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1. Patients Treated for Central Airway Stenosis After Lung Transplantation Have Persistent Airflow Limitation

Author

Andrea Mazzetta, Gilbert Massard, Benjamin Coiffard, Joseph Seitlinger, Benjamin Renaud-Picard, Tristan Dégot, Anne Olland, Romain Kessler, Marianne Riou, and Michele Porzio

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Single Center, 03 medical and health sciences, FEV1/FVC ratio, Postoperative Complications, 0302 clinical medicine, Bronchoscopy, medicine, Humans, Lung transplantation, Respiratory function, Retrospective Studies, Original Paper, Transplantation, Lung, business.industry, Respiratory infection, General Medicine, Middle Aged, respiratory system, Surgery, medicine.anatomical_structure, 030228 respiratory system, Airway Remodeling, Female, Respiratory Insufficiency, Complication, business, Lung Transplantation
Abstract

BACKGROUND Although central airway stenosis (CAS) is a common complication after lung transplantation, its consequences have been poorly evaluated. The objective of our study was to evaluate the impact of CAS on lung function after lung transplantation. MATERIAL AND METHODS All lung transplant recipients from June 2009 to August 2014 in a single center (Strasbourg, France) were retrospectively reviewed. RESULTS A total of 191 lung transplantations were performed: 175 bilateral, 15 single, and 1 heart-lung transplantation. Of the 161 bilateral lung-transplanted patients who survived >3 months, 22 (13.6%) developed CAS requiring endobronchial treatment. All these patients were treated by endoscopic balloon dilatation, and 9 additionally needed endobronchial stents. Respiratory function tests demonstrated persistent obstructive ventilatory pattern despite endoscopic treatment in recipients with CAS compared to those without CAS at 6, 12, and 18 months post-transplant. At 18 months, CAS patients had significantly lower post-transplant FEV1 (1.96±0.60 L versus 2.57±0.76 L, p=0.001) and FEV1/FVC (61±14% versus 81±13%, p

Published
2019
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2. Circulating tumour cells as a potential screening tool for lung cancer (the AIR study): protocol of a prospective multicentre cohort study in France

Author

Sylvie Leroy, Paul Hofman, Julien Mazieres, Jonathan Benzaquen, Pascal Chanez, Andrea Mazzetta, Christophe Pison, Jacques Cadranel, Bernard Padovani, Dominique Israel-Biet, Marius Ilie, Charles-Hugo Marquette, Véronique Hofman, Charlotte Cohen, Sylvain Marchand-Adam, Vincent Jounieaux, Centre Hospitalier Universitaire de Nice (CHU Nice), Institut de pharmacologie moléculaire et cellulaire (IPMC), Centre National de la Recherche Scientifique (CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA), Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Clinique de pneumologie, CHU Grenoble, Unité des Rickettsies et pathogènes émergents (URPE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Amiens-Picardie, Infection bactérienne, inflammation, et carcinogenèse digestive, COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR50-Université Côte d'Azur (UCA), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-IFR50-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), CHU Nice, Institut de pharmacologie moléculaire et cellulaire ( IPMC ), Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de Recherche sur le Cancer et le Vieillissement ( IRCAN ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ), Université de Tours-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire de Tours ( CHRU TOURS ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Unité des Rickettsies et pathogènes émergents ( URPE ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes ( URMITE ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ), Service de pneumologie et réanimation [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Institut Universitaire du Cancer de Toulouse - Oncopole ( IUCT Oncopole - UMR 1037 ), Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ) -IFR50-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Toulouse III - Paul Sabatier (UT3), and Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Oncology, Male, medicine.medical_specialty, Lung Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, cytopathology, Double-Blind Method, Internal medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, medicine, Protocol, Biomarkers, Tumor, Humans, Prospective Studies, Lung cancer, Prospective cohort study, Early Detection of Cancer, Cause of death, Protocol (science), COPD, business.industry, screening, Cancer, copd, General Medicine, medicine.disease, Neoplastic Cells, Circulating, 3. Good health, lung cancer, 030228 respiratory system, Cytopathology, Research Design, 030220 oncology & carcinogenesis, Female, France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cohort study
Abstract

IntroductionLung cancer (LC) is the leading cause of death from cancer. Early diagnosis of LC is of paramount importance in terms of prognosis. The health authorities of most countries do not accept screening programmes based on low-dose chest CT (LDCT), especially in Europe, because they are flawed by a high rate of false-positive results, leading to a large number of invasive diagnostic procedures. These authorities advocated further research, including companion biological tests that could enhance the effectiveness of LC screening. The present project aims to validate early diagnosis of LC by detection and characterisation of circulating tumour cells (CTCs) in a peripheral blood sample taken from a prospective cohort of persons at high-risk of LC.Methods and analysisThe AIR Project is a prospective, multicentre, double-blinded, cohort study conducted by a consortium of 21 French university centres. The primary objective is to determine the operational values of CTCs for the early detection of LC in a cohort of asymptomatic participants at high risk for LC, that is, smokers and ex-smokers (≥30 pack-years, quitted ≤15 years), aged ≥55 years, with chronic obstructive pulmonary disease (COPD). The study participants will undergo yearly screening rounds for 3 years plus a 1-year follow-up. Each round will include LDCT plus peripheral blood sampling for CTC detection. Assuming 5% prevalence of LC in the studied population and a 10% dropout rate, a total of at least 600 volunteers will be enrolled.Ethics and disseminationThe study sponsor is the University Hospital of Nice. The study was approved for France by the ethical committee CPP Sud-Méditerranée V and the ANSM (Ministry of Health) in July 2015. The findings of the trial will be disseminated through peer-reviewed journals and national and international conference presentations.Trial registration numberNCT02500693.

Published
2017
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3. LATE-BREAKING ABSTRACT: Long-term consequences of central airways stenosis after lung transplantation

Author

Andrea Mazzetta, Anne Olland, Michele Porzio, and Romain Kessler

Subjects
medicine.medical_specialty, Lung, business.industry, medicine.medical_treatment, Endoscopic dilatation, respiratory system, Single Center, medicine.disease, respiratory tract diseases, Surgery, Stenosis, medicine.anatomical_structure, Internal medicine, medicine, Cardiology, Lung transplantation, Respiratory function, business, Airway, Complication
Abstract

Central airways stenosis after lung transplantation is a frequent but poorly understood complication. Objectives of our study were to evaluate if stenosis was associated with worse outcomes after transplant. Lung transplant recipients of a single center (Strasbourg, France) between April 2009 and August 2014 were retrospectively reviewed. 191 lung transplants were realized: 175 bilateral lung transplants, 15 single lung, 1 cardiopulmonary. 22 (13%) developed central airway stenosis requiring endobronchial treatment. All these patients were treated by endoscopic dilatation with balloon; 9 patients (43%) needed endobronchial stents. Survival in recipients with or without central airway stenosis was not different. Respiratory infections and duration of hospitalization were significantly increased in recipients with airway stenosis (p=0,006, p=0,048 respectively). Respiratory function tests showed a decreased forced expiratory volume in one second (FEV1, %pred) in recipients with central airway stenosis, despite endoscopic treatment. Central airway stenosis after lung transplantation was not associated with a worse survival in our experience, but it showed an impact on long term lung function and it was a risk factor for respiratory infections.

Published
2016
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4. An unusual presentation of pulmonary complication of crack abuse

Author

Valentina Conio, Isa Cerveri, Andrea Mazzetta, Thomas Galasso, Eti Maria Giulia Di Vincenzo, and Federica Meloni

Subjects
medicine.medical_specialty, Inhalation, business.industry, Pulmonary Complication, respiratory system, medicine.disease, Air trapping, respiratory tract diseases, Surgery, Diffusing capacity, Eosinophilic, medicine, Radiology, medicine.symptom, Presentation (obstetrics), business, Perfusion, Asthma
Abstract

Crack inhalation causes a wide spectrum of pulmonary complications and the diagnosis is often delayed or mistaken. We present the case of a 19-year-old woman, mild cigarette-smoker, who referred for asthma not responsive to therapy. A severe obstructive pattern with severe hyperinflation and decreased carbon dioxide diffusing capacity were documented. At HRCT there was evidence of bilateral mild ground glass opacities, diffuse bronchial wall thickening and mosaic perfusion with air trapping in the expiratory phase. Broncho-alveolar lavage showed an increased total cellularity (lymphocytic cells 25%; eosinophilic cells 11%; CD4/CD8

Published
2015
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5. Severe obstructive pattern mimicking an asthma exacerbation as first presentation of crack smoking: A case report

Author

Isa Cerveri, Eti Maria Giulia Di Vincenzo, Andrea Mazzetta, Valentina Conio, Thomas Galasso, Elena Paracchini, Federica Meloni, and Sara Surbone

Subjects
Intoxicative inhalant, medicine.medical_specialty, Pediatrics, Asthma exacerbations, Inhalation, business.industry, Mechanical Engineering, Metals and Alloys, medicine.disease, Surgery, Pulmonary function testing, Mechanics of Materials, Bronchiolitis, medicine, Presentation (obstetrics), business, Lung function
Abstract

Crack inhalation is known to cause a wide spectrum of acute and chronic pulmonary complications, along with imaging manifestations and lung function patterns. The diagnosis of these conditions is often delayed or mistaken. Only little information about the management and follow up of these pulmonary complications is available in literature. We present the case of a young patient referred to our clinic for symptoms mimicking an asthma exacerbation, not responsive to inhalant treatment. After investigations and the admission of crack abuse by the patient a final diagnosis of bronchiolitis crack-related was made. The patient was then followed for more than a year showing that lung function tests may be useful both for the diagnosis and follow up of such pulmonary complications.

Published
2015
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