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Kopec RE, Caris‐Veyrat C, Nowicki M, Bernard J, Morange S, Chitchumroonchokchai C, Gleize B, Borel P. The Effect of an Iron Supplement on Lycopene Metabolism and Absorption During Digestion in Healthy Humans. Mol Nutr Food Res 2019; 63:e1900644. [DOI: 10.1002/mnfr.201900644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/07/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Rachel E. Kopec
- INRA UMR408University of Avignon Avignon France
- Human Nutrition ProgramThe Ohio State University Columbus Ohio USA
| | | | | | | | | | | | | | - Patrick Borel
- INRA, INSERM, Aix Marseille Univ, C2VN Marseille France
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Benyamine A, Magalon J, Sabatier F, Kaplanski G, Mazodier K, Reynaud Gaubert M, Morange S, Rossi P, Dignat-George F, Paul P, Granel B. Les cellules natural killer de patients souffrant de sclérodermie systémique ont un profil phénotypique particulier et sont de puissants inducteurs de libération de microparticules endothéliales. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.287] [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]
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Benyamine A, Magalon J, Sabatier F, Lyonnet L, Robert S, Dumoulin C, Morange S, Mazodier K, Kaplanski G, Reynaud-Gaubert M, Rossi P, Dignat-George F, Granel B, Paul P. Natural Killer Cells Exhibit a Peculiar Phenotypic Profile in Systemic Sclerosis and Are Potent Inducers of Endothelial Microparticles Release. Front Immunol 2018; 9:1665. [PMID: 30072999 PMCID: PMC6058015 DOI: 10.3389/fimmu.2018.01665] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/04/2018] [Indexed: 12/22/2022] Open
Abstract
The pathophysiology of systemic sclerosis (SSc) involves early endothelial and immune activation, both preceding the onset of fibrosis. We previously identified soluble fractalkine and circulating endothelial microparticles (EMPs) as biomarkers of endothelial inflammatory activation in SSc. Fractalkine plays a dual role as a membrane-bound adhesion molecule expressed in inflamed endothelial cells (ECs) and as a chemokine involved in the recruitment, transmigration, and cytotoxic activation of immune cells that express CX3CR1, the receptor of fractalkine, namely CD8 and γδ T cells and natural killer (NK) cells. We aimed to quantify circulating cytotoxic immune cells and their expression of CX3CR1. We further investigated the expression profile of NK cells chemokine receptors and activation markers and the potential of NK cells to induce EC activation in SSc. We performed a monocentric study (NCT 02636127) enrolling 15 SSc patients [15 females, median age of 55 years (39–63), 11 limited cutaneous form and 4 diffuse] and 15 healthy controls. Serum fractalkine levels were significantly increased in SSc patients. Circulating CD8 T cells numbers were decreased in SSc patients with no difference in their CX3CR1 expression. Circulating γδ T cells and NK cells numbers were preserved. CX3CR1 expression in CD8 and γδ T cells did not differ between SSc patients and controls. The percentage and level of CX3CR1 expression in NK cells were significantly lowered in SSc patients. Percentages of CXCR4, NKG2D, CD69-expressing NK cells, and their expression levels were decreased in NK cells. Conversely, CD16 level expression and percentages of CD16+ NK cells were preserved. The exposure of human microvascular dermic EC line (HMVEC-d) to peripheral blood mononuclear cells resulted in similar NK cells degranulation activity in SSc patients and controls. We further showed that NK cells purified from the blood of SSc patients induced enhanced release of EMPs than NK cells from controls. This study evidenced a peculiar NK cells phenotype in SSc characterized by decreased chemokine and activation receptors expression, that might reflect NK cells involvement in the pathogenic process. It also highlighted the role of NK cells as a potent mechanism inducing endothelial activation through enhanced EMPs release.
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Affiliation(s)
- Audrey Benyamine
- Internal Medicine Department, Pôle MINC, Hôpital Nord, Assistance Publique Hôpitaux de Marseille (AP-HM), Marseille, France.,Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Jérémy Magalon
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.,Cell Therapy Unit, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
| | - Florence Sabatier
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.,Cell Therapy Unit, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France.,Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France.,Centre d'Investigation clinique (CIC), Hôpital de la Conception, AP-HM, Marseille, France
| | - Luc Lyonnet
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | | | - Chloé Dumoulin
- Cell Therapy Unit, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France.,Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Sophie Morange
- Centre d'Investigation clinique (CIC), Hôpital de la Conception, AP-HM, Marseille, France
| | - Karin Mazodier
- Internal Medicine and Clinical Immunology Department, Pôle MINC, Hôpital de la Conception, AP-HM, Marseille, France
| | - Gilles Kaplanski
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.,Internal Medicine and Clinical Immunology Department, Pôle MINC, Hôpital de la Conception, AP-HM, Marseille, France
| | | | - Pascal Rossi
- Internal Medicine Department, Pôle MINC, Hôpital Nord, Assistance Publique Hôpitaux de Marseille (AP-HM), Marseille, France.,Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Françoise Dignat-George
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.,Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Brigitte Granel
- Internal Medicine Department, Pôle MINC, Hôpital Nord, Assistance Publique Hôpitaux de Marseille (AP-HM), Marseille, France.,Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Pascale Paul
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.,Cell Therapy Unit, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France.,Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
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Lloret-Linares C, Daali Y, Chevret S, Nieto I, Molière F, Courtet P, Galtier F, Richieri RM, Morange S, Llorca PM, El-Hage W, Desmidt T, Haesebaert F, Vignaud P, Holtzmann J, Cracowski JL, Leboyer M, Yrondi A, Calvas F, Yon L, Le Corvoisier P, Doumy O, Heron K, Montange D, Davani S, Déglon J, Besson M, Desmeules J, Haffen E, Bellivier F. Exploring venlafaxine pharmacokinetic variability with a phenotyping approach, a multicentric french-swiss study (MARVEL study). BMC Pharmacol Toxicol 2017; 18:70. [PMID: 29115994 PMCID: PMC5678760 DOI: 10.1186/s40360-017-0173-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 05/05/2017] [Accepted: 10/09/2017] [Indexed: 12/18/2022] Open
Abstract
Background It is well known that the standard doses of a given drug may not have equivalent effects in all patients. To date, the management of depression remains mainly empirical and often poorly evaluated. The development of a personalized medicine in psychiatry may reduce treatment failure, intolerance or resistance, and hence the burden and costs of mood depressive disorders. The Geneva Cocktail Phenotypic approach presents several advantages including the “in vivo” measure of different cytochromes and transporter P-gp activities, their simultaneous determination in a single test, avoiding the influence of variability over time on phenotyping results, the administration of low dose substrates, a limited sampling strategy with an analytical method developed on DBS analysis. The goal of this project is to explore the relationship between the activity of drug-metabolizing enzymes (DME), assessed by a phenotypic approach, and the concentrations of Venlafaxine (VLX) + O-demethyl-venlafaxine (ODV), the efficacy and tolerance of VLX. Methods/design This study is a multicentre prospective non-randomized open trial. Eligible patients present a major depressive episode, MADRS over or equal to 20, treatment with VLX regardless of the dose during at least 4 weeks. The Phenotype Visit includes VLX and ODV concentration measurement. Following the oral absorption of low doses of omeprazole, midazolam, dextromethorphan, and fexofenadine, drug metabolizing enzymes activity is assessed by specific metabolite/probe concentration ratios from a sample taken 2 h after cocktail administration for CYP2C19, CYP3A4, CYP2D6; and by the determination of the limited area under the curve from the capillary blood samples taken 2–3 and 6 h after cocktail administration for CYP2C19 and P-gp. Two follow-up visits will take place between 25 and 40 days and 50–70 days after inclusion. They include assessment of efficacy, tolerance and observance. Eleven french centres are involved in recruitment, expected to be completed within approximately 2 years with 205 patients. Metabolic ratios are determined in Geneva, Switzerland. Discussion By showing an association between drug metabolism and VLX concentrations, efficacy and tolerance, there is a hope that testing drug metabolism pathways with a phenotypical approach would help physicians in selecting and dosing antidepressants. The MARVEL study will provide an important contribution to increasing the knowledge of VLX variability and in optimizing the use of methods of personalized therapy in psychiatric settings. Trial registration ClinicalTrials.govNCT02590185 (10/27/2015). This study is currently recruiting participants.
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Affiliation(s)
- Célia Lloret-Linares
- Inserm, U1144, F-75006, Paris, France. .,Université Paris Diderot, UMR-S 1144, F-75013, Paris, France. .,Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Therapeutic Research Unit, F-75010, Paris, France.
| | - Youssef Daali
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Geneva, Switzerland
| | - Sylvie Chevret
- Service de Biostatistiques et Information Médicale, Hôpital Saint-Louis, AP-HP, ECSTRA Team, Inserm UMR-1153, Université Paris Diderot, 1 rue Claude Vellefaux, 75010, Paris, France
| | - Isabelle Nieto
- Department of Psychiatry and Addiction Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital F. Widal, F-75010, Paris, France
| | | | | | | | - Raphaëlle-Marie Richieri
- Pôle psychiatrie, addictologie, pédopsychiatrie, Assistance Publique des hôpitaux de Marseille, Marseille, France
| | - Sophie Morange
- APHM, Aix Marseille Univ, Institut Paoli-Calmettes, INSERM, CIC Hôpital Conception, Marseille, France
| | - Pierre-Michel Llorca
- Service Psychiatrie et Addictologie de l'Adulte CMP B, Centre Hospitalier Universitaire, Rue Montalembert, Clermont-Ferrand, France
| | - Wissam El-Hage
- Inserm U930, Université François Rabelais de Tours, Tours, France.,Inserm CIC 1415, Tours, France.,Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France
| | - Thomas Desmidt
- Inserm U930, Université François Rabelais de Tours, Tours, France.,Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France
| | - Frédéric Haesebaert
- PsyR2 Team, U 1028, INSERM and UMR 5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), CH Le Vinatier, Lyon-1 University, Bron, France.,Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, QC, Québec, Canada
| | - Philippe Vignaud
- PsyR2 Team, U 1028, INSERM and UMR 5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), CH Le Vinatier, Lyon-1 University, Bron, France
| | - Jerôme Holtzmann
- Service Hospitalo-Universitaire de Psychiatrie. CHU Grenoble-Alpes, La Tronche, France
| | - Jean-Luc Cracowski
- Unité de Pharmacologie Clinique, Centre d'Investigation Clinique de Grenoble, INSERM CIC1406, CHU de Grenoble, Grenoble, France
| | - Marion Leboyer
- AP-HP, pole de psychiatrie des HU Henri Mondor, Equipe psychiatrie translationnelle, Créteil, France.,Inserm U955 and foundation FondaMental, Créteil, France
| | - Antoine Yrondi
- Service de psychiatrie et psychologie médicale CHU Toulouse-Purpan, Toulouse, France.,Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Fabienne Calvas
- Inserm CIC 1436, CHU Toulouse, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Liova Yon
- Inserm, Clinical Investigation Center 1430 and Henri Mondor University Hospital, AP-HP, Créteil, France
| | - Philippe Le Corvoisier
- Inserm, Clinical Investigation Center 1430 and Henri Mondor University Hospital, AP-HP, Créteil, France
| | - Olivier Doumy
- Centre Expert Dépression Résistante, Centre Référence Pathologies Anxieuses et Dépression (CERPAD), Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Kyle Heron
- Department of Experimental Psychology, University of Bristol, UK and Somerset Partnership NHS Foundation Trust, Bristol, UK
| | - Damien Montange
- Department of Pharmacology, CHRU Besançon, Univ. Bourgogne-Franche-Comté, EA3920, Besançon, France
| | - Siamak Davani
- Department of Pharmacology, CHRU Besançon, Univ. Bourgogne-Franche-Comté, EA3920, Besançon, France
| | - Julien Déglon
- Unit of Toxicology, CURML, University Hospitals of Lausanne, Lausanne, Switzerland.,Unit of Toxicology, CURML, University Hospitals of Geneva, Geneva, Switzerland
| | - Marie Besson
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Geneva, Switzerland
| | - Jules Desmeules
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Geneva, Switzerland
| | - Emmanuel Haffen
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France
| | - Frank Bellivier
- Inserm, U1144, F-75006, Paris, France.,Université Paris Diderot, UMR-S 1144, F-75013, Paris, France.,Department of Psychiatry and Addiction Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital F. Widal, F-75010, Paris, France
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Desmarchelier C, Reboul E, Goncalves A, Kopec R, Nowicki M, Morange S, Lesavre N, Portugal H, Borel P. Une combinaison de polymorphismes mononucléotidiques est associée à la variabilité interindividuelle de la biodisponibilité du cholécalciférol chez des hommes sains. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2017.06.059] [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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Maffei P, Wiramus S, Bensoussan L, Bienvenu L, Haddad E, Morange S, Fathallah M, Hardwigsen J, Viton JM, Le Treut YP, Albanese J, Gregoire E. Intensive Early Rehabilitation in the Intensive Care Unit for Liver Transplant Recipients: A Randomized Controlled Trial. Arch Phys Med Rehabil 2017; 98:1518-1525. [PMID: 28279659 DOI: 10.1016/j.apmr.2017.01.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/18/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To validate the feasibility and tolerance of an intensive rehabilitation protocol initiated during the postoperative period in an intensive care unit (ICU) in liver transplant recipients. DESIGN Prospective randomized study. SETTING ICU. PARTICIPANTS Liver transplant recipients over a period of 1 year (N=40). INTERVENTIONS The "usual treatment group" (n=20), which benefited from the usual treatment applied in the ICU (based on physician prescription for the physiotherapist, with one session a day), and the experimental group (n=20), which followed a protocol of early and intensive rehabilitation (based on a written protocol validated by physicians and an evaluation by physiotherapist, with 2 sessions a day), were compared. MAIN OUTCOME MEASURES Our primary aims were tolerance, assessed from the number of adverse events during rehabilitation sessions, and feasibility, assessed from the number of sessions discontinued. RESULTS The results revealed a small percentage of adverse events (1.5% in the usual treatment group vs 1.06% in the experimental group) that were considered to be of low intensity. Patients in the experimental group sat on the edge of their beds sooner (2.6 vs 9.7d; P=.048) and their intestinal transit resumed earlier (5.6 vs 3.7d; P=.015) than patients in the usual treatment group. There was no significant difference between the 2 arms regarding length of stay (LOS), despite a decrease in duration in the experimental group. CONCLUSIONS The introduction of an intensive early rehabilitation program for liver transplant recipients was well tolerated and feasible in the ICU. We noted that the different activities proposed were introduced sooner in the experimental group. Moreover, there is a tendency to decreased LOS in the ICU for the experimental group. These results now need to be confirmed by studies on a larger scale.
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Affiliation(s)
- Pierre Maffei
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France
| | - Sandrine Wiramus
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Intensive Care Department, Hôpital de la Conception, Marseille, France
| | - Laurent Bensoussan
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France
| | - Laurence Bienvenu
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France
| | - Eric Haddad
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France
| | - Sophie Morange
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Clinical Evaluation Unit, Hôpital de la Conception, Marseille, France
| | - Mohamed Fathallah
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Clinical Evaluation Unit, Hôpital de la Conception, Marseille, France
| | - Jean Hardwigsen
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, Hôpital de la Conception, Marseille, France
| | - Jean-Michel Viton
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of Physical Medicine and Rehabilitation, Hôpital de la Conception, Marseille, France
| | - Y Patrice Le Treut
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, Hôpital de la Conception, Marseille, France
| | - Jacques Albanese
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Intensive Care Department, Hôpital de la Conception, Marseille, France
| | - Emilie Gregoire
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, Hôpital de la Conception, Marseille, France.
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Lanfranchi MA, Leluc O, Tavano A, Wormser C, Morange S, Chagnaud C, Pradel V, Lafforgue P, Pham T. Are Ultrasound Findings Similar in Patients with Axial Spondyloarthritis and in Athlete Entheses? J Rheumatol 2017; 44:609-612. [PMID: 28250140 DOI: 10.3899/jrheum.160715] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Enthesitis is the spondyloarthritis (SpA) landmark, but can also be seen after entheses overuse, such as during intensive sport. METHODS We aimed to compare entheses ultrasound (US) findings in a prospective cross-sectional study of 30 axial SpA cases, 30 athletes, and 29 controls. RESULTS Mean (SD) MAdrid Sonographic Enthesis Index (MASEI) score was 26.3 (13), 12.2 (7), and 10.4 (6) in patients with SpA, athletes, and non-athlete control groups, respectively (p < 0.0001). CONCLUSION The MASEI score was significantly higher in patients with SpA compared with healthy controls, athletes, and non-athletes, and can be of value to distinguish SpA from healthy subjects, whatever their physical activity.
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Affiliation(s)
- Marie-Alix Lanfranchi
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France.,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University
| | - Olivier Leluc
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France.,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University
| | - Alice Tavano
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France.,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University
| | - Cécile Wormser
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France.,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University
| | - Sophie Morange
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France.,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University
| | - Christophe Chagnaud
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France.,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University
| | - Vincent Pradel
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France.,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University
| | - Pierre Lafforgue
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France.,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University
| | - Thao Pham
- From the Assistance Publique-Hôpitaux de Marseille (APHM), CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; CHU Conception, Radiology Department, Clinical Investigation Center; CHU Sainte Marguerite, Public Health Department; Aix-Marseille University, Marseille, France. .,M.A. Lanfranchi, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; O. Leluc, MD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; A. Tavano, MD, APHM, CHU Conception, Radiology Department; C. Wormser, MD, APHM, CHU Conception, Radiology Department; S. Morange, MD, APHM, CHU Conception, Clinical Investigation Center; C. Chagnaud, MD, PhD, APHM, CHU Conception, Radiology Department, Aix-Marseille University; V. Pradel, MD, APHM, CHU Sainte Marguerite, Public Health Department, Aix-Marseille University; P. Lafforgue, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University; T. Pham, MD, PhD, APHM, CHU Sainte Marguerite, Rheumatology Department, Aix-Marseille University.
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8
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Desmarchelier C, Borel P, Goncalves A, Kopec R, Nowicki M, Morange S, Lesavre N, Portugal H, Reboul E. A Combination of Single-Nucleotide Polymorphisms Is Associated with Interindividual Variability in Cholecalciferol Bioavailability in Healthy Men. J Nutr 2016; 146:2421-2428. [PMID: 27798339 DOI: 10.3945/jn.116.237115] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/10/2016] [Accepted: 09/19/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Most people require dietary vitamin D to achieve the recommended concentration of 25-hydroxyvitamin D [25(OH)D] in the blood. However, the response to vitamin D supplementation is highly variable among individuals. OBJECTIVE We assessed whether the variability in cholecalciferol bioavailability was associated with single-nucleotide polymorphisms (SNPs) in candidate genes. METHODS In a single-group design, 39 healthy adult men with a mean ± SD age of 33 ± 2 y and mean ± SD body mass index (in kg/m2) of 22.9 ± 0.3 were genotyped with the use of whole-genome microarrays. After an overnight fast, plasma 25(OH)D status was measured, and the subjects then consumed a meal that provided 5 mg cholecalciferol as a supplement. Plasma chylomicron cholecalciferol concentration was measured over 8 h, and cholecalciferol response was assessed by calculating the postprandial area under the curve. Partial least squares regression was used to test the association of SNPs in or near candidate genes (61 genes representing 3791 SNPs) with the postprandial cholecalciferol response. RESULTS The postprandial chylomicron cholecalciferol concentration peaked at 5.4 h. The cholecalciferol response was extremely variable among individuals (CV: 47%). It correlated with the chylomicron triglyceride (TG) response (r = 0.60; P < 0.001) but not with the fasting plasma 25(OH)D concentration (r = 0.04; P = 0.83). A significant (P = 1.32 × 10-4) partial least squares regression model that included 17 SNPs in 13 genes (including 5 that have been associated with chylomicron TG response) was associated with the variance in the cholecalciferol response. CONCLUSION In healthy men, there is a high interindividual variability in cholecalciferol bioavailability that is associated with a combination of SNPs located in or near genes involved in both vitamin D and lipid metabolism. This trial was registered at clinicaltrials.gov as NCT02100774.
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Affiliation(s)
- Charles Desmarchelier
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France
| | - Patrick Borel
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France;
| | | | - Rachel Kopec
- National Institute for Agricultural Research, Avignon, France.,Security and Quality of Plant Products, University of Avignon, Avignon, France
| | - Marion Nowicki
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France
| | - Sophie Morange
- Clinical Investigation Centre, Conception Hospital, Marseille, France; and
| | - Nathalie Lesavre
- Clinical Investigation Centre, North Hospital, Marseille, France
| | - Henri Portugal
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France
| | - Emmanuelle Reboul
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France
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9
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Legris T, Picard C, Todorova D, Lyonnet L, Laporte C, Dumoulin C, Nicolino-Brunet C, Daniel L, Loundou A, Morange S, Bataille S, Vacher-Coponat H, Moal V, Berland Y, Dignat-George F, Burtey S, Paul P. Antibody-Dependent NK Cell Activation Is Associated with Late Kidney Allograft Dysfunction and the Complement-Independent Alloreactive Potential of Donor-Specific Antibodies. Front Immunol 2016; 7:288. [PMID: 27563301 PMCID: PMC4980873 DOI: 10.3389/fimmu.2016.00288] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 07/18/2016] [Indexed: 12/21/2022] Open
Abstract
Although kidney transplantation remains the best treatment for end-stage renal failure, it is limited by chronic humoral aggression of the graft vasculature by donor-specific antibodies (DSAs). The complement-independent mechanisms that lead to the antibody-mediated rejection (ABMR) of kidney allografts remain poorly understood. Increasing lines of evidence have revealed the relevance of natural killer (NK) cells as innate immune effectors of antibody-dependent cellular cytotoxicity (ADCC), but few studies have investigated their alloreactive potential in the context of solid organ transplantation. Our study aimed to investigate the potential contribution of the antibody-dependent alloreactive function of NK cells to kidney graft dysfunction. We first conducted an observational study to investigate whether the cytotoxic function of NK cells is associated with chronic allograft dysfunction. The NK-Cellular Humoral Activation Test (NK-CHAT) was designed to evaluate the recipient and antibody-dependent reactivity of NK cells against allogeneic target cells. The release of CD107a/Lamp1+ cytotoxic granules, resulting from the recognition of rituximab-coated B cells by NK cells, was analyzed in 148 kidney transplant recipients (KTRs, mean graft duration: 6.2 years). Enhanced ADCC responsiveness was associated with reduced graft function and identified as an independent risk factor predicting a decline in the estimated glomerular filtration rate over a 1-year period (hazard ratio: 2.83). In a second approach, we used the NK-CHAT to reveal the cytotoxic potential of circulating alloantibodies in vitro. The level of CD16 engagement resulting from the in vitro recognition of serum-coated allogeneic B cells or splenic cells was further identified as a specific marker of DSA-induced ADCC. The NK-CHAT scoring of sera obtained from 40 patients at the time of transplant biopsy was associated with ABMR diagnosis. Our findings indicate that despite the administration of immunosuppressive treatments, robust ADCC responsiveness can be maintained in some KTRs. Because it evaluates both the Fab recognition of alloantigens and Fc-driven NK cell activation, the NK-CHAT represents a potentially valuable tool for the non-invasive and individualized evaluation of humoral risk during transplantation.
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Affiliation(s)
- Tristan Legris
- Nephrology Dialysis Renal Transplantation Center, Assistance Publique des Hôpitaux de Marseille, Hospital de la Conception , Marseille , France
| | - Christophe Picard
- Établissement Français du Sang Alpes Méditerranée, Marseille, France; ADES UMR 7268, CNRS, EFS, Aix-Marseille Université, Marseille, France
| | - Dilyana Todorova
- UMR 1076, Vascular Research Center of Marseille, INSERM, Aix-Marseille University , Marseille , France
| | - Luc Lyonnet
- Hematology Unit, Assistance Publique des Hôpitaux de Marseille, Hopital de la Conception , Marseille , France
| | - Cathy Laporte
- Hematology Unit, Assistance Publique des Hôpitaux de Marseille, Hopital de la Conception , Marseille , France
| | - Chloé Dumoulin
- Hematology Unit, Assistance Publique des Hôpitaux de Marseille, Hopital de la Conception , Marseille , France
| | - Corinne Nicolino-Brunet
- Hematology Unit, Assistance Publique des Hôpitaux de Marseille, Hopital de la Conception , Marseille , France
| | - Laurent Daniel
- Laboratory for Anatomy, Pathology, Neuropathology, Hôpital de la Timone, Aix-Marseille University , Marseille , France
| | - Anderson Loundou
- Unité d'Aide méthodologique à la Recherche Clinique et Epidémiologique, DRRC, Assistance Publique Hôpitaux de Marseille , Marseille , France
| | - Sophie Morange
- Centre d'Investigation Clinique, Hôpital de la Conception , Marseille , France
| | - Stanislas Bataille
- Nephrology Dialysis Renal Transplantation Center, Assistance Publique des Hôpitaux de Marseille, Hospital de la Conception , Marseille , France
| | - Henri Vacher-Coponat
- Nephrology Dialysis Renal Transplantation Center, Assistance Publique des Hôpitaux de Marseille, Hospital de la Conception , Marseille , France
| | - Valérie Moal
- Nephrology Dialysis Renal Transplantation Center, Assistance Publique des Hôpitaux de Marseille, Hospital de la Conception , Marseille , France
| | - Yvon Berland
- Nephrology Dialysis Renal Transplantation Center, Assistance Publique des Hôpitaux de Marseille, Hospital de la Conception , Marseille , France
| | - Francoise Dignat-George
- UMR 1076, Vascular Research Center of Marseille, INSERM, Aix-Marseille University, Marseille, France; Hematology Unit, Assistance Publique des Hôpitaux de Marseille, Hopital de la Conception, Marseille, France
| | - Stéphane Burtey
- Nephrology Dialysis Renal Transplantation Center, Assistance Publique des Hôpitaux de Marseille, Hospital de la Conception, Marseille, France; UMR 1076, Vascular Research Center of Marseille, INSERM, Aix-Marseille University, Marseille, France
| | - Pascale Paul
- UMR 1076, Vascular Research Center of Marseille, INSERM, Aix-Marseille University, Marseille, France; Hematology Unit, Assistance Publique des Hôpitaux de Marseille, Hopital de la Conception, Marseille, France
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10
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Loret EP, Darque A, Jouve E, Loret EA, Nicolino-Brunet C, Morange S, Castanier E, Casanova J, Caloustian C, Bornet C, Coussirou J, Boussetta J, Couallier V, Blin O, Dussol B, Ravaux I. Erratum to: Intradermal injection of a Tat Oyi-based therapeutic HIV vaccine reduces of 1.5 log copies/mL the HIV RNA rebound median and no HIV DNA rebound following cART interruption in a phase I/II randomized controlled clinical trial. Retrovirology 2016; 13:35. [PMID: 27160192 PMCID: PMC4862173 DOI: 10.1186/s12977-016-0264-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Erwann P Loret
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France.
| | - Albert Darque
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France.,Pharmacie Usage Interne, AP-HM, UHC «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Elisabeth Jouve
- Centre de Pharmacologie Clinique et Evaluations Thérapeutiques (AP-HM), UHC «la Timone», 28 Boulevard Jean Moulin, 13385, Marseille, France
| | - Elvenn A Loret
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France
| | - Corinne Nicolino-Brunet
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France
| | - Sophie Morange
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Elisabeth Castanier
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Josiane Casanova
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Christine Caloustian
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Charléric Bornet
- Pharmacie Usage Interne, AP-HM, UHC «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Julie Coussirou
- Pharmacie Usage Interne, AP-HM, UHC «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Jihen Boussetta
- Pharmacie Usage Interne, AP-HM, UHC «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Vincent Couallier
- Unité Mixte de Recherche CNRS 5251, Institut de Mathématique de Bordeaux, CNRS, Bordeaux 2 University, 33000, Bordeaux, France
| | - Olivier Blin
- Centre de Pharmacologie Clinique et Evaluations Thérapeutiques (AP-HM), UHC «la Timone», 28 Boulevard Jean Moulin, 13385, Marseille, France
| | - Bertrand Dussol
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Isabelle Ravaux
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France
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11
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Loret EP, Darque A, Jouve E, Loret EA, Nicolino-Brunet C, Morange S, Castanier E, Casanova J, Caloustian C, Bornet C, Coussirou J, Boussetta J, Couallier V, Blin O, Dussol B, Ravaux I. Intradermal injection of a Tat Oyi-based therapeutic HIV vaccine reduces of 1.5 log copies/mL the HIV RNA rebound median and no HIV DNA rebound following cART interruption in a phase I/II randomized controlled clinical trial. Retrovirology 2016; 13:21. [PMID: 27036656 PMCID: PMC4818470 DOI: 10.1186/s12977-016-0251-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A Tat Oyi vaccine preparation was administered with informed consent to 48 long-term HIV-1 infected volunteers whose viral loads had been suppressed by antiretroviral therapy (cART). These volunteers were randomized in double-blind method into four groups (n = 12) that were injected intradermally with 0, 11, 33, or 99 µg of synthetic Tat Oyi proteins in buffer without adjuvant at times designated by month 0 (M0), M1 and M2, respectively. The volunteers then underwent a structured treatment interruption between M5 and M7. RESULTS The primary outcomes of this phase I/IIa clinical trial were the safety and lowering the extent of HIV RNA rebound after cART interruption. Only one undesirable event possibly due to vaccination was observed. The 33 µg dose was most effective at lowering the extent of HIV RNA and DNA rebound (Mann and Whitney test, p = 0.07 and p = 0.001). Immune responses against Tat were increased at M5 and this correlated with a low HIV RNA rebound at M6 (p = 0.01). CONCLUSION This study suggests in vivo that extracellular Tat activates and protects HIV infected cells. The Tat Oyi vaccine in association with cART may provide an efficient means of controlling the HIV-infected cell reservoir.
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Affiliation(s)
- Erwann P Loret
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France.
| | - Albert Darque
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France.,Pharmacie Usage Interne, AP-HM, UHC «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Elisabeth Jouve
- Centre de Pharmacologie Clinique et Evaluations Thérapeutiques (AP-HM), UHC «la Timone», 28 Boulevard Jean Moulin, 13385, Marseille, France
| | - Elvenn A Loret
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France
| | - Corinne Nicolino-Brunet
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France
| | - Sophie Morange
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Elisabeth Castanier
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Josiane Casanova
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Christine Caloustian
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Charléric Bornet
- Pharmacie Usage Interne, AP-HM, UHC «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Julie Coussirou
- Pharmacie Usage Interne, AP-HM, UHC «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Jihen Boussetta
- Pharmacie Usage Interne, AP-HM, UHC «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Vincent Couallier
- Unité Mixte de Recherche CNRS 5251, Institut de Mathématique de Bordeaux, CNRS, Bordeaux 2 University, 33000, Bordeaux, France
| | - Olivier Blin
- Centre de Pharmacologie Clinique et Evaluations Thérapeutiques (AP-HM), UHC «la Timone», 28 Boulevard Jean Moulin, 13385, Marseille, France
| | - Bertrand Dussol
- Centre d'Investigation Clinique, Assistance Publique -Hôpitaux de Marseille (AP-HM), University Hospital Center (UHC) «la Conception», 147 Bd Baille, 13385, Marseille, France
| | - Isabelle Ravaux
- ETRAV Laboratory, Faculty of Pharmacy, Centre National de la Recherche Scientifique (CNRS), Aix Marseille University, 27 Boulevard Jean Moulin, 13385, Marseille, France
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12
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Gondouin B, Jourde-Chiche N, Sallee M, Dou L, Cerini C, Loundou A, Morange S, Berland Y, Burtey S, Brunet P, Guieu R, Dussol B. Plasma Xanthine Oxidase Activity Is Predictive of Cardiovascular Disease in Patients with Chronic Kidney Disease, Independently of Uric Acid Levels. Nephron Clin Pract 2015; 131:167-74. [PMID: 26426087 DOI: 10.1159/000441091] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/09/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality. Oxidative stress seems to play a pivotal role in this process, and purine metabolism may be involved in CKD-related oxidative stress. Xanthine oxidase (XO) is an enzyme involved in purine metabolism and is also responsible for the production of reactive oxygen species. METHODS This prospective study aimed to analyze the relation between plasma dosages of molecules involved in redox balance, purine metabolism and cardiovascular events in patients with non-diabetic CKD stages 3-5 or on chronic hemodialysis (HD). CKD (n = 51) and HD (n = 50) patients were compared to matched healthy controls (n = 38) and followed-up for 3 years. RESULTS Both CKD and HD patients had decreased plasma levels of antioxidants (selenium, zinc, vitamin C). HD patients had decreased levels of the antioxidant enzyme superoxide dismutase and increased levels of oxidation products (ischemia-modified albumin, malondialdehyde [MDA]). The following substrates and enzymes involved in purine metabolism were increased in the HD cohort: adenosine, adenosine deaminase and the pro-oxidant XO. XO activity was negatively correlated with super oxide dismutase and positively with MDA. Interestingly, XO activity was an independent predictor of cardiovascular events in CKD and HD patients, regardless of uric acid levels. Uric acid was not predictive of events. CONCLUSION This highlights a possible role of XO itself in CKD-related cardiovascular disease (CVD) and raises the hypothesis that beneficial effects observed with XO inhibitors on CVD in CKD may also be due to the reduction of oxidative stress.
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Affiliation(s)
- Bertrand Gondouin
- Centre de Nephrologie et Transplantation Rx00E9;nale, Hopital La Conception, Marseille, France
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Borel P, Desmarchelier C, Nowicki M, Bott R, Morange S, Lesavre N. Interindividual variability of lutein bioavailability in healthy men: characterization, genetic variants involved, and relation with fasting plasma lutein concentration. Am J Clin Nutr 2014; 100:168-75. [PMID: 24808487 DOI: 10.3945/ajcn.114.085720] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Lutein accumulates in the macula and brain, where it is assumed to play physiologic roles. The bioavailability of lutein is assumed to display a high interindividual variability that has been hypothesized to be attributable, at least partly, to genetic polymorphisms. OBJECTIVES We characterized the interindividual variability in lutein bioavailability in humans, assessed the relation between this variability and the fasting blood lutein concentration, and identified single nucleotide polymorphisms (SNPs) involved in this phenomenon. DESIGN In a randomized, 2-way crossover study, 39 healthy men consumed a meal that contained a lutein supplement or the same meal for which lutein was provided through a tomato puree. The lutein concentration was measured in plasma chylomicrons isolated at regular time intervals over 8 h postprandially. Multivariate statistical analyses were used to identify a combination of SNPs associated with the postprandial chylomicron lutein response (0-8-h area under the curve). A total of 1785 SNPs in 51 candidate genes were selected. RESULTS Postprandial chylomicron lutein responses to meals were very variable (CV of 75% and 137% for the lutein-supplement meal and the meal with tomato-sourced lutein, respectively). Postprandial chylomicron lutein responses measured after the 2 meals were positively correlated (r = 0.68, P < 0.0001) and positively correlated to the fasting plasma lutein concentration (r = 0.51, P < 0.005 for the lutein-supplement-containing meal). A significant (P = 1.9 × 10(-4)) and validated partial least-squares regression model, which included 29 SNPs in 15 genes, explained most of the variance in the postprandial chylomicron lutein response. CONCLUSIONS The ability to respond to lutein appears to be, at least in part, genetically determined. The ability is explained, in large part, by a combination of SNPs in 15 genes related to both lutein and chylomicron metabolism. Finally, our results suggest that the ability to respond to lutein and blood lutein status are related. This trial was registered at clinicaltrials.gov as NCT02100774.
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Affiliation(s)
- Patrick Borel
- From Institut National de la Recherche Agronomique (INRA), Unité Mixte de Recherche (UMR) INRA1260, Marseille, France (PB, CD, MN, and RB); the Institut National de la Recherche Médicale (INSERM), UMR_S 1062, Marseille, France (PB, CD, MN, and RB); Aix Marseille Université, Nutrition Obésité et Risque Thrombotique, Marseille, France (PB, CD, MN, and RB); the Centre d'Investigation Clinique (CIC) Hôpital de la Conception, Marseille, France (SM); and the CIC Hôpital Nord, Marseille, France (NL)
| | - Charles Desmarchelier
- From Institut National de la Recherche Agronomique (INRA), Unité Mixte de Recherche (UMR) INRA1260, Marseille, France (PB, CD, MN, and RB); the Institut National de la Recherche Médicale (INSERM), UMR_S 1062, Marseille, France (PB, CD, MN, and RB); Aix Marseille Université, Nutrition Obésité et Risque Thrombotique, Marseille, France (PB, CD, MN, and RB); the Centre d'Investigation Clinique (CIC) Hôpital de la Conception, Marseille, France (SM); and the CIC Hôpital Nord, Marseille, France (NL)
| | - Marion Nowicki
- From Institut National de la Recherche Agronomique (INRA), Unité Mixte de Recherche (UMR) INRA1260, Marseille, France (PB, CD, MN, and RB); the Institut National de la Recherche Médicale (INSERM), UMR_S 1062, Marseille, France (PB, CD, MN, and RB); Aix Marseille Université, Nutrition Obésité et Risque Thrombotique, Marseille, France (PB, CD, MN, and RB); the Centre d'Investigation Clinique (CIC) Hôpital de la Conception, Marseille, France (SM); and the CIC Hôpital Nord, Marseille, France (NL)
| | - Romain Bott
- From Institut National de la Recherche Agronomique (INRA), Unité Mixte de Recherche (UMR) INRA1260, Marseille, France (PB, CD, MN, and RB); the Institut National de la Recherche Médicale (INSERM), UMR_S 1062, Marseille, France (PB, CD, MN, and RB); Aix Marseille Université, Nutrition Obésité et Risque Thrombotique, Marseille, France (PB, CD, MN, and RB); the Centre d'Investigation Clinique (CIC) Hôpital de la Conception, Marseille, France (SM); and the CIC Hôpital Nord, Marseille, France (NL)
| | - Sophie Morange
- From Institut National de la Recherche Agronomique (INRA), Unité Mixte de Recherche (UMR) INRA1260, Marseille, France (PB, CD, MN, and RB); the Institut National de la Recherche Médicale (INSERM), UMR_S 1062, Marseille, France (PB, CD, MN, and RB); Aix Marseille Université, Nutrition Obésité et Risque Thrombotique, Marseille, France (PB, CD, MN, and RB); the Centre d'Investigation Clinique (CIC) Hôpital de la Conception, Marseille, France (SM); and the CIC Hôpital Nord, Marseille, France (NL)
| | - Nathalie Lesavre
- From Institut National de la Recherche Agronomique (INRA), Unité Mixte de Recherche (UMR) INRA1260, Marseille, France (PB, CD, MN, and RB); the Institut National de la Recherche Médicale (INSERM), UMR_S 1062, Marseille, France (PB, CD, MN, and RB); Aix Marseille Université, Nutrition Obésité et Risque Thrombotique, Marseille, France (PB, CD, MN, and RB); the Centre d'Investigation Clinique (CIC) Hôpital de la Conception, Marseille, France (SM); and the CIC Hôpital Nord, Marseille, France (NL)
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Moal V, Legris T, Burtey S, Morange S, Purgus R, Dussol B, Garcia S, Motte A, Gérolami R, Berland Y, Colson P. Infection with hepatitis E virus in kidney transplant recipients in southeastern France. J Med Virol 2012; 85:462-71. [PMID: 23239466 DOI: 10.1002/jmv.23469] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2012] [Indexed: 12/11/2022]
Abstract
Hepatitis E virus (HEV) is an emerging cause of acute hepatitis in Europe, particularly in southern France, and HEV is a new causative agent of chronic hepatitis and cirrhosis in immunocompromised patients. However, the data regarding HEV infection after kidney transplantation are still scarce with respect to the clinical issues that have been raised, and no study has specifically focused on kidney transplant recipients. This study described the clinical features and outcomes of HEV infections in a cohort of kidney transplant recipients living in southeastern France. The epidemiological, clinical, and virological characteristics of HEV infections diagnosed by PCR over a 53-month period were retrospectively analyzed in a cohort of 1,350 kidney transplant recipients monitored at the Marseille University Hospital. Sixteen HEV infections were diagnosed, all of which were autochthonous and involved genotype 3 viruses (HEV-3). Chronic infections occurred in 80% of these patients and resolved in half of the cases after a median time of 39 months. The rate of HEV clearance was 54% after a decrease in the dose of immunosuppressants. One patient developed liver cirrhosis 14 months after infection and experienced acute rejection after a decrease in the dose of immunosuppressants. Autochthonous HEV-3 infections in kidney transplant recipients progress to chronicity in most cases and might be complicated by early liver cirrhosis. Chronic HEV infection can resolve following the reduction of immunosuppressive therapy, but ribavirin may be required if reduction of the immunosuppressant dose is not associated with HEV clearance or is inappropriate for the patient management.
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Affiliation(s)
- Valérie Moal
- Assistance Publique-Hôpitaux de Marseille, Hôpital Conception, Centre de Néphrologie et Transplantation rénale, Marseille, France
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Moal V, Legris T, Burtey S, Morange S, Purgus R, Dussol B, Garcia S, Motte A, Gérolami R, Berland Y, Colson P. Caractéristiques et devenir des infections par le virus de l’hépatite E dans une cohorte de transplantés rénaux. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.339] [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: 11/17/2022]
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Dussol B, Moussi-Frances J, Morange S, Somma-Delpero C, Mundler O, Berland Y. A pilot study comparing furosemide and hydrochlorothiazide in patients with hypertension and stage 4 or 5 chronic kidney disease. J Clin Hypertens (Greenwich) 2012; 14:32-7. [PMID: 22235821 PMCID: PMC8108747 DOI: 10.1111/j.1751-7176.2011.00564.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [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: 08/03/2011] [Revised: 10/03/2011] [Accepted: 10/04/2011] [Indexed: 02/04/2023]
Abstract
Furosemide is the diuretic of choice for the treatment of hypertension in chronic kidney disease but the adaptative changes in the distal nephron may decrease its efficacy. Hydrochlorothiazide is not believed to be efficient in this setting. In a randomized, double-blind, cross-over trial, 23 patients with hypertension and stage 4 or 5 chronic kidney disease received long-acting furosemide (60 mg) and hydrochlorothiazide (25 mg) for 3 months and then both diuretics for 3 months. Sodium and chloride fractional excretions were measured after 3 months of each diuretic and then after their association. A trend towards an increase in the fractional excretion of sodium and chloride was observed with furosemide and hydrochlorothiazide (P=not significant). The association of the two diuretics increased the fractional excretions of sodium and chloride from 3.4±1.8 to 4.9±2.8 and from 3.8±2.0 to 6.0±3.1, respectively (P<.05). Furosemide and hydrochlorothiazide decreased mean blood pressure by the same extent. The association of the two diuretics was more efficient on blood pressure. There were no differences between furosemide and hydrochlorothiazide with respect to natriuresis and blood pressure control in patients with hypertension and chronic kidney disease.
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Todorova D, Sabatier F, Doria E, Lyonnet L, Vacher Coponat H, Robert S, Despoix N, Legris T, Moal V, Loundou A, Morange S, Berland Y, George FD, Burtey S, Paul P. Fractalkine expression induces endothelial progenitor cell lysis by natural killer cells. PLoS One 2011; 6:e26663. [PMID: 22039526 PMCID: PMC3200359 DOI: 10.1371/journal.pone.0026663] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 09/30/2011] [Indexed: 11/19/2022] Open
Abstract
Background Circulating CD34+ cells, a population that includes endothelial progenitors, participate in the maintenance of endothelial integrity. Better understanding of the mechanisms that regulate their survival is crucial to improve their regenerative activity in cardiovascular and renal diseases. Chemokine-receptor cross talk is critical in regulating cell homeostasis. We hypothesized that cell surface expression of the chemokine fractalkine (FKN) could target progenitor cell injury by Natural Killer (NK) cells, thereby limiting their availability for vascular repair. Methodology/Principal Findings We show that CD34+-derived Endothelial Colony Forming Cells (ECFC) can express FKN in response to TNF-α and IFN-γ inflammatory cytokines and that FKN expression by ECFC stimulates NK cell adhesion, NK cell-mediated ECFC lysis and microparticles release in vitro. The specific involvement of membrane FKN in these processes was demonstrated using FKN-transfected ECFC and anti-FKN blocking antibody. FKN expression was also evidenced on circulating CD34+ progenitor cells and was detected at higher frequency in kidney transplant recipients, when compared to healthy controls. The proportion of CD34+ cells expressing FKN was identified as an independent variable inversely correlated to CD34+ progenitor cell count. We further showed that treatment of CD34+ circulating cells isolated from adult blood donors with transplant serum or TNF-α/IFN-γ can induce FKN expression. Conclusions Our data highlights a novel mechanism by which FKN expression on CD34+ progenitor cells may target their NK cell mediated killing and participate to their immune depletion in transplant recipients. Considering the numerous diseased contexts shown to promote FKN expression, our data identify FKN as a hallmark of altered progenitor cell homeostasis with potential implications in better evaluation of vascular repair in patients.
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Affiliation(s)
- Dilyana Todorova
- Aix-Marseille University, Laboratoire de Physiopathologie de l'Endothélium –UMR-S 608 INSERM, 13005, Marseille, France
| | - Florence Sabatier
- Aix-Marseille University, Laboratoire de Physiopathologie de l'Endothélium –UMR-S 608 INSERM, 13005, Marseille, France
| | - Evelyne Doria
- Laboratoire d'Hématologie, CHU Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Luc Lyonnet
- Laboratoire d'Hématologie, CHU Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Henri Vacher Coponat
- Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Stéphane Robert
- Aix-Marseille University, Laboratoire de Physiopathologie de l'Endothélium –UMR-S 608 INSERM, 13005, Marseille, France
| | - Nicolas Despoix
- Aix-Marseille University, Laboratoire de Physiopathologie de l'Endothélium –UMR-S 608 INSERM, 13005, Marseille, France
| | - Tristan Legris
- Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Valérie Moal
- Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Anderson Loundou
- Unité d'Aide méthodologique à la Recherche Clinique et Epidémiologique, DRRC, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Sophie Morange
- Centre d'Investigation Clinique, Hôpital de la Conception, Marseille, France
| | - Yvon Berland
- Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
- Centre d'Investigation Clinique, Hôpital de la Conception, Marseille, France
| | - Francoise Dignat George
- Aix-Marseille University, Laboratoire de Physiopathologie de l'Endothélium –UMR-S 608 INSERM, 13005, Marseille, France
- Laboratoire d'Hématologie, CHU Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Stéphane Burtey
- Aix-Marseille University, Laboratoire de Physiopathologie de l'Endothélium –UMR-S 608 INSERM, 13005, Marseille, France
- Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pascale Paul
- Aix-Marseille University, Laboratoire de Physiopathologie de l'Endothélium –UMR-S 608 INSERM, 13005, Marseille, France
- Laboratoire d'Hématologie, CHU Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
- * E-mail:
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Calaf R, Cerini C, Génovésio C, Verhaeghe P, Jourde-Chiche N, Bergé-Lefranc D, Gondouin B, Dou L, Morange S, Argilés A, Rathelot P, Dignat-George F, Brunet P, Charpiot P. Determination of uremic solutes in biological fluids of chronic kidney disease patients by HPLC assay. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879:2281-6. [PMID: 21727042 DOI: 10.1016/j.jchromb.2011.06.014] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 04/22/2011] [Accepted: 06/06/2011] [Indexed: 11/15/2022]
Abstract
During chronic kidney disease (CKD), solutes called uremic solutes, accumulate in blood and tissues of patients. We developed an HPLC method for the simultaneous determination of several uremic solutes of clinical interest in biological fluids: phenol (Pol), indole-3-acetic acid (3-IAA), p-cresol (p-C), indoxyl sulfate (3-INDS) and p-cresol sulfate (p-CS). These solutes were separated by ion-pairing HPLC using an isocratic flow and quantified with a fluorescence detection. The mean serum concentrations of 3-IAA, 3-INDS and p-CS were 2.12, 1.03 and 13.03 μM respectively in healthy subjects, 3.21, 17.45 and 73.47 μM in non hemodialyzed stage 3-5 CKD patients and 5.9, 81.04 and 120.54 μM in hemodialyzed patients (stage 5D). We found no Pol and no p-C in any population. The limits of quantification for 3-IAA, 3-INDS, and p-CS were 0.83, 0.72, and 3.2 μM respectively. The within-day CVs were between 1.23 and 3.12% for 3-IAA, 0.98 and 2% for 3-INDS, and 1.25 and 3.01% for p-CS. The between-day CVs were between 1.78 and 5.48% for 3-IAA, 1.45 and 4.54% for 3-INDS, and 1.19 and 6.36% for p-CS. This HPLC method permits the simultaneous and quick quantification of several uremic solutes for daily analysis of large numbers of samples.
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Affiliation(s)
- Raymond Calaf
- Laboratoire de Biochimie Moléculaire Fondamentale et Clinique, UFR de Pharmacie, Université de la Méditerranée, 27 boulevard Jean Moulin, 13 385 Marseille cedex 5, France.
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Papazian L, Forel JM, Gacouin A, Penot-Ragon C, Perrin G, Loundou A, Jaber S, Arnal JM, Perez D, Seghboyan JM, Constantin JM, Courant P, Lefrant JY, Guérin C, Prat G, Morange S, Roch A. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 2010; 363:1107-16. [PMID: 20843245 DOI: 10.1056/nejmoa1005372] [Citation(s) in RCA: 1455] [Impact Index Per Article: 103.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND In patients undergoing mechanical ventilation for the acute respiratory distress syndrome (ARDS), neuromuscular blocking agents may improve oxygenation and decrease ventilator-induced lung injury but may also cause muscle weakness. We evaluated clinical outcomes after 2 days of therapy with neuromuscular blocking agents in patients with early, severe ARDS. METHODS In this multicenter, double-blind trial, 340 patients presenting to the intensive care unit (ICU) with an onset of severe ARDS within the previous 48 hours were randomly assigned to receive, for 48 hours, either cisatracurium besylate (178 patients) or placebo (162 patients). Severe ARDS was defined as a ratio of the partial pressure of arterial oxygen (PaO2) to the fraction of inspired oxygen (FIO2) of less than 150, with a positive end-expiratory pressure of 5 cm or more of water and a tidal volume of 6 to 8 ml per kilogram of predicted body weight. The primary outcome was the proportion of patients who died either before hospital discharge or within 90 days after study enrollment (i.e., the 90-day in-hospital mortality rate), adjusted for predefined covariates and baseline differences between groups with the use of a Cox model. RESULTS The hazard ratio for death at 90 days in the cisatracurium group, as compared with the placebo group, was 0.68 (95% confidence interval [CI], 0.48 to 0.98; P=0.04), after adjustment for both the baseline PaO2:FIO2 and plateau pressure and the Simplified Acute Physiology II score. The crude 90-day mortality was 31.6% (95% CI, 25.2 to 38.8) in the cisatracurium group and 40.7% (95% CI, 33.5 to 48.4) in the placebo group (P=0.08). Mortality at 28 days was 23.7% (95% CI, 18.1 to 30.5) with cisatracurium and 33.3% (95% CI, 26.5 to 40.9) with placebo (P=0.05). The rate of ICU-acquired paresis did not differ significantly between the two groups. CONCLUSIONS In patients with severe ARDS, early administration of a neuromuscular blocking agent improved the adjusted 90-day survival and increased the time off the ventilator without increasing muscle weakness. (Funded by Assistance Publique-Hôpitaux de Marseille and the Programme Hospitalier de Recherche Clinique Régional 2004-26 of the French Ministry of Health; ClinicalTrials.gov number, NCT00299650.)
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Affiliation(s)
- Laurent Papazian
- Assistance Publique-Hôpitaux de Marseille Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Centre National de la Recherche Scientifique-Unité Mixte de Recherche 6236, Université de la Méditerranée Aix-Marseille II, Marseille, France.
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Siroux V, Boudier A, Bousquet J, Bresson JL, Cracowski JL, Ferran J, Gormand F, Just J, Le Moual N, Morange S, Nadif R, Oryszczyn MP, Pison C, Scheinmann P, Varraso R, Vervloet D, Pin I, Kauffmann F. Phenotypic determinants of uncontrolled asthma. J Allergy Clin Immunol 2009; 124:681-7.e3. [PMID: 19665764 DOI: 10.1016/j.jaci.2009.06.010] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [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: 01/05/2009] [Revised: 05/11/2009] [Accepted: 06/01/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although uncontrolled asthma remains frequent, determinants of asthma control are poorly studied. OBJECTIVES The aim was to estimate the distribution and the phenotypic characteristics of asthma control in 2 groups of subjects defined by the use of inhaled corticosteroids (ICS) in the past 12 months, in the Epidemiological study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy (EGEA). METHODS Five hundred one adult current patients with asthma who participated in the follow-up of the EGEA study were included. Asthma control was assessed from survey questions reflecting asthma control, as defined in the 2006 Global Initiative for Asthma guidelines. The factors analyzed were age, sex, educational level, body mass index, active and passive smoking, sensitization to aeroallergens, total IgE, rhinitis, chronic cough/phlegm, and age at asthma onset. Analyses were stratified according to ICS use. RESULTS Uncontrolled asthma was more frequent in ICS users (27.6%, 35.0%, and 37.4% with controlled, partly-controlled, and uncontrolled asthma respectively) compared with non-ICS users (60.0%, 23.9%, and 16.1%, respectively). In ICS users, chronic cough or phlegm and female sex were independently and significantly related to uncontrolled asthma. In non-ICS users, high total IgE and sensitization to molds were associated with uncontrolled asthma. Smoking and rhinitis were not associated with asthma control. CONCLUSION Optimal asthma control remained unachieved in the majority of patients with asthma in this study. Factors associated with uncontrolled asthma were different in ICS users (chronic cough/phlegm, female sex) and non-ICS users (high total IgE and sensitization to molds).
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Affiliation(s)
- Valérie Siroux
- INSERM, Institut National de la Santé et de la Recherche Médicale, U823, Institut Albert Bonniot, Grenoble, France.
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Dussol B, Morange S, Burtey S, Indreies M, Cassuto E, Mourad G, Villar E, Pouteil-Noble C, Karaaslan H, Sichez H, Lasseur C, Delmas Y, Nogier MB, Fathallah M, Loundou A, Mayor V, Berland Y. Mycophenolate Mofetil Monotherapy in Membranous Nephropathy: A 1-Year Randomized Controlled Trial. Am J Kidney Dis 2008; 52:699-705. [DOI: 10.1053/j.ajkd.2008.04.013] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Accepted: 04/23/2008] [Indexed: 11/11/2022]
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Dussol B, Iovanna C, Rotily M, Morange S, Leonetti F, Dupuy P, Vazi A, Saveanu A, Loundou A, Berland Y. A Randomized Trial of Low-Animal-Protein or High-Fiber Diets for Secondary Prevention of Calcium Nephrolithiasis. ACTA ACUST UNITED AC 2008; 110:c185-94. [DOI: 10.1159/000167271] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Accepted: 07/22/2008] [Indexed: 11/19/2022]
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Dussol B, Reggio P, Morange S, Fathallah M, Natali F, Ripoll J, Ronflé E, Chanut C, Berland Y. [A case-control study of health benefits in patients with moderate renal failure]. Nephrol Ther 2007; 4:99-104. [PMID: 18053787 DOI: 10.1016/j.nephro.2007.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 07/11/2007] [Accepted: 09/05/2007] [Indexed: 11/29/2022]
Abstract
In order to evaluate medical management in patients with renal failure before dialysis, we conducted a case-control study to analyze the health benefits in 914 moderate renal failure patients with Cockcroft clearance between 30 and 60 ml/min. Health benefits reimbursed by the Social Security in this population were compared with those in 1828 controls randomly chosen in the Social Security files but matched by age and gender. Mean age of the participants was 73+/-11 year-old, 67% were women, Cockcroft clearance was 48+/-8 ml/min. Number of hospitalizations and hospitalization durations were not different between the two populations. Conversely, cases had more specialized outpatients' clinics in cardiology but not in nephrology or urology. Cases had more biological tests and radiological exams and had taken more medicines. For biology, cases had more often renal function tests and markers of renal dysfunction tests than controls. Cases had taken more medicines than controls for erythropoietin, diuretics, renin-angiotensin blockers, hypoglycemic drugs, and anticoagulants. Patients with mild renal failure had higher health benefits than controls for outpatients' clinics in cardiology, for biological tests, for radiological exams, and for some medicines.
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Affiliation(s)
- Bertrand Dussol
- Centre de Néphrologie et de Transplantation Rénale, Assistance Publique à Marseille, Université de la Méditerranée, Aix-Marseille-2, Marseille Cedex 5, France.
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Brunet P, Oddoze C, Paganelli F, Indreies M, Faure V, Opris-Saveanu A, Morange S, Portugal H, Dussol B, Berland Y. Cardiac troponins I and T in hemodialysis patients without acute coronary syndrome. Int J Cardiol 2007; 129:205-9. [PMID: 17662483 DOI: 10.1016/j.ijcard.2007.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2007] [Accepted: 07/01/2007] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is a reluctance to use cardiac troponins (cTn) for the monitoring of acute coronary syndrome (ACS) in hemodialysis (HD) patients because renal failure per se is thought to lead to increased cTn levels. The aim of this study was to analyse the proportion of patients with increased cTn levels in HD patients without ACS. METHODS cTnI was measured with the AccuTnI(trade mark) from Beckman (cTnI-B) and Troponin I Stat(trade mark) from Dade Behring (cTnI-DB) assays; cTnT was measured with the third generation assay from Roche. The study included 105 HD patients. The clinical outcomes were determined after 2.5 years. RESULTS Considering the receiver operator characteristic (ROC) cutoff, the proportion of patients with elevated cTnI-B, cTnI-DB and cTnT levels was respectively 2%, 3% and 27%. The proportion of patients with abnormal cTn values increased when a lower cutoff value was considered, based on the 99th percentile of a reference population with a coefficient of variation of less than 10% (99th percentile-10% CV cutoff). The proportion of patients with elevated values did not differ before and after the HD session. The 2.5 years mortality was associated with increased levels of cTnT but not with increased levels of cTnI. CONCLUSIONS When the ROC cutoff is applied, cTnI assays are suitable for the monitoring of ACS in HD patients. cTnT could lead to false positive diagnosis of myocardial infarction, however it is predictive of long-term mortality. The 99th percentile-10% CV cutoff does not seem appropriate in HD patients.
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Affiliation(s)
- Philippe Brunet
- Centre de Néphrologie et de Transplantation Rénale, Hôpital de la Conception, Aix-Marseille Université et Assistance-Publique Hôpitaux de Marseille, Marseille, France
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Reboul E, Thap S, Tourniaire F, André M, Juhel C, Morange S, Amiot MJ, Lairon D, Borel P. Differential effect of dietary antioxidant classes (carotenoids, polyphenols, vitamins C and E) on lutein absorption. Br J Nutr 2007; 97:440-6. [PMID: 17313704 DOI: 10.1017/s0007114507352604] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [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: 11/06/2022]
Abstract
Lutein is assumed to protect the human retina from blue light and oxidative stress and diminish the incidence of age-related macular degeneration. This antioxidant is commonly ingested with other dietary antioxidants. The aim of the present study was to assess whether the main dietary antioxidants, i.e. carotenoids, polyphenols and vitamins C and E, affect lutein absorption. We measured the effect of adding a mixture of antioxidants (500 mg vitamin C, 67 mg (100 IU) vitamin E and 1 g polyphenols) to a lutein-containing meal (18 mg) on the postprandial lutein response in the chylomicron-rich fraction in eight healthy men. Lutein response was weakest ( − 23 %;P = 0·07) after ingestion of the meal containing antioxidants (21·9 (sem4·6)v.28·4 (sem7·2) nmol × h/l). To assess the effect of each class of antioxidants and potential interactions, we subsequently evaluated the effect of various combinations of antioxidants on lutein uptake by human intestinal Caco-2 TC-7 cells. A full factorial design showed that both a mixture of polyphenols (gallic acid, caffeic acid, (+)-catechin and naringenin) and a mixture of carotenoids (lycopene plus β-carotene) significantly (P < 0·05) impaired lutein uptake by ( − 10 to − 30 %), while vitamins C and E had no significant effect. Subsequent experiments showed that the aglycone flavanone naringenin was the only polyphenol responsible for the effect of the polyphenol mixture, and that the carotenoid effect was not carotenoid species-dependent. Taken together, the present results suggest that lutein absorption is not markedly affected by physiological concentrations of vitamins C and E but can be impaired by carotenoids and naringenin.
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Barlési F, Barrau K, Doddoli C, Morange S, Thirion X, Astoul P, Auquier P, Thomas P. Essai randomisé de phase III de chimiothérapie adjuvante par CDDP/docetaxel versus CDDP/gemcitabine dans les cancers bronchiques non à petites cellules réséqués avec la qualité de vie comme objectif principal. Rev Mal Respir 2006; 23:489-96. [PMID: 17314754 DOI: 10.1016/s0761-8425(06)71825-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/15/2022]
Abstract
BACKGROUND Adjuvant chemotherapy improves survival of completely resected non-small cell lung cancer (NSCLC). However the regimen of choice is not yet defined. METHODS The primary objective of this comparative, open, randomised multicentre trial is to compare two chemotherapy regimens (cisplatin/docetaxel versus cisplatin/gemcitabine) in the management of resected NSCLC with quality of life (QoL) evaluated at the end of treatment as the primary objective. The secondary objectives are to study the impact of these two chemotherapy regimens on overall and relapse free survival, hematological and non-hematological toxicities, and costs. The primary judgement criterion will be the assessment of end of treatment QoL by the standardised questionnaire, EORTC QLQ-C30. Secondary judgement criteria will be Qol measured by EORTC QLQ-LC13 and SF36, overall and relapse free survival, tolerance and costs. The number of subjects needed is 75 in each group, 150 in total, to detect a difference of 10 points on the EORTC QLC-C30 scores with a standard error of 20 points (alpha 0.05; power 80%). EXPECTED RESULTS This trial will provide clinicians with data on the impact of two currently unexplored adjuvant chemotherapy regimens on quality of life, tolerance and costs in NSCLC.
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Affiliation(s)
- F Barlési
- Faculté de Médecine (Université de la Méditerranée), Assistance Publique Hôpitaux de Marseille, Service d'Oncologie Thoracique, Fédération des Maladies Respiratoires, France.
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Dussol B, Iovanna C, Raccah D, Darmon P, Morange S, Vague P, Vialettes B, Oliver C, Loundoun A, Berland Y. A randomized trial of low-protein diet in type 1 and in type 2 diabetes mellitus patients with incipient and overt nephropathy. J Ren Nutr 2006; 15:398-406. [PMID: 16198932 DOI: 10.1053/j.jrn.2005.07.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2004] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The efficacy of a low-protein diet in the secondary prevention of diabetic nephropathy is not established in patients with type 1 or type 2 diabetes mellitus. To determine whether a low-protein diet slows the decrease in glomerular filtration rate (GFR) and decreases the albumin excretion rate (AER) in diabetic patients with incipient and overt nephropathy, we performed a 2-year prospective, randomized controlled trial comparing the effects of a low-protein diet (0.8 g/kg/day) with a usual-protein diet. SETTING AND PATIENTS The study was conducted in a University hospital and included 63 type 1 and type 2 diabetic patients with either incipient or overt nephropathy and mild renal failure (prestudy GFR, 80 +/- 20 mL/min). The primary outcome measures were decreased in GFR and 24-hour AER. RESULTS In the low-protein-diet group, patients were younger (52 +/- 12 versus 63 +/- 9 years old) and more often were type 2 diabetic. During the follow-up period, according to dietary records the low-protein-diet group consumed 16% +/- 3% of total caloric intakes as compared with 19% +/- 4% in the usual-protein-diet group (P < .02), but 24-hour urinary urea excretions did not differ between the two groups. The 2-year GFR decrease was 7 +/- 11 mL/min in the low-protein-diet group and 5 +/- 15 mL/min in the usual-protein-diet group (P = not significant). AER did not increase significantly in the two diet groups during the follow-up period. Blood pressure and glycemic control were similar in the two groups all along the study. The decrease in GFR and AER were also similar in 6 compliant patients according to dietary records and to 24-hour urinary urea excretions from the low-protein-diet group and in 12 patients from the usual-protein-diet group. CONCLUSIONS A 2-year low-protein diet did not alter the course of GFR or of AER in diabetic patients with incipient or overt nephropathy receiving renin-angiotensin blockers with strict blood pressure control.
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Affiliation(s)
- Bertrand Dussol
- Centre d'Investigation Clinique, INSERM-APHM, Marseille, France.
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Dussol B, Morange S, Loundoun A, Auquier P, Berland Y. A randomized trial of saline hydration to prevent contrast nephropathy in chronic renal failure patients. Nephrol Dial Transplant 2006; 21:2120-6. [PMID: 16611682 DOI: 10.1093/ndt/gfl133] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Contrast nephropathy (CN) is a common cause of renal dysfunction that may be prevented by saline hydration and by drugs such as theophylline or furosemide. Whether oral saline hydration is as efficient as intravenous saline hydration is unknown. The preventive efficacy of theophylline and furosemide for CN remains controversial. The purpose of the current study was to evaluate the efficacy of oral saline hydration and of intravenous saline hydration plus theophylline or furosemide for the prevention of CN. METHODS We prospectively studied 312 patients with chronic renal failure (serum creatinine 201+/-81 micromol/l, Cockcroft clearance 37+/-12 ml/min/1.73 m(2)), who were undergoing various radiological procedures with a non-ionic, low osmolality contrast agent. Patients were randomly assigned to four arms. In arm A, patients received 1 g/10 kg of body weight/day of sodium chloride per os for 2 days before the procedure. In arm B, patients received 0.9% saline intravenously at a rate of 15 ml/kg for 6 h before the procedure. In arm C, patients received the same saline hydration as in arm B plus 5 mg/kg theophylline per os in one dose 1 h before the procedure. In arm D, patients received the same saline hydration as in arm B plus 3 mg/kg of furosemide intravenously just after the procedure. RESULTS Patients were well-matched with no significant differences at baseline in any measured parameters. Acute renal failure, defined as an increase in serum creatinine of 44 micromol/l (0.5 mg/dl), occurred in 27 out of 312 patients (8.7%). There was no significant difference between the rate of renal failure in the different arms of the study: five out of 76 (6.6%) in arm A, four out of 77 (5.2%) in arm B, six out of 80 (7.5%) in arm C and 12 out of 79 (15.2%) in arm D. No patient had fluid overload or a significant increase in blood pressure in the 2 days following the radiological procedure. The independent predictors of CN were diabetes mellitus, high baseline serum creatinine and high systolic blood pressure. CONCLUSIONS Oral saline hydration was as efficient as intravenous saline hydration for the prevention of CN in patients with stage 3 renal diseases. Furosemide and theophylline were not protective.
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Affiliation(s)
- Bertrand Dussol
- Service de Néphrologie-Hémodialyse-Transplantation rénale, Hôpital de la Conception, 147 Bd Baille, 13385 Marseille Cedex 5, France.
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Dussol B, Bonnet JL, Sampol J, Savin B, De La Forte C, Mundler O, Habib G, Morange S, Barrau K, Loundoun A, Vacher-Coponat H, Berland Y. Prognostic value of inducible myocardial ischemia in predicting cardiovascular events after renal transplantation. Kidney Int 2005; 66:1633-9. [PMID: 15458460 DOI: 10.1111/j.1523-1755.2004.00929.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aims of the present study were to determine the prevalence of inducible myocardial ischemia (IMI) in renal transplant recipients (RTR) more than 50 years old, to identify predictors of IMI, and to search for its prognostic value. METHODS Among the 377 renal transplantations performed between 1989 and 1998 in a single institution, 120 were done in patients > or =50 years old, and 97 were recruited for the study. During the last quarter of 1998, all of them underwent an exercise test (EST), an exercise-thallium 201 single photon emission computed tomography coupled with dipyridamole (SPECT), and 81% of them had a dobutamine stress echocardiography (DSE). Patients with IMI subsequently underwent coronary angiography to detect coronary stenosis. RESULTS IMI was present in 12 of the 97 patients (10%). The diagnosis was evidenced by EST in four cases, by SPECT in 11 cases, and DSE in three cases. Five of these 12 patients (42%) had significant coronary artery stenosis (> or =50%). Multivariate analysis of several pre- and post-transplant variables evidenced acute rejection and left ventricular hypertrophy as significant correlates of IMI (both P < 0.03). Patients were prospectively followed-up for 48 months for the occurrence of major cardiovascular events. Kaplan-Meier analysis revealed a significant increase in cardiovascular events in the IMI group (P < 0.0001). In addition, the Cox proportional hazards model revealed that IMI and diabetes mellitus had an independent significant effect on the occurrence of major cardiovascular events. CONCLUSION IMI was present in 10% of RTR aged > or =50 years, and was predicted by acute rejection and left ventricular hypertrophy. IMI had a strong effect on major cardiovascular events in this population.
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Affiliation(s)
- Bertrand Dussol
- Service de Néphrologie et Hémodialyse, Hôpital de la Conception, Marseille, France.
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Dussol B, Moussi-Frances J, Morange S, Somma-Delpero C, Mundler O, Berland Y. A randomized trial of furosemide vs hydrochlorothiazide in patients with chronic renal failure and hypertension. Nephrol Dial Transplant 2004; 20:349-53. [PMID: 15615808 DOI: 10.1093/ndt/gfh650] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Loop diuretics are the drugs of choice for the treatment of hypertension in chronic renal failure patients. However, the adaptive changes in the distal nephron and the short half-life of these drugs may decrease their long-term efficacy. Thiazides are not believed to be efficient in advanced renal failure, but this is debated. METHODS We compared the efficacy of long-acting furosemide (60 mg/day) and hydrochlorothiazide (25 mg/day) in a double-blind, randomized crossover trial in seven patients with severe renal failure and hypertension (seven men, 54+/-10 years old). The primary end-points were sodium and chloride fractional excretions after 1 month of each diuretic and then after their combination. During the trial, other treatments and the diet were controlled. RESULTS A trend towards an increase in the fractional excretion of sodium and of chloride was observed with furosemide, but the difference did not reach the level of statistical significance (P = NS). Hydrochlorothiazide significantly increased fractional excretion of sodium and chloride from 3.7+/-0.9 to 5.5+/-0.3 and from 3.9+/-0.19 to 6.5+/-0.3, respectively (P<0.05). The combination of the two diuretics had no additional effect on the increase in sodium and chloride fractional excretion. Furosemide, hydrochlorothiazide and the combination of the two diuretics decreased mean arterial blood pressure by the same extent from 112 to 97, 99 and 97 mmHg, respectively (P<0.05). CONCLUSIONS Hydrochlorothiazide increased the fractional excretion of sodium and chloride more than furosemide did in hypertensive severe renal failure patients. Mean arterial blood pressure decreased by the same amount with both diuretics. Combining furosemide and hydrochlorothiazide did not increase the efficacy of hydrochlorothiazide.
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Affiliation(s)
- Bertrand Dussol
- Service de Néphrologie-Hémodialyse-Transplantation, Hôpital de la Conception, 147 Bd Baille, 13385 Marseille Cedex 5, France.
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Moal V, Brunet P, Dou L, Morange S, Sampol J, Berland Y. Impaired expression of glycoproteins on resting and stimulated platelets in uraemic patients. Nephrol Dial Transplant 2003; 18:1834-41. [PMID: 12937232 DOI: 10.1093/ndt/gfg185] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The increased bleeding tendency of chronic renal failure (CRF) patients has been attributed to platelet dysfunction. However, reports on various platelet functions in uraemic patients have been conflicting. The present study sought to analyse platelet function by examining their surface glycoproteins in well-identified populations of CRF patients. METHODS Three groups were studied: 22 chronic haemodialysis (HD) patients, 25 conservatively treated patients with CRF and 30 controls. Bleeding tendency was assessed by measuring bleeding time and by recording current haemorrhagic symptoms. We measured the fibrinogen receptor GPIIbIIIa, the von Willebrand receptor GPIb, and P-selectin levels on the platelet surface using flow cytometry. RESULTS Forty percent of CRF and 45% of HD patients had bleeding. The bleeding time was similar in the HD and CRF groups, but was longer in both groups than in controls. In resting platelets, GPIb expression was lower in CRF patients than in controls. In stimulated platelets (i) GPIb expression was higher in HD patients than in both controls and CRF patients; and (ii) GPIIbIIIa and P-selectin expression were lower in CRF and HD patients than in controls. CONCLUSIONS These findings indicate that uraemic platelets are hyporesponsive to stimulation.
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Affiliation(s)
- Valérie Moal
- Service de Néphrologie et d'Hémodialyse, Hôpital de la Conception, Marseille Cedex, France
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Vallette-Kasic S, Morange-Ramos I, Selim A, Gunz G, Morange S, Enjalbert A, Martin PM, Jaquet P, Brue T. Macroprolactinemia revisited: a study on 106 patients. J Clin Endocrinol Metab 2002; 87:581-8. [PMID: 11836289 DOI: 10.1210/jcem.87.2.8272] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The predominance of high molecular weight PRL, or macroprolactinemia, has long been known in hyperprolactinemic patients with maintained fertility. Among 1,106 consecutive patients investigated for hyperprolactinemia in our center over a 10-yr period, serum PRL chromatography was performed in 368 cases because of discordant clinical, biological, or neuroradiological findings. We prospectively studied the 106 patients with macroprolactinemia (96 women, 6 men, 4 children) and compared them with the 262 hyperprolactinemic patients with a normal PRL elution pattern. We concluded the following: 1) the incidence of macroprolactinemia in our hyperprolactinemic population was at least 10%; 2) despite preserved fertility with uneventful pregnancies, some of the usual symptoms of hyperprolactinemia were present; 3) mean PRL values were 61 +/- 66 microg/liter (range, 20-663) and exceeded 100 microg/liter in 8.5% of patients; 4) PRL levels usually remained stable over time; 5) on dopaminergic therapy, PRL returned to normal in 21 of 45 treated patients; 6) during follow-up of 7 pregnancies, PRL increased to supraphysiological levels in 5; and 7) pituitary magnetic resonance imaging was normal in 78% of patients or revealed diverse pituitary lesions, including adenomas (n = 5). A diagnostic method for macroprolactinemia should be available to all centers to avoid unnecessary hormonal or radiological investigations and treatments.
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Affiliation(s)
- Sophie Vallette-Kasic
- Department of Endocrinology, Centre Hospitalier Universitaire Timone, 13385 Marseille Cedex 5
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Oddoze C, Morange S, Portugal H, Berland Y, Dussol B. Cystatin C is not more sensitive than creatinine for detecting early renal impairment in patients with diabetes. Am J Kidney Dis 2001; 38:310-6. [PMID: 11479157 DOI: 10.1053/ajkd.2001.26096] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [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: 11/11/2022]
Abstract
This study evaluated serum cystatin C as a potential new marker of glomerular filtration rate (GFR) in 49 patients who had steady-state diabetes with early renal impairment. We determined the correlation between GFR measured by chromium 51-labeled EDTA and levels of serum cystatin C, serum creatinine, serum beta(2)-microglobulin, endogenous creatinine clearance, and Cockcroft formula. Sensitivity and specificity for the diagnosis of renal failure, defined as a GFR less than either 80 or 60 mL/min/1.73 m(2), were calculated by receiver operating characteristic (ROC) curves for creatinine, cystatin C, and beta(2)-microglobulin. Finally, we compared mean values of these three serum parameters in patients grouped according to GFR using the two definitions of renal failure. Correlation coefficients with GFR were -0.77 for serum creatinine level, -0.65 for serum cystatin C level, -0.71 for serum beta(2)-microglobulin level, +0.56 for endogenous creatinine clearance, and +0.69 for Cockcroft formula (all P < 0.001). With a cutoff value of 60 mL/min/1.73 m(2), areas under the ROC curve were 0.972 for beta(2)-microglobulin, 0.925 for cystatin C, and 0.916 for creatinine levels. With a cutoff value of 80 mL/min/1.73 m(2), these were 0.838 for beta(2)-microglobulin, 0.780 for cystatin C, and 0.905 for creatinine levels (P = not significant between parameters). These results were not altered after the exclusion of patients (n = 8) with a serum creatinine level greater than 1.41 mg/dL. When patients were classified into three groups according to GFR (group 1, >80 mL/min/1.73 m(2); group 2, 60 to 80 mL/min/1.73 m(2); group 3, <60 mL/min/1.73 m(2)), mean values of serum parameters in the three groups were statistically different (P < 0.0001) except between groups 1 and 2 for cystatin C and beta(2)-microglobulin. With patients classified into two groups (GFR > or < 80 mL/min/1.73 m(2)), mean values for each parameter were statistically different (P < 0.001). Sensitivity, specificity, and positive and negative predictive values for serum creatinine and serum cystatin C levels were very close for both definitions of renal failure. Serum cystatin C is not better than serum creatinine or serum beta(2)-microglobulin levels for estimating GFR in patients with steady-state diabetes using ROC curves or other validation tests.
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Affiliation(s)
- C Oddoze
- Laboratoire Central and Centre d'Investigation Clinique, Hôpital Sainte Marguerite
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Niccoli-Sire P, Murat A, Rohmer V, Franc S, Chabrier G, Baldet L, Maes B, Savagner F, Giraud S, Bezieau S, Kottler ML, Morange S, Conte-Devolx B. Familial medullary thyroid carcinoma with noncysteine ret mutations: phenotype-genotype relationship in a large series of patients. J Clin Endocrinol Metab 2001; 86:3746-53. [PMID: 11502806 DOI: 10.1210/jcem.86.8.7767] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Familial medullary thyroid carcinoma only is related to germline mutations in the protooncogene RET, mainly in exons 10, whereas noncysteine mutations (exons 13-15) are considered infrequent. We analyzed 148 patients from 47 familial medullary thyroid carcinoma only families, and we found noncysteine RET mutations in 59.5% of these families. Of the index cases with noncysteine mutations, 43.4% presented with a multinodular goiter and high basal calcitonin; they were older at diagnosis than those with mutation in exon 10 and had more multifocal medullary thyroid carcinoma, but no difference in size, bilaterality, presence of C cell hyperplasia, or nodal metastases was found. Gene carriers with noncysteine RET mutations had a lower incidence of medullary thyroid carcinoma (78.2% vs. 94.1%) than those with mutation in exon 10; 20.2% had C cell hyperplasia only, although thyroidectomized at an older age. In conclusion, familial medullary thyroid carcinoma with noncysteine RET mutations are not infrequent and are overrepresented in presumed sporadic medullary thyroid carcinoma, suggesting that RET analysis should routinely be extended to exons 13, 14, and 15. The phenotype is characterized by a late onset of the disease, suggesting a delayed appearance of C cell disease rather than a less aggressive form. In familial medullary thyroid carcinoma gene carriers, the optimal timing for thyroidectomy remains controversial. Based on these data, we propose that surgery should be performed before elevation of the basal calcitonin level, potentially as soon as the pentagastrin test becomes abnormal.
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Affiliation(s)
- P Niccoli-Sire
- Service d'Endocrinologie, CHU Timone, 13385 Marseilles, France.
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Vallette-Kasic S, Dufour H, Mugnier M, Trouillas J, Valdes-Socin H, Caron P, Morange S, Girard N, Grisoli F, Jaquet P, Brue T. Markers of tumor invasion are major predictive factors for the long-term outcome of corticotroph microadenomas treated by transsphenoidal adenomectomy. Eur J Endocrinol 2000; 143:761-8. [PMID: 11124859 DOI: 10.1530/eje.0.1430761] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the postsurgical outcome of patients with corticotroph microadenomas and to define predictors of the long-term outcome, with special emphasis on markers of tumor extension. DESIGN Prospective study of 53 corticotroph microadenomas treated by enlarged adenomectomy. Patients followed for at least 2 years were classified into two groups: those in long-term remission and uncured patients (immediate failures and recurrences). Pre-, per- and postoperative parameters were analyzed as predictors of the long-term outcome. METHODS Baseline hormone assessments were performed preoperatively, 8 days after surgery and every 6-12 months thereafter. Pituitary magnetic resonance imaging (MRI) allowed analysis of possible tumor extension to adjacent structures. Apparent completeness of the surgical removal was determined, and fragments labeled either 'tumor' or 'surrounding pituitary tissue' were submitted to serial sectioning. RESULTS Immediate control of hypercortisolism was achieved in 43/53 patients (81%). However, later recurrences were observed in five patients (9%). Preoperative MRI showed tumor extension into adjacent structures with good specificity (91%) for prediction of surgical failure. Evidence of local invasion at surgery was also significantly predictive of the long-term outcome. A corticotroph adenoma was found at histological examination in 96% of the patients, and 26% had irregular limits, a feature significantly correlated with a poor outcome. Immediate postoperative plasma cortisol did not allow discrimination between long-term remissions and recurrences. CONCLUSION Surgical failure was best predicted by signs of tumor 'invasiveness' at MRI, confirmed by peroperative examination and histology.
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Affiliation(s)
- S Vallette-Kasic
- Department of Endocrinology, Centre Hospitalier Universitaire (CHU) Timone, Marseille, France
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Niccoli-Sire P, Murat A, Baudin E, Henry JF, Proye C, Bigorgne JC, Bstandig B, Modigliani E, Morange S, Schlumberger M, Conte-Devolx B. Early or prophylactic thyroidectomy in MEN 2/FMTC gene carriers: results in 71 thyroidectomized patients. The French Calcitonin Tumours Study Group (GETC). Eur J Endocrinol 1999; 141:468-74. [PMID: 10576762 DOI: 10.1530/eje.0.1410468] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Once genetic testing accurately identifies MEN 2 gene carriers, affected children are given the opportunity to undergo thyroidectomy at the earliest stages of the C-cell disease. OBJECTIVE To define reliable parameters by which to identify the best moment for thyroidectomy in patients who are carriers of the MEN 2 gene. PATIENTS AND METHODS Seventy-one MEN 2/FMTC gene carriers, collected through the national register of the French Calcitonin Tumours Study Group, were evaluated. All the patients included were younger than 20 years of age and underwent total thyroidectomy. Basal and pentagastrin-stimulated calcitonin were assayed using an immunoradiometric method (sensitivity less than 2pg/ml). Calcitonin measurement was evaluated on the basis of histopathological findings in surgical thyroid specimens. RESULTS We found C-cell hyperplasia or medullary thyroid carcinoma in all the 71 gene carriers - even for the youngest patients - and nodal metastases were present in four cases. Calcitonin measurement (basal or pentagastrin-stimulated) detected C-cell disease preoperatively in all patients. Six of the 71 patients were not surgically cured: one had nodal metastases, one had an advanced staged disease and four had an incomplete nodal dissection or had not undergone lymph node surgery. CONCLUSIONS Determination of calcitonin forms an integral part of the management of MEN 2 gene carriers. Thyroidectomy is undisputably indicated when basal calcitonin is abnormal. When basal calcitonin is undetectable, a pentagastrin-stimulated increase in calcitonin to more than 10 pg/ml indicates an early thyroidectomy to cure the patient.
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Affiliation(s)
- P Niccoli-Sire
- Services d'Endocrinologie et de Chirurgie Endocrinienne, CHU Timone, Marseille, France.
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Gayet S, Ville E, Durand JM, Mars ME, Morange S, Kaplanski G, Gallais H, Soubeyrand J. Foscarnet-induced hypercalcaemia in AIDS. AIDS 1997; 11:1068-70. [PMID: 9223751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Narbonne H, Mely C, Picard R, Morange S, Lesluyes L, Vialettes B. [Risk of heavy precipitation of vancomycin in the presence of fluid gelatin in infusion tubes]. Therapie 1996; 51:599. [PMID: 9138403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Affiliation(s)
- J M Durand
- Department of Internal Medicine, Sainte-Marguerite Hospital, Marseilles, France
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Serratrice J, Durand JM, Genty I, Morange S, Kaplanski G, Soubeyrand J. Potentialisation de l'acénocoumarol (Sintron®) par l'interféron a. Rev Med Interne 1995. [DOI: 10.1016/0248-8663(96)86639-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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