P. Demoly - Academia.edu (original) (raw)
Papers by P. Demoly
Current allergy and asthma reports, 2012
ABSTRACTBackgroundNeuromuscular blocking agents (NMBAs) are the leading cause of perioperative an... more ABSTRACTBackgroundNeuromuscular blocking agents (NMBAs) are the leading cause of perioperative anaphylaxis (POA), most reactions being IgE mediated. Allergic sensitization induced by environmental exposure to other quaternary ammonium-containing compounds, such as pholcodine, has been suggested. The aim of this study was to assess the relationship between pholcodine exposure and NMBA-related POA.MethodsALPHO is a multicentre case-control study, comparing pholcodine exposure within a year before anaesthesia between patients with NMBA-related POA (cases) and control patients with uneventful anaesthesia. Each case was matched to two controls by age, sex, type of NMBA, geographic area, and season. Pholcodine exposure was assessed by a self-administered questionnaire and pharmaceutical history retrieved from pharmacy records. The diagnostic values of anti-pholcodine and anti-quaternary ammonium specific IgE (sIgE) were also evaluated.ResultsOverall, 167 cases were matched with 334 contro...
Drug Metabolism Reviews, 2009
Drugs for allergy are often taken in combination with other drugs, either to treat allergy or oth... more Drugs for allergy are often taken in combination with other drugs, either to treat allergy or other conditions. In common with many pharmaceuticals, most such drugs are subject to metabolism by P450 enzymes and to transmembrane transport. This gives rise to considerable potential for drug-drug interactions, to which must be added consideration of drug-diet interactions. The potential for metabolism-based drug interactions is increasingly being taken into account during drug development, using a variety of in silico and in vitro approaches. Prediction of transporter-based interactions is not as advanced. The clinical importance of a drug interaction will depend upon a number of factors, and it is important to address concerns quantitatively, taking into account the therapeutic index of the compound.
Les allergies medicamenteuses constituent une part non negligeable de la iatrogenie medicamenteus... more Les allergies medicamenteuses constituent une part non negligeable de la iatrogenie medicamenteuse, et sont responsables d'une mortalite, d'une morbidite, et de surcouts mal evaluees. Elles representent un probleme frequent, quasi quotidien, pour le medecin prescripteur. Leurs manifestations sont multiples, allant d'une simple urticaire au grand choc anaphylactique ou au decollement cutane parfois mortels. Leurs diagnostics sont trop rarement confirmes. Leurs mecanismes sont varies et loin d'etre parfaitement apprehendes. Les reactions immediates, de type urticaire/angio-oedeme par exemple, sont souvent de mecanisme IgE-dependant, lorsqu'elles sont de nature allergique. Les reactions non immediates, de type exanthemes maculopapuleux par exemple, impliquent l'activation de lymphocytes T specifiques, lorsqu'elles sont de nature allergique. Devant l'impossibilite de detailler ici l'ensemble des connaissances relatives aux allergies medicamenteuses, nous nous limiterons aux actualites et donnees essentielles de leur physiopathologie.
Revue Française d'Allergologie, 2020
Déclaration de liens d'intérêt Pascal Demoly a reçu des honoraires de conseil ou des conférences ... more Déclaration de liens d'intérêt Pascal Demoly a reçu des honoraires de conseil ou des conférences des laboratoires ALK,
Presse médicale (Paris, France : 1983), Jan 7, 2000
DRUG PRESCRIPTION: Many pregnant women have asthma and/or rhinitis. Particular attention is requi... more DRUG PRESCRIPTION: Many pregnant women have asthma and/or rhinitis. Particular attention is required when prescribing drugs in this situation. Medication can be prescribed during pregnancy when the apparent benefit is greater than the apparent risk. Usually at least one drug of each major class used to control these disease can be given safely. In addition, physiological changes associated with pregnancy could affect the upper and lower pathways. CAREFUL MANAGEMENT: Ideally, drug prescription for asthma and/or rhinitis in pregnant women should be part of a global process implicating obstetricians, primary care physicians, and allergy, rhinology or lung specialists. The only way to improve the mother's comfort and avoid complications for both mother and child is to perfectly control the disease. Indeed, it would be regrettable to be too prudent and deprive symptomatic patients of active treatments. Patients should be clearly informed of the benefits and risks of drug therapy.
Revue Française d'Allergologie et d'Immunologie Clinique, 2003
International Archives of Allergy and Immunology, 2005
Background: The flow cytometry CD63-based basophil activation test (Basotest®) has already been v... more Background: The flow cytometry CD63-based basophil activation test (Basotest®) has already been validated for the diagnosis of immediate-type allergy such as venom, house dust mite or cypress pollen allergies. The aim of this study was to evaluate the performance (specificity and sensitivity) of Basotest in the diagnosis of natural rubber latex allergy. Methods: We included 46 latex allergic patients (clinical symptoms of latex allergy, positive latex skin prick tests and/or latex specific IgE) and 33 control subjects and performed Basotest on all subjects. Results: The sensitivity and specificity of Basotest were 84.8 and 87.9%, respectively, when we considered the theoretic cut-off at 15% of CD63-positive cells. Using ROC curves, the optimal cut-off was evaluated at 22%, for which sensitivity and specificity were 79.3 and 96.7%, respectively. Conclusion: The Basotest is a reliable test in addition to clinical history and tests already validated (such as skin prick tests and specif...
Current allergy and asthma reports, 2012
ABSTRACTBackgroundNeuromuscular blocking agents (NMBAs) are the leading cause of perioperative an... more ABSTRACTBackgroundNeuromuscular blocking agents (NMBAs) are the leading cause of perioperative anaphylaxis (POA), most reactions being IgE mediated. Allergic sensitization induced by environmental exposure to other quaternary ammonium-containing compounds, such as pholcodine, has been suggested. The aim of this study was to assess the relationship between pholcodine exposure and NMBA-related POA.MethodsALPHO is a multicentre case-control study, comparing pholcodine exposure within a year before anaesthesia between patients with NMBA-related POA (cases) and control patients with uneventful anaesthesia. Each case was matched to two controls by age, sex, type of NMBA, geographic area, and season. Pholcodine exposure was assessed by a self-administered questionnaire and pharmaceutical history retrieved from pharmacy records. The diagnostic values of anti-pholcodine and anti-quaternary ammonium specific IgE (sIgE) were also evaluated.ResultsOverall, 167 cases were matched with 334 contro...
Drug Metabolism Reviews, 2009
Drugs for allergy are often taken in combination with other drugs, either to treat allergy or oth... more Drugs for allergy are often taken in combination with other drugs, either to treat allergy or other conditions. In common with many pharmaceuticals, most such drugs are subject to metabolism by P450 enzymes and to transmembrane transport. This gives rise to considerable potential for drug-drug interactions, to which must be added consideration of drug-diet interactions. The potential for metabolism-based drug interactions is increasingly being taken into account during drug development, using a variety of in silico and in vitro approaches. Prediction of transporter-based interactions is not as advanced. The clinical importance of a drug interaction will depend upon a number of factors, and it is important to address concerns quantitatively, taking into account the therapeutic index of the compound.
Les allergies medicamenteuses constituent une part non negligeable de la iatrogenie medicamenteus... more Les allergies medicamenteuses constituent une part non negligeable de la iatrogenie medicamenteuse, et sont responsables d'une mortalite, d'une morbidite, et de surcouts mal evaluees. Elles representent un probleme frequent, quasi quotidien, pour le medecin prescripteur. Leurs manifestations sont multiples, allant d'une simple urticaire au grand choc anaphylactique ou au decollement cutane parfois mortels. Leurs diagnostics sont trop rarement confirmes. Leurs mecanismes sont varies et loin d'etre parfaitement apprehendes. Les reactions immediates, de type urticaire/angio-oedeme par exemple, sont souvent de mecanisme IgE-dependant, lorsqu'elles sont de nature allergique. Les reactions non immediates, de type exanthemes maculopapuleux par exemple, impliquent l'activation de lymphocytes T specifiques, lorsqu'elles sont de nature allergique. Devant l'impossibilite de detailler ici l'ensemble des connaissances relatives aux allergies medicamenteuses, nous nous limiterons aux actualites et donnees essentielles de leur physiopathologie.
Revue Française d'Allergologie, 2020
Déclaration de liens d'intérêt Pascal Demoly a reçu des honoraires de conseil ou des conférences ... more Déclaration de liens d'intérêt Pascal Demoly a reçu des honoraires de conseil ou des conférences des laboratoires ALK,
Presse médicale (Paris, France : 1983), Jan 7, 2000
DRUG PRESCRIPTION: Many pregnant women have asthma and/or rhinitis. Particular attention is requi... more DRUG PRESCRIPTION: Many pregnant women have asthma and/or rhinitis. Particular attention is required when prescribing drugs in this situation. Medication can be prescribed during pregnancy when the apparent benefit is greater than the apparent risk. Usually at least one drug of each major class used to control these disease can be given safely. In addition, physiological changes associated with pregnancy could affect the upper and lower pathways. CAREFUL MANAGEMENT: Ideally, drug prescription for asthma and/or rhinitis in pregnant women should be part of a global process implicating obstetricians, primary care physicians, and allergy, rhinology or lung specialists. The only way to improve the mother's comfort and avoid complications for both mother and child is to perfectly control the disease. Indeed, it would be regrettable to be too prudent and deprive symptomatic patients of active treatments. Patients should be clearly informed of the benefits and risks of drug therapy.
Revue Française d'Allergologie et d'Immunologie Clinique, 2003
International Archives of Allergy and Immunology, 2005
Background: The flow cytometry CD63-based basophil activation test (Basotest®) has already been v... more Background: The flow cytometry CD63-based basophil activation test (Basotest®) has already been validated for the diagnosis of immediate-type allergy such as venom, house dust mite or cypress pollen allergies. The aim of this study was to evaluate the performance (specificity and sensitivity) of Basotest in the diagnosis of natural rubber latex allergy. Methods: We included 46 latex allergic patients (clinical symptoms of latex allergy, positive latex skin prick tests and/or latex specific IgE) and 33 control subjects and performed Basotest on all subjects. Results: The sensitivity and specificity of Basotest were 84.8 and 87.9%, respectively, when we considered the theoretic cut-off at 15% of CD63-positive cells. Using ROC curves, the optimal cut-off was evaluated at 22%, for which sensitivity and specificity were 79.3 and 96.7%, respectively. Conclusion: The Basotest is a reliable test in addition to clinical history and tests already validated (such as skin prick tests and specif...