17 results on '"Bourdin, Arnaud"'
Search Results
2. Artificial intelligence to differentiate asthma from COPD in medico-administrative databases
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Joumaa, Hassan, Sigogne, Raphaël, Maravic, Milka, Perray, Lucas, Bourdin, Arnaud, and Roche, Nicolas
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- 2022
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3. Altered skeletal muscle function and beneficial effects of exercise training in a rat model of induced pulmonary emphysema.
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Passerieux, Emilie, Desplanche, Elodie, Alburquerque, Laurie, Wynands, Quentin, Bellanger, Axel, Virsolvy, Anne, Gouzi, Farés, Cazorla, Olivier, Bourdin, Arnaud, Hayot, Maurice, and Pomiès, Pascal
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LABORATORY rats ,PULMONARY emphysema ,EXERCISE therapy ,SKELETAL muscle ,ANIMAL disease models - Abstract
Aim: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction and development of emphysema. Among the comorbidities associated with COPD, skeletal muscle dysfunction is known to affect exercise capacity and the survival rate of patients. Pulmonary rehabilitation (PR), via exercise training, is essential for COPD patients. However, the response to PR is most often moderate. An animal model that recapitulates critical features of chronic human disease and provides access to muscle function should therefore be useful to improve PR benefits. Methods: We used a rat model of induced emphysema based on pulmonary instillations of elastase (ELA) and lipopolysaccharides (LPS). We assessed the long‐term effects of ELA/LPS and the potential effectiveness of endurance training on the skeletal muscle function. In vivo strength of the animals, and ex vivo contractility, endurance, type 1 fiber proportion, fiber cross‐sectional area, and capillarization of both soleus and extensor digitorum longus (EDL) were assessed. Results: An impaired overall muscle strength with decreased force, reduced capillarization, and atrophy of type 1 fiber of EDL was observed in ELA/LPS rats. Soleus was not affected. Endurance training was able to reduce fatigability, and increase type 1 fiber proportion and capillarization of soleus, and improve force, endurance, and capillarization of EDL in control and ELA/LPS rats. Conclusion: Our rat model of induced emphysema, which shares some features with the phenotype present in patients with COPD, could represent a suitable model to study skeletal muscle dysfunction and the effects of exercise training on muscle function in patients. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Association between increased mortality and bronchial fibroscopy in intensive care units and intermediate care units during COPD exacerbations: an analysis of the 2014 and 2015 National French Medical-based Information System Databases (PMSI)
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Amalric, Matthieu, Ahmed, Engi, Jung, Boris, Suehs, Carey, Molinari, Nicolas, Bourdin, Arnaud, and Charriot, Jeremy
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- 2021
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5. The eo-Delphi protocol
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Suehs, Carey, Molinari, Nicolas, Vachier, Isabelle, and Bourdin, Arnaud
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modified delphi process ,COPD ,eo-Delphi ,eosinophils ,protocol ,delphi process ,corticosteroids - Published
- 2022
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6. eo-Drive
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Bourdin, Arnaud, Suehs, Carey, Vachier, Isabelle, Molinari, Nicolas, Chanez, Pascal, Roche, Nicolas, Burgel, Pierre-Régis, Chinet, Thierry, Demoule, Alexandre, Similowski, Thomas, Morelot, Capucine, Londner, Cecile, Chenivesse, Cecile, Le Rouzic, Olivier, Bautin, Nathalie, Perez, Thierry, Raherison, Chantal, Molimard, Mathieu, Berger, Patrick, Girodet, Pierre, Yali, Matthieu, Devouassoux, Gilles, Didier, Alain, Noel-Savina, Elise, Couturaud, Francis, DESLEE, Chabaud, François, Chaouat, Ari, Guillaumot, Anne, Zysman, Maeva, Devillier, Philippe, Kessler, Romain, Just, Nicolas, Gamez, Anne-Sophie, and Boyer, Laurent
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exacerbation ,biomarker driven ,COPD ,eosinophilia ,corticosteroids ,hospitalization - Published
- 2022
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7. Sputum-Rheology-Based Strategy for Guiding Azithromycin Prescription in COPD Patients with Frequent Exacerbations: A Randomized, Controlled Study ("COPD CARhE").
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Charriot, Jeremy, Zysman, Maeva, Guilleminault, Laurent, Volpato, Mathilde, Fort-Petit, Aurelie, Vachier, Isabelle, Patarin, Jeremy, Suehs, Carey, Ahmed, Engi, Molinari, Nicolas, and Bourdin, Arnaud
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CHRONIC obstructive pulmonary disease ,AZITHROMYCIN ,DISEASE exacerbation ,LUNG diseases ,MEDICAL prescriptions ,PULMONARY eosinophilia - Abstract
(1) Background: We have previously shown that sputum rheology can discriminate between patients with COPD and other muco-obstructive lung diseases, and that it is correlated with mucin content and sputum eosinophilia. We now hypothesize that it could be a more-accurate guide than clinical evaluation for the prescription of azithromycin to prevent exacerbations of COPD and to reduce exposure to antibiotics; (2) Methods: "COPD CaRhe" is a multicentric, randomized, controlled trial comparing outcomes in two parallel arms (36 vs. 36 patients). Patients will be recruited in the university hospitals of Montpellier, Bordeaux, and Toulouse, in France, and they should have a diagnosis of COPD with frequent exacerbations (≥3/year). Enrollment will occur during a routine visit to a respiratory department, and follow-up visits will occur every 3 months for a period of 1 year. At each visit, a 3-month prescription of azithromycin will be provided to those patients who obtain a score of <70 on the Cough and Sputum Assessment Questionnaire (CASA-Q) or a critical stress score of σc > 39 on a rheological assessment of sputum, depending upon their randomization group. The primary outcome will be the number of exacerbations of COPD; (3) Discussion: By using sputum rheology, the COPD CaRhe study may provide clinicians with an objective biomarker to guide the prescription of azithromycin while reducing the cumulative exposure to macrolides. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Artificial intelligence to differentiate asthma from COPD in medico-administrative databases
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Joumaa, Hassan, Sigogne, Raphael, Maravic, Milka, Perray, Lucas, Bourdin, Arnaud, Roche, Nicolas, MORNET, Dominique, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), IQVIA, Hôpital Lariboisière-Fernand-Widal [APHP], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Mucoviscidose et bronchopathies chroniques : biopathologie et phénotypes cliniques (EA 2511), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)
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[SDV.IB] Life Sciences [q-bio]/Bioengineering ,[INFO.INFO-AI] Computer Science [cs]/Artificial Intelligence [cs.AI] ,Pulmonary and Respiratory Medicine ,Male ,Databases, Factual ,Epidemiology ,Healthcare administrative databases ,Chronic obstructive pulmonary disease ,[INFO.INFO-IA]Computer Science [cs]/Computer Aided Engineering ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,[INFO.INFO-IA] Computer Science [cs]/Computer Aided Engineering ,Asthma ,Prevalence ,COPD ,Algorithms ,ICD code ,[INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI] ,Pulmonary Disease, Chronic Obstructive ,Artificial Intelligence ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Humans ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology - Abstract
Introduction Discriminating asthma from chronic obstructive pulmonary disease (COPD) using medico-administrative databases is challenging but necessary for medico-economic analyses focusing on respiratory diseases. Artificial intelligence (AI) may improve dedicated algorithms. Objectives To assess performance of different AI-based approaches to distinguish asthmatics from COPD patients in medico-administrative databases where the clinical diagnosis is absent. An “Asthma COPD Overlap” category was defined to further test whether AI can detect complexity. Methods This study included 178,962 patients treated by two “R03” treatment prescriptions at least from January 2016 to December 2018 and managed by either a general practitioner and/or a pulmonologist participating in a permanent longitudinal observatory of prescription in ambulatory medicine (LPD). Clinical diagnoses are available in this database and were used as gold standards to develop diagnostic rules. Three types of AI approaches were explored using data restricted to demographics and treatment dispensations: multinomial regression, gradient boosting and recurrent neural networks (RNN). The best performing model (based on metric properties) was then applied to estimate the size of asthma and COPD populations based on a database (LRx) of treatment dispensations between July, 2018 and June, 2019. Results The best models were obtained with the boosting approach and RNN, with an overall accuracy of 68%. Performance metrics were better for asthma than COPD. Based on LRx data, the extrapolated numbers of patients treated for asthma and COPD in France were 3.7 and 1.2 million, respectively. Asthma patients were younger than COPD patients (mean, 49.9 vs. 72.1 years); COPD occurred mostly in men (68%) compared to asthma (33%). Conclusion AI can provide models with acceptable accuracy to distinguish between asthma, ACO and COPD in medico-administrative databases where the clinical diagnosis is absent. Deep learning and machine learning (RNN) had similar performances in this regard.
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- 2021
9. Rhéologie du mucus à partir d'un modèle d'épithélium bronchique Humain
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JORY, Myriam, Blanc, Christophe, Fort, Aurélie, DONNARUMMA, Dario, CASANELLAS VILAGELIU, Laura, Vachier, Isabelle, Bourdin, Arnaud, MASSIERA, Gladys, Laboratoire Charles Coulomb (L2C), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Matière Molle, Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service d'allergologie et de pneumologie [Hôpital Arnaud de Villeneuve], Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Vaincre la Mucoviscidose, and Projet de thèse: 'Approche biophysique de la fonction mucociliaire: rhéologie du mucus et coordination ciliaireCollaboration avec le CHU de Montpellier
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Mucus ,Human bronchial epithelium ,Optical Tweezers ,[PHYS.PHYS.PHYS-BIO-PH]Physics [physics]/Physics [physics]/Biological Physics [physics.bio-ph] ,Micro rheology ,Adhesion ,COPD ,Macro Rheology - Abstract
National audience; La fonction mucociliaire de l'épithélium bronchique assure le nettoyage continu des voies respiratoires afin d’éviter toutes infections et inflammations par les éléments présents dans l’air que nous respirons. L'efficacité de la clairance mucociliaire repose sur deux éléments principaux : les propriétés rhéologiques du mucus et la coordination du battement ciliaire. Dans cette communication, nous décrirons spécifiquement nos résultats sur la rhéologie du mucus. Notre approche biophysique vise à comprendre les paramètres biochimiques et physiques affectant les propriétés viscoélastiques du mucus et à évaluer l 'utilisation des propriétés viscoélastiques du mucus comme marqueur du diagnostic de maladie respiratoire (BPCO, maladie pulmonaire obstructive chronique ...).Des études sur la rhéologie du mucus ont déjà été réalisées, mais essentiellement sur le crachat ou le mucus reconstitué. Nous avons effectué des expériences rhéologiques sur le mucus extrait des cultures ALI (Air Liquid Interface) de l'épithélium bronchique reconstitué à partir d'une biopsie bronchique. Notre approche consiste à combiner une expérience de macro-rhéologie standard et une micro-rhéologie réalisée avec des pinces optiques afin de quantifier les propriétés viscoélastiques du mucus et de comprendre son comportement d'écoulement à différentes échelles, de l'échelle des cils jusqu'à l'échelle de longueur sur laquelle le mucus est transporté.Nos résultats montrent le comportement d'amincissement par cisaillement et la nature élastique du mucus avec un petit module élastique G 'compris entre 1 et 2 Pa. On observe également la rupture du gel de mucus à très faible taux de cisaillement et même pour la déformation oscillatoire réalisée À des fréquences inférieures à la fréquence de battement des cils (~ 15 Hz), probablement en raison de la structure complexe et hétérogène du mucus. Néanmoins, la structure du mucus et les propriétés viscoélastiques sont récupérées en 5 minutes. La macro et la micro-rhéologie indiquent deux comportements différents : on observe un plateau élastique à la macro-échelle et un comportement visqueux à la micro-échelle, avec une viscoélasticité très faible de l'ordre de 10-3 à 10-2 Pa et proportionnelle À la fréquence de ω0,9 dans la même plage de fréquence. En appliquant des forces locales grâce à des pinces optiques, comme le montre la figure 1, nous montrons que l'adhérence du mucus est impliquée et doit être prise en compte pour comprendre les différences entre les propriétés mécaniques mesurées à ces différentes échelles de longueur et plus généralement pour caractériser les propriétés du mucus.Cette approche biophysique et méthodologie spécifique nous permet de comparer des échantillons correspondant à différentes pathologies du patient et pourrait être appliquée avec succès à l'hypersécrétion de mucus de patients atteints de fibrose kystique. Ce travail s'inscrit dans le cadre d'un projet de plus grande envergure impliquant une étude de physique statistique sur la coordination des cils et son couplage avec la viscoélasticité du mucus.
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- 2017
10. Rising total costs and mortality rates associated with admissions due to COPD exacerbations
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Molinari , Nicolas, Chanez , Pascal, Roche , Nicolas, Ahmed , Engi, Vachier , Arnaud, Bourdin , Arnaud, Vachier , Isabelle, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie et Soins Intensifs Respiratoires, Université Paris Descartes - Paris 5 (UPD5)-Hôpitaux Universitaires Paris Centre, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), 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 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Hôpitaux Universitaires Paris Centre, CHU Saint-Eloi-Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, MORNET, Dominique, and Centre recherche en CardioVasculaire et Nutrition (C2VN)
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Male ,Time Factors ,Databases, Factual ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Severity of Illness Index ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Patient Admission ,Risk Factors ,030212 general & internal medicine ,Hospital Mortality ,Longitudinal Studies ,Registries ,Hospital Costs ,health care economics and organizations ,ComputingMilieux_MISCELLANEOUS ,Aged, 80 and over ,COPD ,Mortality rate ,Incidence (epidemiology) ,Incidence ,Process Assessment, Health Care ,Middle Aged ,3. Good health ,[SDV] Life Sciences [q-bio] ,Treatment Outcome ,Disease Progression ,Female ,France ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Critical Care ,education ,macromolecular substances ,Bronchoscopies ,03 medical and health sciences ,COPD exacerbation ,Severity of illness ,medicine ,Humans ,Intensive care medicine ,Admissions ,Aged ,Mechanical ventilation ,Hospitalizations ,[ SDV ] Life Sciences [q-bio] ,business.industry ,Research ,COPD management ,Length of Stay ,medicine.disease ,Respiration, Artificial ,respiratory tract diseases ,Pneumonia ,030228 respiratory system ,Copd exacerbation ,Deaths ,Emergency medicine ,business - Abstract
Background To examine trends in mortality, costs and in-hospital management and outcomes of severe COPD exacerbations admitted in France. Methods Patients hospitalized from 2007 to 2012 with COPD exacerbation as the primary diagnosis were identified from the exhaustive French medico-administrative hospitalizations database records. Four groups of severe COPD exacerbations were defined: hospitalisation in a general ward (GW) without acute respiratory failure (ARF), GW with ARF, ICU without invasive mechanical ventilation (MV), and ICU with MV. Results A 15.48 % increase in admissions from 113 276 in 2007 to 133 497 in 2012 was recorded. Age (+9.9 months), gender (−2.5 % of male) and length of stay (−0.29 day) slightly changed while the number of ICU admissions increased markedly (+41.78 %). In-hospital mortality rates increased (+8.06 %, p
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- 2016
11. CCSP G38A polymorphism environment interactions regulate CCSP levels differentially in COPD.
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Knabe, Lucie, Varilh, Jessica, Bergougnoux, Anne, Gamez, Anne-Sophie, Bonini, Jennifer, Pommier, Alexandra, Petit, Aurélie, Molinari, Nicolas, Vachier, Isabelle, Taulan-Cadars, Magali, and Bourdin, Arnaud
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GENETIC polymorphisms ,OBSTRUCTIVE lung diseases ,TRANSCRIPTION factors ,CIGARETTE smoke ,BODY mass index ,GENE transfection ,DYSPNEA - Abstract
Impaired airway homeostasis in chronic obstructive pulmonary disease (COPD) could be partly related to club cell secretory protein (CCSP) deficiency. We hypothesize that CCSP G38A polymorphism is involved and aim to examine the influence of the CCSP G38A polymorphism on CCSP transcription levels and its regulatory mechanisms. CCSP genotype and CCSP levels in serum and sputum were assessed in 66 subjects with stable COPD included in a 1-yr observational study. Forty-nine of them had an exacerbation. In an in vitro study, the impact on the CCSP promoter of 38G wild-type or 38A variant was assessed. BEAS-2B cells were transfected by either the 38G or 38A construct, in the presence/absence of cigarette smoke extract (CSE) or lipopolysaccharides (LPS). Cotransfections with modulating transcription factors, p53 and Nkx2.1, identified by in silico analysis by using ConSite and TFSEARCH were conducted. A allele carrier COPD patients had lower serum and sputum CCSP levels, especially among active smokers, and a decreased body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) score. In vitro, baseline CCSP transcription levels were similar between the wild and variant constructs. CSE decreased more profoundly the CCSP transcription level of 38A transfected cells. The opposite effect was observed with p53 cotransfection. LPS stimulation induced CCSP repression in 38A promoter transfected cells. Cotransfection with Nkx2.1 significantly activated the CCSP promoters irrespective of the polymorphism. Circulating CCSP levels are associated with smoking and the CCSP G38A polymorphism. CSE, LPS, and the Nkx2.1 and p53 transcription factors modulated the CCSP promoter efficiency. The 38A polymorphism exaggerated the CCSP repression in response to p53 and CSE. [ABSTRACT FROM AUTHOR]
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- 2016
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12. Is generalization of exhaled CO assessment in primary care helpful for early diagnosis of COPD?
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Molinari, Nicolas, Abou-Badra, Mathieu, Marin, Grégory, Chin-Long Ky, Amador, Noemi, Gamez, Anne Sophie, Vachier, Isabelle, and Bourdin, Arnaud
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OBSTRUCTIVE lung disease diagnosis ,PRIMARY care ,SPIROMETRY ,CARBON monoxide ,DISEASE risk factors - Abstract
Background: COPD is largely under-diagnosed and once diagnosed usually at a late stage. Early diagnosis is thoroughly recommended but most attempts failed as the disease is marginally known and screening marginally accepted. It is a rare cause of concern in primary care and spirometry is not very common. Exhaled carbon monoxide (eCO) is a 5-seconds easy-to-use device dedicated to monitor cigarette smoke consumption. We aimed to assess whether systematic eCO measurement in primary care is a useful tool to improve acceptance for early COPD diagnosis. Methods: This was a two-center randomized controlled trial enrolling 410 patients between March and May, 2013. Whatever was the reason of attendance to the clinic, all adults were proposed to measure eCO during randomly chosen days and outcomes were compared between the two different groups of patients (performing and not performing eCO). Primary outcome was the rates of acceptance for COPD screening. Results: Rate of acceptance for COPD screening was 28% in the eCO group and 26% in the other (P = 0.575). These rates increased to 48 and 51% in smokers (current and former). eCO significantly increased the rate of clinics during which a debate on smoking was initiated (42 vs. 24%, P = 0.001). eCO at 2.5 ppm was the discriminative concentration for identifying active smokers (ROC curve AUC: 0.935). Smoking was the only independent risk factor associated with acceptance for early COPD screening (OR = 364.6 (82.5-901.5) and OR = 78.5 (18.7-330.0) in current and former smokers, respectively) while eCO measurement was not. Conclusions: Early COPD diagnosis is a minor cause of concern in primary care. Systematic eCO assessment failed to improve acceptance for early COPD screening. [ABSTRACT FROM AUTHOR]
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- 2015
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13. Roles of Mesenchymal Cells in the Lung: From Lung Development to Chronic Obstructive Pulmonary Disease.
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Nasri, Amel, Foisset, Florent, Ahmed, Engi, Lahmar, Zakaria, Vachier, Isabelle, Jorgensen, Christian, Assou, Said, Bourdin, Arnaud, and De Vos, John
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CHRONIC obstructive pulmonary disease ,LUNG development ,LUNG diseases - Abstract
Mesenchymal cells are an essential cell type because of their role in tissue support, their multilineage differentiation capacities and their potential clinical applications. They play a crucial role during lung development by interacting with airway epithelium, and also during lung regeneration and remodeling after injury. However, much less is known about their function in lung disease. In this review, we discuss the origins of mesenchymal cells during lung development, their crosstalk with the epithelium, and their role in lung diseases, particularly in chronic obstructive pulmonary disease. [ABSTRACT FROM AUTHOR]
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- 2021
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14. Specificity of basement membrane thickening in severe asthma.
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Bourdin, Arnaud, Neveu, Dorine, Vachier, Isabelle, Paganin, Fabrice, Godard, Philippe, and Chanez, Pascal
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ASTHMA ,OBSTRUCTIVE lung diseases ,ADRENOCORTICAL hormones ,RESPIRATORY obstructions - Abstract
Background: Reticular basement membrane (RBM) thickness is considered a hallmark for airway remodeling in airway diseases such as asthma. It is still unclear whether this measurement could be associated with disease severity or apply to chronic obstructive pulmonary disease (COPD). A wide range of results, at baseline or after therapeutic intervention, have been reported using different measurement methods. Objective: To determine whether increased RBM thickness could be associated specifically with severe asthma and in COPD in large samples. Methods: We blindly measured RBM thickness in endobronchial biopsies from 50 patients with severe asthma (mean age, 53 years; FEV
1 66% predicted, inhaled steroids ≥1500 μg and 20 mg daily dose of oral corticosteroids, lifelong nonsmokers), 50 untreated patients with mild asthma (mean age, 33 years; FEV1 93%pred, lifelong nonsmokers), 50 patients with COPD (mean age, 57 years; FEV1 53%pred, all current smokers), and 18 control subjects using 2 different validated quantitative and computer-assisted methods (repeated multiple point-to-point vs area by length ratio). Results: Reticular basement membrane thickness was higher in severe asthma compared with mild asthma and COPD (P = .0053). On the basis of receiver operating characteristic curves, RBM thickness was effective in differentiating severe asthma from other groups (sensitivity and specificity, 98% and 95%, respectively, above a threshold of 5 μm vs control, 70% and 75% at 7 μm vs mild, 83% and 68% at 6 μm vs COPD). Conclusion: Increased RBM thickness was specifically associated with severe asthma, whereas surprisingly, COPD and mild asthma had similar remodeling features. Clinical implications: Reticular basement membrane thickness can be considered a hallmark of severe asthma. [Copyright &y& Elsevier]- Published
- 2007
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15. Rheology predicts sputum eosinophilia in patients with muco-obstructive lung diseases.
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Volpato, Mathilde, Vialaret, Jerome, Hirtz, Christophe, Petit, Aurélie, Suehs, Carey, Patarin, Jérémy, Matzner-Lober, Eric, Vachier, Isabelle, Molinari, Nicolas, Bourdin, Arnaud, and Charriot, Jeremy
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EOSINOPHILIA , *MUCOCILIARY system , *LUNGS , *LUNG diseases , *NUCLEIC acid amplification techniques , *SPUTUM , *RHEOLOGY - Abstract
Mucus is known to play a pathogenic role in muco-obstructive lung diseases, but little is known about the determinants of mucus rheology. The purpose of this study is to determine which sputum components influence sputum rheology in patients with muco-obstructive lung diseases. We performed a cross sectional prospective cohort study. Spontaneous sputum was collected from consecutive patients with muco-obstructive lung diseases. Sputum rheology was assessed using the Rheomuco® rheometer (Rheonova, Grenoble); the elastic modulus G′, viscous modulus G″, and the critical stress threshold σc were recorded. Key quantitative and qualitative biological sputum components were determined by cytology, nucleic acid amplification tests and mass spectrometry. 48 patients were included from January to August 2019. Among them, 10 had asthma, 14 COPD and 24 non-CF bronchiectasis (NCFB). The critical stress threshold σc predicted a sputum eosinophilia superior to 1.25% with 89.19% accuracy (AUC = 0.8762). G′ and G″ are positively correlated with MUC5AC protein concentration ((rho = 0.361; P =.013) and (rho = 0.335; P =.021), respectively). σc was positively correlated with sputum eosinophilia (rho = 0.394; P =.012), MUC5B (rho = 0.552; P <.001) and total protein (rho = 0.490; P <.001) concentrations. G′ and G″ were significantly higher in asthma patients (G' = 14.49[7.18–25.26]Pa, G'' = 3.0[2.16–5.38]Pa) compared to COPD (G' = 5.01[2.94–6.48]Pa, P =.010; G'' = 1.45[1.16–1.94]Pa, P =.006) and to NCFB (G' = 4.99[1.49–10.49]Pa, P =.003; G" = 1.46[0.71–2.47]Pa, P =.002). In muco-obstructive lung diseases, rheology predicts sputum eosinophilia and is correlated with mucin concentrations, regardless of the underlying disease. (registrar, website, and registration number), where applicable NCT04081740. • Sputum rheology is correlated with mucin content and eosinophils. • Critical stress threshold predicts sputum eosinophilia >1.25% regardless of the underlying disease. • Rheology-based diagnosis and therapeutic strategies can now be tested. [ABSTRACT FROM AUTHOR]
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- 2022
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16. Apport de l’imagerie TDM et IRM quantitative à l’étude des modifications structurales et fonctionnelles respiratoires dans les maladies obstructives chroniques des voies aériennes chez l’homme
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Benlala, Ilyes, STAR, ABES, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux, François Laurent, Gaël Dournes, Laurent, François, Dournes, Gaël, Ferretti, Gilbert, Bourdin, Arnaud, Padovani, Bernard, and Bordenave, Laurence
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[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Remodelage ,Asthme ,Bronche ,Remodeling ,Asthma ,Cystic fibrosis ,Bronchus ,TDM ,Quantification automatique ,Poumon ,Automatic quantification ,BPCO ,COPD ,Mucoviscidose ,Lung ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,CT ,MRI ,IRM - Abstract
Chronic obstructive airway diseases are a major public health problem, characterized by chronic inflammation and airways remodeling. Imaging of the structural elements of the lungs (bronchi, bronchioles, vessels...) is essential for defining, phenotyping and following-up these diseases. Visual assessment is prone to inter-observer variability that affects its reliability. Therefore, the development of reliable and reproducible new quantitative methods is necessary. CT and MRI are the two complete imaging methods of the various structural and functional compartments of the lung. This work focused on the development and the validation of quantitative methods using CT and MRI of the lung.Using quantitative CT, we have shown that measurements of bronchial and vascular remodeling in patients with severe pulmonary hypertension (PH), a particular phenotype in COPD patients, contributed to highlight interactions between the cardiovascular and respiratory systems. We have developed a method for small airway disease quantification, tested in a chronic hypersensitivity pneumonitis cohort, that may contribute to evaluate and monitor chronic obstructive airway diseases.Using quantitative MRI, we have developed a fully automated quantification technique to assess the severity of emphysema extent in COPD patients. In addition, transposing bronchial measurement methods from CT to MRI has become possible thanks to the new ultra short echo time (UTE) sequences. Thus, the quantification of bronchial remodeling at 3DUTE MRI in patients with cystic fibrosis, for whom it is necessary to reduce exposure to ionizing radiation, has shown morphological information similar to that of CT. We have also shown that automatic quantification of destructive and inflammatory phenomena by 3DUTE MRI in cystic fibrosis is a reliable and reproducible method for assessing the severity of structural alterations. Furthermore, the feasibility of an automatic quantification of T2 high signal intensity on MRI has been demonstrated and its relevance as a specific biomarker for inflammatory airway disease has been assessed.Thus, the quantitative analysis, in both CT and MRI, of various structural and functional modifications in chronic obstructive airway diseases could be a reliable method in the follow-up and the evaluation of the response to treatment in these diseases., Les maladies bronchiques obstructives chroniques constituent un problème majeur de santé publique. Leur pathogénie est caractérisée par l’inflammation chronique et le remodelage des voies aériennes. L’étude en imagerie des différents éléments structuraux des poumons (bronches, bronchioles, vaisseaux…) est primordiale dans la définition, le phénotypage, la compréhension des mécanismes obstructifs et le suivi de l’évolution et de ces maladies. Les méthodes d’évaluation visuelles qualitatives sont sujettes à une subjectivité d’analyse et à une variabilité inter observateurs qui altèrent leur fiabilité. Le développement de nouvelles méthodes quantitatives fiables et reproductibles est donc une nécessité. La TDM et l’IRM sont les deux méthodes d’imagerie complètes à la fois des différents compartiments structuraux et fonctionnels du poumon, la première ayant pour avantage son excellente résolution spatiale et la seconde son innocuité. Les travaux ont porté sur la mise au point et la validation de méthodes d’imagerie quantitatives TDM et IRM. Avec la TDM quantitative, nous avons montré que les mesures du remodelage bronchique et vasculaire chez les patients atteints d’une hypertension pulmonaire (HTP) sévère, phénotype particulier à la bronchopneumopathie chronique obstructive (BPCO), permettaient d’appréhender les interactions entre les systèmes cardiovasculaire et respiratoire. D’autre part nous avons mis au point et évalué une méthode de quantification de l’atteinte des voies aériennes distales dans une population de pneumonie chronique d’hypersensibilité. Cette méthode pourrait apporter une contribution à l’étude et au suivi des maladies bronchiques obstructives chroniques.Avec l’IRM quantitative, les solutions que nous avons proposées dans la quantification de l’emphysème à l’IRM protonique permettent une analyse automatisée de la sévérité de l’extension de l’emphysème chez des patients atteints de BPCO. En outre, la transposition des méthodes de mesure des paramètres bronchiques de la TDM à l’IRM est devenue possible grâce aux nouvelles séquences à temps d’écho ultra court (UTE). Ainsi, la quantification du remodelage bronchique à l’IRM 3DUTE chez des patients atteints de mucoviscidose, chez lesquels il est nécessaire de réduire l’exposition aux rayons ionisants, permet d’obtenir des informations morphologiques similaires à celles de la TDM. Nous avons aussi montré que la quantification automatique des phénomènes destructifs et inflammatoires par l’IRM 3DUTE dans l’atteinte pulmonaire de la mucoviscidose était une méthode fiable et reproductible pour évaluer la sévérité de l’atteinte structurale. Par ailleurs, la faisabilité d’une quantification automatique des hypersignaux T2 à l’IRM a été démontrée et sa pertinence comme biomarqueur spécifique de l’atteinte inflammatoire des voies aériennes évaluée. Ainsi, l’étude quantitative, en TDM comme en IRM, de diverses modifications structurales et fonctionnelles des maladies bronchiques obstructives chroniques ouvre le champ d’une analyse objective et fiable par l’imagerie aux évaluations du suivi et de la réponse au traitement.
- Published
- 2019
17. Nouvelles approches en imagerie quantitative non-invasive pour l'évaluation des maladies broncho-pulmonaires obstructives chroniques
- Author
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Dournes, Gaël, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux, François Laurent, Laurent, François, Berger, Patrick, Bourdin, Arnaud, Ferretti, Gilbert, and Brillet, Pierre-Yves
- Subjects
Scanner ,computed tomography ,Airway remodeling ,Asthme ,Remodelage bronchique ,[SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM] ,Asthma ,Cystic fibrosis ,respiratory tract diseases ,BPCO ,Imaging analyses ,COPD ,Micovisidose ,Analyse d’image ,MRI ,IRM - Abstract
Airway remodeling is a critical outcome in broncho-pulmonary obstructive disorders such as asthma, COPD and cystic fibrosis. Research is needed in order to better understand the pathophysiological process underlying these different diseases, as well as their functional significance and consesquences in vivo. Imaging allows non-invasive and quantitative assessment of the remodeling process in vivo. In asthma, we have assessed the value of peribronchial density using microCT in murine models of ovalbumine sensitization. This novel biomarker was shown to relate with remodeling than inflammation of airways and could be used in preclinical studies. In humans, we first optimized an existing chain of post treatment in order to segment in 3 dimensions bronchi volumes in order to improve automation, detection and skeletonization. The software was applied in a prospective randomized double-blinded study in severe asthma, in order to test the effect of a new therapeutic anticalcic agent. Results showed that the software enables a non-invasive assessment of airway smooth muscle remodeling in severe asthma during therapeutic studies. In COPD, we have shown that quantitative CT is able to unravel new complex mechanisms that are involved in COPD but not in asthma, i.e. the development of pulmonary hypertension. CT measurements of small vessels were also shown to add complementary information on COPD phenotypes, supporting the existence of distinct subtypes of COPD related to a vascular rather than a broncho-pulmonary disease. Finally, lung MRI is still a challenging field of investigation, owing to the very low proton density of bronchi, the presence of movement artifact. We have tested and optimized an innovative sequence combined with respiratory synchronization in order to get images in close agreement with CT. Perspectives related to this novel non-invasive, quantitative and radiation-free imaging technique are promising in the evaluation of broncho-pulmonary obstructive diseases.; Le remodelage des voies aériennes est un phénomène mal connu, dont le rôle est central dans la sévérité des maladies broncho-pulmonaires obstructives chroniques telles que l’asthme et la broncho-pneumopathie obstructive chronique (BPCO). La recherche est nécessaire pour comprendre les mécanismes et les conséquences fonctionnelles, qui diffèrent dans ces deux maladies. L’imagerie a le potentiel de pouvoir évaluer de façon non-invasive, in vivo, les mécanismes mis en oeuvre dans ces maladies tandis que la recherche de marqueurs pertinents est une nécessité. Dans l’asthme, chez l’animal, nous avons évalué la densité péribronchique dans des modèles murins de sensibilisation allergique. Ce marqueur a été démontré comme étant un reflet du remodelage des voies aériennes et pourrait être utilisé dans des études précliniques. Chez l’homme, nous avons d’abord optimisé les performances d’un logiciel de segmentation 3D des volumes bronchiques, en termes d’automatisation, détection de bronches distales et squelettisation. Ce logiciel a été appliqué lors d’une étude thérapeutique en double aveugle versus placebo pour évaluer l’effet du gallopamil dans l’asthme sévère. Nos résultats montrent que le remodelage musculaire lisse est une composante clé du remodelage dans l’asthme, et que le TDM quantitatif permet d’évaluer les effets de molécules lors d’essais cliniques. Dans la BPCO, nous avons mis en évidence à l’aide de la TDM quantitative que le remodelage bronchique est impliqué dans une complication particulière qui n’est pas mise en oeuvre dans l’asthme, à savoir le développement d’une hypertension artérielle pulmonaire. D’autre part, nous avons montré que la mesure automatique des petits vaisseaux permet une analyse complémentaire et supporte l’hypothèse d’un phénotype distinct de BPCO associé à une maladie vasculaire. Enfin l’IRM pulmonaire reste un challenge pour l’imagerie du fait de la faible teneur en protons et des mouvements cardiaque et respiratoire. Nous avons testé et optimisé une nouvelle séquence permettant d’obtenir des imageries de qualité très proches de celles du TDM. Ces résultats ouvrent des perspectives sur l’imagerie non irradiante des maladies broncho-pulmonaires chroniques par IRM.
- Published
- 2014
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