Publications by authors named "Paul Quentric"

Background: Fulminant myocarditis (FM) is a severe condition primarily triggered by viruses. Anti-RNA polymerase III autoantibodies (RNApol3) which are typically found in patients with severe systemic sclerosis, have been reported in patients with influenza-related FM. Our objective is to provide additional insight into RNApol3-associated FM.

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  • Severe thrombotic antiphospholipid syndrome (APS) significantly affects critical organs and has not been thoroughly studied in ICU patients, particularly regarding hematological issues.
  • A retrospective study in France tracked 134 APS patients in ICUs, revealing high rates of anemia (95%) and thrombocytopenia (93%), with low platelet counts linked to increased mortality.
  • The findings highlight the importance of understanding the causes of thrombocytopenia in APS patients, as conditions like thrombotic microangiopathy (TMA), heparin-induced thrombocytopenia (HIT), and disseminated intravascular coagulation (DIC) are prevalent in this population.
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  • Fulminant myocarditis is a serious condition that requires accurate diagnosis, typically through a myocardial biopsy, but the procedure carries risks, and its effectiveness for treatment is unclear.
  • A study at a French ICU examined patients who were on mechanical circulatory support (MCS) and underwent biopsy, finding that while the diagnosis of definite myocarditis increased significantly after biopsy, the actual change in treatment was minimal.
  • The study concluded that the risks associated with myocardial biopsy may outweigh its benefits in these vulnerable patients, suggesting a need for more caution in deciding to perform the procedure.
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  • Systemic lupus erythematosus (SLE) is an autoimmune disease that can lead to rare but severe lung complications (acute lung disease - ALD) which may cause respiratory failure.
  • A study reviewed 14 SLE patients with ALD admitted between 1996 and 2018, highlighting that many cases occurred at the onset of SLE and required intensive care.
  • Treatments included corticosteroids and various forms of respiratory support, with a high survival rate to discharge, but some patients experienced relapses of ALD without developing long-term lung disease.
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Objectives: Type-I interferons (IFNs-I) have potent antiviral effects. IFNs-I are also overproduced in patients with systemic lupus erythematosus (SLE). Autoantibodies (AAbs) neutralising IFN-α, IFN-β and/or IFN-ω subtypes are strong determinants of hypoxemic COVID-19 pneumonia, but their impact on inflammation remains unknown.

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Background: The systemic capillary leak syndrome (SCLS), also known as Clarkson disease, is a very rare condition characterized by recurrent life-threatening episodes of vascular hyperpermeability in the presence of a monoclonal gammopathy. Extended intravenous immunoglobulin (IVIG) treatment is associated with fewer recurrences and improved survival, but the optimal treatment dosage and duration remain unknown.

Objective: We aim to evaluate the safety of IVIG tapering and withdrawal in patients with SCLS.

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  • - The study examines adults suffering from fulminant myocarditis related to COVID-19, identifying two distinct groups: those meeting multisystem inflammatory syndrome criteria (MIS-A) and those who do not.
  • - Out of 38 patients analyzed, 66% met the MIS-A criteria, with significant differences in clinical outcomes; those with MIS-A exhibited higher in-hospital mortality (31% vs. 4%) and more severe organ failure.
  • - Biological markers also varied between the groups, suggesting differing underlying inflammatory processes, which could impact treatment approaches in future cases of COVID-19-related myocarditis.
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Objectives: Systemic rheumatic diseases (SRDs) are a group of inflammatory disorders that can need intensive care unit (ICU) admission during a flare-up, requiring administration of immunosuppressants. We undertook this study to determine the frequency, outcome, and occurrence associated factors of infections in flare-up SRD patients receiving immunosuppressant.

Methods: Monocenter, a retrospective study including SRD patients admitted to ICU for a flare-up requiring immunosuppressant from 2004 to 2019.

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The immunopathological pulmonary mechanisms leading to Coronavirus Disease (COVID-19)-related death in adults remain poorly understood. Bronchoalveolar lavage (BAL) and peripheral blood sampling were performed in 74 steroid and non-steroid-treated intensive care unit (ICU) patients (23-75 years; 44 survivors). Peripheral effector SARS-CoV-2-specific T cells were detected in 34/58 cases, mainly directed against the S1 portion of the spike protein.

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The capacity of pre-existing immunity to human common coronaviruses (HCoV) to cross-protect against COVID-19is yet unknown. In this work, we studied the sera of 175 COVID-19 patients, 76 healthy donors and 3 intravenous immunoglobulins (IVIG) batches. We found that most COVID-19 patients developed anti-SARS-CoV-2 IgG antibodies before IgM.

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Background: Lymphopenia and the neutrophil/lymphocyte ratio may have prognostic value in COVID-19 severity.

Objective: We investigated neutrophil subsets and functions in blood and bronchoalveolar lavage (BAL) of COVID-19 patients on the basis of patients' clinical characteristics.

Methods: We used a multiparametric cytometry profiling based to mature and immature neutrophil markers in 146 critical or severe COVID-19 patients.

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  • Innate immune activation linked to Covid-19 infection can lead to severe clinical outcomes, particularly in older individuals and those with pre-existing health issues.* -
  • The study measures neopterin levels in blood, finding that high levels in Covid-19 patients correlate with disease severity and outcomes, potentially serving as a useful biomarker.* -
  • Specifically, neopterin levels above 19nM can differentiate Covid-19 patients from healthy individuals, while levels above 53nM indicate higher risks of mortality.*
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The importance of the adaptive T cell response in the control and resolution of viral infection has been well established. However, the nature of T cell-mediated viral control mechanisms in life-threatening stages of COVID-19 has yet to be determined. The aim of the present study was to determine the function and phenotype of T cell populations associated with survival or death of patients with COVID-19 in intensive care as a result of phenotypic and functional profiling by mass cytometry.

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Background: Markedly elevated levels of proinflammatory cytokines and defective type-I interferon responses were reported in patients with coronavirus disease 2019 (COVID-19).

Objective: We sought to determine whether particular cytokine profiles are associated with COVID-19 severity and mortality.

Methods: Cytokine concentrations and severe acute respiratory syndrome coronavirus 2 antigen were measured at hospital admission in serum of symptomatic patients with COVID-19 (N = 115), classified at hospitalization into 3 respiratory severity groups: no need for mechanical ventilatory support (No-MVS), intermediate severity requiring mechanical ventilatory support (MVS), and critical severity requiring extracorporeal membrane oxygenation (ECMO).

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Humoral immune responses are typically characterized by primary IgM antibody responses followed by secondary antibody responses associated with immune memory and composed of IgG, IgA, and IgE. Here, we measured acute humoral responses to SARS-CoV-2, including the frequency of antibody-secreting cells and the presence of SARS-CoV-2-specific neutralizing antibodies in the serum, saliva, and bronchoalveolar fluid of 159 patients with COVID-19. Early SARS-CoV-2-specific humoral responses were dominated by IgA antibodies.

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