Treg Vaccination in Autoimmune Type 1 Diabetes

Foxp3⁺ regulatory T (Treg) cells are critical contributors to the establishment and maintenance of immunological self-tolerance. Autoimmune type 1 diabetes (T1D) is characterized by the loss of self-tolerance to the insulin-producing β cells in the pancreas and the destruction of β cells, resulting in the development of chronic hyperglycemia at diagnosis. The application of strong-agonistic T-cell receptor ligands provided under subimmunogenic conditions functions as a critical means for the efficient de novo conversion of naive CD4⁺ T cells into Foxp3⁺ Treg cells. The specific induction of Treg cells upon supply of strong-agonistic variants of certain self-antigens could therefore function as a critical instrument in order to achieve safe and specific prevention of autoimmunity such as T1D via the restoration of self-tolerance. Such immunotherapeutic strategies are being developed, and in the case of T1D aim to restrict autoimmunity and β-cell destruction. In this review, we discuss the requirements and opportunities for Treg-based tolerance approaches with the goal of interfering with autoimmune T1D.     

Metamemory with ageing in schizophrenia: A first study

The aim was to study metamemory during encoding in older schizophrenia patients. Thirteen older patients were compared to 13 healthy controls. Despite their memory impairment, older schizophrenia patients were able to assess the material accurately. They were not able, however, to adapt their learning time as efficiently as controls.     

The “employability” of disabled people in France: A labile and speculative notion to be tested against the empirical data from the 2008 “Handicap-Santé” study

Following the passage of the French law of 2005 on equal rights and opportunities, the issue of the “employability” of disabled people became a matter of public discussion. To clarify the debate, the article briefly presents the evolution of this notion and its various meanings, from the social sphere to employment policies. The concept of “employability” is then examined without any preconceived definition using empirical data from the national “Handicap-Santé” (disability-health) survey carried out in 2008 on the general population in France. Five groups illustrate employment patterns, social protection devices and types of disability: remaining employed until retirement; being employed thanks to social systems; leaving employment through “incapacity for work” systems; being employed through one's own resources; and being in sheltered employment or inactive. This construct provides keys to understand how “employability” manifests itself. The results show that, unlike the vision of employability that is focused on individual characteristics and promoted by employment policies in Europe, addressing employability in the domain of disability is only meaningful when considering individuals in their environments. The results also show that disability systems encourage forms of employability but still appear to favour access to inactivity through “incapacity for work”.     

Galactose uncovers face recognition and mental images in congenital prosopagnosia: The first case report

A woman in her early 40s with congenital prosopagnosia and attention deficit hyperactivity disorder observed for the first time sudden and extensive improvement of her face recognition abilities, mental imagery, and sense of navigation after galactose intake. This effect of galactose on prosopagnosia has never been reported before. Even if this effect is restricted to a subform of congenital prosopagnosia, galactose might improve the condition of other prosopagnosics. Congenital prosopagnosia, the inability to recognize other people by their face, has extensive negative impact on everyday life. It has a high prevalence of about 2.5%. Monosaccharides are known to have a positive impact on cognitive performance. Here, we report the case of a prosopagnosic woman for whom the daily intake of 5 g of galactose resulted in a remarkable improvement of her lifelong face blindness, along with improved sense of orientation and more vivid mental imagery. All these improvements vanished after discontinuing galactose intake. The self-reported effects of galactose were wide-ranging and remarkably strong but could not be reproduced for 16 other prosopagnosics tested. Indications about heterogeneity within prosopagnosia have been reported; this could explain the difficulty to find similar effects in other prosopagnosics. Detailed analyses of the effects of galactose in prosopagnosia might give more insight into the effects of galactose on human cognition in general. Galactose is cheap and easy to obtain, therefore, a systematic test of its positive effects on other cases of congenital prosopagnosia may be warranted.     

Market access of cancer drugs in European countries: improving resource allocation

Public health systems need to make well-founded choices in order to distribute their scarce resources in the most efficient way. Given the number of cancer patients, public/private investments in oncology research, the growing number of new anti-cancer agents and consequent budget impact of cancer care, market access of cancer drugs has become delicate over the last decade. Furthermore, decision makers are challenged by ethical objections and endeavour to provide fair and equal access to treatments for cancer patients. The aim of this study is to generate an overview of market access procedures for cancer drugs in eight European countries and formulate advice for improvement of resource allocation. Results are obtained through a literature review and a qualitative questionnaire and validated by experts with proven knowledge about procedures for price setting and reimbursement of drugs. Diverse measures are applied in the studied countries to optimize reimbursement of cancer drugs such as adjusted cost-effectiveness threshold, regulations for off-label use and new market access agreements. Additionally, innovative cancer drugs are excluded from explicit cost control measures such as payback of budget excess by pharmaceutical companies and lump-sum payments per diagnostic related groups (DRG) in the hospital. The results suggest that cancer is prioritized above other disease areas. Further research is necessary to address the question if society attaches higher value to cancer drugs than to treatments for other diseases.