Publications by authors named "Alexandre Thibault Jacques Maria"
Time to use the right classification to predict the severity of checkpoint inhibitor-induced liver injury, as assessed for causality using the updated RUCAM.
Aliment Pharmacol Ther
December 2024
Article Synopsis
- - This study investigates the severity and characteristics of checkpoint inhibitor-induced hepatitis, a significant side effect of cancer immunotherapy, focusing on patients with severe liver injury (grade 3 and 4) based on the Common Terminology Criteria for Adverse Events (CTCAE).
- - A retrospective analysis of 100 patients revealed varying severity classifications and outcomes, indicating that the CTCAE may not effectively assess liver injury severity compared to hepatology-focused classification systems.
- - The findings suggest that using traditional hepatology scores could provide better insights and avoid issues like unnecessary steroid treatments and hindered re-administration of immune checkpoint inhibitors.
[Prerequisite and organisation of health-care pathways for Cell and Gene therapies, using Mesenchymal Stromal Cells (MSC) or Chimeric Antigen Receptor (CAR) T cells, in patients with autoimmune systemic diseases].
Bull Cancer
January 2025
Article Synopsis
- First-line treatments for autoimmune systemic diseases (ARD) typically involve immunosuppressive drugs, but long-term use can lead to significant health risks.
- Innovative therapies like mesenchymal stromal cells (MSCs) and Chimeric Antigen Receptor (CAR) T cell therapies are emerging as promising alternatives for severe or refractory cases of ARD.
- A workshop by the French Speaking Society of Bone Marrow and Cell Transplantation focuses on establishing healthcare pathways and safety protocols for the deployment of MSCs and CAR-T therapies in ARD treatment, emphasizing patient safety and collaboration among specialists.
Article Synopsis
- NLRP3-associated autoinflammatory disease is a collection of genetic disorders caused by mutations that lead to increased activity of the NLRP3 protein, which complicates diagnosis despite effective treatments available.
- The study explores 34 different NLRP3 mutations, illustrating their functional differences based on how they respond to various signals that activate them, and highlights their link to symptom severity and misdiagnosis.
- Findings reveal critical areas in the NLRP3 protein that affect its activity and response to treatments, offering new perspectives on the disorder's variability and potential directions for improving diagnosis and therapy.
Article Synopsis
- * A case study of a 49-year-old patient revealed a significant 2.6-kb deletion in the NFKB1 gene, contributing to severe immune issues like respiratory infections and lymphoma, with similar findings in his brother who had milder symptoms.
- * The case highlights the importance of extensive genetic analyses, including copy number variation (CNV), to better understand and diagnose complex genetic conditions in medical genetics. *
Article Synopsis
- - The study focused on examining the relationship between primary Sjögren's syndrome (pSS) and cancer, specifically analyzing the clinical, pathological, and immunological aspects of pSS patients who also had cancer, compared to those without cancer.
- - Out of 165 pSS patients, 55 had cancers, primarily solid neoplasms, with breast and lung cancers being the most common; significantly, many cancers were diagnosed close to or shortly after the pSS diagnosis.
- - Findings suggest that there may be a connection between breast cancers and pSS, implying that the immune system's behavior in pSS patients could play a role in cancer development or control.
Background: Immune checkpoint inhibitors (ICI) have transformed cancer treatment over the last decade. Alongside this therapeutic improvement, a new variety of side effects has emerged, called immune-related adverse events (irAEs), potentially affecting any organ. Among these irAEs, myocarditis is rare but life-threatening.
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- Immune checkpoint inhibitors (ICIs) can cause liver toxicity in up to 25% of patients, and this study aimed to explore patterns of ICI-induced hepatitis and their outcomes.
- The study included 117 patients, finding that 38.5% had hepatocellular, 36.8% had cholestatic, and 24.8% had mixed liver injury, with severe cases linked to hepatocellular patterns.
- Treatment varied based on the clinical pattern, with steroids used for hepatocellular cases and ursodeoxycholic acid for cholestatic ones, and about 43.6% of patients challenged again with ICIs experienced recurrence of liver injury.
Article Synopsis
- The study aimed to evaluate the safety and effectiveness of long-term home parenteral nutrition (HPN) in patients with systemic sclerosis and intestinal failure (IF), compared to control patients with IF from other causes.
- Conducted in Montpellier, France, the research tracked patients from 1985 to 2020 who were on HPN for at least 4 weeks, focusing on complications and outcomes related to the treatment.
- Results showed that while both groups experienced body mass index increases and no significant difference in infection rates, patients with systemic sclerosis had a higher incidence of HPN-related cardiac overload, highlighting the need for careful cardiac monitoring in these patients.
Article Synopsis
- - Acquired hemophagocytic lymphohistiocytosis (HLH) is a serious condition caused by an overactive immune response, often linked to infections, cancers, autoimmune diseases, and recently, immune checkpoint inhibitors (ICIs) used in cancer treatment.
- - A study analyzed 190 HLH cases related to ICI therapy, finding that most patients were older men, with HLH typically appearing about 102 days post-treatment initiation, particularly with medications like nivolumab and pembrolizumab.
- - Results showed HLH occurrences were significantly higher with ICIs compared to other drugs, leading to serious conditions in patients, with a 15.3% mortality rate, highlighting the need for clinicians to be vigilant for
[Vaccination before and after autologous hematopoietic cell transplantation for autoimmune diseases: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (MATHEC-SFGM-TC)].
Bull Cancer
February 2023
The Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) organized the 12th workshop on hematopoietic stem cell transplantation clinical practices harmonization procedures on September 2021 in Lille, France. In the absence of specific national or international recommendation, the French working group for autologous stem Cell transplantation in Auto-immune Diseases (MATHEC) proposed guidances for vaccinations of patients undergoing autologous hematopoietic stem cell transplantation for autoimmune disease, including in the context of SARS-Cov-2 pandemic.
View Article and Find Full Text PDFCases of adult-onset Still's disease (AOSD) have been reported after COVID-19 vaccination. Here we provide a comprehensive description and analysis of all cases of AOSD reported in the literature and in pharmacovigilance databases through April 2022. Disproportionality analyses of pharmacovigilance data were performed in order to further explore the association between vaccination and AOSD.
View Article and Find Full Text PDFOcular immunotherapy-related adverse events (IRAEs), although rare, can be sight-threatening. Our objective was to analyze ocular IRAEs diagnosed in France from the marketing of immune checkpoint inhibitors (ICPIs) until June 2021 and to review the literature. We collected the cases of 28 patients (36 ocular IRAEs), occurring after an average of 17 weeks (±19).
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- Systemic inflammatory and autoimmune diseases (SIADs) affect 10-20% of patients with myelodysplastic syndrome (MDS), with VEXAS syndrome being a newly identified condition linked to specific genetic mutations.
- This study aimed to analyze myeloid immune cell types (dendritic cells and monocytes) in MDS patients with and without SIADs, revealing significant reductions in these cells in those with SIADs, particularly in those with VEXAS syndrome.
- The findings suggest potential causes for the decreased immune cell counts, including movement to areas of inflammation, increased cell death, or issues with cell formation in the bone marrow.
Article Synopsis
- Aseptic abscess (AA) syndrome is an uncommon inflammatory disorder often linked to inflammatory bowel disease (IBD), analyzed in a study involving 71 patients from 1999 to 2020.
- The majority of abscesses were found in the spleen and lymph nodes, with many patients also presenting with other illnesses, primarily IBD, and treated with medications like corticosteroids and immunosuppressants.
- More than half of the patients experienced relapses, particularly in the same organ, but colchicine was noted to decrease the risk of relapse, while no deaths were attributed to the syndrome.
Objectives: To describe the effectiveness and safety of biologics for the treatment of relapsing and/or refractory polyarteritis nodosa (PAN).
Methods: A retrospective European collaborative study was conducted in patients with PAN who received biologics for relapsing and/or refractory disease.
Results: Forty-two patients with PAN received a total of 53 biologic courses, including TNF-α blockers in 15 cases, rituximab (RTX) in 18 cases, tocilizumab (TCZ) in 10 cases and other biologics in 10 cases.
Safety and preliminary efficacy of allogeneic bone marrow-derived multipotent mesenchymal stromal cells for systemic sclerosis: a single-centre, open-label, dose-escalation, proof-of-concept, phase 1/2 study.
Lancet Rheumatol
February 2022
Article Synopsis
- Systemic sclerosis is a severe autoimmune disease, and mesenchymal stromal cells (MSCs) show potential for treatment due to their immunomodulatory and antifibrotic properties, although their safety in patients has not been confirmed.
- A phase 1/2 study at Saint-Louis Hospital in Paris aimed to determine the safety and feasibility of injecting allogeneic MSCs from family donors into patients with severe diffuse systemic sclerosis.
- The study involved 20 eligible patients, assessing immediate infusion tolerance and monitoring serious adverse events over a 24-month follow-up period.
Background: Systemic sclerosis (SSc) is a severe autoimmune disease for which mesenchymal stromal cells (MSCs)-based therapy was reported to reduce SSc-related symptoms in pre-clinical studies. Recently, extracellular vesicles released by MSCs (MSC-EVs) were shown to mediate most of their therapeutic effect. Here, we aimed at improving their efficacy by increasing the MSC-EV dose or by IFNγ-priming of MSCs.
View Article and Find Full Text PDF[Autologous hematopoietic cells for severe autoimmune diseases: Guidelines of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) for immune monitoring and biobanking].
Bull Cancer
December 2021
Autologous hematopoietic cell transplantation (AHCT) is a new treatment option for patients with severe autoimmune diseases (AD), based on the use of intensive or myeloablative chemotherapy to eradicate the pathogenic autoreactive immune cells and to allow the installation of a new and tolerant immune system during immune reconstitution process. Immune reconstitution analysis after AHCT is required for patients clinical follow-up and to further identify biological and immunological markers of the clinical response to develop individualized AHCT protocols. These MATHEC-SFGM-TC good clinical practice guidelines were developed by a multidisciplinary group of experts including members of the french reference center for stem Cell Therapy in Auto-immune Diseases (MATHEC), hematologists from the French speaking Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) and experts in immune monitoring and biobanking.
View Article and Find Full Text PDFSystemic sclerosis (SSc) is a complex disorder resulting from dysregulated interactions between the three main pathophysiological axes: fibrosis, immune dysfunction, and vasculopathy, with no specific treatment available to date. Adipose tissue-derived mesenchymal stromal cells (ASCs) and their extracellular vesicles (EVs) have proved efficacy in pre-clinical murine models of SSc. However, their precise action mechanism is still not fully understood.
View Article and Find Full Text PDFSystemic sclerosis (SSc) is a potentially lethal disease with no curative treatment. Mesenchymal stromal cells (MSCs) have proved efficacy in SSc but no data is available on MSC-derived extracellular vesicles (EVs) in this multi-organ fibrosis disease. Small size (ssEVs) and large size EVs (lsEVs) were isolated from murine MSCs or human adipose tissue-derived MSCs (ASCs).
View Article and Find Full Text PDFBackground: Various observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. We aimed to investigate whether treatment with rituximab is associated with severe COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases.
Methods: In this cohort study, we analysed data from the French RMD COVID-19 cohort, which included patients aged 18 years or older with inflammatory rheumatic and musculoskeletal diseases and highly suspected or confirmed COVID-19.
Context: Primary Sjögren's syndrome (pSS) is a complex heterogeneous autoimmune disease (AID) which can mimic rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). Our exploratory study investigated serum biomarkers that may discriminate pSS from RA and SLE.
Methods: Serum concentrations of 63 biomarkers involved in immune cell trafficking, inflammatory response, cellular movement, and cell-to-cell signaling were measured in AID patients, included prospectively into the study at the Montpellier University Hospital.
We report the case of a 48-year-old man followed since 2013 for primary antiphospholipid syndrome (APLS) revealed by venous thromboembolism in the presence of antiphospholipid antibodies (APL-Abs, anticardiolipin and anti-β-2-glycoprotein-1), who decompensated in the course of coronavirus disease (COVID-19). Despite efficient anticoagulation, he suffered bilateral adrenal glands hemorrhage and limb arterial ischemia. The tropism of severe acute respiratory syndrome coronavirus-2 for endothelium can lead to microangiopathy and increased risk for thrombosis.
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