Clinical expertise and research areas
Clinical and scientific activity is organised around three complementary fields: reproductive immunology, autoimmune and autoinflammatory diseases, and internal medicine and clinical immunology.
This work combines phenotypic characterisation of patients, identification of biomarkers, understanding of immunological and clonal mechanisms, evaluation of therapeutic strategies and the development of collaborative clinical studies.
Each area sets out the main medical questions under study, the research in progress, the collaborations and networks involved, and the main areas of scientific uncertainty.
I. Reproductive immunology
Reproductive immunology and reproductive failure
Study of the immunological mechanisms that may be involved in repeated reproductive failure, at the interface between internal medicine, clinical immunology, reproductive medicine and placental pathology.
The work focuses on the characterisation of immunological phenotypes, the relevance of the biomarkers proposed in clinical practice, and the critical evaluation of immunomodulatory strategies.
Recurrent pregnancy loss
Investigation of recurrent pregnancy loss, in particular when gynaecological, genetic, endocrine and conventional investigations fail to identify a cause.
The aim is to better characterise unexplained cases, to identify possible immunological subgroups, and to determine which biomarkers can genuinely contribute to diagnosis, prognosis or treatment decisions.
Repeated implantation failure
Study of implantation failure after repeated embryo transfers in assisted reproduction.
The work focuses on maternal-fetal interactions, endometrial and systemic immunity, and the immunological hypotheses proposed in unexplained failure, while distinguishing established data from biomarkers and treatments whose clinical relevance remains to be demonstrated.
Inflammatory placental lesions
Study of the inflammatory placental lesions associated with recurrent obstetric complications, notably chronic histiocytic intervillositis, chronic villitis and massive perivillous fibrin deposition.
The research aims to better understand their immunopathological mechanisms, their risk of recurrence, and the preventive strategies likely to improve the outcome of subsequent pregnancies.
Obstetric antiphospholipid syndrome
Clinical care and research devoted to antiphospholipid syndrome (APS), notably its obstetric manifestations and refractory forms.
The work addresses risk stratification, failure despite conventional treatment, and the evaluation of complementary therapeutic strategies, notably hydroxychloroquine and other immunomodulatory approaches in selected populations.
Pregnancy and systemic autoimmune disease
Preconception assessment and multidisciplinary management of pregnancy in women with autoimmune or autoinflammatory disease.
The main issues are disease activity, maternal and fetal risk, adjustment of immunomodulatory and immunosuppressive treatment, and prevention of obstetric complications.
II. Autoimmune and autoinflammatory diseases, immunohaematology
VEXAS syndrome and clonal inflammation
Study of VEXAS syndrome, an acquired autoinflammatory disease associated with somatic UBA1 variants in haematopoietic cells.
The work covers the characterisation of clinical and haematological phenotypes, prognostic determinants, the mechanisms of clonal inflammation, and the evaluation of the different therapeutic strategies.
This area belongs to the wider study of the relationships between clonal haematopoiesis, myeloid abnormalities and systemic inflammation.
Systemic autoimmune diseases
Clinical expertise and research on several systemic diseases: lupus and systemic sclerosis, Sjögren's disease, inflammatory myopathies, autoimmune cytopenias and other complex immune-mediated conditions.
The approach combines phenotypic characterisation, biomarker research, analysis of multi-organ involvement and optimisation of therapeutic strategies.
Large-vessel vasculitis
Work devoted mainly to Takayasu arteritis and giant cell arteritis.
The research covers the assessment of inflammatory activity, vascular imaging, prognostic factors, immunopathological mechanisms and new therapeutic strategies, notably biologics and inhibitors of intracellular signalling pathways.
Myeloid malignancies and inflammatory manifestations
Study of the inflammatory and autoimmune manifestations associated with myelodysplastic syndromes, chronic myelomonocytic leukaemia and other myeloid malignancies.
This area explores the relationships between haematopoietic clonality and immune dysregulation, notably through the collaborative work of the MINHEMON network.
Immunomodulatory therapies and innovative strategies
Evaluation of new therapeutic strategies in severe or refractory immune-mediated diseases.
The work concerns biologics, signalling-pathway inhibitors, low-dose interleukin-2, treatments targeting the haematopoietic clone, and certain strategies of immune reconstitution or modulation.
The aim is to determine which patients can genuinely benefit from a given intervention, on the basis of clinical, biological and mechanistic data.
III. Internal medicine and clinical immunology
Diagnosis of systemic diseases and complex presentations
Internal medicine is involved when a clinical situation cannot be explained by the isolated involvement of a single organ, or when it combines several manifestations that may be linked by a common mechanism.
The expertise covers unexplained inflammatory syndromes, multi-organ manifestations, rare autoimmune or autoinflammatory diseases, cytopenias, immunological abnormalities and complex presentations without an established diagnosis.
This clinical activity is closely linked to research: unexplained or atypical presentations are often the starting point for new questions about the mechanisms of inflammation, autoimmunity and haematopoietic clonality.
Research at the interface of several disciplines
These areas share a single approach: starting from complex clinical situations to identify relevant phenotypes, understand their immunological or clonal mechanisms, search for reproducible biomarkers and evaluate treatments in structured clinical studies.
The approach brings together internal medicine, clinical immunology, haematology, rheumatology, vascular medicine, reproductive medicine, obstetrics and translational biology.
Particular attention is paid to the distinction between mechanistic hypothesis, biological association and proof of clinical utility. A biologically plausible biomarker is not necessarily a validated diagnostic tool, and a promising therapeutic strategy only becomes standard practice once its efficacy and safety have been sufficiently demonstrated.