Search

Your search keyword '"MESH : Immunosuppression"' showing total 6 results
Start Over Descriptor "MESH : Immunosuppression"
6 results on '"MESH : Immunosuppression"'

1. Mechanisms of action of antithymocyte globulin: old dogs with new tricks!

Author

Béatrice Gaugler, Mohamad Mohty, Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Laennec-Centre National de la Recherche Scientifique ( CNRS ) -Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Service d'hématologie clinique, Hôpital Hôtel-Dieu [Paris], Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and Saas, Philippe

Subjects
Cancer Research, [SDV.IMM] Life Sciences [q-bio]/Immunology, Globulin, medicine.medical_treatment, MESH : Lymphocytes, MESH : Antilymphocyte Serum, Hematopoietic stem cell transplantation, 03 medical and health sciences, 0302 clinical medicine, MESH: Antilymphocyte Serum, Antigen, Antigens, CD, MESH : Antigens, CD, medicine, Humans, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Lymphocytes, MESH: Antigens, CD, Antilymphocyte Serum, 030304 developmental biology, Immunosuppression Therapy, 0303 health sciences, MESH: Humans, MESH: Dendritic Cells, biology, MESH : Humans, MESH: Immunosuppression, Immunosuppression, T-cell depletion, Dendritic Cells, Hematology, 3. Good health, Transplantation, Oncology, Polyclonal antibodies, MESH : Dendritic Cells, MESH : Immunosuppression, Immunology, biology.protein, [SDV.IMM]Life Sciences [q-bio]/Immunology, MESH: Lymphocytes, Antithymocyte globulins, 030215 immunology
Abstract

International audience; Understanding the mechanisms underlying immunological tolerance is the key to successful transplantation. Recent findings demonstrate that polyclonal antibodies such as the antithymocyte globulins preparations can provide wide spectrum immunomodulation, suggesting that their use in the immunosuppression therapeutic armamentarium may help in reducing the incidence of organ rejection and improving patients' outcome after hematopoietic stem cell transplantation.

Published
2008

2. 30-yr course and favorable outcome of alveolar echinococcosis despite multiple metastatic organ involvement in a non-immune suppressed patient

Author

Georges Mantion, Solange Bresson-Hadni, Jean-Philippe Miguet, Frédéric Grenouillet, Dominique A. Vuitton, Oleg Blagosklonov, Karine Bardonnet, Eric Delabrousse, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Service de parasitologie et mycologie [CHRU de Besançon], Service de Médecine nucléaire, biophysique, isotopes [CHRU Besançon], AIREA 'association pour l'information et la recherche sur l'echinococcose alveolaire' Funding Text : This study was supported by a grant from AIREA 'association pour l'information et la recherche sur l'echinococcose alveolaire', Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Parasitologie-Mycologie CHU Besançon, and Dept. of Nucl. Med., Jean Minjoz Univ. Hosp., Besancon

Subjects
Lung Diseases, Male, medicine.medical_treatment, lcsh:QR1-502, Case Report, Disease, Liver transplantation, lcsh:Microbiology, DISEASE, Serology, MESH : Liver Diseases, MESH: Lung Diseases, Lung, MULTICENTER CLINICAL-TRIALS, LIVER-TRANSPLANTATION, MULTILOCULARIS INFECTION, FOLLOW-UP, DIFFERENTIATION, IMMUNODIAGNOSIS, IMPROVEMENT, RECURRENCE, DIAGNOSIS, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, MESH: Treatment Outcome, 0303 health sciences, MESH : Lung Diseases, Antinematodal Agents, Liver Diseases, MESH: Echinococcosis, Hepatic, MESH: Immunosuppression, Immunosuppression, General Medicine, MESH: Follow-Up Studies, MESH : Adult, Echinococcosis, MESH: Positron-Emission Tomography, 3. Good health, Mebendazole, MESH : Antinematodal Agents, Infectious Diseases, medicine.anatomical_structure, Treatment Outcome, medicine.drug, Microbiology (medical), Adult, MESH : Albendazole, medicine.medical_specialty, Echinococcosis, Hepatic, MESH: Liver Diseases, MESH : Male, MESH : Lung, MESH : Treatment Outcome, Albendazole, MESH: Mebendazole, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, medicine, MESH: Albendazole, Humans, lcsh:RC109-216, MESH: Lung, 030304 developmental biology, MESH : Mebendazole, Immunosuppression Therapy, Chemotherapy, MESH: Humans, 030306 microbiology, business.industry, lcsh:RM1-950, MESH : Humans, MESH : Positron-Emission Tomography, MESH : Follow-Up Studies, MESH: Adult, medicine.disease, MESH: Male, Surgery, lcsh:Therapeutics. Pharmacology, Positron-Emission Tomography, MESH : Immunosuppression, business, MESH : Echinococcosis, Hepatic, MESH: Antinematodal Agents, Follow-Up Studies
Abstract

We report the 30-yr history of a well-documented human case of alveolar echinococcosis, with a lung lesion at presentation followed by the discovery of a liver lesion, both removed by surgery. Subsequently, within the 13 years following diagnosis, metastases were disclosed in eye, brain and skull, as well as additional lung lesions. This patient had no immune suppression, and did not have the genetic background known to predispose to severe alveolar echinococcosis; it may thus be hypothesized that iterative multi-organ involvement was mostly due to the poor adherence to benzimidazole treatment for the first decade after diagnosis. Conversely, after a new alveolar echinococcosis recurrence was found in the right lung in 1994, the patient accepted to take albendazole continuously at the right dosage. After serology became negative and a fluoro-deoxy-glucose-Positron Emission Tomography performed in 2005 showed a total regression of the lesions in all organs, albendazole treatment could be definitively withdrawn. In 2011, the fluoro-deoxy-glucose-Positron Emission Tomography showed a total absence of parasitic metabolic activity and the patient had no clinical symptoms related to alveolar echinococcosis. The history of this patient suggests that multi-organ involvement and alveolar echinococcosis recurrence over time may occur in non-immune suppressed patients despite an apparently “radical” surgery. Metastatic dissemination might be favored by a poor adherence to chemotherapy. Combined surgery and continuous administration of albendazole at high dosage may allow alveolar echinococcosis patients to survive more than 30 years after diagnosis despite multi-organ involvement.

Published
2013

3. Diagnosis and treatment of digestive cryptosporidiosis in allogeneic haematopoietic stem cell transplant recipients: a prospective single centre study

Author

E. Deconinck, Faezeh Legrand, Frédéric Grenouillet, Frédéric Dalle, Fabrice Larosa, Philippe Saas, Laurence Millon, Pierre Rohrlich, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Interactions Muqueuses Agents Transmissibles ( LIMA ), Université de Bourgogne ( UB ), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Interactions Muqueuses Agents Transmissibles (LIMA), and Université de Bourgogne (UB)

Subjects
Male, medicine.medical_treatment, MESH : Cryptosporidium parvum, Cryptosporidiosis, Graft vs Host Disease, Hematopoietic stem cell transplantation, Azithromycin, Gastroenterology, 0302 clinical medicine, immune system diseases, MESH : Thiazoles, MESH: Animals, MESH : Female, 030212 general & internal medicine, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, MESH : Azithromycin, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Antibacterial agent, 0303 health sciences, MESH: Middle Aged, biology, MESH : Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, MESH: Immunosuppression, Nitazoxanide, Immunosuppression, Hematology, Middle Aged, MESH : Adult, Nitro Compounds, MESH : Diagnosis, Differential, 3. Good health, Cryptosporidium parvum, surgical procedures, operative, MESH: Young Adult, Female, medicine.symptom, MESH : Lymphopenia, medicine.drug, Adult, medicine.medical_specialty, MESH : Transplantation, Homologous, MESH : Male, MESH : Young Adult, MESH: Thiazoles, MESH: Graft vs Host Disease, Asymptomatic, MESH: Lymphopenia, Diagnosis, Differential, 03 medical and health sciences, Young Adult, MESH: Diagnosis, Differential, Internal medicine, MESH: Azithromycin, Lymphopenia, MESH : Hematopoietic Stem Cell Transplantation, medicine, MESH: Transplantation, Homologous, Animals, Humans, Transplantation, Homologous, MESH : Middle Aged, MESH : Cryptosporidiosis, MESH: Hematopoietic Stem Cell Transplantation, Immunosuppression Therapy, Transplantation, MESH: Humans, 030306 microbiology, business.industry, MESH: Cryptosporidiosis, MESH : Humans, MESH: Adult, biology.organism_classification, MESH: Male, Thiazoles, Immunology, MESH : Immunosuppression, MESH: Cryptosporidium parvum, MESH : Animals, business, MESH: Female
Abstract

International audience; Digestive cryptosporidiosis (DC) can mimic GVHD after allogeneic haematopoietic stem cell transplantation (HSCT), thus requiring a reduction of immunosuppressive drugs and a specific therapy, whereas GVHD requires an intensification of immunosuppression. We systematically searched for cryptosporidiosis by light microscopy, immunochromatography and PCR in HSCT recipients who presented with at least one episode of diarrhoea. Of 115 consecutive patients allografted between July 2006 and November 2008, we analysed stools in 52 of 56 patients meeting these criteria. We identified Cryptosporidium parvum in 5 of the 52 patients (9.6%) at a median of 503 days (range 20-790) after HSCT. In those five patients, the median CD4+ cell and B lymphocyte counts were 60/mm3 (0-234) and 0/mm3 (0-96), respectively. Two patients died of invasive fungal infections. In the other three patients, diarrhoea disappeared after a median of 5 weeks following onset of bitherapy with azithromycine and nitazoxanide; they were still alive 433, 380 and 1179 days after the DC diagnosis. DC is probably under diagnosed after HSCT because it is difficult to detect during the asymptomatic phase. Early bitherapy and reduction of immunosuppression seem efficacious. In our series, DC has a seasonal pattern and is promoted by profound T lymphopenia.

Published
2011

4. Membrane-associated Hsp72 from tumor-derived exosomes mediates STAT3-dependent immunosuppressive function of mouse and human myeloid-derived suppressor cells

Author

Alain Rouleau, Jean-Paul Remy-Martin, David Lanneau, Benoit Simon, Lionel Apetoh, Christophe Borg, Gabriele Multhoff, Grégoire Mignot, Cédric Rébé, Bruno Chauffert, François Ghiringhelli, François Martin, Fanny Chalmin, Eric Solary, Sylvain Ladoire, Mélanie Bruchard, Carmen Garrido, Arlette Hamman, Bernhard Ryffel, Wilfrid Boireau, Julie Vincent, Aurélie de Thonel, Laurence Zitvogel, Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies ( FEMTO-ST ), Université de Technologie de Belfort-Montbeliard ( UTBM ) -Ecole Nationale Supérieure de Mécanique et des Microtechniques ( ENSMM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Department of Radiation Oncology [Munich], Ludwig-Maximilians-Universität München, Role des Cellules Dendritiques Dans la Regulation des Effecteurs de l'Immunite Antitumorale, Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Immunologie et embryologie moléculaires ( IEM ), Université d'Orléans ( UO ) -Centre National de la Recherche Scientifique ( CNRS ), Center for Neurologic Diseases, Harvard Medical School [Boston] ( HMS ), This work was supported by special grants from the Fondation de France, the Association pour la Recherche sur le Cancer, the Institut National de la Santé et de la Recherche Médicale, and the Ligue Nationale Contre le Cancer (Region Bourgogne). F. Chalmin was supported by the Conseil Régional Bourgogne/INSERM, J. Vincent by the Institut National contre le Cancer. G. Mignot was funded by the Association pour la Recherche sur le Cancer. C. Garrido and E. Solary lead teams supported by the 'Ligue Nationale Contre le Cancer.' L. Apetoh is supported by EMBO., Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Ludwig-Maximilians-Universität München (LMU), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Immunologie et Embryologie Moléculaires (IEM), Université d'Orléans (UO)-Centre National de la Recherche Scientifique (CNRS), Harvard Medical School [Boston] (HMS), Centre épigénétique et destin cellulaire (EDC (UMR_7216)), Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Mignot, Grégoire, and Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)

Subjects
MAPK/ERK pathway, MESH : Cell Line, [SDV]Life Sciences [q-bio], T-Lymphocytes, HSP72 Heat-Shock Proteins, Exosomes, T-Lymphocytes, Regulatory, MESH: Amiloride, Amiloride, MESH : T-Lymphocytes, Regulatory, Mice, 0302 clinical medicine, Neoplasms, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, MESH: Animals, MESH: Neoplasms, ComputingMilieux_MISCELLANEOUS, MESH : Cyclophosphamide, 0303 health sciences, education.field_of_study, MESH: Immunosuppression, MESH : Mice, Nude, General Medicine, 3. Good health, Cell biology, medicine.anatomical_structure, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, MESH : HSP72 Heat-Shock Proteins, Research Article, MESH: Cell Line, Tumor, [SDV.IMM] Life Sciences [q-bio]/Immunology, T cell, Population, Mice, Nude, Biology, Exosome, MESH: HSP72 Heat-Shock Proteins, Cell Line, 03 medical and health sciences, MESH : Amiloride, Cell Line, Tumor, MESH : Mice, medicine, MESH: Mice, Nude, Animals, Humans, MESH: Exosomes, education, Autocrine signalling, MESH: Mice, Cyclophosphamide, 030304 developmental biology, MESH : T-Lymphocytes, Immunosuppression Therapy, MESH: Humans, MESH : Cell Line, Tumor, MESH: T-Lymphocytes, Regulatory, MESH : Humans, MESH: Cyclophosphamide, MESH : Exosomes, MESH : Neoplasms, Microvesicles, MESH: Cell Line, TLR2, MESH: T-Lymphocytes, MESH : Immunosuppression, Myeloid-derived Suppressor Cell, MESH : Animals
Abstract

International audience; Myeloid-derived suppressor cells (MDSCs) have been identified in humans and mice as a population of immature myeloid cells with the ability to suppress T cell activation. They accumulate in tumor-bearing mice and humans and have been shown to contribute to cancer development. Here, we have isolated tumor-derived exosomes (TDEs) from mouse cell lines and shown that an interaction between TDE-associated Hsp72 and MDSCs determines the suppressive activity of the MDSCs via activation of Stat3. In addition, tumor-derived soluble factors triggered MDSC expansion via activation of Erk. TDE-associated Hsp72 triggered Stat3 activation in MDSCs in a TLR2/MyD88-dependent manner through autocrine production of IL-6. Importantly, decreasing exosome production using dimethyl amiloride enhanced the in vivo antitumor efficacy of the chemotherapeutic drug cyclophosphamide in 3 different mouse tumor models. We also demonstrated that this mechanism is relevant in cancer patients, as TDEs from a human tumor cell line activated human MDSCs and triggered their suppressive function in an Hsp72/TLR2-dependent manner. Further, MDSCs from cancer patients treated with amiloride, a drug used to treat high blood pressure that also inhibits exosome formation, exhibited reduced suppressor functions. Collectively, our findings show in both mice and humans that Hsp72 expressed at the surface of TDEs restrains tumor immune surveillance by promoting MDSC suppressive functions.

Published
2009

5. In-hospital mortality of infective endocarditis: prognostic factors and evolution over an 8-year period

Author

François Delahaye, François Alla, Isabelle Béguinot, Patrice Bruneval, Thanh Doco-Lecompte, Flore Lacassin, Christine Selton-Suty, François Vandenesch, Véronique Vernet, Bruno Hoen, null FOR THE AEPEI GROUP, Service Médecine légale et Droit de la Santé, Nancy Université, Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Ecole de santé publique, Université Paris Descartes - Paris 5 (UPD5)-Nancy Université, Immunité infection vaccination (I2V), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR128-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Laboratoire de Bactériologie, Hospices Civils de Lyon (HCL), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] ( Pôle S2R ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Université Paris Descartes - Paris 5 ( UPD5 ) -Nancy Université, Immunité infection vaccination ( I2V ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-IFR128-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hospices Civils de Lyon ( HCL ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-IFR128-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), and Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC )

Subjects
Male, MESH : Aged, 030204 cardiovascular system & hematology, MESH : Diabetes Mellitus, Type 1, 0302 clinical medicine, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine, MESH : Female, Hospital Mortality, 030212 general & internal medicine, MESH: Incidence, MESH : Endocarditis, Bacterial, Aged, 80 and over, MESH: Aged, education.field_of_study, MESH : Prognosis, MESH: Middle Aged, Incidence, Mortality rate, MESH: Immunosuppression, General Medicine, Middle Aged, MESH : Adult, Prognosis, Shock, Septic, MESH : Risk Factors, MESH : Incidence, 3. Good health, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Infectious Diseases, Infective endocarditis, Cohort, Female, MESH: Diabetes Mellitus, Type 1, Adult, Microbiology (medical), medicine.medical_specialty, MESH : Male, Population, MESH: Shock, Septic, MESH: Multivariate Analysis, MESH: Prognosis, MESH : Hospital Mortality, 03 medical and health sciences, MESH : Shock, Septic, Internal medicine, Humans, Endocarditis, MESH : Middle Aged, MESH: Endocarditis, Bacterial, MESH: Hospital Mortality, MESH : Aged, 80 and over, education, Aged, Heart Failure, Immunosuppression Therapy, MESH: Humans, General Immunology and Microbiology, business.industry, Septic shock, MESH : Humans, Glasgow Coma Scale, MESH : Multivariate Analysis, MESH: Adult, Endocarditis, Bacterial, Odds ratio, medicine.disease, MESH: Male, Surgery, Diabetes Mellitus, Type 1, Multivariate Analysis, MESH : Immunosuppression, MESH: Heart Failure, MESH : Heart Failure, business, MESH: Female
Abstract

International audience; Infective endocarditis (IE) remains severe. Few predictors of prognosis have been identified. It is not known whether mortality of IE has decreased during recent decades. 559 definite cases of IE were collected in a prospective population-based survey in 1999 in France. In-hospital death rate was 17%. It was lower in operated patients (14.4% vs 19.3%), although not significantly so. In multivariate analysis, the following variables were independent and significant predictors of mortality: history of heart failure (odds ratio: 2.65), history of immunosuppression (OR: 3.34), insulin-requiring diabetes mellitus (OR: 7.82), left-sided IE (OR: 1.97), heart failure (OR: 2.19), septic shock (OR: 4.33), lower Glasgow coma scale score (OR: 4.09), cerebral haemorrhage (OR: 9.46), and higher C-reactive protein level (OR: 2.60). Adjusted mortality was significantly lower in 1999 than in 1991 (22%): OR: 0.64 (p = 0.03). Thus, in a large and unselected cohort of patients hospitalized for IE in 1999, in-hospital mortality rate was lower than in 1991. Multivariate analysis identified factors classically known as having an impact on mortality. However, other factors, such as age and responsibility of Staphylococcus aureus, were not retained in the model.

Published
2007

6. Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma: a multicenter study of 412 patients

Author

Thomas Decaens, Françoise Roudot-Thoraval, Olivier Boillot, François Durand, Solange Bresson-Hadni, Yvon Calmus, Christian Ducerf, Daniel Cherqui, Christophe Duvoux, Pierre-Henri Bernard, Georges Philippe Pageaux, Philippe Compagnon, Sébastien Dharancy, Olivier Chazouillères, Carole Meyer, Jean Hardwigsen, Jean Gugenheim, Service de santé publique [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Service de Chirurgie Digestive / Centre de Transplantation Hépatique [CHU Nice], Centre Hospitalier Universitaire de Nice (CHU Nice), Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] (LAPM), Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Service de Chirurgie Digestive, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Université de Lille, Droit et Santé, Hôpital Duriez, Service des Maladies de l'Appareil digestif et de la Nutrition, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital Archet II, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] ( LAPM ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Cochin [AP-HP], Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), and Grenouillet, Frédéric

Subjects
Oncology, Pathology, MESH : Liver Neoplasms, medicine.medical_treatment, MESH : Analysis of Variance, Liver transplantation, MESH: Proportional Hazards Models, MESH: Cause of Death, 0302 clinical medicine, MESH: Liver Neoplasms, Cause of Death, MESH: Carcinoma, Hepatocellular, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Cause of death, MESH : Neoplasm Recurrence, Local, Liver Neoplasms, Gastroenterology, MESH: Immunosuppression, Immunosuppression, General Medicine, MESH: Predictive Value of Tests, 3. Good health, surgical procedures, operative, 030220 oncology & carcinogenesis, Predictive value of tests, Hepatocellular carcinoma, MESH: Survival Analysis, MESH : Disease-Free Survival, 030211 gastroenterology & hepatology, MESH: Neoplasm Recurrence, Local, Rapid Communication, MESH : Carcinoma, Hepatocellular, medicine.medical_specialty, MESH: Liver Transplantation, Carcinoma, Hepatocellular, Disease-Free Survival, MESH: Multivariate Analysis, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, MESH: Analysis of Variance, medicine, Carcinoma, Humans, MESH : Predictive Value of Tests, Survival analysis, Proportional Hazards Models, MESH : Cause of Death, Immunosuppression Therapy, Analysis of Variance, MESH: Humans, business.industry, Proportional hazards model, MESH : Humans, MESH : Multivariate Analysis, medicine.disease, MESH : Proportional Hazards Models, Survival Analysis, [SDV.MP.MYC] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, digestive system diseases, Liver Transplantation, Multivariate Analysis, MESH : Immunosuppression, MESH: Disease-Free Survival, Neoplasm Recurrence, Local, MESH : Survival Analysis, MESH : Liver Transplantation, business
Abstract

International audience; AIM: To assess pre-orthotopic liver transplantation (OLT) factors that could be evaluated pre-operatively or controlled post-operatively associated with hepatocellular carcinoma (HCC) recurrence and disease-free survival after liver transplantation (LT). METHODS: Four hundred and twelve patients transplanted for HCC between 1988 and 1998 in 14 French centers, who survived the postoperative period were studied. Kaplan Meier estimates were calculated for 24 variables potentially associated with recurrence of HCC. Uni- and multivariate analyses were conducted to identify independent predictors of recurrence. RESULTS: Overall 5-year disease-free survival was 57.1%. By univariate analysis, variables associated with disease-free survival were: presence of cirrhosis (P = 0.001), etiology of liver disease (P = 0.03), alpha fetoprotein level (< 200, 200 to 2000, or > 2000; P < 0.0001), gamma-GT activity (N, N to 2N or > 2N; P = 0.02), the number of nodules (1, 2-3 or > or = 4; P = 0.02), maximal diameter of the largest nodule (< 3 cm, 3 to 5 cm or > 5 cm; P < 0.0001), the sum of the diameter of the nodules (< 3 cm, 3 to 5 cm, 5 to 10 cm or > 10 cm; P < 0.0001), bi-lobar location (P = 0.01), preoperative portal thrombosis (P < 0.0001), peri-operative treatment of the tumor (P = 0.002) and chemoembolization (P = 0.03), tumor differentiation (P = 0.01), initial type of calcineurin inhibitor (P = 0.003), the use of antilymphocyte antibodies (P = 0.02), rejection episodes (P = 0.003) and period of LT (P < 0.0001). By multivariate analysis, 6 variables were independently associated with HCC recurrence: maximal diameter of the largest nodule (P < 0.0001), time of LT (P < 0.0001), tumor differentiation (P < 0.0001), use of anti-lymphocyte antibody (ATG) or anti-CD3 antibody (OKT3) (P = 0.005), preoperative portal thrombosis (P = 0.06) and the number of nodules (P = 0.06). CONCLUSION: This study identifies immunosuppression, through the use of ATG or OKT3, as a predictive factor of tumor recurrence, and confirms the prognostic value of tumor differentiation.

Published
2006

Catalog

Books, media, physical & digital resources
See catalog results