Association between chronic airflow obstruction and socio-economic position in Morocco: BOLD results.

Objective. Chronic Obstructive Lung Disease (COPD) is the third most common cause of death in the world. Other factors than smoking could be involved in the development of COPD such as socio-economic status. The aim of this study was to investigate the association between chronic airflow obstruction and socio-economic status in Morocco. Design. In the BOLD (Burden of Obstructive Lung Disease) study carried out in Fez Morocco, questionnaires and spirometry tests were performed. Socio-economic status was evaluated using a wealth score (0-10) based on household assets. The forced expiratory volume in 1s (FEV1)/ forced vital capacity (FVC) ratio was used to measure airflow obstruction. Results. In total, 760 subjects were included in the analysis. The mean age was 55.3 years (SD=10.2); the wealth score was on average 7.54 (SD=1.63). After controlling for other factors and potential confounders, the FEV1/ FVC increased by 0.4% (95% CI: 0.01, 0.78; p<0.04) per unit increase in wealth score. Aging, tobacco-smoking, underweight, history of tuberculosis and asthma were also independently associated with a higher risk of airflow obstruction. Conclusion. Our findings suggest that airflow obstruction is associated with poverty in Morocco. Further investigations are needed to better understand the mechanisms of this association

On the dilaton and the axion potentials

We extend the Vecchia-Veneziano-Witten (VVW) model of QCD in the chiral limit and for large colour number $N_c$, by introducing an effective dilaton-gluon coupling from which we derive both the axion and dilaton potentials. Furthermore, using a string inspired model, we determine a new interquark potential as a perturbative series in terms of the interquark distance $r$. Our potential goes beyond Dick one obtained in [8] and shares the same features as the Bian-Huang-Shen potential $V_{BHS}$ which depends only on odd powers of $r$ [22].Comment: 15 pages, Late

Mélanome endobronchique

Le mélanome malin a un potentiel métastatique important. Les métastases pulmonaires du mélanome sont communes cependant la localisation endobronchique reste rare et pose le problème de son origine primitive ou secondaire. Nous rapportons le cas d’un mélanome pulmonaire qui présente des particularités intéressantes: une lésion cutanée présumée primitive totalement régressive, la présentation radio clinique mimant parfaitement un cancer bronchique primitif, un aspect endoscopique bourgeonnant et grisâtre dont l’étude histologique a permis de poser le diagnostic, une agressivité tumorale avec une extension intracardiaque et bourgeon tumoral intra cavitaire. A travers cette observation, les auteurs étudient les caractéristiques radio-cliniques pouvant distinguer le mélanome pulmonaire primitif du secondaire; la localisation endobronchique avec une revue de la littérature sur les métastases endo bronchiques; le bilan d’extension à entamer en cas de mélanome pulmonaire ainsi que les difficultés thérapeutiques posés par ce type de lésion dont le pronostic reste péjoratif

Pseudotumoral tracheobronchial amyloidosis mimicking asthma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Tracheobronchial amyloidosis is an uncommon localized form of amyloidosis that can simulate a tracheal tumor. Clinical signs are not specific and the diagnosis is rarely given before performing a bronchoscopy with multiples biopsies.</p> <p>Case presentation</p> <p>We report the case of a 60-year-old Moroccan woman, complaining of dyspnea and wheezing for three years, who was treated at our institution for management of severe asthma. A bronchoscopy revealed a tumor formation of her trachea; multiples biopsies were performed and a diagnosis made of amyloid light-chain amyloidosis. She successfully received an endoscopic resection.</p> <p>Conclusion</p> <p>This case highlights the importance of routinely carrying out an endoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma. Tracheal amyloidosis is a rare disease, confirmed by histological examination of bronchial biopsies, and the treatment of choice is based on the bronchoscopic resection.</p

T cell activation, from atopy to asthma: more a paradox than a paradigm

International audienceDuring the last 15 years, it was largely shown that allergic inflammation was orchestrated by activated Th2 lymphocytes, leading to IgE production and eosinophil activation. Indeed, Th2 activation was shown to be necessary to induce allergic sensitization in animal models. In humans, a Th2 skewing was shown in atopic children soon after birth. In asthma, descriptive studies showed that Th2 cells were more numerous in patients than in controls. In addition, during specific allergen stimulation, an increase of Th2 cells was described in most cases. According to this Th2 paradigm, it was proposed that early avoidance of microbial exposure could explain the increase of atopic diseases seen in the last 20 years in developed countries, as the "hygiene hypothesis". Recently, it was proposed that early exposure to lipopolysaccharide (LPS) could be protective against atopic diseases. However, it is well established that exposure to LPS can induce asthma symptoms, both in animals and humans, although it induces a Th1 inflammatory response. In addition, most infections induce asthma exacerbations and Th1 responses. Recently, some studies have showed that some Th1 cells were present in asthmatic patients, which could be related to bronchial hyperreactivity. There is therefore an "infectious paradox" in asthma, which contributes to show that the Th2 paradigm is insufficient to explain the whole inflammatory reaction of this disease. We propose that the Th2paradigm is relevant to atopy and inception of asthma albeit a Th1 activation would account at least in part for bronchial hyperreactivity and asthma symptoms

Assessment of T lymphocyte cytokine production in induced sputum from asthmatics: a flow cytometry study

International audienceckground: Asthma results from a bronchial inflammation in which Th2 lymphocytes play a pivotal role, as shown in invasive bronchial biopsies and broncho-alveolar lavages. Induced sputum (IS) is a non-invasive method of recovery of bronchial cells, which can be repeated in the same patients. However, lymphocyte activation has not been studied in IS to date, because of the low number of T cells recovered. Herein we took advantage of flow cytometry, a method suitable for the study of small cell populations, to assess T cell cytokine production in IS.Objectives: (1) To assess induced sputum T cell cytokine production by flow cytometry in asthmatic subjects and controls. (2) To compare the T cell cytokine production between symptomatic and non-symptomatic asthmatics.Methods: Thirteen asthmatics and 19 controls were included. Sputum was induced by a hypertonic saline. Sputum cells were stimulated and intracellular IL-13 and IFN-gamma were detected in T cells by flow cytometry.Results: Stimulation induced an increase of IL-13 and IFN-gamma production by T cells. This increase was higher in asthmatics. IL-13-producing T cells were increased in asthmatics after stimulation. In symptomatic asthma, IFN-gamma-producing T cells were in higher proportion than in controlled asthma.Conclusion: IS T cell cytokine production indicates a basic Th2 bias in asthma, accompanied during symptoms by a Th1-like activation. These results open the field for longitudinal studies of the variation of T cell activation in asthma