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1. Adrenal function recovery after durable oral corticosteroid sparing with benralizumab in the PONENTE study

Author

Menzies-Gow, A., Gurnell, M., Heaney, L. G., Corren, J., Bel, E. H., Maspero, J., Harrison, T., Jackson, D. J., Price, D., Lugogo, N., Kreindler, J., Burden, A., de Giorgio-Miller, A., Faison, S., Padilla, K., Martin, U. J., Gil, E. G., Ardusso, L., Bazerque, R. F., Doreski, P. A. C., Elias, P. C., Gattolin, G., Medina, A. C., Ruiz, X. B., Salvado, A., Del Olmo Sansone, R. A., Wehbe, L., Verra, F. J. B., Brusselle, G., Pilette, C., Martinot, J. -B., Antila, M. A., Blanco, D. C., Cerci, A., Cunha, T. M., Fiss, E., Franza, L., Machado, A. S., De Mattos, W. L. L. D., Grava, S., Minamoto, S. E. T., De Oliveira, C. A., Cheema, A. S., Dorscheid, D., Fera, T. A. E., Gagnon, R., Philteos, G., Sussman, G., Yang, W. H. -C., Aguilar, C. D., Jaller, R., Jazime, M. L., Serrano, F. O., Vanegas, A. C., Vargas, L. K., Villegas, M. F., Hilberg, O., Nielsen, H. B., Nielsen, J., Weinreich, U. M., Ulrik, C. S., Adam, S. M., Deslee, G., Pegliasco, H., Pradelli, J., Roux, P. -M., Russier, M., Deckelmann, R., Eich, A., Forster, A., Herth, F., Kirschner, J., Kirsten, A. -M., Schuhmann, M., Schultz, T. K., Ludwig-Sengpiel, A., Teber, I., Zimmermann, G. S., Almerigogna, F., Celi, A., Paggiaro, P., D'Amato, M., Palange, P., Pirina, P., Spanevello, A., Colin, D. D. H., Hernandez, A. R., Garcia, E. A. R., Gonzalez, E. M., Terrones, R. A. R., Javier, R. C., Suarez, J. F. R., Cheimihska, M., Cudzik, K., Olech-Cudzik, A., Filipek, K., Golinski, L., Kwasniewski, A., Madra-Rogacka, D., Mroz, R., Nittner-Marszalska, M., Pawlukiewicz, M., Lekarska, P. P., Pioszczuk, A., Springer, E., Swiderska, A., Zurowska-Gebala, M., Emelyanov, A. V., Kurbacheva, O., Odegova, A., Peskov, A., Petrov, D. V., Rubanik, T. V., Vasilev, M., Vershinina, M., Barcala, F. J. G., Blanco, V. R., Fernandez, A. M. P., Fernandez, C. G., Garcia, J. M. I., Munoz, A. V. A., Ramos, C. C., Sanz, C. C., Bjermer, L., Chen, C. -Y., Fang, W. -F., Hang, L. -W., Hsu, J. -Y., Kuo, H. -P., Lee, K. -Y., Shen, S. -Y., Sheu, C. -C., Gore, R., Saralaya, D., Alpizar, S. A., Bansal, S., Ismail, H., Kaelin, T. D., Koura, F., Lee, M. D., Maddipati, V., Malur, A., Mcevoy, C. E., Mehta, H., Mohan, A., Moore, W. C., Krings, J., Pippins, A., Deaton, I., Hmieleski, B., Field, P., Reibman, J., Siri, D. D., Sumino, K., Swenson, C., Tilley, S. L., Villareal, M., Pulmonology, and Pulmonary medicine

Subjects
Pulmonary and Respiratory Medicine, Adrenal Cortex Hormones, Humans, Anti-Asthmatic Agents, Recovery of Function, Asthma, Adrenal Insufficiency
Abstract

BackgroundOral corticosteroid (OCS) dependence among patients with severe eosinophilic asthma can cause adverse outcomes, including adrenal insufficiency. PONENTE's OCS reduction phase showed that, following benralizumab initiation, 91.5% of patients eliminated corticosteroids or achieved a final dosage ≤5 mg·day−1(median (range) 0.0 (0.0–40.0) mg).MethodsThe maintenance phase assessed the durability of corticosteroid reduction and further adrenal function recovery. For ∼6 months, patients continued benralizumab 30 mg every 8 weeks without corticosteroids or with the final dosage achieved during the reduction phase. Investigators could prescribe corticosteroids for asthma exacerbations or increase daily dosages for asthma control deteriorations. Outcomes included changes in daily OCS dosage, Asthma Control Questionnaire (ACQ)-6 and St George's Respiratory Questionnaire (SGRQ), as well as adrenal status, asthma exacerbations and adverse events.Results598 patients entered PONENTE; 563 (94.1%) completed the reduction phase and entered the maintenance phase. From the end of reduction to the end of maintenance, the median (range) OCS dosage was unchanged (0.0 (0.0–40.0) mg), 3.2% (n=18/563) of patients experienced daily dosage increases, the mean ACQ-6 score decreased from 1.26 to 1.18 and 84.5% (n=476/563) of patients were exacerbation free. The mean SGRQ improvement (–19.65 points) from baseline to the end of maintenance indicated substantial quality-of-life improvements. Of patients entering the maintenance phase with adrenal insufficiency, 32.4% (n=104/321) demonstrated an improvement in adrenal function. Adverse events were consistent with previous reports.ConclusionsMost patients successfully maintained maximal OCS reduction while achieving improved asthma control with few exacerbations and maintaining or recovering adrenal function.

Published
2022
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9. Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials

Author

Fabbri, Leonardo M., Calverley, Peter M. A., Jose Luis Izquierdo Alonso, Bundschuh, Daniela S., Manja, Brose, Martinez, Fernando J., Rabe, Kf M., Study Groups Abdulla, M., Abdullah, I., Adler, M., Aguilaniu, Albert, I., Almonacid, C., Altés, A., Amaducci, S., Angrill, J., Antonana, J. M., Artner, H., Balint, B., Bantje, T. A., Barbe, F., Bateman, E., Bauchnect, E., Belda, J., Bernabeu, L., Bettendorf, A., Blagden, M., Blanquer, R., Blecher, L., Bonnaud, F., Bourbeau, J., Boyer, G. R., Brotons, C., Bruning, A. H., Bucca, C., Burns, G. E., Von Der Heydt, B. B., Caldwell, Canonica, G. W., Carter, J., Chan, V., Chapman, K. R., Chapman, G., Cheung, D., Chiner, E., Chopra, A., Clini, E., Coulet, P., Craig, B., Croonenborghs, L., Czompó, M., Dal Negro, R. W., Dapper, T., De Graaff, C. S., Ramos Pde, L., De Munck, D. R., Decramer, M., Delobbe, A., Denier, W., De Teresa, L., Dhar, A., Di Maria, G., Dupouy, J., Duschek, G., Echave, J., Esteban, C., Farmer, I. S., Flemale, A., Fletcher, P., Foden, Fouquert, L., Franz, K. H., Frognier, Gagnon, M., Garcia, Mdel M., Garelli, G., Gehling, U., Ginko, T., Glekin, B., Gooding, T., Graham, A., Greillier, P., Greses, J. V., Grillenberger, J., Gross, B., Grygier, H., Gyori, Z., Harper, Henein, S., Heredia, J. L., Hernandez, P., Hoefer, M., Hoffstein, V., Holgate, K., Holler, W., Holub, G., Homik, L., Houle, P. A., Hutter, C., Hyvernat, P., Irusen, E. M., Jackson, A., Janisty, W., Jasnot, J. Y., Joubert, J., Juhasz, G., Jullian, H., Kafe, H., Kelly, P., Kidney, J., Killian, K., Kinch, H., Kirsten, D. L., Kleinecke Pohl, U., Korlipara, K., Krige, L. P., Kroker, A., Kuipers, A. F., Labrecque, M., Larivee, P., Laskowitz, C., Le Merre, C., Lemoigne, F., Ludwig Sengpiel, A., Luengo, M., Luton, R., Macnee, W., Ali, S. M., Maltais, F., Mansur, A., Marciniuk, D., Marin, A., Martin, P., Martinot, J. B., Mazza, F., Bride, M. C., Mcdonald, B., Mckinnon, C., Mclvor, A., Mcnally, D., Mengeot, P. M., Messner, J., Moder, G., Mooney, P., Moretti, A. M., Muller, D., Murio, C., Nardini, S., Nel, A., Ochoa, Saracho Jo, D. E., Paggiaro, P., Paradis, B., Patrick, J., Peche, R., Pellicer, C., Perez, T., Perez, E., De Llano, L. A., Philteos, G., Pieters, W. R., Pigearias, B., Pohl, W., Popovic, R., Prins, M., Querfurt, H., Rajkay, K., Ras, G., Road, J., Roig, J., Roldaan, A. C., Rolke, M., Rozen, D., Sanchez Toril, F., Savani, N., Savary, L., Schiavina, M., Schiesbühl, H., Schreurs, A. J., Schröder Babo, W., Schurmann, W., Seiz, V., Sevette, C., Sharma, R., Shum, C., Damsté, H. E., Smithers, A., Soler, J. J., Steffen, H., Steinhauser, U., Sweilem, M., Tellier, G., Terol, B., Terzano, Claudio, Timar, M., Toma, G., Monserrat, P. T., Trauth, H. A., Valyon, E., Brande Van Den, Van Noord, J. A., Vaquer, J. V., Hernandez Hector, H. V., Vereecken, G., Verkindre, C., Vigh, M., Viljoen, J. J., Vincken, W., Vinkler, I., Visser, S., Volgmann, L., Vorderstrasse, W., Voves, R., Vrancken, F., Weber, H. H., Wielders, P. L., Willoughby, P., Wurtz, J., Yang, W., Zabaleta, M., Zachgo, W., Zanini, A., Zeiner, M., Michael, H., Janistyn, W., Abdulla, R., Terzano, C., Fabbri, L., Barbaro, M. P., Izquierdo, J. L., Ramos, Pde L., and Harper, Ochoa

Subjects
Chronic bronchitis, medicine.drug_class, glucocorticosteroids, Placebo, exacerbations, Bronchodilator, medicine, COPD, humans, Roflumilast, Intention-to-treat analysis, business.industry, Body weight, chronic bronchitis, emphysema, inflammation, lung function, phosphodiesterase 4 inhibitor, PDE4, General Medicine, Tiotropium bromide, medicine.disease, respiratory tract diseases, Anesthesia, Salmeterol, business, medicine.drug
Abstract

Summary Background Patients with chronic obstructive pulmonary disease (COPD) have few options for treatment. The efficacy and safety of the phosphodiesterase-4 inhibitor roflumilast have been investigated in studies of patients with moderate-to-severe COPD, but not in those concomitantly treated with longacting inhaled bronchodilators. The effect of roflumilast on lung function in patients with COPD that is moderate to severe who are already being treated with salmeterol or tiotropium was investigated. Methods In two double-blind, multicentre studies done in an outpatient setting, after a 4-week run-in, patients older than 40 years with moderate-to-severe COPD were randomly assigned to oral roflumilast 500 μg or placebo once a day for 24 weeks, in addition to salmeterol (M2-127 study) or tiotropium (M2-128 study). The primary endpoint was change in prebronchodilator forced expiratory volume in 1 s (FEV 1 ). Analysis was by intention to treat. The studies are registered with ClinicalTrials.gov, number NCT00313209 for M2-127, and NCT00424268 for M2-128. Findings In the salmeterol plus roflumilast trial, 466 patients were assigned to and treated with roflumilast and 467 with placebo; in the tiotropium plus roflumilast trial, 371 patients were assigned to and treated with roflumilast and 372 with placebo. Compared with placebo, roflumilast consistently improved mean prebronchodilator FEV 1 by 49 mL (p 1 was noted in both groups. Furthermore, roflumilast had beneficial effects on other lung function measurements and on selected patient-reported outcomes in both groups. Nausea, diarrhoea, weight loss, and, to a lesser extent, headache were more frequent in patients in the roflumilast groups. These adverse events were associated with increased patient withdrawal. Interpretation Roflumilast improves lung function in patients with COPD treated with salmeterol or tiotropium, and could become an important treatment for these patients. Funding Nycomed.

Published
2009
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11. Safety, tolerability and efficacy of indacaterol, a novel once-daily β-agonist, in patients with COPD: A 28-day randomised, placebo controlled clinical trial

Author

Beier , Jutta, Chanez , Pascal, Martinot , J.-B. Jean-Benoit, Schreurs , A.J.M., Tkáčová , R. Ružena, Bao , Weibin, Jack , Damon, Higgins , Mark, insaf Respiratory Research Institute, Human Computer Technology Laboratory ( HCTLab ), Universidad Autonoma de Madrid ( UAM ), Department of Pneumology and Tuberculosis, Faculty Hospital L. Pasteur, and Novartis Horsham Research Centre

Subjects
Medicine, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2007
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19. Partial versus maximal forced exhalations in COPD: Enhanced signal detection for novel therapies.

Author

Martinot, J. B., Chambellan, A., Kays, C., Silkoff, P. E., and Guenard, H.

Subjects
*OBSTRUCTIVE lung disease treatment, *OBSTRUCTIVE lung diseases patients, *BRONCHODILATOR agents, *PLACEBOS, *ANTI-inflammatory agents, *AIRWAY (Anatomy)
Abstract

Background: Evaluation of novel compounds for COPD often relies on FEV1 for signal detection. Partial forced exhalations from end-tidal inspiration (PEFV) might complement FEV1 in identifying such a signal. We examined the prevalence of bronchodilator response (BDR) using PEFV and FEV1 in patients with COPD. Methods: 110 consecutive COPD patients were tested prospectively with PEFV and maximal expiratory flow before and after inhalation of a short-acting β2 agonist (salbutamol, 400 µg). Partial flow at 800 ml above residual volume was derived from the PEFV (PF800). Significant changes in PF800 and/or FEV1 were set at the upper 95% confidence interval after placebo (n = 28). Results: Four groups were identified by the presence (+) or absence (-) of a BDR: Group 1 [PF800 (-)FEV1(-)] when no change was observed (n = 31), Group 2 [PF800(+)FEV1(-)] when PF800 alone improved (n = 31), Group 3 [PF800(-)FEV1(+)] when FEV1 alone improved (n = 26), and Group 4 [PF800(+)FEV1(+)] when both variables improved (n = 18). There were 35 non-responders in any parameter, and 75/110 subjects who showed a response in at least one parameter. The changes in PF800 and FEV1 were not correlated suggesting these assess different airway generations. Conclusions: The use of PF800 increased detection of a BDR in COPD compared to FEV1 alone and may reflect small airway responses. The PEFV maneuver is simple, repeatable and may avoid some of the theoretical disadvantages of FEV1. The role of PF800 for evaluating novel anti-inflammatory agents remains to be determined. [ABSTRACT FROM AUTHOR]

Published
2014
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21. A comparative study of clarithromycin modified release and amoxicillin/clavulanic acid in the treatment of acute exacerbation of chronic bronchitis.

Author

Martinot, Jean-Benoît, Carr, W., Cullen, Stephen, Budo, Josep, Bauer, Karin, MacLeod, Catherine, Sanguinetti, Claudio, Veldhuizen, Wim, Martinot, J B, Carr, W D, Cullen, S, Heredia Budo, J L, Bauer, K, MacLeod, C, Sanguinetti, C M, van Veldhuizen, W C, and Clarithromycin Once-a-Day Study Group

Abstract

This phase III, investigator-blind, randomized, parallel-group study compared the efficacy and tolerability of clarithromycin modified release (MR) with those of amoxicillin/clavulanic acid in 250 adult outpatients with acute exacerbationof chronic bronchitis (AECB). Patients received either clarithromycin MR 500 mg once daily or amoxicillin/clavulanic acid 500 mg/125 mg three times daily for 7 days. Primary endpoints were sponsor-defined clinical response and pathogen outcome at the end of treatment. Secondary endpoints were sponsor-defined clinical response and pathogen outcome at study end, investigator-defined clinical response at end of treatment and end of study, resolution or improvement of signs and symptoms, eradication of baseline pathogens, serologic outcome for atypical pathogens, and occurrence of reinfection and superinfection. Adverse events and compliance were also evaluated. Clinical and bacteriologic outcomes with both treatments for all endpoints were statistically equivalent, as were total adverse events, although the incidences of digestive disturbances (13% vs 4%) and discontinuations due to adverse events (8 vs 2 patients; P < or =.05) were significantly higher with amoxicillin/clavulanic acid. Ninety-five percent of patients receiving clarithromycin MR and 80% receiving amoxicillin/clavulanic acid were 100% compliant with medication (P < or =.05). Clarithromycin MR and amoxicillin/clavulanic acid are both well tolerated and effective as therapy for AECB; however, clarithromycin produced fewer side effects and discontinuations and higher compliance rates. [ABSTRACT FROM AUTHOR]

Published
2001
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22. Relationship between inflammatory processes and gas exchanges in pulmonary sarcoidosis.

Author

UCL - MD/MINT - Département de médecine interne, Martinot, J B, Delaunois, Luc, Rahier, Jacques, Dehennin, Jean-Pierre, Sibille, Yves, UCL - MD/MINT - Département de médecine interne, Martinot, J B, Delaunois, Luc, Rahier, Jacques, Dehennin, Jean-Pierre, and Sibille, Yves

Abstract

In the present study, we investigated whether the analysis of cells and proteins collected by bronchoalveolar lavage (BAL) could accurately reflect the degree of functional impairment in pulmonary sarcoidosis. Eighteen patients with biopsy-proven sarcoidosis were prospectively evaluated. An inverse relationship was demonstrated between BAL coefficient of excretion relative to albumin (RCE) values of IgG and IgA and diffusion for carbon monoxide (Dco). A similar negative correlation existed with PaO2 at the end of a maximal exercise. Steroid therapy in five patients lowered concomitantly BAL RCE of IgA and IgG while Dco values increased. Immunoperoxidase studies in three lung biopsies revealed numerous Ig-containing cells within the lung parenchyma. We suggest that these BAL Ig values reflected the mononuclear cell infiltration of the bronchiolovascular sheaths and lung interstitium. This cellular infiltration likely induces a distortion of the capillary bed and may affect the gas exchanges in a reversible way.

Published
1989

23. Antiproteases are increased in bronchoalveolar lavage in interstitial lung disease.

Author

UCL - ESPO/ECON - Département des sciences économiques, Sibille, Yves, Martinot, J B, Staquet, P., Delaunois, Luc, Chatelain, Bernard, UCL - ESPO/ECON - Département des sciences économiques, Sibille, Yves, Martinot, J B, Staquet, P., Delaunois, Luc, and Chatelain, Bernard

Abstract

The present study evaluates different cellular and soluble components in the bronchoalveolar lavage (BAL) from patients with interstitial lung disease. We observed an increased T4/T8 lymphocyte ratio in BAL but not in blood from 24 patients with active pulmonary sarcoidosis compared to sixteen normal individuals and to eleven patients with inactive pulmonary sarcoidosis. Seven patients with hypersensitivity pneumonitis had a normal T4/T8 ratio. In the active sarcoidosis and hypersensitivity pneumonitis groups, alpha 1-Protease Inhibitor (alpha 1 PI) in BAL is significantly higher than in the normal group and a significant correlation between the two antiproteases (alpha 2-macroglobulin and alpha 1 PI) is observed. These data demonstrate that antiprotease levels (alpha 1 PI and alpha 2 M) are increased in the lower respiratory tract of patients with interstitial lung disease and that among cellular and soluble components of BAL, alpha 2 M represents a sensitive marker of the alveolitis.

Published
1988

24. Clinical and subclinical alveolitis in collagen vascular diseases: contribution of alpha 2-macroglobulin levels in BAL fluid.

Author

UCL, Martinot, J B, Wallaert, B, Hatron, P Y, Francis, C., Voisin, Catherine, Sibille, Yves, UCL, Martinot, J B, Wallaert, B, Hatron, P Y, Francis, C., Voisin, Catherine, and Sibille, Yves

Abstract

The probability that patients with collagen vascular diseases (CVD) will develop fibrosis is unpredictable. Since changes in bronchoalveolar lavage (BAL) cell data can be observed in CVD patients without evidence of lung involvement, we investigated whether the study of soluble components in BAL could help to distinguish CVD patients with lung involvement (n = 15) from those without pulmonary disease (n = 37). Our results demonstrate that the alveolitis observed in patients with overt lung involvement is associated with an increase of BAL alpha 2-macroglobulin (alpha 2-MA). In contrast, the BAL alpha 2-MA levels were found to be normal in CVD patients without evidence of pulmonary disease as well as in CVD patients with overt lung involvement treated with steroids. This was observed even in the presence of high neutrophil or lymphocyte counts in BAL. In conclusion, when neutrophils or lymphocytes accumulate in the lungs of CVD patients without evidence of lung damage, in the majority of patients this cell accumulation is not associated with an increase of BAL soluble components.

Published
1989

25. Onset of effect and impact on health-related quality of life, exacerbation rate, lung function, and nasal polyposis symptoms for patients with severe eosinophilic asthma treated with benralizumab (ANDHI): a randomised, controlled, phase 3b trial

Author

Harrison, Tim W, Chanez, Pascal, Menzella, Francesco, Canonica, Giorgio Walter, Louis, Renaud, Cosio, Borja G, Lugogo, Njira L, Mohan, Arjun, Burden, Annie, McDermott, Lawrence, Garcia Gil, Esther, Zangrilli, James G, Wolfgang Pohl, Robert Voves, Maud Deschampheleire, Renaud Louis, Jean-Benoit Martinot, Rudi Peché, Kenneth Chapman, Amarjit Cheema, Delbert Dorscheid, J Mark FitzGerald, Remi Gagnon, William Patrick Killorn, Ronald Olivenstein, George Philteos, Clare Ramsey, J Douglass Rolf, Brandie Walker, Ole Hilberg, Tina Skjold, Ingrid Titlestad, Auli Hakulinen, Maritta Kilpeläinen, Michèle Ben Hayoun, Philippe Bonniaud, Arnaud Bourdin, Pascal Chanez, Frédéric De Blay, Gaëtan Deslee, Gilles Devouassoux, Alain Didier, Youcef Douadi, Stéphanie Fry, Gilles Garcia, Pierre-Olivier Girodet, Christophe Leroyer, Antoine Magnan, Guillaume Mahay, Cécilia Nocent, Christophe Pison, Pauline-Marie Roux, Camille Taillé, Juliana-Angelica Tiotiu, Ekkehard Beck, Margret Jandl, Christian Kaehler, Frank Kässner, Frank Koesters, Juliane Kronsbein, Thomas Schaum, Christian Schulz, Dirk Skowasch, Christian Taube, Tobias Welte, Andrés de Roux, Bianca Beghé, Francesco Blasi, Giorgio Walter Canonica, Giovanna Carpagnano, Cristiano Caruso, Angelo Guido Corsico, Elio Constantino, Nunzio Crimi, Piero Maestrelli, Francesco Menzella, Manlio Milanese, Alberto Papi, Girolamo Pelaia, Laura Pini, Pierachille Santus, Eleonora Savi, Nicola Scichilone, Gianenrico Senna, Giuseppe Spadaro, Adriano Vaghi, Steven Gans, Jurgen Hölters, B Langeveld, Willem Pieters, G H A Staaks, Ilonka van Veen, J W K van den Berg, Gunnar Einvik, Sverre Lehmann, Ismael Ali García, Carlos Almonacid, Irina Bobolea, Paloma Campo Mozo, Gustavo de Luiz, Christian Domingo Ribas, José María Echave-Sustaeta María-Tomé, Juan Luis García Rivero, Borja García-Cosío Piqueras, Ana Gómez-Bastero Fernández, Ruperto González Pérez, Aythamy Henríquez Santa, Carlos Martínez Rivera, Xavier Muñoz Gall, Jacinto Ramos, Jose Gregorio Soto Campos, Carmen Vidal Pan, Nikolai Stenfors, Alf Tunsäter, Ines Vinge, Rekha Chaudhuri, Timothy Harrison, Adel Mansur, Shuaib Nasser, Monica Nordstrom, Paul Pfeffer, Dinesh Saralaya, Philip Short, Arun Adlakha, Oral Alpan, Francis Averill, Anil Badhwar, Jose Bardelas, Barbara Baxter, George Bensch, William Berger, Jonathan Bernstein, Tracy Bridges, Ryan Brimeyer, William Calhoun, Edward Campbell, William Brett Cherry, Geoffrey Chupp, Lee Clore, John Cohn, Jeremy Cole, John Condemi, James Cury, Benjamin Davis, Samuel DeLeon, Luis Delacruz, Joseph Diaz, David Erb, Emeka Eziri, Faisal Fakih, Douglas Fiedler, David Fost, Stephen Fritz, Erika Gonzalez, Brad Goodman, Peter Gottlieb, Gregory Gottschlich, Richard Gower, Rizan Hajal, James Harris, Hengameh Heidarian-Raissy, Albrecht Heyder, David Hill, Fernando Holguin, Iftikhar Hussain, Jonathan Illowite, Joshua Jacobs, Mikell Jarratt, Harold Kaiser, Neil Kao, Ravindra Kashyap, David Kaufman, Edward Kent, Kenneth Kim, Ryan Klein, Monica Kraft, Ritsu Kono, Shahrukh Kureishy, Jeffrey Leflein, Mila Leong, Huamin Li, Robert Lin, Njira Lugogo, Michael Marcus, Diego Jose Maselli Caceres, Vinay Mehta, Curtis Mello, Mark Millard, Aaron Milstone, Arjun Mohan, Wendy Moore, Mark Moss, Nayla Mumneh, Thomas O'Brien, David Ostransky, Michael Palumbo, Purvi Parikh, Sudhir Parikh, Amit Patel, Guido Perez, Warren Pleskow, Bruce Prenner, Dileep Puppala, John Ramey, Joan Reibman, Ramon Reyes, Emory Robinette, Ileana Rodicio, Stephen Ryan, Sudhir Sekhsaria, Barry Sigal, Vinay Sikand, Weily Soong, Selwyn Spangenthal, Roy St John, Gary Steven, Vijay Subramaniam, Kaharu Sumino, Eric Sztejman, Ricardo A Tan, Tonny Tanus, Charles Thompson, Carl Thornblade, Manuel Villareal, Sally Wenzel, Heidi Zafra, Tomasz Ziedalski, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Tim W, Harrison, Pascal, Chanez, Francesco, Menzella, Giorgio Walter, Canonica, Renaud, Loui, Borja G, Cosio, Njira L, Lugogo, Arjun, Mohan, Annie, Burden, Lawrence, Mcdermott, Esther, Garcia Gil, Zangrilli, G, Jame, Pohl, Wolfgang, Voves, Robert, Deschampheleire, Maud, Louis, Renaud, Martinot, Jean-Benoit, Peché, Rudi, Chapman, Kenneth, Cheema, Amarjit, Dorscheid, Delbert, Mark FitzGerald, J, Gagnon, Remi, Patrick Killorn, William, Olivenstein, Ronald, Philteos, George, Ramsey, Clare, Douglass Rolf, J, Walker, Brandie, Hilberg, Ole, Skjold, Tina, Titlestad, Ingrid, Hakulinen, Auli, Kilpeläinen, Maritta, Ben Hayoun, Michèle, Bonniaud, Philippe, Bourdin, Arnaud, Chanez, Pascal, De Blay, Frédéric, Deslee, Gaëtan, Devouassoux, Gille, Didier, Alain, Douadi, Youcef, Fry, Stéphanie, Garcia, Gille, Girodet, Pierre-Olivier, Leroyer, Christophe, Magnan, Antoine, Mahay, Guillaume, Nocent, Cécilia, Pison, Christophe, Roux, Pauline-Marie, Taillé, Camille, Tiotiu, Juliana-Angelica, Beck, Ekkehard, Jandl, Margret, Kaehler, Christian, Kässner, Frank, Koesters, Frank, Kronsbein, Juliane, Schaum, Thoma, Schulz, Christian, Skowasch, Dirk, Taube, Christian, Welte, Tobia, de Roux, André, Beghé, Bianca, Blasi, Francesco, Walter Canonica, Giorgio, Carpagnano, Giovanna, Caruso, Cristiano, Guido Corsico, Angelo, Constantino, Elio, Crimi, Nunzio, Maestrelli, Piero, Menzella, Francesco, Milanese, Manlio, Papi, Alberto, Pelaia, Girolamo, Pini, Laura, Santus, Pierachille, Savi, Eleonora, Scichilone, Nicola, Senna, Gianenrico, Spadaro, Giuseppe, Vaghi, Adriano, Gans, Steven, Hölters, Jurgen, Langeveld, B, Pieters, Willem, A Staaks, G H, van Veen, Ilonka, K van den Berg, J W, Einvik, Gunnar, Lehmann, Sverre, Ali García, Ismael, Almonacid, Carlo, Bobolea, Irina, Campo Mozo, Paloma, de Luiz, Gustavo, Domingo Ribas, Christian, María Echave-Sustaeta María-Tomé, José, Luis García Rivero, Juan, García-Cosío Piqueras, Borja, Gómez-Bastero Fernández, Ana, González Pérez, Ruperto, Henríquez Santa, Aythamy, Martínez Rivera, Carlo, Muñoz Gall, Xavier, Ramos, Jacinto, Gregorio Soto Campos, Jose, Vidal Pan, Carmen, Stenfors, Nikolai, Tunsäter, Alf, Vinge, Ine, Chaudhuri, Rekha, Harrison, Timothy, Mansur, Adel, Nasser, Shuaib, Nordstrom, Monica, Pfeffer, Paul, Saralaya, Dinesh, Short, Philip, Adlakha, Arun, Alpan, Oral, Averill, Franci, Badhwar, Anil, Bardelas, Jose, Baxter, Barbara, Bensch, George, Berger, William, Bernstein, Jonathan, Bridges, Tracy, Brimeyer, Ryan, Calhoun, William, Campbell, Edward, Brett Cherry, William, Chupp, Geoffrey, Clore, Lee, Cohn, John, Cole, Jeremy, Condemi, John, Cury, Jame, Davis, Benjamin, Deleon, Samuel, Delacruz, Lui, Diaz, Joseph, Erb, David, Eziri, Emeka, Fakih, Faisal, Fiedler, Dougla, Fost, David, Fritz, Stephen, Gonzalez, Erika, Goodman, Brad, Gottlieb, Peter, Gottschlich, Gregory, Gower, Richard, Hajal, Rizan, Harris, Jame, Heidarian-Raissy, Hengameh, Heyder, Albrecht, Hill, DAVID STANLEY, Holguin, Fernando, Hussain, Iftikhar, Illowite, Jonathan, Jacobs, Joshua, Jarratt, Mikell, Kaiser, Harold, Kao, Neil, Kashyap, Ravindra, Kaufman, David, Kent, Edward, Kim, Kenneth, Klein, Ryan, Kraft, Monica, Kono, Ritsu, Kureishy, Shahrukh, Leflein, Jeffrey, Leong, Mila, Li, Huamin, Lin, Robert, Lugogo, Njira, Marcus, Michael, Jose Maselli Caceres, Diego, Mehta, Vinay, Mello, Curti, Millard, Mark, Milstone, Aaron, Mohan, Arjun, Moore, Wendy, Moss, Mark, Mumneh, Nayla, O'Brien, Thoma, Ostransky, David, Palumbo, Michael, Parikh, Purvi, Parikh, Sudhir, Patel, Amit, Perez, Guido, Pleskow, Warren, Prenner, Bruce, Puppala, Dileep, Ramey, John, Reibman, Joan, Reyes, Ramon, Robinette, Emory, Rodicio, Ileana, Ryan, Stephen, Sekhsaria, Sudhir, Sigal, Barry, Sikand, Vinay, Soong, Weily, Spangenthal, Selwyn, St John, Roy, Gary, Steven, Subramaniam, Vijay, Sumino, Kaharu, Sztejman, Eric, A Tan, Ricardo, Tanus, Tonny, Thompson, Charle, Thornblade, Carl, Villareal, Manuel, Wenzel, Sally, Zafra, Heidi, Ziedalski, Tomasz, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de pneumologie, Harrison T.W., Chanez P., Menzella F., Canonica G.W., Louis R., Cosio B.G., Lugogo N.L., Mohan A., Burden A., McDermott L., Garcia Gil E., Zangrilli J.G., Pohl W., Voves R., Deschampheleire M., Martinot J.-B., Peche R., Chapman K., Cheema A., Dorscheid D., FitzGerald J.M., Gagnon R., Killorn W.P., Olivenstein R., Philteos G., Ramsey C., Rolf J.D., Walker B., Hilberg O., Skjold T., Titlestad I., Hakulinen A., Kilpelainen M., Ben Hayoun M., Bonniaud P., Bourdin A., De Blay F., Deslee G., Devouassoux G., Didier A., Douadi Y., Fry S., Garcia G., Girodet P.-O., Leroyer C., Magnan A., Mahay G., Nocent C., Pison C., Roux P.-M., Taille C., Tiotiu J.-A., Beck E., Jandl M., Kaehler C., Kassner F., Koesters F., Kronsbein J., Schaum T., Schulz C., Skowasch D., Taube C., Welte T., de Roux A., Beghe B., Blasi F., Carpagnano G., Caruso C., Corsico A.G., Constantino E., Crimi N., Maestrelli P., Milanese M., Papi A., Pelaia G., Pini L., Santus P., Savi E., Scichilone N., Senna G., Spadaro G., Vaghi A., Gans S., Holters J., Langeveld B., Pieters W., Staaks G.H.A., van Veen I., van den Berg J.W.K., Einvik G., Lehmann S., Ali Garcia I., Almonacid C., Bobolea I., Campo Mozo P., de Luiz G., Domingo Ribas C., Echave-Sustaeta Maria-Tome J.M., Garcia Rivero J.L., Garcia-Cosio Piqueras B., Gomez-Bastero Fernandez A., Gonzalez Perez R., Henriquez Santa A., Martinez Rivera C., Munoz Gall X., Ramos J., Gregorio Soto Campos J., Vidal Pan C., Stenfors N., Tunsater A., Vinge I., Chaudhuri R., Harrison T., Mansur A., Nasser S., Nordstrom M., Pfeffer P., Saralaya D., Short P., Adlakha A., Alpan O., Averill F., Badhwar A., Bardelas J., Baxter B., Bensch G., Berger W., Bernstein J., Bridges T., Brimeyer R., Calhoun W., Campbell E., Cherry W.B., Chupp G., Clore L., Cohn J., Cole J., Condemi J., Cury J., Davis B., DeLeon S., Delacruz L., Diaz J., Erb D., Eziri E., Fakih F., Fiedler D., Fost D., Fritz S., Gonzalez E., Goodman B., Gottlieb P., Gottschlich G., Gower R., Hajal R., Harris J., Heidarian-Raissy H., Heyder A., Hill D., Holguin F., Hussain I., Illowite J., Jacobs J., Jarratt M., Kaiser H., Kao N., Kashyap R., Kaufman D., Kent E., Kim K., Klein R., Kraft M., Kono R., Kureishy S., Leflein J., Leong M., Li H., Lin R., Lugogo N., Marcus M., Maselli Caceres D.J., Mehta V., Mello C., Millard M., Milstone A., Moore W., Moss M., Mumneh N., O'Brien T., Ostransky D., Palumbo M., Parikh P., Parikh S., Patel A., Perez G., Pleskow W., Prenner B., Puppala D., Ramey J., Reibman J., Reyes R., Robinette E., Rodicio I., Ryan S., Sekhsaria S., Sigal B., Sikand V., Soong W., Spangenthal S., St. John R., Steven G., Subramaniam V., Sumino K., Sztejman E., Tan R.A., Tanus T., Thompson C., Thornblade C., Villareal M., Wenzel S., Zafra H., Ziedalski T., and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Pulmonary and Respiratory Medicine, Spirometry, Adult, Male, medicine.medical_specialty, Exacerbation, [SDV]Life Sciences [q-bio], Population, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Placebo, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Double-Blind Method, Internal medicine, medicine, Humans, 030212 general & internal medicine, Anti-Asthmatic Agents, Patient Reported Outcome Measures, education, Sinusitis, Asthma, education.field_of_study, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Benralizumab, 3. Good health, Eosinophils, 030228 respiratory system, chemistry, Asthma Control Questionnaire, Disease Progression, Quality of Life, Female, business
Abstract

Background: ANDHI was done to assess the efficacy of benralizumab, including onset of effect and impact on health-related quality of life (HRQOL), exacerbation rate, lung function, and nasal polyposis symptoms. Methods: This phase 3b, randomised, double-blind, parallel-group, placebo-controlled ANDHI study was completed in adults (aged 18–75 years) with severe eosinophilic asthma with at least 2 exacerbations in the previous year, despite high-dose inhaled corticosteroid plus additional controllers, screening blood eosinophil counts of at least 150 cells per μL, and an Asthma Control Questionnaire 6 (ACQ-6) score of 1·5 or more. Patients who met eligibility criteria were randomly assigned (2:1; stratified by previous exacerbation count [two, or three or more], maintenance oral corticosteroid use, and region), using an integrated web-based response system, to receive benralizumab at 30 mg every 8 weeks (first three doses given 4 weeks apart) or matched placebo for 24 weeks. Primary efficacy measure was annualised asthma exacerbation rate, with rate ratio (RR) calculated over the approximate 24-week follow-up. Secondary efficacy measures included change from baseline to end of treatment (week 24) in St George's Respiratory Questionnaire (SGRQ) total score (key secondary endpoint), FEV1, peak expiratory flow (PEF), ACQ-6, Predominant Symptom and Impairment Assessment (PSIA), Clinician Global Impression of Change (CGI-C), Patient Global Impression of Change (PGI-C), and Sino-Nasal Outcome Test-22 (SNOT-22). All efficacy analyses, except for SNOT-22, were summarised and analysed using the full analysis set on an intention-to-treat population (all randomly assigned patients receiving investigational product, regardless of protocol adherence or continued participation in the study). SNOT-22 was summarised for the subgroup of patients with physician-diagnosed nasal polyposis with informed consent. This study is registered with ClinicalTrials.gov, NCT03170271. Findings: Between July 7, 2017, and Sept 25, 2019, 656 patients received benralizumab (n=427) or placebo (n=229). Baseline characteristics were consistent with severe eosinophilic asthma. Benralizumab significantly reduced exacerbation risk by 49% compared with placebo (RR estimate 0·51, 95% CI 0·39–0·65; p5%) were nasopharyngitis (30 [7%]), headache (37 [9%]), sinusitis (28 [7%]), bronchitis (22 [5%]), and pyrexia (26 [6%]). Fewer serious adverse events were reported for benralizumab (23 [5%]) versus placebo (25 [11%]), and the only common serious adverse event (experienced by >1% of patients) was worsening of asthma, which was reported for nine (2%) patients in the benralizumab group and nine (4%) patients in the placebo group. Interpretation: Our results extend the efficacy profile of benralizumab for patients with severe eosinophilic asthma, showing early clinical benefits in patient-reported outcomes, HRQOL, lung function, and nasal polyposis symptoms. Funding: AstraZeneca.

Published
2021
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26. The measurement of DLNO and DLCO: A manufacturer's perspective.

Author

Giraud X, Le-Dong NN, Hogben K, and Martinot JB

Subjects
Equipment Design, Humans, Pulmonary Diffusing Capacity methods, Carbon Monoxide analysis, Nitric Oxide analysis, Pulmonary Diffusing Capacity instrumentation
Abstract

The simultaneous measurement of the lung transfer factor for carbon monoxide (DLCO) and nitric oxide (DLNO) is now available as a powerful method for studying the alveolar-capillary gas exchange. However, application of the DLNO-CO technique in daily settings is still limited by some technical drawbacks. This paper provides a manufacturer's overview of the measuring principles, technical challenges and current available solutions for implementing the DLNO-CO measurement in to a marketed device. This includes the recent developments in technology for NO sensors, latest findings on NO uptake and new statistical methods., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Published
2017
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27. Phagocyte enzymes in bronchoalveolar lavage from patients with pulmonary sarcoidosis and collagen vascular disorders.

Author

Sibille Y, Martinot JB, Polomski LL, Wallaert B, Demusis M, Rankin JA, Voisin C, and Gee JB

Subjects
Adult, Aged, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Female, Humans, Male, Middle Aged, Neutrophils enzymology, Oligopeptides metabolism, Pancreatic Elastase metabolism, Plasminogen Activators metabolism, Plasminogen Activators physiology, Protease Inhibitors metabolism, Serum Albumin metabolism, Bronchoalveolar Lavage Fluid metabolism, Collagen Diseases enzymology, Peptide Hydrolases metabolism, Phagocytes enzymology, Sarcoidosis enzymology, Vascular Diseases enzymology
Abstract

The balance between proteases and antiproteases in the lower respiratory tract is believed to play a role in the outcome of interstitial lung diseases. In this cross-sectional study, we measure several phagocyte derived enzymes, namely plasminogen activator, neutrophil elastase and an ill-defined protease active on the trialanine chromophore substrate succinyl-alanine3-nitroanilide (SLAPN) in bronchoalveolar lavage (BAL) fluid from 42 patients with pulmonary sarcoidosis and from 43 patients with collagen vascular disease (CVD), 22 without lung disease (group I) and 21 associated with parenchymal lung disease (group II). The results show: a) that sarcoidosis is associated with increased plasminogen activator activity and with the presence of enzymatic activity against SLAPN corresponding at least in part to a metalloprotease; b) that CVD in the absence of radiographic lung disease is associated with an increase of plasminogen activator activity and increased levels of alpha 1-antiprotease-neutrophil elastase complexes; c) that the majority of untreated CVD (group II) patients have detectable levels of neutrophil elastase activity. These data show that patients with pulmonary sarcoidosis and CVD have different enzymatic profiles in their lower respiratory tract as assessed by BAL. Thus, sarcoidosis (mostly lymphocytic) is associated with enhanced macrophage-derived proteolytic activity in BAL, while CVD patients both with and without lung disease have increased neutrophil counts and neutrophil elastase complexed to alpha 1-protease inhibitor and presumably inactive in BAL. Finally, only BAL from untreated CVD patients with interstitial lung disease contain neutrophil elastase activity. This latter activity could contribute to the lung lesions frequently observed in these disorders.

Published
1990

28. Platelet activation by IgE and aspirin.

Author

Joseph M, Capron A, Tsicopoulos A, Ameisen JC, Martinot JB, and Tonnel AB

Subjects
Animals, Asthma chemically induced, Blood Platelets drug effects, Cytotoxicity, Immunologic, Humans, Hypersensitivity etiology, Parasitic Diseases immunology, Receptors, Fc analysis, Receptors, Fc physiology, Receptors, IgE, Aspirin pharmacology, Blood Platelets physiology, Immunoglobulin E immunology
Published
1987
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29. [Blood platelets and asthma caused by aspirin].

Author

Joseph M, Capron A, Ameisen JC, Martinot JB, and Tonnel AB

Subjects
Aspirin immunology, Asthma blood, Blood Platelets enzymology, Blood Platelets immunology, Desensitization, Immunologic, Drug Hypersensitivity immunology, Humans, Immunoglobulin E immunology, Aspirin adverse effects, Asthma chemically induced, Blood Platelets drug effects, Cyclooxygenase Inhibitors, Lipoxygenase Inhibitors
Abstract

Platelets isolated from patients with aspirin-induced asthma (ASA patients) react abnormally in vitro to aspirin and to non-steroid anti-inflammatory drugs (NSAID), by generating cytocidal molecules, that can kill parasitic larvae and to oxygen-dependent free radicles, which may be detected by chemiluminescence, although these drugs do not have a similar effect on platelets from normal donors or allergic asthmatics. The abnormality appears to be associated with the inhibiting properties of NSAID and aspirin on the cyclo-oxygenase pathway, that leads to a defect of the binding of prostaglandin endoperoxide PGH2 to its receptors on the platelet membrane. In addition, another metabolite from the lipoxygenase pathway which is at present poorly defined seems to participate in the anomaly. Sodium salicylate, a naturally produced catabolite of aspirin, that is well-tolerated by ASA patients, inhibits the abnormal response of the platelets and this opens new perspectives in the management of aspirin-sensitive intolerance.

Published
1987

30. Antiproteases are increased in bronchoalveolar lavage in interstitial lung disease.

Author

Sibille Y, Martinot JB, Staquet P, Delaunois L, Chatelain B, and Delacroix DL

Subjects
Bronchoalveolar Lavage Fluid cytology, Humans, T-Lymphocytes, Helper-Inducer classification, T-Lymphocytes, Regulatory classification, alpha 1-Antitrypsin, Alveolitis, Extrinsic Allergic diagnosis, Blood Proteins analysis, Bronchoalveolar Lavage Fluid analysis, Lung Diseases diagnosis, Protease Inhibitors analysis, Sarcoidosis diagnosis, alpha-Macroglobulins analysis
Abstract

The present study evaluates different cellular and soluble components in the bronchoalveolar lavage (BAL) from patients with interstitial lung disease. We observed an increased T4/T8 lymphocyte ratio in BAL but not in blood from 24 patients with active pulmonary sarcoidosis compared to sixteen normal individuals and to eleven patients with inactive pulmonary sarcoidosis. Seven patients with hypersensitivity pneumonitis had a normal T4/T8 ratio. In the active sarcoidosis and hypersensitivity pneumonitis groups, alpha 1-Protease Inhibitor (alpha 1 PI) in BAL is significantly higher than in the normal group and a significant correlation between the two antiproteases (alpha 2-macroglobulin and alpha 1 PI) is observed. These data demonstrate that antiprotease levels (alpha 1 PI and alpha 2 M) are increased in the lower respiratory tract of patients with interstitial lung disease and that among cellular and soluble components of BAL, alpha 2 M represents a sensitive marker of the alveolitis.

Published
1988

31. Relationship between inflammatory processes and gas exchanges in pulmonary sarcoidosis.

Author

Martinot JB, Delaunois L, Rahier J, Dehennin JP, and Sibille Y

Subjects
Adult, Bronchoalveolar Lavage Fluid analysis, Female, Forced Expiratory Volume, Humans, Immunoenzyme Techniques, Immunoglobulin A analysis, Immunoglobulin G analysis, Lung physiopathology, Lung Diseases physiopathology, Male, Middle Aged, Sarcoidosis physiopathology, Vital Capacity, Lung pathology, Lung Diseases pathology, Pulmonary Gas Exchange, Sarcoidosis pathology
Abstract

In the present study, we investigated whether the analysis of cells and proteins collected by bronchoalveolar lavage (BAL) could accurately reflect the degree of functional impairment in pulmonary sarcoidosis. Eighteen patients with biopsy-proven sarcoidosis were prospectively evaluated. An inverse relationship was demonstrated between BAL coefficient of excretion relative to albumin (RCE) values of IgG and IgA and diffusion for carbon monoxide (Dco). A similar negative correlation existed with PaO2 at the end of a maximal exercise. Steroid therapy in five patients lowered concomitantly BAL RCE of IgA and IgG while Dco values increased. Immunoperoxidase studies in three lung biopsies revealed numerous Ig-containing cells within the lung parenchyma. We suggest that these BAL Ig values reflected the mononuclear cell infiltration of the bronchiolovascular sheaths and lung interstitium. This cellular infiltration likely induces a distortion of the capillary bed and may affect the gas exchanges in a reversible way.

Published
1989
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32. Clinical and subclinical alveolitis in collagen vascular diseases: contribution of alpha 2-macroglobulin levels in BAL fluid.

Author

Martinot JB, Wallaert B, Hatron PY, Francis C, Voisin C, and Sibille Y

Subjects
Adult, Bronchoalveolar Lavage Fluid analysis, Bronchoalveolar Lavage Fluid immunology, Collagen Diseases drug therapy, Female, Humans, Immunoglobulin A analysis, Immunoglobulin G analysis, Immunoglobulin M analysis, Male, Methylprednisolone therapeutic use, Middle Aged, Respiratory Function Tests, Vascular Diseases drug therapy, Collagen Diseases complications, Pulmonary Fibrosis complications, Vascular Diseases complications, alpha-Macroglobulins analysis
Abstract

The probability that patients with collagen vascular diseases (CVD) will develop fibrosis is unpredictable. Since changes in bronchoalveolar lavage (BAL) cell data can be observed in CVD patients without evidence of lung involvement, we investigated whether the study of soluble components in BAL could help to distinguish CVD patients with lung involvement (n = 15) from those without pulmonary disease (n = 37). Our results demonstrate that the alveolitis observed in patients with overt lung involvement is associated with an increase of BAL alpha 2-macroglobulin (alpha 2-MA). In contrast, the BAL alpha 2-MA levels were found to be normal in CVD patients without evidence of pulmonary disease as well as in CVD patients with overt lung involvement treated with steroids. This was observed even in the presence of high neutrophil or lymphocyte counts in BAL. In conclusion, when neutrophils or lymphocytes accumulate in the lungs of CVD patients without evidence of lung damage, in the majority of patients this cell accumulation is not associated with an increase of BAL soluble components.

Published
1989

34. Dissecting aneurysm of the ascending aorta with aorto-caval fistula. Fiberoptic oximetric findings and surgical management.

Author

Martinot JB, Pedemonte O, Baele PL, Dautrebande J, Jaumin P, and Goenen M

Subjects
Aged, Aortic Dissection surgery, Aortic Rupture surgery, Aortography, Arteriovenous Fistula diagnostic imaging, Arteriovenous Fistula surgery, Fiber Optic Technology, Humans, Male, Oximetry instrumentation, Aortic Dissection complications, Aorta surgery, Aortic Rupture complications, Arteriovenous Fistula etiology, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior surgery
Abstract

A patient presented the rare complication of a dissecting aneurysm of the ascending aorta ruptured into the superior vena cava producing a left-right fistula. Continuous oximetric measurements by a fiberoptic pulmonary artery floated catheter was used to localize the site of the shunt. Emergency surgical repair was successfully performed.

Published
1985
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