Richard MOREAU
  • E-mail :[email]
  • Phone : 33 1 57 27 75 10
  • Location : UMR_S 1149, Centre de Recherche sur l’Inflammation CRI, 16 Rue Henri Huchard 75890 PARIS cedex 18 Paris, France
Last update 2017-11-21 12:55:27.025

Richard MOREAU MD, Director of Research at the National (French) Institute of Health (Inserm)

Course and current status

ORCID ID: orcid.org/0000-0003-0862-403X

ResearcherID: N-2197-2017

 Current position:

1) Senior Scientist at the INSERM (French NIH)

    Directeur de Recherche de Classe exceptionnelle (DRCE), 2ème échelon.

2) Vice-Chairman, Centre de Recherche sur l’Inflammation CRI, UMR_S1149, 

Endorsed by the INSERM, Université Paris-Diderot-Paris 7, and Cnrs.

3) Consultant in Hepatology, Liver Unit, Beaujon Hospital (Head Prof F Durand), Assistance Publique Hôpitaux de Paris (APHP), Clichy, France

4) Co-Chairman, with Prof. Shiv Sarin (Institute of Liver and Biliary Sciences, ILBS, New Delhi, India) of an International Associated Laboratory entitled “ILBS Associated Laboratory for the Development of Indo-French Research on Severe Liver Diseases”

5) Adjunct Professor, Institute of Liver and Biliary Sciences, ILBS, New Delhi, India

Current affiliations:

1) INSERM U1149, Centre de Recherche sur l’Inflammation CRI, Paris, France

2) UMR S_1149, Université Paris Diderot, Paris, France 

3) Département Hospitalo-Universitaire (DHU) UNITY, Service d'hépatologie, Hôpital beaujon APHP, Clichy, France

4) Laboratoire d'Excellence (Labex) Inflammex, ComUE Sorbonne Paris Cité, Paris, France

Degree:

1983: MD, University of Paris

Academic Appointments: 

1996-Date: Senior Scientist (Directeur de Recherche at the INSERM

       Grade 2 (1996), Grade 1 (2009), Outstanding (2014)

1996-2004: Head of group in the Lebrec’s lab (successively in Inserm Units 24 and 481), Clichy, France

2005-Date: Head of Team (Complications of cirrhosis) at the Centre de Recherche Biomédicale Bichat-Beaujon CRB3, UMR_S 773, Inserm and Université Paris-Diderot, Paris 7, Clichy/Paris, France.

2013: Chairman, Centre de Recherche Biomédicale Bichat-Beaujon CRB3, UMR_S 773, Inserm and Université Paris-Diderot, Paris 7, Clichy/Paris.

2014-Date: Vice-Chirman, Centre de Recherche sur l’Inflammation CRI, UMR_S1149, 

Inserm and Université Paris-Diderot, Paris 7, Clichy/Paris, France.

2013-Date: Co-Chairman, with Prof. Shiv Sarin (Institute of Liver and Biliary Sciences, ILBS, New Delhi, India) of an International Associated Laboratory entitled “ILBS Associated Laboratory for the Development of Indo-French Research on Severe Liver Diseases”

2014-Date: Adjunct Professor, Institute of Liver and Biliary Sciences, ILBS, New Delhi, India

Hospital Appointments:

1983-1996: Physician in Intensive Care Units of Ile-de-France 

1996-Date: Consultant in Hepatology, Liver Unit, Beaujon Hospital (successively Headed by Profs J-P Benhamou, S Erlinger, D Valla, and F Durand), Assistance Publique Hôpitaux de Paris (APHP), Clichy, France

Society Membership: 

  • American Association for the Study of Liver Diseases (AASLD)
  • European Association for the Study of the Liver (EASL)
  • Asian Pacific Association ofr the Study of the Liver (APASL)
  • French Speaking Society of Intensive Care Medicine
  • French Association of the Study of the Liver
  • International Ascites Club (Scientific Committee, 1994-2003)
  • French Club for the Study of Portal Hypertension

Awards:

  • 2014: Award Scientific Excellence (Inserm)

Editorial Activities:

  • 1997-2001 : Associate Editor, Gastroentérologie Clinique et Biologique
  • 2001-2008: Co-Editor: Gastroentérologie Clinique et Biologique
  • 2002-2006: Editorial Board, Hepatology
  • 2007-2009: Editorial Board, Journal of Hepatology
  • 2007-September 2009: Associate Editor, Liver International
  • September 2010-Date: Editorial Board, Hepatology
  • 2010-2014: Associate Editor, Journal of Hepatology
  • 2015-Date: Senior Editor, Journal of Hepatology 

French Organization of Research:

  • 2008-Date: Expert (Liver Branch) at the Aviesan Institute 'Pathophysiology, Metabolism, Nutrition' (Head, Prof C. Boitard).
  • 2010-Date: Elected as Member of the Council advising the Dean of the Faculty of Medicine, University Paris Diderot, Paris  
  • 2013-Date: Member of the Steering Committee (SC) of the 'Département Hospitalo-Universitaire' (DHU) UNITY (for Addressing Unmet Needs through Innovation in HepaTology and GastroenterologY), Beaujon Hospital, APHP, Clichy
  • 2012-Date: Partner of the 'Laboratoire d’excellence (Labex)' Inflamex, ComUE Sorbonne Paris Cité, Paris. 

International SCs:

  • Founding member of the EASL-CLIF (Chronic Liver Failure) Consortium
  • June 2009-Date: Member of the SC of the Consortium EASL-CLIF (for Chronic Liver Failure); 2011: Principal Investigator of the CANONIC Study on Acute-on-Chronic Liver Failure.
  • 2010-2013: Member of the SC of the Special Interest Group on Portal Hypertension of the American Association for the Study of Liver Diseases

Scientific Production:

  • 318 Peer-Reviewed publications (PubMed, updated October 2017), of which 222 Original Articles, 96 Review Articles or Editorials; h-index: 63; SIGAPS (French index): 4537.
  • Other publications in peer-reviewed Journals: 18
  • Editor of 1 book
  • 34 book chapters,
  • 242 Invited conferences (70% outside France), > 250 communications in International meetings

Main publications last 10 years

In bold, representative publications

  1. Macdonald S, Andreola F, Bachtiger P, Amoros A, Pavesi M, Mookerjee R, Zheng YB, Grønbaek H, Gerbes AL, Sola E, Caraceni P, Moreau R, Gines P, Arroyo V, Jalan R. Cell death markers in cirrhotic patients with acute decompensation. Hepatology. 2017 Oct 10. doi: 10.1002/hep.29581. [Epub ahead of print] PMID:29023872
  2. Sharma S, Maras JS, Das S, Hussain S, Mishra AK, Shasthry SM, Sharma CB, Weiss E, Elkrief L, Rautou PE, Gilgenkrantz H, Lotersztajn S, Paradis V, de la Grange P, Junot C, Moreau R, Sarin SK. Pre-therapy liver transcriptome landscape in Indian and French patients with severe alcoholic hepatitis and steroid responsiveness. Sci Rep. 2017 Jul 28;7(1):6816. doi: 10.1038/s41598-017-07161-4. PMID:28754919.
  3. Gustot T, Fernandez J, Szabo G, Albillos A, Louvet A, Jalan R, Moreau R, Moreno C. Sepsis in Alcohol-related Liver Disease. J Hepatol. 2017 Jun 21. pii: S0168-8278(17)32085-8. doi: 10.1016/j.jhep.2017.06.013. [Epub ahead of print] Review. PMID:28647569
  4. Rolas L, Boussif A, Weiss E, Lettéron P, Haddad O, El-Benna J, Rautou PE, Moreau R, Périanin A. NADPH oxidase depletion in neutrophils from patients with cirrhosis and restoration via toll-like receptor 7/8 activation. Gut. 2017 Jun 10. pii: gutjnl-2016-313443. doi: 10.1136/gutjnl-2016-313443. [Epub ahead of print] PMID:28601846
  5. Markwardt D, Holdt L, Steib C, Benesic A, Bendtsen F, Bernardi M, Moreau R, Teupser D, Wendon J, Nevens F, Trebicka J, Garcia E, Pavesi M, Arroyo V, Gerbes AL. Plasma Cystatin C is a predictor of renal dysfunction, ACLF and mortality in patients with acutely decompensated liver cirrhosis. Hepatology. 2017 May 25. doi:10.1002/hep.29290. [Epub ahead of print] PMID:28545169
  6. Weiss E, Rautou PE, Fasseu M, Giabicani M, de Chambrun M, Wan J, Minsart C, Gustot T, Couvineau A, Maiwall R, Hurtado-Nedelec M, Pilard N, Lebrec D, Valla D, Durand F, de la Grange P, Monteiro RC, Paugam-Burtz C, Lotersztajn S, Moreau R. Type I interferon signaling in systemic immune cells from patients with alcoholic cirrhosis and its association with outcome. J Hepatol. 2016 Dec 28. pii: S0168-8278(16)30741-3. doi: 10.1016/j.jhep.2016.12.008. [Epub ahead of print] PMID:28040548
  7. Hernaez R, Solà E, Moreau R*, Ginès P*. Acute-on-chronic liver failure: an update. Gut. 2017 Jan 4. pii: gutjnl-2016-312670. doi: 10.1136/gutjnl-2016-312670. [Epub ahead of print] Review. PMID:2805305. *Equally contributed
  8. Arroyo V, Moreau R. Diagnosis and prognosis of acute on chronic liver failure (ACLF) in cirrhosis. J Hepatol. 2016 Dec 15. pii: S0168-8278(16)30577-3. doi:10.1016/j.jhep.2016.10.012. [Epub ahead of print] PubMed PMID: 27989380.
  9. Clària J, Arroyo V, Moreau R. The Acute-on-Chronic Liver Failure Syndrome, or When the Innate Immune System Goes Astray. J Immunol. 2016 Nov 15;197(10):3755-3761. Review. PubMed PMID: 27815438.
  10. Clària J, Stauber RE, Coenraad MJ, Moreau R, Jalan R, Pavesi M, Amorós À, Titos E, Alcaraz-Quiles J, Oettl K, Morales-Ruiz M, Angeli P, Domenicali M, Alessandria C, Gerbes A, Wendon J, Nevens F, Trebicka J, Laleman W, Saliba F, Welzel TM, Albillos A, Gustot T, Benten D, Durand F, Ginès P, Bernardi M, Arroyo  V; CANONIC Study Investigators of the EASL-CLIF Consortium and the European Foundation for the Study of Chronic Liver Failure (EF-CLIF). Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure. Hepatology. 2016 Oct;64(4):1249-64. doi: 10.1002/hep.28740. PubMed PMID: 27483394.
  11. Poisson J, Lemoinne S, Boulanger C, Durand F, Moreau R, Valla D, Rautou PE. Liver sinusoidal endothelial cells: physiology and role in liver diseases. J Hepatol. 2016 Jul 13. pii: S0168-8278(16)30333-6. doi: 10.1016/j.jhep.2016.07.009. Review. PubMed PMID: 27423426.
  12. Arroyo V, Moreau R, Kamath PS, Jalan R, Ginès P, Nevens F, Fernández J, To U, García-Tsao G, Schnabl B. Acute-on-chronic liver failure in cirrhosis. Nat RevDis Primers. 2016 Jun 9;2:16041. doi: 10.1038/nrdp.2016.41. PubMed PMID: 27277335.
  13. Moreau R. The Pathogenesis of ACLF: The Inflammatory Response and Immune Function. Semin Liver Dis. 2016 May;36(2):133-40. doi: 10.1055/s-0036-1583199. PubMed PMID: 27172355.
  14. Jalan R, Moreau R, Kamath PS, Arroyo V. Acute-on-Chronic Liver Failure: A Distinct Clinical Condition. Semin Liver Dis. 2016 May;36(2):107-8. doi:10.1055/s-0036-1583287. PubMed PMID: 27172350.
  15. Li H, Chen LY, Zhang NN, Li ST, Zeng B, Pavesi M, Amorós À, Mookerjee RP, Xia Q, Xue F, Ma X, Hua J, Sheng L, Qiu DK, Xie Q, Foster GR, Dusheiko G, Moreau R, Gines P, Arroyo V, Jalan R. Characteristics, Diagnosis and Prognosis of Acute-on-Chronic Liver Failure in Cirrhosis Associated to Hepatitis B. Sci Rep. 2016 May 5;6:25487. doi: 10.1038/srep25487. PubMed PMID: 27146801; PubMed Central PMCID: PMC4857102.
  16. Ariza X, Graupera I, Coll M, Solà E, Barreto R, García E, Moreira R, Elia C, Morales-Ruiz M, Llopis M, Huelin P, Solé C, Fabrellas N, Weiss E, Nevens F, Gerbes A, Trebicka J, Saliba F, Fondevila C, Hernández-Gea V, Fernández J, Bernardi M, Arroyo V, Jiménez W, Deulofeu C, Pavesi M, Angeli P, Jalan R, Moreau  R, Sancho-Bru P, Ginès P; CANONIC Investigators, EASL CLIF Consortium. Neutrophil gelatinase-associated lipocalin is a biomarker of acute-on-chronic liver failure and prognosis in cirrhosis. J Hepatol. 2016 Jul;65(1):57-65. doi: 10.1016/j.jhep.2016.03.002. PubMed PMID: 26988732.
  17. Elkrief L, Rautou PE, Sarin S, Valla D, Paradis V, Moreau R. Diabetes mellitus in patients with cirrhosis: clinical implications and management. Liver Int. 2016 Jul;36(7):936-48. doi: 10.1111/liv.13115. Review. PubMed PMID:26972930.
  18. Boussif A, Rolas L, Weiss E, Bouriche H, Moreau R, Périanin A. Impaired intracellular signaling, myeloperoxidase release and bactericidal activity of neutrophils from patients with alcoholic cirrhosis. J Hepatol. 2016 May;64(5):1041-8. doi: 10.1016/j.jhep.2015.12.005. PubMed PMID: 26719020.
  19. Nadim MK, Durand F, Kellum JA, Levitsky J, O'Leary JG, Karvellas CJ, Bajaj JS, Davenport A, Jalan R, Angeli P, Caldwell SH, Fernández J, Francoz C, Garcia-Tsao G, Ginès P, Ison MG, Kramer DJ, Mehta RL, Moreau R, Mulligan D, Olson JC, Pomfret EA, Senzolo M, Steadman RH, Subramanian RM, Vincent JL, Genyk YS. Management of the critically ill patient with cirrhosis: A multidisciplinary perspective. J Hepatol. 2016 Mar;64(3):717-35. doi: 10.1016/j.jhep.2015.10.019. PubMed PMID: 26519602.
  20. Mookerjee RP, Pavesi M, Thomsen KL, Mehta G, Macnaughtan J, Bendtsen F, Coenraad M, Sperl J, Gines P, Moreau R, Arroyo V, Jalan R; CANONIC Study Investigators of the EASL-CLIF Consortium. Treatment with non-selective beta blockers is associated with reduced severity of systemic inflammation and improved survival of patients with acute-on-chronic liver failure. J Hepatol. 2016 Mar;64(3):574-82. doi: 10.1016/j.jhep.2015.10.018. PubMed PMID: 26519600.
  21. Nahon P, Lescat M, Layese R, Bourcier V, Talmat N, Allam S, Marcellin P, Guyader D, Pol S, Larrey D, De Lédinghen V, Ouzan D, Zoulim F, Roulot D, Tran A, Bronowicki JP, Zarski JP,  Goria O, Calès P, Péron JM, Alric L, Bourlière M, Mathurin P, Blanc JF, Abergel A, Serfaty L,  Mallat A, Grangé JD, Attali P, Bacq Y, Wartelle C, Dao T, Benhamou Y, Pilette C, Silvain C, Christidis C, Capron D, Bernard-Chabert B, Hillaire S, Di Martino V, Trinchet JC, Moreau R, Roudot-Thoraval F; ANRS CO12 CirVir and Microcir Groups. Bacterial infection in compensated viral cirrhosis impairs 5-year survival (ANRS CO12 CirVir prospectivecohort). Gut. 2015 Oct 28. pii: gutjnl-2015-310275. doi: 10.1136/gutjnl-2015-310275. PubMed PMID: 26511797.
  22. Sarin SK, Kedarisetty CK, Abbas Z, Amarapurkar D, Bihari C, Chan AC, Chawla YK, Dokmeci AK, Garg H, Ghazinyan H, Hamid S, Kim DJ, Komolmit P, Lata S, Lee GH, Lesmana LA, Mahtab M, Maiwall R, Moreau R, Ning Q, Pamecha V, Payawal DA, Rastogi A, Rahman S, Rela M, Saraya A, Samuel D, Saraswat V, Shah S, Shiha G, Sharma BC, Sharma MK, Sharma K, Butt AS, Tan SS, Vashishtha C, Wani ZA, Yuen MF, Yokosuka O; APASL ACLF Working Party. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014. Hepatol Int. 2014 Oct;8(4):453-71. doi: 10.1007/s12072-014-9580-2.  PubMed PMID: 26202751.
  23. Bernardi M, Moreau R, Angeli P, Schnabl B, Arroyo V. Mechanisms of decompensation and organ failure in cirrhosis: From peripheral arterial vasodilation to systemic inflammation hypothesis. J Hepatol. 2015 Nov;63(5):1272-84. doi: 10.1016/j.jhep.2015.07.004. Review. PubMed PMID: 26192220.
  24. Arroyo V, Moreau R, Jalan R, Ginès P; EASL-CLIF Consortium CANONIC Study. Acute-on-chronic liver failure: A new syndrome that will re-classify cirrhosis. J Hepatol. 2015 Apr;62(1 Suppl):S131-43. doi: 10.1016/j.jhep.2014.11.045. Review. PubMed PMID: 25920082.
  25. Gustot T, Fernandez J, Garcia E, Morando F, Caraceni P, Alessandria C, Laleman W, Trebicka J, Elkrief L, Hopf C, Solís-Munoz P, Saliba F, Zeuzem S, Albillos A, Benten D, Montero-Alvarez JL, Chivas MT, Concepción M, Córdoba J, McCormick A, Stauber R, Vogel W, de Gottardi A, Welzel TM, Domenicali M, Risso A, Wendon J, Deulofeu C, Angeli P, Durand F, Pavesi M, Gerbes A, Jalan R, Moreau R, Ginés P, Bernardi M, Arroyo V; CANONIC Study Investigators of the EASL-CLIF Consortium. Clinical Course of acute-on-chronic liver failure syndrome and effects on prognosis. Hepatology. 2015 Jul;62(1):243-52. doi: 10.1002/hep.27849.  PubMed PMID: 25877702.
  26. Moreau R. Stimulating hepatocyte renewal: a new paradigm for the treatment of severe alcoholic hepatitis unresponsive to corticosteroids? Gut. 2015 Dec;64(12):1839-40. doi: 10.1136/gutjnl-2015-309545. PubMed PMID: 25841240.
  27. Moreau R, Weiss E. Should patients with cirrhosis and variceal hemorrhage receive glucocorticoid therapy? Hepatology. 2015 May;61(5):1758-60. doi: 10.1002/hep.27762. PubMed PMID: 25712004.
  28. Angeli P, Ginès P, Wong F, Bernardi M, Boyer TD, Gerbes A, Moreau R, Jalan R, Sarin SK, Piano S, Moore K, Lee SS, Durand F, Salerno F, Caraceni P, Kim WR, Arroyo V, Garcia-Tsao G. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol. 2015 Apr;62(4):968-74. doi: 10.1016/j.jhep.2014.12.029. Erratum in: J Hepatol. 2015 Jul;63(1):290. PubMed PMID: 25638527.
  29. Angeli P, Gines P, Wong F, Bernardi M, Boyer TD, Gerbes A, Moreau R, Jalan R, Sarin SK, Piano S, Moore K, Lee SS, Durand F, Salerno F, Caraceni P, Kim WR, Arroyo V, Garcia-Tsao G; International Club of Ascites. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. Gut. 2015 Apr;64(4):531-7.  doi: 10.1136/gutjnl-2014-308874. PubMed PMID: 25631669.
  30. Jalan R, Pavesi M, Saliba F, Amorós A, Fernandez J, Holland-Fischer P, Sawhney R, Mookerjee R, Caraceni P, Moreau R, Ginès P, Durand F, Angeli P, Alessandria C, Laleman W, Trebicka J, Samuel D, Zeuzem S, Gustot T, Gerbes AL, Wendon J, Bernardi M, Arroyo V; CANONIC Study Investigators; EASL-CLIF Consortium. The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure. J Hepatol. 2015 Apr;62(4):831-40. doi: 10.1016/j.jhep.2014.11.012. Erratum in: J Hepatol. 2015 Jul;63(1):291. PubMed PMID: 25463539.
  31. Leone M, Moreau R. Leukocyte Toll-like receptor 2-mitochondria axis in sepsis: unraveling immune response sophistication. Anesthesiology. 2014 Dec;121(6):1147-9. doi: 10.1097/ALN.0000000000000471. PubMed PMID: 25285948.
  32. Mallat A, Lodder J, Teixeira-Clerc F, Moreau R, Codogno P, Lotersztajn S. Autophagy: a multifaceted partner in liver fibrosis. Biomed Res Int. 2014;2014:869390. doi: 10.1155/2014/869390. Review. PubMed PMID: 25254217; PubMed Central PMCID: PMC4164803.
  33. Moreau R, Rautou PE. G-CSF therapy for severe alcoholic hepatitis: targeting liver regeneration or neutrophil function? Am J Gastroenterol. 2014Sep;109(9):1424-6. doi: 10.1038/ajg.2014.250. PubMed PMID: 25196873.
  34. Jalan R, Saliba F, Pavesi M, Amoros A, Moreau R, Ginès P, Levesque E, Durand F, Angeli P, Caraceni P, Hopf C, Alessandria C, Rodriguez E, Solis-Muñoz P, Laleman W, Trebicka J, Zeuzem S, Gustot T, Mookerjee R, Elkrief L, Soriano G, Cordoba J, Morando F, Gerbes A, Agarwal B, Samuel D, Bernardi M, Arroyo V; CANONIC study investigators of the EASL-CLIF Consortium. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol. 2014 Nov;61(5):1038-47. doi: 10.1016/j.jhep.2014.06.012. PubMed PMID: 24950482.
  35. Elkrief L, Chouinard P, Bendersky N, Hajage D, Larroque B, Babany G, Kutala B, Francoz C, Boyer N, Moreau R, Durand F, Marcellin P, Rautou PE, Valla D. Diabetes mellitus is an independent prognostic factor for major liver-related outcomes in patients with cirrhosis and chronic hepatitis C. Hepatology. 2014 Sep;60(3):823-31. doi: 10.1002/hep.27228. PubMed PMID: 24841704.
  36. Arroyo V, Moreau R. Tying up PGE2 with albumin to relieve immunosuppression in cirrhosis. Nat Med. 2014 May;20(5):467-9. doi: 10.1038/nm.3553. PubMed PMID: 24804750.
  37. Tarhuni A, Guyot E, Rufat P, Sutton A, Bourcier V, Grando V, Ganne-Carrié N,  Ziol M, Charnaux N, Beaugrand M, Moreau R, Trinchet JC, Mansouri A, Nahon P. Impact of cytokine gene variants on the prediction and prognosis of hepatocellular carcinoma in patients with cirrhosis. J Hepatol. 2014 Aug;61(2):342-50. doi: 10.1016/j.jhep.2014.04.011. PubMed PMID: 24751829.
  38. Mehta G, Gustot T, Mookerjee RP, Garcia-Pagan JC, Fallon MB, Shah VH, Moreau R, Jalan R. Inflammation and portal hypertension - the undiscovered country. J Hepatol. 2014 Jul;61(1):155-63. doi: 10.1016/j.jhep.2014.03.014. Review. PubMed PMID: 24657399.
  39. Durand F, Buyse S, Francoz C, Laouénan C, Bruno O, Belghiti J, Moreau R, Vilgrain V, Valla D. Prognostic value of muscle atrophy in cirrhosis using psoas muscle thickness on computed tomography. J Hepatol. 2014 Jun;60(6):1151-7. doi: 10.1016/j.jhep.2014.02.026. PubMed PMID: 24607622.
  40. Moreau R, Arroyo V. Acute-on-chronic liver failure: a new clinical entity.Clin Gastroenterol  Hepatol. 2015 May;13(5):836-41. doi: 10.1016/j.cgh.2014.02.027. PubMed PMID: 24583872.
  41. Jalan R, Fernandez J, Wiest R, Schnabl B, Moreau R, Angeli P, Stadlbauer V, Gustot T, Bernardi M, Canton R, Albillos A, Lammert F, Wilmer A, Mookerjee R, Vila J, Garcia-Martinez R, Wendon J, Such J, Cordoba J, Sanyal A, Garcia-Tsao G, Arroyo V, Burroughs A, Ginès P. Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013. J Hepatol. 2014 Jun;60(6):1310-24. doi: 10.1016/j.jhep.2014.01.024. PubMed PMID: 24530646.
  42. Lemoinne S, Thabut D, Housset C, Moreau R, Valla D, Boulanger CM, Rautou PE. The emerging roles of microvesicles in liver diseases. Nat Rev Gastroenterol Hepatol. 2014 Jun;11(6):350-61. doi: 10.1038/nrgastro.2014.7. Review. PubMed PMID: 24492276.
  43. Francoz C, Nadim MK, Baron A, Prié D, Antoine C, Belghiti J, Valla D, Moreau R, Durand F. Glomerular filtration rate equations for liver-kidney transplantation in patients with cirrhosis: validation of current recommendations. Hepatology. 2014 Apr;59(4):1514-21. doi: 10.1002/hep.26704. PubMed PMID: 24037821.
  44. Moreau R, Jalan R, Gines P, Pavesi M, Angeli P, Cordoba J, Durand F, Gustot T, Saliba F, Domenicali M, Gerbes A, Wendon J, Alessandria C, Laleman W, Zeuzem S, Trebicka J, Bernardi M, Arroyo V; CANONIC Study Investigators of the EASL–CLIF Consortium. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology. 2013 Jun;144(7):1426-37, 1437.e1-9. doi: 10.1053/j.gastro.2013.02.042. PubMed PMID: 23474284.
  45. Shah N, Mohamed FE, Jover-Cobos M, Macnaughtan J, Davies N, Moreau R, Paradis V, Moore K, Mookerjee R, Jalan R. Increased renal expression and urinary excretion of TLR4 in acute kidney injury associated with cirrhosis. Liver Int. 2013 Mar;33(3):398-409. doi: 10.1111/liv.12047. PubMed PMID: 23402610.
  46. Gandoura S, Weiss E, Rautou PE, Fasseu M, Gustot T, Lemoine F, Hurtado-Nedelec M, Hego C, Vadrot N, Elkrief L, Lettéron P, Tellier Z, Pocidalo MA, Valla D, Lebrec D, Groyer A, Monteiro RC, de la Grange P, Moreau R. Gene- and exon-expression profiling reveals an extensive LPS-induced response in immune cells in patients with cirrhosis. J Hepatol. 2013 May;58(5):936-48. doi: 10.1016/j.jhep.2012.12.025. PubMed PMID: 23321315.
  47. Thevenot T, Degand T, Grelat N, Elkrief L, Christol C, Moreau R, Henrion J, Cadranel JF, Sheppard F, Bureau C, di Martino V, Pauwels A; National Association of General Hospital Hepato-gastroenterologists.. A French national survey on the use of antibiotic prophylaxis in cirrhotic patients. Liver Int. 2013 Mar;33(3):389-97. doi: 10.1111/liv.12093. PubMed PMID: 23302021.
  48. Rolas L, Makhezer N, Hadjoudj S, El-Benna J, Djerdjouri B, Elkrief L, Moreau R, Périanin A. Inhibition of mammalian target of rapamycin aggravates the respiratory burst defect of neutrophils from decompensated patients with cirrhosis. Hepatology. 2013 Mar;57(3):1163-71. doi: 10.1002/hep.26109. PubMed PMID: 23080369.
  49. Guyot E, Sutton A, Rufat P, Laguillier C, Mansouri A, Moreau R, Ganne-Carrié N, Beaugrand M, Charnaux N, Trinchet JC, Nahon P. PNPLA3 rs738409, hepatocellular carcinoma occurrence and risk model prediction in patients with cirrhosis. J Hepatol. 2013 Feb;58(2):312-8. doi: 10.1016/j.jhep.2012.09.036. PubMed PMID:23069476.
  50. Vadrot N, Ghanem S, Braut F, Gavrilescu L, Pilard N, Mansouri A, Moreau R, Reyl-Desmars F. Mitochondrial DNA maintenance is regulated in human hepatoma cells by glycogen synthase kinase 3β and p53 in response to tumor necrosis factor α. PLoS One. 2012;7(7):e40879. doi: 10.1371/journal.pone.0040879. PubMed PMID: 22911714; PubMed Central PMCID: PMC3401193.
  51. Jalan R, Gines P, Olson JC, Mookerjee RP, Moreau R, Garcia-Tsao G, Arroyo V, Kamath PS. Acute-on chronic liver failure. J Hepatol. 2012 Dec;57(6):1336-48. doi: 10.1016/j.jhep.2012.06.026. Review. PubMed PMID: 22750750.
  52. Sersté T, Gustot T, Rautou PE, Francoz C, Njimi H, Durand F, Valla D, Lebrec D, Moreau R. Severe hyponatremia is a better predictor of mortality than MELDNa in patients with cirrhosis and refractory ascites. J Hepatol. 2012 Aug;57(2):274-80. doi: 10.1016/j.jhep.2012.03.018. PubMed PMID: 22521353.
  53. Rautou PE, Bresson J, Sainte-Marie Y, Vion AC, Paradis V, Renard JM, Devue C, Heymes C, Letteron P, Elkrief L, Lebrec D, Valla D, Tedgui A, Moreau R, Boulanger CM. Abnormal plasma microparticles impair vasoconstrictor responses in patients with cirrhosis. Gastroenterology. 2012 Jul;143(1):166-76.e6. doi:10.1053/j.gastro.2012.03.040. PubMed PMID: 22465620.
  54. Lebrec D, Bosch J, Jalan R, Dudley FJ, Jessic R, Moreau R, Garcia-Pagan JC, Mookerjee RP, Chiossi E, Van Giersbergen PL, Kusic-Pajic A, Dingemanse J. Hemodynamics and pharmacokinetics of tezosentan, a dual endothelin receptor antagonist, in patients with cirrhosis. Eur J Clin Pharmacol. 2012 May;68(5):533-41. doi: 10.1007/s00228-011-1157-6. PubMed PMID: 22101624.
  55. Nahon P, Sutton A, Rufat P, Charnaux N, Mansouri A, Moreau R, Ganne-Carrié N, Grando-Lemaire V, N'Kontchou G, Trinchet JC, Pessayre D, Beaugrand M. A variant in myeloperoxidase promoter hastens the emergence of hepatocellular carcinoma in patients with HCV-related cirrhosis. J Hepatol. 2012 Feb;56(2):426-32. doi: 10.1016/j.jhep.2011.08.010. PubMed PMID: 21907168.
  56. Pessayre D, Fromenty B, Berson A, Robin MA, Lettéron P, Moreau R, Mansouri A. Central role of mitochondria in drug-induced liver injury. Drug Metab Rev. 2012 Feb;44(1):34-87. doi: 10.3109/03602532.2011.604086. Review. PubMed PMID:21892896.
  57. Tissandié E, Morelle W, Berthelot L, Vrtovsnik F, Daugas E, Walker F, Lebrec D, Trawalé JM, Francoz C, Durand F, Moura IC, Paradis V, Moreau R, Monteiro RC. Both IgA nephropathy and alcoholic cirrhosis feature abnormally glycosylated IgA1 and soluble CD89-IgA and IgG-IgA complexes: common mechanisms for distinct diseases. Kidney Int. 2011 Dec;80(12):1352-63. doi: 10.1038/ki.2011.276. PubMed PMID: 21866091.
  58. Choumar A, Tarhuni A, Lettéron P, Reyl-Desmars F, Dauhoo N, Damasse J, Vadrot N, Nahon P, Moreau R, Pessayre D, Mansouri A. Lipopolysaccharide-induced mitochondrial DNA depletion. Antioxid Redox Signal. 2011 Dec 1;15(11):2837-54. doi: 10.1089/ars.2010.3713. PubMed PMID: 21767162.
  59. Tréton X, Pédruzzi E, Cazals-Hatem D, Grodet A, Panis Y, Groyer A, Moreau R, Bouhnik Y, Daniel F, Ogier-Denis E. Altered endoplasmic reticulum stress affects  translation in inactive colon tissue from patients with ulcerative colitis. Gastroenterology. 2011 Sep;141(3):1024-35. doi: 10.1053/j.gastro.2011.05.033. PubMed PMID: 21699776.
  60. Francoz C, Belghiti J, Castaing D, Chazouillères O, Duclos-Vallée JC, Duvoux C, Lerut J, Le Treut YP, Moreau R, Mandot A, Pageaux G, Samuel D, Thabut D, Valla D, Durand F. Model for end-stage liver disease exceptions in the context of the French model for end-stage liver disease score-based liver allocation system. Liver Transpl. 2011 Oct;17(10):1137-51. doi: 10.1002/lt.22363. Review. PubMed PMID: 21695771.
  61. Rautou PE, Cazals-Hatem D, Feldmann G, Mansouri A, Grodet A, Barge S, Martinot-Peignoux M, Duces A, Bièche I, Lebrec D, Bedossa P, Paradis V, Marcellin P, Valla D, Asselah T, Moreau R. Changes in autophagic response in patients with chronic hepatitis C virus infection. Am J Pathol. 2011 Jun;178(6):2708-15. doi: 10.1016/j.ajpath.2011.02.021. PubMed PMID: 21641393; PubMed Central PMCID: PMC3124343.
  62. Charni F, Sutton A, Rufat P, Laguillier C, Mansouri A, Moreau R, Ganne-Carrié N, Trinchet JC, Beaugrand M, Charnaux N, Nahon P. Chemokine RANTES promoter dimorphisms and hepatocellular carcinoma occurrence in patients with alcoholic or hepatitis C virus-related cirrhosis. Cancer Epidemiol Biomarkers Prev. 2011 Jul;20(7):1439-46. doi: 10.1158/1055-9965.EPI-11-0341. PubMed PMID: 21610221.
  63. Bialek-Davenet S, Marcon E, Leflon-Guibout V, Lavigne JP, Bert F, Moreau R,  Nicolas-Chanoine MH. In vitro selection of ramR and soxR mutants overexpressing efflux systems by fluoroquinolones as well as cefoxitin in Klebsiella pneumoniae. Antimicrob Agents Chemother. 2011 Jun;55(6):2795-802. doi: 10.1128/AAC.00156-11. PubMed PMID: 21464248; PubMed Central PMCID: PMC3101381.
  64. Sersté T, Bert F, Leflon-Guibout V, Chauvet C, Marcon E, Asselah T, Francoz  C, Durand F, Lebrec D, Valla D, Moreau R, Nicolas-Chanoine MH. Detection of bacterial DNA in serum and ascitic fluid of asymptomatic outpatients withcirrhosis and non-neutrocytic ascites. Liver Int. 2011 Apr;31(4):494-8. doi: 10.1111/j.1478-3231.2011.02448.x. PubMed PMID: 21382159.
  65. Bert F, Huynh B, Dondero F, Johnson JR, Paugam-Burtz C, Durand F, Belghiti J, Valla D, Moreau R, Nicolas-Chanoine MH. Molecular epidemiology of Escherichia coli bacteremia in liver transplant recipients. Transpl Infect Dis. 2011 Aug;13(4):359-65. doi: 10.1111/j.1399-3062.2011.00618.x. PubMed PMID: 21355970.
  66. Sersté T, Francoz C, Durand F, Rautou PE, Melot C, Valla D, Moreau R*, Lebrec *D. Beta-blockers cause paracentesis-induced circulatory dysfunction in patients with cirrhosis and refractory ascites: a cross-over study. J Hepatol. 2011 Oct;55(4):794-9. doi: 10.1016/j.jhep.2011.01.034. PubMed PMID: 21354230.*Equal contributions
  67. Coant N, Simon-Rudler M, Gustot T, Fasseu M, Gandoura S, Ragot K, Abdel-Razek W, Thabut D, Lettéron P, Ogier-Denis E, Ouziel R, Devière J, Lizard G, Tellier Z, Lebrec D, Moreau R. Glycogen synthase kinase 3 involvement in the excessive proinflammatory response to LPS in patients with decompensated cirrhosis. J Hepatol. 2011 Oct;55(4):784-93. doi: 10.1016/j.jhep.2010.12.039. PubMed PMID: 21334395.
  68. Wong F, Nadim MK, Kellum JA, Salerno F, Bellomo R, Gerbes A, Angeli P, Moreau R, Davenport A, Jalan R, Ronco C, Genyk Y, Arroyo V. Working Party proposal for a revised classification system of renal dysfunction in patients with cirrhosis. Gut. 2011 May;60(5):702-9. doi: 10.1136/gut.2010.236133. PubMed PMID: 21325171.
  69. Thabut D, Moreau R, Lebrec D. Noninvasive assessment of portal hypertension in patients with cirrhosis. Hepatology. 2011 Feb;53(2):683-94. doi: 10.1002/hep.24129. Review. PubMed PMID: 21274889.
  70. Fasseu M, Tréton X, Guichard C, Pedruzzi E, Cazals-Hatem D, Richard C, Aparicio T, Daniel F, Soulé JC, Moreau R, Bouhnik Y, Laburthe M, Groyer A, Ogier-Denis E. Identification of restricted subsets of mature microRNA abnormally expressed in inactive colonic mucosa of patients with inflammatory bowel disease. PLoS One. 2010 Oct 5;5(10). pii: e13160. doi: 10.1371/journal.pone.0013160. PubMed PMID: 20957151; PubMed Central PMCID: PMC2950152.
  71. Rautou PE, Douarin L, Denninger MH, Escolano S, Lebrec D, Moreau R, Vidaud M, Itzykson R, Moucari R, Bezeaud A, Valla D, Plessier A. Bleeding in patients with Budd-Chiari syndrome. J Hepatol. 2011 Jan;54(1):56-63. doi: 10.1016/j.jhep.2010.06.019. PubMed PMID: 20889223.
  72. Francoz C, Prié D, Abdelrazek W, Moreau R, Mandot A, Belghiti J, Valla D, Durand F. Inaccuracies of creatinine and creatinine-based equations in candidates for liver transplantation with low creatinine: impact on the model for end-stage liver disease score. Liver Transpl. 2010 Oct;16(10):1169-77. doi: 10.1002/lt.22128. PubMed PMID: 20879015.
  73. Rautou PE, Mansouri A, Lebrec D, Durand F, Valla D, Moreau R. Autophagy in liver diseases. J Hepatol. 2010 Dec;53(6):1123-34. doi: 10.1016/j.jhep.2010.07.006. Review. PubMed PMID: 20810185.
  74. Das V, Boelle PY, Galbois A, Guidet B, Maury E, Carbonell N, Moreau R, Offenstadt G. Cirrhotic patients in the medical intensive care unit: early prognosis and long-term survival. Crit Care Med. 2010 Nov;38(11):2108-16. doi: 10.1097/CCM.0b013e3181f3dea9. PubMed PMID: 20802324.
  75. European Association for the Study of the Liver.  EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010 Sep;53(3):397-417. doi: 10.1016/j.jhep.2010.05.004. Review. PubMed PMID: 20633946.
  76. Sersté T, Melot C, Francoz C, Durand F, Rautou PE, Valla D, Moreau R*, Lebrec D*. Deleterious effects of beta-blockers on survival in patients with cirrhosis and refractory ascites. Hepatology. 2010 Sep;52(3):1017-22. doi: 10.1002/hep.23775. PubMed PMID: 20583214. *Equal contributions.
  77. Asselah T, Bièche I, Mansouri A, Laurendeau I, Cazals-Hatem D, Feldmann G, Bedossa P, Paradis V, Martinot-Peignoux M, Lebrec D, Guichard C, Ogier-Denis E, Vidaud M, Tellier Z, Soumelis V, Marcellin P, Moreau R. In vivo hepatic endoplasmic reticulum stress in patients with chronic hepatitis C. J Pathol. 2010 Jul;221(3):264-74. doi: 10.1002/path.2703. PubMed PMID: 20527020.
  78. Bert F, Johnson JR, Ouattara B, Leflon-Guibout V, Johnston B, Marcon E, Valla D, Moreau R, Nicolas-Chanoine MH. Genetic diversity and virulence profiles of Escherichia coli isolates causing spontaneous bacterial peritonitis and bacteremia in patients with cirrhosis. J Clin Microbiol. 2010 Aug;48(8):2709-14.  doi: 10.1128/JCM.00516-10. PubMed PMID: 20519468; PubMed Central PMCID: PMC2916625.
  79. Salerno F, Guevara M, Bernardi M, Moreau R, Wong F, Angeli P, Garcia-Tsao G, Lee SS. Refractory ascites: pathogenesis, definition and therapy of a severe complication in patients with cirrhosis. Liver Int. 2010 Aug;30(7):937-47. doi: 10.1111/j.1478-3231.2010.02272.x. Review. Erratum in: Liver Int. 2010 Sep;30(8):1244. PubMed PMID: 20492521.
  80. Coant N, Ben Mkaddem S, Pedruzzi E, Guichard C, Tréton X, Ducroc R, Freund JN, Cazals-Hatem D, Bouhnik Y, Woerther PL, Skurnik D, Grodet A, Fay M, Biard D,  Lesuffleur T, Deffert C, Moreau R, Groyer A, Krause KH, Daniel F, Ogier-Denis E.  NADPH oxidase 1 modulates WNT and NOTCH1 signaling to control the fate of proliferative progenitor cells in the colon. Mol Cell Biol. 2010 Jun;30(11):2636-50. doi: 10.1128/MCB.01194-09. PubMed PMID: 20351171; PubMed Central PMCID: PMC2876517.
  81. Francoz C, Glotz D, Moreau R, Durand F. The evaluation of renal function and disease in patients with cirrhosis. J Hepatol. 2010 Apr;52(4):605-13. doi: 10.1016/j.jhep.2009.11.025. Review. PubMed PMID: 20185192.
  82. Lebrec D, Thabut D, Oberti F, Perarnau JM, Condat B, Barraud H, Saliba F, Carbonell N, Renard P, Ramond MJ, Moreau R, Poynard T; Pentocir Group. Pentoxifylline does not decrease short-term mortality but does reduce complications in patients with advanced cirrhosis. Gastroenterology. 2010 May;138(5):1755-62. doi: 10.1053/j.gastro.2010.01.040. PubMed PMID: 20102716.
  83. Trawalé JM, Paradis V, Rautou PE, Francoz C, Escolano S, Sallée M, Durand F, Valla D, Lebrec D, Moreau R. The spectrum of renal lesions in patients withcirrhosis: a clinicopathological study. Liver Int. 2010 May;30(5):725-32. doi: 10.1111/j.1478-3231.2009.02182.x. PubMed PMID: 20040048.
  84. Gustot T, Durand F, Lebrec D, Vincent JL, Moreau R. Severe sepsis in cirrhosis. Hepatology. 2009 Dec;50(6):2022-33. doi: 10.1002/hep.23264. Review. Erratum in: Hepatology. 2010 Feb;51(2):725. PubMed PMID: 19885876.
  85. Tazi KA, Quioc JJ, Abdel-Razek W, Tellier Z, Guichard C, Ogier-Denis E, Lebrec D, Moreau R. Protein array technology to investigate cytokine production by monocytes from patients with advanced alcoholic cirrhosis: An ex vivo pilot study. Hepatol Res. 2009 Jul;39(7):706-15. doi: 10.1111/j.1872-034X.2009.00498.x. PubMed PMID: 19473436.
  86. Galbois A, Thabut D, Tazi KA, Rudler M, Mohammadi MS, Bonnefont-Rousselot D, Bennani H, Bezeaud A, Tellier Z, Guichard C, Coant N, Ogier-Denis E, Moreau R*, Lebrec D*. Ex vivo effects of high-density lipoprotein exposure on the lipopolysaccharide-induced inflammatory response in patients with severe cirrhosis. Hepatology. 2009 Jan;49(1):175-84. doi: 10.1002/hep.22582. PubMed PMID: 19053046.*equal contributions.
  87. Rautou PE, Cazals-Hatem D, Moreau R, Francoz C, Feldmann G, Lebrec D, Ogier-Denis E, Bedossa P, Valla D, Durand F. Acute liver cell damage in patients  with anorexia nervosa: a possible role of starvation-induced hepatocyte autophagy. Gastroenterology. 2008 Sep;135(3):840-8, 848.e1-3. doi: 10.1053/j.gastro.2008.05.055. PubMed PMID: 18644371.
  88. Thabut D, Moreau R, Lebrec D. Screening for esophageal varices: Endoscopy, other tools, or endoscopy and other tools? Hepatology. 2008 May;47(5):1434-6. doi: 10.1002/hep.22315. PubMed PMID: 18435464.
  89. Thabut D, Massard J, Gangloff A, Carbonell N, Francoz C, Nguyen-Khac E, Duhamel C, Lebrec D, Poynard T, Moreau R. Model for end-stage liver disease score and systemic inflammatory response are major prognostic factors in patients with  cirrhosis and acute functional renal failure. Hepatology. 2007 Dec;46(6):1872-82. PubMed PMID: 17972337.
  90. Thabut D, Tazi KA, Bonnefont-Rousselot D, Aller M, Farges O, Guimont MC, Tellier Z, Guichard C, Ogier-Denis E, Poynard T, Moreau R, Lebrec D. High-density lipoprotein administration attenuates liver proinflammatory response, restores liver endothelial nitric oxide synthase activity, and lowers portal pressure in cirrhotic rats. Hepatology. 2007 Dec;46(6):1893-906. PubMed PMID: 17918268.
  91. Nousbaum JB, Cadranel JF, Nahon P, Khac EN, Moreau R, Thévenot T, Silvain C, Bureau C, Nouel O, Pilette C, Paupard T, Vanbiervliet G, Oberti F, Davion T,Jouannaud V, Roche B, Bernard PH, Beaulieu S, Danne O, Thabut D, Chagneau-Derrode C, de Lédinghen V, Mathurin P, Pauwels A, Bronowicki JP, Habersetzer F, Abergel A, Audigier JC, Sapey T, Grangé JD, Tran A; Club Francophone pour l'Etude de l'Hypertension Portale.; Association Nationale des Hépato-Gastroentérologues des  Hôpitaux Généraux de France.. Diagnostic accuracy of the Multistix 8 SG reagent strip in diagnosis of spontaneous bacterial peritonitis. Hepatology. 2007 May;45(5):1275-81. PubMed PMID: 17464969.
  92. Tazi KA, Bièche I, Paradis V, Guichard C, Laurendeau I, Dargère D, Legrand A, Fay M, Pedruzzi E, Robin MA, Cazals-Hatem D, Tellier Z, Bernuau D, Feldmann G, Vidaud M, Lebrec D, Ogier-Denis E, Moreau R. In vivo altered unfolded protein response and apoptosis in livers from lipopolysaccharide-challenged cirrhotic rats. J Hepatol. 2007 Jun;46(6):1075-88. PubMed PMID: 17399843.

 

Scientific summary

Work in the Moreau laboratory concerns the excessive innate immune response to bacterial byproducts, a hallmark of chronic liver diseases such as cirrhosis (which is the 8th most cause of death worldwide). They have shown that immune cells from patients or animals with cirrhosis stimulated with bacterial byproducts, exhibit overactivation of transcription factors (NF-kappaB and AP-1), overproduction of pro-inflammatory cytokines and hypo-production of anti-inflammatory interleukin (IL)-10. This excessive pro-inflammatory response leads to multi-organ failure and death. Their goal is to understand molecular mechanisms responsible for the altered innate immune response in cirrhosis. One question they wish to answer is how negative feed-back pathways (including, Akt/mTOR, STAT3 and CREB) that normally decrease NF-kappaB-dependent transcription are inhibited in cirrhosis. Another question they address is whether deregulation of enzymes modulating histone acetylation and methylation is involved in altered gene expression profile in cirrhotic immune cells. They are also interested in how bacterial byproducts induce failure of cirrhotic livers, addressing the role of impaired liver regeneration, decreased protein synthesis dependent on eIF2apha kinases (PKR and PERK) and mitochondrial dysfunction in animal models of chronic liver diseases. They are also involved in translational research of novel therapeutic approaches aimed to improve prognosis of patients with cirrhosis who are waiting for liver transplantation. Finally, members of the lab including Richard Moreau, are also principal investigators of prospective obersvational studies as well as interventional multicenter randomized double-blind clinical trials.

Image d’exemple