Early high antibody titre convalescent plasma for hospitalised COVID-19 patients: DAWn-plasma.

peer reviewedBACKGROUND: Several randomised clinical trials have studied convalescent plasma for coronavirus disease 2019 (COVID-19) using different protocols, with different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralising antibody titres, at different time-points and severities of illness. METHODS: In the prospective multicentre DAWn-plasma trial, adult patients hospitalised with COVID-19 were randomised to 4 units of open-label convalescent plasma combined with standard of care (intervention group) or standard of care alone (control group). Plasma from donors with neutralising antibody titres (50% neutralisation titre (NT(50))) ≥1/320 was the product of choice for the study. RESULTS: Between 2 May 2020 and 26 January 2021, 320 patients were randomised to convalescent plasma and 163 patients to the control group according to a 2:1 allocation scheme. A median (interquartile range) volume of 884 (806-906) mL) convalescent plasma was administered and 80.68% of the units came from donors with neutralising antibody titres (NT(50)) ≥1/320. Median time from onset of symptoms to randomisation was 7 days. The proportion of patients alive and free of mechanical ventilation on day 15 was not different between both groups (convalescent plasma 83.74% (n=267) versus control 84.05% (n=137)) (OR 0.99, 95% CI 0.59-1.66; p=0.9772). The intervention did not change the natural course of antibody titres. The number of serious or severe adverse events was similar in both study arms and transfusion-related side-effects were reported in 19 out of 320 patients in the intervention group (5.94%). CONCLUSIONS: Transfusion of 4 units of convalescent plasma with high neutralising antibody titres early in hospitalised COVID-19 patients did not result in a significant improvement of clinical status or reduced mortality

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Évolution développementale de la région optique chez le poisson cavernicole, Astyanax mexicanus

Astyanax mexicanus is a fish species comprising two strikingly different morphotypes : the classical river-dwelling surface fish and the blind depigmented cavefish. These two morphs differ in many aspects in terms of sensorial modalities, physiology and behaviour. In the Evo-Devo approach, we try to link early developmental differences to later phenotypic modifications. Here we focus on the early modification of the hypothalamus and the eye of the cavefish. We show that early signalling modification of morphogens such as Shh or Fgfs lead to the modification of neuropeptidergic clusters in the hypothalamus via the neuronal fate-specifying transcription factors Lhx. More particularly, we show an increase in NPY and hypocretin cluster size. In turn, this increased hypocretin cluster size triggers a reduction of sleep in the cavefish larva.We also examine the embryonic eye of the cavefish which first develops before degenerating. This eye was previously reported to have a reduced ventral retina. We refine this description by studying the regionalisation of the cavefish optic cup and suggest that this reduction concerns more specifically the temporal retina. We also attempt a first description of the cavefish eye morphogenesis by live imaging on fluorescent transgenic lines. This description reveals a defect in the optic cup invagination of the cavefish. Overall, this work started deciphering the developmental evolution of the cavefish head.L’espèce Astyanax mexicanus est composée de deux morphotypes de poissons radicalement différents : le très classique poisson de surface vivant dans des rivières et le poisson cavernicole (CF, cavefish) aveugle et dépigmenté. Ces deux morphotypes diffèrent sur de nombreux aspects, aussi bien en termes de modalités sensorielles, qu’en termes de physiologie ou de comportement. L’approche « Evo-Devo » consiste à tenter de relier des différences développementales précoces à des modifications phénotypiques plus tardives. Dans le cadre de ce travail, nous nous sommes concentrés sur les modifications précoces de l’hypothalamus et de l’œil du CF. Nous montrons que des modifications précoces de signalisation de morphogènes tels que Shh ou Fgf conduisent à une modification de la taille des groupes de neurones peptidergiques au sein de l’hypothalamus, via les facteurs de transcription Lhx, impliqués dans la spécification neuronale. Plus particulièrement, nous montrons l’augmentation de taille des groupes de neurones NPY ainsi qu’hypocretine, qui à son tour provoque une réduction du sommeil chez le CF.Nous nous sommes aussi intéressés à l’oeil du CF, qui commence par se développer avant de dégénérer. Une réduction du quadrant ventral de la rétine avait été précédemment décrit. Nous rafinons cette description grâce à une étude de la régionalisation de la coupe optique du CF qui suggère une réduction de la rétine temporale plus spécifiquement. Nous proposons également une première description de la morphogénèse de l’oeil du CF grace à l’imagerie live de lignées transgéniques fluorescentes. Cette étude révèle un défaut d’invagination de la coupe optique chez le CF. Globalement, ce travail ouvre la voie vers une meilleure compréhension de l’évolution de la tête du CF

Evolutionary emergence of the rac3b / rfng / sgca regulatory cluster refined mechanisms for hindbrain boundaries formation

International audienceDevelopmental programs often rely on parallel morphogenetic mechanisms that guarantee precise tissue architecture. While redundancy constitutes an obvious selective advantage, little is known on how novel morphogenetic mechanisms emerge during evolution. In zebrafish, rhombomeric boundaries behave as an elastic barrier, preventing cell intermingling between adjacent compartments. Here, we identify the fundamental role of the small-GTPase Rac3b in actomyosin cable assembly at hindbrain boundaries. We show that the novel rac3b/rfng/sgca regulatory cluster, which is specifically expressed at the boundaries, emerged in the Ostariophysi superorder by chromosomal rearrangement that generated new cis-regulatory interactions. By combining 4C-seq, ATAC-seq, transgenesis, and CRISPR-induced deletions, we characterized this regulatory domain, identifying hindbrain boundary-specific cis-regulatory elements. Our results suggest that the capacity of boundaries to act as an elastic mesh for segregating rhombomeric cells evolved by cooption of critical genes to a novel regulatory block, refining the mechanisms for hindbrain segmentation

The ubiquitin-like modifier FAT10 is induced in MASLD and impairs the lipid-regulatory activity of PPAR\u3b1

Abstract: Background and aims: Peroxisome Proliferator-Activated Receptor alpha (PPAR alpha) is a key regulator of hepatic lipid metabolism and therefore a promising therapeutic target against Metabolic-dysfunction Associated Steatotic Liver Diseases (MASLD). However, its expression and activity decrease during disease progression and several of its agonists did not achieve sufficient efficiency in clinical trials with, surprisingly, a lack of steatosis improvement. Here, we identified the Human leukocyte antigen-F Adjacent Transcript 10 (FAT10) as an inhibitor of PPAR alpha lipid metabolic activity during MASLD progression.Approach and results: In vivo, the expression of FAT10 is upregulated in human and murine MASLD livers upon disease progression and correlates negatively with PPAR alpha expression. The increase of FAT10 occurs in hepatocytes in which both proteins interact. FAT10 silencing in vitro in hepatocytes increases PPAR alpha target gene expression, promotes fatty acid oxidation and decreases intra-cellular lipid droplet content. In line, FAT10 overexpression in hepatocytes in vivo inhibits the lipid regulatory activity of PPAR alpha in response to fasting and agonist treatment in conditions of physiological and pathological hepatic lipid overload.Conclusions: FAT10 is induced during MASLD development and interacts with PPAR alpha resulting in a decreased lipid metabolic response of PPAR alpha to fasting or agonist treatment. Inhibition of the FAT10-PPAR alpha interaction may provide a means to design potential therapeutic strategies against MASLD

Composite cerebellar functional severity score: Validation of a quantitative score of cerebellar impairment

Reliable and easy to perform functional scales are a prerequisite for future therapeutic trials in cerebellar ataxias. In order to assess the specificity of quantitative functional tests of cerebellar dysfunction, we investigated 123 controls, 141 patients with an autosomal dominant cerebellar ataxia (ADCA) and 53 patients with autosomal dominant spastic paraplegia (ADSP). We evaluated four different functional tests (nine-hole pegboard, click, tapping and writing tests), in correlation with the scale for the assessment and rating of cerebellar ataxia (SARA), the scale of functional disability on daily activities (part IV of the Huntington disease rating scale), depression (the Public Health Questionnaire PHQ-9) and the EQ-5D visual analogue scale for self-evaluation of health status. There was a significant correlation between each functional test and a lower limb score. The performance of controls on the functional tests was significantly correlated with age. Subsequent analyses were therefore adjusted for this factor. The performances of ADCA patients on the different tests were significantly worse than that of controls and ADSP patients; there was no difference between ADSP patients and controls. Linear regression analysis showed that only two independent tests, the nine-hole pegboard and the click test on the dominant side (P < 0.0001), accounted for the severity of the cerebellar syndrome as reflected by the SARA scores, and could be represented by a composite cerebellar functional severity (CCFS) score calculated as follows: CCFS=log10(7+Z pegboard dominant hand/10+4×Z click dominant hand/10)The CCFS score was significantly higher in ADCA patients compared to controls (1.12 ± 0.18 versus 0.85 ± 0.05, Pc < 0.0001) and ADSP patients (1.12 ± 0.18 versus 0.90 ± 0.08, Pc < 0.0001) and was correlated with disease duration (P < 0.0001) but independent of self-evaluated depressive mood in ADCA. Among genetically homogeneous subgroups of ADCA patients (Spinocerebellar ataxia 1, 2, 3), SCA3 patients had significantly lower (better) CCFS scores than SCA2 (Pc < 0.04) and the same tendency was observed in SCA1. Their CCFS scores remained significantly worse than those of ADSP patients with identified SPG4 mutations (P < 0.0001). The pegboard and click tests are easy to perform and accurately reflect the severity of the disease. The CCFS is a simple and validated method for assessing cerebellar ataxia over a wide range of severity, and will be particularly useful for discriminating paucisymptomatic carriers from affected patients and for evaluating disease progression in future therapeutic trials. © The Author (2008). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

A randomized, multicentre, open-label phase II proof-of-concept trial investigating the clinical efficacy and safety of the addition of convalescent plasma to the standard of care in patients hospitalized with COVID-19: the Donated Antibodies Working against nCoV (DAWn-Plasma) trial

Abstract Background The COVID-19 pandemic has imposed an enormous burden on health care systems around the world. In the past, the administration of convalescent plasma of patients having recovered from SARS and severe influenza to patients actively having the disease showed promising effects on mortality and appeared safe. Whether or not this also holds true for the novel SARS-CoV-2 virus is currently unknown. Methods DAWn-Plasma is a multicentre nation-wide, randomized, open-label, phase II proof-of-concept clinical trial, evaluating the clinical efficacy and safety of the addition of convalescent plasma to the standard of care in patients hospitalized with COVID-19 in Belgium. Patients hospitalized with a confirmed diagnosis of COVID-19 are eligible when they are symptomatic (i.e. clinical or radiological signs) and have been diagnosed with COVID-19 in the 72 h before study inclusion through a PCR (nasal/nasopharyngeal swab or bronchoalveolar lavage) or a chest-CT scan showing features compatible with COVID-19 in the absence of an alternative diagnosis. Patients are randomized in a 2:1 ratio to either standard of care and convalescent plasma (active treatment group) or standard of care only. The active treatment group receives 2 units of 200 to 250 mL of convalescent plasma within 12 h after randomization, with a second administration of 2 units 24 to 36 h after ending the first administration. The trial aims to include 483 patients and will recruit from 25 centres across Belgium. The primary endpoint is the proportion of patients that require mechanical ventilation or have died at day 15. The main secondary endpoints are clinical status on day 15 and day 30 after randomization, as defined by the WHO Progression 10-point ordinal scale, and safety of the administration of convalescent plasma. Discussion This trial will either provide support or discourage the use of convalescent plasma as an early intervention for the treatment of hospitalized patients with COVID-19 infection. Trial registration ClinicalTrials.gov NCT04429854 .Registered on 12 June 2020 - Retrospectively registered.info:eu-repo/semantics/publishe