Prévalence de la démence dans une population de personnes âgées sénégalaises

Description Avec le vieillissement de la population, survient la démence dans la population de personnes âgées. Objectif. L’objectif de cette étude était d’estimer la prévalence de cette affection dans une population de personnes âgées sénégalaises. Méthodes Par une étude transversale qui s’est déroulée du 01 mars 2004 au 31 décembre 2005, des personnes âgées de 55 ans et plus venant consulter pour un problème de santé au Centre Médico-Social et Universitaire de l’IPRES (Sénégal) ont été évaluées sur le plan clinique et neuropsychologique. Des données sur les caractéristiques sociodémographiques, les antécédents médico-chirurgicaux et familiaux, le mode de vie, le réseau social ont été collectées à l’aide d’un questionnaire structuré avec des réponses fermées. Résultat La population à l’étude était composée de 872 personnes. Elles avaient un âge moyen de 67,2 ans ± 7,5.Elles étaient de sexe masculin (62,6%), mariées (79%), non instruites (50,7%). Dans les antécédents, l’HTA, le diabète, les affections respiratoires, les affections rhumatismales, la cataracte et les troublesdigestifs étaient les plus fréquents. Le tabagisme et l’alcoolisme était faible alors que la marche constituait la principale activité physique. Les personnes âgées vivaient en famille avec un bon réseau social.Cinquante huit (58) personnes ont présenté une démence (6,6%). La prévalence de la maladie variait de manière significative avec l’âge et l’instruction. Conclusion Ce résultat confirme que la prévalence de la démence varie en fonction de l’âge et de l’instruction de la personne âgée

Facteurs de risque de démence dans une population de personnes âgées sénégalaises

Description La démence est devenue un problème de santé publique. Dans le but d’une prévention, il est important de connaitre son épidémiologie au Sénégal. L’objectif de cette étude était d’identifier les facteurs de risque de démence dans une population de personnes âgées sénégalaises. MéthodesUne étude transversale a été réalisée du 01 Mars 2004 au 31 Décembre 2005 auprès d’une population de 872 personnes âgées de 55ans et plus utilisant le Centre Médicosocial et Universitaire de l’Institut de Prévoyance Retraite du Sénégal pour des soins. Par une étude en deux phases, des données sociodémographiques, sur le mode de vie, le réseau social, les antécédents ont été collectées à l’aide d’un questionnaire structuré complété par un examen clinique et une évaluation neuropsychologique. Le diagnostic de démence reposait sur des critères DSM IV-R

Factors Affecting the Statural Growth Retardation in Children using Steroids in Idiopathic Nephrotic Syndrome

Background and Aim: Idiopathic nephrotic syndrome or nephrosis causes massive protein leakage in the urine. Its treatment requires steroids (prednisone, methylprednisolone), often for a prolonged period, notably in case of steroid-dependence or steroid-resistance. In children, long-term use of steroids can lead to several side effects such as statural growth retardation/ stunting. This study evaluated the frequency of stunting in idiopathic nephrotic syndrome in children on steroids and identified the associated factors.     
 Material and Methods: This was a retrospective, descriptive cohort study carried out in children aged 0 to 16 years treated at the paediatric nephrology unit of Aristide Le Dantec Hospital in Dakar, between 1 December 2017 and 31 May 2020. All records of nephrotic children treated in outpatient or inpatient setting were included. These children had to be on corticosteroid therapy for at least 30 months and have a height taken regularly during follow-up consultations.
 Results: Of 259 children followed for idiopathic nephrotic syndrome, 93 were included in the study. The median age was 96.5 months and the sex ratio was 1.9. The mean height of the children at the beginning of the follow-up was -0.26 DS, at the end it was -0.88 DS. At the beginning of the follow-up, 8 children had already stunting. At 12 months follow-up, 72 children (77.4%) had a decrease in z-score; and at 30 months, there were 7 more children (84.9%) who had a decrease in z-score. Methylprednisolone boluses were given to 17 children (18.3%). Calcium supplementation was done in 91 children (97.8%). Vitamin D supplementation was given to 91 children (97.8%). The mean number of relapses was 1.8. Factors associated with stunting were number of relapses ≤3 (p=0.03), duration of corticosteroid therapy >6 months (p<0.0001) and cumulative doses of prednisone >100 mg/kg (p=0.04).
 Conclusion: In prolonged nephrotic syndrome in children, corticosteroids can cause stunting

Productive Hepatitis C Virus Infection of Stem Cell-Derived Hepatocytes Reveals a Critical Transition to Viral Permissiveness during Differentiation

Primary human hepatocytes isolated from patient biopsies represent the most physiologically relevant cell culture model for hepatitis C virus (HCV) infection, but these primary cells are not readily accessible, display individual variability, and are largely refractory to genetic manipulation. Hepatocyte-like cells differentiated from pluripotent stem cells provide an attractive alternative as they not only overcome these shortcomings but can also provide an unlimited source of noncancer cells for both research and cell therapy. Despite its promise, the permissiveness to HCV infection of differentiated human hepatocyte-like cells (DHHs) has not been explored. Here we report a novel infection model based on DHHs derived from human embryonic (hESCs) and induced pluripotent stem cells (iPSCs). DHHs generated in chemically defined media under feeder-free conditions were subjected to infection by both HCV derived in cell culture (HCVcc) and patient-derived virus (HCVser). Pluripotent stem cells and definitive endoderm were not permissive for HCV infection whereas hepatic progenitor cells were persistently infected and secreted infectious particles into culture medium. Permissiveness to infection was correlated with induction of the liver-specific microRNA-122 and modulation of cellular factors that affect HCV replication. RNA interference directed toward essential cellular cofactors in stem cells resulted in HCV-resistant hepatocyte-like cells after differentiation. The ability to infect cultured cells directly with HCV patient serum, to study defined stages of viral permissiveness, and to produce genetically modified cells with desired phenotypes all have broad significance for host-pathogen interactions and cell therapy

Critical role of interleukin (IL)-17 in inflammatory and immune disorders: An updated review of the evidence focusing in controversies

Interleukin 17 (IL-17) is a proinflammatory cytokine that has been the focus of intensive research because of its crucial role in the pathogenesis of different diseases across many medical specialties. In this context, the present review in which a panel of 13 experts in immunology, dermatology, rheumatology, neurology, hematology, infectious diseases, hepatology, cardiology, ophthalmology and oncology have been involved, puts in common the mechanisms through which IL-17 is considered a molecular target for the development of novel biological therapies in these different fields. A comprehensive review of the literature and analysis of the most outstanding evidence have provided the basis for discussing the most relevant data related to IL-17A blocking agents for the treatment of different disorders, such as psoriasis, psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, cardiovascular disorders, non alcoholic fatty liver disease, multiple sclerosis, inflammatory bowel disease, uveitis, hematological and solid cancer. Current controversies are presented giving an opening line for future research.This work was supported by Novartis Pharmaceuticals Spain

Senegal: Presidential elections 2019 - The shining example of democratic transition immersed in muddy power-politics

Whereas Senegal has long been sold as a showcase of democracy in Africa, including peaceful political alternance, things apparently changed fundamentally with the Senegalese presidentials of 2019 that brought new configurations. One of the major issues was political transhumance that has been elevated to the rank of religion in defiance of morality. It threatened political stability and peace. In response, social networks of predominantly young activists, created in 2011 in the aftermath of the Arab Spring focused on grass-roots advocacy with the electorate on good governance and democracy. They proposed a break with a political system that they consider as neo-colonialist. Moreover, Senegal’s justice is frequently accused to be biased, and the servility of the Constitutional Council which is in the first place an electoral court has often been denounced

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Etude de la réponse humorale neutralisante contre le Virus de l’Hépatite C

Hepatitis C Virus (HCV) is the major etiological agent of liver disease in the world with approximately180 million people who are seropositive. The majority (60‐90%) of infected individuals progressesto chronic hepatitis that increases their risk for developing cirrhosis and hepatocellular carcinoma.One of the major limitations of HCV research is the lack of efficient in vitro culture systems andappropriateanimal models. vitro direct cell‐binding assay and an infection system of the human HepaRG cell line were developedby using HCVsp. The HepaRG cells possess potent ability to acquire a mature hepatocyte phenotype.The E1E2‐specific mAb D32.10 was shown to inhibit efficiently and specifically high affinityinteractionsthrough glycosaminoglycans and the CD81 tetraspanin between HCVsp and HepaRGcells with an IC50 = 0.5 μg/ml. This inhibition was more efficient when E1E2‐positive envelopedHCVsp were used selectively for binding studies (IC50 < 0.5 μg/ml). Establishment of infection,replication and propagation of HCVsp were shown to depend on the proliferation/differentiationstage of HepaRG cells. Persistent HCV infection in HepaRG cells could be obtained with production ofE1E2/RNA(+) infectious HCV particles. Preliminary data showed a complete early inhibitory effect ofthe D32.10 mAb on virion RNA production in HepaRG culture supernatants (95% at D14 and 80% atD21 post‐infection).Furthermore, the detection of the anti‐E1E2/D32.10‐binding peptide antibodies during natural HCVinfection demonstrated significant prevalence (90%) of these antibodies: (1) in patients whorecovered spontaneously from HCV infection with high titers compared to patients with chronichepatitis C, and (2) in patients who are complete responders compared to non responders toantivirals. Kinetic analyses revealed that the anti‐E1E2/D32.10‐like humoral response appeared veryearly with high titers (≥ 1/1000) and was associated with complete virus eradication. The positiveand negative predictive values (ROC curve analysis) for achieving or not a sustained viral response toantiviral therapy are 100% and 86%, respectively, reflecting diagnostic accuracy. The anti‐E1E2/D32.10‐binding peptide antibodies may thus predict the outcome of HCV infection andrepresent a new relevant pronostic marker in serum for the HCV diagnosis.Convergence of in vitro and in vivo data strongly support the neutralizing activity of the D32.10 mAb,and thus immunotherapeutic potential of this unique anti‐E1E2 D32.10 mAb.Le virus de l’hépatite C (HCV) est l’agent responsable de l’hépatite C, maladie qui touche environ 3% de lapopulation mondiale. Une des caractéristiques de cette infection est son évolution dans 60 à 90% des casvers des formes chroniques avec des complications sévères telles que la cirrhose et le carcinomehépatocellulaire. Un des handicaps majeurs de la recherche sur le HCV est l’absence de systèmes decultures in vitro efficaces et de modèles animaux adaptés car le HCV n’infecte que l’homme et le chimpanzé.l’anticorps D32.10. Pour cela, nous avons développé un test de cellbindinget nous avons montré quel’interaction des particules virales sériques (HCVsp) radiomarquées à l’Iode 125 avec les celluleshépatocytaires (Huh‐7 et HepaRG) est spécifique et saturable impliquant des sites de haute et faible affinité.De plus, l’anticorps D32.10 est capable d’inhiber spécifiquement et efficacement les interactions de hauteaffinité entre les HCVsp et les cellules HepaRG avec une IC50 ≤ 0,5 μg/ml. Nous avons mis en évidence quel’inhibition est plus efficace lorsque nous utilisons sélectivement une population de particules HCVenveloppées exprimant fortement E1E2. Récemment, nous avons développé un système d’infection originaldes cellules HepaRG qui sont des cellules progénitrices du foie par les HCVsp et avons montré quel’infection, la réplication et la propagation dépendent de l’état de prolifération/différenciation de cescellules. Nous avons aussi démontré que les particules virales produites dans ce système contiennent del’ARN viral, expriment les protéines d’enveloppe E1E2 et sont infectieuses. Des études préliminairesmontrent que l’anticorps D32.10 inhibe fortement l’infection (95% à 80% aux jours 14 et 21 aprèsinfection) vraisemblablement au niveau des étapes précoces du cycle viral.Dans un second temps, nous avons recherché la prévalence des anticorps de même spécificité que le D32.10(anti‐E1E2A,B) dans différents groupes de patients HCV positifs afin de déterminer leur significationbiologique. Par un test ELISA utilisant les peptides biotinylés E1, E2A et E2B dans la phase de capture, nousavons démontré que la réponse anticorps anti‐E1E2A,B était présente dans 90% des cas chez les patientsqui guérissent spontanément avec des titres élevées (≥ 1/1000). Cette réponse humorale est absente ourare (< 10%) chez les patients porteurs chroniques non traités ou non répondeurs aux traitementsantiviraux. Une étude longitudinale a été réalisée chez des patients non répondeurs ou répondeursdéveloppant une réponse virologique soutenue à une bithérapie standard, interféron pégylé plus ribavirine.L’analyse statistique des résultats a montré que les anticorps anti‐E1E2A,B pouvaient être prédictifs de laréponse au traitement avec une spécificité et une valeur prédictive positive de 100%.La convergence des résultats in vitro et in vivo supporte un rôle neutralisant de l’anticorps monoclonalD32.10, permettant d’envisager son utilisation en immunothérapie

Study of the neutralizing antibody response against the hepatitis C virus

Le virus de l’hépatite C (HCV) est l’agent responsable de l’hépatite C, maladie qui touche environ 3% de lapopulation mondiale. Une des caractéristiques de cette infection est son évolution dans 60 à 90% des casvers des formes chroniques avec des complications sévères telles que la cirrhose et le carcinomehépatocellulaire. Un des handicaps majeurs de la recherche sur le HCV est l’absence de systèmes decultures in vitro efficaces et de modèles animaux adaptés car le HCV n’infecte que l’homme et le chimpanzé.l’anticorps D32.10. Pour cela, nous avons développé un test de cellbindinget nous avons montré quel’interaction des particules virales sériques (HCVsp) radiomarquées à l’Iode 125 avec les celluleshépatocytaires (Huh‐7 et HepaRG) est spécifique et saturable impliquant des sites de haute et faible affinité.De plus, l’anticorps D32.10 est capable d’inhiber spécifiquement et efficacement les interactions de hauteaffinité entre les HCVsp et les cellules HepaRG avec une IC50 ≤ 0,5 μg/ml. Nous avons mis en évidence quel’inhibition est plus efficace lorsque nous utilisons sélectivement une population de particules HCVenveloppées exprimant fortement E1E2. Récemment, nous avons développé un système d’infection originaldes cellules HepaRG qui sont des cellules progénitrices du foie par les HCVsp et avons montré quel’infection, la réplication et la propagation dépendent de l’état de prolifération/différenciation de cescellules. Nous avons aussi démontré que les particules virales produites dans ce système contiennent del’ARN viral, expriment les protéines d’enveloppe E1E2 et sont infectieuses. Des études préliminairesmontrent que l’anticorps D32.10 inhibe fortement l’infection (95% à 80% aux jours 14 et 21 aprèsinfection) vraisemblablement au niveau des étapes précoces du cycle viral.Dans un second temps, nous avons recherché la prévalence des anticorps de même spécificité que le D32.10(anti‐E1E2A,B) dans différents groupes de patients HCV positifs afin de déterminer leur significationbiologique. Par un test ELISA utilisant les peptides biotinylés E1, E2A et E2B dans la phase de capture, nousavons démontré que la réponse anticorps anti‐E1E2A,B était présente dans 90% des cas chez les patientsqui guérissent spontanément avec des titres élevées (≥ 1/1000). Cette réponse humorale est absente ourare (< 10%) chez les patients porteurs chroniques non traités ou non répondeurs aux traitementsantiviraux. Une étude longitudinale a été réalisée chez des patients non répondeurs ou répondeursdéveloppant une réponse virologique soutenue à une bithérapie standard, interféron pégylé plus ribavirine.L’analyse statistique des résultats a montré que les anticorps anti‐E1E2A,B pouvaient être prédictifs de laréponse au traitement avec une spécificité et une valeur prédictive positive de 100%.La convergence des résultats in vitro et in vivo supporte un rôle neutralisant de l’anticorps monoclonalD32.10, permettant d’envisager son utilisation en immunothérapie.Hepatitis C Virus (HCV) is the major etiological agent of liver disease in the world with approximately180 million people who are seropositive. The majority (60‐90%) of infected individuals progressesto chronic hepatitis that increases their risk for developing cirrhosis and hepatocellular carcinoma.One of the major limitations of HCV research is the lack of efficient in vitro culture systems andappropriateanimal models. vitro direct cell‐binding assay and an infection system of the human HepaRG cell line were developedby using HCVsp. The HepaRG cells possess potent ability to acquire a mature hepatocyte phenotype.The E1E2‐specific mAb D32.10 was shown to inhibit efficiently and specifically high affinityinteractionsthrough glycosaminoglycans and the CD81 tetraspanin between HCVsp and HepaRGcells with an IC50 = 0.5 μg/ml. This inhibition was more efficient when E1E2‐positive envelopedHCVsp were used selectively for binding studies (IC50 < 0.5 μg/ml). Establishment of infection,replication and propagation of HCVsp were shown to depend on the proliferation/differentiationstage of HepaRG cells. Persistent HCV infection in HepaRG cells could be obtained with production ofE1E2/RNA(+) infectious HCV particles. Preliminary data showed a complete early inhibitory effect ofthe D32.10 mAb on virion RNA production in HepaRG culture supernatants (95% at D14 and 80% atD21 post‐infection).Furthermore, the detection of the anti‐E1E2/D32.10‐binding peptide antibodies during natural HCVinfection demonstrated significant prevalence (90%) of these antibodies: (1) in patients whorecovered spontaneously from HCV infection with high titers compared to patients with chronichepatitis C, and (2) in patients who are complete responders compared to non responders toantivirals. Kinetic analyses revealed that the anti‐E1E2/D32.10‐like humoral response appeared veryearly with high titers (≥ 1/1000) and was associated with complete virus eradication. The positiveand negative predictive values (ROC curve analysis) for achieving or not a sustained viral response toantiviral therapy are 100% and 86%, respectively, reflecting diagnostic accuracy. The anti‐E1E2/D32.10‐binding peptide antibodies may thus predict the outcome of HCV infection andrepresent a new relevant pronostic marker in serum for the HCV diagnosis.Convergence of in vitro and in vivo data strongly support the neutralizing activity of the D32.10 mAb,and thus immunotherapeutic potential of this unique anti‐E1E2 D32.10 mAb