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Nester C, Nast C, Appel G, Barratt J, Fervenza F, Fremeaux-Bacchi V, Remuzzi G, Rovin B, Wong E, Bourne E, Marinucci L, Grayson D, Patel R, Sheridan W. POS-045 Evaluating BCX9930, an Oral Factor D Inhibitor for Treatment of Complement-Mediated Kidney Disease: A Proof-of-Concept Study (RENEW). Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.04.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Boussier J, Yatim N, Marchal A, Hadjadj J, Charbit B, El Sissy C, Carlier N, Pène F, Mouthon L, Tharaux P, Lafaurie-Bergeron A, Smadja D, Rieux-Laucat F, Duffy D, Kerneis S, Fremeaux-Bacchi V, Terrier B. Activation de la voie alterne du complément dans les formes sévères de COVID-19. Rev Med Interne 2021. [PMCID: PMC8610727 DOI: 10.1016/j.revmed.2021.10.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction Le SARS-CoV-2 est désormais responsable de plus de 4 millions de décès dans le monde. Les formes sévères de COVID-19 sont caractérisées par un état d’hyperinflammation, et l’utilisation de la corticothérapie a réduit significativement la mortalité. Des thérapies complémentaires plus spécifiques pourraient permettre d’améliorer la prise en charge des patients présentant des formes sévères. Dans ce contexte, les voies de signalisation en lien avec le système du complément semblent etre une cible idéale : on retrouve une surreprésentation des voies du compléments dans les cellules épithéliales pulmonaires, une élévation des marqueurs d’activation de la cascade du complément dans le plasma des patients atteints de COVID-19, et des déficits congénitaux dans les protéines de régulation du complément ont été associées à des formes plus sévères de la maladie. Cependant, nos connaissances des voies spécifiques activées du complément et leur lien avec la sévérité de la maladie restent limitées. Patients et méthodes Durant la première vague épidémique en France, nous avons recueilli les prélèvements de 32 patients COVID-19 présentant des niveaux de sévérité différents de la maladie. Nous avons déterminé l’expression ARN de 28 gènes du système du complément et les concentrations sériques de 6 protéines, représentant les trois voies du complément. Résultats L’expression des gènes du complément étaient régulées de façon différentielle selon la gravité de la COVID-19 : alors que la voie classique était activée chez tous les patients infectés, la forme sévère de la maladie était associée à une suractivation de la voie de la lectine et de la voie alterne, dont l’expression corrélait avec les marqueurs de l’inflammation et de coagulation. De plus, la properdine, régulateur positif majeur de la voie alterne, était exprimé à des niveaux élevés (ARN) chez les patients les plus graves, tandis que leurs niveaux protéiques étaient diminués, suggérant une consommation importante et la déposition au niveau des sites de l’activation du complément. De façon intéressante, les concentrations sériques basses de properdine étaient significativement associées au recours à la ventilation mécanique. Conclusion Cette étude apporte un éclairage sur le rôle potentiel de la voie alterne du complément dans les formes graves de COVID-19. Bien que des études histologiques et mécanistiques ainsi qu’une confirmation de ces résultats sur une plus grande cohorte soient nécessaires, ces résultats sont en faveur d’essais ciblant la voie alterne du complément chez les patients présentant des formes sévères de COVID-19.
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Boud’hors C, Milon V, Coindre J, Torreggiani M, Croue A, Fremeaux-Bacchi V, Piccoli G, Wacrenier S. « Ce qui me gêne, ce n’est pas mon âge… ». Diagnostic de glomérulonéphrite à dépôt de C3 sur mutation hétérozygote du facteur H chez une femme de 96 ans. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Servais A, Karras A, Delmas Y, Pouteil Noble C, Choukroun G, Golbin L, Lemoine S, Provot F, Mathian A, Fremeaux-Bacchi V. Analyse du complément chez des patients ayant une microangiopathie thrombotique associée au lupus : identification de variants rares du facteur I. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Philipponnet C, Desenclos J, Brailova M, Aniort J, Kemeny JL, Deville C, Fremeaux-Bacchi V, Souweine B, Heng AE. Cobalamin c deficiency associated with antifactor h antibody-associated hemolytic uremic syndrome in a young adult. BMC Nephrol 2020; 21:96. [PMID: 32164588 PMCID: PMC7066776 DOI: 10.1186/s12882-020-01748-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/27/2020] [Indexed: 02/06/2023] Open
Abstract
Background Thrombotic microangiopathy (TMA) syndromes are characterized by the association of hemolytic anemia, thrombocytopenia and organ injury due to arteriolar and capillary thrombosis. Case presentation We report the first case of adult onset cobalamin C (Cbl C) disease associated with anti-factor H antibody-associated hemolytic uremic syndrome (HUS). A 19-year-old woman was admitted to the nephrology department owing to acute kidney failure, proteinuria, and hemolytic anemia with schizocytes. TMA was diagnosed and plasma exchanges were started in emergency. Exhaustive analyses showed 1) circulating anti factor H antibody and 2) hyperhomocysteinemia, hypomethioninemia and high levels of methylmalonic aciduria pointing towards Clb C disease. Cbl C disease has been confirmed by methylmalonic aciduria and homocystinuria type C protein gene sequencing revealing two heterozygous pathogenic variants. The kidney biopsy showed 1) intraglomerular and intravascular thrombi 2) noticeable thickening of the capillary wall with a duplication aspect of the glomerular basement membrane and a glomerular capillary wall IgM associated with Cbl C disease related TMA. We initiated treatment including hydroxycobalamin, folinic acid, betaine and levocarnitine and Eculizumab. Rituximab infusions were performed allowing a high decrease in anti-factor H antibody rate. Six month after the disease onset, Eculizumab was weaning and vitaminotherapy continued. Outcome was favorable with a dramatic improvement in kidney function. Conclusion TMA with renal involvement can have a complex combination of risk factors including anti-FH autoantibody in the presence of cblC deficiency.
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Affiliation(s)
- C Philipponnet
- Nephrology, Dialysis and Transplantation Department, CHU Clermont Ferrand, University Clermont Auvergne, Clermont Ferrand, France.
| | - J Desenclos
- Nephrology, Dialysis and Transplantation Department, CHU Clermont Ferrand, University Clermont Auvergne, Clermont Ferrand, France
| | - M Brailova
- Biochemistry Department, CHU Clermont Ferrand, University Clermont Auvergne, Clermont Ferrand, France
| | - J Aniort
- Nephrology, Dialysis and Transplantation Department, CHU Clermont Ferrand, University Clermont Auvergne, Clermont Ferrand, France
| | - J L Kemeny
- Anatomy and Pathology Department, CHU Clermont Ferrand, University Clermont Auvergne, Clermont Ferrand, France
| | - C Deville
- Nephrology, Dialysis and Transplantation Department, CHU Clermont Ferrand, University Clermont Auvergne, Clermont Ferrand, France
| | - V Fremeaux-Bacchi
- Assistance Publique-Hopitaux de Paris; Laboratory of Immunology, Georges Pompidou Hospital, Paris, France
| | - B Souweine
- Médecine intensive et réanimation, CHU Clermont Ferrand, University Clermont Auvergne, Clermont Ferrand, France
| | - A E Heng
- Nephrology, Dialysis and Transplantation Department, CHU Clermont Ferrand, University Clermont Auvergne, Clermont Ferrand, France
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Thoreau B, Bayer G, Barbet C, Cloarec S, Meriau E, Lachot S, Garot D, Bernard L, Gyan E, Perrotin F, Pouplard C, Maillot F, Gatault P, Sautenet B, Rusch E, Buchler M, Fremeaux-Bacchi V, Vigneau C, Fakhouri F, Halimi J. Microangiopathies thrombotiques (MAT) associées aux infections : particularités et pronostic. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fremeaux-Bacchi V, Vieira Martins P, Loirat C, Fakhouri F. Épidémiologie des variants rares des gènes du complément et leur impact sur la démarche diagnostique des syndromes hémolytiques et urémiques. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Boudhabhay I, El Karoui K, Fakhouri F, Petitprez F, Mesnard L, Viera-Martins P, Groupe D’étude Du Shu Atypique F, Halimi J, Fremeaux-Bacchi V. Urgence hypertensive et syndrome hémolytique et urémique : description phénotypique et génétique. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lebreton C, Fremeaux-Bacchi V, Dijoud F, Ranchin B, Bertholet-Thomas A, Cochat P, Bessenay L, Mestrallet G, Bacchetta J, Sellier-Leclerc A. Glomérulonéphrite membrano-proliférative à dépôts de C3 et éculizumab. Arch Pediatr 2016. [DOI: 10.1016/j.arcped.2016.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Audemard-Verger A, Descloux E, Ponard D, Deroux A, Fantin B, Fieschi C, John M, Bouldouyre A, Karkowsi L, Moulis G, Auvinet H, Valla F, Lechiche C, Davido B, Martinot M, Biron C, Lucht F, Asseray N, Froissart A, Buzelé R, Perlat A, Boutboul D, Fremeaux-Bacchi V, Isnard S, Bienvenu B. Infections Revealing Complement Deficiency in Adults: A French Nationwide Study Enrolling 41 Patients. Medicine (Baltimore) 2016; 95:e3548. [PMID: 27175654 PMCID: PMC4902496 DOI: 10.1097/md.0000000000003548] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Complement system is a part of innate immunity, its main function is to protect human from bacterial infection. As genetic disorders, complement deficiencies are often diagnosed in pediatric population. However, complement deficiencies can also be revealed in adults but have been poorly investigated. Herein, we describe a case series of infections revealing complement deficiency in adults to study clinical spectrum and management of complement deficiencies.A nationwide retrospective study was conducted in French university and general hospitals in departments of internal medicine, infectious diseases enrolling patients older than 15 years old who had presented at least one infection leading to a complement deficiency diagnosis.Forty-one patients included between 2002 and 2015 in 19 different departments were enrolled in this study. The male-to-female ratio was 1.3 and the mean age at diagnosis was 28 ± 14 (15-67) years. The main clinical feature was Neisseria meningitidis meningitis 75% (n = 31/41) often involving rare serotype: Y (n = 9) and W 135 (n = 7). The main complement deficiency observed was the common final pathway deficiency 83% (n = 34/41). Half of the cohort displayed severe sepsis or septic shock at diagnosis (n = 22/41) but no patient died. No patient had family history of complement deficiency. The mean follow-up was 1.15 ± 1.95 (0.1-10) years. Half of the patients had already suffered from at least one infection before diagnosis of complement deficiency: meningitis (n = 13), pneumonia (n = 4), fulminans purpura (n = 1), or recurrent otitis (n = 1). Near one-third (n = 10/39) had received prophylactic antibiotics (cotrimoxazole or penicillin) after diagnosis of complement deficiency. The vaccination coverage rate, at the end of the follow-up, for N meningitidis, Streptococcus pneumonia, and Haemophilius influenzae were, respectively, 90% (n = 33/37), 47% (n = 17/36), and 35% (n = 14/34).This large study emphasizes that complement deficiencies can be revealed in adults by infectious episodes. Most of them were meningococcal infections revealing common final pathway deficiency. To avoid undiagnosis or late diagnosis, adult displaying first episode of N meningitidis infection should be tested for complement deficiency.
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Affiliation(s)
- A Audemard-Verger
- From the CHU de Caen, Department of Internal Medicine, Caen (AA-V, BB), Department of Infectious Diseases, Nouvelle Calédonie University Hospital, Nouvelle Calédonie (ED, MJ), Laboratory of Immunology, Grenoble University Hospital, Grenoble (DP, AD), Department of Internal Medicine, Grenoble University Hospital, Grenoble, Department of Internal Medicine, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris (BF), Department of Clinical Immunology, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris (CF, DB), Department of Internal Medicine, Robert Ballanger General Hospital, Aulnay sous Bois (MAB), Department of Internal Medicine, Hôpital d'Instruction des Armées, Metz (LK), Department of Internal Medicine, Toulouse University Hospital, UMR 1027 INSERM University of Toulouse; CIC 1436, Toulouse (GM), Department of Internal Medicine, Brest University Hospital, Brest (HA), Department of Paediatric Intensive Care Unit, Lyon University Hospital, Lyon (FV), Department of Infectious Diseases, Nîmes University Hospital, Nîmes (CL), Department of Infectious Diseases, Raymond Poincaré University Hospital, Garches (BD), Department of Medicine, Colmar General Hospital, Colmar (MM), Department of Infectious Diseases, Nantes University Hospital, Nantes (CB, NA), Department of Infectious Diseases, Saint Etienne University Hospital, Saint Etienne (FL), Department of Internal Medicine, Créteil Hospital, Créteil (AF), Department of Infectious Diseases, Tours University Hospital, Tour (RB), Department of Internal Medicine, Rennes University Hospital, Rennes (AP), Laboratory of Immunology, Team Dentritic Cells Physiology, Cochin Institute (SI); and Laboratory of Immunology, Européen Georges Pompidou University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris (VF-B), France
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Audemard A, Descloux E, Deroux A, Fantin B, Fieschi C, Bouldouyre M, Karkowski L, Moulis G, Froissart A, Fremeaux-Bacchi V, Ponard D, Bienvenu B. Déficits en complément révélés à l’âge adulte par un épisode infectieux. Résultats des 41 patients inclus dans l’étude DECORAPI. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.326] [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: 10/23/2022]
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Blanc C, Chauvet S, Le Quintrec M, Togarsimalemath S, Roumenina L, Lapeyraque A, Moal V, Moulin B, Fremeaux-Bacchi V, Büchler M, Dragon-Durey M. Auto-anticorps anti-facteur H dans les glomérulopathies à C3. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.170] [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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May O, Merle N, Paule R, Noel C, Roumenina L, Fremeaux-Bacchi V, Frimat M. Analyse des propriétés de protection contre l’activation du complément et de l’expression d’un phénotype prothrombotique de l’endothélium glomérulaire rénal. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fremeaux-Bacchi V, Johnson S, Ariceta G, Ardissino G, Ogawa M, Greenbaum L. Vers l’amélioration de la compréhension du syndrome hémolytique urémique atypique avec le registre international : caractéristiques des patients inclus. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.214] [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: 11/30/2022]
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Davids MR, Marais N, Jacobs J, Cohen E, Krause I, Goldberg E, Garty M, Krause I, Dursun B, Sahan Y, Tanriverdi H, Rota S, Uslu S, Senol H, Minutolo R, Gabbai FB, Agarwal R, Chiodini P, Borrelli S, Stanzione G, Nappi F, Bellizzi V, Conte G, De Nicola L, Van De Walle J, Johnson S, Fremeaux-Bacchi V, Ardissino G, Ariceta G, Beauchamp J, Cohen D, Greenbaum LA, Ogawa M, Schaefer F, Licht C, Scalzotto E, Nalesso F, Zaglia T, Corradi V, Neri M, Martino F, Zanella M, Brendolan A, Mongillo M, Ronco C, Chinnappa S, Mooney A, El Nahas AM, Tu YK, Tan LB, Jung JY, Kim AJ, Ro H, Lee C, Chang JH, Lee HH, Chung W, Clarke AL, Young HM, Hull KL, Hudson N, Burton JO, Smith AC, Marx S, Petrilla A, Filipovic I, Lee WC, Meijers B, Poesen R, Storr M, Claes K, Kuypers D, Evenepoel P, Aukland M, Clarke AL, Hull KL, Burton JO, Smith AC, Betriu A, Martinez-Alonso M, Arcidiacono MV, Cannata-Andia J, Pascual J, Valdivielso JM, Fernandez-Giraldez E, Kingswood JC, Zonnenberg B, Sauter M, Zakar G, Biro B, Besenczi B, Varga A, Pekacs P, Pizzini P, Pisano A, Leonardis D, Panuccio V, Cutrupi S, Tripepi G, Mallamaci F, Zoccali C, Arnold J, Baharani J, Rayner H, So BH, Blackwell S, Jardine AG, Macgregor MS, Cunha C, Barreto P, Pereira S, Ventura A, Mota M, Seabra J, Sakaguchi T, Kobayashi S, Yano T, Yoshimoto W, Bancu I, Bonal Bastons J, Cleries Escayola M, Vela Vallespin E, Bustins Poblet M, Magem Luque D, Pastor Fabregas M, Chen JH, Chen SC, Chang JM, Hwang SJ, Chen HC, Ahbap E, Kara E, Basturk T, Sahutoglu T, Koc Y, Sakaci T, Sevinc M, Akgol C, Ozagari AA, Unsal A, Minami S, Hesaka A, Yamaguchi S, Iwahashi E, Sakai S, Fujimoto T, Sasaki K, Fujita Y, Yokoyama K, Marks A, Fluck N, Prescott G, Robertson L, Smith WC, Black C, Ohsawa M, Fujioka T, Omori S, Isurugi T, Tanno K, Onoda T, Omama S, Ishibashi Y, Makita S, Okayama A, Garland JS, Simpson CS, Metangi MF, Parfrey B, Johri AM, Sloan L, McAuley J, Cunningham R, Mullan R, Quinn M, Harron C, Chiu H, Murphy-Burke D, Werb R, Jung B, Chan-Yan C, Duncan J, Forzley B, Lowry R, Hargrove G, Carson R, Levin A, Karim M, Reznik EV, Storozhakov GIV, Rollino C, Troiano M, Bagatella M, Liuzzo C, Quarello F, Roccatello D, Blaslov K, Bulum T, Prka In I, Duvnjak L, Heleniak Z, Ciepli ska M, Szychli ski T, Pryczkowska M, Bartosi ska E, Wiatr H, Kot owska H, Tylicki L, Rutkowski B, Song YR, Kim SGK, Kim HJ, Noh JW, Tong A, Jesudason S, Craig JC, Winkelmayer WC, Hung PH, Huang YT, Hsiao CY, Sung PS, Guo HR, Tsai KJ, Wu CC, Su SL, Kao SY, Lu KC, Lin YF, Lin WH, Lee HM, Cheng MF, Wang WM, Yang LY, Wang MC, Vukovic Lela I, Sekoranja M, Poljicanin T, Karanovic S, Abramovic M, Matijevic V, Stipancic Z, Leko N, Cvitkovic A, Dika Z, Kos J, Laganovic M, Grollman AP, Jelakovic B, Dryl-Rydzynska T, Prystacki T, Malyszko J, Trifiro G, Sultana J, Giorgianni F, Ingrasciotta Y, Muscianisi M, Tari DU, Perrotta M, Buemi M, Canale V, Arcoraci V, Santoro D, Rizzo M, Iheanacho I, Van Nooten FE, Goldsmith D, Grandtnerova B, Berat ova Z, ErvenOva M, cErven J, Markech M, tefanikova A, Engelen W, Elseviers M, Gheuens E, Colson C, Muyshondt I, Daelemans R. CKD GENERAL AND CLINICAL EPIDEMIOLOGY 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Roumenina L, Strain L, Deury D, Merle N, Halbwachs-Mecarelli L, Goodship T, Fremeaux-Bacchi V. A prevalent CFHR1/FH reverse hybrid gene in aHUS patients induces deregulation of the alternative pathway. Mol Immunol 2013. [DOI: 10.1016/j.molimm.2013.05.030] [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: 10/26/2022]
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Bettoni S, Donadelli R, Ngo S, Fremeaux-Bacchi V, Noris M. Assembly and stability of C3 proconvertase and C3 convertase: Effect of CFH and C3NeF. Mol Immunol 2013. [DOI: 10.1016/j.molimm.2013.05.014] [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: 10/26/2022]
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Bekassy ZD, Kristoffersson AC, Cronqvist M, Roumenina LT, Rybkine T, Vergoz L, Hue C, Fremeaux-Bacchi V, Karpman D. Eculizumab in an anephric patient with atypical haemolytic uraemic syndrome and advanced vascular lesions. Nephrol Dial Transplant 2013; 28:2899-907. [DOI: 10.1093/ndt/gft340] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Loirat C, Mariani-Kurkdjian P, Fremeaux-Bacchi V. [Hemolytic uremic syndrome as of 2013]. Arch Pediatr 2013; 20:827-30. [PMID: 23835098 DOI: 10.1016/j.arcped.2013.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 05/10/2013] [Indexed: 11/17/2022]
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Fremeaux-Bacchi V. Le complément et le syndrome hémolytique et urémique atypique. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.04.097] [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: 10/26/2022]
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Lequintrec M, Servais A, Ngo S, Dragon-Durey M, Roumenina L, Fremeaux-Bacchi V. Factor H and MCP haplotypes don’t confer susceptibility for C3 glomerulopathy. Mol Immunol 2011. [DOI: 10.1016/j.molimm.2011.06.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fremeaux-Bacchi V, Strain L, Beury D, Ngo S, Roumenina L, Dragon-Durey M, Marchbank K, Holmes L, Goodship T. High prevalence of hybrid genes involving CFH and CFHR1 in atypical Hemolytic Uremic Syndrome. Mol Immunol 2011. [DOI: 10.1016/j.molimm.2011.06.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Malina M, Kirschfink M, Boppel T, Fremeaux-Bacchi V, Schaefer F. Komplement-Blockade durch Eculizumab: neue Therapieoption auch bei Shigatoxin-assoziiertem hämolytisch-urämischem Syndrom. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Frimat M, Camous L, Roumenina L, Bigot S, Lesavre P, Fremeaux-Bacchi V, Halbwachs-Mecarelli L. Complement activation by cytokine-activated neutrophils in the context of Anti-Neutrophil-Cytoplasm Autoantibodies vasculitis. Mol Immunol 2009. [DOI: 10.1016/j.molimm.2009.05.213] [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: 11/30/2022]
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Fremeaux-Bacchi V, Fakhouri F, Garnier A, Bienaime F, Sellier-Leclerc A, Dragon-Durey M, Noel C, Loirat C. Influence of genotype on clinical characteristics of atypical hemolytic uremic syndrome (aHUS) with pediatric and adult onset. Mol Immunol 2009. [DOI: 10.1016/j.molimm.2009.05.243] [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: 11/27/2022]
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Fremeaux-Bacchi V, Goodship T, Regnier C, Dragon-Durey M, Janssen B, Atkinson J. Mutations in complement C3 predispose to development of atypical haemolytic uraemic syndrome. Mol Immunol 2007. [DOI: 10.1016/j.molimm.2007.06.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Leveziel N, Barbu V, Richard F, Coscas G, Soubrane G, Fremeaux-Bacchi V, Benlian P, Souied E. 041 Polymorphismes rs10490924 et rs4146894 des gènes HTRA1 et PLEKHA1 : facteurs de risque de Dégénérescence Maculaire Liée à lÂge exsudative dans la population française. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)79853-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zerbib J, Leveziel N, Fremeaux-Bacchi V, Feldman A, Coscas G, Soubrane G, Souied E. 254 Analyse clinique des patients double homozygotes pour les allèles à risque des gènes HTRA1, PLEKHA1 et CFH dans la dégénérescence maculaire liée à l’âge exsudative. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80066-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rameix-Welti MA, Chedani H, Blouin J, Alonso JM, Fridman WH, Fremeaux-Bacchi V. [Neisseria meningitidis infection. Clinical criteria orienting towards a deficiency in the proteins of the complement]. Presse Med 2005; 34:425-30. [PMID: 15902872 DOI: 10.1016/s0755-4982(05)83936-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Complement protein deficiency of the classical pathway or in proteins of the alternate pathway is rare but considerably increase the risk of infection with Neisseria meningitidis. The aim of this study was to determine the clinical criteria of the group at risk. METHODS Retrospective study of the clinical and biological data of patients exhibiting complement protein deficiency associated with one or several N. meningitidis infections. RESULTS Forty cases were studied, including 35 classical pathway protein deficiencies, with a predominance of C7 deficiency, 3 properdin deficiencies and 2 acquired C3 deficiencies. More than 60% of the patients exhibited recurrent N. meningitidis infections. Serogroups of rare strains were isolated in 50% of cases. Properdin deficiency was associated with a fulminating form in 2 cases out of 3. The age at onset of the first manifestations varied from 2 months to 32 years. CONCLUSION A deficiency must be systematically searched for in all patients presenting with a N. meningitidis infection before the age of 6 months or after the age of 5 years. Identification of deficient patients permits the proposal of family screening and appropriate prophylaxis, including preventive vaccination.
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Affiliation(s)
- M A Rameix-Welti
- Service d'immunologie biologique, Hôpital européen Georges Pompidou, Paris
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Fremeaux-Bacchi V, Kemp EJ, Goodship JA, Dragon-Durey MA, Strain L, Loirat C, Deng HW, Goodship THJ. The development of atypical haemolytic-uraemic syndrome is influenced by susceptibility factors in factor H and membrane cofactor protein: evidence from two independent cohorts. J Med Genet 2005; 42:852-6. [PMID: 15784724 PMCID: PMC1735946 DOI: 10.1136/jmg.2005.030783] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND In both familial and sporadic atypical haemolytic-uraemic syndrome (aHUS), mutations have been reported in regulators of the alternative complement pathway including factor H (CFH), membrane cofactor protein (MCP), and the serine protease factor I (IF). A characteristic feature of both MCP and CFH associated HUS is reduced penetrance and variable inheritance; one possible explanation for this is that functional changes in complement proteins act as modifiers. OBJECTIVE To examine single nucleotide polymorphisms in both CFH and MCP genes in two large cohorts of HUS patients (Newcastle and Paris). RESULTS In both cohorts there was an association with HUS for both CFH and MCP alleles. CFH and MCP haplotypes were also significantly different in HUS patients compared with controls. CONCLUSIONS This study suggests that there are naturally occurring susceptibility factors in CFH and MCP for the development of atypical HUS.
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Affiliation(s)
- V Fremeaux-Bacchi
- Service d'Immunologie Biologique, Hôpital Européen Georges Pompidou, Paris, France
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Fremeaux-Bacchi V, Dragon-Durey MA, Blouin J, Vigneau C, Kuypers D, Boudailliez B, Loirat C, Rondeau E, Fridman WH. Complement factor I: a susceptibility gene for atypical haemolytic uraemic syndrome. J Med Genet 2004; 41:e84. [PMID: 15173250 PMCID: PMC1735822 DOI: 10.1136/jmg.2004.019083] [Citation(s) in RCA: 248] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- V Fremeaux-Bacchi
- Service d'Immunologie Biologique, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.
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Abstract
Complement C6 homozygous deficiency (C6D) has been rarely observed in Caucasians but was reported at higher prevalence among African-Americans. We report on the molecular basis of C6D in seven unrelated black individuals of North or Central Africa descent who live in France. These patients have presented Neisseria meningitidis infection (four cases), focal and segmental glomerulosclerosis with hyalinosis (one case), systemic lupus erythematosus (one case) or Still's disease (one case). All patients exhibited undetectable antigenic C6 by using a sensitive ELISA assay. An additional four cases of complete C6 deficiency with no associated disease have been characterized after family studies. Exons 6, 7 and 12 have been described recently as the location of molecular defects on the C6 gene in randomly chosen black Americans. Genomic DNA from the seven patients were subjected to direct polymerase chain reaction amplification of these three exons. Nucleotide sequencing analysis of the amplified DNA fragments revealed a homozygous single-base deletion (1936delG) in exon 12 in three cases and four compound heterozygous deletions for a single base in exon 7 (1195delC) or in exon 6 (878delA) associated with the same deletion in exon 12 (1936delG). Our observations further establish the restricted pattern of genetic defects associated with homozygous C6 complement deficiency in individuals of African descent.
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Affiliation(s)
- M A Dragon-Durey
- Département d'Immunologie, Hôpital Européen Georges Pompidou, INSERM U430, France
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Rougier N, Kazatchkine MD, Rougier JP, Fremeaux-Bacchi V, Blouin J, Deschenes G, Soto B, Baudouin V, Pautard B, Proesmans W, Weiss E, Weiss L. Human complement factor H deficiency associated with hemolytic uremic syndrome. J Am Soc Nephrol 1998; 9:2318-26. [PMID: 9848786 DOI: 10.1681/asn.v9122318] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This study reports on six cases of deficiency in the human complement regulatory protein Factor H (FH) in the context of an acute renal disease. Five of the cases were observed in children presenting with idiopathic hemolytic uremic syndrome (HUS). Two of the children exhibited a homozygous deficiency characterized by the absence of the 150-kD form of Factor H and the presence, upon immunoblotting, of the 42-kD Factor H-like protein 1 (FHL-1) and other FH-related protein (FHR) bands. Southern blot and PCR analysis of DNA of one patient with homozygous deficiency ruled out the presence of a large deletion of the FH gene as the underlying defect for the deficiency. The other four children presented with heterozygous deficiency and exhibited a normal immunoblotting pattern of proteins of the FH family. Factor H deficiency is the only complement deficiency associated with HUS. These observations suggest a role for FH and/or FH receptors in the pathogenesis of idiopathic HUS.
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Affiliation(s)
- N Rougier
- Service d'Immunologie, Hôpital Broussais, Paris, France
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Hartmann D, Fremeaux-Bacchi V, Weiss L, Meyer A, Blouin J, Hauptmann G, Kazatchkine M, Uring-Lambert B. Combined heterozygous deficiency of the classical complement pathway proteins C2 and C4. J Clin Immunol 1997; 17:176-84. [PMID: 9083894 DOI: 10.1023/a:1027334716982] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Genetic deficiencies of components of the classical pathway of complement activation are associated with an increased risk for the development of autoimmune and immune complex-mediated diseases. In the present study we report on the molecular and clinical features associated with combined heterozygous C4 and C2 deficiency in 15 individuals investigated within six families. Approximately 30% of the individuals manifested SLE or another autoimmune condition. Heterozygous C2 deficiency was related to a 28-bp deletion in the C2 gene (C2 deficiency type I), in most cases within the HLA-A25 B18 C2Q0 BfS C4A4B2 DR2 haplotype. Among 13 partial C4-deficient haplotypes transmitted, 8 carried C4A*Q0 alleles and 5 C4B*Q0 alleles. In seven cases the C4A*Q0 alleles were associated with a deletion of the C4A/CYP21P genes within the HLA-B8 C2C BfS C4AQ0B1 DR3 haplotype. In three cases, the C4B*Q0 allele was associated with a deletion of the C4B/CYP21P genes within the HLA-B18 C2C BfF1 C4A3BQ0 DR3 haplotype. In the other cases, C4A*Q0 or C4B*Q0 was dependent on as yet uncharacterized defects in the C4 gene or in C4 gene expression. In view of the relatively high frequency of heterozygous C4 deficiency in the normal Caucasian population, the expected frequency of the combined deficiency should approximate 0.001.
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Affiliation(s)
- D Hartmann
- Laboratoire de Recherches en Immunologie, Université Louis Pasteur, Strasbourg, France
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Bentolila S, Fremeaux-Bacchi V, Weiss L, Blouin J, Kazatchkine MD, Piette JC. High frequency of C4 "null" alleles in primary antiphospholipid syndrome. Ann Med Interne (Paris) 1996; 147:115-116. [PMID: 8760690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Fremeaux-Bacchi V, Uring-Lambert B, Weiss L, Brun P, Blouin J, Hartmann D, Loirat C, Hauptmann G, Kazatchkine MD. Complete inherited deficiency of the fourth complement component in a child with systemic lupus erythematosus and his disease-free brother in a north African family. J Clin Immunol 1994; 14:273-9. [PMID: 7814456 DOI: 10.1007/bf01540980] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Although null alleles of complement C4 genes (C4A*Q0 and C4B*Q0) are frequent in the normal population, the occurrence of two null alleles on the same chromosome is very rare and therefore complete C4 deficiency is exceptional. We describe a 16-year-old North African boy who presented with systemic lupus erythematosus with renal involvement and persistent undetectable classical pathway activity and C4 protein and hemolytic activity in plasma, with normal C3 levels. Similar complement abnormalities were observed in his healthy 12-year-old brother. Complete C4 deficiency was documented in the two brothers by investigation of the family and the lack of C4A and C4B bands upon phenotyping of C4. Southern blot analysis of the C4/CYP21 gene organization in the family indicated that the deficiency resulted from a deletion of the C4B/CYP21A genes associated with nonexpression of a C4A gene. The double-null haplotype was found to be associated with homozygous A2 B17 C2C BFF C4 AQ0 BQ0 DR7 HLA haplotype. Thus, similar C4 deficiencies with HLA identity may lead to different clinical presentations.
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Affiliation(s)
- V Fremeaux-Bacchi
- Service d'Immunologie, INSERM U 28, Hôpital Broussais, Paris, France
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