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Ramel S, Gueganton L, Nowak E, Bihan JL, Arnouat B, Belleguic C, Danner-Boucher I, Mankikian J, Payet A, Urban T, Buyse M, Hubeaux K. Sexual dysfunction in cystic fibrosis. J Cyst Fibros 2024:S1569-1993(24)00056-0. [PMID: 38688746 DOI: 10.1016/j.jcf.2024.04.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/15/2024] [Accepted: 04/20/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Sexual dysfunction (erectile dysfunction in males, sexual dissatisfaction, sexual interest/arousal disorders, and dyspareunia in females) has not been the subject of indepth research in people with cystic fibrosis (CF). This study aimed to determine the prevalence of sexual dysfunction in adults with CF, factors associated with sexual dysfunction, and the impact of sexual dysfunction on quality of life. METHOD We conducted a multicentre study in adults with cystic fibrosis followed in specialist centres in Western France. We assessed erectile dysfunction and its severity using the IIEF5 self-questionnaire (International Index of Erectile Function); the FSFI (Female Sexual Function Index) was used to assess sexual function in females, and we evaluated quality of life in both sexes using the CFQ-R14+ questionnaire. RESULTS In total, 77 males and 74 females completed the sexual function questionnaire (mean age 32+/- 10 and 25+/- 8,5 years respectively). Among them, 21 % of males and 30 % of females reported sexual dysfunction. CFQ-R14+ score was significantly lower in males with erectile dysfunction than those without (p < 0.001). Faecal incontinence was associated with more frequent sexual dysfunction in females and higher severity of erectile dysfunction in males. CONCLUSION The prevalence of sexual disorders is relatively high in males and females with cystic fibrosis. Therefore, it seems important to train specialist teams to address the issue of sexuality without embarrassment, and to encourage them to seek out and treat faecal incontinence, which is associated with greater severity or frequency of these symptoms.
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Affiliation(s)
- Sophie Ramel
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France.
| | - Laetitia Gueganton
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Emmanuel Nowak
- Direction de la Recherche Clinique et de l'Innovation (DRCI), CHU de Brest, Brest, France & Centre d'Investigation Clinique, INSERM CIC 1412, CHU de Brest, Brest, France
| | - Jean Le Bihan
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Baptiste Arnouat
- Dept of Respiratory Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Chantal Belleguic
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France
| | - Isabelle Danner-Boucher
- Service de Pneumologie, L'Institut Du Thorax, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Julie Mankikian
- Service de pneumologie et d'explorations fonctionnelles respiratoires, CHU, hôpital Bretonneau, Tours, France
| | - Annabelle Payet
- Service de Pneumologie, CHU La Réunion Site Sud Réunion, Saint Pierre, Réunion, France
| | - Thierry Urban
- Département de Pneumologie, CHU d'Angers, Angers, France
| | - Marion Buyse
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Katelyne Hubeaux
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France; Service d'explorations fonctionnelles, Fondation Ildys, Roscoff, France
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2
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Burgel PR, Paillasseur JL, Durieu I, Reynaud-Gaubert M, Hamidfar R, Murris-Espin M, Danner-Boucher I, Chiron R, Leroy S, Douvry B, Grenet D, Mely L, Ramel S, Moncouquiol S, Burnet E, Ouaalaya EH, Sogni P, Da Silva J, Martin C. Multisystemic Effects of Elexacaftor-Tezacaftor-Ivacaftor in Adults with Cystic Fibrosis and Advanced Lung Disease. Ann Am Thorac Soc 2024. [PMID: 38579175 DOI: 10.1513/annalsats.202312-1065oc] [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: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 04/07/2024] Open
Abstract
RATIONALE Limited data exist on safety and effectiveness of elexacaftor-tezacaftor-ivacaftor (ETI) in people with cystic fibrosis (pwCF) and advanced lung disease. OBJECTIVE To evaluate the effects of ETI in an unselected population of pwCF and advanced lung disease. METHODS A prospective observational study, including all adults, aged 18 years and older, with a percent predicted FEV1 (ppFEV1)≤ 40 who initiated ETI from December 2019 to June 2021 in France was conducted. PwCF were followed until August 8th, 2022. RESULTS ETI was initiated in 434 pwCF with a median [interquartile range, IQR] ppFEV1=30 [25; 35], including 27 with severe CF liver disease and 183 with diabetes. PwCF were followed for a median [IQR] 587 [396; 728] days after ETI initiation. Discontinuation of ETI occurred in 12 (2.8%) pwCF and was mostly due to lung transplantation (n=5) or death (n=4). Absolute increase in ppFEV1 by a mean +14.2% (95% CI, 13.1-15.4) occurred at 1 month and persisted throughout the study. Increase in ppFEV1 in the younger age quartile was almost twice that of the oldest quartile (P<0.001); body mass index <18.5 kg/m2 was found in 38.6% at initiation vs. 11.3% at 12 months (P=0.0001). Increase in serum concentrations of vitamin A and E, but not 25OHD3, was observed. Significant reduction in the % of pwCF using oxygen therapy, noninvasive ventilation, nutritional support, inhaled and systemic therapies (including antibiotics) were observed; insulin was discontinued in 12% of diabetics. CONCLUSION ETI is safe in pwCF and advanced lung disease with multisystem pulmonary and extrapulmonary benefits.
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Affiliation(s)
| | | | - Isabelle Durieu
- Hospices Civils de Lyon, 26900, Service de médecine interne, Pierre Bénite, Auvergne-Rhône-Alpes , France
| | | | - Rebecca Hamidfar
- Centre Hospitalier Universitaire de Grenoble-Alpes, Service Hospitalo-Universitaire de Pneumologie et Physiologie, Pôle Thorax et Vaisseaux, , La Tronche, France
| | - Marlène Murris-Espin
- Centre Hospitalier Universitaire de Toulouse, 36760, Pulmonology, Toulouse, Midi-Pyrénées, France
| | | | | | - Sylvie Leroy
- University Hospital of Nice, Service de Pneumologie, Nice, France
| | - Benoit Douvry
- Centre Hospitalier Intercommunal de Creteil, 26949, Creteil, Île-de-France, France
| | | | | | | | | | - Espérie Burnet
- Cochin hospital, APHP, Respiratory Medicine, Paris, France
| | | | | | | | - Clémence Martin
- Groupe Hospitalier Cochin-Hotel Dieu, AP-HP, Pulmonary Department and Adult CF Centre, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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Rakotoarisoa L, Weiss L, Lefebvre F, Porzio M, Renaud-Picard B, Ravoninjatovo B, Abely M, Danner-Boucher I, Dubois S, Troussier F, Prevotat A, Rault G, Kessler R, Kessler L. Early glucose abnormalities revealed by continuous glucose monitoring associate with lung function decline in cystic fibrosis: A five-year prospective study. J Diabetes Complications 2024; 38:108703. [PMID: 38430625 DOI: 10.1016/j.jdiacomp.2024.108703] [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: 05/03/2023] [Revised: 01/22/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Cystic fibrosis related diabetes (CFRD) is commonly associated with declining lung function and nutritional status. We aimed to evaluate the pulmonary impact of early glucose abnormalities by using 2-h standard oral glucose tolerance testing (OGTT) and continuous glucose monitoring (CGM) in people with cystic fibrosis (PwCF). METHODS PwCF aged ≥10 years old without known CFRD were included in a five-year prospective multicentre study. Annual evaluation of nutritional status, lung function, OGTT and CGM was set up. Associations between annual rate changes (Δ) in lung function, ΔFEV1 (forced expiratory volume in 1 s) percentage predicted (pp) and ΔFVC (forced vital capacity) pp., and annual rate changes in OGTT or CGM variables were estimated with a mixed model with a random effect for subject. RESULTS From 2009 to 2016, 112 PwCF (age: 21 ± 11 years, BMI (body mass index) z-score: -0.55 ± 1.09, FEV1pp: 77 ± 24 %, 2-h OGTT glucose: 122 ± 44 mg/dL, AUC (area under curve) >140 mg/dL: 1 mg/dL/day (0.2, 3.0) were included. A total of 428 OGTTs and 480 CGMs were collected. The participants presented annual decline of FVCpp and FEV1pp at -1.0 % per year (-1.6, -0.4), p < 0.001 and - 1.9 % per year (-2.5, -1.3), p < 0.001 respectively without change in BMI z-score during the study. Variation of two-hour OGTT glucose was not associated with declining lung function, as measured by ΔFEV1pp (p = 0.94) and ΔFVCpp (p = 0.90). Among CGM variables, only increase in AUC >140 mg/dL between two annual visits was associated with a decrease in ΔFVCpp (p < 0.05) and ΔFEV1pp (p < 0.05). CONCLUSIONS This prospective study supports the fact that early glucose abnormalities revealed by CGM predict pulmonary function decline in PwCF, while 2-h standard OGTT glucose is not associated with pulmonary impairment.
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Affiliation(s)
- Luc Rakotoarisoa
- Department of Endocrinology, Diabetes and Nutrition, Strasbourg University Hospital, France; Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; UMR Inserm 1260, Regenerative Nanomedicine, University of Strasbourg, France
| | - Laurence Weiss
- Pediatric Cystic Fibrosis Centre, Strasbourg University Hospital, France
| | - François Lefebvre
- Group of Methodology in Clinical Research (GMRC), Strasbourg University Hospital, France
| | - Michele Porzio
- Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; Department of Pneumology, Strasbourg University Hospital, France
| | - Benjamin Renaud-Picard
- Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; UMR Inserm 1260, Regenerative Nanomedicine, University of Strasbourg, France; Department of Pneumology, Strasbourg University Hospital, France
| | | | - Michel Abely
- Cystic Fibrosis Centre, Reims University Hospital Centre, France
| | | | | | | | - Anne Prevotat
- Cystic Fibrosis Centre, Lille University Hospital, France
| | - Gilles Rault
- Cystic Fibrosis Centre of Perharidy, Roscoff, France
| | - Romain Kessler
- Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; UMR Inserm 1260, Regenerative Nanomedicine, University of Strasbourg, France; Department of Pneumology, Strasbourg University Hospital, France
| | - Laurence Kessler
- Department of Endocrinology, Diabetes and Nutrition, Strasbourg University Hospital, France; Adult Cystic Fibrosis Centre, Strasbourg University Hospital, France; UMR Inserm 1260, Regenerative Nanomedicine, University of Strasbourg, France.
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4
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Hubeaux K, Gueganton L, Nowak E, Arnouat B, Belleguic C, Danner-Boucher I, Mankikian J, Payet A, Urban T, Buyse M, Ramel S. Prevalence and severity of functional urinary and anorectal disorders and their impact on quality of life in cystic fibrosis. J Cyst Fibros 2023:S1569-1993(23)01659-4. [PMID: 37907384 DOI: 10.1016/j.jcf.2023.10.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/08/2023] [Accepted: 10/14/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND In cystic fibrosis (CF), coughing is associated with a risk of pelvic floor dysfunction. However, data on the prevalence of symptoms (stress urinary incontinence, bladder overactivity, dysuria, and faecal incontinence) are lacking in males and females with CF. The impact of incontinence on adherence to respiratory care has not been studied. METHODS We conducted a multicentre study in adults with CF followed in the North-West French CF network. Urinary disorders and their severity were assessed using the Urinary Symptom Profile (USP) self-report questionnaire; the impact of urinary disorders on general quality of life was measured using the SF-Qualiveen questionnaire; faecal incontinence was assessed using the Wexner self-report questionnaire; and the CFQ-R14+ questionnaire was used to assess quality of life. A self-administered questionnaire developed for the study assessed the impact of symptoms on respiratory care. RESULTS Of the 178 people with CF included, 34 % reported stress urinary incontinence, with a large female predominance (63.5 % of females vs. 7.5 % of males), 65 % bladder overactivity (including 16 % urge incontinence) and 50 % faecal incontinence, also with a female predominance. Neither urinary nor faecal incontinence were related to the severity of the respiratory impairment (FEV1). Quality of life was particularly affected in women. Stress urinary Incontinence symptoms affected respiratory care in both sexes. CONCLUSION The prevalence of functional urinary and faecal disorders was high in adults with CF and impacted on quality of life and respiratory care. Therefore, multidisciplinary teams must have knowledge of symptoms, the diagnostic tools and management strategies to provide specific treatment.
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Affiliation(s)
- Katelyne Hubeaux
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Laetitia Gueganton
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Emmanuel Nowak
- Direction de la Recherche Clinique et de l'Innovation (DRCI), CHU de Brest, Brest, France & Centre d'Investigation Clinique, INSERM CIC 1412, CHU de Brest, Brest, France
| | - Baptiste Arnouat
- Dept of Respiratory Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Chantal Belleguic
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, Rennes F-35033, France
| | - Isabelle Danner-Boucher
- Service de Pneumologie, L'Institut Du Thorax, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Julie Mankikian
- Service de pneumologie et d'explorations fonctionnelles respiratoires, CHU, hôpital Bretonneau, Tours, France
| | - Annabelle Payet
- Service de Pneumologie, CHU La Réunion Site Sud Réunion, Saint Pierre, Réunion, France
| | - Thierry Urban
- Département de Pneumologie, CHU d'Angers, Angers, France
| | - Marion Buyse
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Sophie Ramel
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France.
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5
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Burgel PR, Sermet-Gaudelus I, Durieu I, Kanaan R, Macey J, Grenet D, Porzio M, Coolen-Allou N, Chiron R, Marguet C, Douvry B, Dufeu N, Danner-Boucher I, Foucaud P, Lemonnier L, Girodon E, Da Silva J, Martin C. The French Compassionate Program of elexacaftor-tezacaftor-ivacaftor in people with cystic fibrosis with advanced lung disease and no F508del CFTR variant. Eur Respir J 2023:2202437. [PMID: 36796836 DOI: 10.1183/13993003.02437-2022] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The European Medicines Agency has approved the cystic fibrosis transmembrane conductance regulator (CFTR) modulator combination elexacaftor-tezacaftor-ivacaftor (ETI) for people with cystic fibrosis (pwCF) carrying at least one F508del variant. The United States Food and Drug Administration (FDA) also approved ETI for pwCF carrying one of 177 rare variants. METHODS An observational study was conducted to evaluate the effectiveness of ETI in pwCF with advanced lung disease that were not eligible to ETI in Europe. All patients with no F508del variant and advanced lung disease (defined as having a percent predicted forced expiratory volume (ppFEV1)<40 and/or being under evaluation for lung transplantation) and enrolled in the French Compassionate Program initiated ETI at recommended doses. Effectiveness was evaluated by a centralized adjudication committee at 4-6 weeks in terms of clinical manifestations, sweat chloride concentration and ppFEV1. RESULTS Among the first 84 pwCF included in the program, ETI was effective in 45 (54%) and 39 (46%) were considered to be non-responders. Among the responders 22/45 (49%) carried a CFTR variant that is not currently approved by FDA for ETI eligibility. Important clinical benefits, including suspending the indication for lung transplantation, a significant decrease in sweat chloride concentration by a median [IQR] -30 [-14;-43]mmol·l-1 (n=42; p<0.0001) and an improvement in ppFEV1 by+10.0 [6.0; 20.5] (n=44, p<0.0001), were observed in those for whom treatment was effective. CONCLUSION Clinical benefits were observed in a large subset of pwCF with advanced lung disease and CFTR variants not currently approved for ETI.
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Affiliation(s)
- Pierre-Régis Burgel
- Université Paris-Cité, Institut Cochin, Inserm U1016, Paris, France
- Respiratory Medicine and Cystic Fibrosis National Reference Center; Cochin Hospital; Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF network, Frankfurt, Germany
| | - Isabelle Sermet-Gaudelus
- ERN-Lung CF network, Frankfurt, Germany
- Centre de de Référence Maladies Rares, Mucoviscidose et affections liées à CFTR, Pneumologie Pédiatrique et Allergologie, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris-Cité, Institut Necker Enfants Malades, INSERM U1151, Paris, France
| | - Isabelle Durieu
- ERN-Lung CF network, Frankfurt, Germany
- Centre de référence Adulte de la Mucoviscidose, Service de médecine interne, Hospices civils de Lyon, Pierre Bénite, France
- Université de Lyon, Équipe d'Accueil Health Services and Performance Research (HESPER) 7425, Lyon, France
| | - Reem Kanaan
- Respiratory Medicine and Cystic Fibrosis National Reference Center; Cochin Hospital; Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF network, Frankfurt, Germany
| | - Julie Macey
- Respiratory Medicine and Cystic Fibrosis Center, CHU de Bordeaux, Bordeaux, France
| | - Dominique Grenet
- CRCM - Centre de Transplantation Pulmonaire. Service de pneumologie, hôpital Foch, Suresnes, France
| | - Michele Porzio
- Department of Respiratory Medicine and Cystic Fibrosis Center, Federation of Translational Medicine of Strasbourg (FMTS), University Hospitals, Strasbourg, France
| | | | - Raphael Chiron
- Cystic Fibrosis Center, Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Christophe Marguet
- Pediatric Respiratory Disease and Cystic Fibrosis Center, Hospital, UNIROUEN, Inserm EA 2656, Rouen University Hospital, Normandie Univ, Rouen, France
| | - Benoit Douvry
- Service de Pneumologie, Centre Hospitalier Intercommunal, FHU SENEC, Créteil, France
| | - Nadine Dufeu
- Department of Respiratory Medicine and Lung Transplantation, Aix Marseille Univ, APHM, Hôpital Nord, Marseille, France
| | | | | | | | - Emmanuelle Girodon
- APHP.Centre-Université de Paris Cité, Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, Paris, France
| | - Jennifer Da Silva
- Respiratory Medicine and Cystic Fibrosis National Reference Center; Cochin Hospital; Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF network, Frankfurt, Germany
| | - Clémence Martin
- Université Paris-Cité, Institut Cochin, Inserm U1016, Paris, France
- Respiratory Medicine and Cystic Fibrosis National Reference Center; Cochin Hospital; Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF network, Frankfurt, Germany
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6
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Corvol H, de Miranda S, Dehillotte C, Lemonnier L, Chiron R, Danner-Boucher I, Hamidfar R, Houdouin V, Macey J, Marguet C, Murris-Espin M, Reynaud Q, Reix P, Gaubert MR, Kemgang A, Burgel PR. Cumulative Incidence and Risk Factors for Severe COVID-19 in French People with Cystic Fibrosis. Clin Infect Dis 2022; 75:2135-2144. [PMID: 35475917 PMCID: PMC9129125 DOI: 10.1093/cid/ciac333] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are closely monitored in people with cystic fibrosis (pwCF), with a special emphasis on severe cases. Previous studies used hospitalization rates as proxy for severity. Methods We evaluated data from coronavirus disease 2019 (COVID-19) cases diagnosed in French pwCF followed in one of the 47 French CF center over the first year of the pandemic. Objective criteria were applied for defining severity (e.g., respiratory failure and/or death). Data were compared to those from all French pwCF using the French CF Registry. Results As of April 30, 2021, 223 pwCF were diagnosed with COVID-19, with higher risks in adults (≥18 years, odds ratio [OR] = 2.52, 95% confidence interval [CI] = 1.82-3.48) and post-transplant individuals (OR = 2.68, 95% CI = 1.98-3.63). Sixty (26.9%) patients were hospitalized, with an increased risk in post-transplant individuals (OR = 4.74, 95% CI = 2.49-9.02). In 34 (15%) cases, COVID-19 was considered severe; 28/60 (46.7%) hospitalizations occurred in patients without objective criteria of severity. Severe cases occurred mostly in adults (85.3%) and post-transplant pwCF (61.8%, OR = 6.02, 95% CI = 2.77-13.06). In non-transplanted pwCF, risk factors for severity included low lung function (median ppFEV1 54.6% vs. 75.1%, OR = 1.04, 95% CI = 1.01-1.08) and CF-associated diabetes (OR = 3.26, 95% CI = 1.02-10.4). While most cases recovered without sequelae (n = 204, 91.5%), 16 (13%) were followed for possible sequelae, and three post-transplant females died. Conclusions Severe COVID-19 cases occurred infrequently during the first year of the pandemic in French pwCF. Non-transplanted adults with severe respiratory disease or diabetes and post-transplant individuals were at risk for severe COVID-19. Thus, specific preventive measures should be proposed.
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Affiliation(s)
- Harriet Corvol
- Pediatric Respiratory Department and Pediatric CF Center, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Paris, France.,Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Sandra de Miranda
- Pulmonology Department and CF Center, Hôpital Foch, Suresnes, France
| | | | | | - Raphael Chiron
- CF Center, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Montpellier, France
| | - Isabelle Danner-Boucher
- Pulmonology Department and Adult CF Center, Institut du Thorax, CHU de Nantes, Nantes, France
| | | | - Véronique Houdouin
- Pediatric Pulmonology Department and Pediatric CF Center, APHP, Hôpital Robert Debré, Paris, France
| | - Julie Macey
- Respiratory Medicine and CF Center, CHU de Bordeaux, Bordeaux, France
| | - Christophe Marguet
- Pediatric Respiratory Disease and CF Center, CIC Inserm 1404, Inserm U3111, FHU RESPIR, Rouen University Hospital, Rouen, France
| | - Marlène Murris-Espin
- CF Center and Service de Pneumologie Pôle des Voies Respiratoires, CHU de Toulouse, Toulouse, France
| | - Quitterie Reynaud
- Internal Medicine Department and adult CF center, Hospices Civils de Lyon, Research on Healthcare Performance (RESHAPE), INSERM U1290, Université de Lyon, Lyon, France.,ERN-Lung CF Network, Frankfurt, Germany
| | - Philippe Reix
- Pediatric CF Center, Hospices Civils de Lyon, UMR 5558 CNRS Equipe EMET, Université Claude Bernard Lyon 1, Lyon, France
| | - Martine Reynaud Gaubert
- Respiratory Medicine and adult CF center, Assistance Publique Hôpitaux de Marseille, Aix-Marseille Université UM63, Institut de Recherche pour le Développement, Marseille, France
| | - Astrid Kemgang
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Pierre-Régis Burgel
- Respiratory Medicine and National Reference CF Center, AP-HP, Hôpital Cochin, Paris, France.,Université de Paris, Institut Cochin, Inserm U-1016, Paris, France.,ERN-Lung CF Network, Frankfurt, Germany
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7
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Dauriat G, Beaumont L, Renaud-Picard B, Salpin M, Coiffard B, Danner-Boucher I, Leborgne A, Feuillet S, Penhouet M, Reynaud-Gaubert M, Gallais F, Messika J, Roux A, Pavec JL. SARS‐CoV‐2 Vaccine Response in Lung Transplant Recipients: A French Multicenter Study. J Heart Lung Transplant 2022. [PMCID: PMC8988560 DOI: 10.1016/j.healun.2022.01.258] [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] [Indexed: 11/18/2022] Open
Abstract
Purpose Many scientific societies recommend SARS‐CoV‐2 vaccination for solid-organ transplant recipients. The immunogenicity of two or three vaccine doses in lung transplant (LTx) recipients is unclear. The aim of this study was to evaluate the humoral response to the vaccine in LTx and heart-lung transplant (HLTx) recipients. Methods We conducted a prospective study of LTx and HLTx recipients at seven centers in France. Anti-spike-protein antibody titers after two or three SARS‐CoV‐2 vaccine injections were measured. Results We studied 2186 patients (1091 [51%] males) with a median age of 49 [45-55] years. Double LTx was performed in 1792 (82%) patients. The main reasons for LTx were chronic obstructive pulmonary disease (n=656, 30%), fibrosis (n=459, 21%), and cystic fibrosis (n=350, 16 %). Median time from LTx to vaccination was 59 [29-108] months and mean time from the last vaccine dose to serological testing was 3 months [1.5-3.8]. We used WHO definitions to classify antibody titers as negative (<. 30 BAU/mL), suboptimal (30-260 BAU/mL), or protective (> 260 BAU/mL). Of the first 1081 patients, 270 (25%) were partially vaccinated and 649 (60%) fully vaccinated (three doses or history of COVID-19 then two doses); Among these patients,133 (12%) were infected by covid. Of the 649 fully vaccinated patients, 461 (71%), 84 (13%), and 97 (15%) had negative, suboptimal, and protective antibody titers, respectively. The proportion of patients with protective titers was 8% vs. 18% in patients vaccinated within 5 years vs. 5 or more years after LTx, respectively. Among covid-infected patients, 48% developed a protective rate, whether fully or partially vaccinated. Conclusion LTx recipients usually fail to develop protective antibody titers in response to SARS-CoV-2 vaccination. Once further data are collected, we will seek to identify risk factors for a poor antibody response.
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8
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Delbove A, Senage T, Gazengel P, Tissot A, Lacoste P, Cellerin L, Perigaud C, Danner-Boucher I, Cavailles A, Lepoivre T, Mugniot A, Nicolet J, Horeau-Langlard D, Groleau N, Fedun Y, Rozec B, Magnan A, Roussel JC, Blanc FX. Incidence and risk factors of anastomotic complications after lung transplantation. Ther Adv Respir Dis 2022; 16:17534666221110354. [PMID: 35894432 PMCID: PMC9340386 DOI: 10.1177/17534666221110354] [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] [Indexed: 11/30/2022] Open
Abstract
Background: Anastomotic complications are common after lung transplantation (1.4–33% of
cases) and still associated with a high morbi-mortality. Methods: The current study is a monocenter retrospective analysis of symptomatic
anastomotic complications (SAC) occurring after lung transplantation between
2010 and 2016, using the macroscopic, diameter, and suture (M-D-S)
classification from consensus of French experts in bronchoscopy. The
objectives were to determine incidence from surgery, risk factors, and
impact of survival of SAC. We defined SAC as M-D-S abnormalities
(stenosis ⩾ 50% or dehiscence) requiring bronchoscopic or surgical
interventions. Results: A total of 121 patients were included. SAC occurred in 26.5% of patients
(n = 32), divided in symptomatic stenosis for 23.7%
(n = 29), and symptomatic dehiscence in 2.5%
(n = 3). In multivariate analysis, donor bacterial lung
infection [HR 2.08 (1.04–4.17), p = 0.04] and age above
50 years [HR 3.26 (1.04–10.26), p = 0.04] were associated
with SAC occurrence. Cystic fibrosis etiology was associated with better
survival on Kaplan–Meier curve (p < 0.001). SAC [HR 2.15
(1.07–4.32), p = 0.03] was independently associated with
worst survival. The 29 symptomatic patients because of stenosis required
endoscopic procedure, of whom 16 patients needed bronchial stent placement.
Four patients underwent surgery: three patients because of dehiscence and
one because of severe bilateral stenosis (re-transplantation). Discussion: SAC occurred in 26.5% of patients. Donor lung infection was the only
alterable identified factors. The increase rate of SAC in older patients
above 50 years of age encourages in regular endoscopic monitoring.
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Affiliation(s)
- Agathe Delbove
- Service de Pneumologie, L'institut du thorax, Boulevard Jacques Monod, CHU Nantes, hôpital G. et R. Laennec, 44 093 Nantes cedex 1, France.,Current address: Service de Réanimation polyvalente, Centre Hospitalier Bretagne Atlantique, 20, Boulevard du Général Maurice Guillaudot, 56 017 Vannes Cedex, France
| | - Thomas Senage
- Service de chirurgie thoracique et cardiovasculaire, CHU Nantes, Nantes, France.,INSERM UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Pierre Gazengel
- Service de pneumologie, l'institut du thorax, CHU Nantes, Nantes, France.,Service de transplantation, Clinique chirurgicale Marie Lannelongue, Le Plessis Robinson, France
| | - Adrien Tissot
- Service de pneumologie, l'institut du thorax, CHU Nantes, Nantes, France
| | - Philippe Lacoste
- Service de chirurgie thoracique et cardiovasculaire, CHU Nantes, Nantes, France
| | - Laurent Cellerin
- Service de pneumologie, l'institut du thorax, CHU Nantes, Nantes, France
| | - Christian Perigaud
- Service de chirurgie thoracique et cardiovasculaire, CHU Nantes, Nantes, France
| | | | - Arnaud Cavailles
- Service de pneumologie, l'institut du thorax, CHU Nantes, Nantes, France
| | - Thierry Lepoivre
- INSERM UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Antoine Mugniot
- Service de chirurgie thoracique et cardiovasculaire, CHU Nantes, Nantes, France
| | - Johanna Nicolet
- Service de réanimation chirurgicale thoracique et cardiovasculaire, CHU Nantes, Nantes, France
| | | | - Nicolas Groleau
- Service de réanimation chirurgicale thoracique et cardiovasculaire, CHU Nantes, Nantes, France
| | - Yannick Fedun
- Service de réanimation polyvalente, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Bertrand Rozec
- Service de réanimation chirurgicale thoracique et cardiovasculaire, CHU Nantes, Nantes, France
| | - Antoine Magnan
- Service de pneumologie, l'institut du thorax, CHU Nantes, Nantes, France.,Service de Pneumologie, Hôpital Foch, Suresnes, France
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9
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Meijer L, Hery-Arnaud G, Leven C, Nowak E, Hillion S, Renaudineau Y, Durieu I, Chiron R, Prevotat A, Fajac I, Hubert D, Murris-Espin M, Huge S, Danner-Boucher I, Ravoninjatovo B, Leroy S, Macey J, Urban T, Rault G, Mottier D, Berre RL. Safety and pharmacokinetics of Roscovitine (Seliciclib) in cystic fibrosis patients chronically infected with Pseudomonas aeruginosa, a randomized, placebo-controlled study. J Cyst Fibros 2021; 21:529-536. [PMID: 34961705 DOI: 10.1016/j.jcf.2021.10.013] [Citation(s) in RCA: 3] [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: 07/14/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND The orally available kinase inhibitor R-roscovitine has undergone clinical trials against various cancers and is currently under clinical evaluation against Cushing disease and rheumatoid arthritis. Roscovitine displays biological properties suggesting potential benefits in CF: it partially corrects F508del-CFTR trafficking, stimulates the bactericidal properties of CF alveolar macrophages, and displays anti-inflammatory properties and analgesic effects. METHODS A phase 2 trial study (ROSCO-CF) was launched to evaluate the safety and effects of roscovitine in Pseudomonas aeruginosa infected adult CF patients carrying two CF causing mutations (at least one F508del-CFTR mutation) and harboring a FEV1 ≥40%. ROSCO-CF was a multicenter, double-blind, placebo-controlled, dose-ranging study (200, 400, 800 mg roscovitine, orally administered daily for 4 days/week/4 weeks). RESULTS Among the 34 volunteers enrolled, randomization assigned 11/8/8/7 to receive the 0 (placebo)/ 200/400/800 mg roscovitine doses, respectively. In these subjects with polypharmacy, roscovitine was relatively safe and well-tolerated, with no significant adverse effects (AEs) other than five serious AEs (SAEs) possibly related to roscovitine. Pharmacokinetics of roscovitine were rather variable among subjects. No significant efficacy, at the levels of inflammation, infection, spirometry, sweat chloride, pain and quality of life, was detected in roscovitine-treated groups compared to the placebo-treated group. CONCLUSION Roscovitine was relatively safe and well-tolerated in CF patients especially at the 200 and 400 mg doses. However, there were 5 subject withdrawals due to SAEs in the roscovitine group and none in the placebo group. The lack of evidence for efficacy of roscovitine (despite encouraging cellular and animal results) may be due to high pharmacokinetics variability, short duration of treatment, and/or inappropriate dosing protocol.
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Affiliation(s)
- Laurent Meijer
- ManRos Therapeutics, Presqu'île de Perharidy, Roscoff 29680, France.
| | - Geneviève Hery-Arnaud
- Unité de Bactériologie, Hôpital de la Cavale Blanche, CHRU Brest, Brest cedex 29609, France; Univ Brest, Inserm, EFS, UMR 1078, GGB, Brest 29200, France
| | - Cyril Leven
- Département de Biochimie et Pharmaco-Toxicologie, CHRU Brest, Brest cedex 29609, France; Univ Brest, EA 3878, GETBO, Brest 29200, France
| | - Emmanuel Nowak
- INSERM CIC 1412, Brest University Hospital, Brest cedex 29609, France
| | - Sophie Hillion
- Laboratoire d'Immunologie et Immunothérapie, CHRU de Brest, INSERM U1227, 2 avenue Foch, BP824, 29609 Brest cedex, France
| | - Yves Renaudineau
- Laboratoire d'Immunologie et Immunothérapie, CHRU de Brest, INSERM U1227, 2 avenue Foch, BP824, 29609 Brest cedex, France
| | - Isabelle Durieu
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Claude Bernard Lyon 1 University, 8 Avenue Rockefeller, 69003 Lyon, France; Department of Internal Medicine, Cystic Fibrosis Center, Hospices Civils de Lyon, Pierre-Bénite 69495, France
| | - Raphaël Chiron
- CHU Montpellier, Maladies Respiratoires, Hôpital Arnaud de Villeneuve, 371, avenue du Doyen Gaston Giraud, Montpellier 34295, France
| | - Anne Prevotat
- Service de pneumologie, CHR - Hôpital Calmette, Boulevard du Pr. Leclercq, Lille 59037, France
| | - Isabelle Fajac
- APHP.Centre - Université de Paris, 27 rue du Faubourg Saint-Jacques, Paris 75014, France
| | - Dominique Hubert
- APHP.Centre - Université de Paris, 27 rue du Faubourg Saint-Jacques, Paris 75014, France
| | - Marlène Murris-Espin
- CHU Toulouse, CRCM adulte, Service de Pneumologie, Clinique des Voies Respiratoires. Hôpital Larrey, 24 chemin de Pouvourville, Toulouse 31059, France
| | - Sandrine Huge
- Centre Hospitalier Bretagne Atlantique, CRCM Mixte 56, 20 Boulevard du général Maurice Guillaudot, Vannes cedex 56017, France
| | - Isabelle Danner-Boucher
- CHU de Nantes, Service de Pneumologie, Hôpital Nord Laennec, Boulevard Jacques-Monod, Nantes 44093, Saint-Herblain, France
| | - Bruno Ravoninjatovo
- Centre de Ressources et de Compétences de la Mucoviscidose, Maladies Respiratoires et Allergiques, Hôpital Maison Blanche - CHU Reims, 45 rue Cognacq-Jay, 51100 Reims, France
| | - Sylvie Leroy
- CHU de Nice, Hôpital Pasteur, Service de Pneumologie, Oncologie Thoracique et Soins Intensifs Respiratoires, 30 Voie Romaine, CS 51069, Nice cedex 1 06001, France
| | - Julie Macey
- CHU Bordeaux, Hôpital Haut-Lévêque, Service de Pneumologie, Avenue de Magellan, Pessac cedex 33604, France
| | - Thierry Urban
- Département de Pneumologie, CHU Angers, Site de Larrey, 4 rue de Larrey, Angers cedex 49933, France
| | - Gilles Rault
- Fondation Ildys, Centre de Perharidy, Roscoff cedex 29684, France
| | - Dominique Mottier
- Département de Biochimie et Pharmaco-Toxicologie, CHRU Brest, Brest cedex 29609, France
| | - Rozenn Le Berre
- Univ Brest, Inserm, EFS, UMR 1078, GGB, Brest 29200, France; Département de Médecine Interne et Pneumologie, CHRU Brest, Brest cedex 29609, France
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10
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Burgel PR, Durieu I, Chiron R, Ramel S, Danner-Boucher I, Prevotat A, Grenet D, Marguet C, Reynaud-Gaubert M, Macey J, Mely L, Fanton A, Quetant S, Lemonnier L, Paillasseur JL, Da Silva J, Martin C. Rapid Improvement after Starting Elexacaftor-Tezacaftor-Ivacaftor in Patients with Cystic Fibrosis and Advanced Pulmonary Disease. Am J Respir Crit Care Med 2021; 204:64-73. [PMID: 33600738 DOI: 10.1164/rccm.202011-4153oc] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Elexacaftor-tezacaftor-ivacaftor is a CFTR (cystic fibrosis [CF] transmembrane conductance regulator) modulator combination, developed for patients with CF with at least one Phe508del mutation. Objectives: To evaluate the effects of elexacaftor-tezacaftor- ivacaftor in patients with CF and advanced respiratory disease. Methods: A prospective observational study, including all patients aged ⩾12 years and with a percent-predicted FEV1 (ppFEV1) <40 who initiated elexacaftor-tezacaftor-ivacaftor from December 2019 to August 2020 in France was conducted. Clinical characteristics were collected at initiation and at 1 and 3 months. Safety and effectiveness were evaluated by September 2020. National-level transplantation and mortality figures for 2020 were obtained from the French CF and transplant centers and registries. Measurements and Main Results: Elexacaftor-tezacaftor- ivacaftor was initiated in 245 patients with a median (interquartile range) ppFEV1 = 29 (24-34). The mean (95% confidence interval) absolute increase in the ppFEV1 was +15.1 (+13.8 to +16.4; P < 0.0001), and the mean (95% confidence interval) in weight was +4.2 kg (+3.9 to +4.6; P < 0.0001). The number of patients requiring long-term oxygen, noninvasive ventilation, and/or enteral tube feeding decreased by 50%, 30%, and 50%, respectively (P < 0.01). Although 16 patients were on the transplant waiting list and 37 were undergoing transplantation evaluation at treatment initiation, only 2 received a transplant, and 1 died. By September 2020, only five patients were still on the transplantation path. Compared with the previous 2 years, a twofold decrease in the number of lung transplantations in patients with CF was observed in 2020, whereas the number of deaths without transplantation remained stable. Conclusions: In patients with advanced disease, elexacaftor-tezacaftor-ivacaftor is associated with rapid clinical improvement, often leading to the indication for lung transplantation being suspended.
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Affiliation(s)
- Pierre-Régis Burgel
- Université de Paris, Institut Cochin, Unité 1016, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Respiratory Medicine and Cystic Fibrosis National Reference Center, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Cystic Fibrosis Network, European Reference Network on Rare Respiratory Diseases, Frankfurt, Germany
| | - Isabelle Durieu
- Cystic Fibrosis Network, European Reference Network on Rare Respiratory Diseases, Frankfurt, Germany.,Centre de Référence Adulte de la Mucoviscidose, Service de Médecine Interne, Hospices Civils de Lyon, Pierre Bénite, France.,Équipe d'Accueil 7425, Services de Santé et Recherche sur le Rendement, Université de Lyon, Lyon, France
| | - Raphaël Chiron
- Centre de Mucoviscidose, Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Sophie Ramel
- Centre de Ressources et de Compétences de la Mucoviscidose, Fondation Ildys, Roscoff, France
| | - Isabelle Danner-Boucher
- Service de Pneumologie, L'Institut Du Thorax, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Anne Prevotat
- Centre de Mucoviscidose, Service de Pneumologie et Immuno-allergologie, Hôpital Calmette, Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, France
| | | | - Christophe Marguet
- Centre des Maladies Respiratoires Pédiatriques et de la Mucoviscidose, Hospitalier Universitaire de Rouen Normandie, Université de Rouen Normandie, Équipe d'Accueil 2656, Institut National de la Santé et de la Recherche Médicale, Rouen, France
| | - Martine Reynaud-Gaubert
- Department of Respiratory Medicine and Lung Transplantation, Nord Hospital, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Julie Macey
- Respiratory Medicine and Cystic Fibrosis Center, University Hospital Center of Bordeaux, Bordeaux, France
| | - Laurent Mely
- Cystic Fibrosis Center, Renée Sabran Hospital, Giens, France
| | - Annlyse Fanton
- Cystic Fibrosis Resource and Competence Center for Adults, Department of Pulmonary Medicine, Dijon University Hospital, France
| | - Sébastien Quetant
- Service Hospitalo-Universitaire de Pneumologie et Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire de Grenoble-Alpes, La Tronche, France
| | | | | | - Jennifer Da Silva
- Université de Paris, Institut Cochin, Unité 1016, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Cystic Fibrosis Network, European Reference Network on Rare Respiratory Diseases, Frankfurt, Germany.,Unité de Recherche Clinique, Centre d'Investigation Clinique Paris Descartes Necker-Cochin, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Clémence Martin
- Université de Paris, Institut Cochin, Unité 1016, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Respiratory Medicine and Cystic Fibrosis National Reference Center, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Cystic Fibrosis Network, European Reference Network on Rare Respiratory Diseases, Frankfurt, Germany
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11
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Lavergne RA, Morio F, Danner-Boucher I, Horeau-Langlard D, David V, Hagen F, Meis JF, Le Pape P. One year prospective survey of azole resistance in Aspergillus fumigatus at a French cystic fibrosis reference centre: prevalence and mechanisms of resistance. J Antimicrob Chemother 2020; 74:1884-1889. [PMID: 31038164 DOI: 10.1093/jac/dkz144] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/12/2019] [Accepted: 03/08/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Studies on Aspergillus fumigatus azole resistance in cystic fibrosis patients are scarce despite the fact that it is the most frequently isolated fungus from respiratory samples from these individuals. OBJECTIVES To evaluate resistance prevalence, investigate mechanisms of resistance and explore the relationship between resistant isolates by genotyping. METHODS We conducted a prospective 1 year study (from 1 January to 31 December 2015), based on the investigation of up to five colonies per sample from cystic fibrosis patients. RESULTS Twenty-three (6.5%) isolates among the 355 tested were resistant to at least one triazole drug, using the EUCAST reference method, leading to a prevalence of 6.8% (6/88 patients). Analysis of resistance mechanisms highlighted TR34/L98H (n = 10), TR46/Y121F/T289A (n = 1), WT cyp51A (n = 11) and F46Y/M172V/N248T/D255E/E427K (n = 1). No genotype was shared between patients. CONCLUSIONS This study showed a relatively stable resistance prevalence in comparison with the previous study conducted in 2010-11 (8%), although resistance mechanisms varied between the two studies.
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Affiliation(s)
- R-A Lavergne
- Parasitology and Medical Mycology Laboratory, Nantes University Hospital, Nantes, France.,Parasitology and Medical Mycology Department, Nantes University, Nantes Atlantique Universities, EA1155-IICiMed, Institut de Recherche en Santé 2, Nantes, France
| | - F Morio
- Parasitology and Medical Mycology Laboratory, Nantes University Hospital, Nantes, France.,Parasitology and Medical Mycology Department, Nantes University, Nantes Atlantique Universities, EA1155-IICiMed, Institut de Recherche en Santé 2, Nantes, France
| | - I Danner-Boucher
- Department of Pulmonology, Cystic Fibrosis Reference Centre, Nantes University Hospital, Nantes, France
| | - D Horeau-Langlard
- Department of Pulmonology, Cystic Fibrosis Reference Centre, Nantes University Hospital, Nantes, France
| | - V David
- Department of Paediatrics, Nantes University Hospital, Nantes, France
| | - F Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - J F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - P Le Pape
- Parasitology and Medical Mycology Laboratory, Nantes University Hospital, Nantes, France.,Parasitology and Medical Mycology Department, Nantes University, Nantes Atlantique Universities, EA1155-IICiMed, Institut de Recherche en Santé 2, Nantes, France
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Burgel PR, Munck A, Durieu I, Chiron R, Mely L, Prevotat A, Murris-Espin M, Porzio M, Abely M, Reix P, Marguet C, Macey J, Sermet-Gaudelus I, Corvol H, Bui S, Lemonnier L, Dehillotte C, Da Silva J, Paillasseur JL, Hubert D, Mounard J, Poulet C, Rames C, Person C, Troussier F, Urban T, Dalphin ML, Dalphin JC, Pernet D, Richaud-Thiriez B, Bui S, Fayon M, Macey-Caro J, Campbell K, Laurans M, Borderon C, Heraud MC, Labbé A, Montcouquiol S, Bassinet L, Remus N, Fanton A, Houzel-Charavel A, Huet F, Perez-Martin S, Boldron-Ghaddar A, Scalbert M, Mely L, Camara B, Llerena C, Pin I, Quétant S, Cottereau A, Deschildre A, Gicquello A, Perez T, Stervinou-Wemeau L, Thumerelle C, Wallaert B, Wizla N, Languepin J, Ménétrey C, Dupuy-Grasset M, Bazus L, Buchs C, Jubin V, Werck-Gallois MC, Mainguy C, Perrin T, Reix P, Toutain-Rigolet A, Durieu I, Durupt S, Reynaud Q, Nove-Josserand R, Baravalle-Einaudi M, Coltey B, Dufeu N, Dubus JC, Stremler N, Caimmi D, Chiron R, Billon Y, Derelle J, Kieffer S, Pichon AS, Schweitzer C, Tatopoulos A, Abbes S, Bihouée T, Danner-Boucher I, David V, Haloun A, Tissot A, Leroy S, Bailly-Piccini C, Clément A, Corvol H, Tamalet A, Burgel PR, Honoré I, Hubert D, Kanaan R, Martin C, Bailly C, Chédevergne F, De Blic J, Fauroux B, Le Bourgeois M, Sermet-Gaudelus I, Delaisi B, Gérardin M, Munck A, Abély M, Ravoninjatovo B, Belleguic C, Desrues B, Brinchault G, Dagorne M, Deneuville E, Lefeuvre S, Dirou A, Le Bihan J, Ramel S, Dominique S, Marguet C, Payet A, Kessler R, Porzio M, Rosner V, Weiss L, de Miranda S, Grenet D, Hamid A, Picard C, Brémont F, Didier A, Labouret G, Mittaine M, Murris-Espin M, Têtu L, Cosson L, Giraut C, Henriet AC, Mankikian J, Marchand S, Hugé S, Storni V, Coirier-Duet E. Real-Life Safety and Effectiveness of Lumacaftor–Ivacaftor in Patients with Cystic Fibrosis. Am J Respir Crit Care Med 2020; 201:188-197. [DOI: 10.1164/rccm.201906-1227oc] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Pierre-Régis Burgel
- Université de Paris, Institut Cochin, INSERM U1016, Paris, France
- Respiratory Medicine and National Reference Cystic Fibrosis Reference Center, Cochin Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF Network
| | - Anne Munck
- Hôpital Robert Debré, AP-HP, Paris, France
| | - Isabelle Durieu
- ERN-Lung CF Network
- Centre de Référence Adulte de la Mucoviscidose, Service de Médecine Interne, Hospices Civils de Lyon, Pierre Bénite, France
- Université de Lyon, Équipe d’Accueil Health Services and Performance Research (HESPER) 7425, Lyon, France
| | - Raphaël Chiron
- Cystic Fibrosis Center, Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, Montpellier, France
| | - Laurent Mely
- Hôpital Renée Sabran, Cystic Fibrosis Center, Giens, France
| | - Anne Prevotat
- CHU-Lille, Cystic Fibrosis Center, Service de Pneumologie et Immuno-allergologie, Hôpital Calmette and Université de Lille, Lille, France
| | - Marlene Murris-Espin
- Cystic Fibrosis Center, Service de Pneumologie, Pôle des Voies Respiratoires, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Michele Porzio
- Department of Respiratory Medicine and Cystic Fibrosis Center, Federation of Translational Medicine of Strasbourg, University Hospitals, Strasbourg, France
| | - Michel Abely
- Department of Pediatrics A and Cystic Fibrosis Center, American Memorial Hospital, Reims, France
| | - Philippe Reix
- UMR 5558 CNRS, Equipe EMET, Université Claude Bernard Lyon 1, Lyon, France
- Cystic Fibrosis Center, Hospices Civils de Lyon, Lyon, France
| | - Christophe Marguet
- Pediatric Respiratory Disease and Cystic Fibrosis Center, Hospital, UNIROUEN, INSERM EA 2656, Rouen University Hospital, Université de Normandie, Rouen, France
| | - Julie Macey
- Respiratory Medicine and Cystic Fibrosis Center, CHU de Bordeaux, Bordeaux, France
| | - Isabelle Sermet-Gaudelus
- ERN-Lung CF Network
- Pediatric Respiratory Disease and Cystic Fibrosis Center, National Reference Cystic Fibrosis Reference Center, Hôpital Necker Enfants Malades, Paris France
- INSERM U 1151, Institut Necker Enfants Malades, Paris, France
| | - Harriet Corvol
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
- Pediatric Respiratory Disease and Cystic Fibrosis Center, Hôpital Trousseau, AP-HP, Paris, France
| | - Stéphanie Bui
- Pediatric Respiratory Disease and Cystic Fibrosis Center and CIC 1401, CHU de Bordeaux, Bordeaux, France
| | | | | | - Jennifer Da Silva
- Université de Paris, Institut Cochin, INSERM U1016, Paris, France
- ERN-Lung CF Network
- URC-CIC Paris Descartes Necker Cochin, AP-HP, Hôpital Cochin, Paris, France; and
| | | | - Dominique Hubert
- Respiratory Medicine and National Reference Cystic Fibrosis Reference Center, Cochin Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF Network
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Bry C, Hubert D, Reynaud-Gaubert M, Dromer C, Mal H, Roux A, Boussaud V, Claustre J, Le Pavec J, Murris-Espin M, Danner-Boucher I. Pregnancy after lung and heart-lung transplantation: a French multicentre retrospective study of 39 pregnancies. ERJ Open Res 2019; 5:00254-2018. [PMID: 31687369 PMCID: PMC6819984 DOI: 10.1183/23120541.00254-2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 07/29/2019] [Indexed: 11/30/2022] Open
Abstract
Pregnancy after lung and heart–lung transplantation remains rare. This French study deals with change in lung function after a pregnancy and the maternal and newborn outcomes. We retrospectively included 39 pregnancies in 35 women aged >20 years. Data on patients, course of pregnancies and newborns were collected from nine transplantation centres. Mean age at time of pregnancy was 28 years. Cystic fibrosis affected 71% of patients. Mean±sd time between transplantation and pregnancy was 63±44 months. 26 births occurred (67%) with a mean term of 36 weeks of amenorrhoea and a mean birthweight of 2409 g. Prematurity was observed in 11 cases (43%). Forced expiratory volume in 1 s was 83.9% of predicted before pregnancy and 77.3% of predicted 1 year after the end of pregnancy (p=0.04). 10 patients developed chronic lung allograft dysfunction after delivery. Nine patients died at a mean±sd time after transplantation of 8.2±7 years and a mean±sd time after pregnancy of 4.6±6.5 years. These data show that pregnancy remains feasible in lung and heart–lung transplant recipients, with more frequent maternal and newborn complications than in the general population. Survival in this cohort appears to be similar to the global survival observed in lung transplant recipients. Planned pregnancy and multidisciplinary follow-up are crucial. Pregnancy in lung and heart–lung recipients remains rare but possible. There is a significant decrease in FEV1 pre- and post-pregnancy, but overall outcomes are reassuring. Specialised, multidisciplinary follow-up is necessary.http://bit.ly/31iXxov
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Affiliation(s)
- Charlotte Bry
- Service de Pneumologie, CHU de Nantes, Nantes, France
| | | | - Martine Reynaud-Gaubert
- Centre de Ressource et de Compétences de la Mucoviscidose Adulte, Equipe de Transplantation Pulmonaire, CHU Nord, Marseille, France
| | - Claire Dromer
- Service de Pneumologie, CHU de Bordeaux, Bordeaux, France
| | - Hervé Mal
- Service de Pneumologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Antoine Roux
- Service de Pneumologie, Hôpital Foch, Suresnes, France
| | - Véronique Boussaud
- Service de Pneumologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Johanna Claustre
- Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU de Grenoble, Grenoble, France
| | - Jérôme Le Pavec
- Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Muriel Murris-Espin
- CRCM Adulte, Service de Pneumologie-Allergologie, CHU de Toulouse, Toulouse, France
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Lavergne R, Morio F, Danner-Boucher I, Horeau-langlard D, David V, Hagen F, Meis J, Le Pape P. Prévalence et mécanismes de la résistance aux azolés d’Aspergillus fumigatus dans une cohorte de patients atteints de mucoviscidose : étude prospective monocentrique. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.308] [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]
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Danner-Boucher I, Loppinet V, Boxus A, Dary C, Lambert AB, Prieur M, Vallet C, Tissot A. A quality improvement program to reduce the time on the lung transplant waiting list at the Nantes University Hospital. Orphanet J Rare Dis 2018; 13:11. [PMID: 29799380 PMCID: PMC6225649 DOI: 10.1186/s13023-017-0748-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background In 2010, the time on the lung transplant waiting list in Nantes University Hospital (NUH) was 9.2 months, compared to a French national median of about 4 months. The NUH transplant unit performs both heart and lung transplantations, which can be seen as competing activities. To fix the problem, the adult Cystic Fibrosis (CF) team decided to engage in the French CF Quality Improvement Program (QIP PHARE-M) in 2012. The objectives were: i) To reduce the time on the lung transplant waiting list at the Nantes Transplant Unit by increasing the number of lung transplants per year twhile maintaining a 5-year survival rate above the French national average. ii) To improve the organization of the lung transplant access process and the quality of the waiting time for patients. Methods A quality controller was involved as the QIP referent to coach the CF quality team, analyze the pre-transplant process, and set up meaningful measures. Benchmarking was performed with other transplant units, and staff discussions were held with the Transplant Team (TT) to assess the outcomes of rejected donor lungs. Negotiations were made with the hospital administration. Plan, Do, Study and Act cycles were used to redesign the pre-transplant assessment in connection with the CF centers (CFC) referring patients to the NUH transplant unit. Results i) The flow of patients has been reorganized, decreasing the time spent in surgical intensive care by increasing the number of beds in the intensive care unit, and a chest physician has been recruited ii) The number of organs rejected has been reduced iii) Lung transplant activity has increased to 20–25 transplants per year, and the median waiting time was reduced to 3.5 months for patients transplanted in 2014 and to 1.85 months for patients transplanted in 2015 iv) Added-value activities including education, information, and psychosocial support are now offered to patients during the waiting time. Conclusion The QIP PHARE-M, including coaching by a quality-engineer, has helped our adult CF center address its specific lung transplant issues and redesign the lung transplant process for both local patients and patients referred by other CFC.
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Affiliation(s)
| | - Véronique Loppinet
- Pulmonology Department, Thorax Institute, Nantes University Hospital (NHU), Nantes, France
| | - Aurore Boxus
- Pulmonology Department, Thorax Institute, Nantes University Hospital (NHU), Nantes, France
| | - Claire Dary
- Pulmonology Department, Thorax Institute, Nantes University Hospital (NHU), Nantes, France
| | - Anne Brigitte Lambert
- Pulmonology Department, Thorax Institute, Nantes University Hospital (NHU), Nantes, France
| | - Marine Prieur
- Pulmonology Department, Thorax Institute, Nantes University Hospital (NHU), Nantes, France
| | - Céline Vallet
- Pulmonology Department, Thorax Institute, Nantes University Hospital (NHU), Nantes, France
| | - Adrien Tissot
- Pulmonology Department, Thorax Institute, Nantes University Hospital (NHU), Nantes, France
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Jirka A, Darmaun D, Lepoivre T, Haloun A, Danner-Boucher I. SUN-P010: Nutritional Status and Early Nutritional Support After Lung Transplantation in Patients with Cystic Fibrosis: a Single Center, Preliminary Report. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30616-7] [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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17
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Bourcier J, Heudes PM, Morio F, Gastinne T, Chevallier P, Rialland-Battisti F, Garandeau C, Danner-Boucher I, Le Pape P, Frampas E, Moreau P, Defrance C, Peterlin P. Prevalence of the reversed halo sign in neutropenic patients compared with non-neutropenic patients: Data from a single-centre study involving 27 patients with pulmonary mucormycosis (2003-2016). Mycoses 2017; 60:526-533. [DOI: 10.1111/myc.12624] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/23/2017] [Accepted: 03/15/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Jessie Bourcier
- Service d'Hématologie Clinique; Centre d'Investigation Clinique en Cancérologie (CI2C); Centre Hospitalier et Universitaire (CHU) de Nantes; Nantes France
| | - Pierre-Marie Heudes
- Central Department of Radiology and Medical Imaging; University Hospital; Nantes France
| | - Florent Morio
- Laboratoire de Parasitologie-Mycologie; CHU de Nantes; Nantes France
- Département de Parasitologie et Mycologie Médicale; EA1155-IICiMed; Institut de Recherche en Santé 2; Université de Nantes; Nantes Atlantique Universités; Nantes France
| | - Thomas Gastinne
- Service d'Hématologie Clinique; Centre d'Investigation Clinique en Cancérologie (CI2C); Centre Hospitalier et Universitaire (CHU) de Nantes; Nantes France
| | - Patrice Chevallier
- Service d'Hématologie Clinique; Centre d'Investigation Clinique en Cancérologie (CI2C); Centre Hospitalier et Universitaire (CHU) de Nantes; Nantes France
| | | | - Claire Garandeau
- Service de Néphrologie-Immunologie Clinique; Centre Hospitalier et Universitaire (CHU) de Nantes; Nantes France
| | - Isabelle Danner-Boucher
- Service de Pneumologie et de Transplantation Thoracique; Centre Hospitalier et Universitaire (CHU) de Nantes; Nantes France
| | - Patrice Le Pape
- Laboratoire de Parasitologie-Mycologie; CHU de Nantes; Nantes France
- Département de Parasitologie et Mycologie Médicale; EA1155-IICiMed; Institut de Recherche en Santé 2; Université de Nantes; Nantes Atlantique Universités; Nantes France
| | - Eric Frampas
- Central Department of Radiology and Medical Imaging; University Hospital; Nantes France
| | - Philippe Moreau
- Service d'Hématologie Clinique; Centre d'Investigation Clinique en Cancérologie (CI2C); Centre Hospitalier et Universitaire (CHU) de Nantes; Nantes France
| | - Claire Defrance
- Central Department of Radiology and Medical Imaging; University Hospital; Nantes France
| | - Pierre Peterlin
- Service d'Hématologie Clinique; Centre d'Investigation Clinique en Cancérologie (CI2C); Centre Hospitalier et Universitaire (CHU) de Nantes; Nantes France
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Benmerad M, Slama R, Botturi K, Claustre J, Roux A, Sage E, Reynaud-Gaubert M, Gomez C, Kessler R, Brugière O, Mornex JF, Mussot S, Dahan M, Boussaud V, Danner-Boucher I, Dromer C, Knoop C, Auffray A, Lepeule J, Malherbe L, Meleux F, Nicod L, Magnan A, Pison C, Siroux V. Chronic effects of air pollution on lung function after lung transplantation in the Systems prediction of Chronic Lung Allograft Dysfunction (SysCLAD) study. Eur Respir J 2017; 49:13993003.00206-2016. [PMID: 28100545 DOI: 10.1183/13993003.00206-2016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 09/20/2016] [Indexed: 11/05/2022]
Abstract
An irreversible loss in lung function limits the long-term success in lung transplantation. We evaluated the role of chronic exposure to ambient air pollution on lung function levels in lung transplant recipients (LTRs).The lung function of 520 LTRs from the Cohort in Lung Transplantation (COLT) study was measured every 6 months. The levels of air pollutants (nitrogen dioxide (NO2), particulate matter with an aerodynamic cut-off diameter of x µm (PMx) and ozone (O3)) at the patients' home address were averaged in the 12 months before each spirometry test. The effects of air pollutants on forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in % predicted were estimated using mixed linear regressions. We assessed the effect modification of macrolide antibiotics in this relationship.Increased 12-month levels of pollutants were associated with lower levels of FVC % pred (-2.56%, 95% CI -3.86--1.25 for 5 µg·m-3 of PM10; -0.75%, 95% CI -1.38--0.12 for 2 µg·m-3 of PM2.5 and -2.58%, 95% CI -4.63--0.53 for 10 µg·m-3 of NO2). In patients not taking macrolides, the deleterious association between PM and FVC tended to be stronger and PM10 was associated with lower FEV1Our study suggests a deleterious effect of chronic exposure to air pollutants on lung function levels in LTRs, which might be modified with macrolides.
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Affiliation(s)
- Meriem Benmerad
- Université Grenoble Alpes, CNRS UMR 5309, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,INSERM U1209, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,CHU de Grenoble, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France
| | - Rémy Slama
- Université Grenoble Alpes, CNRS UMR 5309, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,INSERM U1209, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,CHU de Grenoble, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France
| | - Karine Botturi
- Institut du Thorax - INSERM UMR 1087/CNRS UMR 6291, CHU de Nantes, Nantes, France
| | - Johanna Claustre
- Université Grenoble Alpes, Grenoble, France.,Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU de Grenoble, INSERM U1055, Grenoble, France
| | - Antoine Roux
- Thoracic Surgery Dept, Foch Hospital, Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Suresnes, France
| | - Edouard Sage
- Thoracic Surgery Dept, Foch Hospital, Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Suresnes, 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, Aix Marseille Université, Marseille, France
| | - Carine Gomez
- Service de Pneumologie et transplantation pulmonaire, Centre de Compétences des Maladies rares Pulmonaires et de l'Hypertension Pulmonaire, CHU Nord de Marseille, Aix Marseille Université, Marseille, France
| | - Romain Kessler
- Pôle Pathologie thoracique, CHU de Strasbourg, Strasbourg, France
| | - Olivier Brugière
- Unité Pneumologie, Hôpital Bichat, Claude-Bernard AP-HP, Paris, France
| | - Jean-François Mornex
- Université de Lyon, Université Lyon 1, UMR754 INRA, Hospices civils de Lyon, Lyon, France
| | - Sacha Mussot
- Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Marcel Dahan
- Chirurgie thoracique, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Véronique Boussaud
- Chirurgie cardiovasculaire, Hôpital Européen Georges-Pompidou H.E.G.P. AP-HP, Paris, France
| | | | - Claire Dromer
- Unité d'insuffisance respiratoire et transplantation, CHU de Bordeaux, Bordeaux, France
| | | | | | - Johanna Lepeule
- Université Grenoble Alpes, CNRS UMR 5309, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,INSERM U1209, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,CHU de Grenoble, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France
| | - Laure Malherbe
- Direction des Risques Chroniques, INERIS, Verneuil-en-Halatte, France
| | - Frederik Meleux
- Direction des Risques Chroniques, INERIS, Verneuil-en-Halatte, France
| | - Laurent Nicod
- Service de Pneumologie, CHU Vaudois, Lausanne, Switzerland
| | - Antoine Magnan
- Institut du Thorax - INSERM UMR 1087/CNRS UMR 6291, CHU de Nantes, Nantes, France
| | - Christophe Pison
- Université Grenoble Alpes, Grenoble, France.,Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU de Grenoble, INSERM U1055, Grenoble, France
| | - Valérie Siroux
- Université Grenoble Alpes, CNRS UMR 5309, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France .,INSERM U1209, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,CHU de Grenoble, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France
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Nourry-Lecaplain L, Herbert E, Nogues C, Drillaud A, Danner-Boucher I, Chambellan A. Réhabilitation respiratoire des patients atteints de mucoviscidose suivis au CRCM adulte et à l’unité de transplantation thoracique de Nantes : états des lieux et perspectives. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Bry C, Hubert D, Reynaud-Gaubert M, Dromer C, Mal H, Grenet D, Boussaud V, Claustre J, le Pavec J, Murris-Espin M, Danner-Boucher I. WS03.6 Pregnancies after lung transplantation: A retrospective multicenter French study about 39 pregnancies. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30020-5] [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: 11/16/2022]
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21
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Benmerad M, Botturi K, Pison C, Magnan A, Claustre J, Roux A, Gomez C, Kessler R, Brugière O, Mornex J, Mussot S, Dahan M, Boussaud V, Danner-Boucher I, Dromer C, Knoop C, Malherbe L, Meleux F, Slama R, Nicod L, Siroux V. Chronic Effects of Air Pollution on Lung Function in Lung Transplant Patients (SysCLAD). J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.379] [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: 11/28/2022] Open
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David V, Feldman D, Danner-Boucher I, Rhun AL, Guyomarch B, Ravilly S, Marchand C. Identifying the Educational Needs of Lung Transplant Recipients with Cystic Fibrosis. Prog Transplant 2015; 25:18-25. [DOI: 10.7182/pit2015526] [Citation(s) in RCA: 4] [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: 11/13/2022]
Abstract
Purpose To elucidate the education needs of patients who have undergone lung transplant for cystic fibrosis while participating in the development of therapeutic education programs in French transplant centers. Methods From January 2009 to March 2012, in-depth educational diagnosis interviews were conducted with 42 adult transplant recipients with cystic fibrosis who were being followed up at 7 French transplant centers. Several areas were explored: health status, social and occupational outcomes, knowledge about the disease and treatments, and experience of the disease. The interviews combined open- and closed-ended questions for more systematic exploration of knowledge about the disease and treatments. Results After receiving the transplant, the patients' health had improved and their lives were returning to normal. They had acquired much usable knowledge about managing their disease. Educational needs regarding transplant-related complications and management of immunosuppressive drugs were evident. The analysis also demonstrated the need to better inform patients about pregnancy and new social rights and to offer them psychological support in adjusting to their new health status. Conclusion Therapeutic education of patients should continue well after transplant to maintain safety knowledge and meet patients' new needs. A comprehensive therapeutic education program for transplant candidates that includes the preparatory, immediate posttransplant, and late posttransplant phases is needed.
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Affiliation(s)
- Valérie David
- Hôpital Mère et Enfant, Nantes (VD), CHU Nantes (DF, ALR), CHU Nantes-Nord, Saint-Herblain (ID-B, BG), Vaincre la Mucoviscidose, Paris (SR), Université Paris 13, Bobigny (CM), France
| | - David Feldman
- Hôpital Mère et Enfant, Nantes (VD), CHU Nantes (DF, ALR), CHU Nantes-Nord, Saint-Herblain (ID-B, BG), Vaincre la Mucoviscidose, Paris (SR), Université Paris 13, Bobigny (CM), France
| | - Isabelle Danner-Boucher
- Hôpital Mère et Enfant, Nantes (VD), CHU Nantes (DF, ALR), CHU Nantes-Nord, Saint-Herblain (ID-B, BG), Vaincre la Mucoviscidose, Paris (SR), Université Paris 13, Bobigny (CM), France
| | - Anne Le Rhun
- Hôpital Mère et Enfant, Nantes (VD), CHU Nantes (DF, ALR), CHU Nantes-Nord, Saint-Herblain (ID-B, BG), Vaincre la Mucoviscidose, Paris (SR), Université Paris 13, Bobigny (CM), France
| | - Beatrice Guyomarch
- Hôpital Mère et Enfant, Nantes (VD), CHU Nantes (DF, ALR), CHU Nantes-Nord, Saint-Herblain (ID-B, BG), Vaincre la Mucoviscidose, Paris (SR), Université Paris 13, Bobigny (CM), France
| | - Sophie Ravilly
- Hôpital Mère et Enfant, Nantes (VD), CHU Nantes (DF, ALR), CHU Nantes-Nord, Saint-Herblain (ID-B, BG), Vaincre la Mucoviscidose, Paris (SR), Université Paris 13, Bobigny (CM), France
| | - Claire Marchand
- Hôpital Mère et Enfant, Nantes (VD), CHU Nantes (DF, ALR), CHU Nantes-Nord, Saint-Herblain (ID-B, BG), Vaincre la Mucoviscidose, Paris (SR), Université Paris 13, Bobigny (CM), France
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Delom F, Danner-Boucher I, Dromer C, Thumerel M, Marthan R, Nourry-Lecaplain L, Magnan A, Jougon J, Fessart D. Impact of donor-to-recipient weight ratio on survival after bilateral lung transplantation. Transplant Proc 2015; 46:1517-22. [PMID: 24935323 DOI: 10.1016/j.transproceed.2014.02.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 01/27/2014] [Accepted: 02/27/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this study was to investigate the relationship between donor-to-recipient weight ratio and post-transplantation survival. METHODS From February 1988 to November 2006, 255 adult bilateral lung transplantation patients from 2 different centers were retrospectively analyzed. The cohort was divided into 4 groups depending on the quartile ranges of the donor-to-recipient weight ratio. A time-to-event analysis was performed for risk of death after transplantation conditional on 5-year survival using Kaplan-Meier and Cox proportional hazards models. RESULTS The mean weight ratio for the study cohort was 1.23 ± 0.39. For all lung transplant recipients during the study period, survival rate at 5 years was 58%. Median survival was 6.3 years in the cohort subgroup with weight ratio <1.23, whereas the median survival was 7.7 years for the cohort subgroup with weight ratio >1.23. Weight ratio >1.23 recipients had a significant survival advantage out to 5 years compared with weight ratio <1.23 recipients (66.1% vs 51.1%, P = .0126). With the aim to assess underweight and overweight donors vs recipients, we have divided all patients into 4 groups, from quartile 1 to 4, based on donor-to-recipient weight ratio. Weight ratio strata affected overall survival, with quartile 1 (lower weight ratio recipients) experiencing the lowest 5-year survival (39.1%), followed by quartile 2 (57.8%), quartile 4 (68.2%), and quartile 3 (70.3%) recipients. The effect of weight ratio strata on survival was statistically significant for the quartile 1 recipients (lower quartile) as compared with the 3 other quartiles. CONCLUSIONS Our findings show a statistically significant effect of donor-to-recipient weight ratios on bilateral lung transplantation survival. A higher donor-to-recipient weight ratio was associated with improved survival after bilateral lung transplantation and likely reflects a mismatch between a relatively overweight donor vs recipient. In contrast, a lower donor-to-recipient ratio was associated with increased mortality after bilateral lung transplantation.
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Affiliation(s)
- F Delom
- University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - I Danner-Boucher
- Institut du thorax, DHU2020, INSERM UMR 1087, Service de pneumologie, CHU de Nantes, Université de Nantes, France
| | - C Dromer
- Department of Thoracic and Cervical Surgery and Lung Transplantation, Haut-Levêque Hospital, Pessac, France
| | - M Thumerel
- Department of Thoracic and Cervical Surgery and Lung Transplantation, Haut-Levêque Hospital, Pessac, France
| | - R Marthan
- University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - L Nourry-Lecaplain
- Institut du thorax, DHU2020, INSERM UMR 1087, Service de pneumologie, CHU de Nantes, Université de Nantes, France
| | - A Magnan
- Institut du thorax, DHU2020, INSERM UMR 1087, Service de pneumologie, CHU de Nantes, Université de Nantes, France
| | - J Jougon
- Department of Thoracic and Cervical Surgery and Lung Transplantation, Haut-Levêque Hospital, Pessac, France
| | - D Fessart
- University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France; INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France.
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Chesné J, Danger R, Botturi K, Reynaud-Gaubert M, Mussot S, Stern M, Danner-Boucher I, Mornex JF, Pison C, Dromer C, Kessler R, Dahan M, Brugière O, Le Pavec J, Perros F, Humbert M, Gomez C, Brouard S, Magnan A. Systematic analysis of blood cell transcriptome in end-stage chronic respiratory diseases. PLoS One 2014; 9:e109291. [PMID: 25329529 PMCID: PMC4203719 DOI: 10.1371/journal.pone.0109291] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 08/30/2014] [Indexed: 12/14/2022] Open
Abstract
Background End-stage chronic respiratory diseases (CRD) have systemic consequences, such as weight loss and susceptibility to infection. However the mechanisms of such dysfunctions are as yet poorly explained. We hypothesized that the genes putatively involved in these mechanisms would emerge from a systematic analysis of blood mRNA profiles from pre-transplant patients with cystic fibrosis (CF), pulmonary hypertension (PAH), and chronic obstructive pulmonary disease (COPD). Methods Whole blood was first collected from 13 patients with PAH, 23 patients with CF, and 28 Healthy Controls (HC). Microarray results were validated by quantitative PCR on a second and independent group (7PAH, 9CF, and 11HC). Twelve pre-transplant COPD patients were added to validate the common signature shared by patients with CRD for all causes. To further clarify a role for hypoxia in the candidate gene dysregulation, peripheral blood mononuclear cells from HC were analysed for their mRNA profile under hypoxia. Results Unsupervised hierarchical clustering allowed the identification of 3 gene signatures related to CRD. One was common to CF and PAH, another specific to CF, and the final one was specific to PAH. With the common signature, we validated T-Cell Factor 7 (TCF-7) and Interleukin 7 Receptor (IL-7R), two genes related to T lymphocyte activation, as being under-expressed. We showed a strong impact of the hypoxia on modulation of TCF-7 and IL-7R expression in PBMCs from HC under hypoxia or PBMCs from CRD. In addition, we identified and validated genes upregulated in PAH or CF, including Lectin Galactoside-binding Soluble 3 and Toll Like Receptor 4, respectively. Conclusions Systematic analysis of blood cell transcriptome in CRD patients identified common and specific signatures relevant to the systemic pathologies. TCF-7 and IL-7R were downregulated whatever the cause of CRD and this could play a role in the higher susceptibility to infection of these patients.
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Affiliation(s)
- Julie Chesné
- UMR_S 1087 CNRS UMR_6291, l′Institut du Thorax, Université de Nantes, CHU de Nantes, Centre National de Référence Mucoviscidose Nantes-Roscoff, Nantes, France
- Université de Nantes, Nantes, France
| | - Richard Danger
- Université de Nantes, Nantes, France
- Institut National de la Santé et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Karine Botturi
- UMR_S 1087 CNRS UMR_6291, l′Institut du Thorax, Université de Nantes, CHU de Nantes, Centre National de Référence Mucoviscidose Nantes-Roscoff, Nantes, France
- Université de Nantes, Nantes, France
| | | | - Sacha Mussot
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | | | - Isabelle Danner-Boucher
- UMR_S 1087 CNRS UMR_6291, l′Institut du Thorax, Université de Nantes, CHU de Nantes, Centre National de Référence Mucoviscidose Nantes-Roscoff, Nantes, France
| | - Jean-François Mornex
- Université de Lyon, Lyon, France
- Université de Lyon 1, Lyon, France
- INRA, UMR_S 754, Lyon, France
- Hospices Civils de Lyon, Lyon, France
| | - Christophe Pison
- Clinique Universitaire Pneumologie, CHU de Grenoble, Grenoble, France
- Université Joseph Fourier, Grenoble, France
- Inserm U1055, Grenoble, France
- European Institute of Systems Biology and Medicine, Lyon, France
| | | | | | | | - Olivier Brugière
- Hôpital Bichat, Service de Pneumologie B et Transplantation Pulmonaire, Paris, France
| | - Jérôme Le Pavec
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | - Frédéric Perros
- Université Paris-Sud, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Marc Humbert
- Université Paris-Sud, Le Kremlin-Bicêtre, France
- AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Carine Gomez
- CHU de Marseille, Aix Marseille Université, Marseille, France
| | - Sophie Brouard
- Université de Nantes, Nantes, France
- Institut National de la Santé et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Antoine Magnan
- UMR_S 1087 CNRS UMR_6291, l′Institut du Thorax, Université de Nantes, CHU de Nantes, Centre National de Référence Mucoviscidose Nantes-Roscoff, Nantes, France
- Université de Nantes, Nantes, France
- * E-mail:
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Marchand C, Salhi L, Le Rhun A, Ravilly S, Danner-Boucher I, Gagnayre R, David V. [Perceptions of cystic fibrosis patients, patient relatives and physicians: barriers or motivations to lung transplantation]. Rev Mal Respir 2014; 31:237-47. [PMID: 24680115 DOI: 10.1016/j.rmr.2013.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 06/11/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aims of this study are to describe qualitatively the perceptions of three groups involved in the cystic fibrosis transplant decision, looking for similarities and differences between groups, and to identify those that act as motivations or barriers to transplantation. METHODS Thirty patients, 26 patient relatives and 27 physicians were interviewed, and concept maps were constructed from those interviews. Their degree of transplant acceptance at the time of the interview was measured. RESULTS There were motivations and barriers in the pre-, peri- and post-transplant period. Analysis revealed similar perceptions regarding the risks and benefits of transplantation, but also different perceptions in the specific concerns of each group. Patients and patient relatives expressed many questions and fears in their concept maps, and physicians expressed difficulties. CONCLUSIONS This study highlights the value of better understanding the perceptions of patients, relatives and physicians, in order to remove some of the barriers to transplantation. It also demonstrates the benefits of education and support activities for patients and patient relatives prior to transplantation, and continuing education and supervision for physicians.
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Affiliation(s)
- C Marchand
- EA-3412, laboratoire de pédagogie de la santé, université Paris-13, Sorbonne Paris-Cité, 74, rue Marcel-Cachin, 93019 Bobigny cedex, France.
| | - L Salhi
- EA-3412, laboratoire de pédagogie de la santé, université Paris-13, Sorbonne Paris-Cité, 74, rue Marcel-Cachin, 93019 Bobigny cedex, France
| | - A Le Rhun
- Unité d'éducation thérapeutique du patient, CHU de Nantes, 44093 Nantes, France
| | - S Ravilly
- Vaincre La Mucoviscidose, 75013 Paris, France
| | - I Danner-Boucher
- Centre de ressources et de compétences de la mucoviscidose, CHU de Nantes, 44093 Nantes, France
| | - R Gagnayre
- EA-3412, laboratoire de pédagogie de la santé, université Paris-13, Sorbonne Paris-Cité, 74, rue Marcel-Cachin, 93019 Bobigny cedex, France
| | - V David
- Centre de ressources et de compétences de la mucoviscidose, CHU de Nantes, 44093 Nantes, France
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Abu-Aita J, Chintoh P, Fournier B, Danner-Boucher I, Haloun A, Germaud P, Morio F, Loge C, Le Pape P. Étude eco-épidémiologique de la résistance d’ Aspergillus fumigatus aux azoles : la signature TR34/98H. J Mycol Med 2014. [DOI: 10.1016/j.mycmed.2014.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Morio F, Llasera E, Dumortier C, Sacchetto E, Sakka M, Danner-Boucher I, Haloun A, Miegeville M, Le Pape P. Étude prospective de la résistance d’ Aspergillus fumigatus aux azoles dans une cohorte de patients atteints de mucoviscidose au CHU de Nantes : données préliminaires. J Mycol Med 2014. [DOI: 10.1016/j.mycmed.2014.01.044] [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: 10/25/2022]
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Madjer T, Danner-Boucher I, Horeau-Langlard D, Haloun A, Lepoivre T, Sagan C, Magnan A. Severe pulmonary hypertension leading to heart-lung transplantation and revealing breast cancer. Eur Respir J 2012; 40:1057-9. [PMID: 23024331 DOI: 10.1183/09031936.00182711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Tania Madjer
- INSERM UMR 915, Université de Nantes, CHU de Nantes, l’institut du thorax, Service de pneumologie, Plate-forme transversale d’allergologie, Centre de Réfrence National Maladies Rares Mucoviscidose, France.
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Sacchetto E, Morio F, Aubin G, Leterrier M, Danner-Boucher I, Haloun A, Miegeville M, Le Pape P. Resistance d’ Aspergillus fumigatus et de Candida albicans aux triazoles chez un patient atteint de mucoviscidose. J Mycol Med 2012. [DOI: 10.1016/j.mycmed.2012.07.012] [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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De Boeck K, Kent L, Davies J, Derichs N, Amaral M, Rowe SM, Middleton P, de Jonge H, Bronsveld I, Wilschanski M, Melotti P, Danner-Boucher I, Boerner S, Fajac I, Southern K, de Nooijer RA, Bot A, de Rijke Y, de Wachter E, Leal T, Vermeulen F, Hug MJ, Rault G, Nguyen-Khoa T, Barreto C, Proesmans M, Sermet-Gaudelus I. CFTR biomarkers: time for promotion to surrogate end-point. Eur Respir J 2012; 41:203-16. [DOI: 10.1183/09031936.00057512] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Boussaud V, Mal H, Trinquart L, Thabut G, Danner-Boucher I, Dromer C, Raymond CS, Reynaud-Gaubert M, Kessler R, Philit F, Dorent R, Stern M. One-Year Experience With High-Emergency Lung Transplantation in France. Transplantation 2012; 93:1058-63. [DOI: 10.1097/tp.0b013e31824d7079] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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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Morio F, Aubin GG, Danner-Boucher I, Haloun A, Sacchetto E, Garcia-Hermoso D, Bretagne S, Miegeville M, Le Pape P. High prevalence of triazole resistance in Aspergillus fumigatus, especially mediated by TR/L98H, in a French cohort of patients with cystic fibrosis. J Antimicrob Chemother 2012; 67:1870-3. [DOI: 10.1093/jac/dks160] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Robert T, Talarmin JP, Leterrier M, Cassagnau E, Le Pape P, Danner-Boucher I, Malard O, Brocard A, Gay-Andrieu F, Miegeville M, Morio F. Phaeohyphomycosis due to Alternaria infectoria: a single-center experience with utility of PCR for diagnosis and species identification. Med Mycol 2012; 50:594-600. [PMID: 22404860 DOI: 10.3109/13693786.2012.663508] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The term phaeohyphomycosis refers to a rare group of fungal infections characterized by the presence of dark-walled hyphae or yeast-like cells in affected tissues. Herein, we report on the clinical and epidemiological characteristics of six cases of phaeohyphomycosis due to Alternaria spp. that occurred in our hospital over a 30-month period (from January 2008 to June 2010). Interestingly, whereas histopathological examinations were positive and fungal cultures yielded molds in all cases, mycological identification using conventional phenotypic methods was never possible despite prolonged incubation of the isolates. Identification of Alternaria infectoria species complex was obtained for each isolate by amplification and sequencing of the internal transcribed spacer of the ribosomal DNA (ITS rDNA). All patients had favourable outcomes following the introduction of azole-based antifungal therapy. This case series describes the clinical course of these six patients and highlights the utility of molecular identification to help in the identification of the etiologic agent when classical mycological methods have failed.
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Affiliation(s)
- Tiphaine Robert
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalo-Universitaire de Nantes, Hôtel Dieu, Nantes, France
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Morio F, Aubin G, Miegeville M, Danner-Boucher I, David V, Garcia-Hermoso D, Le Pape P. Prévalence et mécanismes moléculaires de la résistance aux antifongiques azoles d’ Aspergillus fumigatus au sein d’une cohorte de patients atteints de mucoviscidose. J Mycol Med 2012. [DOI: 10.1016/j.mycmed.2011.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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