High prevalence of PRPH2 in autosomal dominant retinitis pigmentosa in France and characterization of biochemical and clinical features.

International audiencePURPOSE:To assess the prevalence of PRPH2 in autosomal dominant retinitis pigmentosa (adRP), to report six novel mutations, to characterize the biochemical features of a recurrent novel mutation and to study the clinical features of adRP patients.DESIGN:Retrospective clinical and molecular genetic study.METHODS:Clinical investigations included visual field testing, fundus examination, high-resolution spectral-domain optical coherence tomography (OCT), fundus autofluorescence imaging and electroretinogram (ERG) recording. PRPH2 was screened by Sanger sequencing in a cohort of 310 French families with adRP. Peripherin-2 protein was produced in yeast and analyzed by Western blot.RESULTS:We identified 15 mutations, including 6 novel and 9 previously reported changes in 32 families, accounting for a prevalence of 10.3% in this adRP population. We showed that a new recurrent p.Leu254Gln mutation leads to protein aggregation, suggesting abnormal folding. The clinical severity of the disease in examined patients was moderate with 78% of the eyes having 1 to 0.5 of visual acuity and 52% of the eyes retaining more than 50% of the visual field. Some patients characteristically showed vitelliform deposits or macular involvement. In some families, pericentral RP or macular dystrophy were found in family members while widespread RP was present in other members of the same families.CONCLUSIONS:The mutations in PRPH2 account for 10.3% of adRP in the French population, which is higher than previously reported (0-8%) This makes PRPH2 the second most frequent adRP gene after RHO in our series. PRPH2 mutations cause highly variable phenotypes and moderate forms of adRP, including mild cases which could be underdiagnosed

The genomic landscape of balanced cytogenetic abnormalities associated with human congenital anomalies

Despite the clinical significance of balanced chromosomal abnormalities (BCAs), their characterization has largely been restricted to cytogenetic resolution. We explored the landscape of BCAs at nucleotide resolution in 273 subjects with a spectrum of congenital anomalies. Whole-genome sequencing revised 93% of karyotypes and demonstrated complexity that was cryptic to karyotyping in 21% of BCAs, highlighting the limitations of conventional cytogenetic approaches. At least 33.9% of BCAs resulted in gene disruption that likely contributed to the developmental phenotype, 5.2% were associated with pathogenic genomic imbalances, and 7.3% disrupted topologically associated domains (TADs) encompassing known syndromic loci. Remarkably, BCA breakpoints in eight subjects altered a single TAD encompassing MEF2C, a known driver of 5q14.3 microdeletion syndrome, resulting in decreased MEF2C expression. We propose that sequence-level resolution dramatically improves prediction of clinical outcomes for balanced rearrangements and provides insight into new pathogenic mechanisms, such as altered regulation due to changes in chromosome topology

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Pharmaceutical nanoparticles for the controlled delivery of drugs

La délivrance contrôlée de médicaments constitue un enjeu thérapeutique de première importance pour le milieu médical. Elle doit, en effet, permettre de diminuer la toxicité du médicament en limitant sa concentration dans l'organisme et en ciblant son lieu de délivrance. Ce projet de recherche a conduit à la réalisation de nouveaux nano-vecteurs particulaires utilisables pour la délivrance de médicaments par hyperthermie locale. Ces objets sont constitués d'un cœur de polynorbornène et d'une écorce de poly (oxyde d'éthylène) et sont synthétisés par polymérisation par ouverture de cycle de type métathèse (ROMP) en dispersion. L'acide salicylique est encapsulé dans ces particules en tant que molécule modèle. L'originalité de ce sujet pluridisciplinaire réside : dans la nature de la particule, qui permet une libération du principe actif à partir de 35-45°C et dans la technique d'imprégnation des particules par la voie fluide supercritique.Controlled release systems are attracting increasing interest because of their potential application in biomedical field. Indeed, such systems should enable to lower toxicity of medicines by targeting the therapeutic action and by limiting the concentration of drugs in the organism. In this research project, new nanoparticles have been developed for a thermosensitive control of drugs' delivery. These particles consist of a polynorbornene core and a polyethylene oxide shell and are developed by dispersion ring opening metathesis polymerization. As a model drug, salicylic acid has been encapsulated in those core-shell materials. This multidisciplinary project is original for two reasons. On the one hand, the nature of the particle which enables to release the drug from 35-45°C. On the other hand, the encapsulation technique that has been chosen is the impregnation under supercritical carbon dioxide

Pharmaceutical nanoparticles for the controlled delivery of drugs

La délivrance contrôlée de médicaments constitue un enjeu thérapeutique de première importance pour le milieu médical. Elle doit, en effet, permettre de diminuer la toxicité du médicament en limitant sa concentration dans l'organisme et en ciblant son lieu de délivrance. Ce projet de recherche a conduit à la réalisation de nouveaux nano-vecteurs particulaires utilisables pour la délivrance de médicaments par hyperthermie locale. Ces objets sont constitués d'un cœur de polynorbornène et d'une écorce de poly (oxyde d'éthylène) et sont synthétisés par polymérisation par ouverture de cycle de type métathèse (ROMP) en dispersion. L'acide salicylique est encapsulé dans ces particules en tant que molécule modèle. L'originalité de ce sujet pluridisciplinaire réside : dans la nature de la particule, qui permet une libération du principe actif à partir de 35-45°C et dans la technique d'imprégnation des particules par la voie fluide supercritique.Controlled release systems are attracting increasing interest because of their potential application in biomedical field. Indeed, such systems should enable to lower toxicity of medicines by targeting the therapeutic action and by limiting the concentration of drugs in the organism. In this research project, new nanoparticles have been developed for a thermosensitive control of drugs' delivery. These particles consist of a polynorbornene core and a polyethylene oxide shell and are developed by dispersion ring opening metathesis polymerization. As a model drug, salicylic acid has been encapsulated in those core-shell materials. This multidisciplinary project is original for two reasons. On the one hand, the nature of the particle which enables to release the drug from 35-45°C. On the other hand, the encapsulation technique that has been chosen is the impregnation under supercritical carbon dioxide

Développement de vecteurs pharmaceutiques pour le relargage contrôlé de principes actifs

Controlled release systems are attracting increasing interest because of their potential application in biomedical field. Indeed, such systems should enable to lower toxicity of medicines by targeting the therapeutic action and by limiting the concentration of drugs in the organism. In this research project, new nanoparticles have been developed for a thermosensitive control of drugs' delivery. These particles consist of a polynorbornene core and a polyethylene oxide shell and are developed by dispersion ring opening metathesis polymerization. As a model drug, salicylic acid has been encapsulated in those core-shell materials. This multidisciplinary project is original for two reasons. On the one hand, the nature of the particle which enables to release the drug from 35-45°C. On the other hand, the encapsulation technique that has been chosen is the impregnation under supercritical carbon dioxide.La délivrance contrôlée de médicaments constitue un enjeu thérapeutique de première importance pour le milieu médical. Elle doit, en effet, permettre de diminuer la toxicité du médicament en limitant sa concentration dans l'organisme et en ciblant son lieu de délivrance. Ce projet de recherche a conduit à la réalisation de nouveaux nano-vecteurs particulaires utilisables pour la délivrance de médicaments par hyperthermie locale. Ces objets sont constitués d'un cœur de polynorbornène et d'une écorce de poly (oxyde d'éthylène) et sont synthétisés par polymérisation par ouverture de cycle de type métathèse (ROMP) en dispersion. L'acide salicylique est encapsulé dans ces particules en tant que molécule modèle. L'originalité de ce sujet pluridisciplinaire réside : dans la nature de la particule, qui permet une libération du principe actif à partir de 35-45°C et dans la technique d'imprégnation des particules par la voie fluide supercritique

Pharmaceutical nanoparticles for the controlled delivery of drugs

La délivrance contrôlée de médicaments constitue un enjeu thérapeutique de première importance pour le milieu médical. Elle doit, en effet, permettre de diminuer la toxicité du médicament en limitant sa concentration dans l'organisme et en ciblant son lieu de délivrance. Ce projet de recherche a conduit à la réalisation de nouveaux nano-vecteurs particulaires utilisables pour la délivrance de médicaments par hyperthermie locale. Ces objets sont constitués d'un cœur de polynorbornène et d’une écorce de poly (oxyde d’éthylène) et sont synthétisés par polymérisation par ouverture de cycle de type métathèse (ROMP) en dispersion. L’acide salicylique est encapsulé dans ces particules en tant que molécule modèle. L'originalité de ce sujet pluridisciplinaire réside : dans la nature de la particule, qui permet une libération du principe actif à partir de 35-45°C et dans la technique d'imprégnation des particules par la voie fluide supercritique.Controlled release systems are attracting increasing interest because of their potential application in biomedical field. Indeed, such systems should enable to lower toxicity of medicines by targeting the therapeutic action and by limiting the concentration of drugs in the organism. In this research project, new nanoparticles have been developed for a thermosensitive control of drugs’ delivery. These particles consist of a polynorbornene core and a polyethylene oxide shell and are developed by dispersion ring opening metathesis polymerization. As a model drug, salicylic acid has been encapsulated in those core-shell materials. This multidisciplinary project is original for two reasons. On the one hand, the nature of the particle which enables to release the drug from 35-45°C. On the other hand, the encapsulation technique that has been chosen is the impregnation under supercritical carbon dioxide

Dosage du taux sérique de 25 hydroxyvitamine D chez les patients admis en service de médecine physique et de réadaptation à Rennes (étude prospective multicentrique)

La vitamine D jouerait un rôle d'hormone, intervenant au niveau osseux mais également extra-osseux. Les patients admis en médecine physique et de réadaptation (MPR) présentent des facteurs de risque d'ostéoporose; leurs pathologies nécessiteraient le taux de 25 hydroxyvitamine D [25(OH)D] optimaux. Nous avons étudié de manière prospective sur 3 mois le statut vitaminique D des patients admis en unité de MPR à Rennes. 161 patients n'étaient pas supplémentés en vitamine D; leur taux de 25(OH)D était de 14,1+-8,5 ng/ml. Parmi eux, seuls 3 patients (1,8 %) avaient un taux optimal. Le taux de 25(OH)D était lié à l'existence de chutes dans l'année précédant l'admission. Il semblerait indiqué de doser systématiquement le taux de 25(OH)D, particulièrement chez les patients chuteurs ou atteints de sclérose en plaques. D'autres études doivent être conduites, dans des populations plus spécifiques, couplées à l'analyse de l'efficience de la supplémentation en vitamine D.RENNES1-BU Santé (352382103) / SudocSudocFranceF

The compensation arenas in south New Caledonia. Minescape, governmentality and politics

International audienc

Synthesis of nanocomposite particles using supercritical fluids: a bridge with bio-applications

This chapter focus the potential use of the supercritical fluid (SCF) method, as an alternative way, to design these targeted materials in a controlled way..