Presse Medicale最新文献_第8页

Clinical pharmacology of antidiabetic drugs: What can be expected of their use? 抗糖尿病药物的临床药理学:它们的使用有什么预期?

IF 2.7 3区医学

Presse Medicale Pub Date : 2023-03-01 DOI: 10.1016/j.lpm.2022.104158

André J. Scheen

{"title":"Clinical pharmacology of antidiabetic drugs: What can be expected of their use?","authors":"André J. Scheen","doi":"10.1016/j.lpm.2022.104158","DOIUrl":"10.1016/j.lpm.2022.104158","url":null,"abstract":"<div>The pharmacotherapy of type 2 diabetes mellitus (T2DM) has markedly evolved in the last two decades. Classical antidiabetic agents (sulphonylureas, metformin, insulin) are now in competition with new glucose-lowering medications. Alpha-glucosidase inhibitors and thiazolidinediones (glitazones) were not able to replace older agents, because of insufficient efficacy and/or poor tolerability/safety. In contrast, incretin-based therapies, both dipeptidyl peptidase-4 inhibitors (DPP-4is or gliptins, oral agents) and glucagon-like peptide-1 receptor agonists (GLP-1RAs, subcutaneous injections) are a major breakthrough in the management of T2DM. Because they are not associated with hypoglycaemia and weight gain, DPP-4is tend to replace sulphonylureas as add-on to metformin while GLP-1RAs tend to replace basal insulin therapy after failure of oral therapies. Furthermore, placebo-controlled cardiovascular outcome trials demonstrated neutrality for DPP-4is, but cardiovascular protection for GLP-1RAs in patients with T2DM at high cardiovascular risk. More recently sodium-glucose cotransporter 2 inhibitors (SGLT2is or gliflozins, oral agents) also showed cardiovascular protection, especially a reduction in hospitalization for heart failure, as well as a renal protection in patients with and without T2DM, at high cardiovascular risk, with established heart failure and/or with chronic kidney disease. Thus, GLP-1RAs and SGLT2is are now considered as preferred drugs in T2DM patients with or at high risk of atherosclerotic cardiovascular disease whereas SGLT2is are more specifically recommended in patients with or at risk of heart failure and renal (albuminuric) disease. The management of T2DM is moving from a glucocentric approach to a broader strategy focusing on all risk factors, including overweight/obesity, and to an organ-disease targeted personalized approach.</div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"52 1","pages":"Article 104158"},"PeriodicalIF":2.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738639","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}

引用次数: 6

Renal hemodynamic changes in patients with type 2 diabetes and their clinical impact 2型糖尿病患者肾脏血液动力学变化及其临床影响。

IF 2.7 3区医学

Presse Medicale Pub Date : 2023-03-01 DOI: 10.1016/j.lpm.2023.104175

Pierre-Jean Saulnier , Petter Bjornstad

引用次数: 1

Unraveling complexity of antibody-mediated rejections, the mandatory way towards an accurate diagnosis and a personalized treatment 揭示抗体介导的排斥反应的复杂性，是准确诊断和个性化治疗的必由之路

IF 2.7 3区医学

Presse Medicale Pub Date : 2022-12-01 DOI: 10.1016/j.lpm.2022.104141

Philippe Gatault, Matthias Büchler

{"title":"Unraveling complexity of antibody-mediated rejections, the mandatory way towards an accurate diagnosis and a personalized treatment","authors":"Philippe Gatault, Matthias Büchler","doi":"10.1016/j.lpm.2022.104141","DOIUrl":"10.1016/j.lpm.2022.104141","url":null,"abstract":"<div>Antibody-mediated rejection (ABMR) remains one of the most challenging issues after organ transplantation and particularly after kidney transplantation. Despite many progresses during the last decade, ABMR is still the main cause of kidney graft loss and this all over the post- transplant period.In this review, we describe the recent knowledge about molecular and cellular mechanisms involved in ABMR. We focused our report on the role of the complement pathway in the process of ABMR and we give some insights into the role of inflammatory cells, NK lymphocytes and the role of endothelial cells. We further describe the potential role of non-HLA antibodies, of which the importance has been increasingly emphasized in recent years.Overall, this report could be of interest for all physicians who are working in the field of organ transplantation or who are working in the field of immunology. It gives essential information to understand new diagnosis advances and further therapeutic approaches.Antibody-mediated rejection (ABMR) is the leading cause of graft failure ([1,2]). In contrast to T-cell mediated rejection usually sensitive to steroids, active ABMR remains a therapeutic challenge. ABMR diagnosis relies on the presence of renal injuries and donor-specific antibodies (DSA) (HLA and non HLA antibodies) with sometimes the evidence of interaction between DSA and graft endothelium. Regularly revised during expert conferences, ABMR definition is currently categorized as active or chronic active. [3] The emergence of validated molecular assays targeting a better phenotyping of ABMR and the recent advances regarding the detrimental effect of DSA directed against minor antigens open the way to a better assessment of the heterogeneity of ABMR. In this review, we will address new aspects of ABMR regarding its mechanisms, diagnosis and treatments.</div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 4","pages":"Article 104141"},"PeriodicalIF":2.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10434307","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}

引用次数: 1

What's new in transplantation? 移植有什么新进展?

IF 2.7 3区医学

Presse Medicale Pub Date : 2022-12-01 DOI: 10.1016/j.lpm.2022.104148

Yvon Lebranchu

引用次数: 0

From islet of Langerhans transplantation to the bioartificial pancreas 从朗格汉斯胰岛移植到生物人工胰腺

IF 2.7 3区医学

Presse Medicale Pub Date : 2022-12-01 DOI: 10.1016/j.lpm.2022.104139

Thierry Berney , Charles H. Wassmer , Fanny Lebreton , Kevin Bellofatto , Laura Mar Fonseca , Juliette Bignard , Reine Hanna , Andrea Peloso , Ekaterine Berishvili

{"title":"From islet of Langerhans transplantation to the bioartificial pancreas","authors":"Thierry Berney , Charles H. Wassmer , Fanny Lebreton , Kevin Bellofatto , Laura Mar Fonseca , Juliette Bignard , Reine Hanna , Andrea Peloso , Ekaterine Berishvili","doi":"10.1016/j.lpm.2022.104139","DOIUrl":"10.1016/j.lpm.2022.104139","url":null,"abstract":"<div>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.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.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.</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}

引用次数: 3

COVID-19 and kidney transplantation COVID-19与肾移植

IF 2.7 3区医学

Presse Medicale Pub Date : 2022-12-01 DOI: 10.1016/j.lpm.2022.104146

Sophie Caillard , French Registry of Solid Organ Transplant Patients COVID-19

{"title":"COVID-19 and kidney transplantation","authors":"Sophie Caillard , 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>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.</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}

引用次数: 621

Machine learning in lung transplantation: Where are we? 机器学习在肺移植中的应用:进展如何?

IF 2.7 3区医学

Presse Medicale Pub Date : 2022-12-01 DOI: 10.1016/j.lpm.2022.104140

Evgeni Mekov , Viktoria Ilieva

引用次数: 3

New immunosuppressive agents in transplantation 移植中新的免疫抑制剂

IF 2.7 3区医学

Presse Medicale Pub Date : 2022-12-01 DOI: 10.1016/j.lpm.2022.104142

Delphine Kervella , Gilles Blancho

{"title":"New immunosuppressive agents in transplantation","authors":"Delphine Kervella , Gilles Blancho","doi":"10.1016/j.lpm.2022.104142","DOIUrl":"10.1016/j.lpm.2022.104142","url":null,"abstract":"<div>Immunosuppressive agents have enabled the development of allogenic transplantation during the last 40 years, allowing considerable improvement in graft survival. However, several issues remain such as the nephrotoxicity of calcineurin inhibitors, the cornerstone of immunosuppressive regimens and/or the higher risk of opportunistic infections and cancers. Most immunosuppressive agents target T cell activation and may not be efficient enough to prevent allo-immunization in the long term. Finally, antibody mediated rejection due to donor specific antibodies strongly affects allograft survival.Many drugs 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.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 regulatory T cells. Agents targeting this costimulation pathways are currently evaluated in clinical trials.Immunosuppressive agents for ABMR treatment are scarce since anti-CD20 agent rituximab and proteasome inhibitor bortezomib have failed to demonstrate an interest in ABMR. New drugs focusing on antibodies removal (imlifidase), B cell and 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.</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}

引用次数: 2

How to improve results after DCD (donation after circulation death) 如何提高循环死亡后捐献的效果

IF 2.7 3区医学

Presse Medicale Pub Date : 2022-12-01 DOI: 10.1016/j.lpm.2022.104143

Maryne Lepoittevin , Sébastien Giraud , Thomas Kerforne , Géraldine Allain , Raphaël Thuillier , Thierry Hauet

{"title":"How to improve results after DCD (donation after circulation death)","authors":"Maryne Lepoittevin , Sébastien Giraud , Thomas Kerforne , Géraldine Allain , Raphaël Thuillier , Thierry Hauet","doi":"10.1016/j.lpm.2022.104143","DOIUrl":"10.1016/j.lpm.2022.104143","url":null,"abstract":"<div>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.</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}

引用次数: 1

Cholera in Haiti 海地霍乱

IF 2.7 3区医学

Presse Medicale Pub Date : 2022-09-01 DOI: 10.1016/j.lpm.2022.104136

Renaud Piarroux , Sandy Moore , Stanislas Rebaudet

{"title":"Cholera in Haiti","authors":"Renaud Piarroux , Sandy Moore , Stanislas Rebaudet","doi":"10.1016/j.lpm.2022.104136","DOIUrl":"10.1016/j.lpm.2022.104136","url":null,"abstract":"<div>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 Vibrio cholerae 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 Vibrio cholerae during the seventh cholera pandemic demonstrated that local environmental and global epidemic Vibrio 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.</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}

引用次数: 24