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Hardy M, Lecompte T, Douxfils J, Lessire S, Dogné JM, Chatelain B, Testa S, Gouin-Thibault I, Gruel Y, Medcalf RL, ten Cate H, Lippi G, Mullier F. Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory. Thromb J 2020; 18:17. [PMID: 32922211 PMCID: PMC7474970 DOI: 10.1186/s12959-020-00230-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations.
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Affiliation(s)
- M. Hardy
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Anesthesiology Department, Yvoir, Belgium
| | - T. Lecompte
- Département de Médecine, Hôpitaux Universitaires de Genève, service d’angiologie et d’hémostase et Faculté de Médecine Geneva Platelet Group (GpG), Université de Genève, Geneva, Suisse Switzerland
| | - J. Douxfils
- Pharmacy Department, University of Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur, Belgium
- Qualiblood s.a, Namur, Belgium
| | - S. Lessire
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Anesthesiology Department, Yvoir, Belgium
| | - J. M. Dogné
- Pharmacy Department, University of Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur, Belgium
| | - B. Chatelain
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium
| | - S. Testa
- Haemostasis and Thrombosis Center, Cremona Hospital, Cremona, Italy
| | - I. Gouin-Thibault
- Département d’Hématologie Biologique, INSERM, CIC 1414 (Centre d’Investigation Clinique de Rennes), Université de Rennes, CHU de Rennes, Rennes, France
| | - Y. Gruel
- Laboratoire d’Hématologie-Hémostase, CHRU de Tours, Hôpital Trousseau, Tours, France
| | - R. L. Medcalf
- Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria Australia
| | - H. ten Cate
- Department of Internal Medicine, Cardiovascular Research Institute (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands
| | - G. Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - F. Mullier
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium
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Godier A, Garrigue D, Lasne D, Fontana P, Bonhomme F, Collet JP, de Maistre E, Ickx B, Gruel Y, Mazighi M, Nguyen P, Vincentelli A, Albaladejo P, Lecompte T. Management of antiplatelet therapy for non elective invasive procedures of bleeding complications: proposals from the French working group on perioperative haemostasis (GIHP), in collaboration with the French Society of Anaesthesia and Intensive Care Medicine (SFAR). Anaesth Crit Care Pain Med 2019; 38:289-302. [DOI: 10.1016/j.accpm.2018.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 10/07/2018] [Indexed: 12/12/2022]
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Tromeur C, Le Mao R, Jego P, El-Kouri D, Gruel Y, Pan-Petesch B, Bertoletti L, Morange PE, Lemoigne E, Paleiron N, Leroyer C, Couturaud F. [Risk factors for thromboembolic disease in young women-the role of hormones]. Rev Mal Respir 2018; 36:219-226. [PMID: 30318429 DOI: 10.1016/j.rmr.2018.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
Hormonal exposure in young women increases the risk of venous thromboembolic disease (VTE). Thrombophilia testing is often proposed in women of childbearing age before the initiation of contraception. However, the presence of a familial history of VTE has the potential to be more accurate than the presence of inherited thrombophilia. OBJECTIVE To demonstrate an association between the risk of VTE in young women with hormonal exposure (pregnancy or oral contraceptive use) and the presence of a previous episode of VTE in their first-degree relatives, according to whether or not a detectable inherited thrombophilia was present. METHODS We will perform a multicenter case-control cross-sectional study. The main risk factor is defined by the presence of a symptomatic VTE in young women with hormonal exposure. The principle variable is the presence of an objectively diagnosed episode of VTE in first-degree relatives. We will need to include 2,200 family members in 440 cases. EXPECTED RESULTS We expect to improve understanding of the thrombotic risk in first-degree relatives of patients in hormonal context with or without a past history of VTE.
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Affiliation(s)
- C Tromeur
- EA 3878, CIC Inserm 1412, département de médecine interne et pneumologie, université de Bretagne Occidentale, centre hospitalo universitaire de Brest, 29609 Brest cedex, France
| | - R Le Mao
- EA 3878, CIC Inserm 1412, département de médecine interne et pneumologie, université de Bretagne Occidentale, centre hospitalo universitaire de Brest, 29609 Brest cedex, France
| | - P Jego
- Service de médecine interne, université de Rennes 1, centre hospitalo universitaire de Rennes, 35033 Rennes, France
| | - D El-Kouri
- Service d'hématologie, centre hospitalo universitaire de Nantes, 44093 Nantes, France
| | - Y Gruel
- Service d'hématologie, centre hospitalo universitaire de Tours, 37044 Tours, France
| | - B Pan-Petesch
- EA 3878, CIC Inserm 1412, département de médecine interne et pneumologie, université de Bretagne Occidentale, centre hospitalo universitaire de Brest, 29609 Brest cedex, France
| | - L Bertoletti
- EA3065, unité de pharmacologie clinique, service de médecine et thérapeutique, université Jean-Monnet, centre hospitalo universitaire de Saint-Etienne, 42277 Saint-Etienne, France
| | - P-E Morange
- Inserm 1062, service d'hématologie, centre hospitalo universitaire de la Timone, 13385 Marseille, France
| | - E Lemoigne
- EA 3878, CIC Inserm 1412, département de médecine interne et pneumologie, université de Bretagne Occidentale, centre hospitalo universitaire de Brest, 29609 Brest cedex, France
| | - N Paleiron
- Service de pneumologie, hôpital d'instruction des armées de Clermont-Tonnerre, 29200 Brest, France
| | - C Leroyer
- EA 3878, CIC Inserm 1412, département de médecine interne et pneumologie, université de Bretagne Occidentale, centre hospitalo universitaire de Brest, 29609 Brest cedex, France
| | - F Couturaud
- EA 3878, CIC Inserm 1412, département de médecine interne et pneumologie, université de Bretagne Occidentale, centre hospitalo universitaire de Brest, 29609 Brest cedex, France.
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Reverdiau P, Jarousseau AC, Thibault G, Khalfoun B, Watier H, Lebranchu Y, Bardos P, Gruel Y. Tissue Factor Activity of Syncytiotrophoblast Plasma Membranes and Tumoral Trophoblast Cells in Culture. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1653724] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryDuring pregnancy, important modifications of hemostasis occur resulting in mothers in hypercoagulability and the role of placental cells such as trophoblast cells has been hypothesized. In this study, we first showed that syncytiotrophoblast plasma membranes, isolated from normal human placenta, expressed a strong tissue factor (TF) activity. We then studied TF activity of two continuous trophoblast cell lines (JEG-3 and BeWo) in comparison to human umbilical vein endothelial cells (HUVEC) and transformed human endothelial cells (ECV-304). TF assays were performed on intact detached confluent cells. Unstimulated JEG-3 and BeWo cells exhibited a very high TF activity which slightly increased after 2 to 4 h TNF-α stimulation. In contrast, HUVEC and ECV-304 had a lower basal TF activity which was mainly inducible by TNF-a, with a maximum effect after 4 to 6 h stimulation. For both cell types, TF activity was decreased to basal value after 16-hour TNF-α stimulation. These results support that trophoblast cells are able to express TF but the involvement of this property in the hemostatic physiological changes observed during pregnancy, remains to be demonstrated.
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Affiliation(s)
- P Reverdiau
- The Groupe Interactions “Hôte-Greffon”, Laboratoires d’Hématologie et d’immunologie, Faculté de Médecine, Université François Rabelais, Tours, France
| | - A C Jarousseau
- The Groupe Interactions “Hôte-Greffon”, Laboratoires d’Hématologie et d’immunologie, Faculté de Médecine, Université François Rabelais, Tours, France
| | - G Thibault
- The Groupe Interactions “Hôte-Greffon”, Laboratoires d’Hématologie et d’immunologie, Faculté de Médecine, Université François Rabelais, Tours, France
| | - B Khalfoun
- The Groupe Interactions “Hôte-Greffon”, Laboratoires d’Hématologie et d’immunologie, Faculté de Médecine, Université François Rabelais, Tours, France
| | - H Watier
- The Groupe Interactions “Hôte-Greffon”, Laboratoires d’Hématologie et d’immunologie, Faculté de Médecine, Université François Rabelais, Tours, France
| | - Y Lebranchu
- The Groupe Interactions “Hôte-Greffon”, Laboratoires d’Hématologie et d’immunologie, Faculté de Médecine, Université François Rabelais, Tours, France
| | - P Bardos
- The Groupe Interactions “Hôte-Greffon”, Laboratoires d’Hématologie et d’immunologie, Faculté de Médecine, Université François Rabelais, Tours, France
| | - Y Gruel
- The Groupe Interactions “Hôte-Greffon”, Laboratoires d’Hématologie et d’immunologie, Faculté de Médecine, Université François Rabelais, Tours, France
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Gruel Y, Boizard-Boval B, Wautier JL. Further Evidence that Alpha-Granule Components such as Platelet Factor 4 Are Involved in Platelet-IgG-Heparin Interactions during Heparin-Associated Thrombocytopenia. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1649587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Y Gruel
- Laboratoire d’Hématologie-Hémostase, CHU Trousseau, Faculté de Médecine, 37000 Tours, France
| | - B Boizard-Boval
- Immuno-hématologie, Hôpital Lariboisière, 75010 Paris, France
| | - J L Wautier
- Immuno-hématologie, Hôpital Lariboisière, 75010 Paris, France
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Touzé E, Gruel Y, Gouin-Thibault I, De Maistre E, Susen S, Sie P, Derex L. Intravenous thrombolysis for acute ischaemic stroke in patients on direct oral anticoagulants. Eur J Neurol 2018; 25:747-e52. [PMID: 29360254 DOI: 10.1111/ene.13582] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 01/11/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Whereas intravenous thrombolysis (IVT) is allowed for acute ischaemic stroke in patients on vitamin K antagonists with international normalized ratio ≤1.7, there are no similar recommendations for patients on direct oral anticoagulants (DOACs), notably due to the lack of coagulation tests to assess the therapeutic effects. Although the literature is scarce, consisting of small case series and retrospective studies, considering the frequency of this situation the French Vascular Neurology Society and the French Study Group on Haemostasis and Thrombosis have worked on a joint position paper to provide a practical position regarding the emergency management of ischaemic stroke in patients on DOACs. METHOD Based on a review of the literature, the authors wrote a first text that was submitted to a broad panel of members from the two societies. The text was then amended by the authors to address experts' comments and to reach a consensus. RESULTS In patients with normal renal function and who stopped the DOAC for at least 48 h, the management should not differ from that in patients without oral anticoagulant. In patients who are still on DOACs, mechanical thrombectomy is encouraged preferentially when applicable in first line. Otherwise, when specific tests are available, values <50 ng/ml indicate that IVT is allowed. In the absence of specific tests, standard tests (thrombin time, prothrombin time and activated partial thromboplastin time) can be used for dabigatran and rivaroxaban, although interpretation of these tests may be less reliable. In some patients on dabigatran, idarucizumab may be used before IVT. CONCLUSIONS In this expert opinion paper, it is suggested that IVT can be performed in patients selected according to the time elapsed since the drug was last taken, renal function, type of hospital where the patient is admitted and plasma concentration of DOAC.
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Affiliation(s)
- E Touzé
- Normandie Université, UNICAEN, Unité Neurovasculaire, CHU Caen, Caen, France
| | - Y Gruel
- Service d'Hématologie-Hémostase, Centre Régional de Traitement de l'Hémophilie, UMR CNRS 7292, Hôpital Trousseau, CHRU de Tours et Université François Rabelais, Tours, France
| | - I Gouin-Thibault
- Laboratoire d'Hématologie, Hôpital Cochin, UMR_S1140, Université Paris Descartes, Paris, France
| | - E De Maistre
- Laboratoire d'Hématologie-Hémostase, CHU Dijon Bourgogne, Université de Bourgogne, Dijon Cedex, France
| | - S Susen
- Département d'Hématologie et Transfusion, CHRU, Lille, France
| | - P Sie
- Laboratoire d'Hématologie, Hôpital Rangueil, CHU de Toulouse, Université Toulouse 3, Paul Sabatier, Toulouse, France
| | - L Derex
- Unité Neurovasculaire, Hôpital Neurologique, Hospices Civils, Lyon, France
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Négrier C, Ducloy-Bouthors AS, Piriou V, De Maistre E, Stieltjes N, Borel-Derlon A, Colson P, Picard J, Lambert T, Claeyssens S, Boileau S, Bertrand A, André MH, Fourrier F, Ozier Y, Sié P, Gruel Y, Tellier Z. Postauthorization safety study of Clottafact®
, a triply secured fibrinogen concentrate in acquired fibrinogen deficiency: a prospective observational study. Vox Sang 2017; 113:120-127. [DOI: 10.1111/vox.12624] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/26/2017] [Accepted: 11/14/2017] [Indexed: 01/02/2023]
Affiliation(s)
| | | | - V. Piriou
- South University Hospital; Lyon France
| | | | | | | | - P. Colson
- University Hospital; Montpellier France
| | - J. Picard
- University Hospital; Grenoble France
| | - T. Lambert
- Bicêtre Hospital; Kremlin Bicêtre France
| | | | | | - A. Bertrand
- Medical Affairs; LFB Biomédicaments; Les Ulis France
| | - M.-H. André
- Medical Affairs; LFB Biomédicaments; Les Ulis France
| | | | - Y. Ozier
- University Hospital; Brest France
| | - P. Sié
- Rangueil Hospital; Toulouse France
| | - Y. Gruel
- Trousseau Hospital; Tours France
| | - Z. Tellier
- Medical Affairs; LFB Biomédicaments; Les Ulis France
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Kizlik-Masson C, Vayne C, McKenzie SE, Poupon A, Zhou Y, Champier G, Pouplard C, Gruel Y, Rollin J. 5B9, a monoclonal antiplatelet factor 4/heparin IgG with a human Fc fragment that mimics heparin-induced thrombocytopenia antibodies. J Thromb Haemost 2017; 15:2065-2075. [PMID: 28771917 DOI: 10.1111/jth.13786] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Indexed: 01/12/2023]
Abstract
Essentials No humanized monoclonal antibody was available to study heparin-induced thrombocytopenia (HIT). We developed the first anti-platelet factor 4 (PF4)/heparin antibody with a human Fc fragment. This antibody (5B9) fully mimics the effects of human HIT antibodies. 5B9 binds two regions within PF4 that may be critical for the pathogenicity of HIT antibodies. SUMMARY Background The diagnosis of heparin-induced thrombocytopenia (HIT) is based on clinical and biological criteria, but a standard is lacking for laboratory assays. Moreover, no humanized HIT antibody is available for pathophysiological studies. Objective To characterise 5B9, a chimeric monoclonal antibody, which fully mimics the effects of human HIT antibodies. Methods/Results 5B9, a chimeric anti-platelet factor 4/heparin complexes IgG1 antibody, was obtained after immunizing specific transgenic mice. 5B9 induced heparin FcγRIIA-dependent platelet aggregation and tissue factor mRNA synthesis in monocytes. It also induced significant thrombocytopenia and thrombin generation in mice expressing human PF4 and FcγRIIA receptors. The binding of 5B9 to PF4/H complexes was inhibited by 15 of 25 HIT plasma samples and only three of 25 samples containing non-pathogenic anti-PF4/H antibodies. KKO, a murine IgG2b HIT antibody, also inhibited the binding of 5B9 to PF4/H, suggesting that epitopes recognized by both antibodies are close. A docking analysis based on VH and VL sequences of 5B9 showed that binding of 5B9 Fab to PF4 involved 12 and 12 residues in B and D monomers, respectively, including seven previously identified as critical to the formation of a PF4/KKO complex. Two regions (Asp-7 to Thr-15 and Ala-32 to Thr-38) therefore appeared important for the binding of 5B9 and KKO on PF4 modified by heparin. Conclusions 5B9 is the first anti-PF4/H monoclonal antibody with a human Fc fragment, which induces similar cellular activation as HIT antibodies. Moreover, 5B9 binds epitopes within PF4 that are likely to be critical for the pathogenicity of HIT antibodies.
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Affiliation(s)
- C Kizlik-Masson
- UMR CNRS 7292 and Université François Rabelais, Tours, France
| | - C Vayne
- UMR CNRS 7292 and Université François Rabelais, Tours, France
- Laboratoire d'Hématologie-Hémostase, CHU Tours, Tours, France
| | - S E McKenzie
- Department of Medicine, Cardeza Foundation for Hematologic Research, Thomas Jefferson University, Philadelphia, PA, USA
| | - A Poupon
- PRC, INRA, CNRS, IFCE, Université de Tours, Nouzilly, France
| | - Y Zhou
- Department of Medicine, Cardeza Foundation for Hematologic Research, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - C Pouplard
- UMR CNRS 7292 and Université François Rabelais, Tours, France
- Laboratoire d'Hématologie-Hémostase, CHU Tours, Tours, France
| | - Y Gruel
- UMR CNRS 7292 and Université François Rabelais, Tours, France
- Laboratoire d'Hématologie-Hémostase, CHU Tours, Tours, France
| | - J Rollin
- UMR CNRS 7292 and Université François Rabelais, Tours, France
- Laboratoire d'Hématologie-Hémostase, CHU Tours, Tours, France
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Perez T, Valentin JB, Saliba E, Gruel Y. [Neonatal arterial ischemic stroke: Which thrombotic biological risk factors to investigate and which practical consequences?]. Arch Pediatr 2017; 24:9S28-9S34. [PMID: 28867034 DOI: 10.1016/s0929-693x(17)30328-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
All biological risk factors that have been previously identified to increase the risk of thrombosis in adults, have also been studied in neonates with arterial Ischemic Stroke (NAIS), but most studies were retrospective and included relatively low numbers of affected children. We therefore could not suggest recommendations with a strong level of evidence and only expert proposals potentially useful for clinical practice will be presented in this text. Despite these limitations, the extensive analysis of published data supported that factor V Leiden (FVL) and increased levels of Lp(a) could be significant risk factors for NAIS. Importantly, these 2 risk factors cannot be considered as having provoked NAIS, and moreover, they do not influence the prognosis and the immediate treatment. However, since the FVL may have an impact for the prescription of a thromboprophylaxis when the neonate will become adult, to look for its presence in affected patients may be justified. For clinical practice, the following propositions can be applied: 1. Routine testing for thrombophilia (AT, PC PS deficiency, FV Leiden or FII20210A) or for detecting other biological risk factors such as antiphospholipid antibodies, high FVIII, homocystein or Lp(a) levels, MTHFR thermolabile variant, should not be considered in neonates with NAIS. 2. Testing for FV Leiden can be performed in case of documented family history of venous thromboembolic disease. 3. Testing neonates for the presence of antiphospholipid antibodies (APA) is mandatory in case of clinical events suggesting antiphospholipid syndrome in the mother (vascular thrombosis, and/or pregnancy morbidity). 4. Routine testing for thrombophilia is not proposed in both parents in case of early death of the neonate, apart from APA in the mother.
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Affiliation(s)
- T Perez
- Centre hospitalier régional universitaire, soins intensifs néonataux et pédiatriques, Hôpital d'Enfants de Clocheville, 49 boulevard Béranger, Tours, 37044, France
| | - J B Valentin
- Centre hospitalier régional universitaire, service d'hématologie-hémostase, Hôpital Trousseau, Avenue de la République, Tours, 37170, France
| | - E Saliba
- Centre hospitalier régional universitaire, soins intensifs néonataux et pédiatriques, Hôpital d'Enfants de Clocheville, 49 boulevard Béranger, Tours, 37044, France
| | - Y Gruel
- Centre hospitalier régional universitaire, service d'hématologie-hémostase, Hôpital Trousseau, Avenue de la République, Tours, 37170, France.
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Liesner RJ, Abashidze M, Aleinikova O, Altisent C, Belletrutti MJ, Borel-Derlon A, Carcao M, Chambost H, Chan AKC, Dubey L, Ducore J, Fouzia NA, Gattens M, Gruel Y, Guillet B, Kavardakova N, El Khorassani M, Klukowska A, Lambert T, Lohade S, Sigaud M, Turea V, Wu JKM, Vdovin V, Pavlova A, Jansen M, Belyanskaya L, Walter O, Knaub S, Neufeld EJ. Immunogenicity, efficacy and safety of Nuwiq®
(human-cl rhFVIII) in previously untreated patients with severe haemophilia A-Interim results from the NuProtect Study. Haemophilia 2017; 24:211-220. [PMID: 28815880 DOI: 10.1111/hae.13320] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2017] [Indexed: 01/19/2023]
Affiliation(s)
- R. J. Liesner
- Great Ormond Hospital for Children NHS Trust Haemophilia Centre; London UK
| | - M. Abashidze
- JSC Institute of Haematology and Transfusiology; Tbilisi Georgia
| | - O. Aleinikova
- Republican Scientific and Practical Centre of Children Oncology, Hematology and Immunology; Minsk Belarus
| | - C. Altisent
- Unitat d'Hemofilia; Hospital Vall D'Hebron; Barcelona Spain
| | - M. J. Belletrutti
- Pediatric Hematology; Department of Pediatrics; University of Alberta; Edmonton AB Canada
| | | | - M. Carcao
- Hospital for Sick Children; Toronto ON Canada
| | - H. Chambost
- Department of Pediatric Hematology Oncology; Children Hospital La Timone; APHM and Inserm; UMR 1062; Aix Marseille University; Marseille France
| | - A. K. C. Chan
- Division of Pediatric Hematology/Oncology; McMaster University; Hamilton ON Canada
| | - L. Dubey
- Western Ukrainian Specialized Children's Medical Centre; Lviv Ukraine
| | - J. Ducore
- Department of Pediatrics; UC Davis Medical Center; Sacramento CA USA
| | - N. A. Fouzia
- Christian Medical College Vellore; Vellore India
| | - M. Gattens
- Cambridge University Hospital NHS Foundation Trust; Cambridge UK
| | - Y. Gruel
- Hôpital Trousseau; Centre Régional de Traitement de l'Hémophilie; Tours France
| | - B. Guillet
- Haemophilia Treatment Centre of Rennes-Brittany; University Hospital of Rennes; Rennes France
| | - N. Kavardakova
- National Children's Specialized Clinic “OHMATDET”; Kiev Ukraine
| | - M. El Khorassani
- Centre de traitement de l'hémophilie; University Mohamed V; Rabat Morocco
| | | | - T. Lambert
- CRTH Hôpital Universitaire Bicêtre APHP; Le Kremlin Bicêtre France
| | - S. Lohade
- Sahyadri Speciality Hospital; Pune India
| | - M. Sigaud
- Centre Régional de Traitement de I'Hémophilie; University Hospital of Nantes; Nantes France
| | - V. Turea
- Scientific Research Institute of Mother and Child Health Care; Chişinău Moldova
| | - J. K. M. Wu
- B.C. Children's Hospital; Vancouver BC Canada
| | - V. Vdovin
- Morozovskaya Children's Hospital; Moscow Russia
| | - A. Pavlova
- Institute of Experimental Haematology and Transfusion Medicine; University Clinic Bonn; Bonn Germany
| | - M. Jansen
- Octapharma Pharmazeutika Produktionsges.mbH; Vienna Austria
| | | | | | - S. Knaub
- Octapharma AG; Lachen Switzerland
| | - E. J. Neufeld
- St. Jude Children’s Research Hospital; Memphis TN USA
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Challal F, Ivanes F, Saint-Etienne C, Desveaux B, Gruel Y, Babuty D, Angoulvant D. Peri-procedural serum fibrinogen and CRP elevation before Percutaneous Coronary Intervention significantly predict stent thrombosis and Major Cardiovascular ischemic Events at 15-months. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30372-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saliba E, Debillon T, Auvin S, Baud O, Biran V, Chabernaud JL, Chabrier S, Cneude F, Cordier AG, Darmency-Stamboul V, Diependaele JF, Debillon T, Dinomais M, Durand C, Ego A, Favrais G, Gruel Y, Hertz-Pannier L, Husson B, Marret S, N’Guyen The Tich S, Perez T, Saliba E, Valentin JB, Vuillerot C. Accidents vasculaires cérébraux ischémiques artériels néonatals : synthèse des recommandations. Arch Pediatr 2017; 24:180-188. [DOI: 10.1016/j.arcped.2016.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/25/2016] [Accepted: 11/22/2016] [Indexed: 12/01/2022]
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Pouplard C, Vayne C, Berthomet C, Guery EA, Delahousse B, Gruel Y. The Taipan snake venom time can be used to detect lupus anticoagulant in patients treated by rivaroxaban. Int J Lab Hematol 2016; 39:e60-e63. [DOI: 10.1111/ijlh.12611] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- C. Pouplard
- Department of Haematology-Haemostasis; Trousseau hospital; Tours France
- Unité Mixte de Recherche Centre National de la Recherche Scientifique 7292 and Université François Rabelais; Tours France
| | - C. Vayne
- Department of Haematology-Haemostasis; Trousseau hospital; Tours France
- Unité Mixte de Recherche Centre National de la Recherche Scientifique 7292 and Université François Rabelais; Tours France
| | - C. Berthomet
- Department of Haematology-Haemostasis; Trousseau hospital; Tours France
| | - E. A. Guery
- Department of Haematology-Haemostasis; Trousseau hospital; Tours France
- Unité Mixte de Recherche Centre National de la Recherche Scientifique 7292 and Université François Rabelais; Tours France
| | - B. Delahousse
- Department of Haematology-Haemostasis; Trousseau hospital; Tours France
| | - Y. Gruel
- Department of Haematology-Haemostasis; Trousseau hospital; Tours France
- Unité Mixte de Recherche Centre National de la Recherche Scientifique 7292 and Université François Rabelais; Tours France
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Négrier C, Rothschild C, Borg JY, Lambert T, Claeyssens S, Sanhes L, Stieltjes N, Bertrand A, André MH, Sié P, Gruel Y, Tellier Z. Post-authorization safety study of Clottafact®, a triply secured fibrinogen concentrate in congenital afibrinogenemia. A prospective observational study. Vox Sang 2016; 111:383-390. [DOI: 10.1111/vox.12424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/17/2016] [Accepted: 05/17/2016] [Indexed: 11/25/2022]
Affiliation(s)
| | - C. Rothschild
- Hemophilia Centre; Necker Enfants Malades University Hospital - APHP Paris; Paris France
| | | | - T. Lambert
- Bicêtre Hospital; Kremlin Bicêtre France
| | | | - L. Sanhes
- Saint-Jean Hospital; Perpignan France
| | | | - A. Bertrand
- Medical Affairs; LFB Biomédicaments; Les Ulis France
| | - M.-H. André
- Medical Affairs; LFB Biomédicaments; Les Ulis France
| | - P. Sié
- Rangueil Hospital; Toulouse France
| | - Y. Gruel
- Trousseau Hospital; Tours France
| | - Z. Tellier
- Medical Affairs; LFB Biomédicaments; Les Ulis France
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Guérois G, Gruel Y, Petit A, Kaplan C, Champeix P, Delahousse B, Leroy J. Familial macrothrombocytopenia. Clinical, ultrastructural and biochemical study. Curr Stud Hematol Blood Transfus 2015:153-61. [PMID: 3366001 DOI: 10.1159/000415438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- G Guérois
- Laboratoire d'hématologie, Hôpital Trousseau, Paris, France
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16
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Lapalud P, Rothschild C, Mathieu-Dupas E, Balicchi J, Gruel Y, Laune D, Molina F, Schved JF, Granier C, Lavigne-Lissalde G. Anti-A2 and anti-A1 domain antibodies are potential predictors of immune tolerance induction outcome in children with hemophilia A. J Thromb Haemost 2015; 13:540-7. [PMID: 25603934 DOI: 10.1111/jth.12846] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 12/03/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hemophilia A (HA) is a congenital bleeding disorder resulting from factor VIII deficiency. The most serious complication of HA management is the appearance of inhibitory antibodies (Abs) against injected FVIII concentrates. To eradicate inhibitors, immune tolerance induction (ITI) is usually attempted, but it fails in up to 30% of cases. Currently, no undisputed predictive marker of ITI outcome is available to facilitate the clinical decision. OBJECTIVES To identify predictive markers of ITI efficacy. METHODS The isotypic and epitopic repertoires of inhibitory Abs were analyzed in plasma samples collected before ITI initiation from 15 children with severe HA and high-titer inhibitors, and their levels were compared in the two outcome groups (ITI success [n = 7] and ITI failure [n = 8]). The predictive value of these candidate biomarkers and of the currently used indicators (inhibitor titer and age at ITI initiation, highest inhibitor titer before ITI, and interval between inhibitor diagnosis and ITI initiation) was then compared by statistical analysis (Wilcoxon test and receiver receiver operating characteristic [ROC] curve analysis). RESULTS Whereas current indicators seemed to fail in discriminating patients in the two outcome groups (ITI success or failure), anti-A1 and anti-A2 Ab levels before ITI initiation appeared to be good potential predictive markers of ITI outcome (P < 0.018). ROC analysis showed that anti-A1 and anti-A2 Abs were the best at discriminating between outcome groups (area under the ROC curve of > 0.875). CONCLUSION Anti-A1 and anti-A2 Abs could represent new promising tools for the development of ITI outcome prediction tests for children with severe HA.
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Affiliation(s)
- P Lapalud
- UMR3145 CNRS/BioRad, SysDiag, Montpellier, France
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Gruel Y, Rollin J, Leroux D, Pouplard C. Les thrombocytopénies induites par l’héparine : données récentes. Rev Med Interne 2014; 35:174-82. [DOI: 10.1016/j.revmed.2013.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 04/23/2013] [Accepted: 04/27/2013] [Indexed: 01/08/2023]
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Négrier C, Borg J, Claeyssens S, De Moerloose P, Dreyfus M, Goudemand J, Gruel Y, Peyvandi F, Rothschild C, Alessi M, Scherrmann J, Waegemans T, Padrazzi B. A MULTICENTRE PROSPECTIVE OPEN-LABEL STUDY ASSESSING PHARMACOKINETICS, CLINICAL EFFICACY AND SAFETY OF A TRIPLE-SECURED FIBRINOGEN CONCENTRATE: FIBRINOGENE T-I. J Thromb Haemost 2014. [DOI: 10.1111/j.1538-7836.2007.tb01132.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pernod G, Albaladejo P, Godier A, Samama C, Susen S, Gruel Y, Blais N, Fontana P, Cohen A, Llau J, Rosencher N, Schved J, de Maistre E, Samama M, Mismetti P, Sié P. Prise en charge des complications hémorragiques graves et de la chirurgie en urgence chez les patients recevant un anticoagulant oral anti-IIa ou anti-Xa direct. Propositions du Groupe d’intérêt en Hémostase Périopératoire (GIHP) - mars 2013. ACTA ACUST UNITED AC 2013; 32:691-700. [DOI: 10.1016/j.annfar.2013.04.016] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 04/25/2013] [Indexed: 11/26/2022]
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20
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Salmon Gandonnière C, Pouplard C, Halimi J, Birmelé B, Ehrmann S, Mercier E, Gruel Y, François M. Thrombopénie induite par l’héparine en dialyse : diagnostic et prise en charge. Nephrol Ther 2013. [DOI: 10.1016/j.nephro.2013.07.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Rollin J, Pouplard C, Leroux D, May MA, Gruel Y. Impact of polymorphisms affecting the ACP1 gene on levels of antibodies against platelet factor 4-heparin complexes. J Thromb Haemost 2013; 11:1609-11. [PMID: 23621699 DOI: 10.1111/jth.12278] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 04/22/2013] [Indexed: 11/30/2022]
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22
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Lioger B, Leroux D, Rollin J, Maillot F, Darnige L, Gruel Y, Pouplard C. Étude de la prévalence et caractérisation des anticorps anti-FP4/Héparine dans une cohorte de 61 patients avec un syndrome des antiphospholipides. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rothschild C, D'oiron R, Borel-derlon A, Gruel Y, Navarro R, Negrier C. Use of Haemate®P as immune tolerance induction in patients with severe haemophilia A who failed previous induction attempts: a multicentre observational study. Haemophilia 2012; 19:281-6. [DOI: 10.1111/hae.12018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2012] [Indexed: 11/29/2022]
Affiliation(s)
- C. Rothschild
- Centre de Référence de l'Hémophilie; Hôpital Necker - Enfants Malades AP-HP; Paris; France
| | - R. D'oiron
- Centre de Référence de l'Hémophilie; Hôpital Bicêtre AP-HP; Le Kremlin-Bicêtre; France
| | - A. Borel-derlon
- Centre Régional de Traitement de l'Hémophilie; Hôpital de la Côte de Nacre; Caen; France
| | - Y. Gruel
- Centre Régional de Traitement de l'Hémophilie; Hôpital Trousseau; Chambray-lès-Tours; France
| | - R. Navarro
- Centre Régional de Traitement de l'Hémophilie; Hôpital Saint-Eloi; Montpellier; France
| | - C. Negrier
- Centre de Référence de l'Hémophilie; Hôpital Edouard Herriot - Hospices Civils de Lyon; Lyon; France
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Lapalud P, Ali T, Cayzac C, Mathieu-Dupas E, Levesque H, Pfeiffer C, Balicchi J, Gruel Y, Borg JY, Schved JF, Granier C, Lavigne-Lissalde G. The IgG autoimmune response in postpartum acquired hemophilia A targets mainly the A1a1 domain of FVIII. J Thromb Haemost 2012; 10:1814-22. [PMID: 22784315 DOI: 10.1111/j.1538-7836.2012.04850.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acquired hemophilia A (AHA) is a severe life-threatening autoimmune disease due to the development of autoantibodies that neutralize the procoagulant activity of factor VIII (FVIII). In rare cases, AHA occurs in the postpartum period as a serious complication of an otherwise normal pregnancy and delivery. Due to its rarity, little is known about the features of the antibody response to FVIII in AHA. OBJECTIVES Our study wanted to (i) determine the epitope specificity and the immunoglobulin (Ig) subclasses of anti-FVIII autoantibodies in plasma samples from a large cohort of AHA patients, and (ii) compare the epitope specificity of anti-FVIII autoantibodies in plasma samples from postpartum AHA and other AHA patients. PATIENTS/METHODS Seventy-three plasma samples from patients with postpartum AHA (n = 10) or associated with malignancies (n = 16) or autoimmune diseases (n = 11) or without underlying disease (n = 36) were analyzed with three multiplexed assays. RESULTS AND CONCLUSIONS Our results showed a stronger response against the A1a1-A2a2-B fragments of FVIII and more specifically against the A1a1 domain in patients with postpartum AHA than in the other AHA groups (P < 0.01). Moreover, although IgG4 was the predominant IgG subclass in all groups, anti-A1a1-A2a2-B and anti-A1a1 domain autoantibodies of the IgG(1) and IgG3 subclasses were more frequently detected in postpartum AHA than in the other AHA groups. These findings support the involvement of the Th1-driven response in the generation of autoantibodies in women with postpartum AHA compared with the other groups of AHA patients in whom production of Th2-driven IgG4 was predominant.
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Affiliation(s)
- P Lapalud
- SysDiag, UMR3145 CNRS/BioRad, Montpellier, France.
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Leroux D, Canépa S, Viskov C, Mourier P, Herman F, Rollin J, Gruel Y, Pouplard C. Binding of heparin-dependent antibodies to PF4 modified by enoxaparin oligosaccharides: evaluation by surface plasmon resonance and serotonin release assay. J Thromb Haemost 2012; 10:430-6. [PMID: 22235911 DOI: 10.1111/j.1538-7836.2012.04618.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND The minimal structural requirements of low-molecular-weight heparins that determine the risk of developing heparin-induced thrombocytopenia (HIT) are not fully defined. OBJECTIVES The ability of enoxaparin-derived oligosaccharides (OS) to induce platelet activation and exposure of platelet-factor 4 (PF4) epitopes recognized by antibodies developed in HIT was studied by surface plasmon resonance (SPR) and serotonin release assay. RESULTS Decasaccharides with ≥ 11 sulfate groups induced platelet activation in the presence of plasma from patients with confirmed HIT. Serotonin release of > 80% without full inhibition at 100 μg mL(-1) was achieved with decasaccharides containing 14 or 15 sulfate groups, 2 dodecasaccharides and 2 tetradecasaccharides. An SPR method was developed using purified PF4 immobilized on carboxymethylated dextran. Antibodies from all HIT samples bound to PF4/heparin in SPR assays with resonance units (RU) ratio of 109-173 with HIT plasma vs. 88-93 with control plasma. RU ratios > 100 were measured when PF4 was pre-incubated with OS with ≥ 10 saccharide units and one octasaccharide containing 10 sulfate groups. RU ratios > 140, similar to those measured when PF4 was pre-incubated with unfractionated heparin or enoxaparin, were obtained with purified dodeca- and tetradecasaccharides. RU values strongly correlated with the number of sulfate groups in the decasaccharides tested (r = 0.93, P = 0.02). CONCLUSIONS LMWHs with fragments > 10 saccharides and a large number of sulfate groups are more likely to be associated with a higher risk of HIT. These structure-activity relationships were independent of the ability of the OS to bind antithrombin.
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Affiliation(s)
- D Leroux
- Department of Hematology-Hemostasis, University Hospital of Tours GICC UMR 6239 CNRS, University Francois Rabelais, Tours, France
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Warkentin TE, Greinacher A, Gruel Y, Aster RH, Chong BH. Laboratory testing for heparin-induced thrombocytopenia: a conceptual framework and implications for diagnosis. J Thromb Haemost 2011; 9:2498-500. [PMID: 22947414 DOI: 10.1111/j.1538-7836.2011.04536.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- T E Warkentin
- Department of Pathology and Molecular Medicine and Department of Medicine, McMaster University, Hamilton, Canada.
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Abstract
The haemostasis of healthy newborn differs from those of normal adult but remains well balanced without bleeding or thrombosis. However, this equilibrium is unstable, and the neonate is exposed to acquired or inherited haemostasis disorders that necessitate to be early diagnosed in order to be appropriately treated. Several studies provided reference ranges for haemostatic components in the foetus, the newborn and throughout childhood. The particularities of neonatal haemostasis are therefore better defined and contribute to further understand the pathophysiology and characteristics of hemorrhagic and thrombotic disorders that occur in newborns. Some examples of the impact of age on haemostasis are: the risk of neonatal alloimmune thrombocytopenia is high in the first newborn of a woman at risk since the involved antigens are fully expressed by foetal platelets; the newborn is at risk for vitamin K deficiency with bleeding due to poor transport of vitamin K across the placenta and low levels of coagulation factors II, VII, IX, X; the diagnosis of some inherited coagulation deficiencies can be difficult in the newborn due to physiologically low levels of coagulation factors; thrombotic events are rare in the healthy neonate, despite physiologically very low levels of several coagulation inhibitors; the pharmacokinetic and effects of antithrombotic agents are influenced by the specificities of haemostasis in neonates. This review will discuss about the foetal development of haemostasis until birth, and some implications regarding the pathophysiology, the diagnosis and the treatment of bleeding disorders in the human neonate.
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Affiliation(s)
- Y Gruel
- Service d'Hématologie-Hémostase, Hôpital Trousseau, 37044 Tours cedex 9, France.
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Rollin J, Regina S, Gruel Y. Tumor expression of alternatively spliced tissue factor is a prognostic marker in non-small cell lung cancer. J Thromb Haemost 2010; 8:607-10. [PMID: 19995406 DOI: 10.1111/j.1538-7836.2009.03713.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gruel Y, Pouplard C. Post-operative platelet count profile: the most reliable tool for identifying patients with true heparin-induced thrombocypenia after cardiac surgery. J Thromb Haemost 2010; 8:27-9. [PMID: 19817999 DOI: 10.1111/j.1538-7836.2009.03646.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Y Gruel
- Department of Haematology-Haemostasis, University Hospital of Tours, Tours, France.
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Khalfoun B, Valentin JF, Sizaret PY, Watier H, Thibault G, Gruel Y, Bardos P, Lebranchu Y. In VitroInhibitory Effect of Docosahexaenoic and Eicosapentaenoic Acids on Human Endothelial Cell Production of Interleukin-6. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/10623329409088474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lafosse-Marin M, Marcq M, Diot P, Gruel Y, Diot E. L’hémorragie intra-alvéolaire, une complication rare du syndrome primaire des antiphospholipides. Rev Med Interne 2009; 30:271-3. [DOI: 10.1016/j.revmed.2008.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 04/16/2008] [Accepted: 06/04/2008] [Indexed: 10/21/2022]
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Couturaud F, Pernod G, Pison C, Mismetti P, Sanchez O, Meyer G, Parent F, Girard P, Simonneau G, Drouet L, Gueret P, Jego P, Delaval P, Duhamel E, Gruel Y, Delahousse B, Regina S, Pottier P, Connaud J, Lecomte F, Provost K, Vilmans N, Gosset X, Bura-Rivière A, Meach G, Lacut K, Bosson JL, Guillot K, Mottier D, Leroyer C. [Prolongation of anti vitamin K treatment for 18 months versus placebo after 6 months treatment of a first episode of ideopathic pulmonary embolism: a mutlicentre, randomised double blind trail. The PADIS-EP Trial]. Rev Mal Respir 2008; 25:885-93. [PMID: 18946418 DOI: 10.1016/s0761-8425(08)74358-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND After stopping a 3 to 6 months course of oral anticoagulation for a first episode of idiopathic venous thromboembolism (VTE), the risk of recurrent VTE is high (10% per year). In this setting, international guidelines recommend at least 6 months treatment. However, this recommendation is not satisfactory for the following reasons: (1) no randomized trial has compared 6 months to extended duration (2 years) anticoagulation; and (2), even though the frequency of recurrent VTE is similar after pulmonary embolism (PE) and deep vein thrombosis (DVT), the fatality rate of recurrent VTE after PE is higher than that after DVT. METHODS A French multicentre double blind randomized trial. The main objective is to demonstrate, after a first episode of symptomatic idiopathic PE treated for 6 months using a vitamin K antagonist, that extended anticoagulation for 18 months (INR between 2 and 3) is associated with an increased benefit / risk ratio (recurrent VTE and severe anticoagulant-related bleeding) compared to placebo. The double blind evaluation is ensured using by active warfarin and placebo, and blinded INR. The protocol was approved by the ethics board of the Brest Hospital on the 7th of March 2006. For an alpha risk of 5% and a beta risk of 20%, the estimated sample size is 374 patients. EXPECTED RESULTS This study has the potential to: (1) demonstrate that the benefit / risk ratio of extended anticoagulation for 18 months is higher than that observed with placebo in patients with a first episode of idiopathic PE initially treated for 6 months, during and after the treatment period; and (2) to validate or invalidate the contribution of isotope lung scans, lower limb Doppler ultrasound and D-Dimer at 6 months of treatment as predictors of recurrent VTE (medico-economic analysis included).
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Affiliation(s)
- F Couturaud
- Département de Médecine interne et pneumologie, CHU de Brest, France.
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Brillet B, Petiot S, Iochmann S, Gaud G, Planque C, Blechet C, Heuze-Vourc’h N, Gruel Y, Courty Y, Reverdiau P. Tumor-stromal cell interactions modulate metalloproteinase and kalli Krein expression in direct and indirect co-culture cell models. Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)75015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gaud G, Iochmann S, Brillet B, petiot S, Blechet C, Chabot V, Heuze-Vourc’h N, Gruel Y, Reverdiau P. Impact de l’expression d’un inhibiteur de protéases, le TFPI-2, dans le micro- environnement tumoral pulmonaire. Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)75016-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Iochmann S, Lerondel S, Blechet C, Pesnel S, Heuze-Vourc’h N, Gruel Y, Le Pape A, Reverdiau P. Monitoring of tumor progression using bioluminescence imaging in a nude mice orthotopic model of human small cell lung cancer. Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)75014-9] [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: 10/21/2022]
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Gaud G, Iochmann S, Brillet B, Petiot S, Blechet C, Heuze Vourc'h N, Gruel Y, Reverdiau P. Modulation of cellular response to stable RNA silencing of tissue factor pathway inhibitor-2 in lung cancer cells. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)71454-x] [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: 10/21/2022] Open
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Iochmann S, Lerondel S, Bléchet C, Pesnel S, Heuzé-Vourc'h N, Gruel Y, Le Pape A, Reverdiau P. Monitoring of tumor progression using bioluminescence imaging in a nude mice orthotopic model of human small cell lung cancer. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)71447-2] [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: 11/27/2022] Open
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Iochmann S, Petiot S, Lapaquette P, Gaud G, Brillet B, Sizaret P, Blechet C, Gruel Y, Reverdiau P. 047 Induction des métalloprotéases et d’un inhibiteur de protéases, le TFPI-2 lors d’interactions entre des cellules tumorales bronchiques et des fibroblastes du stroma tumoral. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)74338-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gaud G, Iochmann S, Saulnier A, Ainciburu M, Bousarghin L, Gruel Y, Reverdiau P. 048 Effet de l’inhibition du TFPI-2 par micro ARN sur le potentiel invasif des cellules tumorales pulmonaires NCI-H460. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)74339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dreyfus M, Ladouzi A, Chambost H, Gruel Y, Tardy B, Ffrench P, Bridey F, Tellier Z. Treatment of inherited protein C deficiency by replacement therapy with the French purified plasma-derived protein C concentrate (PROTEXEL®). Vox Sang 2007; 93:233-40. [PMID: 17845261 DOI: 10.1111/j.1423-0410.2007.00953.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES A multicentre retrospective study was performed to assess the efficacy/safety of a French purified plasma-derived protein C (PC) concentrate in inherited PC deficiency. MATERIALS AND METHODS Nine patients were enrolled, five children aged < 5 weeks, among whom four with a severe deficiency were homozygous, and four patients < 37 years with PC levels ranging 14-25%, including one compound heterozygous. RESULTS Thirty replacement therapy courses were recorded with mean PC dosages ranging between 24-90 IU/kg/day for prophylactic courses and 51-209 IU/kg/day for treatment courses. Recoveries varied between 0.8 and 1.12% IU/kg in preventive situations and between 1.09 and 1.91% IU/kg for treatment courses; 23 treatment courses were performed in patients aged 1 day to 18 years, 19 out of 23 treatments resulted in complete recovery with no sequelae. Treatment efficacy was difficult to assess in four out of 23 cases because the thrombotic event was not confirmed in one case and due to late treatment initiation in the three other cases. Seven prophylactic treatments were used either in association of vitamin K antagonists or to prevent thrombotic events due to vitamin K antagonist introduction or withdrawal. The safety assessed during 914 infusions was excellent. No abnormal bleeding was reported, including with high doses, during surgery, with heparin therapy. CONCLUSIONS Replacement therapy with this French PC concentrate is safe and effective in patients with inherited PC deficiency.
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Affiliation(s)
- M Dreyfus
- Bicêtre Hospital, Assistance Publique-Hopitaux de Paris, Paris XI University, Le Kremlin Bicêtre, France.
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Regina S, Leroux D, Pouplard C, Fimbel B, Delahousse B, Gruel Y. IS THE RISK OF VENOUS THROMBOEMBOLISM HIGHER WITH CYPROTERONE CONTRACEPTIVES? J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb02366.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pouplard C, Gueret P, Fouassier M, Ternisien C, Trossaert M, Régina S, Gruel Y. Prospective evaluation of the '4Ts' score and particle gel immunoassay specific to heparin/PF4 for the diagnosis of heparin-induced thrombocytopenia. J Thromb Haemost 2007; 5:1373-9. [PMID: 17362241 DOI: 10.1111/j.1538-7836.2007.02524.x] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Heparin-induced thrombocytopenia (HIT) is a severe disease that is often difficult to diagnose. A clinical scoring system, the '4Ts' score, has been proposed to estimate its probability before laboratory testing, and a particle gel immunoassay (H/PF4 PaGIA) has also been developed for rapid detection of HIT antibodies. AIM To evaluate the performance of both methods when HIT is suspected clinically. METHODS Two hundred thirteen consecutive patients were included in four centers. The probability of HIT was evaluated using the 4Ts score blind to antibody test results. HIT was confirmed only when the serotonin release assay (SRA) was positive. RESULTS The risk of HIT was evaluated by the 4Ts score as low (LowR), intermediate (IR) or high (HR) in 34.7%, 60.6% and 4.7% of patients, respectively. The negative predictive value (NPV) of the 4Ts score was 100%, as the SRA was negative in all LowR patients. PaGIA was negative in 176 patients without HIT (99.4%, NPV) and the negative likelihood ratio (LR-) was 0.05. PaGIA was positive in 37 patients, including 21 with HIT (positive predictive value = 56.8%), with a positive LR of 11.4. A negative PaGIA result decreased the probability of HIT in IR patients from 10.9% before assay to 0.6%, whereas a positive result did not substantially increase the likelihood for HIT. CONCLUSION The use of the 4Ts score with PaGIA appears to be a reliable strategy to rule out HIT.
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Affiliation(s)
- C Pouplard
- Department of Hematology, CHRU de Tours, Tours, France
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Pouplard C, Lequerrec A, Trossaert M, Delahousse B, Guerois C, Giraudeau B, Gruel Y. INFLUENCE OF THE SOURCE OF PHOSPHOLIPIDS FOR APTT-BASED FIX ASSAYS AND POTENTIAL CONSEQUENCES FOR THE DIAGNOSIS OF MILD/MODERATE HAEMOPHILIA B. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb01869.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pouplard C, Regina S, May MA, Gruel Y. Heparin-induced thrombocytopenia: a frequent complication after cardiac surgery. Arch Mal Coeur Vaiss 2007; 100:563-8. [PMID: 17893639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Thrombocytopenia is a common problem in cardiovascular patients, and heparin-induced thrombocytopenia (HIT) is therefore frequently suspected. Unfractionated heparin during cardiopulmonary bypass is particularly immunogenic as 25% to 50% post-cardiac surgery patients develop heparin-dependent antibodies but only 1 to 3% will develop HIT. These antibodies recognize a 'self protein', platelet factor 4 (PF4), bound to heparin. Antibodies associated with a high risk of HIT are mainly IgG1 which strongly activate platelets and coagulation, thereby causing thrombocytopenia and thrombosis. A biphasic evolution of platelet count with a secondary decrease after a previous increase following CPB or non-recovery of thrombocytopenia within 6 days post-operatively always requires screening for HIT antibodies. Both functional (platelet activation tests) and immunologic assays (antigen assays) are necessary in every patient to establish the diagnosis of HIT. When the clinical probability of HIT is high, the first requirement is to discontinue heparin, without waiting for results of laboratory investigations. An alternative anticoagulant such as danaparoid sodium (Orgaran) or lepirudin (Refludan) must then be administered since heparin withdrawal alone is insufficient to control the prothrombotic state associated with HIT. The risk of HIT will probably soon decrease due to the wider use of fondaparinux, which does not interact in vitro with PF4, but it could remain significant in patients undergoing cardiac surgery with CPB.
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Affiliation(s)
- C Pouplard
- Departments of Hematology-Hemostasis and Cardiac Surgery, Hôpital Trousseau, and INSERM U618, CHU de Tours, 37044 Tours cedex, France
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Regina S, Rollin J, Bléchet C, Valentin J, Reverdiau P, Gruel Y. PO-81 Association between tumour tissue factor expression and codon 12 K-ras mutation in non-small cell lung cancer. Thromb Res 2007. [DOI: 10.1016/s0049-3848(07)70234-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gaud G, Iochmann S, Saulnier A, Gruel Y, Reverdiau P. 043 Effet de l’inhibition du TFPI-2 par ARN interférence sur le pouvoir invasif de cellules tumorales pulmonaires. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71871-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Most housekeeping genes, tumor-suppressor genes, and approx 40% of tissue-specific genes contain G+C sequences in their promoter region that were very difficult to amplify. In this report, we propose an improved polymerase chain reaction (PCR) method to be used for successful amplification of the tissue factor pathway inhibitor (TFPI)-2 gene promoter region that exhibit >70% G+C content in a sequence of approx 300 bp and a complete CpG island region spanning exon 1, the three transcription initiation sites, and the translation start site. Therefore, this method can be recommended to amplify other GC-rich genomic templates.
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Affiliation(s)
- F Hubé
- Inserm, U618, Tours, F-37032 France; IFR 135, Tours, F-37044 France
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Pouplard C, Couvret C, Regina S, Gruel Y. Development of antibodies specific to polyanion-modified platelet factor 4 during treatment with fondaparinux. J Thromb Haemost 2005; 3:2813-5. [PMID: 16359523 DOI: 10.1111/j.1538-7836.2005.01632.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Blechet C, Rollin J, Iochmann S, Régina S, Lemarié E, Reverdiau P, Guyétant S, Gruel Y. P-008 Tumour expression and activity of MMP-2 and MMP-9metalloproteinases in non-small cell lung cancer according to TFPI-2 gene expression. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80502-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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