P. Bierling - Academia.edu (original) (raw)

Papers by P. Bierling

$Research paper thumbnail of High-dose methylprednisolone is an alternative treatment for adults with autoimmune thrombocytopenic purpura refractory to intravenous immunoglobulins and oral corticosteroids$

American Journal of Hematology, 1995

Eight patients with severe chronic autoimmune thrombocytopenic purpura (AITP) refractory to high-... more Eight patients with severe chronic autoimmune thrombocytopenic purpura (AITP) refractory to high-dose intravenous immunoglobulin (IVIgG) and/or oral prednisone were treated with one to three infusions of high-dose methylprednisolone (HDMP) (15 mg/kg/ day). The mean platelet count before treatment was 12 * 10 x 109/L. HDMP therapy led to a safe platelet count (>50 x 109/L) after 2-5 days in five patients, and a minimal platelet increase (34 x 10s/L) able to stop bleeding in a sixth patient. The effect of HDMP was, however, transient in four of the five responders. No side effects were observed, even in the four patients older than 70 years. HDMP thus appears to be a good alternative in emergency situations or prior to surgery for patients with AITP refractory to conventional therapy.

Tissue Antigens - TISSUE ANTIGEN, 1998

The molecular characterisation of the major histocompatibility complex (MHC) locus, and of the HL... more The molecular characterisation of the major histocompatibility complex (MHC) locus, and of the HLA-B gene in particular, has revealed an impressive sequence diversity which contributes to the knowledge of its implication in immune specific responses. According to the World Health Organisation (WHO) nomenclature for factors of

Haematologica, 2015

M urine models of red blood cell transfusion show that inflammation associated with viruses or me... more M urine models of red blood cell transfusion show that inflammation associated with viruses or methylated DNA promotes red blood cell alloimmunization. In vaccination studies, the intensity of antigen-specific responses depends on the delay between antigen and adjuvant administration, with a short delay limiting immune responses. In mouse models of alloimmunization, the delay between the injection of Tolllike receptor agonists and transfusion is usually short. In this study, we hypothesized that the timing of Toll-like receptor 3 agonist administration affects red blood cell alloimmunization. Poly(I:C), a Toll-like receptor 3 agonist, was administered to B10BR mice at various time points before the transfusion of HEL-expressing red blood cells. For each time point, we measured the activation of splenic HEL-presenting dendritic cells, HEL-specific CD4 + T cells and anti-HEL antibodies in serum. The phenotype of activated immune cells depended on the delay between transfusion and Tolllike receptor-dependent inflammation. The production of anti-HEL antibodies was highest when transfusion occurred 7 days after agonist injection. The proportion of HEL-presenting CD8α + dendritic cells producing interleukin-12 was highest in mice injected with poly(I:C) 3 days before transfusion. Although the number of early-induced HEL-specific CD4 + T cells was similar between groups, a high proportion of these cells expressed CD134, CD40 and CD44 in mice injected with poly(I:C) 7 days before transfusion. This study clearly shows that the delay between transfusion and Toll-like receptor-induced inflammation influences the immune response to transfused red blood cells.

Vox Sanguinis, 2009

Background Transfusion-related acute lung injury (TRALI) is currently one of the most common caus... more Background Transfusion-related acute lung injury (TRALI) is currently one of the most common causes of transfusion-related major morbidity and death. Among the many TRALI mediators, leucocyte antibodies have been identified as important triggers of severe TRALI.

Blood, 2011

Romiplostim, a thrombopoietic agent with demonstrated efficacy against immune thrombocytopenia (I... more Romiplostim, a thrombopoietic agent with demonstrated efficacy against immune thrombocytopenia (ITP) in prospective controlled studies, was recently licensed for adults with chronic ITP. Only France has allowed romiplostim compassionate use since January 2008. ITP patients could receive romiplostim when they failed to respond to successive corticosteroids, intravenous immunoglobulins, rituximab, and splenectomy, or when splenectomy was not indicated. We included the first 80 patients enrolled in this program with at least 2 years of follow-up. Primary platelet response (platelet count ≥ 50 × 109/L and double baseline) was observed in 74% of all patients. Long-term responses (2 years) were observed in 47 (65%) patients, 37 (79%) had sustained platelet responses with a median platelet count of 106 × 109/L (interquartile range, 75-167 × 109/L), and 10 (21%) were still taking romiplostim, despite a median platelet count of 38 × 109/L (interquartile range, 35-44 × 109/L), but with clinic...

Transfusion Clinique et Biologique, 2015

Tissue Antigens, 2010

Gene frequencies of mainly human platelet antigens (HPA)-1 to-6 and-15 were determined in 116 Tun... more Gene frequencies of mainly human platelet antigens (HPA)-1 to-6 and-15 were determined in 116 Tunisian blood donors. The distribution of HPA-1,-3 and-5 systems approach those found in other Maghrebian populations. Tunisians have the highest frequency of HPA-1b and-5b alleles. The distribution of HPA-1a allele and HPA-4,-6 and-15 systems is similar to Caucasians. Phylogenetic study using the neighbor-joining method and principal component multivariate analysis demonstrate that Tunisians are more closely related to western than to eastern Mediterraneans. This immunogenetic study highlights the relatedness between Mediterranean populations and will serve as a baseline study for future clinical research involving platelet disorders among Tunisians.

ISBT Science Series

On 13 November 2015, between 9:20 pm and 00:20 am, terrorists committed several attacks in Saint-... more On 13 November 2015, between 9:20 pm and 00:20 am, terrorists committed several attacks in Saint-Denis and the East Parisian districts. These attacks, claimed by the organization Islamic State, constitute the deadliest series of multisite attacks that France has experienced. The stake for the Etablissement Franc ßais du Sang (EFS, the French public blood service) was to face the shockwave that propagated throughout the whole establishment from the very minutes following the events, impacting all the processes and stakeholders involved in the transfusion chain, which were challenged by a massive blood donor influx as soon as 14 November 2015. This article covers the impacts of the attacks on immunohaematology and delivery activities as well as the actions that were implemented to ensure sufficient blood supply. Then, the impacts on blood component production are set out. EFS integrated organization and available stocks allowed meeting blood requirements and enabled a strong control of outdating, after unprecedented blood collections during the weeks following 13 November 2015. Lastly, the article presents EFS experience feedback of Paris attacks and of the event that occurred in Nice on 14 July 2016, which helped improve our crisis management pattern with: 1 Specific steps implemented in delivery facilities located in hospitals that were flooded by a large number of victims; 2 An analysis of the postattack donor population; 3 A reflection on optimal organizational schemes to face a donation influx; 4 Actions to leverage the consequences of a 'media wave' that could potentially result in useless, excessive blood collections.

Transfusion Clinique et Biologique, 2008

La nécessité d'adapter les pratiques de gestion des concentrés érythrocytaires en blocs opératoir... more La nécessité d'adapter les pratiques de gestion des concentrés érythrocytaires en blocs opératoires et réanimations à l'évolution du cadre législatif réglementaire a généré une démarche collective d'amélioration des pratiques. Réunis sous l'impulsion des coordonnateurs régionaux d'hémovigilance

Transfusion Clinique et Biologique, 2013

Transfusion Medicine, 2009

Pregnancy may allow alloimmunization against human platelet antigens (HPA), which can lead to neo... more Pregnancy may allow alloimmunization against human platelet antigens (HPA), which can lead to neonatal alloimmune thrombocytopenia (NAIT). The specificities of alloantibodies are closely related to the distribution of the HPA systems. A total of 281 Tunisian multiparous women (mean number of pregnancies: 4.5) were phenotyped for the HPA-1, -3 and -5 systems, by monoclonal antibody immobilization of platelet antigens (MAIPA). We searched for antibodies against HPA-1a, HPA-3a, HPA-5b and HPA-5a in HPA-1b1b, HPA-3b3b, HPA-5a5a and HPA-5b5b individuals, respectively. The gene frequencies were: 0.83 for HPA-1a, 0.17 for HPA-1b, 0.78 for HPA-3a, 0.22 for HPA-3b, 0.82 for HPA-5a and 0.18 for HPA-5b. Anti-HPA-5b antibodies were present in eight sera and anti-HPA-3a antibodies were present in one serum. The anti-HPA-5b system is the most frequently involved in platelet alloimmunization in Tunisian multiparous women. However, prospective trials are required to confirm this result and to determine the exact frequencies and clinical relevance of platelet alloantibodies in pregnant Tunisian women.

Transfusion Clinique Et Biologique, 2008

BackgroundPrevention of hemolytic transfusion reactions depends upon our capacity to prevent allo... more BackgroundPrevention of hemolytic transfusion reactions depends upon our capacity to prevent allo-immunization and conflicts between antigens of transfused red blood cells and antibodies produced by the recipient. In this study, we show that to secure transfusion of sickle cell disease patients, it is necessary to take into account their immunohematologic characteristics in the organization of transfusion.

Blood, 1992

We previously reported the presence in platelet eluates of autoantibodies directed against epitop... more We previously reported the presence in platelet eluates of autoantibodies directed against epitopes of the platelet glycoprotein (GP)IIb/IIIa complex in acquired immunodeficiency syndrome (AIDS)-free human immunodeficiency virus (HIV)-infected patients with immunologic thrombocytopenic purpura (ITP). We investigated whether HIV antibodies recognized platelet membrane antigens to determine whether the virus might be directly or indirectly responsible for the thrombocytopenia in this context. Direct eluates of platelets from 25 patients with HIV-related ITP contained IgG reacting with HIV-GP160/120 and also, in 45% of patients, detectable antiplatelet antibodies, immunochemically characterized as anti-GPIIb and/or anti-GPIIIa in 5 patients. Furthermore, serum HIV-GP160/120 antibodies could be absorbed on and eluted from platelets from normal non-HIV-infected healthy blood donors (indirect eluates). In contrast, GP160/120 antibodies present in the serum of nonthrombocytopenic HIV-infec...