81 results on '"Y. Lebranchu"'
Search Results
2. [IL-2/IL-2R pathway in dendritic cell modulates both their cytokine synthesis profiles and their capacity to activate allogeneic CD4+ T lymphocytes]
- Author
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K, Mnasria, C, Lagaraine, J, Manaa, Y, Lebranchu, and R, Oueslati
- Subjects
CD4-Positive T-Lymphocytes ,Lipopolysaccharides ,Interleukin-2 Receptor alpha Subunit ,Antibodies, Monoclonal ,Granulocyte-Macrophage Colony-Stimulating Factor ,Enzyme-Linked Immunosorbent Assay ,Dendritic Cells ,Flow Cytometry ,Lymphocyte Activation ,Endocytosis ,Monocytes ,Immunophenotyping ,Interleukin-10 ,Autocrine Communication ,Interferon-gamma ,Humans ,Interleukin-2 ,Cells, Cultured ,Signal Transduction - Abstract
The results provide new insights into the role of IL-2/IL-2R pathway in DC. We report that stimulation of human monocyte-derived DC with LPS strongly upregulated CD25 (α chain of the IL-2R) expression. In addition, by using a humanized monoclonal antibody against CD25, we demonstrated that the IL-2 signalling in DC upregulated both IL-12 and γIFN production but decreased IL-10 synthesis. Anti-CD25 treatment reduced the ability of LPS-DC to induce allogeneic CD4(+) T cell proliferation as compared to LPS-matured DC. In addition, LPS-matured DC treated with IL-2 had a higher allostimulatory capacity compared to LPS-DC. We also found that LPS-matured DC produced IL-2. Thus, IL-2 seems to contribute actively to DC activation through an autocrine pathway. Moreover, IL-2 pathway in DC is involved in T helper priming. These findings might be useful for protocols in cellular therapy and a valuable tool to understand graft rejection versus the acquisition of peripheral tolerance.
- Published
- 2008
3. [Difficulties in the management of localised pulmonary Goodpasture's syndrome]
- Author
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J, Buret, M, Marcq, Y, Lebranchu, A, Legras, C, Barbet, G, Mouteaux, and P, Diot
- Subjects
Adult ,Lung Diseases ,Male ,Adrenal Cortex Hormones ,Anti-Glomerular Basement Membrane Disease ,Humans ,Hemorrhage ,Smoking Cessation ,Plasmapheresis - Abstract
The diagnosis of the pulmonary forms of Goodpasture's syndrome is not easy and requires a renal biopsy when no anti-glomerular basement membrane antibodies are detected, since the disease can lead to spontaneous massive intra-alveolar haemorrhage that can be fatal. Treatment for the pulmonary-renal form combining corticosteroids, cyclophosphamide and plasmapheresis should be applied to the pulmonary form to control haemorrhage and prevent relapse.We report the case of a patient suffering from the localised pulmonary form of Goodpasture's syndrome in whom the diagnosis was delayed due to a negative indirect immunofluorescent antibody bioassay. After a serious early relapse remission was achieved with comprehensive treatment and a tobacco withdrawal programme.If there is no delay in diagnosis and comprehensive treatment is given, the prognosis for these patients is good with a recovery rate of 80 to 90%.
- Published
- 2008
4. [Cyclosporin-induced toxic neuromyopathy]
- Author
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A-M, Guennoc, P, Corcia, A, Al-Najjar, A-M, Bergemer-Fouquet, Y, Lebranchu, B, de Toffol, and A, Autret
- Subjects
Graft Rejection ,Nerve Fibers ,Electromyography ,Cyclosporine ,Neural Conduction ,Humans ,Coenzyme A ,Female ,Neuromuscular Diseases ,Middle Aged ,Kidney Transplantation ,Immunosuppressive Agents - Abstract
Cyclosporine is an immunosuppressive treatment whose side effects limit its usefulness. Among neurological side effects, neuropathies or myopathies have been reported, specially inpatients given combinations of cyclosporine with co-enzyme A reductase inhibitors.We report here the case of a 67-year-old woman who developed few months after a kidney graft sensorimotor disorders which progressed rapidly. Since all etiologies of such a disorder were ruled out, the hypothesis of toxicity exclusively induced by cyclosporine was suggested and confirmed by the improvement observed after its withdrawal.This observation highlights the fact that cyclosporine may induce neuromyopathies even when given alone at the therapeutic dosage.
- Published
- 2005
5. [Transplantation and transfer of allergy: a theorical risk to be considered?]
- Author
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C, Hoarau and Y, Lebranchu
- Subjects
Risk Factors ,Hypersensitivity ,Humans ,Organ Transplantation ,Immunoglobulin E - Published
- 2004
6. [ipids and dysfunctional endothelium]
- Author
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Y, Lebranchu
- Subjects
Inflammation ,Vasomotor System ,Oxidative Stress ,Arteriosclerosis ,Humans ,Hyperlipidemias ,Endothelium, Vascular ,Blood Coagulation Disorders ,Lipids ,Muscle, Smooth, Vascular - Published
- 2001
7. [Regulation and dysfunction of endothelium-dependent vasomotricity. What can be applied to clinical practice?]
- Author
-
J M, Halimi and Y, Lebranchu
- Subjects
Vasodilation ,Vasomotor System ,Free Radicals ,Arteriosclerosis ,Vasoconstriction ,Endothelins ,Humans ,Endothelium ,Nitric Oxide - Abstract
FUNCTIONS OF THE ENDOTHELIUM: The endothelium plays a pivotal role in regulating vasomotor tone, vessel permeability, blood cell extravasation, and antiatherogenic, antithrombogenic and antiadhesive processes.Demonstrated, in particular, by endothelium-dependent vasomotricity disorders, endothelium dysfunction occurs in many psysiological and pathological situations that lead to atherosclerosis: advanced age, menopause, high blood pressure, dyslipidemia, diabetes, smoking, elevated homocysteinemia, chronic renal failure.... These dysfunctions of the endothelium constitute the fundamental and very early step in the development of atherosclerosis.Specific treatment of functional anomalies of the endothelium can be an essential element in the prevention of atherosclerosis. In certain cases, he cause of endothelial dysfunction may be related to the presence of radical oxygen species, nitric oxide inhibitors, or increased synthesis or release of endothelin. Potential treatments should be adapted to the specific cause of the underlying endothelial anomaly: antioxidants, statins, anti-endothelins, or converting enzyme inhibitors. In clinical practice, it may be important to recognize the cause of endothelial dysfunction for adapted early drug therapy.
- Published
- 2001
8. [Can man live with a pig kidney?]
- Author
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J F, Valentin, Y, Lebranchu, and H, Nivet
- Subjects
Graft Rejection ,Swine ,Transplantation, Heterologous ,Animals ,Humans ,Kidney ,Kidney Transplantation - Abstract
The transplantation of organs from one species to another introduces a question of compatibility not seen in allotransplantation, the ability of a kidney to perform its physiological function in the new host environment. It has been assumed that an allotransplanted organ will function normally if is not rejected; ample experience supports this assumption. This luxury will not exist in the field of xenotransplantation, where the issues of comparative physiology will assume great importance. From many standpoints, the pig kidney seems an ideal donor for xenotransplantation. They are of similar size and have remarkably similar internal anatomy. Even if the immunological problems could be overcome, there is almost no direct experimental evidence to answer the question of whether or not a pig kidney can function in a human body.
- Published
- 1999
9. [Transplant renal artery stenosis: long term effect of angioplasty on arterial pressure control and renal function]
- Author
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A, al-Najjar, J M, Halimi, M, Buchler, B, Birmelé, F, Tranquart, D, Alison, and Y, Lebranchu
- Subjects
Male ,Angioplasty ,Humans ,Blood Pressure ,Female ,Middle Aged ,Kidney Function Tests ,Renal Artery Obstruction ,Kidney Transplantation ,Follow-Up Studies - Abstract
We assessed the long-term (M +/- SE: 68 +/- 3 months) arterial pressure and renal function of cadaveric kidney transplant recipients with and without significant (70% diameter reduction) transplant renal artery stenosis (TRAS) at angiography. Baseline clinical, immunological and outcome data for 26 patients with TRAS (incidence of TRAS: 6.6%) before and following angioplasty and 72 patients without stenosis at angiography were reviewed and analyzed. The 2 groups were similar with respect to recipient sex ratio and age (45 vs 46), duration of transplantation (7 months), cause of renal failure, donor sex and age, HLA-antigen mismatches and titers of anti-HLA antibodies, CMV infection and anti-CMV antibodies in donors and recipients. The technical success of angioplasty was 92.3%. Restenosis was documented in 6/26 patients (23.1%). Revascularization resulted in a decrease of arterial pressure and number of antihypertensive medications and a lower serum creatinine compared to baseline values. The long-term arterial pressure and serum creatinine levels were similar in patients with and without stenosis. In conclusion, TRAS after revascularization had no detectable influence on the long-term arterial pressure control and renal function within a follow-up period of 68 +/- 3 months.
- Published
- 1998
10. [Role of the endothelium in leukocyte trafficking]
- Author
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H, Watier and Y, Lebranchu
- Subjects
Cell Adhesion ,Leukocytes ,Humans ,Endothelium, Vascular ,Cell Adhesion Molecules - Abstract
Vascular endothelium controls leukocyte recirculation and recruitment, receiving messages from underlying tissues and transforming them into informations quickly read by the passaging leukocytes. These messages induce adhesive interactions between leukocytes and endothelium via adhesion molecules. Multiple receptor-ligand pairs function in 4 steps: initial tethering and rolling of leukocytes; leukocyte triggering by chemotactic factors; arrest and strong adhesion to endothelium; and ultimately transendothelial migration (diapedesis).
- Published
- 1998
11. [Economic contribution of mofetil mycofenolate as preventive immunosuppressive treatment after renal transplantation from cadaver]
- Author
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C, Louis-Touizer, M J, Nuijten, F, Bayle, D, Cantarovich, P, Lang, Y, Lebranchu, P, Le Pogamp, J L, Touraine, P, Vialtel, T, Monroe, and M J, de Vries
- Subjects
Adult ,Graft Rejection ,Time Factors ,Mycophenolic Acid ,Kidney Transplantation ,Hospitalization ,Placebos ,Postoperative Complications ,Azathioprine ,Ambulatory Care ,Cadaver ,Costs and Cost Analysis ,Humans ,Immunosuppressive Agents - Abstract
The economic impact resulting from the clinical consequences of immunosuppressive strategy using mycophenolate mofetil in new renal transplant recipients was conducted considering the viewpoint of the health insurance system.The analysis was based on the results of three controlled randomized double-blind clinical trials comparing mycophenolate mofetil with placebo or azathioprine in 1003 out of 1493 included patients respectively. Health care costs associated with each event were determined by 7 French experts in renal transplantation working in six different hospitals. Direct cumulative costs for each strategy were compared.The studies demonstrated a difference in the incidence of acute rejection and treatment failures whatever the cause. The three trials showed that, compared with current strategies, use of mycophynolate mofetil in the immunosuppression protocol generated a 19 to 38% cost reduction during the 6 months after transplantation. Cost reduction resulted from lower incidence of acute rejection and the subsequent nephrectomics and dialysis sessions. The sensitivity analysis on the most important cost factors-cost of hospitalization per day and number of hospitalization days-confirmed strength of the results.Use of mycophenolate mofetil in the immunosuppressive prophylaxis protocol after renal transplantation allows a reduction in the direct costs during the 6 months following transplantation.
- Published
- 1996
12. [Extensive fibrous endocarditis as first manifestation of systemic lupus erythematosus]
- Author
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I, Durand, G, Blaysat, S, Chauvaud, P, Tron, F, Tron, E, Mallet, Y, Lebranchu, and J, Kachaner
- Subjects
Male ,Adolescent ,Endocarditis ,Child, Preschool ,Humans ,Lupus Erythematosus, Systemic ,Female ,Fibrosis ,Endocardium - Abstract
Cardiac abnormalities, such as myocarditis, pericarditis or verrucous endocarditis (Libman-Sacks endocarditis) occur in about one third of patients with systemic lupus erythematosus. This study describes an unusual aspect of endocardial involvement.Case no. 1: A 14 year-old girl was admitted 3 months after acute hemichorea because of heart failure plus biological inflammatory findings. Echocardiography showed mitral insufficiency with enlargement of the left atrium and ventricle. There was some infiltration involving the endocardium of the left ventricle, the chordae tendinae and the mitral valve. The titres of anti-DNA and anti-nuclear antibodies were elevated while the serum hemolytic complement was depressed. Skin biopsy showed IgG, IgM and C1q deposits along the dermoepidermal junction. Corticosteroids, diuretics and vasodilator drugs failed to completely cure the heart failure; the mitral insufficiency required mitral valve replacement 21 months later. Pathological examination showed extended fibrotic changes of the endocardium. Case no. 2: A 4 year-old boy was admitted for acute heart failure due to mitral insufficiency, associated with biological inflammatory findings. Echocardiography showed mitral insufficiency and enlarged left atrium and ventricle. Anti-DNA and anti-nuclear antibody titres were elevated. The patient was given antibiotics followed by corticosteroids and immunosuppressive drugs. The persistence of the mitral insufficiency required mitral valve replacement 7 months later. Pathological examination showed fibrotic changes of the endocardium. Exacerbation of the inflammatory process was seen 2 months after surgery, with development of diffuse proliferative lupus nephritis. The patient died of kidney failure and neurological complications, 44 months after cardiac surgery.In both patients, the systemic lupus erythematosus was revealed by endocardial involvement, a complication that is usually seen later. The endocardium changes responsible for mitral insufficiency and requiring valve replacement in these two cases were different from those described as verrucous endocarditis in classical forms of the disease.
- Published
- 1993
13. [Kawasaki disease]
- Author
-
Y, Lebranchu
- Subjects
Immunity ,Cytokines ,Humans ,Immunoglobulins, Intravenous ,Mucocutaneous Lymph Node Syndrome ,Lymphocyte Activation - Published
- 1993
14. [Adhesion of lymphocytes to allogenic endothelium. Four different pathways]
- Author
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P, Galéa and Y, Lebranchu
- Subjects
Umbilical Veins ,Tumor Necrosis Factor-alpha ,Antibodies, Monoclonal ,Vascular Cell Adhesion Molecule-1 ,In Vitro Techniques ,Intercellular Adhesion Molecule-1 ,Lymphocyte Function-Associated Antigen-1 ,Depression, Chemical ,Cell Adhesion ,Humans ,Endothelium, Vascular ,Interleukin-4 ,Lymphocytes ,Cell Adhesion Molecules - Abstract
Lymphocyte adhesion to allogeneic endothelium is a critical step in graft rejection. To further characterize the expression and the regulation of adhesion molecules involved in this process, we stimulated endothelial cells with Interleukin 4 or tumor necrosis factor alpha (TNF alpha) and blocked lymphocyte adhesion to stimulated-endothelial cells with monoclonal antibodies. We demonstrated that lymphocytes bound endothelial cells by at least four adhesion pathways: a) a LFA 1/ICAM 1 dependent pathway on TNF alpha-stimulated endothelial cells, b) a LFA 1 dependent/ICAM 1 independent pathway on unstimulated or IL 4-stimulated endothelial cells, c) a VLA 4/VCAM 1 dependent pathway on unstimulated and stimulated-endothelial cells, d) a CD 2 dependent/LFA 3 independent pathway on IL 4 and TNF alpha-stimulated endothelial cells.
- Published
- 1992
15. [Interleukin 4 increases lymphocytic adhesion to allogenic endothelium through a dependent protein kinase A]
- Author
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P, Galéa and Y, Lebranchu
- Subjects
Umbilical Veins ,Tumor Necrosis Factor-alpha ,Cell Adhesion ,Humans ,Endothelium, Vascular ,Interleukin-4 ,Lymphocytes ,In Vitro Techniques ,Cell Adhesion Molecules ,Protein Kinases ,Stimulation, Chemical - Abstract
Interleukin 4 and tumor necrosis factor alpha increase endothelial cell adhesiveness for lymphocytes by promoting adhesion molecules synthesis. We have shown that intracellular mechanisms, which transduce IL 4--but not TNF alpha--signal, involve a protein kinase A.
- Published
- 1992
16. [The contribution of color-coded Doppler in early vascular complications of kidney transplantation]
- Author
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F, Tranquart, D, Pourcelot, Y, Lebranchu, P, Groussin, P, Arbeille, P, Bagros, and L, Pourcelot
- Subjects
Adult ,Male ,Graft Occlusion, Vascular ,Angiography, Digital Subtraction ,Contrast Media ,Thrombosis ,Renal Artery Obstruction ,Kidney Transplantation ,Humans ,Technetium Tc 99m Pentetate ,Ultrasonics ,Child ,Radionuclide Imaging ,Aged ,Ultrasonography - Abstract
Ultrasound techniques and radionuclide studies are very often used to assess vascularization of renal transplants. Although, in acute tubular necrosis or acute rejection, it is difficult to choose between these two techniques, in 3 recent cases of renal artery thrombosis, we conclude that color coded Doppler is preferable to nuclear medicine or duplex system to diagnose this form of thrombosis.
- Published
- 1990
17. [Are theophylline determinations useful to the clinician during treatment with a sustained-release form of theophylline?]
- Author
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E, Autret, Y, Lebranchu, P, Blanchard, F, Nsabiyumua, M, Breteau, B, Grenier, and A P, Jonville
- Subjects
Male ,Adolescent ,Theophylline ,Child, Preschool ,Delayed-Action Preparations ,Humans ,Infant ,Female ,Child ,Asthma ,Drug Administration Schedule - Abstract
The aims of the study were the correlation between dosage and plasmatic levels of slow release theophylline and the reason for dosage adjustment. 64 pharmacokinetic studies were performed in 58 asthmatic children between 17 months and 16 years. Plasmatic levels of theophylline were performed by fluoroimmunology technique at H0 (before the dose) 2 (H2), 4 (H4), 6 (H6) and 8 (H8) hours after the dose of slow release theophylline. The best correlation between dose and plasmatic levels were observed at H4 and H6 for Armophylline and Euphylline respectively. Dosage adjustment were based both upon clinical state and plasmatic levels in 55 cases. In 9 cases the modification of dose were decided only because of plasmatic levels out the therapeutic range. The authors proposed a schema of dosage modifications based upon clinical state; plasmatic levels must be used as a guide for dose adjustment in patients clinically uncontrolled.
- Published
- 1990
18. [Organ procurement in pediatrics. General and ethic aspects]
- Author
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H, Nivet, J, Laugier, Y, Lebranchu, E, Saliba, S, Benoit, C, Mercier, and M, Robert
- Subjects
Parents ,Brain Death ,Tissue and Organ Procurement ,Attitude ,Child, Preschool ,Infant, Newborn ,Humans ,Infant ,Ethics, Medical ,France ,Child ,Pediatrics - Abstract
The progress in organ transplantation is leading an increase in the demand for organs. Any non-harvested organs from a dead child mean at least a delay or even the loss of hope for life. All brain dead children do not undergo organ harvesting because there are still obstacles. The definition of brain death must be clear and include the destruction of all the brain system. Intensive care units must be motivated by improved contacts with transplantation teams. The number of parents who refuse could decrease with better public information, good contacts with medical teams and the quality of discussion with parents when a child dies. Energy should be concentrated on improving the collective consciousness about this new aspect of medicine.
- Published
- 1990
19. [Anti-cytoplasmic antibodies of neutrophil granulocytes in systemic vasculitis]
- Author
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J C, Brugier, G, Touchard, D u, Lê Thi Huong, Y, Lebranchu, and J L, Preud'homme
- Subjects
Cytoplasm ,Neutrophils ,Granulomatosis with Polyangiitis ,Humans ,Antibodies ,Biomarkers ,Polyarteritis Nodosa - Abstract
Autoantibodies to the cytoplasmic components of neutrophil polymorphonuclear granulocytes (ACPA) were searched for by indirect immunofluorescence on ethanol-fixed smears from normal white blood cells in 248 sera from patients with Wegener's granulomatosis, Kawasaki disease and various other vasculitides, connective tissue diseases, nephropathies and infiltrative pulmonary diseases. Apart from a weak positivity in a few Kawasaki disease sera, ACPA were found in Wegener's granulomatosis (and micropolyarteritis) only, with a correlation between ACPA titers and disease activity. These results confirm the value of ACPA in the diagnosis and evaluation of activity of Wegener's granulomatosis.
- Published
- 1989
20. [Hyper-IgE syndrome and recurrent infections (Buckley syndrome). Association with genu varum]
- Author
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Y, Lebranchu, P, Blanchard, G, Lorette, F, Demont, S, Marchand, C, Bonnard, and B, Grenier
- Subjects
Male ,Knee Joint ,Child, Preschool ,Hypergammaglobulinemia ,Phagocyte Bactericidal Dysfunction ,Humans ,Staphylococcal Skin Infections ,Immunoglobulin E ,Job Syndrome - Published
- 1986
21. [Fistula between right pulmonary artery and left atrium. A case report and review of the literature (author's transl)]
- Author
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J C, Rolland, M, Thibert, Y, Lebranchu, G, Lemoine, and O, Lejars
- Subjects
Adult ,Male ,Cardiac Catheterization ,Fistula ,Heart Diseases ,Adolescent ,Angiocardiography ,Infant ,Pulmonary Artery ,Arteriovenous Malformations ,Electrocardiography ,Child, Preschool ,Humans ,Postoperative Period ,Heart Atria ,Child - Abstract
The communication between right pulmonary artery and left atrium is a very uncommon cause of right to left shunt. The 18th case in the world literature and the first case in France is reported here. Normal pressure in the right cavities and in pulmonary artery is evocative. Angiography assesses the diagnosis and precises the place and connections of the fistula. Surgical closing of the fistula must be promptly achieved in order to obviate embolic complications.
- Published
- 1979
22. [Barraquer-Simons' partial lipoatrophy and early drusen of the fundus oculi]
- Author
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G, Lorette, M, Stecken, Y, Lebranchu, C, Carli-Basset, D, Pichot, J, Gouriou, and J M, Greco
- Subjects
Adult ,Lipodystrophy ,Choroid ,Fundus Oculi ,Humans ,Female ,Middle Aged - Published
- 1983
23. [Acute leukemia in 3 children with chronic juvenile arthritis treated with chlorambucil]
- Author
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D, Buriot, A M, Prieur, Y, Lebranchu, J, Messerschmitt, and C, Griscelli
- Subjects
Male ,Alkylating Agents ,Leukemia ,Child, Preschool ,Acute Disease ,Humans ,Infant ,Chlorambucil ,Child ,Arthritis, Juvenile ,Chromosomes - Abstract
Three children out of a total of 40 who had been treated with chlorambucil for juvenile rheumatoid arthritis developed acute leukaemia. No malignancy was detected in 160 patients in those treated with steroids and/or other anti-inflammatory drugs. Chlorambucil may have induced the malignancies and its use should be avoided in rheumatoid arthritis.
- Published
- 1979
24. [Kawasaki's syndrome. Treatment with intravenous gammaglobulins]
- Author
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F, Despert, Y, Lebranchu, B, Caurier, A, Chantepie, J C, Borderon, M, Renoux, C, Casenave, and J, Rudler
- Subjects
Injections, Intravenous ,Immunization, Passive ,Humans ,Infant ,Mucocutaneous Lymph Node Syndrome - Published
- 1984
25. [Bartter's syndrome: seven cases in siblings. Hypothesis of mild forms (author's transl)]
- Author
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H, Nivet, J C, Rolland, Y, Lebranchu, F, Dray, A, Benatre, J, Drucker, B, Grenier, and P, Bagros
- Subjects
Male ,Adolescent ,Angiotensin II ,Prostaglandins E ,Prostaglandins F ,Bartter Syndrome ,Pedigree ,Hyperaldosteronism ,Renin ,Potassium ,Humans ,Female ,Magnesium ,Vascular Resistance ,Child ,Aldosterone ,Growth Disorders - Abstract
Three children with a Bartter's syndrome have been investigated: all of them had growth retardation, hypokalemia (less than 3 mmol/l), raised plasma renin activity and urinary prostaglandins (PGE2 and PGF2 alpha) and a decreased sensibility for angiotensin. In the siblings two children had also growth retardation with mild biological signs of Bartter's syndrome, and two children had normal growth slight hypokalemia raised RPA and urinary PH, and normal sensibility for angiotensin. These data suggest mild forms of this syndrome which could be the Bartter's syndrome diagnosed in adults after laxatives or diuretics absorption. Besides these data stated a negative correlation (p less than 0,01) between plasma K+ and RPA, negative correlation (p less than 0,01) between plasma K+ and urinary PGE2 and a positive correlation (p less than 0,01) between RPA and urinary PGE2. From these observations physiopathology of Bartter's syndrome is discussed.
- Published
- 1980
26. [Case of defibrination syndrome in an infant presenting with hereditary intolerance to fructose]
- Author
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Y, Lebranchu, D, Seigneurin, P, Rambaud, and L, Kolodie
- Subjects
Humans ,Infant ,Female ,Disseminated Intravascular Coagulation ,Fructose Intolerance ,Carbohydrate Metabolism, Inborn Errors - Published
- 1976
27. [The procurement of organs of children. General aspects]
- Author
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H, Nivet, E, Saliba, A, Lacombe, M, Nashashibi, Y, Lebranchu, and J, Laugier
- Subjects
Parents ,Brain Death ,Motivation ,Tissue and Organ Procurement ,Attitude of Health Personnel ,Humans ,Coma ,Child - Abstract
Improved results of organs transplantation have resulted in an increased request for organs. All brain-dead children do not undergo organ harvesting for 3 main reasons. First, the definition of brain death, which should remain strict, is not accepted by everyone, in spite of the laws on this topics. Then, organizing organs harvesting requires specific hospital structures, a co-ordinator and motivated medical staff. Finally, parent's authorization is mandatory before organs harvesting in children. Parents still often refuse. An improvement might be reached by informing the general public, a maintained trust in the medical profession and the quality of the talk with the parents when the child dies. All energies should tend to develop the collective consciousness in order to improve this new aspect of medicine.
- Published
- 1988
28. [A syndrome of hyper-IgE and recurrent infections. Developmental variants? A familial study]
- Author
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G, Lorette, Y, Lebranchu, M F, Legrand, P, Bardos, F, Despert, M F, Grojean, and M, Larrègue
- Subjects
Male ,Neutrophils ,Infant ,Syndrome ,Immunoglobulin E ,Staphylococcal Infections ,Prognosis ,T-Lymphocytes, Regulatory ,Dermatitis, Atopic ,Chemotaxis, Leukocyte ,Recurrence ,Child, Preschool ,Hypergammaglobulinemia ,Humans ,Skin Diseases, Infectious - Abstract
The first patient suffered from a very severe atopic dermatitis with intense pruritus and thickened skin. He had also recurrent infections, particularly related to Staphylococcus coagulase +, and axillary and inguinal lymphodermopathy. The use of tetracosactide given intramuscularly allowed controlling the evolution of his atopic dermatitis. After several months of treatment, the skin became less infiltrated, lymphodermopathy disappeared and no severe infection had happened. The second patient had a less severe atopic dermatitis and recurrent infections without any particular severity. Topical corticosteroids allowed to control the atopic dermatitis. These two patients had high levels of circulating IgE and an important deficiency of polymorphonuclear chemotaxis which was evaluated by migration through boyden room. Study of the family showed atopic manifestations in several members, but with lower levels of IgE. The most characteristic abnormality of this syndrome is the according to considerable increase of IgE. The deficit in polymorphonuclear chemotaxis may vary according to time and even become normal. The prognosis over long periods remains to be determined.
- Published
- 1984
29. [Treatment of Kawasaki syndrome by intravenous gamma globulins. A medium-term clinical and paraclinical study of 5 cases]
- Author
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Y, Lebranchu, F, Despert, J C, Borderon, D, Bloc, M, Renoux, P, Bardos, and J, Laugier
- Subjects
Male ,Time Factors ,Evaluation Studies as Topic ,Child, Preschool ,T-Lymphocytes ,Injections, Intravenous ,Immunization, Passive ,Humans ,Infant ,Mucocutaneous Lymph Node Syndrome - Published
- 1986
30. [Congenital tracheobiliary fistula. Report of a case with choledocal hypoplasia (author's transl)]
- Author
-
J F, Dyon, R, Sarrazin, P, Baudain, Y, Lebranchu, and C, Brambilla
- Subjects
Airway Obstruction ,Male ,Biliary Fistula ,Infant, Newborn ,Humans ,Infant ,Abnormalities, Multiple ,Female ,Bronchography ,Tracheoesophageal Fistula - Abstract
The authors describe a new observation of a congenital aerobiliar fistula in a newborn infant showing choleptysies associated with a pulmonary obstruction. The most remarkable facts are the presence of a radiological pneumogallbladder, and the existence of a real trifurcation of the trachea on the bronchography, associated with a choledocal hypoplasia. The death having occured before the operation, the autopsy allowed the confirmation of the termination on the left hepatical duct and the duality of conformation of the fistula, respiratory and biliary. On the occurence of this 9th case, a review of the literature shows the stereotyped nature of the clinical signs and the course of the fistula which seems invariable. The different aspects of the malformation are considered as well as the treatment which necessitates an exeresis by thoracic pathway.
- Published
- 1978
31. [Kawasaki disease. Treatment with intravenous gammaglobulins]
- Author
-
Y, Lebranchu
- Subjects
Male ,Child, Preschool ,Injections, Intravenous ,Coronary Aneurysm ,Immunization, Passive ,Humans ,Immunoglobulins ,Infant ,Multicenter Studies as Topic ,Female ,gamma-Globulins ,Mucocutaneous Lymph Node Syndrome ,Retrospective Studies - Abstract
Thirty French children (18 males, 12 females; mean age 20 +/- 18 months) presenting with Kawasaki disease were treated with high-dose intravenous plasmin-modified immunoglobulins (Veinoglobulines Institut Mérieux, France) during the acute phase of the disease. The total dose ranged from 1 to 2.5 g/kg (mean 1.88 +/- 0.50) administered in 1 to 5 infusions. In every case the clinical symptoms disappeared rapidly. Hyperfibrinaemia and hyperleucocytosis with granulocytosis regressed within one week, and high platelet counts within 2 to 3 weeks. the disappearance of immunological abnormalities paralleled that of clinical signs. Three-dimensional echocardiography showed dilatation of the left coronary artery in only one of the 30 children at 1 and 6 months, but coronary arteriography performed during the 6th month gave normal results. Intravenous immunoglobulin therapy seems to be effective in preventing the development of coronary aneurysms in patients with Kawasaki disease. The immunoregulatory function of immunoglobulins accounts for this effectiveness and for their value in immune diseases.
- Published
- 1989
32. [Organ transplantation: 10 key messages].
- Author
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Lebranchu Y
- Abstract
Competing Interests: L’auteur déclare n’avoir aucun lien d’intérêts.
- Published
- 2023
33. [Transplant shortage to persist in 2023].
- Author
-
Lebranchu Y
- Subjects
- Humans, Tissue Donors, Tissue and Organ Procurement, Organ Transplantation
- Published
- 2023
34. [Advances in transplantation: Conclusion].
- Author
-
Lebranchu Y
- Abstract
The excellent results of Transplantation over the last decades have highlighted new challenges to be solved in the next years. (1) Modify the storage of harvested organs to improve their quality. (2) Modify strategies by taking into account the immunodeficiency in front of news infections like the one with Sars CoV-2. (3) Better understand the mechanisms of chronic rejection, in particular the role of innate immunity. (4) Rethink immunosuppressive strategies to prevent and to treat chronic rejections., (© 2022 l'Académie nationale de médecine. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
35. ["Immune checkpoint inhibitors: what to remember"].
- Author
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Lebranchu Y
- Subjects
- Humans, Immunotherapy, Immune Checkpoint Inhibitors, Neoplasms drug therapy
- Abstract
Competing Interests: "L'auteur déclare n’avoir aucun lien d’intérêts."
- Published
- 2021
36. ["Immune checkpoint inhibitors: a paradigm shift"].
- Author
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Lebranchu Y
- Subjects
- Humans, Immunotherapy, Immune Checkpoint Inhibitors, Neoplasms drug therapy
- Abstract
Competing Interests: "L'auteur déclare n’avoir aucun lien d’intérêts."
- Published
- 2021
37. [Immunotherapy of cancers by inhibiting control of the immune response honored by a Nobel Prize].
- Author
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Lebranchu Y
- Subjects
- Humans, Immunologic Factors, Nobel Prize, Immunotherapy, Neoplasms
- Abstract
Competing Interests: Y. Lebranchu déclare n’avoir aucun lien d’intérêts.
- Published
- 2019
38. [Orientation of the immune response of the epithelium: epithelial cells, dendritic cells and lymphocytes].
- Author
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Lebranchu Y
- Subjects
- Adaptive Immunity physiology, Humans, Immunity, Innate physiology, Dendritic Cells physiology, Epithelial Cells physiology, Epithelium immunology, Lymphocytes physiology
- Published
- 2014
39. [IL-2/IL-2R pathway in dendritic cell modulates both their cytokine synthesis profiles and their capacity to activate allogeneic CD4+ T lymphocytes].
- Author
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Mnasria K, Lagaraine C, Manaa J, Lebranchu Y, and Oueslati R
- Subjects
- Antibodies, Monoclonal pharmacology, Autocrine Communication, Cells, Cultured, Dendritic Cells drug effects, Dendritic Cells metabolism, Endocytosis drug effects, Enzyme-Linked Immunosorbent Assay, Flow Cytometry, Granulocyte-Macrophage Colony-Stimulating Factor pharmacology, Humans, Immunophenotyping, Interferon-gamma biosynthesis, Interferon-gamma genetics, Interleukin-10 biosynthesis, Interleukin-10 genetics, Interleukin-2 biosynthesis, Interleukin-2 genetics, Interleukin-2 Receptor alpha Subunit antagonists & inhibitors, Interleukin-2 Receptor alpha Subunit biosynthesis, Interleukin-2 Receptor alpha Subunit genetics, Interleukin-2 Receptor alpha Subunit immunology, Lipopolysaccharides pharmacology, Lymphocyte Activation, Monocytes drug effects, Signal Transduction physiology, CD4-Positive T-Lymphocytes immunology, Dendritic Cells immunology, Interleukin-2 physiology, Interleukin-2 Receptor alpha Subunit physiology
- Abstract
The results provide new insights into the role of IL-2/IL-2R pathway in DC. We report that stimulation of human monocyte-derived DC with LPS strongly upregulated CD25 (α chain of the IL-2R) expression. In addition, by using a humanized monoclonal antibody against CD25, we demonstrated that the IL-2 signalling in DC upregulated both IL-12 and γIFN production but decreased IL-10 synthesis. Anti-CD25 treatment reduced the ability of LPS-DC to induce allogeneic CD4(+) T cell proliferation as compared to LPS-matured DC. In addition, LPS-matured DC treated with IL-2 had a higher allostimulatory capacity compared to LPS-DC. We also found that LPS-matured DC produced IL-2. Thus, IL-2 seems to contribute actively to DC activation through an autocrine pathway. Moreover, IL-2 pathway in DC is involved in T helper priming. These findings might be useful for protocols in cellular therapy and a valuable tool to understand graft rejection versus the acquisition of peripheral tolerance., (Copyright © 2009 Elsevier Masson SAS. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
40. [Therapeutic monoclonal antibodies: update on the risk of opportunistic infections].
- Author
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Rigal E, Gateault P, Lebranchu Y, and Hoarau C
- Subjects
- Alemtuzumab, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal, Humanized, Antibodies, Monoclonal, Murine-Derived, Antibodies, Neoplasm adverse effects, Antibodies, Neoplasm therapeutic use, Antigens, CD immunology, Antigens, CD20 immunology, Antigens, Neoplasm immunology, CD52 Antigen, Cohort Studies, Glycoproteins immunology, Humans, Immunosuppression Therapy adverse effects, Integrin alpha4beta1 immunology, Meta-Analysis as Topic, Opportunistic Infections epidemiology, Recurrence, Retrospective Studies, Rituximab, Tuberculosis etiology, Tumor Necrosis Factor-alpha antagonists & inhibitors, Tumor Necrosis Factor-alpha immunology, Virus Activation, Antibodies, Monoclonal adverse effects, Opportunistic Infections etiology
- Abstract
The large experience accumulated with the therapeutic use of monoclonal antibodies has revealed undesirable effects, among which opportunistic infections when prescribed in inflammatory or hematological diseases. This deleterious effect is a direct consequence of the immunosuppression induced by these antibodies through the blockade of several key pathways involved in both innate and adaptative immune responses, including migration of effector cells, depletion of B or T lymphocytes, inhibition of key cell-cell interactions. Four antibodies are concerned, targeting CD52, CD20, TNF-a and VLA-4, and major risks include activation of latent tuberculosis, or of normally silent viruses. Precise evaluation of these risks and understanding of their mechanisms have now led to the improvement of clinical safety, based on the detection of patients at risk, weighting of the benefit/risk ratio, and a very rigorous detection of latent infections before the onset of treatment by monoclonal antibodies know to induce immunosuppression.
- Published
- 2009
- Full Text
- View/download PDF
41. [Incidence and management of anemia in renal transplantation: an observational-French study].
- Author
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Choukroun G, Deray G, Glotz D, Lebranchu Y, Dussol B, Bourbigot B, Lefrançois N, Cassuto-Viguier E, Toupance O, Hacen C, Lang P, Mazouz H, and Martinez F
- Subjects
- Adult, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Creatinine blood, Erythropoiesis physiology, Female, France epidemiology, Glomerular Filtration Rate, Hemoglobins metabolism, Hospitals, University, Humans, Kidney Function Tests, Kidney Transplantation physiology, Male, Middle Aged, Anemia epidemiology, Anemia therapy, Kidney Transplantation adverse effects
- Abstract
The management of anemia after kidney transplantation remains poorly explored. The Management of Anemia in French Kidney Transplant Patients (MATRIX) study is an observational study conducted in 10 academic hospitals among kidney-transplant patients designed to evaluate the prevalence, associated factors and management of post-transplant anemia. Over two consecutive weeks, 418 recipients (males: 248; age: 50.8+/-12.7 years) were included, all were transplanted for more than six months. Mean serum creatinine (Scr) was 152+/-67 micromol/l and mean hemoglobin (Hb) was 12.4+/-1.8 g/dl (males: 12.8+/-1.9 g/dl; females 11.9+/-1.6 g/dl). Irrespective of the delay following transplantation, 23% of patients (n=95) were severely anemic (Hb < or = 11 g/dl). Eighteen percent of the patients received an antianemic treatment (10% oral iron, 7% erythropoiesis stimulating agents (ESA), 4% folic acid) and only 35% of the severely anemic patients were actually treated (n=33). A significantly-negative correlation was observed between eGFR and Hb levels (R= -0.347, p<0.02). Ninety-six percent of the 193 patients transplanted for more than six months and a Scr greater than 150 micromol/l (n=185) suffered at least one comorbidity (89% hypertension, 32% hypercholesterolemia, 13% diabetes); this group represent the second cohort. Seventy-four percent of them were treated with mycophenolate mofetil, 16% with azathioprine, and 62% with an ACEI or angiotensin II receptor antagonists. Since the transplantation, 127 patients (66%) have been anemic (Hb < or = 11 g/dl) and 58% (n=112) were treated (iron and/or ESA, respectively 81 and 55%). Among the patients not treated for anemia, 74% had an Hb level below 12g/dl. ESA-treated patients received a mean dose of 8500 UI+/-2800 per week. Anemia is under-diagnosed and under-treated in renal-transplant recipients, despite its high prevalence. As expected, a correlation between renal function and Hb levels was observed, as in CKD patients. Prospective studies are underway to assess the consequences of postkidney transplant anemia on quality of life, cardiovascular morbidity and chronic allograft nephropathy and to define the benefit of the treatment.
- Published
- 2008
- Full Text
- View/download PDF
42. [Difficulties in the management of localised pulmonary Goodpasture's syndrome].
- Author
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Buret J, Marcq M, Lebranchu Y, Legras A, Barbet C, Mouteaux G, and Diot P
- Subjects
- Adrenal Cortex Hormones therapeutic use, Adult, Anti-Glomerular Basement Membrane Disease therapy, Hemorrhage etiology, Humans, Lung Diseases therapy, Male, Plasmapheresis, Smoking Cessation, Anti-Glomerular Basement Membrane Disease diagnosis, Lung Diseases diagnosis
- Abstract
Introduction: The diagnosis of the pulmonary forms of Goodpasture's syndrome is not easy and requires a renal biopsy when no anti-glomerular basement membrane antibodies are detected, since the disease can lead to spontaneous massive intra-alveolar haemorrhage that can be fatal. Treatment for the pulmonary-renal form combining corticosteroids, cyclophosphamide and plasmapheresis should be applied to the pulmonary form to control haemorrhage and prevent relapse., Case Report: We report the case of a patient suffering from the localised pulmonary form of Goodpasture's syndrome in whom the diagnosis was delayed due to a negative indirect immunofluorescent antibody bioassay. After a serious early relapse remission was achieved with comprehensive treatment and a tobacco withdrawal programme., Conclusion: If there is no delay in diagnosis and comprehensive treatment is given, the prognosis for these patients is good with a recovery rate of 80 to 90%.
- Published
- 2008
- Full Text
- View/download PDF
43. [Renal transplantation in patients with autosomal dominant polycystic kidney disease: pre-transplantation evaluation and follow-up].
- Author
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Bretagnol A, Büchler M, Boutin JM, Nivet H, Lebranchu Y, and Chauveau D
- Subjects
- Aftercare, Colonic Diseases epidemiology, Colonic Diseases etiology, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 etiology, Family Health, France epidemiology, Humans, Incidence, Intestinal Perforation epidemiology, Intestinal Perforation etiology, Intracranial Aneurysm diagnosis, Intracranial Aneurysm genetics, Liver Transplantation, Nephrectomy, Polycystic Kidney, Autosomal Dominant epidemiology, Polycystic Kidney, Autosomal Dominant genetics, Polycystic Kidney, Autosomal Dominant psychology, Postoperative Complications epidemiology, Postoperative Complications etiology, Preoperative Care, Retrospective Studies, Skin Neoplasms epidemiology, Skin Neoplasms etiology, Tissue and Organ Procurement, Kidney Transplantation, Polycystic Kidney, Autosomal Dominant surgery
- Abstract
Autosomal dominant polycystic kidney disease (ADPKD) which accounts for 15% of all renal transplantations emerges as the third cause of kidney transplantation in France. In addition to routine evaluation before transplantation, the ADPKD patient requires special assessment of three aspects: should potential kidney complications (recurrent upper tract infection or haemorrhage) or kidney size assessed by computed tomography require nephrectomy prior to transplantation? Is it advisable to detect intracranial aneurysm (ICA) in patients with a relative having experienced ruptured ICA? When transplantation from a living relative is considered, the existence of ADPKD in the donor should be formally ruled out by imaging or genetic studies. The risk of recurrence of ADPKD post-transplantation does not exist. Nevertheless other complications may occur. Thus, an increased incidence of colonic perforation has been reported. In addition, as compared to non-ADPKD patients, an increased risk for both skin cancer and new-onset post-transplant diabetes mellitus has been reported recently after kidney transplantation. Finally, because these patients suffer from an inherited syndrome, physicians should carefully consider the personal and familial history before and after transplantation in order to respond to fatalism in some cases, or to attenuate excessive enthusiasm in the others. Altogether, it apears that a specific approach is needed for ADPKD patients when considering renal transplantation.
- Published
- 2007
- Full Text
- View/download PDF
44. [Cyclosporin-induced toxic neuromyopathy].
- Author
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Guennoc AM, Corcia P, Al-Najjar A, Bergemer-Fouquet AM, Lebranchu Y, de Toffol B, and Autret A
- Subjects
- Coenzyme A metabolism, Electromyography, Female, Graft Rejection complications, Graft Rejection drug therapy, Humans, Kidney Transplantation immunology, Middle Aged, Nerve Fibers pathology, Neural Conduction drug effects, Neuromuscular Diseases pathology, Cyclosporine adverse effects, Immunosuppressive Agents adverse effects, Neuromuscular Diseases chemically induced
- Abstract
Introduction: Cyclosporine is an immunosuppressive treatment whose side effects limit its usefulness. Among neurological side effects, neuropathies or myopathies have been reported, specially inpatients given combinations of cyclosporine with co-enzyme A reductase inhibitors., Case Report: We report here the case of a 67-year-old woman who developed few months after a kidney graft sensorimotor disorders which progressed rapidly. Since all etiologies of such a disorder were ruled out, the hypothesis of toxicity exclusively induced by cyclosporine was suggested and confirmed by the improvement observed after its withdrawal., Conclusion: This observation highlights the fact that cyclosporine may induce neuromyopathies even when given alone at the therapeutic dosage.
- Published
- 2005
- Full Text
- View/download PDF
45. [Organ transplantation: epidemiological and immunological aspects; principles of treatment and surveillance; complications and prognosis; ethical and legal aspects].
- Author
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Lebranchu Y, Sirinelli A, Wolf P, and Mornex JF
- Subjects
- Adrenal Cortex Hormones therapeutic use, Antibodies, Monoclonal therapeutic use, Azathioprine therapeutic use, Cyclosporine therapeutic use, Follow-Up Studies, Graft Rejection immunology, Heart Transplantation, Humans, Immunosuppressive Agents therapeutic use, Liver Transplantation, Lung Transplantation, Lymphocyte Activation, Pancreas Transplantation, Postoperative Complications, T-Lymphocytes immunology, Tacrolimus therapeutic use, Time Factors, Tissue Donors, Tissue and Organ Harvesting, Transplantation Immunology, Waiting Lists, Organ Transplantation adverse effects, Organ Transplantation ethics, Organ Transplantation legislation & jurisprudence, Organ Transplantation statistics & numerical data
- Published
- 2004
46. [Transplantation and transfer of allergy: a theorical risk to be considered?].
- Author
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Hoarau C and Lebranchu Y
- Subjects
- Humans, Immunoglobulin E immunology, Risk Factors, Hypersensitivity, Organ Transplantation
- Published
- 2004
- Full Text
- View/download PDF
47. [Allorecognition].
- Author
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Lebranchu Y
- Subjects
- Acute Disease, Animals, Antigen-Presenting Cells immunology, Chronic Disease, Graft Rejection immunology, Humans, Lymphocyte Activation immunology, Mice, Receptors, Antigen, T-Cell immunology, Transplantation, Homologous immunology, T-Lymphocytes immunology, Transplantation Tolerance immunology
- Abstract
TWO TYPES OF RECOGNITION: Direct recognition occurs when the recipient's T cells recognize allogenic antigens presented by the donor antigen presenting cells. Indirect recognition occurs when donor antigens on recipient antigen presenting cells are recognized. DIRECT RECOGNITION: Direct recognition occurs during the first days or weeks after transplantation when naive recipient cells recognize donor dendritic cells that have migrated to secondary lymphoid organs. This explains why acute rejection occurs mainly during the first weeks after transplantation. INDIRECT RECOGNITION: This is certainly a less intense mechanism than direct recognition. It probably is involved in acute rejection but is known to play a major role in chronic rejection. CD4 cells that have been activated by indirect recognition play an essential role in activating B cells, leading to the formation of anti-HLA antibodies as well as in activating macrophages and monocytes, endothelial cells and smooth muscle cells. INDUCTION OF TOLERANCE: Three mechanisms of action for regulating the allo-immune response leading to graft tolerance have been put forward: consumption of interleukin-2, production of suppressive cytokins, direct or indirect suppressive contact. T CELL ACTIVATION: Knowledge of the intracellular signals induced by T cell receptor activation makes it possible to target key proteins that could be blocked leading to better immunosuppression than with calcineurin inhibition.
- Published
- 2001
48. [Chicago 2001. What impressions to take from Chicago 2001?].
- Author
-
Lebranchu Y
- Subjects
- Antibodies, Monoclonal immunology, Antibodies, Monoclonal therapeutic use, Antiviral Agents therapeutic use, Chicago, Humans, Immune Tolerance, Immunosuppression Therapy
- Published
- 2001
49. [Microalbuminuria in hypertensive, non-proteinuric renal transplant recipients: role of previous acute rejection episodes and sodium intake].
- Author
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Halimi JM, al-Najjar A, Buchler M, Giraudeau B, Etienne I, Picou S, Marlière J, Nivet H, and Lebranchu Y
- Subjects
- Adult, Albuminuria pathology, Biomarkers analysis, Female, Humans, Male, Middle Aged, Risk Factors, Albuminuria etiology, Graft Rejection, Hypertension complications, Kidney Transplantation, Sodium, Dietary
- Abstract
Unlabelled: Microalbuminuria (Malb: albuminuria: 30-299 mg/24 h) is associated with many cardiovascular parameters (high systolic (SAP) and diastolic (DAP) arterial pressure, total cholesterol, triglycerides, fasting glucose and body weight, low HDL-cholesterol) and may be a marker of cardiovascular and renal risk in the general population. Whether MAlb could be an integrated marker of cardiovascular and renal risk in transplant recipients is unknown., Patients and Methods: 75 hypertensive non-proteinuric renal transplant recipients were selected. Antihypertensive medications were stopped for a month prior to the studies. MAlb (on a 24-hour urine collection), cyclosporine trough levels (CsA-L), fasting glucose and lipids were measured. SAP and DAP were determined with a semi-automatic device., Results: 29 patients (12 W/17M) had normal levels of albuminuria (Nalb: albuminuria < 30 mg/24 h) and 46 had MAlb. As compared to Nalb patients, those with Malb were younger (M +/- SD: 44.3 +/- 13 vs 51.2 +/- 9.7 respectively, p = 0.009), had higher SAP (152 +/- 16 vs 146 +/- 15 mmHg, p = 0.09) et DAP (86 +/- 11 vs 81 +/- 10 mmHg, p = 0.01). No difference in smoking habits, serum creatinine (125 +/- 27 vs 119 +/- 28 mumol/L), total-, HDL- and LDL-cholesterol, triglycerides, fasting glucose, CsA-L (142 +/- 29 vs 144 +/- 26 ng/mL), 24 h-urine urea excretion was observed. History of acute rejection episodes (45.7% vs 17.2%, p = 0.01) was more frequent and 24-hour natriuresis (192 +/- 70 vs 152 +/- 79 mmol/24 h, p < 0.01) was higher in Malb than in Nalb., Conclusion: The determinants of microalbuminuria in renal transplant recipients are different from those found in the general population. History of acute rejection episodes was more frequent in renal transplant recipients with Malb than in those with NAlb despite similar renal function, suggesting that Malb may a marker of subclinical renal lesions due to immunological aggression. The relationship between natriuresis and Malb suggests that sodium intake modulates target-organ damage associated with hypertension.
- Published
- 2001
50. [Regulation and dysfunction of endothelium-dependent vasomotricity. What can be applied to clinical practice?].
- Author
-
Halimi JM and Lebranchu Y
- Subjects
- Arteriosclerosis physiopathology, Arteriosclerosis prevention & control, Endothelins biosynthesis, Endothelins pharmacology, Free Radicals, Humans, Nitric Oxide antagonists & inhibitors, Vasoconstriction physiology, Vasodilation physiology, Arteriosclerosis etiology, Endothelium physiology, Vasomotor System pathology
- Abstract
FUNCTIONS OF THE ENDOTHELIUM: The endothelium plays a pivotal role in regulating vasomotor tone, vessel permeability, blood cell extravasation, and antiatherogenic, antithrombogenic and antiadhesive processes., Dysfunction of the Endothelium: Demonstrated, in particular, by endothelium-dependent vasomotricity disorders, endothelium dysfunction occurs in many psysiological and pathological situations that lead to atherosclerosis: advanced age, menopause, high blood pressure, dyslipidemia, diabetes, smoking, elevated homocysteinemia, chronic renal failure.... These dysfunctions of the endothelium constitute the fundamental and very early step in the development of atherosclerosis., Prevention: Specific treatment of functional anomalies of the endothelium can be an essential element in the prevention of atherosclerosis. In certain cases, he cause of endothelial dysfunction may be related to the presence of radical oxygen species, nitric oxide inhibitors, or increased synthesis or release of endothelin. Potential treatments should be adapted to the specific cause of the underlying endothelial anomaly: antioxidants, statins, anti-endothelins, or converting enzyme inhibitors. In clinical practice, it may be important to recognize the cause of endothelial dysfunction for adapted early drug therapy.
- Published
- 2000
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