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8 results on '"MESH : Disease Progression"'

1. Dynamic evaluation of circulating tumour cells in patients with advanced gastric and oesogastric junction adenocarcinoma: Prognostic value and early assessment of therapeutic effects

Author

Jaafar Bennouna, Christophe Borg, Cécile Badoual, Jean-Baptiste Bachet, Julien Taieb, François Ghiringhelli, Florence Castan, Elie Marcheteau, Sophie Gourgou, Aurélie Cazes, Christelle De La Fouchardiere, Simon Pernot, Olivier Bouché, Trevor Stanbury, Eric Francois, Emmanuelle Samalin, Magali Terme, David Malka, Michel Ducreux, Unité Fonctionnelle de Pharmacogénétique et Oncologie Moléculaire [AP-HP Hôpital Européen Georges Pompidou] (Service de Biochimie), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d’anatomo‑pathologie [AP-HP Hôpital Européen Georges Pompidou] (Centre de Ressources biologiques), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), Institut de Cancérologie de l'Ouest, Centre Antoine Lacassagne, CRLCC Antoine Lacassagne, Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Centre Léon Bérard [Lyon], CRLC Val d'Aurelle-Paul Lamarque, CRLCC Val d'Aurelle - Paul Lamarque, CHU Pitié-Salpêtrière [APHP], Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Institut Gustave Roussy (IGR), Oncologie digestive, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), UNICANCER - Institut régional du Cancer [Montpellier] (ICM), Unité Fonctionnelle de Pharmacogénétique et Oncologie Moléculaire [AP-HP Hôpital Européen Georges Pompidou] ( Service de Biochimie ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Service d’anatomo‑pathologie [AP-HP Hôpital Européen Georges Pompidou] ( Centre de Ressources biologiques ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Institut de Recherche en Cancérologie de Montpellier ( IRCM - U1194 Inserm - UM ), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Centre Hospitalier Universitaire de Reims ( CHU Reims ), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université de Franche-Comté ( UFC ), Institut Gustave Roussy ( IGR ), Institut Gustave Roussy ( IGR ) -Institut Gustave Roussy ( IGR ), UNICANCER - Institut régional du Cancer [Montpellier] ( ICM ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM)

Subjects
Male, 0301 basic medicine, Oncology, Cancer Research, Pathology, Esophageal Neoplasms, Organoplatinum Compounds, MESH : Antineoplastic Combined Chemotherapy Protocols, Leucovorin, Cell Count, MESH : Leucovorin, Kaplan-Meier Estimate, MESH : Cell Count, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Prostate, Circulating tumour cells, Antineoplastic Combined Chemotherapy Protocols, MESH : Stomach Neoplasms, MESH : Esophagogastric Junction, MESH : Female, MESH: Treatment Outcome, MESH : Prognosis, MESH: Organoplatinum Compounds, MESH: Stomach Neoplasms, Neoplastic Cells, Circulating, Prognosis, 3. Good health, Oxaliplatin, Clinical trial, MESH: Antineoplastic Combined Chemotherapy Protocols, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, MESH: Esophageal Neoplasms, Monoclonal, Disease Progression, MESH : Fluorouracil, MESH : Disease-Free Survival, Adenocarcinoma, Female, MESH: Disease Progression, Esophagogastric Junction, Fluorouracil, MESH: Esophagogastric Junction, medicine.drug, medicine.medical_specialty, MESH : Male, Stomach neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, MESH: Neoplastic Cells, Circulating, Antibodies, Monoclonal, Humanized, MESH : Organoplatinum Compounds, Disease-Free Survival, MESH : Antibodies, Monoclonal, Humanized, MESH: Prognosis, MESH : Kaplan-Meier Estimate, 03 medical and health sciences, Internal medicine, medicine, Humans, In patient, Clinical significance, MESH: Kaplan-Meier Estimate, MESH: Humans, MESH: Cell Count, business.industry, MESH : Humans, Therapeutic effect, MESH : Disease Progression, medicine.disease, MESH: Male, 030104 developmental biology, MESH: Antibodies, Monoclonal, Humanized, MESH : Neoplastic Cells, Circulating, MESH: Disease-Free Survival, MESH : Esophageal Neoplasms, MESH: Leucovorin, business, MESH: Female, MESH: Fluorouracil, Biomarkers
Abstract

IF 6.029; International audience; Background: The identification of dynamic biomarkers in advanced gastric and oesogastric junction adenocarcinoma (GOA) could help to tailor strategies for each patient. Enumeration of circulating tumour cells (CTCs) is approved by the US Food and Drug Administration in breast, colon and prostate cancer but is not in advanced GOA. Our study aims to establish the optimal threshold and the clinical significance of CTC count in advanced GOA before and during treatment.Methods: One hundred six patients with untreated advanced GOA were included in the ancillary study of the PRODIGE 17-ACCORD 20 trial. CTCs were detected in the peripheral blood using the CellSearch system on day 0 (D0) and day 28 (D28). The prognostic value of CTCs at D0 and D28 was analysed by testing several thresholds.Results: At baseline, median CTC count was 1 (range, 0-415). While CTCs >= 1, 2 or 3 at D0 were all significantly associated with worse overall survival (OS) and progression-free survival (PFS), CTCs >2 were the optimal threshold, on D0 or D28. CTCs >2 at D28 were also predictive of disease control. Taking into account both D0 and D28 CTC count defined 3 groups (low/low, high/low and low-high/high) with significantly different PFS (p = 0.0002) and OS (p = 0.003).Conclusion: Quantification of CTCs at baseline and during treatment may be a useful prognostic tool in advanced GOA, as it is associated with worse PFS and OS. A threshold >= 2 CTCs seems to have the best discriminant value. Change in CTC count between baseline and D28 could help to tailor treatment to each individual patient. (C) 2017 Elsevier Ltd. All rights reserved.

Published
2017
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2. Coexpression of major histocompatibility complex class II with chemokines and nuclear NFκB p50 in melanoma: a rational for their association with poor prognosis

Author

Olivier Verola, Manuelle Viguier, Frédérique Deshayes, Jessica Lauriol, Dominique Charron, Isabelle Martins, Khaoussou Sylla, Catherine Alcaide-Loridan, Marie-Caroline Dieu-Nosjean, Reem Al-Daccak, Stephanie Ghislin, Institut Jacques Monod (IJM (UMR_7592)), Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Réponses immunes : régulation et développement, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche des Cordeliers (CRC (UMR_S 872)), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de Dermatologie, Université Paris, Service d'anatomo-pathologie [Paris], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CIB-HOG, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Jacques Monod ( IJM ), Université Paris Diderot - Paris 7 ( UPD7 ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de Recherche des Cordeliers ( CRC (UMR_S 872) ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)

Subjects
Male, MESH: NF-kappa B p50 Subunit, Cancer Research, Chemokine, Skin Neoplasms, MESH : Aged, MESH: NF-kappa B, MESH : Neoplasm Invasiveness, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Aged, 80 and over, 0302 clinical medicine, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, MESH : Female, Extracellular Signal-Regulated MAP Kinases, Melanoma, MESH: Extracellular Signal-Regulated MAP Kinases, Aged, 80 and over, MESH: Aged, Regulation of gene expression, MESH : Trans-Activators, 0303 health sciences, MESH : Prognosis, MESH: Middle Aged, Kinase, NF-kappa B, Nuclear Proteins, MESH: Gene Expression Regulation, Neoplastic, MESH : Adult, Middle Aged, Prognosis, MESH: Chemokines, MESH : Extracellular Signal-Regulated MAP Kinases, Gene Expression Regulation, Neoplastic, Oncology, MESH : NF-kappa B, 030220 oncology & carcinogenesis, Disease Progression, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, MESH: Disease Progression, Chemokines, Matrix Metalloproteinase 1, Adult, Proto-Oncogene Proteins B-raf, MESH: Cell Line, Tumor, P50, MESH : Gene Expression Regulation, Neoplastic, MESH: Melanoma, MESH: Trans-Activators, MESH : Male, MESH : Melanoma, [SDV.CAN]Life Sciences [q-bio]/Cancer, Dermatology, Biology, MESH: Prognosis, 03 medical and health sciences, MESH : HLA-DR Antigens, Cell Line, Tumor, Extracellular, medicine, Humans, MESH : Middle Aged, MESH : Chemokines, Neoplasm Invasiveness, MESH : Aged, 80 and over, Protein kinase A, MESH : Proto-Oncogene Proteins B-raf, Aged, 030304 developmental biology, MESH: Proto-Oncogene Proteins B-raf, MESH: Humans, MESH : Matrix Metalloproteinase 1, MESH : Cell Line, Tumor, MESH: Skin Neoplasms, MESH : Humans, MESH : Skin Neoplasms, MESH: Biological Markers, MESH : Nuclear Proteins, NF-kappa B p50 Subunit, MESH: Adult, MESH : Disease Progression, HLA-DR Antigens, MESH: Neoplasm Invasiveness, MESH: HLA-DR Antigens, medicine.disease, MESH: Male, MESH : Biological Markers, MESH: Matrix Metalloproteinase 1, MESH : NF-kappa B p50 Subunit, Tumor progression, Immunology, Trans-Activators, biology.protein, MESH: Nuclear Proteins, MESH: Female, Biomarkers
Abstract

International audience; The constitutive expression of major histocompatibility complex class II (MHC II) molecules in melanoma is highly unusual and has been associated with unfavorable clinical outcome and higher metastatic dissemination. This association remains poorly understood and therefore, in this study we looked to whether it is caused by intracellular events that promote tumor progression. We previously reported that MHC II expression in melanoma cells requires active mitogen-activated protein kinase/extracellular signal-related kinase. However, our comparative and molecular analyses of a panel of melanoma cell lines herein provide clear evidence that mitogen-activated protein kinase/extracellular signal-related kinase is not sufficient for HLA-DR expression. We found that the expression of HLA-DR in these tumors rather coincides with the expression of CXCL-1 and CXCL-8 chemokines, both known to be expressed in tumors that invade early and are related to invasive stages of melanoma. The expression of HLA-DR also nicely paralleled that of the nuclear NFkappaB p50 subunit, regulating the expression of these chemokines in melanoma and previously correlated with poor prognosis of melanoma patients, although we provide evidence that NFkappaB is not directly regulating MHC II expression level. The molecular basis for class II transactivator and HLA-DR expression in melanoma therefore remains unsolved, but our findings linking together the expression of HLA-DR, of chemokines involved in invasiveness, and of nuclear NFkappaB p50 strongly support the content that MHC II may be a marker of invasive primary melanoma, and could explain the long-standing association of MHC II expression with overall poor prognosis and unfavorable clinical outcome.

Published
2009
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3. CXCR7 is up-regulated in human and murine hepatocellular carcinoma and is specifically expressed by endothelial cells

Author

Bruno Turlin, Claire Piquet-Pellorce, Marie-Lise Lacombe, Michel Samson, J. Monnier, Annie L'Helgoualc'h, Nathalie Théret, Mathieu Boissan, Jessica Zucman-Rossi, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de recherche Phytopharmacie et Médiateurs Chimiques (UPMC), Institut National de la Recherche Agronomique (INRA), CHU Pontchaillou [Rennes], Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Centre de Recherche Saint-Antoine ( CR Saint-Antoine ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Unité de recherche Phytopharmacie et Médiateurs Chimiques ( UPMC ), Institut National de la Recherche Agronomique ( INRA ), Service d'anatomopathologie, Genomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -IFR105-Université Paris Diderot - Paris 7 ( UPD7 ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Centre de Recherche Saint-Antoine (UMRS893), INSERM, Ministère de l’Education Nationale de la Recherche et de la Technologie, Région Bretagne, National French Society of Gastroenterology (SNFGE), ‘Ligue contre le cancer’, ‘IFR 140’, and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Male, Cancer Research, Chemokine, MESH : Liver Neoplasms, Hepatocellular carcinoma, MESH : Aged, MESH : Receptors, CXCR, CXCR4, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Chemokine receptor, Jurkat Cells, Mice, 0302 clinical medicine, MESH : Tumor Cells, Cultured, MESH: Liver Neoplasms, MESH: Jurkat Cells, Tumor Cells, Cultured, MESH : Female, MESH: Animals, MESH: Endothelial Cells, MESH: Carcinoma, Hepatocellular, MESH : Jurkat Cells, MESH: Organ Specificity, MESH: Aged, 0303 health sciences, MESH: Middle Aged, biology, Liver cell, Liver Neoplasms, MESH: Receptors, CXCR, MESH: Gene Expression Regulation, Neoplastic, Middle Aged, 3. Good health, Gene Expression Regulation, Neoplastic, Oncology, Liver, Organ Specificity, 030220 oncology & carcinogenesis, Disease Progression, MESH: Disease Progression, Female, Liver cancer, MESH : Carcinoma, Hepatocellular, Carcinoma, Hepatocellular, MESH : Gene Expression Regulation, Neoplastic, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Mice, Inbred C57BL, MESH : Organ Specificity, 03 medical and health sciences, MESH: Mice, Inbred C57BL, MESH : Mice, parasitic diseases, medicine, CXCL10, Animals, Humans, CXCL11, MESH : Middle Aged, MESH: Tumor Cells, Cultured, MESH: Mice, 030304 developmental biology, Aged, Receptors, CXCR, MESH: Humans, MESH : Endothelial Cells, MESH : Humans, Endothelial Cells, MESH : Disease Progression, medicine.disease, CXCR7, MESH: Male, Mice, Inbred C57BL, Hepatic stellate cell, biology.protein, Cancer research, MESH : Animals, MESH: Female
Abstract

International audience; Development of hepatocellular carcinoma (HCC) is a complex and progressive disease that involves cycles of liver cell death, inflammation, and tissue regeneration/remodelling. Chemokines and chemokine receptors play numerous and integral roles in the disease progression of HCC. Here we investigated the novel chemokine receptor CXCR7/RDC1 in HCC progression, its two known ligands CXCL12 and CXCL11, as well as the other CXCL12 receptor, CXCR4. Our results show that in a cohort of 408 human HCCs, CXCR7 and CXCL11 were significantly higher in tumours compared to normal liver controls (5- and 10-fold, respectively). Immunohistochemical (IHC) staining on human HCC sections confirmed that both CXCL11 and CXCR7 were much higher in cancer tissues. Furthermore, IHC staining revealed that CXCR7 protein was only expressed in endothelial cells whereas CXCL11 exhibited a much broader tissue expression. At the cellular level we observed that in vitro, human microvascular endothelial cells (HMEC-1) up-regulated CXCR7 under hypoxic and acidic pH conditions, which are well known characteristics of the HCC tumour micro-environment. As for its ligand, we observed that IFNγ robustly induced CXCL11 in hepatic stellate cells, hepatocytes, and HMEC-1s. In addition, in the mouse Diethylnitrosamine model of hepatocarcinogenesis we observed a very strong induction of CXCR7 and CXCL11 transcripts, confirming that CXCR7/CXCL11 up-regulation is conserved between human and mice liver cancer. Altogether, our results strongly support the hypothesis that the CXCL11/CXCR7 pathway is involved HCC progression.

Published
2011
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4. Hormonal replacement therapy may reduce the risk for RA in women with early arthritis who carry HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP: results from the ESPOIR cohort

Author

Maxime Dougados, Claire Bombardier, Bernard Combe, Alain Saraux, Carine Salliot, Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Institute for Work and Health (IWH), University of Toronto-St. Michael's Hospital-Institute of Medical Sciences, Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 ( UPD7 ), Institute for Work and Health ( IWH ), Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, Centre d'Investigation Clinique ( CIC - Brest ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de Génétique Moléculaire de Montpellier ( IGMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP]

Subjects
[SDV]Life Sciences [q-bio], Arthritis, Severity of Illness Index, Arthritis, Rheumatoid, 0302 clinical medicine, MESH : Peptides, Cyclic, immune system diseases, MESH: Autoantibodies, Immunology and Allergy, MESH : Female, skin and connective tissue diseases, HLA-DRB1, MESH: HLA-DRB1 Chains, MESH: Arthritis, Rheumatoid, 0303 health sciences, MESH : Estrogen Replacement Therapy, MESH: Middle Aged, Estrogen Replacement Therapy, MESH: Genetic Predisposition to Disease, MESH : Adult, Middle Aged, 3. Good health, Menopause, MESH: Young Adult, Transgender hormone therapy, Rheumatoid arthritis, Cohort, Disease Progression, MESH : Severity of Illness Index, MESH: Disease Progression, Female, musculoskeletal diseases, Adult, medicine.medical_specialty, Immunology, MESH : Young Adult, Peptides, Cyclic, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Young Adult, MESH : HLA-DR Antigens, Rheumatology, MESH : Autoantibodies, MESH: Severity of Illness Index, Internal medicine, medicine, Humans, MESH : Middle Aged, Genetic Predisposition to Disease, Risk factor, MESH: Peptides, Cyclic, 030304 developmental biology, Autoantibodies, MESH : HLA-DRB1 Chains, 030203 arthritis & rheumatology, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Humans, MESH: Adult, MESH : Disease Progression, HLA-DR Antigens, MESH: HLA-DR Antigens, medicine.disease, MESH: Estrogen Replacement Therapy, MESH : Arthritis, Rheumatoid, MESH : Genetic Predisposition to Disease, business, MESH: Female, HLA-DRB1 Chains
Abstract

International audience; OBJECTIVE: To assess the effect of reproductive factors, especially hormone replacement therapy (HRT) and its interaction with HLA-DRB1 *01 and/or *04 alleles on the diagnosis of rheumatoid arthritis (RA) and the presence of anti-cyclic citrullinated peptide (CCP) antibodies in women included in the ESPOIR cohort (early arthritis cohort). METHODS: 568 patients were included in the analyses, which were performed using logistic regression. RESULTS: HRT reduced the risk of RA due to the HLA-DRB1 *01 and/or *04 alleles from OR 1.88 (95% CI 1.32 to 2.68, p

Published
2009
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5. Inter- and intrapatients comparison of WHO grade II glioma kinetics before and after surgical resection

Author

Luc Bauchet, Luc Taillandier, Philippe Peruzzi, Johan Pallud, Jacques Guyotat, Denys Fontaine, Marie-Hélène Baron, Emmanuel Mandonnet, Valérie Bernier, Laurent Capelle, Hugues Duffau, Réseau d'Etude des Gliomes, REG, Laboratoire d'Imagerie Fonctionnelle (LIF), Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR14-IFR49-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurochirurgie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Neurochirurgie, Centre Hospitalier Universitaire de Nice (CHU Nice), Service de Neuro-Oncologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de neuro-radiologie, CHU Grenoble, Université de Reims Champagne-Ardenne (URCA), Service de neurochirurgie, Hospices Civils de Lyon (HCL), Centre Alexis Vautrin (CAV), Service de radiothérapie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire d'Imagerie Fonctionnelle ( LIF ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR14-IFR49-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], CHU Nice, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Université de Reims Champagne-Ardenne ( URCA ), Hospices Civils de Lyon ( HCL ), Centre Alexis Vautrin ( CAV ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO)

Subjects
Male, MESH : Oligodendroglioma, MESH : Retrospective Studies, Databases, Factual, MESH: Antineoplastic Agents, Alkylating, Neurosurgical Procedures, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Linear Models, MESH: Magnetic Resonance Imaging, MESH: Glioma, 0302 clinical medicine, MESH : Child, MESH : Linear Models, MESH: Child, Medicine, Statistical analysis, MESH : Female, 10. No inequality, Child, MESH: Middle Aged, MESH : Neoplasm Recurrence, Local, MESH: Kinetics, Brain Neoplasms, General Medicine, MESH: Follow-Up Studies, Glioma, MESH : Adult, MESH : Neurosurgical Procedures, Middle Aged, Magnetic Resonance Imaging, 3. Good health, Dacarbazine, MESH: Young Adult, 030220 oncology & carcinogenesis, MESH: Brain Neoplasms, Disease Progression, MESH: Disease Progression, Female, Neurosurgery, MESH : Kinetics, MESH: Neoplasm Recurrence, Local, Surgical resection, Adult, medicine.medical_specialty, Adolescent, MESH : Male, MESH : Antineoplastic Agents, Alkylating, Oligodendroglioma, MESH : Young Adult, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Databases, Factual, Astrocytoma, MESH: Dacarbazine, 03 medical and health sciences, Young Adult, MESH : Adolescent, MESH : Magnetic Resonance Imaging, Linear regression, Grade II Glioma, Temozolomide, Humans, MESH : Middle Aged, MESH : Brain Neoplasms, MESH : Dacarbazine, MESH: Oligodendroglioma, Antineoplastic Agents, Alkylating, Retrospective Studies, Mean diameter, MESH: Adolescent, MESH: Humans, business.industry, WHO Grade II Glioma, MESH : Humans, MESH : Follow-Up Studies, MESH : Astrocytoma, MESH: Adult, MESH: Neurosurgical Procedures, MESH: Retrospective Studies, MESH : Disease Progression, MESH: Databases, Factual, MESH: Male, Surgery, Kinetics, MESH: Astrocytoma, MESH : Glioma, Linear Models, National database, Neurology (clinical), Neoplasm Recurrence, Local, Nuclear medicine, business, MESH: Female, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

International audience; Grade II gliomas grow slowly and linearly (at rates about 4 mm/year) before undergoing anaplastic transformation. In order to analyze how surgery may affect radiological grade II glioma kinetics, we restrospectively reviewed our national database searching for patients operated on for a supratentorial grade II glioma between 1997 and 2007. We selected patients with at least two postoperative MRI with a minimal delay of 6 months. For each patient, postoperative residues were segmented on successive MRIs. Velocities of diameter expansion were estimated by linear regression of mean diameter evolution for each patient. Fifty-four patients fulfilled inclusion criteria. Median postoperative follow-up was 1.6 years with, on average, 3.4 MRI examinations per patient. Postoperative growth rates of mean diameter were normally distributed, around a mean value of 4.3 mm/year (SD = 3.2 mm/year). Statistical analysis showed no difference between this distribution and the distribution of preoperative growth rates in a previous series of 143 grade II gliomas. For a subset of 23 patients, delay between first MRI and surgery made it possible to estimate also preoperative growth rates. Intrapatient comparison revealed that growth rates were grossly unchanged for 80% of cases. In summary, inter- and intrapatient comparison of pre- and postoperative growth rates proves that surgery does not change grade II glioma dynamics, thus, acting as a cytoreduction.

Published
2009
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6. Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911

Author

Van der Kwast TH, Bolla M, Van Poppel H, Van Cangh P, Vekemans K, Da Pozzo L, Bosset JF, Kurth KH, Schröder FH, Collette L, and EORTC 22911, Van der Kwast, T, Bolla, M, Van Poppel, H, Van Cangh, P, Vekemans, K, Da Pozzo, L, Bosset, J, Kurth, K, Schröder, F, Collette, L, and EORTC, 2, 06 Operations Centre and intensive care, Département de cancérologie et radiothérapie, CHU Grenoble, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Pathology, and Urology

Subjects
Oncology, Male, Cancer Research, MESH: Combined Modality Therapy, medicine.medical_treatment, 030232 urology & nephrology, MESH : Aged, law.invention, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, Prostate cancer, 0302 clinical medicine, Randomized controlled trial, law, MESH: Risk Factors, Risk Factors, Medicine, Stage (cooking), MESH : Prostate-Specific Antigen, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, Prostatectomy, Hazard ratio, Middle Aged, MESH : Risk Factors, Combined Modality Therapy, 3. Good health, MESH: Prostate-Specific Antigen, Europe, Treatment Outcome, 030220 oncology & carcinogenesis, Disease Progression, MESH : Disease-Free Survival, MESH: Disease Progression, Positive Surgical Margin, MESH : Prostatic Neoplasms, medicine.medical_specialty, MESH : Prostatectomy, MESH : Male, MESH : Europe, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Disease-Free Survival, 03 medical and health sciences, MESH: Prostatectomy, SDG 3 - Good Health and Well-being, Internal medicine, Humans, MESH : Middle Aged, Aged, Proportional Hazards Models, MESH: Humans, business.industry, MESH : Humans, Cancer, Prostatic Neoplasms, MESH : Disease Progression, Prostate-Specific Antigen, medicine.disease, MESH : Proportional Hazards Models, MESH: Male, Surgery, Radiation therapy, MESH: Prostatic Neoplasms, MESH: Disease-Free Survival, MESH: Europe, business, MESH : Combined Modality Therapy, adjuvant radiotherapy, prostate cancer, survival, outcomes
Abstract

Purpose The randomized controlled European Organisation for Research and Treatment of Cancer (EORTC) trial 22911 studied the effect of radiotherapy after prostatectomy in patients with adverse risk factors. Review pathology data of specimens from participants in this trial were analyzed to identify which factors predict increased benefit from adjuvant radiotherapy. Patients and Methods After prostatectomy, 1,005 patients with stage pT3 and/or positive surgical margins were randomly assigned to a wait-and-see (n = 503) and an adjuvant radiotherapy (60 Gy conventional irradiation) arm (n = 502). Pathologic review data were available for 552 patients from 11 participating centers. The interaction between the review pathology characteristics and treatment benefit was assessed by log-rank test for heterogeneity (P < .05). Results Margin status assessed by review pathology was the strongest predictor of prolonged biochemical disease-free survival with immediate postoperative radiotherapy (heterogeneity, P < .01): by year 5, immediate postoperative irradiation could prevent 291 events/1,000 patients with positive margins versus 88 events/1,000 patients with negative margins. The hazard ratio for immediate irradiation was 0.38 (95% CI, 0.26 to 0.54) and 0.88 (95% CI, 0.53 to 1.46) in the groups with positive and negative margins, respectively. We could not identify a significant impact of the positive margin localization. Conclusion Provided careful pathology of the prostatectomy is performed, our results suggest that immediate postoperative radiotherapy might not be recommended for prostate cancer patients with negative surgical margins. These findings require validation on an independent data set.

Published
2007
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7. N-cadherin as a novel prognostic marker of progression in superficial urothelial tumors

Author

Sylvie Fauconnet, Hugues Bittard, Stéphane Bernardini, Bernadette Kantelip, Hervé Wallerand, Anne Clairotte, Isabelle Lascombe, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Service de Néphrologie et Urologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Laboratoire d'anatomie pathologique [Besancon], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz-Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Service d'Anatomie pathologique [CHRU Besançon], and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)

Subjects
Cancer Research, Pathology, MESH : Aged, urologic and male genital diseases, Polymerase Chain Reaction, MESH: Cadherins, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Aged, 80 and over, 0302 clinical medicine, MESH : Tumor Markers, Biological, Gene expression, MESH : Neoplasm Staging, MESH : Polymerase Chain Reaction, MESH: Aged, Aged, 80 and over, 0303 health sciences, MESH: Middle Aged, MESH : Prognosis, MESH: Gene Expression Regulation, Neoplastic, MESH: Neoplasm Staging, MESH : Adult, Middle Aged, Cadherins, Prognosis, female genital diseases and pregnancy complications, MESH: Urinary Bladder Neoplasms, 3. Good health, MESH: Reproducibility of Results, Gene Expression Regulation, Neoplastic, Oncology, MESH : Urinary Bladder Neoplasms, 030220 oncology & carcinogenesis, Disease Progression, Immunohistochemistry, MESH: Disease Progression, MESH : Cadherins, Adult, medicine.medical_specialty, MESH : Gene Expression Regulation, Neoplastic, [SDV.CAN]Life Sciences [q-bio]/Cancer, Biology, MESH: Prognosis, 03 medical and health sciences, Carcinoma, medicine, Biomarkers, Tumor, Humans, MESH : Middle Aged, Urothelium, MESH : Aged, 80 and over, 030304 developmental biology, Aged, Neoplasm Staging, Messenger RNA, MESH: Humans, Bladder cancer, Cadherin, MESH : Reproducibility of Results, MESH : Humans, Reproducibility of Results, MESH: Adult, MESH: Polymerase Chain Reaction, MESH : Disease Progression, medicine.disease, Urinary Bladder Neoplasms, Tumor progression, MESH: Tumor Markers, Biological
Abstract

Purpose: Loss of intercellular adhesion and increased cell motility promote tumor cell invasion and spreading. In bladder cancer, loss or reduced E-cadherin expression has been associated with poor survival, and aberrant expression of N-cadherin has been associated with the invasive phenotype of bladder carcinoma cells. The purpose of this study was to investigate whether N-cadherin expression was associated with the bladder tumor progression. Experimental Design: E-cadherin and N-cadherin expression was evaluated by immunohistochemistry in 101 tumors (pT1 and pT2-T3) and by reverse transcription-PCR analysis and immunohistochemistry in 28 other fresh frozen tumors (pTa, pT1, and pT2-T3). Results: N-cadherin expression was absent in normal urothelium, appeared in stage pT1, and increased in pT2-pT3 tumors. In most cases, increased N-cadherin expression in invasive tumors was associated with loss of E-cadherin expression. Progression-free survival and multivariate analyses revealed that N-cadherin expression is an independent prognostic marker for pT1 tumor progression. Analysis of the 28 frozen tumors by immunohistochemistry and reverse transcription-PCR showed a good correlation between protein and gene expression in pT1 and pT2-T3 tumors. Interestingly, in pTa tumors, N-cadherin was not immunodetected, whereas mRNA was present in 50% of cases. Conclusion: Regulatory defects in the N-cadherin promoter, abnormalities at the translational, or protein processing levels could explain the discrepancies between protein and mRNA expression. Most importantly, this study identified N-cadherin as a novel prognostic marker of progression in superficial urothelial tumors. Clearly, N-cadherin acts in an invasive mode in bladder cancer, but whether it has a primary role in urothelial neoplastic progression has yet to be investigated.

Published
2006
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8. Effects of blood pressure lowering on cerebral white matter hyperintensities in patients with stroke: the PROGRESS (Perindopril Protection Against Recurrent Stroke Study) Magnetic Resonance Imaging Substudy. : The PROGRESS MRI Substudy

Author

Nathalie Tzourio-Mazoyer, John Chalmers, Stephen MacMahon, Bruce Neal, Veronique Besancon, Carole Dufouil, Christophe Tzourio, Pierre Guillon, Bernard Mazoyer, Marie-Germaine Bousser, Oghuzham Coskun, Mark Woodward, Neuroépidémiologie, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), The George Institute for International Health, The University of Sydney [Sydney], Groupe d'imagerie neuro-fonctionnelle ( GIN - UMR 6194 ), Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Centre National de la Recherche Scientifique ( CNRS ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), Service de neurologie [Univ. Paris VII], and Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 ( UPD7 )

Subjects
Male, Cerebrovascular disorders, MESH : Recurrence, MESH : Aged, Hemodynamics, Blood Pressure, 030204 cardiovascular system & hematology, MESH : Antihypertensive Agents, 0302 clinical medicine, Perindopril, Secondary Prevention, Multicenter Studies as Topic, MESH : Female, Stroke, Randomized Controlled Trials as Topic, Trials, Indapamide, Brain, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, Magnetic Resonance Imaging, MESH : Perindopril, 3. Good health, Treatment Outcome, Hypertension, Cardiology, Disease Progression, Female, Cardiology and Cardiovascular Medicine, medicine.drug, medicine.medical_specialty, MESH : Male, MESH : Treatment Outcome, Placebo, 03 medical and health sciences, Physiology (medical), Internal medicine, MESH : Magnetic Resonance Imaging, medicine, MESH : Blood Pressure, Humans, MESH : Middle Aged, MESH : Multicenter Studies, Antihypertensive Agents, Aged, Vascular disease, business.industry, MESH : Humans, MESH : Disease Progression, medicine.disease, Hyperintensity, Surgery, Blood pressure, MESH : Brain, [ SDV.NEU ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], MESH : Randomized Controlled Trials, business, MESH : Cerebrovascular Accident, 030217 neurology & neurosurgery
Abstract

Background— The prevalence of white matter hyperintensities (WMHs) detected on cerebral MRI is associated with hypertension, but it is not known whether blood pressure lowering can arrest their progression. We report here the results of an MRI substudy of PROGRESS (Perindopril Protection Against Recurrent Stroke Study), a randomized trial of blood pressure lowering in subjects with cerebrovascular disease. Methods and Results— The substudy comprised 192 participants who had a cerebral MRI both at baseline and after a mean follow-up time of 36 months (SD=6.0 months). At the first MRI, WMHs were graded with a visual rating scale from A (no WMH) to D (severe WMH). Participants were assigned to a combination of perindopril plus indapamide (or their placebos; 58%) or to single therapy with perindopril (or placebo). At the time of the second MRI, the blood pressure reduction in the active arm compared with the placebo arm was 11.2 mm Hg for systolic blood pressure and 4.3 mm Hg for diastolic blood pressure. Twenty-four subjects (12.5%) developed new WMHs at follow-up. The risk of new WMH was reduced by 43% (95% CI −7% to 89%) in the active treatment group compared with the placebo group ( P =0.17). The mean total volume of new WMHs was significantly reduced in the active treatment group (0.4 mm 3 [SE=0.8]) compared with the placebo group (2.0 mm 3 [SE=0.7]; P =0.012). This difference was greatest for patients with severe WMH at entry, 0.0 mm 3 (SE=0) in the active treatment group versus 7.6 mm 3 (SE=1.0) in the placebo group ( P Conclusions— These results indicate that an active blood pressure–lowering regimen stopped or delayed the progression of WMHs in patients with cerebrovascular disease.

Published
2005
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