Contrôle de la neuroinflammation par la kinase PKR dans les processus pathologiques de la maladie d'Alzheimer

Alzheimer's disease (AD) is the most common neurodegenerative disease leading to dementia. More than 3% of those over 65 years are affected. Pathological features of AD are β amyloid (Aβ) deposition and neurofibrillary tangles resulting in neuronal death, specifically in cortex and hippocampus. Brain inflammation is associated and involved in the neurodegeneration process. Murine models of endotoxemia show inflammation in the central nervous system as observed in humans. Using a model of endotoxemia by peripheral LPS injections in mice, we observed an activation of microglia, an increase of Aβ production and BACE1 expression and a decreased metabolism in the hippampus of LPS treated animals. These reactions are controlled by the stress kinase PKR (double stranded RNA-dependent protein kinase) whose invalidation exerts a neuroprotective effect in vivo. Aβ production in this model would be regulated by the PKR-dependent activation of the transcription factor STAT3, responsible for transcriptional control of BACE1. Activation of PKR is involved at several levels of the degenerative process associated with AD and has been identified as a potential diagnostic and prognostic biomarker of AD. These results confirm the role of PKR in the pathogenesis of AD and the interest of PKR down-regulation for therapeutic research.La maladie d’Alzheimer (MA) est la pathologie neurodégénérative entraînant une démence la plus fréquente. Elle touche plus de 3% des plus de 65 ans. Les lésions cérébrales qui la constituent sont les dépôts de substance β amyloïde (Aβ) et les dégénérescences neurofibrillaires responsables de la mort neuronale, en particulier dans le cortex et l’hippocampe. Ces lésions s’accompagnent d’une réaction inflammatoire centrale qui participe au processus de neurodégénérescence. Les modèles murins d’endotoxémie reproduisent une réaction inflammatoire du système nerveux central comme observé chez l’homme. Nous avons utilisé un modèle murin d’endotoxémie par injections périphériques de LPS et mis en évidence une activation microgliale, une augmentation de la production d’Aβ et de l’expression de BACE1 ainsi qu’une altération du métabolisme dans l’hippocampe des animaux en réponse au LPS. Ces réactions sont contrôlées par la kinase de stress PKR (double-stranded RNA-dependant protein kinase) dont l’invalidation exerce in vivo un effet neuroprotecteur. La production d’Aβ serait régulée dans ce modèle par l’activation PKR-dépendante du facteur de transcription STAT3, responsable du contrôle transcriptionnel de BACE1. L’activation de PKR a été retrouvée à plusieurs niveaux du processus dégénératif associé à la MA et a été identifiée comme un potentiel biomarqueur diagnostique et pronostique de la maladie. Nos résultats confirment le rôle de PKR dans la pathogénèse de la MA et l’intérêt de l’inhibition de PKR pour la recherche thérapeutique

Anti-proliferative and anti-tumour effects of lymphocyte-derived microparticles are neither species- nor tumour-type specific

Background: Unregulated cell proliferation or growth is a prominent characteristic of cancer. We have previously demonstrated that LMPs (cell membrane microparticles derived from apoptotic human CEM T lymphoma cells stimulated with actinomycin D) strongly suppress the proliferation of not only human endothelial cells but also mouse Lewis lung carcinoma cells. Methods: LMPs were generated either from CEM T cells using different stimuli or from 3 different types of lymphocytes. The effects of LMPs on cancer cell proliferation were examined using cell lines from different species and tissues. The cell cycle kinetics was evaluated by FACS and the expression of cell cycle-related genes was determined using quantitative RT-PCR. The in vivo anti-tumor effect of LMPs was investigated using xenografts and allografts. Results: LMPs at doses far above physiological levels dramatically suppressed the proliferation of cancer cells in a non species-specific manner. LMPs selectively target high proliferating cells and their anti-proliferative effect is not dependent on parental cell origin or stimuli. The anti-proliferative effect of LMPs was due to induction of cell-cycle arrest in G0/G1, with associated increases in expression of the cyclin-dependent kinase inhibitors p15INK4b, p16INK4a, and p21Cip1. In vivo, LMPs significantly suppressed tumor growth in animal tumor models. Conclusion: These results highlight the potential role of LMPs in modulating the growth of high proliferating cells. Given that cell-based therapies are considered less toxic than pharmacologic approaches and have the potential to target multiple pathways in a synergistic manner, LMPs may serve as a veritable option for cancer treatment

A phase 1 trial of SGNâ CD70A in patients with CD70â positive, metastatic renal cell carcinoma

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148406/1/cncr31912.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148406/2/cncr31912_am.pd

Clinical, radiologic, pathologic, and molecular characteristics of long-term survivors of diffuse intrinsic pontine glioma (DIPG): a collaborative report from the International and European Society for Pediatric Oncology DIPG registries

Purpose Diffuse intrinsic pontine glioma (DIPG) is a brainstem malignancy with a median survival of < 1 year. The International and European Society for Pediatric Oncology DIPG Registries collaborated to compare clinical, radiologic, and histomolecular characteristics between short-term survivors (STSs) and long-term survivors (LTSs). Materials and Methods Data abstracted from registry databases included patients from North America, Australia, Germany, Austria, Switzerland, the Netherlands, Italy, France, the United Kingdom, and Croatia. Results Among 1,130 pediatric and young adults with radiographically confirmed DIPG, 122 (11%) were excluded. Of the 1,008 remaining patients, 101 (10%) were LTSs (survival ≥ 2 years). Median survival time was 11 months (interquartile range, 7.5 to 16 months), and 1-, 2-, 3-, 4-, and 5-year survival rates were 42.3% (95% CI, 38.1% to 44.1%), 9.6% (95% CI, 7.8% to 11.3%), 4.3% (95% CI, 3.2% to 5.8%), 3.2% (95% CI, 2.4% to 4.6%), and 2.2% (95% CI, 1.4% to 3.4%), respectively. LTSs, compared with STSs, more commonly presented at age < 3 or > 10 years (11% v 3% and 33% v 23%, respectively; P < .001) and with longer symptom duration ( P < .001). STSs, compared with LTSs, more commonly presented with cranial nerve palsy (83% v 73%, respectively; P = .008), ring enhancement (38% v 23%, respectively; P = .007), necrosis (42% v 26%, respectively; P = .009), and extrapontine extension (92% v 86%, respectively; P = .04). LTSs more commonly received systemic therapy at diagnosis (88% v 75% for STSs; P = .005). Biopsies and autopsies were performed in 299 patients (30%) and 77 patients (10%), respectively; 181 tumors (48%) were molecularly characterized. LTSs were more likely to harbor a HIST1H3B mutation (odds ratio, 1.28; 95% CI, 1.1 to 1.5; P = .002). Conclusion We report clinical, radiologic, and molecular factors that correlate with survival in children and young adults with DIPG, which are important for risk stratification in future clinical trials

Therapeutic and Prognostic Implications of BRAF V600E in Pediatric Low-Grade Gliomas.

Purpose BRAF V600E is a potentially highly targetable mutation detected in a subset of pediatric low-grade gliomas (PLGGs). Its biologic and clinical effect within this diverse group of tumors remains unknown. Patients and Methods A combined clinical and genetic institutional study of patients with PLGGs with long-term follow-up was performed (N = 510). Clinical and treatment data of patients with BRAF V600E mutated PLGG (n = 99) were compared with a large international independent cohort of patients with BRAF V600E mutated-PLGG (n = 180). Results BRAF V600E mutation was detected in 69 of 405 patients (17%) with PLGG across a broad spectrum of histologies and sites, including midline locations, which are not often routinely biopsied in clinical practice. Patients with BRAF V600E PLGG exhibited poor outcomes after chemotherapy and radiation therapies that resulted in a 10-year progression-free survival of 27% (95% CI, 12.1% to 41.9%) and 60.2% (95% CI, 53.3% to 67.1%) for BRAF V600E and wild-type PLGG, respectively ( P \u3c .001). Additional multivariable clinical and molecular stratification revealed that the extent of resection and CDKN2A deletion contributed independently to poor outcome in BRAF V600E PLGG. A similar independent role for CDKN2A and resection on outcome were observed in the independent cohort. Quantitative imaging analysis revealed progressive disease and a lack of response to conventional chemotherapy in most patients with BRAF V600E PLGG. Conclusion BRAF V600E PLGG constitutes a distinct entity with poor prognosis when treated with current adjuvant therapy

Therapeutic and Prognostic Implications of BRAF V600E in Pediatric Low-Grade Gliomas

Purpose BRAF V600E is a potentially highly targetable mutation detected in a subset of pediatric low-grade gliomas (PLGGs). Its biologic and clinical effect within this diverse group of tumors remains unknown. Patients and Methods A combined clinical and genetic institutional study of patients with PLGGs with long-term follow-up was performed (N = 510). Clinical and treatment data of patients with BRAF V600E mutated PLGG (n = 99) were compared with a large international independent cohort of patients with BRAF V600E mutated-PLGG (n = 180). Results BRAF V600E mutation was detected in 69 of 405 patients (17%) with PLGG across a broad spectrum of histologies and sites, including midline locations, which are not often routinely biopsied in clinical practice. Patients with BRAF V600E PLGG exhibited poor outcomes after chemotherapy and radiation therapies that resulted in a 10-year progression-free survival of 27% (95% CI, 12.1% to 41.9%) and 60.2% (95% CI, 53.3% to 67.1%) for BRAF V600E and wild-type PLGG, respectively (P < .001). Additional multivariable clinical and molecular stratification revealed that the extent of resection and CDKN2A deletion contributed independently to poor outcome in BRAF V600E PLGG. A similar independent role for CDKN2A and resection on outcome were observed in the independent cohort. Quantitative imaging analysis revealed progressive disease and a lack of response to conventional chemotherapy in most patients with BRAF V600E PLGG. Conclusion BRAF V600E PLGG constitutes a distinct entity with poor prognosis when treated with current adjuvant therapy. (C) 2017 by American Society of Clinical Oncolog

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Involvement of PKR-mediated inflammation in Alzheimer's disease pathology

La maladie d’Alzheimer (MA) est la pathologie neurodégénérative entraînant une démence la plus fréquente. Elle touche plus de 3% des plus de 65 ans. Les lésions cérébrales qui la constituent sont les dépôts de substance β amyloïde (Aβ) et les dégénérescences neurofibrillaires responsables de la mort neuronale, en particulier dans le cortex et l’hippocampe. Ces lésions s’accompagnent d’une réaction inflammatoire centrale qui participe au processus de neurodégénérescence. Les modèles murins d’endotoxémie reproduisent une réaction inflammatoire du système nerveux central comme observé chez l’homme. Nous avons utilisé un modèle murin d’endotoxémie par injections périphériques de LPS et mis en évidence une activation microgliale, une augmentation de la production d’Aβ et de l’expression de BACE1 ainsi qu’une altération du métabolisme dans l’hippocampe des animaux en réponse au LPS. Ces réactions sont contrôlées par la kinase de stress PKR (double-stranded RNA-dependant protein kinase) dont l’invalidation exerce in vivo un effet neuroprotecteur. La production d’Aβ serait régulée dans ce modèle par l’activation PKR-dépendante du facteur de transcription STAT3, responsable du contrôle transcriptionnel de BACE1. L’activation de PKR a été retrouvée à plusieurs niveaux du processus dégénératif associé à la MA et a été identifiée comme un potentiel biomarqueur diagnostique et pronostique de la maladie. Nos résultats confirment le rôle de PKR dans la pathogénèse de la MA et l’intérêt de l’inhibition de PKR pour la recherche thérapeutique.Alzheimer's disease (AD) is the most common neurodegenerative disease leading to dementia. More than 3% of those over 65 years are affected. Pathological features of AD are β amyloid (Aβ) deposition and neurofibrillary tangles resulting in neuronal death, specifically in cortex and hippocampus. Brain inflammation is associated and involved in the neurodegeneration process. Murine models of endotoxemia show inflammation in the central nervous system as observed in humans. Using a model of endotoxemia by peripheral LPS injections in mice, we observed an activation of microglia, an increase of Aβ production and BACE1 expression and a decreased metabolism in the hippampus of LPS treated animals. These reactions are controlled by the stress kinase PKR (double stranded RNA-dependent protein kinase) whose invalidation exerts a neuroprotective effect in vivo. Aβ production in this model would be regulated by the PKR-dependent activation of the transcription factor STAT3, responsible for transcriptional control of BACE1. Activation of PKR is involved at several levels of the degenerative process associated with AD and has been identified as a potential diagnostic and prognostic biomarker of AD. These results confirm the role of PKR in the pathogenesis of AD and the interest of PKR down-regulation for therapeutic research