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Bouko-Levy E, Vialaret C, Sallée C, Marquet P, Margueritte F, Dion L, Lavoue V, Gauthier T. Estimation of the prevalence of uterine infertility and its different causes in France according to data from a literature review. J Gynecol Obstet Hum Reprod 2023; 52:102684. [PMID: 37866776 DOI: 10.1016/j.jogoh.2023.102684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/20/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Uterine infertility (UI) is defined as the complete absence of a uterus (absolute uterine infertility or AUI) or the presence of a non functional uterus (non-absolute uterine infertility or NAUI). The exact prevalence of uterine infertility is currently unknown. Our aim was to assess the number of French women concerned by Uterine Infertility according to a recent literature review. MATERIALS AND METHODS We have previously conducted a systematic review of the literature on UI and its various causes in the world. Based on these study and demographic data of 2022 from INSEE (Institut National de la Statistique et des Études Économiques), we attempted to estimate the number of women under 40 years of age in France affected by potential UI using direct standardization. RESULTS AND DISCUSSION Based on the estimation from INSEE data, approximately 2066 women of childbearing age would have MRKH syndrome in France, 380 the Androgen Insensitivity Syndrome and 3700 had an haemostasis hysterectomy in France. We did not find data on the prevalence of hysterectomies before the age of 40 in France. For the following pathologies: uterine malformations, radiation uterus, synechiae, myomas and adenomyosis there was a huge amount of missing data, which does not allow us to estimate the number of potentially infertile patients. CONCLUSION Prevalence of UI is poorly known. UI probably concerns several thousand patients in France. The creation of a UI registry would make enable to assess the number of patients potentially eligible for adoption, uterus transplantation or even surrogacy.
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Affiliation(s)
- E Bouko-Levy
- Department of Gynecology and Obstetrics, Mother and Child Hospital, University Hospital Center of Limoges, Limoges 87000, France
| | - C Vialaret
- Department of Gynecology and Obstetrics, Mother and Child Hospital, University Hospital Center of Limoges, Limoges 87000, France
| | - C Sallée
- Department of Gynecology and Obstetrics, Mother and Child Hospital, University Hospital Center of Limoges, Limoges 87000, France
| | - P Marquet
- Pharmacology and Transplantation, INSERM U1248, Université de Limoges, 2 Rue du Pr Descottes, Limoges 87000, France
| | - F Margueritte
- Department of Gynecology and Obstetrics, Mother and Child Hospital, University Hospital Center of Limoges, Limoges 87000, France
| | - L Dion
- Department of Obstetrics and Gynecology, Hopital Universitaire de Rennes, Rennes 35000, France
| | - V Lavoue
- Department of Obstetrics and Gynecology, Hopital Universitaire de Rennes, Rennes 35000, France
| | - T Gauthier
- Department of Gynecology and Obstetrics, Mother and Child Hospital, University Hospital Center of Limoges, Limoges 87000, France; Pharmacology and Transplantation, INSERM U1248, Université de Limoges, 2 Rue du Pr Descottes, Limoges 87000, France.
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Robin T, Barnes A, Loftus N, Dulaurent S, Marquet P, El Balkhi S, Saint-Marcoux F. Fully automated extraction coupled to LC-MS/MS: Application to the quantitation of about 250 compounds of interest in toxicology. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tardieu A, Chazelas P, Faye PA, Favreau F, Nadal-Desbarats L, Sallée C, Margueritte F, Couquet CY, Marquet P, Guellec CBL, Gauthier T. Changes in the metabolic composition of storage solution with prolonged cold ischemia of the uterus. J Assist Reprod Genet 2019; 36:1169-1178. [PMID: 31079269 DOI: 10.1007/s10815-019-01477-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/03/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The development of uterine transplantation (UTx) from deceased donors requires knowledge of the tolerance of the uterus to prolonged cold ischemia (CI). This can be evaluated through the use of biological parameters to assess degradation of the organ between its procurement and transplantation. The objective of this study was to analyze changes in the metabolic composition of the storage solution in cases of prolonged CI in uteri from ewes. METHODS Eighteen uterine auto-transplantations were performed in ewes. CI time was 1 h (T1) or 24 h (T24). Samples of Celsior® were taken when the explanted uterus was flushed (T0) and at the end of CI. A dual approach to metabolic analyses was followed: targeted biochemical analyses targeting several predefined metabolites and non-targeted metabolomics analyses based on nuclear magnetic resonance (NMR). RESULTS Metabolic analyses were performed on 16 explanted uteri. Metabolomic profiles differed significantly between T1 and T24 (p = 0.003). Hypoxia-associated degradation of the organ was demonstrated by the significantly higher lactate levels at T24 than at T1 (p < 0.05), accompanied by cell lysis, and significantly higher levels of creatine kinase activity in T24 than in T1 uteri (p < 0.05). Oxidative stress increased over time, with a significantly higher oxidized glutathione/glutathione ratio for T24 than for T1 uteri (p < 0.05). CONCLUSION The metabolic results indicate a significant degradation of the uterus during 24 h of CI. Metabolic analysis of the storage solution could be used as a non-invasive tool for evaluating uterine degradation during CI before transplantation.
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Affiliation(s)
- Antoine Tardieu
- INSERM, Inserm Unit U1248, 87000, Limoges, France. .,Department of Gynecologic and Obstetric, Hospital of Limoges, 87000, Limoges, France.
| | - P Chazelas
- Faculty of Medicine, EA 6309 "Maintenance Myélinique et Neuropathies Périphériques", University of Limoges, 87000, Limoges, France.,Laboratory of Biochemistry and Molecular genetics, Hospital of Limoges, 87000, Limoges, France
| | - P-A Faye
- Faculty of Medicine, EA 6309 "Maintenance Myélinique et Neuropathies Périphériques", University of Limoges, 87000, Limoges, France.,Laboratory of Biochemistry and Molecular genetics, Hospital of Limoges, 87000, Limoges, France
| | - F Favreau
- Faculty of Medicine, EA 6309 "Maintenance Myélinique et Neuropathies Périphériques", University of Limoges, 87000, Limoges, France.,Laboratory of Biochemistry and Molecular genetics, Hospital of Limoges, 87000, Limoges, France
| | | | - C Sallée
- Department of Gynecologic and Obstetric, Hospital of Limoges, 87000, Limoges, France
| | - F Margueritte
- Department of Gynecologic and Obstetric, Hospital of Limoges, 87000, Limoges, France
| | - C-Y Couquet
- Platform of Medicine, Imagery and experimental surgery (MICE), Hospital of Limoges, 87000, Limoges, France
| | - P Marquet
- INSERM, Inserm Unit U1248, 87000, Limoges, France
| | - C Barin-Le Guellec
- INSERM, Inserm Unit U1248, 87000, Limoges, France.,Faculty of Medicine, University of Tours, 37000, Tours, France
| | - T Gauthier
- INSERM, Inserm Unit U1248, 87000, Limoges, France.,Department of Gynecologic and Obstetric, Hospital of Limoges, 87000, Limoges, France
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Chantemargue B, Di Meo F, Berka K, Picard N, Arnion H, Essig M, Marquet P, Otyepka M, Trouillas P. Structural patterns of the human ABCC4/MRP4 exporter in lipid bilayers rationalize clinically observed polymorphisms. Pharmacol Res 2018. [DOI: 10.1016/j.phrs.2018.02.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Roché H, Venat-Bouvet L, Debled M, Jacot W, Suc E, Dalenc F, Molnar-Stanciu D, Dohollou N, Franck D, Ferrer C, Laharie-Mineur H, Lavau-Denes S, Massabeau C, Mauries V, Robert J, Pinguet F, Marquet P, Evrard A, Chatelut E, Filleron T. Abstract P3-12-10: First 6-month report of the longitudinal PHACS study ( Pharmacology and Hormonotherapy (HT) for Adjuvant breast Cancer (BC) Study, NCT01127295). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-12-10] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background: BC is a hormone-dependent disease for 75% of pts. HT is used in both adjuvant and metastatic settings for hormone–receptor (HR) positive tumors. In adjuvant situation, a 5-year HT period at least is recommended. Side-effects (SE) frequently alter quality of life and compliance, reducing the well-known benefits in risks of relapses and specific deaths. Underlying mechanisms are well understood for estrogen deprivation-induced events such as hot flashes, but little is known on arthralgia under aromatase inhibitors (AI). So, pharmacogenomics (PG), pharmacokinetics (PK), potential medications interactions are of value to explain individual drugs exposures, possible related side-effects and compliance to treatment.
Methods: We performed a prospective, multicenter, longitudinal study registering early clinical outcomes and SE during the first 3 years of adjuvant HT with tamoxifen (T) or AI. All tumors expressed at least one HR (>10%). The choice of HT molecule and one-drug or sequential treatment were left to the investigator. Pts were followed every 6 months with clinical examination by the referent oncologist and PK sampling each time. Biologic research consisted in PG investigations of different genes involved in the PK and pharmacodynamics of T and AI (95 SNPs) at baseline. SE, concurrent medications and compliance were registered by both the pts on a diary card and the physician. Evaluation was done only on new occurrence or increased grade of symptoms.
Results: This first report focuses on characteristics of the population and the results after the 6 first months of treatment. Between June 2010 and October 2014, 23 centers recruited 2000 pts. 23 were excluded leaving 1977 fully evaluable women; 879 (44%) started with T, 1098 (55%) with AI (554 letrozole (L), 390 anastrozole (A), 154 exemestane (E)). 56% of them had previously received chemotherapy, 96% radiotherapy and 8% trastuzumab.
Main characteristics were well balanced between the 2 classes of drugs; T was given mainly for pre- or perimenopausal pts. Most frequent co-morbidities were hypertension (8% T, 31% AI) and dyslipidemia or diabetes (T 11%, AI 26%). To note, almost 30% of pts described arthralgias at entrance and 37% had hot flashes.
At 6 months, 122 pts (6%; 43 T, 79 AI) had stopped treatment mainly for toxicity (11 T; 12 AI), progression or death (7 T; 4 IA), personal reasons (15 T; 37AI); 4 asked for changing T and 52 AI (equally for the 3 drugs). All these events were significantly more frequent for AI pts (p=0.042) and with E within the AI class (p<0.001).
Main changes in onset or increased intensity of symptoms concerned hot flushes with all drugs (30%), asthenia (20%), insomnia (20%), weight gain (17%), arthralgias (15% for T, 30% for AI), thrombotic events (24 of which 11 with T). 3 grade3 SAE HT-related were reported.
Biological data are reported in 2 other abst. (M. White-Koning. abst.#850248, F. Thomas, abst.#851525).
Conclusions: These preliminary data on the first 6-months exposure to HT on adjuvant setting in the real-life confirm early rates of withdraws and toxicities. Longer follow-up and subsequent PK analysis should help to understand persistent side-effects and reasons for non-compliance to adjuvant HT.
Citation Format: Roché H, Venat-Bouvet L, Debled M, Jacot W, Suc E, Dalenc F, Molnar-Stanciu D, Dohollou N, Franck D, Ferrer C, Laharie-Mineur H, Lavau-Denes S, Massabeau C, Mauries V, Robert J, Pinguet F, Marquet P, Evrard A, Chatelut E, Filleron T. First 6-month report of the longitudinal PHACS study (Pharmacology and Hormonotherapy (HT) for Adjuvant breast Cancer (BC) Study, NCT01127295) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-12-10.
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Affiliation(s)
- H Roché
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - L Venat-Bouvet
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - M Debled
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - W Jacot
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - E Suc
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - F Dalenc
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - D Molnar-Stanciu
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - N Dohollou
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - D Franck
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - C Ferrer
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - H Laharie-Mineur
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - S Lavau-Denes
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - C Massabeau
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - V Mauries
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - J Robert
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - F Pinguet
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - P Marquet
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - A Evrard
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - E Chatelut
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
| | - T Filleron
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse, Cedex 9, France, Metropolitan; CHU Limoges, Limoges, France, Metropolitan; Institut Bergonié, Bordeaux, France, Metropolitan; Institut de Cancérologie de Montpellier, Montpellier, France, Metropolitan; Clinique St Jean du Languedoc, Toulouse, France, Metropolitan; Centre Hospitalier, Brive, France, Metropolitan; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France, Metropolitan; Clinique Pasteur, Toulouse, France, Metropolitan; CHU Carémeau, Nîmes, France, Metropolitan; Clinique Tivoli, Bordeaux, France, Metropolitan; Centre de Recherche en Cancérologie de Toulouse, INSERM, Toulouse, France, Metropolitan
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Thomas F, Marquet P, Pinguet F, White-Koning M, Robert J, Tafzi N, Solassol I, Despax R, Levasseur N, Ellis S, Massoubre A, Mbatchi L, Le Morvan V, Roché H, Chatelut E, Evrard A. Abstract P3-12-07: Pharmacogenetic determinants of aromatase inhibitors pharmacokinetics and side effects: 6-month results of the adjuvant breast cancer longitudinal PHACS study (NCT01127295). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-12-07] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Supported by a PHRC grant (#09-18-005)
Background: Recent literature has suggested that germline genetic variants of drug-metabolizing enzymes or CYP19A1 (coding for aromatase) may be involved in the systemic aromatase inhibitors (AI) concentrations or the occurrence of side effects (Hertz et al. Pharmacogenomics 2017). A prospective multicentre 3-year follow-up study was carried out to investigate the relationships between pharmacogenetics (PG), pharmacokinetics (PK) and toxicity in breast cancer patients treated with adjuvant AI (n=1098) or tamoxifen (n=879). The clinical results and the tamoxifen PG/PK analyses are described elsewhere (abstracts #851544 and #850248).
Methods: SNP genotyping of 95 SNPs was performed on the Biomark (Fluidigm) with Taqman assays and was available for 373, 515 and 151 patients treated with anastrozole (ANA), letrozole (LETRO) and exemestane (EXE) respectively. CYP2A6 metaboliser status (MS) (poor, intermediate or normal) was determined based on alleles function (*1, *9, *2) and number of CYP2A6 copies. Trough plasma concentrations of each drug were determined 6 months after the start of the study by UPLC-MS/MS and were available for 342, 463 and 130 patients of the ANA, LETRO and EXE arms. Patients with AI concentrations below the limit of quantification were excluded for non-compliance (9 patients for ANA, 8 patients for LETRO and 7 patients for EXE). Toxicity was measured as a binary outcome (occurrence or worsening of hot flushes, fatigue, pain, arthralgia, vaginal dryness). All genetic associations were adjusted for multiple testing.
Results: ANA concentration was significantly higher in patients experiencing pain (p=0.025) and was associated with rs28365063 (UGT2B7 g.372A>G).
LETRO concentrations were strongly associated with CYP2A6 metabolizer status (p=0.0001) but did not differ in patients with or without toxicity.
In the EXE arm, patients with hot flushes or arthralgia had a significantly lower level of exemestane (p= 0.0002 and p=0.023 respectively) but since the metabolism of EXE leads to active 17-hydroexemestane, we can hypothesize that the lower EXE concentration is an indirect reflection of the metabolite formation. A SNP (rs2307424) in NR1I3 gene (coding for the constitutive androstane receptor CAR) was associated with EXE concentrations. CAR has been shown to regulate CYP2B6, which is involved in the formation of 6-hydroxy-methyl-exemestane (inactive metabolite).
Regarding the relationships between PG and toxicity, in the ANA arm, 3 SNPs of CYP19A1 gene tended to be associated with hot flushes worsening (rs934635) and arthralgia (rs10046 and rs2304463) but did not remain significant after multiple tests correction. In the EXE arm, several SNPs in NR1I3 gene were associated with fatigue.
In the LETRO arm, patients with a poor CYP2A6 MS had a higher risk of experiencing depression.
Conclusions: Our study confirms the predominant role of CYP2A6 in LETRO PK. To our knowledge, this is the first study to report on the role of UGT2B7 rs28365063 in ANA and NR1I3 in EXE PK and side effects. These relationships need to be re-evaluated with the drug concentrations obtained during the 3-year follow-up.
Citation Format: Thomas F, Marquet P, Pinguet F, White-Koning M, Robert J, Tafzi N, Solassol I, Despax R, Levasseur N, Ellis S, Massoubre A, Mbatchi L, Le Morvan V, Roché H, Chatelut E, Evrard A. Pharmacogenetic determinants of aromatase inhibitors pharmacokinetics and side effects: 6-month results of the adjuvant breast cancer longitudinal PHACS study (NCT01127295) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-12-07.
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Affiliation(s)
- F Thomas
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - P Marquet
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - F Pinguet
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - M White-Koning
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - J Robert
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - N Tafzi
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - I Solassol
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - R Despax
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - N Levasseur
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - S Ellis
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - A Massoubre
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - L Mbatchi
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - V Le Morvan
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - H Roché
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - E Chatelut
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
| | - A Evrard
- Institut Claudius Regaud, IUCT-O, Toulouse, France; CRCT, Inserm, Univ Toulouse, Toulouse, France; CHU Limoges, Limoges, France; ICRM, Montpellier, France; Institut Bergonié, Bordeaux, France; Clinique Pasteur, Toulouse, France; CH Cahors, Cahors, France; Centre Catalan d'Oncologie, Perpignan, France; CHU Carémeaux, Nîmes, France
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Woillard JB, Debord J, Saint-Marcoux F, Turlure P, Girault S, Abraham J, Choquet S, Marquet P, Barin-Le Guellec C. A Time-Dependent Model Describes Methotrexate Elimination and Supports Dynamic Modification of MRP2/ ABCC 2 Activity. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Woillard J, Picard N, Essig M, Merville P, Monchaud C, Marquet P. Effect of CYP3A4*22, CYP3A5*3, POR*28 , and PPARA RS4253728 on Tacrolimus Exposure and Neurotoxicity in Kidney Transplant Recipients. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.045] [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: 11/24/2022]
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Woillard JB, Maffioletti PF, Assikar S, Monchaud C, Marquet P, Couraud A, Matei I, Bedane C. Intérêt du suivi thérapeutique pharmacologique de l’acide mycophénolique chez des patients traités pour pemphigoïde cicatricielle. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.299] [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: 10/20/2022]
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Falkowski S, Deppenweiler M, Monchaud C, Saint-Marcoux F, Laroche ML, Picard N, Venat-Bouvet L, Tubiana-Mathieu N, Marquet P, Woillard JB. Toward therapeutic drug monitoring of everolimus? Results of an exploratory study of the dose-exposure relationships. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw392.33] [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: 11/13/2022] Open
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11
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Burat B, Pinault E, Gonzalez J, Marquet P, Essig M. Analyse protéomique quantitative par technique iTRAQ de la néphrotoxicité des inhibiteurs de la calcineurine. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.270] [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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Jourdain P, Allaman I, Rothenfusser K, Fiumelli H, Marquet P, Magistretti PJ. L-Lactate protects neurons against excitotoxicity: implication of an ATP-mediated signaling cascade. Sci Rep 2016; 6:21250. [PMID: 26893204 PMCID: PMC4759786 DOI: 10.1038/srep21250] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 01/20/2016] [Indexed: 12/20/2022] Open
Abstract
Converging experimental data indicate a neuroprotective action of L-Lactate. Using Digital Holographic Microscopy, we observe that transient application of glutamate (100 μM; 2 min) elicits a NMDA-dependent death in 65% of mouse cortical neurons in culture. In the presence of L-Lactate (or Pyruvate), the percentage of neuronal death decreases to 32%. UK5099, a blocker of the Mitochondrial Pyruvate Carrier, fully prevents L-Lactate-mediated neuroprotection. In addition, L-Lactate-induced neuroprotection is not only inhibited by probenicid and carbenoxolone, two blockers of ATP channel pannexins, but also abolished by apyrase, an enzyme degrading ATP, suggesting that ATP produced by the Lactate/Pyruvate pathway is released to act on purinergic receptors in an autocrine/paracrine manner. Finally, pharmacological approaches support the involvement of the P2Y receptors associated to the PI3-kinase pathway, leading to activation of KATP channels. This set of results indicates that L-Lactate acts as a signalling molecule for neuroprotection against excitotoxicity through coordinated cellular pathways involving ATP production, release and activation of a P2Y/KATP cascade.
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Affiliation(s)
- P Jourdain
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.,Centre de Neurosciences Psychiatriques, CHUV, Département de Psychiatrie, Site de Cery, CH-1008 Prilly/Lausanne, Switzerland
| | - I Allaman
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - K Rothenfusser
- Centre de Neurosciences Psychiatriques, CHUV, Département de Psychiatrie, Site de Cery, CH-1008 Prilly/Lausanne, Switzerland
| | - H Fiumelli
- King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
| | - P Marquet
- Centre de Neurosciences Psychiatriques, CHUV, Département de Psychiatrie, Site de Cery, CH-1008 Prilly/Lausanne, Switzerland
| | - P J Magistretti
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.,King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia.,Centre de Neurosciences Psychiatriques, CHUV, Département de Psychiatrie, Site de Cery, CH-1008 Prilly/Lausanne, Switzerland
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Gauthier T, Piver P, Pichon N, Essig M, Marquet P, Aubard Y. Transplantation utérine : pour demain ? ACTA ACUST UNITED AC 2014; 42:741-3. [DOI: 10.1016/j.gyobfe.2014.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Indexed: 10/24/2022]
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Etienne I, Woillard JB, Marquet P, Estenne M, Knoop C, Monchaud C. 236 The once-daily tacrolimus extended-release formulation provides similar drug exposure in non-CF and CF lung transplant recipients when compared to the conventional twice-daily formulation. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60371-4] [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: 11/27/2022]
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Dulaurent S, Gaulier JM, Marquet P, Lachâtre G. TRAITEMENT DES DEMANDES DE DOSAGES DE PESTICIDES DANS LES MILIEUX BIOLOGIQUES : QUELQUES PROBLÈMES FRÉQUEMMENT RENCONTRÉS. Acta Clin Belg 2014. [DOI: 10.1179/acb.2006.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
In this review, we summarize how the new concept of digital optics applied to the field of holographic microscopy has allowed the development of a reliable and flexible digital holographic quantitative phase microscopy (DH-QPM) technique at the nanoscale particularly suitable for cell imaging. Particular emphasis is placed on the original biological information provided by the quantitative phase signal. We present the most relevant DH-QPM applications in the field of cell biology, including automated cell counts, recognition, classification, three-dimensional tracking, discrimination between physiological and pathophysiological states, and the study of cell membrane fluctuations at the nanoscale. In the last part, original results show how DH-QPM can address two important issues in the field of neurobiology, namely, multiple-site optical recording of neuronal activity and noninvasive visualization of dendritic spine dynamics resulting from a full digital holographic microscopy tomographic approach.
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Affiliation(s)
- P Marquet
- Centre de Neurosciences Psychiatriques, Centre Hospitalier Universitaire Vaudois (CHUV), Département de Psychiatrie, Site de Cery, CH-1008 Prilly/Lausanne, Switzerland
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Youdarene R, Woillard JB, Prémaud A, Rousseau A, Debord J, Neely M, Sinnasse-Raymond G, Marquet P, Saint-Marcoux F. Population Pharmacokinetics and Bayesian Estimation of Mycophenolic Acid Exposure in Heart Transplant Recipients: Comparison of Two Approaches. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.230] [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: 11/29/2022] Open
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Gauthier T, Piver P, Mesnard C, Marquet P, Pichon N, Guillaudeau A, Drouet M, Gardet E, Laskar M, Essig M, Aubard Y. [Uterus transplantation. Current situation]. Gynecol Obstet Fertil 2012; 40:691-694. [PMID: 23084737 DOI: 10.1016/j.gyobfe.2012.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Except adoption, absolute uterine factor infertility lacks solution in case of motherhood desire. Gestational surrogacy is still not approved in France. Over the last decade, uterus transplantation experimentation made advances. Data from animal research, progress in immunosuppressive treatment and knowledge about pregnancy after transplantation provide a scenario in which a human allotransplantation project can become reality.
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Affiliation(s)
- T Gauthier
- Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU Dupuytren, avenue Larrey, 87000 Limoges, France.
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Chassard C, Dapoigny M, Scott KP, Crouzet L, Del'homme C, Marquet P, Martin JC, Pickering G, Ardid D, Eschalier A, Dubray C, Flint HJ, Bernalier-Donadille A. Functional dysbiosis within the gut microbiota of patients with constipated-irritable bowel syndrome. Aliment Pharmacol Ther 2012; 35:828-38. [PMID: 22315951 DOI: 10.1111/j.1365-2036.2012.05007.x] [Citation(s) in RCA: 239] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 09/20/2011] [Accepted: 01/12/2012] [Indexed: 12/08/2022]
Abstract
BACKGROUND The role of the gut microbiota in patho-physiology of irritable bowel syndrome (IBS) is suggested by several studies. However, standard cultural and molecular methods used to date have not revealed specific and consistent IBS-related groups of microbes. AIM To explore the constipated-IBS (C-IBS) gut microbiota using a function-based approach. METHODS The faecal microbiota from 14 C-IBS women and 12 sex-match healthy subjects were examined through a combined strictly anaerobic cultural evaluation of functional groups of microbes and fluorescent in situ hybridisation (16S rDNA gene targeting probes) to quantify main groups of bacteria. Starch fermentation by C-IBS and healthy faecal samples was evaluated in vitro. RESULTS In C-IBS, the numbers of lactate-producing and lactate-utilising bacteria and the number of H(2) -consuming populations, methanogens and reductive acetogens, were at least 10-fold lower (P < 0.05) compared with control subjects. Concomitantly, the number of lactate- and H(2) -utilising sulphate-reducing population was 10 to 100 fold increased in C-IBS compared with healthy subjects. The butyrate-producing Roseburia - E. rectale group was in lower number (0.01 < P < 0.05) in C-IBS than in control. C-IBS faecal microbiota produced more sulphides and H(2) and less butyrate from starch fermentation than healthy ones. CONCLUSIONS A major functional dysbiosis was observed in constipated-irritable bowel syndrome gut microbiota, reflecting altered intestinal fermentation. Sulphate-reducing population increased in the gut of C-IBS and were accompanied by alterations in other microbial groups. This could be responsible for changes in the metabolic output and enhancement in toxic sulphide production which could in turn influence gut physiology and contribute to IBS pathogenesis.
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Affiliation(s)
- C Chassard
- INRA, UR Microbiology Unit, Clermont-Ferrand Research Centre, Saint Genès-Champanelle, France
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Lamoureux F, Mestre E, Essig M, Sauvage FL, Marquet P, Gastinel LN. Quantitative proteomic analysis of cyclosporine-induced toxicity in a human kidney cell line and comparison with tacrolimus. J Proteomics 2011; 75:677-94. [PMID: 21964257 DOI: 10.1016/j.jprot.2011.09.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 08/25/2011] [Accepted: 09/08/2011] [Indexed: 11/19/2022]
Abstract
The calcineurin-inhibitors (CNIs) cyclosporine (CsA) and tacrolimus (TAC) remain the pillars of modern immunosuppression regimens used in solid organ transplantation. Nephrotoxicity is an adverse effect that limits their successful use. The precise molecular mechanisms underlying this nephrotoxicity remain unclear. Using SILAC together with LC-MALDI-TOF/TOF, we investigated the CNIs-induced proteomic perturbations in renal cells. Among the 495 proteins quantifiable in both forward and reverse SILAC, 69 displayed CsA-induced perturbations: proteins involved in ER-stress/protein folding, apoptosis, metabolism/transport or cytoskeleton pathways were up-regulated, while cyclophilin B as well as nuclear and RNA-processing proteins were down-regulated. Co-administration of CsA with the antioxidant N-acetylcysteine significantly decreased lipid peroxidation and also partially corrected the CsA-induced unfolded protein response. TAC toxicity profile was apparently different from that of CsA, especially without perturbation of cyclophilins A and B, up-regulation of ER-chaperones nor down-regulation of a number of nuclear proteins. These results provide a new insight and are consistent with recent data regarding the molecular mechanisms of CNIs-induced nephrotoxicity. Our findings offer new directions for future research aiming to identify specific biomarkers of CsA nephrotoxicity.
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Gauthier T, Bertin F, Fourcade L, Maubon A, Saint Marcoux F, Piver P, Marquet P, Pommepuy I, Plainard X, Couquet C, Cornuejols MJ, Essig M, Aubard Y. Uterine allotransplantation in ewes using an aortocava patch. Hum Reprod 2011; 26:3028-36. [DOI: 10.1093/humrep/der288] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Monchaud C, Pison C, Reynaud-Gaubert M, Stern M, Guillemain R, Knoop C, Estenne M, Kessler R, Marquet P. 202 New Tools for Mycophenolate Mofetil (MMF) Dose Optimization in Lung Transplant Recipients during the First Year Post-Transplantation: The STIMMUGREP Trial. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.209] [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: 10/18/2022] Open
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de Winter B, Monchaud C, Prémaud A, Pison C, Kessler R, Reynaud-Gaubert M, Dromer C, Stern M, Guillemain R, Knoop C, Estenne M, Marquet P, Rousseau A. 413 Pharmacokinetics of Mycophenolate Mofetil (MMF) in Lung Transplantation: Comparison with Renal Transplantation. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.422] [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] Open
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Monchaud C, Marin B, Estenne M, Marquet P. 201 Development of a Composite Endpoint (CEP) for Clinical Trials on Immunosuppressants (IS) in Lung Transplantation. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Saint-Marcoux F, Guigonis V, Decramer S, Gandia P, Ranchin B, Parant F, Bessenay L, Libert F, Harambat J, Bouchet S, Broux F, Compagnon P, Marquet P. Development of a Bayesian estimator for the therapeutic drug monitoring of mycophenolate mofetil in children with idiopathic nephrotic syndrome. Pharmacol Res 2011; 63:423-31. [PMID: 21272643 DOI: 10.1016/j.phrs.2011.01.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 01/13/2011] [Accepted: 01/14/2011] [Indexed: 11/24/2022]
Abstract
The use of mycophenolate mofetil (MMF) in children with idiopathic nephrotic syndrome (INS) is increasing. However, the clinical benefit of its monitoring has been scarcely studied, and little is known about its pharmacokinetics in this context. The objectives of the present study were: (i) to study and model the pharmacokinetics of mycophenolic acid (MPA; the active moiety of MMF) in paediatric patients with INS given MMF, at all stages of the disease; (ii) to develop a Bayesian estimator (MAP-BE) for individual inter-dose area under the concentration-time curve (AUC) prediction in this population, using a limited blood sampling strategy (LSS). Full-pharmacokinetic (PK) profiles of MPA collected in paediatric inpatients with INS already treated with a maintenance immunosuppressive therapy based on MMF (with no calcineurin inhibitors; CNI) were studied. A classical iterative two-stage (ITS) method was applied to model the data and develop MAP-BEs using a one-compartment open model where the absorption is described by a double gamma law allowing the description of a potential enterohepatic recirculation. The performance of the MAP-BE developed for individual exposure assessment was evaluated by the bias and precision of predicted AUCs with respect to measured, trapezoidal AUCs (reference value), and by the proportion of predicted AUCs with absolute error >20%. These PK tools were tested in an independent group of patients. Sixty PK profiles of MPA from children receiving MMF in association to corticosteroids or given alone were included in the study. Forty-five of these PK profiles were used to develop a PK model and a MAP-BE, and 15 for their validation. In the building group, the PK model fitted accurately the PK profiles of MPA: mean residual error of modelled vs. reference AUC was m±SD=-0.015±0.092 (range: -0.153 to 0.204). The MAP-BE which allowed the estimation of MPA AUC on the basis of a 20 min-60 min-180 min LSS was then developed. In the independent group of patients, its mean residual error vs. reference AUCs was m±SD=-0.036±0.145 (range: -0.205 to 0.189). Thus, a PK model and its derived MAP-BE for MMF (without any associated CNI) when given to children with INS have been developed. Clinical trials using these PK tools could test the potential impact of the therapeutic drug monitoring of MMF based on the AUC on the clinical evolution of INS.
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Marquet P, Migacheva E, Chamot S, Seydoux O, Weber B, Depeursinge C, Magistretti P. P19-15 Exploring neurovascular-neurometabolic couplings and activity-mediated water movements in the rodent cortex with an optical probe. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)60893-0] [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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Woillard JB, Rerolle JP, Picard N, Rousseau A, Guillaudeau A, Munteanu E, Essig M, Drouet M, Le Meur Y, Marquet P. Donor P-gp polymorphisms strongly influence renal function and graft loss in a cohort of renal transplant recipients on cyclosporine therapy in a long-term follow-up. Clin Pharmacol Ther 2010; 88:95-100. [PMID: 20505666 DOI: 10.1038/clpt.2010.62] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cyclosporin A (CsA) is a substrate for cytochrome P450 3A and the efflux transporter P-glycoprotein (P-gp; ABCB1), both abundantly expressed in the kidney. In a long-term follow-up of a cohort of patients who had received kidney transplants between the years 1990 and 2005, we retrospectively investigated the effect of CYP3A4, CYP3A5, and ABCB1 polymorphisms in kidney graft donors on recipients' renal function and risk of subsequent graft loss. DNA samples from 227 donors and clinical data from the 259 respective recipients were analyzed. Graft loss was significantly associated with the presence of the ABCB1 variant haplotype 1236T/2677T/3435T in the donor (1236T/2677T/3435T vs. other haplotypes: hazard ratio = 9.346; 95% confidence interval (CI) (2.278-38.461); P = 0.0019) and with previous episodes of acute organ rejection (hazard ratio = 3.077; 95% CI (1.213-7.812); P = 0.0178). The variant haplotype was also associated with a greater decrease in renal function (homozygotes for TTT -3.047 mlxmin(-1)/year; heterozygotes for TTT -4.435 mlxmin(-1)/year; others -2.186 mlxmin(-1)/year; P = 0.0240). The study showed that the presence of ABCB1 polymorphisms in donors influences long-term graft outcome adversely with decrease in renal function and graft loss in transplant recipients receiving CsA.
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Picard N, Yee SW, Woillard JB, Lebranchu Y, Le Meur Y, Giacomini KM, Marquet P. The role of organic anion-transporting polypeptides and their common genetic variants in mycophenolic acid pharmacokinetics. Clin Pharmacol Ther 2009; 87:100-8. [PMID: 19890249 DOI: 10.1038/clpt.2009.205] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The goal of this study was to determine the roles of the organic anion-transporting polypeptides (OATPs) OATP1A2, OATP1B1, and OATP1B3 and their genetic variants in the pharmacokinetics of the immunosuppressive drug mycophenolate mofetil (MMF). Using OATP-transfected human embryonic kidney (HEK) cells, we measured the uptake of mycophenolic acid (MPA) and its glucuronide (MPAG). MPAG, but not MPA, significantly accumulated in cells expressing OATP1B3 or OATP1B1 (P < 0.05). The pharmacokinetics of both MPA and MPAG were significantly influenced by the OATP1B3 polymorphism 334T>G/699G>A in 70 renal transplant patients receiving combination treatment of MMF with either tacrolimus or sirolimus, but not in 115 patients receiving MMF and cyclosporine. The decrease in dose-normalized (dn) MPA exposure and the concomitant increase in the MPAG/MPA metabolic ratio are consistent with reduced enterohepatic cycling in patients carrying the OATP1B3 334G-699A haplotype. Further studies demonstrated that this variant of OATP1B3 exhibited a reduced maximal velocity (V(max)) in transfected HEK cells, thereby providing functional evidence to support our clinical findings.
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Loustaud-Ratti V, Stanke-Labesque F, Marquet P, Gagnieu MC, Maynard M, Babany G, Trépo C. Optimizing ribavirin dosage: a new challenge to improve treatment efficacy in genotype 1 hepatitis C patients. ACTA ACUST UNITED AC 2009; 33:580-3. [PMID: 19481390 DOI: 10.1016/j.gcb.2009.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 03/29/2009] [Accepted: 04/13/2009] [Indexed: 01/27/2023]
Affiliation(s)
- V Loustaud-Ratti
- Service de Médecine Interne et Fédération des Hépatites, CHU Dupuytren, 87042 Limoges cedex, France.
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Monchaud C, Estenne M, Reynaud-Gaubert M, Pison C, Stern M, Kessler R, Dromer C, Guillemain R, Rousseau A, Marquet P. 492: New Tools for Tacrolimus (Tac) Dose Optimization in Lung Transplant Recipients during the First Post-Transplant Year: Preliminary Results of STIMMUGREP Study. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.499] [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: 11/28/2022] Open
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Benkali K, Marquet P, Rérolle J, Le Meur Y, Gastinel L. A new strategy for faster urinary biomarkers identification by Nano-LC-MALDI-TOF/TOF mass spectrometry. BMC Genomics 2008; 9:541. [PMID: 19014585 PMCID: PMC2596142 DOI: 10.1186/1471-2164-9-541] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [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: 07/21/2008] [Accepted: 11/14/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND LC-MALDI-TOF/TOF analysis is a potent tool in biomarkers discovery characterized by its high sensitivity and high throughput capacity. However, methods based on MALDI-TOF/TOF for biomarkers discovery still need optimization, in particular to reduce analysis time and to evaluate their reproducibility for peak intensities measurement. The aims of this methodological study were: (i) to optimize and critically evaluate each step of urine biomarker discovery method based on Nano-LC coupled off-line to MALDI-TOF/TOF, taking full advantage of the dual decoupling between Nano-LC, MS and MS/MS to reduce the overall analysis time; (ii) to evaluate the quantitative performance and reproducibility of nano-LC-MALDI analysis in biomarker discovery; and (iii) to evaluate the robustness of biomarkers selection. RESULTS A pool of urine sample spiked at increasing concentrations with a mixture of standard peptides was used as a specimen for biological samples with or without biomarkers. Extraction and nano-LC-MS variabilities were estimated by analyzing in triplicates and hexaplicates, respectively. The stability of chromatographic fractions immobilised with MALDI matrix on MALDI plates was evaluated by successive MS acquisitions after different storage times at different temperatures.Low coefficient of variation (CV%: 10-22%) and high correlation (R2 > 0.96) values were obtained for the quantification of the spiked peptides, allowing quantification of these peptides in the low fentomole range, correct group discrimination and selection of "specific" markers using principal component analysis. Excellent peptide integrity and stable signal intensity were found when MALDI plates were stored for periods of up to 2 months at +4 degrees C. This allowed storage of MALDI plates between LC separation and MS acquisition (first decoupling), and between MS and MSMS acquisitions while the selection of inter-group discriminative ions is done (second decoupling). Finally the recording of MSMS spectra to obtain structural information was focused only on discriminative ions in order to minimize analysis time. CONCLUSION Contrary to other classical approaches with direct online coupling of chromatographic separation and on the flight MS and/or MSMS data acquisition for all detected analytes, our dual decoupling strategy allowed us to focus on the most discriminative analytes, giving us more time to acquire more replicates of the same urine samples thus increasing detection sensitivity and mass precision.
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Maine G, Wallemacq P, Ait-Youcef H, Berg K, Young J, Schmidt E, Schmid R, Aimo G, Marquet P, Wonigeit K. Analytical evaluation of the Abbott ARCHITECT cyclosporine assay in comparison to LC/MS/MS and Dade Dimension Xpand. Clin Biochem 2008. [DOI: 10.1016/j.clinbiochem.2008.08.032] [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: 11/15/2022]
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Amoura Z, Zahr N, Haroche J, Mathian A, Hulot JS, Marquet P, Piette JC. Étude des facteurs influençant l’exposition à l’acide mycophénolique au cours du lupus systémique. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.03.052] [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: 10/22/2022]
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Robert P, Sauvage F, Thuret G, Alain S, Adenis J, Roussane M, Gain P, Marquet P. 055 Stabilité du Ganciclovir en situation de conservation cornéenne : premières étapes vers la supplémentation du milieu de culture en antiviraux. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70650-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Allorge D, Beaune PH, Becquemont L, Bessard G, Bezieau S, Boisdron-Celle M, Boyer JC, Broly F, Dhaneens CM, Fonrose X, Gagnieu MC, Gamelin E, Gozé C, Jacqz-Aigrain E, Loric S, Loriot MA, Marquet P, Morel A, Namour B, Paintaud G, Peoc’h K, Picard N, Watier H, Verstuyft C. La pharmacogénétique moléculaire hospitalière en France : données actuelles et perspectives. Annales Pharmaceutiques Françaises 2007; 65:371-81. [DOI: 10.1016/s0003-4509(07)74196-2] [Citation(s) in RCA: 2] [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: 10/22/2022]
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Le Meur Y, Büchler M, Thierry A, Caillard S, Villemain F, Lavaud S, Etienne I, Westeel PF, Hurault de Ligny B, Rostaing L, Thervet E, Szelag JC, Rérolle JP, Rousseau A, Touchard G, Marquet P. Individualized mycophenolate mofetil dosing based on drug exposure significantly improves patient outcomes after renal transplantation. Am J Transplant 2007; 7:2496-503. [PMID: 17908276 DOI: 10.1111/j.1600-6143.2007.01983.x] [Citation(s) in RCA: 316] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Efficacy and safety of mycophenolate mofetil (MMF) may be optimized with individualized doses based on therapeutic monitoring of its active metabolite, mycophenolic acid (MPA). In this 12-month study, 137 renal allograft recipients from 11 French centers receiving basiliximab, cyclosporine A, MMF and corticosteroids were randomized to receive either concentration-controlled doses or fixed-dose MMF. A novel Bayesian estimator of MPA AUC based on three-point sampling was used to individualize doses on posttransplant days 7 and 14 and months 1, 3 and 6. The primary endpoint was treatment failure (death, graft loss, acute rejection and MMF discontinuation). Data from 65 patients/group were analyzed. At month 12, the concentration-controlled group had fewer treatment failures (p = 0.03) and acute rejection episodes (p = 0.01) with no differences in adverse event frequency. The MMF dose was higher in the concentration-controlled group at day 14 (p < 0.0001), month 1 (p < 0.0001) and month 3 (p < 0.01), as were median AUCs on day 14 (33.7 vs. 27.1 mg*h/L; p = 0.0001) and at month 1 (45.0 vs. 30.9 mg*h/L; p < 0.0001). Therapeutic MPA monitoring using a limited sampling strategy can reduce the risk of treatment failure and acute rejection in renal allograft recipients 12 months posttransplant with no increase in adverse events.
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Affiliation(s)
- Y Le Meur
- Department of Nephrology, University Hospital, Limoges, France.
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Irtan S, Saint-Marcoux F, Rousseau A, Zhang D, Leroy V, Marquet P, Jacqz-Aigrain E. Population pharmacokinetics and bayesian estimator of cyclosporine in pediatric renal transplant patients. Ther Drug Monit 2007; 29:96-102. [PMID: 17304156 DOI: 10.1097/ftd.0b013e3180310f9d] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [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: 11/26/2022]
Abstract
Cyclosporine A (CsA) is an immunosuppressive drug widely used in pediatric renal graft recipients. Its large interindividual pharmacokinetic variability and narrow therapeutic index render therapeutic drug monitoring necessary. However, information about CsA pharmacokinetics is scarce and no population pharmacokinetic (popPK) studies in these populations have been reported so far. to the objectives of this study were 1) to develop a PKpop model and identify the individual factors influencing the variability of CsA pharmacokinetics in pediatric kidney recipients; and 2) to build a Bayesian estimator allowing the estimation of the main PK parameters and exposure indices to CsA on the basis of a limited sampling strategy (LSS). The popPK analysis was performed using the NONMEM program. A total of 256 PK profiles of CsA collected in 98 pediatric renal transplant patients (mean age 9.7 +/- 4.5 years old) within the first year posttransplantation were studied. A 2-compartment model with first-order elimination, and Erlang distribution to describe the absorption phase, fitted the data adequately. For Bayesian estimation, the best LSS was determined based on its performance in estimating area under the concentration-time curve (AUC0-12h) and validated in an independent group of 20 patients. The popPK analysis identified body weight and posttransplant delay as individual factors influencing the apparent central volume of distribution and the apparent clearance, respectively. Bayesian estimation allowed accurate prediction of AUC0-12h using predose, C1h, and C3h blood samples with a mean bias between observed and estimated AUC of 0.5% +/- 11% and good precision (root mean square error = 10.9%). This article reports the first popPK study of CsA in pediatric renal transplant patients. It confirms the reliability and feasibility of CsA AUC estimation in this population. The body weight and the posttransplantation delay were identified to influence PK interindividual variability of CsA and were included in the Bayesian estimator developed, which could be helpful in further clinical trials.
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Affiliation(s)
- S Irtan
- Department of Paediatric Pharmacology and Pharmacogenetics, Hospital Robert Debré, Paris, France
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Marian A, Charrière F, Colomb T, Montfort F, Kühn J, Marquet P, Depeursinge C. On the complex three-dimensional amplitude point spread function of lenses and microscope objectives: theoretical aspects, simulations and measurements by digital holography. J Microsc 2007; 225:156-69. [PMID: 17359250 DOI: 10.1111/j.1365-2818.2007.01727.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The point spread function is widely used to characterize the three-dimensional imaging capabilities of an optical system. Usually, attention is paid only to the intensity point spread function, whereas the phase point spread function is most often neglected because the phase information is not retrieved in noninterferometric imaging systems. However, phase point spread functions are needed to evaluate phase-sensitive imaging systems and we believe that phase data can play an essential role in the full aberrations' characterization. In this paper, standard diffraction models have been used for the computation of the complex amplitude point spread function. In particular, the Debye vectorial model has been used to compute the amplitude point spread function of x63/0.85 and x100/1.3 microscope objectives, exemplifying the phase point spread function specific for each polarization component of the electromagnetic field. The effect of aberrations on the phase point spread function is then analyzed for a microscope objective used under nondesigned conditions, by developing the Gibson model (Gibson & Lanni, 1991), modified to compute the three-dimensional amplitude point spread function in amplitude and phase. The results have revealed a novel anomalous phase behaviour in the presence of spherical aberration, providing access to the quantification of the aberrations. This work mainly proposes a method to measure the complex three-dimensional amplitude point spread function of an optical imaging system. The approach consists in measuring and interpreting the amplitude point spread function by evaluating in amplitude and phase the image of a single emitting point, a 60-nm-diameter tip of a Near Field Scanning Optical Microscopy fibre, with an original digital holographic experimental setup. A single hologram gives access to the transverse amplitude point spread function. The three-dimensional amplitude point spread function is obtained by performing an axial scan of the Near Field Scanning Optical Microscopy fibre. The phase measurements accuracy is equivalent to lambda/60 when the measurement is performed in air. The method capability is demonstrated on an Achroplan x20 microscope objective with 0.4 numerical aperture. A more complete study on a x100 microscope objective with 1.3 numerical aperture is also presented, in which measurements performed with our setup are compared with the prediction of an analytical aberrations model.
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Affiliation(s)
- A Marian
- Ecole Polytechnique Fédérale de Lausanne (EPFL), Imaging and Applied Optics Institute, Station 17, CH-1015 Lausanne, Switzerland
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Bazille G, Métivier A, Kemmel V, Weiller M, Massard G, Marquet P, Kessler R. 40 Intérêt de l’étude de la pharmacocinétique de la ciclosporine après greffe pulmonaire. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72415-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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40
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Wilson D, Johnston F, Holt D, Moreton M, Engelmayer J, Gaulier JM, Luthe H, Marquet P, Moscato D, Oellerich M, Mosso R, Streit F, Brunet M, Fillee C, Schmid R, Wallemacq P, Barnes G. WITHDRAWN: Multi-center evaluation of analytical performance of the microparticle enzyme immunoassay for sirolimus. Clin Biochem 2006:S0009-9120(06)00312-2. [PMID: 18375204 DOI: 10.1016/j.clinbiochem.2006.10.003] [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: 08/15/2005] [Revised: 01/09/2006] [Accepted: 10/10/2006] [Indexed: 11/28/2022]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published in Clin. Biochem. 39 (2006) 378-386, doi:10.1016/j.clinbiochem.2006.01.017. The duplicate article has therefore been withdrawn. This article has been withdrawn consistent with Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The Publisher apologizes for any inconvenience this may cause.
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Affiliation(s)
- D Wilson
- Abbott Laboratories, Abbott Park, IL, USA
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41
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Sauvage MF, Marquet P, Rousseau A, Buxeraud J, Raby C, Lach[acaron]tre G. Determination of Trimeprazine and Its Main Metabolites in Mouse Serum and Thyroid by Liquid Chromatography-Electrospray-Mass Spectrometry. J LIQ CHROMATOGR R T 2006. [DOI: 10.1080/10826079808001266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M. F. Sauvage
- a Department of Pharmacology and Toxicology , University Hospital , Limoges, France
- b Laboratory of Therapeutic and Organic Chemistry Faculty of Pharmacy , Limoges, France
| | - P. Marquet
- a Department of Pharmacology and Toxicology , University Hospital , Limoges, France
| | - A. Rousseau
- c Laboratory of Biophysics Faculty of Pharmacy , Limoges, France
| | - J. Buxeraud
- b Laboratory of Therapeutic and Organic Chemistry Faculty of Pharmacy , Limoges, France
| | - C. Raby
- b Laboratory of Therapeutic and Organic Chemistry Faculty of Pharmacy , Limoges, France
| | - G. Lach[acaron]tre
- a Department of Pharmacology and Toxicology , University Hospital , Limoges, France
- d Laboratory of Toxicology Faculty of Pharmacy , Limoges, France
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Anglicheau D, Pallet N, Rabant M, Marquet P, Cassinat B, Méria P, Beaune P, Legendre C, Thervet E. Role of P-glycoprotein in cyclosporine cytotoxicity in the cyclosporine-sirolimus interaction. Kidney Int 2006; 70:1019-25. [PMID: 16837925 DOI: 10.1038/sj.ki.5001649] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [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: 11/09/2022]
Abstract
Cyclosporine nephrotoxicity remains a major side effect in solid organ transplantation, and can be exacerbated by concomitant administration of sirolimus. Cyclosporine and sirolimus are P-glycoprotein (Pgp) substrates. We hypothesized that the Pgp activity level may affect cyclosporine cytotoxicity by interfering with the ability of Pgp to remove cyclosporine from within tubular cells, and that an interaction between cyclosporine and sirolimus on Pgp function may explain the enhancement of cyclosporine nephrotoxicity by sirolimus. Cyclosporine cytotoxicity was evaluated in primary cultures of normal human renal epithelial cells (HRECs) by cell viability and cytotoxicity assays. Verapamil, quinine, PSC833, and PGP-4008 were used as Pgp inhibitors. Rhodamine-123 (R-123), a fluorescent substrate of Pgp, was used to assess Pgp-mediated transport. Cellular cyclosporine concentration was measured by high-performance liquid chromatography coupled to tandem mass spectrometry. Pgp expression and function were confirmed in HRECs and cyclosporine and sirolimus were shown to be Pgp inhibitors in this model. Verapamil-induced inhibition of Pgp led to a significant increase in cellular concentration of cyclosporine (P<0.05). Cyclosporine exerted a concentration-dependent cytotoxic effect on HRECs that was significantly increased by inhibition of Pgp activity. Sirolimus exerted an inhibitory effect on R-123 efflux in HRECs and increased cellular cyclosporine concentrations in a dose-dependent manner. These data demonstrate that Pgp plays a critical role in protecting renal epithelial cells from cyclosporine toxicity. The inhibitory effect of sirolimus on Pgp-mediated efflux and the cellular concentration of cyclosporine could explain the exacerbation of cyclosporine nephrotoxicity observed clinically.
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Affiliation(s)
- D Anglicheau
- INSERM, U775, Université René Descartes, Paris, France.
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Bertoye PH, Courcier-Duplantier S, Best N, Abiteboul M, Augiers de Cremiers F, Bélorgey C, Blazejewki S, Bouxin-Métro A, Chene G, Couderc M, Danan-Durieux M, Deneulin A, Faurisson F, Libersa C, Malchiodi M, Marquet P, Orefice C, Postaire E, Rancinan C, Reynier JC, Spriet A, Tibi A, Toneatti C, Treluyer JM, Vicaut A, Vincent-Pelletier A. Adaptation de la mise en œuvre des bonnes pratiques cliniques en fonction des caractéristiques de certaines recherches. Therapie 2006; 61:271-7. [DOI: 10.2515/therapie:2006052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wilson D, Johnston F, Holt D, Moreton M, Engelmayer J, Gaulier JM, Luthe H, Marquet P, Moscato D, Oellerich M, Mosso R, Streit F, Brunet M, Fillee C, Schmid R, Wallemacq P, Barnes G. Multi-center evaluation of analytical performance of the microparticle enzyme immunoassay for sirolimus. Clin Biochem 2006; 39:378-86. [PMID: 16545357 DOI: 10.1016/j.clinbiochem.2006.01.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Revised: 01/09/2006] [Accepted: 01/11/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study evaluated the analytical characteristics of the new Abbott microparticle enzyme immunoassay (MEIA) for sirolimus. DESIGN AND METHODS The protocol consisted of nine sections: evaluation of antibody specificity, linearity, detection limit, quantification limit, endogenous interferents, exogenous interferents, precision, proficiency testing panel, and method comparison. RESULTS The mean analytical detection limit was 0.68 microg/L. The sirolimus concentration corresponding to a total CV of 20% was 1.5 microg/L. Linearity of response was demonstrated across the dynamic range of the assay. Total precision (CVs) at QC control levels from 5 to 22 microg/L ranged from 5.7 to 12.6%. Assay standardization was found to be in good agreement with LC/MS/MS as compared with target values for spiked sirolimus proficiency samples from an international sirolimus proficiency testing program. Good correlations (R values) of the immunoassay were observed in comparisons to LC/MS/MS. R values tended to be lower in comparisons with LC/UV methods. Across both LC-based methods and all study sites, there was approximately 25% overall positive slope bias due to cross reactivity of the MEIA antibody to metabolites of sirolimus. The assay cross-reactivity to metabolites of sirolimus parent drug ranged from 6 to 63%. Assay interferences were minimal with the exception of hematocrit, which presented a negative relationship to measured sirolimus concentration. CONCLUSIONS The MEIA demonstrated acceptable analytical characteristics for use for routine monitoring of sirolimus immunosuppressive therapy, and is a viable alternative to HPLC-based methods for sirolimus monitoring.
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Affiliation(s)
- D Wilson
- Abbott Laboratories, Abbott Park, IL 60064, USA.
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Dulaurent S, Saint-Marcoux F, Marquet P, Lachâtre G. Simultaneous determination of six dialkylphosphates in urine by liquid chromatography tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2006; 831:223-9. [PMID: 16412711 DOI: 10.1016/j.jchromb.2005.12.012] [Citation(s) in RCA: 36] [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] [Received: 08/02/2005] [Revised: 11/30/2005] [Accepted: 12/06/2005] [Indexed: 10/25/2022]
Abstract
Dialkylphosphates (DAP) are urinary markers of the exposure to organophosphates pesticides. The aim of this study was to develop a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the simultaneous quantitative determination of the following DAP: dimethylphosphate (DMP), dimethythiophosphate (DMTP), dimethyldithiophosphate (DMDTP), diethylphosphate (DEP), diethylthiophosphate (DETP) and diethyldithiophosphate (DEDTP). Dibutylphosphate (DBP) was used as internal standard. This method was based on a liquid-liquid extraction procedure, a chromatographic separation using an Inertsil ODS3 C18 column and mass spectrometric detection in the negative ion, multiple reaction monitoring (MRM) mode, following two ion transitions per compound. It yielded a limit of quantification of 2 microg/L for the six compounds and intra-assay coefficients of variation (CV%) lower than 20%. This method was applied to the analysis of urines samples from a small cohort of non-exposed volunteers. At least one of the six DAP was detected in each sample. This result confirmed the feasibility of a LC-MS/MS procedure for monitoring the general population exposure to some frequently employed organophosphate pesticides.
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Affiliation(s)
- S Dulaurent
- Department of Pharmacology and Toxicology, University Hospital, 2 Avenue Martin Luther King, 87042 Limoges, France
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Sauvage FL, Gaulier JM, Lachâtre G, Marquet P. A Fully Automated Turbulent-Flow Liquid Chromatography-Tandem Mass Spectrometry Technique for Monitoring Antidepressants in Human Serum. Ther Drug Monit 2006; 28:123-30. [PMID: 16418706 DOI: 10.1097/01.ftd.0000194026.04483.c3] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Antidepressants belong to a variety of chemical and pharmacologic classes. Most require therapeutic drug monitoring, at least in certain circumstances, such as unexplained inefficacy or suspected toxicity. Several types of chromatographic methods have generally been used. This paper presents a fully automated, sensitive, and specific method for the therapeutic drug monitoring of 13 antidepressants of all classes (amoxapine, amitriptyline, citalopram, clomipramine, dothiepin, doxepin, fluoxetine, imipramine, maprotiline, mianserin, paroxetine, sertraline, trimipramine) and some of their respective active metabolites (nortriptyline, monodesmethylcitalopram, desmethylclomipramine, desipramine, norfluoxetine, desmethylmianserin, N-desmethylsertraline), based on the innovative turbulent-flow liquid chromatography (TFC) technology, coupled to tandem-mass spectrometry (MS/MS). The antidepressants were divided in two groups depending on their chromatographic properties, so that two injections would be necessary to screen all compounds (which is infrequent for therapeutic drug monitoring). Calibration curves ranged from 10 to 500 ng/mL. No significant memory effect was observed after the injection of a blank serum sample spiked at 500 ng/mL. The intra-assay and inter-assay precision CVs ranged from 0.4% to 12% and from 1% to 16%, respectively. The method was further validated by blindly analyzing Heathcontrol-Therapeutic Drugs Scheme samples (Cardiff Bioanalytical Services Ltd.) containing several antidepressants.
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Affiliation(s)
- F L Sauvage
- Department of Pharmacology-Toxicology, University Hospital, Limoges, France
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Collins WD, Ramaswamy V, Schwarzkopf MD, Sun Y, Portmann RW, Fu Q, Casanova SEB, Dufresne JL, Fillmore DW, Forster PMD, Galin VY, Gohar LK, Ingram WJ, Kratz DP, Lefebvre MP, Li J, Marquet P, Oinas V, Tsushima Y, Uchiyama T, Zhong WY. Radiative forcing by well-mixed greenhouse gases: Estimates from climate models in the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4). ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2005jd006713] [Citation(s) in RCA: 189] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Dulaurent S, Gaulier JM, Marquet P, Lachâtre G. [Treatment of pesticides determination requests in biological samples: some problems frequently encountered ]. Acta Clin Belg 2006; 61 Suppl 1:71-6. [PMID: 16700158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Currently, the determination of pesticides in human fluids is complex. Our scientific knowledge on pesticide intoxication is fragmentary. This leads to numerous difficulties regarding the diagnosis, the analysis request, the choice of the analytical technique, the interpretation of the results. Consequently the waiting time to provide a result is not compatible with the initiation of a treatment in the intoxicated patients. Very few information about Human intoxication with pesticides is available from the literature. In this context, we tried to acquire our own experience. We chose to deal with all pesticides intoxication suspicions received, in collaboration with clinicians. We are presenting the main problems we encounter.
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Affiliation(s)
- S Dulaurent
- Service de Pharmacologie et Toxicologie, CHU Dupuytren 87042 Limoges, France.
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Jacqmin P, Labouret N, Gueyffier F, Armengaud D, Bost I, Carpentier A, Caulin C, Crépin C, Fuseau EM, Gerberg M, Grosskopf C, Gueyffier F, Labouret NH, Jacqmin P, Laveille C, Le Gellec C, Marquet P, Ouslimani A, Pons G, Simeoni U, Simon N, Tranchand B, Treluyer JM. Modelling and Clinical Trials in Paediatrics. Therapie 2005. [DOI: 10.2515/therapie:2005056] [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: 11/20/2022]
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Rousseau A, Léger F, Le Meur Y, Saint-Marcoux F, Paintaud G, Buchler M, Marquet P. Population pharmacokinetic modeling of oral cyclosporin using NONMEM: comparison of absorption pharmacokinetic models and design of a Bayesian estimator. Ther Drug Monit 2004; 26:23-30. [PMID: 14749545 DOI: 10.1097/00007691-200402000-00006] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There have been very few population pharmacokinetic (PopPK) studies and Bayesian forecasting methods dealing with cyclosporin (CsA) so far, probably because of the difficulty of modeling the particular absorption profiles of CsA. The present study was conducted in stable renal transplant patients treated with Neoral and employed the NONMEM program. Its goals were (1) to develop a population pharmacokinetic model for CsA based on an Erlang frequency distribution (which describes asymmetric S-shaped absorption profiles) combined with a 2-compartment model; (2) to compare this model with models combining a time-lag parameter and either a zero-order or first-order rate constant and with a model based on a Weibull distribution; and (3) to develop a PK Bayesian estimator for full AUC estimation based on that "Erlang model." The PopPK model was developed in an index set of 70 patients, and then individual PK parameters and AUC were estimated in 10 other patients using Bayesian estimation. The "Erlang" model best described the data, with mean absorption time (MAT), apparent clearance (CL/F), and apparent volume of the central compartment (Vc/F) of 0.78 hours, 26.3 L/h, and 76 L, respectively (interindividual variability CV = 33, 30, and 48%). Bayesian estimation allowed accurate prediction of systemic exposure using only 3 samples collected at 0, 1, and 3 hours. Regression analysis found no significant difference between the predicted and observed concentrations (10 per patient), and AUC(0-12) were estimated with a nonsignificant bias (0.6 to 8.7%) and good precision (RMSE = 5.3%). In conclusion, the Erlang distribution best described CsA absorption profiles, and a Bayesian estimator developed using this model and a mixed-effect PK modeling program provided accurate estimates of CsA systemic exposure using only 3 blood samples.
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Affiliation(s)
- A Rousseau
- Department of Pharmacology, University Hospital, Limoges, France.
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