1
|
Régnier-Rosencher E, Dupont B, Jacobelli S, Paugam A, Carlotti A, Boitier F, Gorin I, Dupin N, Avril MF. Late occurrence of Histoplasma duboisii cutaneous and pulmonary infection 18 years after exposure. J Mycol Med 2014; 24:229-33. [PMID: 25155354 DOI: 10.1016/j.mycmed.2014.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/23/2014] [Accepted: 08/01/2014] [Indexed: 10/24/2022]
Abstract
We report an imported case of Histoplasma capsulatum var. duboisii (H. duboisii) infection in a white French woman revealed by cutaneous lesions of the scalp, 18 years after her last stay in West and Central Africa. Asymptomatic bilateral pulmonary infiltrates were discovered on thoracic computed tomography. Skin biopsy allowed the positive diagnosis showing the typical yeasts; culture of biopsy specimens was positive for H. capsulatum. In the absence of criteria of severity, the patient was treated for one year with oral itraconazole 400mg/day. The outcome was favourable, skin and pulmonary lesions resolved slowly. The follow up is 5 years without relapse after the end of treatment. This case illustrates the possibility of late occurrence of H. duboisii infection, many years after exposure and the major importance of asking any patient for travelling or residency in tropical countries.
Collapse
Affiliation(s)
- E Régnier-Rosencher
- Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France.
| | - B Dupont
- Department of infectious diseases, Necker hospital, AP-HP, université René-Descartes Paris V, Paris, France
| | - S Jacobelli
- Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France
| | - A Paugam
- Department of parasitology and mycology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France
| | - A Carlotti
- Department of pathology, Cochin hospital, APHP, Université René-Descartes Paris V, Paris, France
| | - F Boitier
- Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France
| | - I Gorin
- Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France
| | - N Dupin
- Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France
| | - M F Avril
- Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France
| |
Collapse
|
2
|
Beqqal K, Horellou MH, Philippe A, Alhene Gelas M, Flaujac C, Gorin I, Jacobelli S, Dupin N, Hassam B, Avril MF. Skin necrosis due to fluindione treatment: a rare but serious complication. J Wound Care 2014; 23:S16-9. [PMID: 24526169 DOI: 10.12968/jowc.2014.23.sup2b.s16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the setting of protein C deficiency, skin necrosis, which occurs most often at the initial phase of oral anticoagulants therapy, is a rare side effect. Six cases have previously been reported in the literature. In this case report, we present a protein C deficient 42-year-old woman who was being treated for venous thrombosis. Five days after the initiation of oral anticoagulant treatment, she developed extensive skin necrosis on her left calf, followed by a painful leg ulcer. The pathogenesis underlying skin necrosis caused by anticoagulation therapy is still not clear. Despite only a few cases being reported in the literature, it is important to recognise this complication since adequate therapeutic approaches leading to a stable anticoagulation state may prevent it.
Collapse
Affiliation(s)
- K Beqqal
- MD, Dermatologist, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France, Department of Dermatology, Ibn Sina Hospital, University of Mohammed V-Souissi, Rabat, Morocco
| | - M H Horellou
- MD, Biologist, APHP, Department of Haematology and Biology, Cochin Hospital, Paris Descartes University, Paris, France
| | - A Philippe
- Nurse, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France
| | - M Alhene Gelas
- MD, Geneticist, APHP, Department of Haematology and Biology, Georges Pompidou European Hospital, Paris, France
| | - C Flaujac
- MD, Biologist, APHP, Department of Haematology and Biology, Cochin Hospital, Paris Descartes University, Paris, France
| | - I Gorin
- MD, Dermatologist, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France
| | - S Jacobelli
- MD, Dermatologist, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France
| | - N Dupin
- MD, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France
| | - B Hassam
- MD, Dermatologist, Department of Dermatology, Ibn Sina Hospital, University of Mohammed V-Souissi, Rabat, Morocco
| | - M F Avril
- MD, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France
| |
Collapse
|
3
|
Qasmi S, Sutra-Loubet C, Maubec E, Boitier F, Duvillard P, Carlotti A, Marinho E, Jacobelli S, Franck N, Gorin I, Vacher-Lavenu MC, Bouscarat F, Crickx B, Dupin N, Avril MF. [Melanoma in HIV patients: 14 cases]. Ann Dermatol Venereol 2010; 137:769-74. [PMID: 21134578 DOI: 10.1016/j.annder.2010.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Accepted: 08/02/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND a clinical study of 14 patients presenting both malignant melanoma and HIV infection, and analysis of the literature to determine the frequency and specific features of this association. PATIENTS AND METHODS ten men and four women of median age 43 years were included. In 50% of cases, the primary melanoma consisted of spreading superficial melanoma with a mean Breslow thickness of 2.83 mm. In two cases, regional lymph node metastasis was discovered but with no primary melanoma being identified. HIV infection was already documented on diagnosis of melanoma in 11 cases, and it was discovered in three cases at the time of surgery for melanoma (treatment of the primary melanoma in two cases, and in one case, regional lymph node dissection two years after the initial diagnosis). Eight patients died within a mean period of 39 months, with melanoma being the cause of death in six cases. Following relapse of melanoma, the course of the disease was severe, with mean stage IV survival of 3.6 months. No response to chemotherapy was observed where such treatment was feasible. DISCUSSION the presence of HIV appears to be an aggravating factor for the outcome of metastatic melanoma. CONCLUSION our study suggests the importance of clinical examination of pigmented lesions in HIV patients in order to ensure early identification of melanoma.
Collapse
Affiliation(s)
- S Qasmi
- Service de Dermatologie, Université Paris 5, Hôpital Cochin-pavillon Tornier, 89, rue d'Assas, AP-HP, 75006 Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Pécuchet N, Avril M, Kerob D, Billemont B, Blanchet B, Herait P, Gorin I, Viguier M, Lebbé C, Goldwasser F. Relationship between dose, exposure, and antitumoral activity of sorafenib in melanoma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
5
|
Wallet-Faber N, Farhi D, Gorin I, Carlotti A, Plantier F, Dupin N, Avril MF. Outcome of granuloma annulare: shorter duration is associated with younger age and recent onset. J Eur Acad Dermatol Venereol 2010; 24:103-4. [DOI: 10.1111/j.1468-3083.2009.03343.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Boussemart L, Jacobelli S, Batteux F, Goulvestre C, Grange P, Carlotti A, Morini J, Gorin I, Ziza J, Avril M, Dupin N. Autoimmune Bullous Skin Diseases Occurring under Anti-Tumor Necrosis Factor Therapy: Two Case Reports. Dermatology 2010; 221:201-5. [DOI: 10.1159/000318008] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 06/23/2010] [Indexed: 11/19/2022] Open
|
7
|
Alimova E, Farhi D, Plantier F, Carlotti A, Gorin I, Mouthon L, Franck N, Avril MF, Dupin N. Morphoea (localized scleroderma): baseline body surface involvement and antinuclear antibody may have a prognostic value. Clin Exp Dermatol 2009; 34:e491-2. [DOI: 10.1111/j.1365-2230.2009.03557.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
8
|
Alimova E, Gorin I, Gressier L, Hugol D, Bouillot JL, Cavalcanti A, Terrier-Lacombe MJ, Blondet C, Franck N, Morini JP, Dupin N, Avril MF. [Metastatic melanoma of the gallbladder: two cases]. Ann Dermatol Venereol 2009; 136:368-70. [PMID: 19361709 DOI: 10.1016/j.annder.2008.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 11/21/2008] [Indexed: 11/26/2022]
|
9
|
Jacobelli S, Soufir N, Lacapere JJ, Regnier S, Bourillon A, Grandchamp B, Hétet G, Pham D, Palangie A, Avril MF, Dupin N, Sarasin A, Gorin I. Xeroderma pigmentosum group C in a French Caucasian patient with multiple melanoma and unusual long-term survival. Br J Dermatol 2008; 159:968-73. [PMID: 18717677 DOI: 10.1111/j.1365-2133.2008.08791.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We report the case of an 83-year-old French woman with multiple melanomas showing a severe DNA repair deficiency, corrected after transfection by XPC cDNA. Two biallelic mutations in the XPC gene are reported: an inactivating frameshift mutation in exon 15 (c.2544delG, p.W848X) and a missense mutation in exon 11 (c.2108 C>T, P703L). We demonstrate that these new mutations are involved in the DNA repair deficiency and confirm the diagnosis of xeroderma pigmentosum from complementation group C (XP-C). We speculate that the coexistence of a MC1R variant may be involved in the phenotype of multiple melanomas and that the unusual long-term survival may be related to a lower ultraviolet radiation exposure and to a regular clinical follow-up. This patient appears to be the first French Caucasian XP-C case and one of the oldest living patients with XP reported worldwide.
Collapse
Affiliation(s)
- S Jacobelli
- Department of Dermatology, Tarnier-Cochin Hospital APHP, UPRES EA1833, Faculty of Medicine Paris 5, 89 rue d'Assas, 75006 Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Soufir N, Gerard B, Portela M, Brice A, Liboutet M, Saiag P, Descamps V, Kerob D, Wolkenstein P, Gorin I, Lebbe C, Dupin N, Crickx B, Basset-Seguin N, Grandchamp B. PTCH mutations and deletions in patients with typical nevoid basal cell carcinoma syndrome and in patients with a suspected genetic predisposition to basal cell carcinoma: a French study. Br J Cancer 2006; 95:548-53. [PMID: 16909134 PMCID: PMC2360669 DOI: 10.1038/sj.bjc.6603303] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The patched (PTCH) mutation rate in nevoid basal cell carcinoma syndrome (NBCCS) reported in various studies ranges from 40 to 80%. However, few studies have investigated the role of PTCH in clinical conditions suggesting an inherited predisposition to basal cell carcinoma (BCC), although it has been suggested that PTCH polymorphisms could predispose to multiple BCC (MBCC). In this study, we therefore performed an exhaustive analysis of PTCH (mutations detection and deletion analysis) in 17 patients with the full complement of criteria for NBCCS (14 sporadic and three familial cases), and in 48 patients suspected of having a genetic predisposition to BCC (MBCC and/or age at diagnosis ⩽40 years and/or familial BCC). Eleven new germline alterations of the PTCH gene were characterised in 12 out of 17 patients harbouring the full complement of criteria for the syndrome (70%). These were frameshift mutations in five patients, nonsense mutations in five patients, a small inframe deletion in one patient, and a large germline deletion in another patient. Only one missense mutation (G774R) was found, and this was in a patient affected with MBCC, but without any other NBCCS criterion. We therefore suggest that patients harbouring the full complement of NBCCS criteria should as a priority be screened for PTCH mutations by sequencing, followed by a deletion analysis if no mutation is detected. In other clinical situations that suggest genetic predisposition to BCC, germline mutations of PTCH are not common.
Collapse
Affiliation(s)
- N Soufir
- Laboratoire de Biochimie Hormonale et Génétique, IFR-02, Hôpital Bichat-Claude Bernard, AP-HP, Faculté de Médecine Paris VII, 46 rue Henri Huchard, 75018 Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Martinez V, Caumes E, Gambotti L, Ittah H, Morini JP, Deleuze J, Gorin I, Katlama C, Bricaire F, Dupin N. Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy. Br J Cancer 2006; 94:1000-6. [PMID: 16570046 PMCID: PMC2361239 DOI: 10.1038/sj.bjc.6603056] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Highly active antiretroviral therapy (HAART) reduces the incidence and improves the prognosis of Kaposi's sarcoma (KS). This study was designed to identify factors associated with KS clinical responses in HIV-infected patients during HAART. We reviewed the files of 138 HIV-1-infected patients with KS. Epidemiologic and HIV-related clinical and biological parameters were recorded at KS diagnosis (baseline) and every 6 months thereafter. In a subset of 73 antiretroviral-naive patients, we compared the clinical outcome of KS according to the use or nonuse of protease inhibitors (PI). After 6 months of follow-up, KS remission was more frequent in patients who were naive of HAART and who were at ACTG stage S0 at baseline (P=0.03 and 0.02). Undetectable HIV viral load was strongly associated with KS remission (P⩽0.004 at all time points), while CD4 cell count was not. Among the 73 antiretroviral-naive patients at baseline, and who were studied for 24 months, KS outcome did not differ between patients who were prescribed PI-containing and PI-sparing regimens. Intercurrent multicentric Castleman's disease was associated with poor outcome after 60 months of follow-up (P⩽0.0001). Fourteen deaths occurred after a median follow-up of 37.5 months, eight of which were KS related. Suppression of HIV replication appears to be crucial to control KS. Non-PI-based regimens were equivalent to PI-based regimens as regards the clinical and virological outcome of antiretroviral-naive HIV-infected patients with KS.
Collapse
Affiliation(s)
- V Martinez
- Service de Dermatologie, Hôpital Tarnier-Cochin, AP-HP, UPRES 1833, Université Paris V 89, rue d'Assas, Paris 75006, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Cremer G, Viguie C, Gorin I, Loria-Kanza Y, Verpilleux M. P249 - L’examen mycologique en pratique de ville devant une onychomycose. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79978-6] [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: 10/15/2022]
|
13
|
Landry J, Regnier S, Carlotti A, De Maricourt S, Cerceau M, Gorin I, Dupin N. P138 - Tumeur d’Abrikossoff de l’ongle : une localisation inhabituelle. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79867-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
14
|
Soufir N, Gerard B, Portela M, Liboutet M, Wolkenstein P, Saiag P, Descamps V, Kerob D, Gorin I, Lebbe C, Dupin N, Crickx B, Grandchamp B, Basset-Seguin N. C35 - Anomalies germinales du gène patched chez les sujets à risque de carcinomes basocellulaires : indications du test génétique. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79656-3] [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: 11/29/2022]
|
15
|
Jacobelli S, Regnier S, Carlotti A, Mateus C, Dupin N, Franck N, Gorin I. P75 - Efficacité du thalidomide sur les manifestations cutanées spécifiques et systémiques d’une myélodysplasie. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79804-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
16
|
Landry J, Regnier S, Plantier F, Cerceau M, Gorin I, Dupin N. P137 - Un histiocytofibrome bénin mais géant. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79866-5] [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: 10/15/2022]
|
17
|
Gorin I, Prince M, Grob JJ, Leccia MT, Lesimple T, Ferriès E, Bercovici N, Tartour E, Taylor R, Robert C. A phase I/II study of a multivalent dendritic cell vaccine in patients with metastatic melanoma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2542] [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: 11/20/2022] Open
Affiliation(s)
- I. Gorin
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - M. Prince
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - J.-J. Grob
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - M.-T. Leccia
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - T. Lesimple
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - E. Ferriès
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - N. Bercovici
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - E. Tartour
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - R. Taylor
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| | - C. Robert
- Hôpital Tarnier-Cochin, Paris, France; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Hôpital Ste Marguerite, Marseille, France; Hôpital Michallon, Grenoble, France; Ctr Eugène Marquis, Rennes, France; IDM S. A., Paris, France; Hôpital Européen Georges Pompidou, Paris, France; Inst Gustave Roussy, Villejuif, France
| |
Collapse
|
18
|
Treluyer J, Morini J, Dimet J, Gorin I, Rey E, Pons G, Dupin N. High concentrations of nelfinavir as an independent risk factor for lipodystrophy in HIV-infected patients. Clin Pharmacol Ther 2003. [DOI: 10.1016/s0009-9236(03)90615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
19
|
Roux-Guinot S, Gorin I, Vadrot D, Djid R, Bethoux JP, Escande JP. [Androgenic alopecia revealing an androgen secreting ovarian tumor]. Ann Dermatol Venereol 2001; 128:1241-4. [PMID: 11908171] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Androgen-producing tumors of the ovary are rare in postmenopausal women and are revealed by severe virilization. Leydig hilus cell tumors are the most frequent postmenopausal virilizing tumors. In this report, an unusual and rare cause of alopecia due to Leydig cell hyperplasia within the wall of a simple cyst and in the ovarian hilus is described. OBSERVATION An 80 year-old woman complained of a 10-year history of severe androgenic alopecia associated with very mild facial hirsutism, without others signs of virilization. Hormonal blood levels showed markedly elevated testosterone. Computed tomographic scan of the adrenals and the ovaries revealed an enormous left ovarian cystic mass. Bilateral hystero-ophorectomy was performed. Histological examination demonstrated bilateral Leydig cell hyperplasia within the wall of the cyst and in the right ovarian hilus. Two months postoperative hormonal evaluation demonstrated dramatically decreased plasma levels of testosterone. COMMENTARY The clinical, X ray and histologic aspects of this case, although rare, show that the presence of virilization should lead to a search for an androgen-secreting ovarian or adrenal tumor.
Collapse
Affiliation(s)
- S Roux-Guinot
- Service de Dermatologie, Hôpital Tarnier, 89, rue d'Assas 75006 Paris.
| | | | | | | | | | | |
Collapse
|
20
|
Clément A, Hoeffel C, Fayet P, Benkanoun S, Sahut D'izarn J, Oudjit A, Legmann P, Gorin I, Escande J, Bonnin A. [Value of high frequency (20mhZ) and doppler ultrasound in the diagnosis of pigmented cutaneous tumors]. J Radiol 2001; 82:563-71. [PMID: 11416794] [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] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
PURPOSE Diagnosis of pigmented skin tumors is often difficult. The aim of the present study is to evaluate high frequency ultrasound and Doppler ultrasound in the localization and the characterization of these tumors. MATERIAL AND METHODS One hundred and seventy six pigmented skin tumors including melanocytic and non melanocytic, benign and malignant lesions have been examined before resection using high frequency ultrasound (20MHz probe) and Doppler ultrasound (13MHz probe-Doppler frequency: 7MHz). Imaging data have been correlated with histological data, available in all cases. RESULTS Tumors seen at ultrasound were hypoechoic lesions, some of which, particularly malignant melanocytic tumors were vascularized. Precise ultrasonographic location of the tumor was correlated to its histological location: epidermis for purely epidermal proliferations (seborrheic keratoses), superficial dermis for dermal proliferations originating from epidermis (benign dermal nevi, melanomas during vertical growth phase, basal cell carcinomas), middle and deep dermis for dermal proliferations originating from dermis (fibrous histiocytomas, angiomas). CONCLUSION Ultrasound may help in assessing positive and differential diagnosis of pigmented skin tumors as it precises, before histological examination, the exact location of the lesion within the different skin layers and its origin. As far as malignant melanocytic tumors are concerned, high frequency ultrasound and Doppler ultrasound appear promising in diagnosis algorithm and pronosic of these lesions.
Collapse
Affiliation(s)
- A Clément
- Service de Radiologie A, Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Affiliation(s)
- N Dupin
- Service de Dermato-Vénéréologie, Dispensaire Anti-vénérien, Hôpital Tarnier-Cochin, Paris, France
| | | | | | | | | | | |
Collapse
|
22
|
Salmon-Céron D, Deleuze J, Coste J, Guerin C, Ginsburg C, Blanche P, Finkielsztejn L, Pecqueux L, Chaput S, Gorin I, Sicard D. [Adherence to antiretroviral treatments with a protease inhibitor in HIV-infected patients]. Ann Med Interne (Paris) 2000; 151:297-302. [PMID: 10922958] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Long-term therapeutic success of powerful antiretroviral treatments dependent on patient adherence. This study was conducted to assess the difficulties HIV-infected patients with advanced-stage disease encounter in adhering to antiretroviral treatments with a protease inhibitor. PATIENTS AND METHODS A prospective self-administered questionnaire survey was conducted at our outpatient clinic for 2 months. CD4 counts and HIV viral loads were also determined. RESULTS Seventy-one percent of the study population which included 262 responded to the questionnaire. The survey was made a median 215 days after initiating the antiprotease treatment with indinavir (71% of the cases), ritonavir (13%), saquinavir (6%), or a combination of protease inhibitors (10%). At onset of antiprotease treatment, mean CD4 count was 171+/-150/mm(3) and mean HIV viral load was 75,000 copies/ml. The treatment was considered to be difficult to take by 43% of the patients; 66% stated they had forgotten to take their drugs at least once a month. It was most difficult to take the drugs prescribed for the afternoon. Shifts of 1 hour were observed in 58% of patients. Non-adherence was frequent (1 failure to take drugs per week), observed in 13% of patients. Most often, the patients stated they had forgotten to take their drugs because of occupational or relational difficulties (52%). Non-adherence increased with duration of treatment. The drug most often associated with non-adherence was indinavir (73%). Age and sex did not influence adherence. Mean RNA HIV serum level was lower than at onset of the antiprotease treatment in the most non-adherent patients. At the time of the questionnaire, there was no difference in serum RNA HIV level or in the percentage of patients with an undetectable level between non-adherent and adherent patients. CONCLUSION This survey confirmed difficulties in adherence are frequent and worsen with time. No relationship was found between non-adherence and reduction in viral load, suggesting that a short-term effect of these very active drugs despite lack of perfect adherence. Other factors (pharmacology, sensitivity to antiretroviral drugs.) also play a major role in therapeutic success.
Collapse
|
23
|
Soufir N, Bressac-de Paillerets B, Desjardins L, Lévy C, Bombled J, Gorin I, Schlienger P, Stoppa-Lyonnet D. Individuals with presumably hereditary uveal melanoma do not harbour germline mutations in the coding regions of either the P16INK4A, P14ARF or cdk4 genes. Br J Cancer 2000; 82:818-22. [PMID: 10732752 PMCID: PMC2374387 DOI: 10.1054/bjoc.1999.1005] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In familial cutaneous malignant melanoma (CMM), disruption of the retinoblastoma (pRB) pathway frequently occurs through inactivating mutations in the p16 (p16INK4A/CDKN2A/MTS1) gene or activating mutations in the G1-specific cyclin dependent kinase 4 gene (CDK4). Uveal malignant melanoma (UMM) also occurs in a familial setting, or sometimes in association with familial or sporadic CMM. Molecular studies of sporadic UMM have revealed somatic deletions covering the INK4A-ARF locus (encoding P16INK4A and P14ARF) in a large proportion of tumours. We hypothesized that germline mutations in the p16INK4A, p14ARF or CDK4 genes might contribute to some cases of familial UMM, or to some cases of UMM associated with another melanoma. Out of 155 patients treated at the Institut Curie for UMM between 1994 and 1997, and interviewed about their personal and familial history of melanoma, we identified seven patients with a relative affected with UMM (n = 6) or CMM (n = 1), and two patients who have had, in addition to UMM, a personal history of second melanoma, UMM (n = 1), or CMM (n = 1). We screened by polymerase chain reaction single-strand conformation polymorphism the entire coding sequence of the INK4A-ARF locus (exon 1alpha from p16INK4A, exon 1beta from p14ARF, and exons 2 and 3, common to both genes), as well as the exons 2, 5 and 8 of the CDK4 gene, coding for the functional domains involved in p16 and/or cyclin D1 binding. A previously reported polymorphism in exon 3 of the INK4A-ARF locus was found in one patient affected with bilateral UMM, but no germline mutations were detected, either in the p16INK4A, p14ARF or CDK4 genes. Our data support the involvement of other genes in predisposition to uveal melanoma.
Collapse
Affiliation(s)
- N Soufir
- Unité des Marqueurs Génétiques des Cancers, Institut Gustave Roussy, Villejuif, France
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Dupin N, Rubin De Cervens V, Gorin I, Calvez V, Pessis E, Grandadam M, Rabian C, Viard JP, Huraux JM, Escande JP. The influence of highly active antiretroviral therapy on AIDS-associated Kaposi's sarcoma. Br J Dermatol 1999; 140:875-81. [PMID: 10354025 DOI: 10.1046/j.1365-2133.1999.02818.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [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: 11/20/2022]
Abstract
To assess the clinical and biological benefit of highly active antiretroviral therapy on AIDS-associated Kaposi's sarcoma (KS), 13 patients with AIDS-associated Kaposi's sarcoma (five pulmonary KS and eight cutaneous KS) were prospectively followed for a mean duration of 12 months. Six patients were treated with specific anti-KS chemotherapy before or simultaneously with the introduction of antiretroviral therapy. Clinical response was assessed according to the AIDS Clinical Trial Group (ACTG) criteria. CD4 cell counts, plasma HIV-1 RNA and human herpesvirus 8 (HHV-8) viraemia were measured at baseline and at different points. Among patients with pulmonary KS, we observed three complete responses (CR), one partial response (PR) and one progression. The median survival time after the diagnosis of pulmonary KS was 15 months with a median duration of the response after the discontinuation of specific chemotherapy for KS of 8 months. Among patients with cutaneous KS, we observed four CR, three PR and one stable response. A complete response was significantly associated with a reversal in HHV-8 viraemia (five of six vs. one of six; P = 0.02, Mann-Whitney test).
Collapse
Affiliation(s)
- N Dupin
- Service de Dermato-Vénéréologie, Hôpital Tarnier-Cochin, Paris, France; Laboratoire de Virologie, Groupe Hospitalier Pitié-Salpétrière, Paris, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Dupin N, Fisher C, Kellam P, Ariad S, Tulliez M, Franck N, van Marck E, Salmon D, Gorin I, Escande JP, Weiss RA, Alitalo K, Boshoff C. Distribution of human herpesvirus-8 latently infected cells in Kaposi's sarcoma, multicentric Castleman's disease, and primary effusion lymphoma. Proc Natl Acad Sci U S A 1999; 96:4546-51. [PMID: 10200299 PMCID: PMC16369 DOI: 10.1073/pnas.96.8.4546] [Citation(s) in RCA: 505] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Human herpesvirus 8 (HHV-8, also called KSHV) is linked to the etiopathogenesis of Kaposi's sarcoma (KS), multicentric Castleman's disease (MCD), and primary effusion lymphoma (PEL). The universal presence of HHV-8 in early KS has not yet been shown. We used a mAb (LN53) against latent nuclear antigen-1 (LNA-1) of HHV-8 encoded by ORF73 to study the distribution of the cell types latently infected by HHV-8 in patch, plaque, and nodular KS, MCD, and PEL. In early KS, HHV-8 is present in <10% of cells forming the walls of ectatic vessels. In nodular KS, HHV-8 is present in cells surrounding slit-like vessels and in >90% of spindle cells, but not in normal vascular endothelium. In addition, HHV-8 colocalizes with vascular endothelial growth factor receptor-3 (VEGFR-3), a marker of lymphatic and precursor endothelium. In early KS lesions, VEGFR-3 is more extensively expressed than LNA-1, indicating that HHV-8 is not inducing the proliferation of VEGFR-3-positive endothelium directly. In MCD, HHV-8 is present in mantle zone large immunoblastic B cells. No staining for LNA-1 is seen in samples from multiple myeloma, prostate cancer, and angiosarcoma, supporting the absence of any etiological link between these diseases and HHV-8.
Collapse
Affiliation(s)
- N Dupin
- Departments of Oncology and Molecular Pathology, Royal Free and University College Medical School, UCL, London, United Kingdom W1P 6BT
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Dupin N, Marcelin AG, Gorin I, Bossi P, Franck N, Weill B, Huraux JM, Escande JP, Calvez V. Prevalence of human herpesvirus 8 infection measured by antibodies to a latent nuclear antigen in patients with various dermatologic diseases. Arch Dermatol 1998; 134:700-2. [PMID: 9645638 DOI: 10.1001/archderm.134.6.700] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Human herpesvirus 8 (HHV-8) has been detected in all epidemiological forms of Kaposi sarcoma (KS). The role of HHV-8 in dermatologic diseases other than KS is controversial. Some studies based on polymerase chain reaction findings suggest an association between HHV-8 and epithelial tumors of the skin, lymphoproliferative disorders, or pemphigus. OBJECTIVE To assess the prevalence of antibodies against a latent nuclear antigen of HHV-8 in patients with various dermatologic diseases. DESIGN An indirect immunofluorescence assay was used to search for HHV-8 antibodies. SETTING Ambulatory or hospitalized patients from a university hospital associated with a research laboratory. PATIENTS Eighty-three patients with various non-KS dermatologic diseases and 16 patients with KS who were seronegative for the human immunodeficiency virus. Controls were 100 healthy subjects living in the same area. RESULTS Antibodies to HHV-8 were found in 100% (16/16) of the patients with KS and 3.6% (3/83) of the patients with non-KS dermatologic diseases: 1 patient with pemphigus vulgaris, 1 with discoid lupus erythematosus, and 1 with bullous pemphigoid. The prevalence of antibodies to HHV-8 in controls was 2% (2/100) and was not significantly different than the prevalence in patients with dermatologic diseases other than KS (P =.28). CONCLUSIONS Our serologic study confirms the higher prevalence of HHV-8 antibodies in patients with KS and demonstrates that contrary to other human herpesviruses, HHV-8 is not a ubiquitous virus in France. We could not determine any causal association between HHV-8 and pemphigus or lymphoproliferative disorders of the skin.
Collapse
Affiliation(s)
- N Dupin
- Department of Dermatovenereology, Hôpital Tarnier-Cochin, Paris, France
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Clément A, Fayet P, Hoeffel C, Oudjit A, Hazebroucq V, Zavarro A, Gorin I, Legmann P, Bonnin A. [Value of high-frequency (20 MHz)in the diagnosis of cutaneous tumors]. J Radiol 1998; 79:313-7. [PMID: 9757255] [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] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The purpose of the present study is to asses the value of high frequency ultrasonography (20 MHz), a new noninvasive imaging technique, in cutaneous tumors. Cutaneous tumors are clinically varied and their diagnosis is still based on histopathological analysis. 140 cutaneous tumors have been examined with US and imaging findings have been compared to the results of clinical and histological examinations. This study shows that high frequency ultrasonography, even though it cannot replace pathological analysis, may help the dermatologist in the positive diagnosis of some cutaneous tumors and in accessing the location and the in depth-extension of the lesions in the different layers of the skin.
Collapse
Affiliation(s)
- A Clément
- Service de Radiologie A, Hôpital Cochin, Paris
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Dupin N, Enjolras O, Wassef M, Gorin I, Gradadam M, Huraux JM, Agut H, Escande JP. [Absence of HHV-8 virus detected in immature hemangiomas in infants]. Ann Dermatol Venereol 1998; 125:98-9. [PMID: 9747222] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The aim of our study was to search for the presence of HHV-8 DNA sequences in Biopsy specimens from hemangioma of the infancy. MATERIAL AND METHODS The study included 9 biopsies from hemangioma. DNA of human beta-globin gene and HHV-8 were searched for by PCR using specific primers. Amplified products were revealed after an hybridization with an internal probe digoxigenin-labelled. RESULTS Human beta-globin gene could be detected in all samples illustrating the absence of PCR inhibitor. HHV-8 could never be detected in samples analyzed. DISCUSSION Our study does not imply any causative role of HHV-8 in the pathogenesis of hemangioma. This result must be confirmed by serologic studies.
Collapse
Affiliation(s)
- N Dupin
- Service de Dermato-Vénéréologie, Hôpital Tarnier-Cochin, Paris
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Pulik M, Dupin N, Gorin I. Herpesvirus-like DNA sequences in Kaposi's sarcoma lesions from two women with AIDS. Clin Infect Dis 1997; 25:740-1. [PMID: 9314474 DOI: 10.1086/516939] [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] [Indexed: 02/05/2023] Open
Affiliation(s)
- M Pulik
- Department of Hematology, Centre Hospitalier d'Argenteuil, France
| | | | | |
Collapse
|
30
|
Dupin N, Krivine A, Calvez V, Gorin I, Franck N, Escande JP. No effect of protease inhibitor on clinical and virological evolution of Castleman's disease in an HIV-1-infected patient. AIDS 1997; 11:1400-1. [PMID: 9302455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
31
|
Montero-Julian FA, Brailly H, Sautès C, Joyeux I, Dorval T, Mosseri V, Yasukawa K, Wijdenes J, Adler A, Gorin I, Fridman WH, Tartour E. Characterization of soluble gp130 released by melanoma cell lines: A polyvalent antagonist of cytokines from the interleukin 6 family. Clin Cancer Res 1997; 3:1443-51. [PMID: 9815830] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
gp130 acts as a common transducing signal chain for all receptors belonging to the interleukin (IL)-6 receptor family. The IL-6-related cytokines [IL-6, IL-11, oncostatin M (OSM), leukemia inhibitory factor, ciliary neurotrophic factor, and cardiotrophin] often modulate tumor phenotype and control the proliferation of many tumor cell lines. We demonstrate that melanoma cell lines release, in vitro and in vivo (when transplanted in nude mice), soluble gp130 (sgp130), a potential antagonist of cytokines from the IL-6 family. Biochemical analysis revealed that sgp130 derived from melanoma patients' sera or from culture supernatants of melanoma cell lines is a Mr 104,000 protein that resolved after deglycosylation as a Mr 58,000 protein. PCR and Northern blot analysis only identified one gp130 membrane mRNA, suggesting that the soluble form of gp130 is generated by proteolytic cleavage. OSM reproducibly increases sgp130 released by melanoma cell lines, whereas leukemia inhibitory factor stimulates the production of sgp130 in only one of three cell lines tested. This tumor-derived sgp130 is functional because it binds in solution to the IL-6-soluble IL-6 receptor (gp80) complex. Recombinant sgp130 inhibits the growth inhibitory activity of the IL-6-soluble IL-6 receptor complex and OSM on some melanoma cell lines. Therefore, this soluble gp130 represents a natural antagonist of cytokines from the IL-6 family.
Collapse
Affiliation(s)
- F A Montero-Julian
- Immunotech S.A., 130 Avenue de Lattre de Tassigny, BP 177 F, 13276 Marseille Cedex 09, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Mathez D, Bagnarelli P, Gorin I, Katlama C, Pialoux G, Saimot G, Tubiana P, De Truchis P, Chauvin JP, Mills R, Rode R, Clementi M, Leibowitch J. Reductions in viral load and increases in T lymphocyte numbers in treatment-naive patients with advanced HIV-1 infection treated with ritonavir, zidovudine and zalcitabine triple therapy. Antivir Ther 1997; 2:175-83. [PMID: 11322272] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
In order to test the hypothesis that a combination of protease inhibitors with nucleoside analogues-agents known to inhibit different steps of the human immunodeficiency virus (HIV) life cycle--is likely to prove more effective in reducing viral loads than either of those modalities alone, we performed a 60 week, open-label trial in 32 HIV-positive patients with depressed CD4 T lymphocyte cell counts but no active AIDS-defining illnesses. For the first 2 weeks, patients received 600 mg twice daily of liquid ritonavir, a protease inhibitor; then zidovudine 200 mg three times daily and zalcitabine 0.75 mg three times daily were added to the treatment regimen. Mononuclear blood cell fractions were analysed for infected cell levels, using a co-culture system. HIV-1 RNA in plasma was measured both by reverse transcriptase-polymerase chain reaction (RT-PCR) and reverse transcriptase quantitative PCR (QcRT-PCR); lymphocyte counts were determined by standard laboratory methods. In the 2 weeks of ritonavir therapy, both the mean count of infectious blood cells and plasma HIV RNA levels decreased dramatically. Mean CD4 cell counts increased from 173 cells/mm3 at baseline to 286 cells/mm3; CD8 cell counts rose from 951 cells/mm3 to 1,141 cells/mm3. With the introduction of the nucleoside analogues, infectious cell counts and plasma virus dropped another log unit to a nadir at 8 weeks, while CD4 T lymphocyte counts continued to rise slowly. By week 28, 12 patients had withdrawn due to adverse events, none of which were life-threatening. At week 36, infectious material could not be detected in the cells of 10 of the 17 remaining patients; by week 60, four of the seven patients with residual viraemia at week 24 had undergone viral relapse. After the introduction of a more palatable capsule formulation of ritonavir at week 52, infectious cells and plasma virus were undetectable in 50-60% of patients. The combination of protease inhibitors and nucleoside analogues significantly reduces HIV load, and in some patients may suppress viral activity for sustained periods.
Collapse
Affiliation(s)
- D Mathez
- Unite d'Immunovirologie, H pital Raymond Poincaré, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Dupin N, Franck N, Calvez V, Gorin I, Grandadam M, Huraux JM, Leibowitch M, Agut H, Escande JP. Lack of evidence of human herpesvirus 8 DNA sequences in HIV-negative patients with various lymphoproliferative disorders of the skin. Br J Dermatol 1997; 136:827-30. [PMID: 9217812 DOI: 10.1111/j.1365-2133.1997.tb03920.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [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: 02/04/2023]
Abstract
Human herpesvirus 8 (HHV-8) is a new virus which has been reported in Kaposi's sarcoma and some lymphoproliferative disorders such as Castleman's disease and body-cavity-based lymphoma. Because HHV-8 shares homology with Epstein-Barr virus (EBV), we searched for the presence of HHV-8 DNA sequences in various cutaneous T- and B-cell lymphoma by the polymerase chain reaction (PCR). Forty-seven HIV-negative patients with cutaneous lymphoma or large plaque parapsoriasis were enrolled in the study. For the detection of HHV-8 DNA sequences we used PCR followed by a hybridization with a digoxigenin-labelled probe and nested-PCR. HHV-8 DNA sequences could only be detected in a patient with large plaque parapsoriasis. Our study does not suggest any direct implication of HHV-8 in the pathogenesis of most cutaneous lymphoma. Serological studies will be helpful to appreciate if there is an epidemiological link between HHV-8 and cutaneous lymphomas.
Collapse
Affiliation(s)
- N Dupin
- Department of Dermatology, Hôpital Tarnier-Cochin, France
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Grandadam M, Dupin N, Calvez V, Gorin I, Blum L, Kernbaum S, Sicard D, Buisson Y, Agut H, Escande JP, Huraux JM. Exacerbations of clinical symptoms in human immunodeficiency virus type 1-infected patients with multicentric Castleman's disease are associated with a high increase in Kaposi's sarcoma herpesvirus DNA load in peripheral blood mononuclear cells. J Infect Dis 1997; 175:1198-201. [PMID: 9129085 DOI: 10.1086/593567] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.4] [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: 02/04/2023] Open
Abstract
The epidemiologic link between multicentric Castleman's disease (MCD) and Kaposi's sarcoma (KS) and the high frequency of KS herpesvirus (KSHV) detection in both diseases raise the question of a role of this new virus in the pathogenesis of MCD. To explore this hypothesis, the KSHV DNA load was investigated in peripheral blood mononuclear cells of 3 human immunodeficiency virus (HIV)-infected patients with MCD at different points during the clinical course. Clinical parameters, such as fever and the presence of lymphadenopathy, were systematically assessed. Hemogram and C-reactive protein level determinations were performed as standard procedures. KSHV DNA load was investigated by means of semiquantitative polymerase chain reaction assay using peripheral blood mononuclear cells of the patients. A correlation between the variation in clinical and biologic parameters related to MCD and KSHV DNA load was found, suggesting a close relationship between KSHV and MCD in HIV-1-infected patients.
Collapse
Affiliation(s)
- M Grandadam
- Laboratoire de Virologie, CNRS EP 57, Hôpital Tarnier, Paris, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Dupin N, Gorin I, Escande JP, Calvez V, Grandadam M, Huraux JM, Agut H. Lack of evidence of any association between human herpesvirus 8 and various skin tumors from both immunocompetent and immunosuppressed patients. Arch Dermatol 1997; 133:537. [PMID: 9126020 DOI: 10.1001/archderm.133.4.537] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
36
|
Raynaud F, Evain-Brion D, Gerbaud P, Marciano D, Gorin I, Liapi C, Anderson WB. Oxidative modulation of cyclic AMP-dependent protein kinase in human fibroblasts: possible role in psoriasis. Free Radic Biol Med 1997; 22:623-32. [PMID: 9013125 DOI: 10.1016/s0891-5849(96)00353-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Previous studies have established that cyclic AMP-dependent protein kinase (PKA) activity, as well as 8-azido-[32P]-cAMP binding to the RI and RII regulatory subunits, are decreased in cells from psoriatic patients compared to cells from normal patients. Here we show that the exposure of normal human dermal fibroblasts in culture to hydrogen peroxide and to oxygen free-radical generating systems decreased PKA activity, as well as cyclic AMP binding to the RI and RII regulatory subunits, to levels similar to those observed with psoriatic fibroblasts. Likewise, treatment of normal cytosolic preparations of PKA, as well as purified bovine PKA II, in vitro with free radical generating systems also resulted in decreased PKA activity and 8-azido [32P]-cAMP binding to the RI and RII regulatory subunits. Further, treatment of psoriatic fibroblasts with free radical scavenging agents such as vitamins E and C, and mannitol, and also with superoxide dismutase, restored the ability of RI and RII to bind 8-azido-[32P]-cAMP toward normal levels. Western blot analysis showed that the protein levels of the RI and RII subunits are similar in normal and psoriatic fibroblasts, and that the amounts of RI and RII are not altered by treatment of the cells with free radical-generating systems. These results suggest that oxidative modification may serve as a mechanism to alter PKA activity in human cells, and that an altered oxidative state may be involved in mediating the decrease in PKA activity and cyclic AMP binding noted in cells from psoriatic patients.
Collapse
Affiliation(s)
- F Raynaud
- Unité INSERM 427, Faculté des Sciences Pharmaceutiques et Biologiques de Paris, Université René Descartes, France
| | | | | | | | | | | | | |
Collapse
|
37
|
|
38
|
Dupin N, Gorin I, Djien V, Helal H, Zylberberg L, Leibowitch M, Escande JP. Acute generalized exanthematous pustulosis induced by terbinafine. Arch Dermatol 1996; 132:1253-4. [PMID: 8859047 DOI: 10.1001/archderm.132.10.1253] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
39
|
Tartour E, Blay JY, Dorval T, Escudier B, Mosseri V, Douillard JY, Deneux L, Gorin I, Negrier S, Mathiot C, Pouillart P, Fridman WH. Predictors of clinical response to interleukin-2--based immunotherapy in melanoma patients: a French multiinstitutional study. J Clin Oncol 1996; 14:1697-703. [PMID: 8622090 DOI: 10.1200/jco.1996.14.5.1697] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.8] [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: 01/31/2023] Open
Abstract
PURPOSE Various parameters have been reported to be correlated with response to interleukin-2 (IL-2) therapy. A multiinstitutional study was performed to assess by multivariate analysis the predictive value of known clinical and biologic melanoma prognostic markers recorded before the onset of IL-2 therapy on the likelihood of objective clinical response. PATIENTS AND METHODS Serum C-reactive protein (CRP), IL-6, and lactate dehydrogenase (LDH) levels were measured in 81 metastatic melanoma patients included in different IL-2-based regimens before the starting of IL-2-therapy. Clinically defined prognostic groups, i.e., patients with superficial or visceral metastases, were also analyzed for response correlates. Patients were evaluated for response to treatment 4 to 6 weeks after completion of one course of therapy. RESULTS On univariate analysis, the pretreatment values of CRP (P = .001), IL-6 (P = .007), and LDH (P = .02) and site of metastases (P = .0004) were correlated with clinical response. However, only CRP (P < .007) and clinically defined group (P < .004) were independent predictors on multifactorial analysis. Indeed, when adjusted to CRP, IL-6 tended to improve patient selection, but did not reach statistical significance (P = .07). Furthermore, using multivariate survival analysis based on the Cox proportional hazards model, only CRP was found to be an independent prognostic factor for survival (P < .0001). CONCLUSION In this study, patients with high serum levels of CRP and/or visceral organ involvement before therapy were unlikely to respond to IL-2 therapy. Therefore, clinical classification based on the site of metastases and serum CRP determination before the start of IL-2 therapy may help to improve selection of melanoma patients who may benefit from IL-2 and could prevent unnecessary morbidity.
Collapse
Affiliation(s)
- E Tartour
- French Cancer Centers' Immunotherapy Group, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Dupin N, Gorin I, Deleuze J, Agut H, Huraux JM, Escande JP. Herpes-like DNA sequences, AIDS-related tumors, and Castleman's disease. N Engl J Med 1995; 333:798; author reply 798-9. [PMID: 7643891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
41
|
|
42
|
Dupin N, Grandadam M, Calvez V, Gorin I, Aubin JT, Havard S, Lamy F, Leibowitch M, Huraux JM, Escande JP. Herpesvirus-like DNA sequences in patients with Mediterranean Kaposi's sarcoma. Lancet 1995; 345:761-2. [PMID: 7891488 DOI: 10.1016/s0140-6736(95)90642-8] [Citation(s) in RCA: 259] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
DNA sequences closely related to herpesvirus-like sequences have been found in AIDS-associated Kaposi's sarcoma. Using PCR, we found herpesvirus-like DNA sequences in Kaposi's lesions and normal adjacent skin in five patients with Mediterranean Kaposi's sarcoma. We did not find these sequences in tissues from patients without Kaposi's sarcoma. Semi-quantitative PCR revealed many more herpesvirus-like sequences in Kaposi's lesions than in unaffected skin. Our results reinforce the hypothesis that an infectious agent closely related to gamma-herpesvirus is implicated in the pathogenesis of Mediterranean and AIDS-associated Kaposi's sarcoma.
Collapse
Affiliation(s)
- N Dupin
- Laboratory of Virology, CNRS EP 57, Pité Salpêtrière Hospital, Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Dupin N, Grandadam M, Calvez V, Gorin I, Aubin JT, Havar S, Lamy F, Leibowitch M, Huraux JM, Escande JP, Agut H. Détection de séquences d'ADN apparentées aux virus herpès au cours de la maladie de Kaposi. Med Sci (Paris) 1995. [DOI: 10.4267/10608/2311] [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: 11/30/2022] Open
|
44
|
Bachmeyer C, Gorin I, Deleuze J, Morini JP, Escande JP. Pyrimethamine as primary prophylaxis of toxoplasmic encephalitis in patients infected with human immunodeficiency virus: open study. Clin Infect Dis 1994; 18:479-80. [PMID: 8011845 DOI: 10.1093/clinids/18.3.479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
|
45
|
Namer V, Blanche P, Salmon D, Boissonnas A, Zylberberg L, Gorin I, Escande J, Christoforov B, Sicard D. Syndrome hémolytique et urémique et infection par le VIH. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
46
|
Bachmeyer C, Grateau G, Morin C, Zylberberg L, Gorin I, Tulliez M, Lessana Leibowitch M, Escande J, Séréni D. Syndrome hémophagocytaire et infection par le VIH. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80558-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
47
|
Pretet S, Salmon D, Rousseau F, Guillon JM, Taki BE, Roux ME, Belguendouz A, Deleuze J, Morini JP, Gorin I. Long-term results of monthly inhaled pentamidine as primary prophylaxis of Pneumocystis carinii pneumonia in HIV-infected patients. Am J Med 1993; 94:35-40. [PMID: 8420298 DOI: 10.1016/0002-9343(93)90117-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE To evaluate the long-term efficacy and safety of inhaled pentamidine as primary prophylaxis against Pneumocystis carinii pneumonia (PCP) in patients infected with human immunodeficiency virus (HIV). PATIENTS Two hundred thirty-two HIV-infected patients with a CD4 cell count below 20% of the total lymphocyte count were given aerosolized pentamidine once every 4 weeks for more than 3 months. Pentamidine aerosols were administered at the hospital under medical supervision. Prevention of bronchospasm was carried out using inhaled salbutamol. RESULTS Mean duration of prophylaxis was 15.9 months. Eleven patients (4.7%; [95% confidence interval 2% to 7.4%]) developed PCP. Probability to remain free of PCP is 95.6% at 12 months, 94% at 18 months, and 88% at 24 months. Mean delay between the onset of the prophylaxis and the occurrence of PCP for the 11 patients was 12.9 months (range: 4 to 26 months). No major side effect was observed, and minor side effects (cough, acute dyspnea) were infrequent. CONCLUSION The efficacy and tolerance of aerosolized pentamidine as shown in our study support its use as primary prophylaxis against P. carinii in HIV-infected patients.
Collapse
Affiliation(s)
- S Pretet
- Department of Chest Medicine, Hôpital Cochin, Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Raynaud F, Gerbaud P, Bouloc A, Gorin I, Anderson WB, Evain-Brion D. Rapid effect of treatment of psoriatic erythrocytes with the synthetic retinoid acitretin to increase 8-azido cyclic AMP binding to the RI regulatory subunit. J Invest Dermatol 1993; 100:77-81. [PMID: 8380830 DOI: 10.1111/1523-1747.ep12354923] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [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: 01/30/2023]
Abstract
We have recently demonstrated a deficiency in the cyclic adenosine monophosphate (cAMP)-dependent protein kinases (PKA), the intracellular mediator of AMP, in psoriasis. This enzyme defect is expressed in fibroblasts and in red blood cells isolated from psoriatic patients. In these cells, the abnormality noted in cAMP binding to PKA correlates well with the severity of the disease and is corrected by long-term treatment with etretinate. In this study, we determined the effect of oral administration of acitretin in four psoriatic patients on the altered cAMP binding observed with the RI regulatory subunit of PKA in erythrocytes prepared from these patients. Acitretin (30 mg/day) induced a rapid (within 1 h) increase in the ability of the RI regulatory subunit of erythrocytes to bind the 8-azido[32P]cAMP photoaffinity analogue of cAMP. The maximal plateau for this effect of acitretin was observed within 24 h of treatment and preceded the clinical improvement of the disease. The effect of acitretin was dose-dependent, with the maximal response observed at 40 mg acitretin/d. In addition, the rapid exposure (15 min) of erythrocytes isolated from untreated patients exhibiting severe psoriasis to acitretin also promoted an increase in binding of 8-azido[32P]cAMP to the RI cAMP binding protein. Retinoic acid and 13-cis-retinoic acid were as efficient as acitretin in inducing the increase in binding of 8-azido[32P]cAMP to the RI regulatory subunit, whereas arotinoid was without effect. These results suggest that acitretin may act to modify PKA (the RI regulatory subunit) at the post-transcriptional level, and this may reflect, in part, on the mechanism of action of this synthetic retinoid. Further, monitoring this biochemical event may be helpful in determining the choice of retinoid therapy and in the management of its pharmacology.
Collapse
Affiliation(s)
- F Raynaud
- Laboratoire de Physiopathologie du Développement, CNRS-Ecole Normale Supérieure, Paris, France
| | | | | | | | | | | |
Collapse
|
49
|
Lopez M, Fechtenbaum J, David B, Martinache C, Chokri M, Canepa S, De Gramont A, Louvet C, Gorin I, Mortel O. Adoptive immunotherapy with activated macrophages grown in vitro from blood monocytes in cancer patients: a pilot study. J Immunother 1992; 11:209-17. [PMID: 1515425 DOI: 10.1097/00002371-199204000-00008] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Ninety-three collections of leucocytes by cytapheresis followed by separation of monocytes by centrifugal elutriation were undertaken in twelve metastatic cancer patients (four melanomas, six colon carcinomas, one ovarian carcinoma, and one lung cancer). The leucaphereses were performed aiming to collect a product, ready for introduction into the elutriation chamber, i.e., with low contamination by erythrocytes and granulocytes. The median collection of leucocytes was 7.3 x 10(9). After elutriation, purified monocytes (mean: 0.91 x 10(9)) were cultured with 3-5% autologous serum for 7 days in the presence of 250 IU/ml of recombinant human gamma-interferon (Rh-IFN gamma) for the last 18 h of culture. The median number of activated macrophages (MAK) available for reinfusion was 2.4 x 10(8) for each culture. The phenotypes and the antitumoral potentiality of MAK cells were documented. Reinfusions performed i.v. or i.p. were well tolerated with no major side effects. No complete tumor response was obtained. One partial response and two stabilizations of the disease were observed in one melanoma and two colon carcinomas.
Collapse
|
50
|
Abstract
Kaposi's sarcoma (KS) is very unusual in Caucasian women with AIDS. We conducted a retrospective survey of 12 female AIDS patients with KS, including 11 Caucasian women. HIV infection was thought to have been acquired after sexual contact, intravenous drug use (nine cases) or blood transfusion (three cases). In these patients KS was often the first manifestation of AIDS and showed an aggressive course. The disease was associated with a severe immunodeficiency (CD4 T lymphocyte count less than 100 x 10(6)/l in 50% of cases) and a poor prognosis. In four patients, lesions first developed on areas of sexual contact, supporting the hypothesis that KS is a sexually transmitted disease.
Collapse
Affiliation(s)
- K Lassoued
- Service d'Immunohématologie, Hôpital Saint-Louis, Paris, France
| | | | | | | | | | | |
Collapse
|