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See detailAzacytidine prevents experimental xenogeneic graft-versus-host disease without abrogating graft-versus-leukemia effects
Ehx, Grégory ULiege; Fransolet, Gilles ULiege; de Leval, Laurence ULiege et al

Conference (2016, November 18)

The demethylating agent 5-azacytidine (AZA) has proven its efficacy as treatment for myelodysplastic syndrome and acute myeloid leukemia. In addition, AZA can demethylate FOXP3 intron 1 (FOXP3i1) leading ... [more ▼]

The demethylating agent 5-azacytidine (AZA) has proven its efficacy as treatment for myelodysplastic syndrome and acute myeloid leukemia. In addition, AZA can demethylate FOXP3 intron 1 (FOXP3i1) leading to the generation of regulatory T cells (Treg). Here, we investigated the impact of AZA on xenogeneic graft-versus-host disease (xGVHD) and graft-versus-leukemia effects in a humanized murine model of transplantation (human PBMCs-infused NSG mice), and described the impact of the drug on human T cells in vivo. We observed that AZA improved both survival and xGVHD scores. Further, AZA significantly decreased human T-cell proliferation as well as IFN-γ and TNF-α serum levels, and reduced the expression of GRANZYME B and PERFORIN 1 by cytotoxic T cells. In addition, AZA significantly increased Treg frequency through hypomethylation of FOXP3i1 as well as increased Treg proliferation. The later was subsequent to higher STAT5 signaling in Treg from AZA-treated mice, which resulted from higher IL-2 secretion by conventional T cells from AZA-treated mice itself secondary to demethylation of the IL-2 gene promoter by AZA. Importantly, Tregs harvested from AZA-treated mice were suppressive and stable over time since they persisted at high frequency in secondary transplant experiments. Finally, graft-versus-leukemia effects (assessed by growth inhibition of THP-1 cells, transfected to express the luciferase gene) were not abrogated by AZA. In summary, our data demonstrate that AZA prevents xGVHD without abrogating graft-versus-leukemia effects. These findings could serve of basis for further studies of GVHD prevention by AZA in acute myeloid leukemia patients offered an allogeneic transplantation. [less ▲]

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See detailLimited impact of imatinib in a murine model of sclerodermic chronic graft-versus-host disease
Belle, Ludovic; Fransolet, Gilles ULiege; SOMJA, Joan ULiege et al

Poster (2016, November 17)

Background: Graft-versus-host disease (GVHD) remains one of the major complications following haematopoietic stem cell transplantation (HSCT). Approximately 15% of the patients with chronic GVHD develop ... [more ▼]

Background: Graft-versus-host disease (GVHD) remains one of the major complications following haematopoietic stem cell transplantation (HSCT). Approximately 15% of the patients with chronic GVHD develop the sclerodermatous form of the disease characterized by multiple organ fibrosis and loss of skin elasticity. Several studies have shown the potential benefits of imatinib, a tyrosine kinase inhibitor, as a treatment of fibrosis in cGVHD due to its ability to inhibit simultaneously PDGF-R and c-Abl pathways which are both involved in fibrosis mechanisms. This work investigates the possible benefits of imatinib on fibrosis in a murine model of sclerodermatous chronic GVHD (sclcGVHD). Methods: Lethally irradiated Balb/cJ mice (7 Gy TBI) were injected i.v. with 10.106 bone marrow cells and 70.106 splenocytes from B10.D2 donnor mice. Mice were then treated with sterile water or imatinib (150 mg/kg/day) by oral gavage from day +7 to day +52 following transplantation. GVHD severity was assessed three times/week with a scoring system encompassing 5 criteria (mice posture, weight loss, activity, hair loss, skin integrity ; 0-1-2 point(s)/criteria). Results: Our results show that imatinib failed to prevent/improve GVHD with a similar evolution of the GVHD severity with no differences between groups. Histological analyses indicate a significant reduction of the phosphorylation level of the PDGR receptor (p = 0,033) and a trend to a decreased level of phosphorylated c-Abl (p = 0,1854). In vivo cell proliferation assay with CFSE were also performed and showed a reduced proliferation of T cells and subsets (CD4, CD8 and Tregs) in spleen, lymph nodes, bone marrow and blood after imatinib treatment. Finally, FACS analyses performed on days +21 and +35 after transplantation did not show any differences in the absolute T-cell counts. Conclusion: Although we have observed a decreased phosphorylation level of PDGR receptor and less proliferation of T cells and subsets in vivo, imatinib failed to alleviate scl-cGVHD in a murine model of severe scl-cGVHD. [less ▲]

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See detailAzacytidine prevents experimental xenogeneic graft-versus-host disease without abrogating graft-versus-leukemia effects
Ehx, Grégory ULiege; Fransolet, Gilles ULiege; de Leval, Laurence ULiege et al

Poster (2016, October 14)

The demethylating agent 5-azacytidine (AZA) has proven its efficacy as treatment for myelodysplastic syndrome and acute myeloid leukemia. In addition, AZA can demethylate FOXP3 intron 1 (FOXP3i1) leading ... [more ▼]

The demethylating agent 5-azacytidine (AZA) has proven its efficacy as treatment for myelodysplastic syndrome and acute myeloid leukemia. In addition, AZA can demethylate FOXP3 intron 1 (FOXP3i1) leading to the generation of regulatory T cells (Treg). Here, we investigated the impact of AZA on xenogeneic graft-versus-host disease (xGVHD) and graft-versus-leukemia effects in a humanized murine model of transplantation (human PBMCs-infused NSG mice), and described the impact of the drug on human T cells in vivo. We observed that AZA improved both survival and xGVHD scores. Further, AZA significantly decreased human T-cell proliferation as well as IFN-γ and TNF-α serum levels, and reduced the expression of GRANZYME B and PERFORIN 1 by cytotoxic T cells. In addition, AZA significantly increased Treg frequency through hypomethylation of FOXP3i1 as well as increased Treg proliferation. The later was subsequent to higher STAT5 signaling in Treg from AZA-treated mice, which resulted from higher IL-2 secretion by conventional T cells from AZA-treated mice itself secondary to demethylation of the IL-2 gene promoter by AZA. Importantly, Tregs harvested from AZA-treated mice were suppressive and stable over time since they persisted at high frequency in secondary transplant experiments. Finally, graft-versus-leukemia effects (assessed by growth inhibition of THP-1 cells, transfected to express the luciferase gene) were not abrogated by AZA. In summary, our data demonstrate that AZA prevents xGVHD without abrogating graft-versus-leukemia effects. These findings could serve of basis for further studies of GVHD prevention by AZA in acute myeloid leukemia patients offered an allogeneic transplantation. [less ▲]

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See detailOstéoblastes autologues (PREOB®) versus concentré de moelle autologue dans l’ostéonécrose de la tête fémorale : étude randomisée
HAUZEUR, Jean-Philippe ULiege; Tungouz, Michel; LECHANTEUR, Chantal ULiege et al

in Revue de Chirurgie Orthopédique et Traumatologie (2016, October), 102

In non-traumatic osteonecrosis of the femoral head (ONFH), implantation of bone marrow concentrate (BMC) containing mesenchymal stem cells (MSC) could delay ONFH progression and improve symptoms (Hernigou ... [more ▼]

In non-traumatic osteonecrosis of the femoral head (ONFH), implantation of bone marrow concentrate (BMC) containing mesenchymal stem cells (MSC) could delay ONFH progression and improve symptoms (Hernigou 2002, Gangji 2004). The next step was to assess the hypothesis that a population of autologous osteoblastic cells (OB) consisting in a more differentiated cell than MSC, could be more efficacious than BMC in early stages ON. [less ▲]

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See detailAzacytidine mitigates experimental sclerodermic chronic graft-versus-host disease
Fransolet, Gilles ULiege; Ehx, Grégory ULiege; SOMJA, Joan ULiege et al

in Journal of Hematology & Oncology (2016), 9

Background <br />Previous studies have demonstrated that regulatory T cells (Tregs) play a protective role in the pathogenesis of chronic graft-versus-host disease (cGVHD). Tregs constitutively express ... [more ▼]

Background <br />Previous studies have demonstrated that regulatory T cells (Tregs) play a protective role in the pathogenesis of chronic graft-versus-host disease (cGVHD). Tregs constitutively express the gene of the transcription factor Foxp3 whose CNS2 region is heavily methylated in conventional CD4+ T cells (CD4+Tconvs) but demethylated in Tregs. <br />Methods <br />Here, we assessed the impact of azacytidine (AZA) on cGVHD in a well-established murine model of sclerodermic cGVHD (B10.D2 (H-2d) → BALB/cJ (H-2d)). <br />Results <br />The administration of AZA every 48 h from day +10 to day +30 at the dose of 0.5 mg/kg or 2 mg/kg mitigated chronic GVHD. Further, AZA-treated mice exhibited higher blood and thymic Treg frequencies on day +35, as well as higher demethylation levels of the Foxp3 enhancer and the IL-2 promoter in splenocytes at day +52. Interestingly, Tregs from AZA-treated mice expressed more frequently the activation marker CD103 on day +52. AZA-treated mice had also lower counts of CD4+Tconvs and CD8+ T cells from day +21 to day +35 after transplantation, as well as a lower proportion of CD4+Tconvs expressing the Ki67 antigen on day +21 demonstrating an anti-proliferating effect of the drug on T cells. <br />Conclusions <br />Our results indicate that AZA prevented sclerodermic cGVHD in a well-established murine model of cGVHD. These data might serve as the basis for a pilot study of AZA administration for cGVHD prevention in patients at high risk for cGVHD. [less ▲]

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See detailComparison of combined whole-body 18F-NAF and 18F-FDG PET/CT versus MRI for the detection of myeloma lesions
WITHOFS, Nadia ULiege; COUSIN, François ULiege; TANCREDI, Tino et al

Conference (2016, June 14)

Objectives Imaging requirements for the diagnosis of multiple myeloma (MM) recently changed and 蠅 1 osteolytic bone destruction (蠅 5 mm in size) seen on whole-body (WB) low-dose computed tomography (ldCT ... [more ▼]

Objectives Imaging requirements for the diagnosis of multiple myeloma (MM) recently changed and 蠅 1 osteolytic bone destruction (蠅 5 mm in size) seen on whole-body (WB) low-dose computed tomography (ldCT) or positron emission tomography combined with CT (PET/CT) does fulfill the criteria for bone disease. The present work assessed the lesion detection rate of WB combined [18F]NaF and [18F]FDG PET/CT versus ldCT alone and MRI in patients with newly diagnosed MM. Methods Patients with newly diagnosed MM, prospectively included, underwent WB (from vertex to toes) XR, MRI and combined [18F]NaF and [18F]FDG PET/CT (median delay between scans: 6 days). PET/CT scans were acquired after injection of 134 ± 13 MBq [18F]NaF and 249 ± 18 MBq [18F]FDG (median uptake time: 64 min). The ldCT (3 mm slice thickness; 120 kV; 50-80 mAs) followed by PET emission scan (90 seconds per bed position) were performed. The MR images were acquired in coronal planes in T1-weighted and T2-weighted short-tau inversion recovery. Diffusion-weighted with background suppression images were acquired in the axial plane and reconstructed on coronal planes. PET and LdCT images were reviewed by 2 experienced nuclear medicine physicians and 1 radiologist to detect focal lesions (FLs) and/or diffuse bone marrow involvement. The focal areas of visually detectable increased tracers’ uptake were considered as PET FLs. The MR, ldCT alone and XR images were analyzed by 3 radiologists blinded to each other and to PET/CT results. The FLs were classified according to their location: pelvis, skull, limbs, spine, ribs and one location including the sternum, scapula and clavicles. The McNemar’s test was used to compare the detection rate of each technique and the Kruskal-Wallis test was used to estimate a relationship between the detection rate and the size of FLs measured with ldCT. Results Out of 14 patients initially included, two were excluded (one for a delay > 40 days with XR and one who experienced claustrophobia during MRI acquisition). Twelve myeloma patients (median age 64y) with stage 1 (n = 4), 2 (n = 5) or 3 (n = 3) were included in the analyses. The pattern of bone marrow involvement was focal (n = 7) or combined diffuse and focal (n = 5). Per patient, 1-3 FL (n = 4), 4-10 FLs (n = 2) or > 10 FLs (n = 6) were detected. The total number of FLs detected was 281; no extramedullary disease was detected. The detection rate of MM lesions between techniques was significantly different (p < 0.05): XR (89; 32%) < PET (158; 56%) < MRI (183, 65%) < LdCT alone (219; 78%) < PET/CT (277; 99%). Out of 158 FLs detected with PET, 125 (79%) were also detected with MRI. Out of 183 MM lesions detected with MRI, 125 (68%) were detected with PET; PET positivity was significantly associated with lesion size (p = 0.002). Out of 145 FLs (蠅 5 mm) detected with ldCT, the detection rate of MRI (n = 87; 60%) and PET (n = 96; 66%) was similar (p = 0.17) and significantly associated with lesion size only for MRI (p = 0.014). Whatever FLs location, the detection rate of PET and MRI was similar except for rib MM lesions for which PET was superior to MRI (p = 0.0005). Seventeen osteolytic rib lesions detected with PET were not detected with MRI, of which only one corresponded to a pathologic fracture. At the patient’s level, the diagnosis of MM was based on biological data in 7/12 patients. For the 5 remaining patients, MM diagnosis required imaging. PET/CT and ldCT alone correctly identified bone involvement in all 5 patients; MRI would have missed the correct MM diagnosis in 3 patients (2 with diffuse pattern only and one with 1 FL); WBXR would have missed MM diagnosis in 1/5 patient (one pelvic FL missed). Conclusions The MM lesion detection rate of PET/CT was superior to ldCT alone and MRI, respectively. At the patient’s level, the accuracy of PET/CT and CT alone was superior to MRI and WB-XR for the diagnosis of MM. [less ▲]

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See detailNovel approaches for preventing acute graftversus- host disease after allogeneic hematopoietic stem cell transplantation
SERVAIS, Sophie ULiege; BEGUIN, Yves ULiege; Delens, Loïc ULiege et al

in Expert Opinion on Investigational Drugs (2016), 9

Introduction Allogeneic hematopoietic stem cell transplantation (alloHSCT) offers potential curative treatment for a wide range of malignant and nonmalignant hematological disorders. However, its success ... [more ▼]

Introduction Allogeneic hematopoietic stem cell transplantation (alloHSCT) offers potential curative treatment for a wide range of malignant and nonmalignant hematological disorders. However, its success may be limited by post-transplant acute graft-versus-host disease (aGVHD), a systemic syndrome in which donor’s immune cells attack healthy tissues in the immunocompromised host. aGVHD is one of the main causes of morbidity and mortality after alloHSCT. Despite standard GVHD prophylaxis regimens, aGVHD still develops in approximately 40–60% of alloHSCT recipients. Areas covered In this review, after a brief summary of current knowledge on the pathogenesis of aGVHD, the authors review the current combination of a calcineurin inhibitor with an antimetabolite with or without added anti-thymocyte globulin (ATG) and emerging strategies for GVHD prevention. Expert opinion A new understanding of the involvement of cytokines, intracellular signaling pathways, epigenetics and immunoregulatory cells in GVHD pathogenesis will lead to new standards for aGVHD prophylaxis allowing better prevention of severe aGVHD without affecting graft-versus-tumor effects. [less ▲]

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See detailAdministration of Third-Party Mesenchymal Stromal Cells at the Time of Kidney Transplantation: Interim Safety Analysis at One-Year Follow-Up
Erpicum, Pauline ULiege; WEEKERS, Laurent ULiege; DETRY, Olivier ULiege et al

Conference (2016, April 28)

Objective. Mesenchymal stromal cells (MSC) therapy has been suggested in kidney transplantation (KTx). We report on the 1-year follow-up of an open-label phase I trial using MSC at the time of KTx ... [more ▼]

Objective. Mesenchymal stromal cells (MSC) therapy has been suggested in kidney transplantation (KTx). We report on the 1-year follow-up of an open-label phase I trial using MSC at the time of KTx. Methods. On postoperative day 3 (D3), third-party MSC (~2.0x106/kg) were administered to 7 non-immunized first-transplant recipients from deceased donors, under standard immunosuppression (Basiliximab, Tacrolimus, MMF and steroids). No HLA matching was required for MSC donors. In parallel, 7 comparable KTx recipients were included as controls. Written informed consent was obtained from all participants. Results. No hemodynamic or immune-allergic side-effect was noted at the time of MSC injection. Still, 1 patient with a history of ischemic heart disease had a NSTEMI ~3h after MSC infusion. Four MSC patients presented with CMV reactivation within 165 ± 96 days post KTx, whereas 3 controls had positive polyoma-BK viremia within 92 ± 4d post KTx. Three MSC patients were affected by pneumonia within 269 ± 98d post KTx, whereas 3 controls had urinary infection within 48 ± 43d post KTx. No MSC engraftment syndrome was observed. At D14, eGFR in MSC and control groups was 47.1 ± 6.8 and 39.7 ± 5.9 ml/min, respectively (p, 0.05). At 1 year, eGFR in MSC and control groups was 43.1 ± 17.8 and 53.9 ± 13.4 ml/min, respectively (p, 0.25). At 3-month protocol biopsy, no rejection was evidenced in MSC or control patients. Later on, 1 acute rejection was diagnosed at D330 in 1 MSC patient. No biopsy-proven AR was noted in controls. Three patients developed anti-HLA antibodies against MSC (n=1) or shared kidney/MSC (n=2) mismatches. Conclusions. MSC infusion was safe in all patients except one. Incidence of opportunist and non-opportunist infections was similar in both MSC and control groups. No MSC engraftment syndrome was documented. No difference in eGFR was found at 1 year post KTx. Putative immunization against MSC was observed in 3 patients. [less ▲]

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See detailAzacytidine Enhances Regulatory T-Cells In Vivo and Prevents Experimental Xenogeneic Graft-Versus-Host Disease
Ehx, Grégory ULiege; Fransolet, Gilles ULiege; de Leval, Laurence ULiege et al

in Biology of Blood and Marrow Transplantation (2016, March), 22(3), 393

Background. The demethylating agent 5-azacytidine (AZA) has proven its efficacy as treatment for myelodysplastic syndrome and acute myeloid leukemia. In addition, AZA can demethylate FOXP3 intron 1 ... [more ▼]

Background. The demethylating agent 5-azacytidine (AZA) has proven its efficacy as treatment for myelodysplastic syndrome and acute myeloid leukemia. In addition, AZA can demethylate FOXP3 intron 1 (FOXP3i1) leading to the generation of regulatory T cells (Tregs). Objective. We investigated the impact of AZA on xenogeneic graft-versus-host disease (xGVHD) in a humanized murine model of transplantation, and described the impact of the drug on human T cells in vivo. Methods. In order to induce xGVHD, human peripheral blood mononuclear cells (huPBMC) were administered intravenously in NOD-scid IL-2Rγnull (NSG) mice. Results. AZA successfully improved both survival (p<0.0001) and xGVHD scores (p<0.0001). Further, AZA significantly decreased human T-cell proliferation as well as INF-γ and TNF-α serum levels, and reduced the expression of GRANZYME B and PERFORIN 1 by cytotoxic T cells. In addition, AZA administration significantly increased the function, proliferation and frequency of Tregs through demethylation of FOXP3i1 and higher secretion of IL-2 by conventional T cells due to IL2 gene promoter site 1 demethylation. Interestingly, among AZA-treated mice surviving the acute phase of xGVHD, there was an inverse correlation between the presence of Tregs and signs of chronic GVHD. Finally, Tregs harvested from the spleen of AZA-treated mice were suppressive and stable over time since they persisted at high frequency in secondary transplant experiments. Conclusion. These findings emphasize a potential role for AZA as prevention or treatment of GVHD and other autoimmune diseases. [less ▲]

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See detailGalectin-1 is involved in osteoclast biology
Muller, Joséphine ULiege; Binsfeld, Marilène ULiege; DUBOIS, Sophie ULiege et al

Poster (2016, February 28)

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See detailYellow nail syndrome after allogeneic haematopoietic stem cell transplantation in two patients with multiple myeloma
Grégoire, Céline ULiege; GUIOT, Julien ULiege; Vertenoeil, Gaëlle ULiege et al

in Acta Clinica Belgica (2016), 71

Objective and Importance: Yellow nail syndrome (YNS) is a rare disorder of unknown aetiology characterized by the triad of yellow nails, lymphoedema and respiratory manifestations. About 200 cases have ... [more ▼]

Objective and Importance: Yellow nail syndrome (YNS) is a rare disorder of unknown aetiology characterized by the triad of yellow nails, lymphoedema and respiratory manifestations. About 200 cases have been reported, but a lot of patients probably elude proper diagnosis because of both variability of symptoms and ignorance of this syndrome by many physicians. The pathogenesis remains unclear, and could involve functional lymphatic abnormalities, microvasculopathy or lymphocyte deficiency, but none of these hypotheses seems fully satisfactory. Clinical Presentation: We report for the first time two cases of YNS associated with multiple myeloma relapsing after non-myeloablative haematopoietic cell transplantation (HCT). In these two cases, onset or worsening of YNS symptoms followed graft-versus-host disease (GvHD) manifestations. Intervention: Corticosteroids given to treat GvHD also improved YNS manifestations. Conclusion: YNS after HCT might be a microvascular manifestation of endothelial GvHD and corticosteroids might be an effective treatment. [less ▲]

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See detailImmunomodulatory effects of rapamycin in Graft versus Host Disease
Ehx, Grégory ULiege; Hannon, Muriel ULiege; Humblet-Baron, Stéphanie et al

Poster (2016, January 29)

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See detailAzacytidine and Decitabine prevent experimental sclerodermic chronic graft-versus-host disease
Fransolet, Gilles ULiege; Ehx, Grégory ULiege; SOMJA, Joan ULiege et al

Poster (2016, January 29)

Introduction: Graft-versus-host disease (GVHD) remains a major complication of allogeneic hematopoietic stem cell transplantation (HSCT). Following allo-transplantation, 60% of the patients experience ... [more ▼]

Introduction: Graft-versus-host disease (GVHD) remains a major complication of allogeneic hematopoietic stem cell transplantation (HSCT). Following allo-transplantation, 60% of the patients experience chronic GVHD while approximately 15% of them develop a sclerodermic form of chronic GVHD characterized by multiple organ fibrosis and loss of skin elasticity. Regulatory T cells (Tregs) play a pivotal protective role in the pathogenesis of chronic GVHD by inhibiting alloreactive conventional T cells (Tconvs). Several studies have shown that hypomethylating agents such as Azacytidine (AZA) or Decitabine (DAC) can demethylate the master transcription factor of Treg (FoxP3), thus promoting Treg differentiation from Tconvs. This work investigates the impact of AZA and DAC in a murine model of sclerodermic chronic GVHD. Methods: Lethally irradiated (7 Gy) BALB/cJ recipient mice were injected with 107 bone marrow cells + 7.107splenocytes from B10.D2 donor mice to induce scl-cGVHD. Recipients were injected with 0.5 or 2 mg/kg of AZA or 0.75 mg/kg of DAC every 48h from day 10 to 30 following transplantation. GVHD was scored using a five criteria scale (weight loss, activity, fibrosis, hair loss and mice posture; 0-1-2 points/criteria). Mice were sacrificed at a score of 8/10. Results: Mice treated with AZA 0.5 mg/kg (n=14) or 2 mg/kg (n=17) or DAC 0.75 mg/kg (n=5) had lower clinical scores of GVHD compared to control (n=15). FACS analyses showed a higher proportion of Treg in the blood of AZA 0.5 or 2 mg/kg or DAC 0.75 mg/kg mice than in control at day 35. Results also showed a decreased number of Tconv and CD8 in AZA and DAC treated mice while proliferation of these cells expressing Ki67 was lower during AZA/DAC treatment but higher after discontinuation. Histological analyses showed less skin fibrosis in mice treated with 2 mg/kg of AZA. Finally, analyses of the blood components demonstrated that AZA mice were leuco- and lymphopenic as compared to control at day 21 and 35. Conclusion : AZA and DAC prevented sclerodermic GVHD in this murine model. [less ▲]

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See detailSalt but not glucocorticoïds enhances Th17 differentiation from naïve T cells in vitro
Delens, Loïc ULiege; SERVAIS, Sophie ULiege; Vrancken, Louise et al

Poster (2016, January 29)

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See detailL'anémie dans la bronchopneumopathie chronique obstructive sévère : Une comorbidité plus fréquente qu'on ne le croit
Pirotte, Michèle ULiege; Guiot, Joël ULiege; Beguin, Yves ULiege et al

in Revue Médicale de Liège (2016), 71(11), 488-494

Chronic Obstructive Pulmonary Disease (COPD) is traditionally associated with polycythemia which results from chronic hypoxemia. Nevertheless, recent studies have shown that anemia may be more frequent ... [more ▼]

Chronic Obstructive Pulmonary Disease (COPD) is traditionally associated with polycythemia which results from chronic hypoxemia. Nevertheless, recent studies have shown that anemia may be more frequent than expected in patients with COPD. In this retrospective study, we investigated the prevalence of hemoglobin disorders in a cohort of 100 patients with stable, moderate to severe COPD (II to IV GOLD classification). We identified 31 % patients with anemia while only 15 % had polycythemia. Anemia was more frequent in male patients. We also demonstrated a negative correlation between hemoglobin and CRP levels (R=-0.56, p < 0.0001). COPD patients with anemia had experienced a higher rate of hospitalizations for exacerbation in the previous year than those with polycythemia (p < 0.05). Anemia is a frequent comorbidity in COPD; it is associated with systemic inflammation and a propensity to hospitalization for exacerbation. [less ▲]

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See detailL'anémie dans la bronchopneumopathie chronique obstructive sévère: une comorbidité plus fréquente que l'on ne croit
Pirotte, Michèle ULiege; GUIOT, Julien ULiege; BEGUIN, Yves ULiege et al

in Revue Médicale de Liège (2016), 71

Chronic obstructive pulmonary disease (COPD) is traditionally associated with polycythemia which results from chronic hypoxemia. Nevertheless, recent studies have shown that anemia may be more frequent ... [more ▼]

Chronic obstructive pulmonary disease (COPD) is traditionally associated with polycythemia which results from chronic hypoxemia. Nevertheless, recent studies have shown that anemia may be more frequent than expected in patients with COPD. In this retrospective study, we investigated the prevalence of hemoglobin disorders in a cohort of 100 patients with stable, moderate to severe COPD (II to IV GOLD classification). We identified 31 % patients with anemia while only 15 % had polycythemia. Anemia was more frequent in male patients. We also demonstrated a negative correlation between hemoglobin and CRP levels (R=-0.56, p < 0.0001). COPD patients with anemia had experienced a higher rate of hospitalizations for exacerbation in the previous year than those with polycythemia (p < 0.05). Anemia is a frequent comorbidity in COPD; it is associated with systemic inflammation and a propensity to hospitalization for exacerbation. [less ▲]

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