Publications by authors named "Yvan Jamilloux"

Background/objectives: The large number and heterogeneity of causes of uveitis make the etiological diagnosis a complex task. The clinician must consider all the information concerning the ophthalmological and extra-ophthalmological features of the patient. Diagnostic machine learning algorithms have been developed and provide a correct diagnosis in one-half to three-quarters of cases.

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Background: The objective was to assess the agreement between therapeutic proposals derived from basic critical care echocardiography performed by novice operators in ultrasonography after a limited training (residents) and by experts considered as reference. Secondary objectives were to assess the agreement between operators' answers to simple clinical questions and the concordance between basic two-dimensional measurements.

Methods: This observational, prospective, single-center study was conducted over a 3-year period in a medical-surgical intensive care unit.

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Objectives: Vacuoles, E1 enzyme, X-linked, autoinflammatory and somatic (VEXAS) syndrome is an adult-onset autoinflammatory disease associated with somatic ubiquitin-like modifier-activating enzyme 1 (UBA1) mutations. We aimed to evaluate the efficacy and safety of targeted therapies.

Methods: Multicentre retrospective study including patients with genetically proven VEXAS syndrome who had received at least one targeted therapy.

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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.
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Article Synopsis
  • * Researchers measured cytokines and conducted immune functional assays to analyze the immune status of patients, finding increased levels of specific cytokines in those requiring mechanical ventilation (MV).
  • * Results indicate that severe LD patients exhibit a hyper-inflammatory response initially, followed by significant immunoparalysis affecting many cytokines, except for IL-18, which remained elevated in these individuals.
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Purpose: Determining uveitis etiology is a challenge. It is based primarily on demographic data and the characteristics of eye examination. It is not clear to what extent extraocular physical signs contribute to elucidating the etiology.

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Article Synopsis
  • - Granulomatous hepatitis (GH) can result from various causes, with sarcoidosis being a key granulomatous disease affecting the liver.
  • - This study examined the potential of serum angiotensin converting enzyme (sACE) levels and lymphopenia as diagnostic markers for sarcoidosis in patients with GH by analyzing records from a French hospital.
  • - Findings showed that lymphopenia had a high specificity for sarcoidosis diagnosis, especially when paired with elevated sACE levels, and this specificity was particularly high (100%) in patients under 50 years old.
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The recently discovered VEXAS syndrome is caused by the clonal expansion of hematopoietic stem or progenitor cells with acquired mutations in UBA1 gene, which encodes for a key enzyme of the ubiquitylation proteasome system. As a result, a shorter cytoplasmic isoform of UBA1 is transcribed, which is non-functional. The disease is characterized by non-specific and highly heterogeneous inflammatory manifestations and macrocytic anemia.

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H syndrome is a rare autosomal recessive genetic disorder characterized by the following clinical features: cutaneous hyperpigmentation, hypertrichosis, hepatosplenomegaly, heart anomalies, hearing loss, hypogonadism, short stature, hallux valgus, hyperglycemia, fixed flexion contractures of the toe joints, and the proximal interphalangeal joints. In rare cases, autoinflammatory and lymphoproliferative manifestations have also been reported. This disorder is due to loss-of-function mutations in gene, which encode the equilibrative nucleoside transporter ENT3.

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Objective: FMF is the most common monogenic autoinflammatory disease associated with MEFV mutations. Disease phenotype and response to treatment vary from one patient to another, despite similar genotype, suggesting the role of environmental factors. The objective of this study was to analyse the gut microbiota of a large cohort of FMF patients in relation to disease characteristics.

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Sarcoidosis is an inflammatory disease that involves the eyes in 10-55% of cases, sometimes without systemic involvement. All eye structures can be affected, but uveitis is the most common ocular manifestation and causes vision loss. The typical ophthalmological appearance of these uveitis is granulomatous (in cases with anterior involvement), which are usually bilateral and with synechiae.

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Article Synopsis
  • VEXAS syndrome is a newly described condition that raises questions about the classification of myelodysplastic syndromes in medical diagnosis.
  • This syndrome involves clonal expansion from somatic mutations and is linked to features like dysplastic blood cells and low blood cell counts, complicating the lines between healthy and unhealthy hematopoiesis.
  • The authors propose a refined classification system for hematopoiesis, suggesting that VEXAS may not fit the traditional criteria for myelodysplastic syndromes, and introducing terms to better differentiate types of clonal hematopoiesis.
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Article Synopsis
  • - Familial Mediterranean Fever (FMF) is caused by mutations in the MEFV gene, particularly in exon 10, which codes for the B30.2 domain of the pyrin protein, a key player in the body’s inflammatory response.
  • - Researchers found that the B30.2 domain is not essential for activating the pyrin inflammasome in response to bacterial toxins; instead, it acts as a negative regulator.
  • - They also identified the central helical scaffold (CHS) domain, which, along with B30.2, provides distinct regulatory controls on the inflammasome activation, revealing how different mutations can affect inflammation responses in FMF patients.
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Introduction: The definite diagnosis of neurosarcoidosis is challenging since it requires a compatible histology of the nervous system. When neurosarcoidosis is suspected, other systemic manifestations are investigated to confirm the diagnosis. A minor salivary gland biopsy (MSGB) is often performed since it is minimally invasive.

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Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome with an overall mortality rate of 40%. A multiple-cause-of-death analysis allows for the characterization of mortality and associated causes over an extended period. Death certificates, collected between 2000 and 2016 by the French Epidemiological Centre for the Medical Causes of Death (CepiDC, Inserm), containing the ICD10 codes for HLH (D76.

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Background/purpose: To assess the efficacy and tolerance of hydroxychloroquine in sarcoidosis-associated uveitis.

Methods: Retrospective study on all patients with sarcoidosis-associated uveitis who were treated with hydroxychloroquine between 2003 and 2019 in a French university hospital.

Results: Twenty-seven patients with sarcoidosis-associated uveitis received hydroxychloroquine.

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Article Synopsis
  • The review explores current knowledge of VEXAS syndrome, focusing on its underlying mechanisms and treatment options since its recognition two years ago.
  • Recent research highlights the effectiveness of the JAK inhibitor ruxolitinib for managing inflammation, while azacytidine also shows promise; however, allogeneic stem cell transplantation is the only known cure for selected patients.
  • To enhance understanding and treatment of VEXAS, the authors suggest standardized criteria for reporting therapeutic outcomes, aiming for better data collection and analysis in future clinical trials.
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Introduction: Sarcoidosis is a systemic granulomatosis of unknown etiology, characterized by the presence of immune granulomas. Liver damage is a relatively common extra-pulmonary manifestation, occurring in 3.6-30% of cases.

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