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Raoux M, Lablanche S, Jaffredo M, Pirog A, Benhamou PY, Lebreton F, Wojtusciszyn A, Bosco D, Berney T, Renaud S, Lang J, Catargi B. Islets-on-Chip: A Tool for Real-Time Assessment of Islet Function Prior to Transplantation. Transpl Int 2023; 36:11512. [PMID: 37885808 PMCID: PMC10598278 DOI: 10.3389/ti.2023.11512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023]
Abstract
Islet transplantation improves metabolic control in patients with unstable type 1 diabetes. Clinical outcomes have been improving over the last decade, and the widely used beta-score allows the evaluation of transplantation results. However, predictive pre-transplantation criteria of islet quality for clinical outcomes are lacking. In this proof-of-concept study, we examined whether characterization of the electrical activity of donor islets could provide a criterion. Aliquots of 8 human donor islets from the STABILOT study, sampled from islet preparations before transplantation, were characterized for purity and split for glucose-induced insulin secretion and electrical activity using multi-electrode-arrays. The latter tests glucose concentration dependencies, biphasic activity, hormones, and drug effects (adrenalin, GLP-1, glibenclamide) and provides a ranking of CHIP-scores from 1 to 6 (best) based on electrical islet activity. The analysis was performed online in real time using a dedicated board or offline. Grouping of beta-scores and CHIP-scores with high, intermediate, and low values was observed. Further analysis indicated correlation between CHIP-score and beta-score, although significance was not attained (R = 0.51, p = 0.1). This novel approach is easily implantable in islet isolation units and might provide means for the prediction of clinical outcomes. We acknowledge the small cohort size as the limitation of this pilot study.
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Affiliation(s)
- Matthieu Raoux
- University of Bordeaux, CNRS, Institute of Chemistry and Biology of Membranes and Nano-Objects, UMR 5248, Pessac, France
| | - Sandrine Lablanche
- University of Grenoble Alpes, Clinique d’Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Grenoble Alpes, U1055 INSERM, Grenoble, France
| | - Manon Jaffredo
- University of Bordeaux, CNRS, Institute of Chemistry and Biology of Membranes and Nano-Objects, UMR 5248, Pessac, France
| | - Antoine Pirog
- University of Bordeaux, CNRS, Bordeaux INP, Laboratoire de l’Intégration du Matériau au Système, IMS UMR 5218, Talence, France
| | - Pierre-Yves Benhamou
- University of Grenoble Alpes, Clinique d’Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Grenoble Alpes, U1055 INSERM, Grenoble, France
| | - Fanny Lebreton
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Anne Wojtusciszyn
- Centre Hospitalier de Montpellier, Service d’Endocrinologie, Université de Montpellier, Montpellier, France
| | - Domenico Bosco
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Thierry Berney
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Sylvie Renaud
- University of Bordeaux, CNRS, Bordeaux INP, Laboratoire de l’Intégration du Matériau au Système, IMS UMR 5218, Talence, France
| | - Jochen Lang
- University of Bordeaux, CNRS, Institute of Chemistry and Biology of Membranes and Nano-Objects, UMR 5248, Pessac, France
| | - Bogdan Catargi
- Service d’Endocrinologie-Diabétologie, Hôpital St André, CHU de Bordeaux, Bordeaux, France
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Jornayvaz FR, Wojtusciszyn A. Traitement du diabète de type 2 : et si nous revenions à l’essentiel ? Rev Med Suisse 2023; 19:1063-1064. [PMID: 37260200 DOI: 10.53738/revmed.2023.19.829.1063] [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: 06/11/2023]
Affiliation(s)
- François R Jornayvaz
- Service d'endocrinologie, diabétologie, nutrition et éducation thérapeutique du patient, Hôpitaux universitaires de Genève
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, Lausanne
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3
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Deschamps A, Wojtusciszyn A. [Place of the insulin pump for the treatment of type 2 diabetic patients]. Rev Med Suisse 2023; 19:1066-1071. [PMID: 37260201 DOI: 10.53738/revmed.2023.19.829.1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Continuous subcutaneous insulin infusion devices, commonly called insulin pumps, have been used for the treatment of patients with type 1 diabetes for several years. The benefits on glycemic control and on the quality of life of these patients are clear and well documented in the literature. On the other hand, their use in insulin-requiring patients with type 2 diabetes is less widespread. However, studies have shown that this therapeutic option is safe and effective for this population as well. In all cases, individualized assessment and follow-up by a specialized multidisciplinary care team is necessary to support patients with type 2 diabetes for whom an insulin pump is considered. We propose to describe here the current state of this clinical practice.
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Affiliation(s)
- Amélie Deschamps
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
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Tariq M, de Souza AH, Bensellam M, Chae H, Jaffredo M, Close AF, Deglasse JP, Santos LRB, Buemi A, Mourad NI, Wojtusciszyn A, Raoux M, Gilon P, Broca C, Jonas JC. Prolonged culture of human pancreatic islets under glucotoxic conditions changes their acute beta cell calcium and insulin secretion glucose response curves from sigmoid to bell-shaped. Diabetologia 2023; 66:709-723. [PMID: 36459178 DOI: 10.1007/s00125-022-05842-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/18/2022] [Indexed: 12/04/2022]
Abstract
AIMS/HYPOTHESIS The rapid remission of type 2 diabetes by a diet very low in energy correlates with a marked improvement in glucose-stimulated insulin secretion (GSIS), emphasising the role of beta cell dysfunction in the early stages of the disease. In search of novel mechanisms of beta cell dysfunction after long-term exposure to mild to severe glucotoxic conditions, we extensively characterised the alterations in insulin secretion and upstream coupling events in human islets cultured for 1-3 weeks at ~5, 8, 10 or 20 mmol/l glucose and subsequently stimulated by an acute stepwise increase in glucose concentration. METHODS Human islets from 49 non-diabetic donors (ND-islets) and six type 2 diabetic donors (T2D-islets) were obtained from five isolation centres. After shipment, the islets were precultured for 3-7 days in RPMI medium containing ~5 mmol/l glucose and 10% (vol/vol) heat-inactivated FBS with selective islet picking at each medium renewal. Islets were then cultured for 1-3 weeks in RPMI containing ~5, 8, 10 or 20 mmol/l glucose before measurement of insulin secretion during culture, islet insulin and DNA content, beta cell apoptosis and cytosolic and mitochondrial glutathione redox state, and assessment of dynamic insulin secretion and upstream coupling events during acute stepwise stimulation with glucose [NAD(P)H autofluorescence, ATP/(ATP+ADP) ratio, electrical activity, cytosolic Ca2+ concentration ([Ca2+]c)]. RESULTS Culture of ND-islets for 1-3 weeks at 8, 10 or 20 vs 5 mmol/l glucose did not significantly increase beta cell apoptosis or oxidative stress but decreased insulin content in a concentration-dependent manner and increased beta cell sensitivity to subsequent acute stimulation with glucose. Islet glucose responsiveness was higher after culture at 8 or 10 vs 5 mmol/l glucose and markedly reduced after culture at 20 vs 5 mmol/l glucose. In addition, the [Ca2+]c and insulin secretion responses to acute stepwise stimulation with glucose were no longer sigmoid but bell-shaped, with maximal stimulation at 5 or 10 mmol/l glucose and rapid sustained inhibition above that concentration. Such paradoxical inhibition was, however, no longer observed when islets were acutely depolarised by 30 mmol/l extracellular K+. The glucotoxic alterations of beta cell function were fully reversible after culture at 5 mmol/l glucose and were mimicked by pharmacological activation of glucokinase during culture at 5 mmol/l glucose. Similar results to those seen in ND-islets were obtained in T2D-islets, except that their rate of insulin secretion during culture at 8 and 20 mmol/l glucose was lower, their cytosolic glutathione oxidation increased after culture at 8 and 20 mmol/l glucose, and the alterations in GSIS and upstream coupling events were greater after culture at 8 mmol/l glucose. CONCLUSIONS/INTERPRETATION Prolonged culture of human islets under moderate to severe glucotoxic conditions markedly increased their glucose sensitivity and revealed a bell-shaped acute glucose response curve for changes in [Ca2+]c and insulin secretion, with maximal stimulation at 5 or 10 mmol/l glucose and rapid inhibition above that concentration. This novel glucotoxic alteration may contribute to beta cell dysfunction in type 2 diabetes independently from a detectable increase in beta cell apoptosis.
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Affiliation(s)
- Mohammad Tariq
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium
- Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Arnaldo H de Souza
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium
| | - Mohammed Bensellam
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium
| | - Heeyoung Chae
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium
| | - Manon Jaffredo
- CNRS, Institute of Chemistry and Biology of Membranes and Nano-objects, UMR 5248, University of Bordeaux, Pessac, France
| | - Anne-Françoise Close
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium
| | - Jean-Philippe Deglasse
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium
| | - Laila R B Santos
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium
- Bio Base Europe Pilot Plant (BBEPP), Ghent, Belgium
| | - Antoine Buemi
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle de chirurgie expérimentale, Université catholique de Louvain, Brussels, Belgium
| | - Nizar I Mourad
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle de chirurgie expérimentale, Université catholique de Louvain, Brussels, Belgium
| | - Anne Wojtusciszyn
- Laboratoire de Thérapie Cellulaire du Diabète, Institut de Médecine Régénérative et Biothérapies, Hôpital St Eloi, CHU Montpellier, Montpellier, France
- Service d'Endocrinologie, Diabétologie et Métabolisme, Centre Hospitalier Universitaire Vaudois and Université de Lausanne, Lausanne, Switzerland
| | - Matthieu Raoux
- CNRS, Institute of Chemistry and Biology of Membranes and Nano-objects, UMR 5248, University of Bordeaux, Pessac, France
| | - Patrick Gilon
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium
| | - Christophe Broca
- Laboratoire de Thérapie Cellulaire du Diabète, Institut de Médecine Régénérative et Biothérapies, Hôpital St Eloi, CHU Montpellier, Montpellier, France
| | - Jean-Christophe Jonas
- Secteur des sciences de la santé, Institut de recherche expérimentale et clinique, Pôle d'endocrinologie, diabète et nutrition, Université catholique de Louvain, Brussels, Belgium.
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Fontcuberta-PiSunyer M, García-Alamán A, Prades È, Téllez N, Alves-Figueiredo H, Ramos-Rodríguez M, Enrich C, Fernandez-Ruiz R, Cervantes S, Clua L, Ramón-Azcón J, Broca C, Wojtusciszyn A, Montserrat N, Pasquali L, Novials A, Servitja JM, Vidal J, Gomis R, Gasa R. Direct reprogramming of human fibroblasts into insulin-producing cells using transcription factors. Commun Biol 2023; 6:256. [PMID: 36964318 PMCID: PMC10039074 DOI: 10.1038/s42003-023-04627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/24/2023] [Indexed: 03/26/2023] Open
Abstract
Direct lineage reprogramming of one somatic cell into another without transitioning through a progenitor stage has emerged as a strategy to generate clinically relevant cell types. One cell type of interest is the pancreatic insulin-producing β cell whose loss and/or dysfunction leads to diabetes. To date it has been possible to create β-like cells from related endodermal cell types by forcing the expression of developmental transcription factors, but not from more distant cell lineages like fibroblasts. In light of the therapeutic benefits of choosing an accessible cell type as the cell of origin, in this study we set out to analyze the feasibility of transforming human skin fibroblasts into β-like cells. We describe how the timed-introduction of five developmental transcription factors (Neurog3, Pdx1, MafA, Pax4, and Nkx2-2) promotes conversion of fibroblasts toward a β-cell fate. Reprogrammed cells exhibit β-cell features including β-cell gene expression and glucose-responsive intracellular calcium mobilization. Moreover, reprogrammed cells display glucose-induced insulin secretion in vitro and in vivo. This work provides proof-of-concept of the capacity to make insulin-producing cells from human fibroblasts via transcription factor-mediated direct reprogramming.
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Affiliation(s)
| | - Ainhoa García-Alamán
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Èlia Prades
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Noèlia Téllez
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine of University of Vic, Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute of Health Research and Innovation at Central Catalonia (IRIS-CC), Vic, Spain
| | - Hugo Alves-Figueiredo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, N.L., México
| | | | - Carlos Enrich
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Rebeca Fernandez-Ruiz
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Cervantes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Clua
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Technology (BIST), Barcelona, Spain
| | - Javier Ramón-Azcón
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Technology (BIST), Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Christophe Broca
- CHU Montpellier, Laboratory of Cell Therapy for Diabetes (LTCD), Hospital St-Eloi, Montpellier, France
| | - Anne Wojtusciszyn
- CHU Montpellier, Laboratory of Cell Therapy for Diabetes (LTCD), Hospital St-Eloi, Montpellier, France
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Nuria Montserrat
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Technology (BIST), Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - Lorenzo Pasquali
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Anna Novials
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Joan-Marc Servitja
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Vidal
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ramon Gomis
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Rosa Gasa
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain.
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Cleary D, Hannou S, Quiaios L, Monney P, Hullin R, Wojtusciszyn A, Büla C, Nguyen S. [Treatment of congestive heart failure in older persons and SGLT2 inhibitors - Having your patient's best interests at heart]. Rev Med Suisse 2022; 18:2057-2062. [PMID: 36326223 DOI: 10.53738/revmed.2022.18.802.2057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The treatment and management of heart failure (HF) are constantly evolving. The latest guidelines recommend the use of SGLT2 inhibitors (SGLT2i) as an integral part to treating HF with reduced ejection fraction (< 40%). However, given that the patients included in these trials do not reflect the heterogeneity of the health of many elderly patients, we recommend basing the therapeutic decision on the patient's state of frailty. If a SGLT2i treatment at a standard dose (10 mg 1x/day) is recommended for robust patients, we suggest initiating treatment at 5 mg 1x/day for vulnerable patients, and then after 1 month increasing the dose to 10 mg 1x/day. Finally, for dependent patients, we recommend therapeutic abstention in the absence of sufficient scientific evidence.
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Affiliation(s)
- Damaris Cleary
- Service de gériatrie et de réadaptation gériatrique, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Sophia Hannou
- Pharmacienne, Service de pharmacie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Linda Quiaios
- Service de gériatrie et de réadaptation gériatrique, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Roger Hullin
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie et diabétologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Christophe Büla
- Service de gériatrie et de réadaptation gériatrique, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Sylvain Nguyen
- Service de gériatrie et de réadaptation gériatrique, Centre hospitalier universitaire vaudois, 1011 Lausanne
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7
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Hepprich M, Mudry JM, Gregoriano C, Jornayvaz FR, Carballo S, Wojtusciszyn A, Bart PA, Chiche JD, Fischli S, Baumgartner T, Cavelti-Weder C, Braun DL, Günthard HF, Beuschlein F, Conen A, West E, Isenring E, Zechmann S, Bucklar G, Aubry Y, Dey L, Müller B, Hunziker P, Schütz P, Cattaneo M, Donath MY. Canakinumab in patients with COVID-19 and type 2 diabetes - A multicentre, randomised, double-blind, placebo-controlled trial. EClinicalMedicine 2022; 53:101649. [PMID: 36128334 PMCID: PMC9481336 DOI: 10.1016/j.eclinm.2022.101649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Patients with type 2 diabetes and obesity have chronic activation of the innate immune system possibly contributing to the higher risk of hyperinflammatory response to SARS-CoV2 and severe COVID-19 observed in this population. We tested whether interleukin-1β (IL-1β) blockade using canakinumab improves clinical outcome. METHODS CanCovDia was a multicenter, randomised, double-blind, placebo-controlled trial to assess the efficacy of canakinumab plus standard-of-care compared with placebo plus standard-of-care in patients with type 2 diabetes and a BMI > 25 kg/m2 hospitalised with SARS-CoV2 infection in seven tertiary-hospitals in Switzerland. Patients were randomly assigned 1:1 to a single intravenous dose of canakinumab (body weight adapted dose of 450-750 mg) or placebo. Canakinumab and placebo were compared based on an unmatched win-ratio approach based on length of survival, ventilation, ICU stay and hospitalization at day 29. This study is registered with ClinicalTrials.gov, NCT04510493. FINDINGS Between October 17, 2020, and May 12, 2021, 116 patients were randomly assigned with 58 in each group. One participant dropped out in each group for the primary analysis. At the time of randomization, 85 patients (74·6 %) were treated with dexamethasone. The win-ratio of canakinumab vs placebo was 1·08 (95 % CI 0·69-1·69; p = 0·72). During four weeks, in the canakinumab vs placebo group 4 (7·0%) vs 7 (12·3%) participants died, 11 (20·0 %) vs 16 (28·1%) patients were on ICU, 12 (23·5 %) vs 11 (21·6%) were hospitalised for more than 3 weeks, respectively. Median ventilation time at four weeks in the canakinumab vs placebo group was 10 [IQR 6.0, 16.5] and 16 days [IQR 14.0, 23.0], respectively. There was no statistically significant difference in HbA1c after four weeks despite a lower number of anti-diabetes drug administered in patients treated with canakinumab. Finally, high-sensitive CRP and IL-6 was lowered by canakinumab. Serious adverse events were reported in 13 patients (11·4%) in each group. INTERPRETATION In patients with type 2 diabetes who were hospitalised with COVID-19, treatment with canakinumab in addition to standard-of-care did not result in a statistically significant improvement of the primary composite outcome. Patients treated with canakinumab required significantly less anti-diabetes drugs to achieve similar glycaemic control. Canakinumab was associated with a prolonged reduction of systemic inflammation. FUNDING Swiss National Science Foundation grant #198415 and University of Basel. Novartis supplied study medication.
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Affiliation(s)
- Matthias Hepprich
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Jonathan M. Mudry
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Claudia Gregoriano
- Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Francois R. Jornayvaz
- Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, Geneva University Hospital, Genève, Switzerland
| | - Sebastian Carballo
- Sevice of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Anne Wojtusciszyn
- Service d'Endocrinologie Diabète et Métabolisme, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Pierre-Alexandre Bart
- Service of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean-Daniel Chiche
- Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Stefan Fischli
- Department of Endocrinology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Thomas Baumgartner
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
| | - Claudia Cavelti-Weder
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
| | - Dominique L. Braun
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Huldrych F. Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Felix Beuschlein
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
| | - Anna Conen
- Division of Infectious Diseases and Infection Prevention, Kantonsspital Aarau, Aarau, Switzerland
| | - Emily West
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Egon Isenring
- Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Stefan Zechmann
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Gabriela Bucklar
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Yoann Aubry
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Ludovic Dey
- Hôpital du Jura, Site de Delémont, Delémont, Switzerland
| | - Beat Müller
- Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Patrick Hunziker
- Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philipp Schütz
- Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Marco Cattaneo
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Marc Y. Donath
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
- Corresponding author.
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8
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Riveline J, Wojtusciszyn A, Guerci B, Alves C, Kao K, Xu Y, Dunn TC. Real world hypoglycaemia related to glucose variability and Flash glucose scan frequency assessed from global FreeStyle Libre data. Diabetes Obes Metab 2022; 24:2102-2107. [PMID: 35695037 PMCID: PMC9796411 DOI: 10.1111/dom.14795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/19/2022] [Accepted: 06/01/2022] [Indexed: 01/01/2023]
Abstract
AIM Flash glucose monitoring provides a range of glucose metrics. In the current study, we aim to identify those that indicate that glycaemic targets can be consistently met and contrast the total (t-CV) and within-day coefficient of variation (wd-CV) to guide the assessment of glucose variability and hypoglycaemia exposure. METHODS De-identified data from Flash readers were collected. The readers were sorted into 10 equally sized groups of scan frequency followed by quartiles of estimated A1c (eA1c). A similar grouping was performed for the total coefficient of variation (t-CV) and within-day coefficient of variation (wd-CV). In addition, analysis of the association of time below 54 mg/dl and glucose variability measured by t-CV and wd-CV was performed. RESULTS The dataset included 1 002 946 readers. Readers sorted by 10 equal groups of scan rate and quartiles by eA1c, t-CV and wd-CV represented 25 074 readers per group. The association of lower eA1c with higher time in range and reduced time above range was clear. The correlation of eA1c quartiles and time below range was not consistent. An association between glucose variability and hypoglycaemia was found. Both wd-CV and t-CV were associated with time below range. For achieving the consensus target of <1% time below 54 mg/dl, the associated wd-CV and t-CV values were 33.5% and 39.5%, respectively. CONCLUSIONS The type of CV reported by the different continuous glucose monitoring systems should be acknowledged. CV <36% might not be adequate to ensure low hypoglycaemia exposure. To our knowledge, the majority of continuous glucose monitoring reports the t-CV. Appropriate thresholds should be used to identify patients that would probably meet time below range targets (t-CV <40% or wd-CV <34%).
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Affiliation(s)
- Jean‐Pierre Riveline
- Department of Diabetology and EndocrinologyHôpital Lariboisière, APHPParisFrance
- Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab TeamCentre de Recherches des CordeliersParisFrance
| | - Anne Wojtusciszyn
- Department of Endocrinology, Diabetes and Metabolism, CHUVUniversity of LausanneLausanneSwitzerland
| | - Bruno Guerci
- Department of Endocrinology Diabetology and NutritionBrabois Hospital, CHRU of Nancy & University of LorraineVandoeuvre‐Lès‐NancyFrance
| | - Clara Alves
- Medical AffairsAbbott Diabetes CareDelkenheimGermany
| | - Kalvin Kao
- Clinical AffairsAbbott Diabetes CareAlamedaCaliforniaUSA
| | - Yongjin Xu
- Clinical AffairsAbbott Diabetes CareAlamedaCaliforniaUSA
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9
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Lutula J, Lamine F, Andrey M, Galfetti L, Wojtusciszyn A. [Continuous glucose monitoring Respective roles of healthcare professionals and quick interpretation guide]. Rev Med Suisse 2022; 18:1116-1122. [PMID: 35647750 DOI: 10.53738/revmed.2022.18.784.1116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of continuous interstitial glucose measurement systems (CGM) has revolutionized the management of patients with diabetes for 15 years. This is true both for professional use (diagnostic CGM) and personal use for patients (therapeutic CGM). The role of health professionals - general practitioners, diabetologists, nurses, dieticians - is important to coordinate, with a specific role for each. The clinical situations are all different and the systematic analysis of the data has ideally to be carried out with the participation of the patient. These devices allow significant improvements in glycemic control, making this technology one of the most important advances in diabetes for many years.
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Affiliation(s)
- Joachim Lutula
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Faiza Lamine
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Unité d'endocrinologie-diabétologie, Service de Médecine Interne, Hôpital Riviera Chablais, 1847 Rennaz
| | - Magali Andrey
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Lyse Galfetti
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
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10
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Vuignier Y, Wojtusciszyn A, Kosinski C. [Rapid and ultrarapid insulins: when and how?]. Rev Med Suisse 2022; 18:1110-1114. [PMID: 35647749 DOI: 10.53738/revmed.2022.18.784.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Treatment combining long-acting and short-acting insulins is essential for people with type 1 diabetes, but may become also compulsory in other forms of diabetes in case of insulinopenia. The purpose of short-acting insulins is to mimic physiological insulin secretion in response to carbohydrate intake at meals. There is a delay between the injection and its action, sometimes limiting their use and effectiveness. Ultra-rapid insulins have been developed to more closely approximate the expected insulin response to a meal, through faster absorption. They do not improve diabetes control but allow more flexibility with mealtime injections. These new analogues are also an attractive alternative for use in insulin pumps.
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Affiliation(s)
- Yann Vuignier
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Christophe Kosinski
- Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire vaudois, 1011 Lausanne
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11
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Brown MR, Laouteouet D, Delobel M, Villard O, Broca C, Bertrand G, Wojtusciszyn A, Dalle S, Ravier MA, Matveyenko AV, Costes S. The nuclear receptor REV-ERBα is implicated in the alteration of β-cell autophagy and survival under diabetogenic conditions. Cell Death Dis 2022; 13:353. [PMID: 35428762 PMCID: PMC9012816 DOI: 10.1038/s41419-022-04767-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 03/16/2022] [Accepted: 03/25/2022] [Indexed: 01/07/2023]
Abstract
Pancreatic β-cell failure in type 2 diabetes mellitus (T2DM) is associated with impaired regulation of autophagy which controls β-cell development, function, and survival through clearance of misfolded proteins and damaged organelles. However, the mechanisms responsible for defective autophagy in T2DM β-cells remain unknown. Since recent studies identified circadian clock transcriptional repressor REV-ERBα as a novel regulator of autophagy in cancer, in this study we set out to test whether REV-ERBα-mediated inhibition of autophagy contributes to the β-cell failure in T2DM. Our study provides evidence that common diabetogenic stressors (e.g., glucotoxicity and cytokine-mediated inflammation) augment β-cell REV-ERBα expression and impair β-cell autophagy and survival. Notably, pharmacological activation of REV-ERBα was shown to phenocopy effects of diabetogenic stressors on the β-cell through inhibition of autophagic flux, survival, and insulin secretion. In contrast, negative modulation of REV-ERBα was shown to provide partial protection from inflammation and glucotoxicity-induced β-cell failure. Finally, using bioinformatic approaches, we provide further supporting evidence for augmented REV-ERBα activity in T2DM human islets associated with impaired transcriptional regulation of autophagy and protein degradation pathways. In conclusion, our study reveals a previously unexplored causative relationship between REV-ERBα expression, inhibition of autophagy, and β-cell failure in T2DM.
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Affiliation(s)
- Matthew R. Brown
- grid.66875.3a0000 0004 0459 167XDepartment of Physiology and Biomedical Engineering, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN USA
| | - Damien Laouteouet
- grid.121334.60000 0001 2097 0141Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Morgane Delobel
- grid.121334.60000 0001 2097 0141Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Orianne Villard
- grid.157868.50000 0000 9961 060XLaboratory of Cell Therapy for Diabetes (LTCD), PRIMS facility, Institute for Regenerative Medicine and Biotherapy (IRMB), University hospital of Montpellier, Montpellier, France ,grid.157868.50000 0000 9961 060XDepartment of Endocrinology, Diabetes, and Nutrition, University Hospital of Montpellier, Montpellier, France
| | - Christophe Broca
- grid.157868.50000 0000 9961 060XLaboratory of Cell Therapy for Diabetes (LTCD), PRIMS facility, Institute for Regenerative Medicine and Biotherapy (IRMB), University hospital of Montpellier, Montpellier, France
| | - Gyslaine Bertrand
- grid.121334.60000 0001 2097 0141Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Anne Wojtusciszyn
- grid.121334.60000 0001 2097 0141Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France ,grid.157868.50000 0000 9961 060XLaboratory of Cell Therapy for Diabetes (LTCD), PRIMS facility, Institute for Regenerative Medicine and Biotherapy (IRMB), University hospital of Montpellier, Montpellier, France ,grid.157868.50000 0000 9961 060XDepartment of Endocrinology, Diabetes, and Nutrition, University Hospital of Montpellier, Montpellier, France
| | - Stéphane Dalle
- grid.121334.60000 0001 2097 0141Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Magalie A. Ravier
- grid.121334.60000 0001 2097 0141Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Aleksey V. Matveyenko
- grid.66875.3a0000 0004 0459 167XDepartment of Physiology and Biomedical Engineering, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN USA ,grid.66875.3a0000 0004 0459 167XDivision of Endocrinology, Metabolism, Diabetes, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN USA
| | - Safia Costes
- grid.121334.60000 0001 2097 0141Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
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12
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Lablanche S, Borot S, Wojtusciszyn A, Skaare K, Penfornis A, Malvezzi P, Badet L, Thivolet C, Morelon E, Buron F, Renard E, Tauveron I, Villard O, Munch M, Sommacal S, Clouaire L, Jacquet M, Gonsaud L, Camillo-Brault C, Colin C, Bosson JL, Bosco D, Berney T, Kessler L, Benhamou PY. Ten-year outcomes of islet transplantation in patients with type 1 diabetes: Data from the Swiss-French GRAGIL network. Am J Transplant 2021; 21:3725-3733. [PMID: 33961335 DOI: 10.1111/ajt.16637] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 01/25/2023]
Abstract
To describe the 10-year outcomes of islet transplantation within the Swiss-French GRAGIL Network, in patients with type 1 diabetes experiencing high glucose variability associated with severe hypoglycemia and/or with functional kidney graft. We conducted a retrospective analysis of all subjects transplanted in the GRAGIL-1c and GARGIL-2 islet transplantation trials and analyzed components of metabolic control, graft function and safety outcomes over the 10-year period of follow-up. Forty-four patients were included between September 2003 and April 2010. Thirty-one patients completed a 10-year follow-up. Ten years after islet transplantation, median HbA1c was 7.2% (6.2-8.0) (55 mmol/mol [44-64]) versus 8.0% (7.1-9.1) (64 mmol/mol [54-76]) before transplantation (p < .001). Seventeen of 23 (73.9%) recipients were free of severe hypoglycemia, 1/21 patients (4.8%) was insulin-independent and median C-peptide was 0.6 ng/ml (0.2-1.2). Insulin requirements (UI/kg/day) were 0.3 (0.1-0.5) versus 0.5 (0.4-0.6) before transplantation (p < .001). Median (IQR) β-score was 1 (0-4) (p < .05 when comparing with pre-transplantation values) and 51.9% recipients had a functional islet graft at 10 years. With a 10-year follow-up in a multicentric network, islet transplantation provided sustained improvement of glycemic control and was efficient to prevent severe hypoglycemia in almost 75% of the recipients.
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Affiliation(s)
- Sandrine Lablanche
- Université Grenoble Alpes, LBFA, Grenoble, France.,Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes, Grenoble, France.,INSERM, Grenoble, France
| | - Sophie Borot
- Centre Hospitalier Universitaire Jean Minjoz, Service d'Endocrinologie-Métabolisme et Diabétologie-Nutrition, Besançon, France
| | - Anne Wojtusciszyn
- Centre Hospitalier de Montpellier, Pôle Rein Hypertension Métabolisme, Service d'Endocrinologie, Montpellier, France et Département de Médecine, Service d'endocrinologie diabète et métabolisme, Lausanne, Suisse
| | - Kristina Skaare
- Department of Public Health, University Grenoble Alpes, CNRS, Grenoble University Hospital and TIMC-IMAG, Grenoble, France
| | - Alfred Penfornis
- Service d'endocrinologie, diabétologie et maladies métaboliques, Centre Hospitalier Sud-Francilien, Corbeil-Essonnes, France
| | - Paolo Malvezzi
- Service de Néphrologie, Dialyse, Aphérèses et Transplantation, CHU Grenoble Alpes, Grenoble, France
| | - Lionel Badet
- Hospices Civils de Lyon, Service d'Urologie et de Chirurgie de la Transplantation, Pôle Chirurgie, Lyon, France
| | - Charles Thivolet
- Hospices Civils de Lyon, Service d'Endocrinologie Diabète Nutrition, Lyon, France
| | - Emmanuel Morelon
- Hospices Civils de Lyon, Service de transplantation, néphrologie et immunologie clinique, Lyon, France
| | - Fanny Buron
- Hospices Civils de Lyon, Service de transplantation, néphrologie et immunologie clinique, Lyon, France
| | - Eric Renard
- Centre Hospitalier de Montpellier, Pôle Rein Hypertension Métabolisme, Service d'Endocrinologie, Montpellier, France et Département de Médecine, Service d'endocrinologie diabète et métabolisme, Lausanne, Suisse
| | - Igor Tauveron
- CHU de Clermont-Ferrand, Service Endocrinologie-Diabète-Maladies Métaboliques, Clermont Ferrand and UMR GreD CNR56293 INSERM 1103, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Oriane Villard
- Centre Hospitalier de Montpellier, Pôle Rein Hypertension Métabolisme, Service d'Endocrinologie, Montpellier, France et Département de Médecine, Service d'endocrinologie diabète et métabolisme, Lausanne, Suisse
| | - Marion Munch
- Service d'endocrinologie diabète et nutrition, Pôle MIRNED, Hôpitaux Universitaires de Strasbourg et Inserm UMR 1260, Nano médecine Régénérative, Université de Strasbourg, Strasbourg, France
| | - Salomé Sommacal
- Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes, Grenoble, France
| | - Léa Clouaire
- Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes, Grenoble, France
| | - Morgane Jacquet
- Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes, Grenoble, France
| | - Laura Gonsaud
- Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes, Grenoble, France
| | - Coralie Camillo-Brault
- Hospices Civils de Lyon, Pôle Santé Publique, Service Évaluation Économique en Santé, Lyon, France
| | - Cyrille Colin
- Hospices Civils de Lyon, Pôle Santé Publique, Service Évaluation Économique en Santé, Lyon, France
| | - Jean-Luc Bosson
- Department of Public Health, University Grenoble Alpes, CNRS, Grenoble University Hospital and TIMC-IMAG, Grenoble, France
| | - Domenico Bosco
- Departement of Surgery, Islet Isolation, and Transplantation Center, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Thierry Berney
- Departement of Surgery, Islet Isolation, and Transplantation Center, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Laurence Kessler
- Service d'endocrinologie diabète et nutrition, Pôle MIRNED, Hôpitaux Universitaires de Strasbourg et Inserm UMR 1260, Nano médecine Régénérative, Université de Strasbourg, Strasbourg, France
| | - Pierre-Yves Benhamou
- Université Grenoble Alpes, LBFA, Grenoble, France.,Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes, Grenoble, France.,INSERM, Grenoble, France
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13
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Arditi C, Coendoz S, Labud H, Wojtusciszyn A, Peytremann-Bridevaux I. [Not Available]. Rev Med Suisse 2021; 17:1804. [PMID: 34669296] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Chantal Arditi
- Département Épidémiologie et systèmes de santé, Unisanté, 1011 Lausanne
| | | | - Heike Labud
- Ensemble Hospitalier de la Côte, 1110 Morges
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
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14
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Arditi C, Coendoz S, Labud H, Wojtusciszyn A, Peytremann-Bridevaux I. [Not Available]. Rev Med Suisse 2021; 17:1717. [PMID: 34614314] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Chantal Arditi
- Département Épidémiologie et systèmes de santé, Unisanté, 1011 Lausanne
| | | | - Heike Labud
- Ensemble Hospitalier de la Côte, 1110 Morges
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
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15
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Arditi C, Coendoz S, Kehl C, Labud H, Wojtusciszyn A, Peytremann-Bridevaux I. [Not Available]. Rev Med Suisse 2021; 17:1481. [PMID: 34468100] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Chantal Arditi
- Département Épidémiologie et systèmes de santé, Unisanté, 1011 Lausanne
| | | | - Corinne Kehl
- Filière nutrition et diététique, Haute École de santé de Genève, 1227 Carouge
| | - Heike Labud
- Ensemble Hospitalier de la Côte, 1110 Morges
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
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16
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Sanchez PKM, Khazaei M, Gatineau E, Geravandi S, Lupse B, Liu H, Dringen R, Wojtusciszyn A, Gilon P, Maedler K, Ardestani A. LDHA is enriched in human islet alpha cells and upregulated in type 2 diabetes. Biochem Biophys Res Commun 2021; 568:158-166. [PMID: 34217973 DOI: 10.1016/j.bbrc.2021.06.065] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/25/2022]
Abstract
The lactate dehydrogenase isoform A (LDHA) is a key metabolic enzyme that preferentially catalyzes the conversion of pyruvate to lactate. Whereas LDHA is highly expressed in many tissues, its expression is turned off in the differentiated adult β-cell within the pancreatic islets. The repression of LDHA under normal physiological condition and its inappropriate upregulation under a diabetogenic environment is well-documented in rodent islets/β-cells but little is known about LDHA expression in human islet cells and whether its abundance is altered under diabetic conditions. Analysis of public single-cell RNA-seq (sc-RNA seq) data as well as cell type-specific immunolabeling of human pancreatic islets showed that LDHA was mainly localized in human α-cells while it is expressed at a very low level in β-cells. Furthermore, LDHA, both at mRNA and protein, as well as lactate production is upregulated in human pancreatic islets exposed to chronic high glucose treatment. Microscopic analysis of stressed human islets and autopsy pancreases from individuals with type 2 diabetes (T2D) showed LDHA upregulation mainly in human α-cells. Pharmacological inhibition of LDHA in isolated human islets enhanced insulin secretion under physiological conditions but did not significantly correct the deregulated secretion of insulin or glucagon under diabetic conditions.
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Affiliation(s)
| | - Mona Khazaei
- Centre for Biomolecular Interactions Bremen, University of Bremen, Bremen, Germany
| | - Eva Gatineau
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Shirin Geravandi
- Centre for Biomolecular Interactions Bremen, University of Bremen, Bremen, Germany
| | - Blaz Lupse
- Centre for Biomolecular Interactions Bremen, University of Bremen, Bremen, Germany
| | - Huan Liu
- Centre for Biomolecular Interactions Bremen, University of Bremen, Bremen, Germany
| | - Ralf Dringen
- Centre for Biomolecular Interactions Bremen, University of Bremen, Bremen, Germany
| | - Anne Wojtusciszyn
- Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Patrick Gilon
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Kathrin Maedler
- Centre for Biomolecular Interactions Bremen, University of Bremen, Bremen, Germany.
| | - Amin Ardestani
- Centre for Biomolecular Interactions Bremen, University of Bremen, Bremen, Germany; Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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17
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Vuignier Y, Roukain A, Kosinski C, Wojtusciszyn A. [Basal insulin therapy in patients with type 2 diabetes]. Rev Med Suisse 2021; 17:1078-1082. [PMID: 34077039] [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: 06/12/2023]
Abstract
Insulin therapy, often initiated after hygiene and dietary measures and non-insulin antidiabetics, is part of the treatment of patients with type 2 diabetes. Fear of injections or hypoglycemia often delays its implementation. However, its introduction is recommended in cases of poorly balanced diabetes despite a well-controlled therapeutic escalation but also in cases of acute imbalance. Introduction of insulin therapy requires patient education and close monitoring by the healthcare team. Type of insulin and its titration reduce the incidence of hypoglycemia in patients at risk. The determination of the fasting glycemic target - relative to HbA1c - for the titration of insulin is important to define for an optimal benefit (prevention of secondary complications)/risk (hypoglycemia, weight gain) balance.
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Affiliation(s)
- Yann Vuignier
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | - Abdallah Roukain
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | | | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
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18
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Zordan A, Kosinski C, Zaman K, Wojtusciszyn A. [New-onset diabetes and novel targeted therapies against cancer]. Rev Med Suisse 2021; 17:1067-1071. [PMID: 34077037] [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: 06/12/2023]
Abstract
New systemic cancer therapies are increasingly oriented towards specific signaling pathways involved in carcinogenesis. However, these new treatments may lead to disorders of glycemic homeostasis ranging from glucose intolerance, diabetes or the occurrence of severe acute hyperglycemic syndrome due to blockade of certain pathways common to glucose metabolism. This article discusses the estimated frequency of new-onset diabetes, the pathophysiological mechanisms as well as the diagnostic, therapeutic, monitoring and prognostic management of glycemic dysfunction in patients treated with these novel systemic cancer therapies.
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Affiliation(s)
- Alessandro Zordan
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | | | - Khalil Zaman
- Centre du sein, Service d'oncologie, CHUV, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
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19
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Jornayvaz FR, Wojtusciszyn A. [Not Available]. Rev Med Suisse 2021; 17:1059-1060. [PMID: 34077035] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- François R Jornayvaz
- Service d'endocrinologie, diabétologie, nutrition et éducation thérapeutique du patient, HUG, Genève
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, Lausanne
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20
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Lu H, Lu H, Kosinski C, Wojtusciszyn A, Zanchi A, Carron PN, Müller M, Meyer P, Martin J, Muller O, Hullin R. SGLT2 Inhibitors, What the Emergency Physician Needs to Know: A Narrative Review. J Clin Med 2021; 10:jcm10092036. [PMID: 34068655 PMCID: PMC8126052 DOI: 10.3390/jcm10092036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 01/10/2023] Open
Abstract
Canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin belong to a class of antidiabetic treatments referred to as sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors, or SGLT2is). SGLT2is are currently indicated in North America and in Europe in type 2 diabetes mellitus, especially in patients with cardiovascular (CV) disease, high CV risk, heart failure, or renal disease. In Europe, dapagliflozin is also approved as an adjunct to insulin in patients with type 1 diabetes mellitus. New data provide evidence for benefits in heart failure with reduced ejection fraction and chronic kidney disease, including in patients without diabetes. The use of SGLT2is is expected to increase, suggesting that a growing number of patients will present to the emergency departments with these drugs. Most common adverse events are easily treatable, including mild genitourinary infections and conditions related to volume depletion. However, attention must be paid to some potentially serious adverse events, such as hypoglycemia (when combined with insulin or insulin secretagogues), lower limb ischemia, and diabetic ketoacidosis. We provide an up-to-date practical guide highlighting important elements on the adverse effects of SGLT2is and their handling in some frequently encountered clinical situations such as acute heart failure and decompensated diabetes.
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Affiliation(s)
- Henri Lu
- Service of Cardiology, Cardiovascular Department, Lausanne University Hospital, 1011 Lausanne, Switzerland; (O.M.); (R.H.)
- Correspondence: ; Tel.: +41-79-556-03-89
| | - Hortense Lu
- Emergency Department, Saint-Joseph Hospital, 75014 Paris, France;
| | - Christophe Kosinski
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, 1011 Lausanne, Switzerland; (C.K.); (A.W.); (A.Z.)
| | - Anne Wojtusciszyn
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, 1011 Lausanne, Switzerland; (C.K.); (A.W.); (A.Z.)
| | - Anne Zanchi
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, 1011 Lausanne, Switzerland; (C.K.); (A.W.); (A.Z.)
| | | | - Martin Müller
- Emergency Department, Bern University Hospital, 3010 Bern, Switzerland;
| | - Philippe Meyer
- Cardiology Service, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Jehan Martin
- Emergency Department, Geneva University Hospital, 1205 Geneva, Switzerland;
| | - Olivier Muller
- Service of Cardiology, Cardiovascular Department, Lausanne University Hospital, 1011 Lausanne, Switzerland; (O.M.); (R.H.)
| | - Roger Hullin
- Service of Cardiology, Cardiovascular Department, Lausanne University Hospital, 1011 Lausanne, Switzerland; (O.M.); (R.H.)
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21
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Wassmer CH, Perrier Q, Combescure C, Pernin N, Parnaud G, Cottet-Dumoulin D, Brioudes E, Bellofatto K, Lebreton F, Berishvili E, Lablanche S, Kessler L, Wojtusciszyn A, Buron F, Borot S, Bosco D, Berney T, Lavallard V. Impact of ischemia time on islet isolation success and posttransplantation outcomes: A retrospective study of 452 pancreas isolations. Am J Transplant 2021; 21:1493-1502. [PMID: 32986297 DOI: 10.1111/ajt.16320] [Citation(s) in RCA: 5] [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] [Received: 04/10/2020] [Revised: 08/03/2020] [Accepted: 09/04/2020] [Indexed: 01/25/2023]
Abstract
Many variables impact islet isolation, including pancreas ischemia time. The ischemia time upper limit that should be respected to avoid a negative impact on the isolation outcome is not well defined. We have performed a retrospective analysis of all islet isolations in our center between 2008 and 2018. Total ischemia time, cold ischemia time, and organ removal time were analyzed. Isolation success was defined as an islet yield ≥200 000 IEQ. Of the 452 pancreases included, 288 (64%) were successfully isolated. Probability of isolation success showed a significant decrease after 8 hours of total ischemia time, 7 hours of cold ischemia time, and 80 minutes of organ removal time. Although we observed an impact of ischemia time on islet yield, a probability of isolation success of 50% was still present even when total ischemia time exceeds 12 hours. Posttransplantation clinical outcomes were assessed in 32 recipients and no significant difference was found regardless of ischemia time. These data indicate that although shorter ischemia times are associated with better islet isolation outcomes, total ischemia time >12 hours can provide excellent results in appropriately selected donors.
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Affiliation(s)
- Charles-Henri Wassmer
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - Quentin Perrier
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Christophe Combescure
- Division of Clinical Epidemiology, Faculty of Medicine, University of Geneva, and Geneva University Hospitals, Geneva, Switzerland
| | - Nadine Pernin
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - Géraldine Parnaud
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - David Cottet-Dumoulin
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - Estelle Brioudes
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - Kevin Bellofatto
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - Fanny Lebreton
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - Ekaterine Berishvili
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland.,Institute of Medical Research, Ilia State University, Tbilisi, Georgia
| | - Sandrine Lablanche
- Endocrinology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Laurence Kessler
- Department of Diabetology, University Hospital, Strasbourg, France.,Federation of Translational Medicine of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Anne Wojtusciszyn
- Department of Endocrinology, Diabetes, and Nutrition, Montpellier University Hospital, Montpellier, France.,Laboratory of Cell Therapy of Diabetes, Institute of Functional Genomics, Mixed Research Unit, French National Center for Scientific Research 5203, Inserm U1191, University of Montpellier, Montpellier, France
| | - Fanny Buron
- Department of Transplantation, Nephrology and Clinical Immunology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sophie Borot
- Endocrinology Department, Besancon University Hospital, Besancon, France
| | - Domenico Bosco
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - Thierry Berney
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
| | - Vanessa Lavallard
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Faculty Diabetes Center, University of Geneva Medical Center, Geneva, Switzerland
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22
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Subramanian M, Wojtusciszyn A, Favre L, Boughorbel S, Shan J, Letaief KB, Pitteloud N, Chouchane L. Precision medicine in the era of artificial intelligence: implications in chronic disease management. J Transl Med 2020; 18:472. [PMID: 33298113 PMCID: PMC7725219 DOI: 10.1186/s12967-020-02658-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [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: 11/05/2020] [Accepted: 12/02/2020] [Indexed: 02/07/2023] Open
Abstract
Aberrant metabolism is the root cause of several serious health issues, creating a huge burden to health and leading to diminished life expectancy. A dysregulated metabolism induces the secretion of several molecules which in turn trigger the inflammatory pathway. Inflammation is the natural reaction of the immune system to a variety of stimuli, such as pathogens, damaged cells, and harmful substances. Metabolically triggered inflammation, also called metaflammation or low-grade chronic inflammation, is the consequence of a synergic interaction between the host and the exposome-a combination of environmental drivers, including diet, lifestyle, pollutants and other factors throughout the life span of an individual. Various levels of chronic inflammation are associated with several lifestyle-related diseases such as diabetes, obesity, metabolic associated fatty liver disease (MAFLD), cancers, cardiovascular disorders (CVDs), autoimmune diseases, and chronic lung diseases. Chronic diseases are a growing concern worldwide, placing a heavy burden on individuals, families, governments, and health-care systems. New strategies are needed to empower communities worldwide to prevent and treat these diseases. Precision medicine provides a model for the next generation of lifestyle modification. This will capitalize on the dynamic interaction between an individual's biology, lifestyle, behavior, and environment. The aim of precision medicine is to design and improve diagnosis, therapeutics and prognostication through the use of large complex datasets that incorporate individual gene, function, and environmental variations. The implementation of high-performance computing (HPC) and artificial intelligence (AI) can predict risks with greater accuracy based on available multidimensional clinical and biological datasets. AI-powered precision medicine provides clinicians with an opportunity to specifically tailor early interventions to each individual. In this article, we discuss the strengths and limitations of existing and evolving recent, data-driven technologies, such as AI, in preventing, treating and reversing lifestyle-related diseases.
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Affiliation(s)
- Murugan Subramanian
- Department of Microbiology and Immunology, Weill Cornell Medicine, New York, USA.,Genetic Intelligence Laboratory, Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar
| | - Anne Wojtusciszyn
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Lucie Favre
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Sabri Boughorbel
- Clinical Bioinformatics Section, Research Division, Sidra Medicine, Doha, Qatar
| | - Jingxuan Shan
- Genetic Intelligence Laboratory, Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar.,Department of Genetic Medicine, Weill Cornell Medicine, 45 E 69th Street, Suite 432, New York, NY, 10021, USA
| | - Khaled B Letaief
- Department of Electronic and Computer Engineering, Hong Kong University of Science and Technology, Kowloon, Hong Kong
| | - Nelly Pitteloud
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.
| | - Lotfi Chouchane
- Department of Microbiology and Immunology, Weill Cornell Medicine, New York, USA. .,Genetic Intelligence Laboratory, Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar. .,Department of Genetic Medicine, Weill Cornell Medicine, 45 E 69th Street, Suite 432, New York, NY, 10021, USA.
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23
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Chae H, Augustin R, Gatineau E, Mayoux E, Bensellam M, Antoine N, Khattab F, Lai BK, Brusa D, Stierstorfer B, Klein H, Singh B, Ruiz L, Pieper M, Mark M, Herrera PL, Gribble FM, Reimann F, Wojtusciszyn A, Broca C, Rita N, Piemonti L, Gilon P. SGLT2 is not expressed in pancreatic α- and β-cells, and its inhibition does not directly affect glucagon and insulin secretion in rodents and humans. Mol Metab 2020; 42:101071. [PMID: 32896668 PMCID: PMC7554656 DOI: 10.1016/j.molmet.2020.101071] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 12/22/2022] Open
Abstract
Objective Sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2i), or gliflozins, are anti-diabetic drugs that lower glycemia by promoting glucosuria, but they also stimulate endogenous glucose and ketone body production. The likely causes of these metabolic responses are increased blood glucagon levels, and decreased blood insulin levels, but the mechanisms involved are hotly debated. This study verified whether or not SGLT2i affect glucagon and insulin secretion by a direct action on islet cells in three species, using multiple approaches. Methods We tested the in vivo effects of two selective SGLT2i (dapagliflozin, empagliflozin) and a SGLT1/2i (sotagliflozin) on various biological parameters (glucosuria, glycemia, glucagonemia, insulinemia) in mice. mRNA expression of SGLT2 and other glucose transporters was assessed in rat, mouse, and human FACS-purified α- and β-cells, and by analysis of two human islet cell transcriptomic datasets. Immunodetection of SGLT2 in pancreatic tissues was performed with a validated antibody. The effects of dapagliflozin, empagliflozin, and sotagliflozin on glucagon and insulin secretion were assessed using isolated rat, mouse and human islets and the in situ perfused mouse pancreas. Finally, we tested the long-term effect of SGLT2i on glucagon gene expression. Results SGLT2 inhibition in mice increased the plasma glucagon/insulin ratio in the fasted state, an effect correlated with a decline in glycemia. Gene expression analyses and immunodetections showed no SGLT2 mRNA or protein expression in rodent and human islet cells, but moderate SGLT1 mRNA expression in human α-cells. However, functional experiments on rat, mouse, and human (29 donors) islets and the in situ perfused mouse pancreas did not identify any direct effect of dapagliflozin, empagliflozin or sotagliflozin on glucagon and insulin secretion. SGLT2i did not affect glucagon gene expression in rat and human islets. Conclusions The data indicate that the SGLT2i-induced increase of the plasma glucagon/insulin ratio in vivo does not result from a direct action of the gliflozins on islet cells. Gliflozins (SGLT2 and SGLT1/2 inhibitors) increase plasma glucagon/insulin ratio. SGLT2 is not expressed in rodent and human pancreatic α- and β-cells. SGLT1 is however expressed in human α-cells. SGLT2 and SGLT1/2 inhibitors do not directly affect glucagon and insulin secretion.
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Affiliation(s)
- Heeyoung Chae
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Robert Augustin
- Department of Cardiometabolic Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Eva Gatineau
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Eric Mayoux
- Department of Cardiometabolic Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Mohammed Bensellam
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Nancy Antoine
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Firas Khattab
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Bao-Khanh Lai
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Davide Brusa
- Flow Cytometry Platform, Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Birgit Stierstorfer
- Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Holger Klein
- Global Computational Biology and Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Bilal Singh
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Lucie Ruiz
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium
| | - Michael Pieper
- Department of Cardiometabolic Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Michael Mark
- Department of Cardiometabolic Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Pedro L Herrera
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Fiona M Gribble
- Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Frank Reimann
- Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Anne Wojtusciszyn
- Laboratory of Cellular Therapy for Diabetes, University Hospital of Montpellier, Montpellier, France; Department of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Christophe Broca
- Laboratory of Cellular Therapy for Diabetes, University Hospital of Montpellier, Montpellier, France
| | - Nano Rita
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Lorenzo Piemonti
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Patrick Gilon
- Pole of Endocrinology, Diabetes, and Nutrition (EDIN), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), 1200, Brussels, Belgium.
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24
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Castex F, Leroy J, Broca C, Mezghenna K, Duranton F, Lavallard V, Lebreton F, Gross R, Wojtusciszyn A, Lajoix AD. Differential sensitivity of human islets from obese versus lean donors to chronic high glucose or palmitate. J Diabetes 2020; 12:532-541. [PMID: 32090456 DOI: 10.1111/1753-0407.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/15/2020] [Accepted: 02/19/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Due to the shortage of multi-organ donors, human pancreatic islet transplantation has now been extended to islets originating from obese subjects. In this study, our aim is to compare the respective sensitivity of human islets from lean vs obese donors to chronic high glucose or high palmitate. METHODS Human islets were isolated from pancreases harvested from brain-dead multi-organ donors. Islets were cultured during 72 hours in the presence of moderate (16.7 mmol/L) or high (28 mmoL/L) glucose concentrations, or glucose (5.6 mmoL/L) and palmitate (0.4 mmoL/L), before measurement of their response to glucose. RESULTS We first observed a greater insulin response in islets from obese donors under both basal and high-glucose conditions, confirming their hyperresponsiveness to glucose. When islets from obese donors were cultured in the presence of moderate or high glucose concentrations, insulin response to glucose remained unchanged or was slightly reduced, as opposed to that observed in lean subjects. Moreover, culturing islets from obese donors with high palmitate also induced less reduction in insulin response to glucose than in lean subjects. This partial protection of obese islets is associated with less induction of inducible nitric oxide synthase in islets, together with a greater expression of the transcription factor forkhead box O1 (FOXO1). CONCLUSIONS Our data suggest that in addition to an increased sensitivity to glucose, islets from obese subjects can be considered as more resistant to glucose and fatty acid excursions and are thus valuable candidates for transplantation.
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Affiliation(s)
- Françoise Castex
- Biocommunication in Cardio-Metabolism (BC2M), University Montpellier, Montpellier, France
| | - Jeremy Leroy
- Biocommunication in Cardio-Metabolism (BC2M), University Montpellier, Montpellier, France
| | - Christophe Broca
- Laboratory of Cell Therapy for Diabetes, Institute for Regenerative Medicine & Biotherapy (IRMB), University Montpellier, INSERM, University Hospital Montpellier, Montpellier, France
| | - Karima Mezghenna
- Biocommunication in Cardio-Metabolism (BC2M), University Montpellier, Montpellier, France
| | - Flore Duranton
- Biocommunication in Cardio-Metabolism (BC2M), University Montpellier, Montpellier, France
- RD Néphrologie, Montpellier, France
| | - Vanessa Lavallard
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospitals and University of Geneva, Genève, Switzerland
| | | | - René Gross
- Biocommunication in Cardio-Metabolism (BC2M), University Montpellier, Montpellier, France
| | - Anne Wojtusciszyn
- Laboratory of Cell Therapy for Diabetes, Institute for Regenerative Medicine & Biotherapy (IRMB), University Montpellier, INSERM, University Hospital Montpellier, Montpellier, France
| | - Anne-Dominique Lajoix
- Biocommunication in Cardio-Metabolism (BC2M), University Montpellier, Montpellier, France
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25
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Figueiredo H, Figueroa ALC, Garcia A, Fernandez-Ruiz R, Broca C, Wojtusciszyn A, Malpique R, Gasa R, Gomis R. Targeting pancreatic islet PTP1B improves islet graft revascularization and transplant outcomes. Sci Transl Med 2020; 11:11/497/eaar6294. [PMID: 31217339 DOI: 10.1126/scitranslmed.aar6294] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 01/16/2019] [Accepted: 05/23/2019] [Indexed: 12/12/2022]
Abstract
Deficient vascularization is a major driver of early islet graft loss and one of the primary reasons for the failure of islet transplantation as a viable treatment for type 1 diabetes. This study identifies the protein tyrosine phosphatase 1B (PTP1B) as a potential modulator of islet graft revascularization. We demonstrate that grafts of pancreatic islets lacking PTP1B exhibit increased revascularization, which is accompanied by improved graft survival and function, and recovery of normoglycemia and glucose tolerance in diabetic mice transplanted with PTP1B-deficient islets. Mechanistically, we show that the absence of PTP1B leads to activation of hypoxia-inducible factor 1α-independent peroxisome proliferator-activated receptor γ coactivator 1α/estrogen-related receptor α signaling and enhanced expression and production of vascular endothelial growth factor A (VEGF-A) by β cells. These observations were reproduced in human islets. Together, these findings reveal that PTP1B regulates islet VEGF-A production and suggest that this phosphatase could be targeted to improve islet transplantation outcomes.
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Affiliation(s)
- Hugo Figueiredo
- Diabetes and Obesity Research Laboratory, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.,University of Barcelona, 08036 Barcelona, Spain.,Escuela de Medicina y Ciencias de la Salud, Dept. Medicina Cardiovascular y Metabolómica, Tecnológico de Monterrey, 66278 San Pedro Garza García, Nuevo León, Mexico
| | - Ana Lucia C Figueroa
- Diabetes and Obesity Research Laboratory, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.,University of Barcelona, 08036 Barcelona, Spain
| | - Ainhoa Garcia
- Diabetes and Obesity Research Laboratory, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Rebeca Fernandez-Ruiz
- Diabetes and Obesity Research Laboratory, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Christophe Broca
- CHU Montpellier, Laboratory of Cell Therapy for Diabetes (LTCD), Hospital St-Eloi, 34295 Montpellier, France
| | - Anne Wojtusciszyn
- CHU Montpellier, Laboratory of Cell Therapy for Diabetes (LTCD), Hospital St-Eloi, 34295 Montpellier, France.,Department of Endocrinology, Diabetes and Nutrition, University Hospital of Montpellier, Lapeyronie Hospital, 34295 Montpellier, France.,Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Rita Malpique
- Diabetes and Obesity Research Laboratory, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain
| | - Rosa Gasa
- Diabetes and Obesity Research Laboratory, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Ramon Gomis
- Diabetes and Obesity Research Laboratory, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain. .,University of Barcelona, 08036 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.,Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain.,Department of Endocrinology and Nutrition, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
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26
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Mbundu Ilunga R, Camponovo C, Le Dizès O, Wojtusciszyn A. [Insulin pump treatment: For whom and how to set it up on an outpatient?]. Rev Med Suisse 2020; 16:1191-1196. [PMID: 32520457] [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: 06/11/2023]
Abstract
Pump therapy has existed for over 40 years and provides a more flexible delivery of insulin. To date, almost 25% of type 1 diabetic patients have chosen this therapeutic option. In recent years, it has also been offered to patients with type 2 insulin-requiring diabetes. The choice of insulin pump is based on its indication, the patient's preference, lifestyle and knowledge of the disease. A risk of developing ketoacidosis in case of interruption of insulin delivery exists. Its implementation therefore requires a specialized interdisciplinary care team available in case of emergency.
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Affiliation(s)
| | - Chiara Camponovo
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | - Olivier Le Dizès
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
- Service d'endocrinologie, diabétologie et nutrition, Centre hospitalier universitaire de Montpellier 191 avenue du Doyen-Giraud, 34295 Montpellier
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Wojtusciszyn A, Jornayvaz FR. [Not Available]. Rev Med Suisse 2020; 16:1183-1184. [PMID: 32520455] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, Lausanne
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Pauchet A, Schwotzer N, Lamine F, Perrottet N, Zanchi A, Golshayan D, Wojtusciszyn A. [Post-transplantation diabetes in kidney transplant: from the diabetologist point of view]. Rev Med Suisse 2020; 16:1200-1205. [PMID: 32520459] [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: 06/11/2023]
Abstract
Post-transplantation diabetes (PTDM) exposes to increased morbidity (cardiovascular or infectious complications, early graft dysfunction) and to a risk of premature death. Recognition of risk factors is essential for early and individualized care. The management of a PTDM requires the use of oral antidiabetic treatments (metformin or DPP4 inhibitors) or GLP1 receptor agonists for their favorable effects on weight and kidney that seem ideal in this context. Corticosteroid-induced diabetes or the rare occurrence of diabetic ketoacidosis require insulin therapy. In the long term, the main objective remains to integrate PTDM treatment in a more comprehensive management, targeting the reduction of cardiovascular risk of vulnerable transplant patients.
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Affiliation(s)
- Amélie Pauchet
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | - Nora Schwotzer
- Service de néphrologie, CHUV, 1011 Lausanne
- Centre de transplantation d'organes (CTO), CHUV, 1011 Lausanne
| | - Faiza Lamine
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | | | - Anne Zanchi
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | - Déla Golshayan
- Centre de transplantation d'organes (CTO), CHUV, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
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Villard O, Armanet M, Couderc G, Bony C, Moreaux J, Noël D, De Vos J, Klein B, Veyrune JL, Wojtusciszyn A. Correction to: Characterization of immortalized human islet stromal cells reveals a MSC-like profile with pancreatic features. Stem Cell Res Ther 2020; 11:190. [PMID: 32438928 PMCID: PMC7240903 DOI: 10.1186/s13287-020-01717-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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)
- Orianne Villard
- Laboratory of Cell Therapy for Diabetes, Institute of Regenerative Medicine and Biotherapy, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Department of Endocrinology, Diabetes, and Nutrition, Univ. Montpellier, CHU Montpellier, Montpellier, France
| | - Mathieu Armanet
- Laboratory of Cell Therapy for Diabetes, Institute of Regenerative Medicine and Biotherapy, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Cell Therapy Unit, Hospital Saint- Louis, AP-HP, Paris, France.,Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, 8 avenue de la Sallaz -, 1011, Lausanne, Switzerland
| | - Guilhem Couderc
- Department of Biological Haematology, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Department of Cell and Tissue Engineering, Univ. Montpellier, CHU Montpellier, Montpellier, France
| | - Claire Bony
- IRMB, INSERM U 1183, Univ Montpellier, INSERM, Montpellier, France
| | - Jerome Moreaux
- Department of Biological Haematology, Univ. Montpellier, CHU Montpellier, Montpellier, France.,IGH, Univ Montpellier, CNRS, Montpellier, France
| | - Daniele Noël
- IRMB, INSERM U 1183, Univ Montpellier, INSERM, Montpellier, France
| | - John De Vos
- Department of Biological Haematology, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Department of Cell and Tissue Engineering, Univ. Montpellier, CHU Montpellier, Montpellier, France.,IRMB, INSERM U 1183, Univ Montpellier, INSERM, Montpellier, France
| | - Bernard Klein
- Department of Cell and Tissue Engineering, Univ. Montpellier, CHU Montpellier, Montpellier, France
| | - Jean-Luc Veyrune
- Department of Biological Haematology, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Department of Cell and Tissue Engineering, Univ. Montpellier, CHU Montpellier, Montpellier, France
| | - Anne Wojtusciszyn
- Laboratory of Cell Therapy for Diabetes, Institute of Regenerative Medicine and Biotherapy, Univ. Montpellier, CHU Montpellier, Montpellier, France. .,Department of Endocrinology, Diabetes, and Nutrition, Univ. Montpellier, CHU Montpellier, Montpellier, France. .,Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, 8 avenue de la Sallaz, 1011, Lausanne, Switzerland.
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30
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Kosinski C, Zanchi A, Wojtusciszyn A. [Diabetes and COVID-19 infection]. Rev Med Suisse 2020; 16:939-943. [PMID: 32374541] [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: 06/11/2023]
Abstract
Based on the epidemiological data currently available, diabetes does not seem to be a risk factor for infection with SARS-CoV-2 but may be associated with a more severe course. Diabetes is extremely common in older patients with co-morbidities who are at risk of unfavorable outcomes. As with any other infection, poorly controlled pre-existing diabetes can promote secondary infections and lead to acute complications related to hyperglycemia, worsened itself by the infection. It is important to advise patients to have enough diabetic equipment and supplies at home, to make regular blood glucose self-tests, and to contact a caregiver immediately in case of glycemic imbalance or signs of infection. Antidiabetic therapy may need adjustments following usual sick day rules. Insulin therapy should be considered to treat any persistent hyperglycemia in patients hospitalized for an acute infection.
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Affiliation(s)
| | - Anne Zanchi
- Service d'Endocrinologie, Diabétologie et Métabolisme, CHUV, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'Endocrinologie, Diabétologie et Métabolisme, CHUV, 1011 Lausanne
- Laboratoire de Thérapie Cellulaire du Diabète, IRMB, CHU Montpellier, 34295 Montpellier, France
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31
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Villard O, Armanet M, Couderc G, Bony C, Moreaux J, Noël D, De Vos J, Klein B, Veyrune JL, Wojtusciszyn A. Characterization of immortalized human islet stromal cells reveals a MSC-like profile with pancreatic features. Stem Cell Res Ther 2020; 11:158. [PMID: 32303252 PMCID: PMC7165390 DOI: 10.1186/s13287-020-01649-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/12/2020] [Accepted: 03/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Mesenchymal stromal cells (MSCs) represent an interesting tool to improve pancreatic islet transplantation. They have immunomodulatory properties and secrete supportive proteins. However, the functional properties of MSCs vary according to many factors such as donor characteristics, tissue origin, or isolation methods. To counteract this heterogeneity, we aimed to immortalize and characterize adherent cells derived from human pancreatic islets (hISCs), using phenotypic, transcriptomic, and functional analysis. METHODS Adherent cells derived from human islets in culture were infected with a hTERT retrovirus vector and then characterized by microarray hybridization, flow cytometry analysis, and immunofluorescence assays. Osteogenic, adipogenic, and chondrogenic differentiation as well as PBMC proliferation suppression assays were used to compare the functional abilities of hISCs and MSCs. Extracellular matrix (ECM) gene expression profile analysis was performed using the SAM (Significance Analysis of Microarrays) software, and protein expression was confirmed by western blotting. RESULTS hISCs kept an unlimited proliferative potential. They exhibited several properties of MSCs such as CD73, CD90, and CD105 expression and differentiation capacity. From a functional point of view, hISCs inhibited the proliferation of activated peripheral blood mononuclear cells. The transcriptomic profile of hISCs highly clusterized with bone marrow (BM)-MSCs and revealed a differential enrichment of genes involved in the organization of the ECM. Indeed, the expression and secretion profiles of ECM proteins including collagens I, IV, and VI, fibronectin, and laminins, known to be expressed in abundance around and within the islets, were different between hISCs and BM-MSCs. CONCLUSION We generated a new human cell line from pancreatic islets, with MSCs properties and retaining some pancreatic specificities related to the production of ECM proteins. hISCs appear as a very promising tool in islet transplantation by their availability (as a source of inexhaustible source of cells) and ability to secrete a supportive "pancreatic" microenvironment.
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Affiliation(s)
- Orianne Villard
- Laboratory of Cell Therapy for Diabetes, Institute of Regenerative Medicine and Biotherapy, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Department of Endocrinology, Diabetes, and Nutrition, Univ. Montpellier, CHU Montpellier, Montpellier, France
| | - Mathieu Armanet
- Laboratory of Cell Therapy for Diabetes, Institute of Regenerative Medicine and Biotherapy, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Cell Therapy Unit, Hospital Saint- Louis, AP-HP, Paris, France.,Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, 8 avenue de la Sallaz - 1011, Lausanne, Switzerland
| | - Guilhem Couderc
- Department of Biological Haematology, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Department of Cell and Tissue Engineering, Univ. Montpellier, CHU Montpellier, Montpellier, France
| | - Claire Bony
- IRMB, INSERM U 1183, Univ Montpellier, INSERM, Montpellier, France
| | - Jerome Moreaux
- Department of Biological Haematology, Univ. Montpellier, CHU Montpellier, Montpellier, France.,IGH, Univ Montpellier, CNRS, Montpellier, France
| | - Daniele Noël
- IRMB, INSERM U 1183, Univ Montpellier, INSERM, Montpellier, France
| | - John De Vos
- Department of Biological Haematology, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Department of Cell and Tissue Engineering, Univ. Montpellier, CHU Montpellier, Montpellier, France.,IRMB, INSERM U 1183, Univ Montpellier, INSERM, Montpellier, France
| | - Bernard Klein
- Department of Cell and Tissue Engineering, Univ. Montpellier, CHU Montpellier, Montpellier, France
| | - Jean-Luc Veyrune
- Department of Biological Haematology, Univ. Montpellier, CHU Montpellier, Montpellier, France.,Department of Cell and Tissue Engineering, Univ. Montpellier, CHU Montpellier, Montpellier, France
| | - Anne Wojtusciszyn
- Laboratory of Cell Therapy for Diabetes, Institute of Regenerative Medicine and Biotherapy, Univ. Montpellier, CHU Montpellier, Montpellier, France. .,Department of Endocrinology, Diabetes, and Nutrition, Univ. Montpellier, CHU Montpellier, Montpellier, France. .,Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, 8 avenue de la Sallaz - 1011, Lausanne, Switzerland.
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32
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Zheng F, Jalbert M, Forbes F, Bonnet S, Wojtusciszyn A, Lablanche S, Benhamou PY. Characterization of Daily Glycemic Variability in Subjects with Type 1 Diabetes Using a Mixture of Metrics. Diabetes Technol Ther 2020; 22:301-313. [PMID: 31657620 DOI: 10.1089/dia.2019.0250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Glycemic variability (GV) is an important component of glycemic control for patients with type 1 diabetes (T1D). The inadequacy of existing measurements lies in the fact that they view the variability from different aspects, so that no consensus has been reached among physicians as to which metrics to use in practice. Moreover, although GV, from 1 day to another, can show very different patterns, few metrics have been dedicated to daily evaluations. Materials and Methods: A reference (stable glycemia) statistical model is built based on a combination of daily computed canonical glycemic control metrics including variability. The metrics are computed for subjects from the TRIMECO islet transplantation trial, selected when their β-score (composite score for grading success) is ≥6 after a transplantation. Then, for any new daily glycemia recording, its likelihood with respect to this reference model provides a multimetric score of daily GV severity. In addition, determining the likelihood value that best separates the daily glycemia with β-score = 0 from that with β-score ≥6, we propose an objective decision rule to classify daily glycemia into "stable" or "unstable." Results: The proposed characterization framework integrates multiple standard metrics and provides a comprehensive daily GV index, based on which, long-term variability evaluations and investigations on the implicit link between variability and β-score can be carried out. Evaluation, in a daily GV classification task, shows that the proposed method is highly concordant to the experience of diabetologists. Conclusion: A multivariate statistical model is proposed to characterize the daily GV of subjects with T1D. The model has the advantage to provide a single variability score that gathers the information power of a number of canonical scores, too partial to be used individually. A reliable decision rule to classify daily variability measurements into stable or unstable is also provided.
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Affiliation(s)
- Fei Zheng
- LJK, CNRS, Inria, Grenoble INP, University Grenoble Alpes, Grenoble, France
- CEA LETI, DTBS, University Grenoble Alpes, Grenoble, France
| | - Manon Jalbert
- Endocrinologie Diabétologie Nutrition, CHU Grenoble-Alpes, Grenoble, France
| | - Florence Forbes
- LJK, CNRS, Inria, Grenoble INP, University Grenoble Alpes, Grenoble, France
| | | | - Anne Wojtusciszyn
- Endocrinologie Diabétologie Nutrition, CHU Montpellier, Montpellier, France
| | - Sandrine Lablanche
- Endocrinologie Diabétologie Nutrition, CHU Grenoble-Alpes, Grenoble, France
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33
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Monnier L, Wojtusciszyn A, Molinari N, Colette C, Renard E, Owens D. Respective Contributions of Glycemic Variability and Mean Daily Glucose as Predictors of Hypoglycemia in Type 1 Diabetes: Are They Equivalent? Diabetes Care 2020; 43:821-827. [PMID: 31988062 DOI: 10.2337/dc19-1549] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/31/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the respective contributions of short-term glycemic variability and mean daily glucose (MDG) concentration to the risk of hypoglycemia in type 1 diabetes. RESEARCH DESIGN AND METHODS People with type 1 diabetes (n = 100) investigated at the University Hospital of Montpellier (France) underwent continuous glucose monitoring (CGM) on two consecutive days, providing a total of 200 24-h glycemic profiles. The following parameters were computed: MDG concentration, within-day glycemic variability (coefficient of variation for glucose [%CV]), and risk of hypoglycemia (presented as the percentage of time spent below three glycemic thresholds: 3.9, 3.45, and 3.0 mmol/L). RESULTS MDG was significantly higher, and %CV significantly lower (both P < 0.001), when comparing the 24-h glycemic profiles according to whether no time or a certain duration of time was spent below the thresholds. Univariate regression analyses showed that MDG and %CV were the two explanatory variables that entered the model with the outcome variable (time spent below the thresholds). The classification and regression tree procedure indicated that the predominant predictor for hypoglycemia was %CV when the threshold was 3.0 mmol/L. In people with mean glucose ≤7.8 mmol/L, the time spent below 3.0 mmol/L was shortest (P < 0.001) when %CV was below 34%. CONCLUSIONS In type 1 diabetes, short-term glycemic variability relative to mean glucose (i.e., %CV) explains more hypoglycemia than does mean glucose alone when the glucose threshold is 3.0 mmol/L. Minimizing the risk of hypoglycemia requires a %CV below 34%.
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Affiliation(s)
- Louis Monnier
- Institute of Clinical Research, University of Montpellier, Montpellier, France
| | - Anne Wojtusciszyn
- Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Nicolas Molinari
- Department of Statistics and Epidemiology, UMR 5149, Montpellier University Hospital, Montpellier, France
| | - Claude Colette
- Institute of Clinical Research, University of Montpellier, Montpellier, France
| | - Eric Renard
- Department of Endocrinology, Diabetes and Nutrition, Clinical Investigation Center CIC 1411, Montpellier University Hospital, and University of Montpellier, Montpellier, France
| | - David Owens
- Diabetes Research Group, Cymru, Swansea University, Swansea, Wales, U.K
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34
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Camponovo C, Wojtusciszyn A, Gilet P, Favre L. [Treatment of type 2 diabetes before, during and after metabolic surgery]. Rev Med Suisse 2020; 16:582-585. [PMID: 32216181] [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: 06/10/2023]
Abstract
Metabolic surgery is becoming increasingly important in the treatment of obese and diabetic patients. Its impact is major on immediate post-operative glycemic control and adaptation of anti-diabetic treatments is necessary. Over time, a recurrence of diabetes may be observed and the choice of treatments to be reintroduced must take into account the surgery performed. By discussing pharmacological options during the preoperative, peri-operative and post-operative periods, this article provides a review of the literature on a subject for which few guidelines are currently proposed.
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Affiliation(s)
- Chiara Camponovo
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | - Patricia Gilet
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
| | - Lucie Favre
- Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne
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35
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Jalbert M, Zheng F, Wojtusciszyn A, Forbes F, Bonnet S, Skaare K, Benhamou PY, Lablanche S. Glycemic variability indices can be used to diagnose islet transplantation success in type 1 diabetic patients. Acta Diabetol 2020; 57:335-345. [PMID: 31602530 DOI: 10.1007/s00592-019-01425-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Abstract
AIMS High glycemic variability (GV) is the major indication for islet transplantation (IT) in patients with type 1 diabetes (T1D). The actual criteria used to assess graft function do not consider GV improvement. Our study aimed to describe GV indices' evolution in T1D patients who benefited from IT during the TRIMECO trial and to evaluate if thresholds might be defined to diagnose IT success. METHODS We collected data from 29 patients of the TRIMECO trial, a clinical trial (NCT01148680) comparing the metabolic efficacy of IT with intensive insulin therapy. Based on CGM data, we analyzed mean glucose level and four GV indices (standard deviation, coefficient of variation, MAGE and GVP) before (M0) and 6 months (M6) after IT. RESULTS Each GV index decreased significantly between M0 and M6: SD 53.9 mg/dL [44.6-61.5] versus 20.1 mg/dL [13.5-24.3]; CV 35.2% [30.6-37.7] versus 17.3% [12.0-20.5]; MAGE 134.9 mg/dl [111.2-155.8] versus 51.9 mg/dL [32.4-62.4]; GVP 35.3% [24.9-47.2] versus 12.2% [6.2-18.8] (p ≤ 0.0001). Thresholds diagnosing IT success at 6 months post-transplant were an SD at 22.76 mg/dL (sensibility 88.89%, specificity 80.00%), a CV at 17.47% (sensibility 88.89%, specificity 70.00%), a MAGE at 54.81 mg/dL (sensibility 88.89%, specificity 80.00%) and a GVP at 12.27% (sensibility 88.89%, specificity 70.00%). CONCLUSIONS This study confirms a positive impact of IT on GV. The proposed thresholds allow an easy evaluation of IT success using only CGM data and may be a clinical tool for the follow-up of transplanted patients.
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Affiliation(s)
- Manon Jalbert
- Department of Endocrinology, Diabetes and Nutrition, Grenoble Alpes University Hospital, CS10217, 38043, Grenoble, France.
| | - Fei Zheng
- Inria, CNRS, Grenoble INP, LJK, Grenoble Alpes University, Grenoble, France
- CEA LETI, DTBS, Univ. Grenoble Alpes, Minatec Campus, Grenoble, France
| | - Anne Wojtusciszyn
- Department of Endocrinology, Diabetes and Nutrition, Montpellier University Hospital, Montpellier, France
| | - Florence Forbes
- Inria, CNRS, Grenoble INP, LJK, Grenoble Alpes University, Grenoble, France
- CEA LETI, DTBS, Univ. Grenoble Alpes, Minatec Campus, Grenoble, France
| | - Stéphane Bonnet
- Inria, CNRS, Grenoble INP, LJK, Grenoble Alpes University, Grenoble, France
- CEA LETI, DTBS, Univ. Grenoble Alpes, Minatec Campus, Grenoble, France
| | - Kristina Skaare
- Department of Public Health, Grenoble Alpes University, Grenoble, France
| | - Pierre-Yves Benhamou
- Department of Endocrinology, Diabetes and Nutrition, Grenoble Alpes University Hospital, CS10217, 38043, Grenoble, France
| | - Sandrine Lablanche
- Department of Endocrinology, Diabetes and Nutrition, Grenoble Alpes University Hospital, CS10217, 38043, Grenoble, France
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36
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Buso G, Collet TH, Wojtusciszyn A, Maufus M, Ney B, Mazzolai L. [Should patients with type 2 diabetes be screened for lower extremity arterial disease?]. Rev Med Suisse 2019; 15:2236-2240. [PMID: 31804035] [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: 06/10/2023]
Abstract
Lower extremity arterial disease (LEAD) is a serious and invalidating disease with a relatively high prevalence in the diabetic population. Patients suffering from both conditions have a less favourable prognosis of affected limbs compared to non-diabetic patients, with more frequent adverse limb events such as amputations. Nevertheless, awareness of LEAD remains sub-optimal in the diabetic population. Regular and appropriate screening for this condition is therefore recommended. Affected individuals should receive optimal medical treatment, including intensive management of the various cardiovascular risk factors and strict blood glucose control.
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Affiliation(s)
- Giacomo Buso
- Service d'angiologie, Département cœur-vaisseaux, CHUV, 1011 Lausanne
| | - Tinh-Hai Collet
- Service d'angiologie, Département cœur-vaisseaux, CHUV, 1011 Lausanne
| | - Anne Wojtusciszyn
- Service d'endocrinologie, diabétologie et métabolisme, Département de médecine, CHUV, 1011 Lausanne
| | - Mario Maufus
- Service d'angiologie, Département cœur-vaisseaux, CHUV, 1011 Lausanne
| | - Barbara Ney
- Service d'angiologie, Département cœur-vaisseaux, CHUV, 1011 Lausanne
| | - Lucia Mazzolai
- Service d'angiologie, Département cœur-vaisseaux, CHUV, 1011 Lausanne
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37
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Lablanche S, Vantyghem MC, Kessler L, Wojtusciszyn A, Borot S, Thivolet C, Girerd S, Bosco D, Bosson JL, Colin C, Tetaz R, Logerot S, Kerr-Conte J, Renard E, Penfornis A, Morelon E, Buron F, Skaare K, Grguric G, Camillo-Brault C, Egelhofer H, Benomar K, Badet L, Berney T, Pattou F, Benhamou PY. Islet transplantation versus insulin therapy in patients with type 1 diabetes with severe hypoglycaemia or poorly controlled glycaemia after kidney transplantation (TRIMECO): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol 2018; 6:527-537. [PMID: 29776895 DOI: 10.1016/s2213-8587(18)30078-0] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [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] [Received: 11/14/2017] [Revised: 02/28/2018] [Accepted: 02/28/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Islet transplantation is indicated for patients with type 1 diabetes with severe hypoglycaemia or after kidney transplantation. We did a randomised trial to assess the efficacy and safety of islet transplantation compared with insulin therapy in these patients. METHODS In this multicentre, open-label, randomised controlled trial, we randomly assigned (1:1) patients with type 1 diabetes at 15 university hospitals to receive immediate islet transplantation or intensive insulin therapy (followed by delayed islet transplantation). Eligible patients were aged 18-65 years and had severe hypoglycaemia or hypoglycaemia unawareness, or kidney grafts with poor glycaemic control. We used computer-generated randomisation, stratified by centre and type of patient. Islet recipients were scheduled to receive 11 000 islet equivalents per kg bodyweight in one to three infusions. The primary outcome was proportion of patients with a modified β-score (in which an overall score of 0 was not allocated when stimulated C-peptide was negative) of 6 or higher at 6 months after first islet infusion in the immediate transplantation group or 6 months after randomisation in the insulin group. The primary analysis included all patients who received the allocated intervention; safety was assessed in all patients who received islet infusions. This trial is registered with ClinicalTrials.gov, number NCT01148680, and is completed. FINDINGS Between July 8, 2010, and July 29, 2013, 50 patients were randomly assigned to immediate islet transplantation (n=26) or insulin treatment (n=24), of whom three (one in the immediate islet transplantation group and two in the insulin therapy group) did not receive the allocated intervention. Median follow-up was 184 days (IQR 181-186) in the immediate transplantation group and 185 days (172-201) in the insulin therapy group. At 6 months, 16 (64% [95% CI 43-82]) of 25 patients in the immediate islet transplantation group had a modified β-score of 6 or higher versus none (0% [0-15]) of the 22 patients in the insulin group (p<0·0001). At 12 months after first infusion, bleeding complications had occurred in four (7% [2-18]) of 55 infusions, and a decrease in median glomerular filtration rate from 90·5 mL/min (IQR 76·6-94·0) to 71·8 mL/min (59·0-89·0) was observed in islet recipients who had not previously received a kidney graft and from 63·0 mL/min (55·0-71·0) to 57·0 mL/min (45·5-65·1) in islet recipients who had previously received a kidney graft. INTERPRETATION For the indications assessed in this study, islet transplantation effectively improves metabolic outcomes. Although studies with longer-term follow-up are needed, islet transplantation seems to be a valid option for patients with severe, unstable type 1 diabetes who are not responding to intensive medical treatments. However, immunosuppression can affect kidney function, necessitating careful selection of patients. FUNDING Programme Hospitalier de Recherche Clinique grant from the French Government.
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Affiliation(s)
- Sandrine Lablanche
- Department of Endocrinology, Diabetes, and Nutrition, Grenoble Alpes University, Grenoble, France; Inserm U1055, Laboratory of Fundamental and Applied Bioenergetics Grenoble, Grenoble, France.
| | - Marie-Christine Vantyghem
- Department of Endocrinology, Diabetes, and Nutrition, C Huriez Hospital, Lille University Hospital, Lille, France; Inserm 1190, European Genomic Institute for Diabetes, Lille, France
| | - Laurence Kessler
- Hôpitaux Universitaires de Strasbourg, Service d'Endocrinologie Diabète et Maladies Métaboliques, and Equipe d'Accueil 7293, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Anne Wojtusciszyn
- Department of Endocrinology, Diabetes, and Nutrition, Montpellier University Hospital, Montpellier, France; Laboratory of Cell Therapy of Diabetes, Institute of Functional Genomics, Mixed Research Unit, French National Center for Scientific Research 5203, Inserm U1191, University of Montpellier, Montpellier, France
| | - Sophie Borot
- Centre Hospitalier Universitaire Jean Minjoz, Service d'Endocrinologie-Métabolisme et Diabétologie-Nutrition, Besançon, France
| | - Charles Thivolet
- Service d'Endocrinologie Diabète Nutrition, Hospices Civils de Lyon, Groupement Hospitalier Centre, Université de Lyon, Lyon, France
| | - Sophie Girerd
- Service de Néphrologie, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Domenico Bosco
- Department of Surgery, Islet Isolation, and Transplantation, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Luc Bosson
- French National Center for Scientific Research, Grenoble Alpes University, Grenoble, France; Department of Public Health, Grenoble Alpes University, Grenoble, France; Laboratoire des Techniques de l'Ingénierie Médicale et de la Complexité-Informatique, Mathématiques et Applications de Grenoble, Grenoble, France
| | - Cyrille Colin
- Pôle de Santé Publique Service Evaluation Economique en Santé, Hospices Civils de Lyon, Groupement Hospitalier Centre, Université de Lyon, Lyon, France; F-69003, EA 7425 Health Services and Performance Research, Public Health Service and Health Economic Evaluation, Claude Bernard University Lyon 1, Lyon, France
| | - Rachel Tetaz
- Department of Nephrology, Grenoble Alpes University, Grenoble, France
| | - Sophie Logerot
- Department of Clinical Trial Surveillance, Direction of Clinical Research and Innovation, Grenoble Alpes University, Grenoble, France
| | - Julie Kerr-Conte
- Department of Endocrinology, Diabetes, and Nutrition, C Huriez Hospital, Lille University Hospital, Lille, France; Inserm 1190, European Genomic Institute for Diabetes, Lille, France
| | - Eric Renard
- Department of Endocrinology, Diabetes, and Nutrition, Montpellier University Hospital, Montpellier, France; Laboratory of Cell Therapy of Diabetes, Institute of Functional Genomics, Mixed Research Unit, French National Center for Scientific Research 5203, Inserm U1191, University of Montpellier, Montpellier, France
| | - Alfred Penfornis
- Department of Diabetes, Sud-Francilien Hospital, Corbeil-Essonnes, France; Université Paris-Sud, Orsay, France
| | - Emmanuel Morelon
- Service de Transplantation, Néphrologie et Immunologie Clinique, Hospices Civils de Lyon, Groupement Hospitalier Centre, Université de Lyon, Lyon, France
| | - Fanny Buron
- Service de Transplantation, Néphrologie et Immunologie Clinique, Hospices Civils de Lyon, Groupement Hospitalier Centre, Université de Lyon, Lyon, France
| | - Kristina Skaare
- French National Center for Scientific Research, Grenoble Alpes University, Grenoble, France; Department of Public Health, Grenoble Alpes University, Grenoble, France; Laboratoire des Techniques de l'Ingénierie Médicale et de la Complexité-Informatique, Mathématiques et Applications de Grenoble, Grenoble, France
| | - Gwen Grguric
- Pôle de Santé Publique Service Evaluation Economique en Santé, Hospices Civils de Lyon, Groupement Hospitalier Centre, Université de Lyon, Lyon, France; F-69003, EA 7425 Health Services and Performance Research, Public Health Service and Health Economic Evaluation, Claude Bernard University Lyon 1, Lyon, France
| | - Coralie Camillo-Brault
- Pôle de Santé Publique Service Evaluation Economique en Santé, Hospices Civils de Lyon, Groupement Hospitalier Centre, Université de Lyon, Lyon, France; F-69003, EA 7425 Health Services and Performance Research, Public Health Service and Health Economic Evaluation, Claude Bernard University Lyon 1, Lyon, France
| | - Harald Egelhofer
- Cellular Therapy Unit, National Blood Service Rhône-Alpes, Grenoble University Hospital, Grenoble Alpes University, Grenoble, France
| | - Kanza Benomar
- Department of Endocrinology, Diabetes, and Nutrition, C Huriez Hospital, Lille University Hospital, Lille, France; Inserm 1190, European Genomic Institute for Diabetes, Lille, France
| | - Lionel Badet
- Service d'Urologie et de Chirurgie de la Transplantation, Hospices Civils de Lyon, Groupement Hospitalier Centre, Université de Lyon, Lyon, France
| | - Thierry Berney
- Department of Surgery, Islet Isolation, and Transplantation, Geneva University Hospitals, Geneva, Switzerland
| | - François Pattou
- Department of Endocrinology, Diabetes, and Nutrition, C Huriez Hospital, Lille University Hospital, Lille, France; Inserm 1190, European Genomic Institute for Diabetes, Lille, France
| | - Pierre-Yves Benhamou
- Department of Endocrinology, Diabetes, and Nutrition, Grenoble Alpes University, Grenoble, France; Inserm U1055, Laboratory of Fundamental and Applied Bioenergetics Grenoble, Grenoble, France
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Ruiz L, Gurlo T, Ravier MA, Wojtusciszyn A, Mathieu J, Brown MR, Broca C, Bertrand G, Butler PC, Matveyenko AV, Dalle S, Costes S. Proteasomal degradation of the histone acetyl transferase p300 contributes to beta-cell injury in a diabetes environment. Cell Death Dis 2018; 9:600. [PMID: 29789539 PMCID: PMC5964068 DOI: 10.1038/s41419-018-0603-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 03/09/2018] [Accepted: 04/17/2018] [Indexed: 12/25/2022]
Abstract
In type 2 diabetes, amyloid oligomers, chronic hyperglycemia, lipotoxicity, and pro-inflammatory cytokines are detrimental to beta-cells, causing apoptosis and impaired insulin secretion. The histone acetyl transferase p300, involved in remodeling of chromatin structure by epigenetic mechanisms, is a key ubiquitous activator of the transcriptional machinery. In this study, we report that loss of p300 acetyl transferase activity and expression leads to beta-cell apoptosis, and most importantly, that stress situations known to be associated with diabetes alter p300 levels and functional integrity. We found that proteasomal degradation is the mechanism subserving p300 loss in beta-cells exposed to hyperglycemia or pro-inflammatory cytokines. We also report that melatonin, a hormone produced in the pineal gland and known to play key roles in beta-cell health, preserves p300 levels altered by these toxic conditions. Collectively, these data imply an important role for p300 in the pathophysiology of diabetes.
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Affiliation(s)
- Lucie Ruiz
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Tatyana Gurlo
- Larry L. Hillblom Islet Research Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Magalie A Ravier
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Anne Wojtusciszyn
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France.,Laboratory of Cell Therapy for Diabetes (LTCD), Institute for Regenerative Medicine and Biotherapy (IRMB), University Hospital of Montpellier, Montpellier, France.,Department of Endocrinology, Diabetes, and Nutrition, University Hospital of Montpellier, Montpellier, France
| | - Julia Mathieu
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Matthew R Brown
- Department of Physiology and Biomedical Engineering, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Christophe Broca
- Laboratory of Cell Therapy for Diabetes (LTCD), Institute for Regenerative Medicine and Biotherapy (IRMB), University Hospital of Montpellier, Montpellier, France
| | | | - Peter C Butler
- Larry L. Hillblom Islet Research Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Aleksey V Matveyenko
- Department of Physiology and Biomedical Engineering, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Stéphane Dalle
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Safia Costes
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France.
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39
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Meier RPH, Andrey DO, Sun P, Niclauss N, Bédat B, Demuylder-Mischler S, Borot S, Benhamou PY, Wojtusciszyn A, Buron F, Pernin N, Muller YD, Bosco D, van Delden C, Berney T. Pancreas preservation fluid microbial contamination is associated with poor islet isolation outcomes - a multi-centre cohort study. Transpl Int 2018; 31:917-929. [PMID: 29603452 DOI: 10.1111/tri.13159] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/09/2018] [Accepted: 03/21/2018] [Indexed: 12/15/2022]
Abstract
The microbiological safety of islet preparations is paramount. Preservation medium contamination is frequent, and its impact on islet yield and function remains unclear. Microbiological samples collected during islet isolations from 2006 to 2016 were analyzed and correlated to isolation and allo- and autotransplantation outcomes. Microbial contamination of preservation medium was found in 64.4% of processed donor pancreases (291/452). We identified 464 microorganisms including Staphylococcus (253/464, 54.5%), Streptococcus (31/464, 6.7%), and Candida species (25/464, 5.4%). Microbial contamination was associated with longer warm and cold ischemia times and lower numbers of postpurification islet equivalents, purity, transplant rate, and stimulation index (all P < 0.05). Six percent of the preparations accepted for transplantation showed microbial contamination after isolation (12/200); 9 of 12 were Candida species. Six patients were transplanted with a sample with late microbial growth discovered after the infusion. Insulin independence rate was not affected. This risk of transplanting a contaminated islets preparation was reduced by half following the implementation of an additional sampling after 24 h of islet culture. Pancreas preservation fluid microbial contamination is associated with lower transplant rate and poorer in vitro function, but not with changes in graft survival. Culture medium testing 1 day after isolation reduces the risk of incidental transplantation with contaminated islets.
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Affiliation(s)
- Raphael P H Meier
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland.,Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland.,Transplant Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Diego O Andrey
- Transplant Infectious Diseases Unit, Department of Medical Specialties, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
| | - Pamela Sun
- Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
| | - Nadja Niclauss
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland.,Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
| | - Benoît Bédat
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
| | - Sandrine Demuylder-Mischler
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
| | - Sophie Borot
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland.,Service d'Endocrinologie-Métabolisme et Diabétologie-Nutrition, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
| | - Pierre-Yves Benhamou
- Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, University Grenoble Alpes, Grenoble, France
| | - Anne Wojtusciszyn
- Laboratory of Cell Therapy for Diabetes, IRMB, Saint Eloi Hospital, Montpellier University Hospital, Montpellier, France.,Department of Endocrinology, Diabetes and Nutrition, Lapeyronie Hospital, Montpellier University Hospital, Montpellier, France
| | - Fanny Buron
- Nephrology Unit, Department of Transplantation, Edouard Herriot Hospital, Lyon, France
| | - Nadine Pernin
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
| | - Yannick D Muller
- Transplant Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Domenico Bosco
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
| | - Christian van Delden
- Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland.,Transplant Infectious Diseases Unit, Department of Medical Specialties, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
| | - Thierry Berney
- Department of Surgery, Cell Isolation and Transplantation Center, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland.,Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospital, University of Geneva Medical School, Geneva, Switzerland
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40
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Villard O, Brun JF, Bories L, Molinari N, Benhamou PY, Berney T, Wojtusciszyn A. The Second Phase of Insulin Secretion in Nondiabetic Islet-Grafted Recipients Is Altered and Can Predict Graft Outcome. J Clin Endocrinol Metab 2018; 103:1310-1319. [PMID: 29319810 DOI: 10.1210/jc.2017-01342] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 01/03/2018] [Indexed: 11/19/2022]
Abstract
CONTEXT Islet transplantation (IT) can treat patients with severely unstable type 1 diabetes. Prehepatic kinetics of insulin secretion (ISec) in two phases can be calculated by C-peptide levels during meal tests. We proposed to describe the ISec profile after a mixed-meal tolerance test (MMTT) in IT recipients and to determine whether the calculated ISec indexes can predict graft outcome. METHODS We analyzed 34 MMTT among 11 patients who underwent IT between 2011 and 2016 and compared them with healthy controls and patients with type 2 diabetes (T2D). ISec indexes and insulin sensitivity were calculated from models of Van Cauter, Breda, and Mari after MMTT. Graft success was defined by total insulin independence without any criteria for diabetes. RESULTS In patients with successful IT, the first- and second-phase ISec indexes were lower than those of controls (P < 0.001) and did not differ from those of the T2D group. Nevertheless, insulin sensitivity of IT recipients was similar to that of the control group and higher than that of the T2D group. The index of the second phase of ISec ɸS was correlated with total infused islet equivalents (IEQs), was a good predictor of diabetes (re)occurrence, and allowed us to calculate 9500 IEQ/kg as the minimum needed to reach insulin independence. CONCLUSION We showed that indexes from the first and second phases of ISec are altered in insulin-independent IT recipients. Higher sensitivity distinguishes them from patients with T2D. Even in insulin-independent patients, IT remains a marginal mass model. Moreover, ɸS can estimate transplanted islet mass and predict IT recipient outcomes.
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Affiliation(s)
- Orianne Villard
- Laboratory of Cell Therapy for Diabetes, Institute of Regenerative Medicine and Biotherapy, University Hospital of Montpellier, Saint Eloi Hospital, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale U1191, Institute of Functional Genomics, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5203, Montpellier University, Montpellier, France
| | - Jean Frédéric Brun
- Unité Mixte de Recherche, Centre National de la Recherche Scientifique 9214, Institut National de la Santé et de la Recherche Médicale U1046, Physiologie et Médecine Experimentale du coeur et des muscles, Montpellier University, Montpellier, France
- Department of Clinical Physiology, Metabolic Explorations, University Hospital of Montpellier, Montpellier, France
| | - Lisa Bories
- Department of Endocrinology, Diabetes and Nutrition, University Hospital of Montpellier, Lapeyronie Hospital, Montpellier, France
| | - Nicolas Molinari
- Department of Medical Information, University Hospital of Montpellier, La Colombière Hospital, Montpellier, France
| | - Pierre Yves Benhamou
- Department of Diabetology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes University, Grenoble, France
- Grenoble Alpes University, Institut National de la Santé et de la Recherche Médicale U1055, Laboratory of Fundamental and Applied Bioenergetics, Grenoble, France
| | - Thierry Berney
- Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Anne Wojtusciszyn
- Laboratory of Cell Therapy for Diabetes, Institute of Regenerative Medicine and Biotherapy, University Hospital of Montpellier, Saint Eloi Hospital, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale U1191, Institute of Functional Genomics, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5203, Montpellier University, Montpellier, France
- Department of Endocrinology, Diabetes and Nutrition, University Hospital of Montpellier, Lapeyronie Hospital, Montpellier, France
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Monnier L, Colette C, Wojtusciszyn A, Dejager S, Renard E, Molinari N, Owens DR. Toward Defining the Threshold Between Low and High Glucose Variability in Diabetes. Diabetes Care 2017; 40:832-838. [PMID: 28039172 DOI: 10.2337/dc16-1769] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/05/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To define the threshold for excess glucose variability (GV), one of the main features of dysglycemia in diabetes. RESEARCH DESIGN AND METHODS A total of 376 persons with diabetes investigated at the University Hospital of Montpellier (Montpellier, France) underwent continuous glucose monitoring. Participants with type 2 diabetes were divided into several groups-groups 1, 2a, 2b, and 3 (n = 82, 28, 65, and 79, respectively)-according to treatment: 1) diet and/or insulin sensitizers alone; 2) oral therapy including an insulinotropic agent, dipeptidyl peptidase 4 inhibitors (group 2a) or sulfonylureas (group 2b); or 3) insulin. Group 4 included 122 persons with type 1 diabetes. Percentage coefficient of variation for glucose (%CV = [(SD of glucose)/(mean glucose)] × 100) and frequencies of hypoglycemia (interstitial glucose <56 mg/dL [3.1 mmol/L]) were computed. RESULTS Percentages of CV (median [interquartile range]; %) increased significantly (P < 0.0001) from group 1 (18.1 [15.2-23.9]) to group 4 (37.2 [31.0-42.3]). In group 1, the upper limit of %CV, which served as reference for defining excess GV, was 36%. Percentages of patients with %CVs above this threshold in groups 2a, 2b, 3, and 4 were 0, 12.3, 19.0, and 55.7%, respectively. Hypoglycemia was more frequent in group 2b (P < 0.01) and groups 3 and 4 (P < 0.0001) when subjects with a %CV >36% were compared with those with %CV ≤36%. CONCLUSIONS A %CV of 36% appears to be a suitable threshold to distinguish between stable and unstable glycemia in diabetes because beyond this limit, the frequency of hypoglycemia is significantly increased, especially in insulin-treated subjects.
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Affiliation(s)
- Louis Monnier
- Institute of Clinical Research, University of Montpellier, Montpellier, France
| | - Claude Colette
- Institute of Clinical Research, University of Montpellier, Montpellier, France
| | - Anne Wojtusciszyn
- Department of Endocrinology, Diabetes, and Nutrition, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - Sylvie Dejager
- Department of Endocrinology, Pitiê-Salpétrière Hospital, Paris, France
| | - Eric Renard
- Department of Endocrinology, Diabetes, and Nutrition, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - Nicolas Molinari
- Department of Statistics and Epidemiology, UMR 5149, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - David R Owens
- Diabetes Research Group, Swansea University, Swansea, Wales, U.K
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42
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Lablanche S, David-Tchouda S, Margier J, Schir E, Wojtusciszyn A, Borot S, Kessler L, Morelon E, Thivolet C, Pattou F, Vantyghem MC, Berney T, Benhamou PY. Randomised, prospective, medico-economic nationwide French study of islet transplantation in patients with severely unstable type 1 diabetes: the STABILOT study protocol. BMJ Open 2017; 7:e013434. [PMID: 28219959 PMCID: PMC5337667 DOI: 10.1136/bmjopen-2016-013434] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy. METHODS The trial will adopt an open-label, randomised, multicentred design. The study will include 30 patients with severely unstable type 1 diabetes. Eligible participants will be 18-65 years old, with type 1 diabetes duration >5 years, a negative basal or stimulated C-peptide, and severe instability defined by persistent, recurrent and disabling severe hypoglycaemia, despite optimised medical treatment. Participants will be randomised into two groups: one group with immediate registration for islet transplantation, and one group with delayed registration for 1 year while patients receive SAP therapy. The primary endpoint will be the incremental cost-utility ratio at 1 year between islet transplantation and SAP therapy. Perspectives of both the French Health Insurance System and the hospitals will be retained. ETHICS AND DISSEMINATION Ethical approval has been obtained at all sites. The trial has been approved by ClinicalTrials.gov (Trial registration ID NCT02854696). All participants will sign a free and informed consent form before randomisation. Results of the study will be communicated during national and international meetings in the field of diabetes and transplantation. A publication will be sought in journals usually read by physicians involved in diabetes care, transplantation and internal medicine. TRIAL REGISTRATION NUMBER NCT02854696; Pre-results.
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Affiliation(s)
- Sandrine Lablanche
- Department of Diabetology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes University, Grenoble, France
- Grenoble Alpes University, INSERM, U1055Laboratory of Fundamental and Applied Bioenergetics, Grenoble, France
| | - Sandra David-Tchouda
- Cellule d’évaluation médico-économique des innovations, CHU Grenoble Alpes, CIC 1406 Grenoble, TIMC-Imag UMR 5525 Univ. Grenoble Alpes, Grenoble, France
| | - Jennifer Margier
- Cellule d’évaluation médico-économique des innovations, CHU Grenoble Alpes, CIC 1406 Grenoble, TIMC-Imag UMR 5525 Univ. Grenoble Alpes, Grenoble, France
| | - Edith Schir
- Centre régional de Pharmacovigilance, Grenoble, France
| | - Anne Wojtusciszyn
- Centre Hospitalier de Montpellier, Pôle Rein Hypertension Métabolisme, Service d'Endocrinologie, Montpellier, France
| | - Sophie Borot
- Centre Hospitalier Universitaire Jean Minjoz, Service d'Endocrinologie-Métabolisme et Diabétologie-Nutrition, Besançon, France
| | - Laurence Kessler
- Hôpitaux Universitaires de Strasbourg, Service d'Endocrinologie Diabète et Maladies Métaboliques, Pôle NUDE, Strasbourg, France
| | - Emmanuel Morelon
- Hospices Civils de Lyon, Service d'Urologie et de Chirurgie de la Transplantation, Pôle Chirurgie, Lyon, France
| | - Charles Thivolet
- Hospices Civils de Lyon, Service de Diabétologie—Endocrinologie—Maladies Métaboliques et de Chirurgie de la Transplantation, Pôle Chirurgie, Lyon, France
| | - François Pattou
- University Lille, CHRU Lille, Inserm U1190 Translational research for diabetes, Lille, France
- European Genomic Institute for Diabetes, EGID, Lille, France
- Department of Endocrine Surgery, Hôpital Huriez Lille University Hospital, Lille Cedex, France
| | - Marie Christine Vantyghem
- Department of Endocrine Surgery, Hôpital Huriez Lille University Hospital, Lille Cedex, France
- Department of Endocrinology and Metabolism, Hôpital Huriez, Lille University Hospital, Lille Cedex, France
| | - Thierry Berney
- Departement of Surgery, Islet Isolation, and Transplantation Center, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre-Yves Benhamou
- Department of Diabetology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes University, Grenoble, France
- Grenoble Alpes University, INSERM, U1055Laboratory of Fundamental and Applied Bioenergetics, Grenoble, France
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Delaune V, Toso C, Benhamou PY, Wojtusciszyn A, Kessler L, Slits F, Demuylder-Mischler S, Pernin N, Lablanche S, Orci LA, Oldani G, Morel P, Berney T, Lacotte S. Alloimmune Monitoring After Islet Transplantation: A Prospective Multicenter Assessment of 25 Recipients. Cell Transplant 2016; 25:2259-2268. [PMID: 27302287 DOI: 10.3727/096368916x692023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Islet transplantation is an effective treatment for selected patients with type 1 diabetes. However, an accurate test still lacks for the early detection of graft rejection. Blood samples were prospectively collected in four university centers (Geneva, Grenoble, Montpellier, and Strasbourg). Peripheral blood mononuclear cells were stimulated with donor splenocytes in the presence of interleukin-2. After 24 h of incubation, interferon- (IFN-) ELISpot analysis was performed. After a total of 5 days of incubation, cell proliferation was assessed by fluorescence-activated cell sorting (FACS) analysis for Ki-67. Immunological events were correlated with adverse metabolic events determined by loss of 1 point of -score and/or an increased insulin intake 10%. Twenty-five patients were analyzed; 14 were recipients of islets alone, and 11 combined with kidney. Overall, 76% (19/25) reached insulin independence at one point during a mean follow-up of 30.7 months. IFN- ELISpot showed no detectable correlation with adverse metabolic events [area under the curve (AUC)=0.57]. Similarly, cell proliferation analysis showed no detectable correlation with adverse metabolic events (CD3+/CD4+ AUC=0.54; CD3+/CD8+ AUC=0.55; CD3/CD56+ AUC=0.50). CD3/CD56+ cell proliferation was significantly higher in patients with combined kidney transplantation versus islet alone (6 months, p=0.010; 12 months, p=0.016; and 24 months, p=0.018). Donor antigen-stimulated IFN- production and cell proliferation do not predict adverse metabolic events after islet transplantation. This suggests that the volume of transplanted islets is too small to produce a detectable systemic immune response and/or that alloimmune rejection is not the sole reason for the loss of islet graft function.
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Bousquet J, Bourret R, Camuzat T, Augé P, Domy P, Bringer J, Best N, Jonquet O, de la Coussaye JE, Noguès M, Robine JM, Avignon A, Blain H, Combe B, Dray G, Dufour V, Fouletier M, Giraudeau N, Hève D, Jeandel C, Laffont I, Larrey D, Laune D, Laurent C, Mares P, Marion C, Pastor E, Pélissier JY, Radier-Pontal F, Reynes J, Royère E, Ychou M, Bedbrook A, Granier S, Abecassis F, Albert S, Adnet PA, Alomène B, Amouyal M, Arnavielhe S, Asteriou T, Attalin V, Aubas P, Azevedo C, Badin M, Bakhti, Baptista G, Bardy B, Battesti MP, Bénézet O, Bernard PL, Berr C, Berthe J, Bobia X, Bockaert J, Boegner C, Boichot S, Bonnin HY, Boulet P, Bouly S, Boubakri C, Bourdin A, Bourrain JL, Bourrel G, Bouix V, Breuker C, Bruguière V, Burille J, Cade S, Caimmi D, Calmels MV, Camu W, Canovas G, Carre V, Cavalli G, Cayla G, Chiron R, Claret PG, Coignard P, Coroian F, Costa DJ, Costa P, Cottalorda, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cristol JP, Cros V, Cuisinier F, Daien C, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dhivert-Donnadieu H, Dujols P, Dupeyron A, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fesler P, Fraisse P, Froger J, Gabrion P, Galano E, Gellerat-Rogier M, Gellis A, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hantkié H, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Journot L, Kaczorek M, Kouyoudjian P, Labauge P, Landreau L, Lapierre M, Leblond C, Léglise MS, Lemaitre JM, Le Moing V, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert JM, Makinson A, Mandrick K, Marmelat V, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Morquin D, Mottet D, Nérin P, Nicolas P, Ninot G, Nouvel F, Ortiz JP, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Picot MC, Pin JP, Pinto N, Porte E, Portejoie F, Pujol JL, Quantin X, Quéré I, Raffort N, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Rolland C, Roubille F, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Soua B, Stephan Y, Strubel D, Sultan A, Taddei-Ologeanu, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Touchon J, Tribout V, Uziel A, Van de Perre P, Vasquez X, Verdier JM, Vergne-Richard C, Vergotte G, Vian L, Viarouge-Reunier C, Vialla F, Viart F, Villain M, Villiet M, Viollet E, Wojtusciszyn A, Aoustin M, Bourquin C, Mercier J. Introduction. Presse Med 2015; 44 Suppl 1:S1-5. [DOI: 10.1016/j.lpm.2015.07.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Lablanche S, Borot S, Wojtusciszyn A, Bayle F, Tétaz R, Badet L, Thivolet C, Morelon E, Frimat L, Penfornis A, Kessler L, Brault C, Colin C, Tauveron I, Bosco D, Berney T, Benhamou PY. Five-Year Metabolic, Functional, and Safety Results of Patients With Type 1 Diabetes Transplanted With Allogenic Islets Within the Swiss-French GRAGIL Network. Diabetes Care 2015; 38:1714-22. [PMID: 26068866 DOI: 10.2337/dc15-0094] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/25/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe the 5-year outcomes of islet transplantation within the Swiss-French GRAGIL Network. RESEARCH DESIGN AND METHODS Retrospective analysis of all subjects enrolled in the GRAGIL-1c and GRAGIL-2 islet transplantation trials. Parameters related to metabolic control, graft function, and safety outcomes were studied. RESULTS Forty-four patients received islet transplantation (islet transplantation alone [ITA] 24 patients [54.5%], islet after kidney [IAK] transplantation 20 patients [45.5%]) between September 2003 and April 2010. Recipients received a total islet mass of 9,715.75 ± 3,444.40 IEQ/kg. Thirty-four patients completed a 5-year follow-up, and 10 patients completed a 4-year follow-up. At 1, 4, and 5 years after islet transplantation, respectively, 83%, 67%, and 58% of the ITA recipients and 80%, 70%, and 60% of the IAK transplant recipients reached HbA1c under 7% (53 mmol/mol) and were free of severe hypoglycemia, while none of the ITA recipients and only 10% of the IAK transplant recipients met this composite criterion at the preinfusion stage. Thirty-three of 44 patients (75%) experienced insulin independence during the entire follow-up period, with a median duration of insulin independence of 19.25 months (interquartile range 2-58). Twenty-nine of 44 recipients (66%) exhibited at least one adverse event; 18 of 55 adverse events (33%) were possibly related to immunosuppression; and complications related to the islet infusion (n = 84) occurred in 10 recipients (11.9%). CONCLUSIONS In a large cohort with a 5-year follow-up and in a multicenter network setting, islet transplantation was safe and efficient in restoring good and lasting glycemic control and preventing severe hypoglycemia in patients with type 1 diabetes.
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Affiliation(s)
- Sandrine Lablanche
- Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Joseph Fourier University, Grenoble, France
| | - Sophie Borot
- Centre Hospitalier Universitaire Jean Minjoz, Service d'Endocrinologie-Métabolisme et Diabétologie-Nutrition, Besançon, France
| | - Anne Wojtusciszyn
- Centre Hospitalier de Montpellier, Pôle Rein Hypertension Métabolisme, Service d'Endocrinologie, Montpellier, France
| | - Francois Bayle
- Department of Nephrology, Pôle DigiDune, Grenoble University Hospital, Joseph Fourier University, Grenoble, France
| | - Rachel Tétaz
- Department of Nephrology, Pôle DigiDune, Grenoble University Hospital, Joseph Fourier University, Grenoble, France
| | - Lionel Badet
- Hospices Civils de Lyon, Service d'Urologie et de Chirurgie de la Transplantation, Pôle Chirurgie, Lyon, France
| | - Charles Thivolet
- Hospices Civils de Lyon, Service d'Endocrinologie Diabète Nutrition, Lyon, France
| | - Emmanuel Morelon
- Hospices Civils de Lyon, Service de Néphrologie Médecine de la Transplantation et Immunologie Clinique, Lyon, France
| | - Luc Frimat
- Centre Hospitalier Universitaire de Nancy, Service de Néphrologie, Nancy, France
| | - Alfred Penfornis
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, Centre Hospitalier Sud-Francilien, Corbeil-Essonnes, France
| | - Laurence Kessler
- Hôpitaux Universitaires de Strasbourg, Service d'Endocrinologie Diabète et Maladies Métaboliques, Pôle NUDE, Strasbourg, France
| | - Coralie Brault
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, and Université de Lyon, EA Santé-Individu-Société 4129, Lyon, France
| | - Cyrille Colin
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, and Université de Lyon, EA Santé-Individu-Société 4129, Lyon, France
| | - Igor Tauveron
- CHU de Clermont-Ferrand, Service Endocrinologie-Diabète-Maladies Métaboliques, Clermont Ferrand Université, Clermont-Ferrand, France
| | - Domenico Bosco
- Departement of Surgery, Islet Isolation, and Transplantation Center, Geneva University Hospitals, Geneva, Switzerland
| | - Thierry Berney
- Departement of Surgery, Islet Isolation, and Transplantation Center, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre-Yves Benhamou
- Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Joseph Fourier University, Grenoble, France
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Broca C, Varin E, Armanet M, Tourrel-Cuzin C, Bosco D, Dalle S, Wojtusciszyn A. Correction: proteasome dysfunction mediates high glucose-induced apoptosis in rodent Beta cells and human islets. PLoS One 2014; 9:e102652. [PMID: 25000098 PMCID: PMC4085027 DOI: 10.1371/journal.pone.0102652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0092066.].
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Broca C, Varin E, Armanet M, Tourrel-Cuzin C, Bosco D, Dalle S, Wojtusciszyn A. Proteasome dysfunction mediates high glucose-induced apoptosis in rodent beta cells and human islets. PLoS One 2014; 9:e92066. [PMID: 24642635 PMCID: PMC3958412 DOI: 10.1371/journal.pone.0092066] [Citation(s) in RCA: 30] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/17/2014] [Indexed: 01/23/2023] Open
Abstract
The ubiquitin/proteasome system (UPS), a major cellular protein degradation machinery, plays key roles in the regulation of many cell functions. Glucotoxicity mediated by chronic hyperglycaemia is detrimental to the function and survival of pancreatic beta cells. The aim of our study was to determine whether proteasome dysfunction could be involved in beta cell apoptosis in glucotoxic conditions, and to evaluate whether such a dysfunction might be pharmacologically corrected. Therefore, UPS activity was measured in GK rats islets, INS-1E beta cells or human islets after high glucose and/or UPS inhibitor exposure. Immunoblotting was used to quantify polyubiquitinated proteins, endoplasmic reticulum (ER) stress through CHOP expression, and apoptosis through the cleavage of PARP and caspase-3, whereas total cell death was detected through histone-associated DNA fragments measurement. In vitro, we found that chronic exposure of INS-1E cells to high glucose concentrations significantly decreases the three proteasome activities by 20% and leads to caspase-3-dependent apoptosis. We showed that pharmacological blockade of UPS activity by 20% leads to apoptosis in a same way. Indeed, ER stress was involved in both conditions. These results were confirmed in human islets, and proteasome activities were also decreased in hyperglycemic GK rats islets. Moreover, we observed that a high glucose treatment hypersensitized beta cells to the apoptotic effect of proteasome inhibitors. Noteworthily, the decreased proteasome activity can be corrected with Exendin-4, which also protected against glucotoxicity-induced apoptosis. Taken together, our findings reveal an important role of proteasome activity in high glucose-induced beta cell apoptosis, potentially linking ER stress and glucotoxicity. These proteasome dysfunctions can be reversed by a GLP-1 analog. Thus, UPS may be a potent target to treat deleterious metabolic conditions leading to type 2 diabetes.
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Affiliation(s)
- Christophe Broca
- CNRS UMR 5203, INSERM U661, and Montpellier 1 & 2 University, Institute of Functional Genomics, Montpellier, France
- Laboratory for Diabetes Cell Therapy, Institute for Research in Biotherapy, University Hospital St-Eloi, Montpellier, France
| | - Elodie Varin
- CNRS UMR 5203, INSERM U661, and Montpellier 1 & 2 University, Institute of Functional Genomics, Montpellier, France
- Laboratory for Diabetes Cell Therapy, Institute for Research in Biotherapy, University Hospital St-Eloi, Montpellier, France
| | - Mathieu Armanet
- Laboratory for Diabetes Cell Therapy, Institute for Research in Biotherapy, University Hospital St-Eloi, Montpellier, France
| | - Cécile Tourrel-Cuzin
- B2PE Laboratory (Biology & Pathology of Endocrine Pancreas), BFA Unit, Univ. Paris-Diderot, CNRS EAC4413, Paris, France
| | - Domenico Bosco
- Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Stéphane Dalle
- CNRS UMR 5203, INSERM U661, and Montpellier 1 & 2 University, Institute of Functional Genomics, Montpellier, France
- Laboratory for Diabetes Cell Therapy, Institute for Research in Biotherapy, University Hospital St-Eloi, Montpellier, France
| | - Anne Wojtusciszyn
- CNRS UMR 5203, INSERM U661, and Montpellier 1 & 2 University, Institute of Functional Genomics, Montpellier, France
- Laboratory for Diabetes Cell Therapy, Institute for Research in Biotherapy, University Hospital St-Eloi, Montpellier, France
- Department of Endocrinology-Diabetes-Nutrition, University Hospital Lapeyronie, Montpellier, France
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Bousquet J, Jorgensen C, Dauzat M, Cesario A, Camuzat T, Bourret R, Best N, Anto J, Abecassis F, Aubas P, Avignon A, Badin M, Bedbrook A, Blain H, Bourdin A, Bringer J, Camu W, Cayla G, Costa D, Courtet P, Cristol JP, Demoly P, Coussaye JE, Fesler P, Gouzi F, Gris JC, Guillot B, Hayot M, Jeandel C, Jonquet O, Journot L, Lehmann S, Mathieu G, Morel J, Ninot G, Pelissier J, Picot MC, Radier-Pontal F, Robine JM, Rodier M, Roubille F, Sultan A, Wojtusciszyn A, Auffray C, Balling R, Barbara C, Cambon-Thomsen A, Chavannes N, Chuchalin A, Crooks G, Dedeu A, Fabbri L, Garcia-Aymerich J, Hajjam J, Gomes E, Palkonen S, Piette F, Pison C, Price D, Samolinski B, Schunemann H, Sterk P, Yiallouros P, Roca J, Perre P, Mercier J. Systems Medicine Approaches for the Definition of Complex Phenotypes in Chronic Diseases and Ageing. From Concept to Implementation and Policies. Curr Pharm Des 2014; 20:5928-44. [DOI: 10.2174/1381612820666140314115505] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/12/2014] [Indexed: 11/22/2022]
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Wojtusciszyn A, Mourad G, Bringer J, Renard E. Continuous glucose monitoring after kidney transplantation in non-diabetic patients: early hyperglycaemia is frequent and may herald post-transplantation diabetes mellitus and graft failure. Diabetes Metab 2013; 39:404-10. [PMID: 23999231 DOI: 10.1016/j.diabet.2012.10.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 10/23/2012] [Accepted: 10/23/2012] [Indexed: 01/28/2023]
Abstract
OBJECTIVES New onset of diabetes after transplantation (NODAT) is a known complication of renal transplantation, but early glycaemic status after transplantation has not been described prospectively. This study aimed to assess blood glucose (BG) levels immediately following kidney transplantation in non-diabetic subjects and to explore their relationship to later graft outcomes and NODAT occurrence. PATIENTS AND METHODS Over a 9-month period, 43 consecutive non-diabetic patients who received a kidney transplant were prospectively investigated. During the first 4 days after transplantation, fasting BG was measured and the 24-h BG profile assessed by continuous glucose monitoring (CGM). Capillary BG was measured on hospital admittance and at least four times a day for CGM calibration thereafter. All adverse events were recorded, and fasting BG and HbA1c were assessed at 3, 6 and 12 months and at the last visit to our centre. RESULTS Immediately following renal transplantation, capillary BG was 12.2 ± 3.8 mmol/L. On day 1 (D1), fasting BG was 9.9 ± 4.3 mmol/L and decreased to 6.0 ± 1.5 mmol/L on D3. The CGM-reported mean 24-h BG (mmol/L) was 10.2±2.4 on D1, 7.7 ± 1.3 on D2 and 7.5 ± 1.1 on D3. From D1 to D4, 43% of patients spent>12h/day with BG levels>7.7 mmol/L. While morbidity during the 3 months following transplantation appeared unrelated to BG, the first post-transplantation capillary BG measurement and fasting BG on D1 tended to be higher in patients who developed diabetes 3 months later. Tacrolimus treatment was associated with a higher incidence of dysglycaemia at 3 and 6 months. After a mean follow-up of 72 months, NODAT was frequently seen (18.6%), and was associated with tacrolimus medication (P<0.01) and a higher rate of renal transplantation failure (RR: 3.6, P<0.02). CONCLUSION Hyperglycaemia appears to be a nearly constant characteristic immediately following transplantation in non-diabetic kidney recipients. Higher BG values could identify patients at risk for later post-transplant diabetes and graft failure.
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Affiliation(s)
- A Wojtusciszyn
- Department of Endocrinology, Diabetes, Nutrition, Lapeyronie Hospital, CHU Montpellier, 391, avenue du Doyen-Giraud, 34295 Montpellier cedex 5, France; Institute of Functional Genomics, UMR CNRS 5203, Inserm U661, University of Montpellier, Montpellier, France; Institute of Research in Biotherapies, Montpellier University Hospital, Montpellier, France.
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Vaquer G, Magous R, Cros G, Wojtusciszyn A, Renard E, Chevassus H, Petit P, Lajoix AD, Oiry C. Short-term intravenous insulin infusion is associated with reduced expression of NADPH oxidase p47(phox) subunit in monocytes from type 2 diabetes patients. Fundam Clin Pharmacol 2012; 27:669-71. [PMID: 22780425 DOI: 10.1111/j.1472-8206.2012.01057.x] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 05/30/2012] [Accepted: 06/07/2012] [Indexed: 01/04/2023]
Abstract
Hyperglycemia is a well-known inducing factor of oxidative stress through activation of NADPH oxidase. In addition to its plasma glucose lowering effect, insulin may also have antioxidant activity and was shown to downregulate NADPH oxidase expression in vitro. In this study, we show that a short-term (3-day) intravenous insulin infusion in patients with type 2 diabetes induces normalization of both glycemia and mRNA expression of circulating monocyte p47(phox) subunit.
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Affiliation(s)
- Guillaume Vaquer
- Center of Pharmacology and Innovation in Diabetes, University Montpellier I, CNRS FRE 3400, 34093 Montpellier, France
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