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Le Touquet – Paris-Plage, France

Pham-Thi N.,Service de pneumologie et dallergologie pediatriques | Pham-Thi N.,University of Paris Descartes | Leite-de-Moraes M.-C.,University of Paris Descartes
Revue Francaise d'Allergologie | Year: 2010

The term "Natural Killer T (NKT) cells" was first used in the 1990s to designate T lymphocytes expressing the NK marker NK1.1 (NKR-P1A or CD161). Subsequently, this population turned out to be quite heterogeneous and it is now well-established that it includes several subsets with distinct functional capacities. Among them, the invariant NKT (iNKT) cells are at present the most abundant and best characterized subset. They express the invariant Vα14J αφ{symbol}0α18 chain in mice and the Vα14J α18 chain in humans, preferentially paired with limited TCR Vβ chains. This particular T cell population, which recognizes glycolipids instead of peptides, is implicated in the severity of experimental allergic asthma. The influence of iNKT cells in the human pathology is still a matter of discussion. Here, we will briefly address these points in the following paragraphs. © 2010 Elsevier Masson SAS. All rights reserved.

Marcy O.,Institute Pasteur in Cambodia | Marcy O.,University of Bordeaux 1 | Ung V.,National Pediatric Hospital | Ung V.,University of Health Sciences | And 14 more authors.
Clinical Infectious Diseases | Year: 2016

The diagnosis of tuberculosis in human immunodeficiency virus (HIV)-infected children is challenging. We assessed the performance of alternative specimen collection methods for tuberculosis diagnosis in HIV-infected children using Xpert MTB/RIF (Xpert). Methods. HIV-infected children aged ≤13 years with suspected intrathoracic tuberculosis were enrolled in 8 hospitals in Burkina Faso, Cambodia, Cameroon, and Vietnam. Gastric aspirates were taken for children aged <10 years and expectorated sputum samples were taken for children aged ≥10 years (standard samples); nasopharyngeal aspirate and stool were taken for all children, and a string test was performed if the child was aged ≥4 years (alternative samples). All samples were tested with Xpert. The diagnostic accuracy of Xpert for culture-confirmed tuberculosis was analyzed in intention-to-diagnose and per-protocol approaches. Results. Of 281 children enrolled, 272 (96.8%) had ≥1 specimen tested with Xpert (intention-to-diagnose population), and 179 (63.5%) had all samples tested with Xpert (per-protocol population). Tuberculosis was culture-confirmed in 29/272 (10.7%) children. Intention-to-diagnose sensitivities of Xpert performed on all, standard, and alternative samples were 79.3% (95% confidence interval [CI], 60.3-92.0), 72.4% (95% CI, 52.8-87.3), and 75.9% (95% CI, 56.5-89.7), respectively. Specificities were ≥97.5%. Xpert combined on nasopharyngeal aspirate and stool had intention-to-diagnose and per-protocol sensitivities of 75.9% (95% CI, 56.5-89.7) and 75.0% (95% CI, 47.6-92.7), respectively. Conclusions. The combination of nasopharyngeal aspirate and stool sample is a promising alternative to methods usually recommended by national programs. Xpert performed on respiratory and stools samples enables rapid confirmation of tuberculosis diagnosis in HIV-infected children. © 2016 The Author.

Denery-Papini S.,French National Institute for Agricultural Research | Bodinier M.,French National Institute for Agricultural Research | Larre C.,French National Institute for Agricultural Research | Brossard C.,French National Institute for Agricultural Research | And 7 more authors.
Allergy: European Journal of Allergy and Clinical Immunology | Year: 2012

Background Gluten proteins can be modified by deamidation to enhance their solubility and technological applications. However, severe allergic reactions have been reported after the consumption of food products containing deamidated gluten (DG) in subjects tolerant to wheat. This work aimed to characterize allergen profiles for these patients in comparison with those of patients allergic to wheat and to identify IgE-binding epitopes. Methods Sera were obtained from 15 patients allergic to DG and from nine patients allergic to wheat proteins (WP). IgE-binding profiles were characterized both in ELISA and in a humanized rat basophilic leukaemia (RBL) cell model. Epitopes were mapped on γ- and ω2-gliadin sequences by Pepscan, and effect of glutamine/glutamic acid substitutions was studied. Results Compared to the heterogeneous pattern of allergens detected by IgE from patients allergic to WP, responses of patients allergic to DG were homogeneous. In ELISA, all the sera displayed IgE binding to deamidated γ- and ω2-gliadins and deamidated total gliadins, frequently with high concentrations. These modified proteins induced RBL degranulation with most of the sera from DG-allergic patients. A consensus epitope was found on native γ- and ω2-gliadins (QPQQPFPQ); it was repeated several times in their sequences. The substitution of two or three glutamines of this epitope into glutamic acid at positions Q3 or Q4 and Q8 (QPEEPFPE) increased its recognition the best. Conclusion Allergy to DG is a separate entity from wheat allergy. It can be evidenced by strong IgE binding to deamidated gliadins or peptides of the type QPEEPFPE. © 2012 John Wiley & Sons A/S.

Odievre M.-H.,Service de pediatrie | Odievre M.-H.,French Institute of Health and Medical Research | Danekova N.,Service de pediatrie | Picard C.,Center detude des deficits immunitaires | And 7 more authors.
Archives de Pediatrie | Year: 2011

A 15-month-old boy treated with amoxicillin and clavulanic acid therapy for 8 days was admitted for persistent gastroenteritis and fever. He received ceftriaxone for pneumonia modified on day 4 for cefotaxime and josamycin due to extension of alveolar lesions. On day 7, persistent fever and worsened respiratory distress led to addition of rifampicin. The child was then admitted to an intensive care unit. A hemophagocytic syndrome was suspected based on clinical signs and laboratory findings and confirmed by cytological examination of bone marrow. Adenovirus type 7 was identified by polymerase chain reaction and culture of bronchoalveolar fluid. Prognosis was good within 3 weeks. B and T immunologic evaluations were normal 5 months after the infection. This case of severe adenovirus pneumonia was associated with hemophagocytic syndrome in a child without identified primary immunodeficiency. Adenovirus type 3 and 7 are most frequently responsible for severe or fatal respiratory infections. © 2011 Elsevier Masson SAS.

Drummond D.,Service de pneumologie et dallergologie pediatriques | Drummond D.,University Paris DescartesParis | Thumerelle C.,Unite de Pneumologie Pediatrique | Reix P.,University of Lyon | And 14 more authors.
Pediatric Pulmonology | Year: 2016

Introduction: There is a lack of evidence concerning the effectiveness of immunoprophylaxis with palivizumab in children with childhood interstitial lung disease (chILD). In this retrospective study, we evaluated the effectiveness of palivizumab for decreasing the rate of RSV-related hospitalizations in children under the age of 24 months with chILD treated with corticosteroids. Methods: A retrospective national study was conducted in France. Patients born between 2007 and 2013, diagnosed with chILD and on corticosteroid treatment were identified through the French online database for pediatric interstitial lung disease (Respirare®). Data were collected for the etiology and severity of chILD, risk factors and preventive measures for bronchiolitis, palivizumab immunoprophylaxis, and hospitalizations for bronchiolitis and RSV-bronchiolitis. Results: We included and evaluated 24 children during their first two RSV seasons, corresponding to 36 patient-seasons. The observed rate of RSV-related hospitalization (305/1000 patient-seasons), and the median length of stay (7 days), were higher than those for the general population. RSV-related hospitalization rates did not differ significantly between children with and without palivizumab prophylaxis (5/16 vs. 4/18, respectively, P = 0.70). Conclusion: Children with chILD on corticosteroid treatment are at high risk of hospitalization for RSV-bronchiolitis, which tends to be more severe in these children than in the general population. The effectiveness of palivizumab prophylaxis in this population remains to be demonstrated. Pediatr Pulmonol. 2016;51:688–695. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

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