3
|
Koubi M, Rossi P, Arcani R, Gomes De Pihno Q, Chau C, Blanc J, Grosdidier C, Guervilly C, Bretelle F, Bernard-Guervilly F. Relevance of systematic anti-nuclear antibodies testing after obstetrical complications. J Reprod Immunol 2021; 148:103437. [PMID: 34700104 DOI: 10.1016/j.jri.2021.103437] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 01/24/2023]
Abstract
Adverses pregnancy outcomes are commonly encountered with autoimmune disease (AID). Although anti-nuclear antibodies (ANA) are often present several years before AID diagnosis, the importance of ANA testing has not been evaluated in this context. The objective of this study was to determine if ANA discovery after obstetrical complications is associated with a diagnosis of AID and improves the prognosis of subsequent pregnancies. All patients presented at the multidisciplinary board meeting (MBM) "Thrombophilia and Pregnancy", whose ANA were discovered after an obstetrical complication, were included in a multicenter descriptive study. All patients were referred to an internal medicine consultation for diagnosis. Data were collected retrospectively by computer chart analysis and updated by phone. A total of 404 patients were included, of which 50 (12.4 %) had a diagnosis of AID related to ANA. Patients with AID had higher ANA levels (p < 0.001), with more frequent specificity (26%, versus 6.7%, p < 0.0001), and more often persistent (84% versus 30.8%, p < 0.0001) compared to patients without AID. Subsequent pregnancy outcomes were not significantly affected by ANA levels and AID diagnoses. Our study shows that the discovery of ANA after obstetrical complications may lead to an early diagnosis of AID. It makes us reconsider the systematic determination of ANA after an obstetrical event because in the case where ANA are found positive, an adapted follow-up would reduce the negative impact of ANA presence on subsequent pregnancies.
Collapse
Affiliation(s)
- Marie Koubi
- Department of Internal Medicine, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France.
| | - Pascal Rossi
- Department of Internal Medicine, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France
| | - Robin Arcani
- Department of Internal Medicine and Clinical Immunology, La Conception Hospital, APHM, 147 Bd Baille, 13005 Marseille, France
| | - Quentin Gomes De Pihno
- Department of Internal Medicine, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France
| | - Cecile Chau
- Gynecology and Obstetrics Department, North Hospital, Public Hospitals of Marseille, Aix-Marseille University, France
| | - Julie Blanc
- Gynecology and Obstetrics Department, North Hospital, Public Hospitals of Marseille, Aix-Marseille University, France; EA3279, CEReSS, Health Service Research and Quality of Life Center, Aix-Marseille University, 13284 Marseille, France
| | - Charlotte Grosdidier
- Laboratory of Hematology, North Hospital, Public Hospitals of Marseille, Aix-Marseille University, France
| | - Christophe Guervilly
- Medical Intensive Care Unit, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France
| | - Florence Bretelle
- Gynecology and Obstetrics Department, North Hospital, Public Hospitals of Marseille, Aix-Marseille University, France
| | - Fanny Bernard-Guervilly
- Department of Internal Medicine, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France
| |
Collapse
|
4
|
Daviet F, Guervilly C, Baldesi O, Bernard-Guervilly F, Pilarczyk E, Genin A, Lefebvre L, Forel JM, Papazian L, Camoin-Jau L. Heparin-Induced Thrombocytopenia in Severe COVID-19. Circulation 2020; 142:1875-1877. [PMID: 32990022 PMCID: PMC7643786 DOI: 10.1161/circulationaha.120.049015] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Florence Daviet
- Médecine Intensive Réanimation (F.D., C.G., E.P., J.M.F., L.P.), Assistance Publique-Hôpitaux de Marseille, France.,Centre d'Etudes et de Recherches sur les Services de Santé et Qualité de Vie EA 3279, Faculté de Médecine, Aix-Marseille Université, Marseille, France (F.D., C.G., J.M.F., L.P.)
| | - Christophe Guervilly
- Médecine Intensive Réanimation (F.D., C.G., E.P., J.M.F., L.P.), Assistance Publique-Hôpitaux de Marseille, France.,Centre d'Etudes et de Recherches sur les Services de Santé et Qualité de Vie EA 3279, Faculté de Médecine, Aix-Marseille Université, Marseille, France (F.D., C.G., J.M.F., L.P.)
| | - Olivier Baldesi
- Réanimation et Surveillance Continue Médico-Chirurgicales Polyvalentes (O.B., L.L.), Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France
| | | | - Estelle Pilarczyk
- Médecine Intensive Réanimation (F.D., C.G., E.P., J.M.F., L.P.), Assistance Publique-Hôpitaux de Marseille, France.,Service d'Accueil des Urgences (E.P.), Assistance Publique-Hôpitaux de Marseille, France
| | - Adrien Genin
- Laboratoire d'Hématologie et d'Immunologie (A.G.), Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France
| | - Laurent Lefebvre
- Réanimation et Surveillance Continue Médico-Chirurgicales Polyvalentes (O.B., L.L.), Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France
| | - Jean Marie Forel
- Médecine Intensive Réanimation (F.D., C.G., E.P., J.M.F., L.P.), Assistance Publique-Hôpitaux de Marseille, France.,Centre d'Etudes et de Recherches sur les Services de Santé et Qualité de Vie EA 3279, Faculté de Médecine, Aix-Marseille Université, Marseille, France (F.D., C.G., J.M.F., L.P.)
| | - Laurent Papazian
- Médecine Intensive Réanimation (F.D., C.G., E.P., J.M.F., L.P.), Assistance Publique-Hôpitaux de Marseille, France.,Centre d'Etudes et de Recherches sur les Services de Santé et Qualité de Vie EA 3279, Faculté de Médecine, Aix-Marseille Université, Marseille, France (F.D., C.G., J.M.F., L.P.)
| | - Laurence Camoin-Jau
- Aix-Marseille Université, Hôpital Nord, and Laboratoire d'Hématologie, Hôpital de la Timone (L.C.-J.), Assistance Publique-Hôpitaux de Marseille, France
| |
Collapse
|
5
|
Benyamine A, Magalon J, Cointe S, Lacroix R, Arnaud L, Bardin N, Rossi P, Francès Y, Bernard-Guervilly F, Kaplanski G, Harlé JR, Weiller PJ, Berbis P, Braunstein D, Jouve E, Lesavre N, Couranjou F, Dignat-George F, Sabatier F, Paul P, Granel B. Increased serum levels of fractalkine and mobilisation of CD34 +CD45 - endothelial progenitor cells in systemic sclerosis. Arthritis Res Ther 2017; 19:60. [PMID: 28320472 PMCID: PMC5359964 DOI: 10.1186/s13075-017-1271-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 12/16/2016] [Accepted: 02/23/2017] [Indexed: 01/12/2023] Open
Abstract
Background The disruption of endothelial homeostasis is a major determinant in the pathogenesis of systemic sclerosis (SSc) and is reflected by soluble and cellular markers of activation, injury and repair. We aimed to provide a combined assessment of endothelial markers to delineate specific profiles associated with SSc disease and its severity. Methods We conducted an observational, single-centre study comprising 45 patients with SSc and 41 healthy control subjects. Flow cytometry was used to quantify circulating endothelial microparticles (EMPs) and CD34+ progenitor cell subsets. Colony-forming unit-endothelial cells (CFU-ECs) were counted by culture assay. Circulating endothelial cells were enumerated using anti-CD146-based immunomagnetic separation. Blood levels of endothelin-1, vascular endothelial growth factor (VEGF) and soluble fractalkine (s-Fractalkine) were evaluated by enzyme-linked immunosorbent assay. Disease-associated markers were identified using univariate, correlation and multivariate analyses. Results Enhanced numbers of EMPs, CFU-ECs and non-haematopoietic CD34+CD45− endothelial progenitor cells (EPCs) were observed in patients with SSc. Patients with SSc also displayed higher serum levels of VEGF, endothelin-1 and s-Fractalkine. s-Fractalkine levels positively correlated with CD34+CD45− EPC numbers. EMPs, s-Fractalkine and endothelin-1 were independent factors associated with SSc. Patients with high CD34+CD45− EPC numbers had lower forced vital capacity values. Elevated s-Fractalkine levels were associated with disease severity, a higher frequency of pulmonary fibrosis and altered carbon monoxide diffusion. Conclusions This study identifies the mobilisation of CD34+CD45− EPCs and high levels of s-Fractalkine as specific features of SSc-associated vascular activation and disease severity. This signature may provide novel insights linking endothelial inflammation and defective repair processes in the pathogenesis of SSc. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1271-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Audrey Benyamine
- Internal Medicine Department, Assistance Publique-Hôpitaux de Marseille (APHM), CHU Nord, 13015, Marseilles, France. .,Haematology and Vascular Biology Laboratory, APHM, CHU Conception, 13005, Marseilles, France. .,Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France.
| | - Jérémy Magalon
- Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France.,Culture and Cell Therapy Laboratory, CICBT 1409, APHM, CHU Conception, 13005, Marseilles, France
| | - Sylvie Cointe
- Haematology and Vascular Biology Laboratory, APHM, CHU Conception, 13005, Marseilles, France.,Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France
| | - Romaric Lacroix
- Haematology and Vascular Biology Laboratory, APHM, CHU Conception, 13005, Marseilles, France.,Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France
| | - Laurent Arnaud
- Haematology and Vascular Biology Laboratory, APHM, CHU Conception, 13005, Marseilles, France
| | - Nathalie Bardin
- Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France.,Immunology Laboratory, APHM, CHU Conception, 13005, Marseilles, France
| | - Pascal Rossi
- Internal Medicine Department, Assistance Publique-Hôpitaux de Marseille (APHM), CHU Nord, 13015, Marseilles, France.,Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France
| | - Yves Francès
- Internal Medicine Department, Assistance Publique-Hôpitaux de Marseille (APHM), CHU Nord, 13015, Marseilles, France
| | - Fanny Bernard-Guervilly
- Internal Medicine Department, Assistance Publique-Hôpitaux de Marseille (APHM), CHU Nord, 13015, Marseilles, France
| | - Gilles Kaplanski
- Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France.,Internal Medicine Department, APHM, CHU Conception, 13005, Marseilles, France
| | - Jean-Robert Harlé
- Internal Medicine Department, APHM, CHU Timone, 13005, Marseilles, France
| | | | - Philippe Berbis
- Dermatology Department, APHM, CHU Nord, 13015, Marseilles, France
| | - David Braunstein
- Centre d'Investigation Clinique Centre de Pharmacologie Clinique et d'Evaluations Thérapeutiques, APHM, CHU Timone, CHU Nord, Marseille, France
| | - Elisabeth Jouve
- Centre d'Investigation Clinique Centre de Pharmacologie Clinique et d'Evaluations Thérapeutiques, APHM, CHU Timone, CHU Nord, Marseille, France
| | - Nathalie Lesavre
- Centre d'Investigation Clinique Centre de Pharmacologie Clinique et d'Evaluations Thérapeutiques, APHM, CHU Timone, CHU Nord, Marseille, France
| | - Françoise Couranjou
- Centre d'Investigation Clinique Centre de Pharmacologie Clinique et d'Evaluations Thérapeutiques, APHM, CHU Timone, CHU Nord, Marseille, France
| | - Françoise Dignat-George
- Haematology and Vascular Biology Laboratory, APHM, CHU Conception, 13005, Marseilles, France.,Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France
| | - Florence Sabatier
- Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France.,Culture and Cell Therapy Laboratory, CICBT 1409, APHM, CHU Conception, 13005, Marseilles, France
| | - Pascale Paul
- Haematology and Vascular Biology Laboratory, APHM, CHU Conception, 13005, Marseilles, France.,Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France
| | - Brigitte Granel
- Internal Medicine Department, Assistance Publique-Hôpitaux de Marseille (APHM), CHU Nord, 13015, Marseilles, France.,Vascular Research Centre of Marseille (VRCM) UMR-S1076, INSERM, Aix-Marseille Université, 13385, Marseilles, Cedex, France
| |
Collapse
|