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Brigitte Dreno

Publications and source records attributed to Brigitte Dreno.

30 records · Page 2Linked to original sources
PubMed2003

Diagnosis of primary cutaneous B-cell lymphoma by immunohistochemical and in situ hybridization methods.

A diagnosis of primary cutaneous B-cell lymphoma is mainly supported by identification of a monoclonal B-cell population in the skin. This identification is made either by immunohistochemistry techniques using monoclonal antibodies towards the lambda or kappa chains, or by PCR for the heavy chain of immunoglobulins. Immunohistochemistry has a low sensitivity in detecting monoclonality, whereas the PCR technique is sensitive, but does not permit the localization of tumour cells in the skin. The aim of this study was to determine whether a monoclonal population in the skin could be detected by in situ hybridization. Thirty-eight skin biopsies from patients with primary cutaneous B-cell lymphoma were studied. Monoclonality was observed in 24/38 (63%) biopsies using immunohistochemical methods and 32/38 (84%) when combining this with in situ hybridization. It is concluded that kappa or lambda chain in situ hybridization is an interesting complementary technique to detect monoclonal B cells, if the immunohistochemical technique is negative.

Adult↗
PubMed2003

[Passive immunotherapy of melanoma].

The protocols of tumor immunotherapy have been largely developed in the past ten years due to the identification of many tumor antigens recognized specifically by CD8 and CD4 T lymphocytes. Among the various immunotherapies currently tested, passive immunotherapy (i.e injection of T lymphocytes generated and selected ex-vivo from blood or from the tumor), seems to be particularly promising. Indeed, three recent studies evidence the efficacy of such therapy in melanoma treatment. For the first time, a precise immunological follow-up was carried out, thus showing the correlation between the therapeutic benefit and the injection of tumor antigen specific T lymphocytes, and the survival and the preferential migration of these lymphocytes to the tumor sites. Although all the questions about optimal methods for this mode of therapy are not solved, these recent results constitute a major breakthrough in the field of the tumor immunotherapy.

CD4-Positive T-Lymphocytes↗
PubMed2002

A comparison of oral and topical corticosteroids in patients with bullous pemphigoid.

BACKGROUND: Bullous pemphigoid is the most common autoimmune blistering skin disease of the elderly. Because elderly people have low tolerance for standard regimens of oral corticosteroids, we studied whether highly potent topical corticosteroids could decrease mortality while controlling disease. METHODS: A total of 341 patients with bullous pemphigoid were enrolled in a randomized, multicenter trial and stratified according to the severity of their disease (moderate or extensive). Patients were randomly assigned to receive either topical clobetasol propionate cream (40 g per day) or oral prednisone (0.5 mg per kilogram of body weight per day for those with moderate disease and 1 mg per kilogram per day for those with extensive disease). The primary end point was overall survival. RESULTS: Among the 188 patients with extensive bullous pemphigoid, topical corticosteroids were superior to oral prednisone (P=0.02). The one-year survival rate was 76 percent in the topical-corticosteroid group and 58 percent in the oral-prednisone group. Disease was controlled at three weeks in 92 of the 93 patients in the topical-corticosteroid group (99 percent) and 86 of the 95 patients in the oral-prednisone group (91 percent, P=0.02). Severe complications occurred in 27 of the 93 patients in the topical-corticosteroid group (29 percent) and in 51 of the 95 patients in the oral-prednisone group (54 percent, P=0.006). Among the 153 patients with moderate bullous pemphigoid, there were no significant differences between the topical-corticosteroid group and the oral-prednisone group in terms of overall survival, the rate of control at three weeks, or the incidence of severe complications. CONCLUSIONS: Topical corticosteroid therapy is effective for both moderate and severe bullous pemphigoid and is superior to oral corticosteroid therapy for extensive disease.

Administration, Oral↗
PubMed2002

Immunotherapy of metastatic melanoma by intratumoral injections of Vero cells producing human IL-2: phase II randomized study comparing two dose levels.

BACKGROUND: Systemic IL-2 has shown some activity in metastatic melanoma, but its use is severely limited by toxicity. TG2001 is a product in which the human IL-2 cDNA was incorporated into the genome of Vero cells, a monkey fibroblast cell line. The goal of this intratumorally applied therapy was to create an antitumor immune response stimulated by xeno-antigens and local production of IL-2 in the close vicinity of tumor-specific antigens. TG2001 was reported to have a good safety profile in two previous dose-escalating phase I studies performed in 18 patients with various solid tumors, with encouraging clinical responses in three patients. The objectives of this study were to evaluate the tolerance and incidence of tumor regression in patients with metastatic melanoma, following repeated administration of Vero-IL-2 cells. PATIENTS AND METHODS: This was on open-label, randomized phase II study comparing two doses of Vero-IL-2, 5x10(5) and 5x10(6) cells. Twenty-eight patients with metastatic melanoma were enrolled in the study, 14 in each treatment group. Patients received TG2001 by intratumoral injection on days 1, 3, and 5 every 4 weeks for four cycles, and every 8 weeks thereafter, until evidence of progressive disease (PD). Criteria for patient selection included histologically proven metastatic melanoma, with one tumor accessible for product administration, and at least another tumor site for response assessment. Evaluation included tumor measurements, humoral and T cell-mediated local and systemic immune response, humoral response to Vero cells, adverse events and standard laboratory parameters. RESULTS: None of the patients achieved a confirmed objective response. Stable disease (SD) was seen in six (43%) and eight patients (57%) at the 5x10(5) and the 5x10(6) dose level, respectively. Two patients, one in each group, died during the study (i.e., within 1 month after the last injection) due to PD. Three patients exhibited antibody responses to Vero cells. T-cell immunity, serum cytokine levels and cytokine mRNA expression in tumor biopsies did not show meaningful alterations after therapy, except for a trend toward an increase in intratumoral TH2 cytokine (IL-4 and/or IL-10) levels. The study drug was well tolerated at both dose levels and side effects mainly consisted of injection site pain and erythema, and pyrexia. CONCLUSION: The intratumoral administration of TG2001 was generally well tolerated in patients with metastatic melanoma, and transient disease stabilization was observed in 50% of patients.

Adult↗
PubMed2002

Modulation in vitro of keratinocyte integrins by interferon-alpha and interferon-gamma.

BACKGROUND: Interferon-alpha and -gamma are glycoproteins with antiviral and immunoregulatory properties. In vitro studies have shown a role for these cytokines in the regulation of epidermal keratinocyte growth and differentiation. In the same way, integrins are adhesion molecules which regulate keratinocyte proliferation and differentiation. AIM: To determine whether the regulatory activity of interferons on keratinocyte proliferation and differentiation is related to a modulation of keratinocyte integrins. METHODS: Two different methods were used: monolayers and reconstituted skin, incubated either with 1,200 U/mL interferon-alpha or 500 U/mL interferon-gamma or control medium for 48 h. The integrin expression was assessed by flow cytometry and immunohistochemistry. RESULTS: In monolayers, only the alpha3 subunit was significantly inhibited by interferon-gamma. In reconstituted skin, where keratinocytes are differentiated, both interferons had an inductive effect on beta1 expression and interferon-alpha had an inhibitory effect on alpha6 expression. CONCLUSION: Interferon-alpha and -gamma induce a modulatory effect on alpha3, alpha6 and beta1 which appears to be related to the state of differentiation. Moreover, the decreased expression of alpha6 and alpha3 could be one of the mechanisms involved in the formation of bullous lesions during long-term interferon therapy.

Antigenic Modulation↗
PubMedDate not supplied

Acne: physical treatment.

Different physical treatments may be used in acne therapy. The main indications are for treating retentional lesions (open and comedones), inflamed lesions, and scars.

Acne Vulgaris↗
PubMedDate not supplied

Lithium gluconate in the treatment of seborrhoeic dermatitis: a multicenter, randomised, double-blind study versus placebo.

Seborrhoeic dermatitis is a frequent and chronic dermatitis of the face for which the 2 main treatments used are topical antifungals and corticosteroids. The aim of this study was to investigate the effect of topical lithium gluconate in the treatment of this affection. One hundred and twenty-nine patients with a facial seborrhoeic dermatitis for at least two months and presenting erythema and desquamation of moderate to severe intensity, were randomised to either lithium gluconate ointment dosed at 8% or placebo. The products were applied twice a day for eight weeks. The primary endpoint was to obtain a complete remission. One hundred and twenty-three patients were valid for efficacy analysis. Lithium gluconate ointment was significantly more effective than placebo, with a complete clinical remission after 4 and 8 weeks respectively of 11.3% and 29.1% of the patients in the lithium group, and 5.1% and 3.8% respectively in the placebo group. This study confirms the effectiveness of 8% lithium gluconate ointment in the treatment of seborrhoeic dermatitis.

Administration, Topical↗
PubMedDate not supplied

Acne: evolution of the clinical practice and therapeutic management of acne between 1996 and 2000.

According to epidemiological studies, acne is a common condition affecting 80% of young people between 12 and 18 years of age. It is also the most common reason for consultation in private dermatology practices. Yet, paradoxically, very few studies have been concerned with the profile and therapeutic treatment of acne patients. The aim of this study was to compare both the evolution of the profile of acne patients and the therapies used by dermatologists between 1996 and 2000 through a survey. Two questionnaires had to be filled in by the dermatologists for all patients consulting for acne, the first in 1996 and the second in 2000. The purpose of these questions was to obtain information about the demographic characteristics of the patients, a clinical evaluation of the patients' acne, their quality of life and finally their treatment. The statistical tests used Chi2 tests and variance analysis. The alpha risk was fixed at 0.05. Two thousand two hundred and eighty four patients were included in the survey in 1996 and 2363 in 2000. The mean age was 21 7.6 in 1996 and 20.5 7.7 in 2000, the majority of whom were female (64.4% in 1996 and 63.6% in 2000). In 1996 37.4% were students, and 52.4% in 2000. For 81.1% of the patients, the consultations were spontaneous on their own initiative both in 1996 and 2000. As regards topical treatment, a decrease of antibiotic prescriptions was noted between 1996 and 2000 associated with a decrease of benzoyl peroxyde use. Concerning the systemic treatments, an increase of doxycyclin and isotretinoin prescriptions was reported together with a decrease of minocycline treatment. Prescription of zinc salts and hormonal treatments were stable. The frequency of biological investigations remained similar and low. The repercussions of acne on the patient's quality of life were more numerous in 1996 compared to 2000 but they remained equally intense for those who reported them. The profile of acne patients evolved slightly between 1996 and 2000 and interestingly the treatments were modified to take into account the information in the literature such as bacterial resistance or severe side effects.

Acne Vulgaris↗
PubMedDate not supplied

Effect of zinc gluconate on propionibacterium acnes resistance to erythromycin in patients with inflammatory acne: in vitro and in vivo study.

Tetracyclines and macrolide antibiotics have been in use for acne treatment for more than 20 years. Since 1992 increasing resistance to these antibiotics, and especially to erythromycin, is reported with Propionibacterium acnes. Zinc salts have demonstrated their efficacy in inflammatory acne treatment as well as their bacteriostatic activity against Propionibacterium acnes. The objective of our work was firstly to determine whether the clinical anti-inflammatory efficacy of zinc salts was altered in the presence of erythromycin resistant strains in vivo, and secondly to study the in vitro and in vivo effect of zinc on the sensitivity of Propionibacterium acnes strains to erythromycin. Thirty patients with inflammatory acne were treated by zinc gluconate with a daily dose of 30 mg for two months and bacteriologic samples were taken at D0, D30 and D60. In vivo, this study displayed a reduction in the number of inflammatory lesions after a 2-month treatment whether or not Propionibacterium acnes carriage was present. Concurrently, in vitro addition of zinc salts in the culture media of Propionibacterium acnes reduced resistance of Propionibacterium acnes strains to erythromycin. Thus, association of zinc salts via a systemic route and topical erythromycin treatment seems an interesting option in the light of an increasing number of patients carrying erythromycin resistant Propionibacterium acnes strains.

Acne Vulgaris↗
PubMedDate not supplied

Gluten intolerance and skin diseases.

Gluten sensitivity with or without coeliac disease (CD) symptoms and intestinal pathology has been suggested as a potentially treatable cause of various diseases. CD is a chronic disease which improves on withdrawal of wheat gliadins and barley, rye and oat prolamins from the diet. There have been numerous reports linking CD with several skin conditions. A body of evidence shows that dermatitis herpetiformis is actually a cutaneous manifestation of CD. Autoimmune diseases, allergic diseases, psoriasis and miscellaneous diseases have also been described with gluten intolerance. Dermatologists should be familiar with the appraisal of gluten sensitive enteropathy and should be able to search for an underlying gluten intolerance (GI). Serological screening by means of antigliadin, antiendomysial and transglutaminase antibodies should be performed. HLA typing is often useful in association with serologic tests. Intestinal biopsy is usually needed to establish the diagnosis of CD or GI. Thus, gluten intolerance gives rise to a variety of dermatological manifestations which may benefit from a gluten-free diet.

Celiac Disease↗