« Anticorps anti-TNF,quelles applications,quels effets secondaires ? »

TNF-α is a pivotal cytokine with pleiotropic effects in the innate and adaptive immune systems. Clinically, two strategies have been developed to neutralize it: monoclonal anti-TNF-α antibodies and a recombinant protein containing the p75 receptor. These products have been shown to be remarkably efficacious in the treatment of certain autoimmune and inflammatory conditions, in particular, in rheumatoid arthritis, spondyloarthropathies and psoriasis, and the monoclonal antibody in Crohn's disease; this list of diseases is constantly growing. Inhibitors of TNF-α are generally well tolerated, but there is still a lack of data on their long-term tolerance, for example, concerning lymphoproliferative syndromes. Most of the studies have revealed an increase in the susceptibility to certain infections, in particular, intracellular pathogens such as Mycobacterium tuberculosis. It is now clear that TNF-α inhibitors are not equivalent with respect to both their therapeutic efficacy and their adverse effects. Better appreciation of the mechanisms responsible for these differences is an important challenge, not only to sharpen their therapeutic indications but also to begin new research programs aimed at the development of new generations of biotherapies that are more efficacious and better tolerated than those presently available.     

Clinical trials update from the American College of Cardiology 2009: ADMIRE‐HF,PRIMA, STICH,REVERSE, IRIS,partial ventricular support,FIX‐HF‐5, vagal stimulation,REVIVAL‐3, pre‐RELAX‐AHF,ACTIVE‐A,HF‐ACTION,JUPITER, AURORA,and OMEGA

This article provides information and a commentary on trials relevant to the pathophysiology, prevention and treatment of heart failure presented at the American College of Cardiology meeting in 2009. Unpublished reports should be considered as preliminary, since analyses may change in the final publication. ¹²³I‐mIBG myocardial scintigraphy was a good predictor of mortality in patients with heart failure in ADMIRE‐HF. In PRIMA, use of individualized target NT‐proBNP levels failed to improve outcomes compared with usual care in patients hospitalized with symptomatic heart failure. In the STICH trial, additional ventricular reconstruction surgery failed to improve outcomes in patients with ischaemic heart failure undergoing CABG. Cardiac resynchronization therapy may modify disease progression in patients with mild heart failure, according to data from REVERSE. Implantation of a defibrillator early after MI in high‐risk patients in the IRIS study failed to improve outcomes compared with usual care. Cardiac contractility modulation showed some beneficial effects on symptoms and exercise capacity in the unblinded FIX‐HF‐5 study. Data from pre‐RELAX‐AHF show that relaxin may have potential as a treatment for acute heart failure. HF‐ACTION showed that patients who complied with an exercise training regime achieved a better outcome, although this may be confounded by the ability of patients with a good prognosis to exercise for longer.     

Parasites of carp bream, <Emphasis Type="Italic">Abramis brama</Emphasis>, from Lake Jamno,Poland

Summary A total of 40 carp bream, Abramis brama (L.) from Lake Jamno were examined for their parasites in May 2002. Lake Jamno is a brackish-water coastal lagoon, strongly eutrophied and polluted by communal and industrial sewage from the city of Koszalin. The survey yielded 15 parasite species, representing different systematic groups, including 7 monogeneans Dactylogyrus auriculatus, D. falcatus, D. wunderi, D. zandti, Gyrodactylus elegans, Gyrodactylus sp., Diplozoon paradoxum; 4 digeneans (at the stage of metacercaria) Diplostomum sp., Tylodelphys clavata, Ichthyocotylurus platycephalus, I. variegatus; 1 cestode Caryophyllaeus laticeps; 2 crustaceans Ergasilus sieboldi, Argulus foliaceus; and 1 hirudinean Caspiobdella fadejewi. Monogeneans constituted the most abundant parasite group, accounting for 61.5 % of all parasite individuals collected. They were followed by the cestodes (20.7 %), digenean flukes (16 %), crustaceans (0.7 %), and leeches (0.2 %).     

Alternaria,Cladosporium : dispersion atmosphérique,rythmes nycthéméral et saisonnier

Are respiratory allergies due to atmospheric moulds a myth or a reality? The aim of the present report is to present the results obtained by the National Network of Aerobiology Monitoring (RNSA) from traps that are distributed throughout France. The results show both geographical and inter-annual variability of the dispersion of the principal airborne allergenic moulds, Alternaria and Cladosporium. Likewise, the intensity of the emission of these moulds throughout the day is not regular, and it has often been noted that there are hourly peaks, which are concomitant with certain peaks of air pollution.     

Genes, peoples, and languages

The genetic history of a group of populations is usually analyzed by reconstructing a tree of their origins. Reliability of the reconstruction depends on the validity of the hypothesis that genetic differentiation of the populations is mostly due to population fissions followed by independent evolution. If necessary, adjustment for major population admixtures can be made. Dating the fissions requires comparisons with paleoanthropological and paleontological dates, which are few and uncertain. A method of absolute genetic dating recently introduced uses mutation rates as molecular clocks; it was applied to human evolution using microsatellites, which have a sufficiently high mutation rate. Results are comparable with those of other methods and agree with a recent expansion of modern humans from Africa. An alternative method of analysis, useful when there is adequate geographic coverage of regions, is the geographic study of frequencies of alleles or haplotypes. As in the case of trees, it is necessary to summarize data from many loci for conclusions to be acceptable. Results must be independent from the loci used. Multivariate analyses like principal components or multidimensional scaling reveal a number of hidden patterns and evaluate their relative importance. Most patterns found in the analysis of human living populations are likely to be consequences of demographic expansions, determined by technological developments affecting food availability, transportation, or military power. During such expansions, both genes and languages are spread to potentially vast areas. In principle, this tends to create a correlation between the respective evolutionary trees. The correlation is usually positive and often remarkably high. It can be decreased or hidden by phenomena of language replacement and also of gene replacement, usually partial, due to gene flow.