Lipid phosphate phosphatase 3 enables efficient thymic egress

Lipid phosphate phosphatase 3 in endothelial and epithelial cells promotes efficient T cell emigration from the thymus to the periphery

: Santé périnatale en 1995, 1998 et 2003

International audienceOBJECTIVE: To study trends in the main indicators of health, medical practice and risk factors in France. Population and method. A sample of all births during one week was set up in 1995 (N=13,318), 1998 (N=13,718) et 2003 (N=14,737). We compared data from these three years. RESULTS: Between 1995 and 2003, there was an increase in maternal age, a development of some characteristics of care (HIV screening procedure, maternal serum screening of Down syndrome, in utero transfers) and an increase in the proportion of caesarean sections, epidurals and spinal anesthesia. The proportion of livebirths before 37 weeks of gestation and the proportion of newborns under 2,500 g slightly increased but the differences were mainly between 1995 et 1998. In 2003, obstetrician gynecologists were the main care providers during pregnancy. However 24.3% of women had their first visit with a general practitioner. For the following visits, 15.4% of women had seen a GP at least once and 26.9% had seen a midwife in maternity unit at least once. CONCLUSION: Because of the trends in obstetrical practice and organisation of services, routine national perinatal surveys are useful to show major changes and yield quick answers to specific questions

Socioeconomic Barriers to Informed Decisionmaking Regarding Maternal Serum Screening for Down Syndrome: Results of the French National Perinatal Survey of 1998

Objectives. We sought to evaluate socioeconomic disparities in serum screening for Down syndrome and assess whether such disparities are more likely to reflect limits in access or information or, rather, informed decisionmaking. Methods. A nationally representative sample of 12 869 French women completed interviews after giving birth. Results. We found substantial disparities in the likelihood of (1) women not being offered screening, (2) screening not being offered as a result of late prenatal care, and (3) women not knowing whether or not they had undergone screening. Except in the case of nationality, there was essentially no evidence of differences in refusal of testing. Conclusions. Rather than representing informed decisionmaking, socioeconomic disparities in screening for Down syndrome are mostly due to limits in access or to information

Imaging the mechanisms of anti-CD20 therapy in vivo uncovers spatiotemporal bottlenecks in antibody-dependent phagocytosis

International audienceAnti-CD20 antibody (mAb) represents an effective strategy for the treatment of B cell malignancies, possibly involving complement activity, antibody-dependent cellular cytotoxicity and phagocytosis (ADP). While ADP by Kupffer cells deplete circulating tumors, mechanisms targeting non-circulating tumors remain unclear. Using intravital imaging in a model of B cell lymphoma, we establish here the dominance and limitations of ADP in the bone marrow (BM). We found that tumor cells were stably residing in the BM with little evidence for recirculation. To elucidate the mechanism of depletion, we designed a dual fluorescent reporter to visualize phagocytosis and apoptosis. ADP by BM-associated macrophages was the primary mode of tumor elimination but was no longer active after one hour, resulting in partial depletion. Moreover, macrophages were present at low density in tumor-rich regions, targeting only neighboring tumors. Overcoming spatiotemporal bottlenecks in tumor-targeting Ab therapy thus represents a critical path towards the design of optimized therapies

Impact of maternity unit closures on access to obstetrical care: the French experience between 1998 and 2003

International audienc

Collecting population-based perinatal data efficiently: the example of the Lebanese National Perinatal Survey.

International audienceWe describe the methodology and the main results of the Lebanese perinatal health survey. The survey was carried out during two consecutive weeks in autumn 1999 and spring 2000, with the aim of obtaining a minimum data set on all births occurring during a short period of time. All live births and stillbirths occurring during these periods in medical settings were recorded. The sample included 5231 women and 5333 newborns. Data were obtained from medical records and by interviewing the women in hospital after delivery. All maternity units and birth centres agreed to participate. Maternal characteristics, medical care during pregnancy and delivery, and pregnancy outcome were similar for the two study periods. However, gestational age distribution differed between the two periods. In total, 9.0% of infants were born < 37 weeks of gestation and 7.0% weighed < 2500 g at birth. Wide regional variations were observed for many indicators of health, care and risk factors. For instance, the caesarean section rate varied from 16.2% in the North Region to 28.0% in Beirut. The survey protocol was successfully applied in Lebanon and may be useful in other countries that have a relatively well-developed healthcare system, but few sources of reliable population-based statistics on health and medical care. This type of survey may also be an appropriate instrument for collecting additional data for health policy evaluations

Advances in Medical Technology and Creation of Disparities: The Case of Down Syndrome

Objectives. We assessed socioeconomic differences in probabilities of prena-tal diagnoses of Down syndrome and continuation of pregnancies after such diagnoses, along with the effects of these differences on disparities in live-birth prevalences of Down syndrome. Methods. Using population-based data derived from 1433 cases of Down syndrome and 3731 control births, we assessed age-adjusted effects of maternal occupation and geographic origin on prenatal diagnoses, as well as overall and live-birth odds, of Down syndrome. Results. Maternal occupation and geographic origin had significant effects on the probability of a prenatal diagnosis of Down syndrome and on continuation of pregnancy after such a diagnosis. Women in lower-status occupational categories had higher odds of delivering a live-born infant with Down syndrome. In comparison with women in the highest-status occupational category, the age-adjusted odds ratio for a Down syndrome live birth among women without an occupation was 2.4 (95% confidence interval [CI] = 1.7, 3.3). By contrast, there were no disparities in age-adjusted overall likelihood of Down syndrome. Conclusions. Socioeconomic differences in use of prenatal testing have created disparities in the live-birth prevalence of Down syndrome. Overall Down syndrome risk does not vary according to socioeconomic status

Primed antigen-specific CD4+ T cells are required for NK cell activation in vivo upon Leishmania major infection.

International audienceThe ability of NK cells to rapidly produce IFN-gamma is an important innate mechanism of resistance to many pathogens including Leishmania major. Molecular and cellular components involved in NK cell activation in vivo are still poorly defined, although a central role for dendritic cells has been described. In this study, we demonstrate that Ag-specific CD4(+) T cells are required to initiate NK cell activation early on in draining lymph nodes of L. major-infected mice. We show that early IFN-gamma secretion by NK cells is controlled by IL-2 and IL-12 and is dependent on CD40/CD40L interaction. These findings suggest that newly primed Ag-specific CD4(+) T cells could directly activate NK cells through the secretion of IL-2 but also indirectly through the regulation of IL-12 secretion by dendritic cells. Our results reveal an unappreciated role for Ag-specific CD4(+) T cells in the initiation of NK cell activation in vivo upon L. major infection and demonstrate bidirectional regulations between innate and adaptive immunity