ATRA (all trans retinoic acid), an active derivative of vitamin A, allows the healing of HCE human corneal epithelial cells and base-burned corneal epithelium in a mouse model.

De par son rôle dans de nombreuses fonctions biologiques, la vitamine A est une molécule majeure et cruciale du développement embryonnaire à l’âge adulte. Celle-ci est aussi, à l’heure actuelle, déjà largement utilisée comme agent thérapeutique pour de nombreuses pathologies affectant principalement la peau et les yeux (cancer, acné, psoriasis,brûlures oculaires) et certains cancers. Son action pro-cicatrisante - bien que largement étudiée grâce à de nombreux modèles humains et animaux - reste encore aujourd’hui mal caractérisée quant aux mécanismes d’action moléculaire (régulation de gènes) et cellulaire(migration, prolifération…) qu’elle utilise.Dans le but d’améliorer et de mieux maîtriser l’utilisation de la vitamine A dans le traitement de lésions telles que les brûlures oculaires, ce travail visait d’une part, à étudier, plus en détail,l’effet de l’acide tout-trans rétinoïque ou ATRA - dérivé le plus actif - sur la cicatrisation de ’épithélium cornéen en utilisant un modèle in vivo de brûlures cornéennes par base chez la souris. Son but était également de déterminer par quels processus cellulaires, l’ATRA agit, en utilisant cette fois-ci un modèle in vitro (cellules épithéliales cornéennes humaines). Enfin,nous nous sommes intéressés à la régulation de gènes cibles par l’ATRA au niveau de la sphère oculaire, connus pour être impliqués dans la dynamique de la MEC.Ainsi, nous avons démontré que l’ATRA permettait la cicatrisation de l’épithélium cornéen en agissant principalement sur la migration cellulaire. Puis nous avons identifié un gène :LOXL4 - membre de la famille des lysyl oxydases - dont l’expression est induite par l’ATRA,et nous avons prouvé que son rôle était essentiel dans la cicatrisation cornéenne, décrivant ainsi pour la première fois un lien génique direct et protéique entre la vitamine A, substance active et son action clinique pro-cicatrisante.Because of its role in many biological functions, Vitamin A is a major and crucialmolecule from development to adulthood. Currently, it is largely used as therapeutic agent inseveral eye or skin pathologies (acne, psoriasis, ocular burns) and cancers. Its pro-healingproperties have been largely studied in human and animal models but molecular (generegulations) and cellular (migration, proliferation…) mechanisms of the vitamin A actionhave to be more detailed.In order to better improve and control its use in the treatment of lesions such as ocular burns,this work aimed to study, more in details, the effects of atRA (all-trans-retinoic acid), activederivative form of vitamin A, on corneal epithelium healing using an in vivo model of alkaliocular burns in mouse and then, to determine by which cellular process atRA acts, by usingthis time, an in vitro model (human corneal epithelial cells). Finally, we were interested intargeting genes regulation by atRA in the ocular sphere, specially known to be implied in theECM dynamic.First, we demonstrated that atRA improves corneal epithelium wound healing, essentially byacting on migration. Then, we identified a gene, LOXL4, member of the lysyl oxidase family,which expression is induced by atRA and we proved that this one is essential in cornealwound healing, describing for the first time a direct gene and protein link between vitamin A,active substance, and its clinical pro-healing action

Long-Term Evolution of Quality of Life and Symptoms Following Surgical Treatment for Endometriosis: Different Trajectories for Which Patients?

Many studies have shown a global efficacy of laparoscopic surgery for patients with endometriosis in reducing painful symptoms and improving quality of life (QoL) in the short and long-term. The aim of this study was to analyze the different trajectories of long-term evolution in QoL and symptoms following surgical treatment for endometriosis, and to identify corresponding patient profiles. This prospective and multicenter cohort study concerned 962 patients who underwent laparoscopic treatment for endometriosis. QoL was evaluated using the Short Form (SF)-36 questionnaire and intensity of pain was reported using a visual analog scale prior to surgery and at 6, 12, 18, 24 and 36 months after surgery. Distinctive trajectories of pain and QoL evolution were identified using group-based trajectory modeling, an approach which gathers individuals into meaningful subgroups with statistically similar trajectories. Pelvic symptom trajectories (models of the evolution of dysmenorrhea, dyspareunia and chronic pelvic pain intensity over years) correspond to (1) patients with no pain or pain no longer after surgery, (2) patients with the biggest improvement in pain and (3) patients with continued severe pain after surgery. Our study reveals clear trajectories for the progression of symptoms and QoL after surgery that correspond to clusters of patients. This information may serve to complete information obtained from epidemiological methods currently used in selecting patients eligible for surgery

Le condensé de cigarettes perturbe le signal rétinoïdes au sein de l'amnios humain

International audienceIntroduction: The preterm premature rupture of membranes (PPROM) is a frequent pathology responsible of more than 30% of preterm births. Tobacco smoking is one of the most frequently described risk factors identified and contributes to the pre term weakening of fetal membranes. As previously demonstrated, all-trans retinoic acid (atRA) regulates several genes involved in the extracellular matrix dynamics, an essential actor in fetal membrane ruptures. We hypothesized that cigarette smoke may affect this pathway in human amnion. Methods: Amnion was obtained from full-term fetal membranes collected from non-smoking women after cesarean births and used either as explants or for the isolation of derived epithelial cells. The pro-healing and transcriptomic effects of atRA were studied by a scratch assay experiment and quantitative RT-PCR, respectively, after treatment with dimethyl sulfoxyde (DMSO), atRA, DMSO þ cigarette smoke condensate (CSC), or atRA þ CSC. Results: Our results show a strong alteration of the retinoid pathway after CSC treatment on amnion-derived epithelial cells and explants. We first demonstrated that CSC inhibits the activity of the RARE reporter gene in amnion-derived epithelial cells. Then, atRA's effects on both the transcription of its target genes and wound healing were demonstrated to be inhibited or at least decreased by the CSC in human amnion epithelial cells. Discussion: Here, we demonstrated that CSC altered the retinoid signal, already known to have roles in fetal membrane physiopathology. These results highlight a potential negative action of maternal smoking on the retinoid pathway in human amnion and more generally on pregnancy

Nuclear retinoid receptors and pregnancy: placental transfer, functions, and pharmacological aspects

International audienceAnimal models of vitamin A (retinol) deficiency have highlighted its crucial role in reproduction and placentation, whereas an excess of retinoids (structurally or functionally related entities) can cause toxic and teratogenic effects in the embryo and foetus, especially in the first trimester of human pregnancy. Knock-out experimental strategies-targeting retinoid nuclear receptors RARs and RXRs have confirmed that the effects of vitamin A are mediated by retinoic acid (especially all-trans retinoic acid) and that this vitamin is essential for the developmental process. All these data show that the vitamin A pathway and metabolism are as important for the well-being of the foetus, as they are for that of the adult. Accordingly, during this last decade, extensive research on retinoid metabolism has yielded detailed knowledge on all the actors in this pathway, spurring the development of antagonists and agonists for therapeutic and research applications. Natural and synthetic retinoids are currently used in clinical practice, most often on the skin for the treatment of acne, and as anti-oncogenic agents in acute promyelocytic leukaemia. However, because of the toxicity and teratogenicity of retinoids during pregnancy, their pharmacological use needs a sound knowledge of their metabolism, molecular aspects, placental transfer, and action

Factors of Non-Compliance with a Protocol for Oral Administration of Misoprostol (Angusta^®) 25 Micrograms to Induce Labor: An Observational Study

We set out to identify factors of non-compliance with a protocol for the oral administration of misoprostol 25 µg (Angusta®) every 2 h (up to eight tablets), for the induction of labor (IOL). We conducted a retrospective study on IOL at term, on singleton pregnancies from 2019 to 2021, in a university hospital. The study included 195 patients, comprising 144 compliant protocols. Pain was statistically more frequent in the non-compliance group (92.2% vs. 62.5%, p p < 0.001). A multivariable analysis found factors of good response (defined as going into labor before the administration of the median number of tablets, i.e., six) to be an indication for PROM (OR: 12.03, 95% CI: 5.42–26.71), and gestational age at induction (OR: 1.54, 95% CI: 1.19–2.01), independently of BMI, initial Bishop score, and parity. Patients with pain who were able to follow the protocol delivered 9 h earlier than patients with pain who interrupted the protocol and 16 h earlier than patients who experienced no pain. We identified two key elements that favored compliance: (i) providing the next tablet in advance; and (ii) offering patients early epidural analgesia when in pain in order to continue the protocol and go into labor promptly

Success to reach 3cm of dilation with a Dinoprostone Vaginal Insert in primiparous women with a previous cesarean section versus nulliparous: A retrospective case-control study

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Feelings and expectations in endometriosis: Analysis of open comments from a cohort of endometriosis patients.

International audienceEndometriosis symptoms may have a negative effect on health-related quality of life (HRQoL). Analyses of open comments are known to be a key source of information and support. The authors aimed to analyse open comments associated with a validation scale study, in order to ascertain whether the questionnaires allowed an adequate exploration of patient preoccupations and in so doing define important quality of life themes not assessed in HRQoL scales

Myocilin expression is regulated by retinoic acid in the trabecular meshwork-derived cellular environment

International audienceGlaucoma is the leading cause of irreversible blindness and is usually classified as angle closure and open angle glaucoma (OAG). Primary open angle glaucoma represents the most frequent clinical presentation leading to ganglion cell death and optic nerve degeneration as a main consequence of an intraocular pressure' (IOP) increase. The mechanisms of this IOP increase in such pathology remain unclear but one protein called Myocilin could be a part of the puzzle in the trabecular meshwork (TM). Previously described to be transcriptionally regulated by glucocorticoids, the comprehension of the trabecular regulation of Myocilin' expression has only weakly progressed since 15 years. Due to the essential molecular and cellular implications of retinoids' pathway in eye development and physiology, we investigate the potential role of the retinoic acid in such regulation and expression. This study demonstrates that the global retinoids signaling machinery is present in immortalized TM cells and that Myocilin (MYOC) expression is upregulated by retinoic acid alone or combined with a glucocorticoid co-treatment. This regulation by retinoic acid acts through the MYOC promoter which contains a critical cluster of four retinoic acid responsive elements (RAREs), with the RARE-DR2 presenting the strongest effect and binding the RARα/RXRα heterodimer. All together, these results open up new perspectives for the molecular understanding glaucoma pathophysiology and provide further actionable clues on Myocilin gene regulation

Lysyl oxidase-like 4 involvement in retinoic acid epithelial wound healing

International audienceVitamin A and its active forms (retinoic acids/RAs) are known to have pro-healing properties, but their mechanisms of action are still poorly understood. This work aimed to identify the cellular and molecular processes by which atRA (all-trans RA) improves wound healing, using an in vivo model of mouse corneal alkali burns and an in vitro cellular human corneal epithelial injury model. Regulation by atRA has been studied on most of the cellular events that occur in wound healing. We investigated the direct influence of atRA on a specific target gene known to be involved in the extracellular matrix (ECM) dynamics, one of the pathways contributing to epithelial repair. Our results demonstrate that atRA promotes corneal epithelial wound healing by acting preferentially on migration. The induction of lysyl oxidase-like 4 (LOXL4) expression by atRA in the corneal epithelium environment was established as essential in the mechanism of atRA-dependent wound healing. Our study describes for the first time a direct link between a retinoic-induced gene and protein, LOXL4, and its general clinical pro-healing properties in ECM dynamics