Benralizumab in severe eosinophilic asthma in real life: confirmed effectiveness and contrasted effect on sputum eosinophilia versus exhaled nitric oxide fraction - PROMISE.

peer reviewedBACKGROUND: Randomised controlled trials have shown that benralizumab, an anti-interleukin-5 receptor monoclonal antibody, reduces exacerbations and oral corticosteroid dose and improves asthma control and lung function in severe eosinophilic asthma. The aim of this study was to confirm results of randomised controlled trials in real life in a population of 73 patients with severe eosinophilic asthma treated with benralizumab for at least 12 months. METHODS: Patients underwent careful monitoring of asthma exacerbations, exhaled nitric oxide fraction, lung function, asthma control and quality of life questionnaire responses and sputum induction, and gave a blood sample at baseline, after 6 months and then every year. RESULTS: We found significant reductions in exacerbations (by 92%, p<0.0001) and oral corticosteroid dose (by 83%, p<0.001) after 6 months that were maintained over time, with 78% of patients able to stop oral corticosteroid therapy. Patients improved their Asthma Control Test (ACT) score (from 11.7±5.1 to 16.9±5.35, p<0.0001), Asthma Control Questionnaire (ACQ) score (from 2.88±1.26 to 1.77±1.32, p<0.0001) and Asthma Quality of Life Questionnaire score (+1.04, p<0.0001) at 6 months and this was maintained during follow-up. Only 35% and 43% of patients reached asthma control according to an ACT score ≥20 and ACQ score <1.5, respectively. We observed stable post-bronchodilation lung function over time and a significant reduction in sputum eosinophil count, with 85% of patients exhibiting sputum eosinophil counts <3% after 6 months (p<0.01) with no effect on exhaled nitric oxide fraction. CONCLUSION: In our real-life study, we confirm the results published in randomised controlled trials showing a sharp reduction in exacerbations and oral corticosteroid therapy, an improvement in asthma control and quality of life, and a dramatic reduction in sputum eosinophil count

MixInYeast: A Multicenter Study on Mixed Yeast Infections

Invasive candidiasis remains one of the most prevalent systemic mycoses, and several studies have documented the presence of mixed yeast (MY) infections. Here, we describe the epidemiology, clinical, and microbiological characteristics of MY infections causing invasive candidiasis in a multicenter prospective study. Thirty-four centers from 14 countries participated. Samples were collected in each center between April to September 2018, and they were sent to a reference center to confirm identification by sequencing methods and to perform antifungal susceptibility testing, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 6895 yeast cultures were identified and MY occurred in 150 cases (2.2%). Europe accounted for the highest number of centers, with an overall MY rate of 4.2% (118 out of 2840 yeast cultures). Of 122 MY cases, the most frequent combinations were Candida albicans/C. glabrata (42, 34.4%), C. albicans/C. parapsilosis (17, 14%), and C. glabrata/C. tropicalis (8, 6.5%). All Candida isolates were susceptible to amphotericin B, 6.4% were fluconazole-resistant, and two isolates (1.6%) were echinocandin-resistant. Accurate identification of the species involved in MY infections is essential to guide treatment decisions

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P &lt; 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P &lt; 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P &lt; 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P &lt; 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P &lt; 0.001; OR(BP) = 2.4, P &lt; 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P &lt; 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P &lt; 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

Preclinical investigation of a series of 4-hydroxybenzoic acids as histone deacetylase inhibitors

L'acétylation des lysines est une modification post-traductionnelle des protéines dont l’ajout et l’élimination sont catalysés respectivement par les histones acétyltransférases (HAT) et les désacétylases d'histones (HDAC). Cette modification joue un rôle majeur dans la régulation de processus cellulaires tels que l'expression génique, la mobilité cellulaire et le métabolisme. Il est maintenant bien établi qu'une altération de l'activité des désacétylases, entrainant ainsi une dérégulation de l'acétylome, est associée au développement tumoral. Par conséquent, les HDAC sont considérées comme des cibles prometteuses en thérapie anti-cancéreuse ce qui a conduit au développement de nombreux inhibiteurs de HDAC. Cependant, la recherche de nouvelles molécules avec un potentiel anti-cancéreux accru et moins d’effets secondaires est indispensable. Nous avons identifié cinq acides 4-hydroxybenzoïques comme nouveaux inhibiteurs de HDAC, trois inhibiteurs qui ciblent plusieurs HDAC et deux inhibiteurs spécifiques de HDAC6. Les inhibiteurs qui ciblent plusieurs HDAC induisent l'acétylation de certaines lysines des histones H3 et H4 dans les cellules de leucémie myéloïde chronique humaine K-562. Le traitement des cellules induit un arrêt de la progression du cycle cellulaire associé à la modulation de l'expression des cyclines et l'activation de la transcription du gène codant p21. Enfin, les trois composés qui inhibent plusieurs HDAC induisent une mort par apoptose qui est confirmée par l'observation du clivage et de l'activation des caspases. Les inhibiteurs spécifiques de HDAC6 induisent une hyperacétylation importante de la tubuline-α corrélée à une condensation des microtubules dans les cellules cancéreuses adhérentes de prostate (cellules PC-3 et LNCaP). Ces composés induisent une mort par apoptose des cellules cancéreuses en suspension K-562 accompagnée du clivage des caspases et de l'activation de la protéine pro-apoptotique BAX. Enfin, les molécules altèrent la fonction de la protéine chaperonne HSP90α observée par une forte diminution de l'expression de ses protéines clientes: Bcr-Abl et le récepteur aux androgènes. Par ailleurs, les cinq composés n'affectent pas la viabilité des cellules saines. L'ensemble de ce travail révèle que les acides 4-hydroxybenzoïques sont des molécules prometteuses pour le développement de nouveaux composés ayant des propriétés anti-tumorales intéressantesLysine acetylation is a post-translational modification characterized by addition and removal acetyl group by histone acetyltransferases (HATs) and histone deacetylases (HDACs), respectively. This modification plays a crucial role in multiple cellular processes including gene expression, cell motility and metabolism. It is now well established that disruption of deacetylase activity, leading to a pathological acetylation profile, is associated to cancer development. Consequently, HDACs are considered as promising targets for anticancer therapy, which led to the development of novel HDAC inhibitors. However, discovery and synthesis of new molecules is essential to increase anticancer potential and decrease adverse health effects of already known compounds. We identified five 4-hydroxybenzoic acids as new HDAC inhibitors: three pan-HDAC inhibitors and two HDAC6-specific inhibitors. Pan-HDAC inhibitors induce acetylation of selected lysines within histones H3 and H4 in human chronic myeloid leukemia K-562 cells. Treatment of cells induces cell cycle arrest associated with increased cyclin expression and the transcriptional activation of p21. Finally, these pan-HDAC inhibitors induce apoptotic cell death further confirmed by the cleavage and activation of caspases. HDAC6-specific inhibitors induce hyperacetylation of α-tubulin in correlation with microtubule condensation in adherent prostate cancer cells (PC-3 and LNCaP cells). These compounds induce apoptotic cell death in K-562 cells accompanied by caspase cleavage and the activation of the pro-apoptotic protein BAX. Furthermore, these molecules alter the chaperon function of HSP90α, which is observed through the robust decrease of the expression of its client proteins (i.e. Bcr-Abl and androgen receptor). Noteworthy, the five compounds did not affect healthy cell viability. Taken together these results revealed that 4-hydroxybenzoic acids are attractive molecules for the development of new compounds with promising anticancer propertie

Étude pré-clinique d'une série d'acides 4-hydroxybenzoïques comme inhibiteurs de désacétylases d'histones

Lysine acetylation is a post-translational modification characterized by addition and removal acetyl group by histone acetyltransferases (HATs) and histone deacetylases (HDACs), respectively. This modification plays a crucial role in multiple cellular processes including gene expression, cell motility and metabolism. It is now well established that disruption of deacetylase activity, leading to a pathological acetylation profile, is associated to cancer development. Consequently, HDACs are considered as promising targets for anticancer therapy, which led to the development of novel HDAC inhibitors. However, discovery and synthesis of new molecules is essential to increase anticancer potential and decrease adverse health effects of already known compounds. We identified five 4-hydroxybenzoic acids as new HDAC inhibitors: three pan-HDAC inhibitors and two HDAC6-specific inhibitors. Pan-HDAC inhibitors induce acetylation of selected lysines within histones H3 and H4 in human chronic myeloid leukemia K-562 cells. Treatment of cells induces cell cycle arrest associated with increased cyclin expression and the transcriptional activation of p21. Finally, these pan-HDAC inhibitors induce apoptotic cell death further confirmed by the cleavage and activation of caspases. HDAC6-specific inhibitors induce hyperacetylation of [alpha]-tubulin in correlation with microtubule condensation in adherent prostate cancer cells (PC-3 and LNCaP cells). These compounds induce apoptotic cell death in K-562 cells accompanied by caspase cleavage and the activation of the pro-apoptotic protein BAX. Furthermore, these molecules alter the chaperon function of HSP90[alpha], which is observed through the robust decrease of the expression of its client proteins (i.e. Bcr-Abl and androgen receptor). Noteworthy, the five compounds did not affect healthy cell viability. Taken together these results revealed that 4-hydroxybenzoic acids are attractive molecules for the development of new compounds with promising anticancer propertiesL'acétylation des lysines est une modification post-traductionnelle des protéines dont l’ajout et l’élimination sont catalysés respectivement par les histones acétyltransférases (HAT) et les désacétylases d'histones (HDAC). Cette modification joue un rôle majeur dans la régulation de processus cellulaires tels que l'expression génique, la mobilité cellulaire et le métabolisme. Il est maintenant bien établi qu'une altération de l'activité des désacétylases, entrainant ainsi une dérégulation de l'acétylome, est associée au développement tumoral. Par conséquent, les HDAC sont considérées comme des cibles prometteuses en thérapie anti-cancéreuse ce qui a conduit au développement de nombreux inhibiteurs de HDAC. Cependant, la recherche de nouvelles molécules avec un potentiel anti-cancéreux accru et moins d’effets secondaires est indispensable. Nous avons identifié cinq acides 4-hydroxybenzoïques comme nouveaux inhibiteurs de HDAC, trois inhibiteurs qui ciblent plusieurs HDAC et deux inhibiteurs spécifiques de HDAC6. Les inhibiteurs qui ciblent plusieurs HDAC induisent l'acétylation de certaines lysines des histones H3 et H4 dans les cellules de leucémie myéloïde chronique humaine K-562. Le traitement des cellules induit un arrêt de la progression du cycle cellulaire associé à la modulation de l'expression des cyclines et l'activation de la transcription du gène codant p21. Enfin, les trois composés qui inhibent plusieurs HDAC induisent une mort par apoptose qui est confirmée par l'observation du clivage et de l'activation des caspases. Les inhibiteurs spécifiques de HDAC6 induisent une hyperacétylation importante de la tubuline-[alpha] corrélée à une condensation des microtubules dans les cellules cancéreuses adhérentes de prostate (cellules PC-3 et LNCaP). Ces composés induisent une mort par apoptose des cellules cancéreuses en suspension K-562 accompagnée du clivage des caspases et de l'activation de la protéine pro-apoptotique BAX. Enfin, les molécules altèrent la fonction de la protéine chaperonne HSP90[alpha] observée par une forte diminution de l'expression de ses protéines clientes: Bcr-Abl et le récepteur aux androgènes. Par ailleurs, les cinq composés n'affectent pas la viabilité des cellules saines. L'ensemble de ce travail révèle que les acides 4-hydroxybenzoïques sont des molécules prometteuses pour le développement de nouveaux composés ayant des propriétés anti-tumorales intéressante

Continuous Long-Term Exposure to Low Concentrations of MWCNTs Induces an Epithelial-Mesenchymal Transition in BEAS-2B Cells

In the field of nanotechnology, the use of multi-walled carbon nanotubes (MWCNTs) is growing. Pulmonary exposure during their production, use, and handling is raising concerns about their potential adverse health effects. The purpose of this study is to assess how the physical characteristics of MWCNTs, such as diameter and/or length, can play a role in cellular toxicity. Our experimental design is based on the treatment of human bronchial epithelial cells (BEAS-2B) for six weeks with low concentrations (0.125–1 µg/cm2) of MWCNTs having opposite characteristics: NM-403 and Mitsui-7. Following treatment with both MWCNTs, we observed an increase in mitotic abnormalities and micronucleus-positive cells. The cytotoxic effect was delayed in cells treated with NM-403 compared to Mitsui-7. After 4–6 weeks of treatment, a clear cellular morphological change from epithelial to fibroblast-like phenotype was noted, together with a change in the cell population composition. BEAS-2B cells underwent a conversion from the epithelial to mesenchymal state as we observed a decrease in the epithelial marker E-cadherin and an increased expression of mesenchymal markers N-cadherin, Vimentin, and Fibronectin. After four weeks of recovery, we showed that the induced epithelial-mesenchymal transition is reversible, and that the degree of reversibility depends on the MWCNT

Ciliary neurotrophic factor (CNTF) activation of astrocytes decreases spreading depolarization susceptibility and increases potassium clearance

International audienceWaves of spreading depolarization (SD) have been implicated in the progressive expansion of acute brain injuries. SD can persist over several days, coincident with the time course of astrocyte activation, but little is known about how astrocyte activation may influence SD susceptibility. We examined whether activation of astrocytes modified SD threshold in hippocampal slices. Injection of a lentiviral vector encoding Ciliary neurotrophic factor (CNTF) into the hippocampus in vivo, led to sustained astrocyte activation, verified by up-regulation of glial fibrillary acidic protein (GFAP) at the mRNA and protein levels, as compared to controls injected with vector encoding LacZ. In acute brain slices from LacZ controls, localized 1M KCl microinjections invariably generated SD in CA1 hippocampus, but SD was never induced with this stimulus in CNTF tissues. No significant change in intrinsic excitability was observed in CA1 neurons, but excitatory synaptic transmission was significantly reduced in CNTF samples. mRNA levels of the predominantly astrocytic Na(+) /K(+) -ATPase pump α2 subunit were higher in CNTF samples, and the kinetics of extracellular K(+) transients during matched synaptic activation were consistent with increased K(+) uptake in CNTF tissues. Supporting a role for the Na(+) /K(+) -ATPase pump in increased SD threshold, ouabain, an inhibitor of the pump, was able to generate SD in CNTF tissues. These data support the hypothesis that activated astrocytes can limit SD onset via increased K(+) clearance and suggest that therapeutic strategies targeting these glial cells could improve the outcome following acute brain injuries associated with SD

Exposure to TiO2 Nanostructured Aerosol Induces Specific Gene Expression Profile Modifications in the Lungs of Young and Elderly Rats

Although aging is associated with a higher risk of developing respiratory pathologies, very few studies have assessed the impact of age on the adverse effects of inhaled nanoparticles. Using conventional and transcriptomic approaches, this study aimed to compare in young (12–13-week-old) and elderly (19-month-old) fisher F344 rats the pulmonary toxicity of an inhaled nanostructured aerosol of titanium dioxide (TiO2). Animals were nose-only exposed to this aerosol at a concentration of 10 mg/m3 for 6 h per day, 5 days per week for 4 weeks. Tissues were collected immediately (D0), and 28 days after exposure (D28). A pulmonary influx of neutrophilic granulocytes was observed in exposed rats at D0, but diminished with time while remaining significant until D28. Similarly, an increased expression of several genes involved in inflammation at the two post-exposure time-points was seen. Apart from an age-specific pulmonary influx of lymphocyte, only slight differences in physio-pathological responses following TiO2 exposure between young and elderly animals were noticed. Conversely, marked age-related differences in gene expression profiles were observed making possible to establish lists of genes specific to each age group and post-exposure times. These results highlight different signaling pathways that were disrupted in rats according to their age

Needlelike, short and thin multi-walled carbon nanotubes: comparison of effects on wild type and p53^+/− rat lungs

Carbon nanotubes (CNTs) are nanomaterials presenting an occupational inhalation risk during production or handling. The International Agency for Research on Cancer classified one CNT, Mitsui-7 (MWNT-7), as ‘possibly carcinogenic to humans’. In recognition of their similarities, a proposal has been submitted to the risk assessment committee of ECHA to classify all fibers with ‘Fibre Paradigm’ (FP)-compatible dimensions as carcinogenic. However, there is a lack of clarity surrounding the toxicity of fibers that do not fit the FP criteria. In this study, we compared the effects of the FP-compatible Mitsui-7, to those of NM-403, a CNT that is too short and thin to fit the paradigm. Female Sprague Dawley rats deficient for p53 (GMO) and wild type (WT) rats were exposed to the two CNTs (0.25 mg/rat/week) by intratracheal instillation. Animals (GMO and WT) were exposed weekly for four consecutive weeks and were sacrificed 3 days or 8 months after the last instillation. Exposure to both CNTs induced acute lung inflammation. However, persistent inflammation at 8 months was only observed in the lungs of rats exposed to NM-403. In addition to the persistent inflammation, NM-403 stimulated hyperplasic changes in rat lungs, and no adenomas or carcinomas were detected. The degree and extent of hyperplasia was significantly more pronounced in GMO rats. These results suggest that CNT not meeting the FP criteria can cause persistent inflammation and hyperplasia. Consequently, their health effects should be carefully assessed.</p