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  1. Article ; Online: Immunosuppressive therapy after solid organ transplantation and the gut microbiota: Bidirectional interactions with clinical consequences.

    Gabarre, Paul / Loens, Christopher / Tamzali, Yanis / Barrou, Benoit / Jaisser, Frédéric / Tourret, Jérôme

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2021  Volume 22, Issue 4, Page(s) 1014–1030

    Abstract: Our understanding of the involvement of the gut microbiota (GM) in human health has expanded exponentially over the last few decades, particularly in the fields of metabolism, inflammation, and immunology. Immunosuppressive treatment (IST) prescribed to ... ...

    Abstract Our understanding of the involvement of the gut microbiota (GM) in human health has expanded exponentially over the last few decades, particularly in the fields of metabolism, inflammation, and immunology. Immunosuppressive treatment (IST) prescribed to solid organ transplant (SOT) recipients produces GM changes that affect these different processes. This review aims at describing the current knowledge of how IST changes the GM. Overall, SOT followed by IST results in persistent changes in the GM, with a consistent increase in proteobacteria including opportunistic pathobionts. In mice, Tacrolimus induces dysbiosis and metabolic disorders, and alters the intestinal barrier. The transfer of the GM from Tacrolimus-treated hosts confers immunosuppressive properties, suggesting a contributory role for the GM in this drug's efficacy. Steroids induce dysbiosis and intestinal barrier alterations, and also seem to depend partly on the GM for their immunosuppressive and metabolic effects. Mycophenolate Mofetil, frequently responsible for digestive side effects such as diarrhea and colitis, is associated with pro-inflammatory dysbiosis and increased endotoxemia. Alemtuzumab, m-TOR inhibitors, and belatacept have shown more marginal impact on the GM. Most of these observations are descriptive. Future studies should explore the underlying mechanism of IST-induced dysbiosis in order to better understand their efficacy and safety characteristics.
    MeSH term(s) Animals ; Dysbiosis ; Gastrointestinal Microbiome ; Immunosuppression Therapy ; Mice ; Organ Transplantation/adverse effects ; Tacrolimus/pharmacology
    Chemical Substances Tacrolimus (WM0HAQ4WNM)
    Language English
    Publishing date 2021-10-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.16836
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5542: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Néphrotoxicité des antirétroviraux autres que le ténofovir.

    Loens, Christopher / Amet, Sabine / Isnard-Bagnis, Corinne / Deray, Gilbert / Tourret, Jérôme

    Nephrologie & therapeutique

    2018  Volume 14, Issue 1, Page(s) 55–66

    Abstract: The remarkable improvement of the outcome of HIV infection came with the price of substantial toxicity of some antiretrovirals. The first molecules used to treat HIV included an important nephrotoxicity. Zalcitabine, stavudine and didanosine can induce ... ...

    Title translation Nephrotoxicity of antiretrovirals other than tenofovir.
    Abstract The remarkable improvement of the outcome of HIV infection came with the price of substantial toxicity of some antiretrovirals. The first molecules used to treat HIV included an important nephrotoxicity. Zalcitabine, stavudine and didanosine can induce severe lactic acidosis. Lactate production is enhanced and the renal capacity to regulate pH is overwhelmed. However, this side effect is not due to a direct dysfunction of the kidneys. Zalcitabine was withdrawn from the market because of this risk. Indinavir, a protease inhibitor, is soluble only in very acidic solutions. Consequently, the small fraction that is excreted in the urine precipitates and can be responsible for uro-nephrolithiasis, leukocyturia, cristalluria, obstructive acute kidney failure, and acute or chronic interstitial nephritis. This is the reason why indinavir is almost not prescribed nowadays, even if it is still marketed. In addition to the direct nephrotoxicity of some antiretrovirals, anti-HIV treatment also includes a toxicity which pathophysiology is not completely elucidated. This nephrotoxicity is the consequence of organ accelerated ageing and of an increased vascular risk. Kidney vascularization (from renal arteries to capillaries) is essential to kidney function and all cardiovascular risks are also renal risks. It is now clearly established that combined antiretroviral treatment increases the vascular risk. A better comprehension of the links between HIV infection, its treatment and very long-term kidney risk is needed to improve the complex management of patients who have now cumulated several decades of HIV infection and treatment with various toxicities.
    MeSH term(s) HIV Infections/drug therapy ; Humans ; Kidney/pathology ; Kidney Diseases/chemically induced ; Reverse Transcriptase Inhibitors/adverse effects ; Tenofovir/adverse effects
    Chemical Substances Reverse Transcriptase Inhibitors ; Tenofovir (99YXE507IL)
    Language French
    Publishing date 2018-03-01
    Publishing country France
    Document type Journal Article
    ZDB-ID 2229575-6
    ISSN 1872-9177 ; 1769-7255
    ISSN (online) 1872-9177
    ISSN 1769-7255
    DOI 10.1016/j.nephro.2017.12.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6298: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: COVID-19 in Patients on Maintenance Dialysis in the Paris Region.

    Tortonese, Sarah / Scriabine, Ivan / Anjou, Louis / Loens, Christopher / Michon, Arthur / Benabdelhak, Mohammed / Ouali, Sarah / Morin, Gabriel / Laifi, Marwa / Dobosziewicz, Hélène / Guillet, Matthieu / Dekeyser, Manon / Luong Nguyen, Liem Binh / Grünenwald, Anne / Dang, Julien / Desbuissons, Geoffroy / Becquemont, Laurent / Snanoudj, Renaud / Legendre, Christophe /
    Hebibi, Hadia / Lefèvre, Edouard / Beaudreuil, Séverine / Zaidan, Mohamad

    Kidney international reports

    2020  Volume 5, Issue 9, Page(s) 1535–1544

    Abstract: Introduction: Coronavirus disease 2019 (COVID-19) represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate, and prognostic factors in these patients have not been well established.: Methods: We included ... ...

    Abstract Introduction: Coronavirus disease 2019 (COVID-19) represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate, and prognostic factors in these patients have not been well established.
    Methods: We included all dialyzed patients with COVID-19 referred to our dialysis center between March 11 and April 11, 2020. Data were obtained through the review of the medical records and were censored at the time of data cutoff, on May 11, 2020.
    Results: Forty-four patients on maintenance dialysis with COVID-19 were referred to our dialysis unit during the COVID-19 epidemic. Median age was 61 years (interquartile range [IQR]: 51.5-72.5); 65.9% were men. Comorbidities included hypertension (97.7%), diabetes mellitus (50%), and chronic cardiac (38.6%) and respiratory (27.3%) diseases. Initial symptoms were fever (79.5%), shortness of breath (29.5%), cough (43.2%), and diarrhea (13.6%). Three profiles of severity were distinguished based on the World Health Organization (WHO) progression scale. Forty-one (93.2%) were hospitalized and only 3 were maintained on outpatient hemodialysis. Thirty-three (75%) patients required oxygen therapy, including 15 (45.5%) who were referred to the intensive care unit. Overall, 27.3% of patients died, and 58.5% were discharged from hospital, including only 2 (13.3%) of those admitted to the intensive care unit. By multivariate analysis, cough, thrombopenia <120 g/l, lactate dehydrogenase (LDH) level greater than 2 times the upper limit of normal, and blood C-reactive protein (CRP) >175 mg/l were significantly associated with death.
    Conclusion: A major outbreak of COVID-19 occurred in the Paris region, and spread among dialyzed patients. Our study underscores the severity of COVID-19 in these patients and identified prognostic markers.
    Keywords covid19
    Language English
    Publishing date 2020-07-18
    Publishing country United States
    Document type Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2020.07.016
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  4. Article: COVID-19 in Patients on Maintenance Dialysis in the Paris Region

    Tortonese, Sarah / Scriabine, Ivan / Anjou, Louis / Loens, Christopher / Michon, Arthur / Benabdelhak, Mohammed / Ouali, Sarah / Morin, Gabriel / Laifi, Marwa / Dobosziewicz, Hélène / Guillet, Matthieu / Dekeyser, Manon / Luong Nguyen, Liem Binh / Grünenwald, Anne / Dang, Julien / Desbuissons, Geoffroy / Becquemont, Laurent / Snanoudj, Renaud / Legendre, Christophe /
    Hebibi, Hadia / Lefèvre, Edouard / Beaudreuil, Séverine / Zaidan, Mohamad

    Abstract: Introduction: Coronavirus disease 2019 (COVID-19) represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate, and prognostic factors in these patients have not been well established. Methods: We included all ... ...

    Abstract Introduction: Coronavirus disease 2019 (COVID-19) represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate, and prognostic factors in these patients have not been well established. Methods: We included all dialyzed patients with COVID-19 referred to our dialysis center between March 11 and April 11, 2020. Data were obtained through the review of the medical records and were censored at the time of data cutoff, on May 11, 2020. Results: Forty-four patients on maintenance dialysis with COVID-19 were referred to our dialysis unit during the COVID-19 epidemic. Median age was 61 years (interquartile range [IQR]: 51.5-72.5); 65.9% were men. Comorbidities included hypertension (97.7%), diabetes mellitus (50%), and chronic cardiac (38.6%) and respiratory (27.3%) diseases. Initial symptoms were fever (79.5%), shortness of breath (29.5%), cough (43.2%), and diarrhea (13.6%). Three profiles of severity were distinguished based on the World Health Organization (WHO) progression scale. Forty-one (93.2%) were hospitalized and only 3 were maintained on outpatient hemodialysis. Thirty-three (75%) patients required oxygen therapy, including 15 (45.5%) who were referred to the intensive care unit. Overall, 27.3% of patients died, and 58.5% were discharged from hospital, including only 2 (13.3%) of those admitted to the intensive care unit. By multivariate analysis, cough, thrombopenia <120 g/l, lactate dehydrogenase (LDH) level greater than 2 times the upper limit of normal, and blood C-reactive protein (CRP) >175 mg/l were significantly associated with death. Conclusion: A major outbreak of COVID-19 occurred in the Paris region, and spread among dialyzed patients. Our study underscores the severity of COVID-19 in these patients and identified prognostic markers.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #651323
    Database COVID19

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  5. Article ; Online: COVID-19 in Patients on Maintenance Dialysis in the Paris Region

    Tortonese, Sarah / Scriabine, Ivan / Anjou, Louis / Loens, Christopher / Michon, Arthur / Benabdelhak, Mohammed / Ouali, Sarah / Morin, Gabriel / Laifi, Marwa / Dobosziewicz, Hélène / Guillet, Matthieu / Dekeyser, Manon / Luong Nguyen, Liem Binh / Grünenwald, Anne / Dang, Julien / Desbuissons, Geoffroy / Becquemont, Laurent / Snanoudj, Renaud / Legendre, Christophe /
    Hebibi, Hadia / Lefèvre, Edouard / Beaudreuil, Séverine / Zaidan, Mohamad

    Kidney International Reports

    2020  Volume 5, Issue 9, Page(s) 1535–1544

    Keywords Nephrology ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ISSN 2468-0249
    DOI 10.1016/j.ekir.2020.07.016
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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