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Philip R, Aouba A, Martin Silva N, Mariotte D, Hamidi H, Rhouni S, Darnige L, Dragon-Durey MA. Autoantibodies against complement proteins in patients with antiphospholipid syndrome: Prevalence and clinical associations. Eur J Immunol 2024:e2350832. [PMID: 38700064 DOI: 10.1002/eji.202350832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024]
Abstract
Seventy-seven patients with antiphospholipid syndrome were tested for autoantibodies against C1q, C3, FB, FH, and C4bp. Fifty-seven patients had at least one anti-complement antibody. IgM anti-FH positivity was associated with thrombosis when anti-C3 and anti-FB were, negatively or positively, associated with various noncriteria manifestations of antiphospholipid syndrome.
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Affiliation(s)
- Rémi Philip
- Department of Clinical Immunology and Internal Medicine, CHU of Caen Normandie, Caen, France
- INSERM UMRS 1138 Team "Inflammation, Complement and Cancer", Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, France
- UNICAEN, CHU de Caen Normandie, Normandie University, Caen, France
| | - Achille Aouba
- Department of Clinical Immunology and Internal Medicine, CHU of Caen Normandie, Caen, France
- UNICAEN, CHU de Caen Normandie, Normandie University, Caen, France
| | - Nicolas Martin Silva
- Department of Clinical Immunology and Internal Medicine, CHU of Caen Normandie, Caen, France
| | - Delphine Mariotte
- Laboratory of Immunology and Histocompatibility, Department of Biology, CHU of Caen Normandie, Caen, France
| | - Houcine Hamidi
- INSERM UMRS 1138 Team "Inflammation, Complement and Cancer", Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, France
- Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique Hopitaux de Paris (APHP), Paris, France
| | - Sanae Rhouni
- Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique Hopitaux de Paris (APHP), Paris, France
| | - Luc Darnige
- Hematology Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Université Paris Cité, Innovative Therapies in Haemostasis, INSERM UMR-S1140, Paris, France
| | - Marie-Agnès Dragon-Durey
- INSERM UMRS 1138 Team "Inflammation, Complement and Cancer", Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, France
- Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique Hopitaux de Paris (APHP), Paris, France
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de Boysson H, Cuchet M, Cassius C, Cuchet P, Agard C, Audemard-Verger A, Marchand-Adam S, Cohen-Sors R, Gallay L, Graveleau J, Lesort C, Ly K, Meyer A, Monseau G, Néel A, Bonnotte B, Pérard L, Schleinitz N, Mariotte D, Le Mauff B, Bourdenet G, Masmoudi W, Deshayes S, Dumont A, Dompmartin A, Kottler D, Aouba A. Disease patterns and specific trajectories of anti-MDA5-related disease: a multicentre retrospective study of 70 adult patients. Front Immunol 2024; 14:1319957. [PMID: 38259447 PMCID: PMC10800864 DOI: 10.3389/fimmu.2023.1319957] [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: 10/11/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction This study aimed to provide an updated analysis of the different prognostic trajectories of patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibodies. Methods Among a cohort of 70 patients, baseline characteristics and phenotypes, treatments and outcomes were analyzed. A Cox proportional hazards model was used to identify factors associated with poor outcomes, i.e., death or progressive disease at the last follow-up. Results Among the 70 patients, 45 were women, and 54 were Caucasian. A dermatologic involvement was observed in 58 (83%) patients, including 40 with MDA5 vasculopathy-related skin lesions. Muscular involvement was observed in 39 (56%) patients. Interstitial lung disease (ILD) was observed at baseline in 52 (74%) patients, including 23 (44%) who developed rapidly progressive (RP) ILD. Seven (10%) patients showed thromboembolic complications within the first weeks of diagnosis, and eight (11%) other patients developed a malignancy (4 before the diagnosis of anti-MDA5 disease). Poor outcomes were observed in 28 (40%) patients, including 13 (19%) deaths. Among the 23 patients with RP-ILD, 19 (79%) showed poor outcomes, including 12 (63%) who died. In multivariate analyses, RP-ILD (hazard ratio (HR), 95% CI: 8.24 [3.21-22], p<0.0001), the occurrence of thromboembolic events (HR: 5.22 [1.61-14.77], p=0.008) and the presence of any malignancy (HR: 19.73 [6.67-60], p<0.0001) were the three factors independently associated with poor outcomes. Discussion This new independent cohort confirms the presence of different clinical phenotypes of anti-MDA5 diseases at baseline and the poor prognosis associated with RP-ILD. Thromboembolic events and malignancies were also identified as prognostic factors.
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Affiliation(s)
- Hubert de Boysson
- Department of Internal Medicine, Caen University Hospital, Caen, France
| | - Marie Cuchet
- Department of Dermatology, Caen University Hospital, Caen, France
| | - Charles Cassius
- Department of Dermatology, France Saint Louis Hospital, (AP-HP), Paris, France
| | - Pierre Cuchet
- Department of Pneumology, Caen University Hospital, Caen, France
| | - Christian Agard
- Nantes Université, Centre Hospitalier et Universitaire (CHU) Nantes, Service de Médecine Interne, Nantes, France
| | | | | | | | - Laure Gallay
- Service de Médecine Interne et Immunologie Clinique, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Julie Graveleau
- Department of Internal Medicine, Saint-Nazaire Hospital, Saint-Nazaire, France
| | - Cécile Lesort
- Department of Dermatology, Edouard Herriot Hospital, Hospices civiles de Lyon (HCL), Lyon, France
| | - Kim Ly
- Department of Internal Medicine, Limoges University Hospital, Limoges, France
| | - Alain Meyer
- Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | - Grégoire Monseau
- Department of Intensive Medicine, Poitiers University Hospital Center, Poitiers, France
| | - Antoine Néel
- Nantes Université, Centre Hospitalier et Universitaire (CHU) Nantes, Service de Médecine Interne, Nantes, France
| | - Bernard Bonnotte
- Department of Internal Medicine, Dijon University Hospital, Dijon, France
| | - Laurent Pérard
- Department of Internal Medicine, Saint Joseph Saint Luc Hospital, Lyon, France
| | - Nicolas Schleinitz
- Department of Internal Medicine, La Timone University Hospital, Assistance Publique - Hopitaux de Marseille (AP-HM), Marseille, France
| | | | | | - Gwladys Bourdenet
- Department of Immunology, Amiens University Hospital, Amiens, France
- HEMATIM – EA4666, Jules Verne University of Picardie, Amiens, France
| | - Wafa Masmoudi
- Department of Dermatology, Rouen University Hospital, Rouen, France
| | - Samuel Deshayes
- Department of Internal Medicine, Caen University Hospital, Caen, France
| | - Anaël Dumont
- Department of Internal Medicine, Caen University Hospital, Caen, France
| | - Anne Dompmartin
- Department of Dermatology, Caen University Hospital, Caen, France
| | - Diane Kottler
- Department of Dermatology, Caen University Hospital, Caen, France
| | - Achille Aouba
- Department of Internal Medicine, Caen University Hospital, Caen, France
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Bradatan E, Beaudoin E, Beaumont P, Demoly P, Dumond P, Fardeau M, Liabeuf V, Mariotte D, Pouessel G, Tscheiller S, Van der Brempt X, Renaudin J, Ponvert C, Sabouraud-Leclerc D. Le recueil des cofacteurs et comorbidités lors des déclarations d’anaphylaxie : vers une médecine personnalisée adaptée au patient. Revue Française d'Allergologie 2023. [DOI: 10.1016/j.reval.2023.103329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Gérard M, de Boysson H, Morello R, Martin-Silva N, Leroux AC, Dumont A, Maigné G, Boutemy J, Khoy K, Mariotte D, Lobbedez T, Aouba A, Deshayes S. Early infectious risk in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis according to remission-induction therapy. Scand J Rheumatol 2023; 52:161-173. [PMID: 35048797 DOI: 10.1080/03009742.2021.2001929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Few comparative data exist on early infections secondary to remission-induction therapy (RIT) with rituximab (RTX) versus cyclophosphamide (CYC) in newly diagnosed anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients. We compared and analysed the rates and predictors of severe infection in such patients within the first 6 months following RIT. METHOD From the Caen University Hospital databases, we included all consecutive adults newly diagnosed with ANCA-positive granulomatosis with polyangiitis or microscopic polyangiitis between January 2006 and December 2019. We compared rates of survival without severe infection and survival without infections of any severity within 6 months of RIT and used a multivariate Cox analysis to identify predictors of infection. RESULTS We included 145 patients, 27 in the RTX and 118 in the CYC group. Patients in the RTX group more frequently had pneumococcal vaccination (p < 0.01) and creatinine < 150 µmol/L; other characteristics were comparable between the two groups. Overall, 37 severe infections and 65 infections of any severity were recorded. Rates of survival without severe infection were similar in both groups (p = 0.69), but survival without infections of any severity was lower in the RTX group (p = 0.005). In multivariate analysis, risk factors at diagnosis for severe infections included chronic urinary tract disease, dialysis, and absence of trimethoprim-sulfamethoxazole prophylaxis (p < 0.01 each). CONCLUSIONS Within 6 months of RIT, rates of survival without severe infection were similar in newly diagnosed ANCA-positive AAV patients treated with RTX or CYC, but survival rates without infections of any severity appeared to be lower with RTX treatment.
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Affiliation(s)
- M Gérard
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - H de Boysson
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France.,Faculty of Caen, Université de Caen Normandie (UNICAEN), Caen, France
| | - R Morello
- Functional Unit of Biostatistics and Clinical Research, CHU de Caen Normandie, Caen, France
| | - N Martin-Silva
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - A-C Leroux
- Department of Nephrology, Centre Hospitalier Mémorial, Saint-Lô, France
| | - A Dumont
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France.,Faculty of Caen, Université de Caen Normandie (UNICAEN), Caen, France
| | - G Maigné
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - J Boutemy
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - K Khoy
- Department of Immunology, CHU de Caen Normandie, Caen, France
| | - D Mariotte
- Department of Immunology, CHU de Caen Normandie, Caen, France
| | - T Lobbedez
- Department of Nephrology, CHU de Caen Normandie, Caen, France
| | - A Aouba
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France.,Faculty of Caen, Université de Caen Normandie (UNICAEN), Caen, France
| | - S Deshayes
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France.,Faculty of Caen, Université de Caen Normandie (UNICAEN), Caen, France
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Elhani I, Khoy K, Mariotte D, Comby E, Marcelli C, Le Mauff B, Audemard-Verger A, Boutemy J, Maigné G, Martin Silva N, Aouba A, de Boysson H. The diagnostic challenge of patients with anti-U1-RNP antibodies. Rheumatol Int 2023; 43:509-521. [PMID: 35896805 DOI: 10.1007/s00296-022-05161-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/02/2022] [Indexed: 11/30/2022]
Abstract
Anti-U1-RNP antibodies are necessary for the diagnosis of mixed connective tissue disease (MCTD), but they are also prevalent in other connective tissue diseases, especially systemic lupus erythematosus (SLE), from which distinction remains challenging. We aimed to describe the presentation and outcome of patients with anti-U1-RNP antibodies and to identify factors to distinguish MCTD from SLE. We retrospectively applied the criteria sets for MCTD, SLE, systemic sclerosis (SSc) and rheumatoid arthritis (RA) to all patients displaying anti-U1-RNP antibodies in the hospital of Caen from 2000 to 2020. Thirty-six patients were included in the analysis. Eighteen patients (50%) satisfied at least one of the MCTD classifications, 11 of whom (61%) also met 2019 ACR/EULAR criteria for SLE. Twelve other patients only met SLE without MCTD criteria, and a total of 23 patients (64%) met SLE criteria. The most frequent manifestations included Raynaud's phenomenon (RP, 91%) and arthralgia (67%). We compared the characteristics of patients meeting only the MCTD (n = 7), SLE (n = 12), or both (n = 11) criteria. Patients meeting the MCTD criteria were more likely to display SSc features, including sclerodactyly (p < 0.01), swollen hands (p < 0.01), RP (p = 0.04) and esophageal reflux (p < 0.01). The presence of scleroderma features (swollen hands, sclerodactyly, gastro-oesophageal reflux), was significantly associated with the diagnosis of MCTD. Conversely, the absence of those manifestations suggested the diagnosis of another definite connective tissue disease, especially SLE.
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Affiliation(s)
- Ines Elhani
- Department of Internal Medicine, Caen University Hospital, Caen, France
| | - Kathy Khoy
- Laboratory of Immunology, Department of Biology, Caen University Hospital, Caen, France
| | - Delphine Mariotte
- Laboratory of Immunology, Department of Biology, Caen University Hospital, Caen, France
| | - Elisabeth Comby
- Laboratory of Immunology, Department of Biology, Caen University Hospital, Caen, France
| | | | - Brigitte Le Mauff
- Laboratory of Immunology, Department of Biology, Caen University Hospital, Caen, France.,UMR-S1237, Physiopathology and Imaging of Neurological Disorders, INSERM, Caen, France.,Normandie Université, UNICAEN, Caen, France
| | - Alexandra Audemard-Verger
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France.,University of Tours, Tours, France
| | - Jonathan Boutemy
- Department of Internal Medicine, Caen University Hospital, Caen, France
| | - Gwénola Maigné
- Department of Internal Medicine, Caen University Hospital, Caen, France
| | | | - Achille Aouba
- Department of Internal Medicine, Caen University Hospital, Caen, France.,Normandie Université, UNICAEN, Caen, France
| | - Hubert de Boysson
- Department of Internal Medicine, Caen University Hospital, Caen, France. .,Normandie Université, UNICAEN, Caen, France.
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Serrier J, Davy JB, Dupont B, Clarisse B, Parienti JJ, Petit G, Khoy K, Ollivier Y, Gervais R, Mariotte D, Le Mauff B. Validation of an anti-α-Gal IgE fluoroenzyme-immunoassay for the screening of patients at risk of severe anaphylaxis to cetuximab. BMC Cancer 2023; 23:32. [PMID: 36624467 PMCID: PMC9827640 DOI: 10.1186/s12885-023-10501-5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/02/2023] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The link between immediate hypersensitivity reactions (HSR) following the first cetuximab infusion and the IgE sensitization against anti-galactose-α-1,3-galactose (α-Gal) is now well-established. An automated Fluoroenzyme-Immunoassay (FEIA) is available and may facilitate the screening of patients with anti-α-Gal IgE before treatment. METHODS This study aimed to evaluate its performances as compared to a previously validated anti-cetuximab IgE ELISA, using 185 samples from two previously studied cohorts. RESULTS Despite 21.1% of discrepancies between the two techniques, FEIA discriminated better positive patients and similarly negative ones with a ≥ 0.525 kUA/L threshold. Sensitivity was 87.5% for both tests, specificity was better for FEIA (96.3% vs ELISA: 82.1%). FEIA had a higher positive likelihood ratio (23.9 vs ELISA: 4.89) and a similar negative likelihood ratio (0.13 vs ELISA: 0.15). In our population, the risk of severe HSR following a positive test was higher with FEIA (56.7% vs ELISA: 19.6%) and similar following a negative test (0.7% vs ELISA: 0.8%). CONCLUSION Although the predictive value of the IgE screening before cetuximab infusion remains discussed, this automated commercial test can identify high-risk patients and is suitable for routine use in laboratories. It could help avoiding cetuximab-induced HSR by a systematic anti-α-Gal IgE screening before treatment.
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Affiliation(s)
- Julien Serrier
- grid.411149.80000 0004 0472 0160Department of Immunology and Histocompatibility, CHU Caen, Caen, France ,grid.412043.00000 0001 2186 4076University of Caen Normandy, Caen, France ,INSERM U1237, Physiopathology and Imaging of Neurological Disorders, Caen, France
| | - Jean-Baptiste Davy
- grid.411149.80000 0004 0472 0160Department of Immunology and Histocompatibility, CHU Caen, Caen, France
| | - Benoît Dupont
- grid.411149.80000 0004 0472 0160Department of Hepato-Gastroenterology and Nutrition, CHU Caen, Caen, France
| | - Bénédicte Clarisse
- grid.418189.d0000 0001 2175 1768Clinical Research Department, Centre François Baclesse, Caen, France
| | - Jean-Jacques Parienti
- grid.412043.00000 0001 2186 4076University of Caen Normandy, Caen, France ,grid.411149.80000 0004 0472 0160Department of Clinical Research and Biostatistics, CHU Caen, Caen, France
| | - Gautier Petit
- grid.411149.80000 0004 0472 0160Department of Immunology and Histocompatibility, CHU Caen, Caen, France
| | - Kathy Khoy
- grid.411149.80000 0004 0472 0160Department of Immunology and Histocompatibility, CHU Caen, Caen, France
| | - Yann Ollivier
- grid.411149.80000 0004 0472 0160 University Center for Allergic Diseases (CUMA), CHU Caen, Caen, France
| | - Radj Gervais
- grid.418189.d0000 0001 2175 1768Medical Oncology Department, Centre François Baclesse, Caen, France
| | - Delphine Mariotte
- grid.411149.80000 0004 0472 0160Department of Immunology and Histocompatibility, CHU Caen, Caen, France
| | - Brigitte Le Mauff
- grid.411149.80000 0004 0472 0160Department of Immunology and Histocompatibility, CHU Caen, Caen, France ,grid.412043.00000 0001 2186 4076University of Caen Normandy, Caen, France ,INSERM U1237, Physiopathology and Imaging of Neurological Disorders, Caen, France
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Pouessel G, Tanno L, Beaudouin E, Chatain C, Corriger J, Demoly P, Flabbée J, Jacquier J, Larroche Y, Neukirch C, Leroy S, Mariotte D, le Mauff B, Mertes P, Thi N, Pouessel G, Tacquard C, Tanno L, Vitte J. Les sapeurs-pompiers en première ligne dans l’anaphylaxie ! Revue Française d'Allergologie 2022. [DOI: 10.1016/j.reval.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bazin A, Tanguy S, Theault L, Cheze S, Mariotte D, Hanouz JL. CL-24 Formation Transfusion des internes, expérience du CHU de Caen. Transfus Clin Biol 2022. [DOI: 10.1016/j.tracli.2022.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Camboulive L, Grandhomme F, Silva NM, de Boysson H, Dumont A, Nguyen A, Mariotte D, Khoy K, Lobbedez T, Aouba A, Deshayes S. AB0615 Clinical impact of ceruloplasmin levels at ANCA-associated vasculitis diagnosis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMyeloperoxidase (MPO) plays a major role in loss of immunological tolerance leading to tissue destruction in ANCA-associated vasculitis (AAV). Ceruloplasmin is a protein with antiproteinase and antioxidant properties that inhibits MPO activity. Whether serum level of ceruloplasmin at AAV diagnosis has an impact is unknown.ObjectivesThe objective of this study was to evaluate the prognostic impact of serum level of ceruloplasmin at diagnosis in patients with granulomatosis with polyangiitis or microscopic polyangiitis.MethodsWe conducted a retrospective unicentric study at Caen University Hospital, involving consecutive adult patients with granulomatosis with polyangiitis or microscopic polyangiitis between 2010 and 2021 who had available serum at diagnosis. Data was collected using the health records.Ceruloplasmin was measured by standardized nephelometry (normal values: 0.15 – 0.50 g/L). Patients in each subgroup (whole cohort, microscopic polyangiitis and anti-MPO patients) were divided into two groups based on the median serum level of ceruloplasmin.We estimated survival using the Kaplan-Meier survival curve, and between-group differences were evaluated by the log-rank test. The study was approved by the local ethics committee of Caen University Hospital (n° 1947).ResultsNinety-two patients were included, 46 (50%) granulomatosis with polyangiitis (41 anti-proteinase 3 and 5 anti-MPO) and 46 (50%) microscopic polyangiitis (45 anti-MPO and 1 anti-proteinase 3). The median level of ceruloplasmin was 0.44 g/L. No significant differences in the clinical presentation were observed between patients in the two groups (p>0.05). We observed 9 (19.6%) deaths in the low ceruloplasmin group and 5 (10.9%) in the high ceruloplasmin group (p=0.39). Vasculitis relapse occurred in 10/46 patients (22%) and 11/46 patients (24%) (p=1), renal failure leading to dialysis and/or renal transplant in 6/46 patients (13%) and 8/46 patients (17%) (p=0.77), respectively. No significant difference in survival was found (p=0.07). The same analyses were performed between the low and the high ceruloplasmin group with the microscopic polyangiitis subgroup (n=46), and no significant differences were found (p>0.05). However, within the anti-MPO subgroup (n=50), the survival was worse in the low ceruloplasmin group (p=0.03).ConclusionIn anti-MPO AAV patients, serum level of ceruloplasmin at diagnosis seems to be associated with a significant impact on survival.References[1]Baskin E, et al. Ceruloplasmin levels in antineutrophil cytoplasmic antibody-positive patients. Pediatr Nephrol. 2002;17(11):917–9.[2]Ara J, et al. Ceruloplasmin in small vessel vasculitis. Nephrol Dial Transplant. févr 1999;14(2):515-7.isclosure of Interests: None declared
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Gérard M, De Boysson H, Morello R, Martin Silva N, Dumont A, Maigné G, Boutemy J, Khoy K, Mariotte D, Lobbedez T, Aouba A, Deshayes S. Risque infectieux associé au traitement d’induction des vascularites à ANCA : une étude rétrospective monocentrique française incluant 145 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gérard M, De Boysson H, Morello R, Silva NM, Leroux AC, Dumont A, Maigné G, Boutemy J, Khoy K, Mariotte D, Lobbedez T, Aouba A, Deshayes S. POS0831 EARLY INFECTIOUS RISK IN PATIENTS WITH NEWLY-DIAGNOSED ANTI-NEUTROPHILCYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS ACCORDING TO THE REMISSION-INDUCTIONTHERAPY: A FRENCH MONOCENTRIC RETROSPECTIVE STUDY INCLUDING 145 PATIENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Few comparative data exist on early infections secondary to remission-induction therapy (RIT) with rituximab versus cyclophosphamide in newly-diagnosed ANCA-associated vasculitis (AAV) patients.Objectives:We compared and analyzed the rate and predictors of severe infections in such patients within the first six months following RIT.Methods:We included, from the databases of Caen University Hospital, all consecutive adults newly-diagnosed with granulomatosis with polyangiitis or microscopic polyangiitis between January 2006 and December 2019. We compared the survival without severe infections (WSI) and the survival without infection of any severity (WIOAS) within 6 months from the RIT, and used a multivariate cox analysis to identify predictors of infection.Results:We included 145 patients, 27 in rituximab group and 118 in cyclophosphamide group. Patients in the rituximab group more frequently had pneumococcal vaccination (p<0.01) and creatinine level <150 µmol/L, while other characteristics, including Birmingham Vasculitis Activity Score, were comparable between both groups.Overall, 37 severe infections and 65 infections of any severity were recorded. The survival WSI was similar in both groups (p=0.69), but survival WIOAS was lower in rituximab group (p=0.005).In multivariate analysis, risk factors at diagnosis for severe infections were chronic urinary tract disease, dialysis and absence of prophylaxis with trimethoprim-sulfamethoxazole (p<0.01 each).Conclusion:The survival WIS within the 6 months following RIT was similar in patients with newly-diagnosed AAV treated by rituximab or cyclophosphamide, but survival WIOAS appeared to be lower within the 6 months following rituximab despite a better pneumococcal vaccination coverage.Figure 1.Comparison of the 6-month survival without severe infection (A) or without infection of any severity (B) in patients with newly-diagnosed ANCA-associated vasculitis treated by rituximab or cyclophosphamideDisclosure of Interests:None declared
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Serrier J, Khoy K, Petit G, Parienti J, Laroche D, Mariotte D, Le Mauff B. Mediators of anaphylactic reactions: Tryptase and histamine stability in whole blood. Allergy 2021; 76:1579-1583. [PMID: 33202058 DOI: 10.1111/all.14663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/23/2020] [Accepted: 11/12/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Julien Serrier
- Laboratoire d'Immunologie et Immunopathologie Centre Hospitalier Universitaire de Caen Caen France
| | - Kathy Khoy
- Laboratoire d'Immunologie et Immunopathologie Centre Hospitalier Universitaire de Caen Caen France
| | - Gautier Petit
- Laboratoire d'Immunologie et Immunopathologie Centre Hospitalier Universitaire de Caen Caen France
| | - Jean‐Jacques Parienti
- Unité de Biostatistique et de Recherche Clinique, Direction Recherche et Enseignement Centre Hospitalier Universitaire de Caen Caen France
- Université de Caen Normandie Caen France
| | - Dominique Laroche
- Université de Caen Normandie Caen France
- Laboratoire d'Hormonologie Centre Hospitalier Universitaire de Caen Caen France
| | - Delphine Mariotte
- Laboratoire d'Immunologie et Immunopathologie Centre Hospitalier Universitaire de Caen Caen France
| | - Brigitte Le Mauff
- Laboratoire d'Immunologie et Immunopathologie Centre Hospitalier Universitaire de Caen Caen France
- Université de Caen Normandie Caen France
- INSERM U1237 Physiopathology and Imaging of Neurological Disorders Caen France
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13
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Khoy K, Mariotte D, Defer G, Petit G, Toutirais O, Le Mauff B. Natalizumab in Multiple Sclerosis Treatment: From Biological Effects to Immune Monitoring. Front Immunol 2020; 11:549842. [PMID: 33072089 PMCID: PMC7541830 DOI: 10.3389/fimmu.2020.549842] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [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: 04/07/2020] [Accepted: 09/04/2020] [Indexed: 12/13/2022] Open
Abstract
Multiple sclerosis is a chronic demyelinating disease of the central nervous system (CNS) with an autoimmune component. Among the recent disease-modifying treatments available, Natalizumab, a monoclonal antibody directed against the alpha chain of the VLA-4 integrin (CD49d), is a potent inhibitor of cell migration toward the tissues including CNS. It potently reduces relapses and active brain lesions in the relapsing remitting form of the disease. However, it has also been associated with a severe infectious complication, the progressive multifocal leukoencephalitis (PML). Using the standard protocol with an injection every 4 weeks it has been shown by a close monitoring of the drug that trough levels soon reach a plateau with an almost saturation of the target cell receptor as well as a down modulation of this receptor. In this review, mechanisms of action involved in therapeutic efficacy as well as in PML risk will be discussed. Furthermore the interest of a biological monitoring that may be helpful to rapidly adapt treatment is presented. Indeed, development of anti-NAT antibodies, although sometimes unapparent, can be detected indirectly by normalization of CD49d expression on circulating mononuclear cells and might require to switch to another drug. On the other hand a stable modulation of CD49d expression might be useful to follow the circulating NAT levels and apply an extended interval dose scheme that could contribute to limiting the risk of PML.
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Affiliation(s)
- Kathy Khoy
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France
| | - Delphine Mariotte
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France
| | - Gilles Defer
- Department of Neurology, MS Expert Centre, CHU Caen Normandie, Caen, France.,UMR-S1237, Physiopathology and Imaging of Neurological Disorders, INSERM, Caen, France.,Normandie Université, UNICAEN, Caen, France
| | - Gautier Petit
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France
| | - Olivier Toutirais
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France.,UMR-S1237, Physiopathology and Imaging of Neurological Disorders, INSERM, Caen, France.,Normandie Université, UNICAEN, Caen, France
| | - Brigitte Le Mauff
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France.,UMR-S1237, Physiopathology and Imaging of Neurological Disorders, INSERM, Caen, France.,Normandie Université, UNICAEN, Caen, France
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14
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Deshayes S, Martin Silva N, Khoy K, Mariotte D, Le Mauff B, Mornex JF, Pison C, Cuvelier A, Balduyck M, Pujazon MC, Fournier M, Ait Ilalne B, Thabut G, Mal H, Aouba A. Prevalence of Anti-Neutrophil Cytoplasmic Antibodies and Associated Vasculitis in COPD Associated With Alpha-1 Antitrypsin Deficiency: An Ancillary Study to a Prospective Study on 180 French Patients. Chest 2020; 158:1919-1922. [PMID: 32417149 DOI: 10.1016/j.chest.2020.04.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/18/2020] [Accepted: 04/25/2020] [Indexed: 01/01/2023] Open
Affiliation(s)
- Samuel Deshayes
- Service de Médecine Interne, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Nicolas Martin Silva
- Service de Médecine Interne, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Kathy Khoy
- Laboratoire d'Immunologie, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Delphine Mariotte
- Laboratoire d'Immunologie, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Brigitte Le Mauff
- Laboratoire d'Immunologie, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Jean-François Mornex
- Service de Pneumologie, Hospices Civils de Lyon, Lyon, France; INRA UMR754, Université Lyon 1, Lyon, France
| | - Christophe Pison
- Service Hospitalier Universitaire Pneumologie Physiologie, CHU Grenoble Alpes, Grenoble, France; INSERM U1055, Université Grenoble Alpes, Grenoble, France
| | - Antoine Cuvelier
- Service de Pneumologie, Oncologie Thoracique et Soins Intensifs Respiratoires, CHU de Rouen, Rouen, France; UPRES EA 3830, Institut de Recherche et d'Innovation Biomédicale, Université Normandie Rouen, Rouen, France
| | - Malika Balduyck
- Laboratoire de Biochimie et Biologie Moléculaire, Centre de Biologie Pathologie, CHRU de Lille, Lille, France; Faculté de Pharmacie, Université de Lille Nord de France, Lille, France
| | | | - Michel Fournier
- Service de Pneumologie B et Transplantation Pulmonaire, APHP, Paris, France; INSERM U700, Université Paris Diderot-Paris 7, Paris, France
| | - Brahim Ait Ilalne
- INSERM U700, Université Paris Diderot-Paris 7, Paris, France; Centre d'Investigation Clinique, Hôpital Bichat, APHP, Paris, France
| | - Gabriel Thabut
- Service de Pneumologie B et Transplantation Pulmonaire, APHP, Paris, France; INSERM U700, Université Paris Diderot-Paris 7, Paris, France
| | - Hervé Mal
- Service de Pneumologie B et Transplantation Pulmonaire, APHP, Paris, France; INSERM U700, Université Paris Diderot-Paris 7, Paris, France
| | - Achille Aouba
- Service de Médecine Interne, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France.
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15
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Deshayes S, Martin Silva N, Khoy K, Yameogo S, Mariotte D, Lobbedez T, Aouba A. Clinical impact of subgrouping ANCA-associated vasculitis according to antibody specificity beyond the clinicopathological classification. Rheumatology (Oxford) 2020; 58:1731-1739. [PMID: 30805643 DOI: 10.1093/rheumatology/kez016] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 10/02/2018] [Accepted: 01/09/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES In ANCA-associated vasculitis (AAV), classifications have emerged to individualize homogeneous clinical and outcomes patterns, including the recently defined anti-MPO granulomatosis with polyangiitis (GPA) subgroup. This study aimed to retrospectively evaluate the impacts of re-classification based on clinicopathological criteria and/or ANCA specificity. METHODS A retrospective monocentric study conducted at Caen University Hospital led to the identification of PR3 or MPO-ANCA AAV patients from January 2000 or September 2011, respectively, to June 2016. Eosinophilic GPA patients were excluded. AAVs were thereby also classified either as GPA or microscopic polyangiitis (MPA) according to the European Medicines Agency vasculitis algorithm. RESULTS A total of 150 AAV patients were included (94 GPA, 56 MPA; 87 anti-PR3 and 63 anti-MPO patients). GPA patients exhibited a worse relapse-free survival but a better renal survival (P < 0.001 and P = 0.021, respectively) than MPA patients. Overall, relapse-free and renal survival rates were similar between anti-PR3 and anti-MPO patients (P = 0.35, 0.17 and 0.15, respectively). Similarly, the prognosis was identical between anti-MPO MPA patients and anti-PR3 MPA patients (P = 0.33, 0.19 and 0.65, respectively), and between anti-MPO GPA patients and anti-PR3 GPA patients (P = 0.06, 0.99 and 0.64, respectively). Moreover, anti-PR3 GPA and anti-MPO GPA patients exhibited no differences in clinical manifestations or BVAS score. CONCLUSION Clinicopathological classification appeared to be the strongest criterion for distinguishing among homogeneous prognoses of AAV. Individualizing the anti-MPO GPA subgroup does not appear to bring additional value to clinical practice, but multicentre studies are required to confirm this trend.
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Affiliation(s)
- Samuel Deshayes
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Nicolas Martin Silva
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Kathy Khoy
- Department of Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Seydou Yameogo
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Delphine Mariotte
- Department of Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Thierry Lobbedez
- Department of Nephrology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Achille Aouba
- Department of Internal Medicine and Clinical Immunology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
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16
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Lejeune S, Deschildre A, Beaudouin E, Labreuche J, Meininger C, Lefort H, Mauriaucourt P, Ganansia O, Wiel E, Pouessel G, Birnbaum J, Charles Bonneau J, Charpin D, Codreanu F, Dona M, Flabbee J, Larroche Y, Lemauff B, Leroy S, Mariotte D, Moneret‐Vautrin D, Michel Mertes P, Morisset N, Neukirch C, Pham‐Thi N, Tazi‐Daoudi L. Pre‐hospital management of paediatric anaphylaxis by French Emergency Medicine physicians: Still to be improved. Clin Exp Allergy 2019; 49:1047-1050. [DOI: 10.1111/cea.13405] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/16/2019] [Accepted: 04/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Stéphanie Lejeune
- Pediatric Pulmonology and Allergy Department Pôle Enfant, Hôpital Jeanne de Flandre CHU de Lille and Université Nord de France Lille France
| | - Antoine Deschildre
- Pediatric Pulmonology and Allergy Department Pôle Enfant, Hôpital Jeanne de Flandre CHU de Lille and Université Nord de France Lille France
- Allergy Vigilance Network Vandoeuvre les Nancy France
| | - Etienne Beaudouin
- Allergy Vigilance Network Vandoeuvre les Nancy France
- Institute of Allergology Regional Hospital Center of Metz‐Thionville Metz Cedex France
| | | | | | - Hugues Lefort
- Department of emergency medicine Hôpital d'Instruction des Armées Legouest Metz France
| | - Patrick Mauriaucourt
- Department of emergency medicine Pôle Urgences, Hôpital Roger Salengro CHU de Lille and Université Nord de France Lille France
| | - Olivier Ganansia
- Department of emergency medicine Groupe Hospitalier Paris Saint Joseph Paris France
| | - Eric Wiel
- Department of emergency medicine Pôle Urgences, Hôpital Roger Salengro CHU de Lille and Université Nord de France Lille France
| | - Guillaume Pouessel
- Pediatric Pulmonology and Allergy Department Pôle Enfant, Hôpital Jeanne de Flandre CHU de Lille and Université Nord de France Lille France
- Allergy Vigilance Network Vandoeuvre les Nancy France
- Department of Pediatrics Children's Hospital Roubaix France
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17
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Deshayes S, Martin Silva N, Grandhomme F, Khoy K, Mariotte D, Boutemy J, Maigné G, Brière-Bellier C, Delmas C, Bienvenu B, Lobbedez T, de Boysson H, Aouba A. Clinical Effect of Alpha-1 Antitrypsin Deficiency in Antineutrophil Cytoplasmic Antibody-associated Vasculitis: Results from a French Retrospective Monocentric Cohort. J Rheumatol 2019; 46:1502-1508. [PMID: 30824651 DOI: 10.3899/jrheum.180591] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Deficiency in alpha-1 antitrypsin (AAT) is a possible pathogenic cofactor in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). However, the clinical effect of AAT deficiency remains poorly established in this setting. This study aimed to describe the clinical phenotypes and outcomes of AAV according to AAT phenotypes. METHODS This study was conducted retrospectively at Caen University Hospital and included all consecutive granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) patients with positive proteinase 3-ANCA or myeloperoxidase-ANCA, from January 2000 or September 2011, respectively, to June 2016. AAT dosage (nephelometry) and phenotyping (isoelectric focusing in agarose gel) were performed. RESULTS Among the 142 patients with AAV, including 88 GPA and 54 MPA, 102 (72%) had the MM phenotype, 5 (4%) had a nonpolymerogenic M-variant phenotype, 18 (13%) had the deficient allele MZ, 12 (8%) had MS, 2 (1%) had ZZ, 2 (1%) had SZ, and 1 (1%) had SS. M, Z, and S allele frequencies were 84%, 8%, and 6%, respectively. No association was observed between AAT deficiency and ANCA subtype or AAV phenotype, except for intraalveolar hemorrhage (IAH), which was more frequent in patients harboring at least 1 of the deficient Z or S alleles than in those without any deficient alleles (p < 0.01). Global, renal, or relapse-free survival rates were similar for all subgroups. CONCLUSION This study shows that AAT deficiency confers, independently of ANCA subtype, a higher risk of IAH. Prospective studies are required to refine these data and to assess the need for replacement therapy in AAT-deficient patients with AAV.
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Affiliation(s)
- Samuel Deshayes
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Nicolas Martin Silva
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Frédérique Grandhomme
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Kathy Khoy
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Delphine Mariotte
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Jonathan Boutemy
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Gwénola Maigné
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Claire Brière-Bellier
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Claire Delmas
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Boris Bienvenu
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Thierry Lobbedez
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Hubert de Boysson
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France.,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie
| | - Achille Aouba
- From the Department of Internal Medicine, the Department of Biochemistry, the Department of Immunology, and the Department of Nephrology, Normandie Université, UNICAEN, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen; Department of Infectious Diseases, CH Mémorial, Saint-Lô, France. .,S. Deshayes, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; N. Martin Silva, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; F. Grandhomme, MD, Department of Biochemistry, Normandie Université, UNICAEN, CHU de Caen Normandie; K. Khoy, PharmD, PhD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; D. Mariotte, PharmD, Department of Immunology, Normandie Université, UNICAEN, CHU de Caen Normandie; J. Boutemy, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; G. Maigné, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; C. Brière-Bellier, MD, Department of Infectious Diseases, CH Mémorial; C. Delmas, MD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; B. Bienvenu, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; T. Lobbedez, MD, PhD, Department of Nephrology, Normandie Université, UNICAEN, CHU de Caen Normandie; H. de Boysson, MD, MSc, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie; A. Aouba, MD, PhD, Department of Internal Medicine, Normandie Université, UNICAEN, CHU de Caen Normandie.
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Deshayes S, Aouba A, Khoy K, Mariotte D, Lobbedez T, Martin Silva N. Hypocomplementemia is associated with worse renal survival in ANCA-positive granulomatosis with polyangiitis and microscopic polyangiitis. PLoS One 2018; 13:e0195680. [PMID: 29621352 PMCID: PMC5886583 DOI: 10.1371/journal.pone.0195680] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 01/12/2018] [Accepted: 03/27/2018] [Indexed: 11/18/2022] Open
Abstract
Recent data suggest the existence of a complement alternative pathway activation in the pathogenesis of antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis (AAV), a condition that remains poorly understood. This study aims to assess the clinical characteristics and outcomes of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) patients with regard to their plasma complement levels at diagnosis. A retrospective monocentric study carried out at Caen University Hospital led to the identification of proteinase-3- or myeloperoxidase-ANCA-positive GPA and MPA patients from January 2000 to June 2016 and from September 2011 to June 2016, respectively. All patients with available C3 and C4 levels at diagnosis were included. Patients were categorized in the hypocomplementemia group if their C3 and/or C4 levels at diagnosis were below the lower limit of the normal range. Among the 76 AAV patients (43 GPA, 33 MPA), 4 (5%) had hypocomplementemia, and the 72 remaining patients exhibited normal plasma complement levels. All 4 hypocomplementemia patients had renal involvement. Hypocomplementemia was followed in 1 patient whose post-treatment complement level normalized within 1 month. Among all clinical and ANCA specificity, including relapse-free survival (p = 0.093), only overall and renal survival rates were significantly lower in the hypocomplementemia group (p = 0.0011 and p<0.001, respectively). Hypocomplementemia with low C3 and/or C4 levels at GPA or MPA diagnosis may be responsible for worse survival and renal prognosis. These results argue for larger and prospective studies to better determine the epidemiology of the disease and to assess complement-targeting therapy in these patients.
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Affiliation(s)
| | - Achille Aouba
- Department of Internal Medicine, CHU de Caen, Caen, France
| | - Kathy Khoy
- Department of Immunology, CHU de Caen, Caen, France
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Dupont B, Mariotte D, Dugué AE, Clarisse B, Grellard JM, Babin E, Chauffert B, Dakpé S, Moldovan C, Bouhier-Leporrier K, Reimund JM, Di Fiore F, Zanetta S, Mailliez A, Do P, Peytier A, Galais MP, Florescu C, Schott R, Le Mauff B, Gervais R. Utility of serum anti-cetuximab immunoglobulin E levels to identify patients at a high risk of severe hypersensitivity reaction to cetuximab. Br J Clin Pharmacol 2016; 83:623-631. [PMID: 27662818 DOI: 10.1111/bcp.13140] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 08/28/2016] [Accepted: 09/18/2016] [Indexed: 12/14/2022] Open
Abstract
AIM Cetuximab is an anti-epidermal growth factor receptor antibody used for the treatment of metastatic colorectal cancer and head and neck cancer. Hypersensitivity reactions (HSRs) are associated with cetuximab use. The aim of the study was to evaluate the utility of anti-cetuximab immunoglobulin E (IgE) detection in order to identify patients at risk of HSR to cetuximab. METHODS We included patients ready to receive a first cetuximab infusion in a prospective cohort carried out at nine French centres. Pretreatment anti-cetuximab IgE levels were measured. We compared the proportion of severe HSRs in the low anti-cetuximab IgE levels (≤29 IgE arbitrary units) subgroup with that in a historical cohort of 213 patients extracted from a previous study. RESULTS Of the 301 assessable patients (mean age: 60.9 ± 9.3 years, head-and-neck cancer: 77%), 66 patients (22%) had high anti-cetuximab IgE levels, and 247 patients received cetuximab (including 38 with high anti-cetuximab levels). Severe HSRs occurred in eight patients (five grade 3 and three grade 4). The proportion of severe HSRs was lower in the low anti-cetuximab IgE levels subgroup vs. the historical cohort (3/209 [1.4%] vs. 11/213 [5.2%], odds ratio, 0.27, 95% confidence interval, 0.07-0.97), and higher in high vs. low anti-cetuximab IgE levels subgroup (5/38 [13.2%] vs. 3/209 [1.4%]; odds ratio, 10.4, 95% confidence interval, 2.4-45.6). Patients with severe HSRs had higher anti-cetuximab IgE levels than patients without reaction (median, 45 vs. 2 IgE arbitrary units, P = 0.006). CONCLUSIONS Detection of pretreatment anti-cetuximab IgE is feasible and helpful to identify patients at risk of severe cetuximab-induced HSRs.
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Affiliation(s)
- Benoît Dupont
- Department of Hepato-Gastroenterology and Nutrition, CHU de Caen, Caen, France
| | - Delphine Mariotte
- Laboratory of Immunology and Immunopathology, CHU de Caen, Caen, France
| | - Audrey E Dugué
- Clinical Research Department, Centre François Baclesse, Caen, France
| | | | | | - Emmanuel Babin
- Department of Otolaryngology-Head and Neck Surgery, CHU de Caen, Caen, France
| | | | - Stéphanie Dakpé
- Department of Maxillofacial Surgery and Stomatology, CHU d'Amiens, Amiens, France
| | | | | | - Jean-Marie Reimund
- Department of Hepato-Gastroenterology and Nutrition, CHU de Caen, Caen, France.,Department of Hepato-Gastroenterology and Nutritional Support, CHU de Strasbourg, Strasbourg, France
| | - Frederic Di Fiore
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France.,Digestive Oncology Unit, Gastroenterology Department, CHU de Rouen, Rouen, France
| | - Sylvie Zanetta
- Medical Oncology Department, Centre Georges-François Leclerc, Dijon, France
| | - Audrey Mailliez
- Head and Neck Department, Centre Oscar Lambret, Lille, France
| | - Pascal Do
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - Annie Peytier
- Gastroenterology Department, Centre Hospitalier de Bayeux, Bayeux, France
| | | | - Carmen Florescu
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - Roland Schott
- Medical Oncology Department, Centre Paul Strauss, Strasbourg, France
| | - Brigitte Le Mauff
- Laboratory of Immunology and Immunopathology, CHU de Caen, Caen, France
| | - Radj Gervais
- Medical Oncology Department, Centre François Baclesse, Caen, France
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Tacquard C, Laroche D, Stenger R, Mariotte D, Uring-Lambert B, De Blay F, Malinovsky JM, Mertes PM. Diagnostic procedure after an immediate hypersensitivity reaction in the operating room. Presse Med 2016; 45:784-90. [PMID: 27374263 DOI: 10.1016/j.lpm.2016.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 10/21/2022] Open
Abstract
The diagnosis of a perioperative allergic reaction is based on clinical features associated with a suggestive timeline, the exclusion of other diagnoses, elevated concentrations of degranulation markers (histamine, tryptase), and positive allergy assessments (skin tests, specific IgE). After initiating appropriate treatment, the anesthesiologist should take blood samples to measure histamine and tryptase concentrations just after the reaction and repeat them 1-2hours later to validate the diagnosis of immediate hypersensitivity. A delayed measurement of basal tryptase is useful to rule out mastocytosis and to interpret moderate tryptase levels. The anesthesiologist must inform the patient of the reaction to obtain adhesion and consent to subsequent investigations and must record the timing of the reaction and of the blood sampling, the possible causal agents, and the treatment administered. These data must be shared with the laboratory and the allergist. An adverse drug reaction report must be filed. The gold standard for allergy assessment is skin testing. These tests should be done in an appropriate facility, with experienced staff and in compliance with current guidelines. Specific IgE assays and cellular assays can help when clinical features and skin tests are discordant. Provocation tests are sometimes required. After allergy assessment, the safest protocol for subsequent anesthesia is determined in collaboration with the anesthesiologist. The patient must be informed and carry an allergy alert card.
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Affiliation(s)
- Charles Tacquard
- Hôpitaux universitaires de Strasbourg, département d'anesthésie-réanimation, 67000 Strasbourg, France.
| | | | - Rodolphe Stenger
- Hôpitaux universitaires de Strasbourg, université de Strasbourg, pôle de pathologie thoracique, fédération de médecine translationnelle, 67000 Strasbourg, France
| | | | - Béatrice Uring-Lambert
- Hôpitaux universitaires de Strasbourg, laboratoire central d'immunologie, 67000 Strasbourg, France
| | - Frédéric De Blay
- Hôpitaux universitaires de Strasbourg, université de Strasbourg, pôle de pathologie thoracique, fédération de médecine translationnelle, 67000 Strasbourg, France
| | - Jean-Marc Malinovsky
- CHU de Reims, hôpital Maison-Blanche, département d'anesthésie-réanimation, 51100 Reims, France
| | - Paul Michel Mertes
- Hôpitaux universitaires de Strasbourg, département d'anesthésie-réanimation, 67000 Strasbourg, France
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Lecluse Y, Comby E, Mariotte D, Tual S, Le Mauff B, Lebailly P, Gauduchon P. Prevalence of monoclonal gammopathy of undetermined significance (MGUS) among farmers involved in open field farming and/or cattle breading in France. Leuk Lymphoma 2015; 57:1727-30. [PMID: 26689498 DOI: 10.3109/10428194.2015.1113277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Yannick Lecluse
- a U1086 INSERM , Cancers & Preventions Unit, Caen , France ;,b Normandy Univ , UNICAEN , France ;,c Comprehensive Cancer Center François Baclesse , Unicancer , Caen , France
| | - Elisabeth Comby
- d Laboratory of Immunology , University Hospital Center , Caen , France
| | - Delphine Mariotte
- d Laboratory of Immunology , University Hospital Center , Caen , France
| | - Séverine Tual
- a U1086 INSERM , Cancers & Preventions Unit, Caen , France ;,b Normandy Univ , UNICAEN , France ;,c Comprehensive Cancer Center François Baclesse , Unicancer , Caen , France
| | - Brigitte Le Mauff
- b Normandy Univ , UNICAEN , France ;,d Laboratory of Immunology , University Hospital Center , Caen , France
| | - Pierre Lebailly
- a U1086 INSERM , Cancers & Preventions Unit, Caen , France ;,b Normandy Univ , UNICAEN , France ;,c Comprehensive Cancer Center François Baclesse , Unicancer , Caen , France
| | - Pascal Gauduchon
- b Normandy Univ , UNICAEN , France ;,c Comprehensive Cancer Center François Baclesse , Unicancer , Caen , France ;,e U1199 INSERM , Biology and Innovative Therapeutics for Locally Aggressive Cancer Unit, Caen , France
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22
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Dupont B, Mariotte D, Clarisse B, Galais MP, Bouhier-Leporrier K, Grellard JM, Le Mauff B, Reimund JM, Gervais R. Risk factors associated with hypersensitivity reactions to cetuximab: anti-cetuximab IgE detection as screening test. Future Oncol 2015; 10:2133-40. [PMID: 25471028 DOI: 10.2217/fon.14.153] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
AIM To describe the factors associated with a high risk of a hypersensitivity reaction to cetuximab. PATIENTS & METHODS We retrospectively studied a cohort of patients living in Normandy (France) treated with cetuximab. RESULTS Among the 229 treated patients, 24 (10.5%) had a hypersensitivity reaction to cetuximab, including 11 grade 3-5 reactions. Detection of anti-cetuximab IgE could be performed in 108 patients. Anti-cetuximab IgE was found in 13 of 17 patients (76.5%) who had a hypersensitivity reaction to cetuximab compared with 17 of 91 control patients (18.7%; adjusted odds ratio: 14.99; 95% CI: 3.59-62.63). No clinical criteria predicted the risk of allergy to cetuximab. CONCLUSION Anti-cetuximab IgE may help physicians identify patients at risk of a hypersensitivity reaction to cetuximab.
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Affiliation(s)
- Benoît Dupont
- Department of Hepato-Gastroenterology & Nutrition, Caen University Hospital, Avenue Côte de Nacre, CHU Côte de Nacre, 14033 Caen cedex 9, France
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23
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Lambert C, Sarrat A, Bienvenu F, Brabant S, Nicaise-Roland P, Alyanakian MA, Apoil PA, Capron C, Couderc R, Evrard B, Jaby D, Hémont C, Lainé C, Lelong M, Mariotte D, Martinet J, Rénier G, Sainte-Laudy J, Tabary T, Treiner E, Uring-Lambert B, Vigneron C, Vivinus M, Witthuhn F, Vitte J. The importance of EN ISO 15189 accreditation of allergen-specific IgE determination for reliable in vitro allergy diagnosis. Allergy 2015; 70:180-6. [PMID: 25394543 DOI: 10.1111/all.12546] [Citation(s) in RCA: 18] [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] [Accepted: 11/09/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Allergen-specific serum immunoglobulin E detection and quantification have become an important step in allergy diagnosis and follow-up. In line with the current trend of laboratory test accreditation to international standards, we set out to design and assess an accreditation procedure for allergen-specific serum IgE. METHODS Method validation according to the accreditation procedure under the EN ISO 15189 standard was carried out for allergen-specific immunoglobulin E determination using the fluoroimmunoenzymatic method ImmunoCAP(®) (ThermoFisher). Data were produced by 25 hospital laboratories in France. A total of 29 allergen specificities including mixes, extracts, and molecular allergens were assayed. Allergen-specific serum immunoglobulin E concentrations ranged from 0.1 to 100 kUA /l. RESULTS Repeatability, reproducibility, and accuracy results fulfilled method validation criteria for automated laboratory tests and proved similar irrespective of the allergen specificity, allergen-specific serum immunoglobulin E concentration, or individual laboratory. CONCLUSION Allergen-specific serum immunoglobulin E determination with the fluoroimmunoenzymatic method ImmunoCAP(®) is a highly repeatable, reproducible, and accurate method which may be considered as a single analyte assay in view of the EN ISO 15189 accreditation procedure.
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Affiliation(s)
- C. Lambert
- Laboratoire d'Immunologie; Pôle de Biologie-Pathologie; CHU St Etienne; Saint-Etienne France
| | - A. Sarrat
- Laboratoire Immunologie-Immunogénétique; Hôpital Pellegrin; CHU Bordeaux; Bordeaux France
| | - F. Bienvenu
- Laboratoire d'Immunologie; CH Lyon-Sud; CHU Lyon; Hospices Civils de Lyon; Pierre-Bénite France
| | - S. Brabant
- Laboratoire d'Immunologie; CHRU Lille; Lille France
| | - P. Nicaise-Roland
- UF d'Immunologie Autoimmunité et Hypersensibilités; Hôpital Bichat Claude Bernard, AP-HP; Paris France
| | - M.-A. Alyanakian
- Laboratoire d'Immunologie Biologique; Hôpital Universitaire Necker Enfants-Malades, AP-HP; Paris France
| | - P.-A. Apoil
- Laboratoire d'Immunologie; Pôle de Biologie; Hôpital de Rangueil; CHU Toulouse; Toulouse France
| | - C. Capron
- Laboratoire d'Hématologie Immunologie; Hôpital Ambroise-Paré; Boulogne Billancourt; France
| | - R. Couderc
- Service de Biochimie et Département d'Immunologie; Hôpital Armand Trousseau; Groupe Hospitalier HUEP, AP-HP; Paris France
| | - B. Evrard
- Laboratoire d'Immunologie CHU Clermont-Ferrand; Clermont-Ferrand France
| | - D. Jaby
- Laboratoire de Biochimie Immunologie Hôpital Delafontaine; CH Saint-Denis; Saint-Denis France
| | - C. Hémont
- Laboratoire d'Immunologie; CHU Nantes; Nantes France
| | - C. Lainé
- Laboratoire Immunologie Cellulaire - Allergologie; Hôpital Pontchaillou; CHU Rennes; Rennes France
| | - M. Lelong
- Laboratoire de Biochimie; CH Le Mans; Le Mans France
| | - D. Mariotte
- Laboratoire d'Immunologie et Immunopathologie; CHU Clemenceau; Caen France
| | - J. Martinet
- Department of Immunology; Rouen University Hospital; Rouen France
| | - G. Rénier
- Laboratoire d'Immunologie et d'Allergologie; CHU Angers; Angers France
| | - J. Sainte-Laudy
- Laboratoire d'immunologie; Hôpital Dupuytren; CHU Limoges; Limoges France
| | - T. Tabary
- Laboratoire d'Immunologie; Hôpital Robert Debré; CHU Reims; Reims France
| | - E. Treiner
- Laboratoire d'Immunologie; Hôpital Sud; CHU Amiens; Amiens France
| | - B. Uring-Lambert
- Laboratoire d'Immunologie; NHC; CHU Strasbourg; Strasbourg France
| | - C. Vigneron
- Laboratoire d'Immunologie; Hôpital Bretonneau; CHRU Tours; Tours France
| | - M. Vivinus
- Laboratoire d'Immunologie; Pôle de Biologie; Hôpital l'Archet 1; CHU Nice; Nice France
| | - F. Witthuhn
- Service Immunologie et Inflammation; Pôle Biologie Santé; CHU Poitiers; Poitiers France
| | - J. Vitte
- Laboratoire d'Immunologie; Assistance Publique Hôpitaux de Marseille; Marseille France
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Dupont B, Mariotte D, Moldovan C, Grellard JM, Vergnaud MC, Laroche D, Gervais R. Case Report About Fatal or Near-Fatal Hypersensitivity Reactions to Cetuximab: Anticetuximab IgE as a Valuable Screening Test. Clin Med Insights Oncol 2014; 8:91-4. [PMID: 25089092 PMCID: PMC4116358 DOI: 10.4137/cmo.s13897] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/27/2014] [Accepted: 02/28/2014] [Indexed: 11/10/2022]
Abstract
Hypersensitivity reactions are a classic side effect of cetuximab. We report the cases of three patients who developed life-threatening hypersensitivity to cetuximab, which could have been predicted by assessing the concentration of serum anticetuximab immunoglobulin (Ig)E. The anticetuximab IgE concentration could be an interesting test to predict which patients are at risk of experiencing severe hypersensitivity reactions to cetuximab.
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Affiliation(s)
- Benoît Dupont
- CHU de Caen, Service d'Hépato-Gastroentérologie et Nutrition, Caen, France. ; Université de Caen Basse-Normandie, UFR Médecine, Caen, France
| | - Delphine Mariotte
- CHU de Caen, Laboratoire d'Immunologie et Immunopathologie, Caen, France
| | | | | | | | - Dominique Laroche
- Université de Caen Basse-Normandie, UFR Médecine, Caen, France. ; CHU de Caen, Laboratoire d'Hormonologie, Caen, France
| | - Radj Gervais
- Centre François Baclesse, Oncologie Médicale, Caen, France
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Dupont B, Mariotte D, Dugue AE, Clarisse B, Grellard JM, Babin E, Chauffert B, Dakpe S, Moldovan C, Reimund JM, Di Fiore F, Zanetta S, Degardin M, Do P, Peytier A, Galais MP, Florescu C, Schott R, Le Mauff B, Gervais R. Interest of pretreatment quantification of anti-cetuximab IgE to prevent severe hypersensitivity reaction to cetuximab. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.6028] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Pascal Do
- Centre Francois Baclesse, Caen, France
| | | | | | | | | | - Brigitte Le Mauff
- University Hospital (CHU) Laboratoire d'Immunologie et Immunopathologie, Caen, France
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26
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Mariotte D, Bazin A, Da Silva Costa-Aze V, Pottier V, Samba D, Vergnaud MC, Comby E, Le Mauff B, Laroche D. Immediate hypersensitivity to platelet concentrate: allergic or not? Transfus Med 2013; 23:136-7. [PMID: 23356776 DOI: 10.1111/tme.12007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 11/19/2012] [Accepted: 12/20/2012] [Indexed: 12/01/2022]
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Bazin A, Mariotte D, Vergnaud MC, Lesage A, Brunet A, Toutirais O, Dupuis M, Hervé I, Laroche D. Exploration des effets indésirables receveurs allergiques. Transfus Clin Biol 2012. [DOI: 10.1016/j.tracli.2012.08.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Defer G, Mariotte D, Derache N, Toutirais O, Lamotte G, Legros H, Cauquelin B, Le Mauff B. Increase of Infusion Interval Do Not Impair Natalizumab Efficacy in RR-MS Patients: A Pilot Study Based on Monthly Monitoring of CD49d (P06.166). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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29
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Ranc AG, Mestres S, Fournier M, Mariotte D, Cambon M, Poirier P. Enquête rétrospective des cas de candidémies survenus entre 2005 et 2010 dans les services chirurgicaux du CHU de Clermont-Ferrand. J Mycol Med 2012. [DOI: 10.1016/j.mycmed.2011.12.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Defer G, Mariotte D, Derache N, Toutirais O, Legros H, Cauquelin B, Le Mauff B. CD49d expression as a promising biomarker to monitor natalizumab efficacy. J Neurol Sci 2011; 314:138-42. [PMID: 22050952 DOI: 10.1016/j.jns.2011.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 10/04/2011] [Accepted: 10/06/2011] [Indexed: 10/15/2022]
Abstract
Natalizumab (Tysabri™), a monoclonal antibody against the α4-integrin of VLA-4 (CD49d) antigen of leukocytes, is highly effective in multiple sclerosis (MS). The most common reason for treatment failure is the development of neutralizing antibodies (NAbs). According to health authorities Nabs testing is recommended in case of relapse or repeated infusion reactions. However NAbs may develop in clinically asymptomatic patients. In this study we investigated if CD49d expression could serve as a biomarker of natalizumab bioavailability and treatment response. In a cohort of 49 natalizumab treated relapsing-remitting MS, followed over 2 years, CD49d expression was determined on peripheral blood mononuclear cells (PBMCs) before each infusion and compared to NAbs and serum natalizumab levels. In a majority of patients (41/49) the CD49d expression in PBMCs was strongly inhibited (>50%) after the first infusion and maintained at low levels throughout the treatment period. In contrast, in eight patients (16%) there was an early recovery of CD49d expression to pre-treatment levels related to NABs development. While three cases experienced hypersensitivity reactions, three others were identified solely on the basis of an undiminished level of CD49d, with neither infusion reaction nor clinical worsening. These 3 patients had very high levels of NAbs and no detectable serum natalizumab. Two additional patients had early but transient recovery of CD49d expression. These patients had low levels of transient Nabs and returned to significant CD49d inhibition after few natalizumab infusions. We suggest that monitoring of CD49d expression can be used as a surrogate biomarker of natalizumab efficiency. If the CD49d expression is sustained at pre-treatment levels, patients should be tested for persistent NAbs and considered for treatment interruption.
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Affiliation(s)
- Gilles Defer
- CHU de Caen, Department of Neurology, Caen, F-14000, France.
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31
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Mariotte D, Dupont B, Gervais R, Galais MP, Laroche D, Tranchant A, Comby E, Bouhier-Leporrier K, Reimund JM, Le Mauff B. Anti-cetuximab IgE ELISA for identification of patients at a high risk of cetuximab-induced anaphylaxis. MAbs 2011; 3:396-401. [PMID: 21654207 DOI: 10.4161/mabs.3.4.16293] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Cetuximab, a chimeric mouse-human IgG1 monoclonal antibody against the epidermal growth factor receptor, has proven effective in the treatment of metastatic colorectal cancer and squamous cell carcinoma of the head and neck. However, a high incidence of immediate hypersensitivity reactions (HSR) to cetuximab after the first infusion has been observed. We have developed a test for identification of patients likely to show treatment-related HSR to cetuximab. An enzyme-linked immunosorbent assay (ELISA) for detecting anti-cetuximab IgEs was developed and tested on serum samples collected from cancer patients before start of cetuximab treatment, and from healthy blood donors. Similar levels of anti-cetuximab IgE were detected in pre-treatment patient sera (24/92, 26.1%) and sera from healthy blood donors (33/117, 28.2%). HSR were observed in 14 out of the 92 patients (15.2%), and 8 of these (57.1%) were grade 3-4. Anti-cetuximab IgEs were detected in 7/8 of the patients (87.5%) with severe HSRs as compared with 14/78 patients (17.9%) with no HSR (p=0.0002). Predictive value of the anti-cetuximab IgE test for HSR events of grades 3-4 was calculated using Receiver Operating Characteristics analysis. With a cut-off value of 29 arbitrary units for the anti-cetuximab IgE, the ELISA test showed a sensitivity of 87.5%, specificity of 82.1%, positive predictive value of 33.3% and negative predictive value of 98.5%. Anti-cetuximab IgE ELISA detection could be a valuable tool to help the physician anticipate an anaphylaxis episode following cetuximab infusion and opt for a suitable alternative treatment.
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Affiliation(s)
- Delphine Mariotte
- Laboratoire d'Immunologie et Immunopathologie, Centre Hospitalier Universitaire, Caen, France
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Taright H, Faucon M, Kamga Totouom H, Mariotte D, Laroche D, Vergnaud MC, Le Mauff B, Hanouz JL, Bazin A. Pourquoi et comment explorer les réactions transfusionnelles allergiques ? Premiers résultats au CHU de Caen. Transfus Clin Biol 2010. [DOI: 10.1016/j.tracli.2010.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dupont B, Mariotte D, Galais M, Bouhier K, Le Mauff B, Reimund J, Gervais R. Can cetuximab specific IgE antibodies predict cetuximab-induced anaphylaxis? J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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34
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Dupont B, Mariotte D, Galais M, Bouhier-Leporrier K, Laroche D, Reimund J, Le Mauff B, Gervais R. 6124 Cetuximab specific IgE antibodies can predict cetuximab-induced anaphylaxis. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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35
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Comby E, Tanaff P, Mariotte D, Costentin-Pignol V, Marcelli C, Ballet JJ. Evolution of antinuclear antibodies and clinical patterns in patients with active rheumatoid arthritis with longterm infliximab therapy. J Rheumatol 2006; 33:24-30. [PMID: 16395746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To investigate the effect of longterm infliximab therapy on serum levels of fluorescent antinuclear and anti-double and single-stranded DNA antibodies (FANA, anti-dsDNA, anti-ssDNA) in patients with rheumatoid arthritis (RA), and their possible association with clinical evolution. METHODS Sera from 58 RA patients, treated for one to 3 years with infliximab, were retrospectively analyzed. Matched control groups were RA patients treated with corticosteroids or methotrexate. FANA were tested using HEp-2 cells, and anti-dsDNA and anti-ssDNA IgG by ELISA. After 28 months of infliximab therapy, clinical status was evaluated in 43/58 patients with uninterrupted therapy and associations with autoantibody levels were investigated. Data were documented for patients who discontinued infliximab. RESULTS Over the 3 year period, significant increases in FANA and anti-ssDNA IgG levels were observed in infliximab treated patients (p < 0.001 and p < 0.01, respectively). In 43 patients with an uninterrupted infliximab regimen, association was found between high FANA (>or= 1/1280) and lower age (p = 0.048) and patient's assessment of infliximab's efficacy (p = 0.014). Three patients developed anti-dsDNA IgG, preceded by high anti-ssDNA IgG levels, and one of them developed a lupus-like syndrome. Neither the initial presence of high FANA levels nor their increase >or= 1/1280 was significantly associated with discontinuation of infliximab. In contrast, at baseline (p = 0.0012) and at the time of infliximab discontinuation (p = 0.0078), anti-ssDNA IgG (>or= 500 arbitrary units) were more frequent in 7 patients who stopped infliximab due to skin or systemic anaphylactoid reactions. CONCLUSION Monitoring of serum FANA, anti-dsDNA, and anti-ssDNA IgG antibodies provided predictors of lupus-like symptoms and/or anaphylactoid reactions in patients with RA.
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Affiliation(s)
- Elisabeth Comby
- Laboratoire d'Immunologie et Immunopathologie, UPRES-EA 2128, and Service de Rhumatologie, CHU, Caen, France.
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Mariotte D, Comby E, Brasseur P, Ballet JJ. Kinetics of spleen and Peyer's patch lymphocyte populations during gut parasite clearing in Cryptosporidium parvum infected suckling mice. Parasite Immunol 2004; 26:1-6. [PMID: 15198640 DOI: 10.1111/j.0141-9838.2004.00676.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Data from experimental and human cryptosporidiosis have established a major role of specific immunity in the control of Cryptosporidium parvum infection. In this work, alterations in spleen and Peyer's patch (Pp) lymphocytes were investigated in the course of a spontaneously resolutive gut cryptosporidiosis in four-day-old suckling NMRI mice infected with either 4 x 10(5) or 30 viable oocysts. Oocysts from entire small intestines, and spleen and Pp lymphocytes were examined using flow cytometry from day 7 to day 27 post-infection. Compared to uninfected animals, a 3-5 fold increase in the numbers of spleen TCR alphabeta+, CD4+, CD8+, TCR gammadelta+ and CD45R/B220+ lymphocytes was observed on day 17 post-infection in heavily infected animals. In Pp, more than ten-fold increases were observed, except for TCR gammadelta+ lymphocytes. At termination of infection, i.e. on days 21-23 after ingestion of 4 x 105 oocysts, T and B lymphocytes decreased rapidly in both organs, and remained lower than in uninfected animals on days 19-23 post-infection. In mice infected with 30 oocysts, similar alterations were observed in Pp, but not in spleen. Data suggest that in normally developing mice, clearance of gut C. parvum infection is associated with an initial increase in systemic and local lymphocyte numbers, followed by their decrease to below control levels during the recovery phase.
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Affiliation(s)
- D Mariotte
- Laboratoire d'Immunologie et Immunopathologie, CHU-Clemenceau, Caen, France.
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