Étude de la livraison de nanoparticules au niveau de la barrière hémato-encéphalique

La barrière hémato-encéphalique protège le cerveau de par son imperméabilité. Cela empêche toutefois le passage de potentielles molécules thérapeutiques contre les maladies du système nerveux central. En effet, à cause de leurs poids moléculaire et de leurs propriétés physicochimiques, nombreuses sont les molécules thérapeutiques développées par l’industrie pharmaceutique qui ne parviennent pas à atteindre leur cible au cerveau car elles sont bloquées par cette barrière. Les objectifs de mes travaux sont donc de valider puis de modifier des formulations d’immunoliposomes PEGylés pour améliorer leur devenir intracellulaire dans les cellules endothéliales des capillaires cérébraux qui forment la barrière hématoencéphalique. Après injection chez la souris, les liposomes atteignent les capillaires mais nous ne sommes pas parvenus à démontrer qu’ils y livrent leur contenu. Pour se faire, différentes formulations ont été testées in vitro et in vivo chez des modèles murins. Cela a permis de confirmer que les anticorps et les lipides formant les immunoliposomes atteignent bien les cellules endothéliales des capillaires du cerveau. Toutefois, le devenir du contenu des immunoliposomes reste incertain. Par la suite, l’idée était d’utiliser des fragments Fab’ à la surface des liposomes plutôt que des anticorps complets. Toutefois, la digestion des anticorps n’est pas complète et l’obtention de fragments Fab’ pures très complexe. Cela reste donc à améliorer avant de conjuguer les fragments aux liposomes

Gravitational Waves from Extragalactic Inspiraling Binaries: Selection Effects and Expected Detection Rates

We examine the selection effects that determine how the population of inspiraling binary compact objects (BCOs) is reflected by those potentially observed with ground-based interferometers like LIGO. We lay the ground-work for the interpretation of future observations in terms of constraints on the real population and, correspondingly, binary star evolution models. To determine the extra-galactic population of inspiraling binaries we combine data on distance and blue luminosity from galaxy catalogs with current models of the galactic BCO mass distribution to simulate the physical distribution of binaries in the nearby universe. We use Monte Carlo methods to determine the fraction of binaries observable by the LIGO detectors from each galaxy as a function of the BCO chirp mass. We examine separately the role of source distance, sky position, time of detection, and binary system chirp mass on detection efficiency and selection effects relevant to the three LIGO detectors. Finally, we discuss the implications of the nearby geography of space on anticipated GW detection and compare our results to previous studies, which have assumed uniform galaxy volume density and fixed chirp mass for binary compact objects. From these considerations, actual BCO inspiral observations or significant upper limits on the coalescence rate anticipated in the near future by ground-based interferometers can be used to improve our knowledge of the galactic binary inspiral rate and to constrain models of radio pulsar characteristics and binary star evolution channels leading to neutron star or black hole binaries.Comment: 35 pages, including 12 figures. Revised following refereeing. Accepted for September publication in Ap

Tetrahydrobiopterin improves recognition memory in the triple-transgenic mouse model of Alzheimer's disease, without altering amyloid-β and tau pathologies

*Background: Alzheimer's disease (AD) is a multifactorial disease, implying that multi-target treatments may be necessary to effectively cure AD. Tetrahydrobiopterin (BH4) is an enzymatic cofactor required for the synthesis of monoamines and nitric oxide that also exerts antioxidant and anti-inflammatory effects. Despite its crucial role in the CNS, the potential of BH4 as a treatment in AD has never been scrutinized. *Objective: Here, we investigated whether BH4 peripheral administration improves cognitive symptoms and AD neuropathology in the triple-transgenic mouse model of AD (3xTg-AD), a model of age-related tau and amyloid-beta (A beta) neuropathologies associated with behavior impairment. *Methods: Non-transgenic (NonTg) and 3xTg-AD mice were subjected to a control diet (5% fat - CD) or to a high-fat diet (35% fat - HFD) from 6 to 13 months to exacerbate metabolic disorders. Then, mice received either BH4 (15 mg/kg/day, i.p.) or vehicle for ten consecutive days. *Results: This sub-chronic administration of BH4 rescued memory impairment in 13-month-old 3 xTg-AD mice, as determined using the novel object recognition test. Moreover, the HFD-induced glucose intolerance was completely reversed by the BH4 treatment in 3xTg-AD mice. However, the HFD or BH4 treatment had no significant impact on A beta and tau neuropathologies. *Conclusion: Overall, our data suggest a potential benefit from BH4 administration against AD cognitive and metabolic deficits accentuated by HFD consumption in 3xTg-AD mice, without altering classical neuropathology. Therefore, BH4 should be considered as a candidate for drug repurposing, at least in subtypes of cognitively impaired patients experiencing metabolic disorders.IdEx BordeauxProgram Initiative d’Excellenc

Role of Retinoid X Receptors (RXRs) and dietary vitamin A in Alzheimer's disease: Evidence from clinicopathological and preclinical studies.

BACKGROUND Vitamin A (VitA), via its active metabolite retinoic acid (RA), is critical for the maintenance of memory function with advancing age. Although its role in Alzheimer's disease (AD) is not well understood, data suggest that impaired brain VitA signaling is associated with the accumulation of β-amyloid peptides (Aβ), and could thus contribute to the onset of AD. METHODS We evaluated the protective action of a six-month-long dietary VitA-supplementation (20 IU/g), starting at 8 months of age, on the memory and the neuropathology of the 3xTg-AD mouse model of AD (n = 11-14/group; including 4-6 females and 7-8 males). We also measured protein levels of Retinoic Acid Receptor β (RARβ) and Retinoid X Receptor γ (RXRγ) in homogenates from the inferior parietal cortex of 60 participants of the Religious Orders study (ROS) divided in three groups: no cognitive impairment (NCI) (n = 20), mild cognitive impairment (MCI) (n = 20) and AD (n = 20). RESULTS The VitA-enriched diet preserved spatial memory of 3xTg-AD mice in the Y maze. VitA-supplementation affected hippocampal RXR expression in an opposite way according to sex by tending to increase in males and decrease in females their mRNA expression. VitA-enriched diet also reduced the amount of hippocampal Aβ40 and Aβ42, as well as the phosphorylation of tau protein at sites Ser396/Ser404 (PHF-1) in males. VitA-supplementation had no effect on tau phosphorylation in females but worsened their hippocampal Aβ load. However, the expression of Rxr-β in the hippocampus was negatively correlated with the amount of both soluble and insoluble Aβ in both males and females. Western immunoblotting in the human cortical samples of the ROS study did not reveal differences in RARβ levels. However, it evidenced a switch from a 60-kDa-RXRγ to a 55-kDa-RXRγ in AD, correlating with ante mortem cognitive decline and the accumulation of neuritic plaques in the brain cortex. CONCLUSION Our data suggest that (i) an altered expression of RXRs receptors is a contributor to β-amyloid pathology in both humans and 3xTg-AD mice, (ii) a chronic exposure of 3xTg-AD mice to a VitA-enriched diet may be protective in males, but not in females

Pain Squad+ smartphone app to support real-time pain treatment for adolescents with cancer: protocol for a randomised controlled trial.

INTRODUCTION: Pain negatively affects the health-related quality of life (HRQL) of adolescents with cancer. The Pain Squad+ smartphone-based application (app), has been developed to provide adolescents with real-time pain self-management support. The app uses a validated pain assessment and personalised pain treatment advice with centralised decision support via a registered nurse to enable real-time pain treatment in all settings. The algorithm informing pain treatment advice is evidence-based and expert-vetted. This trial will longitudinally evaluate the impact of Pain Squad+, with or without the addition of nurse support, on adolescent health and cost outcomes. METHODS AND ANALYSIS: This will be a pragmatic, multicentre, waitlist controlled, 3-arm parallel-group superiority randomised trial with 1:1:1 allocation enrolling 74 adolescents with cancer per arm from nine cancer centres. Participants will be 12 to 18 years, English-speaking and with ≥3/10 pain. Exclusion criteria are significant comorbidities, end-of-life status or enrolment in a concurrent pain study. The primary aim is to determine the effect of Pain Squad+, with and without nurse support, on pain intensity in adolescents with cancer, when compared with a waitlist control group. The secondary aims are to determine the immediate and sustained effect over time of using Pain Squad+, with and without nurse support, as per prospective outcome measurements of pain interference, HRQL, pain self-efficacy and cost. Linear mixed models with baseline scores as a covariate will be used. Qualitative interviews with adolescents from all trial arms will be conducted and analysed. ETHICS AND DISSEMINATION: This trial is approved by the Hospital for Sick Children Research Ethics Board. Results will provide data to guide adolescents with cancer and healthcare teams in treating pain. Dissemination will occur through partnerships with stakeholder groups, scientific meetings, publications, mass media releases and consumer detailing. TRIAL REGISTRATION NUMBER: NCT03632343

Understanding the relation between Zika virus infection during pregnancy and adverse fetal, infant and child outcomes: a protocol for a systematic review and individual participant data meta-analysis of longitudinal studies of pregnant women and their infants and children

IntroductionZika virus (ZIKV) infection during pregnancy is a known cause of microcephaly and other congenital and developmental anomalies. In the absence of a ZIKV vaccine or prophylactics, principal investigators (PIs) and international leaders in ZIKV research have formed the ZIKV Individual Participant Data (IPD) Consortium to identify, collect and synthesise IPD from longitudinal studies of pregnant women that measure ZIKV infection during pregnancy and fetal, infant or child outcomes.Methods and analysisWe will identify eligible studies through the ZIKV IPD Consortium membership and a systematic review and invite study PIs to participate in the IPD meta-analysis (IPD-MA). We will use the combined dataset to estimate the relative and absolute risk of congenital Zika syndrome (CZS), including microcephaly and late symptomatic congenital infections; identify and explore sources of heterogeneity in those estimates and develop and validate a risk prediction model to identify the pregnancies at the highest risk of CZS or adverse developmental outcomes. The variable accuracy of diagnostic assays and differences in exposure and outcome definitions means that included studies will have a higher level of systematic variability, a component of measurement error, than an IPD-MA of studies of an established pathogen. We will use expert testimony, existing internal and external diagnostic accuracy validation studies and laboratory external quality assessments to inform the distribution of measurement error in our models. We will apply both Bayesian and frequentist methods to directly account for these and other sources of uncertainty.Ethics and disseminationThe IPD-MA was deemed exempt from ethical review. We will convene a group of patient advocates to evaluate the ethical implications and utility of the risk stratification tool. Findings from these analyses will be shared via national and international conferences and through publication in open access, peer-reviewed journals.Trial registration numberPROSPERO International prospective register of systematic reviews (CRD42017068915).</jats:sec

SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immune responses and infection outcomes were evaluated in 2,686 patients with varying immune-suppressive disease states after administration of two Coronavirus Disease 2019 (COVID-19) vaccines. Overall, 255 of 2,204 (12%) patients failed to develop anti-spike antibodies, with an additional 600 of 2,204 (27%) patients generating low levels (&lt;380 AU ml−1). Vaccine failure rates were highest in ANCA-associated vasculitis on rituximab (21/29, 72%), hemodialysis on immunosuppressive therapy (6/30, 20%) and solid organ transplant recipients (20/81, 25% and 141/458, 31%). SARS-CoV-2-specific T cell responses were detected in 513 of 580 (88%) patients, with lower T cell magnitude or proportion in hemodialysis, allogeneic hematopoietic stem cell transplantation and liver transplant recipients (versus healthy controls). Humoral responses against Omicron (BA.1) were reduced, although cross-reactive T cell responses were sustained in all participants for whom these data were available. BNT162b2 was associated with higher antibody but lower cellular responses compared to ChAdOx1 nCoV-19 vaccination. We report 474 SARS-CoV-2 infection episodes, including 48 individuals with hospitalization or death from COVID-19. Decreased magnitude of both the serological and the T cell response was associated with severe COVID-19. Overall, we identified clinical phenotypes that may benefit from targeted COVID-19 therapeutic strategies

Élaboration d’un outil écosystémique et participatif pour l’analyse des besoins des enfants en contexte de négligence : L’outil Place aux parents

La négligence auprès des enfants est un phénomène reconnu et largement documenté. Malgré les nombreuses études sur le sujet, il demeure difficile de bien mesurer quelle réponse la famille et son environnement offrent aux besoins des enfants. Cette difficulté pourrait expliquer pourquoi les études actuelles peinent à documenter des changements au sein des familles en contexte de négligence. L’article s’appuie sur une définition écosystémique de la négligence et présente l’élaboration d’un outil destiné à fournir une analyse des besoins de l’enfant, de la réponse qu’il obtient, ainsi que des caractéristiques de l’environnement familial et social dans lequel il grandit. L’outil préconise en outre une approche participative auprès des familles en permettant aux intervenants, mais également aux figures parentales de se prononcer sur la situation familiale. Les propos de 54 parents et de 8 intervenants ont été analysés de façon qualitative afin de connaître les avantages et les défis reliés à l’utilisation de l’outil proposé.Child neglect is a well-recognized problem that has important negative consequences on children’s development. Despite numerous studies on the subject, measuring changes in the response those children receive to their needs is still challenging. We present a tool that could offer a portrait of families’ situation and evolution in time. The tool is based on the ecological model of neglect. It also offers a participative approach, whereby social workers, as well as parents, are engaged in the evaluation of the children’s need, the parental responses and the environmental factors contributing to the family situation. 54 parents and 8 intervenors were interviewed concerning the benefit and challenges related to the usage of the tool

Histone methyltransferase inhibitors are orally bioavailable, fast-acting molecules with activity against different species causing malaria in humans.

Current antimalarials are under continuous threat due to the relentless development of drug resistance by malaria parasites. We previously reported promising in vitro parasite-killing activity with the histone methyltransferase inhibitor BIX-01294 and its analogue TM2-115. Here, we further characterize these diaminoquinazolines for in vitro and in vivo efficacy and pharmacokinetic properties to prioritize and direct compound development. BIX-01294 and TM2-115 displayed potent in vitro activity, with 50% inhibitory concentrations (IC50s) of <50 nM against drug-sensitive laboratory strains and multidrug-resistant field isolates, including artemisinin-refractory Plasmodium falciparum isolates. Activities against ex vivo clinical isolates of both P. falciparum and Plasmodium vivax were similar, with potencies of 300 to 400 nM. Sexual-stage gametocyte inhibition occurs at micromolar levels; however, mature gametocyte progression to gamete formation is inhibited at submicromolar concentrations. Parasite reduction ratio analysis confirms a high asexual-stage rate of killing. Both compounds examined displayed oral efficacy in in vivo mouse models of Plasmodium berghei and P. falciparum infection. The discovery of a rapid and broadly acting antimalarial compound class targeting blood stage infection, including transmission stage parasites, and effective against multiple malaria-causing species reveals the diaminoquinazoline scaffold to be a very promising lead for development into greatly needed novel therapies to control malaria