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Mohammed J, Beura LK, Bobr A, Astry B, Chicoine B, Kashem SW, Welty NE, Igyártó BZ, Wijeyesinghe S, Thompson EA, Matte C, Bartholin L, Kaplan A, Sheppard D, Bridges AG, Shlomchik WD, Masopust D, Kaplan DH. Stromal cells control the epithelial residence of DCs and memory T cells by regulated activation of TGF-β. Nat Immunol 2016; 17:414-21. [PMID: 26901152 PMCID: PMC5135085 DOI: 10.1038/ni.3396] [Citation(s) in RCA: 178] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/05/2016] [Indexed: 01/02/2023]
Abstract
Cells of the immune system that reside in barrier epithelia provide a first line of defense against pathogens. Langerhans cells (LCs) and CD8(+) tissue-resident memory T cells (TRM cells) require active transforming growth factor-β1 (TGF-β) for epidermal residence. Here we found that integrins αvβ6 and αvβ8 were expressed in non-overlapping patterns by keratinocytes (KCs) and maintained the epidermal residence of LCs and TRM cells by activating latent TGF-β. Similarly, the residence of dendritic cells and TRM cells in the small intestine epithelium also required αvβ6. Treatment of the skin with ultraviolet irradiation decreased integrin expression on KCs and reduced the availability of active TGF-β, which resulted in LC migration. Our data demonstrated that regulated activation of TGF-β by stromal cells was able to directly control epithelial residence of cells of the immune system through a novel mechanism of intercellular communication.
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Research Support, N.I.H., Extramural |
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Anderson BE, McNiff JM, Matte C, Athanasiadis I, Shlomchik WD, Shlomchik MJ. Recipient CD4+ T cells that survive irradiation regulate chronic graft-versus-host disease. Blood 2004; 104:1565-73. [PMID: 15150080 DOI: 10.1182/blood-2004-01-0328] [Citation(s) in RCA: 165] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Chronic graft-versus-host disease (cGVHD) is an increasingly common cause of morbidity and mortality in allogeneic stem cell transplantation (alloSCT). Relative to acute GVHD (aGVHD), much less is understood about cGVHD. Using the B10.D2 → BALB/c murine cGVHD model, which shares critical pathologic features with human cGVHD, we find that radiation-resistant host T cells regulate cGVHD. We initially observed that recipients lacking all lymphocytes developed accelerated and more severe cGVHD. Using genetically deficient recipients, we determined that αβ+CD4+ T cells were required to regulate cGVHD. Increased cGVHD severity was not due to the absence of T cells per se. Rather, the potency of regulation was proportional to host T-cell receptor (TCR) diversity. Only CD4+CD25+, and not CD4+CD25-, host T cells ameliorated cGVHD when added back, indicating that host T cells acted not via host-versus-graft activity or by reducing homeostatic proliferation but by an undefined regulatory mechanism. Thus, preparative regimens that spare host CD4+CD25+ T cells may reduce cGVHD. Donor CD4+CD25+ T cells also reduced cGVHD. Depletion of CD4+CD25+ cells from the inoculum exacerbated disease, whereas transplantation of additional CD4+CD25+ cells protected against severe cGVHD. Additional CD4+CD25+ cells also promoted healing of established lesions, suggesting that their effects persist during the evolution of cGVHD.
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Olivier M, Romero-Gallo BJ, Matte C, Blanchette J, Posner BI, Tremblay MJ, Faure R. Modulation of interferon-gamma-induced macrophage activation by phosphotyrosine phosphatases inhibition. Effect on murine Leishmaniasis progression. J Biol Chem 1998; 273:13944-9. [PMID: 9593743 DOI: 10.1074/jbc.273.22.13944] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Phagocyte functions are markedly inhibited after infection with the intracellular protozoan parasite Leishmania. This situation strongly favors the installation and propagation of this pathogen within its mammalian host. Previous findings by us and others have established that alteration of several signaling pathways (protein kinase C-, Ca2+- and protein-tyrosine kinases-dependent signaling events) were directly responsible for Leishmania-induced macrophage (MO) dysfunctions. Here we report that modulation of phosphotyrosine-dependent events with a protein tyrosine phosphatases (PTP) inhibitor, the peroxovanadium (pV) compound bpV(phen) (potassium bisperoxo(1,10-phenanthroline)oxovanadate(Vi)), can control host-pathogen interactions by different mechanisms. We observed that the inhibition of parasite PTP resulted in an arrest of proliferation and death of the latter in coincidence with cyclin-dependent kinase (CDK1) tyrosine 15 phosphorylation. Moreover the treatment of MO with bpV(phen) resulted in an increased sensitivity to interferon-gamma stimulation, which was reflected by enhanced nitric oxide (NO) production. This enhanced IFN-gamma-induced NO generation was accompanied by a marked increase of inducible nitric oxide synthase (iNOS) mRNA gene and protein expression. Finally we have verified the in vivo potency of bpV(phen) over a 6-week period of daily administration of a sub-toxic dose. The results revealed its effectiveness in controlling the progression of visceral and cutaneous leishmaniasis. Therefore PTP inhibition of Leishmania and MO by the pV compound bpV(phen) can differentially affect these eukaryotic cells. This strongly suggests that PTP plays an important role in the progression of Leishmania infection and pathogenesis. The apparent potency of pV compounds along with their relatively simple and versatile structure render them attractive pharmacological agents for the management of parasitic infections.
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Matte C, Lacaille J, Zijenah L, Ward B, Roger M. HLA-G and HLA-E polymorphisms in an indigenous African population. The ZVITAMBO Study Group. Hum Immunol 2000; 61:1150-6. [PMID: 11137220 DOI: 10.1016/s0198-8859(00)00200-7] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Studies of HLA-G and HLA-E polymorphisms in different populations from many industrialized countries have uniformly reported little sequence variation within these genes. To date, the polymorphism of these genes has not been characterized in populations from developing countries where more sequence variation would be anticipated due to greater exposure to microbial pathogens. In order to address this issue, we have recently investigated the polymorphism of these MHC genes in an indigenous African population (Shona ethnic group). HLA-G and HLA-E alleles were determined by PCR-restriction fragment length polymorphism (PCR-RFLP) and amplification refractory mutation system (ARMS) analysis in 108 unrelated women recruited from maternity clinics and hospitals in Harare (Zimbabwe). The genotyping analysis identified six different HLA-G alleles and three HLA-E alleles in this population. Of interest, the null-allele HLA-G*0105N was found with 11.1% of frequency, which is higher than in other populations tested so far. We observed the presence of 15 distinct HLA-G genotypes and 6 HLA-E genotypes. These data indicate that this African population contains low levels of allelic polymorphism similar to ethnic groups from industrialized countries. This is the first report describing HLA-G and HLA-E polymorphisms in an indigenous African population.
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Matte C, Marquis JF, Blanchette J, Gros P, Faure R, Posner BI, Olivier M. Peroxovanadium-mediated protection against murine leishmaniasis: role of the modulation of nitric oxide. Eur J Immunol 2000; 30:2555-64. [PMID: 11009089 DOI: 10.1002/1521-4141(200009)30:9<2555::aid-immu2555>3.0.co;2-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The phosphotyrosine phosphatase inhibitor bpV(phen) has the ability to markedly decrease the progression of leishmaniasis in vivo. Here, we have identified the mechanisms that are responsible for this protective effect. We report that two potent peroxovanadium (pV) compounds, bpV(phen) and bpV(pic), control progression of leishmaniasis in a similar manner by modulating NO-dependent microbicidal action. We observed that their injection can rapidly and transiently induce the expression of inducible NO synthase (iNOS) in livers of mice and enhance circulating nitrate levels. Treatment of mice with bpV(phen) or bpV(pic) completely controlled progression of leishmaniasis in an NO-dependent manner, since inhibition of iNOS with aminoguanidine completely reversed this pV-mediated protection. This NO-dependent pV-mediated protection was further demonstrated by the incapacity of bpV(phen)-treated Nramp-/-, iNOS-/- mutant mice to control Leishmania major infection. Using an air pouch model, we showed that bpV(phen) can strongly modulate secretion of L. major-induced pro-inflammatory molecules and neutrophil recruitment. In addition, we observed that bpV(phen) per se can strongly induce the expression of Th1 type cytokines over Th2 in spleens of animals. Overall, this study has allowed us to establish the in vivo functional and immunological events involved in pV-mediated protective mechanism against leishmaniasis and that NO plays a pivotal role in this process.
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Matte C, Maion G, Mourad W, Olivier M. Leishmania donovani-induced macrophages cyclooxygenase-2 and prostaglandin E2 synthesis. Parasite Immunol 2001; 23:177-84. [PMID: 11298294 DOI: 10.1046/j.1365-3024.2001.00372.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Prostaglandin E2 (PGE2) secretion during Leishmania infection has been reported. However, the signalling mechanisms mediating this response are not well understood. Since cyclooxygenase-2 (COX-2) and cytosolic phospholipase A2 (cPLA2) are involved in PGE2 synthesis in response to various stimuli, the implication of these enzymes was evaluated in Leishmania-infected phorbol myristate acetate-differentiated U937 human monocytic cell line. Time-course experiments showed that PGE2 synthesis increased significantly in parallel with COX-2 expression when cells were incubated in the presence of Leishmania donovani promastigotes or lipopolysaccharides (LPS). Increase in cPLA2 mRNA expression was only detected when cells were stimulated with LPS. Indomethacin, genistein, and H7, which are antagonists of COX-2, protein tyrosine kinase (PTK) and protein kinase C (PKC), respectively, inhibited PGE2 production induced by L. donovani and LPS. However, only H7 inhibited COX-2 mRNA synthesis, and there was a significant correlation between PGE2 inhibition and reduced COX-2 expression. Collectively, our results indicate that infection of U937 by L. donovani leads to the generation of PGE2 in part through a PKC-dependent signalling pathway involving COX-2 expression. They further reveal that PTK-dependent events are necessary for Leishmania-induced PGE2 generation, but not for COX-2 expression. A better understanding of the mechanisms by which Leishmania can induce PGE2 production could provide insight into the pathophysiology of leishmaniasis and may help to improve therapeutic approaches.
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Fernandez J, Olea N, Matte C. Structure and development of the egg of the glossiphoniid leech Theromyzon rude: characterization of developmental stages and structure of the early uncleaved egg. Development 1987. [DOI: 10.1242/dev.100.2.211] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Some aspects of the reproductive biology of the glossiphoniid leech, Theromyzon rude, under laboratory conditions, and the staging and structure of its uncleaved egg were studied. Sexually mature animals form breeding communities and fertilization occurs in the ovisacs, presumably around the time of egg laying. Oviposition may be postponed for hours or days, but the eggs in the ovisacs remain blocked at first meiotic metaphase. Development of the uncleaved egg, from the time of oviposition to completion of the first cleavage division, has been sub-divided into six stages. At 20°C, the six developmental stages take 5–6h. Characterization of the stages is based on observations of both live and fixed/cleared eggs. Discharge of the first pole cell, by the end of stage 1a, is associated with the movement of a ring of contraction between the equator and the animal pole. Discharge of the second pole cell, by the end of stage 1b, is accompanied by contraction of the animal hemisphere which becomes a cone-shaped structure. Polar rings and meridional bands of contraction make their appearance by stages 1c and 1d, respectively. Constriction of the polar rings and shortening of the meridional bands, during stage 1e, lead to accumulation of ooplasm at both egg poles. In this manner, the teloplasm or pole plasm forms. Completion of the first cleavage furrow, by the end of stage 1f, is preceded by dorsoventral flattening of the egg and rearrangement of its teloplasm and perinuclear plasm. Structure of the early uncleaved egg has been studied with transmission and scanning electron microscopy of intact or permeabilized preparations. The plasmalemma forms numerous long and some short microvilli evenly distributed across the egg surface. The ectoplasm includes many vesicles, mitochondria, granules and an elaborate network of filament bundles. Staining of this network with rhodamine-labelled phalloidin indicates that it contains F-actin. A less complex network of similar filaments is also present throughout the yolky endoplasm. The meiotic spindle lies close to the egg surface and not far from the presumptive animal pole ectoplasm. It comprises highly developed poles whose structure and relationships are described.
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Garretta M, Muller A, Gener J, Matte C, Moullec J. Reliability in automatic determination of the ABO group by the groupamatic system. Vox Sang 1974; 27:141-55. [PMID: 4854096 DOI: 10.1111/j.1423-0410.1974.tb02402.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Segura M, Matte C, Thawani N, Su Z, Stevenson MM. Modulation of malaria-induced immunopathology by concurrent gastrointestinal nematode infection in mice. Int J Parasitol 2009; 39:1525-32. [PMID: 19716371 DOI: 10.1016/j.ijpara.2009.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2009] [Revised: 07/28/2009] [Accepted: 08/14/2009] [Indexed: 10/20/2022]
Abstract
We investigated malaria-associated pathology in mice co-infected with Heligmosomoides polygyrus (Hp) and Plasmodium chabaudi AS (Pc). Despite higher peak parasitemia, co-infected wild-type (WT) C57BL/6 mice displayed similar body weight losses, malarial anaemia, and tissue damage but less severe hypothermia and hypoglycaemia, and earlier reticulocytosis than Pc-infected WT mice. Co-infected STAT6(-/-) mice, deficient in nematode-induced Th2 responses, experienced similar peak parasitemias and generally suffered malaria-associated pathology to a similar degree as co-infected WT mice. These data indicate a complex relationship amongst helminths, malaria and host immune responses resulting in modulation of some but not all aspects of malaria-associated pathology.
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Research Support, Non-U.S. Gov't |
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Fernández J, Olea N, Téllez V, Matte C. Structure and development of the egg of the glossiphoniid leech Theromyzon rude: reorganization of the fertilized egg during completion of the first meiotic division. Dev Biol 1990; 137:142-54. [PMID: 2295361 DOI: 10.1016/0012-1606(90)90015-b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Reorganization of the fertilized egg during completion of the first meiotic division was studied in the glossiphoniid leech Theromyzon rude. Rotation of the meiotic spindle, presumably as a result of changes in the length and arrangement of astral fibers, allows one of its poles to approach the prospective animal pole (AP), which appears as a differentiated region of the ectoplasm. The peripheral spindle pole is greatly modified during its anchorage to the AP and is dismantled upon emission of the first pole cell. Meanwhile, the central spindle pole is less modified and is reused during the second meiotic division. Redistribution of microvilli, as well as rearrangement of the ectoplasmic actin lattice, lead to remodeling of the egg surface. Emission of the first pole cell is preceded by a contraction wave that seems to arise by condensation of subcortical actin filaments at the equator of the egg. Poleward displacement of this wave causes evagination of the AP and ooplasmic segregation. A cytokinetic contractile ring forms by assembly of cortical actin filaments at the base of the AP evagination. When this process is disturbed by colchicine or cytochalasin B treatment, abortive or ghost pole cells may be formed.
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Abstract
Approximately 6000,000 routine immunohematological tests have been conducted with Groupamatic GC systems at the National Blood Transfusion Center in Paris. The system is used for determination of the ABO group including A1 and A2 subgrouping; the Rh factors including Du, C, c, E, e, CW;K;Lea; P1; M and N. The detection and identification of irregular alloantibodies is carried out systematically together with detection of the anti-A and anti-B antibodies. Simultaneously, testing for syphilis is done with a cardiolipid antigen. Groupamatic equipment allows 340 samples to be tested per hour and 12 reactions can be carried out simultaneously on each sample. The system is fully automated.
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Kukuvitis A, Matte C, Polychronakos C. Central precocious puberty following feminizing right ovarian granulosa cell tumor. HORMONE RESEARCH 1995; 44:268-70. [PMID: 8808012 DOI: 10.1159/000184639] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 7-month-old girl presented with ascites and breast enlargement due to right ovarian granulosa cell tumor. After tumor removal, the clinical signs of incomplete precocious puberty regressed. Four years later, the patient reappeared with signs of precocious puberty. Our investigations proved that this was not due to tumor recurrence, but it was a true central precocious puberty. She responded well to therapy with a luteinizing hormone releasing hormone agonist, and 3 years after onset of this therapy, she is growing at a normal prepubertal rate.
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Case Reports |
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Matte C. [Automatic determination of blood groups. Development of an experimental apparatus]. REVUE FRANCAISE DE TRANSFUSION 1969; 12:213-32. [PMID: 5806722 DOI: 10.1016/s0035-2977(69)80064-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Garreta M, Muller A, André J, Moullec J, Matte C. [Detection of ABO chimeras on Groupamatic 360 GC]. REVUE FRANCAISE DE TRANSFUSION 1973; 16:147-60. [PMID: 4603455 DOI: 10.1016/s0035-2977(73)80073-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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English Abstract |
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7 |
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Garretta M, Paris-Hamelin A, Gener J, Muller A, Matte C, Vaisman A, Moullec J. [Automatic detection of syphilis on Groupamatic. Preliminary results]. REVUE FRANCAISE DE TRANSFUSION 1973; 16:349-64. [PMID: 4601576 DOI: 10.1016/s0035-2977(73)80044-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Clinical Trial |
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Matte C, Lacroix Y, Jarricot A. [A rapid red cell washer for antiglobulin tests on Groupamatic]. REVUE FRANCAISE DE TRANSFUSION ET IMMUNO-HEMATOLOGIE 1978; 21:479-84. [PMID: 675003 DOI: 10.1016/s0338-4535(78)80086-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Steinbuch M, Matte C, Audran R, Moullec J. Molecular support of rheumatoid factor and anti-Gm(a) activity. Nature 1965; 207:92. [PMID: 4160061 DOI: 10.1038/207092a0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Martel S, Lambertini M, Simon R, Matte C, Prady C. Adherence to guidelines in requesting Oncotype DX in a publicly funded health care system. ACTA ACUST UNITED AC 2018; 25:e311-e318. [PMID: 30111977 DOI: 10.3747/co.25.3965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Oncotype dx [odx (Genomic Health, Redwood City, CA, U.S.A.)] is an approved prognostic tool for women with node-negative, hormone receptor-positive, her2-negative breast cancer. Because of cost, optimal use of this test is crucial, especially in a publicly funded health care system. We evaluated adherence with our provincial guidelines for odx requests, the management of patients with an intermediate recurrence score (rs), and the cost impact of odx. Methods This retrospective study included 201 consecutive patients with an odx request from two university institutions in Quebec between May 2012 and December 2014. Concordance with provincial guidelines was estimated, with its 95% confidence interval (ci). For patients with an intermediate rs, factors influencing the final treatment decision were assessed. The cost impact of odx was derived from the proportion of patients for whom chemotherapy was not recommended. Results In 93.0% of patients (95% ci: 89.5% to 96.6%), odx was ordered according to guidelines. The concordance was similar in both institutions (92.7%; 95% ci: 88.1% to 97.3%; and 93.6%; 95% ci: 88.2% to 99.0%). In 112 (55.7%), 78 (38.8%), and 9 (4.5%) patients, the rs suggested low, intermediate, and high risk respectively. In the intermediate-risk group, most patients (n = 58, 74.4%) did not receive chemotherapy, mainly because of patient preference and the absence of a clear proven benefit. Savings of CA$100,000 for the study period (2.5 years) were estimated to be associated with odx use. Conclusions In our experience, the use of odx was concordant with published recommendations and had a positive cost impact.
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Multicenter Study |
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Steinbuch M, Audran R, Matte C. The detection of Gm (a) specificity by passive hemagglutination using normal anti-Gm (a) serum (SNagg). Vox Sang 1965; 10:744-7. [PMID: 4159412 DOI: 10.1111/j.1423-0410.1965.tb05190.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Garretta M, Muller A, Gener J, Matte C, Moullec J. Reliability in Automatic Determination of the ABO Group
by the Groupamatic System. Vox Sang 1974. [DOI: 10.1159/000466733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Steinbuch M, Audran R, Matte C. The Detection of Gm (a) Specificity by Passive
Hemagglutination Using Normal Anti-Gm (a) Serum
(SNagg). Vox Sang 1965. [DOI: 10.1159/000465068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Matte C, Hoang J, Jayaraman D, Green L, Morin SN. Duration of corticosteroid use in chronic obstructive pulmonary disease exacerbations: improving prescribing practices on clinical teaching units with peer-to-peer teaching. BMJ Open Qual 2018; 7:e000333. [PMID: 30057960 PMCID: PMC6059259 DOI: 10.1136/bmjoq-2018-000333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/09/2018] [Accepted: 07/05/2018] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The most recent Global Initiative for Chronic Obstructive Lung Disease consensus recommends a 5-day course of corticosteroid (CS) therapy for acute chronic obstructive pulmonary disease exacerbations (ACOPDE). As inappropriate use of CS therapy is associated with adverse events, we implemented a peer-to-peer education intervention to improve adherence to guidelines for patients with ACOPDE admitted to a medical clinical teaching unit at a tertiary care university centre. METHODS Our study was a before-after design study with a concurrent control of a 15 min peer-to-peer educational intervention targeting medical residents at the beginning of a 4-week rotation for 12 consecutive months. Another medical teaching unit within the same university network, but at a different site, served as a concurrent control. The primary outcome was the proportion of patients who received appropriate duration of CS therapy (5 days) for ACOPDE during the intervention period as compared with the 12-month preintervention period at the intervention and control hospitals. RESULTS Following the intervention, there was an increase in the proportion of patients receiving appropriate duration of CS therapy (34.2% to 51.3%, p=0.02) at the intervention hospital and no significant difference at the control hospital (22.8% to 34.1%, p=0.15). This effect was maintained at the intervention hospital 3 months postintervention period. CONCLUSION A short peer-to-peer educational intervention targeting medical residents on a clinical teaching unit improved adherence to appropriate duration of CS therapy for ACOPDE.
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Review |
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Martel S, Prady C, Simon R, Matte C. Abstract P2-05-30: OncotypeDX® for breast cancer: A multigene assay that makes a difference? Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-05-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective: OncotypeDX® (ODX) is a multigene diagnostic assay that can estimate the 10 year-risk of distant recurrence in women with hormone receptor positive (HR+) and node negative (N–) early breast cancer. The testreports a Recurrence Score® (RS) and three risk group categories have been described: low-risk (<18), intermediate-risk (18-30) and high-risk (≥31). It helps the oncologist in the adjuvant chemotherapy decision process and globally leads to a reduction in the recommendation for chemotherapy use. This test is expensive and represents an economic burden in a publicly funded province. Nonetheless, its use has been approved over other gene expression profiling like Mammaprint® based on the evidence of its prognostic and predictive ability. We evaluated the adequacy of the requests for the ODX in an academic setting after the introduction in May 2012 of a reference framework for its use in Québec, Canada and the impact on chemotherapy recommendation. The costs generated by the test were also determined. Methods: We included all patients with an ODX request from two University Centers, CICM and CHUS, and estimated the concordance with the current provincial guideline for which an ODX may be ordered (invasive breast cancer HR+/Her2–/N- that is T1b with unfavorable characteristics or T1c or T2). For the intermediate-risk group, the factors influencing the final decision to use systemic chemotherapy were analysed. The projected cost-effectiveness of the ODX was derived from the proportion of patients (pts) for which the chemotherapy was not recommended. Results: Between May 2012 and December 2014, a total of 201 pts, 123 pts from CICM and 78 from CHUS, had an ODX done. In 93,0% (95%CI, 89,5-96,6) of pts, ODX was ordered correctly with respect to the guideline. There was no statistical differences between both sites (CICM: 92,7% [95%CI, 97,3-88,1]; CHUS 93,6% [95%CI, 88,2-99,0]). A total of 9 pts had high-risk RS (4,5%), 78 pts had intermediate-risk RS (38,8%) and 112 pts had low-risk RS (55,7%). Chemotherapy was recommended for 31 pts (18,2%) instead of an estimated 58,0% prior to the use of ODX according to previous reports published. In the intermediate-risk group, the majority of pts (74,4%) did not receive chemotherapy. The patient's preference and the absence of a proven benefit were the main reasons for withholding chemotherapy in this group. The additional cost associated with the use of the ODX was compensated with the reduction of the adjuvant systemic chemotherapy prescribed and its derived expenses (chemotherapy cost, nursing time and hospitalisations) and savings of 100 K were observed. Conclusions: In early breast cancer HR+ and N-, the use of ODX in two University Hospitals is concordant with published recommendations. ODX use is cost effective. This benefice does not take into account the psychological burden that comes with the decision to use adjuvant chemotherapy; neither does it evaluate potential long term complications. The widespread use of ODX must be looked at critically in face of other emerging gene signature tests like Endopredict® and PAM50®. As for the predictive ability of the ODX for adjuvant chemotherapy, one can question the strength of the actual evidence and argue if it confers this test an advantage over other multigene assays.
Citation Format: Martel S, Prady C, Simon R, Matte C. OncotypeDX® for breast cancer: A multigene assay that makes a difference? [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-05-30.
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Pédarriosse AM, Paget-Maj V, Amrein R, Matte C, Ranavoson L, Piette F, Salvatore R. Les dépressions associées aux détériorations intellectuelles des sujets âgés doivent être reconnues et traitées. Rev Med Interne 1994. [DOI: 10.1016/s0248-8663(05)82566-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Matte AC, Schirren C, Matte C. [Sex role and identity of childless andrology patients]. Andrologia 1984; 16:76-82. [PMID: 6721244 DOI: 10.1111/j.1439-0272.1984.tb00238.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
By means of the Bem Sex-Role Inventory (BSRI) 1000 childless married patients of andrology have been examined in order to determine their masculinity, femininity, androgynity and social desire scores. The results have been compared with a control group of 111 students of medicine and dentistry and with data of a study on 444 students at Stanford University. Significant differences have been shown in social desire only, but in no other respect. Thus, the results do not indicate differences of sex role and self image between andrological patients and control groups in Hamburg as well as in Stanford.
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