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Gabsi A, Benaboud S, Pouradier D, Reix P, L'Excellent S, Weiss L, Le-Clainche L, Dalphin ML, Perisson C, Deneuville E, Bonnel AS, Sermet-Gaudelus I. Can we decondition TRIKAFTA® tablets for the younger ones? J Cyst Fibros 2023:S1569-1993(23)00929-3. [PMID: 37891070 DOI: 10.1016/j.jcf.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Affiliation(s)
- Asma Gabsi
- Versailles Pediatric CF center CRCM Centre Hospitalier de Versailles, 177 rue de Versailles LE CHESNAY, 78150, France.
| | - Sihem Benaboud
- EA 7323, Université Paris Cité, Pharmacologie et évaluations thérapeutiques chez l'enfant et la femme enceinte, Service de Pharmacologie Clinique, Hôpital Cochin, AP-HP, Université Paris Cité, Paris, France
| | - Delphine Pouradier
- Versailles Pediatric CF center CRCM Centre Hospitalier de Versailles, 177 rue de Versailles LE CHESNAY, 78150, France
| | - Philippe Reix
- Lyon CF Center, Hôpital Femme Mère Enfant, 59 Boulevard Pinel BRON, 69677, France
| | - Sophie L'Excellent
- Lyon CF Center, Hôpital Femme Mère Enfant, 59 Boulevard Pinel BRON, 69677, France
| | - Laurence Weiss
- Strasbourg CF Center Hôpital de Hautepierre, 1 avenue Molière STRASBOURD, 67098, France
| | - Laurence Le-Clainche
- Paris Debré CF Center Hôpital Robert Debré, 48 boulevard Sérurier, Paris, 75019, France
| | - Marie-Laure Dalphin
- Besançon CF Center CH Jean Minjoz, 3 boulevard A. Flemming BESANÇON, 25030, France
| | - Caroline Perisson
- SAINT-DENIS CF CENTER CHU Réunion Allée Topazes SAINT DENIS-LA REUNION, 97400, France
| | - Eric Deneuville
- RENNES ST BRIEUC CF Center Hopital Sud, 16 boulevard de Bulgarie RENNES, 35200, France
| | - Anne Sophie Bonnel
- Versailles Pediatric CF center CRCM Centre Hospitalier de Versailles, 177 rue de Versailles LE CHESNAY, 78150, France
| | - Isabelle Sermet-Gaudelus
- INSERM U1151, Université Paris Cité, Centre de Références Maladies Rares Mucoviscidose et Maladies Apparentées, Hôpital Necker Enfants Malades, Paris, France
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2
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Marguet C, Houdouin V, Pin I, Reix P, Huet F, Mittaine M, Ramel S, Wizla-Derambure N, Abely M, Dalphin ML, Fayon M, Bihouée T, Le Bourgeois M, Deneuville E, Corvol H, Laurans M, Couderc L, Leroux E, Lémée L. Chest physiotherapy enhances detection of Pseudomonas aeruginosa in nonexpectorating children with cystic fibrosis. ERJ Open Res 2021; 7:00513-2020. [PMID: 33718497 PMCID: PMC7938055 DOI: 10.1183/23120541.00513-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/06/2020] [Indexed: 11/05/2022] Open
Abstract
Lung damage in cystic fibrosis (CF) is strongly associated with lower airway infections. Early treatment of Pseudomonas aeruginosa is recommended. Pathogen detection requires sampling of lower airway secretions, which remains a challenge in nonexpectorating patients. Our hypothesis was that chest physiotherapy would improve the quality of airway secretion samples and increase the rates of pathogens detected in nonexpectorating patients. This prospective multicentre study compared three successive methods for sampling airway secretions applied through the same session: 1) an oropharyngeal swab (OP), 2) a chest physiotherapy session followed by a provoked cough to obtain sputum (CP-SP) and 3) a second oropharyngeal swab collected after chest physiotherapy (CP-OP). Haemophilus influenzae, Staphylococcus aureus and P. aeruginosa growth cultures were assessed. Accuracy tests and an equivalence test were performed to compare the three successive methods of collection. 300 nonexpectorating children with CF were included. P. aeruginosa was detected cumulatively in 56 (18.9%) children, and according to the different collection methods in 28 (9.8%), 37 (12.4%) and 44 (14.7%) children by using OP, CP-OP and CP-SP, respectively. Compared with OP, the increased detection rate was +22% for CP-OP (p=0.029) and +57% for CP-SP (p=0.003). CP-SP had the best positive predictive value (86.3%) and negative predictive value (96.0%) for P. aeruginosa compared with the overall detection. The results of this adequately powered study show differences in the rates of pathogens detected according to the sampling method used. Chest physiotherapy enhanced detection of P. aeruginosa in nonexpectorating children with CF. Sputum collection after a chest physiotherapy session strongly enhances the detection of P. aeruginosa in nonexpectorating CF children compared with the commonly used oropharyngeal swab method. Oropharyngeal swab after physiotherapy may be an acceptable alternative.https://bit.ly/3757ewq
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Affiliation(s)
- Christophe Marguet
- CF Centre, Dept of Paediatrics and Adolescent Medicine, University Hospital Charles Nicolle, CIC INSERM 1404, EA 2656, Rouen University, Rouen, France
| | - Véronique Houdouin
- Paediatric CF Centre, University Hospital Robert Debre, INSERM UMR S 976, Paris Diderot University, Paris, France
| | - Isabelle Pin
- Paediatric CF Centre, Grenoble Alpes University Hospital, INSERM, Institute for Advanced Bioscences, Grenoble Alpes University, Grenoble, France
| | - Philippe Reix
- Paediatric CF Centre, Hospices Civils de Lyon, UMR 5558 (EMET), CNRS, LBBE, Lyon University, Villeurbanne, France
| | - Frédéric Huet
- Paediatric CF Centre, Dijon University Hospital, Bourgogne University, Dijon, France
| | - Marie Mittaine
- Paediatric CF Centre, Toulouse University Hospital, Toulouse III Paul Sabatier University, Toulouse, France
| | - Sophie Ramel
- CF Centre, Centre Perardihy, Service de Soins de Suite Nutritionnelle et Respiratoire, Roskoff, France
| | - Nathalie Wizla-Derambure
- Pediatric CF Centre, Dept of Paediatrics, Lille University Jeanne de Flandre Hospital, Lille University, Lille, France
| | - Michel Abely
- CF Centre, Dept of Paediatrcs, Reims University Hospital, Reims Champagne Ardennes University, Reims, France
| | - Marie-Laure Dalphin
- CF Centre, Dept of Paediatrics, Besançon University Hospital, Franche-Comté University, Besançon, France
| | - Michael Fayon
- Paediatric CF Centre, GH Pellegrin, Hôpital des Enfants, Bordeaux University Hospital, Bordeaux University, Bordeaux, France
| | - Tiphaine Bihouée
- Paediatric CF Centre, Nantes Children and Adolescent University Hospital, Nantes University, Nantes, France
| | - Muriel Le Bourgeois
- Paediatric CF Centre, Service de Pneumo-Allergologie Pédiatrique, Hôpital Universitaire Necker-Enfant Malades, AP-HP, Paris, France
| | - Eric Deneuville
- CF Centre, Dept of Paediatrics, Rennes University South Hospital, Rennes University, Rennes, France
| | - Harriet Corvol
- Paediatric CF Centre, Trousseau Hospital, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), AP-HP, Paris, France
| | - Muriel Laurans
- CF Centre, Dept of Paediatrics, Caen University Childrens Hospital, Caen University, Caen, France
| | - Laure Couderc
- CF Centre, Dept of Paediatrics and Adolescent Medicine, University Hospital Charles Nicolle, CIC INSERM 1404, EA 2656, Rouen University, Rouen, France
| | | | - Ludovic Lémée
- Bacteriology Unit, Dept of Microbiology, University Hospital Charles Nicolle, EA 2656, Rouen University, Rouen, France
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Corvol H, de Miranda S, Lemonnier L, Kemgang A, Reynaud Gaubert M, Chiron R, Dalphin ML, Durieu I, Dubus JC, Houdouin V, Prevotat A, Ramel S, Revillion M, Weiss L, Guillot L, Boelle PY, Burgel PR. First Wave of COVID-19 in French Patients with Cystic Fibrosis. J Clin Med 2020; 9:E3624. [PMID: 33182847 PMCID: PMC7697588 DOI: 10.3390/jcm9113624] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022] Open
Abstract
Viral infections are known to lead to serious respiratory complications in cystic fibrosis (CF) patients. Hypothesizing that CF patients were a population at high risk for severe respiratory complications from SARS-CoV-2 infection, we conducted a national study to describe the clinical expression of COVID-19 in French CF patients. This prospective observational study involves all 47 French CF centers caring for approximately 7500 CF patients. Between March 1st and June 30th 2020, 31 patients were diagnosed with COVID-19: 19 had positive SARS-CoV-2 RT-PCR in nasopharyngeal swabs; 1 had negative RT-PCR but typical COVID-19 signs on a CT scan; and 11 had positive SARS-CoV-2 serology. Fifteen were males, median (range) age was 31 (9-60) years, and 12 patients were living with a lung transplant. The majority of the patients had CF-related diabetes (n = 19, 61.3%), and a mild lung disease (n = 19, 65%, with percent-predicted forced expiratory volume in 1 s (ppFEV1) > 70). Three (10%) patients remained asymptomatic. For the 28 (90%) patients who displayed symptoms, most common symptoms at admission were fever (n = 22, 78.6%), fatigue (n = 14, 50%), and increased cough (n = 14, 50%). Nineteen were hospitalized (including 11 out of the 12 post-lung transplant patients), seven required oxygen therapy, and four (3 post-lung transplant patients) were admitted to an Intensive Care Unit (ICU). Ten developed complications (including acute respiratory distress syndrome in two post-lung transplant patients), but all recovered and were discharged home without noticeable short-term sequelae. Overall, French CF patients were rarely diagnosed with COVID-19. Further research should establish whether they were not infected or remained asymptomatic upon infection. In diagnosed cases, the short-term evolution was favorable with rare acute respiratory distress syndrome and no death. Post-lung transplant patients had more severe outcomes and should be monitored more closely.
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Affiliation(s)
- Harriet Corvol
- Pediatric Pulmonology Department and Pediatric CF Center, Assistance Publique Hôpitaux de Paris (APHP) Hôpital Trousseau, 75012 Paris, France
- Centre de Recherche Saint‑Antoine (CRSA), INSERM UMR_S938, Sorbonne Université, 75012 Paris, France; (A.K.); (L.G.)
| | - Sandra de Miranda
- Pulmonology Department and CF Center, Hôpital Foch, 92151 Suresnes, France;
| | | | - Astrid Kemgang
- Centre de Recherche Saint‑Antoine (CRSA), INSERM UMR_S938, Sorbonne Université, 75012 Paris, France; (A.K.); (L.G.)
| | - Martine Reynaud Gaubert
- Pulmonology Department and CF Adult Center, Hôpital Nord, Assistance Publique Hôpitaux de Marseille (APHM), 13915 Marseille, France;
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), IHU Méditerranée Infection, MEPHI, 13005 Marseille, France
| | - Raphael Chiron
- CF Center, Hôpital Arnaud de Villeneuve, CHU de Montpellier, 34295 Montpellier, France;
| | - Marie-Laure Dalphin
- Pediatric CF Center, Hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon, France;
| | - Isabelle Durieu
- Internal Medicine Department and Adult CF Center, Hospices Civils de Lyon, EA 7425 HESPER, Université de Lyon, 69495 Lyon, France;
| | - Jean-Christophe Dubus
- Pediatric Pulmonology Department and Pediatric CF Center, APHM, 13385 Marseille, France;
| | | | - Anne Prevotat
- Adult CF Center, Hôpital Calmette and University Lille, 59037 Lille, France;
| | - Sophie Ramel
- Pediatric and Adult CF Center, 29680 Roscoff, France;
| | - Marine Revillion
- Pediatric CF Center, Hôpital Jeanne de Flandres, CHU Lille, 59037 Lille, France;
| | - Laurence Weiss
- Pediatric CF Center, Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg, France;
| | - Loic Guillot
- Centre de Recherche Saint‑Antoine (CRSA), INSERM UMR_S938, Sorbonne Université, 75012 Paris, France; (A.K.); (L.G.)
| | - Pierre-Yves Boelle
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, APHP, Sorbonne Université, 75012 Paris, France;
| | - Pierre-Régis Burgel
- Respiratory Medicine and National Reference CF Center, AP-HP Hôpital Cochin, 75014 Paris, France;
- Institut Cochin, Inserm U-1016, Université de Paris, 75014 Paris, 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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5
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Lauby C, Boelle PY, Abou Taam R, Bessaci K, Brouard J, Dalphin ML, Delacourt C, Delestrain C, Deschildre A, Dubus JC, Fayon M, Giovannini-Chami L, Houdouin V, Houzel A, Marguet C, Pin I, Reix P, Renoux MC, Schweitzer C, Tatopoulos A, Thumerelle C, Troussier F, Wanin S, Weiss L, Clement A, Epaud R, Nathan N. Health-related quality of life in infants and children with interstitial lung disease. Pediatr Pulmonol 2019; 54:828-836. [PMID: 30868755 DOI: 10.1002/ppul.24308] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/27/2019] [Accepted: 02/17/2019] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Interstitial lung disease in children (chILD) is a highly heterogeneous group of rare and severe respiratory disorders. The disease by itself, the burden of the treatments (oxygen therapy, corticosteroid pulses, nutritional support) and recurrent hospitalizations may impair the quality of life (QoL) of these children. The aim of the study was to compare the health-related QoL (HR-QoL) in chILD compared to a healthy population and to find out the predictive factors of an altered QoL. METHODS Patients aged 1 month to 18 years with ILD of known or unknown etiology were prospectively included. Parents and children over 8 years old were asked to fill the PedsQL 4.0 Generic Core Scale ranging from 0 to 100 points. RESULTS A total of 78 children were recruited in 13 French pediatric centers. Total scores were 11.94 points (P = 0.0003) less for child self-report and 14.08 points ( P < 0.0001) less for parent proxy-report with respect to the healthy population. The clinical factors associated with a lower total score were: extrapulmonary expression of the disease, higher Fan severity score, long-term oxygen therapy, nutritional support, and a number of oral treatments. CONCLUSION Using a validated quality of life (QoL) scale, we showed that health-related-QoL is significantly impaired in chILD compared with a healthy population. Factors altering QoL score are easy to recognize and could help identify children at a heightened risk of low QoL.
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Affiliation(s)
- Clara Lauby
- Reference Centre for Rare Lung Diseases, RespiRare, France
| | - Pierre-Yves Boelle
- Inserm UMR S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Rola Abou Taam
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, APHP, Necker Enfants Malades Hospital, Paris, France
| | - Katia Bessaci
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Reims, France
| | - Jacques Brouard
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Caen, France
| | - Marie-Laure Dalphin
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Besançon, France
| | - Christophe Delacourt
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, APHP, Necker Enfants Malades Hospital, Paris, France
| | - Céline Delestrain
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Antoine Deschildre
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Lille, France
| | - Jean-Christophe Dubus
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, La Timone University Hospital, Marseille, France
| | - Michaël Fayon
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, Pellegrin University Hospital, Bordeaux, France
| | - Lisa Giovannini-Chami
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, Lenval University Hospital, Nice, France
| | - Véronique Houdouin
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, APHP, Robert Debré Hospital, Paris, France
| | - Anne Houzel
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Dijon, France
| | - Christophe Marguet
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Rouen, France
| | - Isabelle Pin
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Grenoble, France
| | - Philippe Reix
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, Femme Mere Enfants University Hospital, Hospices Civils de Lyon, Lyon, France
| | - Marie-Catherine Renoux
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Montpellier, France
| | - Cyril Schweitzer
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Nancy, France
| | - Aurélie Tatopoulos
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Nancy, France
| | - Caroline Thumerelle
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Lille, France
| | - Françoise Troussier
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Angers, France
| | - Stéphanie Wanin
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, APHP, Robert Debré Hospital, Paris, France
| | - Laurence Weiss
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, University Hospital, Strasbourg, France
| | - Annick Clement
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department and Inserm UMR S933, APHP and Sorbonne Université, Armand Trousseau Hospital, Paris, France
| | - Ralph Epaud
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Nadia Nathan
- Reference Centre for Rare Lung Diseases, RespiRare, France.,Pediatric Pulmonology Department and Inserm UMR S933, APHP and Sorbonne Université, Armand Trousseau Hospital, Paris, France
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6
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Abstract
Hypersensitivity pneumonitis (HP) is an interstitial lung disease caused by an immune response to a variety of antigens to which patients have been previously sensitised. It can occur at any age. In children, it is a rare disease, probably under-diagnosed, with an estimated prevalence of 4 per million. The paediatric forms are not really different from those of adults but present some particularities. Avian exposure is by far the most frequent cause of HP, accounting for nearly two-thirds of cases. Although there is no current recommendation for the diagnosis of HP, it is commonly considered that the diagnosis can be made with confidence on the combination of (1) compatible respiratory symptoms, (2) exposure to a known offending antigen, (3) lymphocytic alveolitis, (4) decreased transfer factor for carbon monoxide or hypoxia on exertion and (5) compatible radiologic features. The treatment is based on antigen avoidance that must be complete and definitive. Corticosteroids can be necessary in severe forms. The prognosis of HP in children is better than in adults, with a full clinical and functional recovery in the majority of cases after complete antigenic withdrawal.
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Affiliation(s)
- T Soumagne
- Service de pneumologie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France.
| | - M L Dalphin
- Service de pédiatrie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France
| | - J C Dalphin
- Service de pneumologie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; UMR CNRS 6249, Chrono-environnement, université de Franche-Comté, 25000 Besançon, France.
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7
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Roduit C, Frei R, Ferstl R, Loeliger S, Westermann P, Rhyner C, Schiavi E, Barcik W, Rodriguez‐Perez N, Wawrzyniak M, Chassard C, Lacroix C, Schmausser‐Hechfellner E, Depner M, Mutius E, Braun‐Fahrländer C, Karvonen AM, Kirjavainen PV, Pekkanen J, Dalphin J, Riedler J, Akdis C, Lauener R, O'Mahony L, Hyvärinen A, Remes S, Roponen M, Chauveau A, Dalphin ML, Kaulek V, Ege M, Genuneit J, Illi S, Kabesch M, Schaub B, Pfefferle P, Doekes G. High levels of butyrate and propionate in early life are associated with protection against atopy. Allergy 2019; 74:799-809. [PMID: 30390309 DOI: 10.1111/all.13660] [Citation(s) in RCA: 272] [Impact Index Per Article: 54.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/30/2018] [Accepted: 10/02/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dietary changes are suggested to play a role in the increasing prevalence of allergic diseases and asthma. Short-chain fatty acids (SCFAs) are metabolites present in certain foods and are produced by microbes in the gut following fermentation of fibers. SCFAs have been shown to have anti-inflammatory properties in animal models. Our objective was to investigate the potential role of SCFAs in the prevention of allergy and asthma. METHODS We analyzed SCFA levels by high-performance liquid chromatography (HPLC) in fecal samples from 301 one-year-old children from a birth cohort and examined their association with early life exposures, especially diet, and allergy and asthma later in life. Data on exposures and allergic diseases were collected by questionnaires. In addition, we treated mice with SCFAs to examine their effect on allergic airway inflammation. RESULTS Significant associations between the levels of SCFAs and the infant's diet were identified. Children with the highest levels of butyrate and propionate (≥95th percentile) in feces at the age of one year had significantly less atopic sensitization and were less likely to have asthma between 3 and 6 years. Children with the highest levels of butyrate were also less likely to have a reported diagnosis of food allergy or allergic rhinitis. Oral administration of SCFAs to mice significantly reduced the severity of allergic airway inflammation. CONCLUSION Our results suggest that strategies to increase SCFA levels could be a new dietary preventive option for allergic diseases in children.
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Affiliation(s)
- Caroline Roduit
- University Children's Hospital Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Children's Hospital St Gallen St Gallen Switzerland
| | - Remo Frei
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Ruth Ferstl
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Susanne Loeliger
- University Children's Hospital Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - Patrick Westermann
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Claudio Rhyner
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Elisa Schiavi
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Weronika Barcik
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Noelia Rodriguez‐Perez
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Marcin Wawrzyniak
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | - Christophe Lacroix
- Department of Health Sciences and Technology ETH‐Zurich Zurich Switzerland
| | - Elisabeth Schmausser‐Hechfellner
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
| | - Martin Depner
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
| | - Erika Mutius
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
- Dr von Hauner Children's Hospital of Ludwig Maximilian University of Munich Comprehensive Pneumology Center Munich (CPC‐M) Munich Germany
| | | | - Anne M. Karvonen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
| | - Pirkka V. Kirjavainen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Juha Pekkanen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
- Department of Public Health University of Helsinki Helsinki Finland
| | - Jean‐Charles Dalphin
- Department of Respiratory Disease University of Besançon UMR/CNRS 6249 Chrono‐environment University Hospital Besançon France
| | | | - Cezmi Akdis
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Roger Lauener
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Children's Hospital St Gallen St Gallen Switzerland
| | - Liam O'Mahony
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Departments of Medicine and Microbiology APC Microbiome Ireland National University of Ireland Cork Ireland
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8
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Vongthilath R, Richaud Thiriez B, Dehillotte C, Lemonnier L, Guillien A, Degano B, Dalphin ML, Dalphin JC, Plésiat P. Clinical and microbiological characteristics of cystic fibrosis adults never colonized by Pseudomonas aeruginosa: Analysis of the French CF registry. PLoS One 2019; 14:e0210201. [PMID: 30620748 PMCID: PMC6324790 DOI: 10.1371/journal.pone.0210201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 09/04/2018] [Accepted: 12/18/2018] [Indexed: 01/13/2023] Open
Abstract
Pseudomonas aeruginosa is the main cause of chronic airway infection in cystic fibrosis (CF). However, for unclear reasons some patients are never colonized by P. aeruginosa. The objectives of this study were to better define the clinical, genetic, and microbiological characteristics of such a subpopulation and to identify predictive factors of non-colonization with P. aeruginosa. The French CF patient registry 2013–2014 was used to identify CF patients aged ≥ 20 years. The clinical outcomes, CF Transmembrane conductance Regulator (CFTR) genotypes, and microbiological data of patients reported positive at least once for P. aeruginosa (“Pyo” group, n = 1,827) were compared to those of patients with no history of P. aeruginosa isolation (“Never” group, n = 303). Predictive factors of non-colonization by P. aeruginosa were identified by multivariate logistic regression model with backward selection. Absence of aspergillosis (odds ratio (OR) [95% CI] = 1.64 [1.01–2.66]), absence of diabetes (2.25 [1.21–4.18]), pancreatic sufficiency (1.81 [1.30–2.52]), forced expiratory volume 1 (FEV1) ≥ 80% (3.03 [2.28–4.03]), older age at CF diagnosis (1.03 [1.02–1.04]), and absence of F508del/F508del genotype (2.17 [1.48–3.19]) were predictive clinical factors associated with absence of infection (“Never” group). Microbiologically, this same group was associated with more frequent detection of Haemophilus influenzae and lower rates of Stenotrophomonas maltophilia, Achromobacter xylosoxidans and Aspergillus spp. (all p<0.01) in sputum. This study strongly suggests that the absence of pulmonary colonization by P. aeruginosa in a minority of CF adults (14.2%) is associated with a milder form of the disease. Recent progress in the development of drugs to correct CFTR deficiency thus may be decisive in the control of P. aeruginosa lung infection.
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Affiliation(s)
- Réchana Vongthilath
- Department of Respiratory Medicine, University Hospital Jean Minjoz, Besançon, France
| | | | | | - Lydie Lemonnier
- Medical Department of Vaincre La Mucoviscidose, Paris, France
| | - Alicia Guillien
- Department of Physiology, University Hospital Jean Minjoz, Besançon, France
| | - Bruno Degano
- Department of Physiology, University Hospital Jean Minjoz, Besançon, France
- EA3920, University of Franche-Comté, Besançon, France
| | - Marie-Laure Dalphin
- Department of Pediatric Medicine, University Hospital Jean Minjoz, Besançon, France
| | - Jean-Charles Dalphin
- Department of Respiratory Medicine, University Hospital Jean Minjoz, Besançon, France
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France
| | - Patrick Plésiat
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France
- Department of Bacteriology, University Hospital Jean Minjoz, Besançon, France
- * E-mail:
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9
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Twardziok M, Schröder PC, Krusche J, Casaca VI, Illi S, Böck A, Loss GJ, Kabesch M, Toncheva AA, Roduit C, Depner M, Genuneit J, Renz H, Roponen M, Weber J, Braun-Fahrländer C, Riedler J, Lauener R, Vuitton DA, Dalphin JC, Pekkanen J, von Mutius E, Schaub B, Hyvärinen A, Karvonen AM, Kirjavainen PV, Remes S, Kaulek V, Dalphin ML, Ege M, Pfefferle PI, Doekes G. Asthmatic farm children show increased CD3 +CD8 low T-cells compared to non-asthmatic farm children. Clin Immunol 2017; 183:285-292. [PMID: 28917722 DOI: 10.1016/j.clim.2017.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/28/2017] [Accepted: 09/12/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Monika Twardziok
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Paul C Schröder
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Johanna Krusche
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany; Member of German Center for Lung Research, DZL, LMU Munich, Germany
| | - Vera I Casaca
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Sabina Illi
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Andreas Böck
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Georg J Loss
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany; University of California, San Diego, School of Medicine, Department of Pediatrics, CA, USA
| | - Michael Kabesch
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - Antoaneta A Toncheva
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - Caroline Roduit
- Zurich University Children's Hospital, Zurich, Switzerland; Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland and Christine Kühne-Center for Allergy Research and Education, St. Gallen, Switzerland
| | - Martin Depner
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Harald Renz
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany; Member of German Center for Lung Research, DZL, LMU Munich, Germany
| | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Juliane Weber
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | | | | | - Roger Lauener
- Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland and Christine Kühne-Center for Allergy Research and Education, St. Gallen, Switzerland
| | | | | | - Juha Pekkanen
- Department of Public health, University of Helsinki, Helsinki, Finland; Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Erika von Mutius
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany; Member of German Center for Lung Research, DZL, LMU Munich, Germany
| | - Bianca Schaub
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany; Member of German Center for Lung Research, DZL, LMU Munich, Germany.
| | | | - Anne Hyvärinen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Anne M Karvonen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Pirkka V Kirjavainen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Sami Remes
- Kuopio University Hospital, Department of Paediatrics, Kuopio, Finland
| | - Vincent Kaulek
- University Hospital of Besançon, University of Franche-Comté, Besançon, France
| | - Marie-Laure Dalphin
- University Hospital of Besançon, University of Franche-Comté, Besançon, France
| | - Markus Ege
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany; Member of German Center for Lung Research, DZL, LMU Munich, Germany
| | - Petra I Pfefferle
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany; Member of German Center for Lung Research, DZL, LMU Munich, Germany
| | - Gert Doekes
- Utrecht University, Institut for Risk Assessment Sciences (IRAS), Devision of Environmental Epidemiology, Utrecht, Netherlands
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10
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Roduit C, Frei R, Depner M, Karvonen AM, Renz H, Braun-Fahrländer C, Schmausser-Hechfellner E, Pekkanen J, Riedler J, Dalphin JC, von Mutius E, Lauener RP, Hyvärinen A, Kirjavainen P, Remes S, Roponen M, Dalphin ML, Kaulek V, Ege M, Genuneit J, Illi S, Kabesch M, Schaub B, Pfefferle PI, Doekes G. Phenotypes of Atopic Dermatitis Depending on the Timing of Onset and Progression in Childhood. JAMA Pediatr 2017; 171:655-662. [PMID: 28531273 PMCID: PMC5710337 DOI: 10.1001/jamapediatrics.2017.0556] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Atopic dermatitis is an inflammatory, pruritic skin disease that often occurs in early infancy with a chronic course. However, a specific description of subtypes of atopic dermatitis depending on the timing of onset and progression of the disease in childhood is lacking. OBJECTIVE To identify different phenotypes of atopic dermatitis using a definition based on symptoms before age 6 years and to determine whether some subtypes are more at risk for developing other allergic diseases. DESIGN, SETTING, AND PARTICIPANTS The Protection Against Allergy Study in Rural Environments (PASTURE) is a European birth cohort where pregnant women were recruited between August 2002 and March 2005 and divided in 2 groups dependent on whether they lived on a farm. Children from this cohort with data on atopic dermatitis from birth to 6 years of age were included. EXPOSURES Atopic dermatitis, defined as an itchy rash on typical locations from birth to 6 years. MAIN OUTCOMES AND MEASURES The latent class analysis was used to identify subtypes of atopic dermatitis in childhood based on the course of symptoms. Multivariable logistic regressions were used to analyze the association between atopic dermatitis phenotypes and other allergic diseases. RESULTS We included 1038 children; of these, 506 were girls. The latent class analysis model with the best fit to PASTURE data separated 4 phenotypes of atopic dermatitis in childhood: 2 early phenotypes with onset before age 2 years (early transient [n = 96; 9.2%] and early persistent [n = 67; 6.5%]), the late phenotype with onset at age 2 years or older (n = 50; 4.8%), and the never/infrequent phenotype (n = 825; 79.5%), defined as children with no atopic dermatitis. Children with both parents with history of allergies were 5 times more at risk to develop atopic dermatitis with an early-persistent phenotype compared with children with parents with no history of allergies. Both early phenotypes were strongly associated with food allergy. The risk of developing asthma was significantly increased among the early-persistent phenotype (adjusted odds ratio, 2.87; 95% CI, 1.31-6.31). The late phenotype was only positively associated with allergic rhinitis. CONCLUSIONS AND RELEVANCE Using latent class analysis, 4 phenotypes of atopic dermatitis were identified depending on the onset and course of the disease. The prevalence of asthma and food allergy by 6 years of age was strongly increased among children with early phenotypes (within age 2 years), especially with persistent symptoms. These findings are important for the development of strategies in allergy prevention.
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Affiliation(s)
- Caroline Roduit
- University Children’s Hospital, Zurich, Switzerland,Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
| | - Remo Frei
- Christine Kühne Center for Allergy Research and Education, Davos, Switzerland,Swiss Institute of Allergy and Asthma Research, University of Zurich, Zurich, Switzerland
| | - Martin Depner
- Dr von Hauner Children’s Hospital, Ludwig Maximilian University, Munich, Germany
| | - Anne M. Karvonen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Harald Renz
- Institute for Laboratory Medicine, Pathobiochemistry and Molecular Diagnostics, Philipps University of Marburg, Marburg, Germany
| | | | | | - Juha Pekkanen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Josef Riedler
- Children’s Hospital Schwarzach, Teaching Hospital Paracelsus Private Medical University Salzburg, Salzburg, Austria
| | - Jean-Charles Dalphin
- University of Besançon, Department of Respiratory Disease, Unités Mixtes de Recherche/Le Centre National de la Recherche Scientifique 6249 Chrono-environment, University Hospital, Besançon, France
| | - Erika von Mutius
- Dr von Hauner Children’s Hospital, Ludwig Maximilian University, Munich, Germany,Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research, Munich, Germany
| | - Roger Pascal Lauener
- Christine Kühne Center for Allergy Research and Education, Davos, Switzerland,Children’s Hospital of Eastern Switzerland, St Gallen, Switzerland
| | | | - Anne Hyvärinen
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | | | | | | | | | - Vincent Kaulek
- University of Besançon, Department of Respiratory Disease, Unités Mixtes de Recherche/Le Centre National de la Recherche Scientifique 6249 Chrono-environment, University Hospital, Besançon, France
| | - Markus Ege
- Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research, Munich, Germany
| | | | - Sabina Illi
- Asthma and Allergy Research Group, University of Munich, Munich, Germany
| | - Micahel Kabesch
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg, Regensburg, Germany
| | - Bianca Schaub
- Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research, Munich, Germany
| | | | - Gert Doekes
- Utrecht University, Institue for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht, Germany
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11
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Hose AJ, Depner M, Illi S, Lau S, Keil T, Wahn U, Fuchs O, Pfefferle PI, Schmaußer-Hechfellner E, Genuneit J, Lauener R, Karvonen AM, Roduit C, Dalphin JC, Riedler J, Pekkanen J, von Mutius E, Ege MJ, Zepp F, Wahn V, Schuster A, Bergmann RL, Bergmann KE, Reich A, Grabenhenrich L, Schaub B, Loss GJ, Renz H, Kabesch M, Roponen M, Hyvärinen A, Tiittanen P, Remes S, Braun-Fahrländer C, Frei R, Kaulek V, Dalphin ML, Doekes G, Blümer N, Frey U. Latent class analysis reveals clinically relevant atopy phenotypes in 2 birth cohorts. J Allergy Clin Immunol 2016; 139:1935-1945.e12. [PMID: 27771325 DOI: 10.1016/j.jaci.2016.08.046] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 08/11/2016] [Accepted: 08/22/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Phenotypes of childhood-onset asthma are characterized by distinct trajectories and functional features. For atopy, definition of phenotypes during childhood is less clear. OBJECTIVE We sought to define phenotypes of atopic sensitization over the first 6 years of life using a latent class analysis (LCA) integrating 3 dimensions of atopy: allergen specificity, time course, and levels of specific IgE (sIgE). METHODS Phenotypes were defined by means of LCA in 680 children of the Multizentrische Allergiestudie (MAS) and 766 children of the Protection against allergy: Study in Rural Environments (PASTURE) birth cohorts and compared with classical nondisjunctive definitions of seasonal, perennial, and food sensitization with respect to atopic diseases and lung function. Cytokine levels were measured in the PASTURE cohort. RESULTS The LCA classified predominantly by type and multiplicity of sensitization (food vs inhalant), allergen combinations, and sIgE levels. Latent classes were related to atopic disease manifestations with higher sensitivity and specificity than the classical definitions. LCA detected consistently in both cohorts a distinct group of children with severe atopy characterized by high seasonal sIgE levels and a strong propensity for asthma; hay fever; eczema; and impaired lung function, also in children without an established asthma diagnosis. Severe atopy was associated with an increased IL-5/IFN-γ ratio. A path analysis among sensitized children revealed that among all features of severe atopy, only excessive sIgE production early in life affected asthma risk. CONCLUSIONS LCA revealed a set of benign, symptomatic, and severe atopy phenotypes. The severe phenotype emerged as a latent condition with signs of a dysbalanced immune response. It determined high asthma risk through excessive sIgE production and directly affected impaired lung function.
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Affiliation(s)
| | - Martin Depner
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany
| | - Sabina Illi
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany
| | - Susanne Lau
- Department for Pediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | - Ulrich Wahn
- Department for Pediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Oliver Fuchs
- Dr von Hauner Children's Hospital, LMU Munich, and the Comprehensive Pneumology Center, Munich (CPC-M), Germany (Member of the German Center for Lung Research [DZL]), Munich, Germany; Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland; University Children's Hospital (UKBB), University of Basel, Basel, Switzerland
| | - Petra Ina Pfefferle
- Comprehensive Biomaterial Bank Marburg CBBM, Fachbereich Medizin der Philipps Universität Marburg, Zentrum für Tumor und Immunbiologie ZTI Marburg (Member of the German Center for Lung Research), Marburg, Germany
| | | | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Roger Lauener
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland; Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
| | - Anne M Karvonen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - Caroline Roduit
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland; Children's Hospital, University of Zürich, Zürich, Switzerland
| | - Jean-Charles Dalphin
- Department of Respiratory Disease, University of Besançon, UMR/CNRS6249 Chrono-environment, University Hospital, Besançon, France
| | - Josef Riedler
- Children's Hospital Schwarzach, and the Teaching Hospital of Paracelsus Medical Private University Salzburg, Salzburg, Austria
| | - Juha Pekkanen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Erika von Mutius
- Dr von Hauner Children's Hospital, LMU Munich, and the Comprehensive Pneumology Center, Munich (CPC-M), Germany (Member of the German Center for Lung Research [DZL]), Munich, Germany
| | - Markus J Ege
- Dr von Hauner Children's Hospital, LMU Munich, and the Comprehensive Pneumology Center, Munich (CPC-M), Germany (Member of the German Center for Lung Research [DZL]), Munich, Germany
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12
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Chauveau A, Dalphin ML, Kaulek V, Roduit C, Pugin A, von Mutius E, Vuitton DA, Dalphin JC. Disagreement between Skin Prick Tests and Specific IgE in Early Childhood. Int Arch Allergy Immunol 2016; 170:69-74. [DOI: 10.1159/000446776] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 05/03/2016] [Indexed: 11/19/2022] Open
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13
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Loss G, Bitter S, Wohlgensinger J, Frei R, Roduit C, Genuneit J, Pekkanen J, Roponen M, Hirvonen MR, Dalphin JC, Dalphin ML, Riedler J, von Mutius E, Weber J, Kabesch M, Michel S, Braun-Fahrländer C, Lauener R. Prenatal and early-life exposures alter expression of innate immunity genes: the PASTURE cohort study. J Allergy Clin Immunol 2012; 130:523-30.e9. [PMID: 22846753 DOI: 10.1016/j.jaci.2012.05.049] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 04/20/2012] [Accepted: 05/23/2012] [Indexed: 01/01/2023]
Abstract
BACKGROUND There is evidence that gene expression of innate immunity receptors is upregulated by farming-related exposures. OBJECTIVE We sought to determine environmental and nutritional exposures associated with the gene expression of innate immunity receptors during pregnancy and the first year of a child's life. METHODS For the Protection Against Allergy: Study in Rural Environments (PASTURE) birth cohort study, 1133 pregnant women were recruited in rural areas of Austria, Finland, France, Germany, and Switzerland. mRNA expression of the Toll-like receptor (TLR) 1 through TLR9 and CD14 was assessed in blood samples at birth (n= 938) and year 1 (n= 752). Environmental exposures, as assessed by using questionnaires and a diary kept during year 1, and polymorphisms in innate receptor genes were related to gene expression of innate immunity receptors by using ANOVA and multivariate regression analysis. RESULTS Gene expression of innate immunity receptors in cord blood was overall higher in neonates of farmers (P for multifactorial multivariate ANOVA= .041), significantly so for TLR7 (adjusted geometric means ratio [aGMR], 1.15; 95% CI, 1.02-1.30) and TLR8 (aGMR, 1.15; 95% CI, 1.04-1.26). Unboiled farm milk consumption during the first year of life showed the strongest association with mRNA expression at year 1, taking the diversity of other foods introduced during that period into account: TLR4 (aGMR, 1.22; 95% CI, 1.03-1.45), TLR5 (aGMR, 1.19; 95% CI, 1.01-1.41), and TLR6 (aGMR, 1.20; 95% CI, 1.04-1.38). A previously described modification of the association between farm milk consumption and CD14 gene expression by the single nucleotide polymorphism CD14/C-1721T was not found. CONCLUSION Farming-related exposures, such as raw farm milk consumption, that were previously reported to decrease the risk for allergic outcomes were associated with a change in gene expression of innate immunity receptors in early life.
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Affiliation(s)
- Georg Loss
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
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Nathan N, Taam RA, Epaud R, Delacourt C, Deschildre A, Reix P, Chiron R, de Pontbriand U, Brouard J, Fayon M, Dubus JC, Giovannini-Chami L, Bremont F, Bessaci K, Schweitzer C, Dalphin ML, Marguet C, Houdouin V, Troussier F, Sardet A, Hullo E, Gibertini I, Mahloul M, Michon D, Priouzeau A, Galeron L, Vibert JF, Thouvenin G, Corvol H, Deblic J, Clement A. A national internet-linked based database for pediatric interstitial lung diseases: the French network. Orphanet J Rare Dis 2012; 7:40. [PMID: 22704798 PMCID: PMC3458912 DOI: 10.1186/1750-1172-7-40] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [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: 01/23/2012] [Accepted: 06/15/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Interstitial lung diseases (ILDs) in children represent a heterogeneous group of rare respiratory disorders that affect the lung parenchyma. After the launch of the French Reference Centre for Rare Lung Diseases (RespiRare®), we created a national network and a web-linked database to collect data on pediatric ILD. METHODS Since 2008, the database has been set up in all RespiRare® centres. After patient's parents' oral consent is obtained, physicians enter the data of children with ILD: identity, social data and environmental data; specific aetiological diagnosis of the ILD if known, genetics, patient visits to the centre, and all medical examinations and tests done for the diagnosis and/or during follow up. Each participating centre has a free access to his own patients' data only, and cross-centre studies require mutual agreement. Physicians may use the system as a daily aid for patient care through a web-linked medical file, backed on this database. RESULTS Data was collected for 205 cases of ILD. The M/F sex ratio was 0.9. Median age at diagnosis was 1.5 years old [0-16.9]. A specific aetiology was identified in 149 (72.7%) patients while 56 (27.3%) cases remain undiagnosed. Surfactant deficiencies and alveolar proteinosis, haemosiderosis, and sarcoidosis represent almost half of the diagnoses. Median length of follow-up is 2.9 years [0-17.2]. CONCLUSIONS We introduce here the French network and the largest national database in pediatric ILDs. The diagnosis spectrum and the estimated incidence are consistent with other European databases. An important challenge will be to reduce the proportion of unclassified ILDs by a standardized diagnosis work-up. This database is a great opportunity to improve patient care and disease pathogenesis knowledge. A European network including physicians and European foundations is now emerging with the initial aim of devising a simplified European database/register as a first step to larger European studies.
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Affiliation(s)
- Nadia Nathan
- AP-HP, Hôpital Trousseau, Pediatric Pulmonary Department, Paris, France.
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15
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Duhamel JF, Le Gall E, Dalphin ML, Payen-Champenois C. Antipyretic efficacy and safety of a single intravenous administration of 15 mg/kg paracetamol versus 30 mg/kg propacetamol in children with acute fever due to infection. Int J Clin Pharmacol Ther 2007; 45:221-9. [PMID: 17474540 DOI: 10.5414/cpp45221] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES An intravenous formulation of paracetamol and an intravenous formulation of propacetamol (prodrug of paracetamol) were compared in children with acute fever due to infection in order to determine the antipyretic efficacy and safety during the 6-hour period after administration. METHODS A total of 67 patients aged 1 month to 12 years and with a rectal body temperature between 38.5 degrees C and 41 degrees C, were randomized to receive either intravenous paracetamol 15 mg/kg (n = 35) or propacetamol 30 mg/kg (n = 32) under double-blind conditions. RESULTS The non-inferiority of intravenous paracetamol compared to propacetamol was demonstrated (non-inferiority margin = 0.5 degrees C) by the median body temperature reduction of 1.9 degrees C in the intravenous paracetamol group and the reduction of 2.05 degrees C in the propacetamol group. The difference in the incidence of local adverse events was statistically significant (p = 0.0134) with more local adverse events in the propacetamol group (9, 28.1%) than in the intravenous paracetamol group (2, 5.7%). CONCLUSION This double-blind, randomized, clinical trial demonstrates the non-inferiority of a single administration of 15 mg/kg intravenous paracetamol in comparison to 30 mg/kg propacetamol in terms of body temperature reduction in children aged 1 month to 12 years with acute fever due to infection. It confirms the better local safety of intravenous paracetamol in comparison to propacetamol.
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Affiliation(s)
- J F Duhamel
- CHU Caen, Pediatric Service, Caen cedex, France.
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16
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Vassal S, Taamma R, Marty N, Sardet A, d'athis P, Brémont F, Dalphin ML, Plésiat P, Rault G, Thubert J, Dominique S, Lemeland JF, Derelle J, Blech MF, Roussey M, Perrin M, Sautegeau A. Microbiologic contamination study of nebulizers after aerosol therapy in patients with cystic fibrosis. Am J Infect Control 2000; 28:347-51. [PMID: 11029133 DOI: 10.1067/mic.2000.110214] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND To evaluate the contamination of delivery systems after an aerosol therapy session in patients with cystic fibrosis who have chronic Pseudomonas aeruginosa infection. METHODS Fifty-three patients with cystic fibrosis were enrolled in the study from March 1996 to June 1997. All patients were age 7 years or older and had P aeruginosa infection. They also had been treated with recombinant deoxyribonuclease and were capable of producing sputum for culture. RESULTS Nine devices were excluded for the study. A total of 44 nebulizers were included: 37 from patients with P aeruginosa colonization with a count of 10(6) colony-forming units/mL or more and 7 with a count of between 10(5) colony-forming units/mL and 10(6) colony-forming units/mL. CONCLUSION This study demonstrates that in the absence of cleaning, nebulizers of patients with cystic fibrosis who are infected with P aeruginosa are likely to be contaminated by a pathogenic flora.
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Affiliation(s)
- S Vassal
- Rouen University Hospital, France
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17
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Burguet A, Monnet E, Pauchard JY, Roth P, Fromentin C, Dalphin ML, Allemand H, Maillet R, Menget A. Some risk factors for cerebral palsy in very premature infants: importance of premature rupture of membranes and monochorionic twin placentation. Biol Neonate 1999; 75:177-86. [PMID: 9925905 DOI: 10.1159/000014094] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To delineate the perinatal risk factors of neurodevelopmental disabilities in very preterm birth applying logistic regression analysis. DESIGN This prospective, geographically defined collaborative study was carried out in the Franche-Comté region of France. SUBJECTS From October 1, 1990 to September 30, 1992, perinatal and follow-up data were collected on 203 consecutive live-born singleton or twin non-malformed infants with strictly ascertained gestational ages of less than 33 weeks. MAIN OUTCOME MEASURE The rate of cerebral palsy and/or severe mental retardation as diagnosed by a family physician or pediatrician with a screening-skill test performed at 2 years of age. RESULTS 167/171 (98%) survivors were evaluated. Twenty-two of the 167 examined infants (13%) showed signs of cerebral palsy, and 10 of these had severe cerebral palsy or mental retardation. Risk factors for disabilities were selected by a multivariate approach: premature rupture of membranes >/=48 h (OR 4.3, 95% CI 1.6-11.8); monochorionic twin placentation (OR 6.0, 95% CI 1.7-21.3), and respiratory distress syndrome (OR 2.8, 95% CI 1.1-7.1). CONCLUSION This geographically defined prospective study gives epidemiological data and highly suggests that there is a link between prenatal events (premature rupture of membranes, monochorionic twin placentation), postnatal events (respiratory distress syndrome), and neurological disabilities in former preterm infants.
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Affiliation(s)
- A Burguet
- Réanimation Infantile Polyvalente, Centre Hospitalo-Universitaire de Besançon, France
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Roth P, Maillet R, Dalphin ML, Schaal JP, Colette C. [Toxoplasmosis and pregnancy: is it possible to simplify the diagnostic procedures?]. J Gynecol Obstet Biol Reprod (Paris) 1993; 22:277-283. [PMID: 8345152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
About 1% of all pregnancies in France are complicated by a primary infection with toxoplasmosis. The risk for the fetus being affected increases during the pregnancy but the seriousness of the effect on the fetus becomes less with more advanced pregnancies. Treatment of the mother using Spiramycin have been proven to be efficient, lessening the risk for the fetus being affected. The diagnosis of the fetus being affected rests on a whole bundle of presumptive evidence culled from non-invasive methods and invasive methods which are not without risk. (Direct or over-enthusiastic diagnostic techniques or none at all). We have studied a series of 101 primary infections with toxoplasmosis for which we have not carried out any invasive diagnostic techniques. The long term results in 77 infants show no difference in fetal morbidity and better results as far as mortality are concerned. We therefore propose simplifying the diagnostic approach in cases of primary infection with toxoplasmosis during pregnancy.
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Affiliation(s)
- P Roth
- Clinique Universitaire de Gynécologie, d'Obstétrique et de la Reproduction, CHRU Besançon
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Dalphin ML, Schirrer J, Colette C, Bertrand AM, Noir A. [Screening for hepatitis B carriers at the maternity unit of Besançon teaching hospital]. Rev Fr Gynecol Obstet 1991; 86:271-3. [PMID: 2068490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There are more than 280 carriers of the hepatitis B virus worldwide. The risk of chronic carriers, and a fatal outcome due to hepatocarcinoma, is estimated to be about 50% in Asian children contaminated by materno-fetal transmission. Serovaccination of the neonatal infant born to a HBV carrying mother provides protection in nearly 100% of cases. Routine screening for HBV carriers at the Besançon teaching hospital maternity unit led to the vaccination of 1.12% of the babies born in 1990, which corresponds to the current national average.
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