Mathurin P.,Universitelille Nord Of France |
Moreno C.,Universitelibre Of Bruxelles |
Samuel D.,Center Hepato Biliaire |
Samuel D.,University Paris - Sud |
And 21 more authors.
New England Journal of Medicine | Year: 2011
BACKGROUND: A 6-month abstinence from alcohol is usually required before patients with severe alcoholic hepatitis are considered for liver transplantation. Patients whose hepatitis is not responding to medical therapy have a 6-month survival rate of approximately 30%. Since most alcoholic hepatitis deaths occur within 2 months, early liver transplantation is attractive but controversial. METHODS: We selected patients from seven centers for early liver transplantation. The patients had no prior episodes of alcoholic hepatitis and had scores of 0.45 or higher according to the Lille model (which calculates scores ranging from 0 to 1, with a score ≥0.45 indicating nonresponse to medical therapy and an increased risk of death in the absence of transplantation) or rapid worsening of liver function despite medical therapy. Selected patients also had supportive family members, no severe coexisting conditions, and a commitment to alcohol abstinence. Survival was compared between patients who underwent early liver transplantation and matched patients who did not. RESULTS:In all, 26 patients with severe alcoholic hepatitis at high risk of death (median Lille score, 0.88) were selected and placed on the list for a liver transplant within a median of 13 days after nonresponse to medical therapy. Fewer than 2% of patients admitted for an episode of severe alcoholic hepatitis were selected. The centers used 2.9% of available grafts for this indication. The cumulative 6-month survival rate (±SE) was higher among patients who received early transplantation than among those who did not (77±8% vs. 23±8%, P<0.001). This benefit of early transplantation was maintained through 2 years of follow-up (hazard ratio, 6.08; P = 0.004). Three patients resumed drinking alcohol: one at 720 days, one at 740 days, and one at 1140 days after transplantation. CONCLUSIONS:Early liver transplantation can improve survival in patients with a first episode of severe alcoholic hepatitis not responding to medical therapy. Copyright © 2011 Massachusetts Medical Society.
Fournier A.,French Institute of Health and Medical Research |
Fournier A.,UniversiteJoseph Fourier Grenoble I |
McLeer-Florin A.,French Institute of Health and Medical Research |
McLeer-Florin A.,UniversiteJoseph Fourier Grenoble I |
And 52 more authors.
EMBO Molecular Medicine | Year: 2010
Epigenetic perturbations are increasingly described in cancer cells where they are thought to contribute to deregulated gene expression and genome instability. Here, we report the first evidence that a distinct category of chromosomal translocations observed in human tumours-those targeting 1q12 satellite DNA-can directly mediate such perturbations by promoting the formation of aberrant heterochromatic foci (aHCF). By detailed investigations of a 1q12 translocation to chromosome 2p, in a case of human B cell lymphoma, aberrant aHCF were shown to be localized to the nuclear periphery and to arise as a consequence of long range 'pairing' between the translocated 1q12 and chromosome 2 centromeric regions. Remarkably, adjacent 2p sequences showed increased levels of repressive histone modifications, including H4K20me3 and H3K9me3, and were bound by HP1. aHCF were associated to aberrant spatial localization and deregulated expression of a novel 2p gene (GMCL1) that was found to have prognostic impact in diffuse large B cell lymphoma. Thus constitutive heterochromatin rearrangements can contribute to tumourigenesis by perturbing gene expression via long range epigenetic mechanisms. © 2010 EMBO Molecular Medicine.
Berezowski V.,Universitelille Nord Of France |
Berezowski V.,University of Artois |
Berezowski V.,University of Lille Nord de France |
Mysiorek C.,Universitelille Nord Of France |
And 11 more authors.
Biologie Aujourd'hui | Year: 2012
Since it was discovered and its brain-protective role characterized, the blood-brain barrier (BBB), through the permeability-restricting action of the brain capillary endothelial cells, has been representing a hurdle for 95% of new medical compounds targeting the central nervous system. Recently, a BBB dysfunction is being found in an increasing number of pathologies such as brain ischaemic stroke, whose only therapy consists in a pharmacological thrombolysis limited to a small percentage of the admitted patients, because of the toxical effects of thrombolytics. And since the clinical failure of promising neuroprotectants, numerous studies of brain ischaemia were carried out, with physiopathological or pharmacological approaches refocused on the BBB, whose structural complexity is now expanded to perivascular cells, all forming a functional unit named the neurovascular unit (NVU). Nevertheless, in spite of the numerous molecular mechanisms identified, the process of BBB dysfunction in the ischaemia/reperfusion cascade remains insufficiently established to explain the pleiotropic action exerted by new pharmacological compounds, possibly protecting the entire NVU and representing potential treatments. ©2012 Société de Biologie.
Fovet T.,Universitelille Nord Of France |
Amad A.,Universitelille Nord Of France |
Geoffroy P.A.,Universitelille Nord Of France |
Geoffroy P.A.,French Institute of Health and Medical Research |
And 2 more authors.
Information Psychiatrique | Year: 2014
Currently, the significant place of general practitioners in the management of patients with psychiatric disorders, contrasts with their insufficient training in psychiatry. In this article, we describe psychiatric training in the various courses for general practitioners in France, from the first to the third cycle of medical studies, and beyond (during their medical career). We also suggest potential areas of improvement to develop innovative ways of teaching psychiatry and particularly emphasize the new technologies and simulation-based strategies offering promising perspectives in these areas.
Machut-Binkowski C.,Universitelille Nord Of France |
Machut-Binkowski C.,University of Artois |
Machut-Binkowski C.,CNRS Laboratory of Catalysis and Solid State Chemistry |
Legrand F.-X.,Universitelille Nord Of France |
And 9 more authors.
Chemistry - A European Journal | Year: 2010
A new diphenylphosphane based on a β-cyclodextrin skeleton that exhibits a dual solubility in water and in organic solvent was synthesised. Interestingly, a solvent-dependent conformation change was evidenced by NMR spectroscopy studies; the self-inclusion of a phenyl group of the phosphane moiety into cyclodextrin cavity observed in water disappeared in organic solvents due to a change in conformation. Hydrogenation or hydroformylation reactions performed in water and in organic solvents showed that this ligand was able to stabilise catalytically active rhodium species in solution. In the case of the hydroformylation reaction, it was demonstrated that regioselectivity was influenced by the solventdependent conformation of the ligand. © 2010 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
Fernandez E.M.,Universitelille Nord Of France |
Valenti V.,Universitelille Nord Of France |
Rockel C.,University of Konstanz |
Hermann C.,University of Konstanz |
And 4 more authors.
Gut | Year: 2011
Background and aims: Inflammatory bowel disease (IBD) has been linked to a loss of tolerance towards the resident microflora. Therapeutic use of probiotics is known to be strain specific, but precise mechanisms remain unclear. The role of NOD2 signalling and the protective effect of Lactobacillus peptidoglycan (PGN) and derived muropeptides in experimental colitis were evaluated. Methods: The anti-inflammatory capacity of lactobacilli and derived bacterial compounds was evaluated using the 2,4,6-trinitrobenzene sulfonic acid (TNBS) colitis model. The role of NOD2, MyD88 and interleukin 10 (IL-10) in this protection was studied using Nod2-/-, MyD88-/- and Il10-deficient mice, while induction of regulatory dendritic cells (DCs) was monitored through the expansion of CD103+ DCs in mesenteric lymph nodes or after adoptive transfer of bone marrow-derived DCs. The development of regulatory T cells was investigated by following the expansion of CD4+FoxP3+ cells. High-performance liquid chromatography and mass spectrometry were used to analyse the PGN structural differences. Results: The protective capacity of strain Lactobacillus salivarius Ls33 was correlated with a local IL-10 production and was abolished in Nod2-deficient mice. PGN purified from Ls33 rescued mice from colitis in an IL-10-dependent manner and favoured the development of CD103+ DCs and CD4+Foxp3+ regulatory T cells. In vitro Ls33 PGN induced IL-10-producing DCs able to achieve in vivo protection after adoptive transfer in a NOD2-dependent way. This protection was also correlated with an upregulation of the indoleamine 2,3-dioxygenase immunosuppressive pathway. The protective capacity was not obtained with PGN purified from a non-anti-inflammatory strain. Structural analysis of PGNs highlighted in Ls33 the presence of an additional muropeptide, M-tri-Lys. The synthesised ligand protected mice from colitis in a NOD2-dependent but MyD88-independent manner. Conclusions: The results indicated that PGN and derived muropeptides are active compounds in probiotic functionality and might represent a useful therapeutic strategy in IBD.
Mysoet J.,Universitelille Nord Of France |
Mysoet J.,UniversiteLille 1 |
Canu M.-H.,Universitelille Nord Of France |
Canu M.-H.,UniversiteLille 1 |
And 6 more authors.
PLoS ONE | Year: 2014
A chronic reduction in neuromuscular activity through prolonged body immobilization in human alters motor task performance through a combination of peripheral and central factors. Studies performed in a rat model of sensorimotor restriction have shown functional and biochemical changes in sensorimotor cortex. However, the underlying mechanisms are still unclear. Interest was turned towards a possible implication of Insulin-like Growth Factor 1 (IGF-1), a growth factor known to mediate neuronal excitability and synaptic plasticity by inducing phosphorylation cascades which include the PI3K-AKT pathway. In order to better understand the influence of IGF-1 in cortical plasticity in rats submitted to a sensorimotor restriction, we analyzed the effect of hindlimb unloading on IGF-1 and its main molecular pathway in structures implied in motor control (sensorimotor cortex, striatum, cerebellum). IGF-1 level was determined by ELISA, and phosphorylation of its receptor and proteins of the PI3K-AKT pathway by immunoblot. In the sensorimotor cortex, our results indicate that HU induces a decrease in IGF-1 level; this alteration is associated to a decrease in activation of PI3K-AKT pathway. The same effect was observed in the striatum, although to a lower extent. No variation was noticed in the cerebellum. These results suggest that IGF-1 might contribute to cortical and striatal plasticity induced by a chronic sensorimotor restriction. © 2014 Mysoet et al.