Publications of Nicolas Lambert
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See detailAtezolizumab Treatment for Progressive Multifocal Leukoencephalopathy
Lambert, Nicolas ULiege; Dauby, Solène ULiege; DIVE, Dominique ULiege et al

in Emerging Infectious Diseases (2022), 28(1),

Atezolizumab successfully reinvigorated JC virus immunity in a patient in Belgium with progressive multifocal leukoencephalopathy, as demonstrated by clinical, virologic, and radiologic response to ... [more ▼]

Atezolizumab successfully reinvigorated JC virus immunity in a patient in Belgium with progressive multifocal leukoencephalopathy, as demonstrated by clinical, virologic, and radiologic response to treatment. However, the treatment also resulted in immune reconstitution inflammatory syndrome and life-threatening immune-related adverse events. These conditions were treated with corticosteroids, leading to treatment resistance. [less ▲]

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See detailImpact of the COVID-19 pandemic situation on HIV care in Liège, Belgium
El Moussaoui, Majdouline ULiege; Lambert, Nicolas ULiege; MAES, Nathalie ULiege et al

Poster (2021, November 30)

Background: The COVID-19 pandemic and associated containment measures dramatically affected the health care systems including the screening of human immunodeficiency virus and the management of people ... [more ▼]

Background: The COVID-19 pandemic and associated containment measures dramatically affected the health care systems including the screening of human immunodeficiency virus and the management of people living with HIV around the world by making the access to preventive care services and specific medical monitoring more difficult. Objective: To study the impact of the COVID-19 pandemic on the holistic care of people living with HIV in Liège (Belgium). Methods: In this retrospective observational study conducted in Liège University Hospital, we compared the out-patient follow-up of HIV-infected individuals as well as the number of new HIV diagnoses between 2019 and 2020 and between the different waves of the COVID-19 pandemic in 2020. Results: In 2020, when compared to 2019, we observed a significant decrease in the number of new HIV diagnoses, especially during the first wave of the pandemic, and in the number of consultations undertaken by sexual health services, psychologists and specialists in infectious diseases at our HIV clinic. We also observed a decrease in the number of viral load assays and blood CD4+ T-cells count analyses performed, although we found less patients with HIV plasma viral load above 400 copies per mL in 2020. Finally, we noted a significant reduction in terms of screening of our HIV-infected patients for hepatitis C, syphilis, colorectal and anal cancers and hypercholesterolemia. Conclusions: Our experience exhibits the deleterious impact of the COVID-19 pandemic on the HIV care and the need to implement new strategies to guarantee its continuum. [less ▲]

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See detailImpact of the COVID-19 pandemic situation on HIV care in Liège, Belgium
El Moussaoui, Majdouline ULiege; Lambert, Nicolas ULiege; MAES, Nathalie ULiege et al

in HIV Research & Clinical Practice (2021)

Background: The COVID-19 pandemic and associated containment measures dramatically affected the health care systems including the screening of human immunodeficiency virus and the management people living ... [more ▼]

Background: The COVID-19 pandemic and associated containment measures dramatically affected the health care systems including the screening of human immunodeficiency virus and the management people living with HIV around the world by making the access to preventive care services and specific medical monitoring more difficult. Objective: To study the impact of the COVID-19 pandemic on the holistic care of people living with HIV in Liège (Belgium). Methods: In this retrospective observational study conducted in Liège University Hospital, we compared the out-patient follow-up of HIV-infected individuals as well as the number of new HIV diagnoses between 2019 and 2020 and between the different waves of the COVID-19 pandemic in 2020. Results: In 2020, when compared to 2019, we observed a significant decrease in the number of new HIV diagnoses, especially during the first wave of the pandemic, and in the number of consultations undertaken by sexual health services, psychologists and specialists in infectious diseases at our HIV clinic. We also observed a decrease in the number of viral load assays and blood CD4 + T-cells count analyses performed, although we found less patients with HIV plasma viral load above 400 copies per mL in 2020. Finally, we noted a significant reduction in terms of screening of our HIV-infected patients for hepatitis C, syphilis, colorectal and anal cancers and hypercholesterolemia. Conclusions: Our experience exhibits the deleterious impact of the COVID-19 pandemic on the HIV care and the need to implement new strategies to guarantee its continuum. [less ▲]

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See detailImmune checkpoint inhibitors for progressive multifocal leukoencephalopathy: identifying relevant outcome factors
Lambert, Nicolas ULiege; El Moussaoui, Majdouline ULiege; MAQUET, Pierre ULiege

in European Journal of Neurology (2021)

Introduction: Progressive multifocal leukoencephalopathy (PML) is an infectious brain disease caused by JC virus in immunocompromised individuals. Immune checkpoint inhibitors (ICIs) recently emerged as a ... [more ▼]

Introduction: Progressive multifocal leukoencephalopathy (PML) is an infectious brain disease caused by JC virus in immunocompromised individuals. Immune checkpoint inhibitors (ICIs) recently emerged as a therapeutic hope for these patients but identification of those likely to respond to the treatment is still an unmet need. Method: We performed a systematic PubMed search for reports of patients treated for PML using an ICI. Clinical, biological and radiological characteristics were contrasted between patients who responded to the treatment (RP) and those who did not (NRP). Results: 35 patients were included in the present study. 21 of them reportedly benefited from the treatment. Age, blood CD4+ cells count, pre-treatment viral load in the cerebrospinal fluid (CSF), PML lesions localization, treatment delay since first PML symptoms, type of ICI used and immune-related adverse events (irAEs) occurrence did not significantly differ between RP and NRP. By contrast, a history of therapeutic immune suppression and the use of an immunosuppressive therapy at treatment initiation were significantly associated with a poor response. Besides, reaching an undetectable viral load the CSF and reduction of the lesion load on magnetic resonance imaging after ICI administration were associated with a good clinical response. Conclusion: Current data suggest that patients with PML under immunosuppressive therapy are less likely to respond to ICIs and raise the issue of the optimal management of irAEs during ICI treatment in this setting. [less ▲]

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See detailLes syndromes neurologiques paranéoplasiques
Lambert, Nicolas ULiege; LUTTERI, Laurence ULiege; SADZOT, Bernard ULiege et al

in Revue Médicale de Liège (2021), 76(5-6), 413-418

Neurological paraneoplastic syndromes are non-metastatic complications of systemic cancers, often resulting from an immune response triggered by the crossed expression of neuronal antigens by tumour cells ... [more ▼]

Neurological paraneoplastic syndromes are non-metastatic complications of systemic cancers, often resulting from an immune response triggered by the crossed expression of neuronal antigens by tumour cells. Several neurological syndromes such as cerebellar dege-neration, sensory neuronopathy, limbic encephalitis, ence-phalomyelitis or the Lambert-Eaton myasthenic syndrome are most often paraneoplastic and require prompt cancer screening, particularly if the patient shows risk factors for cancer. Although there are many exceptions to this rule, a given syndrome is often associated with a particular anti-body and the corresponding tumour. A prompt diagnosis of neurological paraneoplastic syndrome is of major impor-tance as it often reveals the underlying tumour. The treat-ment relies on both the elimination of the neoplasia and the control of the immune response. [less ▲]

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See detailLa leucoencéphalopathie multifocale progressive hier, aujourd'hui et demain
Lambert, Nicolas ULiege

Scientific conference (2021, April 27)

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See detailLung and liver sarcoidosis‐like reaction induced by tocilizumab
Lambert, Nicolas ULiege; Hansen, Isabelle ULiege; El Moussaoui, Majdouline ULiege et al

in British Journal of Clinical Pharmacology (2021)

A drug‐induced sarcoidosis‐like reaction is a systemic granulomatous reaction indistinguishable from sarcoidosis and occurring in temporal relationship with a drug initiation. In this article, we report a ... [more ▼]

A drug‐induced sarcoidosis‐like reaction is a systemic granulomatous reaction indistinguishable from sarcoidosis and occurring in temporal relationship with a drug initiation. In this article, we report a patient who developed lung and liver granulomatous lesions following tocilizumab initiation for a giant cell arteritis. Infectious, toxic, neoplastic and inflammatory differential diagnoses were ruled out and lesions regressed after treatment cessation, leading to the diagnosis of tocilizumab induced sarcoidosis‐like reaction. We review the six cases reported so far and emphasize the value of a prompt diagnosis. Finally, we discuss the potential pathophysiological mechanisms underlying this rare reaction, which could help to better understand the pathophysiology of sarcoidosis. [less ▲]

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See detailPembrolizumab‐induced migrating cortico‐subcortical brain lesions
Lambert, Nicolas ULiege; Steinmetz, Maximilien ULiege; SIBILLE, Anne ULiege et al

in Annals of Neurology (2021)

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See detailPrésentation d'article: NLRP3-dependent pyroptosis is required for HIV-1 gp120-induced neuropathology
Lambert, Nicolas ULiege

Scientific conference (2019, December 14)

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See detailAmylose rénale secondaire à une fièvre méditerranéenne familiale résistante à la colchicine
Lambert, Nicolas ULiege

Master's dissertation (2018)

Familial Mediterranean Fever (FMF) is the most prevalent monogenic hereditary autoinflammatory disease. FMF occurs mainly among Turks, Armenians, Arabs and non-Ashkenazi Jews. Signs and symptoms include ... [more ▼]

Familial Mediterranean Fever (FMF) is the most prevalent monogenic hereditary autoinflammatory disease. FMF occurs mainly among Turks, Armenians, Arabs and non-Ashkenazi Jews. Signs and symptoms include reccurent fever, seritis and arthritis during 1 to 3 days. The main complication of FMF is the development of amyloidosis which may cause renal failure. In the majority of cases, life-long colchicine therapy can control the disease and prevent this complication. When colchicine is not efficient, interleukine-1 (IL-1) beta inhibitors are used and are, in general, able to control the illness. My thesis is a case-report on a man of Armenian descent, born in 1981, who has a FMF diagnosed late at the age of 21. The disease didn’t respond to colchicine and the patient continued to develop crisis several times a month. The patient moved to Belgium and, in 2011, a nephrotic syndrome was diagnosed. The latter was caused by renal amyloidosis, itself secondary to the FMF. As of 2012, the patient was treated with anakinra (a human IL-1 receptor antagonist binding competitively to IL-1α and IL-1β) but this treatment was too expensive for the patient and was stopped. From 2014, as part of a clinical study, the patient was treated with canakinumab (an anti-IL-1β monoclonal antibody) which caused a spectacular clinical and biological response (complete stop of the attacks and decrease of the SAA blood level under 10 mg/L which is the target level for the prevention of secondary amyloidosis). Nevertheless, the renal damage progressed and finally evolved into terminal renal failure. The likelihood of developing amyloidosis and making it progress to renal failure is directly related to the SAA blood level8 (SAA is a marker of inflammation and the precursor of AA amyloidosis). High SAA blood level was long been cosnsidered as the only risk factor for amyloidosis but our patient developed amyloidosis and renal insufficiency despite his treatment by canakinumab perfectly controlling the inflammation. This supports the emerging idea arguing that there are other amyloidosis risk factors. One of these risk factors (and probably the most important) is the country of residence. The countries associated with an increased risk of amyloidosis are the ones associated with high infant mortality rates. Since infant mortality rate is an indicator of population health, this finding suggests that the living environnement impacts amyloidosis susceptibility (poverty, difficult access to healthcare…). If our patient had been diagnosed and treated earlier in Armenia, he could not have developed amyloidosis this early. In Armenia, one in 500 people has FMF. A better healthcare program would lead to a better prognosis for many people suffering from FMF. This sentence is actually true for plenty of people with various diseases all around the world. The current treatment for AA amyloidosis consists of controlling the underlying inflammatory disease. Our patient exemplifies that this isn’t always possible or sufficient. Other treatments must be actively looked for. The Serum Amyloid P component (SAP) is a pentameric protein found in all types of amyloid deposits. Amyloid P component stabilizes these deposits by preventing proteolytic cleavage and by inhibiting fibrils removal. Ongoing studies show promising results on the combination of CPHPC (R-1-[6-[R-2-carboxy-pyrrolidin-1-yl]-6-oxohexanoyl] pyrrolidine-2-carboxylic acid) and anti-SAP antibodies. CPHPC liaises with two SAP pentamers, promoting their removal from the blood by the liver. Anti-SAP antibodies combined with CPHPC leads to a significant regression of the amyloid deposits. These studies could lead to new therapeutic possibilities. In conclusion, the development of amyloidosis secondary to FMF depends on various risk factors not particulary well known. A better understanding of these ones, as well as a better healthcare program around the world, would lead to a better care of the patients. Current therapies for AA amyloidosis are not always sufficient but ongoing researches could lead to new treatment guidelines. [less ▲]

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