Presse Medicale最新文献

{"title":"What's new in transplantation?","authors":"Yvon Lebranchu","doi":"10.1016/j.lpm.2022.104148","DOIUrl":"10.1016/j.lpm.2022.104148","url":null,"abstract":"","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 4","pages":"Article 104148"},"PeriodicalIF":2.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10618494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From islet of Langerhans transplantation to the bioartificial pancreas","authors":"Thierry Berney ,&nbsp;Charles H. Wassmer ,&nbsp;Fanny Lebreton ,&nbsp;Kevin Bellofatto ,&nbsp;Laura Mar Fonseca ,&nbsp;Juliette Bignard ,&nbsp;Reine Hanna ,&nbsp;Andrea Peloso ,&nbsp;Ekaterine Berishvili","doi":"10.1016/j.lpm.2022.104139","DOIUrl":"10.1016/j.lpm.2022.104139","url":null,"abstract":"<div><p>Type 1 diabetes is a disease resulting from autoimmune destruction of the insulin-producing beta cells in the pancreas. When type 1 diabetes develops into severe secondary complications, in particular end-stage nephropathy, or life-threatening severe hypoglycemia, the best therapeutic approach is pancreas transplantation, or more recently transplantation of the pancreatic islets of Langerhans. Islet transplantation is a cell therapy procedure, that is minimally invasive and has a low morbidity, but does not display the same rate of functional success as the more invasive pancreas transplantation because of suboptimal engraftment and survival. Another issue is that pancreas or islet transplantation (collectively known as beta cell replacement therapy) is limited by the shortage of organ donors and by the need for lifelong immunosuppression to prevent immune rejection and recurrence of autoimmunity.</p><p>A bioartificial pancreas is a construct made of functional, insulin-producing tissue, embedded in an anti-inflammatory, immunomodulatory microenvironment and encapsulated in a perm-selective membrane allowing glucose sensing and insulin release, but isolating from attacks by cells of the immune system. A successful bioartificial pancreas would address the issues of engraftment, survival and rejection. Inclusion of unlimited sources of insulin-producing cells, such as xenogeneic porcine islets or stem cell-derived beta cells would further solve the problem of organ shortage.</p><p>This article reviews the current status of clinical islet transplantation, the strategies aiming at developing a bioartificial pancreas, the clinical trials conducted in the field and the perspectives for further progress.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 4","pages":"Article 104139"},"PeriodicalIF":2.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S075549822200032X/pdfft?md5=af38f0b1e858116ac7f2616d4b851328&pid=1-s2.0-S075549822200032X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10781625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and kidney transplantation","authors":"Sophie Caillard ,&nbsp;French Registry of Solid Organ Transplant Patients COVID-19","doi":"10.1016/j.lpm.2022.104146","DOIUrl":"10.1016/j.lpm.2022.104146","url":null,"abstract":"<div><p>The COVID-19 pandemic affects the transplant recipients since March 2020. Transplant centers quickly organized themselves to optimize the management of the immunocompromised patients and to progress in the knowledge of this new disease. To this end, a French Registry was created, which includes all solid organ transplant patients who have developed a SARS Cov2 infection. Numerous studies have been carried out using these data to describe this new disease in transplant patients, to characterize its clinical and biological risk factors and to define its prognosis. The 60 days-mortality of transplant patients hospitalized for COVID-19 was evaluated at 23% and renal failure plays a major role in the poor prognosis in addition to the classical risk factors described in the general population. The advent of vaccination has been a great relief but transplanted patients have shown a poor vaccine response keeping them at risk of severe disease even after an adapted vaccination scheme. Specific strategies was proposed in this particularly fragile population like increasing vaccine doses or using anti SARS Cov-2 monoclonal antibodies.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 4","pages":"Article 104146"},"PeriodicalIF":2.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9636029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10434347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning in lung transplantation: Where are we?","authors":"Evgeni Mekov ,&nbsp;Viktoria Ilieva","doi":"10.1016/j.lpm.2022.104140","DOIUrl":"10.1016/j.lpm.2022.104140","url":null,"abstract":"<div><p>Lung transplantation<span><span> has been accepted as a viable treatment for end-stage respiratory failure. While regression models continue to be a standard approach for attempting to predict patients’ outcomes after lung transplantation, more sophisticated supervised machine learning (ML) techniques are being developed and show encouraging results. Transplant clinicians could utilize ML as a decision-support tool in a variety of situations (e.g. waiting list mortality, donor selection, </span>immunosuppression, rejection prediction). Although for some topics ML is at an advanced stage of research (i.e. imaging and pathology) there are certain topics in lung transplantation that needs to be aware of the benefits it could provide.</span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 4","pages":"Article 104140"},"PeriodicalIF":2.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10434036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New immunosuppressive agents in transplantation","authors":"Delphine Kervella ,&nbsp;Gilles Blancho","doi":"10.1016/j.lpm.2022.104142","DOIUrl":"10.1016/j.lpm.2022.104142","url":null,"abstract":"<div><p>Immunosuppressive agents<span><span> have enabled the development of allogenic transplantation during the last 40 years, allowing considerable improvement in </span>graft survival<span><span><span>. However, several issues remain such as the nephrotoxicity of </span>calcineurin inhibitors, the cornerstone of immunosuppressive regimens and/or the higher risk of </span>opportunistic infections<span><span> and cancers. Most immunosuppressive agents target T cell activation and may not be efficient enough to prevent allo-immunization in the long term. Finally, </span>antibody mediated rejection due to donor specific antibodies strongly affects allograft survival.</span></span></span></p><p>Many drugs<span> have been tested in the last decades, but very few have come to clinical use. The most recent one is CTLA4-Ig (belatacept), a costimulation blockade molecule that targets the second signal of T cell activation and is associated with a better long term kidney function than calcineurin inhibitors, despite an increased risk of acute cellular rejection.</span></p><p><span><span>The research of new maintenance long-term immunosuppressive agents focuses on costimulation blockade. Agents inhibiting CD40-CD40 ligand interaction may enable a good control of both T cells and B cells responses. Anti-CD28 antibodies may promote </span>regulatory T cells. Agents targeting this costimulation pathways are currently evaluated in </span>clinical trials.</p><p><span><span>Immunosuppressive agents for ABMR treatment<span> are scarce since anti-CD20 agent rituximab and proteasome inhibitor </span></span>bortezomib have failed to demonstrate an interest in ABMR. New drugs focusing on antibodies removal (imlifidase), B cell and </span>plasmablasts (anti-IL-6/IL-6R, anti-CD38…) and complement inhibition are in the pipeline, with the challenge of their evaluation in such a heterogeneous pathology.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 4","pages":"Article 104142"},"PeriodicalIF":2.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10478317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to improve results after DCD (donation after circulation death)","authors":"Maryne Lepoittevin ,&nbsp;Sébastien Giraud ,&nbsp;Thomas Kerforne ,&nbsp;Géraldine Allain ,&nbsp;Raphaël Thuillier ,&nbsp;Thierry Hauet","doi":"10.1016/j.lpm.2022.104143","DOIUrl":"10.1016/j.lpm.2022.104143","url":null,"abstract":"<div><p>The shortage of organs for transplantation has led health professionals to look for alternative sources of donors. One of the avenues concerns donors who have died after circulatory arrest. This is a special situation because the organs from these donors are exposed to warm ischaemia-reperfusion lesions that are unavoidable during the journey of the organs from the donor to the moment of transplantation in the recipient. We will address and discuss the key issues from the perspective of team organization, legislation and its evolution, and the ethical framework. In a second part, the avenues to improve the quality of organs will be presented following the itinerary of the organs between the donor and the recipient. The important moments from the point of view of therapeutic strategy will be put into perspective. New connections between key players involved in pathophysiological mechanisms and implications for innate immunity and injury processes are among the avenues to explore. Technological developments to improve the quality of organs from these recipients will be analyzed, such as perfusion techniques with new modalities of temperatures and oxygenation. New molecules are being investigated for their potential role in protecting these organs and an analysis of potential prospects will be proposed. Finally, the important perspectives that seem to be favored will be discussed in order to reposition the use of deceased donors after circulatory arrest. The use of these organs has become a routine procedure and improving their quality and providing the means for their evaluation is absolutely inevitable.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 4","pages":"Article 104143"},"PeriodicalIF":2.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10431973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholera in Haiti","authors":"Renaud Piarroux ,&nbsp;Sandy Moore ,&nbsp;Stanislas Rebaudet","doi":"10.1016/j.lpm.2022.104136","DOIUrl":"10.1016/j.lpm.2022.104136","url":null,"abstract":"<div><p>The cholera epidemic that hit Haiti from October 2010 to February 2019 was the world's deadliest of the last 25 years. Officially, the successive waves caused 9789 deaths, although numerous additional casualties could not be recorded. The origin of this epidemic has been the subject of a controversy involving two opposing theories. The first hypothesis, put forward by renowned American academics, was that the cholera epidemic originated from the environment, due to the proliferation and transmission of aquatic <em>Vibrio cholerae</em> bacteria driven by a confluence of circumstances, i.e., the earthquake followed by a hot summer and, ultimately, heavy rainfall and flooding. The alternative hypothesis, which was subsequently confirmed by epidemiological and genomic studies, attributed the epidemic to the recent importation of cholera by UN peacekeepers recently arrived from Nepal, and to a river polluted with sewage. In late 2016, the Secretary General of the United Nations finally begged the Haitian people for forgiveness. This implicit recognition of the role of the UN in the cholera epidemic helped to fund the ongoing fight against it. Case-area targeted interventions aimed at interrupting cholera transmission were reinforced, which resulted in the extinction of the epidemic within two years. In the meantime, several phylogenetic studies on <em>Vibrio cholerae</em> during the seventh cholera pandemic demonstrated that local environmental and global epidemic <em>Vibrio</em> populations were distinct. These studies also showed that epidemics arose when the bacterium had diversified and that it had spread during transmission events associated with human travel.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 3","pages":"Article 104136"},"PeriodicalIF":2.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S075549822200029X/pdfft?md5=108ce1e7f2ee63118d3c409c6a6699b4&pid=1-s2.0-S075549822200029X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10347721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Covid-19, an unfinished story","authors":"Yves Buisson","doi":"10.1016/j.lpm.2022.104131","DOIUrl":"10.1016/j.lpm.2022.104131","url":null,"abstract":"<div><p>The Covid-19 pandemic appeared in China in December 2019 as a cluster of transmissible pneumonia caused by a new betacoronavirus. On March 11, 2020, the World Health Organization (WHO) declared it a pandemic. Covid-19 is a mild infection in 80% of cases, serious in 15% and critical in 5%. Symptomatic forms include a first phase of flu-like viral invasion, and at times a second phase, dysimmune and inflammatory, with acute respiratory distress syndrome, multiorgan failure and thromboembolic complications. Degree of severity is related to age and comorbidities.</p><p>SARS-CoV-2 is the third highly pathogenic Betacoronavirus to cross the species barrier. Its genome, an RNA of 29,903 nucleotides, shows strong homogeneity with bat coronaviruses from southern China, but the conditions for its passage in humans have yet to be elucidated. Mutations can give rise to variants of concern (VOC) that are more transmissible and able to evade the host's immune response. Several VOCs have succeeded and replaced one another: Alpha in October 2020, Beta and Gamma in December 2020, Delta in spring 2021 and Omicron in November 2021. The Covid-19 pandemic has evolved in five waves of unequal amplitude and severity, with geographical disparities. Worldwide, it has caused 395,000,000 confirmed cases including 5,700,000 deaths.</p><p>Epidemiological surveillance applies several indicators (incidence rate, test positivity rate, effective R and occupancy rate of intensive care beds) supplemented by genomic monitoring to detect variants by sequencing.</p><p>Non-pharmacological measures, particularly face mask wearing, have been effective in preventing the transmission of SARS-CoV-2. Few currently available drugs have proven useful, with the exception of dexamethazone for patients requiring oxygen therapy. Development of SARS-CoV-2 vaccines began early on many platforms. Innovation was brought about by the Pfizer-BioNTech and Moderna messenger RNA vaccines, which claim protective efficacy of 95% and 94.1% respectively, far higher than the 70% minimum set by the WHO.</p><p>Governments have hesitated between two strategies, mitigation and suppression. The second has been favored in critical periods such as April 2020, when 2.5 billion people throughout the world were confined. Vaccination campaigns got underway at the end of December 2020 and progressed without reaching sufficient herd immunity, leading some nations to consider compulsory vaccination or to require a vaccine or health pass, in order for persons to access different activities.</p><p>Will the pandemic stop with Omicron and become endemic? This part of the Covid-19 story remains to be told.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 3","pages":"Article 104131"},"PeriodicalIF":2.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9395148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10386329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The enigma of the 1889 Russian flu pandemic: A coronavirus?","authors":"Patrick Berche","doi":"10.1016/j.lpm.2022.104111","DOIUrl":"10.1016/j.lpm.2022.104111","url":null,"abstract":"<div><p>The “Russian flu”, which raged from 1889 to 1894, is considered as the first pandemic of the industrial era for which statistics have been collected. This planetary event started in Turkestan and hit the Russian Empire, before reaching all European countries, the United States of America, and the whole world. Contemporaries were surprised by its high contagiousness as evidenced by attack rates averaging 60% in urban populations, its rapid spread in successive waves circling the globe in a few months by rail and sea, and the tendency of the disease to relapse. Despite its low case-fatality rate (0.10%-0.28%), it is estimated to have caused one million deaths worldwide. On serological grounds, it is generally accepted that the causative agent of Russian influenza was <em>Myxovirus influenzae</em>, the virus identified for all influenza pandemics since the “Spanish flu” of 1918. In light of the Covid-19 pandemic, which has underscored the extraordinary epidemic potential of coronaviruses, this assumption has recently been questioned. Coronaviruses come from wild reservoirs (bats, rodents, birds, …). They induce respiratory symptoms mimicking influenza, possibly leading to respiratory distress with pneumonia. In addition to the Covid-19 pandemic, recent deadly and limited epidemics, such as SARS in 2002 and MERS in 2012, have occurred. Russian influenza presented as an influenza-like syndrome with clinical peculiarities (multivisceral and neurological involvement, skin rash, early iterative relapses), evoking some particularities of Covid-19. Four other coronaviruses circulating in the human population for decades (HCoV-229E, HCoV-NL63, HCoV-OC43, HCoV-HKU1) have been found to be responsible for 15 to 30% of seasonal colds. All of these viruses are of animal origin. Recently, phylogenetic studies have revealed the genetic proximity between a bovine coronavirus BCoV and the human virus HCoV-OC43, indicating that the latter emerged around 1890, at the time of the Russian flu, when an epizootic was raging among cattle throughout Europe. Could the current human virus be the attenuated remnant that appeared after the Russian flu in 1894? Was there a coronavirus pandemic before Covid-19 ?</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 3","pages":"Article 104111"},"PeriodicalIF":2.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10457357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yellow fever: A brief history of a tropical Virosis","authors":"Francois Rodhain","doi":"10.1016/j.lpm.2022.104132","DOIUrl":"10.1016/j.lpm.2022.104132","url":null,"abstract":"<div><p>Yellow fever is a zoonotic arbovirosis, the agent of which is transmitted by mosquitoes. In humans, this virus can cause hemorrhagic hepato-nephritis, while mild or inapparent infections are common.</p><p>The catastrophic epidemics that occurred, mainly in the 18^th and the 19^th centuries, in Latin America and the United States as well as in the port cities of West Africa and Europe, had considerable demographic, socio-economic and political repercussions.</p><p>The viral nature of the infectious agent and its transmission by the <em>Aedes aegypti</em> mosquito, previously suspected by Beauperthuy, were demonstrated by Carlos Finlay in 1881 and confirmed by the American Commission led by Walter Reed in Havana in 1900 and by the French Commission led by Emile Marchoux in Rio de Janeiro in 1901-1905. The control of <em>Ae. aegypti</em> could then be implemented effectively.</p><p>It was only in 1927 that the yellow fever virus was isolated in Africa, its continent of origin, by French researchers from the Pasteur Institute in Dakar and by the American and English teams of the Rockefeller Foundation. Soon after, epidemiologists realized that there were forest cycles of the virus, involving monkeys and vectors other than <em>Ae. aegypti</em>, and consequently recognized the existence of a wild reservoir of the virus.</p><p>Once the virus was isolated, work on vaccine development could begin. This research was carried out by the Institut Pasteur in Dakar and by the Rockefeller Foundation. The two teams succeeded in obtaining two live vaccines conferring excellent and long-lasting protection: the neurotropic \"Dakar\" vaccine (1934) and the \"Rockefeller\" 17D vaccine (1937), which was better tolerated.</p><p>From then on, the fight against of yellow fever involved entomological control and vaccine protection, and it was a huge success until the 1960s. Unfortunately, the control programs were gradually reduced, and in some countries terminated. This resulted in the return of <em>Ae. aegypti</em> in urban areas and in insufficient vaccination coverage. Risks of epidemics reappeared, in Latin America as well as Africa.</p><p>In the early 21^st century, epidemiologists are worried about these resurgences, especially since we still have no indisputable explanation for the absence of the disease on the Asian continent. Obviously, yellow fever is not a disease of the past.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 3","pages":"Article 104132"},"PeriodicalIF":2.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0755498222000252/pdfft?md5=edb92e1f4d2db2896ce863aef54e6144&pid=1-s2.0-S0755498222000252-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10408784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}