Détermination des seuils de réactivité au cours des allergies alimentaires

It is important for an individual allergic to food to be aware of the threshold (the minimal amount) of the allergenic food that can trigger a reaction. This information is equally essential to the food-processing industry for labeling of pre-packaged foodstuffs. Three methods are available to determine the threshold: case reports, statistical methods and oral provocation tests. Published data available at present allow only limited analysis for three foods (cow milk, chicken egg and peanut). In addition, the absence of standardized oral provocation tests limits determination of thresholds.     

Lymphocytes T régulateurs et maladies auto-immunes systémiques : lupus érythémateux systémique,polyarthrite rhumatoïde et syndrome de Gougerot-Sjögren primaire

Regulatory/suppressor T cells (Tregs) maintain immunologic homeostasis and prevent autoimmunity. They are the guardians of dominant tolerance. Recent research reveals quantitative and/or functional defect of Tregs in systemic autoimmune diseases. In this article, past and recent studies of Tregs in human systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and primary Sjögren's syndrome (pGSS) are reviewed. Most studies report that Tregs are decreased in peripheral blood of subjects with active SLE. A population of CD4+CD25−Foxp3+ is specifically described in SLE. Tregs functions are still discussed. Tregs counts in peripheral blood of RA patients vary across studies. Enrichment of synovial fluid in Tregs contrasts with inflammation. Tregs suppressive effects are altered in vivo in RA secondary to proinflammatory cytokines environment and resistance of effector T cells to Tregs. In pGSS, the conflicting place of Tregs in the balance prevention of autoimmunity/antitumor immunity is unspecified. Immunosuppressive treatments, like corticosteroids and anti-TNF, modulate Tregs cells population. There is increasing interest in the use of Tregs as a biological therapy to preserve and restore tolerance to self-antigen. However, difficulties to characterize these lymphocytes and controversies in the results of studies refrain their use in current clinical practice.     

Actualités sur la prise en charge de l’hyperplasie bénigne de la prostate. Quel adénome traiter et comment ?

Benign prostatic hyperplasia is a state of the nature rather than a disease. It affects mainly men over 50 years and represents a public health problem. A literature review on the therapeutic management of benign prostatic hyperplasia was carried out from a selection of publications with the highest level of evidence. Medical treatment is based on herbal medicine, alpha-blockers and 5-alpha-reductase inhibitors. Surgical treatment is used in case of complications or failure of medical management. Surgical options are numerous. Transurethral prostate resection and prostate adenomectomy are the most usual procedures. Due to their significant morbidity, other less invasive procedures have recently been developed. The choice of treatment will depend on prostate volume and anatomy and patient's comorbidities.     

Les facteurs de risque et le problème de la démarcation entre le normal et le pathologique : une analyse épistémologique

The fact that numerous risk factors are continuous raises the problem of the boundary between the normal and the pathological states. Moreover, a risk factor approach to disease deeply calls into question the relevance of these concepts. In this paper, I propose an epistemological analysis of the notion of “continuity” as it is used in the context of “risk factor epidemiology”.