Immunogenicity Profile of a 3.75-μg Hemagglutinin Pandemic rH5N1 Split Virion AS03A-Adjuvanted Vaccine in Elderly Persons: A Randomized Trial

Background. Elderly persons often experience a reduced immune response to influenza vaccination. We evaluated the usual dose of AS03A-adjuvanted H5N1 pandemic vaccine (3.75 μg hemagglutinin of A/Vietnam/1194/2004-like strain) compared with a double dose in an elderly population

Podocyte Antigen Staining to Identify Distinct Phenotypes and Outcomes in Membranous Nephropathy: A Retrospective Multicenter Cohort Study.

Membranous nephropathy (MN) is characterized by the deposition of immune complexes along glomerular basement membranes. M-Type phospholipase A receptor (PLAR), thrombospondin type 1 domain-containing 7A (THSD7A), exostosin 1 and 2 (EXT1/2), and neural epidermal growth factor-like 1 protein (NELL-1) have been identified as established or potential podocyte antigens in MN. We investigated the association of podocyte antigen staining with MN clinical phenotype and outcomes. Multicenter retrospective cohort study. 177 consecutive patients with MN unrelated to lupus erythematosus, identified after screening of 3,875 native kidney biopsies performed in the Belgian UCLouvain Kidney Disease Network from 2000 through 2018. Positive immunostaining for podocyte antigens on archived kidney biopsy samples. Association with different phenotypes (baseline characteristics of patients and pathologic findings on kidney biopsy), time to cancer and to kidney failure. Kaplan-Meier estimates and Cox regression analyses to assess time to cancer and kidney failure. 177 patients were followed up for a median of 4.0 (IQR, 1.3-8.0) years. Diagnosis of PLAR-positive (PLAR), THSD7A, and double-negative (PLAR/THSD7A) MN was made in 117 (66.1%), 6 (3.4%), and 54 (30.5%) patients, respectively. Progression to kidney failure was similar in all groups. Although the number of patients with THSD7AMN was small, they showed a higher incidence (50%) and increased risk for developing cancer during follow-up (adjusted HR, 5.0 [95% CI, 1.4-17.9]; P=0.01). 8% and 5% of patients with double-negative MN stained positively for EXT1/2 and NELL-1, respectively. Most patients with EXT1/2MN were women, had features of systemic autoimmunity, and showed glomerular C1q deposits. Retrospective design; small number of patients in the THSD7A group; lack of evaluation of immunoglobulin G subclasses deposition. Our real-world data describe the relative prevalence of subgroups of MN and support the hypothesis that a novel classification of MN based on podocyte antigen staining may be clinically relevant

Des mondes de confiance

Comment le concept de confiance est-il décliné dans les relations sociales ? dans les relations universités/entreprises ? dans les relations à l’autre ? Cet ouvrage éprouve le rôle, l’utilité et le fonctionnement de la confiance dans des situations de crise. Quelle confiance s’établit entre des magistrats et des délinquants ? Comment la confiance se construit-elle entre les pompes funèbres et leurs clients ? Pourquoi les populations sédentaires feraient-elles confiance aux nomades ? Quelles sont les béquilles de la confiance dans les échanges économiques ? Pourquoi le consommateur fait-il confiance à son boucher, son pâtissier ou son guide vinicole ? Confiance, jamais ce mot n’a été autant prononcé ou écrit qu’à l’heure actuelle dans des domaines aussi divers que l’économie, la politique, le développement ou les relations internationales. Le livre explore la construction de ce concept dans les sciences sociales et analyse comment la confiance est éprouvée quand deux mondes se rencontrent