Philippe JEAN-PIERRE

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• Type de publi. : Article dans une revue
• Date de publi. : 01/12/2021
• Auteurs : Alexandre IngelsSophie DucKarim BensalahPierre BigotPhilippe PaparelJean-Baptiste BeauvalLaurent SalomonAlexandre de La TailleHervé LangFrançois-Xavier NouhaudJosé Batista da CostaCharles DarianeHervé BaumertMorgan RoupretThibaut WaeckelCédric LebacleJean-Alexandre LongFrançois HenonJean-Jacques PatardNicolas DoumercArnaud MejeanMarie-Neige VideauJean-Christophe Bernhard
• Organismes : CHU Henri Mondor [Créteil] Centre Hospitalier Universitaire de Bordeaux Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou] Centre Hospitalier Universitaire d'Angers Centre Hospitalier Lyon Sud [CHU - HCL] Clinique La Croix du Sud CHU Mont de Marsan CHU Henri Mondor [Créteil] Centre Hospitalier Universitaire [Strasbourg] CHU Rouen CHU Henri Mondor [Créteil] Hôpital Européen Georges Pompidou [APHP] Centre hospitalier Saint-Joseph [Paris] CHU Pitié-Salpêtrière [AP-HP] CHU Caen Normandie – Centre Hospitalier Universitaire de Caen Normandie Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre] Centre Hospitalier Universitaire [CHU Grenoble] Centre Hospitalier Régional Universitaire [CHU Lille] CHU Mont de Marsan Centre Hospitalier Universitaire de Toulouse Centre hospitalier Saint-Joseph [Paris] Centre Hospitalier Universitaire de Bordeaux Centre Hospitalier Universitaire de Bordeaux
• Publié dans Scientific Reports le 26/10/2020

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Résumé : To describe clinical outcomes of patients aged 75 years and above after partial nephrectomy (PN), and to assess independent factors of postoperative complications. We retrospectively reviewed information from our multi-institutional database. Every patient over 75 years old who underwent a PN between 2003 and 2016 was included. Peri-operative and follow up data were collected. Multivariate logistic regression was performed to determine independent predictive factors of postoperative complications. We reviewed 191 procedures including 69 (40%) open-surgery, and 122 (60%) laparoscopic procedures, of which 105 were robot-assisted. Median follow-up was 25 months. The mean age was 78 [75–88]. The American Society of Anesthesiologist’s score was 1, 2, 3 and 4 in 10.5%, 60%, 29% and 0.5% of patients respectively. The mean tumor size was 4.6 cm. Indication of PN was elective in 122 (65%) patients and imperative in 52 patients (28%). The median length of surgery was 150(± 60) minutes, and the median estimated blood loss 200 ml. The mean glomerular filtration rate was 71.5 ml/minute preoperatively, and 62 ml/min three months after surgery. The severe complications (Clavien III-V) rate was 6.2%. On multivariate analysis, the robotic-assisted procedure was an independent protective factor of medical postoperative complications (Odds Ration (OR) = 0.31 [0.12–0.80], p = 0.01). It was adjusted for age and RENAL score, robotic-assisted surgery (OR = 0.22 [0.06–0.79], p = 0.02), and tumor size (OR = 1.13 [1.02–1.26], p = 0.01), but the patients age did not forecast surgical complications. Partial nephrectomy can be performed safely in elderly patients with an acceptable morbidity, and should be considered as a viable treatment option. Robotic assistance is an independent protective factor of postoperative complications.

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Fichiers liés : s41598-021-96676-y.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/12/2021
• Auteurs : Clémence MaraisCaroline ClaudeNada SemaanRamy CharbelSimon BarreaultBrendan TravertJean-Eudes PiloquetZoé DemaillyLuc MorinZied MerchaouiJean-Louis TeboulPhilippe DurandJordi MiatelloPierre TissièresSimon BarreaultMélissa BeggazRamy CharbelCaroline ClaudeZoé DemaillyPhilippe DurandGaspard GerschenfeldJessica GiraldiMatteo GuerraManon HilyMartin JournauxChristopher LaiPauline LerouxClémence MaraisZied MerchaouiJordi MiatelloClarisse NiçaiseJean-Eudes PiloquetMelissa RenMarie SimbozelNada SemaanJean-Louis TeboulPierre TissieresBrendan Travert
• Organismes : Assistance publique - Hôpitaux de Paris (AP-HP)
• Publié dans Annals of Intensive Care le 23/10/2020

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Résumé : Abstract Background De-regulated host response to severe coronavirus disease 2019 (COVID-19), directly referring to the concept of sepsis-associated immunological dysregulation, seems to be a strong signature of severe COVID-19. Myeloid cells phenotyping is well recognized to diagnose critical illness-induced immunodepression in sepsis and has not been well characterized in COVID-19. The aim of this study is to review phenotypic characteristics of myeloid cells and evaluate their relations with the occurrence of secondary infection and mortality in patients with COVID-19 admitted in an intensive care unit. Methods Retrospective analysis of the circulating myeloid cells phenotypes of adult COVID-19 critically ill patients. Phenotyping circulating immune cells was performed by flow cytometry daily for routine analysis and twice weekly for lymphocytes and monocytes subpopulations analysis, as well as monocyte human leukocyte antigen (mHLA)-DR expression. Results Out of the 29 critically ill adult patients with severe COVID-19 analyzed, 12 (41.4%) developed secondary infection and six patients died during their stay. Monocyte HLA-DR kinetics was significantly different between patients developing secondary infection and those without, respectively, at day 5–7 and 8–10 following admission. The monocytes myeloid-derived suppressor cells to total monocytes ratio was associated with 28- and 60-day mortality. Those myeloid characteristics suggest three phenotypes: hyperactivated monocyte/macrophage is significantly associated with mortality, whereas persistent immunodepression is associated with secondary infection occurrence compared to transient immunodepression. Conclusions Myeloid phenotypes of critically ill COVID-19 patients may be associated with development of secondary infection, 28- and 60-day mortality.

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• Type de publi. :
• Date de publi. : 01/12/2021
• Auteurs : Julien Gomez-MartinezVincent FoulongneDidier LaureillardNicolas NagotBrigitte MontèsJean-François CantaloubePhilippe Van De PerreChantal Fournier-WirthJean-Pierre MolèsJean-Charles Brès
• Organismes : Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections Pathogenesis and Control of Chronic and Emerging Infections

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• Type de publi. : Article dans une revue
• Date de publi. : 01/12/2021
• Auteurs : Maeva RodriguezStéphanie RagotRémi CoudroyJean-Pierre QuenotPhilippe VignonJean-Marie ForelAlexandre DemouleJean-Paul MiraJean-Damien RicardSaad NseirGwenhael ColinBertrand PonsPierre-Eric DaninJérome DevaquetGwenael PratHamid MerdjiFranck PetitpasEmmanuel VivierArmand Mekontso-DessapMai-Anh NayPierre AsfarJean DellamonicaLaurent ArgaudStephan EhrmannMuriel FartoukhChristophe GiraultNancy Kentish-BarnesArnaud W. ThilleJean-Pierre FratDelphine ChatellierFlorence BoissierAnne VeinsteinClaire Dahyot-FizelierAuguste DargentAudrey LargeEmmanuelle BegotClaire ManciaMaxence DecaveleMartin DresSamuel LehingueLaurent PapazianMarine PaulNathalie MarinMatthieu Le MeurMohammed LaissyAnahita RouzéMatthieu Henry-LagarrigueAihem YehiaFrédéric MartinoCharles CerfPierre BaillyJulie HelmsJean Baptiste PutegnatKeyvan RazaziThierry BoulainSéverin CabassonFlorent WalletKada KloucheFrédéric Bellec
• Organismes : Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 Service de Médecine Intensive et Réanimation [Strasbourg] Nanomédecine Régénérative Centre Hospitalier Régional Universitaire de Tours Centre d’Etude des Pathologies Respiratoires [Tours] CIC de Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402)
• Publié dans Annals of Intensive Care le 23/10/2020

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Résumé : Abstract Background Critically ill patients with obesity may have an increased risk of difficult intubation and subsequent severe hypoxemia. We hypothesized that pre-oxygenation with noninvasive ventilation before intubation as compared with high-flow nasal cannula oxygen may decrease the risk of severe hypoxemia in patients with obesity. Methods Post hoc subgroup analysis of critically ill patients with obesity (body mass index ≥ 30 kg·m −2 ) from a multicenter randomized controlled trial comparing preoxygenation with noninvasive ventilation and high-flow nasal oxygen before intubation of patients with acute hypoxemic respiratory failure (PaO 2 /FiO 2 < 300 mm Hg). The primary outcome was the occurrence of severe hypoxemia (pulse oximetry < 80%) during the intubation procedure. Results Among the 313 patients included in the original trial, 91 (29%) had obesity with a mean body mass index of 35 ± 5 kg·m −2 . Patients with obesity were more likely to experience an episode of severe hypoxemia during intubation procedure than patients without obesity: 34% (31/91) vs. 22% (49/222); difference, 12%; 95% CI 1 to 23%; P = 0.03. Among patients with obesity, 40 received preoxygenation with noninvasive ventilation and 51 with high-flow nasal oxygen. Severe hypoxemia occurred in 15 patients (37%) with noninvasive ventilation and 16 patients (31%) with high-flow nasal oxygen (difference, 6%; 95% CI − 13 to 25%; P = 0.54). The lowest pulse oximetry values during intubation procedure were 87% [interquartile range, 77–93] with noninvasive ventilation and 86% [78–92] with high-flow nasal oxygen ( P = 0.98). After multivariable analysis, factors independently associated with severe hypoxemia in patients with obesity were intubation difficulty scale > 5 points and respiratory primary failure as reason for admission. Conclusions Patients with obesity and acute hypoxemic respiratory failure had an increased risk of severe hypoxemia during intubation procedure as compared to patients without obesity. However, preoxygenation with noninvasive ventilation may not reduce this risk compared with high-flow nasal oxygen. Trial registration Clinical trial number: NCT02668458 ( http://www.clinicaltrials.gov )

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• Type de publi. : Article dans une revue
• Date de publi. : 01/12/2021
• Auteurs : Salim Si-MohamedJade MiailhesPierre-Antoine RodeschSara BoccaliniHugo LacombeValérie LeitmanVincent CottinL. BousselPhilippe Douek
• Organismes : Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Hospices Civils de Lyon Modeling & analysis for medical imaging and Diagnosis Hospices Civils de Lyon Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Hospices Civils de Lyon Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Infections Virales et Pathologie Comparée - UMR 754 Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Hospices Civils de Lyon Modeling & analysis for medical imaging and Diagnosis Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Hospices Civils de Lyon Modeling & analysis for medical imaging and Diagnosis
• Publié dans Journal of Clinical Medicine le 29/10/2020

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Résumé : The X-ray imaging field is currently undergoing a period of rapid technological innovation in diagnostic imaging equipment. An important recent development is the advent of new X-ray detectors, i.e., photon-counting detectors (PCD), which have been introduced in recent clinical prototype systems, called PCD computed tomography (PCD-CT) or photon-counting CT (PCCT) or spectral photon-counting CT (SPCCT) systems. PCD allows a pixel up to 200 microns pixels at iso-center, which is much smaller than that can be obtained with conventional energy integrating detectors (EID). PCDs have also a higher dose efficiency than EID mainly because of electronic noise suppression. In addition, the energy-resolving capabilities of these detectors allow generating spectral basis imaging, such as the mono-energetic images or the water/iodine material images as well as the K-edge imaging of a contrast agent based on atoms of high atomic number. In recent years, studies have therefore been conducted to determine the potential of PCD-CT as an alternative to conventional CT for chest imaging.

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Fichiers liés : jcm-10-05757.pdf

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• Type de publi. : Rapport
• Date de publi. : 01/12/2021
• Auteurs : Alain BadieSandrine DubourgJean-Charles MorettiAnna PapadopoulouDominique TardyLisa ShindoCarine Cenzon-SalvayreArnaud CoutelasAsma AmriPierre RochetteGilles A.R. ConesaPhilippe Bromblet
• Organismes : Institut de recherche sur l'architecture antique Institut de recherche sur l'architecture antique Institut de recherche sur l'architecture antique Institut de recherche sur l'architecture antique Cluster of Excellence ROOTS, Kiel University Centre Européen de Recherche et d'Enseignement des Géosciences de l'Environnement Centre Européen de Recherche et d'Enseignement des Géosciences de l'Environnement Centre Européen de Recherche et d'Enseignement des Géosciences de l'Environnement Centre Interdisciplinaire de Conservation et Restauration du Patrimoine

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• Type de publi. : Article dans une revue
• Date de publi. : 01/12/2021
• Auteurs : Romain GarousteJérôme MunzingerAndrew LeslieJessica FisherNicolas FolcherEmma LocatelliWyndy FoyThibault ChaillonDavid J. CantrillPierre MaurizotDominique CluzelPorter P. Lowry IiPeter CraneJean-Jacques BahainPierre VoinchetHerve JourdanPhilippe GrandcolasAndré Nel
• Organismes : Institut de Systématique, Evolution, Biodiversité Botanique et Modélisation de l'Architecture des Plantes et des Végétations Stanford University Brown University Université de la Nouvelle-Calédonie Botanique et Modélisation de l'Architecture des Plantes et des Végétations Botanique et Modélisation de l'Architecture des Plantes et des Végétations Royal Botanic Gardens [Kew] Service Geologique de la Nouvelle-Calédonie Université de la Nouvelle-Calédonie Institut de Systématique, Evolution, Biodiversité Missouri Botanical Garden Histoire naturelle de l'Homme préhistorique Histoire naturelle de l'Homme préhistorique Institut méditerranéen de biodiversité et d'écologie marine et continentale Institut de Systématique, Evolution, Biodiversité Institut de Systématique, Evolution, Biodiversité
• Publié dans Scientific Reports le 26/10/2020

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Résumé : New Caledonia was, until recently, considered an old continental island harbouring a rich biota with outstanding Gondwanan relicts. However, deep marine sedimentation and tectonic evidence suggest complete submergence of the island during the latest Cretaceous to the Paleocene. Molecular phylogenies provide evidence for some deeply-diverging clades that may predate the Eocene and abundant post-Oligocene colonisation events. Extinction and colonization biases, as well as survival of some groups in refuges on neighbouring paleo-islands, may have obscured biogeographic trends over long time scales. Fossil data are therefore crucial for understanding the history of the New Caledonian biota, but occurrences are sparse and have received only limited attention. Here we describe five exceptional fossil assemblages that provide important new insights into New Caledonia’s terrestrial paleobiota from three key time intervals: prior to the submersion of the island, following re-emergence, and prior to Pleistocene climatic shifts. These will be of major importance for elucidating changes in New Caledonia’s floristic composition over time.

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Fichiers liés : Garrouste_etal_Scientifc_reports_2021.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/12/2021
• Auteurs : Anne-Marie BaconNicolas BourgonFrido WelkerEnrico CappelliniDenis FiorilloOlivier TombretNguyen Thi Mai HuongNguyen Anh TuanThongsa SayavonkhamdyViengkeo SouksavatdyPhonephanh SichanthongtipPierre-Olivier AntoinePhilippe DuringerJean-Luc PoncheKira WestawayRenaud Joannes-BoyauQuentin BoeschEric SuzzoniSébastien FrangeulElise Patole-EdoumbaAlexandra J ZachwiejaLaura ShackelfordFabrice DemeterElise DufourJean-Jacques Hublin
• Organismes : Biologie, anthropologie, biométrie, épigénétique, lignées : De la diversité des populations à l'individu, de l'identification à l'identité Max-Planck-Institut für evolutionäre Anthropologie = Max Planck Institute for Evolutionary Anthropology Johannes Gutenberg - Universität Mainz = Johannes Gutenberg University University of Copenhagen = Københavns Universitet University of Copenhagen = Københavns Universitet BioArchéologie, Interactions Sociétés Environnements BioArchéologie, Interactions Sociétés Environnements Institut des Sciences de l'Evolution de Montpellier Institut de physique du globe de Strasbourg Ecole et Observatoire des sciences de la terre Laboratoire Image, Ville, Environnement Macquarie University [Sydney] Southern Cross University Institute of Vertebrate Paleontology and Paleoanthropology Ecole et Observatoire des sciences de la terre Institut de physique du globe de Strasbourg Museum d'Histoire Naturelle de La Rochelle University of Minnesota Medical School University of Illinois at Urbana-Champaign [Urbana] Section for GeoGenetics Éco-Anthropologie BioArchéologie, Interactions Sociétés Environnements Collège de France - Chaire Paléoanthropologie Max-Planck-Institut für evolutionäre Anthropologie = Max Planck Institute for Evolutionary Anthropology
• Publié dans Scientific Reports le 26/10/2020

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Résumé : Abstract The capability of Pleistocene hominins to successfully adapt to different types of tropical forested environments has long been debated. In order to investigate environmental changes in Southeast Asia during a critical period for the turnover of hominin species, we analysed palaeoenvironmental proxies from five late Middle to Late Pleistocene faunas. Human teeth discoveries have been reported at Duoi U’Oi, Vietnam (70–60 ka) and Nam Lot, Laos (86–72 ka). However, the use of palaeoproteomics allowed us to discard the latter, and, to date, no human remains older than ~ 70 ka are documented in the area. Our findings indicate that tropical rainforests were highly sensitive to climatic changes over that period, with significant fluctuations of the canopy forests. Locally, large-bodied faunas were resilient to these fluctuations until the cooling period of the Marine Isotope Stage 4 (MIS 4; 74–59 ka) that transformed the overall biotope. Then, under strong selective pressures, populations with new phenotypic characteristics emerged while some other species disappeared . We argue that this climate-driven shift offered new foraging opportunities for hominins in a novel rainforest environment and was most likely a key factor in the settlement and dispersal of our species during MIS 4 in SE Asia.

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Fichiers liés : Bacon et al 2021 -Scientific Reports.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/12/2021
• Auteurs : Philippe JeanneretGisela LüscherManuel K SchneiderPhilippe PointereauMichaela ArndorferDebra BaileyKatalin BalázsAndrás BáldiJean-Philippe ChoisisPeter DennisMario DíazSebastian EiterZoltán ElekWendy FjellstadThomas FrankJürgen K FriedelIlse R. GeijzendorfferPippa GillinghamTiziano GomieroGergely JerkovichRob H G JongmanMax KainzAnikó Kovács-HostyánszkiGerardo MorenoJuri NascimbeneMarie-Louise OschatzMaurizio G PaolettiJean-Pierre SarthouNorman SiebrechtDaniele SommaggioSebastian WolfrumFélix Herzog
• Organismes : Agroscope Agroscope University of Applied Science Schmalkalden Association Solagro Arche Noah University Natural Resources and Life Agroscope Department of Radiation Medicine MTA Centre for Ecological Research [Tihany] Systèmes d'élevage méditerranéens et tropicaux Institute of Biological, Environmental and Rural Sciences CSIC, Museo Nacl Ciencias Nat The Norwegian Forest and Landscape Institute MTA Centre for Ecological Research [Tihany] The Norwegian Forest and Landscape Institute Universität für Bodenkultur Wien = University of Natural Resources and Life Sciences [Vienne, Autriche] Universität für Bodenkultur Wien = University of Natural Resources and Life Sciences [Vienne, Autriche] Wageningen Environmental Research (Alterra) Institut méditerranéen de biodiversité et d'écologie marine et continentale Aberystwyth University Università degli Studi di Padova = University of Padua Università degli Studi di Padova = University of Padua Wageningen Environmental Research (Alterra) Technische Universität Munchen = Technical University Munich = Université Technique de Munich MTA Centre for Ecological Research [Tihany] Universidad de Extremadura - University of Extremadura Alma Mater Studiorum Università di Bologna = University of Bologna Universität für Bodenkultur Wien = University of Natural Resources and Life Sciences [Vienne, Autriche] Università degli Studi di Padova = University of Padua AGroécologie, Innovations, teRritoires Technische Universität Munchen = Technical University Munich = Université Technique de Munich Università degli Studi di Padova = University of Padua Technische Universität Munchen = Technical University Munich = Université Technique de Munich Agroscope
• Publié dans Communications Earth & Environment le 27/10/2020

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Résumé : Conversion of semi-natural habitats, such as field margins, fallows, hedgerows, grassland, woodlots and forests, to agricultural land could increase agricultural production and help meet rising global food demand. Yet, the extent to which such habitat loss would impact biodiversity and wild species is unknown. Here we survey species richness for four taxa (vascular plants, earthworms, spiders, wild bees) and agricultural yield across a range of arable, grassland, mixed, horticulture, permanent crop, for organic and non-organic agricultural land on 169 farms across 10 European regions. We find that semi-natural habitats currently constitute 23% of land area with 49% of species unique to these habitats. We estimate that conversion of semi-natural land that achieves a 10% increase in agricultural production will have the greatest impact on biodiversity in arable systems and the least impact in grassland systems, with organic practices having better species retention than non-organic practices. Our findings will help inform sustainable agricultural development.

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Fichiers liés : 2021-choisis-Commearthandenv.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/12/2021
• Auteurs : Vincent DurlachDominique Bonnefont-RousselotFranck BoccaraMathilde VarretMathilde Di FilippoBertrand CariouRené ValéroSybil CharrièreMichel FarnierPierre MorangeOlivier MeilhacGilles LambertPhilippe MoulinPhilippe GillerySophie Beliard-LasserreÉric BruckertAlain CarriéJean FerrièresXavier ColletM. John John ChapmanEduardo Anglés-Cano
• Organismes : Université de Reims Champagne-Ardenne Matrice Extracellulaire et Dynamique Cellulaire - UMR CNRS 7369 CHU Pitié-Salpêtrière [AP-HP] Unité de Technologies Chimiques et Biologiques pour la Santé Centre de Recherche Saint-Antoine Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases CHU Saint-Antoine [AP-HP] Laboratoire de Recherche Vasculaire Translationnelle AP-HP - Hôpital Bichat - Claude Bernard [Paris] Hospices Civils de Lyon Cardiovasculaire, métabolisme, diabétologie et nutrition Centre Hospitalier Universitaire de Nantes = Nantes University Hospital ITX - unité de recherche de l'institut du thorax Hôpital de la Conception [CHU - APHM] Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research Cardiovasculaire, métabolisme, diabétologie et nutrition Hospices Civils de Lyon Physiopathologie et épidémiologie cérébro-cardiovasculaires [Dijon] CHU Dijon Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research Diabète athérothrombose et thérapies Réunion Océan Indien Centre Hospitalier Universitaire de La Réunion Centre d'Investigation Clinique de La Réunion - INSERM Diabète athérothrombose et thérapies Réunion Océan Indien Centre Hospitalier Universitaire de La Réunion Centre d'Investigation Clinique de La Réunion - INSERM Cardiovasculaire, métabolisme, diabétologie et nutrition Hospices Civils de Lyon Matrice Extracellulaire et Dynamique Cellulaire - UMR CNRS 7369 Hôpital universitaire Robert Debré [Reims] Hôpital de la Conception [CHU - APHM] Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research CHU Pitié-Salpêtrière [AP-HP] Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases CHU Pitié-Salpêtrière [AP-HP] Equipe AGING (CERPOP) Centre Hospitalier Universitaire de Toulouse Institut des Maladies Métaboliques et Cardiovasculaires Centre Hospitalier Universitaire de Toulouse CHU Pitié-Salpêtrière [AP-HP] Innovations thérapeutiques en hémostase = Innovative Therapies in Haemostasis
• Publié dans Archives of cardiovascular diseases le 30/10/2020

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Résumé : Lipoprotein(a) is an apolipoprotein B100-containing low-density lipoprotein-like particle that is rich in cholesterol, and is associated with a second major protein, apolipoprotein(a). Apolipoprotein(a) possesses structural similarity to plasminogen but lacks fibrinolytic activity. As a consequence of its composite structure, lipoprotein(a) may: (1) elicit a prothrombotic/antifibrinolytic action favouring clot stability; and (2) enhance atherosclerosis progression via its propensity for retention in the arterial intima, with deposition of its cholesterol load at sites of plaque formation. Equally, lipoprotein(a) may induce inflammation and calcification in the aortic leaflet valve interstitium, leading to calcific aortic valve stenosis. Experimental, epidemiological and genetic evidence support the contention that elevated concentrations of lipoprotein(a) are causally related to atherothrombotic risk and equally to calcific aortic valve stenosis. The plasma concentration of lipoprotein(a) is principally determined by genetic factors, is not influenced by dietary habits, remains essentially constant over the lifetime of a given individual and is the most powerful variable for prediction of lipoprotein(a)-associated cardiovascular risk. However, major interindividual variations (up to 1000-fold) are characteristic of lipoprotein(a) concentrations. In this context, lipoprotein(a) assays, although currently insufficiently standardized, are of considerable interest, not only in stratifying cardiovascular risk, but equally in the clinical follow-up of patients treated with novel lipid-lowering therapies targeted at lipoprotein(a) (e.g. antiapolipoprotein(a) antisense oligonucleotides and small interfering ribonucleic acids) that markedly reduce circulating lipoprotein(a) concentrations. We recommend that lipoprotein(a) be measured once in subjects at high cardiovascular risk with premature coronary heart disease, in familial hypercholesterolaemia, in those with a family history of coronary heart disease and in those with recurrent coronary heart disease despite lipid-lowering treatment. Because of its clinical relevance, the cost of lipoprotein(a) testing should be covered by social security and health authorities.

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Fichiers liés : Arch CardioVasc Diseases 2021.pdf

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