Prevalence and public health relevance of micronutrient deficiencies and undernutrition in pre-school children and women of reproductive age in Côte d'Ivoire, West Africa

Abstract Objective To provide nationally representative data on the prevalence of anaemia, vitamin A and Fe deficiencies among pre-school age children (pre-SAC) and non-pregnant women of reproductive age (WRA), and on vitamin B12 and folate deficiencies in WRA, and the influence of inflammation on their interpretation. Design A cross-sectional survey to measure anthropometry, malaria parasitaemia and micronutrient status. Specifically, blood samples were analysed for Hb, plasma ferritin, soluble transferrin receptors, C-reactive protein, α1-acid glycoprotein, retinol-binding protein, vitamin B12 and folate. Setting Côte d'Ivoire in 2007. Subjects Nine hundred and twenty-eight WRA and 879 pre-SAC. Results In WRA, prevalence of Plasmodium parasitaemia (5 %) was low, but inflammation (34 %) was higher. Anaemia was a severe public health problem and prevalence differed by residency and eco-region. Inflammation-adjusted Fe deficiency was highest in urban areas (20 %). Nationally, folate deficiency was 86 %, higher in urban areas and varied by eco-region. Prevalence of vitamin B12 deficiency was low but higher in the rural areas and the north. Inflammation-adjusted vitamin A deficiency was very low (1 %). In pre-SAC, prevalence of inflammation (67 %) and Plasmodium parasites (25 %) was high; the latter was associated with poverty, rural residency and higher ferritin concentrations. Anaemia was classified as a severe public health problem (72 %), and was higher in rural areas (76 %) and the north (87 %). A quarter of pre-SAC suffered from vitamin A deficiency (inflammation-adjusted) and prevalence of undernutrition was high. Conclusions Prevalence of inflammation, Plasmodium parasitaemia and micronutrient deficiencies were high in Côte d'Ivoire, particularly in pre-SAC. Nutritional interventions should be accompanied by strategies to reduce exposure to infection

TWEAK Affects Keratinocyte G2/M Growth Arrest and Induces Apoptosis through the Translocation of the AIF Protein to the Nucleus

The soluble TNF-like weak inducer of apoptosis (TWEAK, TNFSF12) binds to the fibroblast growth factor-inducible 14 receptor (FN14, TNFRSF12A) on the cell membrane and induces multiple biological responses, such as proliferation, migration, differentiation, angiogenesis and apoptosis. Previous reports show that TWEAK, which does not contain a death domain in its cytoplasmic tail, induces the apoptosis of tumor cell lines through the induction of TNFα secretion. TWEAK induces apoptosis in human keratinocytes. Our experiments clearly demonstrate that TWEAK does not induce the secretion of TNFα or TRAIL proteins. The use of specific inhibitors and the absence of procaspase-3 cleavage suggest that the apoptosis of keratinocytes follows a caspase- and cathepsin B-independent pathway. Further investigation showed that TWEAK induces a decrease in the mitochondrial membrane potential of keratinocytes. Confocal microscopy showed that TWEAK induces the cleavage and the translocation of apoptosis inducing factor (AIF) from the mitochondria to the nucleus, thus initiating caspase-independent apoptosis. Moreover, TWEAK induces FOXO3 and GADD45 expression, cdc2 phosphorylation and cdc2 and cyclinB1 degradation, resulting in the arrest of cell growth at the G2/M phase. Finally, we report that TWEAK and FN14 are normally expressed in the basal layer of the physiological epidermis and are greatly enhanced in benign (psoriasis) and malignant (squamous cell carcinoma) skin pathologies that are characterized by an inflammatory component. TWEAK might play an essential role in skin homeostasis and pathology

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Different conditioning protocols result in distinct lymphopenic environments: consequences for regulatory T cells and anti-tumor immunotherapy

Different conditioning protocols result in distinct lymphopenic environments: consequences for regulatory T cells and anti-tumor immunotherapy. ATTACK Cellular Therapy of Cancer Symposiu

Different conditioning protocols result in distinct lymphopenic environments: consequences for regulatory T cells and anti-tumor immunotherapy

Different conditioning protocols result in distinct lymphopenic environments: consequences for regulatory T cells and anti-tumor immunotherapy. Annual Meeting of the French Society for Immunolog

Modulation de la prise de greffe de progéniteurs hématopoiétiques et de la différenciation T (rôle du conditionnement et de la voie d'aministration)

Les déficits lymphocytaires T peuvent être corrigés par l'administration en intraveineuse (IV) de cellules souches hématopoiétiques (CSH) provenant d'un donneur. Dans un modèle d'immunodéficience lié à l'absence de la protéine kinase ZAP-70, notre équipe avait précédemment montré que l'injection intrathymique (IT) de CSH histocompatibles conduit à une reconstitution du compartiment T plus robuste et plus rapide que dans le cas où les CSH sont administrées par voie IV. Au cours de ma thèse, je me suis intéressée à l'approche IT dans un contexte non-histocompatible, où j'ai montré que l'injection de CSH semi-allogéniques directement dans le thymus permet le développement d'une thymopoièse à long-terme, même en absence de conditionnement. De plus, j'ai également montré la persistence de progéniteurs thymiques précoces (ETP) provenant du donneur dans le thymus des souris transplantées. De façon remarquable, ces ETP retiennent un potentiel de différenciation plus divers que ceux rencontrés dans le thymus d'une souris sauvage, et leur fréquence est significativement élévée après IT, ce dernier suggérant une disponibilité accrue des niches thymiques. De façon intéressante, j'ai également montré que les progéniteurs déficients en ZAP-70 pouvaient se différencier de façon importante vers le lignage CD8 lors d'une activation constante de la voie de signalisation Notch couplée à la présence d'interleukine 7 (IL-7). Après la greffe de CSH par voie IV de souris ZAP-70-/-, en absence de conditionnemt, j'ai également identifié l'accumulation d'une population de CSH présentant un phénotype particulier (Lin- Sca 1+ c-kit-), nommée LSAPT. Ces cellules LSAPT présentent un biais de différenciation vers le lignage T g ainsi qu'une production élevée d'IL-17, ce qui suggère que les fonctions effectrices d'une cellule T g sont dépendantes de leur origine progénitrices. L'ensemble de mes résultats apporte à la fois de nouveaux éléments concernant l'identification de progéniteurs T et démontrent de l'influence/coopération entre voies de signalisation et facteurs environnementaux dans la modulation de la différenciation T et de leur fonctions effectrices.T cell deficiencies can be corrected by the intravenous (IV) injection of donor hematopoietic stem cells (HSCs). Using a murine model of ZAP-70-/- deficiency, our group previously showed that the intrathymic (IT) administration of histocompatible HSCs leads to a more robust and long-term thymopoiesis as compared to that achieved by the classical IV route. During my PhD, I found that the direct IT administration of semiallogeneic HSCs results in a sustained donor-derived thymopoiesis, overcoming histocompatibility barriers, even in the absence of conditioning. Furthermore, I found that donor-derived early thymic progenitors (ETPs) persist in the thymi of ZAP-70-/- transplanted mice, and present increased multi-lineage potential as compared to wild-type ETPs. Importantly, the frequency of donor-derived ETPs was augmented following IT transplantation, indicative of an increased progenitor niche. Interestingly, ZAP-70-deficient HSC could themselves be driven to a CD8 lineage fate in an environment where IL-7 potentiates continuous activation of the Notch pathway. Following IV transplantation of donor HSC into non-conditioned ZAP-70-/- mice, I determined that there is an accumulation of lineage-/Sca1+ donor progenitors lacking expression of the stem cell marker c-kit, termed LSAPT. These LSAPT show a biased differentiation towards the g T cell lineage with high IL-17-producing effector function, suggesting that progenitor origin regulates g T cell fate. The ensemble of my experiments provide new insights into the identity of T lineage progenitors and demonstrate how signaling pathways as well as environmental factors modulate T cell differentiation and effector function.MONTPELLIER-BU Sciences (341722106) / SudocSudocFranceF

La place de la psychothérapie dans les soins aux personnes toxicodépendantes

Cet article présente une réflexion au sujet de la psychothérapie destinée spécifiquement aux personnes toxicodépendantes. La prise en charge de ce type de problématiques a longtemps été considérée comme difficile, voire quasi impossible dans une pratique « classique » de la psychothérapie. Après avoir fourni quelques repères épidémiologiques et psychiatriques, cet article aborde la place et les spécificités (par exemple niveau de soin, aménagement du cadre et relation thérapeutique) du travail psychothérapeutique dans les soins proposés à la personne toxicodépendante. This article proposes a reflection about the psychotherapeutic work in the treatment of persons with substance use disorders. For a long time, substance abusers have been stereotyped by mental health practitioners, notably as being unresponsive to psychotherapy. After a brief survey of epidemiological and psychiatric elements, this article tackles the role and the specificities (e.g. level of care, setting and therapeutic relationship) of the psychotherapy practice in the care of patients suffering from substance use disorders

Different conditionning protocols result in distinct lymphopenic environments: consequences for anti-tumor immunotherapies

Different conditionning protocols result in distinct lymphopenic environments: consequences for anti-tumor immunotherapies. 18. Edition du Congrès Nantes/Actualités/Transplantation (N.A.T.

Matérialité et traçabilité ? - discussion

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