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Gauckler P, Kesenheimer JS, Geetha D, Odler B, Eller K, Laboux T, Alberici F, Zappa M, Chebotareva N, Moiseev S, Bonilla M, Jhaveri KD, Oniszczuk J, Audard V, Costa D, Mastroianni-Kirsztajn G, Bruchfeld A, Muto M, Windpessl M, Mayer G, Kronbichler A. COVID-19 outcomes in patients with a history of immune-mediated glomerular diseases. Front Immunol 2023; 14:1228457. [PMID: 37767096 PMCID: PMC10520971 DOI: 10.3389/fimmu.2023.1228457] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Patients with immune-mediated glomerular diseases are considered at high risk for severe COVID-19 outcomes. However, conclusive evidence for this patient population is scarce. Methods We created a global registry and retrospectively collected clinical data of patients with COVID-19 and a previously diagnosed immune-mediated glomerular disease to characterize specific risk factors for severe COVID-19 outcomes. Results Fifty-nine patients with a history of immune-mediated glomerular diseases were diagnosed with COVID-19 between 01.03.2020 and 31.08.2021. Over a mean follow-up period of 24.79 ± 18.89 days, ten patients (16.9%) developed acute kidney injury. Overall, 44.1% of patients were managed in an outpatient setting and therefore considered as having "non-severe" COVID-19, while 55.9% of patients had severe COVID-19 requiring hospitalization including worse outcomes. Comparing both groups, patients with severe COVID-19 were significantly older (53.55 ± 17.91 versus 39.77 ± 14.95 years, p = .003), had lower serum albumin levels at presentation (3.00 ± 0.80 g/dL versus 3.99 ± 0.68 g/dL, p = .016) and had a higher risk of developing acute kidney injury (27% versus 4%, p = .018). Male sex (p <.001) and ongoing intake of corticosteroids at presentation (p = .047) were also significantly associated with severe COVID-19 outcomes, while the overall use of ongoing immunosuppressive agents and glomerular disease remission status showed no significant association with the severity of COVID-19 (p = .430 and p = .326, respectively). Conclusion Older age, male sex, ongoing intake of corticosteroids and lower serum albumin levels at presentation were identified as risk factors for severe COVID-19 outcomes in patients with a history of various immune-mediated glomerular diseases.
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Affiliation(s)
- Philipp Gauckler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | | | - Duvuru Geetha
- Division of Nephrology, Johns Hopkins University, Baltimore, MD, United States
| | - Balazs Odler
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Kathrin Eller
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Timothee Laboux
- Nephrology Department, Univ. Lille, Centre Hospitalier Universitaire de Lille (CHU Lille), Lille, France
- Institut Pasteur de Lille, Univ. Lille, Inserm, Centre Hospitalier Universitaire de Lille (CHU Lille), Lille, France
| | - Federico Alberici
- Division of Nephrology and Dialysis, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Mattia Zappa
- Division of Nephrology and Dialysis, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Natasha Chebotareva
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sergey Moiseev
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Marco Bonilla
- Glomerular Center at Northwell Health, Division of Kidney Diseases and Hypertension, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Great Neck, NY, United States
| | - Kenar D. Jhaveri
- Glomerular Center at Northwell Health, Division of Kidney Diseases and Hypertension, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Great Neck, NY, United States
| | - Julie Oniszczuk
- Department of Nephrology and Transplantation, Rare French Disease Centre “Idiopathic Nephrotic Syndrome”, Henri-Mondor/Albert-Chenevier Hospital Assistance Publique-Hôpitaux de Paris, Inserm U955, Paris-East University, Créteil, France
| | - Vincent Audard
- Department of Nephrology and Transplantation, Rare French Disease Centre “Idiopathic Nephrotic Syndrome”, Henri-Mondor/Albert-Chenevier Hospital Assistance Publique-Hôpitaux de Paris, Inserm U955, Paris-East University, Créteil, France
| | - Denise Costa
- Department of Nephrology, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil
- Recife Medical School, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Annette Bruchfeld
- Department of Health, Medicine and Caring Sciences, Linköpings Universitet, Linköping, Sweden
- Department of Clinical Science, Intervention and Technology, Division of Renal Medicine Karolinska Institutet, Stockholm, Sweden
| | - Masahiro Muto
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Martin Windpessl
- Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Gert Mayer
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | - Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
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Moktefi A, Mulé S, Joher N, Blanc-Durand P, Oniszczuk J, Matignon M, Le Bras F, El Karoui K. IgG4-related disease and small lymphocytic lymphoma. QJM 2023; 116:523-524. [PMID: 36749002 DOI: 10.1093/qjmed/hcad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/08/2023] Open
Affiliation(s)
- Anissa Moktefi
- Pathology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Sébastien Mulé
- Medical Imaging Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Nizar Joher
- Nephrology and Renal Transplantation Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Paul Blanc-Durand
- Nuclear Medicine Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Julie Oniszczuk
- Nephrology and Renal Transplantation Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Fabien Le Bras
- Lymphoid Malignancies Unit, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Khalil El Karoui
- Nephrology and Renal Transplantation Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
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3
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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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4
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Colucci M, Oniszczuk J, Vivarelli M, Audard V. B-Cell Dysregulation in Idiopathic Nephrotic Syndrome: What We Know and What We Need to Discover. Front Immunol 2022; 13:823204. [PMID: 35140723 PMCID: PMC8819007 DOI: 10.3389/fimmu.2022.823204] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/04/2022] [Indexed: 11/18/2022] Open
Abstract
The therapeutic efficacy of B-cell depletion by anti-CD20 treatment in pediatric and, more recently, in adult idiopathic nephrotic syndrome patients suggests a key role of B cells in the pathogenesis of the disease. However, their exact role is still unclear. B cells are able to secrete a large variety of antibodies that can protect against infections. However, B-cell dysregulation is well-established in a variety of autoimmune diseases. In parallel with their ability to produce antibodies, pathogenic B cells display altered effector functions by expressing activating surface molecules, which can strongly modify the immune homeostasis, or by producing specific cytokines, which can directly affect either podocyte structure and functions or modulate T-cell homeostasis. Herein, we report the most relevant clinical and experimental evidences of a pathogenic role of B cells in idiopathic nephrotic syndrome. We further highlight similarities and differences between children and adults affected by non-genetic forms of the disease and discuss what needs to be investigated in order to define the exact mechanisms underlying the pathogenic role of B cells and to identify more tailored therapeutic approaches.
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Affiliation(s)
- Manuela Colucci
- Renal Diseases Research Unit, Genetics and Rare Diseases Research Area, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- *Correspondence: Manuela Colucci,
| | - Julie Oniszczuk
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare “Syndrome Néphrotique Idiopathique”, Fédération Hospitalo-Universitaire, Innovative Therapy for Immune Disorders, Créteil, France
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Marina Vivarelli
- Division of Nephrology, Department of Pediatric Subspecialties, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Vincent Audard
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare “Syndrome Néphrotique Idiopathique”, Fédération Hospitalo-Universitaire, Innovative Therapy for Immune Disorders, Créteil, France
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
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5
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Oniszczuk J, Bettuzzi T, Anjou L, Audard V, Sbidian E, El Karoui K, Moktefi A. De novo IgA vasculitis following adenovirus-based SARS-CoV-2 vaccination. Clin Kidney J 2021; 15:587-589. [PMID: 35211316 PMCID: PMC8862086 DOI: 10.1093/ckj/sfab257] [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: 09/09/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Julie Oniszczuk
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire TRUE, Créteil, France
- UnivParis 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
| | - Thomas Bettuzzi
- AP-HP, Hôpitaux Universitaires Henri Mondor, Dermatology Department, Fédération Hospitalo-Universitaire TRUE, Créteil, France
| | - Louis Anjou
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire TRUE, Créteil, France
- UnivParis 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
| | - Vincent Audard
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire TRUE, Créteil, France
- UnivParis 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
| | - Emilie Sbidian
- AP-HP, Hôpitaux Universitaires Henri Mondor, Dermatology Department, Fédération Hospitalo-Universitaire TRUE, Créteil, France
| | - Khalil El Karoui
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire TRUE, Créteil, France
- UnivParis 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
| | - Anissa Moktefi
- UnivParis 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
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département de Pathologie, Créteil, France
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6
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Lanaret C, Anglicheau D, Audard V, Büchler M, Caillard S, Couzi L, Malvezzi P, Mesnard L, Bertrand D, Martinez F, Pernin V, Ducloux D, Poulain C, Thierry A, Del Bello A, Rerolle JP, Greze C, Uro-Coste C, Aniort J, Lambert C, Bouvier N, Schvartz B, Maillard N, Sayegh J, Oniszczuk J, Morin MP, Legendre C, Kamar N, Heng AE, Garrouste C. Rituximab for recurrence of primary focal segmental glomerulosclerosis after kidney transplantation: Results of a nationwide study. Am J Transplant 2021; 21:3021-3033. [PMID: 33512779 DOI: 10.1111/ajt.16504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 01/25/2023]
Abstract
Rituximab (RTX) therapy for primary focal segmental glomerulosclerosis recurrence after kidney transplantation (KT) has been extensively debated. We aimed to assess the benefit of adding RTX to plasmapheresis (PP), corticosteroids, and calcineurin inhibitors (standard of care, SOC). We identified 148 adult patients who received KT in 12/2004-12/2018 at 21 French centers: 109 received SOC (Group 1, G1), and 39 received immediate RTX along with SOC (Group 2, G2). In G1, RTX was introduced after 28 days of SOC in the event of failure (G1a, n = 19) or PP withdrawal (G1b, n = 12). Complete remission (CR) was achieved in 46.6% of patients, and partial remission (PR) was achieved in 33.1%. The 10-year graft survival rates were 64.7% and 17.9% in responders and nonresponders, respectively. Propensity score analysis showed no difference in CR+PR rates between G1 (82.6%) and G2 (71.8%) (p = .08). Following the addition of RTX (G1a), 26.3% of patients had CR, and 31.6% had PR. The incidence of severe infections was similar between patients treated with and without RTX. In multivariable analysis, infection episodes were associated with hypogammaglobulinemia <5 g/L. RTX could be used in cases of SOC failure or remission for early discontinuation of PP without increasing the risk of infection.
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Affiliation(s)
- Camille Lanaret
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Dany Anglicheau
- Assistance Publique des Hôpitaux de Paris, Service de Néphrologie et Transplantation, Hôpital Universitaire Necker-Enfants Malades, Université de Paris, Paris, France
| | - Vincent Audard
- Assistance Publique des Hôpitaux de Paris (AP-HP, Service de Néphrologie et Transplantation Centre de Référence Maladie Rare «Syndrome Néphrotique Idiopathique», Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, INSERM, IMRB, Créteil, France
| | - Mathias Büchler
- Service de Néphrologie et Immunologie Clinique, CHRU de Tours, Tours, France
| | - Sophie Caillard
- Service de Néphrologie, University Hospital, Strasbourg, France
| | - Lionel Couzi
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
| | - Paolo Malvezzi
- Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, CHU Grenoble-Alpes, Grenoble, France
| | - Laurent Mesnard
- Assistance Publique des Hôpitaux de Paris, Hôpital Universitaire Tenon, Urgences Néphrologiques et Transplantation Rénale, Université de Paris, Paris, France
| | | | - Franck Martinez
- Assistance Publique des Hôpitaux de Paris, Service de Néphrologie et Transplantation, Hôpital Universitaire Necker-Enfants Malades, Université de Paris, Paris, France
| | - Vincent Pernin
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France
| | - Didier Ducloux
- Service de Néphrologie, Dialyse et Transplantation, CHU Besançon, Besançon, France
| | - Coralie Poulain
- Service de Néphrologie-Médecine Interne-Dialyse-Transplantation, CHU d'Amiens, Amiens, France
| | - Antoine Thierry
- Service de Néphrologie-Hémodialyse-Transplantation Rénale, CHU de Poitiers, Poitiers, France
| | - Arnaud Del Bello
- Département de Néphrologie et Transplantation d'Organes, CHU Toulouse, INSERM U1043, IFR-BMT, Université Paul Sabatier, Toulouse, France
| | - Jean P Rerolle
- Service de Néphrologie, Dialyse et Transplantation, CHU Limoges, Limoges, France
| | - Clarisse Greze
- Assistance Publique des Hôpitaux de Paris, Service de Néphrologie, Hôpital Universitaire Bichat-Claude-Bernard, Université de Paris, Paris, France
| | - Charlotte Uro-Coste
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Julien Aniort
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Céline Lambert
- Unité de Biostatistiques (DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nicolas Bouvier
- Service de Néphrologie et Transplantation, CHU Caen, Caen, France
| | | | - Nicolas Maillard
- Service de Néphrologie et Transplantation, CHU Saint-Etienne, Saint-Etienne, France
| | - Johnny Sayegh
- Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers, France
| | - Julie Oniszczuk
- Assistance Publique des Hôpitaux de Paris (AP-HP, Service de Néphrologie et Transplantation Centre de Référence Maladie Rare «Syndrome Néphrotique Idiopathique», Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, INSERM, IMRB, Créteil, France
| | | | - Christophe Legendre
- Assistance Publique des Hôpitaux de Paris, Service de Néphrologie et Transplantation, Hôpital Universitaire Necker-Enfants Malades, Université de Paris, Paris, France
| | - Nassim Kamar
- Département de Néphrologie et Transplantation d'Organes, CHU Toulouse, INSERM U1043, IFR-BMT, Université Paul Sabatier, Toulouse, France
| | - Anne E Heng
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Cyril Garrouste
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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7
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Oniszczuk J, Pagot E, Limal N, Hüe S, Audard V, Moktefi A, El Karoui K. Scleroderma renal crisis following mRNA vaccination against SARS-CoV-2. Kidney Int 2021; 100:940-941. [PMID: 34339745 PMCID: PMC8321963 DOI: 10.1016/j.kint.2021.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 07/05/2021] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Julie Oniszczuk
- Assistance publique Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Fédération Hospitalo-Universitaire InnovaTive theRapy for immUne disordErs (TRUE), 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
| | - Eléonore Pagot
- Assistance publique Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Fédération Hospitalo-Universitaire InnovaTive theRapy for immUne disordErs (TRUE), 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
| | - Nicolas Limal
- Assistance Publique Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Médecine Interne, Centre de Référence Maladie Rare "Cytopénies auto-immunes", Créteil, France
| | - Sophie Hüe
- Assistance Publique Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Département d'Immunologie Biologique, Créteil, France
| | - Vincent Audard
- Assistance publique Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Fédération Hospitalo-Universitaire InnovaTive theRapy for immUne disordErs (TRUE), 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
| | - Anissa Moktefi
- 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; Assistance Publique Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Département de Pathologie, Créteil, France
| | - Khalil El Karoui
- Assistance publique Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Fédération Hospitalo-Universitaire InnovaTive theRapy for immUne disordErs (TRUE), 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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8
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Oniszczuk J, Beldi-Ferchiou A, Audureau E, Azzaoui I, Molinier-Frenkel V, Frontera V, Karras A, Moktefi A, Pillebout E, Zaidan M, El Karoui K, Delfau-Larue MH, Hénique C, Ollero M, Sahali D, Mahévas M, Audard V. Circulating plasmablasts and high level of BAFF are hallmarks of minimal change nephrotic syndrome in adults. Nephrol Dial Transplant 2021; 36:609-617. [PMID: 33241414 DOI: 10.1093/ndt/gfaa279] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The recent success achieved with the use of B cell-depleting agents in some patients with minimal change nephrotic syndrome (MCNS) suggests an unexpected role for B lymphocytes in the pathogenesis of this immune-mediated glomerular disease. Nevertheless, no extensive B-cell phenotyping analysis has ever been performed in untreated adult patients soon after MCNS diagnosis. METHODS We investigated the distribution of the different B-cell subpopulations in 22 untreated adult patients with biopsy-proven MCNS [MCNS relapse (MCNS-Rel)]. We compared these data with those for 24 healthy controls, 13 MCNS patients in remission (with no specific treatment) and 19 patients with idiopathic membranous nephropathy (IMN). RESULTS Patients with MCNS-Rel or IMN had higher proteinuria and lower serum albumin and gammaglobulin levels (P < 0.0001 for all comparisons) than MCNS patients in remission. Plasmablasts were the only B-cell subsets present at significantly higher levels in MCNS-Rel patients than in the patients of the other three groups (P < 0.05 for all comparisons). The lower albumin levels and higher proteinuria levels were positively correlated with the percentage of circulating plasmablasts (Spearman test's ρ = -0.54, P = 0.01 and ρ = 0.65, P = 0.002, respectively). Similarly, the increase of immunoglobulin M (IgM) and the decrease of IgG levels were significantly associated with the percentage of plasmablasts in MCNS-Rel patients (Spearman's ρ = 0.36, P = 0.01 and Spearman's ρ = -0.60, P = 0.01, respectively). Increased production of interleukin (IL)-21, IL-6 and B-cell activating factor (BAFF) in the serum of MCNS-Rel patients was found significantly correlated with the percentage of plasmablasts (ρ = 0.72, P = 0.0002, ρ = 0.49, P = 0.04 and ρ = 0.62, P = 0.009, respectively). CONCLUSIONS An increase in the proportion of circulating plasmablasts seems to be a hallmark of untreated MCNS in adult patients. Further studies are required to more precisely determine the phenotype and functions of these cells.
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Affiliation(s)
- Julie Oniszczuk
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », Créteil, France.,Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Asma Beldi-Ferchiou
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département d'Hématologie et Immunologie Biologiques, Créteil, France.,Univ Paris Est Créteil, INSERM U955, IMRB, Equipe Immunorégulation et Biothérapie, Créteil, France
| | - Etienne Audureau
- AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Santé Publique, Unité de Recherche Clinique, Université Paris Est Créteil, INSERM U955, IMRB, Equipe CEPIA, Créteil, France
| | - Imane Azzaoui
- Univ Paris Est Créteil, INSERM U955, IMRB, Equipe 2, Créteil, France
| | - Valérie Molinier-Frenkel
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département d'Hématologie et Immunologie Biologiques, Créteil, France.,Univ Paris Est Créteil, INSERM U955, IMRB, Equipe Immunorégulation et Biothérapie, Créteil, France
| | - Vincent Frontera
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Alexandre Karras
- AP-HP, Hôpital Européen Georges Pompidou, Service de Néphrologie, Paris, France.,Faculté de Médecine Paris-Descartes, Université de Paris, Paris, France
| | - Anissa Moktefi
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France.,AP-HP, Hôpitaux Universitaires Henri Mondor, Département de Pathologie, Créteil, France
| | - Evangeline Pillebout
- Service de Néphrologie et Transplantation, AP-HP, Hôpital Saint Louis, Paris, France
| | - Mohamad Zaidan
- AP-HP, Hôpitaux Universitaires du Kremlin Bicêtre, Service de Néphrologie-Dialyse-Transplantation, Le Kremlin-Bicêtre, France
| | - Khalil El Karoui
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », Créteil, France.,Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Marie-Hélène Delfau-Larue
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département d'Hématologie et Immunologie Biologiques, Créteil, France.,Univ Paris Est Créteil, INSERM U955, IMRB, Equipe 9, Créteil, France
| | - Carole Hénique
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Mario Ollero
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Dil Sahali
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », Créteil, France.,Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Matthieu Mahévas
- Univ Paris Est Créteil, INSERM U955, IMRB, Equipe 2, Créteil, France.,AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Médecine interne, Centre de Référence Maladie Rare « Cytopénies Auto-immunes », Créteil, France
| | - Vincent Audard
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », Créteil, France.,Univ Paris Est Créteil, 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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9
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Ferlicot S, Jamme M, Gaillard F, Oniszczuk J, Couturier A, May O, Grünenwald A, Sannier A, Moktefi A, Le Monnier O, Petit-Hoang C, Maroun N, Brodin-Sartorius A, Michon A, Dobosziewicz H, Andreelli F, Guillet M, Izzedine H, Richard C, Dekeyser M, Arrestier R, Sthelé T, Lefèvre E, Mathian A, Legendre C, Mussini C, Verpont MC, Pallet N, Amoura Z, Essig M, Snanoudj R, Brocheriou-Spelle I, François H, Belenfant X, Geri G, Daugas E, Audard V, Buob D, Massy ZA, Zaidan M. The spectrum of kidney biopsies in hospitalized patients with COVID-19, acute kidney injury, and/or proteinuria. Nephrol Dial Transplant 2021; 36:gfab042. [PMID: 33576823 PMCID: PMC7928708 DOI: 10.1093/ndt/gfab042] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/27/2021] [Indexed: 01/08/2023] Open
Abstract
We report a multicentric retrospective case series of patients with COVID-19 who developed acute kidney injury and/or proteinuria and underwent a kidney biopsy in the Paris and its metropolitan area. Forty-seven patients (80.9% men) with COVID-19 who underwent a kidney biopsy between March 08 and May 19, 2020 were included. Median age was 63 years IQR [52-69]. Comorbidities included hypertension (66.0%), diabetes mellitus (27.7%), obesity (27.7%), history of chronic kidney (25.5%), cardiac (38.6%) and respiratory (27.3%) diseases. Initial symptoms were fever (85.1%), cough (63.8%), shortness of breath (55.3%), and diarrhea (23.4%). Almost all patients developed acute kidney injury (97.9%) and 63.8% required renal replacement therapy. Kidney biopsy showed two main histopathological patterns, including acute tubular injury in 20 (42.6%) patients, and glomerular injury consisting of collapsing glomerulopathy and focal segmental glomerulosclerosis in 17 (36.2%) patients. Two (4.3%) patients had acute vascular nephropathy, while eight (17%) had alternative diagnosis most likely unrelated to COVID-19. Acute tubular injury occurred almost invariably in the setting of severe forms of COVID-19, whereas patients with glomerular injury had various profiles of COVID-19 severity and collapsing glomerulopathy was only observed in patients harboring a combination of APOL1 risk variants. At last follow-up, 16 of the 30 patients who initially required dialysis were still on dialysis, and 9 died. The present study describes the spectrum of kidney lesions in patients with COVID-19. While acute tubular injury is correlated with COVID-19 severity, the pattern of glomerular injury is intimately associated with the expression of APOL1 risk variants.
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Affiliation(s)
- Sophie Ferlicot
- Service d’Anatomie Pathologique, Assistance Publique-Hôpitaux de Paris (APHP) Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Club Francophone de Pathologie Rénale (CFPR) group
| | - Matthieu Jamme
- Service de Réanimation polyvalente, CH Intercommunal de Poissy Saint Germain en Laye, Poissy, France
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
| | - François Gaillard
- Service de Néphrologie, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, INSERM U1149, Paris, France
| | - Julie Oniszczuk
- Service de Néphrologie et Transplantation, Centre de Référence Maladies Rares « Syndrome Néphrotique Idiopathique », Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Créteil, France
| | - Aymeric Couturier
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
- Service de Néphrologie et Dialyse, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Universitaire Ambroise Paré, Boulogne Billancourt, France
| | - Olivia May
- Service de néphrologie-dialyse, GHT Grand Paris Nord Est, Hôpital André Grégoire, Montreuil sous Bois
| | - Anne Grünenwald
- Service de médecine intensive-réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Aurélie Sannier
- Club Francophone de Pathologie Rénale (CFPR) group
- Université de Paris, Assistance Publique-Hôpitaux de Paris (APHP), Service d’Anatomie et Cytologie Pathologiques, Hôpital Bichat, F-75018, Paris, France
| | - Anissa Moktefi
- Club Francophone de Pathologie Rénale (CFPR) group
- Service d’Anatomie Pathologique, Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Créteil, France
| | - Ophélie Le Monnier
- Sorbonne Université, Assistance Publique–Hôpitaux de Paris, Groupement Hospitalier Pitié–Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Camille Petit-Hoang
- Service UNTR, Assistance Publique-Hôpitaux de Paris (APHP), INSERM 1155, Sorbonne Université, Hôpital Tenon, Paris, France
| | - Nadine Maroun
- Service de Néphrologie et Dialyse, CH Intercommunal de Poissy Saint-Germain-en-Laye, Poissy, France
| | | | - Arthur Michon
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Hélène Dobosziewicz
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Fabrizio Andreelli
- Service de Diabétologie-Métabolismes, Assistance Publique-Hôpitaux de Paris (APHP), CHU Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Matthieu Guillet
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Hassane Izzedine
- Service de Néphrologie, Hôpital Privé des Peupliers, Ramsay Générale de Santé, Paris, France
| | - Christian Richard
- Service de médecine intensive-réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Manon Dekeyser
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Romain Arrestier
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, Assistance Publique-Hôpitaux de Paris (APHP), Univ Paris Est Créteil, Créteil, France
| | - Thomas Sthelé
- Service de Néphrologie et Transplantation, Centre de Référence Maladies Rares « Syndrome Néphrotique Idiopathique », Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Créteil, France
| | - Edouard Lefèvre
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Alexis Mathian
- Sorbonne Université, Assistance Publique–Hôpitaux de Paris, Groupement Hospitalier Pitié–Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Christophe Legendre
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
| | - Charlotte Mussini
- Service d’Anatomie Pathologique, Assistance Publique-Hôpitaux de Paris (APHP) Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Club Francophone de Pathologie Rénale (CFPR) group
| | - Marie-Christine Verpont
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, and Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1155, plate-forme d'Imagerie et de Cytométrie de Tenon, F-75020, Paris, France
| | - Nicolas Pallet
- Service de Biochimie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Européen Georges Pompidou, Paris, France
| | - Zahir Amoura
- Sorbonne Université, Assistance Publique–Hôpitaux de Paris, Groupement Hospitalier Pitié–Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Marie Essig
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
- Service de Néphrologie et Dialyse, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Universitaire Ambroise Paré, Boulogne Billancourt, France
| | - Renaud Snanoudj
- Service de Néphrologie-Dialyse-Transplantation, Hôpital Foch, Suresnes, France
| | - Isabelle Brocheriou-Spelle
- Club Francophone de Pathologie Rénale (CFPR) group
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1155, Assistance Publique-Hôpitaux de Paris, Pathology department, Hôpital de la Pitié-Salpêtrière
| | - Hélène François
- Service UNTR, Assistance Publique-Hôpitaux de Paris (APHP), INSERM 1155, Sorbonne Université, Hôpital Tenon, Paris, France
| | - Xavier Belenfant
- Service de néphrologie-dialyse, GHT Grand Paris Nord Est, Hôpital André Grégoire, Montreuil sous Bois
| | - Guillaume Geri
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
- Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Universitaire Ambroise Paré, Boulogne Billancourt, France
| | - Eric Daugas
- Service de Néphrologie, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris (APHP), Université de Paris, INSERM U1149, Paris, France
| | - Vincent Audard
- Service de Néphrologie et Transplantation, Centre de Référence Maladies Rares « Syndrome Néphrotique Idiopathique », Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Créteil, France
| | - David Buob
- Club Francophone de Pathologie Rénale (CFPR) group
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Service d’Anatomie et Cytologie Pathologiques, Hôpital Tenon, F-75020, Paris, France
| | - Ziad A Massy
- INSERM U1018, Equipe 5, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Université Paris Saclay et Université Versailles Saint Quentin en Yvelines), Villejuif, France
- Service de Néphrologie et Dialyse, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Universitaire Ambroise Paré, Boulogne Billancourt, France
| | - Mohamad Zaidan
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), 94270 Le Kremlin-Bicêtre, France
- INSERM U1163, Institut IMAGINE, Hôpital Necker-Enfants malades, 75005 Paris, France
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10
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Oniszczuk J, Sendeyo K, Chhuon C, Savas B, Cogné E, Vachin P, Henique C, Guerrera IC, Astarita G, Frontera V, Pawlak A, Audard V, Sahali D, Ollero M. CMIP is a negative regulator of T cell signaling. Cell Mol Immunol 2019; 17:1026-1041. [PMID: 31395948 PMCID: PMC7609264 DOI: 10.1038/s41423-019-0266-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 07/10/2019] [Indexed: 11/24/2022] Open
Abstract
Upon their interaction with cognate antigen, T cells integrate different extracellular and intracellular signals involving basal and induced protein–protein interactions, as well as the binding of proteins to lipids, which can lead to either cell activation or inhibition. Here, we show that the selective T cell expression of CMIP, a new adapter protein, by targeted transgenesis drives T cells toward a naïve phenotype. We found that CMIP inhibits activation of the Src kinases Fyn and Lck after CD3/CD28 costimulation and the subsequent localization of Fyn and Lck to LRs. Video microscopy analysis showed that CMIP blocks the recruitment of LAT and the lipid raft marker cholera toxin B at the site of TCR engagement. Proteomic analysis identified several protein clusters differentially modulated by CMIP and, notably, Cofilin-1, which is inactivated in CMIP-expressing T cells. Moreover, transgenic T cells exhibited the downregulation of GM3 synthase, a key enzyme involved in the biosynthesis of gangliosides. These results suggest that CMIP negatively impacts proximal signaling and cytoskeletal rearrangement and defines a new mechanism for the negative regulation of T cells that could be a therapeutic target.
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Affiliation(s)
- Julie Oniszczuk
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
| | - Kelhia Sendeyo
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
| | - Cerina Chhuon
- Proteomic Platform Necker, PPN-3P5, Structure Fédérative de Recherche SFR Necker US24, 75015, Paris, France
| | - Berkan Savas
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
| | - Etienne Cogné
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
| | - Pauline Vachin
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
| | - Carole Henique
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
| | - Ida Chiara Guerrera
- Proteomic Platform Necker, PPN-3P5, Structure Fédérative de Recherche SFR Necker US24, 75015, Paris, France
| | - Giuseppe Astarita
- Department of Biochemistry, Molecular and Cellular Biology, Georgetown University, Washington, DC, USA
| | - Vincent Frontera
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
| | - Andre Pawlak
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
| | - Vincent Audard
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France.,AP-HP, Groupe Henri-Mondor Albert-Chenevier, Service de Néphrologie, F-94010, Créteil, France.,Institut Francilien De Recherche En Néphrologie Et Transplantation, F-94010, Créteil, France
| | - Dil Sahali
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France. .,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France. .,AP-HP, Groupe Henri-Mondor Albert-Chenevier, Service de Néphrologie, F-94010, Créteil, France. .,Institut Francilien De Recherche En Néphrologie Et Transplantation, F-94010, Créteil, France.
| | - Mario Ollero
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS 955, Equipe 21, F-94010, Créteil, France.,Faculté de Médecine, Université Paris Est, UMRS 955, Equipe 21, F-94010, Créteil, France
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11
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Garrouste C, Baudenon J, Gatault P, Pereira B, Etienne I, Thierry A, Szlavik N, Aniort J, Rabant M, Lambert C, Sayegh J, Oniszczuk J, Anglicheau D, Heng AE. No impact of disseminated intravascular coagulation in kidney donors on long-term kidney transplantation outcome: A multicenter propensity-matched study. Am J Transplant 2019; 19:448-456. [PMID: 29981217 DOI: 10.1111/ajt.15008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/08/2017] [Revised: 06/14/2018] [Accepted: 06/24/2018] [Indexed: 01/25/2023]
Abstract
The diagnosis of disseminated intravascular coagulation (DIC) is often considered to be a contraindication to organ donation. The aim of this study was to evaluate the impact of DIC+ donors on kidney recipient (KR) evolution. We identified 169 KRs with DIC+ donation after brain death donors between January 1996 and December 2012 in 6 French transplant centers. Individuals were matched using propensity scores to 338 recipients with DIC- donors according to donor age and sex, whether expanded criteria for the donor existed, graft year, and transplantation center. After kidney transplantation, delayed graft function was observed in 28.1% of DIC+ KRs and in 22.8% of DIC- KRs (NS). Renal allograft survival at 1, 5, and 10 years was 94.5%, 89.3%, and 73.9% and 96.2%, 90.8%, and 81.3% in DIC+ KRs and DIC- KRs, respectively (NS). The median estimated glomerular filtration rate (eGFR) was similar between DIC+ and DIC- KRs at 3 months, 1 year, and 10 years: 45.9 vs 48.1 mL/min, 42.1 vs 43.1 mL/min, and 33.9 vs 38.1 mL/min, respectively. Delayed calcineurin inhibitor introduction or induction had no impact on delayed graft function rate or eGFR evolution at 10 years after transplantation in DIC+ KRs. Donor DIC did not seem to affect initial outcome, long-term graft function, or allograft survival.
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Affiliation(s)
- Cyril Garrouste
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Julien Baudenon
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Philippe Gatault
- Department of Nephrology and Clinical Immunology, CHRU de Tours, Tours, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Antoine Thierry
- Department of Nephrology Dialysis and Kidney Transplantation, CHU de Poitiers, Poitiers, France
| | - Nora Szlavik
- Pathology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Julien Aniort
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Marion Rabant
- Pathology Department, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Céline Lambert
- Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, Clermont-Ferrand, France
| | - Johnny Sayegh
- Department of Nephrology Dialysis and Kidney Transplantation, CHU d' Angers, Angers, France
| | - Julie Oniszczuk
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Dany Anglicheau
- Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne Elisabeth Heng
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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12
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Bouachi K, Moktefi A, Zhang SY, Oniszczuk J, Sendeyo K, Remy P, Audard V, Pawlak A, Ollero M, Sahali D. Expression of CMIP in podocytes is restricted to specific classes of lupus nephritis. PLoS One 2018; 13:e0207066. [PMID: 30439969 PMCID: PMC6237342 DOI: 10.1371/journal.pone.0207066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/24/2018] [Indexed: 11/18/2022] Open
Abstract
Lupus glomerulopathies are classified into various histological patterns, which probably result from different pathophysiological origins. Podocyte injury can be demonstrated in lupus nephritis but its clinical relevance is far little appreciated and is often masked by proliferative lesions and inflammatory cell infiltrations. Two patterns of podocyte lesions may be considered, either occurring in the context of renal inflammation or reflecting podocyte dysfunction in non-proliferative and non-inflammatory glomerulopathies. This distinction remains elusive since no reliable biomarker discriminates between both entities. CMIP was recently found induced in some glomerular disease but its expression in different lupus nephritis classes has not been investigated. Twenty-four adult patients with lupus nephritis, including non-proliferative (n = 11) and proliferative (n = 13) glomerulopathies were analyzed. Clinical, biological and immunological data were compared with immunomorphological findings. We analyzed by quantitative and qualitative methods the expression of CMIP in different histological classes. We found CMIP abundance selectively increased in podocytes in class II and class V glomerulopathies, while in proliferative forms (class III and class IV), CMIP was rarely detected. CMIP was not expressed in cellular crescents, endothelial cells or mesangial cells. CMIP colocalized with some subsets of B and T cells within glomerular or interstitial mononuclear cell infiltrates but never with macrophages. Hematuria is rarely present in lupus glomerulopathies expressing CMIP. There was no correlation between classical immunological markers and CMIP expression. Thus, CMIP induction in lupus nephritis seems restricted to non-proliferative glomerulopathies and may define a specific pattern of podocyte injury.
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Affiliation(s)
- Khedidja Bouachi
- AP-HP (Assistance Publique des Hôpitaux de Paris), Groupe Hospitalier Henri-Mondor, Department of Nephrology and Renal Transplantation, Créteil, France
| | - Anissa Moktefi
- AP-HP (Assistance Publique des Hôpitaux de Paris), Groupe Hospitalier Henri-Mondor, Department of Pathology, Créteil, France
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Shao-yu Zhang
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Julie Oniszczuk
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Kelhia Sendeyo
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Philippe Remy
- AP-HP (Assistance Publique des Hôpitaux de Paris), Groupe Hospitalier Henri-Mondor, Department of Nephrology and Renal Transplantation, Créteil, France
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Vincent Audard
- AP-HP (Assistance Publique des Hôpitaux de Paris), Groupe Hospitalier Henri-Mondor, Department of Nephrology and Renal Transplantation, Créteil, France
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Andre Pawlak
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Mario Ollero
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
| | - Djillali Sahali
- AP-HP (Assistance Publique des Hôpitaux de Paris), Groupe Hospitalier Henri-Mondor, Department of Nephrology and Renal Transplantation, Créteil, France
- UPEC (Université Paris Est Créteil), INSERM (Institut National de la Santé et de la Recherche Médicale) U955, Institut Mondor de Recherche Biomédicale (IMRB), Equipe 21, Créteil, France
- * E-mail:
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13
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Leibler C, Moktefi A, Matignon M, Debiais-Delpech C, Oniszczuk J, Sahali D, Cohen JL, Grimbert P, Audard V. Rituximab and Fibrillary Glomerulonephritis: Interest of B Cell Reconstitution Monitoring. J Clin Med 2018; 7:jcm7110430. [PMID: 30423930 PMCID: PMC6262590 DOI: 10.3390/jcm7110430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/29/2018] [Accepted: 11/05/2018] [Indexed: 01/02/2023] Open
Abstract
Fibrillary glomerulonephritis (FGN) is a rare glomerular disease characterized by glomerular deposition of randomly arranged non-amyloid fibrils. FGN has a poor renal prognosis and its optimal treatment is a medical challenge. Rituximab therapy has recently emerged as a promising approach even though its mechanism of action remains hypothetical. We describe the case of a 55-year-old woman with FGN successfully treated by rituximab. During the 36-month follow-up, she had three relapses of FGN, occurring each time in the context of B cell recovery. Investigation of the distribution of B cell subpopulations at the time of the third relapse showed, as previously described for some immunological diseases, an increase in the proportion of switched memory B cells relative to healthy subjects, whereas global memory B cell pool was not yet recovered. This case suggests that B cell reconstitution should be carefully monitored in the management of FGN treated with rituximab.
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Affiliation(s)
- Claire Leibler
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Hôpital Henri-Mondor/Albert-Chenevier, F-94000 Créteil, France.
- Université Paris-Est, UMR-S955, UPEC, F-94000 Créteil, France.
- Inserm, U955, Equipe 21, F-94000 Créteil, France.
| | - Anissa Moktefi
- Université Paris-Est, UMR-S955, UPEC, F-94000 Créteil, France.
- Inserm, U955, Equipe 21, F-94000 Créteil, France.
- AP-HP, Département de Pathologie, Hôpital Henri-Mondor/Albert-Chenevier, F-94000 Créteil, France.
| | - Marie Matignon
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Hôpital Henri-Mondor/Albert-Chenevier, F-94000 Créteil, France.
- Université Paris-Est, UMR-S955, UPEC, F-94000 Créteil, France.
- Inserm, U955, Equipe 21, F-94000 Créteil, France.
| | - Céline Debiais-Delpech
- Centre de Référence des Amyloses Primitives et des Maladies de Dépôts d'Immunoglobulines Monoclonales, F-86000 Poitiers, France.
- Département de Pathologie, Centre Hospitalier Universitaire de Poitiers, F-86000 Poitiers, France.
| | - Julie Oniszczuk
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Hôpital Henri-Mondor/Albert-Chenevier, F-94000 Créteil, France.
- Université Paris-Est, UMR-S955, UPEC, F-94000 Créteil, France.
- Inserm, U955, Equipe 21, F-94000 Créteil, France.
| | - Dil Sahali
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Hôpital Henri-Mondor/Albert-Chenevier, F-94000 Créteil, France.
- Université Paris-Est, UMR-S955, UPEC, F-94000 Créteil, France.
- Inserm, U955, Equipe 21, F-94000 Créteil, France.
| | - José L Cohen
- Université Paris-Est, UMR-S955, UPEC, F-94000 Créteil, France.
- Inserm, U955, Equipe 21, F-94000 Créteil, France.
- APHP, Hôpital Henri Mondor-A. Chenevier, Centre d'Investigation Clinique Biothérapie, F-94000 Créteil, France.
| | - Philippe Grimbert
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Hôpital Henri-Mondor/Albert-Chenevier, F-94000 Créteil, France.
- Université Paris-Est, UMR-S955, UPEC, F-94000 Créteil, France.
- Inserm, U955, Equipe 21, F-94000 Créteil, France.
| | - Vincent Audard
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Hôpital Henri-Mondor/Albert-Chenevier, F-94000 Créteil, France.
- Université Paris-Est, UMR-S955, UPEC, F-94000 Créteil, France.
- Inserm, U955, Equipe 21, F-94000 Créteil, France.
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14
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Zerouali-Blondeau S, Maas R, Oniszczuk J, Zhang S, Pawlak A, Sahali D, Ollero M. Recherche de marqueurs in vitro spécifiques de la récidive post-greffe de la hyalinose segmentaire et focale. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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15
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Abstract
Recurrence of glomerular disease after renal transplantation is a frequent cause of graft loss. Incidence, risk factors and outcome of recurrence are widely due to the underlying glomerular disease. Graft biopsy analysis is required to confirm the definitive diagnosis of recurrence and to start an appropriate therapy that, in some cases, remains challenging to prevent graft failure. Increased use of protocol biopsy and recent advances in our understanding of the pathogenesis of some glomerular diseases with the identification of some relevant biomarkers provide a unique opportunity to initiate kidney-protective therapy at early stages of recurrence on the graft. This review summarizes our current knowledge on the management of many recurrent primary and secondary glomerulonephritis after kidney transplantation.
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Affiliation(s)
- Tomek Kofman
- Service de néphrologie et transplantation, hôpital Henri-Mondor, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Institut francilien de recherche en néphrologie et transplantation (IFRNT), université Paris Est-Créteil (Upec), avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - Julie Oniszczuk
- Service de néphrologie et transplantation, hôpital Henri-Mondor, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Institut francilien de recherche en néphrologie et transplantation (IFRNT), université Paris Est-Créteil (Upec), avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - Philippe Lang
- Service de néphrologie et transplantation, hôpital Henri-Mondor, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Institut francilien de recherche en néphrologie et transplantation (IFRNT), université Paris Est-Créteil (Upec), avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - Philippe Grimbert
- Service de néphrologie et transplantation, hôpital Henri-Mondor, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Institut francilien de recherche en néphrologie et transplantation (IFRNT), université Paris Est-Créteil (Upec), avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - Vincent Audard
- Service de néphrologie et transplantation, hôpital Henri-Mondor, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Institut francilien de recherche en néphrologie et transplantation (IFRNT), université Paris Est-Créteil (Upec), avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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16
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Boumediene A, Vachin P, Sendeyo K, Oniszczuk J, Zhang SY, Henique C, Pawlak A, Audard V, Ollero M, Guigonis V, Sahali D. NEPHRUTIX: A randomized, double-blind, placebo vs Rituximab-controlled trial assessing T-cell subset changes in Minimal Change Nephrotic Syndrome. J Autoimmun 2017; 88:91-102. [PMID: 29056249 DOI: 10.1016/j.jaut.2017.10.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 12/11/2022]
Abstract
Minimal-change nephrotic syndrome (MCNS) is an immune-mediated glomerular disease. We have analyzed the modifications on T-cell subsets in twenty-three patients who were highly steroid/calcineurin inhibitor and/or mycophenolate mofetil-dependent for frequently relapsing nephrotic syndrome (FRNS) and who were enrolled in a multicenter, double-blind, randomized, placebo vs Rituximab-controlled trial. Patients with FRNS entered the trial at remission and were randomly assigned to receive either Rituximab or placebo. In both groups, patient blood samples were analyzed at inclusion and then monthly until six months post-perfusion. Disclosure of patient's allocation code occurred in relapse or at the end of the trial. All patients under placebo displaying relapse were subsequently treated with Rituximab. Despite the significant decrease of immunosuppressive drugs, remission was maintained in all patients included in the Rituximab group, except one (n = 9/10). On the other hand, relapses occurred within a few weeks (means ≈ 7.3 weeks) in all patients receiving placebo (n = 13). At inclusion, before rituximab therapy, the frequency of different T-cell subsets were highly similar in both groups, except for CD8+ and invariant TCRVα24 T-cell subsets, which were significantly increased in patients of the Placebo group ((p = 0,0414 and p = 0.0428, respectively). Despite the significant decrease of immunosuppressive drugs, remission was maintained in all patients included in the Rituximab group (n = 10), except one. Relapses were associated with a significant decrease in CD4+CD25highFoxP3high Tregulatory cells (p = 0.0005) and IL2 expression (p = 0.0032), while CMIP abundance was significantly increased (p = 0.03). Remissions after Rituximab therapy were associated in both groups with significant decrease in the frequency of CD4+CD45RO+CXCR5+, invariant natural killer T-cells (INKT) and CD4-CD8- (double-negative, DN) T-cells expressing the invariant Vα24 chain (DN-TCR Vα24) T-cells, suggesting that MCNS involves a disorder of innate and adaptive immune response, which can be stabilized by Rituximab treatment.
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Affiliation(s)
- Ahmed Boumediene
- Centre de Biologie et de Recherche en Santé, Hôpital universitaire Limoges Dupuytren, 87000, Limoges, France
| | - Pauline Vachin
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France
| | - Kelhia Sendeyo
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France
| | - Julie Oniszczuk
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France
| | - Shao-Yu Zhang
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France
| | - Carole Henique
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France
| | - Andre Pawlak
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France
| | - Vincent Audard
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Henri-Mondor Albert-Chenevier, Service de Néphrologie-Transplantation, Créteil, F-94010, France; Institut francilien de recherche en néphrologie et transplantation, France
| | - Mario Ollero
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France
| | - Vincent Guigonis
- Département de Pédiatrie, Hôpital universitaire Limoges Dupuytren, 87000, Limoges, France
| | - Djillali Sahali
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 955, Equipe 21, Créteil, F-94010, France; Université Paris-Est-Créteil (UPEC), Faculté de Médecine, UMRS 955, Equipe 21, Créteil, F-94010, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Henri-Mondor Albert-Chenevier, Service de Néphrologie-Transplantation, Créteil, F-94010, France; Institut francilien de recherche en néphrologie et transplantation, France.
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Bouatou Y, Koessler T, Oniszczuk J, Zhang SY, Moll S, Audard V, de Seigneux S, Sahali D. Nephrotic Syndrome in Small Cell Lung Cancer and Induction of C-Mip in Podocytes. Am J Kidney Dis 2017; 69:477-480. [PMID: 28063735 DOI: 10.1053/j.ajkd.2016.09.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 04/23/2016] [Accepted: 09/04/2016] [Indexed: 11/11/2022]
Abstract
Paraneoplastic nephrotic syndrome is often a complication in patients with cancer, and various histologic lesions have been described in the kidney. We report the case of a 76-year-old woman who presented with a podocytopathy that was found to be associated with a small cell lung carcinoma (SCLC). One cycle of carboplatin-etoposide combination therapy led to resolution of nephrotic syndrome and remission of the lung carcinoma. C-Maf-inducing protein (C-Mip) was overexpressed in both podocytes and cancer cells, but was not found in control kidney and lung tissue samples. C-Mip also was absent in SCLC cells from 30 patients without nephrotic syndrome. Exposing cultured podocytes to a sample of our patient's serum that was collected prior to chemotherapy led to disorganization of the podocyte cytoskeleton and induction of C-Mip expression, which was not observed with control serum or our patient's serum sampled after chemotherapy. These observations suggest that C-Mip may play an important role in SCLC-related podocytopathy and that a circulating factor likely induces its expression in the kidney.
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Affiliation(s)
- Yassine Bouatou
- Division of Nephrology, Geneva University Hospitals, Geneva, Switzerland
| | - Thibaud Koessler
- Division of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Julie Oniszczuk
- INSERM, U955, Equipe 21, Créteil, France; Université Paris-Est Créteil Val-de-Marne, Créteil, France; AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, Service de Néphrologie, Créteil, France
| | - Shao-Yu Zhang
- INSERM, U955, Equipe 21, Créteil, France; Université Paris-Est Créteil Val-de-Marne, Créteil, France; AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, Service de Néphrologie, Créteil, France
| | - Solange Moll
- Division of Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Vincent Audard
- INSERM, U955, Equipe 21, Créteil, France; Université Paris-Est Créteil Val-de-Marne, Créteil, France; AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, Service de Néphrologie, Créteil, France
| | - Sophie de Seigneux
- Division of Nephrology, Geneva University Hospitals, Geneva, Switzerland.
| | - Djillali Sahali
- INSERM, U955, Equipe 21, Créteil, France; Université Paris-Est Créteil Val-de-Marne, Créteil, France; AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, Service de Néphrologie, Créteil, France.
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18
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Oniszczuk J, Nielsen L, Mangier M, Audard V, Sahali D. c-mip altère la régulation de CD20 et l’activation du lymphocyte B. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.235] [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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