Integrated trajectories of the maternal metabolome, proteome, and immunome predict labor onset

Estimating the time of delivery is of high clinical importance because pre- and postterm deviations are associated with complications for the mother and her offspring. However, current estimations are inaccurate. As pregnancy progresses toward labor, major transitions occur in fetomaternal immune, metabolic, and endocrine systems that culminate in birth. The comprehensive characterization of maternal biology that precedes labor is key to understanding these physiological transitions and identifying predictive biomarkers of delivery. Here, a longitudinal study was conducted in 63 women who went into labor spontaneously. More than 7000 plasma analytes and peripheral immune cell responses were analyzed using untargeted mass spectrometry, aptamer-based proteomic technology, and single-cell mass cytometry in serial blood samples collected during the last 100 days of pregnancy. The high-dimensional dataset was integrated into a multiomic model that predicted the time to spontaneous labor [R = 0.85, 95% confidence interval (CI) [0.79 to 0.89], P = 1.2 × 10−40, N = 53, training set; R = 0.81, 95% CI [0.61 to 0.91], P = 3.9 × 10−7, N = 10, independent test set]. Coordinated alterations in maternal metabolome, proteome, and immunome marked a molecular shift from pregnancy maintenance to prelabor biology 2 to 4 weeks before delivery. A surge in steroid hormone metabolites and interleukin-1 receptor type 4 that preceded labor coincided with a switch from immune activation to regulation of inflammatory responses. Our study lays the groundwork for developing blood-based methods for predicting the day of labor, anchored in mechanisms shared in preterm and term pregnancies

Impact de la préhabilitation pré-chirurgicale sur la morbidité postopératoire, une revue systématique et méta-analyse

Introduction : Les complications postopératoires sont fréquentes avec une incidence comprise entre 5,8 et 43,5% dans les chirurgies majeures et sont associées à un coût humain et financier important. La préhabilitation (préhab), qui vise à améliorer la réserve fonctionnelle des patients en préopératoire afin d'améliorer les résultats postopératoires, est un concept qui s’est développé au cours des dernières années. Cependant, l’effet bénéfique de la préhab et ses modalités ne sont pas bien établies et les résultats rapportés sont contradictoires. L’objectif de cette revue systématique était d’évaluer l’effet de la préhab sur les résultats postopératoires, notamment les complications postopératoires (objectif principal), la durée de séjour et la douleur (objectifs secondaires) avec un focus particulier sur ses modalités (uni vs multimodale).Méthode : Nous avons réalisé une revue systématique et une méta-analyse d’essais contrôlés randomisés publiés entre le 1er janvier 2006 et le 18 janvier 2021 testant des programmes de préhab uni ou multimodale pendant plus de 14 jours en comparaison à un « standard de soins » et mesurant les complications postopératoires dans les 30 premiers jours post-opératoires et/ou la durée de séjour hospitalière et/ou la douleur postopératoire. Les recherches ont été effectuées dans 4 bases de données : PubMed, CINAHL, EMBASE et PsycINFO. Nous avons réalisé une analyse d’effet aléatoire des odds ratio (OR) pour la variable dichotomique (complications) et une analyse d’effet aléatoire des différences de médianes pour les variables catégoriques (douleur et durée de séjour).Résultats : Vingt-neuf études ont été incluses avec 1134 patients préhabilités et 1098 « standard de soins » analysés. La qualité méthodologique moyenne de ces études était modérée. Parmi ces 29 études, 14 études mesuraient les complications postopératoires, 22 la médiane de la durée de séjour et aucune la douleur postopératoire. Aucune différence significative entre les groupes préhab et « standard de soins » pour les complications postopératoires (OR 0,98 ; intervalle de confiance (IC) à 95% [0,82 ; 1.17] ; p=0,09 ; I2=36%), ni pour la durée de séjour totale (différence de médianes (Dif.med) -0,13 ; IC à 95% [-0.56 ; 0.28] ; p=0,53 ; I2= 28%), ni pour la douleur postopératoire n’a été mise en évidence. La durée de séjour en unité de soins critiques était significativement réduite dans le groupe préhab (Dif.med -0,57 ; IC à 95% [-1,10; -0,04] ; p=0,03 ; I2= 46%).Conclusion : Dans notre revue La préhabilitation est efficace pour réduire la durée de séjour en unité de soins critiques. On ne constate pas d’effet sur les critères de complication, de durée de séjour totale ou de douleur postopératoire. Les programmes de préhab délivrés dans ces études, toutes chirurgies confondues, étaient hétérogènes mettant en valeur la nécessité d’une standardisation rigoureuse des programmes ainsi que la stratification des patients les plus à même d’en bénéficier

Disentangling complex parasite interactions : protection against cerebral malaria by one helminth species is jeopardized by co-infection with another

Multi-species interactions can often have non-intuitive consequences. However, the study of parasite interactions has rarely gone beyond the effects of pairwise combinations of species, and the outcomes of multi-parasite interactions are poorly understood. We investigated the effects of co-infection by four gastrointestinal helminth species on the development of cerebral malaria among Plasmodium falciparum-infected patients. We characterized associations among the helminth parasite infra-community, and then tested for independent (direct) and co-infection dependent (indirect) effects of helminths on cerebral malaria risk. We found that infection by Ascaris lumbricoides and Trichuris trichiura were both associated with direct reductions in cerebral malaria risk. However, the benefit of T. trichiura infection was halved in the presence of hookworm, revealing a strong indirect effect. Our study suggests that the outcome of interactions between two parasite species can be significantly modified by a third, emphasizing the critical role that parasite community interactions play in shaping infection outcomes

Disentangling complex parasite interactions : protection against cerebral malaria by one helminth species is jeopardized by co-infection with another

Multi-species interactions can often have non-intuitive consequences. However, the study of parasite interactions has rarely gone beyond the effects of pairwise combinations of species, and the outcomes of multi-parasite interactions are poorly understood. We investigated the effects of co-infection by four gastrointestinal helminth species on the development of cerebral malaria among Plasmodium falciparum-infected patients. We characterized associations among the helminth parasite infra-community, and then tested for independent (direct) and co-infection dependent (indirect) effects of helminths on cerebral malaria risk. We found that infection by Ascaris lumbricoides and Trichuris trichiura were both associated with direct reductions in cerebral malaria risk. However, the benefit of T. trichiura infection was halved in the presence of hookworm, revealing a strong indirect effect. Our study suggests that the outcome of interactions between two parasite species can be significantly modified by a third, emphasizing the critical role that parasite community interactions play in shaping infection outcomes

Disentangling complex parasite interactions: Protection against cerebral malaria by one helminth species is jeopardized by co-infection with another.

Multi-species interactions can often have non-intuitive consequences. However, the study of parasite interactions has rarely gone beyond the effects of pairwise combinations of species, and the outcomes of multi-parasite interactions are poorly understood. We investigated the effects of co-infection by four gastrointestinal helminth species on the development of cerebral malaria among Plasmodium falciparum-infected patients. We characterized associations among the helminth parasite infra-community, and then tested for independent (direct) and co-infection dependent (indirect) effects of helminths on cerebral malaria risk. We found that infection by Ascaris lumbricoides and Trichuris trichiura were both associated with direct reductions in cerebral malaria risk. However, the benefit of T. trichiura infection was halved in the presence of hookworm, revealing a strong indirect effect. Our study suggests that the outcome of interactions between two parasite species can be significantly modified by a third, emphasizing the critical role that parasite community interactions play in shaping infection outcomes

La culture matérielle : la céramique de Port-Blanc

Dossiers du CeRAA, Supplément AM-2016International audienc

The niche reduction approach: an opportunity for optimal control of infectious diseases in low-income countries?

International audienceBACKGROUND: During the last century, WHO led public health interventions that resulted in spectacular achievements such as the worldwide eradication of smallpox and the elimination of malaria from the Western world. However, besides major successes achieved worldwide in infectious diseases control, most elimination/control programs remain frustrating in many tropical countries where specific biological and socio-economical features prevented implementation of disease control over broad spatial and temporal scales. Emblematic examples include malaria, yellow fever, measles and HIV. There is consequently an urgent need to develop affordable and sustainable disease control strategies that can target the core of infectious diseases transmission in highly endemic areas. DISCUSSION: Meanwhile, although most pathogens appear so difficult to eradicate, it is surprising to realize that human activities are major drivers of the current high rate of extinction among upper organisms through alteration of their ecology and evolution, i.e., their "niche". During the last decades, the accumulation of ecological and evolutionary studies focused on infectious diseases has shown that the niche of a pathogen holds more dimensions than just the immune system targeted by vaccination and treatment. Indeed, it is situated at various intra- and inter- host levels involved on very different spatial and temporal scales. After developing a precise definition of the niche of a pathogen, we detail how major advances in the field of ecology and evolutionary biology of infectious diseases can enlighten the planning and implementation of infectious diseases control in tropical countries with challenging economic constraints. SUMMARY: We develop how the approach could translate into applied cases, explore its expected benefits and constraints, and we conclude on the necessity of such approach for pathogen control in low-income countries

Association screening (SCN) analysis results for all detected gastrointestinal helminth species infecting hyperparasitemic malaria patients.

<p>The observed (Obs) frequency of each co-infection status is given along with the lower (LL) and upper (UL) limits of the 95% confidence envelope. Robustness scores are given for significant associations (SCN <i>p</i><0.05 for at least 95% of runs, see main text). SCN <i>P</i>-values reported are the maximum <i>p</i>-value returned by the SCN analysis when 100% of the data are sampled. Significant or trending associations are highlighted in bold for emphasis.</p

Significant interaction between <i>T</i>. <i>trichiura</i> and hookworm infection on development of cerebral malaria.

<p>Error bars represent 95% confidence intervals around the proportions. Cerebral malaria incidence (proportion of hyperparasiteic <i>P</i>. <i>falciparum</i> cases that developed cerebral malaria) is reported here without considering other co-factors or co-infections (<i>χ</i>^<i>2</i> = 5.56, p = 0.018).</p

Demographic composition of study population.

<p>There were slightly more females in the <20 age group (35%) than in those 20–40 (23%) or over 40 (24%), but this was not statistically significant (<i>χ</i>^<i>2</i> = 4.3, df = 2, p = 0.12).</p