Vital NETosis vs. suicidal NETosis during normal pregnancy and preeclampsia

Background: NETosis occurs in the context of infection or inflammation and results in the expulsion of decondensed DNA filaments called NETs (Neutrophil Extracellular Traps) into the extracellular environment. NETosis activates coagulation and contributes to the thrombotic risk of inflammatory diseases. To date, two mechanisms of NETosis have been identified: suicidal NETosis, in which neutrophils die after expelling the filaments; and vital NETosis, in which expulsion appears without altering the membrane. Human pregnancy is associated with a mild pro-inflammatory state, which is increased in the event of complications such as preeclampsia (PE). NETosis has been observed in these situations, but the mechanism of its production has not yet been studied. The aim of our study was to evaluate the balance of vital vs. suicidal NETosis in normal pregnancy and in PE.Patients/Methods: Neutrophils from healthy volunteers were stimulated with plasma from normal pregnancies (n = 13) and from women developing preeclampsia (n = 13). Immunofluorescent labelling was performed to determine the percentages and origin of NETs in both groups. Inhibition with suicidal or vital NETosis inhibitors was also performed to validate our results.Results: We found a significant increase in NETs in women with PE compared to women with normal pregnancies. We showed that vital and non-vital NETosis are present in normal and preeclamptic pregnancies. We demonstrated that the higher proportion of NETs observed in PE was due to non-vital NETosis whose main component is represented by suicidal NETosis.Discussion: These results suggest the important part of non-vital NETosis in the pathophysiology of PE

The Risk of Thrombosis Around Pregnancy: Where Do We Stand?

International audiencePregnancy and puerperium increase the relative risk of venous thromboembolism (VTE) and the absolute risk remains low, around 1 per 1,000, with induced mortality of around 1 per 100,000. Analysis of large databases has helped specify the modes of presentation and risk factors (RF) whose impact is greater after than before childbirth, since VTE during pregnancy and post-partum obey different RFs. The evolution of the population concerned (mostly women over 35, obese, of multi-ethnicity undergoing medically assisted reproduction) affects the frequency of these RFs. Pulmonary embolism (PE) is over-represented after childbirth, but 30% of PE in pregnancy occurs without any RFs. Recommendations for prevention, mainly from expert groups, are heterogeneous and often discordant. Low molecular weight heparins (LMWH) are the mainstay of pharmacological thromboprophylaxis, in a field where randomized controlled studies are definitely lacking. VTE risk assessment in pregnancy must be systematic and repetitive. Risk assessment methods and scores are beginning to emerge to guide thromboprophylaxis and should be used more systematically. In the future, analyzing observational data from huge, nationwide registries and prospective cluster clinical trials may bring to light clinically relevant outcomes likely to feed comprehensive guidelines

Pasteurs des âmes, Passeurs des Arts

Les disciplines historiques ont porté un éclairage décisif sur la diversité du clergé séculier et sur sa place dans la société française d’Ancien Régime ; analysée à travers les prismes de la culture matérielle, de l’histoire sociale et politique ou de l’anthropologie religieuse, la figure du prêtre de campagne est aujourd’hui mieux cernée. Sans être totalement négligées, les recherches sur l’implication du bas clergé dans la commande artistique des temps modernes attendent cependant des approfondissements, dont cet ouvrage livre tes premières réflexions. Les prêtres étaient probablement les premiers concernés par le décor de leurs églises mais quelle était précisément la nature de leurs « participations » ? Quelques interrogations ont déjà leurs réponses : textes et documents livrent des preuves de leur immixtion dans la commande, allant de la mise en œuvre des adjudications au choix des artistes ou des ateliers, à la gestion des coûts, la sélection des matériaux, etc. Et si nous pouvons saisir la manière dont les hommes d’église s’immisçaient dans la création, l’examen des portraits qu’ils ont laissés documente conjointement la perception de leur propre condition : des guides de cortèges processionnels aux faiseurs de miracles, des célébrants d’autels aux « notables » en soutanes, ces représentations sont autant d’indices qui éclairent la vie et la culture des dites paroissiales qu’ils constituaient

Impact on disease mortality of clinical, biological, and virological characteristics at hospital admission and overtime in COVID‐19 patients

International audienc