Patterning of educational attainment across inflammatory markers : Findings from a multi-cohort study

Background: Evidence suggests that the inflammatory reaction, an adaptive response triggered by a variety of harmful stimuli and conditions involved in the risk and development of many chronic diseases, is a potential pathway through which the socioeconomic environment is biologically embedded. Difficulty in interpreting the role of the inflammatory system in the embodiment dynamic arises because of heterogeneity across studies that use a limited but varied number of inflammatory markers. There is no consensus in the literature as to which inflammatory markers beyond the C-reactive protein and to a lesser extent interleukin 6 are related to the social environment. Accordingly, we aimed to investigate the association between educational attainment, and several markers of inflammation - C-reactive protein, fibrinogen, interleukin 6, interleukin 1 beta and tumor necrosis factor alpha- in 6 European cohort studies. Methods: Up to 17,470 participants from six European cohort studies with data on educational attainment, health behaviors and lifestyle factors, and at least two different inflammatory markers. Four sub-datasets were drawn with varying numbers of participants to allow pairwise comparison of the social patterning of C-reactive protein and any other inflammatory markers. To evaluate within each sub-dataset the importance of the context and cohort specificities, linear regression-based analyses were performed separately for each cohort and combined in a random effect meta-analysis to determine the relationship between educational attainment and inflammation. Results: We found that the magnitude of the relationship between educational attainment and five inflammatory biomarkers (C-reactive protein, fibrinogen, interleukin 6 and 1 beta and tumor necrosis factor alpha) was variable. By far the most socially patterned biomarker was C-reactive protein, followed by fibrinogen and to lesser extent interleukin 6, where a low educational attainment was associated with higher inflammation even after adjusting for health behaviours and body mass index. No association was found with interleukin 1 beta and tumor necrosis factor alpha. Conclusions: Our study suggests different educational patterning of inflammatory biomarkers. Further large-scale research is needed to explore social differences in the inflammatory cascade in greater detail and the extent to which these differences contribute to social inequalities in health.Peer reviewe

Influenza vaccine effectiveness against influenza A subtypes in Europe: Results from the 2021-2022 I-MOVE primary care multicentre study

Background: In 2021-2022, influenza A viruses dominated in Europe. The I-MOVE primary care network conducted a multicentre test-negative study to measure influenza vaccine effectiveness (VE). Methods: Primary care practitioners collected information on patients presenting with acute respiratory infection. Cases were influenza A(H3N2) or A(H1N1)pdm09 RT-PCR positive, and controls were influenza virus negative. We calculated VE using logistic regression, adjusting for study site, age, sex, onset date, and presence of chronic conditions. Results: Between week 40 2021 and week 20 2022, we included over 11 000 patients of whom 253 and 1595 were positive for influenza A(H1N1)pdm09 and A(H3N2), respectively. Overall VE against influenza A(H1N1)pdm09 was 75% (95% CI: 43-89) and 81% (95% CI: 45-93) among those aged 15-64 years. Overall VE against influenza A(H3N2) was 29% (95% CI: 12-42) and 25% (95% CI: -41 to 61), 33% (95% CI: 14-49), and 26% (95% CI: -22 to 55) among those aged 0-14, 15-64, and over 65 years, respectively. The A(H3N2) VE among the influenza vaccination target group was 20% (95% CI: -6 to 39). All 53 sequenced A(H1N1)pdm09 viruses belonged to clade 6B.1A.5a.1. Among 410 sequenced influenza A(H3N2) viruses, all but eight belonged to clade 3C.2a1b.2a.2. Discussion: Despite antigenic mismatch between vaccine and circulating strains for influenza A(H3N2) and A(H1N1)pdm09, 2021-2022 VE estimates against circulating influenza A(H1N1)pdm09 were the highest within the I-MOVE network since the 2009 influenza pandemic. VE against A(H3N2) was lower than A(H1N1)pdm09, but at least one in five individuals vaccinated against influenza were protected against presentation to primary care with laboratory-confirmed influenza.This project has received funding from the European Centre for Disease Prevention and Control with in the framework contract ECDC/2018/029.S

Patterning of educational attainment across inflammatory markers: Findings from a multi-cohort study

Background: Evidence suggests that the inflammatory reaction, an adaptive response triggered by a variety of harmful stimuli and conditions involved in the risk and development of many chronic diseases, is a potential pathway through which the socioeconomic environment is biologically embedded. Difficulty in interpreting the role of the inflammatory system in the embodiment dynamic arises because of heterogeneity across studies that use a limited but varied number of inflammatory markers. There is no consensus in the literature as to which inflammatory markers beyond the C-reactive protein and to a lesser extent interleukin 6 are related to the social environment. Accordingly, we aimed to investigate the association between educational attainment, and several markers of inflammation - C-reactive protein, fibrinogen, interleukin 6, interleukin 1 beta and tumor necrosis factor alpha- in 6 European cohort studies.Methods: Up to 17,470 participants from six European cohort studies with data on educational attainment, health behaviors and lifestyle factors, and at least two different inflammatory markers. Four sub-datasets were drawn with varying numbers of participants to allow pairwise comparison of the social patterning of C-reactive protein and any other inflammatory markers. To evaluate within each sub-dataset the importance of the context and cohort specificities, linear regression-based analyses were performed separately for each cohort and combined in a random effect meta-analysis to determine the relationship between educational attainment and inflammation.Results: We found that the magnitude of the relationship between educational attainment and five inflammatory biomarkers (C-reactive protein, fibrinogen, interleukin 6 and 1 beta and tumor necrosis factor alpha) was variable. By far the most socially patterned biomarker was C-reactive protein, followed by fibrinogen and to lesser extent interleukin 6, where a low educational attainment was associated with higher inflammation even after adjusting for health behaviours and body mass index. No association was found with interleukin 1 beta and tumor necrosis factor alpha.Conclusions: Our study suggests different educational patterning of inflammatory biomarkers. Further large-scale research is needed to explore social differences in the inflammatory cascade in greater detail and the extent to which these differences contribute to social inequalities in health.</div

Inégalités entre hommes et femmes face au risque d'infection par le virus Sars-Cov-2 durant le confinement du printemps 2020 en France

International audienceIntroduction – The social distribution of SARS-CoV-2 infection among men and women and the role of gender have been largely neglected in France, mainly due to a lack of data. The aim of this article is to describe and analyse the risk of SARS-CoV-2 infection with respect to sex, and the influence of other social factors, especially occupation, in this relationship. Methods – We used data from the “COVID-19 Barometer”. Each week, a cross-sectional survey was administered via Internet to a sample of 5,000 people representative of the French metropolitan population, aged 18 and over, established by the quota method. A total of 25,001 participants were questioned between 7 April and 11 May 2020. The relationship between sex, occupation and SARS-CoV-2 infection was studied using multi- variate nested logistic regression modelling. Results – During the first lockdown of spring 2020 in France, women reported a medical diagnosis of SARS-CoV-2 infection more often than men (4% vs 3.2%). However, when taking into account the relationship between sex and socioeconomic variables (occupation), the additional risk of infection for women was no longer observed. Specifically, while men in executive positions were more likely to report a diagnosis of infection compared to those in other occupations, this association was not observed amongst women. Conclusions – The relationship between gender and SARS-CoV-2 infection was modified by the inclusion of occupation, suggesting the distribution of occupations by sex is important to consider. The differences in the risk of infection between men and women therefore require further exploration with regard to socioeconomic factors.Introduction – La distribution sociale de l’infection au SARS-CoV-2 et le rôle du genre ont été largement négligés en France, principalement en raison du manque de données. L’objectif de cet article est d’analyser le risque d’infection au SARS-CoV-2 en fonction du sexe, en étudiant l’influence d’autres dimensions sociales dans cette relation, en particulier la profession.Méthodes – Nous avons utilisé les données du Baromètre Covid-19. Chaque semaine, une vague de sondage était administrée sur Internet auprès d’un échantillon de 5 000 personnes représentatif de la population française métropolitaine âgée de 18 ans et plus, établi par la méthode des quotas. Au total, 25 001 participants ont été interrogés entre le 7 avril et le 11 mai 2020. La relation entre le sexe, la profession et l’infection au SARS-CoV-2 a été étudiée par des modèles de régression logistique emboités.Résultats – Durant la période du premier confinement en 2020 en France, les femmes déclarent plus souvent que les hommes un diagnostic médical d’infection au SARS-CoV-2 (4% vs 3,2%). Cependant, lorsque l’on prend en compte la relation entre le sexe et les professions et catégories socioprofessionnelles, le sur-risque d’infection chez les femmes ne s’observe plus. Plus spécifiquement, les hommes cadres sont plus à risque de déclarer l’infection que ceux appartenant aux autres professions et catégories socioprofessionnelles, ce qui n’est pasobservé chez les femmes.Conclusions – Le lien entre sexe et infection au SARS-CoV-2 est modifié par la prise en compte de la profession, suggérant que la distribution des professions par sexe est une dimension importante à considérer. Les différences de risque d’infection entre hommes et femmes méritent donc d’être analysées au regard des facteurs socioéconomiques et des rôles sociaux qui leur sont dévolus

Inégalités entre hommes et femmes face au risque d'infection par le virus Sars-Cov-2 durant le confinement du printemps 2020 en France

International audienceIntroduction – The social distribution of SARS-CoV-2 infection among men and women and the role of gender have been largely neglected in France, mainly due to a lack of data. The aim of this article is to describe and analyse the risk of SARS-CoV-2 infection with respect to sex, and the influence of other social factors, especially occupation, in this relationship. Methods – We used data from the “COVID-19 Barometer”. Each week, a cross-sectional survey was administered via Internet to a sample of 5,000 people representative of the French metropolitan population, aged 18 and over, established by the quota method. A total of 25,001 participants were questioned between 7 April and 11 May 2020. The relationship between sex, occupation and SARS-CoV-2 infection was studied using multi- variate nested logistic regression modelling. Results – During the first lockdown of spring 2020 in France, women reported a medical diagnosis of SARS-CoV-2 infection more often than men (4% vs 3.2%). However, when taking into account the relationship between sex and socioeconomic variables (occupation), the additional risk of infection for women was no longer observed. Specifically, while men in executive positions were more likely to report a diagnosis of infection compared to those in other occupations, this association was not observed amongst women. Conclusions – The relationship between gender and SARS-CoV-2 infection was modified by the inclusion of occupation, suggesting the distribution of occupations by sex is important to consider. The differences in the risk of infection between men and women therefore require further exploration with regard to socioeconomic factors.Introduction – La distribution sociale de l’infection au SARS-CoV-2 et le rôle du genre ont été largement négligés en France, principalement en raison du manque de données. L’objectif de cet article est d’analyser le risque d’infection au SARS-CoV-2 en fonction du sexe, en étudiant l’influence d’autres dimensions sociales dans cette relation, en particulier la profession.Méthodes – Nous avons utilisé les données du Baromètre Covid-19. Chaque semaine, une vague de sondage était administrée sur Internet auprès d’un échantillon de 5 000 personnes représentatif de la population française métropolitaine âgée de 18 ans et plus, établi par la méthode des quotas. Au total, 25 001 participants ont été interrogés entre le 7 avril et le 11 mai 2020. La relation entre le sexe, la profession et l’infection au SARS-CoV-2 a été étudiée par des modèles de régression logistique emboités.Résultats – Durant la période du premier confinement en 2020 en France, les femmes déclarent plus souvent que les hommes un diagnostic médical d’infection au SARS-CoV-2 (4% vs 3,2%). Cependant, lorsque l’on prend en compte la relation entre le sexe et les professions et catégories socioprofessionnelles, le sur-risque d’infection chez les femmes ne s’observe plus. Plus spécifiquement, les hommes cadres sont plus à risque de déclarer l’infection que ceux appartenant aux autres professions et catégories socioprofessionnelles, ce qui n’est pasobservé chez les femmes.Conclusions – Le lien entre sexe et infection au SARS-CoV-2 est modifié par la prise en compte de la profession, suggérant que la distribution des professions par sexe est une dimension importante à considérer. Les différences de risque d’infection entre hommes et femmes méritent donc d’être analysées au regard des facteurs socioéconomiques et des rôles sociaux qui leur sont dévolus

The effect of social deprivation on the dynamic of SARS-CoV-2 infection in France: a population-based analysis

International audienceBACKGROUND: Data on health inequalities related to the dynamic of SARS-CoV-2 infection in France are scarce. The aim of this study was to analyse the association between an area-based deprivation indicator and SARS-CoV-2 incidence, positivity, and testing rates between May 2020 and April 2021.METHODS: We analysed data reported to the Système d'Information de Dépistage Populationnel surveillance system between May 14, 2020 and April 29, 2021, which records the results of all SARS-CoV-2 tests in France. Residential addresses of tested individuals were geocoded to retrieve the associated aggregated units for the statistical information (IRIS) scale, corresponding to an area comprising 2000 inhabitants relatively homogenous in terms of socioeconomic characteristics. A social deprivation score was assigned to each area using the European Deprivation Index (EDI). We fitted negative binomial generalised additive models to model the age-standardised and sex-standardised ratios for SARS-CoV-2 incidence, positivity rates, and testing rates, and to estimate incidence rate ratios (IRRs) and 95% CIs of their association with EDI quintiles, using the first quintile (least deprived) as the reference category, adjusted for week, population density, and region.FINDINGS: Analyses were based on 70 990 478 SARS-CoV-2 tests, of which 5 000 972 were positive. SARS-CoV-2 incidence was higher in the most deprived areas than the least deprived areas (IRR 1·148 [95% CI 1·138-1·158]) and positivity rates were also higher (IRR 1·283 [1·273-1·294]), whereas testing rates were lower in the most deprived areas than the least deprived areas (IRR 0·905 [0·904-0·907]). SARS-CoV-2 incidence and positivity rates remained higher in the most deprived areas than the least deprived areas during the second and third national lockdowns, and variation in testing rate was observed according to population density.INTERPRETATION: Our results highlight a positive social gradient between deprivation and the risk of testing positive for SARS-CoV-2, with the highest risk among individuals living in the most deprived areas and a negative social gradient for testing rate. These findings might reflect structural barriers to health-care access in France and lower capacity of deprived populations to benefit from protective measures.FUNDING: None

High syphilis prevalence and incidence in people living with HIV and Preexposure Prophylaxis users: A retrospective review in the French Dat’AIDS cohort

International audienceBackground In the past years, we observed a sharp increase of Syphilis, especially among male who have sex with male (MSM), either HIV-infected, or on pre-exposure prophylaxis (PrEP). Our aim was to assess syphilis prevalence and incidence among people living with HIV (PLWH) and PrEP users.Methods PLWH were included from 2010 to 2020 and PrEP users from 2016 to 2020 from the Dat’AIDS French cohort. We calculated syphilis prevalence and incidences for first infections, re-infections, and iterative infections (> 2 times). T-Tests, Wilcoxon tests and Chi2 test were used for descriptive analysis and multivariate logistic regression models were used to estimate Odds ratios (OR) and 95% confidence intervals (95% CI) for factors associated with syphilis.Results Among the 8 583 PLWH, prevalence of subject with past or present syphilis was 19.9%. These subjects were more likely MSM or transgender and aged over 35 years, but prevalence was lower in AIDS subjects. Same pattern was seen for incident infection and re-infection. Incidence was 3.8 per 100 person-years for infection and 6.5 per 100 person-years for re-infection. Among 1 680 PrEP users, syphilis prevalence was 25.8%, with an estimated 7.2% frequency of active syphilis. Risk of syphilis infection was higher in male and increased with age. Incidence was 11.2 per 100 person-years for infection and 11.1 per 100 person-years for re-infection.Conclusion Syphilis prevalence and incidence were high, especially in older MSM with controlled HIV infection and PrEP users, enhancing the need to improve syphilis screening and behavioral risk reduction counseling among high-risk subjects

M1BP is an essential transcriptional activator of oxidative metabolism during Drosophila development

Abstract Oxidative metabolism is the predominant energy source for aerobic muscle contraction in adult animals. How the cellular and molecular components that support aerobic muscle physiology are put in place during development through their transcriptional regulation is not well understood. Using the Drosophila flight muscle model, we show that the formation of mitochondria cristae harbouring the respiratory chain is concomitant with a large-scale transcriptional upregulation of genes linked with oxidative phosphorylation (OXPHOS) during specific stages of flight muscle development. We further demonstrate using high-resolution imaging, transcriptomic and biochemical analyses that Motif-1-binding protein (M1BP) transcriptionally regulates the expression of genes encoding critical components for OXPHOS complex assembly and integrity. In the absence of M1BP function, the quantity of assembled mitochondrial respiratory complexes is reduced and OXPHOS proteins aggregate in the mitochondrial matrix, triggering a strong protein quality control response. This results in isolation of the aggregate from the rest of the matrix by multiple layers of the inner mitochondrial membrane, representing a previously undocumented mitochondrial stress response mechanism. Together, this study provides mechanistic insight into the transcriptional regulation of oxidative metabolism during Drosophila development and identifies M1BP as a critical player in this process

Interim 2022/23 influenza vaccine effectiveness: six European studies, October 2022 to January 2023

BackgroundBetween October 2022 and January 2023, influenza A(H1N1)pdm09, A(H3N2) and B/Victoria viruses circulated in Europe with different influenza (sub)types dominating in different areas.AimTo provide interim 2022/23 influenza vaccine effectiveness (VE) estimates from six European studies, covering 16 countries in primary care, emergency care and hospital inpatient settings.MethodsAll studies used the test-negative design, but with differences in other study characteristics, such as data sources, patient selection, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders.ResultsThere were 20,477 influenza cases recruited across the six studies, of which 16,589 (81%) were influenza A. Among all ages and settings, VE against influenza A ranged from 27 to 44%. Against A(H1N1)pdm09 (all ages and settings), VE point estimates ranged from 28% to 46%, higher among children (< 18 years) at 49-77%. Against A(H3N2), overall VE ranged from 2% to 44%, also higher among children (62-70%). Against influenza B/Victoria, overall and age-specific VE were ≥ 50% (87-95% among children < 18 years).ConclusionsInterim results from six European studies during the 2022/23 influenza season indicate a ≥ 27% and ≥ 50% reduction in disease occurrence among all-age influenza vaccine recipients for influenza A and B, respectively, with higher reductions among children. Genetic virus characterisation results and end-of-season VE estimates will contribute to greater understanding of differences in influenza (sub)type-specific results across studies