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2. Artificial intelligence outperforms pulmonologists in the interpretation of pulmonary function tests

Author

Topalovic, Marko, Das, Nilakash, Burgel, Pierre-Regis, Daenen, Marc, Derom, Eric, Haenebalcke, Christel, Janssen, Rob, Kerstjens, Huib AM, Liistro, Giuseppe, Louis, Renaud, Ninane, Vincent, Pison, Christophe, Schlesser, Marc, Vercauter, Piet, Vogelmeier, Claus F, Wouters, Emiel, Wynants, Jokke, Janssens, Wim, De Pauw, R, Depuydt, C, Haenebalcke, C, Muyldermans, S, Ringoet, V, Stevens, D, Bayat, S, Benet, J, Catho, E, Claustre, J, Fedi, A, Ferjani, MA, Guzun, R, Isnard, M, Nicolas, S, Pierret, T, Pison, C, Rouches, S, Wuyam, B, Corhay, JL, Guiot, J, Ghysen, K, Renaud, L, Sibille, A, De La Barriere, H, Charpentier, C, Corhut, S, Hamdan, KA, Schlesser, M, Wirtz, G, Alabadan, E, Birsen, G, Burgel, PR, Chohra, A, Hamard, C, Lemarie, B, Lothe, MN, Martin, C, Sainte-Marie, AC, Sebane, L, Berk, Y, de Brouwer, B, Janssen, R, Kerkhoff, J, Spaanderman, A, Stegers, M, Termeer, A, van Grimbergen, I, van Veen, A, van Ruitenbeek, L, Vermeer, L, Zaal, R, Zijlker, M, Aumann, J, Cuppens, K, Degraeve, D, Demuynck, K, Dieriks, B, Pat, K, Spaas, L, Van Puijenbroek, R, Weytjens, K, Wynants, J, Adam, V, Berendes, BJ, Hardeman, E, Jordens, P, Munghen, E, Tournoy, K, Vercauter, P, Alame, T, Bruyneel, M, Gabrovska, M, Muylle, I, Ninane, V, Rozen, D, Rummens, P, Van den Broecke, S, Froidure, A, Gohy, S, Liistro, G, Pieters, T, Pilette, C, Pirson, F, Kerstjens, H, Van den Berge, M, Ten Hacken, N, Duiverman, M, Koster, D, Vosse, B, Conemans, L, Maus, M, Bischoff, M, Rutten, M, Agterhuis, D, Sprooten, R, Beutel, B, Jerrentrup, A, Klemmer, A, Viniol, C, Vogelmeier, C, Bode, H, Dooms, C, Gullentops, D, Janssens, W, Nackaerts, K, Rutens, D, Wauters, E, Wuyts, W, Derom, E, Dobbelaere, S, Loof, S, Serry, G, Putman, B, Van Acker, L, Vandeweygaerde, Y, Criel, M, Daenen, M, Gubbelmans, R, Klerkx, S, Michiels, E, Thomeer, M, Vanhauwaert, A, UCL - (SLuc) Service de pneumologie, Groningen Research Institute for Asthma and COPD (GRIAC), Lifestyle Medicine (LM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire [Grenoble] (CHU), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), RS: NUTRIM - R3 - Respiratory & Age-related Health, MUMC+: MA Longziekten (3), Pulmonologie, MUMC+: MA Med Staf Spec Longziekten (9), and MUMC+: MA Med Staf Artsass Longziekten (9)

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, Pulmonary function, STRATEGIES, Pulmonary Function Study Investigators, Context (language use), DIAGNOSIS, GUIDELINES, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Pulmonary function testing, 03 medical and health sciences, 0302 clinical medicine, Clinical history, Artificial Intelligence, Pulmonary Medicine, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Medical diagnosis, Pulmonologists, Aged, Aged, 80 and over, Interpretation (logic), business.industry, Gold standard (test), STANDARDIZATION, PERFORMANCE, Middle Aged, 3. Good health, Respiratory Function Tests, Clinical Practice, 030228 respiratory system, Female, Artificial intelligence, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Software
Abstract

The interpretation of pulmonary function tests (PFTs) to diagnose respiratory diseases is built on expert opinion that relies on the recognition of patterns and the clinical context for detection of specific diseases. In this study, we aimed to explore the accuracy and interrater variability of pulmonologists when interpreting PFTs compared with artificial intelligence (AI)-based software that was developed and validated in more than 1500 historical patient cases.120 pulmonologists from 16 European hospitals evaluated 50 cases with PFT and clinical information, resulting in 6000 independent interpretations. The AI software examined the same data. American Thoracic Society/European Respiratory Society guidelines were used as the gold standard for PFT pattern interpretation. The gold standard for diagnosis was derived from clinical history, PFT and all additional tests.The pattern recognition of PFTs by pulmonologists (senior 73%, junior 27%) matched the guidelines in 74.4±5.9% of the cases (range 56-88%). The interrater variability of κ=0.67 pointed to a common agreement. Pulmonologists made correct diagnoses in 44.6±8.7% of the cases (range 24-62%) with a large interrater variability (κ=0.35). The AI-based software perfectly matched the PFT pattern interpretations (100%) and assigned a correct diagnosis in 82% of all cases (p

Published
2018

3. Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper

Author

WHO Collaborating Center for Asthma and Rhinitis, Bousquet J, Anto JM, Demoly P, Schünemann HJ, Togias A, Akdis M, Auffray C, Bachert C, Bieber T, Bousquet PJ, Carlsen KH, Casale TB, Cruz AA, Keil T, Lodrup Carlsen KC, Maurer M, Ohta K, Papadopoulos NG, Roman Rodriguez M, Samolinski B, Agache I, Andrianarisoa A, Ang CS, Annesi-Maesano I, Ballester F, Baena-Cagnani CE, Basagaña X, Bateman ED, Bel EH, Bedbrook A, Beghé B, Beji M, Ben Kheder A, Benet M, Bennoor KS, Bergmann KC, Berrissoul F, Bindslev Jensen C, Bleecker ER, Bonini S, Boner AL, Boulet LP, Brightling CE, Brozek JL, Bush A, Busse WW, Camargos PA, Canonica GW, Carr W, Cesario A, Chen YZ, Chiriac AM, Costa DJ, Cox L, Custovic A, Dahl R, Darsow U, Didi T, Dolen WK, Douagui H, Dubakiene R, El-Meziane A, Fonseca JA, Fokkens WJ, Fthenou E, Gamkrelidze A, Garcia-Aymerich J, Gerth van Wijk R, Gimeno-Santos E, Guerra S, Haahtela T, Haddad H, Hellings PW, Hellquist-Dahl B, Hohmann C, Howarth P, Hourihane JO, Humbert M, Jacquemin B, Just J, Kalayci O, Kaliner MA, Kauffmann F, Kerkhof M, Khayat G, Koffi N'Goran B, Kogevinas M, Koppelman GH, Kowalski ML, Kull I, Kuna P, Larenas D, Lavi I, Le LT, Lieberman P, Lipworth B, Mahboub B, Makela MJ, Martin F, Martinez FD, Marshall GD, Mazon A, Melen E, Meltzer EO, Mihaltan F, Mohammad Y, Mohammadi A, Momas I, Morais-Almeida M, Mullol J, Muraro A, Naclerio R, Nafti S, Namazova-Baranova L, Nawijn MC, Nyembue TD, Oddie S, O'Hehir RE, Okamoto Y, Orru MP, Ozdemir C, Ouedraogo GS, Palkonen S, Panzner P, Passalacqua G, Pawankar R, Pigearias B, Pin I, Pinart M, Pison C, Popov TA, Porta D, Postma DS, Price D, Rabe KF, Ratomaharo J, Reitamo S, Rezagui D, Ring J, Roberts R, Roca J, Rogala B, Romano A, Rosado-Pinto J, Ryan D, Sanchez-Borges M, Scadding GK, Sheikh A, Simons FE, Siroux V, Schmid-Grendelmeier PD, Smit HA, Sooronbaev T, Stein RT, Sterk PJ, Sunyer J, Terreehorst I, Toskala E, Tremblay Y, Valenta R, Valeyre D, Vandenplas O, van Weel C, Vassilaki M, Varraso R, Viegi G, Wang DY, Wickman M, Williams D, Wöhrl S, Wright J, Yorgancioglu A, Yusuf OM, Zar HJ, Zernotti ME, Zidarn M, Zhong N, and Zuberbier T

Subjects
Urticaria, Rhinosinusitis, macromolecular substances, Immunoglobulin E, Asthma, Rhinitis, Atopic dermatitis
Abstract

Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.

Published
2012

4. Changes in left ventricular ejection fraction during REM sleep and exercise in chronic obstructive pulmonary disease and sleep apnoea syndrome

Author

Patrick Lévy, Guilleminault, C., Fagret, D., Gaio, J. M., Romand Ph., Bonnet, C., Pison, C. M., Wolf, J. E., and Paramelle, B.

Subjects
Pulmonary and Respiratory Medicine
Abstract

Nine patients, 4 with chronic obstructive pulmonary disease (COPD) and 5 with obstructive sleep apnoea syndrome (OSAS) were monitored during sleep, rest and exercise. Left ventricular ejection fraction (LVEF) was investigated using gated equilibrium 99mtechnetium ventricular scintigraphy during rapid eye movement (REM) sleep, during exercise, and during wakeful rest. Control wakeful rest periods used for comparison with a study state (either REM sleep or exercise) were always selected during the same circadian segment as that state. Myocardial stress thallium-201 scintigraphy was performed during, and 4 h after, exercise, and results were compared to a daytime rest period. Several patients had myocardial hypoperfusion despite a normal electrocardiographic (ECG) treadmill test. During REM sleep, all patients exhibited a significant change in LVEF (greater than 5%) compared to wakefulness. During exercise, 5 subjects increased their LVEF normally (greater than 5%) and 4 (1 COPD, 3 OSAS) decreased it. All patients had a similar change (increase or decrease) during REM and at maximal exercise. Our results suggest that REM sleep in COPD and in OSAS can produce a myocardial stress as great as that produced by exercise. We conclude that REM sleep, like exercise, is a state in which morbidity may become higher and that it may account for mortality in COPD and OSAS patients with compromised myocardial circulation.

Published
1991

5. Operational definitions of asthma in studies on its aetiology

Author

Pekkanen, J, Sunyer, J, Anto, Jm, Burney, Pl, Abramson, M, Kutin, J, Vermeire, P, van Bastelaer, F, Bousquet, J, Neukirch, F, Liard, R, Pin, I, Pison, C, Taytard, A, Magnussen, H, Nowak, D, Wichmann, He, Heinrich, J, Gislason, T, Gislason, D, Prichard, J, Allwright, S, Macleod, D, Bugiani, M, Bucca, Caterina, Romano, Canzio, de Marco, R, Lo Cascio, V, Campello, C, Marinoni, A, Cerveri, I, Casali, L, Rijcken, B, Kremer, A, Crane, J, Lewis, S, Gulsvik, A, Omenaas, E, Soriano, J, Tobías, A, Roca, J, Kogevinas, M, Muniozguren, N, Ramos González, J, Capelastegui, A, Martinez Moratalla, J, Almar, E, Maldonado, J, Pereira, A, Sánchez, J, Payo, F, Huerta, I, Boman, G, Janson, C, Bjornsson, E, Rosenhall, L, Norrman, E, Lundback, B, Lindholm, N, Plaschke, P, Ackermann Liebrich, U, Künzli, N, Perruchoud, A, Burr, M, Layzqll, J, Hall, R, Harrison, B, Stark, J, Chinn, S, Luczynska, C, Jarvis, D, Lai, E, Buist, S, Vollmer, W, and Osborne, M.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Multivariate analysis, Cross-sectional study, International Cooperation, Asthma, definition, epidemiology, method, risk factor, Sensitivity and Specificity, Severity of Illness Index, Age Distribution, immune system diseases, Risk Factors, Surveys and Questionnaires, Severity of illness, Epidemiology, medicine, Confidence Intervals, Prevalence, Humans, Risk factor, Sex Distribution, Respiratory Sounds, business.industry, Airway Resistance, Odds ratio, Middle Aged, medicine.disease, Prognosis, respiratory tract diseases, Respiratory Function Tests, Cross-Sectional Studies, Dyspnea, Bronchial hyperresponsiveness, Multivariate Analysis, Physical therapy, Female, business, Clinical psychology
Abstract

The most popular way to define asthma based on questionnaires is to use definitions taken from cross-sectional international studies on asthma. These definitions may not, however, be optimal for future studies focusing on risk factors of asthma. The current authors, therefore, compared the performance of different operational definitions of asthma. The European Community Respiratory Health Study I was a cross-sectional study of 21,924 subjects aged between 25-44 yrs in 18 countries. Operational definitions of asthma compared included different combinations of symptoms of asthma and bronchial hyperresponsiveness. A continuous asthma score, ranging from 0-8, was defined as the sum of positive answers to eight main symptom questions. There was no threshold in the associations of asthma symptoms with severity or risk factors of asthma, which would have suggested a dichotomous definition of asthma. Using dichotomous definitions requiring the presence of several asthma symptoms strengthened associations with studied risk factors, and also increased the estimated specificity and positive predictive value. Using a continuous asthma score also improved the power of the analyses. In conclusion, dichotomous definitions of asthma yielding higher odds ratios are achieved by requiring positive responses to several questions on symptoms. However, symptoms of asthma are possibly best analysed as a continuous asthma score.

Published
2005

6. Relationships of allergic sensitization, total immunoglobulin E and blood eosinophils to asthma severity in children of the EGEA Study

Author

Valérie SIROUX, Oryszczyn, M. P., Paty, E., Kauffmann, F., Pison, C., Vervloet, D., Pin, I., Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie et Biostatistique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie Allergologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de médecine aiguë spécialisée, CHU Grenoble-Hôpital Michallon, Clinique de pneumologie, CHU Grenoble, Service de Pneumologie-Allergologie [Hôpital de la Timone - APHM], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Equipe 12 (Epidémiologie Environnementale appliquée à la Reproduction et la Santé Respiratoire), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Département de pédiatrie, CHU Grenoble-Hôpital Michallon-Hôpital Michallon, Boudier, Anne, Institut d'oncologie/développement Albert Bonniot de Grenoble ( INSERM U823 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Département de pédiatrie, Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Département de pédiatrie

Subjects
Male, MESH : Case-Control Studies, MESH: Asthma, Adolescent, MESH: Hypersensitivity, MESH : Male, macromolecular substances, MESH : Child, Preschool, MESH : Asthma, MESH : Immunoglobulin E, MESH: Eosinophilia, Leukocyte Count, MESH : Child, MESH : Chronic Disease, immune system diseases, MESH: Skin Tests, MESH : Adolescent, MESH: Child, Eosinophilia, Hypersensitivity, Humans, MESH : Female, Child, Skin Tests, MESH: Adolescent, MESH : Hypersensitivity, MESH: Humans, MESH: Chronic Disease, MESH : Humans, MESH: Immunoglobulin E, MESH: Child, Preschool, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Leukocyte Count, Immunoglobulin E, MESH: Case-Control Studies, MESH: Male, Asthma, respiratory tract diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Eosinophilia, MESH: Leukocyte Count, Case-Control Studies, Child, Preschool, Chronic Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, MESH: Female, MESH : Skin Tests
Abstract

International audience; BACKGROUND: Although allergy is highly associated with childhood asthma, it is not well known if there is a relationship between the intensity of allergic sensitization and asthma severity. OBJECTIVE: The objectives of the study were to examine the relationships between several markers of allergy and asthma severity in asthmatic children included in the Epidemiological study on the Genetics and Environment of Asthma, bronchial hyper-responsiveness and atopy (EGEA). METHODS: The population comprised 216 asthmatic children below 16 years of age. Total IgE and blood eosinophil counts were measured and skin prick tests to 11 aeroallergens were performed. The intensity of the allergic sensitization was assessed by the number of positive skin prick tests and by skin weal sizes. Asthma severity was measured with four criteria: a clinical severity score, history of hospitalization for asthma, FEV1% predicted and inhaled steroid use in the last 12 months. RESULTS: Most of the children were sensitized to at least one aeroallergen (88.2%). Atopy was not related to the severity of asthma, except for a tendency for a more severe clinical score in non-atopic children. The type and intensity of the allergic sensitization were not associated with any criteria of asthma severity. Total IgE was significantly increased in children treated with inhaled corticosteroids and in children ever hospitalized for asthma (P-values 0.009 and 0.04, respectively). Eosinophil counts were not related to asthma severity. CONCLUSION: Our results suggest that severe childhood asthma may be related to a high level of total IgE but not to blood eosinophil counts. The lack of positive relationships between both atopy and the intensity of allergic sensitization with asthma severity supports the hypothesis of different risk factors being associated with asthma and with the severity of asthma.

Published
2003

7. Aspergillus and lung transplant recipients: a mycologic and molecular epidemiologic study

Author

Marie-Pierre Brenier-Pinchart, Lebeau B, Devouassoux G, Mondon P, Pison C, Ambroise-Thomas P, and Grillot R

Subjects
Adult, Male, Polymorphism, Genetic, Heart-Lung Transplantation, Aspergillus fumigatus, Bronchi, Middle Aged, Opportunistic Infections, Diagnosis, Differential, Aspergillosis, Humans, Female, Bronchoalveolar Lavage Fluid, Sequence Analysis, DNA Primers, Lung Transplantation, Retrospective Studies
Abstract

After lung transplantation, filamentous fungi and more particularly Aspergillus fumigatus are commonly isolated, although the origin of contamination is unclear.To investigate the fungal flora in bronchoscopic fluids, we retrospectively reviewed 20 cases of lung transplant recipients. Using sequence-specific DNA primers analysis, we typed the clinical strains of A. fumigatus isolated from 6 lung transplant recipients. For 4 of them, the strains of this species were isolated from their environment.At least once 90% of patients had filamentous fungi, and A. fumigatus was the most frequently isolated. Bronchial colonization was detected in 14 patients, invasive bronchial mycosis was diagnosed in 4 others, and no case of invasive pulmonary fungal infection was detected. Genome typing of the 47 clinical strains revealed that a given patient could be affected by several different strains. A very extensive polymorphism existed among the 38 environmental strains. Origin of contamination at home was possible in 1 case and in the hospital in 3 cases.Bronchial colonization is frequent after lung transplantation. Although the clinical strains show a polymorphism, it is less widespread than the polymorphism of environmental strains. The origin of acquisition may be in the patient's community.

Published
1998

8. EGEA (Epidemiological study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy) - descriptive characteristics

Author

Kauffmann, F., Marie-Hélène Dizier, Annesi-Maesano, I., Bousquet, J., Charpin, D., Demenais, F., Ecochard, D., Feingold, J., Gormand, F., Grimfeld, A., Lathrop, M., Matran, R., Neukirch, F., Paty, E., Pin, I., Pison, C., Scheinmann, P., Vervloet, D., Lockhart, A., Groupe de Recherche en Informatique, Image et Instrumentation de Caen (GREYC), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS), Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Hematology, Centre Hospitalier de la Côte Basque (CHCB), Centre National de Génotypage (CNG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Institut de Biologie du Développement de Marseille (IBDM), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Public Hospital Medical Service, Ministry of Health [Mozambique], Service de Pneumologie-Allergologie [Hôpital de la Timone - APHM], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Kauffmann F, Dizier MH, Lathrop M, Matran R, Neukirch F, Paty E, Pin I, Pison C, Scheinmann P, Vervloet D, Lockhart A., Annesi-Maesano I, Bousquet J, Charpin D, Demenais F, Ecochard D, Feingold J, Gormand F, Grimfeld A, Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Le CHCB, Centre Hospitalier de la Côte Basque, and Annesi-Maesano, Isabella

Subjects
Adult, Male, Adolescent, MESH: Asthma, MESH: Hypersensitivity, Environment, Risk Factors, MESH: Risk Factors, MESH: Child, Hypersensitivity, Humans, Child, MESH: Environment, MESH: Adolescent, MESH: Humans, MESH: Child, Preschool, MESH: Bronchial Hyperreactivity, Infant, MESH: Adult, MESH: Infant, Asthma, MESH: Male, respiratory tract diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Child, Preschool, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Bronchial Hyperreactivity, MESH: Female
Abstract

International audience; The Epidemiological study on the Genetics and Environment of Asthma (EGEA) was planned to assess genetic, environmental risk factors and their interactions for asthma and for the two related traits of bronchial hyperresponsiveness and atopy. The population examined includes 348 nuclear families ascertained by one asthmatic (213 adult and 135 paediatric probands) and 416 controls, totalling 1,847 subjects (EGEA I). Prevalences of asthma, skin prick test response, high IgE and bronchial hyperresponsiveness were for parents, siblings, and offspring of cases intermediate between cases and spouses or controls, both in adults and children, confirming the familial resemblance for asthma and related traits. With an additional sample of 40 families ascertained by two asthmatic siblings (EGEA II), a total of 119 families with two asthmatic siblings has been ascertained for a genome screening.

10. Therapeutic education of adult and adolescent asthmatic patients,Éducation thérapeutique du patient ashmatique adulte et adolescent

Author

Matillon, Y., Roche, N., Godard, P., Bouchet, M. -F, Compagnon, A., Gouilly, P., Morel, H., Pujet, J. -C, Sandrin-Berthon, B., Tunon Lara, J. -M, Pauchet-Traversat, A. -F, Berthon, I., Bridon, F., Dubreuil, C., Halimi, L., Iguenane, J., Martin-Dupont, F., Michel, C. P., Mouren-Provensal, A., Pellet, F., Petite, J., Prud Homme, A., Rizzolini, C., Serrier, P., Sevin, C., Alfonso-Roca, M. T., Aubreton, S., Benard, A., Bidat, E., Boisserie-Lacroix, V., Boulet, L. -P, Chaumier, P., Chevallier, P., Colin, J. -P, Cusin, F., D Ivernois, J. -F, Dantzer, C., David, M., Blay, F., Deccache, A., Demeaux, J. -L, Develay, A. -E, Didier, A., Dumarcet, N., Dusser, D., Emeriaud, P., Farinotti, R., Ferry, J. -P, Gagnayre, R., Galtier, L., Garabedian, M., Gay, B., Ginieres, B., Gras, D., Hamon, M., Leroyer, C., Lhez, P., Lyon, G., Magar, Y., Mangiapan, G., Renzo Marcolongo, Martin, F., Moulines, C., Navarro, F., Nguyen Thanh, P., Nicot, P., Paganin, F., Papa, M., Pennamen, H., Piroux, S., Pison, C., Ploin, D., Prouff, B., Provitolo, F., Querleu, D., Racineux, J. -L, Reidiboym, M., Rostoker, G., Sapene, M., Sevette, C., Steenhouwer, F., Stenger, R., Taytard, A., Es, P., Vervloet, D., Villanueva, P., and Vergnenègre, A.

11. MeDALL (Mechanisms of the Development of ALLergy): An integrated approach from phenotypes to systems medicine,MeDALL (Mechanizmy powstawania alergii): Zintegrowane podejście - od fenotypów do medycyny systemowej

Author

Kowalski, M. L., Akdis, M., Auffray, C., Keil, T., Anto, J., Bousquet, J., Grupa Badawcza Medall, I., Haahtela, T., Cambon-Thomsen, A., Lambrecht, B. N., Postma, D. S., Sunyer, J., Valenta, R., Akdis, C. A., Annesi-Maesano, I., Arno, A., Bachert, C., Ballester, F., Basagana, X., Baumgartner, U., Bindslev-Jensen, C., Brunekreef, B., Carlsen, K. H., Chatzi, L., Crameri, R., Eveno, E., Forastiere, F., Garcia-Aymerich, J., Guerra, S., Hammad, H., Heinrich, J., Hirsch, D., Jacquemin, B., Kauffmann, F., Kerkhof, M., Kogevinas, M., Koppelman, G. H., Lau, S., Lodrup-Carlsen, K. C., Lopez-Botet, M., Lotvall, J., Lupinek, C., Maier, D., Makela, M. J., Martinez, F. D., Mestres, J., Momas, I., Martijn Nawijn, Neubauer, A., Oddie, S., Palkonen, S., Pin, I., Pison, C., Rancé, F., Reitamo, S., Rial-Sebbag, E., Salapatas, M., Siroux, V., Smagghe, D., Torrent, M., Toskala, E., Cauwenberge, P., Oosterhout, A. J. M., Varraso, R., Hertzen, L., Wickman, M., Wijmenga, C., Worm, M., Wright, J., and Zuberbier, T.

14. Genes for asthma? An analysis of the European Community Respiratory Health Survey

Author

Burney, P., Chinn, S., Luczynska, C., Jarvis, D., Vermeire, P., Bousquet, J., Nowak, D., Prichard, J., Marco, R., Rijcken, B., Anto, J., Alves, J., Boman, G., Nielsen, N., Paoletti, P., Kesteloot, H., Ait-Khaled, N., Popp, W., Michael Abramson, Kutin, J., Bastelaer, F., Dahl, R., Iversen, M., Jögi, R., Neukirch, F., Liard, R., Pin, I., Pison, C., Taytard, A., Teculescu, D., Magnussen, H., Heinrich, J., Wichmann, H. E., Papageorgiou, N., Avarlis, P., Gaga, M., Marossis, C., Gislason, T., Gislason, D., Chowgule, R., Allwright, S., Macleod, D., Bugiani, M., Bucca, C., Romano, C., Marco Lo Cascio, R., Campello, C., Marinoni, A., Cerveri, I., Casali, L., Kresmer, A., Crane, J., Lewis, S., Gulsvik, A., Omenaas, E., Avila, R., Amaral Marques, R., Loureiro, C., Chieira, C., Cordeiro, R., Marques, J. A., Castellasague, J., Sunyer, J., Soriano, J., Galobardes, M., Roca, J., Muniozguren, N., Ramos, J., Ramos González, J., Capelastegui, A., Castillo, J., Rodriguez Portal, J., Martinez-Motatella, J., Almar, E., Maldonado Pérez, J., Pereira, A., Sánchez, J., Quiros, J., Huerta, I., Janson, C., Björnsson, E., Rosenhall, L., Norrman, E., Lundbät, B., Lindholm, N., Plaschke, P., Ackermann-Liebrich, U., Künzli, N., Perruchoud, A., Burr, M., Layzell, J., Hall, R., Harrison, B., Stark, J., Florey, C., Da Costa Pereira, A., and Wjst, M.

16. [Allergic bronchopulmonary aspergillosis disclosing mucoviscidosis]

Author

Coltey B, Pin I, Gilbert Ferretti, Bonadona A, Pison C, and Brambilla C

Subjects
Adult, Cystic Fibrosis, Aspergillosis, Allergic Bronchopulmonary, Humans, Female
Abstract

In predisposed patients, allergic bronchopulmonary aspergillosis (ABPA) can arise from aspergillus bronchial colonization. We report the case of a young woman who presented with a right basal pneumonia, ground glass opacities and mediastinal adenopathies on CT scan. Biological, radiological and clinical criteria, as well as an history of childhood asthma, allowed the initial diagnosis of ABPA. However, the unusual coexistence of an additional infection with Pseudomonas Aeruginosa evoked the diagnosis of cystic fibrosis, confirmed by a sweat test and genetic analysis. Under corticosteroid and antifungal therapy and antibiotics, the clinical and radiological evolution was favourable but immuno-allergic sensitisation persisted. The ABPA-cystic fibrosis association is not rare with an estimated prevalence of 2% to 11% according to previous studies. This variability is partly explained by the difficulty of the diagnosis due to confounding clinical, radiological, and biological signs between ABPA and cystic fibrosis. Many predictive development factors of ABPA in the context of cystic fibrosis have been reported, including respiratory function, personal or familial atopy, colonization with Pseudomonas Aeruginosa and age. As in non cystic fibrosis patients, the treatment requires systemic corticotherapy and itraconazole. ABPA is still often under diagnosed and should be evoked in the context of cystic fibrosis.

18. MeDALL (Mechanisms of the Development of ALLergy): An integrated approach from phenotypes to systems medicine | MeDALL (Mechanizmy powstawania alergii): Zintegrowane podejście - od fenotypów do medycyny systemowej

Author

Kowalski, M. L., Akdis, M., Auffray, C., Keil, T., Anto, J., Bousquet, J., Grupa Badawcza Medall, I., Haahtela, T., Cambon-Thomsen, A., Lambrecht, B. N., Postma, D. S., Sunyer, J., Valenta, R., Akdis, C. A., Annesi-Maesano, I., Arno, A., Bachert, C., Ballester, F., Basagana, X., Baumgartner, U., Bindslev-Jensen, C., Brunekreef, B., Carlsen, K. H., Chatzi, L., Crameri, R., Eveno, E., Francesco Forastiere, Garcia-Aymerich, J., Guerra, S., Hammad, H., Heinrich, J., Hirsch, D., Jacquemin, B., Kauffmann, F., Kerkhof, M., Kogevinas, M., Koppelman, G. H., Lau, S., Lodrup-Carlsen, K. C., Lopez-Botet, M., Lotvall, J., Lupinek, C., Maier, D., Makela, M. J., Martinez, F. D., Mestres, J., Momas, I., Nawijn, M. C., Neubauer, A., Oddie, S., Palkonen, S., Pin, I., Pison, C., Rancé, F., Reitamo, S., Rial-Sebbag, E., Salapatas, M., Siroux, V., Smagghe, D., Torrent, M., Toskala, E., Cauwenberge, P., Oosterhout, A. J. M., Varraso, R., Hertzen, L., Wickman, M., Wijmenga, C., Worm, M., Wright, J., and Zuberbier, T.

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