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1. Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study

Author: Ariane Duval-Sabatier, Stephane Burtey, Marion Pelletier, Manon Laforet, Laetitia Dou, Marion Sallee, Anne-Marie Lorec, Hafssa Knidiri, Floriane Darbon, Yvon Berland, and Philippe Brunet
Subjects: dialysis, hemodiafiltration, uremic toxin removal, protein bound solutes, dialysis membrane, Biology (General), QH301-705.5
Abstract: Many hypotheses could explain the mortality decrease observed using hemodiafiltration, such as reduction of intradialytic hypotension and more efficient toxin removal. We led a systematic analysis of representative uremic toxin removal with hemodialysis (HD), online postdilution hemodiafiltration (postHDF) and online predilution hemodiafiltration (preHDF), in a single-center crossover and prospective observational study. The primary outcome was the reduction ratio of uremic toxins of the three categories defined by the Eutox group. Twenty-six patients were treated by those three techniques of extra renal epuration. Mean Kt/Vurea was not different between the treatment methods. Mean reduction ratio of beta2microglobulin was significantly higher for both HDF treatments than for HD (p < 0.001). Myoglobin, kappa, and lambda free light chain reduction ratio was significantly different between the modes: 37.75 ± 11.95%, 45.31 ± 11% and 61.22 ± 10.56%/57.21 ± 12.5%, 63.53 ± 7.93%, and 68.40 ± 11.79%/29.12 ± 8.44%, 34.73 ± 9.01%, and 45.55 ± 12.31% HD, preHDF, and postHDF, respectively (p < 0.001). Mean protein-bound solutes reduction ratio was not different between the different treatments except for PCS with a higher reduction ratio during HDF treatments. Mean albumin loss was always less than 2 g. HDF improved removal of middle molecules but had no effect on indoles concentration without any difference between synthetic dialysis membranes.
Published: 2023
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2. Indole 3-acetic acid, indoxyl sulfate and paracresyl-sulfate do not influence anemia parameters in hemodialysis patients

Author: Stanislas Bataille, Marion Pelletier, Marion Sallée, Yvon Berland, Nathalie McKay, Ariane Duval, Stéphanie Gentile, Yosra Mouelhi, Philippe Brunet, and Stéphane Burtey
Subjects: Anemia, Chronic hemodialysis, Uremic toxins, Erythropoietin, Indoxyl sulfate, Indolic solutes, Diseases of the genitourinary system. Urology, RC870-923
Abstract: Abstract Background The main reason for anemia in renal failure patients is the insufficient erythropoietin production by the kidneys. Beside erythropoietin deficiency, in vitro studies have incriminated uremic toxins in the pathophysiology of anemia but clinical data are sparse. In order to assess if indole 3-acetic acid (IAA), indoxyl sulfate (IS), and paracresyl sulfate (PCS) -three protein bound uremic toxins- are clinically implicated in end-stage renal disease anemia we studied the correlation between IAA, IS and PCS plasmatic concentrations with hemoglobin and Erythropoietin Stimulating Agents (ESA) use in hemodialysis patients. Methods Between June and July 2014, we conducted an observational cross sectional study in two hemodialysis center. Three statistical approaches were conducted. First, we compared patients treated with ESA and those not treated. Second, we performed linear regression models between IAA, IS, and PCS plasma concentrations and hemoglobin, the ESA dose over hemoglobin ratio (ESA/Hemoglobin) or the ESA resistance index (ERI). Third, we used a polytomous logistic regression model to compare groups of patients with no/low/high ESA dose and low/high hemoglobin statuses. Results Overall, 240 patients were included in the study. Mean age ± SD was 67.6 ± 16.0 years, 55.4% were men and 42.5% had diabetes mellitus. When compared with ESA treated patients, patients with no ESA had higher hemoglobin (mean 11.4 ± 1.1 versus 10.6 ± 1.2 g/dL; p 20%) linear regression between IAA, IS or PCS and any anemia parameter did not reach significance. In the third model, univariate analysis showed no intergroup significant differences for IAA and IS. Regarding PCS, the Low Hb/High ESA group had lower concentrations. However, when we compared PCS with the other significant characteristics of the five groups to the Low Hb/high ESA (our reference group), the polytomous logistic regression model didn’t show any significant difference for PCS. Conclusions In our study, using three different statistical models, we were unable to show any correlation between IAA, IS and PCS plasmatic concentrations and any anemia parameter in hemodialysis patients. Indolic uremic toxins and PCS have no or a very low effect on anemia parameters.
Published: 2017
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3. Antibody-dependent NK cell activation is associated with late kidney allograft dysfunction and the complement-independent alloreactive potential of donor-specific antibodies

Author: Tristan Legris, Christophe Picard, Dilyana Todorova, Luc Lyonnet, Cathy Laporte, Chloe Dumoulin, Corinne Nicolino-Brunet, Laurent Daniel, Anderson Loundou, Sophie Morange, Stanislas Bataille, Henri Vacher Coponat, Valerie Moal, Yvon Berland, Francoise Dignat George, Stephane Burtey, and Pascale Paul
Subjects: Kidney Transplantation, natural killer (NK) cells, Antibody mediated rejection, donor-specific antibodies, Antibody-dependent cellular cytotoxicity, Immunologic diseases. Allergy, RC581-607
Abstract: Although kidney transplantation remains the best treatment for end-stage renal failure, it is limited by chronic humoral aggression of the graft vasculature by donor-specific antibodies (DSAs). The complement-independent mechanisms that lead to the antibody-mediated rejection (ABMR) of kidney allografts remain poorly understood. Increasing lines of evidence have revealed the relevance of natural killer (NK) cells as innate immune effectors of antibody-dependent cellular cytotoxicity, but few studies have investigated their alloreactive potential in the context of solid organ transplantation. Our study aimed to investigate the potential contribution of the antibody-dependent alloreactive function of NK cells to kidney graft dysfunction. We first conducted an observational study to investigate whether the cytotoxic function of NK cells is associated with chronic allograft dysfunction. The NK-Cellular Humoral Activation Test (NK-CHAT) was designed to evaluate the recipient and antibody-dependent reactivity of NK cells against allogeneic target cells. The release of CD107a/Lamp1+ cytotoxic granules, resulting from the recognition of rituximab-coated B cells by NK cells, was analyzed in 148 kidney transplant recipients (KTRs, mean graft duration: 6.2 years). Enhanced ADCC responsiveness was associated with reduced graft function and identified as an independent risk factor predicting a decline in the estimated glomerular filtration rate (eGFR) over a 1-year period (hazard ratio: 2.83). In a second approach, we used the NK-CHAT to reveal the cytotoxic potential of circulating alloantibodies in vitro. The level of CD16 engagement resulting from the in vitro recognition of serum-coated allogeneic B cells or splenic cells was further identified as a specific marker of DSA-induced ADCC. The NK-CHAT scoring of sera obtained from 40 patients at the time of transplant biopsy was associated with ABMR diagnosis. Our findings indicate that despite the administration of immunosuppressive treatments, robust ADCC responsiveness can be maintained in some KTRs. Because it evaluates both the Fab recognition of alloantigens and Fc-driven NK cell activation, the NK-CHAT represents a potentially valuable tool for the non-invasive and individualized evaluation of humoral risk during transplantation.
Published: 2016
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4. Fractalkine expression induces endothelial progenitor cell lysis by natural killer cells.

Author: Dilyana Todorova, Florence Sabatier, Evelyne Doria, Luc Lyonnet, Henri Vacher Coponat, Stéphane Robert, Nicolas Despoix, Tristan Legris, Valérie Moal, Anderson Loundou, Sophie Morange, Yvon Berland, Francoise Dignat George, Stéphane Burtey, and Pascale Paul
Subjects: Medicine, Science
Abstract: BACKGROUND: Circulating CD34(+) cells, a population that includes endothelial progenitors, participate in the maintenance of endothelial integrity. Better understanding of the mechanisms that regulate their survival is crucial to improve their regenerative activity in cardiovascular and renal diseases. Chemokine-receptor cross talk is critical in regulating cell homeostasis. We hypothesized that cell surface expression of the chemokine fractalkine (FKN) could target progenitor cell injury by Natural Killer (NK) cells, thereby limiting their availability for vascular repair. METHODOLOGY/PRINCIPAL FINDINGS: We show that CD34(+)-derived Endothelial Colony Forming Cells (ECFC) can express FKN in response to TNF-α and IFN-γ inflammatory cytokines and that FKN expression by ECFC stimulates NK cell adhesion, NK cell-mediated ECFC lysis and microparticles release in vitro. The specific involvement of membrane FKN in these processes was demonstrated using FKN-transfected ECFC and anti-FKN blocking antibody. FKN expression was also evidenced on circulating CD34(+) progenitor cells and was detected at higher frequency in kidney transplant recipients, when compared to healthy controls. The proportion of CD34(+) cells expressing FKN was identified as an independent variable inversely correlated to CD34(+) progenitor cell count. We further showed that treatment of CD34(+) circulating cells isolated from adult blood donors with transplant serum or TNF-α/IFN-γ can induce FKN expression. CONCLUSIONS: Our data highlights a novel mechanism by which FKN expression on CD34(+) progenitor cells may target their NK cell mediated killing and participate to their immune depletion in transplant recipients. Considering the numerous diseased contexts shown to promote FKN expression, our data identify FKN as a hallmark of altered progenitor cell homeostasis with potential implications in better evaluation of vascular repair in patients.
Published: 2011
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5. Pepper mild mottle virus, a plant virus associated with specific immune responses, Fever, abdominal pains, and pruritus in humans.

Author: Philippe Colson, Hervé Richet, Christelle Desnues, Fanny Balique, Valérie Moal, Jean-Jacques Grob, Philippe Berbis, Hervé Lecoq, Jean-Robert Harlé, Yvon Berland, and Didier Raoult
Subjects: Medicine, Science
Abstract: BackgroundRecently, metagenomic studies have identified viable Pepper mild mottle virus (PMMoV), a plant virus, in the stool of healthy subjects. However, its source and role as pathogen have not been determined.Methods and findings21 commercialized food products containing peppers, 357 stool samples from 304 adults and 208 stool samples from 137 children were tested for PMMoV using real-time PCR, sequencing, and electron microscopy. Anti-PMMoV IgM antibody testing was concurrently performed. A case-control study tested the association of biological and clinical symptoms with the presence of PMMoV in the stool. Twelve (57%) food products were positive for PMMoV RNA sequencing. Stool samples from twenty-two (7.2%) adults and one child (0.7%) were positive for PMMoV by real-time PCR. Positive cases were significantly more likely to have been sampled in Dermatology Units (pConclusionsOur study identified a local source of PMMoV and linked the presence of PMMoV RNA in stool with a specific immune response and clinical symptoms. Although clinical symptoms may be imputable to another cofactor, including spicy food, our data suggest the possibility of a direct or indirect pathogenic role of plant viruses in humans.
Published: 2010
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6. Nanobacteria are mineralo fetuin complexes.

Author: Didier Raoult, Michel Drancourt, Saïd Azza, Claude Nappez, Régis Guieu, Jean-Marc Rolain, Patrick Fourquet, Bernard Campagna, Bernard La Scola, Jean-Louis Mege, Pascal Mansuelle, Eric Lechevalier, Yvon Berland, Jean-Pierre Gorvel, and Patricia Renesto
Subjects: Immunologic diseases. Allergy, RC581-607, Biology (General), QH301-705.5
Abstract: "Nanobacteria" are nanometer-scale spherical and ovoid particles which have spurred one of the biggest controversies in modern microbiology. Their biological nature has been severely challenged by both geologists and microbiologists, with opinions ranging from considering them crystal structures to new life forms. Although the nature of these autonomously replicating particles is still under debate, their role in several calcification-related diseases has been reported. In order to gain better insights on this calciferous agent, we performed a large-scale project, including the analysis of "nanobacteria" susceptibility to physical and chemical compounds as well as the comprehensive nucleotide, biochemical, proteomic, and antigenic analysis of these particles. Our results definitively ruled out the existence of "nanobacteria" as living organisms and pointed out the paradoxical role of fetuin (an anti-mineralization protein) in the formation of these self-propagating mineral complexes which we propose to call "nanons." The presence of fetuin within renal calculi was also evidenced, suggesting its role as a hydroxyapatite nucleating factor.
Published: 2008
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7. Human Parvovirus 4 in Kidney Transplant Patients, France

Author: Philippe Biagini, Bertrand Dussol, Mhammed Touinssi, Philippe Brunet, Christophe Picard, Valérie Moal, Mourad Belhouchet, Pierre Gallian, Jean-François Cantaloube, Houssam Attoui, Yvon Berland, and Philippe de Micco
Subjects: PARV4, blood, transplant, kidney, hemodialysis, blood donors, Medicine, Infectious and parasitic diseases, RC109-216
Published: 2008
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8. Vingt ans après, quid des propositions du rapport Berland ?

Author: Yvon Berland
Published: 2022

9. Erratum à : Diagnostic performance of pulmonary ultrasonography and a clinical score for the evaluation of fluid overload in haemodialysis patients [Nephrol. & Therap. 17 (1) (2021) 42–49]

Author: Mickaël Bobot, Laurent Zieleskiewicz, Noémie Jourde-Chiche, Clarissa Von Kotze, Manon Ebersolt, Bertrand Dussol, Marion Sallée, Sophie Chopinet, Yvon Berland, Philippe Brunet, Thomas Robert, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), and 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)
Subjects: Nephrology, [SDV]Life Sciences [q-bio]
Abstract: International audience
Published: 2022

10. Diagnostic performance of pulmonary ultrasonography and a clinical score for the evaluation of fluid overload in haemodialysis patients

Author: Thomas Robert, Bertrand Dussol, Laurent Zieleskiewicz, Sophie Chopinet, Clarissa Von Kotze, Mickaël Bobot, Manon Ebersolt, Noémie Jourde-Chiche, Marion Sallée, Yvon Berland, Philippe Brunet, 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), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital Nord [CHU - APHM], Aix Marseille Université (AMU), Aix-Marseille Université - École de médecine (AMU SMPM MED), Aix-Marseille Université - Faculté des sciences médicales et paramédicales (AMU SMPM), Aix Marseille Université (AMU)-Aix Marseille Université (AMU), Hôpital de la Timone [CHU - APHM] (TIMONE), CCSD, Accord Elsevier, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Assistance Publique - Hôpitaux de Marseille (APHM), and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
Subjects: medicine.medical_specialty, Water-Electrolyte Imbalance, 030232 urology & nephrology, Physical examination, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Internal medicine, medicine, Humans, Chronic hemodialysis, Lung, Daily routine, Ultrasonography, Hydration status, Lung ultrasound, medicine.diagnostic_test, business.industry, Ultrasound, Reflux, Gold standard (test), [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 3. Good health, Haemodialysis, Echocardiography, Nephrology, Fluid overload, Cardiology, business
Abstract: International audience; Introduction. - There is no feasible benchmark in daily routine to estimate the hydration status of haemodialysis patients, which is essential to their management. Objective. - We performed a study in haemodialysis patients to assess the diagnostic performance of pulmonary ultrasound and clinical examination for the evaluation of fluid overload using transthoracic echocardiography as a gold standard.Methods. - Thirty-one patients receiving chronic haemodialysis patients were included. Evaluation of hydration status was assessed weekly before haemodialysis sessions using clinical and Echo Comet Score from pulmonary ultrasound and transthoracic echocardiography (reference method).Results. - Five patients had a transthoracic echocardiography overload. Compared with transthoracic echocardiography, the diagnostic performance of the clinical overload score has a sensitivity of 100%, a specificity of 77%, a positive predictive value of 50% and a negative predictive value of 100% with a k of 0.79. Only orthopnoea (P = 0.008), jugular turgor (P = 0.005) and hepatic-jugular reflux (P = 0.008) were significantly associated with transthoracic echocardiography overload diagnosis. The diagnostic performance of Echo Comet Score by pulmonary ultrasound has a sensitivity of 80%, a specificity of 58%, a positive predictive value of 26% and a negative predictive value of 94%. Ten patients (32.3%) had an increase of extravascular pulmonary water without evidence of transthoracic echocardiography or clinical overload.Conclusions. - Our clinical score has a convincing diagnostic performance compared to transthoracic echocardiography and could be easily used in daily clinical routine to adjust dry weight. The evaluation of the overload using pulmonary ultrasound seems poorly correlated with the overload evaluated by transthoracic echocardiography. Extravascular pulmonary water undetected by clinical examination and transthoracic echocardiography remains a parameter that requires further investigation. (C) 2020 Societe francophone de nephrologie, dialyse et transplantation.
Published: 2021

11. Indole 3-acetic acid, indoxyl sulfate and paracresyl-sulfate do not influence anemia parameters in hemodialysis patients

Author: Yvon Berland, Stanislas Bataille, M. Pelletier, A. Duval, Marion Sallée, Stéphane Burtey, Nathalie McKay, Yosra Mouelhi, Stéphanie Gentile, Philippe Brunet, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université Bordeaux Segalen - Bordeaux 2, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), and Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: Nephrology, Male, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Indican, 030204 cardiovascular system & hematology, lcsh:RC870-923, Gastroenterology, Indoxyl sulfate, chemistry.chemical_compound, 0302 clinical medicine, hemic and lymphatic diseases, Aged, 80 and over, Univariate analysis, Sulfates, Anemia, Middle Aged, Publisher Correction, 3. Good health, Female, Hemodialysis, medicine.drug, Research Article, medicine.medical_specialty, Uremic toxins, 03 medical and health sciences, Renal Dialysis, Internal medicine, Diabetes mellitus, medicine, Humans, Renal Insufficiency, Chronic, Erythropoietin, Aged, Indoleacetic Acids, business.industry, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Surgery, Indolic solutes, Cross-Sectional Studies, chemistry, Hemoglobin, business, Chronic hemodialysis, Biomarkers
Abstract: Background The main reason for anemia in renal failure patients is the insufficient erythropoietin production by the kidneys. Beside erythropoietin deficiency, in vitro studies have incriminated uremic toxins in the pathophysiology of anemia but clinical data are sparse. In order to assess if indole 3-acetic acid (IAA), indoxyl sulfate (IS), and paracresyl sulfate (PCS) -three protein bound uremic toxins- are clinically implicated in end-stage renal disease anemia we studied the correlation between IAA, IS and PCS plasmatic concentrations with hemoglobin and Erythropoietin Stimulating Agents (ESA) use in hemodialysis patients. Methods Between June and July 2014, we conducted an observational cross sectional study in two hemodialysis center. Three statistical approaches were conducted. First, we compared patients treated with ESA and those not treated. Second, we performed linear regression models between IAA, IS, and PCS plasma concentrations and hemoglobin, the ESA dose over hemoglobin ratio (ESA/Hemoglobin) or the ESA resistance index (ERI). Third, we used a polytomous logistic regression model to compare groups of patients with no/low/high ESA dose and low/high hemoglobin statuses. Results Overall, 240 patients were included in the study. Mean age ± SD was 67.6 ± 16.0 years, 55.4% were men and 42.5% had diabetes mellitus. When compared with ESA treated patients, patients with no ESA had higher hemoglobin (mean 11.4 ± 1.1 versus 10.6 ± 1.2 g/dL; p 20%) linear regression between IAA, IS or PCS and any anemia parameter did not reach significance. In the third model, univariate analysis showed no intergroup significant differences for IAA and IS. Regarding PCS, the Low Hb/High ESA group had lower concentrations. However, when we compared PCS with the other significant characteristics of the five groups to the Low Hb/high ESA (our reference group), the polytomous logistic regression model didn’t show any significant difference for PCS. Conclusions In our study, using three different statistical models, we were unable to show any correlation between IAA, IS and PCS plasmatic concentrations and any anemia parameter in hemodialysis patients. Indolic uremic toxins and PCS have no or a very low effect on anemia parameters.
Published: 2017

12. Diagnostic performance of pulmonary ultrasonography and a clinical score for the evaluation of hydration status in haemodialysis patients

Author: Mickaël Bobot, Laurent Zieleskiewicz, Noémie Jourde-Chiche, Clarissa Von Kotze, Manon Ebersolt, Bertrand Dussol, Marion Sallée, Sophie Chopinet, Yvon Berland, Philippe Brunet, and Thomas Robert
Subjects: body regions
Abstract: BACKGROUND There is no feasible benchmark in daily routine to estimate the hydration status of haemodialysis patients, which is essential to their management. We performed a retrospective study in HD patients to assess the diagnostic performance of pulmonary ultrasound and clinical examination for the evaluation of fluid overload using transthoracic echocardiography (TTE) as a gold standard. METHODS 31 patients receiving chronic HD were included. Evaluation of hydration status was assessed weekly before haemodialysis sessions using clinical and Echo Comet Scores from pulmonary ultrasound and TTE (reference method). RESULTS Five patients had a TTE overload. Compared with TTE, the diagnostic performance of the clinical overload score has a sensitivity (Se) of 100%, a specificity (Sp) of 77%, a positive predictive value (PPV) of 50% and a negative predictive value (NPV) of 100% with a κ of 0.79. Only orthopnoea (P=0.008), jugular turgor (P=0.005) and hepatic-jugular reflux (P=0.008) were significantly associated with TTE overload diagnosis. The diagnostic performance of Echo Comet Score by pulmonary ultrasound has a Se of 80%, a Sp of 58%, a PPV of 26% and a NPV of 94%. Ten patients (32.3%) had an increase of extravascular pulmonary water without evidence of TTE or clinical overload. CONCLUSIONS Our clinical score has a convincing diagnostic performance compared to TTE and could be easily used in daily clinical routine to adjust dry weight. The evaluation of the overload using pulmonary ultrasound seems poorly correlated with the overload evaluated by TTE. The presence of extravascular pulmonary water undetected by clinical examination and TTE remains a parameter which requires further investigation.
Published: 2019

13. A patient university in Marseille : a pilot experiment

Author: Laurent, Bensoussan and Yvon, Berland
Published: 2018

14. De Novo Renal Cell Carcinoma of Native Kidney in Renal Transplant Recipients

Author: Neuzillet, Yann, Lay, Franck, Luccioni, Aline, Daniel, Laurent, Berland, Yvon, Berland, Coulange, Christian, and Lechevallier, Eric
Subjects: Kidneys -- Diseases, Carcinoma, Renal cell -- Analysis, Kidneys -- Transplantation, Kidneys -- Complications and side effects, Health
Published: 2005

15. Diagnostic performance of [ 18 F]fluorodeoxyglucose positron emission tomography–computed tomography in cyst infection in patients with autosomal dominant polycystic kidney disease

Author: Bertrand Gondouin, Marion Sallée, Serge Cammilleri, Tristan Legris, P. Souteyrand, C. Ghez, Mickaël Bobot, Stéphane Burtey, Noémie Jourde-Chiche, Bertrand Dussol, L. Tessonnier, Yvon Berland, Pierre-Edouard Fournier, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), ESCMID (ESCAR), ESCMID [Basel], European Network for Surveillance of Tick-Borne Diseases, European Community, 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), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), 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, and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, Microbiology (medical), medicine.medical_specialty, 030232 urology & nephrology, Autosomal dominant polycystic kidney disease, Infections, Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Fluorodeoxyglucose F18, medicine, Humans, Cyst, Hospitals, Teaching, Aged, Retrospective Studies, Fluorodeoxyglucose, Staining and Labeling, medicine.diagnostic_test, Cysts, business.industry, Magnetic resonance imaging, General Medicine, Middle Aged, Polycystic Kidney, Autosomal Dominant, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Contrast medium, Infectious Diseases, Positron-Emission Tomography, Hypermetabolism, Female, France, Radiology, Differential diagnosis, Tomography, X-Ray Computed, Complication, business, medicine.drug
Abstract: International audience; Cyst infection is a common complication of autosomal dominant polycystic kidney disease (ADPKD). Diagnosis is challenging with standard imaging techniques. We aimed to evaluate the diagnostic performance of [F-18] fluorodeoxyglucose positron emission tomography-computed tomography (18-FDG PET-CT) for the diagnosis of cyst infections among ADPKD patients, in comparison with computed tomography (CT) and magnetic resonance imaging (MRI). All APKD patients who underwent 18-FDG PET-CT for suspected cyst infection between 2006 and 2013 in a French teaching hospital were included. Diagnosis of cyst infection was retained a posteriori on an index of clinical suspicion. 18-FDG PET-CT findings were was considered to be positive in cases of cyst wall hypermetabolism. CT or MRI findings were were considered to be positive in cases of cyst wall thickening (and enhancement if contrast medium was injected) and infiltration of the adjacent fat. A control group of ADPKD patients with 18-FDG PET-CT performed for other reasons was included. Thirty-two 18-FDG PET-CT scans were performed in 24 ADPKD patients with suspected cyst infection. A diagnosis of cyst infection was retained in 18 of 32 cases: 14 with positive 18-FDG PET-CT findings, and four false negatives. There were no false positives and no hypermetabolism of cyst walls in nine ADPKD control patients. 18-FDG PET-CT had a sensitivity of 77%, a specificity of 100%, and a negative predictive value of 77%. 18-FDG PET-CT allowed a differential diagnosis in three patients. In contrast, CT had a sensitivity of 7% and a negative predictive value of 35% (p < 0.001 vs. 18-FDG PET-CT). Only eight MRI scans were performed. The diagnostic performance of 18-FDG PET-CT is superior to that of CT in cyst infections, for comparable radiation doses and with no injection of nephrotoxic contrast medium, in ADPKD patients. (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Published: 2016

16. Mimivirus in the urine of a kidney-transplant recipient

Author: Didier Raoult, Yvon Berland, Sarah Aherfi, P. Colson, W. Kodangasse, Valérie Moal, B. La Scola, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), and Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)
Subjects: 0301 basic medicine, Microbiology (medical), Mimivirus, Dna virus infections, biology, 030106 microbiology, General Medicine, Urine, biology.organism_classification, medicine.disease, Virology, Acanthamoeba, Kidney transplant recipient, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine, Mimiviridae, 030212 general & internal medicine, Dna viral, Kidney transplantation, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2018

17. Hemodialysis vascular graft as a focus of persistent Q fever

Author: Pierre-Edouard Fournier, Didier Raoult, Eric Guedj, Vincent Ernest, Yvon Berland, Raafat Boustani, Cindy Perron, Serge Cammilleri, Stéphane Burtey, Valérie Moal, Noémie Jourde-Chiche, M. Pelletier, Mathilde Fedi, Clarissa Von Kotze, Philippe Brunet, Philippe Amabile, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Department of nuclear medicine aphm Timone, Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), HOPITAL DE MANOSQUE, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Département de Médecine Nucléaire [AP-HM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)- Hôpital Nord [CHU - APHM], Université Bordeaux Segalen - Bordeaux 2, Service de médecine nucléaire [Marseille], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Institut Hospitalier Universitaire Méditerranée Infection (IHU AMU), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Imagerie MOléculaire pour applications THéranostiques personnalisées (IMOTHEP), Institut FRESNEL (FRESNEL), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)- Hôpital de la Timone [CHU - APHM] (TIMONE), and Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)
Subjects: DNA, Bacterial, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Prosthesis-Related Infections, COXIELLA-BURNETII, Vascular graft infection, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030106 microbiology, Q fever, DIAGNOSIS, Gastroenterology, Serology, 03 medical and health sciences, Renal Dialysis, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Positron Emission Tomography Computed Tomography, Internal medicine, INFECTION, medicine, Humans, Chronic fever, ComputingMilieux_MISCELLANEOUS, biology, business.industry, General Medicine, Middle Aged, Coxiella burnetii, biology.organism_classification, medicine.disease, bacterial infections and mycoses, 3. Good health, Treatment Outcome, Infectious Diseases, Hemodialysis, Hypermetabolism, bacteria, Female, Vascular Grafting, France, Complication, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Vascular graft
Abstract: International audience; Vascular access infection is a frequent complication in hemodialysis patients. We report the second case worldwide of a prosthetic hemodialysis vascular graft infection by Coxiella burnetii, with intense hypermetabolism on PET-CT, Q fever serology consistent with persistent infection, and positive C. burnetii DNA in the blood and removed vascular graft.
Published: 2018

18. Considerable decrease in antibodies against hepatitis B surface antigen following kidney transplantation

Author: Anne Motte, Catherine Tamalet, Yvon Berland, Henri Vacher-Coponat, Valérie Moal, and Philippe Colson
Subjects: Adult, Male, HBsAg, medicine.disease_cause, Serology, Virology, medicine, Humans, Longitudinal Studies, Hepatitis B Antibodies, Kidney transplantation, Aged, Retrospective Studies, Hepatitis B virus, Hepatitis B Surface Antigens, biology, business.industry, Middle Aged, Hepatitis B, medicine.disease, Kidney Transplantation, Vaccination, Titer, Infectious Diseases, Immunization, Immunology, biology.protein, Female, Antibody, business
Abstract: Immunization against hepatitis B virus (HBV) in kidney transplantation (KT) candidates and recipients is recommended. If anti-HBV surface antigen antibody (anti-HBsAb) titer of 10 IU/L is admitted to be protective, the optimal threshold, at and after KT, is unknown. In addition, the natural evolution of anti-HBsAb titers after KT is not reported.To describe rates of protective immunity to HBV at time of KT (baseline) and evolution of anti-HBsAb titers during the following year.We retrospectively analyzed HBV serology at baseline, 15 days, and 4 and 12 months post-KT. No patient received vaccination during the study period, but information about previous vaccination was unavailable.At baseline 80% of 141 recipients had anti-HBsAb titer ≥10 IU/L. Among these 113 patients, 84 had subsequent HBV serologies at day 15 and month 4, and 67 had also serology at month 12. At month 12, 25% of patients had lost protective anti-HBsAb titers (p0.001). The duration of protective anti-HBsAb titers was significantly longer when the initial titer was ≥ 100 IU/L versus100 IU/L (log-rank test p0.0001). Protective titers at month 12 persisted in 93% of patients with initial titer ≥100 IU/L compared to 33% with 10-100IU/L titer (p0.0001). In contrast, duration of protective titers did not differ according to the anti-HBV core antigen antibody status at baseline.Despite a high prevalence of protective anti-HBsAb titer at KT, the loss of protective immunity during the following year was considerable, particularly when initial anti-HBsAb titer was100 IU/L.
Published: 2015

19. Polymorphonuclear activation measured by surface expression of CD11b and CD62L in uremic patients

Author: Philippe Brunet, Laetitia Dou, Francoise Dignat-George, Sampol, J., Yvon Berland, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and Dou, Laetitia
Subjects: [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract: International audience; no abstract
Published: 2017

20. Elevation of endothelial microparticles in chronic renal failure: Role of uremic toxins

Author: Faure, V., Laetitia Dou, Sabatier, F., Claire Cerini, Sampol, J., Yvon Berland, Philippe Brunet, Francoise Dignat-George, Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Physiopathologie de l'Endothelium, Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Dou, Laetitia
Subjects: [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract: 42nd Annual Meeting of the European-Renal-Association/European-Dialysis-and-Transplant-Association (ERA-EDTA), Istanbul, TURKEY, JUN 04-07, 2005; International audience; no abstract
Published: 2017

21. Modular Transcriptional Repertoire Analyses of Adults With Systemic Lupus Erythematosus Reveal Distinct Type I and Type II Interferon Signatures

Author: Damien Chaussabel, Vivian H. Gersuk, Scott R. Presnell, Charlie Quinn, Laurent Chiche, Virginia Pascual, Stéphane Burtey, Jean Robert Harlé, Kristen K. Dang, Elizabeth Whalen, Yvon Berland, Esperanza Anguiano, Noémie Jourde-Chiche, and Gilles Kaplanski
Subjects: Autoimmune disease, Lupus erythematosus, Immunology, Biology, Dermatomyositis, medicine.disease, Pathogenesis, Immune system, Rheumatology, Antigen, medicine, Immunology and Allergy, Biomarker (medicine), IRGs
Abstract: Interferons (IFNs) regulate the function of most immune cells. Type-I (including IFN-α and IFN-β) and type-II (IFN-γ) IFNs are the most studied members of the family. Many cell types, especially macrophages and dendritic cells, secrete type-I IFN, whereas type-II IFN is mostly produced by T lymphocytes and natural-killer cells. IFN-regulated genes (IRGs) (1) play a major role in controlling viral infections, and non-viral inflammatory and autoimmune disorders, such as systemic lupus erythematosus (SLE) (2). SLE is a chronic autoimmune disease characterized by the breakdown of tolerance to nuclear antigens, especially nucleic acids, resulting in widespread organ damage. Its broad-spectrum manifestations and waning and waxing course make evaluation of disease activity challenging for clinicians. Some laboratory tests, including anti-double-stranded DNA (anti-dsDNA) antibody titers and complement factor levels, are often monitored, but several longitudinal studies have demonstrated their shortcomings (3) and no surrogate biomarker for disease activity has been validated to date. Hence, there is an important need to develop objective, simple, and robust SLE biomarkers (4). Defining the molecular pathways responsible for the pathogenesis of SLE could aid diagnosis, biomarker development, and therapy. A pivotal role for type-I IFN (IFN-α) in the pathogenesis of SLE is strongly supported by many data, including gene-expression studies (5). Over the past decade, several groups have reported increased expression of type-I IRGs in SLE: i.e., the so-called "type-I IFN signature" (5,6). This discovery prompted the initiation of therapeutic trials aimed at evaluating the benefits of anti-IFN-α therapy in SLE patients (7), and of IFN-related biomarkers or “scores” to assess SLE disease activity or response to therapy (5,6). Although type-I IFN activation has been previously correlated with SLE activity (5,6), this association has not been validated in recent longitudinal studies (8,9). This is probably because few longitudinal gene-expression studies have been conducted (10), and the contribution of type-II IFN to the “IFN signature” in blood and tissues may have been overlooked, as recently shown in dermatomyositis (11), Sjogren's syndrome (12), or even in SLE (13–15). In addition, because the transition from genome-wide RNA-expression analysis (thousands of genes) to only a few target genes is challenging, scores may have been biased by a knowledge-driven data-reduction process. Our group has developed an original approach based on modules that correspond to co-clustered gene sets built via an unbiased data-driven approach (16). This approach has shown promising results in pediatric SLE (17). The aim of this study was to use modular transcriptional repertoire analysis to improve characterization of the blood-IFN signature in adult patients with SLE.
Published: 2014

22. Survival of patients with ANCA-associated vasculitis on chronic dialysis: data from the French REIN registry from 2002 to 2011

Author: Laurent Chiche, Jean-Robert Harlé, Noémie Jourde-Chiche, Cécile Couchoud, M. Romeu, Bertrand Gondouin, Jean-Christophe Delarozière, Stéphane Burtey, Philippe Brunet, and Yvon Berland
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, viruses, medicine.medical_treatment, Renal function, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Kaplan-Meier Estimate, Gastroenterology, Young Adult, Renal Dialysis, Risk Factors, Cause of Death, Internal medicine, medicine, Humans, Registries, Child, Survival rate, Dialysis, Aged, Cause of death, Aged, 80 and over, Kidney, business.industry, General Medicine, Middle Aged, medicine.disease, Kidney Transplantation, Surgery, Transplantation, medicine.anatomical_structure, Case-Control Studies, Kidney Failure, Chronic, Female, France, Hemodialysis, Granulomatosis with polyangiitis, business
Abstract: Background: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) can lead to end-stage renal disease in patients with renal involvement. Objective: This study evaluated the survival of AAV patients on chronic dialysis in France. Methods: Between 2002 and 2011, a total of 425 AAV patients started chronic dialysis and were registered in the Renal Epidemiology and Information Network. We analysed survival censored for renal transplantation, recovery of renal function and loss to follow-up. AAV patients were compared with 794 matched non-AAV patients on chronic dialysis. Results: A total of 166 (39%) patients with microscopic polyangiitis and 259 (61%) patients with granulomatosis with polyangiitis were registered. Within a median follow-up of 23 months, 58 (14%) patients received a renal allograft and 19 (4%) recovered renal function. Median survival on dialysis was 5.35 years (95% CI, 4.4–6.3) and survival rates at 3 months, 1, 3 and 5 years were 96%, 85%, 68% and 53%, respectively. A total of 143 (41%) patients died after a median of 16 months. Causes of death were cardiovascular (29%), infections (20%), malnutrition (13%), malignancies (4%), AAV relapse (2%), miscellaneous (14%) and unknown (18%). Multivariate logistic regression identified three independent risk factors associated with AAV patients’ mortality: age (HR = 1.05/year, P < 0.001), peripheral artery disease (HR = 2.62, P = 0.003) and frailty (HR = 2.43, P < 0.001). Survival of AAV patients did not differ from non-AAV controls, but infectious mortality was higher in AAV patients (20% vs. 8%, P < 0.001). Conclusion: Survival of AAV patients in chronic dialysis, although poor, was comparable to survival of non-AAV controls on dialysis. There was a similar burden of cardiovascular mortality, but higher infectious mortality.
Published: 2014

23. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study

Author: Odile Fremin-Batteux, Juliette Clarissou-Philippe, Benoît Jauhlac, Severine Guyetand, Jacques Gasnault, Corinne Haioun, Liamine Aissaoui, Marie-Christine Pages, Marie-Pierre Fos, Christian Rose, Didier Hubert, Marie-Rose Rothe, N. Bouziges, Benoît Huc, François Devianne, Sabine Bidart, Anne Forest, Kevin Bertrand, Mohamed Eldeghedy, Annick Verhaeghe, Caroline Malderet, Anne Bertrou, Bernard Guerquin, Catherine Duche, Muriel Archambaud, Rabea Cotteret, Olivier Toullalan, Yves Devaux, Smail Bergheul, Valérie Sivadon-Tardy, Pierre-Gilles Merville, Geneviève Blanchard-Marche, Didier Raoult, Bernard Hory, Florence Richardin, Evelyne Belle, Mohamed Menouar, K Guitteaud, Mohamad Mohty, Ambroise Montcriol, Max Laurin, Aurélia Picard, Jean-Paul Mira, Marie-Charlotte Chopin, Richard Bonnet, Michel Wolff, Sébastien Maillez, Jeanne Maugein, Véronique Leblond, Nicola Walid, Bernard Gauche, Mathieu Evillard, Hassen Jeddi, Anne Bourlet, Isabelle Grawey, Thierry Jault, Sandrine Hiret, Valerie Gaborieau, Véronique Boin-Gay, An Kim, Thierry Constans, Jean-François Gaide, Martine Giraud, Eric Meaudre Desgouttes, Alain Fur, Abdallah Maakaroun, Olivier Matray, Bertrand Maubert, Frédérique Péchinot, Aurelie Garbi, Claire Delbrouck, Benoît Grandclerc, Vincent Cadiergue, Hervé Lécuyer, Bernadette Grignon, Thierry Bensaid, Nicole Constantin, Yannick Chevalier, Hassène Rahmani, Thierry Levent, Joelle Desliers, Florence Van de Velde, Xavier Adhoute, Clara Andriau, Christophe Charasse, Rémi Vatan, Benoît Martha, Alain Lecis, Didier Albert, Romain Jacobs, Hélène Lefranc, Christian Martin, Nasseur Rezgui, Bertrand Pigeon, Catherine Le Henaff, Dominique Cassignard, Françoise Cotes, Eric Pujade Lauraine, Jean-François Gattault, Nicole Ferreira-Maident, Noémie Jourde-Chiche, Hélène Garrec, Olivier Darchen, Carole Schwebel, Marie-Christine Bezian, Patrick Daoud, Tsouria Becaid, Simone Laluque, David Broche, Christine Boisselier, Pascale Martres, Sarah Hammami, Brigitte Olivier, Jean-Marie Nkunzimana, Eric Monlun, Isabelle Marterl-Lafay, Marion Carboni, Marie-Françoise Mattei, Sandrine Castelin, Isabelle Barillot, Marie-Noelle Cufi, Thomas Kaiser, Catherine Herry, Pascal Hutin, Jean-Pierre Bronowicki, Bernard Branger, Pierre Thomas, Elie Zagdoun, Anne Goquelin, Ziad Assaf, Ingrid Croquet, Bruno Pozzetto, Thomas Similowski, Anne-Isabelle Briere, Marie-Thérèse Albertini, Mariam Blaka, Christelle Tassot, Anne Gaschet, Jean-Philippe Lavigne, Antoine Pujol, Philippe Colombat, Edouard Devaud, Hana Talabani-Boizot, François Barière, Anne-Marie Cordier, Philippe Gueudet, Georges Simon, Anne-Sophie Lipovac, Françoise Bandaly, Anne Beauplet-Lepage, Sylvie Prince, Charlotte Jouzel, Jean-Luc Deboutin, Patrick Zavadil, Louis Puybasset, Marie-Cécile Petit, Loïc Guillevin, Kamel Touati, Christophe Ntalu Nkato, Sylvie Carette, Jacques Vaucel, Chantal Delasalle, Marine Gross Goupil, Laurent Gutmann, Christiane Payen, Annick Barboteau, Firouzé Bani-Sadr, Christophe Legendre, Philippe Roulier, Elie Azria, Ibrahim Farah, Isabelle Rouquette-Vincent, Anne-Sophie Erena-Penet, Philippe Labadie, Eric Josien, Aicha Derragui, Mathieu Legrand, Odile Beyne-Rauzy, Jean-Marc Nabholtz, Marie-Joelle Demarcq, Olivier Garosi, Michel Deiber, Fabrice Chaix, Bertrand Souweine, Anne Collignon, Gisèle Renard, Mickael Jego, Gilles Bernardin, Anne Allart, Jocelyn Barrier, Marc Vasse, Philippe Ménager, Marc Wurmser, Abderkader Ouazir, Olivier Gontieron, Yvon Berland, Sébastien Trouiller, David Leysenne, Christophe Ozanon, Fanny Autret, Tahar Saghi, Loïc Dopeux, Sophie Benoit-Coustou, T. Fraisse, Christine Maillard, Karine Nikodijevic, Georges Kaltenbach, Angéline Jamet, Philippe Aucher, Julie Bottero, Marie-Claude Piffaut, Marianne Besnard, Florence Courillon, Marie Bonfils, Christine Ghevaert, Marie Destors, Eliette Jeanmaire, Franck Zerbib, Manuel-Luis Gameiro, T Prazuck, Laurent Mandin, Olivier Guisset, Marguerite Fines, Toufik Feddal, Agnès Jouffret, Louis Mesnard, Thomas Bourrée, Hasinrina Razafimahefa, Sylvestre Tigaud, Vincent Estève, Philippe Malherbe, Jean-Michel Salord, Pascal Adam, Bertrand Rozec, Michel Fuillet, Olivier Lemenand, Denis Quinsat, Ana Danalaché, Véronique Vialette, François Brosset, Patrick Messner Pellenc, Nicolas Heisel, Edouard Girard, Régine Martin, Olivier Garesslin, Catherine Mille, Alexandre Gascon, Marc Nicolino, Laurence Mouly, Claire Fabre, Bénédicte Ponceau, Marie-Etiennette Emeriau, Pascal Cathebras, Bérangère Bernardaud, Michèle Pérouse de Montclos, O. Arsene, Karine Grenet, Yazdan Yazdanpanah, Sten De Witte, Anne Scemla, Laurence Bouillet, Christophe Burucoa, Vincent Loffeier, Séverine Visentin, Luc Desfrere, Miloud Arabi, Frédérique Costa, Sylvie Lechat, Ali Chekroun, Raymond Ruimy, Marie, Jérôme Bizet, Xavier Nassif, Baihas Dib, Patrick Bert-Marcaz, Laurent Martin Lefèvre, Nicholas Sedillot, Blandine Cattier, Emilie Boidin, Daniel Sondag, Aude Bourrouillou, Alain Noirot, Franck Desemerie, Fréderic Heluwaert, Catherine Tamalet, Marc G. Berger, Jean-Daniel Lelièvre, Dominique Perotin, Abdelkader Bemrah, Alain Lozniewski, Bernard Borstein, Hanna Eid, Diana Suatean, Virginie Mignaut, Jean-Claude N'guyen, Valérie Le Goff, Laurent Teillet, Christophe Rolland, Gwenaël Alfonsi, Florence Lachenal, Philippe Bossi, Yves Botreau, Florence Doucet Populaire, Henry Jardel, Nicolas Gallo, Elias Jabre-Sikias, Michel Dupon, Hélène Brihier, Isabelle Patry, Alexandre Leclercq, Bernadette Tourrand, Christophe Roussel, Jean-Emmanuel Kurtz, Bénédicte Paindaveine, Simon Elhadad, Richard Sanchez, Eric Sgro, Pierre Berger, Valérie Murbach, Anne Holstein, Florence Martin, Taoufik Merabet, Amélie Benbara, Milagros Ferreyra, Laure Esposito, Pierre Delobel, Antoine Andremont, Marc Bourlière, Carole-Anne Boudy, Jean-Baptiste Gaulthier, Laurent Tacchini, Olivier Marpeau, Sonia Tesseydre, Marie-Pierre Coulhon, Nathalie Hodee, Marie-Chrsitine Conroy, Pierre Weinbreck, Roland Leclercq, Laurent Souply, Christian Bidault, Annie Elbez, Marie-Annick Lebreton, Patrick Brisou, Agnès Ferroni, Jean-Louis Pourriat, Nadia Anguel, Christian Noel, Philippe Jouvencel, Eric Pichard, Xavier Martin, Mathieu Coste, Pierre Zuber, Catherine Neuwirth, Jean-Pierre Hacot, Paul Aye, Jérôme Guinard, Yves Pean, Jean-Christophe Dengo, Fabrice Petassou, Didier Viole, Thierry Messiaen, Jean Beytout, Philippe Petitjean, Ferdinand Savare, Patrice Cuvillier, Sophie Coignard, Hélène Anglaret, Nassim Kamar, Elisabeth Chachaty, Karine Guimard, Louis Braem, Hacene Fezoui, Pierre Martin, Jean-Paul Viard, Claire Larroche, Nicolai Claudiu-Plesa, Thierry Benoit-Cattin, Olivier Moquet, Thierry Pasdeloup, David Rosay, Rodolphe Jean, Jean-Bernard Mariette, Marc Debouverie, Hervé Peltier, Mustapha Terki, Jacques Daleas, Valérie Dattin-Dorrière, Michel Vergnaud, Emmanuel Grimprel, Sylvène Rosselli, Jean-Marc Didier, Pierre Faurie, Luc Frimat, Aziza Mandjee, Sabine Etchemendy, Pierre Tissières, Jean Nakhleh, Sylvie Mariette, Christian Perronne, Bruno Carbonne, Nathalie Houssiaux-Maisonneuve, Tristan Ferry, S Beague, Anthony Sebban, Marie-Thérèse Hili, Jean-Michel De Kermadec, Lucien Brasme, Gilles Blaison, Caroline Garandeau, Jean-Pierre Sollet, Laurent Tronchon, Thierry Samson, Julien Gesquière, Nicolas Ettahar, Alain Créange, Etienne Laurens, Véronique Equy, Fréderic Bart, Bernard Bouffandeau, Christine Vaillant, Valerie Pesque, Jean-Marc Lalot, Marc Levy, Michel Kaidomar, Mihaela Saplacan, Sterenn Yvenou, Marie-Isabelle Steibach, Emmanuelle Cambau, Agnès Riche, François Fourrier, François Raffi, Mélissa Lalu, Henri Bérard, Danielle Clave, Jean-Claude Mouries, Martine Porcheron, Jean Cabalion, Richard Lamarca, Nathalie Canu, Jean-Baptiste Roseau, Annabelle Stoclin, Luca Luminitan Elena Lupean, Rémi Gebeile, Celia Salanoubat, Carole Marmouset, Pierre Bigot, Anne-Laure Breton, Pierre Kalfon, Colette Vincent, Sophie Marty, Olivier Tandonnet, Alexis Redor, Xavier Valette, Ourida Aoudia, Jacques-Arnaud Seyrig, Bertrand Beaune, Hugues Aumaitre, Georges Pinon, Yann Leveneur, Sylvie Charachon, Raoul Herbrecht, Henriette de Valk, Gary David, Julien Pouyanne, Marc Dommergues, Majed Al Chaar, Véronique Blanc-Amrane, Pascale Guillarmé Grossmann, Bruno Abraham, Yves Morel, Philippe Suel, Denis Sautereau, Olivier Guilloy, Tu Anh Tran, Frédéric Laurent, Zahir Amoura, Jacques-Olivier Bay, Zoubida Elharie-Heraux, Joyce Sibony-Prat, Bernard Guillois, Dominique Rohmer-Heitz, Audrey Barrelet, Jérémie Courouble, Jean-Paul Herry, Daniel Vittecoq, Annie Vermesch-Langlin, Jean Auroux, Claude Aubert, Thierry Harvey, Ghislaine Lamoine-Gimet, J. Riahi, Florence Soraudeau, Bachar Al-Jalaby, Caroline Périsson, Khélifa Ayouz, Florence Cardot, François Maillet, Alain Goux, Théophile Magna, Bertille de Barbeyrac, Adrien May, Dominique Andreotti, Olivier Jonquet, Hélène Dumouchel, Didier Thibaud, Philippe Morlat, Pascal Chevalet, Pascal Ancelin, Guy Chambreuil, Cécile Le Boterff, Anne Ceriez, Olivier Detante, B Pangon, Claude C.A. Bernard, Vincent Cailleaux Pierre-Etienne Cailleux, Jordi Miatello, Pierre-Yves le Berruyer, Sylvain Kouaho, Michel Briaud, Hélène Delaby, Patrick Herbecq, Christine Segonds, Véronique Jault, Pascale Brunel, Christine Dussopt, Jean Thore, Jean-Marc Thouret, Jean-Marc Kerleau, François Le Baron, Slavius Matica, Sophie Leautez-Nainville, Matthieu Pecquet, Laurent Bret, Yacine Sedjelmaci, Pierre Metton, Habiboulaye Diallo, Jany Rey Zermati, Arnaud Delahaye, Hélène Chaussade, Laurent Mandelbrot, Emilie Bessede, Olivier Casanovas, Paul Pierrot, Annick Legras, Dominique Lauque, Hélène Gatti, Jean Catineau, Ebutu Likose, Gilles Capellier, Eric Kibbrecht, Freddy Thibaut, Patrick Valadier, Chantal Lemble, Joël Gaudelus, Joelle Mellier, Joëlle Brochen, Emmanuel Gascou, Stéphane Bonacorsi, Stéphanie Bannier, Bruno Fantin, Didier Raffenot, Valérie Revel, Hakim Amroun, Huguette Negrery, Anne-Laure Fauchais, Paul Mercury, Michel Chuzeville, Christian Zumbo, Nicolas Després, Pascal Roblot, Jérôme Pasche, Jean Claude Boufetteau, Jocelyne Caillon, Julien Boileau, V. Rabier, Benjamin Manéglier, Emilie Jourdes, Franck Ceppa, Christine Recule, Nicolas Degand, Benoît Henry, Thierry Baranger, Dominique Pateron, Agnès Pélaquier, Gérard Bouchet, Hélène Fiette, Ozel Guiden, Dana Ranta, Etienne Ruppé, Nabil Chiouk, Jacques Breuil, Dominique Leduc, Véronique Loustaud, Hervé Métenier, Michel Durand, Isabelle Mahé, Leila Karaoui, Marie-José Collus, Mehran Monchi, Olivier Belmonte, Romain Blondet, Jacques Thierry, Karine Humbert, Gilles Salama, Marie-Noelle Heurtaux, Cécile Goujard, Bruno Sivery, Martial Boisseau, Redouane Dahoumane, Pierre Delour, Christian Niels Meyer, Anne Faudon-Gibelin, Gérard Poulain, Roger-Charles Luciani, J.-C. Souquet, Olivier Grossi, François Vandenesch, Sylvain Mermont, Jacques Bronner, Sonia Dahan, Paul Marzouk, Pascal Pouedras, Noureddine Djafari, François-Xavier Caroli-Bosc, Jean-François Dessin, Brigitte Gruffat, Armelle Morin-Fatome, Sylvie Thoinet, Bano Konate, Jean-Winoc Decousser, Claire Poyart, Patrick Plessis, Olivier Millet, Vincent Cattoir, Françoise Geffroy, Manica Vasseur, Pierre Carli, Isabelle Citony, Christian Richard, Nicolas Sigur, Patrick Marthelet, Luwawu Mbimba, Pierre Feugier, Philippe Sauder, Hama Djerad, Evelyne Bourgerette, Hanen Chahtour, Adrien Lemaignen, Dominique Bechade, Patrick Ochocki, Antoine Vieillard Baron, Dominique Astruc, Marie-Pierre Moiton, Nicolas Dubois, Sylvie Ledru, Corinne Seknazi, Hélène Poupet, Jean-Philippe Brieux, Gérard Barthélémy, Aihem Yehia, Louis-Jean Couderc, Ahmed, Françoise Rigaux, Yohann N'guyen, Philippe Bethery, Damien Corberand, Etienne Auvray, Paul-Louis Woerther, Christian Combe, Sophie Delesalle, Jean-Marie Piala, Faraj Al Freijat, Philippe Juvin, Malcolm Lemyze, Hyacine Rey, Claire Larible, Noel Milpied, Lémia Zgarni, Julia Gaillard, Agnès Juven, Paola Otean, Adrien Melis, André Pechinot, Olivier Bouchaud, Olivier Chassin, Pierre Hausfater, Asma Trabelsi-Jnifen, Vincent Grobost, Didier Lemery, Pierre Soury, Françoise Brevet, Jacques Tankovic, Dominique Sansot, Jean Louis Salomon, Charlotte Cordonnier, Brigitte Lamy, Antoine Maisonneuve, Dominique Pressac, Claude Rémy, Rodolphe Sobesky, Stéphanie Cognet, Pierre Cougoul, Didier Jan, Dominique Perrotin, Cécile Hombrouk-Alet, Thierry André, Gilbert Pochmalicki, Serge Girard, Vincent Zerr, Guillaume Cadiot, Claudine Lasbasses, Michel Slama, Abderrazak El Yamani, Sophie Brovedani, Jean Armengaud, Romain Hernu, Géraldine Mascade, Aurélien Lorléa'ch, Ali Akkari, Mathieu Tourdjman, Christopher Payan, Eric Jullian, Nathalie Fonsale, Frédéric Riehl, Paul Strock, Geneviève Grise, Philippe Mottaz, Christian Floriot, Marie-Noëlle Ungeheuer, Denis Caillot, Arnaud 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Piquet, Franck Leibinger, Charles Cerf, Robin Stephan, Jean-Philippe Redonnet, Jean-Paul Stahl, Ella Dzeing, Simona Pavel, Guy Vernet, Ghada Hatem, Samer Kayal, Jacques Deschamps, Dominique Descamps, Marion Levast, Marc Bouiller, Sylvie Dargere, Claire Dingremont, Stéphane Gaudry, François Maillot, Sylvie Odent, Nathalie Cervantes, Hélène Zanaldi, Laurence Gachassin, Olivier Ruyer, David Patin, Benoît Cazenave, Pascal Jacquier, Michelle Boyer, Béatrice Berteaux, Virginie Zarrouk, Jacques Bor, Isabelle Legoff, Hélène Albinet, Florence Rousseau, Gilles Pialoux, Guenaelle Salaun-Beretta, Alexandra Moura, Véronique Vernet Garnier, Didier Lepelletier, Pierre-Alexandre Hauss, Joëlle Belaisch-Amart, Didier Lepeletier, Jacob Xavier, Aline Nare, Annie Motard-Picheloup, Alain Améri, Bertrand Lioger, Jean-Valère Malfuson, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Listeria - National Reference Center Listeria (CNRL), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria / WHO Collaborating Centre Listeria (CC-OMS / WHO-CC), Institut Pasteur [Paris] (IP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Département de Médecine interne [Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Biologie des Infections - Biology of Infection, Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Institut Pasteur [Paris] (IP), Infectious Disease Department [Saint Maurice], Agence Nationale de la Santé Publique [Saint-Maurice] (ANSP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, MONALISA study group, Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency., ROZIER, marie-Claire, CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections (CNRL), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria - Biologie des Infections (CCOMS), CHU Pitié-Salpêtrière [APHP], Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections ( CNRL ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre collaborateur de l'OMS (CCOMS) des Listeria ( CCOMS ), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Lariboisière, Biologie des Infections, Institut Pasteur [Paris]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources ( ICAReB ), Agence Nationale de la Santé Publique [Saint-Maurice] ( ANSP ), Assistance Publique - Hôpitaux de Paris, Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Paris 5 ( UPD5 ), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris]-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)
Subjects: Bacteremia/epidemiology/mortality, 0301 basic medicine, Male, Pediatrics, bacteraemia, Infectious Disease Transmission, [SDV]Life Sciences [q-bio], Bacteremia, France/epidemiology, Infant, Newborn, Diseases, Foodborne Diseases, Meningoencephalitis, Pregnancy, Risk Factors, Vertical, Medicine, Listeriosis, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, ddc:618, diabetes, alcoholism, Hazard ratio, Foodborne Diseases/microbiology, immuno suppressive therapies, Prognosis, 3. Good health, [SDV] Life Sciences [q-bio], Hospitalization, Infectious Diseases, isolates, Population Surveillance, Female, France, Listeria monocytogenes/classification/isolation & purification, Cohort study, Adult, medicine.medical_specialty, 030106 microbiology, Notifiable disease, Listeriosis/diagnosis/epidemiology/microbiology, Context (language use), macromolecular substances, 03 medical and health sciences, Humans, study, Aged, [ SDV ] Life Sciences [q-bio], business.industry, Public health, cirrhosis, Infant, Newborn, Infant, Diseases/epidemiology/microbiology, HIV, Mandatory Reporting, Newborn, medicine.disease, Listeria monocytogenes, infection, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious/epidemiology/microbiology, Meningoencephalitis/epidemiology/microbiology/mortality, Observational study, business, prognostic, mellitus
Abstract: International audience; Evidence before this study We searched PubMed on June 30, 2016, for English-language cohort studies published since Jan 1, 1980, of patients with invasive listeriosis worldwide with the keywords " listeria " , " listeriosis " , " maternal " , and " neurolisteriosis ". Studies had to include epidemiological or clinical data on listeriosis. All clinical forms of infection were included (bacteraemia, neurolisteriosis, and maternal–neonatal infection). Host risk factors for listeriosis have been well identified, but the clinical features and prognostic factors of the disease are based on retrospective studies compiling heterogeneous data or random collected cases. Furthermore, no clinical trial has ever been done and medical management is not evidence based. Added value of the study Our study is the first prospective clinical study focusing on all forms of invasive listeriosis. The study is based on a national mandatory system that allowed the nearly complete capture of microbiologically proven cases. The study shows a higher burden of listeriosis than reported before: more than 80% of infected mothers experienced major fetal or neonatal complications (fetal loss, very high prematurity, early or late onset disease); only 39% of patients with neurolisteriosis survived and fully recovered. The study provides important new data to improve management and predict outcome in listeriosis, such as determination of the time window for fetal losses (
Published: 2016

24. NATURAL KILLER CELL ACTIVATION IS A POTENT CYTOTOXIC MECHANISM ă SUSTAINING ADVERSE CYTOTOXIC EFFECTS OF DONOR-SPECIFIC ANTIBODIES IN ă SOLID ORGAN TRANSPLANTATION

Author: Pascale Paul, Tristan Legris, Luc Lyonnet, Ă, Dilyana Todorova, Emmanuelle Sampol, Julie Di Cristofaro, Laurent Daniel, Valerie Moal, yvon Berland, Frederic Collart, Ă, Florence Sabatier, Stéphane Burtey, Francoise Dignat-George, Ă, Annick Mouly Bandini, Christophe Picard, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Physiopathologie de l'Endothelium, Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), 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, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), and COMBE, Isabelle
Subjects: [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract
Published: 2016

25. NATURAL KILLER CELL ACTIVATION IS A POTENT CYTOTOXIC MECHANISM SUSTAINING ADVERSE CYTOTOXIC EFFECTS OF DONOR-SPECIFIC ANTIBODIES IN SOLID ORGAN TRANSPLANTATION

Author: Pascale Paul, Tristan Legris, Luc Lyonnet, Dilyana Todorova, Emmanuelle Sampol, Julie Di Cristofaro, Laurent Daniel, Valérie Moal, yvon Berland, Frederic Collart, Florence Sabatier, Stéphane Burtey, Francoise Dignat-George, Annick Mouly Bandini, Christophe Picard, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Héritages et Constructions dans le Texte et l'Image (HCTI), Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois des Sciences de l'Homme et de la Société (IBSHS), Université de Brest (UBO), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Assistance Publique - Hôpitaux de Marseille (APHM), COMBE, Isabelle, Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and Université de Brest (UBO)-Université de Brest (UBO)
Subjects: [SDV] Life Sciences [q-bio], [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV]Life Sciences [q-bio], [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract
Published: 2016

26. Évolution du temps de transport des patients hémodialysés en région Provence-Alpes-Côte-d’Azur entre 1995 et 2008

Author: Roland Sambuc, Yvon Berland, A.C. Durand, Bénédicte Devictor, néphrologues référents du réseau Rein Paca, Philippe Brunet, Jean-Christophe Delarozière, and Stéphanie Gentile
Subjects: Nephrology, Political science, Humanities
Abstract: Resume Objectif Analyser l’evolution des temps de transport des patients hemodialyses en region Provence-Alpes-Cotes-d’Azur entre 1995 et 2008 au regard de l’evolution de la reglementation concernant l’offre d’hemodialyse. Materiel et methode Les donnees sont issues de trois enquetes transversales pour 1995, 1999 et 2002 incluant l’ensemble des patients dialyses et, pour l’annee 2008 du registre mis en place par le Reseau epidemiologie et information en nephrologie. Les donnees portent sur les caracteristiques sociodemographiques, medicales et sur les temps de transport. Resultats Le nombre de patients hemodialyses augmente, passant de 1807 patients en 1995 a 3141 en 2008. Le temps de transport a diminue regulierement entre 1995 et 2008 (15 minutes versus 18,3 ; p Conclusion L’evolution favorable de l’offre de soins a eu pour consequence une amelioration de l’accessibilite par la diminution des temps de transport.
Published: 2012

27. A Randomized Trial With Steroids and Antithymocyte Globulins Comparing Cyclosporine/Azathioprine Versus Tacrolimus/Mycophenolate Mofetil (CATM2) in Renal Transplantation

Author: Stéphane Burtey, Henri Vacher-Coponat, Raj Purgus, Bertrand Dussol, Laurent Daniel, Yvon Berland, Philippe Brunet, Anderson Loundou, Julie Moussi-Frances, Monica Indreies, and Valérie Moal
Subjects: Adult, Graft Rejection, Male, medicine.medical_specialty, Urology, Renal function, Azathioprine, Kidney, Risk Assessment, Tacrolimus, Cohort Studies, Risk Factors, Prednisone, medicine, Humans, Prospective Studies, Adverse effect, Prospective cohort study, Antilymphocyte Serum, Transplantation, business.industry, Graft Survival, Middle Aged, Mycophenolic Acid, Kidney Transplantation, stomatognathic diseases, Regimen, Cardiovascular Diseases, Cyclosporine, Drug Therapy, Combination, Female, Steroids, business, Immunosuppressive Agents, Follow-Up Studies, Glomerular Filtration Rate, medicine.drug
Abstract: Background The best immunosuppressive regimen in benefit-risk ratio in renal transplantation is debated. Nowadays, tacrolimus (Tac) and mycophenolate mofetil (MMF) are considered more efficient than cyclosporine A (CsA) and MMF, but recent studies have challenged this assumption. Methods We conducted a monocentric, prospective, open-labeled, randomized, and controlled trial comparing CsA/azathioprine (Aza) versus Tac/MMF in 289 kidney transplant recipients treated with antithymocyte globulins and prednisone. Primary outcome was the number of patients with clinically suspected acute rejection at 1 year. Secondary outcomes were the number of patients with biopsy-proven acute rejection (BPAR), estimated glomerular filtration rate (eGFR), patient and graft survivals, and adverse events at 1 and 3 years. Results During the first year, 21 patients had clinically suspected acute rejection with CsA/Aza (14.4%) vs. 11 (7.7%) with Tac/MMF (P=0.07). BPAR, including borderline, was more frequent in the CsA/Aza group (14.4%) than in the Tac/MMF group (5.6%; P=0.013). At 1 year, patient and graft survivals were not different, and eGFR was 48±1 in the CsA/Aza group and 53±1 mL/min/1.73 m in the Tac/MMF group (P=0.007). There was no significant difference in diabetes after transplantation (16.8% and 18.8%, respectively). Conclusions With antithymocyte globulins and steroids, clinically suspected acute rejections did not differ between CsA/Aza and Tac/MMF arms. Analysis of secondary endpoints showed a lower rate of BPAR, including border line, and a higher eGFR in the Tac/MMF group. CsA/Aza allowed a low acute rejection rate, but Tac/MMF seemed as a better regimen regarding severe secondary outcomes.
Published: 2012

28. Comparative Safety and Efficiency of Five Percutaneous Kidney Biopsy Approaches of Native Kidneys: A Multicenter Study

Author: Bertrand Dussol, Michel Lankester, Magali Faure, Laurent Daniel, Jean Gaudart, Zarih Alcheikh-Hassan, Noémie Jourde, Stanislas Bataille, Yvon Berland, Pierre Gobert, Stéphane Burtey, Philippe Giaime, and Jean-René Mondain
Subjects: Adult, Male, medicine.medical_specialty, Percutaneous, Kidney Glomerulus, 030232 urology & nephrology, Comparative safety, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Biopsy, Humans, Medicine, Native kidney, Aged, Retrospective Studies, Kidney, medicine.diagnostic_test, business.industry, Biopsy, Needle, Retrospective cohort study, Middle Aged, 3. Good health, medicine.anatomical_structure, Multicenter study, Nephrology, Female, France, Renal biopsy, Radiology, business
Abstract: Background: Renal biopsy (RB) is necessary for the diagnosis, prognosis, and therapy guidance of native kidney diseases. Few studies have compared outcomes of RB procedures. We retrospectively compared the safety and efficiency of five biopsy procedures. Methods: The number of glomeruli on light microscopy (LM) and on immunofluorescence (IF) and serious adverse events following RB performed in five nephrology units (C1–C5) were collected. C1 performed ultrasound (US) assessment before RB and used a 14-gauge core-cutting needle biopsy gun, C2 US guidance and a 14-gauge needle, C3 tomodensitometry guidance and a 14-gauge needle, C4 US guidance and a 16-gauge needle, and C5 tomodensitometry guidance and a 16-gauge needle. Results: RB was performed in 943 adults between January 2006 and July 2010. Serious adverse events occurred in 1.5% of biopsies. The complication rate was not different between nephrology units. The mean number of glomeruli on biopsy was 14.2 ± 8.6 with LM and 4.4 ± 3.3 on IF. It was different according to the nephrology unit for LM (p = 0.01) and for IF (p < 0.001). The number of failed biopsies was influenced by the nephrology unit and radiological guidance technique, favoring real-time US guidance. Failed biopsies using US or tomodensitometry assessment before RB was certainly due to kidney imprecise localization since it was often non-renal tissue sampling. At least 10 glomeruli were found in 69% of biopsies on LM. This rate varied according to the nephrology unit (p = 0.004) and was higher when 14-gauge needles were used in comparison with 16-gauge needles. Conclusion: RB is safe regardless of the technical procedure, but radiological guidance and needle size influence the efficiency of biopsies.
Published: 2012

29. L’indole-3-acétique acide, l’indoxyl sulfate et le para-cresyl sulfate ne sont pas corrélés aux marqueurs de l’anémie des patients hémodialysés chroniques

Author: Nathalie McKay, Stéphane Burtey, Yosra Mouelhi, Stéphanie Gentile, A. Duval-Sabatier, Philippe Brunet, Marion Sallée, Stanislas Bataille, M. Pelletier, and Yvon Berland
Subjects: 0301 basic medicine, 03 medical and health sciences, 030104 developmental biology, Nephrology
Abstract: Introduction Des experiences in vitro ont incrimine les toxines uremiques dans la survenue de l’anemie des patients hemodialyses (HD), mais peu de donnees cliniques ont ete publiees. Nous avons etudie si l’acide indole 3-acetique (IAA), l’indoxyl sulfate (IS), et le para-cresyl sulfate (PCS) sont impliques dans l’anemie des HD en correlant leurs concentrations plasmatiques avec le taux d’hemoglobine (Hb) et les besoins en erythropoietine (EPO). Patients et methodes Etude observationnelle transversale incluant les patients HD de 2 centres. 3 approches statistiques differentes : – comparaison des HD traites ou non traites par EPO ; – regression lineaire entre les concentrations plasmatiques des toxines uremiques et l’Hb, le ratio Dose d’EPO/Hb, ou l’indice de resistance a l’EPO (IRE ; EPO/Hb/kg de poids corporel) ; – regression logistique multinomiale de 6 groupes de patients classes selon le traitement par EPO ou non et les taux d’Hb ( 12 g/dL). Resultats Deux cent quarante patients HD ont ete inclus, dont 55,4 % d’hommes ; 42,5 % etaient diabetiques. L’âge moyen etait de 67,6 ± 16,0 ans. Les patients avec et sans EPO avaient des concentrations identiques de IAA, IS ou PCS. Dans le modele lineaire multivarie les correlations entre la concentration plasmatique d’IAA, d’IS et de PCS et l’Hb, l’EPO/Hb et l’IRE n’etaient pas statistiquement significatives. Enfin, le modele multinomial ne retrouvait pas non plus de relation entre la concentration en IAA, IS ou PCS et l’appartenance aux differents groupes. Discussion Malgre 3 approches statistiques differentes, nous n’avons pas pu etablir de lien entre les concentrations plasmatiques d’IAA, IS et PCS, et les marqueurs de l’anemie des HD. Nos donnees in vivo ne vont pas dans le sens des donnees in vitro concernant l’implication de ces toxines uremiques dans la survenue de l’anemie des HD. Par exemple, il a ete montre in vitro que l’IS inhibe l’activation de HIF en conditions d’hypoxie et donc la production d’EPO [1] . Les donnees de cette etude observationnelle transversale necessitent d’etre confirmees dans des etudes prospectives. Neanmoins, il s’agit de la premiere etude clinique sur ce sujet. Conclusion Les toxines uremiques indoliques (IS et IAA) ainsi que le PCS n’ont pas ou peu d’effet sur les parametres de l’anemie des patients HD chroniques.
Published: 2017

30. A Pilot Study Comparing Furosemide and Hydrochlorothiazide in Patients With Hypertension and Stage 4 or 5 Chronic Kidney Disease

Author: Sophie Morange, Yvon Berland, Bertrand Dussol, Claude Somma-Delpero, Olivier Mundler, and Julie Moussi-Frances
Subjects: medicine.medical_specialty, Fractional excretion of sodium, business.industry, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Urology, Furosemide, Renal function, medicine.disease, Natriuresis, Endocrinology, Hydrochlorothiazide, Blood pressure, Internal medicine, Internal Medicine, medicine, Diuretic, Cardiology and Cardiovascular Medicine, business, medicine.drug, Kidney disease
Abstract: Furosemide is the diuretic of choice for the treatment of hypertension in chronic kidney disease but the adaptative changes in the distal nephron may decrease its efficacy. Hydrochlorothiazide is not believed to be efficient in this setting. In a randomized, double-blind, cross-over trial, 23 patients with hypertension and stage 4 or 5 chronic kidney disease received long-acting furosemide (60 mg) and hydrochlorothiazide (25 mg) for 3 months and then both diuretics for 3 months. Sodium and chloride fractional excretions were measured after 3 months of each diuretic and then after their association. A trend towards an increase in the fractional excretion of sodium and chloride was observed with furosemide and hydrochlorothiazide (P=not significant). The association of the two diuretics increased the fractional excretions of sodium and chloride from 3.4±1.8 to 4.9±2.8 and from 3.8±2.0 to 6.0±3.1, respectively (P
Published: 2011

31. Immune reconstitution inflammatory syndrome mimicking relapsing cryptococcal meningitis in a renal transplant recipient

Author: T Legris, Stéphane Ranque, M Massad, Yvon Berland, Raj Purgus, N Girard, H. Vacher-Coponat, and V. Moal
Subjects: Transplantation, urogenital system, business.industry, medicine.medical_treatment, Immunosuppression, medicine.disease, Regimen, Infectious Diseases, Immune system, Immune reconstitution inflammatory syndrome, Immunology, Cryptococcosis, medicine, Differential diagnosis, business, Meningitis, Kidney transplantation
Abstract: Immune reconstitution inflammatory syndrome (IRIS) is a rare entity that has been described recently in solid organ transplant (SOT) recipients. IRIS is characterized by an exuberant and dysregulated immune response following treatment of opportunistic infections. We describe here the case of a kidney transplant recipient who developed cryptococcal meningitis that was efficiently treated with antifungal therapy and decreased immunosuppression regimen. Eight months later, a paradoxical worsening of neurological symptoms and neuroradiological findings led to the diagnosis of IRIS. A short course of high-dose steroid therapy allowed complete resolution of neurological symptoms. This report highlights the challenge for physicians to distinguish IRIS from a relapsing cryptococcal infection. Clinical improvement of cryptococcosis-associated IRIS by anti-inflammatory drugs needs to be confirmed among SOT recipients.
Published: 2010

32. Les résidus de fabrication des hémodialyseurs diminuent la phosphorylation oxydative des mitochondries isolées de rat

Author: Bernard Bruguerolle, Philippe Brunet, Nicolas Simon, Christa Roubicek, Yvon Berland, and Kassim Papa
Subjects: Nephrology, Chemistry, Molecular biology
Abstract: Resume Introduction La persistance de residus de fabrication dans les hemodialyseurs est un aspect neglige du manque de biocompatibilite de l’hemodialyse. L’effet de ces residus de fabrication a ete teste sur des mitochondries isolees de foie de rat. Materiel et methodes Apres avoir jete les deux premiers litres de rincage des hemodialyseurs, le troisieme litre est lyophilise. Le residu est mis en presence des mitochondries. Le parametre V3 correspond a la synthese d’ATP, le controle respiratoire (CR) represente la capacite a activer la phosphorylation en presence d’ADP, ADP/O correspond au rapport de l’ADP utilise sur l’oxygene consomme. L’etude a ete realisee sur deux hemodialyseurs sterilises par rayons gamma (Tricea et APS) et sur un dialyseur sterilise a la vapeur fluente (FX60). Resultats Les parametres respiratoires en presence des residus sont exprimes en pourcentage des valeurs obtenues en presence du controle (eau sterile). Les valeurs respectives avec le Tricea, l’APS et le FX sont pour V3 : 67 ± 14, 79 ± 10, et 81 ± 8 % (T vs A p = 0,02 ; T vs F p = 0,01 ; A vs F p = 0,68) ; pour le CR : 44 ± 6, 63 ± 7, et 74 ± 9 % (T vs A p Conclusion Les hemodialyseurs contiennent des residus qui exercent un effet toxique sur les mitochondries isolees. Ces residus alterent globalement la phosphorylation oxydative. Le fait que ces residus soient encore presents dans les dialyseurs apres un rincage de deux litres doit alerter les utilisateurs sur l’importance du rincage et les fabricants sur l’importance des procedures d’elimination des residus de fabrication.
Published: 2010

33. Insuffisance rénale aiguë et boli préemptifs de corticoïdes chez les transplantés rénaux : une étude rétrospective

Author: Valérie Moal, Yvon Berland, Tristan Legris, Laurent Daniel, M. Meunier, A. Basire, Philippe Brunet, O. Aubert, and R. Purgus
Subjects: Nephrology
Abstract: Introduction Les fortes doses parenterales de corticoides (ou boli) font partie de la premiere ligne de traitement des rejets aigus prouves histologiquement. Peu d’etudes ont evalue le rationnel de l’administration preemptive (avant les resultats histologiques) de boli de corticoides en cas de suspicion de rejet chez les transplantes renaux (TR). Patients/Materiels et methodes Nous avons mene une etude observationnelle retrospective monocentrique de suivi de cohorte, incluant tous les patients TR hospitalises au CHU de Marseille entre 2009 et 2014 presentant une insuffisance renale aigue (IRA) sans cause urologique, vasculaire, infectieuse ou toxique, indiquant une 1re ponction biopsie du transplant. Les caracteristiques cliniques, biologiques, immunologiques et anatomopathologiques ont ete recueillies a l’inclusion. La duree mediane de suivi etait de 49 [35–66] mois. Les TR qui ont recu de boli de corticoides preemptifs constituaient le groupe « strategie preemptive ». Observation/Resultats Deux-cent quarante-trois TR ont ete inclus, 17 % ont beneficie d’une « strategie preemptive ». Parmi eux 51 % ont recu des boli sans diagnostic final de rejet histologiquement prouve. En cas de rejet, la strategie preemptive etait associee a un gain median d’administration de boli de 5 jours. Dans le groupe « strategie preemptive », les facteurs associes au diagnostic de rejet histologiquement prouve etaient, d’une part, la severite de l’IRA (p = 0,002), et d’autre part, des caracteristiques immunologiques telles qu’un antecedent de rejet (p = 0,032), une immunisation anti-HLA contre le donneur (p = 0,041) ou un traitement immunosuppresseur moindre (p = 0,045). Il a ete observe dans les suites des boli de corticoides une incidence de 20 % de diabetes induits et 10 % de pneumocystoses. La strategie preemptive de boli de corticoides chez les patients avec diagnostic prouve de rejet n’etait pas independamment associee en analyse multivariee, a la survie du transplant censuree sur les deces bien que significative en analyse univariee (p = 0,002). Chez ces patients, les facteurs pronostiques independants de perte du transplant etaient la severite de l’IRA initiale (Hazard Ratio = 2,67 ; p = 0,001) et un diagnostic de rejet medie par anticorps (Hazard Ratio = 1,43 ; p = 0,012). Discussion Il s’agit d’une etude retrospective. Neanmoins il s’agit a notre connaissance de la premiere etude ayant analyse l’impact de la prescription preemptive de boli de corticoides, a l’ere de la definition moderne du rejet humoral. Conclusion Les benefices de la « strategie preemptive » d’administration de boli de corticoides en cas d’IRA sans cause evidente semblent limites chez les TR. Ces resultats sont a confirmer de maniere prospective.
Published: 2018

34. Cytomegalovirus risk factors in renal transplantation with modern immunosuppression

Author: V. Moal, Bertrand Dussol, H. Vacher-Coponat, M. Indreies, Stanislas Bataille, Raj Purgus, Jean Gaudart, Christine Zandotti, and Yvon Berland
Subjects: Transplantation, medicine.medical_specialty, business.industry, medicine.medical_treatment, virus diseases, Azathioprine, Immunosuppression, medicine.disease, Gastroenterology, Tacrolimus, Infectious Diseases, Cyclosporin a, Internal medicine, Relative risk, Immunology, Medicine, Risk factor, business, Kidney transplantation, medicine.drug
Abstract: S. Bataille, V. Moal, J. Gaudart, M. Indreies, R. Purgus, B. Dussol, C. Zandotti, Y. Berland, H. Vacher-Coponat. Cytomegalovirus risk factors in renal transplantation with modern immunosuppression Transpl Infect Dis 2010: 12: 480–488. All rights reserved Background. Immunosuppressive regimens have lowered the rate of kidney rejection, but with increasing immunodeficiency-related complications. New cytomegalovirus (CMV) prophylaxis also has become available. The impact of these 2 developments on CMV diseases has not been well evaluated. We conducted a randomized trial comparing a drug regimen common in the 1980s, cyclosporin A (CsA) with azathioprine (Aza), with a drug combination used most today, tacrolimus (Tac) with mycophenolate mofetil (MMF), and we analyzed CMV risk factors in kidney transplant patients. Methods. The 300 patients included in the trial underwent the same universal prophylaxis and preemptive therapy. CMV events and risk factors were prospectively recorded. Results. With preventive and preemptive strategies combined for 3 months, CMV replication was detected in 32.6% and CMV disease in 18.1% of patients. Multivariate analysis on risk factors for CMV disease were CMV donor (D)/recipient (R) matching and first month renal function (risk ratio [95% confidence interval]: 1.02 [1.01; 1.04]; P=0.011), but not the immunosuppressive regimen (P=0.35). The D+/R− combination increased the risk of CMV disease by a factor of 9 (P
Published: 2010

35. Kidney Transplantation Decreases the Level and Procoagulant Activity of Circulating Microparticles

Author: Laurent Arnaud, Pascale Paul, Stéphane Robert, Valérie Moal, A. Loundou, Françoise Dignat-George, Laurence Camoin-Jau, G. Al-Massarani, Yvon Berland, and H. Vacher-Coponat
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Urinary system, Urology, Graft vs Host Disease, Renal function, Cell-Derived Microparticles, Humans, Immunology and Allergy, Medicine, Pharmacology (medical), In patient, Blood Coagulation, Kidney transplantation, Diminution, Transplantation, Kidney, business.industry, Graft Survival, Immunosuppression, Middle Aged, medicine.disease, Kidney Transplantation, Kinetics, medicine.anatomical_structure, Cardiovascular Diseases, Immunology, Female, business, Immunosuppressive Agents
Abstract: Microparticles (MP) are important players in cardiovascular disorders. Renal transplantation significantly improves the survival of hemodialyzed patients, in part because cardiovascular disease (CVD) progression is lessened. We hypothesized that the beneficial effect of renal transplantation on cardiovascular outcome might involve decreased levels of circulating MP. We evaluated the kinetics of MP subpopulations and their procoagulant activity (MP-PCA) in 52 patients before and 3, 6, 9 and 12 months after graft with reference to 50 healthy controls and we evaluated the impact of cardiovascular complications. During the follow-up, the increased levels of MP observed before graft were significantly decreased and reached normal values with different kinetics according to their cellular origin whereas MP-PCA remained significantly higher than in controls. From multivariate analysis, the levels of MP were negatively correlated with renal function. At 12 months, the decrease in MP and MP-PCA was more pronounced in patients without history of CVD than those with. In conclusion, we demonstrated that renal graft is associated with decreased levels of MP levels and MP-PCA, even more pronounced so in patients without history of CVD. Therefore, we suggest that MP lowering could be involved in the vascular dysfunction improvements reported after transplantation.
Published: 2009

36. Impact of Immunosuppressive Treatment on Endothelial Biomarkers After Kidney Transplantation

Author: G. Al-Massarani, Pascale Paul, A. Widemann, Laurence Camoin-Jau, Françoise Dignat-George, Stéphane Robert, Laurent Arnaud, A. Loundou, H. Vacher-Coponat, and Yvon Berland
Subjects: Adult, Male, medicine.medical_specialty, Endothelium, medicine.medical_treatment, Vascular Cell Adhesion Molecule-1, Azathioprine, Gastroenterology, Tacrolimus, Cohort Studies, Internal medicine, medicine, Humans, Immunology and Allergy, Pharmacology (medical), Prospective Studies, Endothelial dysfunction, Kidney transplantation, Transplantation, business.industry, Vascular disease, Immunosuppression, Middle Aged, Mycophenolic Acid, medicine.disease, Kidney Transplantation, Kinetics, medicine.anatomical_structure, Cardiovascular Diseases, Immunology, cardiovascular system, Female, Endothelium, Vascular, business, Biomarkers, Immunosuppressive Agents, medicine.drug
Abstract: Endothelial dysfunction occurs in hemodialysis and kidney-transplanted patients and can be enhanced by immunosuppressive therapy. Circulating endothelial cells (CEC), endothelial microparticles (EMP) and sVCAM-1 provide information on endothelium activation and damage. We compared the impact of two immunosuppressive regimens (CsA/Aza vs. Tac/MMF) on the kinetics of CEC, EMP and sVCAM-1 levels in 52 patients, both before graft and 3, 6, 9 and 12 months after graft, in reference to 50 healthy controls. CEC, EMP and sVCAM-1 levels were significantly decreased 1 year after transplantation (M12) as compared to pretransplant values. At M12, CEC and sVCAM-1 levels were significantly higher than those of controls whereas EMP reached normal values. Nine months postgraft, lower CEC and normalized EMP levels were found in patients receiving cyclosporine microemulsion/ azathioprine (CsA/Aza) when compared to patients treated with tacrolimus/ mycophenolate mofetil (Tac/MMF). Multivariate analysis evidenced positive correlations between CEC and history of cardiovascular diseases and between EMP and cytomegalovirus infection at M12. In conclusion, our combined analysis of endothelial injury markers confirms the favorable impact of renal transplantation on endothelium, and show that CEC levels discriminate treatment-associated endothelial toxicity. These results enlighten the potential of these noninvasive blood biomarkers in indexing vascular injury and optimize therapeutic options.
Published: 2008

37. Cardiac troponins I and T in hemodialysis patients without acute coronary syndrome

Author: Henri Portugal, Franck Paganelli, Bertrand Dussol, Philippe Brunet, Adriana Opris-Saveanu, Monica Indreies, Sophie Morange, Valérie Faure, Yvon Berland, and Christiane Oddoze
Subjects: Male, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Myocardial Infarction, macromolecular substances, Sensitivity and Specificity, Troponin T, Troponin complex, Renal Dialysis, Internal medicine, Troponin I, medicine, Humans, Cutoff, Myocardial infarction, Acute Coronary Syndrome, Receiver operating characteristic, business.industry, Prognosis, medicine.disease, ROC Curve, cardiovascular system, Cardiology, Female, Hemodialysis, Cardiology and Cardiovascular Medicine, business, Biomarkers
Abstract: Background There is a reluctance to use cardiac troponins (cTn) for the monitoring of acute coronary syndrome (ACS) in hemodialysis (HD) patients because renal failure per se is thought to lead to increased cTn levels. The aim of this study was to analyse the proportion of patients with increased cTn levels in HD patients without ACS. Methods cTnI was measured with the AccuTnI ™ from Beckman (cTnI-B) and Troponin I Stat ™ from Dade Behring (cTnI-DB) assays; cTnT was measured with the third generation assay from Roche. The study included 105 HD patients. The clinical outcomes were determined after 2.5 years. Results Considering the receiver operator characteristic (ROC) cutoff, the proportion of patients with elevated cTnI-B, cTnI-DB and cTnT levels was respectively 2%, 3% and 27%. The proportion of patients with abnormal cTn values increased when a lower cutoff value was considered, based on the 99th percentile of a reference population with a coefficient of variation of less than 10% (99th percentile–10% CV cutoff). The proportion of patients with elevated values did not differ before and after the HD session. The 2.5 years mortality was associated with increased levels of cTnT but not with increased levels of cTnI. Conclusions When the ROC cutoff is applied, cTnI assays are suitable for the monitoring of ACS in HD patients. cTnT could lead to false positive diagnosis of myocardial infarction, however it is predictive of long-term mortality. The 99th percentile–10% CV cutoff does not seem appropriate in HD patients.
Published: 2008

38. Procédure d’hémodialyse chez un patient traité par iode 131

Author: Adriana Opris, Yvon Berland, Valérie Faure, P. Ramananarivo, Philippe Brunet, Bertrand Dussol, Monica Indreies, Marc Bourrelly, Catherine Bouvier, D. Bouchouareb, and Olivier Mundler
Subjects: Nephrology, medicine.medical_specialty, Isolation (health care), business.industry, medicine.medical_treatment, Technician, medicine.disease, Surgery, Internal medicine, Emergency medicine, medicine, Session (computer science), Hemodialysis, Radiation protection, business, Dialysis, Kidney disease
Abstract: The treatment of a patient with 131I at activity over 740 mega Becquerel (MBq) must be performed in a nuclear medicine department. Isolation is stopped if the patient radiation level is less than 20 muSv/hour at one meter. As regards patients with chronic renal failure treated with hemodialysis (HD), the first HD session will eliminate the major part of the radioactivity. French regulations do not give definite recommendations for this session. However, it imposes to collect liquid and solid wastes contaminated by radioactivity. Thus, it seems necessary to collect dialysate and solid wastes and to stock them in a room dedicated to radiation decay. The risk for dialysis staff is to be contaminated by an accidental ingestion of a biologic fluid from the patient. The usual protection barriers used during the HD session are sufficient: mask, gloves, overgarments, cap. There is no risk linked to external exposure to radiations. The maximal theoretical dose received by the staff during the session is 65 muSv, while annual maximal dose for public exposed to radiations is 1000 muSv. Although the dosimetric follow-up of dialysis staff is not mandatory, the nuclear medicine department of Marseille University Hospital has decided to do it in an information perspective. The session is performed in the presence of a radiation safety technician who gives film badges and active dosimeters to the dialysis staff. He reports the dialysis staff to the nuclear safety agency (Autorite de surete nucleaire).
Published: 2008

39. Pharmacodynamics of Unfractionated Heparin During and After a Hemodialysis Session

Author: Henri Portugal, Yvon Berland, Valérie Faure, Nicolas Simon, Bertrand Dussol, Anne-Marie Lorec-Penet, Adriana Opris, and Philippe Brunet
Subjects: Male, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Population, Pharmacokinetics, Renal Dialysis, Humans, Medicine, Dosing, education, Aged, Aged, 80 and over, education.field_of_study, Dose-Response Relationship, Drug, Heparin, business.industry, Drug Administration Routes, Anticoagulant, Anticoagulants, Middle Aged, Surgery, Regimen, Cross-Sectional Studies, Nephrology, Pharmacodynamics, Anesthesia, Factor Xa, Kidney Failure, Chronic, Female, Hemodialysis, business, medicine.drug
Abstract: Background Anti-Xa activity is used as a clinical guide to anticoagulation with heparin, but heparin dosing regimens for hemodialysis were established before anti-Xa assays were developed; thus, the optimal regimen for heparin dosing was not determined. The aim is to confirm the interesting characteristics of unfractionated heparin pharmacokinetics for hemodialysis anticoagulation, provide insight into the hemorrhagic risk of hemodialysis patients, and determine the dose of unfractionated heparin and its adequate mode of administration. Study Design Cross-sectional study of the pharmacokinetics of unfractionated heparin performed during and after a 4-hour midweek hemodialysis session. Setting & Participants 35 long-term hemodialysis patients at the Sainte-Marguerite Unit of the Marseille University Hospital, Marseille, France. Predictor Hemodialysis anticoagulation with continuous unfractionated heparin infusion at a dose of 50 IU/kg/session (25 IU/kg/h during the first hour, 12.5 IU/kg during the second and third hours, and stop during the last hour). Outcome & Measurements Anti-Xa activity was monitored during the 10 hours after the beginning of the hemodialysis session. Levels of 0.3 to 0.7 IU/mL are considered sufficient for anticoagulation. Pharmacokinetics was determined by using a population approach (nonlinear mixed-effects modeling). The final model and corresponding parameter values (including interindividual and residual variability) were used to simulate 1,000 replicates. Results No case of clotting was recorded. A pharmacokinetic model with 1 compartment and first-order elimination best fitted the data. Terminal half-life was 54 minutes. Median anti-Xa activities were 0.55 IU/mL at peak, 0.25 IU/mL at end of the 4-hour session, and less than 0.1 IU/mL at 90 minutes after the session. We simulated a continuous infusion of the dose of 50 IU/kg for 1, 2, 3, and 4 hours. Peak values were 1.1, 0.8, 0.6, and 0.5 IU/mL, respectively. Values at the end of the session were 0.12, 0.18, 0.3, and 0.5 IU/mL, respectively. Values became less than 0.1 IU/mL at 15, 60, 105, and 120 minutes after the session, respectively. Limitations Interindividual variability in unfractionated heparin pharmacokinetics. Conclusions Unfractionated heparin administered by means of a 3-hour continuous infusion for hemodialysis anticoagulation provided an efficient and safe effect that quickly disappeared after the end of the session.
Published: 2008

40. Une étude cas–témoin évaluant les prestations de santé dans une population de malades insuffisants rénaux modérés

Author: François Natali, Jean Ripoll, Bertrand Dussol, M. Fathallah, Patrick Reggio, Charles Chanut, Sophie Morange, Eléonore Ronflé, and Yvon Berland
Subjects: Nephrology
Abstract: Resume Pour evaluer la prise en charge medicale des malades insuffisants renaux avant le stade de dialyse, nous avons realise une etude cas–temoins analysant les prestations de sante chez 914 sujets insuffisants renaux moderes ayant une clairance de Cockcroft entre 30 et 60 ml par minute. Les prestations de sante ayant fait l’objet d’un remboursement par l’Assurance maladie dans cette population ont ete comparees a celles de 1828 sujets tires au hasard dans le fichier des assures sociaux mais apparies pour l’âge et le sexe. L’âge moyen des cas etait de 73 ± 11 ans, 67 % etait des femmes, la clairance de Cockcroft etait de 48 ± 8 ml par minute. Le nombre d’hospitalisations et le nombre de jours d’hospitalisation n’etaient pas differents entre les deux populations. En revanche, les cas avaient beneficie de plus de consultations specialisees en cardiologie, mais pas en nephrologie ou en urologie. Les cas avaient eu plus d’actes de biologie et de radiologie et plus de specialites pharmaceutiques. Pour la biologie, les cas avaient beneficie plus souvent que les temoins de dosages des marqueurs de la fonction renale et des marqueurs d’atteinte renale. Pour la pharmacie, les prescriptions d’erythropoietine, de diuretiques, de bloqueurs du systeme renine–angiotensine, d’hypoglycemiants et d’anticoagulants ont ete statistiquement plus frequentes chez les cas que chez les temoins. Les malades insuffisants renaux moderes ont une prise en charge superieure pour les consultations de cardiologie, la biologie, la radiologie et certaines classes medicamenteuses par rapport aux sujets sains.
Published: 2008

41. Influence of Parathyroidectomy on Mortality in Hemodialysis Patients: A Prospective Observational Study

Author: Philippe Brunet, Bertrand Dussol, Yvon Berland, Henri Portugal, Pascal Morand, Catherine Martinat, and Elise Lombard
Subjects: Male, Parathyroidectomy, medicine.medical_specialty, Hypoparathyroidism, Cross-sectional study, medicine.medical_treatment, Parathyroid hormone, Critical Care and Intensive Care Medicine, Renal Dialysis, Internal medicine, Epidemiology, Prevalence, medicine, Humans, Prospective Studies, Prospective cohort study, Survival analysis, business.industry, General Medicine, Middle Aged, medicine.disease, Surgery, Cross-Sectional Studies, Parathyroid Hormone, Nephrology, Female, Hemodialysis, business
Abstract: In hemodialysis patients, the relationships between serum PTH and phosphorus levels and mortality are debated because both high and low turnover bone diseases increase the risk of vascular calcifications. Furthermore, the prevalence of hypoparathyroidism is increasing, and there is a fear that this state is associated with an increase in bone fractures.We performed a cross-sectional study to determine the prevalence and the causes of hypoparathyroidism (defined as basal and post-hypocalcemic-challenge serum PTH levels55 pg/mL) in 97 patients undergoing chronic hemodialysis treatment in our unit. We then prospectively observed patients with low PTH levels (55 pg/mL, n = 26) and those with hyperparathyroidism defined as a PTH levels200 pg/mL (n = 25) during eight years for all causes of mortality and bone fractures. Kaplan-Meyer survival curves were adjusted for age and sex.Hypoparathyroidism was present in 30% of our patients. The main causes of hypoparathyroidism were parathyroidectomy (77%) and aluminium and iron overload. Survival did not differ between patients with hypoparathyroidism and hyperparathyroidism and between patients with serum phosphorusor2 mmol/L. Parathyroidectomy was associated with better survival (p0.01). Similarly, incidence of bone fractures did not differ for the two groups.Parathyroidectomy is the main cause of hypoparathyroidism in hemodialysis patients and is associated with a lower mortality risk. This result suggests that a more aggressive treatment of secondary hyperparathyroidism could decrease mortality in this high-risk population.
Published: 2007

42. Artificial neural networks for assessing the risk factors for urinary calcium stones according to gender and family history of stone

Author: Jean-Marc Le Goff, Yvon Berland, Patrice Berthezene, Jean-Michel Verdier, and Bertrand Dussol
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Urology, Calcium oxalate, Sensitivity and Specificity, Kidney Calculi, chemistry.chemical_compound, Predictive Value of Tests, Risk Factors, Internal medicine, Humans, Medicine, Family, Family history, Risk factor, Sex Characteristics, Calcium Oxalate, Receiver operating characteristic, business.industry, Case-control study, Middle Aged, Urinary calcium, Endocrinology, ROC Curve, chemistry, Nephrology, Case-Control Studies, Predictive value of tests, Female, Neural Networks, Computer, business, Body mass index
Abstract: In a previous work, we evidenced that artificial neural networks (ANNs) were more informative than classical statistical analyses for assessing the risk of idiopathic calcium nephrolithiasis in male stone-formers.We compared risk factors for idiopathic calcium nephrolithiasis (age, body mass index, calcemia, calcium oxalate supersaturation, and 24-h calciuria, oxaluria, uricosuria, citraturia, urea, and sodium) in four populations: men and women with and without a family history of stone (FHS). A total of 119 males (58 with an FHS, 61 without) and 59 females (30 with an FHS, 29 without) were compared to healthy controls. For each variable, receiver operating characteristic (ROC) curve indices were calculated by means of ANNs.In men without an FHS, the most discriminant variables were 24-h urea (ROC curve index 0.76), supersaturation (ROC curve index 0.72), 24-h calciuria (ROC curve index 0.68), 24-h uricosuria (ROC curve index 0.64), 24-h oxaluria (ROC curve index 0.63), 24-h sodium (ROC curve index 0.62), and calcemia (ROC curve index 0.60). In men with an FHS, only supersaturation (ROC curve index 0.67) was discriminant. In women without FHS, calcemia (ROC curve index 0.67), 24-h calciuria (ROC curve index 0.64), and 24-h uricosuria (ROC curve index 0.62) were discriminant. In women with an FHS, supersaturation (ROC curve index 0.70), 24-h uricosuria (ROC curve index 0.69), 24-h urea (ROC curve index 0.68), and 24-h calciuria (ROC curve index 0.67) were discriminant.Risk factors for idiopathic calcium nephrolithiasis were roughly the same in men with or without an FHS, and in women with an FHS. In these patients, calcium oxalate supersaturation and 24-h urea were the most discriminant factors. Conversely, in women without an FHS, calcium abnormalities (calcemia, 24-h calciuria) were discriminant and should prompt a search for infraclinical primary hyperparathyroidism or sarcoidosis.
Published: 2007

43. Dialysate Biocompatibility: Evaluation and Expectations

Author: A. Ragon, A. Crevat, Yvon Berland, G. Frenkian, and Ph. Brunet
Subjects: medicine.medical_specialty, Biocompatibility, business.industry, MEDLINE, Medicine, business, Intensive care medicine
Published: 2015

44. Ultrafiltration and Depurative Parameters

Author: Bertrand Dussol, Philippe Brunet, and Yvon Berland
Subjects: Chromatography, business.industry, Ultrafiltration, Medicine, Depurative, business
Published: 2015

45. Hyperparathyroidism and Bone Aluminum Deposits May Coexist

Author: Toga M, S. Charhon, Michel Olmer, and Yvon Berland
Subjects: Hyperparathyroidism, Pathology, medicine.medical_specialty, business.industry, medicine, medicine.disease, business
Published: 2015

46. Plasma Xanthine Oxidase Activity Is Predictive of Cardiovascular Disease in Patients with Chronic Kidney Disease, Independently of Uric Acid Levels

Author: Noémie Jourde-Chiche, Claire Cerini, Laetitia Dou, Anderson Loundou, Bertrand Gondouin, Yvon Berland, Bertrand Dussol, Sophie Morange, Régis Guieu, Marion Sallée, Stéphane Burtey, Philippe Brunet, Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Physiopathologie de l'Endothelium, Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Assistance Publique - Hôpitaux de Marseille (APHM), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, medicine.medical_specialty, Xanthine Oxidase, Antioxidant, medicine.medical_treatment, Kaplan-Meier Estimate, urologic and male genital diseases, medicine.disease_cause, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, End stage renal disease, chemistry.chemical_compound, Adenosine deaminase, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Renal Dialysis, Risk Factors, Internal medicine, medicine, Humans, Longitudinal Studies, Prospective Studies, Renal Insufficiency, Chronic, Xanthine oxidase, Aged, Aged, 80 and over, Super oxide dismutase, biology, business.industry, Middle Aged, medicine.disease, 3. Good health, Uric Acid, Oxidative Stress, Endocrinology, chemistry, Cardiovascular Diseases, Purines, biology.protein, Uric acid, Female, business, Oxidation-Reduction, Oxidative stress, Kidney disease, Follow-Up Studies
Abstract: Background: Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality. Oxidative stress seems to play a pivotal role in this process, and purine metabolism may be involved in CKD-related oxidative stress. Xanthine oxidase (XO) is an enzyme involved in purine metabolism and is also responsible for the production of reactive oxygen species. Methods: This prospective study aimed to analyze the relation between plasma dosages of molecules involved in redox balance, purine metabolism and cardiovascular events in patients with non-diabetic CKD stages 3-5 or on chronic hemodialysis (HD). CKD (n = 51) and HD (n = 50) patients were compared to matched healthy controls (n = 38) and followed-up for 3 years. Results: Both CKD and HD patients had decreased plasma levels of antioxidants (selenium, zinc, vitamin C). HD patients had decreased levels of the antioxidant enzyme superoxide dismutase and increased levels of oxidation products (ischemia-modified albumin, malondialdehyde [MDA]). The following substrates and enzymes involved in purine metabolism were increased in the HD cohort: adenosine, adenosine deaminase and the pro-oxidant XO. XO activity was negatively correlated with super oxide dismutase and positively with MDA. Interestingly, XO activity was an independent predictor of cardiovascular events in CKD and HD patients, regardless of uric acid levels. Uric acid was not predictive of events. Conclusion: This highlights a possible role of XO itself in CKD-related cardiovascular disease (CVD) and raises the hypothesis that beneficial effects observed with XO inhibitors on CVD in CKD may also be due to the reduction of oxidative stress.
Published: 2015

47. À propos de deux cas de paralysie périodique hypokaliémique

Author: Henri Vacher-Coponat, Yvon Berland, Bertrand Dussol, and Stéphane Burtey
Subjects: Proband, medicine.medical_specialty, Pediatrics, business.industry, Metabolic disorder, Periodic paralysis, Familial periodic paralysis, medicine.disease, Hypokalemia, Surgery, Hypokalemic periodic paralysis, Nephrology, medicine, Paralysis, medicine.symptom, business, Intracellular
Abstract: We report on two cases of hypokaliemic periodic paralysis due to a potassium shift from the extracellular to the intracellular compartment of skeletal muscle cells. The first case occurred in a 15-year-old boy who experienced rapid onset flaccid tetraplegia without neurological abnormalities. Physical exam revealed facial dysmorphy, and EKG a long QT. Biology evidenced shift hypokalemia that was quickly reversible after administration of intravenous potassium. After exclusion of Andersen-Tawil syndrom, hypokalemic familial paralysis (Westphall disease) was diagnosed by molecular genetic testing (disease-causing mutation in CACNA1S) in the proband and in three other family members. The second case occurred in a 24-year-old male who experienced rapid onset flaccid tetraplegia due to intracellular potassium shift that was quickly reversible after administration of intravenous potassium. Biology revealed thyrotoxicosis due to Grave's disease. To the best of our knowledge, this is the first case described in a people from pacific origin. The clinical, biological, and electromyographic findings of the most frequent causes of periodic paralysis are underlined as well as the molecular genetic diagnosis in familial forms.
Published: 2006

48. Tacrolimus/Mycophenolate Mofetil Improved Natural Killer Lymphocyte Reconstitution One Year After Kidney Transplant by Reference to Cyclosporine/Azathioprine

Author: Pascale Paul, Emmanuelle Sampol-Manos, A. Loundou, Valérie Moal, Elodie Bonnet, Corinne Brunet, Yvon Berland, Henri Vacher-Coponat, Françoise Dignat George, Luc Lyonnet, Sophie Ravet, and José Sampol
Subjects: Adult, Male, T-Lymphocytes, medicine.medical_treatment, Lymphocyte, T cell, Azathioprine, Tacrolimus, Mycophenolic acid, Natural killer cell, medicine, Humans, Prospective Studies, Aged, B-Lymphocytes, Transplantation, business.industry, Immunosuppression, Middle Aged, Mycophenolic Acid, Kidney Transplantation, Killer Cells, Natural, Calcineurin, medicine.anatomical_structure, Immunology, Cyclosporine, Drug Therapy, Combination, Female, business, Immunosuppressive Agents, medicine.drug
Abstract: Background. Recently introduced immunosuppressive drugs are more potent to control graft rejection, but current concerns are raised regarding their potential to increase long-term neoplastic and infectious complications. Considering the role of B, T, or natural killer (NK) lymphocyte in controlling alloreactive, anti-infectious, and antitumoral immune responses, we compared the impact of two immunosuppressive regimens on lymphocyte subsets one year following kidney transplant. Methods. Multivariate regression analysis of variables affecting lymphocyte subset counts was retrospectively performed on 91 kidney-transplanted patients, analyzed before graft, at day 15 and 1-year postgraft. These patients were included in a randomized prospective open trial comparing tacrolimus/mycophenolate mofetil (FK/MMF) versus cyclosporine/azathioprine (CSA/Aza), both used in association with rabbit antithymocyte globulines (rATG) induction and prednisone. Results. Fifteen days postgraft, severe T and NK lymphocyte depletion were observed in all patients, while B cell counts were selectively higher in the FK/MMF group as compared to before graft. One-year posttransplant, NK cell counts and NK cell cytotoxicity was significantly higher in patients receiving FK/MMF therapy, as compared to CSA/Aza. Cytomegalovirus (CMV) infection during the first year posttransplant was also associated to higher NK, CD8 + , and CD4 - CD8 - T cell counts at month 12. Conclusions. In addition to its higher potential in preventing graft rejection, we show that after one year of transplant, FK/MMF better preserves NK innate immune effector cells and their cytotoxic potential. These data prompt to further evaluate the role of NK cells in relation to antiviral and tumoral surveillance of transplanted patients, which are common complications of long-term immunosuppression.
Published: 2006

49. The uremic solute p-cresol decreases leukocyte transendothelial migration in vitro

Author: V. Faure, Claire Cerini, Pascale Paul, Françoise Dignat-George, Philippe Brunet, and Yvon Berland
Subjects: medicine.medical_specialty, Chemokine, Endothelium, Immunology, Peripheral blood mononuclear cell, Cresols, Internal medicine, parasitic diseases, Leukocytes, medicine, Humans, Immunology and Allergy, RNA, Messenger, Cells, Cultured, Immunodeficiency, Uremia, biology, Monocyte, Immunologic Deficiency Syndromes, Endothelial Cells, General Medicine, medicine.disease, Chemotaxis, Leukocyte, medicine.anatomical_structure, Endocrinology, Gene Expression Regulation, Cell culture, biology.protein, Cytokines, Kidney Failure, Chronic, Human umbilical vein endothelial cell, Junctional Adhesion Molecule A
Abstract: Chronic renal failure (CRF) patients display an immunodeficiency state, and uremic solutes that accumulate during CRF may be involved in this immunodeficiency. In this study, we examined whether the uremic solute para-cresol (p-cresol), at concentrations similar to those found in patients, alters leukocyte transmigration in vitro. We found that p-cresol significantly inhibited monocyte THP-1 cell line and PBMCs transmigration across IL-1beta-stimulated human umbilical vein endothelial cell (HUVEC) in a static two-compartment model. This inhibitory effect of p-cresol persisted in the presence of a physiologic concentration of human serum albumin. In order to investigate the mechanism involved, expression of endothelial chemokines, fractalkine, monocyte chemoattractant protein 1 (MCP-1) and IL-8 and membrane expression of junctional adhesion molecule A (JAM-A or JAM-1) were studied. We found that p-cresol decreased mRNA expression of the chemokine fractalkine in IL-1beta-stimulated HUVEC, without modifying mRNA expression of MCP-1 and IL-8. In addition, p-cresol decreased IL-1beta-induced expression of membrane-bound and soluble forms of fractalkine and impaired the membrane expression of JAM-A. Taken together, these results suggest that p-cresol, by impairing leukocyte transendothelial migration, plays a role in the immune dysfunction of uremic patients.
Published: 2006

50. Que nous apprennent les grands essais cliniques de prévention cardiovasculaire et rénale chez le malade diabétique de type 2 hypertendu ?

Author: Bertrand Dussol and Yvon Berland
Subjects: Nephrology, medicine.medical_specialty, business.industry, Type 2 diabetes, medicine.disease, Surgery, Diabetic nephropathy, Blood pressure, Internal medicine, Diabetes mellitus, medicine, Albuminuria, Microalbuminuria, medicine.symptom, business, Kidney disease
Abstract: Type 2 diabetes mellitus and hypertension are frequently associated. Cardiovascular morbidity is a major burden in these patients. Furthermore a renal disease appears in 40% of them that may lead to chronic terminal renal failure. Whatever the stage of the renal disease, it increases the cardiovascular risk. A majority of type 2 diabetic patients will eventually died of cardiovascular complications before having reached chronic terminal renal failure. Many large clinical trials including type 2 diabetic patients with hypertension have been performed in the last 20 years with cardiovascular morbidity and mortality as primary outcomes. These trials mainly evaluated the role of glycemic control, of hypertension as well as the decrease of LDL-cholesterol. Based on these trials, the prescription type of hypertensive type 2 diabetic patient should include, besides hygienic and dietary advices, antidiabetic treatment, thiazide and/or betablocker and platelet inhibitor. Statin should be prescribed for secondary prevention if serum LDL-cholesterol is above 1,3 g/l and for primary prevention depending on serum LDL-cholesterol and on the number of cardiovascular risk factors. The objectives are an HbA1c below 6,5%, a LDL-cholesterol below 1g/l and a blood pressure below 150/80 mmHg. The appearance of diabetic nephropathy alters the treatment and the therapeutic objectives. Many large trials aimed at preventing microalbuminuria (primary prevention), macroproteinuria (secondary prevention), and chronic renal failure (tertiary prevention) have been conducted. For primary prevention, angiotensin-converting-enzyme inhibitors should be prescribed in case of hypertension because they delay the appearance of microalbuminuria. For secondary prevention, angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers decrease albuminuria excretion rate and delay the appearance of macroproteinuria whatever the blood pressure. Tertiary prevention is based on angiotensin-receptor blockers since they slow down the decrease of renal function. The objectives are a blood pressure below 130/80 mmHg and the regression or the reduction of albuminuria excretion rate. Intensified and target-driven interventions aimed at multiple risk factors implicated in cardiovascular and renal lesions, as successfully performed in the STENO-2 study, reduce the risk of cardiovascular and renal morbidity and mortality. In this article, large clinical trials having the prevention of cardiovascular and renal risks as primary outcomes were analyzed.
Published: 2006

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