Monitoring guidance for patients with hypophosphatasia treated with asfotase alfa.
Identifieur interne : 000781 ( PubMed/Checkpoint ); précédent : 000780; suivant : 000782Monitoring guidance for patients with hypophosphatasia treated with asfotase alfa.
Auteurs : Priya S. Kishnani [États-Unis] ; Eric T. Rush [États-Unis] ; Paul Arundel [Royaume-Uni] ; Nick Bishop [Royaume-Uni] ; Kathryn Dahir [États-Unis] ; William Fraser [Royaume-Uni] ; Paul Harmatz [États-Unis] ; Agnès Linglart [France] ; Craig F. Munns [Australie] ; Mark E. Nunes [États-Unis] ; Howard M. Saal [États-Unis] ; Lothar Seefried [Allemagne] ; Keiichi Ozono [Japon]Source :
- Molecular genetics and metabolism [ 1096-7206 ] ; 2017.
Abstract
Hypophosphatasia (HPP) is a rare, inherited, systemic, metabolic disorder caused by autosomal recessive mutations or a single dominant-negative mutation in the gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). The disease is associated with a broad range of signs, symptoms, and complications, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, respiratory problems, impaired growth and mobility, premature tooth loss, developmental delay, and seizures. Asfotase alfa is a human, recombinant enzyme replacement therapy that is approved in many countries for the treatment of patients with HPP. To address the unmet need for guidance in the monitoring of patients receiving asfotase alfa, an international panel of physicians with experience in diagnosing and managing HPP convened in May 2016 to discuss treatment monitoring parameters. The panel discussions focused on recommendations for assessing and monitoring patients after the decision to treat with asfotase alfa had been made and did not include recommendations for whom to treat. Based on the consensus of panel members, this review provides guidance on the monitoring of patients with HPP during treatment with asfotase alfa, including recommendations for laboratory, efficacy, and safety assessments and the frequency with which these should be performed during the course of treatment. Recommended assessments are based on patient age and include regular monitoring of biochemistry, skeletal radiographs, respiratory function, growth, pain, mobility and motor function, and quality of life. Because of the systemic presentation of HPP, a coordinated, multidisciplinary, team-based, patient-focused approach is recommended in the management of patients receiving asfotase alfa. Monitoring of efficacy and safety outcomes must be tailored to the individual patient, depending on medical history, clinical manifestations, availability of resources in the clinical setting, and the clinician's professional judgment.
DOI: 10.1016/j.ymgme.2017.07.010
PubMed: 28888853
Affiliations:
- Allemagne, Australie, France, Japon, Royaume-Uni, États-Unis
- Bavière, Californie, Caroline du Nord, District de Basse-Franconie, Nebraska, Nouvelle-Galles du Sud, Ohio, Tennessee, Île-de-France
- Le Kremlin Bicêtre, Sydney, Wurtzbourg
- Université de Sydney
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Kishnani</name><affiliation wicri:level="2"><nlm:affiliation>Division of Medical Genetics, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: priya.kishnani@duke.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Medical Genetics, Duke University Medical Center, Durham, NC 27710</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Rush, Eric T" sort="Rush, Eric T" uniqKey="Rush E" first="Eric T" last="Rush">Eric T. Rush</name><affiliation wicri:level="2"><nlm:affiliation>Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA(2).</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198</wicri:regionArea><placeName><region type="state">Nebraska</region></placeName></affiliation></author><author><name sortKey="Arundel, Paul" sort="Arundel, Paul" uniqKey="Arundel P" first="Paul" last="Arundel">Paul Arundel</name><affiliation wicri:level="1"><nlm:affiliation>Metabolic Bone Team, Sheffield Children's NHS Foundation Trust, Sheffield S10 2TH, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Metabolic Bone Team, Sheffield Children's NHS Foundation Trust, Sheffield S10 2TH</wicri:regionArea><wicri:noRegion>Sheffield S10 2TH</wicri:noRegion></affiliation></author><author><name sortKey="Bishop, Nick" sort="Bishop, Nick" uniqKey="Bishop N" first="Nick" last="Bishop">Nick Bishop</name><affiliation wicri:level="1"><nlm:affiliation>Academic Unit of Child Health, University of Sheffield and Sheffield Children's Hospital, Sheffield S10 2TH, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Unit of Child Health, University of Sheffield and Sheffield Children's Hospital, Sheffield S10 2TH</wicri:regionArea><wicri:noRegion>Sheffield S10 2TH</wicri:noRegion></affiliation></author><author><name sortKey="Dahir, Kathryn" sort="Dahir, Kathryn" uniqKey="Dahir K" first="Kathryn" last="Dahir">Kathryn Dahir</name><affiliation wicri:level="2"><nlm:affiliation>Division of Diabetes and Endocrinology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Diabetes and Endocrinology, Vanderbilt University Medical Center, Nashville, TN 37232</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Fraser, William" sort="Fraser, William" uniqKey="Fraser W" first="William" last="Fraser">William Fraser</name><affiliation wicri:level="1"><nlm:affiliation>Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7UY, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7UY</wicri:regionArea><wicri:noRegion>Norwich NR4 7UY</wicri:noRegion></affiliation></author><author><name sortKey="Harmatz, Paul" sort="Harmatz, Paul" uniqKey="Harmatz P" first="Paul" last="Harmatz">Paul Harmatz</name><affiliation wicri:level="2"><nlm:affiliation>Pediatric Gastroenterology and Nutrition, UCSF Benioff Children's Hospital Oakland, Oakland, CA 94609, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Pediatric Gastroenterology and Nutrition, UCSF Benioff Children's Hospital Oakland, Oakland, CA 94609</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Linglart, Agnes" sort="Linglart, Agnes" uniqKey="Linglart A" first="Agnès" last="Linglart">Agnès Linglart</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Endocrinologie Pédiatrique, Hôpital Bicêtre Paris-Sud, APHP, 94270 Le Kremlin Bicêtre, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Endocrinologie Pédiatrique, Hôpital Bicêtre Paris-Sud, APHP, 94270 Le Kremlin Bicêtre</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Le Kremlin Bicêtre</settlement></placeName></affiliation></author><author><name sortKey="Munns, Craig F" sort="Munns, Craig F" uniqKey="Munns C" first="Craig F" last="Munns">Craig F. Munns</name><affiliation wicri:level="4"><nlm:affiliation>Paediatrics & Child Health, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Paediatrics & Child Health, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Sydney Medical School, University of Sydney, Sydney, NSW 2006</wicri:regionArea><orgName type="university">Université de Sydney</orgName><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Nunes, Mark E" sort="Nunes, Mark E" uniqKey="Nunes M" first="Mark E" last="Nunes">Mark E. Nunes</name><affiliation wicri:level="2"><nlm:affiliation>Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pediatrics, University of California, San Diego, San Diego, CA 92093</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Saal, Howard M" sort="Saal, Howard M" uniqKey="Saal H" first="Howard M" last="Saal">Howard M. Saal</name><affiliation wicri:level="2"><nlm:affiliation>Division of Human Genetics, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Human Genetics, Cincinnati Children's Hospital, Cincinnati, OH 45229</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Seefried, Lothar" sort="Seefried, Lothar" uniqKey="Seefried L" first="Lothar" last="Seefried">Lothar Seefried</name><affiliation wicri:level="3"><nlm:affiliation>Orthopedic Department, University of Würzburg, Würzburg, Bavaria 97074, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Orthopedic Department, University of Würzburg, Würzburg, Bavaria 97074</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Ozono, Keiichi" sort="Ozono, Keiichi" uniqKey="Ozono K" first="Keiichi" last="Ozono">Keiichi Ozono</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pediatrics, Osaka University, Suita, Osaka 565-0871, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Pediatrics, Osaka University, Suita, Osaka 565-0871</wicri:regionArea><wicri:noRegion>Osaka 565-0871</wicri:noRegion></affiliation></author></analytic><series><title level="j">Molecular genetics and metabolism</title><idno type="eISSN">1096-7206</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Hypophosphatasia (HPP) is a rare, inherited, systemic, metabolic disorder caused by autosomal recessive mutations or a single dominant-negative mutation in the gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). The disease is associated with a broad range of signs, symptoms, and complications, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, respiratory problems, impaired growth and mobility, premature tooth loss, developmental delay, and seizures. Asfotase alfa is a human, recombinant enzyme replacement therapy that is approved in many countries for the treatment of patients with HPP. To address the unmet need for guidance in the monitoring of patients receiving asfotase alfa, an international panel of physicians with experience in diagnosing and managing HPP convened in May 2016 to discuss treatment monitoring parameters. The panel discussions focused on recommendations for assessing and monitoring patients after the decision to treat with asfotase alfa had been made and did not include recommendations for whom to treat. Based on the consensus of panel members, this review provides guidance on the monitoring of patients with HPP during treatment with asfotase alfa, including recommendations for laboratory, efficacy, and safety assessments and the frequency with which these should be performed during the course of treatment. Recommended assessments are based on patient age and include regular monitoring of biochemistry, skeletal radiographs, respiratory function, growth, pain, mobility and motor function, and quality of life. Because of the systemic presentation of HPP, a coordinated, multidisciplinary, team-based, patient-focused approach is recommended in the management of patients receiving asfotase alfa. Monitoring of efficacy and safety outcomes must be tailored to the individual patient, depending on medical history, clinical manifestations, availability of resources in the clinical setting, and the clinician's professional judgment.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28888853</PMID><DateCreated><Year>2017</Year><Month>09</Month><Day>10</Day></DateCreated><DateRevised><Year>2017</Year><Month>09</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1096-7206</ISSN><JournalIssue CitedMedium="Internet"><Volume>122</Volume><Issue>1-2</Issue><PubDate><Year>2017</Year><Month>Sep</Month></PubDate></JournalIssue><Title>Molecular genetics and metabolism</Title><ISOAbbreviation>Mol. Genet. Metab.</ISOAbbreviation></Journal><ArticleTitle>Monitoring guidance for patients with hypophosphatasia treated with asfotase alfa.</ArticleTitle><Pagination><MedlinePgn>4-17</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1096-7192(16)30374-2</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ymgme.2017.07.010</ELocationID><Abstract><AbstractText>Hypophosphatasia (HPP) is a rare, inherited, systemic, metabolic disorder caused by autosomal recessive mutations or a single dominant-negative mutation in the gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). The disease is associated with a broad range of signs, symptoms, and complications, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, respiratory problems, impaired growth and mobility, premature tooth loss, developmental delay, and seizures. Asfotase alfa is a human, recombinant enzyme replacement therapy that is approved in many countries for the treatment of patients with HPP. To address the unmet need for guidance in the monitoring of patients receiving asfotase alfa, an international panel of physicians with experience in diagnosing and managing HPP convened in May 2016 to discuss treatment monitoring parameters. The panel discussions focused on recommendations for assessing and monitoring patients after the decision to treat with asfotase alfa had been made and did not include recommendations for whom to treat. Based on the consensus of panel members, this review provides guidance on the monitoring of patients with HPP during treatment with asfotase alfa, including recommendations for laboratory, efficacy, and safety assessments and the frequency with which these should be performed during the course of treatment. Recommended assessments are based on patient age and include regular monitoring of biochemistry, skeletal radiographs, respiratory function, growth, pain, mobility and motor function, and quality of life. Because of the systemic presentation of HPP, a coordinated, multidisciplinary, team-based, patient-focused approach is recommended in the management of patients receiving asfotase alfa. Monitoring of efficacy and safety outcomes must be tailored to the individual patient, depending on medical history, clinical manifestations, availability of resources in the clinical setting, and the clinician's professional judgment.</AbstractText><CopyrightInformation>Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kishnani</LastName><ForeName>Priya S</ForeName><Initials>PS</Initials><AffiliationInfo><Affiliation>Division of Medical Genetics, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: priya.kishnani@duke.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rush</LastName><ForeName>Eric T</ForeName><Initials>ET</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA(2).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arundel</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Metabolic Bone Team, Sheffield Children's NHS Foundation Trust, Sheffield S10 2TH, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bishop</LastName><ForeName>Nick</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Academic Unit of Child Health, University of Sheffield and Sheffield Children's Hospital, Sheffield S10 2TH, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dahir</LastName><ForeName>Kathryn</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Division of Diabetes and Endocrinology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fraser</LastName><ForeName>William</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7UY, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Harmatz</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Pediatric Gastroenterology and Nutrition, UCSF Benioff Children's Hospital Oakland, Oakland, CA 94609, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Linglart</LastName><ForeName>Agnès</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service d'Endocrinologie Pédiatrique, Hôpital Bicêtre Paris-Sud, APHP, 94270 Le Kremlin Bicêtre, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Munns</LastName><ForeName>Craig F</ForeName><Initials>CF</Initials><AffiliationInfo><Affiliation>Paediatrics & Child Health, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nunes</LastName><ForeName>Mark E</ForeName><Initials>ME</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Saal</LastName><ForeName>Howard M</ForeName><Initials>HM</Initials><AffiliationInfo><Affiliation>Division of Human Genetics, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seefried</LastName><ForeName>Lothar</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Orthopedic Department, University of Würzburg, Würzburg, Bavaria 97074, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ozono</LastName><ForeName>Keiichi</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Osaka University, Suita, Osaka 565-0871, Japan.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>07</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mol Genet Metab</MedlineTA><NlmUniqueID>9805456</NlmUniqueID><ISSNLinking>1096-7192</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Alkaline phosphatase</Keyword><Keyword MajorTopicYN="N">Asfotase alfa</Keyword><Keyword MajorTopicYN="N">Enzyme replacement therapy</Keyword><Keyword MajorTopicYN="N">Hypophosphatasia</Keyword><Keyword MajorTopicYN="N">Metabolic bone diseases</Keyword><Keyword MajorTopicYN="N">Therapeutic drug monitoring</Keyword><Keyword MajorTopicYN="N">Tissue-nonspecific alkaline phosphatase</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>11</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2017</Year><Month>07</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>07</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>9</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>9</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>9</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28888853</ArticleId><ArticleId IdType="pii">S1096-7192(16)30374-2</ArticleId><ArticleId IdType="doi">10.1016/j.ymgme.2017.07.010</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>France</li><li>Japon</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Bavière</li><li>Californie</li><li>Caroline du Nord</li><li>District de Basse-Franconie</li><li>Nebraska</li><li>Nouvelle-Galles du Sud</li><li>Ohio</li><li>Tennessee</li><li>Île-de-France</li></region><settlement><li>Le Kremlin Bicêtre</li><li>Sydney</li><li>Wurtzbourg</li></settlement><orgName><li>Université de Sydney</li></orgName></list><tree><country name="États-Unis"><region name="Caroline du Nord"><name sortKey="Kishnani, Priya S" sort="Kishnani, Priya S" uniqKey="Kishnani P" first="Priya S" last="Kishnani">Priya S. Kishnani</name></region><name sortKey="Dahir, Kathryn" sort="Dahir, Kathryn" uniqKey="Dahir K" first="Kathryn" last="Dahir">Kathryn Dahir</name><name sortKey="Harmatz, Paul" sort="Harmatz, Paul" uniqKey="Harmatz P" first="Paul" last="Harmatz">Paul Harmatz</name><name sortKey="Nunes, Mark E" sort="Nunes, Mark E" uniqKey="Nunes M" first="Mark E" last="Nunes">Mark E. Nunes</name><name sortKey="Rush, Eric T" sort="Rush, Eric T" uniqKey="Rush E" first="Eric T" last="Rush">Eric T. Rush</name><name sortKey="Saal, Howard M" sort="Saal, Howard M" uniqKey="Saal H" first="Howard M" last="Saal">Howard M. Saal</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Arundel, Paul" sort="Arundel, Paul" uniqKey="Arundel P" first="Paul" last="Arundel">Paul Arundel</name></noRegion><name sortKey="Bishop, Nick" sort="Bishop, Nick" uniqKey="Bishop N" first="Nick" last="Bishop">Nick Bishop</name><name sortKey="Fraser, William" sort="Fraser, William" uniqKey="Fraser W" first="William" last="Fraser">William Fraser</name></country><country name="France"><region name="Île-de-France"><name sortKey="Linglart, Agnes" sort="Linglart, Agnes" uniqKey="Linglart A" first="Agnès" last="Linglart">Agnès Linglart</name></region></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Munns, Craig F" sort="Munns, Craig F" uniqKey="Munns C" first="Craig F" last="Munns">Craig F. Munns</name></region></country><country name="Allemagne"><region name="Bavière"><name sortKey="Seefried, Lothar" sort="Seefried, Lothar" uniqKey="Seefried L" first="Lothar" last="Seefried">Lothar Seefried</name></region></country><country name="Japon"><noRegion><name sortKey="Ozono, Keiichi" sort="Ozono, Keiichi" uniqKey="Ozono K" first="Keiichi" last="Ozono">Keiichi Ozono</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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