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Le Touquet – Paris-Plage, France

Ple C.,French Institute of Health and Medical Research | Ple C.,Institute Pasteur Of Lille | Ple C.,French National Center for Scientific Research | Ple C.,University of Lille Nord de France | And 40 more authors.

Pollution, including polycyclic aromatic hydrocarbons (PAH), may contribute to increased prevalence of asthma. PAH can bind to the Aryl hydrocarbon Receptor (AhR), a transcription factor involved in Th17/Th22 type polarization. These cells produce IL17A and IL-22, which allow neutrophil recruitment, airway smooth muscle proliferation and tissue repair and remodeling. Increased IL-17 and IL-22 productions have been associated with asthma. We hypothesized that PAH might affect, through their effects on AhR, IL-17 and IL-22 production in allergic asthmatics. Activated peripheral blood mononuclear cells (PBMCs) from 16 nonallergic nonasthmatic (NA) and 16 intermittent allergic asthmatic (AA) subjects were incubated with PAH, and IL-17 and IL-22 productions were assessed. At baseline, activated PBMCs from AA exhibited an increased IL-17/IL-22 profile compared with NA subjects. Diesel exhaust particle (DEP)-PAH and Benzo[a]Pyrene (B[a]P) stimulation further increased IL-22 but decreased IL-17A production in both groups. The PAH-induced IL-22 levels in asthmatic patients were significantly higher than in healthy subjects. Among PBMCs, PAHinduced IL-22 expression originated principally from single IL-22- but not from IL-17- expressing CD4 T cells. The Th17 transcription factors RORA and RORC were down regulated, whereas AhR target gene CYP1A1 was upregulated. IL-22 induction by DEP-PAH was mainly dependent upon AhR whereas IL-22 induction by B[a]P was dependent upon activation of PI3K and JNK. Altogether, these data suggest that DEP-PAH and B[a]P may contribute to increased IL22 production in both healthy and asthmatic subjects through mechanisms involving both AhR -dependent and -independent pathways. © 2015 Plé et al. Source

Piper A.J.,Royal Prince Alfred Hospital | Piper A.J.,Woolcock Institute of Medical Research | Gonzalez-Bermejo J.,Groupe Hospitalier Pitie Salpetriere Charles Foix | Gonzalez-Bermejo J.,French Institute of Health and Medical Research | Janssens J.-P.,University of Geneva
Sleep Medicine Clinics

Nocturnal hypoventilation is an early manifestation of progressive hypercapnic respiratory failure in a range of disorders affecting the respiratory system. Identifying sleep-breathing abnormalities early can help plan treatment options and avoid unexpected sudden decompensation. Although daytime measures are widely used to identify individuals at high risk of hypoventilating during sleep, they are limited in their ability to detect hypercapnia confined to sleep. However, daytime evaluation can assist in determining the most appropriate time to undertake more complex nocturnal monitoring to achieve a positive finding. Advances in technology, particularly in continuous CO2 monitoring techniques, are increasing our ability to identify and quantify nocturnal hypoventilation not only in supervised settings but also increasingly in the home. © 2014 Elsevier Inc. All rights reserved. Source

Nau A.,Groupe Hospitalier Pitie Salpetriere Charles Foix | Hadj M.,Groupe Hospitalier Pitie Salpetriere Charles Foix | Raux M.,Groupe Hospitalier Pitie Salpetriere Charles Foix | Raux M.,French Institute of Health and Medical Research
Praticien en Anesthesie Reanimation

Respiratory complications are common after surgery. Several complex mechanisms such as postoperative diaphragmatic dysfunction, ventilation perfusion mismatching, atelectasis and pulmonary infection are responsible for such complications. Several scoring scales allow to evaluate the risk of postoperative pulmonary complications that depends especially of the surgical procedure performed (upper abdominal and thoracic surgery). Smoking cessation as soon as possible, chest physiotherapy, incitative spirometry and peroperative protective ventilation are the main preventive measures. Postoperative epidural analgesia plays a role but its impact is vanishing with the decreasing incidence of respiratory complications. Non-invasive ventilation, incitative spirometry and physiotherapy need to be maintained postoperatively in patients at risk. © 2016 Elsevier Masson SAS. Source

Rossi A.,University of Verona | Aisanov Z.,Pulmonology Research Institute | Avdeev S.,Pulmonology Research Institute | Di Maria G.,University of Catania | And 9 more authors.
Respiratory Medicine

The main complaint of patients with chronic obstructive pulmonary disease (COPD) is shortness of breath with exercise, that is usually progressive. The principal mechanism that explains this symptom is the development of lung hyperinflation (LH) which is defined by an increase of functional residual capacity (FRC) above predicted values. Patients with COPD may develop static LH (sLH) because of destruction of pulmonary parenchyma and loss of elastic recoil. In addition, dynamic LH (dLH) develops when patients with COPD breathe in before achieving a full exhalation and, as a consequence, air is trapped within the lungs with each further breath. Dynamic LH may also occur at rest but it becomes clinically relevant during exercise and exacerbation. Lung hyperinflation may have an impact beyond the lungs and the effects of LH on cardiovascular function have been extensively analysed. The importance of LH makes its identification and measurement crucial. The demonstration of LH in COPD leads to the adoption of strategies to minimise its impact on the daily activities of patients. Several strategies reduce the impact of LH; the use of long-acting bronchodilators has been shown to reduce LH and improve exercise capacity. Non pharmacologic interventions have also been demonstrated to be useful. This article describes the pathophysiology of LH, its impact on the lungs and beyond and reviews the strategies that improve LH in COPD. © 2015 Elsevier Ltd. Source

Spano J.P.,Groupe Hospitalier Pitie Salpetriere Charles Foix | Spano J.P.,French Institute of Health and Medical Research | Spano J.P.,Paris-Sorbonne University | Poizot-Martin I.,Aix - Marseille University | And 20 more authors.
Annals of Oncology

Malignancies represent a major cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected patients. The introduction of combined antiretroviral therapy has modified the spectrum of malignancies in HIV infection with a decreased incidence of acquired immunodeficiency syndrome (AIDS) malignancies such as Kaposi's sarcoma and non-Hodgkin's lymphoma due to partial immune recovery and an increase in non-AIDS-defining malignancies due to prolonged survival. Management of HIV-infected patients with cancer requires a multidisciplinary approach, involving both oncologists and HIV physicians to optimally manage both diseases and drug interactions between anticancer and anti-HIV drugs. The French CANCERVIH group presents here a review and an experience of managing non-AIDS malignancies in HIV-infected individuals. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. Source

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