ophthalmological TRG diseases in 82%, 77%, 55%, 39%, and 30% of cases, respectively. Liver biopsy was performed in 52/95 patients, identifying porto-sinusoidal vascular disease in 48% and advanced fibrosis/cirrhosis in 15%. After a follow-up of 21 months (12-54), ascites, hepato-pulmonary syndrome, variceal bleeding, and HCC occurred in 14%, 13%, 13%, and 2% of cases, respectively. Five-year liver transplantation-free survival was 69%. A FIB-4 score ≥ 3·25 and ≥1 risk factor for cirrhosis were associated with poor liver transplantation-free survival. Liver disease was more frequent in patients with TRG mutations than in the paired control group [80/396, (20%)], OR 12.9 (CI 95%: 7.8-21.3, p < 0.001). CONCLUSIONS TRG mutations significantly increase the risk of developing liver disease. Although symptoms may be mild, they may be associated with severe disease. Porto-sinusoidal vascular disease and cirrhosis were the most frequent lesions, suggesting that the mechanism of action is multifactorial.
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Affiliation(s)
- Sabrina Sidali
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Hépato-Gastroentérologie, Rouen, France
| | - Raphaël Borie
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | - Flore Sicre de Fontbrune
- Hematology Transplant Unit, Hôpital Saint louis, APHP, Paris, France, and French National Referral Center for Aplastic Anemia, CRMR
| | - Kinan El Husseini
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Pneumologie, Rouen, France
| | - Pierre-Emmanuel Rautou
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | - Odile Goria
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Hépato-Gastroentérologie, Rouen, France
| | - Bruno Crestani
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | | | - Vincent Cottin
- Centre Hospitalier Universitaire Lyon Sud, Pneumologie, Pierre-Bénite, France
| | - Vincent Bunel
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | | | - Emmanuel Jacquemin
- Hôpital Kremlin-Bicêtre AP-HP, Hépatologie Pédiatrique, Le Kremlin-Bicêtre, France
| | - Noémi Reboux
- Centre Hospitalier Régional Universitaire Morvan, Hépatologie, Brest, France
| | - Sandrine Hirschi
- Centre Hospitalier Universitaire de Strasbourg, Pneumologie, Strasbourg, France
| | - Arnaud Bourdin
- Centre Hospitalier Universitaire de Montpellier, Pneumologie, Montpellier, France
| | - Magdalena Meszaros
- Centre Hospitalier Universitaire de Montpellier, Hépatologie, Montpellier, France
| | - Sebastien Dharancy
- Centre Hospitalier Régional Universitaire de Lille, Hépatologie, Lille, France
| | | | | | | | - Louis Terriou
- Centre Hospitalier Régional Universitaire de Lille, Médecine interne- Hématologie, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, CHU Lille, Department of pediatric gastroenterology hepatology and nutrition, Inserm, Lille, France
| | - Wadih Abou Chahla
- Centre Hospitalier Régional Universitaire de Lille, Hémato-Pédiatrie, Lille, France
| | | | - Paul Carrier
- Hôpital Universitaire Dupuytren, Hépatologie, Limoges, France
| | - Faouzi Saliba
- Hôpital Paul-Brousse, AP-HP, Hépatologie, Villejuif, France
| | | | - John-David Aubert
- Centre Hospitalier Universitaire Vaudois, Pneumologie, Lausanne, Suisse
| | - Laure Elkrief
- Centre Hospitalier Régional Universitaire de Tours, Hépatologie, Tours, France
| | - Victor de Lédinghen
- Centre Hospitalier Universitaire - Haut-Lévêque, Hépatologie, Pessac, France
| | - Armand Abergel
- Centre Hospitalier Universitaire, Hépatologie, Clermont-Ferrand, France
| | | | - Pauline Houssel
- Centre Hospitalier Universitaire, Hépatologie, Rennes, France
| | | | - Lidwine Wemeau
- Centre Hospitalier Régional Universitaire de Lille, Pneumologie, Lille, France
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève (HUG), Pneumologie, Genève, Suisse
| | - Thierry Leblanc
- Hematology Transplant Unit, Hôpital Saint louis, APHP, Paris, France, and French National Referral Center for Aplastic Anemia, CRMR
| | | | - Eric Nguyen Khac
- Centre Hospitalier Universitaire Amiens-Picardie Site Sud, Hépatologie, Amiens, France
| | | | - Ibrahima Ba
- Hôpital Bichat-Claude Bernard AP-HP, Génétique, Paris, France
| | | | | | | | | | - Hilario Nunes
- Hôpital Avicenne AP-HP, Pneumologie, Bobigny, France
| | | | - François Durand
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | - Claire Francoz
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | - Dominique Valla
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | | | - Aurélie Plessier
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
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14
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Guerra X, Rennotte S, Fetita C, Boubaya M, Debray MP, Israël-Biet D, Bernaudin JF, Valeyre D, Cadranel J, Naccache JM, Nunes H, Brillet PY. U-net convolutional neural network applied to progressive fibrotic interstitial lung disease: Is progression at CT scan associated with a clinical outcome? Respir Med Res 2023; 85:101058. [PMID: 38141579 DOI: 10.1016/j.resmer.2023.101058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/18/2023] [Accepted: 10/17/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Computational advances in artificial intelligence have led to the recent emergence of U-Net convolutional neural networks (CNNs) applied to medical imaging. Our objectives were to assess the progression of fibrotic interstitial lung disease (ILD) using routine CT scans processed by a U-Net CNN developed by our research team, and to identify a progression threshold indicative of poor prognosis. METHODS CT scans and clinical history of 32 patients with idiopathic fibrotic ILDs were retrospectively reviewed. Successive CT scans were processed by the U-Net CNN and ILD quantification was obtained. Correlation between ILD and FVC changes was assessed. ROC curve was used to define a threshold of ILD progression rate (PR) to predict poor prognostic (mortality or lung transplantation). The PR threshold was used to compare the cohort survival with Kaplan Mayer curves and log-rank test. RESULTS The follow-up was 3.8 ± 1.5 years encompassing 105 CT scans, with 3.3 ± 1.1 CT scans per patient. A significant correlation between ILD and FVC changes was obtained (p = 0.004, ρ = -0.30 [95% CI: -0.16 to -0.45]). Sixteen patients (50%) experienced unfavorable outcome including 13 deaths and 3 lung transplantations. ROC curve analysis showed an aera under curve of 0.83 (p < 0.001), with an optimal cut-off PR value of 4%/year. Patients exhibiting a PR ≥ 4%/year during the first two years had a poorer prognosis (p = 0.001). CONCLUSIONS Applying a U-Net CNN to routine CT scan allowed identifying patients with a rapid progression and unfavorable outcome.
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Affiliation(s)
- Xavier Guerra
- Department of Radiology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France.
| | - Simon Rennotte
- Samovar Laboratory, Télécom SudParis, Institut Polytechnique de Paris, Evry, France
| | - Catalin Fetita
- Samovar Laboratory, Télécom SudParis, Institut Polytechnique de Paris, Evry, France
| | - Marouane Boubaya
- Clinical Research Unit, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Sorbonne Paris-Nord, Bobigny, France
| | - Marie-Pierre Debray
- Department of Radiology, Bichat-Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Dominique Israël-Biet
- Department of Pulmonology, Georges Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Université Paris - Cité, Paris, France
| | - Jean-François Bernaudin
- INSERM UMR 1272 Hypoxie & Poumon SMBH, Université Sorbonne Paris - Nord, Bobigny, France; Medicine Sorbonne Université, Paris, France
| | - Dominique Valeyre
- INSERM UMR 1272 Hypoxie & Poumon SMBH, Université Sorbonne Paris - Nord, Bobigny, France; Department of Pulmonology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Jacques Cadranel
- Medicine Sorbonne Université, Paris, France; Department of Pulmonology, Tenon Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-Marc Naccache
- Department of Pulmonology, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Hilario Nunes
- INSERM UMR 1272 Hypoxie & Poumon SMBH, Université Sorbonne Paris - Nord, Bobigny, France; Department of Pulmonology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France
| | - Pierre-Yves Brillet
- Department of Radiology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris, Bobigny, France; INSERM UMR 1272 Hypoxie & Poumon SMBH, Université Sorbonne Paris - Nord, Bobigny, France
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15
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Sesé L, Gille T, Pau G, Dessimond B, Uzunhan Y, Bouvry D, Hervé A, Didier M, Kort F, Freynet O, Rotenberg C, Jeny F, Khamis W, Hindre R, Maesano CN, Planes C, Nunes H, Annesi-Maesano I. Low-cost air quality portable sensors and their potential use in respiratory health. Int J Tuberc Lung Dis 2023; 27:803-809. [PMID: 37880892 DOI: 10.5588/ijtld.23.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Abstract
Air pollution is an environmental risk for the general population and for patients with various diseases, particularly respiratory diseases. Little data are available on personal exposure, but the recent emergence of low-cost air quality sensors (LCSs) should enable a better understanding of the health impacts of air pollution at the individual level. However, the reliability and accuracy of most sensors in the market have not been established, and a thorough understanding of their strengths and limitations is needed. We therefore conducted a review to address the following questions: 1) What is an LCS and what is the extent of its possible application? 2) Is the data obtained a reliable indicator of exposure? 3) What are the advantages and disadvantages of LCSs? 4) Could LCSs be useful in investigating the impact of air pollution on respiratory health? Further studies are needed to promote the use of LCS in research settings and among respiratory patients. This will allow us to monitor exposure levels, provide alerts and study the respiratory effects of individual-level air pollution.
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Affiliation(s)
- L Sesé
- Department of Physiology and Functional Explorations, Assistance Publique-Hôpitaux de Paris (AP-HP), and, Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - T Gille
- Department of Physiology and Functional Explorations, Assistance Publique-Hôpitaux de Paris (AP-HP), and, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - G Pau
- Department of Computer Science and Engineering University of Bologna, Bologna, Italy
| | - B Dessimond
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM
| | - Y Uzunhan
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - D Bouvry
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - A Hervé
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - M Didier
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - F Kort
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - O Freynet
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - C Rotenberg
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - F Jeny
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - W Khamis
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - R Hindre
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - C N Maesano
- Department of Computer Science and Engineering University of Bologna, Bologna, Italy
| | - C Planes
- Department of Physiology and Functional Explorations, Assistance Publique-Hôpitaux de Paris (AP-HP), and, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - H Nunes
- Department of Pneumology, Centre Constitutif de Référence des Maladies pulmonaires rares, AP-HP, Hôpital Avicenne, Bobigny, Unité mixte de recherche 1272 'Hypoxia and the Lung', Institut national de la santé et de la recherche médicale (INSERM), Université Sorbonne Paris Nord, Bobigny
| | - I Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Departement of Allergic and Respiratory Diseases, Montpellier University Hospital, Montpellier, France
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16
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Taieb D, Pastré J, Juvin K, Bouvry D, Jeny F, Sanchez O, Uzunhan Y, Valeyre D, Nunes H, Israël-Biet D. Prognostic impact of venous thromboembolism on the course of sarcoidosis: A multicenter retrospective case-control study. Respir Med Res 2023; 84:101050. [PMID: 37897877 DOI: 10.1016/j.resmer.2023.101050] [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: 05/16/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 10/30/2023]
Abstract
Sarcoidosis is an independent risk factor for venous thromboembolism (VTE). However, the characteristics and clinical evolution of sarcoidosis patients presenting a VTE (sarcoidosis/VTE group) in the course of their disease are not known. Consequently, if VTE occurrence is associated with a more severe disease is still pending. We conducted a retrospective case-control study of sarcoidosis/VTE patients compared to matched sarcoidosis controls without VTE in two French tertiary centers, analysed and compared the clinical, biological, functional, imaging and evolutive profiles of the two groups. Sixty-one patients were included with at least one episode of VTE during course of sarcoidosis. At sarcoidosis onset (before/at the time of VTE occurrence) the number of affected organs, radiological stages and pulmonary functional tests were not significantly different between the two groups. In contrast, we found that sarcoidosis/VTE patients required more frequently a systemic immunosuppressive therapy (corticosteroids and/or immunosuppressors, 79% versus 58%; p = 0.008). The functional course was also poorer in sarcoidosis/VTE patients with a more frequent decrease in functional vital capacity (33% versus 18% in sarcoidosis/VTE patients and controls, respectively, p = 0.008). Finally, sarcoidosis/VTE patients presented more frequently with pulmonary hypertension (10% versus 1% in patients and controls, respectively, p = 0.006), and their survival was significantly worse (log-rank p <0.001). The occurrence of VTE during sarcoidosis is associated with a more severe disease and a poorer prognosis. The occurrence of VTE during sarcoidosis might signal a more inflammatory and/or evolutive disease in sarcoidosis/VTE patients and should be taken in consideration when designing therapeutic strategies for them.
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Affiliation(s)
- Dov Taieb
- Service de Pneumologie et Soins Intensifs, Assistance Publique-Hôpitaux de Paris Centre, Hôpital Européen Georges Pompidou, 75015 Paris, France; UFR de Médecine, Université Paris Cité, Paris, France.
| | - Jean Pastré
- Service de Pneumologie et Soins Intensifs, Assistance Publique-Hôpitaux de Paris Centre, Hôpital Européen Georges Pompidou, 75015 Paris, France
| | - Karine Juvin
- Service de Pneumologie et Soins Intensifs, Assistance Publique-Hôpitaux de Paris Centre, Hôpital Européen Georges Pompidou, 75015 Paris, France
| | - Diane Bouvry
- Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, 93009 Bobigny, France
| | - Florence Jeny
- Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, 93009 Bobigny, France; INSERM UMR 1272, Université Sorbonne Paris Nord, Bobigny, France
| | - Olivier Sanchez
- Service de Pneumologie et Soins Intensifs, Assistance Publique-Hôpitaux de Paris Centre, Hôpital Européen Georges Pompidou, 75015 Paris, France; UFR de Médecine, Université Paris Cité, Paris, France
| | - Yurdagül Uzunhan
- Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, 93009 Bobigny, France; INSERM UMR 1272, Université Sorbonne Paris Nord, Bobigny, France
| | | | - Hilario Nunes
- Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, 93009 Bobigny, France; INSERM UMR 1272, Université Sorbonne Paris Nord, Bobigny, France
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17
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Laville C, Fetita C, Gille T, Brillet PY, Nunes H, Bernaudin JF, Genet M. Comparison of optimization parametrizations for regional lung compliance estimation using personalized pulmonary poromechanical modeling. Biomech Model Mechanobiol 2023; 22:1541-1554. [PMID: 36913005 PMCID: PMC10009868 DOI: 10.1007/s10237-023-01691-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/09/2023] [Indexed: 03/14/2023]
Abstract
Interstitial lung diseases, such as idiopathic pulmonary fibrosis (IPF) or post-COVID-19 pulmonary fibrosis, are progressive and severe diseases characterized by an irreversible scarring of interstitial tissues that affects lung function. Despite many efforts, these diseases remain poorly understood and poorly treated. In this paper, we propose an automated method for the estimation of personalized regional lung compliances based on a poromechanical model of the lung. The model is personalized by integrating routine clinical imaging data - namely computed tomography images taken at two breathing levels in order to reproduce the breathing kinematic-notably through an inverse problem with fully personalized boundary conditions that is solved to estimate patient-specific regional lung compliances. A new parametrization of the inverse problem is introduced in this paper, based on the combined estimation of a personalized breathing pressure in addition to material parameters, improving the robustness and consistency of estimation results. The method is applied to three IPF patients and one post-COVID-19 patient. This personalized model could help better understand the role of mechanics in pulmonary remodeling due to fibrosis; moreover, patient-specific regional lung compliances could be used as an objective and quantitative biomarker for improved diagnosis and treatment follow up for various interstitial lung diseases.
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Affiliation(s)
- Colin Laville
- Laboratoire de Mécanique des Solides, École Polytechnique/CNRS/IPP, Palaiseau, France
- Inria, Palaiseau, France
| | | | - Thomas Gille
- Hypoxie et Poumon, Université Sorbonne Paris Nord/INSERM, Bobigny, France
- Hôpital Avicenne, APHP, Bobigny, France
| | - Pierre-Yves Brillet
- Hypoxie et Poumon, Université Sorbonne Paris Nord/INSERM, Bobigny, France
- Hôpital Avicenne, APHP, Bobigny, France
| | - Hilario Nunes
- Hypoxie et Poumon, Université Sorbonne Paris Nord/INSERM, Bobigny, France
- Hôpital Avicenne, APHP, Bobigny, France
| | | | - Martin Genet
- Laboratoire de Mécanique des Solides, École Polytechnique/CNRS/IPP, Palaiseau, France
- Inria, Palaiseau, France
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18
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Perez T, Roche N, Nunes H, Burgel PR, Chaouat A, Surpas P, Herengt F, Garcia G, Grosbois JM, Stelianides S, de Rigal P, Guérin P, Arnould B, Coste J. Dyspnea-induced Limitation (DYSLIM), a new self-administered concise questionnaire to evaluate dyspnea-related activity limitation in chronic respiratory diseases. Respir Med 2023; 217:107309. [PMID: 37394196 DOI: 10.1016/j.rmed.2023.107309] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/28/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND AND AIM Few questionnaires are available for routine assessment of dyspnea. The study aimed to design a self-administered questionnaire assessing the impact of chronic dyspnea on daily activities, named DYSLIM (Dyspnea-induced Limitation). METHODS The development followed 4 steps: 1: selection of relevant activities and related questions (focus groups); 2: clinical study: internal and concurrent validity vs. modified Medical Research Council (mMRC), Baseline Dyspnea Index (BDI) and Saint George Respiratory Questionnaire (SGRQ); 3: item reduction; 4: responsiveness. Eighteen activities (from eating to climbing stairs) were considered with 5 modalities for each: doing the task slowly, taking breaks, seeking assistance, changing habits, and activity avoidance. Each modality was graded from 5 (never) to 1 (very often). Validation study included 194 patients: COPD (FEV1 ≥ 50% pred: n = 40; FEV1 < 50% pred: n = 65); cystic fibrosis (n = 30), interstitial lung disease (n = 30), pulmonary hypertension (n = 29). Responsiveness was evaluated by post-pulmonary rehabilitation data in 52 COPD patients. RESULTS Acceptability was high and short term (7 days) reproducibility was satisfactory (Kappa mostly above 0.7). Concurrent validity was high vs. mMRC (Spearman correlation coefficient, r = 0.71), BDI (r = - 0.75) and SGRQ (r = - 0.79). The reduced questionnaire with 8 activities (from cleaning to climbing stairs) and 3 modalities (slowly, seeking help, changing habits) showed a comparable validity and was chosen as the final short version. Effect size of rehabilitation was good for both the full (0.57) and short (0.51) versions. A significant correlation was also found between changes of SGRQ and DYSLIM post rehabilitation: r = - 0.68 and r = - 0.60 for full and reduced questionnaires, respectively. CONCLUSION The DYSLIM questionnaire appears promising for the evaluation of dyspnea-induced limitations in chronic respiratory diseases and seems suitable for use in various contexts.
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Affiliation(s)
- Thierry Perez
- CHU de Lille, Service de Pneumologie et Immuno-allergologie, Service d'Explorations Fonctionnelles Respiratoires, Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Lille, France.
| | - Nicolas Roche
- Hôpital Cochin, Service de Pneumologie, APHP, Paris, France
| | - Hilario Nunes
- Hôpital Avicenne, APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares (site constitutif), Bobigny, France
| | | | - Ari Chaouat
- Département de Pneumologie, CHU de Nancy, Nancy, France
| | | | - Frédéric Herengt
- Centre de réadaptation cardio-respiratoire Dieulefit Santé, Dieulefit, France
| | - Gilles Garcia
- Hôpital du Kremlin Bicêtre, Service de Pneumologie, APHP, Kremlin Bicêtre, France
| | | | - Sandrine Stelianides
- Soins de Suite et Réadaptation en Pneumologie, Hôpital NOVO, Site d'Aincourt, France
| | | | - Philippe Guérin
- Clinique du Souffle « Les Clarines », Riom-es-Montagnes, France
| | | | - Joël Coste
- Biostatistics and Epidemiology Unit, Hôpitaux Universitaires Paris Centre, APHP, Université Paris Cité, Paris, France
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Sigaux J, Cavalin C, Lescoat A, El Rharras S, Macchi O, Brillet PY, Sesé L, Nunes H, Boissier MC, Rosental PA, Semerano L. Are cleaning activities a source of exposure to crystalline silica in women with rheumatoid arthritis? A case-control study. RMD Open 2023; 9:e003205. [PMID: 37532470 PMCID: PMC10401212 DOI: 10.1136/rmdopen-2023-003205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/30/2023] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION Inhalation of crystalline silica (silicon dioxide, SiO2) is associated with a wide range of acute and chronic diseases, including rheumatoid arthritis (RA). The objectives of this work were to identify the main sources of exposure to SiO2 in a series of patients with RA not selected on the basis of their professional activity, compared with a representative sample of the French general population, and to assess the association between silica exposure and disease features. METHODS The Dust Exposure Life-Course Questionnaire (DELCQ) is a tool that enables retrospective quantification of both occupational and non-occupational lifetime exposure to SiO2. DELCQ-previously validated in a large representative sample of the French general population-was administered to 97 consecutive RA patients, and exposure scores were compared between cases and age, gender and smoking status-matched controls (1:4). The main sources of SiO2 exposure were identified in cases and controls, and source-specific exposure levels were compared. The association between DELCQ scores and disease variables in cases was tested via univariable and multivariable analyses. RESULTS In women with RA, the main sources of SiO2 exposure were cleaning activities and dusty clothes laundry, with higher exposure levels from these sources versus the general population (p<0.005). Across the whole series of RA patients, high SiO2 exposure was independently associated with mediastinal lymphadenopathy (OR 6.3, 95% CI 1.4 to 27.7). CONCLUSION Cleaning activities and dusty clothes laundry may be underestimated sources of SiO2 exposure in women with RA.
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Affiliation(s)
- Johanna Sigaux
- UMR Inserm U1125, Université Sorbonne Paris Nord, Bobigny, France
- Rheumatology Department, Assistance Publique-Hôpitaux de Paris, GH HUPSSD, Bobigny, France
| | - Catherine Cavalin
- UMR CNRS-INRAE 7170-1427, Université Paris Dauphine, Paris, France
- Laboratoire interdisciplinaire d'évaluation des politiques publiques (LIEPP), Paris, France
| | - Alain Lescoat
- University Hospital Centre Rennes, Rennes, France
- Institut de Recherche en Santé, Environnement et Travail, INSERM, Paris, France
| | - Sarah El Rharras
- Rheumatology Department, Assistance Publique-Hôpitaux de Paris, GH HUPSSD, Bobigny, France
| | - Odile Macchi
- Centre d'études des mouvements sociaux, Ecole des Hautes Etudes en Sciences Sociales (EHESS), Paris, France
| | - Pierre-Yves Brillet
- Radiology Department, Assistance Publique-Hôpitaux de Paris, GH HUPSSD, Bobigny, France
| | - Lucile Sesé
- Physiology Department, Assistance Publique-Hôpitaux de Paris, GH HUPSSD, Bobigny, France
| | - Hilario Nunes
- Respiratory Department, Assistance Publique-Hôpitaux de Paris, GH HUPSSD, Bobigny, France
| | - Marie-Christophe Boissier
- UMR Inserm U1125, Université Sorbonne Paris Nord, Bobigny, France
- Rheumatology Department, Assistance Publique-Hôpitaux de Paris, GH HUPSSD, Bobigny, France
| | | | - Luca Semerano
- UMR Inserm U1125, Université Sorbonne Paris Nord, Bobigny, France
- Rheumatology Department, Assistance Publique-Hôpitaux de Paris, GH HUPSSD, Bobigny, France
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Braga S, Jeny F, Latrasse M, Saidenberg Kermanac'h N, Tran Ba S, Nunes H. Frontal cutaneous and bone sarcoidosis: an example of the contiguous spread of granulomas. Sarcoidosis Vasc Diffuse Lung Dis 2023; 40:e2023023. [PMID: 37382068 PMCID: PMC10494748 DOI: 10.36141/svdld.v40i2.14594] [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] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 05/26/2023] [Indexed: 06/30/2023]
Abstract
Sarcoidosis is a multisystemic granulomatous disease of unknown origin. It has been argued that the skin is one of the entry doors of the possible antigen that causes sarcoidosis and after entering the skin, the causal agent may progress to the underlying bone. We report four cases with development of sarcoidosis in old scars located on the forehead, and contiguous bone involvement of the frontal bone. In most cases scar sarcoidosis was the first manifestation of the disease, and in most cases it was asymptomatic. Two patients never required treatment, and in all cases the frontal problem improved or remained stable spontaneously or under sarcoidosis treatment. Scar sarcoidosis in the frontal area may have contiguous bone damage. This bone involvement does not seem to be associated with neurological extension.
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Affiliation(s)
| | - Florence Jeny
- Department of Pulmonology, Avicenne Hospital (Assistance Publique - Hôpitaux de Paris), Bobigny, Paris.
| | - Marjorie Latrasse
- Department of Radiology, Avicenne Hospital (Assistance Publique - Hôpitaux de Paris), Bobigny, Paris.
| | | | - Stéphane Tran Ba
- Department of Radiology, Avicenne Hospital (Assistance Publique - Hôpitaux de Paris), Bobigny, Paris.
| | - Hilario Nunes
- Department of Pulmonology, Avicenne Hospital (Assistance Publique - Hôpitaux de Paris), Bobigny, Paris.
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21
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Laville C, Fetita C, Gille T, Brillet PY, Nunes H, Bernaudin JF, Genet M. Correction to: Comparison of optimization parametrizations for regional lung compliance estimation using personalized pulmonary poromechanical modelling. Biomech Model Mechanobiol 2023:10.1007/s10237-023-01719-0. [PMID: 37294483 DOI: 10.1007/s10237-023-01719-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Colin Laville
- Laboratoire de Mécanique des Solides, École Polytechnique/CNRS/IPP, Palaiseau, France
- Inria, Palaiseau, France
| | | | - Thomas Gille
- Hypoxie et Poumon, Université Sorbonne Paris Nord/INSERM, Bobigny, France
- Hôpital Avicenne, APHP, Bobigny, France
| | - Pierre-Yves Brillet
- Hypoxie et Poumon, Université Sorbonne Paris Nord/INSERM, Bobigny, France
- Hôpital Avicenne, APHP, Bobigny, France
| | - Hilario Nunes
- Hypoxie et Poumon, Université Sorbonne Paris Nord/INSERM, Bobigny, France
- Hôpital Avicenne, APHP, Bobigny, France
| | | | - Martin Genet
- Laboratoire de Mécanique des Solides, École Polytechnique/CNRS/IPP, Palaiseau, France.
- Inria, Palaiseau, France.
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22
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Roeser A, Sese L, Chassagnon G, Chaigne B, Dunogue B, Tran Ba S, Jebri S, Brillet PY, Revel MP, Aubourg F, Dhote R, Caux F, Annesi-Maesano I, Mouthon L, Nunes H, Uzunhan Y. The association between air pollution and the severity at diagnosis and progression of systemic sclerosis-associated interstitial lung disease: results from the retrospective ScleroPol study. Respir Res 2023; 24:151. [PMID: 37291562 DOI: 10.1186/s12931-023-02463-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE To investigate the association of air pollution exposure with the severity of interstitial lung disease (ILD) at diagnosis and ILD progression among patients with systemic sclerosis (SSc)-associated ILD. METHODS We conducted a retrospective two-center study of patients with SSc-associated ILD diagnosed between 2006 and 2019. Exposure to the air pollutants particulate matter of up to 10 and 2.5 µm in diameter (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3) was assessed at the geolocalization coordinates of the patients' residential address. Logistic regression models were used to evaluate the association between air pollution and severity at diagnosis according to the Goh staging algorithm, and progression at 12 and 24 months. RESULTS We included 181 patients, 80% of whom were women; 44% had diffuse cutaneous scleroderma, and 56% had anti-topoisomerase I antibodies. ILD was extensive, according to the Goh staging algorithm, in 29% of patients. O3 exposure was associated with the presence of extensive ILD at diagnosis (adjusted OR: 1.12, 95% CI 1.05-1.21; p value = 0.002). At 12 and 24 months, progression was noted in 27/105 (26%) and 48/113 (43%) patients, respectively. O3 exposure was associated with progression at 24 months (adjusted OR: 1.10, 95% CI 1.02-1.19; p value = 0.02). We found no association between exposure to other air pollutants and severity at diagnosis and progression. CONCLUSION Our findings suggest that high levels of O3 exposure are associated with more severe SSc-associated ILD at diagnosis, and progression at 24 months.
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Affiliation(s)
- Anaïs Roeser
- Department of Pulmonology, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Bobigny, France
| | - Lucile Sese
- Department of Pulmonology, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Bobigny, France
- INSERM UMR1272 Hypoxie et poumon, Paris 13 - Université Paris Nord, Bobigny, France
| | - Guillaume Chassagnon
- Department of Radiology A, Assistance Publique-Hôpitaux de Paris (APHP), Cochin Hospital, Paris, France
| | - Benjamin Chaigne
- Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris (APHP), Cochin Hospital, Paris, France
| | - Bertrand Dunogue
- Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris (APHP), Cochin Hospital, Paris, France
| | - Stéphane Tran Ba
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Bobigny, France
| | - Salma Jebri
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Bobigny, France
| | - Pierre-Yves Brillet
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Bobigny, France
| | - Marie Pierre Revel
- Department of Radiology A, Assistance Publique-Hôpitaux de Paris (APHP), Cochin Hospital, Paris, France
| | - Frédérique Aubourg
- Department of Physiology, Assistance Publique-Hôpitaux de Paris (APHP), Cochin Hospital, Paris, France
| | - Robin Dhote
- Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Paris, France
| | - Frédéric Caux
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Paris, France
| | - Isabella Annesi-Maesano
- INSERM, Department of Allergic and Respiratory Disease, Montpellier University Hospital, Institute Desbrest of Epidemiology and Public Health, University of Montpellier, Montpellier, France
| | - Luc Mouthon
- Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris (APHP), Cochin Hospital, Paris, France
| | - Hilario Nunes
- Department of Pulmonology, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Bobigny, France
- INSERM UMR1272 Hypoxie et poumon, Paris 13 - Université Paris Nord, Bobigny, France
| | - Yurdagül Uzunhan
- Department of Pulmonology, Assistance Publique-Hôpitaux de Paris (APHP), Avicenne Hospital, Bobigny, France.
- INSERM UMR1272 Hypoxie et poumon, Paris 13 - Université Paris Nord, Bobigny, France.
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23
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Mankikian J, Caille A, Reynaud-Gaubert M, Agier MS, Bermudez J, Bonniaud P, Borie R, Brillet PY, Cadranel J, Court-Fortune I, Crestani B, Debray MP, Gomez E, Gondouin A, Hirschi-Santelmo S, Israel-Biet D, Jouneau S, Juvin K, Leger J, Kerjouan M, Marquette CH, Naccache JM, Nunes H, Plantier L, Prevot G, Quetant S, Traclet J, Valentin V, Uzunhan Y, Wémeau-Stervinou L, Bejan-Angoulvant T, Cottin V, Marchand-Adam S. Rituximab and mycophenolate mofetil combination in patients with interstitial lung disease (EVER-ILD): a double-blind, randomised, placebo-controlled trial. Eur Respir J 2023; 61:2202071. [PMID: 37230499 DOI: 10.1183/13993003.02071-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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: 10/27/2022] [Accepted: 03/21/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Standard of care for interstitial lung disease (ILD) with a nonspecific interstitial pneumonia (NSIP) pattern proposes mycophenolate mofetil (MMF) as one of the first-step therapies while rituximab is used as rescue therapy. METHODS In a randomised, double-blind, two-parallel group, placebo-controlled trial (NCT02990286), patients with connective tissue disease-associated ILD or idiopathic interstitial pneumonia (with or without autoimmune features) and a NSIP pattern (defined on NSIP pathological pattern or on integration of clinicobiological data and a NSIP-like high-resolution computed tomography pattern) were randomly assigned in a 1:1 ratio to receive rituximab (1000 mg) or placebo on day 1 and day 15 in addition to MMF (2 g daily) for 6 months. The primary end-point was the change in percent predicted forced vital capacity (FVC) from baseline to 6 months analysed by a linear mixed model for repeated measures analysis. Secondary end-points included progression-free survival (PFS) up to 6 months and safety. FINDINGS Between January 2017 and January 2019, 122 randomised patients received at least one dose of rituximab (n=63) or placebo (n=59). The least-squares mean change from baseline to 6 months in FVC (% predicted) was +1.60 (se 1.13) in the rituximab+MMF group and -2.01 (se 1.17) in the placebo+MMF group (between-group difference 3.60, 95% CI 0.41-6.80; p=0.0273). PFS was better in the rituximab+MMF group (crude hazard ratio 0.47, 95% CI 0.23-0.96; p=0.03). Serious adverse events occurred in 26 (41%) patients of the rituximab+MMF group and in 23 (39%) of the placebo+MMF group. Nine infections were reported in the rituximab+MMF group (five bacterial infections, three viral infections, one other) and four bacterial infections in the placebo+MMF group. INTERPRETATION Combination of rituximab and MMF was superior to MMF alone in patients with ILD and a NSIP pattern. The use of this combination must take into consideration the risk of viral infection.
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Affiliation(s)
- Julie Mankikian
- CHRU Tours, Service de Pneumologie et d'Explorations Fonctionnelles Respiratoires, Tours, France
| | - Agnès Caille
- CIC, INSERM 1415, CHRU Tours, Tours, France
- Methods in Patients-Centered Outcomes and Health Research, INSERM UMR 1246, Nantes, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre de Compétences des Maladies Pulmonaires Rares, APHM, CHU Nord, 13015 Marseille, France
- Aix Marseille Université, Marseille, France
| | - Marie-Sara Agier
- CHRU Tours, Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance, Tours, France
| | - Julien Bermudez
- Service de Pneumologie, Centre de Compétences des Maladies Pulmonaires Rares, APHM, CHU Nord, 13015 Marseille, France
- Aix Marseille Université, Marseille, France
| | - Philippe Bonniaud
- Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adulte, Service de Pneumologie et Soins Intensifs Respiratoires, Centre Hospitalo-Universitaire de Dijon-Bourgogne, Dijon, France
- UFR des Sciences de Santé, Université de Bourgogne-Franche Comté et INSERM UMR 1231, Dijon, France
| | - Raphael Borie
- Université de Paris, Inserm, U1152, laboratoire d'excellence INFLAMEX, F-75018 Paris, France
- Hôpital Bichat, APHP, Service de Pneumologie A, Centre Constitutif du Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, F-75018 Paris, France
| | - Pierre-Yves Brillet
- APHP, Service de Radiologie, Hôpital Avicenne, Université Paris Sorbonne Nord, Bobigny, France
| | - Jacques Cadranel
- APHP, Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'adulte et Sorbonne Université, Hôpital Tenon, Paris, France
| | - Isabelle Court-Fortune
- Sainbiose DVH U1059 Inserm, Faculté de Médecine J Lisfranc, Université Jean Monnet, Saint Etienne, France
| | - Bruno Crestani
- Université de Paris, Inserm, U1152, laboratoire d'excellence INFLAMEX, F-75018 Paris, France
- Hôpital Bichat, APHP, Service de Pneumologie A, Centre Constitutif du Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, F-75018 Paris, France
| | - Marie-Pierre Debray
- Université de Paris, Inserm, U1152, laboratoire d'excellence INFLAMEX, F-75018 Paris, France
- APHP, Service de Radiologie, Hôpital Bichat, Paris, France
| | - Emmanuel Gomez
- Service de Pneumologie et Transplantation, Hopitaux Universitaires de Strasbourg - Nouvel Hôpital Civil, Strasbourg, France
| | - Anne Gondouin
- Université de Paris, APHP, Service de Pneumologie, Centre de Compétences Maladies Pulmonaires Rares, Hôpital Européen Georges Pompidou, Paris, France
| | - Sandrine Hirschi-Santelmo
- Hôpital de Pontchaillou, Service de Pneumologie, Centre de Compétences pour les Maladies Pulmonaires Rares, Rennes, France
| | | | - Stéphane Jouneau
- Université Côte d'Azur, Département de Pneumologie, CHU de Nice, Nice, France
- Groupe Hospitalier Paris Saint Joseph, Service de Pneumologie-Allergologie-Oncologie Thoracique, Paris, France
| | - Karine Juvin
- Université de Paris, APHP, Service de Pneumologie, Centre de Compétences Maladies Pulmonaires Rares, Hôpital Européen Georges Pompidou, Paris, France
| | | | - Mallorie Kerjouan
- Hôpital de Pontchaillou, Service de Pneumologie, Centre de Compétences pour les Maladies Pulmonaires Rares, Rennes, France
| | - Charles-Hugo Marquette
- APHP, Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'Adulte, Hôpital Avicenne, Bobigny, France
| | - Jean-Marc Naccache
- APHP, Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'adulte et Sorbonne Université, Hôpital Tenon, Paris, France
- Université de Tours, Centre d'Etude des Pathologies Respiratoires (CEPR) INSERM U1100 Faculté de Médecine, Tours, France
| | - Hilario Nunes
- Service de Pneumologie, Hôpital Larrey, Toulouse, France
| | - Laurent Plantier
- CHRU Tours, Service de Pneumologie et d'Explorations Fonctionnelles Respiratoires, Tours, France
- CHU de Grenoble-Alpes Service de Pneumologie et Physiologie, Pôle Thorax et Vaisseaux, La Tronche, France
| | - Grégoire Prevot
- Centre National de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service de Pneumologie, Lyon, France
| | - Sébastien Quetant
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence des Maladies Pulmonaires Rares (site constitutif), Lille, France
| | | | - Victor Valentin
- CHRU de Tours, Service de Pharmacologie Clinique, Tours, France
| | - Yurdagul Uzunhan
- APHP, Service de Pneumologie et Oncologie Thoracique, Centre Constitutif Maladies Pulmonaires Rares de l'Adulte, Hôpital Avicenne, Bobigny, France
| | - Lidwine Wémeau-Stervinou
- CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence des Maladies Pulmonaires Rares (site constitutif), Lille, France
| | - Theodora Bejan-Angoulvant
- Université de Tours, EA 4245, Tours, France
- CHRU de Tours, Service de Pharmacologie Clinique, Tours, France
| | - Vincent Cottin
- Centre National de Référence des Maladies Pulmonaires Rares, Hôpital Louis-Pradel, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service de Pneumologie, Lyon, France
| | - Sylvain Marchand-Adam
- CHRU Tours, Service de Pneumologie et d'Explorations Fonctionnelles Respiratoires, Tours, France
- Université de Tours, Centre d'Etude des Pathologies Respiratoires (CEPR) INSERM U1100 Faculté de Médecine, Tours, France
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Cottin V, Blanchard E, Kerjouan M, Lazor R, Reynaud-Gaubert M, Taille C, Uzunhan Y, Wemeau L, Andrejak C, Baud D, Bonniaud P, Brillet PY, Calender A, Chalabreysse L, Court-Fortune I, Desbaillets NP, Ferretti G, Guillemot A, Hardelin L, Kambouchner M, Leclerc V, Lederlin M, Malinge MC, Mancel A, Marchand-Adam S, Maury JM, Naccache JM, Nasser M, Nunes H, Pagnoux G, Prévot G, Rousset-Jablonski C, Rouviere O, Si-Mohamed S, Touraine R, Traclet J, Turquier S, Vagnarelli S, Ahmad K. French recommendations for the diagnosis and management of lymphangioleiomyomatosis. Respir Med Res 2023; 83:101010. [PMID: 37087906 DOI: 10.1016/j.resmer.2023.101010] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND The present article is an English-language version of the French National Diagnostic and Care Protocol, a pragmatic tool to optimize and harmonize the diagnosis, care pathway, management and follow-up of lymphangioleiomyomatosis in France. METHODS Practical recommendations were developed in accordance with the method for developing a National Diagnosis and Care Protocol for rare diseases of the Haute Autorité de Santé and following international guidelines and literature on lymphangioleiomyomatosis. It was developed by a multidisciplinary group, with the help of patient representatives and of RespiFIL, the rare disease network on respiratory diseases. RESULTS Lymphangioleiomyomatosis is a rare lung disease characterised by a proliferation of smooth muscle cells that leads to the formation of multiple lung cysts. It occurs sporadically or as part of a genetic disease called tuberous sclerosis complex (TSC). The document addresses multiple aspects of the disease, to guide the clinicians regarding when to suspect a diagnosis of lymphangioleiomyomatosis, what to do in case of recurrent pneumothorax or angiomyolipomas, what investigations are needed to make the diagnosis of lymphangioleiomyomatosis, what the diagnostic criteria are for lymphangioleiomyomatosis, what the principles of management are, and how follow-up can be organised. Recommendations are made regarding the use of pharmaceutical specialties and treatment other than medications. CONCLUSION These recommendations are intended to guide the diagnosis and practical management of pulmonary lymphangioleiomyomatosis.
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Affiliation(s)
- Vincent Cottin
- Centre de Référence Coordinateur des maladies pulmonaires rares (OrphaLung), Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, ERN-LUNG, 69677 Lyon, France; UMR 754, INRAE, Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France.
| | - Elodie Blanchard
- Centre de Compétence des maladies pulmonaires rares (OrphaLung), GH Sud Haut-Lévêque, Avenue Magellan, 33600 Pessac, France
| | - Mallorie Kerjouan
- Centre de Compétence des maladies pulmonaires rares (OrphaLung), CHU Pontchailloux, 2 rue Henri le Guilloux, 35000 Rennes, France
| | - Romain Lazor
- Service de Pneumologie, Centre Hospitalier Universitaire Vaudois, BU44/07.2137, Rue du Bugnon 46, 1011 Lausanne, Suisse
| | - Martine Reynaud-Gaubert
- Centre de Compétence des maladies pulmonaires rares (OrphaLung), Hôpital Nord, Chemin Bourrely, 13015 Marseille, France; URMITE-CNRS-IRD UMR 6236, Aix-Marseille Université, 51 boulevard Pierre Dramard, 13344 Marseille cedex 15, France
| | - Camille Taille
- Centre de Référence Constitutif des maladies pulmonaires rares (OrphaLung), Hôpital Bichat, 46 rue Henri Huchard, 75018 Paris, France; Université Paris-Diderot, 17 rue Jean Antoine de Baïf, 75013 Paris, France
| | - Yurdagül Uzunhan
- Centre de Référence constitutif des maladies pulmonaires rares (OrphaLung), Hôpital Avicenne, 125 rue Stalingrad, 93000 Bobigny, France; Université Sorbonne Paris Nord, INSERM UMR 1272 "Hypoxie et Poumon", 1 rue Chablis, 93000 Bobigny, Paris, France
| | - Lidwine Wemeau
- Centre de Référence constitutif des maladies pulmonaires rares, CHRU, 5 rue Oscar Lambret, 59000 Lille, France
| | - Claire Andrejak
- Service de pneumologie, CHU Amiens, 1 Place Victor Pauchet, 80054 Amiens, France; UFR de médecine, 3 rue Louvels, 80000 Amiens, France
| | - Dany Baud
- Hôpital Suisse de Paris, 10 rue Minard, 92130 Issy les Moulineaux, France
| | - Philippe Bonniaud
- Centre de Référence constitutif des maladies pulmonaires rares, CHU de Dijon, BP 77908, 21079, Dijon, France; INSERM, LNC UMR1231, LipSTIC LabEx Team, 21000 Dijon, France
| | - Pierre-Yves Brillet
- Université Sorbonne Paris Nord, INSERM UMR 1272 "Hypoxie et Poumon", 1 rue Chablis, 93000 Bobigny, Paris, France; Service de radiologie, hôpital Avicenne, 125 rue Stalingrad, 93000 Bobigny, France
| | - Alain Calender
- Département de génétique, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677 Lyon, France; IBCP, Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France
| | - Lara Chalabreysse
- Service de pathologie, Groupe hospitalier est, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677 Lyon, France; Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France
| | | | | | - Gilbert Ferretti
- Pole imagerie, CHU Grenoble Alpes, Boulevard Chantourne, 38700 La Tronche, France
| | - Anne Guillemot
- Centre de Référence Coordinateur des maladies pulmonaires rares (OrphaLung), Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, ERN-LUNG, 69677 Lyon, France
| | - Laurane Hardelin
- Centre de Référence Coordinateur des maladies pulmonaires rares (OrphaLung), Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, ERN-LUNG, 69677 Lyon, France
| | - Marianne Kambouchner
- Service d'anatomopatholologie, Hôpital Avicenne, 125 rue Stalingrad, 93000 Bobigny, France
| | - Violette Leclerc
- Association France Lymphangioléiomyomatose, 4, Rue des Vieux-Moulins, 56 680 Plouhinec, France
| | - Mathieu Lederlin
- Service de radiologie, CHU Pontchailloux, 2 rue Henri le Guilloux, 35000 Rennes, France
| | | | - Alain Mancel
- Association France Lymphangioléiomyomatose, 4, Rue des Vieux-Moulins, 56 680 Plouhinec, France
| | - Sylvain Marchand-Adam
- Centre de Compétence des maladies pulmonaires rares (OrphaLung), Hôpital Bretonneau, CHRU Tours, 2 Boulevard Tonnellé, 37000 Tours, France; Université de Tours, CEPR INSERMU1100, 10 Boulevard Tonnellé, 37000 Tours, France
| | - Jean-Michel Maury
- Service de chirurgie thoracique, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677 Lyon, France
| | - Jean-Marc Naccache
- Service de pneumologie, Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014 Paris, France
| | - Mouhamad Nasser
- Centre de Référence Coordinateur des maladies pulmonaires rares (OrphaLung), Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, ERN-LUNG, 69677 Lyon, France
| | - Hilario Nunes
- Centre de Référence constitutif des maladies pulmonaires rares (OrphaLung), Hôpital Avicenne, 125 rue Stalingrad, 93000 Bobigny, France; Université Sorbonne Paris Nord, INSERM UMR 1272 "Hypoxie et Poumon", 1 rue Chablis, 93000 Bobigny, Paris, France
| | - Gaële Pagnoux
- Service de radiologie, Hôpital Edouard Herriot, 5 place d'Arsonval, 69008 Lyon, France
| | - Grégoire Prévot
- Centre de Compétence des maladies pulmonaires rares (OrphaLung), service de pneumologie, hôpital Larrey, 24 chemin de Pouvourville, 31059 Toulouse cedex 9, France
| | | | - Olivier Rouviere
- Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France; Service de radiologie, Hôpital Edouard Herriot, 5 place d'Arsonval, 69008 Lyon, France
| | - Salim Si-Mohamed
- Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France; Service d'imagerie, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677 Lyon, France
| | - Renaud Touraine
- Laboratoire de Génétique Chromosomique et Moléculaire, CHU-Hôpital Nord, Laboratoire AURAGEN (Plan France Médecine Génomique 2025), 42270 Saint Priest en Jarest, France
| | - Julie Traclet
- Centre de Référence Coordinateur des maladies pulmonaires rares (OrphaLung), Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, ERN-LUNG, 69677 Lyon, France
| | - Ségolène Turquier
- Service d'exploration fonctionnelle respiratoire, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677 Lyon, France
| | - Stéphane Vagnarelli
- Centre de Référence constitutif des maladies pulmonaires rares (OrphaLung), Hôpital Avicenne, 125 rue Stalingrad, 93000 Bobigny, France
| | - Kaïs Ahmad
- Centre de Référence Coordinateur des maladies pulmonaires rares (OrphaLung), Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lepine, ERN-LUNG, 69677 Lyon, France
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Brillet PY, Tran Ba S, Nunes H. How does the MESA Lung Study sharpen blurry edges in interstitial lung abnormalities? Eur Respir J 2023; 61:2300397. [PMID: 37290811 DOI: 10.1183/13993003.00397-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023]
Affiliation(s)
- Pierre-Yves Brillet
- Inserm UMR 1272 "Hypoxie et Poumon", UFR SMBH, Université Sorbonne Paris-Nord, 93000 Bobigny, France
- Service de Radiologie, Hôpital Avicenne, Assistance Publique des Hôpitaux de Paris, 93009 Bobigny cedex, France
| | - Stéphane Tran Ba
- Service de Radiologie, Hôpital Avicenne, Assistance Publique des Hôpitaux de Paris, 93009 Bobigny cedex, France
| | - Hilario Nunes
- Inserm UMR 1272 "Hypoxie et Poumon", UFR SMBH, Université Sorbonne Paris-Nord, 93000 Bobigny, France
- Service de Pneumologie, Hôpital Avicenne, Assistance Publique des Hôpitaux de Paris, 93009 Bobigny cedex, France
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Valeyre D, Brauner M, Bernaudin JF, Carbonnelle E, Duchemann B, Rotenberg C, Berger I, Martin A, Nunes H, Naccache JM, Jeny F. Differential diagnosis of pulmonary sarcoidosis: a review. Front Med (Lausanne) 2023; 10:1150751. [PMID: 37250639 PMCID: PMC10213276 DOI: 10.3389/fmed.2023.1150751] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 01/24/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Diagnosing pulmonary sarcoidosis raises challenges due to both the absence of a specific diagnostic criterion and the varied presentations capable of mimicking many other conditions. The aim of this review is to help non-sarcoidosis experts establish optimal differential-diagnosis strategies tailored to each situation. Alternative granulomatous diseases that must be ruled out include infections (notably tuberculosis, nontuberculous mycobacterial infections, and histoplasmosis), chronic beryllium disease, hypersensitivity pneumonitis, granulomatous talcosis, drug-induced granulomatosis (notably due to TNF-a antagonists, immune checkpoint inhibitors, targeted therapies, and interferons), immune deficiencies, genetic disorders (Blau syndrome), Crohn's disease, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, and malignancy-associated granulomatosis. Ruling out lymphoproliferative disorders may also be very challenging before obtaining typical biopsy specimen. The first step is an assessment of epidemiological factors, notably the incidence of sarcoidosis and of alternative diagnoses; exposure to risk factors (e.g., infectious, occupational, and environmental agents); and exposure to drugs taken for therapeutic or recreational purposes. The clinical history, physical examination and, above all, chest computed tomography indicate which differential diagnoses are most likely, thereby guiding the choice of subsequent investigations (e.g., microbiological investigations, lymphocyte proliferation tests with metals, autoantibody assays, and genetic tests). The goal is to rule out all diagnoses other than sarcoidosis that are consistent with the clinical situation. Chest computed tomography findings, from common to rare and from typical to atypical, are described for sarcoidosis and the alternatives. The pathology of granulomas and associated lesions is discussed and diagnostically helpful stains specified. In some patients, the definite diagnosis may require the continuous gathering of information during follow-up. Diseases that often closely mimic sarcoidosis include chronic beryllium disease and drug-induced granulomatosis. Tuberculosis rarely resembles sarcoidosis but is a leading differential diagnosis in regions of high tuberculosis endemicity.
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Affiliation(s)
- Dominique Valeyre
- Pulmonology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
| | - Michel Brauner
- Radiology Department, Avicenne University Hospital, Bobigny, France
| | - Jean-François Bernaudin
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Faculté de Médecine, Sorbonne University Paris, Paris, France
| | | | - Boris Duchemann
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Thoracic and Oncology Department, Avicenne University Hospital, Bobigny, France
| | - Cécile Rotenberg
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Pulmonology Department, Avicenne University Hospital, Bobigny, France
| | - Ingrid Berger
- Pulmonology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Antoine Martin
- Pathology Department, Avicenne University Hospital, Bobigny, France
| | - Hilario Nunes
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Pulmonology Department, Avicenne University Hospital, Bobigny, France
| | - Jean-Marc Naccache
- Pulmonology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Florence Jeny
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Pulmonology Department, Avicenne University Hospital, Bobigny, France
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Köther K, Besnard V, Sandig H, Carruthers A, Miranda E, Grootenboer-Mignot S, Taillé C, Chevret S, Valeyre D, Nunes H, Israel-Biet D, Lim WK, Cottin V, Corkill D, Dobson C, Groves M, Ferraro F, Guenzi E, Huang L, Sulikowski M, Mailleux A, Murray LA, Mustelin T, Strickland I, Sleeman MA, Crestani B. Autoantibodies are associated with disease progression of idiopathic pulmonary fibrosis. Eur Respir J 2023; 61:13993003.02381-2021. [PMID: 37080573 DOI: 10.1183/13993003.02381-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/05/2023] [Indexed: 04/22/2023]
Abstract
Several reports have highlighted a potential role of auto-reactive B cells and autoantibodies that correlates with increased disease severity in patients with IPF. Here we show that patients with IPF have an altered B cell phenotype and that those subjects that have autoantibodies against the intermediate filament protein periplakin (PPL) have a significantly worse outcome in terms of progression free survival. Using a mouse model of lung fibrosis, we demonstrate that the instillation of antibodies targeting the endogenous protein PPL, mimicking naturally occurring autoantibodies seen in patients, directly to the lung increased lung injury, inflammation, collagen and fibronectin expression, through direct activation of follicular dendritic cells which in turn activates and drive proliferation of fibroblasts. This fibrocyte population was also observed in fibrotic foci of patients with IPF and increased in peripheral blood of IPF patients compared to aged matched control. This study re-iterates complex and heterogeneous nature of IPF, identifying new pathways that may prove suitable for therapeutic intervention.
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Affiliation(s)
- Katerina Köther
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Valérie Besnard
- INSERM U1152, Université Paris Cité, Labex Inflamex, Paris, France
| | - Hilary Sandig
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Alan Carruthers
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Elena Miranda
- Imaging and AI, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
| | - Sabine Grootenboer-Mignot
- INSERM U1152, Université Paris Cité, Labex Inflamex, Paris, France
- AP-HP, Hôpital Bichat, Laboratoire d'Immunologie ''Autoimmunité et Hypersensibilités"
| | - Camille Taillé
- INSERM U1152, Université Paris Cité, Labex Inflamex, Paris, France
- AP-HP, Hôpital Bichat, Service de Pneumologie, FHU APOLLO, Paris, France
| | - Sylvie Chevret
- Biostatistics and Clinical Epidemiology team, INSERM UMR 1153, Université de Paris, SBIM- Hôpital Saint Louis, Paris, France
| | - Dominique Valeyre
- AP-HP, Hôpital Avicenne, Service de Pneumologie, UMR Inserm 1272, Université Paris Nord, Bobigny, France
| | - Hilario Nunes
- AP-HP, Hôpital Avicenne, Service de Pneumologie, UMR Inserm 1272, Université Paris Nord, Bobigny, France
| | - Dominique Israel-Biet
- AP-HP, Hôpital Européen Georges Pompidou, Service de Pneumologie, Université de Paris, Paris, France
| | | | - Vincent Cottin
- Hospices Civils de Lyon, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Lyon, France
| | - Dominic Corkill
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Claire Dobson
- Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Maria Groves
- Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Franco Ferraro
- Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Edouard Guenzi
- INSERM U1152, Université Paris Cité, Labex Inflamex, Paris, France
- Département d'Anatomopathologie, AP-HP, Hôpital Bichat
| | - Ling Huang
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Michal Sulikowski
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Arnaud Mailleux
- AP-HP, Hôpital Bichat, Laboratoire d'Immunologie ''Autoimmunité et Hypersensibilités"
| | - Lynne Anne Murray
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Thomas Mustelin
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
- Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA
| | - Ian Strickland
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
- authors contributed equally to this manuscript
| | - Matthew A Sleeman
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
- authors contributed equally to this manuscript
| | - Bruno Crestani
- INSERM U1152, Université Paris Cité, Labex Inflamex, Paris, France
- AP-HP, Hôpital Bichat, Service de Pneumologie, FHU APOLLO, Paris, France
- authors contributed equally to this manuscript
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Olland A, Valeyre D, Nunes H, Le Pavec J. [Lung transplantation for sarcoidosis]. Rev Mal Respir 2023; 40 Suppl 1:e58-e61. [PMID: 36639340 DOI: 10.1016/j.rmr.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- A Olland
- Lung Transplantation Group, University Hospital Strasbourg, Strasbourg, France; INSERM (French institute for health and medical research) 1260 Regenerative Nanomedecine, Translational Medicine Federation of Strasbourg, University of Strasbourg, Strasbourg, France
| | - D Valeyre
- Service de Pneumologie, Inserm UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne, Bobigny, France; Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - H Nunes
- Service de Pneumologie, Inserm UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne, Bobigny, France; Service de Pneumologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Paris, France
| | - J Le Pavec
- Service de Pneumologie et de Transplantation Pulmonaire, Groupe Hospitalier Marie-Lannelongue -Paris Saint Joseph, Le Plessis-Robinson, France; Université Paris-Saclay, Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Sud, Inserm, Groupe hospitalier Marie-Lannelongue-Saint Joseph, Le Plessis-Robinson, France.
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Assié JB, Chouaïd C, Nunes H, Reynaud D, Gaudin AF, Grumberg V, Jolivel R, Jouaneton B, Cotté FE, Duchemann B. Outcome following nivolumab treatment in patients with advanced non-small cell lung cancer and comorbid interstitial lung disease in a real-world setting. Ther Adv Med Oncol 2023; 15:17588359231152847. [PMID: 36743523 PMCID: PMC9893351 DOI: 10.1177/17588359231152847] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023] Open
Abstract
Background Up to 10% of patients with advanced non-small cell lung cancer (aNSCLC) have pre-existing interstitial lung disease (ILD). These patients are usually excluded from immunotherapy clinical trials. Consequently, knowledge on outcomes following nivolumab treatment in these patients remains limited. The primary objective of this study was to evaluate survival outcome following nivolumab treatment in ILD patients with pre-treated aNSCLC in the real-world setting. Patients and methods The study included all patients with aNSCLC recorded in the French hospital database, starting nivolumab in 2015-2016. Patients were stratified by pre-existing ILD and three subgroups were studied [auto-immune or granulomatous (AI/G) ILD, other known causes ILD and idiopathic ILD]. Time to discontinuation of nivolumab treatment [time to treatment duration (TTD)] and overall survival (OS) were estimated using Kaplan-Meier survival analysis. Results Of 10,452 aNSCLC patients initiating nivolumab, 148 (1.4%) had pre-existing ILD. Mean age at nivolumab initiation was 64.6 ± 9.4 years in ILD and 63.8 ± 9.6 years in non-ILD. Compared to non-ILD, patients in the ILD group were more frequently men (p < 0.05) and had more comorbidities (p < 0.001). There was no significant difference between ILD and non-ILD groups for median TTD (2.5 versus 2.8 months; p = 0.6) or median OS (9.6 versus 11.9 months; p = 0.1). Median OS in AI/G ILD (n = 14), other known causes ILD (n = 75), and idiopathic ILD (n = 59) were 8.6, 10.7, and 9.6 months, respectively. Conclusion In this large cohort of aNSCLC patients with ILD, outcomes are similar to those obtained in the non-ILD population. Immunotherapy could be beneficial for these patients.
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Affiliation(s)
- Jean-Baptiste Assié
- Functional Genomics of Solid Tumors Laboratory, Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France,Centre Hospitalier Intercommunal Créteil, Créteil, France
| | | | - Hilario Nunes
- Department of Respiratory Medicine, Centre de Référence des Maladies Pulmonaires Rares, Avicenne Hospital, Université Sorbonne Paris Nord, Paris, France
| | | | | | | | | | | | | | - Boris Duchemann
- Department of Thoracic and Medical Oncology, Avicenne Hospital, Université Sorbonne Paris Nord, Paris, France,Laboratoire d’Immunomonitoring en Oncologie, INSERM US23, CNRS UMS 3655, Institut Gustave Roussy, Villejuif, France
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Bay P, de Chambrun MP, Rothstein V, Mahevas M, De Prost N, Roux A, Zuber B, Biet DI, Hervier B, Tazi A, Mouthon L, Mekinian A, Deligny C, Borie R, Meurice JC, Meyer A, Priou P, Savale L, De Saint Martin L, Gallay L, Cottin V, Blanchard E, Brillet PY, Khafagy P, Benveniste O, Nunes H, Allenbach Y, Uzunhan Y. Efficacy of plasma exchange in patients with anti-MDA5 rapidly progressive interstitial lung disease. J Autoimmun 2022; 133:102941. [PMID: 36323067 DOI: 10.1016/j.jaut.2022.102941] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Rapidly progressive interstitial lung disease (RP-ILD) is a frequent and severe manifestation of anti-MDA5 dermatomyositis (MDA5-DM) associated with poor outcome. The optimal treatment regimen for MDA5-DM RP-ILD is yet to be determined. Specifically, the value of adding plasma exchange (PLEX) to corticosteroids and immunosuppressants remains unclear. We aimed to evaluate the effect of PLEX on the outcome of patients with MDA5-DM RP-ILD. METHODS This French nationwide multicentre retrospective study included all MDA5-DM RP-ILD patients from 2012 to 2021 admitted to 18 centres. The primary endpoint was one-year transplant-free survival. RESULTS 51 patients with MDA5-DM RP-ILD (female 67%; mean age at disease onset: 51 ± 11.6 years) were included. Thirty-two (63%) patients required mechanical ventilation and twenty-five (49%) received PLEX. One-year mortality or lung transplant occurred in 63% cases after a median follow-up of 77 [38-264] days. The Cox proportional hazards multivariable model only retained mechanical ventilation but not PLEX (p = 0.7) as independent predictor of the primary endpoint. One-year transplant-free survival rates in PLEX + vs. PLEX-were 20% vs. 54% (p = 0.01), respectively. The Kaplan-Meier estimated probabilities of one-year transplant-free survival was statistically higher in PLEX-compared to PLEX + patients (p = 0.05). PLEX + compared to PLEX-patients more frequently received mechanical ventilation and immunosuppressants suggesting PLEX + patients had a more severe disease. CONCLUSION MDA5-DM RP-ILD is associated with poor rate of one-year transplant-free survival. The use of PLEX was not associated with a better outcome albeit they were mainly given to more severe patients. While our study reports the largest series of MDA5-DM RP-ILD given PLEX, these results needs to be interpreted with caution owing the numerous selection, indication and interpretation bias. Further studies are needed to evaluate their efficacy in this setting.
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Affiliation(s)
- Pierre Bay
- Université Sorbonne Paris Nord, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France; Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique - Hôpitaux de Paris (AP-HP), Créteil, France
| | - Marc Pineton de Chambrun
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital La Pitié-Salpêtrière, Service de Médecine Intensive-Réanimation, Paris, France; Sorbonne Université, INSERM, UMRS_1166-ICAN, Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France; Sorbonne Université, AP-HP, Hôpital La Pitié-Salpêtrière, Institut E3M, Service de Médecine Interne 2, Paris, France
| | - Vincent Rothstein
- Université Sorbonne Paris Nord, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France; Université de Paris, Assistance Publique-Hôpitaux de Paris, Service de Pneumologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Matthieu Mahevas
- Université Paris-Est Créteil, Service de Médecine Interne, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Nicolas De Prost
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique - Hôpitaux de Paris (AP-HP), Créteil, France
| | - Antoine Roux
- Service de Pneumologie, Hôpital Foch, Suresnes, France; Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Benjamin Zuber
- Service de Réanimation Polyvalente, Hôpital Foch, Suresnes, France
| | | | - Baptiste Hervier
- Université de Paris Cité, Assistance Publique Hôpitaux de Paris, Hôpital Saint-Louis, Service de Médecine Interne, Paris, France; Inserm UMR-S 976, "HIPI", Hopital Saint-Louis & Université Paris Cité, France
| | - Abdellatif Tazi
- Service de Pneumologie, Assistance Publique Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Arsène Mekinian
- DMU I3, Sorbonne Université, Service de Médecine Interne, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Raphaël Borie
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Pneumologie A, Paris, France
| | | | - Alain Meyer
- Département de Physiologie, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Pascaline Priou
- Département de Pneumologie, Centre Hospitalier Universitaire D'Angers, Angers, France
| | - Laurent Savale
- Department Service de Pneumologie et Unité de Soins Intensifs Respiratoires, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Laure Gallay
- Hospices Civils de Lyon, Médecine Interne, Hôpital Edouard Herriot, Lyon, France; Université de Lyon, France
| | - Vincent Cottin
- Centre National de Référence des Maladies Pulmonaires Rares, Service de Pneumologie, Hôpital Louis Pradel, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Elodie Blanchard
- Service des Maladies Respiratoires,CHU Bordeaux, Hôpital Haut-Lévêque, Bordeaux, France
| | - Pierre-Yves Brillet
- Service de Radiologie, Université Paris Sorbonne Nord, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Bobigny, France
| | - Philippe Khafagy
- Service de Radiologie, Université Paris Sorbonne Nord, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Avicenne, Bobigny, France
| | - Olivier Benveniste
- Centre de Recherche en Myologie, Unité Mixte de Recherche Scientifique 974, Université Pierre et Marie Curie, INSERM, France; Département de Médecine Interne et Immunologie Clinique, Centre de Référence Maladies Neuro-Musculaires, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, DHUi2B, Paris, France
| | - Hilario Nunes
- Université Sorbonne Paris Nord, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France; Université Sorbonne Paris Nord, INSERM U1272, France
| | - Yves Allenbach
- Centre de Recherche en Myologie, Unité Mixte de Recherche Scientifique 974, Université Pierre et Marie Curie, INSERM, France; Département de Médecine Interne et Immunologie Clinique, Centre de Référence Maladies Neuro-Musculaires, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, DHUi2B, Paris, France
| | - Yurdagül Uzunhan
- Université Sorbonne Paris Nord, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France; Université Sorbonne Paris Nord, INSERM U1272, France
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Abstract
Sarcoidosis is a heterogeneous disease, which can affect virtually every body organ, even though lungs and intra thoracic lymph nodes are almost universally affected. The presence of noncaseating granulomas is the histopathological hallmark of the disease, and clinical picture depends on the organs affected. Data about interaction between sarcoidosis and comorbidities, such as cardiovascular and pulmonary diseases, autoimmune disorders, malignancy and drug-related adverse events are limited. Several lung conditions can be associated with sarcoidosis, such as pulmonary hypertension and fibrosis, making it difficult sometimes the differentiation between complications and distinctive pathologies. Their coexistence may complicate the diagnosis of sarcoidosis and contribute to the highly variable and unpredictable natural history, particularly if several diseases are recognised. A thorough assessment of specific disorders that can be associated with sarcoidosis should always be carried out, and future studies will need to evaluate sarcoidosis not only as a single disorder, but also in the light of possible concomitant conditions.Key messagesComorbidities in sarcoidosis are common, especially cardiovascular and pulmonary diseases.In the diagnostic workup, a distinction must be made between sarcoidosis-related complaints and complaints caused by other separate disorders. It can be very difficult to distinguish between complications of sarcoidosis and other concomitant conditions.The coexistence of multiple conditions may complicate the diagnosis of sarcoidosis, affect its natural course and response to treatment.
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Affiliation(s)
- Claudio Tana
- Geriatrics Clinic, Medicine Department, SS Annunziata Hospital of Chieti, Chieti, Italy
| | - Marjolein Drent
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, The Netherlands.,ILD Center of Excellence, Department of Respiratory Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.,ILD Care Foundation Research Team, Ede, The Netherlands
| | - Hilario Nunes
- AP-HP, Hôpital Avicenne, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares de l'adulte, Université Sorbonne Paris Nord, Bobigny, France
| | - Vasilis Kouranos
- Interstitial Lung Disease Unit, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, UK
| | - Francesco Cinetto
- Rare Diseases Referral Center, Internal Medicine 1, Ca' Foncello Hospital - AULSS2 Marca Trevigiana and Department of Medicine - DIMED, University of Padova, Italy
| | - Naomi T Jessurun
- ILD Care Foundation Research Team, Ede, The Netherlands.,Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
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Rivière A, Picard C, Berastegui C, Mora VM, Bunel V, Godinas L, Salvaterra E, Rossetti V, Savale L, Israel-Biet D, Demant X, Bermudez J, Meloni F, Jaksch P, Magnusson J, Beaumont L, Perch M, Mornex JF, Knoop C, Aubert JD, Hervier B, Nunes H, Humbert M, Gottlieb J, Uzunhan Y, Le Pavec J. Lung transplantation for interstitial lung disease in idiopathic inflammatory myositis: A cohort study. Am J Transplant 2022; 22:2990-3001. [PMID: 35988032 PMCID: PMC10086953 DOI: 10.1111/ajt.17177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/29/2022] [Accepted: 08/14/2022] [Indexed: 01/25/2023]
Abstract
In patients with interstitial lung disease (ILD) complicating classical or amyopathic idiopathic inflammatory myopathy (IIM), lung transplantation outcomes might be affected by the disease and treatments. Here, our objective was to assess survival and prognostic factors in lung transplant recipients with IIM-ILD. We retrospectively reviewed data for 64 patients who underwent lung transplantation between 2009 and 2021 at 19 European centers. Patient survival was the primary outcome. At transplantation, the median age was 53 [46-59] years, 35 (55%) patients were male, 31 (48%) had classical IIM, 25 (39%) had rapidly progressive ILD, and 21 (33%) were in a high-priority transplant allocation program. Survival rates after 1, 3, and 5 years were 78%, 73%, and 70%, respectively. During follow-up (median, 33 [7-63] months), 23% of patients developed chronic lung allograft dysfunction. Compared to amyopathic IIM, classical IIM was characterized by longer disease duration, higher-intensity immunosuppression before transplantation, and significantly worse posttransplantation survival. Five (8%) patients had a clinical IIM relapse, with mild manifestations. No patient experienced ILD recurrence in the allograft. Posttransplantation survival in IIM-ILD was similar to that in international all-cause-transplantation registries. The main factor associated with worse survival was a history of muscle involvement (classical IIM). In lung transplant recipients with idiopathic inflammatory myopathy, survival was similar to that in all-cause transplantation and was worse in patients with muscle involvement compared to those with the amyopathic disease.
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Affiliation(s)
- Amélie Rivière
- Service de Pneumologie, Hôpital Avicenne (AP-HP), Université Sorbonne Paris Nord, INSERM U1272, Bobigny, France
| | - Clément Picard
- Service de Transplantation Pulmonaire et Centre de Compétence de la Mucoviscidose, Hôpital Foch, Suresnes, France
| | - Cristina Berastegui
- Department of Respiratory Medicine, Lung Transplant Unit, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Victor Manuel Mora
- Lung Transplant Unit, Department of Respiratory Medicine, H. Marqués de Valdecilla, Santander, Spain
| | - Vincent Bunel
- Service de Pneumologie, Hôpital Bichat (AP-HP), Paris, France
| | - Laurent Godinas
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Elena Salvaterra
- Interventional Pulmonology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Valeria Rossetti
- Respiratory Unit and Adult Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laurent Savale
- Pulmonology Department, Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.,UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France.,Pulmonology Department, Hôpital Kremlin Bicêtre (AP-HP), Le Kremlin-Bicetre, France
| | - Dominique Israel-Biet
- Pulmonology Department, Intensive Care and Bronchial Endoscopies, Paris University, Georges-Pompidou European Hospital, Paris, France
| | - Xavier Demant
- Department of Respiratory Medicine, Haut-Lévêque Hospital, Bordeaux University, Pessac, France
| | - Julien Bermudez
- Service de Pneumologie et Équipe de Transplantation Pulmonaire, Centre Hospitalo-Universitaire Nord (Assistance Publique-Hôpitaux de Marseille), Université Aix-Marseille, Marseille, France
| | - Federica Meloni
- Transplant Center, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Peter Jaksch
- Thoracic Surgery Department, Medical University of Vienna, Vienna, Austria
| | - Jesper Magnusson
- Department of Internal Medicine/Respiratory Medicine and Allergology, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Laurence Beaumont
- Service de Transplantation Pulmonaire et Centre de Compétence de la Mucoviscidose, Hôpital Foch, Suresnes, France
| | - Michael Perch
- Department of Cardiology, Lung Transplantation Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jean-François Mornex
- Pulmonology Department, Université de Lyon, INRAE, EPHE, UMR754, IVPC, Lyon, France.,Pulmonology Department, Hospices civils de Lyon, Hôpital Louis Pradel, Centre de référence coordonnateur des maladies pulmonaires rares, Bron, France
| | - Christiane Knoop
- Department of Chest Medicine, Brussels Lung Transplant Program, Erasme University, Brussels, Belgium
| | - John-David Aubert
- Division of Pulmonology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Baptiste Hervier
- Internal Medicine Department, Hôpital Saint-Louis (AP-HP), Université de Paris, Paris, France
| | - Hilario Nunes
- Service de Pneumologie, Hôpital Avicenne (AP-HP), Université Sorbonne Paris Nord, INSERM U1272, Bobigny, France
| | - Marc Humbert
- Pulmonology Department, Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.,UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France.,Pulmonology Department, Hôpital Kremlin Bicêtre (AP-HP), Le Kremlin-Bicetre, France
| | - Jens Gottlieb
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Yurdagul Uzunhan
- Service de Pneumologie, Hôpital Avicenne (AP-HP), Université Sorbonne Paris Nord, INSERM U1272, Bobigny, France
| | - Jérôme Le Pavec
- Pulmonology Department, Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.,UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France.,Service de Pneumologie et Transplantation Pulmonaire, Hôpital Marie Lannelogue, Groupe Hospitalier Paris-Saint Joseph, Le Plessis-Robinson, France
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33
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Le Pavec J, Pison C, Hirschi S, Bunel V, Mordant P, Brugière O, Guen ML, Olland A, Coiffard B, Renaud-Picard B, Tissot A, Brioude G, Borie R, Crestani B, Deslée G, Stelianides S, Mal H, Schuller A, Falque L, Lorillon G, Tazi A, Burgel PR, Grenet D, De Miranda S, Bergeron A, Launay D, Cottin V, Nunes H, Valeyre D, Uzunhan Y, Prévot G, Sitbon O, Montani D, Savale L, Humbert M, Fadel E, Mercier O, Mornex JF, Dauriat G, Reynaud-Gaubert M. 2022 Update of indications and contraindications for lung transplantation in France. Respir Med Res 2022; 83:100981. [PMID: 36565563 DOI: 10.1016/j.resmer.2022.100981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022]
Abstract
Lung transplantation (LTx) is a steadily expanding field. The considerable developments have been driven over the years by indefatigable work conducted at LTx centers to improve donor and recipient selection, combined with multifaceted efforts to overcome challenges raised by the surgical procedure, perioperative care, and long-term medical complications. One consequence has been a pruning away of contraindications over time, which has, in some ways, complicated the patient selection process. The Francophone Pulmonology Society (Société de Pneumology de Langue Française, SPLF) set up a task force to produce up-to-date working guidelines designed to assist pulmonologists in managing end-stage respiratory insufficiency, determining which patients may be eligible for LTx, and appropriately timing LTx-center referral. The task force examined the most recent literature and evaluated the risk factors that limit patient survival after LTx. Ideally, the objectives of LTx are to prolong life while also improving quality of life. The guidelines developed by the task force apply to a limited resource and are consistent with the ethical principles described below.
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Affiliation(s)
- Jérôme Le Pavec
- Service de Pneumologie et Transplantation Pulmonaire, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France.
| | - Christophe Pison
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Av. des Maquis du Grésivaudan, 38700 La Tronche, France; INSERM 1055, Laboratoire de Bioénergétique Fondamentale et Appliquée, Bâtiment B Biologie, 2280 Rue de la piscine 38400 Saint Martin d'Hères, France; Université Grenoble Alpes, Av. des Maquis du Grésivaudan, 38700 La Tronche, France
| | - Sandrine Hirschi
- Service de Pneumologie et Transplantation Pulmonaire, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Hôpital Civil, 1 place de l'hôpital BP 426, 67091 Strasbourg, France
| | - Vincent Bunel
- Service de Pneumologie B et Transplantation pulmonaire, Hôpital Bichat, APHP, Inserm U1152, Université de Paris, 46 Rue Henri Huchard, 75018 Paris, France
| | - Pierre Mordant
- Service de chirurgie vasculaire, thoracique, et de transplantation pulmonaire, Hôpital Bichat, Assistance Publique - Hôpitaux de Paris, Université de Paris, 46 Rue Henri Huchard, 75018, Paris, France
| | - Olivier Brugière
- Centre de Transplantation Pulmonaire et CRCM, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Morgan Le Guen
- Département d'Anesthésie, Hôpital Foch, 40 Rue Worth, 92150 Suresnes, France; INRA UMR 892 VIM, équipe Vaccins Immunopathologie Immunomodulation, Domaine de Vilvert, 78350, Jouy-en-Josas, France; Université Versailles Saint Quentin, 45 Av. des États Unis, 78000 Versailles France
| | - Anne Olland
- Lung Transplantation Group, University Hospital Strasbourg, Strasbourg, France; INSERM (French institute for health and medical research) 1260 Regenerative, University Hospital Strasbourg, 1 place de l'hôpital, BP 426, 67091 Strasbourg, France
| | - Benjamin Coiffard
- Service de Pneumologie et Equipe de Transplantation Pulmonaire, Centre Hospitalo-Universitaire Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Chemin des Bourrely, 13915 Marseille cedex 20, France
| | - Benjamin Renaud-Picard
- Service de Pneumologie et Transplantation Pulmonaire, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Hôpital Civil, 1 place de l'hôpital BP 426, 67091 Strasbourg, France; INSERM (French institute for health and medical research) 1260 Regenerative, University Hospital Strasbourg, 1 place de l'hôpital, BP 426, 67091 Strasbourg, France
| | - Adrien Tissot
- Nantes Université, CHU Nantes, Service de Pneumologie, l'institut du thorax, F-44000 Nantes, France; Nantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, 8 Quai Moncousu, 44007, Nantes, France
| | - Geoffrey Brioude
- Service de Chirurgie Thoracique, Centre Hospitalo-Universitaire Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Chemin des Bourrely, 13915 Marseille cedex 20, France
| | - Raphaël Borie
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Bruno Crestani
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Gaétan Deslée
- Service de Pneumologie, Inserm U1250, CHU Reims, Université Reims Champagne Ardenne, 45 Rue Cognacq-Jay, 51092, Reims, France
| | - Sandrine Stelianides
- Institut de réadaptation d'Achères, 7, place Simone-Veil, 78260, Achères, France
| | - Hervé Mal
- Service de Pneumologie B et Transplantation pulmonaire, Hôpital Bichat, APHP, Inserm U1152, Université de Paris, 46 Rue Henri Huchard, 75018 Paris, France
| | - Armelle Schuller
- Service de Pneumologie et Transplantation Pulmonaire, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Hôpital Civil, 1 place de l'hôpital BP 426, 67091 Strasbourg, France
| | - Loïc Falque
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Av. des Maquis du Grésivaudan, 38700 La Tronche, France
| | - Gwenaëlle Lorillon
- Université de Paris, INSERM UMR 976 HIPI, F-75006; Centre national de référence des histiocytoses, Service de Pneumologie, Hôpital Saint Louis, 1 Av. Claude Vellefaux, 75010, Paris, AP-HP, France
| | - Abdellatif Tazi
- Université de Paris, INSERM UMR 976 HIPI, F-75006; Centre national de référence des histiocytoses, Service de Pneumologie, Hôpital Saint Louis, 1 Av. Claude Vellefaux, 75010, Paris, AP-HP, France
| | - Pierre Regis Burgel
- Université Paris Cité, Inserm U1016, Institut Cochin, Paris, France; Pulmonary Department and National Cystic Fibrosis Reference Centre, Cochin Hospital; Assistance Publique Hôpitaux de Paris, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Dominique Grenet
- Centre de Transplantation Pulmonaire et CRCM, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Sandra De Miranda
- Centre de Transplantation Pulmonaire et CRCM, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland; Université de Paris, UMR 1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Parvis Notre-Dame - Pl. Jean-Paul II, 75004, Paris, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institute for Translational Research in Inflammation, rue Michel Polonowski, 5900, Lille, France; Univ. Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, rue Michel Polonowski, 5900, Lille France; Inserm, rue Michel Polonowski, 5900, Lille, France
| | - Vincent Cottin
- Université de Lyon, INRA, IVPC, Lyon; Centre national de référence des maladies pulmonaires rares, hôpital Louis Pradel, Hospices Civils de Lyon, 59 Bd Pinel, 69500, Bron, France
| | - Hilario Nunes
- INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne Service de Pneumologie, 125 Rue de Stalingrad, 93000, Bobigny, France; Service de Pneumologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - Dominique Valeyre
- INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne Service de Pneumologie, 125 Rue de Stalingrad, 93000, Bobigny, France; Hôpital Saint Joseph, Groupe Hospitalier Paris Saint Joseph, 185 Rue Raymond Losserand, 75014, Paris, France
| | - Yurdagul Uzunhan
- INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne Service de Pneumologie, 125 Rue de Stalingrad, 93000, Bobigny, France; Service de Pneumologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - Grégoire Prévot
- Pôle des voies respiratoires-Hôpital Larrey, Centre Hopitalo-Universitaire, 24 Chem. de Pouvourville, 31400, Toulouse, France
| | - Olivier Sitbon
- AP-HP, Service de Pneumologie, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - David Montani
- AP-HP, Service de Pneumologie, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Laurent Savale
- AP-HP, Service de Pneumologie, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Marc Humbert
- AP-HP, Service de Pneumologie, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Elie Fadel
- Service de Chirurgie Thoracique et Transplantation Cardio-pulmonaire, Groupe Hospitalier Marie-Lannelongue -Paris Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Olaf Mercier
- Service de Chirurgie Thoracique et Transplantation Cardio-pulmonaire, Groupe Hospitalier Marie-Lannelongue -Paris Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France; Université Paris-Saclay, 78 Rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; UMR_S 999, Université Paris-Saclay, INSERM, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Jean François Mornex
- Université de Lyon, université Lyon 1; PSL, EPHE; INRAE; IVPC; 69007, Lyon, France; Hospices civils de Lyon, GHE, service de pneumologie; RESPIFIL, Orphalung; Inserm, CIC1407, 59 Bd Pinel, 69500 Bron, France
| | - Gaëlle Dauriat
- Service de Pneumologie et Transplantation Pulmonaire, Groupe hospitalier Marie-Lannelongue -Saint Joseph, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie et Equipe de Transplantation Pulmonaire, Centre Hospitalo-Universitaire Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Chemin des Bourrely, 13915 Marseille cedex 20, France
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Freitas P, Pina A, Carola S, Cardoso C, Gouveia E, Vaz F, Santos M, Mira M, Alexandre M, Miguel I, Brito M, Moreira A, Nunes H. Lobular carcinoma of the breast and response to targeted therapy with CDK4/6 inhibitors – a single Portuguese center experience. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01545-3] [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: 11/19/2022]
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Cottin V, Guéguen S, Nunes H, Jouneau S, Crestani B, Bonniaud P, Wemeau L, Israël-Biet D, Reynaud-Gaubert M, Gondouin A, Cadranel J, Marchand-Adam S, Bramki M, Dufaure-Garé I, Amselem S, Clément A, RaDiCo team. Exemples de partenariats réussis d'une cohorte de maladie rare. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Le Pavec J, Pison C, Hirschi S, Bunel V, Mordant P, Brugière O, Le Guen M, Olland A, Coiffard B, Renaud-Picard B, Tissot A, Brioude G, Borie R, Crestani B, Deslée G, Stelianides S, Mal H, Schuller A, Falque L, Lorillon G, Tazi A, Burgel P, Grenet D, De Miranda S, Bergeron A, Launay D, Cottin V, Nunes H, Valeyre D, Uzunhan Y, Prévot G, Sitbon O, Montani D, Savale L, Humbert M, Fadel E, Mercier O, Mornex J, Dauriat G, Reynaud-Gaubert M. Transplantation pulmonaire en France : actualisation des indications et contre-indications en 2022. Rev Mal Respir 2022; 39:855-872. [DOI: 10.1016/j.rmr.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/18/2022] [Indexed: 11/11/2022]
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Breillat P, Mariampillai K, Legendre P, Martins P, Dunogue B, Charuel JL, Miyara M, Goulvestre C, Paule R, Vanquaethem H, Ackermann F, Benveniste O, Nunes H, Mouthon L, Allenbach Y, Uzunhan Y. Anti-PM-Scl antibodies positive patients encompass three different groups with distinct prognosis. Rheumatology (Oxford) 2022; 62:1467-1475. [PMID: 36063462 DOI: 10.1093/rheumatology/keac508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/03/2022] [Accepted: 08/23/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To help identify homogeneous subgroups among patients with anti-polymyositis-scleroderma-antibodies (PM-Scl-Abs) positive auto-immune diseases regardless of diagnostic classifications. METHODS This multicentric (four hospitals) retrospective study collected all consecutive patients (from 2011 to 2021) with positive testing for anti-PM-Scl-Abs in a context of connective tissue disease. Subgroups of patients with similar clinico-biological phenotypes were defined using unsupervised multiple correspondence analysis and hierarchical clustering analysis of the features recorded in the first year of follow-up. RESULTS One hundred and forty-two patients with anti-PM-Scl-Abs were evaluated and 129 patients were included in the clustering analysis and divided into 3 clusters. Cluster n°1 (n = 47) included patients with frequent skin thickening, digestive involvement and interstitial lung disease (ILD) with Non Specific Interstitial Pneumonia (NSIP). They were more likely to develop progressive fibrosing ILD. Cluster n°2 (n = 36) included patients who all featured NSIP with frequent Organizing pneumonia associated pattern and mechanic's hands. This subgroup had increased risk of relapse and ILD was characterized by a good functional outcome. Cluster n°3 (n = 46) was characterized by predominant or isolated musculoskeletal involvement and frequently matched undifferentiated connective tissue disease (UCTD) criteria. Although very frequent among Anti PM-Scl-Abs positive patients, muscle involvement was less discriminating compared with skin thickening and ILD pattern to classify patients into subgroups. CONCLUSION Anti-PM-Scl-Abs associated auto-immune diseases are segregated into 3 subgroups with distinct clinical phenotype and outcomes. Skin thickening and NSIP are determinant predictors in segregation of theses populations.
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Affiliation(s)
- Paul Breillat
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France.,Sorbonne Université, Paris, France
| | - Kuberaka Mariampillai
- Sorbonne Université, INSERM, Association Institut de Myologie, Centre de Recherche en Myologie, UMRS 974, Paris, France
| | - Paul Legendre
- Département de Médecine Interne Hôpital Foch, Suresnes, France
| | - Pauline Martins
- Département de Médecine Interne, Hôpitaux La Rochelle Ré Aunis, La Rochelle, France
| | - Bertrand Dunogue
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France
| | - Jean Luc Charuel
- Département d'Immunologie, Laboratoire d'immunochimie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Makoto Miyara
- Département d'Immunologie, Laboratoire d'immunochimie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Claire Goulvestre
- Laboratoire d'immunologie, Groupe Hospitalier Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Romain Paule
- Département de Médecine Interne Hôpital Foch, Suresnes, France
| | - Helene Vanquaethem
- Clinique médicale, hôpital d'instruction des armées de Bégin, Saint-Mandé, France
| | - Felix Ackermann
- Département de Médecine Interne Hôpital Foch, Suresnes, France
| | - Olivier Benveniste
- Sorbonne Université, INSERM, Association Institut de Myologie, Centre de Recherche en Myologie, UMRS 974, Paris, France.,Département de Médecine Interne et Immunologie Clinique, Centre de Référence Maladies Neuro-Musculaires, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Hilario Nunes
- Département de Pneumologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, INSERM U1272, Université Sorbonne Paris Nord, Bobigny, France
| | - Luc Mouthon
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France
| | - Yves Allenbach
- Sorbonne Université, INSERM, Association Institut de Myologie, Centre de Recherche en Myologie, UMRS 974, Paris, France.,Département de Médecine Interne et Immunologie Clinique, Centre de Référence Maladies Neuro-Musculaires, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Yurdagul Uzunhan
- Département de Pneumologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, INSERM U1272, Université Sorbonne Paris Nord, Bobigny, France
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Cottin V, Bonniaud P, Cadranel J, Crestani B, Jouneau S, Marchand-Adam S, Nunes H, Wémeau-Stervinou L, Bergot E, Blanchard E, Borie R, Bourdin A, Chenivesse C, Clément A, Gomez E, Gondouin A, Hirschi S, Lebargy F, Marquette CH, Montani D, Prévot G, Quetant S, Reynaud-Gaubert M, Salaun M, Sanchez O, Trumbic B, Berkani K, Brillet PY, Campana M, Chalabreysse L, Chatté G, Debieuvre D, Ferretti G, Fourrier JM, Just N, Kambouchner M, Legrand B, Le Guillou F, Lhuillier JP, Mehdaoui A, Naccache JM, Paganon C, Rémy-Jardin M, Si-Mohamed S, Terrioux P. [French practical guidelines for the diagnosis and management of IPF - 2021 update, full version]. Rev Mal Respir 2022; 39:e35-e106. [PMID: 35752506 DOI: 10.1016/j.rmr.2022.01.014] [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] [Indexed: 10/17/2022]
Abstract
BACKGROUND Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients' association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.
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Affiliation(s)
- V Cottin
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France; UMR 754, IVPC, INRAE, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; Membre d'OrphaLung, RespiFil, Radico-ILD2, et ERN-LUNG, Lyon, France.
| | - P Bonniaud
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et soins intensifs respiratoires, centre hospitalo-universitaire de Bourgogne et faculté de médecine et pharmacie, université de Bourgogne-Franche Comté, Dijon ; Inserm U123-1, Dijon, France
| | - J Cadranel
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et oncologie thoracique, Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Tenon, Paris ; Sorbonne université GRC 04 Theranoscan, Paris, France
| | - B Crestani
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - S Jouneau
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Pontchaillou, Rennes ; IRSET UMR1085, université de Rennes 1, Rennes, France
| | - S Marchand-Adam
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, hôpital Bretonneau, service de pneumologie, CHRU, Tours, France
| | - H Nunes
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie, AP-HP, hôpital Avicenne, Bobigny ; université Sorbonne Paris Nord, Bobigny, France
| | - L Wémeau-Stervinou
- Centre de référence constitutif des maladies pulmonaires rares, Institut Cœur-Poumon, service de pneumologie et immuno-allergologie, CHRU de Lille, Lille, France
| | - E Bergot
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie et oncologie thoracique, hôpital Côte de Nacre, CHU de Caen, Caen, France
| | - E Blanchard
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Haut Levêque, CHU de Bordeaux, Pessac, France
| | - R Borie
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - A Bourdin
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, département de pneumologie et addictologie, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, Montpellier ; Inserm U1046, CNRS UMR 921, Montpellier, France
| | - C Chenivesse
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et d'immuno-allergologie, hôpital Albert Calmette ; CHRU de Lille, Lille ; centre d'infection et d'immunité de Lille U1019 - UMR 9017, Université de Lille, CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, Lille, France
| | - A Clément
- Centre de ressources et de compétence de la mucoviscidose pédiatrique, centre de référence des maladies respiratoires rares (RespiRare), service de pneumologie pédiatrique, hôpital d'enfants Armand-Trousseau, CHU Paris Est, Paris ; Sorbonne université, Paris, France
| | - E Gomez
- Centre de compétence pour les maladies pulmonaires rares, département de pneumologie, hôpitaux de Brabois, CHRU de Nancy, Vandoeuvre-les Nancy, France
| | - A Gondouin
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Jean-Minjoz, Besançon, France
| | - S Hirschi
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, Nouvel Hôpital civil, Strasbourg, France
| | - F Lebargy
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Maison Blanche, Reims, France
| | - C-H Marquette
- Centre de compétence pour les maladies pulmonaires rares, FHU OncoAge, département de pneumologie et oncologie thoracique, hôpital Pasteur, CHU de Nice, Nice cedex 1 ; Université Côte d'Azur, CNRS, Inserm, Institute of Research on Cancer and Aging (IRCAN), Nice, France
| | - D Montani
- Centre de compétence pour les maladies pulmonaires rares, centre national coordonnateur de référence de l'hypertension pulmonaire, service de pneumologie et soins intensifs pneumologiques, AP-HP, DMU 5 Thorinno, Inserm UMR S999, CHU Paris-Sud, hôpital de Bicêtre, Le Kremlin-Bicêtre ; Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
| | - G Prévot
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Larrey, Toulouse, France
| | - S Quetant
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et physiologie, CHU Grenoble Alpes, Grenoble, France
| | - M Reynaud-Gaubert
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, AP-HM, CHU Nord, Marseille ; Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - M Salaun
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, oncologie thoracique et soins intensifs respiratoires & CIC 1404, hôpital Charles Nicole, CHU de Rouen, Rouen ; IRIB, laboratoire QuantiIF-LITIS, EA 4108, université de Rouen, Rouen, France
| | - O Sanchez
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et soins intensifs, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | | | - K Berkani
- Clinique Pierre de Soleil, Vetraz Monthoux, France
| | - P-Y Brillet
- Université Paris 13, UPRES EA 2363, Bobigny ; service de radiologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - M Campana
- Service de pneumologie et oncologie thoracique, CHR Orléans, Orléans, France
| | - L Chalabreysse
- Service d'anatomie-pathologique, groupement hospitalier est, HCL, Bron, France
| | - G Chatté
- Cabinet de pneumologie et infirmerie protestante, Caluire, France
| | - D Debieuvre
- Service de pneumologie, GHRMSA, hôpital Emile-Muller, Mulhouse, France
| | - G Ferretti
- Université Grenoble Alpes, Grenoble ; service de radiologie diagnostique et interventionnelle, CHU Grenoble Alpes, Grenoble, France
| | - J-M Fourrier
- Association Pierre-Enjalran Fibrose Pulmonaire Idiopathique (APEFPI), Meyzieu, France
| | - N Just
- Service de pneumologie, CH Victor-Provo, Roubaix, France
| | - M Kambouchner
- Service de pathologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - B Legrand
- Cabinet médical de la Bourgogne, Tourcoing ; Université de Lille, CHU Lille, ULR 2694 METRICS, CERIM, Lille, France
| | - F Le Guillou
- Cabinet de pneumologie, pôle santé de l'Esquirol, Le Pradet, France
| | - J-P Lhuillier
- Cabinet de pneumologie, La Varenne Saint-Hilaire, France
| | - A Mehdaoui
- Service de pneumologie et oncologie thoracique, CH Eure-Seine, Évreux, France
| | - J-M Naccache
- Service de pneumologie, allergologie et oncologie thoracique, GH Paris Saint-Joseph, Paris, France
| | - C Paganon
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France
| | - M Rémy-Jardin
- Institut Cœur-Poumon, service de radiologie et d'imagerie thoracique, CHRU de Lille, Lille, France
| | - S Si-Mohamed
- Département d'imagerie cardiovasculaire et thoracique, hôpital Louis-Pradel, HCL, Bron ; Université de Lyon, INSA-Lyon, Université Claude-Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Villeurbanne, France
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Kam M, Caliez J, Nunes H, Gille T. The road to hell is paved with good intentions: a look back at the PANTHER-IPF trial. Breathe (Sheff) 2022; 18:220074. [PMID: 36340823 PMCID: PMC9584592 DOI: 10.1183/20734735.0074-2022] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/18/2022] [Indexed: 11/05/2022] Open
Abstract
The PANTHER-IPF trial was a turning point in treatment of idiopathic pulmonary fibrosis (#IPF) highlighting the importance of randomised controlled trials in determining treatment strategies, even for rare diseases and/or potentially fatal acute events https://bit.ly/3Oi0KwD.
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Affiliation(s)
- Michelle Kam
- Dept of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore,Both authors contributed equally to this manuscript,Corresponding author: Michelle Kam ()
| | - Julien Caliez
- Dept of Pulmonology, Reference Center for Rare Pulmonary Diseases, Avicenne University Hospital, Hôpitaux Universitaires de Paris Seine-Saint-Denis (HUPSSD), Assistance Publique - Hôpitaux de Paris (AP-HP), Bobigny, France,Both authors contributed equally to this manuscript
| | - Hilario Nunes
- Dept of Pulmonology, Reference Center for Rare Pulmonary Diseases, Avicenne University Hospital, Hôpitaux Universitaires de Paris Seine-Saint-Denis (HUPSSD), Assistance Publique - Hôpitaux de Paris (AP-HP), Bobigny, France,Inserm UMR 1272 “Hypoxia & the Lung”, UFR Santé, Médecine, Biologie Humaine (SMBH), Université Sorbonne Paris Nord (USPN), Bobigny, France
| | - Thomas Gille
- Inserm UMR 1272 “Hypoxia & the Lung”, UFR Santé, Médecine, Biologie Humaine (SMBH), Université Sorbonne Paris Nord (USPN), Bobigny, France,Dept of Physiology and Functional Explorations, Avicenne University Hospital, Hôpitaux Universitaires de Paris Seine-Saint-Denis (HUPSSD), Assistance Publique - Hôpitaux de Paris (AP-HP), Bobigny, France,Dept of Physiology and Functional Explorations, Jean Verdier University Hospital, Hôpitaux Universitaires de Paris Seine-Saint-Denis (HUPSSD), Assistance Publique - Hôpitaux de Paris (AP-HP), Bondy, France
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Bay P, Pineton De Chambrun M, Roux A, Bunel V, Combes A, Israël-Biet D, Zuber B, Nunes H, Allenbach Y, Uzunhan Y. L’assistance extracorporelle en bridge à la transplantation pulmonaire en urgence pour les patients avec une atteinte pulmonaire rapidement progressive d’une dermatomyosite anti-MDA5. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.320] [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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Bay P, Pineton De Chambrun M, Rothstein V, Mahevas M, Roux A, Zuber B, Israël-Biet D, Hervier B, Tazi A, Mouthon L, Mekinian A, Deligny C, Borie R, Meyer A, Priou P, Savale L, Brillet P, Nunes H, Allenbach Y, Uzunhan Y. Les échanges plasmatiques ne semblent pas être associés à un meilleur pronostic chez les patients avec une atteinte pulmonaire rapidement progressive d’une dermatomyosite anti-MDA5. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.288] [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: 10/18/2022]
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Sigaux J, Cavalin C, Lescoat A, Brillet PY, Sese L, Nunes H, Boissier MC, Semerano L. OP0006 CLEANING ACTIVITIES, DUSTY CLOTHES LAUNDRY AND TALCUM HANDLING ARE UNDERESTIMATED MAJOR SOURCES OF EXPOSURE TO CRYSTALLINE SILICA IN WOMEN WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundInhalation of crystalline silica (cSiO2) is associated with rheumatoid arthritis (RA). Research on cSiO2 has historically focused on professional exposures and on male workers. However, cSiO2 is ubiquitously present in the environment, substantial exposure can take place in both men and women, in other professional activities and even beyond occupational context.ObjectivesTo identify the main sources of exposure to crystalline silica in a series of RA patients not selected based on their professional activity, and to assess the association between silica exposure and disease features.MethodsThe Dust Exposure Life-Course Questionnaire (DELCQ) is a novel tool that longitudinally quantifies both occupational and non-occupational lifetime exposure to crystalline silica. The DELCQ was previously validated in a representative sample of the general French population that serves as control source for studies in specific diseases. The DELCQ was administered to 97 consecutive patients with RA, exposure scores were compared between cases and age-, sex- and smoking status-matched controls (1:4). The main sources of silica exposure were identified in cases and controls and source-specific exposure levels compared. The association between DELCQ scores and disease variables in cases was tested at uni- and multivariable analysis.ResultsIn women with RA, the main sources of crystalline silica exposure were: cleaning activities, dusty clothes laundry and talcum powder handling, with higher exposure levels from these sources vs. the general population (p<0.005). In the whole series of RA patients, high silica exposure was independently associated with interstitial lung disease (OR 6.5 (95% CI: 1.3 to 32.6)) and mediastinal lymphadenopathy (OR 6.3 (95% CI: 1.4 to 27.7).ConclusionCleaning activities, dusty clothes laundry and talcum handling are underestimated sources of crystalline silica exposure that are overrepresented in women with RA compared to the general population and may contribute to the pathogenesis of the disease.Table 1.Association between occupational silica exposure (by quartile) and HRCT lung abnormalitiesHRCT abnormalityOES(Quartiles)UnadjustedOR (95% CI)AdjustedOR (95% CI)Mediastinal lymphadenopathyQ1-Q3(ref)(ref)Q44.1 (1.2 to 13.9)6.3 (1.4 to 27.7)Interstitial lung diseaseQ1-Q3(ref)(ref)Q46.3 (1.5 to 26.6)6.5 (1.3 to 32.6)EmphysemaQ1-Q3(ref)(ref)Q46.4 (1.6 to 24.7)2.9 (0.6 to 13.7)Abbreviations: OES occupational exposure score. Adjusted OR: adjusted on smoking, sex, disease duration, ACPA and RF status.Disclosure of InterestsNone declared.
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Phillips-Houlbracq M, Mal H, Cottin V, Gauvain C, Beier F, Sicre de Fontbrune F, Sidali S, Mornex JF, Hirschi S, Roux A, Weisenburger G, Roussel A, Wémeau-Stervinou L, Le Pavec J, Pison C, Marchand Adam S, Froidure A, Lazor R, Naccache JM, Jouneau S, Nunes H, Reynaud-Gaubert M, Le Borgne A, Boutboul D, Ba I, Boileau C, Crestani B, Kannengiesser C, Borie R. Determinants of survival after lung transplantation in telomerase-related gene mutation carriers: A retrospective cohort. Am J Transplant 2022; 22:1236-1244. [PMID: 34854205 DOI: 10.1111/ajt.16893] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 10/01/2021] [Accepted: 10/20/2021] [Indexed: 01/25/2023]
Abstract
Carriers of germline telomerase-related gene (TRG) mutations can show poor prognosis, with an increase in common hematological complications after lung transplantation (LT) for pulmonary fibrosis. The aim of this study was to describe the outcomes after LT in recipients carrying a germline TRG mutation and to identify the predictors of survival. In a multicenter cohort of LT patients, we retrospectively reviewed those carrying pathogenic TRG variations (n = 38; TERT, n = 23, TERC, n = 9, RTEL1, n = 6) between 2009 and 2018. The median age at LT was 54 years (interquartile range [IQR] 46-59); 68% were male and 71% had idiopathic pulmonary fibrosis. During the diagnosis of pulmonary fibrosis, 28 (74%) had a hematological disease, including eight with myelodysplasia. After a median follow-up of 26 months (IQR 15-46), 38 patients received LT. The overall post-LT median survival was 3.75 years (IQR 1.8-NA). The risk of death after LT was increased for patients with myelodysplasia (HR 4.1 [95% CI 1.5-11.5]) or short telomere (HR 2.2 [1.0-5.0]) before LT. After LT, all patients had anemia, 66% had thrombocytopenia, and 39% had neutropenia. Chronic lung allograft dysfunction frequency was 29% at 4 years. The present findings support the use of LT in TRG mutation carriers without myelodysplasia. Hematological evaluation should be systematically performed before LT.
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Affiliation(s)
- Mathilde Phillips-Houlbracq
- Service de Pneumologie A, Centre de référence des maladies pulmonaires rares (site constitutif), APHP, Hôpital Bichat, Paris, France
| | - Hervé Mal
- Université de Paris and INSERM U1152, Paris, France.,Service de Pneumologie B, APHP, Hôpital Bichat, Paris, France
| | - Vincent Cottin
- Service de Pneumologie, Centre coordonnateur national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Université de Lyon, INRAE, ERN-LUNG, Lyon, France
| | - Clément Gauvain
- Service d'oncologie, Hôpital Calmette, CHU de Lille, Lille, France
| | - Fabian Beier
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | | | - Sabrina Sidali
- Service d'hépatologie, Hôpital Beaujon, APHP, Clichy, France
| | - Jean François Mornex
- Service de Pneumologie, Centre coordonnateur national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Université de Lyon, INRAE, ERN-LUNG, Lyon, France
| | - Sandrine Hirschi
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Antoine Roux
- Service de Pneumologie, Hôpital Foch, Suresnes, France
| | - Gaelle Weisenburger
- Université de Paris and INSERM U1152, Paris, France.,Service de Pneumologie B, APHP, Hôpital Bichat, Paris, France
| | - Arnaud Roussel
- Service de chirurgie vasculaire et thoracique, Hopital Bichat, Paris, France
| | - Lidwine Wémeau-Stervinou
- Service de Pneumologie, Centre de référence des maladies pulmonaires rares (site constitutif), CHU de Lille, Lille, France
| | - Jérôme Le Pavec
- Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Groupe Hospitalier Saint Joseph/Marie-Lannelongue, Le Plessis-Robinson, France.,Faculté de Médecine, Université Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France.,UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Christophe Pison
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | | | - Antoine Froidure
- Service de pneumologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
| | - Romain Lazor
- Service de Pneumologie, Centre hospitalier universitaire vaudois, Lausanne, Suisse
| | - Jean-Marc Naccache
- Service de Pneumologie, Centre de référence des maladies pulmonaires rares (site constitutif), Hôpital Tenon, Paris, France
| | - Stéphane Jouneau
- Service de Pneumologie, Centre de compétences des maladies rares pulmonaires, Hôpital Pontchaillou, IRSET UMR 1085, Université de Rennes 1, Rennes, France
| | - Hilario Nunes
- Service de Pneumologie Centre de référence des maladies pulmonaires rares (site constitutif), Hôpital Avicenne, Bobigny, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre de compétences des maladies pulmonaires rares, CHU Nord, AP-HM, Marseille, France.,Aix-Marseille Université, IHU Méditerranée Infection, MEPHI, Marseille, France
| | - Aurélie Le Borgne
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares Hôpital Larrey CHU Toulouse, Toulouse, France
| | - David Boutboul
- Service d'Immunopathologie Clinique, Hôpital St Louis, APHP, Paris, France
| | - Ibrahima Ba
- Laboratoire de Génétique, APHP, Hôpital Bichat, Paris, France
| | | | - Bruno Crestani
- Service de Pneumologie A, Centre de référence des maladies pulmonaires rares (site constitutif), APHP, Hôpital Bichat, Paris, France
| | | | - Raphaël Borie
- Service de Pneumologie A, Centre de référence des maladies pulmonaires rares (site constitutif), APHP, Hôpital Bichat, Paris, France
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Tandjaoui-Lambiotte Y, Crockett F, Nunes H, Annesi-Maesano I, Sésé L. Air pollution: the silent killer is also indoors. Int J Tuberc Lung Dis 2022; 26:296-297. [PMID: 35351232 DOI: 10.5588/ijtld.22.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Y Tandjaoui-Lambiotte
- Pulmonology and Infectiology Department, Delafontaine Hospital, Saint Denis, France, Hypoxia & Lung, Institut national de la santé et de la recherche médicale (INSERM) 1272, Bobigny, France, Unité mixte de recherche 1137, INSERM IAME (Infection, Antimicrobiens, Modélisation, Evolution), Paris, France
| | - F Crockett
- Pulmonology and Infectiology Department, Delafontaine Hospital, Saint Denis, France
| | - H Nunes
- Hypoxia & Lung, Institut national de la santé et de la recherche médicale (INSERM) 1272, Bobigny, France, Pulmonology Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France, Sorbonne Paris Nord University, Bobigny, France
| | - I Annesi-Maesano
- INSERM UA11, Institut Desbrest d´Épidémiologie et de Santé Publique (IDESP), Montpellier University, Montpellier, France
| | - L Sésé
- Hypoxia & Lung, Institut national de la santé et de la recherche médicale (INSERM) 1272, Bobigny, France, Physiology Department, Avicenne Hospital, AP-HP, Bobigny, France, Sorbonne Paris Nord University, Bobigny, France
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Cottin V, Bonniaud P, Cadranel J, Jouneau S, Marchand-Adam S, Nunes H, Wémeau-Stervinou L, Crestani B. [Idiopathic pulmonary fibrosis: Update of French practical guidelines]. Rev Mal Respir 2022; 39:193-198. [PMID: 35337709 DOI: 10.1016/j.rmr.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 10/18/2022]
Affiliation(s)
- V Cottin
- Service de pneumologie, centre national coordonnateur de référence des maladies pulmonaires rares (OrphaLung), UMR 754, INRAE, hospices civils de Lyon (HCL), université Claude-Bernard Lyon 1, hôpital Louis-Pradel, Lyon, France.
| | - P Bonniaud
- Inserm U123-1, faculté de médecine et pharmacie, centre de référence constitutif des maladies pulmonaires rares, centre hospitalo-universitaire de Bourgogne, université de Bourgogne-Franche Comté, Dijon, France
| | - J Cadranel
- Centre de référence constitutif des maladies pulmonaires rares, Sorbonne université GRC 04 Theranoscan, hôpital Tenon, AP-HP, Paris, France
| | - S Jouneau
- Service de pneumologie, centre de compétence pour les maladies pulmonaires rares de l'adulte, IRSET UMR1085, université de Rennes 1, hôpital Pontchaillou, Rennes, France
| | - S Marchand-Adam
- Service de pneumologie, centre de compétence pour les maladies pulmonaires rares de l'adulte, CHRU, hôpital Bretonneau, Tours, France
| | - H Nunes
- Service de pneumologie, centre de référence constitutif des maladies pulmonaires rares, université Sorbonne Paris Nord, hôpital Avicenne, AP-HP, Bobigny, France
| | - L Wémeau-Stervinou
- Service de pneumologie et immuno-allergologie, centre de référence constitutif des maladies pulmonaires rares, institut Cœur-Poumon, CHU de Lille, Lille, France
| | - B Crestani
- Service de pneumologie A, centre de référence constitutif des maladies pulmonaires rares, université Paris Cité, hôpital Bichat, AP-HP, Paris, France
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Patte C, Brillet PY, Fetita C, Bernaudin JF, Gille T, Nunes H, Chapelle D, Genet M. Estimation of Regional Pulmonary Compliance in Idiopathic Pulmonary Fibrosis Based On Personalized Lung Poromechanical Modeling. J Biomech Eng 2022; 144:1139545. [PMID: 35292805 DOI: 10.1115/1.4054106] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Indexed: 11/08/2022]
Abstract
Pulmonary function is tightly linked to the lung mechanical behavior, especially large deformation during breathing. Interstitial lung diseases, such as Idiopathic Pulmonary Fibrosis (IPF), have an impact on the pulmonary mechanics and consequently alter lung function. However, IPF remains poorly understood, poorly diagnosed and poorly treated. Currently, the mechanical impact of such diseases is assessed by pressure-volume curves, giving only global information. We developed a poromechanical model of the lung that can be personalized to a patient based on routine clinical data. The personalization pipeline uses clinical data, mainly CT-images at two time steps and involves the formulation of an inverse problem to estimate regional compliances. The estimation problem can be formulated both in terms of "effective", i.e., without considering the mixture porosity, or "rescaled", i.e., where the first-order effect of the porosity has been taken into account, compliances. Regional compliances are estimated for one control subject and three IPF patients, allowing to quantify the IPF-induced tissue stiffening. This personalized model could be used in the clinic as an objective and quantitative tool for IPF diagnosis.
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Affiliation(s)
- Cécile Patte
- Inria, Palaiseau, France, Laboratoire de Mécanique des Solides, École Polytechnique/CNRS/IPP, Palaiseau, France
| | - Pierre-Yves Brillet
- Hypoxie et Poumon, Universit é Sorbonne Paris Nord/INSERM, Bobigny, France; Hôpital Avicenne, APHP, Bobigny, France
| | - Catalin Fetita
- SAMOVAR, Telecom SudParis/Institut Mines-Télécom/IPP, Évry, France
| | | | - Thomas Gille
- Hypoxie et Poumon, Universit é Sorbonne Paris Nord/INSERM, Bobigny, France; Hôpital Avicenne, APHP, Bobigny, France
| | - Hilario Nunes
- Hypoxie et Poumon, Universit é Sorbonne Paris Nord/INSERM, Bobigny, France; Hôpital Avicenne, APHP, Bobigny, France
| | - Dominique Chapelle
- Inria, Palaiseau, France, Laboratoire de Mécanique des Solides, École Polytechnique/CNRS/IPP, Palaiseau, France
| | - Martin Genet
- Laboratoire de Mecanique des Solides, École Polytechnique/CNRS/IPP, Palaiseau, France; Inria, Palaiseau, France
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Bay P, de Chambrun MP, Roux A, Bunel V, Combes A, Biet DI, Zuber B, Nunes H, Allenbach Y, Uzunhan Y. Extracorporeal Life Support Allows Lung Transplant in anti-MDA5+ Rapidly Progressive-Interstitial Lung Disease. Eur Respir J 2022; 59:13993003.02968-2021. [PMID: 35236721 DOI: 10.1183/13993003.02968-2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/08/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Pierre Bay
- Université Sorbonne Paris Nord, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France.,Service de Médecine Intensive Réanimation, DHU A-TVB, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique - Hôpitaux de Paris (AP-HP), , , Créteil, France
| | - Marc Pineton de Chambrun
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital La Pitié-Salpêtrière, Service de Médecine Intensive-Réanimation, Paris, France.,Sorbonne Université, INSERM, UMRS_1166-ICAN, Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France
| | - Antoine Roux
- Service de Pneumologie, Hôpital Foch, Suresnes, France.,Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Vincent Bunel
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Pneumologie B et Transplantation Pulmonaire, Paris, France.,Physiopathologie et Epidémiologie des maladies respiratoires, UMR1152 INSERM and Université de Paris, Paris, France
| | - Alain Combes
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital La Pitié-Salpêtrière, Service de Médecine Intensive-Réanimation, Paris, France.,Sorbonne Université, INSERM, UMRS_1166-ICAN, Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France
| | - Dominique Israël Biet
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Service de Pneumologie, Georges Pompidou European Hospital, Paris, France
| | - Benjamin Zuber
- Service de Réanimation Polyvalente, Hôpital Foch, Suresnes, France
| | - Hilario Nunes
- Université Sorbonne Paris Nord, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France.,Université Sorbonne Paris Nord, INSERM U1272
| | - Yves Allenbach
- Centre de Recherche en Myologie, Unité Mixte de Recherche Scientifique 974, Université Pierre et Marie Curie, INSERM.,Département de Médecine Interne et Immunologie Clinique, Centre de Référence Maladies Neuro-Musculaires, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, DHUi2B, Paris, France
| | - Yurdagül Uzunhan
- Université Sorbonne Paris Nord, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France .,Université Sorbonne Paris Nord, INSERM U1272
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Cottin V, Bonniaud P, Cadranel J, Crestani B, Jouneau S, Marchand-Adam S, Nunes H, Wémeau-Stervinou L, Bergot E, Blanchard E, Borie R, Bourdin A, Chenivesse C, Clément A, Gomez E, Gondouin A, Hirschi S, Lebargy F, Marquette CH, Montani D, Prévot G, Quetant S, Reynaud-Gaubert M, Salaun M, Sanchez O, Trumbic B, Berkani K, Brillet PY, Campana M, Chalabreysse L, Chatté G, Debieuvre D, Ferretti G, Fourrier JM, Just N, Kambouchner M, Legrand B, Le Guillou F, Lhuillier JP, Mehdaoui A, Naccache JM, Paganon C, Rémy-Jardin M, Si-Mohamed S, Terrioux P. [French practical guidelines for the diagnosis and management of IPF - 2021 update, short version]. Rev Mal Respir 2022; 39:275-312. [PMID: 35304014 DOI: 10.1016/j.rmr.2022.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients' association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.
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Affiliation(s)
- V Cottin
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France; UMR 754, IVPC, INRAE, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; Membre d'OrphaLung, RespiFil, Radico-ILD2, et ERN-LUNG, Lyon, France.
| | - P Bonniaud
- Service de pneumologie et soins intensifs respiratoires, centre de référence constitutif des maladies pulmonaires rares, centre hospitalo-universitaire de Bourgogne et faculté de médecine et pharmacie, université de Bourgogne-Franche Comté, Dijon ; Inserm U123-1, Dijon, France
| | - J Cadranel
- Service de pneumologie et oncologie thoracique, centre de référence constitutif des maladies pulmonaires rares, assistance publique-hôpitaux de Paris (AP-HP), hôpital Tenon, Paris ; Sorbonne université GRC 04 Theranoscan, Paris, France
| | - B Crestani
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - S Jouneau
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Pontchaillou, Rennes ; IRSET UMR1085, université de Rennes 1, Rennes, France
| | - S Marchand-Adam
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, hôpital Bretonneau, service de pneumologie, CHRU, Tours, France
| | - H Nunes
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie, AP-HP, hôpital Avicenne, Bobigny ; université Sorbonne Paris Nord, Bobigny, France
| | - L Wémeau-Stervinou
- Centre de référence constitutif des maladies pulmonaires rares, Institut Cœur-Poumon, service de pneumologie et immuno-allergologie, CHRU de Lille, Lille, France
| | - E Bergot
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie et oncologie thoracique, hôpital Côte de Nacre, CHU de Caen, Caen, France
| | - E Blanchard
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Haut Levêque, CHU de Bordeaux, Pessac, France
| | - R Borie
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - A Bourdin
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, département de pneumologie et addictologie, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, Montpellier ; Inserm U1046, CNRS UMR 921, Montpellier, France
| | - C Chenivesse
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et d'immuno-allergologie, hôpital Albert Calmette ; CHRU de Lille, Lille ; centre d'infection et d'immunité de Lille U1019 - UMR 9017, Université de Lille, CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, Lille, France
| | - A Clément
- Centre de ressources et de compétences de la mucoviscidose pédiatrique, centre de référence des maladies respiratoires rares (RespiRare), service de pneumologie pédiatrique, hôpital d'enfants Armand-Trousseau, CHU Paris Est, Paris ; Sorbonne université, Paris, France
| | - E Gomez
- Centre de compétence pour les maladies pulmonaires rares, département de pneumologie, hôpitaux de Brabois, CHRU de Nancy, Vandoeuvre-les Nancy, France
| | - A Gondouin
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Jean Minjoz, Besançon, France
| | - S Hirschi
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, Nouvel Hôpital civil, Strasbourg, France
| | - F Lebargy
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Maison Blanche, Reims, France
| | - C-H Marquette
- Centre de compétence pour les maladies pulmonaires rares, FHU OncoAge, département de pneumologie et oncologie thoracique, hôpital Pasteur, CHU de Nice, Nice cedex 1 ; Université Côte d'Azur, CNRS, Inserm, Institute of Research on Cancer and Aging (IRCAN), Nice, France
| | - D Montani
- Centre de compétence pour les maladies pulmonaires rares, centre national coordonnateur de référence de l'hypertension pulmonaire, unité pneumologie et soins intensifs pneumologiques, AP-HP, DMU 5 Thorinno, Inserm UMR S999, CHU Paris-Sud, hôpital de Bicêtre, Le Kremlin-Bicêtre ; Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
| | - G Prévot
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Larrey, Toulouse, France
| | - S Quetant
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et physiologie, CHU Grenoble Alpes, Grenoble, France
| | - M Reynaud-Gaubert
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, AP-HM, CHU Nord, Marseille ; Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - M Salaun
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, oncologie thoracique et soins intensifs respiratoires & CIC 1404, hôpital Charles Nicole, CHU de Rouen, Rouen ; IRIB, laboratoire QuantiIF-LITIS, EA 4108, université de Rouen, Rouen, France
| | - O Sanchez
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et soins intensifs, hôpital européen Georges Pompidou, AP-HP, Paris, France
| | | | - K Berkani
- Clinique Pierre de Soleil, Vetraz Monthoux, France
| | - P-Y Brillet
- Université Paris 13, UPRES EA 2363, Bobigny ; service de radiologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - M Campana
- Service de pneumologie et oncologie thoracique, CHR Orléans, Orléans, France
| | - L Chalabreysse
- Service d'anatomie-pathologique, groupement hospitalier est, HCL, Bron, France
| | - G Chatté
- Cabinet de pneumologie et infirmerie protestante, Caluire, France
| | - D Debieuvre
- Service de Pneumologie, GHRMSA, hôpital Emile Muller, Mulhouse, France
| | - G Ferretti
- Université Grenoble Alpes, Grenoble ; service de radiologie diagnostique et interventionnelle, CHU Grenoble Alpes, Grenoble, France
| | - J-M Fourrier
- Association Pierre Enjalran Fibrose Pulmonaire Idiopathique (APEFPI), Meyzieu, France
| | - N Just
- Service de pneumologie, CH Victor Provo, Roubaix, France
| | - M Kambouchner
- Service de pathologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - B Legrand
- Cabinet médical de la Bourgogne, Tourcoing ; Université de Lille, CHU Lille, ULR 2694 METRICS, CERIM, Lille, France
| | - F Le Guillou
- Cabinet de pneumologie, pôle santé de l'Esquirol, Le Pradet, France
| | - J-P Lhuillier
- Cabinet de pneumologie, La Varenne Saint-Hilaire, France
| | - A Mehdaoui
- Service de pneumologie et oncologie thoracique, CH Eure-Seine, Évreux, France
| | - J-M Naccache
- Service de pneumologie, allergologie et oncologie thoracique, GH Paris Saint-Joseph, Paris, France
| | - C Paganon
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France
| | - M Rémy-Jardin
- Institut Cœur-Poumon, service de radiologie et d'imagerie thoracique, CHRU de Lille, Lille, France
| | - S Si-Mohamed
- Département d'imagerie cardiovasculaire et thoracique, hôpital Louis Pradel, HCL, Bron ; Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Villeurbanne, France
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Guler SA, Cuevas-Ocaña S, Nasser M, Wuyts WA, Wijsenbeek MS, Froidure A, Bargagli E, Renzoni EA, Veltkamp M, Spagnolo P, Nunes H, McCarthy C, Molina-Molina M, Bonella F, Poletti V, Kreuter M, Antoniou KM, Moor CC. ERS International Congress 2021: highlights from the Interstitial Lung Diseases Assembly. ERJ Open Res 2022; 8:00640-2021. [PMID: 35615418 PMCID: PMC9124869 DOI: 10.1183/23120541.00640-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/04/2021] [Indexed: 11/05/2022] Open
Abstract
This article provides an overview of scientific highlights in the field of interstitial lung disease (ILD), presented at the virtual European Respiratory Society Congress 2021. A broad range of topics was discussed this year, ranging from translational and genetic aspects to novel innovations with the potential to improve the patient pathway. Early Career Members summarize a selection of interesting findings from different congress sessions, together with the leadership of Assembly 12 – Interstitial Lung Disease.
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Philippot Q, Kannengiesser C, Debray MP, Gauvain C, Ba I, Vieri M, Gondouin A, Naccache JM, Reynaud-Gaubert M, Uzunhan Y, Bondue B, Israël-Biet D, Dieudé P, Fourrage C, Lainey E, Manali E, Papiris S, Wemeau L, Hirschi S, Mal H, Nunes H, Schlemmer F, Blanchard E, Beier F, Cottin V, Crestani B, Borie R. Interstitial lung diseases associated with mutations of poly(A)-specific ribonuclease: A multicentre retrospective study. Respirology 2022; 27:226-235. [PMID: 34981600 DOI: 10.1111/resp.14195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/21/2021] [Accepted: 11/29/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Poly(A)-specific ribonuclease (PARN) mutations have been associated with familial pulmonary fibrosis. This study aims to describe the phenotype of patients with interstitial lung disease (ILD) and heterozygous PARN mutations. METHODS We performed a retrospective, observational, non-interventional study of patients with an ILD diagnosis and a pathogenic heterozygous PARN mutation followed up in a centre of the OrphaLung network. RESULTS We included 31 patients (29 from 16 kindreds and two sporadic patients). The median age at ILD diagnosis was 59 years (range 54 to 63). In total, 23 (74%) patients had a smoking history and/or fibrogenic exposure. The pulmonary phenotypes were heterogenous, but the most frequent diagnosis was idiopathic pulmonary fibrosis (n = 12, 39%). Haematological abnormalities were identified in three patients and liver disease in two. In total, 21 patients received a specific treatment for ILD: steroids (n = 13), antifibrotic agents (n = 11), immunosuppressants (n = 5) and N-acetyl cysteine (n = 2). The median forced vital capacity decline for the whole sample was 256 ml/year (range -363 to -148). After a median follow-up of 32 months (range 18 to 66), 10 patients had died and six had undergone lung transplantation. The median transplantation-free survival was 54 months (95% CI 29 to ∞). Extra-pulmonary features were less frequent with PARN mutation than telomerase reverse transcriptase (TERT) or telomerase RNA component (TERC) mutation. CONCLUSION IPF is common among individuals with PARN mutation, but other ILD subtypes may be observed.
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Affiliation(s)
| | - Caroline Kannengiesser
- INSERM, Unité 1152, Université de Paris, Paris, France.,Laboratoire de Génétique, Hôpital Bichat, APHP, Paris, France
| | - Marie Pierre Debray
- INSERM, Unité 1152, Université de Paris, Paris, France.,Service de Radiologie, Hôpital Bichat, APHP, Paris, France
| | | | - Ibrahima Ba
- Laboratoire de Génétique, Hôpital Bichat, APHP, Paris, France
| | - Margherita Vieri
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Anne Gondouin
- Service de Pneumologie, CHU de Besançon, Besancon, France
| | | | | | | | | | | | - Philippe Dieudé
- INSERM, Unité 1152, Université de Paris, Paris, France.,Service de Rhumatologie, Hôpital Bichat, APHP, Paris, France
| | - Cécile Fourrage
- Service de Génétique Hôpital Necker Enfants Malades, APHP, Paris, France.,Plateforme de Bio-informatique, Institut Imagine, Université de Paris, Paris, France
| | - Elodie Lainey
- Laboratoire d'Hématologie Hôpital Robert Debré, APHP, Paris, France
| | - Effrosyne Manali
- 2nd Pulmonary department, Attikon University Hospital, Athens, Greece
| | - Spyros Papiris
- 2nd Pulmonary department, Attikon University Hospital, Athens, Greece
| | | | | | - Hervé Mal
- INSERM, Unité 1152, Université de Paris, Paris, France.,Service de Pneumologie B, Hôpital Bichat, APHP, Paris, France
| | - Hilario Nunes
- Service de Pneumologie, Hôpital Avicenne, APHP, Bobigny, France
| | - Frédéric Schlemmer
- Unité de Pneumologie, Université Paris-Est Créteil, APHP, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | | | - Fabian Beier
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Vincent Cottin
- Coordonnateur OrphaLung, Centre coordonnateur national de référence des maladies pulmonaires rares, Service de Pneumologie, Hôpital Louis Pradel, Université de Lyon, INRAE, member of Radico-ILD, Lyon, France.,RespiFil, ERN-LUNG, Lyon, France
| | - Bruno Crestani
- Service de Pneumologie A, Hôpital Bichat, APHP, Paris, France.,INSERM, Unité 1152, Université de Paris, Paris, France
| | - Raphaël Borie
- Service de Pneumologie A, Hôpital Bichat, APHP, Paris, France.,INSERM, Unité 1152, Université de Paris, Paris, France
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