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Bertrand D, Laurent C, Lemoine M, Lebourg L, Hanoy M, Le Roy F, Nezam D, Pruteanu D, Grange S, De Nattes T, Lemée V, Guerrot D, Candon S. Evaluation of T Cell Response to SARS-CoV-2 in Kidney Transplant Recipients Receiving Monoclonal Antibody Prophylaxis and the Utility of a Bivalent mRNA Vaccine Booster Dose. Microorganisms 2024; 12:722. [PMID: 38674666 PMCID: PMC11052329 DOI: 10.3390/microorganisms12040722] [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: 01/22/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Monoclonal antibodies have been administered to kidney transplant recipients (KTRs) with a poor or non-responder status to SARS-CoV-2 vaccination. The cellular response to SARS-CoV-2 has been poorly studied in this context. We assessed the T cell response to SARS-CoV-2 in 97 patients on the day of the injection of tixagevimab/cilgavimab using an IFNγ enzyme-linked immunospot assay (ELISPOT). Among the 97 patients, 34 (35%) developed COVID-19 before the injection. Twenty-nine (85.3%) had an ELISPOT compatible with a SARS-CoV-2 infection. There was no difference between KTRs under belatacept or tacrolimus treatment. Sixty-three patients (64.9%) had no known COVID-19 prior to the ELISPOT, but nine (14.3%) had a positive ELISPOT. In 21 KTRs with a positive ELISPOT who received a booster dose of a bivalent mRNA vaccine, median antibody titers and spike-reactive T cells increased significantly in patients under tacrolimus but not belatacept. Our study emphasizes the potential usefulness of the exploration of immune cellular response to SARS-CoV-2 by ELISPOT. In KTRs with a positive ELISPOT and under CNI therapy, a booster dose of mRNA vaccine seems effective in inducing an immune response to SARS-CoV-2.
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Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Frank Le Roy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Dorian Nezam
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Diana Pruteanu
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Steven Grange
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
| | - Tristan De Nattes
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
- INSERM U1234, University of Rouen Normandy, 76000 Rouen, France;
| | - Véronique Lemée
- Department of Virology, Rouen University Hospital, 76000 Rouen, France;
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, 76000 Rouen, France; (C.L.); (M.L.); (L.L.); (M.H.); (F.L.R.); (D.N.); (D.P.); (S.G.); (T.D.N.); (D.G.)
- INSERM U1096, University of Rouen Normandy, 76000 Rouen, France
| | - Sophie Candon
- INSERM U1234, University of Rouen Normandy, 76000 Rouen, France;
- Department of Immunology and Biotherapies, Rouen University Hospital, 76000 Rouen, France
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Romero A, Laurent C, Lebourg L, Lemée V, Hanoy M, Le Roy F, Grange S, Lemoine M, Guerrot D, Bertrand D. Anti SARS-CoV-2 Monoclonal Antibodies in Pre-Exposure or Post-Exposure in No- or Weak Responder to Vaccine Kidney Transplant Recipients: Is One Strategy Better than Another? Viruses 2024; 16:381. [PMID: 38543747 PMCID: PMC10975193 DOI: 10.3390/v16030381] [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: 01/03/2024] [Revised: 02/07/2024] [Accepted: 02/27/2024] [Indexed: 05/23/2024] Open
Abstract
Background: Kidney transplant recipients (KTRs) are likely to develop severe COVID-19 and are less well-protected by vaccines than immunocompetent subjects. Thus, the use of neutralizing anti-SARS-CoV-2 monoclonal antibodies (mAbs) to confer a passive immunity appears attractive in KTRs. Methods: This retrospective monocentric cohort study was conducted between 1 January 2022 and 30 September 2022. All KTRs with a weak antibody response one month after three doses of mRNA vaccine (anti spike IgG < 264 (BAU/mL)) have received tixagevimab-cilgavimab in pre-exposure (group 1), post-exposure (group 2) or no specific treatment (group 3). We compared COVID-19 symptomatic hospitalizations, including intensive care unit hospitalizations, oxygen therapy, and death, between the three groups. Results: A total of 418 KTRs had SARS-CoV-2 infection in 2022. During the study period, we included 112 KTRs in group 1, 40 KTRs in group 2, and 27 KTRs in group 3. The occurrence of intensive care unit hospitalization, oxygen therapy, and COVID-19 death was significantly increased in group 3 compared to group 1 or 2. In group 3, 5 KTRs (18.5%) were admitted to the intensive care unit, 7 KTRs (25.9%) needed oxygen therapy, and 3 KTRs (11.1%) died. Patients who received tixagevimab-cilgavimab pre- or post-exposure had similar outcomes. Conclusions: This retrospective real-life study supports the relative effectiveness of tixagevimab-cilgavimab on COVID-19 infection caused by Omicron, used as a pre- or post-exposure therapy. The continued evolution of Omicron variants has made tixagevimab-cilgavimab ineffective and reinforces the need for new therapeutic monoclonal antibodies for COVID-19 active on new variants.
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Affiliation(s)
- Anais Romero
- Department of Nephrology and Hemodialysis, Hôpital de la Croix Rouge, 76230 Bois Guillaume, France;
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and Hemodialysis, 1 Rue de Germont, Rouen University Hospital, 76000 Rouen, France; (C.L.); (L.L.); (M.H.); (F.L.R.); (S.G.); (M.L.); (D.G.)
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and Hemodialysis, 1 Rue de Germont, Rouen University Hospital, 76000 Rouen, France; (C.L.); (L.L.); (M.H.); (F.L.R.); (S.G.); (M.L.); (D.G.)
| | - Veronique Lemée
- Department of Virology, Rouen University Hospital, 76000 Rouen, France;
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and Hemodialysis, 1 Rue de Germont, Rouen University Hospital, 76000 Rouen, France; (C.L.); (L.L.); (M.H.); (F.L.R.); (S.G.); (M.L.); (D.G.)
| | - Frank Le Roy
- Department of Nephrology, Transplantation and Hemodialysis, 1 Rue de Germont, Rouen University Hospital, 76000 Rouen, France; (C.L.); (L.L.); (M.H.); (F.L.R.); (S.G.); (M.L.); (D.G.)
| | - Steven Grange
- Department of Nephrology, Transplantation and Hemodialysis, 1 Rue de Germont, Rouen University Hospital, 76000 Rouen, France; (C.L.); (L.L.); (M.H.); (F.L.R.); (S.G.); (M.L.); (D.G.)
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and Hemodialysis, 1 Rue de Germont, Rouen University Hospital, 76000 Rouen, France; (C.L.); (L.L.); (M.H.); (F.L.R.); (S.G.); (M.L.); (D.G.)
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and Hemodialysis, 1 Rue de Germont, Rouen University Hospital, 76000 Rouen, France; (C.L.); (L.L.); (M.H.); (F.L.R.); (S.G.); (M.L.); (D.G.)
- INSERM U1096, University of Rouen Normandy, 76000 Rouen, France
| | - Dominique Bertrand
- Department of Nephrology, Transplantation and Hemodialysis, 1 Rue de Germont, Rouen University Hospital, 76000 Rouen, France; (C.L.); (L.L.); (M.H.); (F.L.R.); (S.G.); (M.L.); (D.G.)
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de Laforcade L, Bobot M, Boffa JJ, Bovy C, Cartery C, Chauveau D, Gueutin V, Isnard-Bagnis C, Jourde Chiche N, Karras A, Meftah A, Müller C, Sié P, Stehlé T, Vrigneaud L, Vuiblet V, Guerrot D. Kidney biopsy for the diagnosis and treatment of kidney diseases. Recommendations from the French speaking Society of Nephrology (SFNDT) and French National Authority for Health (HAS) 2022. Nephrol Ther 2024; 20:61-80. [PMID: 38379375 DOI: 10.1684/ndt.2024.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Kidney Biopsy (KB) is a crucial diagnostic tool in the field of renal diseases and is routinely performed in nephrology departments. A previous survey conducted by the Société Francophone de Néphrologie Dialyse Transplantation (SFNDT) revealed significant disparities in clinical practices, sometimes conflicting with the existing literature and recently published recommendations. In response, the SFNDT wished to promote the development of best practice guidelines, under the auspices of the French National Authority for Health (HAS), to establish a standardized framework for performing kidney biopsies in France.
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Affiliation(s)
- Louis de Laforcade
- Service de néphrologie-dialyse, Centre hospitalier Robert Boulin, Libourne, France
| | - Mickaël Bobot
- Centre de néphrologie et transplantation rénale, Hôpital de la Conception, AP-HM, Marseille, France
- C2VN, Aix-Marseille Université, Inserm 1263, INRAE 1260, Marseille, France
| | - Jean-Jacques Boffa
- Inserm UMRS 1155, département de néphrologie, Sorbonne université, Hôpital Tenon, AP-HP, Paris, France
| | - Christophe Bovy
- Service de néphrologie, dialyse, transplantation, CHU Liège, Belgique
| | - Claire Cartery
- Centre hospitalier de Valenciennes, service de néphrologie et médecine interne, Valencienne, France
| | - Dominique Chauveau
- Département de néphrologie et transplantation d’organes, CHU Rangueil et Université Toulouse-3, Toulouse, France
| | - Victor Gueutin
- Service de néphrologie-dialyse, Centre hospitalier Monod, Flers, France
- Service de néphrologie, dialyse et transplantation, CHU Caen, France
| | | | - Noémie Jourde Chiche
- Centre de néphrologie et transplantation rénale, Hôpital de la Conception, AP-HM, Marseille, France
- C2VN, Aix-Marseille Université, Inserm 1263, INRAE 1260, Marseille, France
| | - Alexandre Karras
- Hôpital européen Georges Pompidou, service de néphrologie, AP-HP, Université Paris Cité, Paris, France
| | - Aimèle Meftah
- Centre d’hémodialyse des Alpes, Hôpital de Manosque, Manosque France
| | - Clotilde Müller
- Service de néphrologie et dialyse, Clinique Sainte-Anne, Strasbourg, France
| | - Pierre Sié
- Laboratoire d’hématologie, Hôpital Rangueil, Toulouse France
| | - Thomas Stehlé
- Université Paris Est Créteil, Inserm U955, Institut Mondor de recherche biomédicale, Créteil, France
- Hôpitaux Universitaires Henri Mondor, AP-HP, service de néphrologie et transplantation, Fédération hospitalo-universitaire « Innovative therapy for immune disorders », Créteil, France
| | | | - Vincent Vuiblet
- Département de néphro-pathologie, Unité de pathologie, CHU Reims, France
| | - Dominique Guerrot
- Service de néphrologie-dialyse-transplantation, CHU Rouen, France ; Normandie Univ, UNIROUEN, Inserm U1096, Rouen, France
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de Nattes T, Kaveri R, Farce F, François A, Guerrot D, Hanoy M, Laurent C, Candon S, Bertrand D. Daratumumab for antibody-mediated rejection: Is it time to target the real culprit? Am J Transplant 2023; 23:1990-1994. [PMID: 37414251 DOI: 10.1016/j.ajt.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
We report the case of a sensitized woman who underwent successful transplantation after a desensitization protocol, with an optically normal 8-day biopsy. At 3 months, she developed active antibody-mediated rejection (AMR) due to preformed donor-specific antibodies. It was decided to treat the patient with daratumumab, an anti-CD38 monoclonal antibody. The mean fluorescence intensity of donor-specific antibodies decreased, pathologic signs of AMR regressed, and kidney function returned to normal. A molecular assessment of biopsies was retrospectively performed. By doing so, regression of the molecular signature of AMR was evidenced between the second and third biopsies. Interestingly, the first biopsy revealed a gene expression profile of AMR, which helped retrospectively classify this biopsy as AMR, illustrating the relevance of molecular phenotyping of biopsy in high-risk situations such as desensitization.
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Affiliation(s)
- Tristan de Nattes
- Univ Rouen Normandie, INSERM U1234, CHU Rouen, Service de Néphrologie, Rouen, France.
| | - Rangolie Kaveri
- EFS Hauts de France-Normandie, Service d'Histocompatibilité, Rouen, France
| | - Fabienne Farce
- EFS Hauts de France-Normandie, Service d'Histocompatibilité, Rouen, France
| | | | - Dominique Guerrot
- Univ Rouen Normandie, INSERM U1096, CHU Rouen, CIC-CRB 1404, Service de Néphrologie, Rouen, France
| | | | | | - Sophie Candon
- Univ Rouen Normandie, INSERM U1234, CHU Rouen, Service d'Immunologie et de Biothérapies, Rouen, France
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Bertrand D, Laurent C, Lemée V, Lebourg L, Hanoy M, Le Roy F, Nezam D, Pruteanu D, Grange S, de Nattes T, Lemoine M, Candon S, Guerrot D. Efficacy of Tixagevimab/Cilgavimab Prophylaxis and Vaccination on Omicron Variants (BA.1, BA.2, BA.5, and BQ.1.1) in Kidney Transplant Recipients. Clin J Am Soc Nephrol 2023; 18:1343-1345. [PMID: 37382950 PMCID: PMC10578625 DOI: 10.2215/cjn.0000000000000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Veronique Lemée
- Department of Virology, Rouen University Hospital, Rouen, France
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Diana Pruteanu
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Steven Grange
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Tristan de Nattes
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
- INSERM U1234, University of Rouen Normandy, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Sophie Candon
- INSERM U1234, University of Rouen Normandy, Rouen, France
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
- INSERM U1096, University of Rouen Normandy, Rouen, France
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Rondeaux J, Groussard D, Renet S, Tardif V, Dumesnil A, Chu A, Di Maria L, Lemarcis T, Valet M, Henry JP, Badji Z, Vézier C, Béziau-Gasnier D, Neele AE, de Winther MPJ, Guerrot D, Brand M, Richard V, Durand E, Brakenhielm E, Fraineau S. Ezh2 emerges as an epigenetic checkpoint regulator during monocyte differentiation limiting cardiac dysfunction post-MI. Nat Commun 2023; 14:4461. [PMID: 37491334 PMCID: PMC10368741 DOI: 10.1038/s41467-023-40186-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 07/18/2023] [Indexed: 07/27/2023] Open
Abstract
Epigenetic regulation of histone H3K27 methylation has recently emerged as a key step during alternative immunoregulatory M2-like macrophage polarization; known to impact cardiac repair after Myocardial Infarction (MI). We hypothesized that EZH2, responsible for H3K27 methylation, could act as an epigenetic checkpoint regulator during this process. We demonstrate for the first time an ectopic EZH2, and putative, cytoplasmic inactive localization of the epigenetic enzyme, during monocyte differentiation into M2 macrophages in vitro as well as in immunomodulatory cardiac macrophages in vivo in the post-MI acute inflammatory phase. Moreover, we show that pharmacological EZH2 inhibition, with GSK-343, resolves H3K27 methylation of bivalent gene promoters, thus enhancing their expression to promote human monocyte repair functions. In line with this protective effect, GSK-343 treatment accelerated cardiac inflammatory resolution preventing infarct expansion and subsequent cardiac dysfunction in female mice post-MI in vivo. In conclusion, our study reveals that pharmacological epigenetic modulation of cardiac-infiltrating immune cells may hold promise to limit adverse cardiac remodeling after MI.
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Affiliation(s)
- Julie Rondeaux
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | | | - Sylvanie Renet
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | - Virginie Tardif
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | - Anaïs Dumesnil
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | - Alphonse Chu
- Sprott Center for Stem Cell Research, Regenerative Medicine Program, Ottawa Hospital Research Institute, General Hospital, Mailbox 511, 501 Smyth Road, Ottawa, ON K1H8L6, Canada
| | - Léa Di Maria
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | - Théo Lemarcis
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | - Manon Valet
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | - Jean-Paul Henry
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | - Zina Badji
- CHU Rouen, Department of Cardiology, F-76000, Rouen, France
| | - Claire Vézier
- CHU Rouen, Department of Cardiology, F-76000, Rouen, France
| | | | - Annette E Neele
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Menno P J de Winther
- Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Dominique Guerrot
- Univ Rouen Normandie, Inserm EnVI UMR 1096, CHU Rouen, Department of Nephrology, F-76000, Rouen, France
| | - Marjorie Brand
- Sprott Center for Stem Cell Research, Regenerative Medicine Program, Ottawa Hospital Research Institute, General Hospital, Mailbox 511, 501 Smyth Road, Ottawa, ON K1H8L6, Canada
| | - Vincent Richard
- Univ Rouen Normandie, Inserm EnVI UMR 1096, CHU Rouen, Department of Pharmacology, F-76000, Rouen, France
| | - Eric Durand
- Univ Rouen Normandie, Inserm EnVI UMR 1096, CHU Rouen, Department of Cardiology, F-76000, Rouen, France
| | - Ebba Brakenhielm
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France
| | - Sylvain Fraineau
- Univ Rouen Normandie, Inserm EnVI UMR 1096, F-76000, Rouen, France.
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Bertrand D, Brunel M, Lebourg L, Scemla A, Lemoine M, Amrouche L, Laurent C, Legendre C, Guerrot D, Anglicheau D, Sberro-Soussan R. Conversion From Intravenous In-Hospital Belatacept Injection to Subcutaneous Abatacept Injection in Kidney Transplant Recipients During the First COVID-19 Stay-at-Home Order in France. Transpl Int 2023; 36:11328. [PMID: 37554319 PMCID: PMC10405172 DOI: 10.3389/ti.2023.11328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023]
Abstract
The first COVID-19 stay-at-home order came into effect in France on 17 March 2020. Immunocompromised patients were asked to isolate themselves, and outpatient clinic visits were dramatically reduced. In order to avoid visits to the hospital by belatacept-treated kidney transplant recipients (KTRs) during the initial period of the pandemic, we promptly converted 176 KTRs at two French transplant centers from once-monthly 5 mg/kg in-hospital belatacept infusion to once-weekly 125 mg subcutaneous abatacept injection. At the end of follow-up (3 months), 171 (97.16%) KTRs survived with a functioning graft, 2 (1.14%) had died, and 3 (1.70%) had experienced graft loss. Two patients (1.1%) experienced acute T cell-mediated rejection. Nineteen patients (10.80%) discontinued abatacept; 47% of the KTRs found the use of abatacept less restrictive than belatacept, and 38% would have preferred to continue abatacept. Mean eGFR remained stable compared to baseline. Seven patients (3.9%) had COVID-19; among these, two developed severe symptoms but survived. Only one patient had a de novo DSA. Side effects of abatacept injection were uncommon and non-severe. Our study reports for the first time in a large cohort that once-weekly injection of abatacept appears to be feasible and safe in KTRs previously treated with belatacept.
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Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Brunel
- Department of Kidney Transplantation, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Ludivine Lebourg
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Anne Scemla
- Department of Kidney Transplantation, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Mathilde Lemoine
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Lucile Amrouche
- Department of Kidney Transplantation, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Charlotte Laurent
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Christophe Legendre
- Department of Kidney Transplantation, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Dominique Guerrot
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
- INSERM U1096, University of Rouen Normandy, Rouen, France
| | - Dany Anglicheau
- Department of Kidney Transplantation, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Rebecca Sberro-Soussan
- Department of Kidney Transplantation, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
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8
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Caillard P, Vigneau C, Halimi JM, Hazzan M, Thervet E, Heitz M, Juillard L, Audard V, Rabant M, Hertig A, Subra JF, Vuiblet V, Guerrot D, Tamain M, Essig M, Lobbedez T, Quemeneur T, Legendre M, Ganea A, Peraldi MN, Vrtovsnik F, Daroux M, Makdassi R, Choukroun G, Titeca-Beauport D. Prognostic value of complement serum C3 level and glomerular C3 deposits in anti-glomerular basement membrane disease. Front Immunol 2023; 14:1190394. [PMID: 37475859 PMCID: PMC10354545 DOI: 10.3389/fimmu.2023.1190394] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Background and objectives Activation of the complement system is involved in the pathogenesis of anti-glomerular basement membrane (anti-GBM) disease. Glomerular deposits of complement 3 (C3) are often detected on kidney biopsies. The primary objective of this study was to analyze the prognostic value of the serum C3 level and the presence of C3 glomerular deposits in patients with anti-GBM disease. Methods We conducted a retrospective cohort study of 150 single-positive patients with anti-GBM disease diagnosed between 1997 and 2017. Patients were categorized according to the serum C3 level (forming a low C3 (C3<1.23 g/L) and a high C3 (C3≥1.23 g/L) groups) and positivity for C3 glomerular staining (forming the C3+ and C3- groups). The main outcomes were kidney survival and patient survival. Results Of the 150 patients included, 89 (65%) were men. The median [interquartile range (IQR)] age was 45 [26-64]. At diagnosis, kidney involvement was characterized by a median [IQR] peak serum creatinine (SCr) level of 578 [298-977] µmol/L, and 106 (71%) patients required dialysis. Patients in the low C3 group (72 patients) had more severe kidney disease at presentation, as characterized by higher prevalences of oligoanuria, peak SCr ≥500 µmol/L (69%, vs. 53% in the high C3 group; p=0.03), nephrotic syndrome (42%, vs. 24%, respectively; p=0.02) and fibrous forms on the kidney biopsy (21%, vs. 8%, respectively; p=0.04). Similarly, we observed a negative association between the presence of C3 glomerular deposits (in 52 (41%) patients) and the prevalence of cellular forms (83%, vs. 58% in the C3- group; p=0.003) and acute tubulo-interstitial lesions (60%, vs. 36% in the C3- group; p=0.007). When considering patients not on dialysis at diagnosis, the kidney survival rate at 12 months was poorer in the C3+ group (50% [25-76], vs. 91% [78-100] in the C3- group; p=0.01), with a hazard ratio [95% confidence interval] of 5.71 [1.13-28.85] (p=0.04, after adjusting for SCr). Conclusion In patients with anti-GBM disease, a low serum C3 level and the presence of C3 glomerular deposits were associated with more severe disease and histological kidney involvement at diagnosis. In patients not on dialysis at diagnosis, the presence of C3 deposits was associated with worse kidney survival.
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Affiliation(s)
- Pauline Caillard
- Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, Amiens, France
- Mécanismes Physiopathologiques et Conséquences des Calcifications Cardiovasculaires (MP3CV) laboratory, Centre de Recherche en Santé (CURS), Amiens, France
| | - Cécile Vigneau
- Rennes University Hospital, Inserm, Ecole des hautes études en santé publique (EHESP), Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Jean-Michel Halimi
- Department of Nephrology, Tours University Hospital and EA4245, University of Tours, Tours, France
| | - Marc Hazzan
- Nephrology Department, Lille University Hospital, University of Lille, UMR 995, Lille, France
| | - Eric Thervet
- Department of Nephrology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris and INSERM UMRS970, Boulogne-Billancourt, France
| | - Morgane Heitz
- Department of Nephrology and Dialysis, Annecy Genevois Hospital, Pringy, France
| | - Laurent Juillard
- Department of Nephrology, Edouard Herriot Hospital, Hospices Civils de Lyon, Carmen INSERM 1060 and Univ Lyon, Lyon, France
| | - Vincent Audard
- Department of Nephrology and Renal Transplantation, Reference Center-Idiopathic Nephrotic Syndrome, Henri-Mondor Hospital/Albert-Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP) Créteil, INSERMU955, Paris Est Créteil University, Créteil, France
| | - Marion Rabant
- Pathology Department, Necker University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP). Centre-Université de Paris, Paris, France
| | - Alexandre Hertig
- Department of Nephrology, Dialysis and Transplantation, Foch Hospital, Paris-Saclay University, Suresnes, France
| | - Jean-François Subra
- Department of Nephrology, Dialysis and Transplantation, University Hospital, Angers and Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), INSERM, Nantes University, Angers University, Angers, France
| | - Vincent Vuiblet
- Department of Nephrology and Renal Transplantation, Reims University Hospital, Reims, France
| | - Dominique Guerrot
- Department of Nephrology, Rouen University Hospital, Rouen and INSERM, U1096 Rouen, France
| | - Mathilde Tamain
- Department of Nephrology and Dialysis, Vichy Hospital, Vichy, France
| | - Marie Essig
- Department of Nephrology, Dialysis, and Renal Transplantation, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, Boulogne-Billancourt, France
| | - Thierry Lobbedez
- Department of Nephrology, Caen University Hospital, Caen, France and the French Registry of Peritoneal Dialysis, Langue Française, Pontoise, France
| | - Thomas Quemeneur
- Department of Nephrology and Internal Medicine, Valenciennes General Hospital, Valenciennes, France
| | - Mathieu Legendre
- Department of Nephrology, Dialysis and Renal Transplantation, University Hospital, Dijon, France
| | | | - Marie-Noëlle Peraldi
- Department of Nephrology, Dialysis and Renal Transplantation, Necker University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre-Université de Paris, Paris, France
| | - François Vrtovsnik
- Nephrology Department, Bichat-Claude Bernard Hospital, APHP, Paris, France. Faculty of Medicine, Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Maïté Daroux
- Department of Nephrology, Duchenne Hospital, Boulogne-Sur-Mer, France
| | - Raïfah Makdassi
- Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, Amiens, France
| | - Gabriel Choukroun
- Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, Amiens, France
- Mécanismes Physiopathologiques et Conséquences des Calcifications Cardiovasculaires (MP3CV) laboratory, Centre de Recherche en Santé (CURS), Amiens, France
| | - Dimitri Titeca-Beauport
- Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, Amiens, France
- Mécanismes Physiopathologiques et Conséquences des Calcifications Cardiovasculaires (MP3CV) laboratory, Centre de Recherche en Santé (CURS), Amiens, France
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9
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Maisons V, Hamzaoui M, Hanoy M, Pezel T, Guerrot D, Nezam D. Syndrome cardio-rénal : quoi de neuf en 2023 ? Nephrol Ther 2023; 19:121-138. [PMID: 37098707 DOI: 10.1684/ndt.2023.15] [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: 04/05/2023]
Abstract
Cardiac and renal pathologies lead to a high morbidity and mortality rate. The cardio-renal syndrome is characterized by the coexistence of renal and cardiac dysfunction and represents a polymorphic situation that is often complex to understand. This is a common occurrence that constitutes a real public health problem. In this review article, we propose to review the current state of knowledge on this syndrome by focusing on the main physiopathological, epidemiological, clinical and therapeutic aspects.
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10
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de Nattes T, Beadle J, Toulza F, Candon E, Ruminy P, François A, Bertrand D, Guerrot D, Drieux F, Roufosse C, Candon S. A Simple Molecular Tool for the Assessment of Kidney Transplant Biopsies. Clin J Am Soc Nephrol 2023; 18:499-509. [PMID: 36723289 PMCID: PMC10103338 DOI: 10.2215/cjn.0000000000000100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/17/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Banff Classification for Allograft Pathology recommendations for the diagnosis of kidney transplant rejection includes molecular assessment of the transplant biopsy. However, implementation of molecular tools in clinical practice is still limited, partly due to the required expertise and financial investment. The reverse transcriptase multiplex ligation-dependent probe amplification (RT-MLPA) assay is a simple, rapid, and inexpensive assay that permits simultaneous evaluation of a restricted gene panel using paraffin-embedded tissue blocks. The aim of this study was to develop and validate a RT-MLPA assay for diagnosis and classification of rejection. METHODS A retrospective cohort of 220 kidney transplant biopsies from two centers, which included 52 antibody-mediated rejection, 51 T-cell-mediated rejection, and 117 no-rejection controls, was assessed. A 17-gene panel was identified on the basis of relevant pathophysiological pathways. A support vector machine classifier was developed. A subset of 109 biopsies was also assessed using the Nanostring Banff Human Organ Transplant panel to compare the two assays. RESULTS The support vector machine classifier train and test accuracy scores were 0.84 and 0.83, respectively. In the test cohort, the F1 score for antibody-mediated rejection, T-cell-mediated rejection, and control were 0.88, 0.86, and 0.69, respectively. Using receiver-operating characteristic curves, the area under the curve for class predictions was 0.96, 0.89, and 0.91, respectively, with a weighted average at 0.94. Classifiers' performances were highest for antibody-mediated rejection diagnosis with 94% correct predictions, compared with 88% correct predictions for control biopsies and 60% for T-cell-mediated rejection biopsies. Gene expression levels assessed by RT-MLPA and Nanostring were correlated: r = 0.68, P < 0.001. Equivalent gene expression profiles were obtained with both assays in 81% of the samples. CONCLUSIONS The 17-gene panel RT-MLPA assay, developed here for formalin-fixed paraffin-embedded kidney transplant biopsies, classified kidney transplant rejection with an overall accurate prediction ratio of 0.83. PODCAST This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/CJASN/2023_04_10_CJN10100822.mp3.
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Affiliation(s)
- Tristan de Nattes
- Nephrology – Kidney Transplant Unit, Rouen University Hospital, Rouen, France
- Univ Rouen Normandie, INSERM U1234, Rouen, France
- Department of Immunology and Inflammation, Centre for Inflammatory Diseases, Imperial College, London, United Kingdom
| | - Jack Beadle
- Department of Immunology and Inflammation, Centre for Inflammatory Diseases, Imperial College, London, United Kingdom
| | - Frederic Toulza
- Department of Immunology and Inflammation, Centre for Inflammatory Diseases, Imperial College, London, United Kingdom
| | - Edvin Candon
- Nephrology – Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Philippe Ruminy
- Univ Rouen Normandie, INSERM U1245, Centre Henri Becquerel, Rouen, France
| | - Arnaud François
- Pathology Department, Rouen University Hospital, Rouen, France
| | - Dominique Bertrand
- Nephrology – Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Nephrology – Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Fanny Drieux
- Univ Rouen Normandie, INSERM U1245, Centre Henri Becquerel, Rouen, France
- Pathology Department, Rouen University Hospital, Rouen, France
| | - Candice Roufosse
- Department of Immunology and Inflammation, Centre for Inflammatory Diseases, Imperial College, London, United Kingdom
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11
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Bankir L, Guerrot D, Bichet DG. Vaptans or voluntary increased hydration to protect the kidney: how do they compare? Nephrol Dial Transplant 2023; 38:562-574. [PMID: 34586414 DOI: 10.1093/ndt/gfab278] [Citation(s) in RCA: 3] [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: 07/13/2021] [Indexed: 11/13/2022] Open
Abstract
The adverse effects of vasopressin (AVP) in diverse forms of chronic kidney disease have been well described. They depend on the antidiuretic action of AVP mediated by V2 receptors (V2R). Tolvaptan, a selective V2R antagonist, is now largely used for the treatment of patients with autosomal dominant polycystic kidney disease. Another way to reduce the adverse effects of AVP is to reduce endogenous AVP secretion by a voluntary increase in fluid intake. These two approaches differ in several ways, including the level of thirst and AVP. With voluntary increased drinking, plasma osmolality will decline and so will AVP secretion. Thus, not only will V2R-mediated effects be reduced, but also those mediated by V1a and V1b receptors (V1aR and V1bR). In contrast, selective V2R antagonism will induce a loss of fluid that will stimulate AVP secretion and thus increase AVP's influence on V1a and V1b receptors. V1aR is expressed in the luminal side of the collecting duct (CD) and in inner medullary interstitial cells, and their activation induces the production of prostaglandins, mostly prostaglandin E2 (PGE2). Intrarenal PGE2 has been shown to reduce sodium and water reabsorption in the CD and increase blood flow in the renal medulla, both effects contributing to increase sodium and water excretion and reduce urine-concentrating activity. Conversely, non-steroidal anti-inflammatory drugs have been shown to induce significant water and sodium retention and potentiate the antidiuretic effects of AVP. Thus, during V2R antagonism, V1aR-mediated actions may be responsible for part of the diuresis observed with this drug. These V1aR-dependent effects do not take place with a voluntary increase in fluid intake. In summary, while both strategies may have beneficial effects, the information reviewed here leads us to assume that pharmacological V2R antagonism, with resulting stimulation of V1aR and increased PGE2 production, may provide greater benefit than voluntary high water intake. The influence of tolvaptan on the PGE2 excretion rate and the possibility to use somewhat lower tolvaptan doses than presently prescribed remain to be evaluated.
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Affiliation(s)
- Lise Bankir
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France.,CNRS, ERL 8228-Laboratoire de Physiologie Rénale et Tubulopathies, Paris, France
| | - Dominique Guerrot
- Départment de Néphrologie, Hôpital Universitaire de Rouen, Rouen, France.,Université de Normandie, UNIROUEN, INSERM U1096, Rouen, France
| | - Daniel G Bichet
- Université de Montréal, Montréal, Quebec, Canada.,Département de Pharmacologie, Département de Physiologie, and Département de Médecine, Hôpital du Sacré-Coeur de Montréal, Montréal, Quebec, Canada
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12
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Messaoudi H, Levesque T, Perzo N, Berg E, Feugray G, Dumesnil A, Brunel V, Guerrot D, Eltchaninoff H, Richard V, Kamel S, Durand E, Bennis Y, Bellien J. Subtotal Nephrectomy Associated with a High-Phosphate Diet in Rats Mimics the Development of Calcified Aortic Valve Disease Associated with Chronic Renal Failure. J Clin Med 2023; 12:jcm12041539. [PMID: 36836075 PMCID: PMC9963294 DOI: 10.3390/jcm12041539] [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: 12/26/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction. This study addressed the hypothesis that subtotal nephrectomy associated with a high-phosphorus diet (5/6Nx + P) in rats represents a suitable animal model to mimic the cardiovascular consequences of chronic kidney disease (CKD) including calcified aortic valve disease (CAVD). Indeed, the latter contributes to the high morbidity and mortality of CKD patients and sorely lacks preclinical models for pathophysiological and pharmacological studies. Methods. Renal and cardiovascular function and structure were compared between sham-operated and 5/6 Nx rats + P 10 to 12 weeks after surgery. Results. As expected, 11 weeks after surgery, 5/6Nx + P rats developed CKD as demonstrated by their increase in plasma creatinine and urea nitrogen and decrease in glomerular filtration rate, estimated by using fluorescein-isothiocyanate-labelled sinistrin, anemia, polyuria, and polydipsia compared to sham-operated animals on a normal-phosphorus diet. At the vascular level, 5/6Nx + P rats had an increase in the calcium content of the aorta; a decrease in mesenteric artery dilatation in response to a stepwise increase in flow, illustrating the vascular dysfunction; and an increase in blood pressure. Moreover, immunohistology showed a marked deposition of hydroxyapatite crystals in the aortic valve of 5/6Nx + P rats. Echocardiography demonstrated that this was associated with a decrease in aortic valve cusp separation and an increase in aortic valve mean pressure gradient and in peak aortic valve velocity. Left-ventricular diastolic and systolic dysfunction as well as fibrosis were also present in 5/6Nx + P rats. Conclusion. This study demonstrates that 5/6Nx + P recapitulates the cardiovascular consequences observed in humans with CKD. In particular, the initiation of CAVD was shown, highlighting the interest of this animal model to study the mechanisms involved in the development of aortic stenosis and test new therapeutic strategies at an early stage of the disease.
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Affiliation(s)
- Hind Messaoudi
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
| | - Thomas Levesque
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Cardiology, CHU Rouen, F-76000 Rouen, France
| | - Nicolas Perzo
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
| | - Elodie Berg
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Thoracic Surgery, CHU Rouen, F-76000 Rouen, France
| | - Guillaume Feugray
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of General Biochemistry, CHU Rouen, F-76000 Rouen, France
| | - Anaïs Dumesnil
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
| | - Valéry Brunel
- Department of General Biochemistry, CHU Rouen, F-76000 Rouen, France
| | - Dominique Guerrot
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Nephrology, CHU Rouen, F-76000 Rouen, France
| | - Hélène Eltchaninoff
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Cardiology, CHU Rouen, F-76000 Rouen, France
| | - Vincent Richard
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Pharmacology, CHU Rouen, F-76000 Rouen, France
| | - Saïd Kamel
- UR UPJV 7517, Mécanismes Physiopathologiques et Conséquences des Calcifications Cardiovasculaires (MP3CV), Centre de Recherche Universitaire en Santé, Université de Picardie Jules Verne, F-80054 Amiens, France
- Department of Biochemistry, Amiens-Picardie University Hospital, F-80054 Amiens, France
| | - Eric Durand
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Cardiology, CHU Rouen, F-76000 Rouen, France
| | - Youssef Bennis
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- UR UPJV 7517, Mécanismes Physiopathologiques et Conséquences des Calcifications Cardiovasculaires (MP3CV), Centre de Recherche Universitaire en Santé, Université de Picardie Jules Verne, F-80054 Amiens, France
- Department of Pharmacology, Amiens-Picardie University Hospital, F-80054 Amiens, France
| | - Jérémy Bellien
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Pharmacology, CHU Rouen, F-76000 Rouen, France
- Correspondence: ; Tel.: +33-(0)2-35-14-83-68
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13
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Bertrand D, Matignon M, Morel A, Ludivine L, Lemoine M, Hanoy M, Roy FL, Nezam D, Hamzaoui M, de Nattes T, Moktefi A, François A, Laurent C, Etienne I, Guerrot D. Belatacept rescue conversion in kidney transplant recipients with vascular lesions (Banff cv score >2): a retrospective cohort study. Nephrol Dial Transplant 2023; 38:481-490. [PMID: 35544123 DOI: 10.1093/ndt/gfac178] [Citation(s) in RCA: 3] [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: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Immunosuppression in kidney transplant recipients with decreased graft function and histological vascular changes can be particularly challenging. The impact of a late rescue conversion to belatacept on kidney graft survival in this context has never been studied. METHODS We report a bicentric retrospective cohort study comparing a calcineurin inhibitor (CNI) to belatacept switch versus CNI continuation in 139 kidney transplant recipients with histological kidney vascular damage (cv ≥2, g + cpt ≤1, i + t ≤1) and low estimated glomerular filtration rate (≤40 mL/min/1.73 m²). Primary outcome was death-censored graft survival. RESULTS During the study follow-up, 10 graft losses (14.5%) occurred in the belatacept group (n = 69) versus 26 (37.1%) in the matched CNI group (n = 70) (P = .005). Death-censored graft survival was significantly higher in the belatacept group (P = .001). At 3 years, graft survival was 84.0% in the belatacept group compared with 65.1% in the control group. Continuing CNI was an independent risk factor for graft loss [hazard ratio (HR) 3.46; P < .005]. The incidence of cellular rejection after the conversion was low (4.3% in both groups) and not significantly different between groups (P = .84). Patients switched to belatacept developed significantly less donor-specific antibodies de novo. Belatacept was an independent risk factor for the occurrence of opportunistic infections (HR 4.84; P < .005). CONCLUSION The replacement of CNI with belatacept in patients with decreased allograft function and vascular lesions is associated with an improvement in graft survival and represents a valuable option in a context of organ shortage. Caution should be exercised regarding the increased risk of opportunistic infection.
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Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Marie Matignon
- Nephrology and Transplantation Department, Cancerology-Immunity-Transplantation-Infectiology, Clinical Investigation Center-Biotherapies, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, INSERM U955, Paris-Est-Créteil University, Paris, France
| | - Antoine Morel
- Nephrology and Transplantation Department, Cancerology-Immunity-Transplantation-Infectiology, Clinical Investigation Center-Biotherapies, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, INSERM U955, Paris-Est-Créteil University, Paris, France
| | - Lebourg Ludivine
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mouad Hamzaoui
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Tristan de Nattes
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Anissa Moktefi
- Department of Pathology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est-Créteil University, Paris, France
| | | | - Charlotte Laurent
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France.,INSERM U1096, Normandie Univ, UNIROUEN, Rouen, France
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14
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Hamzaoui M, Groussard D, Nezam D, Djerada Z, Lamy G, Tardif V, Dumesnil A, Renet S, Brunel V, Peters DJ, Chevalier L, Hanoy M, Mulder P, Richard V, Bellien J, Guerrot D. Endothelium-Specific Deficiency of Polycystin-1 Promotes Hypertension and Cardiovascular Disorders. Hypertension 2022; 79:2542-2551. [DOI: 10.1161/hypertensionaha.122.19057] [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: 11/16/2022]
Abstract
Background:
Autosomal dominant polycystic kidney disease is the most frequent hereditary kidney disease and is generally due to mutations in
PKD1
and
PKD2
, encoding polycystins 1 and 2. In autosomal dominant polycystic kidney disease, hypertension and cardiovascular disorders are highly prevalent, but their mechanisms are partially understood.
Methods:
Since endothelial cells express the polycystin complex, where it plays a central role in the mechanotransduction of blood flow, we generated a murine model with inducible deletion of
Pkd1
in endothelial cells (
Cdh5-Cre
ERT2
;
Pkd1
fl/fl
) to specifically determine the role of endothelial polycystin-1 in autosomal dominant polycystic kidney disease.
Results:
Endothelial deletion of
Pkd1
induced endothelial dysfunction, as demonstrated by impaired flow-mediated dilatation of resistance arteries and impaired relaxation to acetylcholine, increased blood pressure and prevented the normal development of arteriovenous fistula. In experimental chronic kidney disease induced by subtotal nephrectomy, endothelial deletion of
Pkd1
further aggravated endothelial dysfunction, vascular remodeling, and heart hypertrophy.
Conclusions:
Altogether, this study provides the first in vivo demonstration that specific deletion of
Pkd1
in endothelial cells promotes endothelial dysfunction and hypertension, impairs arteriovenous fistula development, and potentiates the cardiovascular alterations associated with chronic kidney disease.
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Affiliation(s)
- Mouad Hamzaoui
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
- Nephrology Department, Rouen University Hospital, Rouen, France (M.H., D.N., G.L., M.H., D.G.)
| | - Deborah Groussard
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
| | - Dorian Nezam
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
- Nephrology Department, Rouen University Hospital, Rouen, France (M.H., D.N., G.L., M.H., D.G.)
| | - Zoubir Djerada
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
- Pharmacology Department, Reims University Hospital, Reims, France (Z.D.)
| | - Gaspard Lamy
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
- Nephrology Department, Rouen University Hospital, Rouen, France (M.H., D.N., G.L., M.H., D.G.)
| | - Virginie Tardif
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
| | - Anais Dumesnil
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
| | - Sylvanie Renet
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
| | - Valery Brunel
- Biochemistry Department, Rouen University Hospital, Rouen, France (V.B.)
| | - Dorien J.M. Peters
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands (D.J.M.P.)
| | - Laurence Chevalier
- Normandie Univ, UNIROUEN, GPM, UMR CNRS 6634, Saint Etienne de Rouvray (L.C.)
| | - Mélanie Hanoy
- Nephrology Department, Rouen University Hospital, Rouen, France (M.H., D.N., G.L., M.H., D.G.)
| | - Paul Mulder
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
| | - Vincent Richard
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
| | - Jeremy Bellien
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
- Pharmacology Department, Rouen University Hospital, Rouen, France (J.B.)
| | - Dominique Guerrot
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France (M.H., D.G., D.N., Z.D., G.L., V.T., A.D., S.R., P.M., V.R., J.B., D.G.)
- Nephrology Department, Rouen University Hospital, Rouen, France (M.H., D.N., G.L., M.H., D.G.)
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Mahevas M, Audard V, Rousseau A, Cez A, Guerrot D, Verhelst D, Delahousse M, Hanrotel C, Pillebout E, Daugas E, Krastinova E, Valeyre D, Boffa JJ. Efficacy and safety of methylprednisolone pulse followed by oral prednisone versus oral prednisone alone in sarcoidosis tubulointerstitial nephritis. A randomized, open-label, controlled clinical trial. Nephrol Dial Transplant 2022; 38:961-968. [PMID: 36066903 DOI: 10.1093/ndt/gfac227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To determine the benefit of pulsed methylprednisolone for improving renal function in sarcoidosis tubulointerstitial nephritis (TIN). PATIENTS AND METHODS A multicenter, prospective, randomized, open-labeled, controlled trial in patients with biopsy-proven acute TIN due to sarcoidosis was conducted in 21 sites in France. Patients were randomly assigned to receive a methylprednisolone pulse 15 mg/kg/day for 3 days then oral prednisone (MP group) or oral prednisone 1 mg/kg/day alone (PRD group). The primary endpoint was a positive response at 3 months, defined as a doubling of eGFR as compared with before randomization. RESULTS We randomized 40 participants. Baseline eGFR before PRD was 22 ml/min/1.73m2 (interquartile range [IQR] 16-44) and before MP was 25 ml/min/1.73m2 (IQR 22-36) (P = 0.3). The two groups did not differ in underlying pathological lesions, including mean percentage of interstitial fibrosis and intensity of interstitial infiltrate. In the intent-to-treat population, the median eGFR at 3 months did not significantly differ between the PRD and MP groups: 45 (IQR 34-74) and 46 (IQR 39-65) ml/min/1.73m2. The primary endpoint at 3 months was achieved in 16/20 (80%) PRD patients and 10/20 (50%) MP patients (P = 0.0467). eGFR was similar between the two groups after 1, 3, 6, and 12 months of treatment. For both groups, eGFR at 1 month was highly correlated with eGFR at 12 months (P < 0.0001). The two groups did not differ in severe adverse events. CONCLUSION As compared with a standard oral-steroid regimen, intravenous MP may have no supplemental benefit for renal function in patients with TIN due to sarcoidosis. ClinicalTrials.gov: NCT01652417; EudraCT: 2012-000149-11.
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Affiliation(s)
- Matthieu Mahevas
- Service de Médecine Interne, Centre national de référence des cytopénies auto-immunes de l'adulte, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris Est Créteil, Créteil, France
| | - Vincent Audard
- Nephrology and Renal Transplantation Department, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France.,Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Alexandra Rousseau
- Assistance Publique-Hôpitaux de Paris (AP-HP), Clinical Research Platform of East of Paris (URC-CRC-CRB), Hôpital Saint Antoine, Paris, France
| | - Alexandre Cez
- Sorbonne Université, INSERM UMRS 1155, Nephrology Department, AP-HP, Hôpital Tenon, Paris, France
| | - Dominique Guerrot
- Nephrology Department, Rouen University Hospital, Normandie Univ, INSERM U1096, Rouen, France
| | | | - Michel Delahousse
- Nephrology and Renal Transplantation department, Hôpital Foch, Suresnes, France
| | - Catherine Hanrotel
- Nephrology, Dialysis and Renal Transplantation Department, Hôpital Universitaire de la Cavale Blanche, BREST, France
| | - Evangeline Pillebout
- Service de néphrologie, Hôpital St-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Daugas
- Department of Nephrology, Hôpital Bichat-Claude-Bernard, Assistance Publique-Hôpitaux de Paris; Université de Paris; INSERM U1149, Paris, France
| | - Evguenia Krastinova
- Assistance Publique-Hôpitaux de Paris (AP-HP), Clinical Research Platform of East of Paris (URC-CRC-CRB), Hôpital Saint Antoine, Paris, France
| | - Dominique Valeyre
- INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, hôpital Avicenne, Bobigny, France
| | - Jean-Jacques Boffa
- Sorbonne Université, INSERM UMRS 1155, Nephrology Department, AP-HP, Hôpital Tenon, Paris, France
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16
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Dumont A, Bellien J, Guerrot D, Bertrand D, Hanoy M, Laurent C, Lemoine M, Le Roy F, Lebourg L, Edet S. Impact de la stimulation chronique dopaminergique par la Rotigotine sur la fonction vasculaire chez des patients atteints de Polykystose rénale autosomique dominante (IMPROVE-PKD). Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Guerrot D, Hamzaoui M, Groussard D, Nezam D, Mulder P, Richard V, Bellien J. Endotheilum-specific deficiency of polycystin-1 promotes hypertension and cardiovascular disorders, and impairs arterio-venous fistula maturation. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.259] [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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18
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De Nattes T, Beadle J, Toulza F, Candon E, François A, Bertrand D, Guerrot D, Drieux F, Candon S, Roufosse C. La reverse transcriptase multiplex ligation-dépendent probe amplification (RT-MLPA) pour le diagnostic et la classification des rejets en transplantation rénale. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.265] [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: 11/24/2022]
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Deberny Q, Quemeneur T, Lebas C, Mesbah R, Guerrot D, Hachulla E, Gibier JB, Titeca-Beauport D. Validation du score de risque rénal chez les patients de plus de 65 ans avec une atteinte rénale de vascularite à ANCA : une cohorte rétrospective multicentrique. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.251] [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: 11/26/2022]
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20
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Rousselin C, Amoura Z, Faguer S, Bataille P, Boffa JJ, Canaud G, Guerrot D, Jourde-Chiche For The Gclr N, Karras A, Auxenfants E, Chapelet A, Lambert M, Behal H, Nochy D, Jean-Paul DVH, Brocheriou For The Cfpr I, Gnemmi V, Quemeneur T. Renal and vascular outcomes in patients with isolated antiphospholipid syndrome nephropathy. J Autoimmun 2022; 132:102889. [PMID: 35987174 DOI: 10.1016/j.jaut.2022.102889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/24/2022] [Accepted: 07/24/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Antiphospholipid syndrome (APS) nephropathy (APSN) is a rare pattern with specific features resulting from microvascular lesions. The prognosis of APSN, outside of lupus nephritis, is unknown. The aim of this study was to describe the renal, vascular and overall outcomes of patients with APSN. METHODS Retrospective multicenter study of patients with antiphospholipid antibodies (aPL) associated with histological APSN lesions and no other nephropathy, identified through a national call for medical records. End-stage renal disease (ESRD)-free survival, thrombosis recurrence-free survival and overall survival were assessed. RESULTS Thirty patients were included (19 women) with a median age of 40 years (34-52 years). Fifteen patients had APS, 26/28 had lupus anticoagulant, and 15/26 had triple positivity for aPL. Median eGFR was 50 (31-60) mL/min/1.73 m2. Glomerular thrombotic microangiopathy was found in 12/24 cases, fibrous intimal hyperplasia in 12/22 cases and focal cortical atrophy in 17/29 cases. Nineteen patients had moderate to severe interstitial fibrosis (>25%). Six patients developed ESRD at a median follow-up of 6.2 (1.8-9.1) years. The ESRD-free survival rates at 5 and 10 years were 80.0% (95% CI 57.6%-91.4%) and 72.7% (95% CI, 46.9%-87.4%) respectively. None of the histological factors considered was significantly associated with a decrease in eGFR at 12 months. Thrombosis recurrence-free survival was 77.8% (95% CI 48.2%-91.6%) at 10 years. Overall survival was 94% at 10 years (95% CI 65.0%-99.2%). CONCLUSIONS The renal prognosis of isolated APSN is poor. The severe fibrotic lesions observed are suggestive of late diagnosis.
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Affiliation(s)
| | - Zahir Amoura
- Médecine Interne 2, French National Reference Center for SLE and APS, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation D'Organes, Centre de Référence des Maladies Rénales Rares, CHU de Toulouse, F-31000 Toulouse, France
| | | | | | | | | | | | | | | | | | | | - Hélène Behal
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France
| | - Dominique Nochy
- Anatomo-pathologie, Hôpital Européen Georges Pompidou, Paris, France
| | | | | | | | - Thomas Quemeneur
- Néphrologie et Médecine Interne, Hôpital de Valenciennes, France
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Lemoine H, Raud L, Foulquier F, Sayer JA, Lambert B, Olinger E, Lefèvre S, Knebelmann B, Harris PC, Trouvé P, Desprès A, Duneau G, Matignon M, Poyet A, Jourde-Chiche N, Guerrot D, Lemoine S, Seret G, Barroso-Gil M, Bingham C, Gilbert R, Le Meur Y, Audrézet MP, Cornec-Le Gall E. Monoallelic pathogenic ALG5 variants cause atypical polycystic kidney disease and interstitial fibrosis. Am J Hum Genet 2022; 109:1484-1499. [PMID: 35896117 PMCID: PMC9388391 DOI: 10.1016/j.ajhg.2022.06.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/23/2022] [Indexed: 02/06/2023] Open
Abstract
Disorders of the autosomal dominant polycystic kidney disease (ADPKD) spectrum are characterized by the development of kidney cysts and progressive kidney function decline. PKD1 and PKD2, encoding polycystin (PC)1 and 2, are the two major genes associated with ADPKD; other genes include IFT140, GANAB, DNAJB11, and ALG9. Genetic testing remains inconclusive in ∼7% of the families. We performed whole-exome sequencing in a large multiplex genetically unresolved (GUR) family affected by ADPKD-like symptoms and identified a monoallelic frameshift variant (c.703_704delCA) in ALG5. ALG5 encodes an endoplasmic-reticulum-resident enzyme required for addition of glucose molecules to the assembling N-glycan precursors. To identify additional families, we screened a cohort of 1,213 families with ADPKD-like and/or autosomal-dominant tubulointerstitial kidney diseases (ADTKD), GUR (n = 137) or naive to genetic testing (n = 1,076), by targeted massively parallel sequencing, and we accessed Genomics England 100,000 Genomes Project data. Four additional families with pathogenic variants in ALG5 were identified. Clinical presentation was consistent in the 23 affected members, with non-enlarged cystic kidneys and few or no liver cysts; 8 subjects reached end-stage kidney disease from 62 to 91 years of age. We demonstrate that ALG5 haploinsufficiency is sufficient to alter the synthesis of the N-glycan chain in renal epithelial cells. We also show that ALG5 is required for PC1 maturation and membrane and ciliary localization and that heterozygous loss of ALG5 affects PC1 maturation. Overall, our results indicate that monoallelic variants of ALG5 lead to a disorder of the ADPKD-spectrum characterized by multiple small kidney cysts, progressive interstitial fibrosis, and kidney function decline.
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Affiliation(s)
- Hugo Lemoine
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France
| | - Loann Raud
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France
| | - François Foulquier
- Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - John A Sayer
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 3BZ, UK; The Newcastle upon Tyne Hospitals NHS Foundation Trust, Renal Services, Freeman Road, Newcastle Upon Tyne NE7 7DN, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK
| | - Baptiste Lambert
- Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - Eric Olinger
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 3BZ, UK
| | - Siriane Lefèvre
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France; Service de Néphrologie, Hôpital de Lorient, 56322 Lorient, France
| | - Bertrand Knebelmann
- Service de Néphrologie et Transplantation rénale, Hôpital Necker, APHP, Université de Paris, Paris, France
| | - Peter C Harris
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55902, USA
| | - Pascal Trouvé
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France
| | - Aurore Desprès
- Service de Génétique moléculaire, CHRU Brest, 29609 Brest, France
| | | | - Marie Matignon
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Anais Poyet
- Association Régionale d'Aide aux Urémiques du Centre Ouest (ARAUCO), Bourges, France
| | - Noémie Jourde-Chiche
- Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception (APHM), Marseille, France
| | - Dominique Guerrot
- Service de Néphrologie, Dialyse et Transplantation, CHU de Rouen, Rouen, France
| | - Sandrine Lemoine
- Néphrologie, Dialyse, Hypertension artérielle et Exploration Fonctionnelle rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | - Miguel Barroso-Gil
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 3BZ, UK
| | - Coralie Bingham
- Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW, UK
| | - Rodney Gilbert
- Southampton Children's Hospital, University of Southampton, Southampton SO16 6YD, UK
| | - Yannick Le Meur
- Univ Brest, UMR 1227, LBAI, Labex IGO, 29200 Brest, France; Service de Néphrologie, Hémodialyse et Transplantation rénale, CHRU Brest, 29609 Brest, France
| | - Marie-Pierre Audrézet
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France; Service de Génétique moléculaire, CHRU Brest, 29609 Brest, France
| | - Emilie Cornec-Le Gall
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France; Service de Néphrologie, Hémodialyse et Transplantation rénale, CHRU Brest, 29609 Brest, France.
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de Nattes T, Candon S, Lemée V, Laurent C, Guerrot D, Bertrand D. Humoral response to a fourth dose of mRNA vaccine in kidney transplant recipients responders to 3 doses of mRNA vaccine. Clin Kidney J 2022; 15:2343-2345. [PMID: 36381362 PMCID: PMC9664567 DOI: 10.1093/ckj/sfac183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Tristan de Nattes
- Nephrology - Kidney Transplant Unit, Rouen University Hospital , Rouen , France
- Department of Immunology, and Biotherapies, UNIROUEN, INSERM U1234, Normandy University, Rouen University Hospital , Rouen , France
| | - Sophie Candon
- Department of Immunology, and Biotherapies, UNIROUEN, INSERM U1234, Normandy University, Rouen University Hospital , Rouen , France
| | - Véronique Lemée
- Department of Virology, Rouen University Hospital , Rouen , France
| | - Charlotte Laurent
- Nephrology - Kidney Transplant Unit, Rouen University Hospital , Rouen , France
| | - Dominique Guerrot
- Nephrology - Kidney Transplant Unit, Rouen University Hospital , Rouen , France
| | - Dominique Bertrand
- Nephrology - Kidney Transplant Unit, Rouen University Hospital , Rouen , France
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Guerrot D, de Nattes T, Lanot A, Hazzan M. La néphrologie 2.0 : communication avec les patients connectés et les professionnels de santé. Nephrol Ther 2022; 18:222-227. [DOI: 10.1016/j.nephro.2022.02.003] [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] [Received: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 11/26/2022]
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Saeed S, Guerrot D. Incidence, predictors and prognostic impact of acute kidney injury in patients with COVID-19. Pak J Med Sci 2022; 38:1413-1415. [PMID: 35991225 PMCID: PMC9378407 DOI: 10.12669/pjms.38.6.6475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 04/26/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sahrai Saeed
- Sahrai Saeed, MD, PhD, FESC. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- Correspondence: Sahrai Saeed, MD, PhD, FESC. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
| | - Dominique Guerrot
- Dominique Guerrot, MD, PhD. Service de Néphrologie & INSERM U1096, CHU Hôpitaux de Rouen, Rouen, France
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de Nattes T, Lebourg L, Etienne I, Laurent C, Lemoine M, Dumont A, Guerrot D, Jacquot S, Candon S, Bertrand D. CD86 occupancy in belatacept-treated kidney transplant patients is not associated with clinical and infectious outcomes. Am J Transplant 2022; 22:1691-1698. [PMID: 35181996 DOI: 10.1111/ajt.17005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/11/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 01/25/2023]
Abstract
The CD86 occupancy assay has been developed to measure the number of CD86 molecules unbound to belatacept, but its association with clinical outcomes has not been assessed yet. All kidney transplant patients switched to belatacept in our center between 2016 and 2018 were included. Blood samples were collected before each infusion for 1 year to assess CD86 occupancy by CD86 antibody cytometry staining on the surface of CD14+ monocytes. Results were expressed as the median fluorescence intensity (MFI) value of CD86 staining. At each infusion, the MFIDay of infusion /MFIDay 0 ratio was calculated. Forty-one patients were consecutively included. After every 2-week infusion period, CD86 MFI ratio dropped from 1.00 to 0.73 [0.57-0.98], p = .07. However, this ratio progressively increased to 0.78 [0.53-1.13] at 1 year, which was not statistically different from pre-switch ratio, p = .4. Over the first year, the MFI ratio coefficient of variation was 31.58% [23.75-38.31]. MFI ratio was not different between patients with or without opportunistic infections: 0.73 [0.60-0.88] versus 0.80 [0.71-1.00], p = .2, or between patients with or without EBV DNAemia, p = .2. Despite previous in vitro results, the CD86 occupancy assay suffers from a high intra-individual variability and does not appear to be relevant to clinical outcomes.
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Affiliation(s)
- Tristan de Nattes
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France.,Department of Immunology, and Biotherapies, UNIROUEN, INSERM U1234, Normandy University, Rouen University Hospital, Rouen, France
| | - Ludivine Lebourg
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Charlotte Laurent
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Audrey Dumont
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Serge Jacquot
- Department of Immunology, and Biotherapies, UNIROUEN, INSERM U1234, Normandy University, Rouen University Hospital, Rouen, France
| | - Sophie Candon
- Department of Immunology, and Biotherapies, UNIROUEN, INSERM U1234, Normandy University, Rouen University Hospital, Rouen, France
| | - Dominique Bertrand
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
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Hummel A, Oniszczuk J, Kervella D, Charbit M, Guerrot D, Testa A, Philipponnet C, Chauvet C, Guincestre T, Brochard K, Benezech A, Figueres L, Belenfant X, Guarnieri A, Demoulin N, Benetti E, Miglinas M, Dessaix K, Morelle J, Angeletti A, Sellier-Leclerc AL, Ranchin B, Goussard G, Hudier L, Bacchetta J, Servais A, Audard V. Idiopathic nephrotic syndrome relapse following SARS-CoV-2 vaccination: a series of 25 cases. Clin Kidney J 2022; 15:1574-1582. [PMID: 35979142 PMCID: PMC9129143 DOI: 10.1093/ckj/sfac134] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Several cases of idiopathic nephrotic syndrome (INS) relapse following the administration of coronavirus disease 2019 (COVID-19) vaccines have recently been reported, raising questions about the potential relationship between the immune response to COVID-19 vaccination and INS pathogenesis. Methods We performed a retrospective multicentre survey describing the clinical and biological characteristics of patients presenting a relapse of INS after COVID-19 vaccination, with an assessment of outcome under treatment. Results We identified 25 patients (16 men and 9 women) presenting a relapse within 1 month of a COVID-19 vaccine injection. The glomerular disease was of childhood onset in half of the patients and most patients (21/25) had received at least one immunosuppressive drug in addition to steroids for frequently relapsing or steroid-dependent nephrotic syndrome (NS). All patients were in a stable condition at the time of injection and 11 had no specific treatment. In five patients, the last relapse was reported >5 years before vaccine injection. The Pfizer-BioNTech (BNT162b2) vaccine was used in 80% of the patients. In 18 cases, INS relapse occurred after the first injection, a mean of 17.5 days after vaccination. A second injection was nevertheless administered in 14 of these patients. Five relapses occurred after administration of the second dose and two relapses after the administration of the third dose. All but one of the patients received steroids as first-line treatment, with an additional immunosuppressive agent in nine cases. During follow-up, complete remission was achieved in 21 patients, within 1 month in 17 cases. Only one patient had not achieved at least partial remission after 3 months of follow-up. Conclusions This case series suggests that, in rare patients, COVID-19 vaccination may trigger INS relapse that is generally easy to control. These findings should encourage physicians to persuade their patients to complete the COVID-19 vaccination schedule.
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Affiliation(s)
- Aurélie Hummel
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique » (SNI), Paris, France
| | - Julie Oniszczuk
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare SNI, Créteil, France
- Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Delphine Kervella
- Institut de Transplantation Urologie Néphrologie, Centre Hospitalo Universitaire (CHU) Nantes, Nantes, France
- Centre de Recherche en Transplantation et Immunologie, Unité Mixte de Recherche (UMR) 1064, INSERM, Université de Nantes, Nantes, France
| | - Marina Charbit
- AP-HP, Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie pédiatrique, Centre de référence MARHEA, centre de référence SNI, Institut Imagine, Université de Paris, Paris, France
| | - Dominique Guerrot
- Department of Nephrology, Hemodialysis and Transplantation, Rouen University Hospital, Rouen, France
- Normandy University, UNIROUEN, INSERM U1096, Rouen, France
| | - Angelo Testa
- E.C.H.O. (Expansion Centre Hémodialyse de l'Ouest) Site Confluent REZE, France
| | - Carole Philipponnet
- Service Nephrologie Dialyse et Transplantation rénale CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Cécile Chauvet
- Service de Néphrologie, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France
| | - Thomas Guincestre
- Service de Néphrologie, Centre Hospitalier de Roubaix, Roubaix, France
| | - Karine Brochard
- Service de Néphrologie-Rhumatologie-Médecine Interne pédiatrique, Centre de Référence des Maladies rénales Rares du Sud-Ouest (SORARE), Hôpital des enfants, Toulouse, France
| | - Ariane Benezech
- Service de Néphrologie-Rhumatologie-Médecine Interne pédiatrique, Centre de Référence des Maladies rénales Rares du Sud-Ouest (SORARE), Hôpital des enfants, Toulouse, France
| | - Lucile Figueres
- Institut de Transplantation Urologie Néphrologie, Centre Hospitalo Universitaire (CHU) Nantes, Nantes, France
- Centre de Recherche en Transplantation et Immunologie, Unité Mixte de Recherche (UMR) 1064, INSERM, Université de Nantes, Nantes, France
| | - Xavier Belenfant
- Groupe Hospitalier Grand Paris Nord Est, Hôpital André Grégoire, Service de Néphrologie-Dialyse, Montreuil, France
| | | | - Nathalie Demoulin
- Nephrology Division, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Elisa Benetti
- Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy
| | - Marius Miglinas
- Nephrology Center, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Kathleen Dessaix
- Université de Montpellier, Service de Nephrologie, CHU Montpellier, Hôpital Lapeyronie, Montpellier, France
| | - Johann Morelle
- Nephrology Division, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Andrea Angeletti
- Division of Nephrology, Dialysis, Transplantation, IRCCS Giannini Gaslini Children's Hospital, Via Gerolamo Gaslini 5, Genova, Italy
| | - Anne-Laure Sellier-Leclerc
- Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France
| | - Bruno Ranchin
- Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France
| | - Guillaume Goussard
- Service de Néphrologie et Transplantation CHU Poitiers, Poitiers, France
| | - Laurent Hudier
- Service de Néphrologie, Centre Hospitalier Broussais, Saint Malo, France
| | - Justine Bacchetta
- Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France
| | - Aude Servais
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique » (SNI), Paris, France
| | - Vincent Audard
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare SNI, Créteil, France
- Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
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Bertrand D, Lemée V, Laurent C, Lemoine M, Hanoy M, Le Roy F, Nezam D, Pruteanu D, Lebourg L, Grange S, Plantier JC, Boyer O, Guerrot D, Candon S. Waning antibody response and cellular immunity 6 months after third dose SARS-Cov-2 mRNA BNT162b2 vaccine in kidney transplant recipients. Am J Transplant 2022; 22:1498-1500. [PMID: 35007383 PMCID: PMC10149233 DOI: 10.1111/ajt.16954] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Veronique Lemée
- Department of Virology, Rouen University Hospital, Rouen, France
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Diana Pruteanu
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Steven Grange
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | | | - Olivier Boyer
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France.,INSERM U1234, University of Rouen Normandy, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and hemodialysis, Rouen University Hospital, Rouen, France
| | - Sophie Candon
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France.,INSERM U1234, University of Rouen Normandy, Rouen, France
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Martzloff J, Guerrot D, Moulin B. Adequacy between practice and european guidelines on hyponatremia: a survey among french nephrologists. Clin Kidney J 2022; 15:2159-2160. [PMID: 36325014 PMCID: PMC9613430 DOI: 10.1093/ckj/sfac110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jonas Martzloff
- Nephrology Department, Strasbourg University Hospital, Strasbourg, France
| | - Dominique Guerrot
- Nephrology Department, Rouen University Hospital, Rouen, France
- Inserm U1096, UniRouen, Normandie Université, Rouen, France
| | - Bruno Moulin
- Nephrology Department, Strasbourg University Hospital, Strasbourg, France
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29
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Fourdinier O, Ulrich M, Karras A, Olagne J, Buob D, Audard V, Vigneau C, Gibier JB, Guerrot D, Massy Z, Vuiblet V, Rabot N, Goujon JM, Cordonnier C, Choukroun G, Titeca-Beauport D. Glomerulonephritis with non-Randall-type, non-cryoglobulinemic monoclonal immunoglobulin G deposits [PGNMID and ITG]. Clin Kidney J 2022; 15:1727-1736. [PMID: 36003672 PMCID: PMC9394706 DOI: 10.1093/ckj/sfac085] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Glomerulonephritis (GN) with non-Randall-type, non-cryoglobulinemic monoclonal immunoglobulin G deposits encompasses rare diseases [proliferative GN with non-organized deposits (PGNMID) and immunotactoid GN] that cannot be distinguished without ultrastructural analysis by electron microscopy (EM).
Methods
Here, we report and analyze the prognosis of 41 EM-proven (PGNMID for 39/41) and 22 non-EM-proven/DNAJB9-negative cases, diagnosed between 2001 and 2019 in 12 French nephrology centers.
Results
Median serum creatinine (SCr) at presentation was 150 [92-256] μmol/L. The predominant histological pattern was membranoproliferative GN (79%), with IgG3 (74%) kappa (78%) deposits the most frequently observed. Disease presentation and patient management were similar between EM-proven and non-EM-proven cases. A serum monoclonal spike was detected for 21 patients and 10 had an underlying hematological malignancy. First-line therapy was mixed between clone-targeted therapy (n = 33), corticosteroids (n = 9), and RAAS-inhibitors (n = 19). After six months, nine patients achieved complete and 23 partial renal recovery. In univariate analysis, renal recovery was associated with baseline SCr (OR 0.70, p = 0.07). After a median follow-up of 52 [35–74] months, 38% of patients had progressed to end-stage kidney disease independently associated with baseline SCr (HR 1.41, p = 0.003) and glomerular crescentic proliferation (HR 4.38, p = 0.004).
Conclusions
Our results confirm that non-cryoglobulinemic and non-Randall GN with monoclonal IgG deposits are rarely associated with hematological malignancy. The prognosis is uncertain but may be improved by early introduction of a specific therapy.
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Affiliation(s)
- Ophélie Fourdinier
- Department of Nephrology, Dialysis and Transplantation, University Hospital, and MP3CV Research Laboratory, Jules Verne Picardie University, Amiens, France
| | - Marc Ulrich
- Department of Nephrology, Hôpital Jean Bernard, Valenciennes, France
| | - Alexandre Karras
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France
| | - Jérôme Olagne
- Department of Nephrology and Transplantation, Department of Pathology, University Hospital, Strasbourg, France
| | - David Buob
- Department of Pathology, Hôpital Tenon, APHP, Paris, France
| | - Vincent Audard
- Department of Nephrology and Transplantation, Henri Mondor University Hospital, APHP, and Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U 955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Cécile Vigneau
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | | | | | - Ziad Massy
- Department of Nephrology, Ambroise Paré Hospital, APHP, Boulogne Billancourt, Paris, and Inserm Unit 1018, Team 5, CESP, Versailles Saint-Quentin-en-Yvelines University, Paris Saclay University, Villejuif, France
| | - Vincent Vuiblet
- Department of Nephrology and Transplantation, University Hospital, Reims, France
| | - Nolwenn Rabot
- Department of Nephrology, University Hospital, Tours, France
| | - Jean-Michel Goujon
- Department of Nephrology, and Department of Pathology and Ultrastructural Pathology, University Hospital, Poitiers, France
| | | | - Gabriel Choukroun
- Department of Nephrology, Dialysis and Transplantation, University Hospital, and MP3CV Research Laboratory, Jules Verne Picardie University, Amiens, France
| | - Dimitri Titeca-Beauport
- Department of Nephrology, Dialysis and Transplantation, University Hospital, and MP3CV Research Laboratory, Jules Verne Picardie University, Amiens, France
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30
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Nezam D, Porcher R, Grolleau F, Morel P, Titeca-Beauport D, Faguer S, Karras A, Solignac J, Jourde-Chiche N, Maurier F, Sakhi H, El Karoui K, Mesbah R, Carron PL, Audard V, Ducloux D, Paule R, Augusto JF, Aniort J, Tiple A, Rafat C, Beaudreuil S, Puéchal X, Gobert P, Massy Z, Hanrotel C, Bally S, Martis N, Durel CA, Desbuissons G, Godmer P, Hummel A, Perrin F, Néel A, De Moreuil C, Goulenok T, Guerrot D, Grange S, Foucher A, Deroux A, Cordonnier C, Guilbeau-Frugier C, Modesto-Segonds A, Nochy D, Daniel L, Moktefi A, Rabant M, Guillevin L, Régent A, Terrier B. Kidney Histopathology Can Predict Kidney Function in ANCA-Associated Vasculitides with Acute Kidney Injury Treated with Plasma Exchanges. J Am Soc Nephrol 2022; 33:628-637. [PMID: 35074934 PMCID: PMC8975074 DOI: 10.1681/asn.2021060771] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/24/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Data from the PEXIVAS trial challenged the role of plasma exchange (PLEX) in ANCA-associated vasculitides (AAV). We aimed to describe kidney biopsy from patients with AAV treated with PLEX, evaluate whether histopathologic findings could predict kidney function, and identify which patients would most benefit from PLEX. METHODS We performed a multicenter, retrospective study on 188 patients with AAV and AKI treated with PLEX and 237 not treated with PLEX. The primary outcome was mortality or KRT at 12 months (M12). RESULTS No significant benefit of PLEX for the primary outcome was found. To identify patients benefitting from PLEX, we developed a model predicting the average treatment effect of PLEX for an individual depending on covariables. Using the prediction model, 223 patients had a better predicted outcome with PLEX than without PLEX, and 177 of them had >5% increased predicted probability with PLEX compared with without PLEX of being alive and free from KRT at M12, which defined the PLEX-recommended group. Risk difference for death or KRT at M12 was significantly lower with PLEX in the PLEX-recommended group (-15.9%; 95% CI, -29.4 to -2.5) compared with the PLEX not recommended group (-4.8%; 95% CI, 14.9 to 5.3). Microscopic polyangiitis, MPO-ANCA, higher serum creatinine, crescentic and sclerotic classes, and higher Brix score were more frequent in the PLEX-recommended group. An easy to use score identified patients who would benefit from PLEX. The average treatment effect of PLEX for those with recommended treatment corresponded to an absolute risk reduction for death or KRT at M12 of 24.6%. CONCLUSIONS PLEX was not associated with a better primary outcome in the whole study population, but we identified a subset of patients who could benefit from PLEX. However, these findings must be validated before utilized in clinical decision making.
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Affiliation(s)
- Dorian Nezam
- Service de Néphrologie, Dialyse et Transplantation, CHU de Rouen, France
| | - Raphaël Porcher
- Centre de Recherche Épidémiologie et Statistiques, Université de Paris, Paris, France
| | - François Grolleau
- Centre de Recherche Épidémiologie et Statistiques, Université de Paris, Paris, France
| | - Pauline Morel
- Service de dialyse et aphérèse, AURA Paris Plaisance, Paris, France
| | | | - Stanislas Faguer
- Département de Néphrologie et Transplantation d’organes, Hôpital Rangueil, Toulouse, France
| | - Alexandre Karras
- Service de Néphrologie, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | - Justine Solignac
- Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception (APHM), Marseille, France
| | - Noémie Jourde-Chiche
- Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception (APHM), Marseille, France
| | - François Maurier
- Hôpital Belle-Isle, Groupe Hospitalier Associatif UNEOS, Metz, France
| | - Hamza Sakhi
- Service de Néphrologie et Transplantation, Hôpital Henri Mondor, Creteil, France,Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Creteil, France
| | - Khalil El Karoui
- Service de Néphrologie et Transplantation, Hôpital Henri Mondor, Creteil, France,Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Creteil, France
| | - Rafik Mesbah
- Service de Néphrologie, Centre Hospitalier, Boulogne-sur-mer, France
| | | | - Vincent Audard
- Service de Néphrologie et Transplantation, Hôpital Henri Mondor, Creteil, France,Institut National de la Santé et de la Recherche Médicale U955, Institut Mondor de Recherche Biomédicale, Creteil, France
| | - Didier Ducloux
- Service de Néphrologie, Dialyse et Transplantation, CHU Besançon, France
| | - Romain Paule
- Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | | | - Julien Aniort
- Service de Néphrologie, Dialyse et Transplantation rénale, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Aurélien Tiple
- Service de Néphrologie, CHU Jacques Lacarin, Vichy, France
| | - Cédric Rafat
- Unité de Néphrologie, Transplantation Rénale, Hôpital Tenon (Assistance Publique des Hôpitaux de Paris), Paris, France
| | - Séverine Beaudreuil
- Service de Néphrologie, Dialyse et Transplantation rénale, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Xavier Puéchal
- Service de Médecine Interne, Hôpital Cochin, Université de Paris, Paris, France
| | - Pierre Gobert
- Service de Médecine Interne et Immunologie clinique, Clinique Rhône Durance, Avignon, France
| | - Ziad Massy
- Département de Néphrologie, Hôpital Ambroise Paré, Boulogne Billancourt, France
| | - Catherine Hanrotel
- Service de Néphrologie, Dialyse et Transplantation rénale, Hôpital La Cavale Blanche, Brest, France
| | - Stéphane Bally
- Service de Néphrologie Dialyse, Centre Hospitalier Métropole Savoie, Chambery, France
| | | | - Cécile-Audrey Durel
- Service de Médecine, Interne Hôpital Edouard Herriot, Hospices civils de Lyon, France
| | | | - Pascal Godmer
- Service de Médecine Interne, CHBA site de Vannes, Vannes, France
| | - Aurélie Hummel
- Service de Néphrologie et Transplantation Rénale, Hôpital Necker-Enfants Malades (Assistance Publique des Hôpitaux de Paris), Paris, France
| | | | - Antoine Néel
- Service de Médecine Interne, CHU de Nantes, France
| | | | - Tiphaine Goulenok
- Service de Médecine Interne, Hôpital Bichat (Assistance Publique des Hôpitaux de Paris), Paris, France
| | - Dominique Guerrot
- Service de Néphrologie, Dialyse et Transplantation, CHU de Rouen, France
| | - Steven Grange
- Service de Réanimation médicale, CHU Charles Nicolle, Rouen, France
| | - Aurélie Foucher
- Service de Médecine Interne, CHU site Sud Saint-Pierre, Saint-Pierre, France
| | - Alban Deroux
- Service de Médecine Interne, CHU de Grenoble, France
| | - Carole Cordonnier
- Service d’anatomie et de cytologie pathologiques, Hôpital Nord, CHU d’Amiens, France
| | - Céline Guilbeau-Frugier
- Service d’anatomie pathologique et histologie-cytologie, Hôpital de Rangueil-Larrey, CHU Toulouse, Toulouse, France
| | - Anne Modesto-Segonds
- Service d’anatomie pathologique et histologie-cytologie, Hôpital de Rangueil-Larrey, CHU Toulouse, Toulouse, France
| | - Dominique Nochy
- Service d’Anatomie et Cytologie Pathologiques, Hôpital Européen Georges Pompidou (Assistance Publique des Hôpitaux de Paris), Paris, France
| | - Laurent Daniel
- Service d’Anatomie et cytologie pathologiques, Hôpital La Timone (APHM), Marseille, France
| | - Anissa Moktefi
- Assistance Publique des Hôpitaux de Paris, Department of Pathology, Groupe Hospitalier Henri-Mondor 94010 Creteil, France
| | - Marion Rabant
- Department of Pathology, Necker Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Loïc Guillevin
- Service de Médecine Interne, Hôpital Cochin, Université de Paris, Paris, France
| | - Alexis Régent
- Service de Médecine Interne, Hôpital Cochin, Université de Paris, Paris, France
| | - Benjamin Terrier
- Service de Médecine Interne, Hôpital Cochin, Université de Paris, Paris, France
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Romero A, Drieux F, François A, Dervaux A, Xu XL, Titeca-Beauport D, Bertrand D, Guerrot D. Prognostic Value of C4d Immunolabelling in Adult Patients With IgA Vasculitis. Front Med (Lausanne) 2021; 8:735775. [PMID: 34912816 PMCID: PMC8666566 DOI: 10.3389/fmed.2021.735775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/08/2021] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives: Glomerular C4d deposits are associated the severity and outcomes of IgA nephropathy. Whether this holds true in immunoglobulin A vasculitis (IgAV) is not known. The main objective of the study was to analyze the prognostic value of glomerular C4d immunolabelling on kidney impairment in adults with IgAV. Design, Setting, Participants, Measurements: This retrospective cohort study included 120 adults with IgAV and a kidney biopsy performed between 1995 and 2018 in two French university hospital centers. All paraffin-embedded biopsies were reassessed according to Oxford classification. Immunofluorescence for C4d was performed in all cases. For analysis, patients were grouped according to positivity for C4d in the glomerular area. The main outcome was a composite endpoint of 50% increase in 24 h-proteinuria, or eGFR decrease by 50%, or kidney replacement therapy. Results: The median follow-up was 28.3 months. Twenty-three patients met the composite endpoint, 12 for kidney replacement therapy, 6 for an eGFR decrease >50% and 5 for a >50% increase in proteinuria. At time of biopsy, the median proteinuria was 1.9 g/24 h and the median eGFR 73.5 mL/min/1.73 m2. Among the 102 patients evaluable for C4d, 24 were positive on >30% glomeruli, mainly with a parieto-mesangial pattern. In this group, the initial proteinuria was more frequently nephrotic than in the C4d– group (60% vs. 33%, P = 0.039). Mesangial hypercellularity was more frequent in the C4d+ group (42% vs. 13%; P = 0.006) whereas macroscopic hematuria was more frequent in the C4d– group (18% vs. 0%; P = 0.03). After a median follow-up of 28 months, kidney survival did not differ according to C4d status. Conclusion: In a population of adult IgAV patients, glomerular positivity for C4d was associated with the severity of the kidney disease at presentation, but not with subsequent renal function deterioration.
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Affiliation(s)
- Anais Romero
- Department of Nephrology, Hemodialysis, Kidney Transplantation, Rouen University Hospital, Rouen, France
| | - Fanny Drieux
- Pathology Department, Centre Henri Becquerel, Rouen, France
| | | | | | - Xiao Li Xu
- Pathology Department, Amiens University Hospital, Amiens, France
| | - Dimitri Titeca-Beauport
- Department of Nephrology, Hemodialysis, Renal Transplant, Amiens University Hospital, Amiens, France
| | - Dominique Bertrand
- Department of Nephrology, Hemodialysis, Kidney Transplantation, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Hemodialysis, Kidney Transplantation, Rouen University Hospital, Rouen, France.,UNIROUEN, INSERM U1096, Rouen, France
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32
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Deghmani I, Miranda S, Guerrot D, Nouhaud F, Benhamou Y, Levesque H, Armengol G. Fibrose rétropéritonéale: analyse descriptive retrospective d’une cohorte de 56 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bertrand D, Hamzaoui M, Drouot L, Lamulle J, Hanoy M, Edet S, Laurent C, Lebourg L, Etienne I, Lemoine M, Le Roy F, Nezam D, Mauger E, Boyer O, Guerrot D, Candon S. SARS-CoV-2-specific Humoral and Cellular Immunities in Kidney Transplant Recipients and Dialyzed Patients Recovered From Severe and Nonsevere COVID-19. Transplant Direct 2021; 7:e792. [PMID: 34805494 PMCID: PMC8601300 DOI: 10.1097/txd.0000000000001230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/23/2022] Open
Abstract
Kidney transplantation and dialysis are two major risk factors for severe forms of coronavirus disease 2019 (COVID-19). The dynamics of the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in this population remain largely unknown. Methods We report here the analysis of anti-SARS-CoV-2 antibody- and T cell-mediated immune responses in 26 kidney transplant recipients (KTRs) and 11 dialyzed patients (DPs) who recovered from COVID-19. Results After a mean time of 83 ± 26 d post-symptom onset for KTRs and 97 ± 31 d for DPs, 20 KTRs (76.9%) and 10 DPs (90.9%) displayed anti-S1 immunoglobulin G SARS-CoV-2 antibodies (P = 0.34), at similar titers in both groups. SARS-CoV-2-specific interferon-γ-producing T cells were evidenced in 26 KTRs (100%) and 10 DPs (90.9%). Total numbers of SARS-CoV-2-reactive T cells were high and not statistically different between the 2 groups. No correlation between the severity of the disease and the number of reactive T cells was found in KTRs. In 5 KTRs, also evaluated 10 mo after COVID-19, weak or absent antibody response was observed, whereas specific memory T-cell response was detected in all cases. Conclusion T-cell response persisted up to 3 mo post-symptom onset, even in KTRs in whom full immunosuppressive regimen was reinstated at recovery, and seems to be present up to 10 mo after infection. Our findings have implications in the understanding of the natural course of the disease in transplant patients and DPs.
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Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mouad Hamzaoui
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Laurent Drouot
- Normandy University, UNIROUEN, INSERM U1234, Rouen, France
| | - Julie Lamulle
- Normandy University, UNIROUEN, INSERM U1234, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Stéphane Edet
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France.,ANIDER, Rouen, France
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Eleusis Mauger
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Olivier Boyer
- Normandy University, UNIROUEN, INSERM U1234, Rouen, France.,Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Sophie Candon
- Normandy University, UNIROUEN, INSERM U1234, Rouen, France.,Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France
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34
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Bertrand D, Hamzaoui M, Lemée V, Lamulle J, Laurent C, Etienne I, Lemoine M, Lebourg L, Hanoy M, Le Roy F, Nezam D, Farce F, Plantier JC, Boyer O, Guerrot D, Candon S. Antibody and T-cell response to a third dose of SARS-CoV-2 mRNA BNT162b2 vaccine in kidney transplant recipients. Kidney Int 2021; 100:1337-1340. [PMID: 34619232 PMCID: PMC8489274 DOI: 10.1016/j.kint.2021.09.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France.
| | - Mouad Hamzaoui
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Veronique Lemée
- Department of Virology, Rouen University Hospital, Rouen, France
| | - Julie Lamulle
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Fabienne Farce
- HLA Laboratory, Etablissement Français du Sang (EFS) Normandie, Rouen, France
| | | | - Olivier Boyer
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France; INSERM U1234, University of Rouen Normandy, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Sophie Candon
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France; INSERM U1234, University of Rouen Normandy, Rouen, France
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Stevens KI, Melilli E, Diniz H, Gillis K, Guerrot D, Montero N, Soler MJ, Desai T. Tweet me: conferencing in the era of COVID-19 and 280 characters. Clin Kidney J 2021; 14:2142-2150. [PMID: 34603691 PMCID: PMC8083586 DOI: 10.1093/ckj/sfab075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Indexed: 01/23/2023] Open
Abstract
The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Social Media (SoMe) Team provides Twitter coverage of the annual congress. During the coronavirus disease 2019 (COVID-19) pandemic, #ERAEDTA20 was the first major Nephrology congress to be delivered virtually. The effect of The SoMe Team and the consequences of the COVID-19 pandemic have not been explored previously. Tweets of the ERA-EDTA congresses 2016–20, using official hashtags, were evaluated. Metadata of each tweet were collected prospectively; original tweets, retweets and evidence-based tweets were identified. The gender of tweet author and location of Twitter activity were established. Network maps were created to ascertain the degree of polarization between the 2019 and 2020 Twitter activity, using Gephi 0.9.2. Between 2016 and 2019, the total number of tweets and the number of tweet authors increased, as did the proportion of female authors (20% versus 27%). In 2019, there were fewer multimedia and evidence-based tweets: 8% versus 20% in 2016. Globally, there were fewer Nephrology conferences in 2020 and the number of tweets per day reduced by 53% from 2019. In 2020, The ERA-EDTA congress saw an increase in authors of 9% and only an 8% reduction in tweets. It was easier to disseminate information in 2020, measured by increased correlation coefficient (0.14 versus 0.12 in 2019). A higher proportion of countries was represented (n = 55 versus n = 48 in 2019) and a higher proportion of tweets came from women. In conclusion, the introduction of SoMe Team was associated with increased usage of Twitter and ease of information dissemination. Compared with #nephtwitter activity as a whole in 2020, SoMe Team has mitigated some of the pandemic's deleterious effects in scientific dissemination, relevant to Nephrology.
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Affiliation(s)
- Kate I Stevens
- Glasgow Renal &Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Edoardo Melilli
- Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Hugo Diniz
- Nephrology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Keith Gillis
- Glasgow Renal &Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Dominique Guerrot
- Inserm U1096, Normandie Université, 76000 Rouen, France.,Nephrology Department, Rouen University Hospital, 76000, Rouen, France
| | - Nuria Montero
- Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Maria Jose Soler
- Nephrology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain
| | - Tejas Desai
- United States Department of Veterans Affairs, Charlotte, NC, USA
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36
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Bertrand D, Hanoy M, Edet S, Lemée V, Hamzaoui M, Laurent C, Ludivine L, Etienne I, Lemoine M, Nezam D, Candon S, Plantier JC, Le Roy F, Guerrot D. Antibody response to SARS-CoV-2 mRNA BNT162b2 vaccine in kidney transplant recipients and in-centre and satellite centre haemodialysis patients. Clin Kidney J 2021; 14:2127-2128. [PMID: 34471524 PMCID: PMC8344605 DOI: 10.1093/ckj/sfab100] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Stéphane Edet
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France.,ANIDER, Rouen, France
| | - Veronique Lemée
- Department of Virology, Rouen University Hospital, Rouen, France
| | - Mouad Hamzaoui
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Lebourg Ludivine
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Sophie Candon
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France
| | | | - Frank Le Roy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
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Bertrand D, Hamzaoui M, Lemée V, Lamulle J, Hanoy M, Laurent C, Lebourg L, Etienne I, Lemoine M, Le Roy F, Nezam D, Plantier JC, Boyer O, Guerrot D, Candon S. Antibody and T Cell Response to SARS-CoV-2 Messenger RNA BNT162b2 Vaccine in Kidney Transplant Recipients and Hemodialysis Patients. J Am Soc Nephrol 2021; 32:2147-2152. [PMID: 34112706 PMCID: PMC8729845 DOI: 10.1681/asn.2021040480] [Citation(s) in RCA: 137] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/04/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in patients with ESKD, and vaccination is hoped to prevent infection. METHODS Between January 18 and February 24, 2021, 225 kidney transplant recipients (KTRs) and 45 patients on hemodialysis (HDPs) received two injections of mRNA BNT162b2 vaccine. The postvaccinal humoral and cellular response was explored in the first 45 KTRs and ten HDPs. RESULTS After the second dose, eight HDPs (88.9%) and eight KTRs (17.8%) developed antispike SARS-CoV-2 antibodies (P<0.001). Median titers of antibodies in responders were 1052 AU/ml (IQR, 515-2689) in HDPs and 671 AU/ml (IQR, 172-1523) in KTRs (P=0.40). Nine HDPs (100%) and 26 KTRs (57.8%) showed a specific T cell response (P=0.06) after the second injection. In responders, median numbers of spike-reactive T cells were 305 SFCs per 106 CD3+ T cells (IQR, 95-947) in HDPs and 212 SFCs per 106 CD3+ T cells (IQR, 61-330) in KTRs (P=0.40). In KTRs, the immune response to BNT162b2 seemed influenced by the immunosuppressive regimen, particularly tacrolimus or belatacept. CONCLUSION Immunization with BNT162b2 seems more efficient in HDPs, indicating that vaccination should be highly recommended in these patients awaiting a transplant. However, the current vaccinal strategy for KTRs may not provide effective protection against COVID-19 and will likely need to be improved.
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Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mouad Hamzaoui
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Veronique Lemée
- Department of Virology, Rouen University Hospital, Rouen, France
| | - Julie Lamulle
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | | | - Olivier Boyer
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France,Institut National de la Santé et de la Recherche Médicale U1234, University of Rouen Normandy, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Sophie Candon
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France,Institut National de la Santé et de la Recherche Médicale U1234, University of Rouen Normandy, Rouen, France
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38
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Le Roy F, Nicolas J, Hamzaoui M, Guerrot D, Hanoy M. Influence de la modalité de prescription de la teneur en sel du dialysat sur l’extraction sodée en hémodiafiltration. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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de Nattes T, Camus V, François A, Dallet G, Ferrand C, Guerrot D, Lemoine M, Morin F, Thieblemont C, Veresezan EL, Candon S, Latouche JB, Bertrand D. Kidney Transplant T Cell-Mediated Rejection Occurring After Anti-CD19 CAR T-Cell Therapy for Refractory Aggressive Burkitt-like Lymphoma With 11q Aberration: A Case Report. Am J Kidney Dis 2021; 79:760-764. [PMID: 34461166 DOI: 10.1053/j.ajkd.2021.07.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/17/2021] [Indexed: 02/06/2023]
Abstract
Post-transplant lymphoproliferative disorder is a growing complication of kidney transplantation and is associated with a poor prognosis. Anti-CD19 chimeric antigen receptor (CAR) T-cell therapy is an important new treatment option modifying the outcome of refractory hematological cancers. Here, we report the case of a 40-year-old kidney transplant recipient who developed a Burkitt-like lymphoma with 11q aberration 5 years after transplantation. After 3 unsuccessful lines of chemotherapy, it was decided to treat the patient with anti-CD19 CAR T cells as a salvage therapy. Three months after CAR T-cell infusion, she experienced a grade IIB T cell-mediated rejection with severe tubulitis (T3), slight interstitial inflammation (I1), and severe intimal arteritis (V2) with blood suffusion. Among T cells infiltrating the graft, some of them expressed the anti-CD19 CAR. CAR T cells within the graft and in blood samples were also detected by droplet digital polymerase chain reaction. Function of the kidney transplant improved after corticosteroid treatment and remained stable. However, lymphoma progressed, with a massive pulmonary mass leading to the patient's death 10 months after CAR T-cell infusion.
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Affiliation(s)
- Tristan de Nattes
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France; Normandy University, UNIROUEN, INSERM, U1234, Rouen, France.
| | - Vincent Camus
- Department of Hematology, Centre Henri Becquerel, Normandie University, Rouen, France
| | - Arnaud François
- Pathology Department, Rouen University Hospital, Rouen, France
| | - Grégoire Dallet
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Christophe Ferrand
- INSERM UMR1098 Right, Etablissement Français du Sang Bourgogne Franche-Comté University Franche-Comté, Besançon, France
| | - Dominique Guerrot
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
| | - Florence Morin
- Laboratoire d'Immunologie-Histocompatibilité, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Catherine Thieblemont
- Hemato-Oncology Department, Saint-Louis Hospital, Diderot University-Sorbonne Paris Cité, Paris, France
| | | | - Sophie Candon
- Normandy University, UNIROUEN, INSERM, U1234, Rouen, France
| | | | - Dominique Bertrand
- Nephrology - Kidney Transplant Unit, Rouen University Hospital, Rouen, France
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40
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Grall M, Daviet F, Chiche NJ, Provot F, Presne C, Coindre JP, Pouteil-Noble C, Karras A, Guerrot D, François A, Benhamou Y, Veyradier A, Frémeaux-Bacchi V, Coppo P, Grangé S. Eculizumab in gemcitabine-induced thrombotic microangiopathy: experience of the French thrombotic microangiopathies reference centre. BMC Nephrol 2021; 22:267. [PMID: 34284729 PMCID: PMC8293501 DOI: 10.1186/s12882-021-02470-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gemcitabine is a broadly prescribed chemotherapy, the use of which can be limited by renal adverse events, including thrombotic microangiopathy (TMA). METHODS This study evaluated the efficacy of eculizumab, a monoclonal antibody targeting the terminal complement pathway, in patients with gemcitabine-induced TMA (G-TMA). We conducted an observational, retrospective, multicenter study in 5 French centres, between 2011 and 2016. RESULTS Twelve patients with a G-TMA treated by eculizumab were included. The main characteristics were acute renal failure (100%), including stage 3 acute kidney injury (AKI, 58%) and renal replacement therapy (17%), hypertension (92%) and diffuse oedema (83%). Eculizumab was started after a median of 15 days (range 4-44) following TMA diagnosis. A median of 4 injections of eculizumab was performed (range 2-22). Complete hematological remission was achieved in 10 patients (83%) and blood transfusion significantly decreased after only one injection of eculizumab (median of 3 packed red blood cells (range 0-10) before treatment vs 0 (range 0-1) after one injection, P < 0.001). Two patients recovered completely renal function (17%), and 8 achieved a partial remission (67%). Compared to a control group of G-TMA without use of eculizumab, renal outcome was more favourable. At the end of the follow up, median eGFR was 45 vs 33 ml/min/1.73m2 respectively in the eculizumab group and in the control group. CONCLUSIONS These results suggest that eculizumab is efficient on haemolysis and reduces transfusion requirement in G-TMA. Moreover, eculizumab may improve renal function recovery.
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Affiliation(s)
- Maximilien Grall
- Medical Intensive Care Unit, Rouen University Hospital, 37 boulevard Gambetta, 76031, Rouen Cedex, France
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
| | - Florence Daviet
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Nephrology, Conception University Hospital, APHM, Marseille, France
| | - Noémie Jourde Chiche
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Nephrology, Conception University Hospital, APHM, Marseille, France
| | - François Provot
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Nephrology, Lille University Hospital, Lille, France
| | - Claire Presne
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Nephrology, Amiens University Hospital, Amiens, France
| | - Jean-Philippe Coindre
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Nephrology, Le Mans General Hospital, Le Mans, France
| | - Claire Pouteil-Noble
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Nephrology, E. Herriot Hospital, Lyon I university, Lyon, France
| | - Alexandre Karras
- Department of Nephrology, Georges Pompidou Hospital, APHP, Paris, France
| | | | - Arnaud François
- Department of Pathology, Rouen University Hospital, Rouen, France
| | - Ygal Benhamou
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
| | - Agnès Veyradier
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Biological Hematology, Lariboisière University Hospital, APHP, Paris, France
| | - Véronique Frémeaux-Bacchi
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of immunology, Georges Pompidou Hospital, APHP, Paris, France
| | - Paul Coppo
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
- Department of Hematology, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France
| | - Steven Grangé
- Medical Intensive Care Unit, Rouen University Hospital, 37 boulevard Gambetta, 76031, Rouen Cedex, France.
- French TMA Reference Centre, Hopital Saint-Antoine, Sorbonne Université, AP-HP, Paris, France.
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41
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Meuleman MS, Guilmin-Crépon S, Hummel A, Daugas E, Dumas A, Leye F, Dantal J, Rigothier C, Provot F, Chauveau D, Burtey S, Hertig A, Dahan K, Durrbach A, Dossier C, Karras A, Guerrot D, Esnault V, Rémy P, Massy ZA, Tostivint I, Morin MP, Zaoui P, Fritz O, Le Quintrec M, Wynckel A, Bourmaud A, Boyer O, Sahali D, Alberti C, Audard V, Mellerio H. Long-term health-related quality of life outcomes of adults with pediatric onset of frequently relapsing or steroid-dependent nephrotic syndrome. J Nephrol 2021; 35:1123-1134. [PMID: 34224090 DOI: 10.1007/s40620-021-01111-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Long-term psychosocial outcomes and health-related quality of life (HRQOL) in adults with pediatric onset of frequently relapsing or steroid-dependent idiopathic nephrotic syndrome (FRNS or SDNS) remain to be determined. METHODS In this prospective cohort study, 59 adults with pediatric onset of FRNS/SDNS and persistent active glomerular disease in adulthood completed the GEDEPAC-2 questionnaire exploring 11 well-being domains. Data were compared to the French general population (FGP) with standardized incidence ratio ([SIR]; adjusted for period, age, gender). Regression models were performed to identify predictive factors of psychosocial well-being. RESULTS In 82% of cases, the questionnaire was completed while the participants (n = 59; 47 men; median age = 32 years; median number of relapses = 13) were in complete remission (under specific therapy in 76% of cases). Participants had higher educational degree than in the FGP (SIR = 6.3; p < 0.01) and more frequently a managerial occupation (SIR = 3.1; p < 0.01). Social integration was acceptable with regard to marital status and experience of sexual intercourse, but experiences of discrimination were far more frequent (SIR = 12.5; p < 0.01). The SF-12 mental component summary (MCS) score was altered (Z-score = - 0.6; p < 0.01) and mean multidimensional fatigue inventory (MFI-20) global fatigue score appeared high (12). Transfer from pediatric to adult healthcare was followed by a period of discontinued care for 33% of participants. Multivariate analysis revealed a close relationship between MFI-20, physical health, and MCS. CONCLUSIONS This study shows that pediatric onset FRNS and SDNS may have a long-term negative impact on mental HRQOL and highlights the impact of fatigue, which is often not adequately considered in routine care.
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Affiliation(s)
- Marie-Sophie Meuleman
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, Equipe 21, Creteil, France.
| | - Sophie Guilmin-Crépon
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France.,Unité d'Épidémiologie Clinique, CIC 1426, AP-HP.Nord, Hôpital Universitaire Robert Debré, Inserm, 75019, Paris, France
| | - Aurélie Hummel
- Service de Néphrologie, AP-HP, Hôpital Necker, Paris, France
| | - Eric Daugas
- Service de Néphrologie, AP-HP, Hôpital Bichat, Université de Paris, INSERM U1149, Paris, France
| | - Agnès Dumas
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France
| | - Fallou Leye
- Unité d'Épidémiologie Clinique, CIC 1426, AP-HP.Nord, Hôpital Universitaire Robert Debré, Inserm, 75019, Paris, France
| | - Jacques Dantal
- Service de Néphrologie Immunologie Clinique Transplantation, Centre de Recherche en Transplantation et Immunologie (CRTI), Centre Hospitalier Universitaire (CHU) de Nantes, Nantes, France
| | - Claire Rigothier
- Service de Néphrologie Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
| | - François Provot
- Service de Néphrologie, Hôpital Huriez, CHU de Lille, Lille, France
| | - Dominique Chauveau
- Service de Néphrologie et Transplantation d'Organes, Hôpital de Rangueil et Centre de Référence Maladies Rénales Rares, CHU de Toulouse, Toulouse, France
| | - Stéphane Burtey
- APHM, INSERM, INRAe, C2VN, Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Aix Marseille University, Marseille, France
| | - Alexandre Hertig
- Service de Néphrologie et Transplantation Rénale, AP-HP, Hôpital Tenon, Paris, France
| | - Karine Dahan
- Service de Néphrologie et Dialyse, AP-HP, Hôpital Tenon, Paris, France
| | - Antoine Durrbach
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France
| | - Claire Dossier
- Service de Néphrologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Alexandre Karras
- Service de Néphrologie, AP-HP, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | | | - Vincent Esnault
- Service de Néphrologie, Hôpital Pasteur, CHU de Nice, Nice, France
| | - Philippe Rémy
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, Equipe 21, Creteil, France
| | - Ziad A Massy
- Service de Néphrologie, AP-HP, Hôpital Ambroise Paré, Boulogne-Billancourt, France.,INSERM U1018 CESP, UVSQ, UPS Villejuif, Villejuif, France
| | - Isabelle Tostivint
- Service de Néphrologie et Transplantation, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Marie-Pascale Morin
- Service de Néphrologie, Hôpital de Pontchaillou, CHU de Rennes, Rennes, France
| | - Philippe Zaoui
- Service de Néphrologie, Hémodialyse, Aphérèse et Transplantation Rénale, CHU de Grenoble Alpes, Université Grenoble-Alpes, Grenoble, France
| | - Olivier Fritz
- Service de Néphrologie, Centre Hospitalier (CH) La Rochelle, La Rochelle, France
| | - Moglie Le Quintrec
- Service de Néphrologie Dialyse et Transplantation Rénale, Hôpital Lapeyronie, CHU de Montpellier, Montpellier, France
| | | | - Aurélie Bourmaud
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France.,Unité d'Épidémiologie Clinique, CIC 1426, AP-HP.Nord, Hôpital Universitaire Robert Debré, Inserm, 75019, Paris, France
| | - Olivia Boyer
- Service de Néphrologie Pédiatrique, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Institut Imagine, AP-HP, Hôpital Necker-Enfants Malades, Université de Paris, Paris, France
| | - Dil Sahali
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, Equipe 21, Creteil, France
| | - Corinne Alberti
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France.,Unité d'Épidémiologie Clinique, CIC 1426, AP-HP.Nord, Hôpital Universitaire Robert Debré, Inserm, 75019, Paris, France
| | - Vincent Audard
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, Equipe 21, Creteil, France
| | - Hélène Mellerio
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France.,Service de médecine d'adolescent, Plateforme de Transition AD'venir, AP-HP, Hôpital Robert Debré, Paris, France.,Groupe Français de Recherche en Médecine et Santé de l'Adolescent, Paris, France
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42
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Martins M, Morel A, Laurent C, Kamar N, Anglicheau D, Matignon M, Vigneau C, Guerrot D, Chavarot N, Chemouny JM. Belatacept as maintenance therapy in kidney transplant recipients with ANCA-associated vasculitis. Clin Exp Rheumatol 2021; 39 Suppl 129:194-195. [DOI: 10.55563/clinexprheumatol/7jue09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Manon Martins
- University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | - Antoine Morel
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Service de Néphrologie et Transplantation, Créteil, France
| | | | - Nassim Kamar
- Service de Néphrologie et de Transplantation d'Organes, CHU Toulouse, France
| | - Dany Anglicheau
- Service de Néphrologie et Transplantation Adulte, Hôpital Necker-Enfants Malades, Université de Paris, Assistance Publique-Hôpitaux de Paris, France
| | - Marie Matignon
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Service de Néphrologie et Transplantation, Créteil, France
| | - Cécile Vigneau
- University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | | | - Nathalie Chavarot
- Service de Néphrologie et Transplantation Adulte, Hôpital Necker-Enfants Malades, Université de Paris, Assistance Publique-Hôpitaux de Paris, France
| | - Jonathan M. Chemouny
- University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France.
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43
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Bertrand D, Kaveri R, Laurent C, Gatault P, Jauréguy M, Garrouste C, Sayegh J, Bouvier N, Caillard S, Lanfranco L, Thierry A, François A, Hau F, Etienne I, Guerrot D, Farce F. Intensity of de novo DSA detected by Immucor Lifecodes assay and C3d fixing antibodies are not predictive of subclinical ABMR after Kidney Transplantation. PLoS One 2021; 16:e0249934. [PMID: 33886604 PMCID: PMC8062066 DOI: 10.1371/journal.pone.0249934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/04/2021] [Accepted: 03/27/2021] [Indexed: 01/06/2023] Open
Abstract
De novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and allograft loss. We tested Immucor* (IM) Luminex Single-antigen beads (LSAB) assay and C3d-fixing antibodies in the setting of dnDSA and subclinical (s) ABMR. This retrospective multicentric study included 123 patients biopsied because of the presence of subclinical de novo DSA detected by One Lamda* Labscreen (MFI > 1000). In 112 patients, sera of the day of the biopsy were available and tested in a central lab with IM Lifecodes LSAB and C3d fixing antibodies assays. In 16 patients (14.3%), no DSA was detected using Immucor test. In 96 patients, at least one DSA was determined with IM. Systematic biopsies showed active sABMR in 30 patients (31.2%), chronic active sABMR in 17 patients (17.7%) and no lesions of sABMR in 49 KT recipients (51%). Intensitity criteria (BCM, BCR and AD-BCR) of DSA were not statistically different between these 3 histological groups. The proportion of patients with C3d-fixing DSA was not statistically different between the 3 groups and did not offer any prognostic value regarding graft survival. Performing biopsy for dnDSA could not be guided by the intensity criteria of IM LSAB assay. C3d-fixing DSA do not offer added value.
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Affiliation(s)
- Dominique Bertrand
- Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France
- * E-mail:
| | | | - Charlotte Laurent
- Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France
| | | | - Maïté Jauréguy
- Nephrology Kidney Transplantation, CHU Amiens, Amiens, France
| | - Cyril Garrouste
- Nephrology Kidney Transplantation, CHU Clermont Ferrand, Clermont Ferrand, France
| | - Johnny Sayegh
- Nephrology Kidney Transplantation, CHU Angers, Angers, France
| | | | - Sophie Caillard
- Nephrology Kidney Transplantation, CHU Strasbourg, Strasbourg, France
| | - Luca Lanfranco
- Nephrology Kidney Transplantation, CHU Brest, Brest, France
| | - Antoine Thierry
- Nephrology Kidney Transplantation, CHU Poitiers, Poitiers, France
| | | | | | - Isabelle Etienne
- Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France
| | - Dominique Guerrot
- Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France
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44
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Hamzaoui M, Roche C, Coquerel D, Duflot T, Brunel V, Mulder P, Richard V, Bellien J, Guerrot D. Soluble Epoxide Hydrolase Inhibition Prevents Experimental Type 4 Cardiorenal Syndrome. Front Mol Biosci 2021; 7:604042. [PMID: 33777999 PMCID: PMC7991096 DOI: 10.3389/fmolb.2020.604042] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: Cardiovascular diseases (CVD) remain the leading cause of morbimortality in patients with chronic kidney disease (CKD). The aim of this study was to assess the cardiovascular impact of the pharmacological inhibition of soluble epoxide hydrolase (sEH), which metabolizes the endothelium-derived vasodilatory and anti-inflammatory epoxyeicosatrienoic acids (EETs) to dihydroxyeicosatrienoic acid (DHETs), in the 5/6 nephrectomy (Nx) mouse model. Methods and Results: Compared to sham-operated mice, there was decrease in EET-to-DHET ratio 3 months after surgery in vehicle-treated Nx mice but not in mice treated with the sEH inhibitor t-AUCB. Nx induced an increase in plasma creatinine and in urine albumin-to-creatinine ratio as well as the development of kidney histological lesions, all of which were not modified by t-AUCB. In addition, t-AUCB did not oppose Nx-induced blood pressure increase. However, t-AUCB prevented the development of cardiac hypertrophy and fibrosis induced by Nx, as well as normalized the echocardiographic indices of diastolic and systolic function. Moreover, the reduction in endothelium-dependent flow-mediated dilatation of isolated mesenteric arteries induced by Nx was blunted by t-AUCB without change in endothelium-independent dilatation to sodium nitroprusside. Conclusion: Inhibition of sEH reduces the cardiac remodelling, and the diastolic and systolic dysfunctions associated with CKD. These beneficial effects may be mediated by the prevention of endothelial dysfunction, independent from kidney preservation and antihypertensor effect. Thus, inhibition of sEH holds a therapeutic potential in preventing type 4 cardiorenal syndrome.
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Affiliation(s)
- Mouad Hamzaoui
- Normandie University, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France.,Nephrology Department, Rouen University Hospital, Rouen, France
| | - Clothilde Roche
- Normandie University, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - David Coquerel
- Normandie University, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Thomas Duflot
- Normandie University, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France.,Pharmacology Department, Rouen University Hospital, Rouen, France
| | - Valery Brunel
- Biochemistry Department, Rouen University Hospital, Rouen, France
| | - Paul Mulder
- Normandie University, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Vincent Richard
- Normandie University, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Jérémy Bellien
- Normandie University, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France.,Pharmacology Department, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Normandie University, UNIROUEN, INSERM U1096, FHU REMOD-VHF, Rouen, France.,Nephrology Department, Rouen University Hospital, Rouen, France
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45
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Duflot T, Laurent C, Soudey A, Fonrose X, Hamzaoui M, Iacob M, Bertrand D, Favre J, Etienne I, Roche C, Coquerel D, Le Besnerais M, Louhichi S, Tarlet T, Li D, Brunel V, Morisseau C, Richard V, Joannidès R, Stanke-Labesque F, Lamoureux F, Guerrot D, Bellien J. Preservation of epoxyeicosatrienoic acid bioavailability prevents renal allograft dysfunction and cardiovascular alterations in kidney transplant recipients. Sci Rep 2021; 11:3739. [PMID: 33580125 PMCID: PMC7881112 DOI: 10.1038/s41598-021-83274-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/27/2021] [Indexed: 12/25/2022] Open
Abstract
This study addressed the hypothesis that epoxyeicosatrienoic acids (EETs) synthesized by CYP450 and catabolized by soluble epoxide hydrolase (sEH) are involved in the maintenance of renal allograft function, either directly or through modulation of cardiovascular function. The impact of single nucleotide polymorphisms (SNPs) in the sEH gene EPHX2 and CYP450 on renal and vascular function, plasma levels of EETs and peripheral blood monuclear cell sEH activity was assessed in 79 kidney transplant recipients explored at least one year after transplantation. Additional experiments in a mouse model mimicking the ischemia–reperfusion (I/R) injury suffered by the transplanted kidney evaluated the cardiovascular and renal effects of the sEH inhibitor t-AUCB administered in drinking water (10 mg/l) during 28 days after surgery. There was a long-term protective effect of the sEH SNP rs6558004, which increased EET plasma levels, on renal allograft function and a deleterious effect of K55R, which increased sEH activity. Surprisingly, the loss-of-function CYP2C9*3 was associated with a better renal function without affecting EET levels. R287Q SNP, which decreased sEH activity, was protective against vascular dysfunction while CYP2C8*3 and 2C9*2 loss-of-function SNP, altered endothelial function by reducing flow-induced EET release. In I/R mice, sEH inhibition reduced kidney lesions, prevented cardiac fibrosis and dysfunction as well as preserved endothelial function. The preservation of EET bioavailability may prevent allograft dysfunction and improve cardiovascular disease in kidney transplant recipients. Inhibition of sEH appears thus as a novel therapeutic option but its impact on other epoxyfatty acids should be carefully evaluated.
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Affiliation(s)
- Thomas Duflot
- Department of Pharmacology, Rouen University Hospital, 76000, Rouen, France.,UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France.,Laboratory of Pharmacokinetics, Toxicology and Pharmacogenetics, Rouen University Hospital, 76000, Rouen, France
| | - Charlotte Laurent
- Department of Nephrology, Rouen University Hospital, 76000, Rouen, France
| | - Anne Soudey
- UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France
| | - Xavier Fonrose
- Department of Pharmacology, Grenoble Alpes University Hospital, HP2, INSERM U1042, University of Grenoble Alpes, 38000, Grenoble, France
| | - Mouad Hamzaoui
- UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France.,Department of Nephrology, Rouen University Hospital, 76000, Rouen, France
| | - Michèle Iacob
- Department of Pharmacology, Rouen University Hospital, 76000, Rouen, France
| | - Dominique Bertrand
- Department of Nephrology, Rouen University Hospital, 76000, Rouen, France
| | - Julie Favre
- UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Rouen University Hospital, 76000, Rouen, France
| | - Clothilde Roche
- UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France
| | - David Coquerel
- UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France
| | - Maëlle Le Besnerais
- UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France
| | - Safa Louhichi
- Department of Pharmacology, Rouen University Hospital, 76000, Rouen, France.,UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France
| | - Tracy Tarlet
- Department of Pharmacology, Rouen University Hospital, 76000, Rouen, France.,UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France
| | - Dongyang Li
- Department of Entomology and Nematology, and Comprehensive Cancer Center, University of California, Davis, Davis, CA, 95616, USA
| | - Valéry Brunel
- Department of General Biochemistry, Rouen University Hospital, 76000, Rouen, France
| | - Christophe Morisseau
- Department of Entomology and Nematology, and Comprehensive Cancer Center, University of California, Davis, Davis, CA, 95616, USA
| | - Vincent Richard
- Department of Pharmacology, Rouen University Hospital, 76000, Rouen, France.,UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France
| | - Robinson Joannidès
- Department of Pharmacology, Rouen University Hospital, 76000, Rouen, France.,UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France.,Centre d'Investigation Clinique (CIC)-INSERM 1404, Rouen University Hospital, 76000, Rouen, France
| | - Françoise Stanke-Labesque
- Department of Pharmacology, Grenoble Alpes University Hospital, HP2, INSERM U1042, University of Grenoble Alpes, 38000, Grenoble, France
| | - Fabien Lamoureux
- Department of Pharmacology, Rouen University Hospital, 76000, Rouen, France.,UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France.,Laboratory of Pharmacokinetics, Toxicology and Pharmacogenetics, Rouen University Hospital, 76000, Rouen, France
| | - Dominique Guerrot
- UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France.,Department of Nephrology, Rouen University Hospital, 76000, Rouen, France
| | - Jérémy Bellien
- Department of Pharmacology, Rouen University Hospital, 76000, Rouen, France. .,UNIROUEN, INSERM U1096, FHU CARNAVAL, Normandie University, 76000, Rouen, France. .,Centre d'Investigation Clinique (CIC)-INSERM 1404, Rouen University Hospital, 76000, Rouen, France. .,Department of Pharmacology, Rouen University Hospital, 76031, Rouen Cedex, France.
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de Laforcade L, Bobot M, Bellin MF, Clément O, Grangé S, Grenier N, Wynckel A, Guerrot D. [ESUR recommendations on the use of contrast media: Practice survey, review and commentary by CJN, FIRN and SFNDT]. Nephrol Ther 2021; 17:80-91. [PMID: 33551369 DOI: 10.1016/j.nephro.2020.10.011] [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: 05/12/2020] [Revised: 09/20/2020] [Accepted: 10/19/2020] [Indexed: 10/22/2022]
Abstract
Contrast media administration is classically considered to cause or worsen kidney failure. Recent data may moderate this assertion. The European Society of Urogenital Radiology recently published guidelines re-evaluating the precautions before administering contrast media. The present work evaluates the practice of French nephrologists, and provides a commentary on these recommendations based on an updated review of the literature. We conducted survey among French nephrologists, using an electronic questionnaire distributed by the Société Francophone de Néphrologie, Dialyse et Transplantation, the French Intensive care Renal Network and the Club des Jeunes Néphrologues. 266 responses were collected. The European Society of Urogenital Radiology guidelines are poorly known among the panel of nephrologists. Their practices differ from the guidelines by the more frequent and earlier implementation of measures to prevent renal failure post contrast media. In accordance with the guidelines, hydration is prescribed as a first-line preventive measure, mainly with saline and bicarbonate. Inhibitors of the renin-angiotensin-aldosterone system are frequently discontinued before an injection of contrast media, contrary to what is recommended. In conclusion, the European Society of Urogenital Radiology guidelines, which the working group endorses, but which are still too little known and applied in clinical nephrology in France, prompt nephrologists to lift some of the restrictions on the use of PCI as well as on the continuation of ARS inhibitors before injecting PCI.
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Affiliation(s)
- Louis de Laforcade
- Service d'endocrinologie-diabétologie-néphrologie, centre hospitalier Pierre-Oudot, 30, avenue du Médipole, 38300 Bourgoin-Jallieu, France; Commission Néphrologie Clinique de la SFNDT, 24, Montée des Roches, Saint-Sorlin, 69440 Chabanière, France.
| | - Mickaël Bobot
- Commission Néphrologie Clinique de la SFNDT, 24, Montée des Roches, Saint-Sorlin, 69440 Chabanière, France; Centre de néphrologie et transplantation rénale, CHU de conception, 147, boulevard Baille, 13005 Marseille, France; Inserm 1263, Inrae 1260, C2VN, université Aix-Marseille, 27, boulevard Jean-Moulin, 13385 Marseille, France; Comité Scientifique du Club des Jeunes Néphrologues, clinique du Landy, 93400 Saint-Ouen, France
| | - Marie-France Bellin
- CEA, CNRS, Inserm, BioMaps, service de radiologie, hôpital-bicêtre Paul-Brousse, université Paris-Saclay, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Olivier Clément
- Service de radiologie, hôpital européen Georges-Pompidou, université de Paris, 20, rue Leblanc, 75015 Paris, France
| | - Steven Grangé
- Service de réanimation médicale, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France; French Intensive care Renal Network,24, Montée des Roches, Saint-Sorlin, 69440 Chabanière, France
| | - Nicolas Grenier
- Service de radiologie et d'imagerie diagnostique et interventionnelle de l'adulte, CHU de Bordeaux, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France
| | - Alain Wynckel
- French Intensive care Renal Network,24, Montée des Roches, Saint-Sorlin, 69440 Chabanière, France; Service de néphrologie, hôpital Maison Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France
| | - Dominique Guerrot
- Commission Néphrologie Clinique de la SFNDT, 24, Montée des Roches, Saint-Sorlin, 69440 Chabanière, France; Service de néphrologie, hémodialyse, transplantation rénale, lithiase rénale, hypertension artérielle, unité de surveillance continue, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France
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Candon S, Guerrot D, Drouot L, Lemoine M, Lebourg L, Hanoy M, Boyer O, Bertrand D. T cell and antibody responses to SARS-CoV-2: Experience from a French transplantation and hemodialysis center during the COVID-19 pandemic. Am J Transplant 2021; 21:854-863. [PMID: 33047493 PMCID: PMC7675512 DOI: 10.1111/ajt.16348] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/08/2020] [Accepted: 09/25/2020] [Indexed: 01/25/2023]
Abstract
Immunosuppressed organ-transplanted patients are considered at risk for severe forms of COVID-19. Moreover, exaggerated innate and adaptive immune responses might be involved in severe progression of the disease. However, no data on the immune response to SARS-CoV-2 in transplanted patients are currently available. Here, we report the first assessment of antibody and T cell responses to SARS-CoV-2 in 11 kidney-transplanted patients recovered from RT-PCR-confirmed (n = 5) or initially suspected (n = 6) COVID-19. After reduction of immunosuppressive therapy, RT-PCR-confirmed COVID-19 transplant patients were able to mount vigorous antiviral T cell and antibody responses, as efficiently as two nontherapeutically immunosuppressed COVID-19 patients on hemodialysis. By contrast, six RT-PCR-negative patients displayed no antibody response. Among them, three showed very low numbers of SARS-CoV-2-reactive T cells, whereas no T cell response was detected in the other three, potentially ruling out COVID-19 diagnosis. Low levels of T cell reactivity to SARS-CoV-2 were also detected in seronegative healthy controls without known exposure to the virus. These results suggest that during COVID-19, monitoring both T cell and serological immunity might be helpful for the differential diagnosis of COVID-19 but are also needed to evaluate a potential role of antiviral T cells in the development of severe forms of the disease.
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Affiliation(s)
- Sophie Candon
- Department of Immunology and BiotherapiesRouen University HospitalRouenFrance,INSERM U1234University of Rouen NormandyRouenFrance
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and hemodialysisRouen University HospitalRouenFrance
| | | | - Mathilde Lemoine
- Department of Nephrology, Transplantation and hemodialysisRouen University HospitalRouenFrance
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and hemodialysisRouen University HospitalRouenFrance
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and hemodialysisRouen University HospitalRouenFrance
| | - Olivier Boyer
- Department of Immunology and BiotherapiesRouen University HospitalRouenFrance,INSERM U1234University of Rouen NormandyRouenFrance
| | - Dominique Bertrand
- Department of Nephrology, Transplantation and hemodialysisRouen University HospitalRouenFrance
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48
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de Laforcade L, Bobot M, Bellin MF, Clément O, Grangé S, Grenier N, Wynckel A, Guerrot D. Kidney and contrast media: Common viewpoint of the French Nephrology societies (SFNDT, FIRN, CJN) and the French Radiological Society (SFR) following ESUR guidelines. Diagn Interv Imaging 2021; 102:131-139. [PMID: 33531265 DOI: 10.1016/j.diii.2021.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/29/2022]
Abstract
Contrast medium administration is classically considered to cause or worsen kidney failure, but recent data may moderate this assertion. The European Society of Urogenital Radiology recently published guidelines re-evaluating the precautions before administering contrast media. Kidney injury does not constitute a contra-indication to the administration of iodinated contrast medium, as long as the benefit-risk ratio justifies it. Intravenous hydration with 0.9% NaCl or 1.4% sodium bicarbonate is the only validated measure for the prevention of post-iodine contrast nephropathy. This is necessary for intravenous or intra-arterial administration of iodinated contrast agent without first renal pass when the glomerular filtration rate is less than 30mL/min/1.73m2, for intra-arterial administration of iodinated contrast agent with first renal passage when the glomerular filtration rate is less than 45mL/min/1.73m2, or in patients with acute renal failure. The use of iodinated contrast medium should allow the carrying out of relevant examinations based on an analysis of the benefit-risk ratio and the implementation of measures to prevent toxicity when necessary.
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Affiliation(s)
- Louis de Laforcade
- Department of Nephrology, Bourgoin-Jallieu Hospital, 38300 Bourgoin-Jallieu, France.
| | - Mickaël Bobot
- Department of Nephrology and Renal Transplantation, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France; C2VN, INSERM 1263, INRAE 1260, Aix-Marseille Univ, 13005 Marseille, France
| | - Marie-France Bellin
- Department of Radiology, Bicêtre Hospital, APHP, University Paris-Saclay, BioMaps, 94043 Le Kremlin Bicêtre, France
| | - Olivier Clément
- Department of Radiology, Hopital Européen Georges Pompidou, AP-HP, Centre, 75015 Paris, France; Université de Paris, 75006 Paris, France
| | - Steven Grangé
- Medical Intensive Care Unit, Rouen University Hospital, 76000 Rouen, France
| | - Nicolas Grenier
- Radiology Department, Bordeaux University Hospital, 33000 Bordeaux, France
| | - Alain Wynckel
- Nephrology Department, Reims University Hospital, 51100 Reims, France
| | - Dominique Guerrot
- Normandie Univ, UNIROUEN, INSERM U1096, FHU REMOD-VHF, 76000 Rouen, France
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49
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Denize J, Defortescu G, Guerrot D, Jeannot P, Bertrand D, Cornu JN, Pfister C, Nouhaud FX. Is intraoperative heparin during renal transplantation useful to reduce graft vascular thrombosis? Prog Urol 2021; 31:531-538. [PMID: 33516612 DOI: 10.1016/j.purol.2020.12.007] [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: 07/31/2020] [Revised: 12/04/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The standard treatment for end-stage renal disease is renal transplantation. As vascular anastomoses are performed during the surgery, it may expose to a risk of vascular thrombosis. This raises the question of using intravenous heparin during the procedure. The purpose of this study was to compare the incidence of renal transplant vascular thrombosis in the perioperative period based on whether the patients received or not intraoperative heparin. METHODS A single center retrospective study was conducted on a cohort of consecutive patients who underwent renal transplantation between 2011 and 2015. Patients were divided into two groups: patients not receiving heparin vs. receiving heparin at the dose of 0.5mg/kg. A Doppler ultrasound was performed at day one postoperatively to assess the occurrence of vascular thrombosis. Hemorrhagic complications and the need for postoperative transfusion were also assessed. RESULTS In total, 261 patients were included. Fifty-one patients received heparin (19.5%). Patient's baseline characteristics were comparable between the groups. No significant difference was found regarding the incidence of vascular thrombosis (6% for both groups, P=1). In addition, no difference was found regarding hemorrhagic complications requiring surgical revision (P=1) as well as early postoperative transfusion rate (P=0.57). CONCLUSIONS Our results suggest that intraoperative IV heparin doesn't improve the risk of vascular thrombosis following renal transplantation. However, intraoperative IV heparin was not significantly associated with a higher rate of hemorrhagic complications suggesting that heparin can be safely used if required in some selected patients at higher risk of thrombosis. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- J Denize
- Department of Urology, Rouen University Hospital, Rouen, France.
| | - G Defortescu
- Department of Urology, Rouen University Hospital, Rouen, France.
| | - D Guerrot
- Department of Nephrology, Rouen University Hospital, Rouen, France.
| | - P Jeannot
- Department of Urology, Rouen University Hospital, Rouen, France.
| | - D Bertrand
- Department of Nephrology, Rouen University Hospital, Rouen, France.
| | - J-N Cornu
- Department of Urology, Rouen University Hospital, Rouen, France.
| | - C Pfister
- Department of Urology, Rouen University Hospital, Rouen, France.
| | - F-X Nouhaud
- Department of Urology, Rouen University Hospital, Rouen, France.
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50
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Hamzaoui M, Lamy G, Bellien J, Guerrot D. [Cardiovascular disorders in autosomal dominant polycystic kidney disease]. Nephrol Ther 2021; 17:18-29. [PMID: 33431311 DOI: 10.1016/j.nephro.2020.09.003] [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: 01/20/2020] [Revised: 08/13/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022]
Abstract
Autosomal dominant polycystic kidney disease is the most frequent genetic kidney disease. Cardiovascular disorders associated with autosomal dominant polycystic kidney disease are multiple and may occur early in life. In autosomal dominant polycystic kidney disease cardiovascular morbidity and mortality are related both to the nonspecific consequences of chronic kidney disease and to the particular phenotype of autosomal dominant polycystic kidney disease. Compared to the general population, patients with autosomal dominant polycystic kidney disease present an increased prevalence of hypertension, left ventricular hypertrophy, atrial fibrillation, valvular diseases, aneurisms and arterial dissections. This review article provides an update on cardiovascular disorders associated with autosomal dominant polycystic kidney disease and recent pathophysiological developments.
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Affiliation(s)
- Mouad Hamzaoui
- Inserm U1096, FHU REMOD-VHF, UniRouen, Normandie Université, 76000 Rouen, France; Service de néphrologie, CHU de Rouen, 76000 Rouen, France
| | - Gaspard Lamy
- Inserm U1096, FHU REMOD-VHF, UniRouen, Normandie Université, 76000 Rouen, France; Service de néphrologie, CHU de Rouen, 76000 Rouen, France
| | - Jérémy Bellien
- Inserm U1096, FHU REMOD-VHF, UniRouen, Normandie Université, 76000 Rouen, France; Service de pharmacologie clinique, CHU de Rouen, 76000 Rouen, France
| | - Dominique Guerrot
- Inserm U1096, FHU REMOD-VHF, UniRouen, Normandie Université, 76000 Rouen, France; Service de néphrologie, CHU de Rouen, 76000 Rouen, France.
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