Morphological variability of the shape of striped red mullet Mullus surmuletus in relation to stock discrimination between the Bay of Biscay and the eastern English Channel

Truss analysis and length measurements were made on 168 striped red mullet Mullus surmuletus. Multivariate statistical analyses with principal component analysis and partial redundancy analysis (pRDA) were used on these measurements to evaluate the influence of maturity, sex and geographical area distribution on body shape. Truss measurements were important to quantify and discriminate changing body shape, presumably due to changing environmental conditions. Sexual dimorphism was not observed and juveniles could be distinguished from adults based on their body shape. More importantly, M. surmuletus occurring in different geographical areas could be differentiated using this method. Based on pRDA, a significant difference of head morphological dimensions was observed between populations occurring in the eastern English Channel and those occurring in the Bay of Biscay, suggesting that fish from these areas could represent two subpopulations.

[Muscle biopsy in children: Usefulness in 2012]

Muscle biopsy is a mainstay diagnostic tool for investigating neuromuscular disorders in children. We report the yield of pediatric muscle biopsy in a population of 415 children by a retrospective study of 419 biopsies performed between 1/01/2000 and 31/12/2009 in a neuropediatric department, including mitochondrial respiratory chain analysis for 87 children. Two hundred and fifty-five biopsies were from boys (61%) 164 from girls (39%). Their mean age at biopsy was 6.5years; 155 (37%) biopsies were obtained before the child was 5years old. Final histopathological diagnoses were: congenital myopathy (n=193, including 15 structural congenital myopathies); progressive muscular dystrophy (n=75 [18%] including 57 dystrophinopathies); congenital muscular dystrophy (n=17, including six primary merosinopathies); dermatomyositis (n=11); spinal muscular atrophy (n=9, including six atypical spinal muscular atrophies); metabolic myopathy (n=32, including 19 mitochondrial myopathies); encephalomyopathy (n=53 [13%], including 27 with a mitochondrial respiratory chain defect). Pathological diagnosis remained undetermined in 16 cases. In 184 patients (44%), the muscle biopsy revealed specific histopathological anomalies (dystrophic process; specific ultrastructural abnormalities; perifascicular atrophy; neurogenic atrophy; metabolic anomalies) enabling a precise etiological diagnosis. For 85% of progressive muscular dystrophies, the biopsy resulted in a genetic diagnosis after identification of the protein defect. In 15% of the congenital myopathies, histopathological anomalies focused attention on one or several genes. Concerning dystrophinopathies, quantification of dystrophin deficiency on the biopsy specimen contributed to the definition of the clinical phenotype: Duchenne, or Becker. In children with a myopathy, muscle biopsy is often indispensable to establish the etiological diagnosis. Based on the results from this series, muscle biopsy can provide a precise orientation in 45% of patients, leading to a genetic hypothesis.

Vitamin D deficiency is associated with greater tumor size and poorer outcome in Merkel cell carcinoma patients

BACKGROUND

Merkel cell polyomavirus has been recognized to be associated with Merkel cell carcinoma (MCC), but the evolution of this cancer probably depends on various factors. Vitamin D deficiency, defined by serum 25-hydroxyvitamin D levels <50 nmol/L, seems to influence cancer behavior and progression, but has never been assessed in MCC patients.

OBJECTIVES

First, to evaluate whether vitamin D deficiency was associated with tumor characteristics and prognosis in a cohort of MCC patients. Second, to assess expression of the vitamin D receptor (VDR) in MCC tumors.

METHODS

Clinical findings, Merkel cell polyomavirus markers and vitamin D status were assessed in a cohort of French MCC patients. The study was limited to the 89 patients for whom the serum sample had been collected within 3 years after the diagnosis of MCC. Correlation between vitamin D deficiency and MCC characteristics and outcome were determined in regression analyses. VDR expression in MCC tumours was assessed by immunohistochemistry.

RESULTS

Vitamin D deficiency was noted in 65.1% of the patients and was independently associated with greater tumor size at diagnosis (P = 0.006) and with metastasis recurrence (HR, 2.89; 95% CI, 1.03 to 8.13; P = 0.043), but not with death from MCC, although there was a trend (HR, 5.28; 95% CI, 0.75 to 36.96; P = 0.093). VDR was found to be strongly expressed in all 28 MCC tumor specimens investigated.

CONCLUSION

The association between vitamin D deficiency and MCC characteristics and outcome, together with detection of the VDR in MCC cells, suggest that vitamin D could influence the biology of MCC.

Protein turnover, amino acid requirements and recommendations for athletes and active populations

Skeletal muscle is the major deposit of protein molecules. As for any cell or tissue, total muscle protein reflects a dynamic turnover between net protein synthesis and degradation. Noninvasive and invasive techniques have been applied to determine amino acid catabolism and muscle protein building at rest, during exercise and during the recovery period after a single experiment or training sessions. Stable isotopic tracers (¹³C-lysine, ¹⁵N-glycine, ²H₅-phenylalanine) and arteriovenous differences have been used in studies of skeletal muscle and collagen tissues under resting and exercise conditions. There are different fractional synthesis rates in skeletal muscle and tendon tissues, but there is no major difference between collagen and myofibrillar protein synthesis. Strenuous exercise provokes increased proteolysis and decreased protein synthesis, the opposite occurring during the recovery period. Individuals who exercise respond differently when resistance and endurance types of contractions are compared. Endurance exercise induces a greater oxidative capacity (enzymes) compared to resistance exercise, which induces fiber hypertrophy (myofibrils). Nitrogen balance (difference between protein intake and protein degradation) for athletes is usually balanced when the intake of protein reaches 1.2 g·kg⁻¹·day⁻¹ compared to 0.8 g·kg⁻¹·day⁻¹ in resting individuals. Muscular activities promote a cascade of signals leading to the stimulation of eukaryotic initiation of myofibrillar protein synthesis. As suggested in several publications, a bolus of 15-20 g protein (from skimmed milk or whey proteins) and carbohydrate (± 30 g maltodextrine) drinks is needed immediately after stopping exercise to stimulate muscle protein and tendon collagen turnover within 1 h.

Inhibitory effects of cyclosporine on human regulatory T cells in vitro

BACKGROUND

Inevitable hepatitis C virus (HCV) recurrence after liver transplantation is a major barrier to the survival of a transplanted liver. It may be promoted by immunosuppression and the emergence of CD4+CD25+ regulatory T cells (Treg). Treg cells can mediate the induction and maintenance of immunological self-tolerance as well as transplant tolerance. We investigated the effects of cyclosporine (CsA), a widely used immunosuppressive agent, on human CD4+CD25+ Treg cells.

METHODS

Human CD4+CD25+ cells isolated from healthy donors were cultured in the presence of 40 or 400 ng/mL CsA. The suppressive activity of Treg was assessed in mixed leukocyte reactions (MLR) using CD25+ and autologous activated peripheral blood mononuclear cells (PBMC). Phenotype analysis (flow cytometric, Q-PCR) and cytokine production (ELISA) of Treg cells were then performed on cultures.

RESULTS

CsA (40 or 400 ng/mL) inhibited the proliferative capacity of PBMC and CD4+CD25+ Treg in a dose-dependent manner. Interestingly, addition of 40 ng/mL CsA in MLR impaired the suppressive activity of CD4+CD25+ cells, whereas a higher dose of CsA had no effect on Treg function. It appears that a therapeutic dose of CsA (40 ng/mL) did not change the phenotype of CD4+CD25+ T cells, but altered Treg activity by switching the regulatory to an inflammatory cytokine profile.

CONCLUSION

CsA significantly impaired the function of CD4+CD25+ Treg cells by inducing interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) secretion. The present studies suggested that CsA may block the induction of immune tolerance and decrease the risk of hepatitis C recurrence.

Increased expression of regulatory Tr1 cells in recurrent hepatitis C after liver transplantation

Immune response failure during HCV infection has been associated with the activity of regulatory T cells. Hepatitis C-related cirrhosis is the main reason for liver transplantation. However, 80% of transplanted patients present an accelerated recurrence of the disease. This study assessed the involvement of regulatory T-cell subsets (CD4+CD25+ cells: 'Treg' and CD49b+CD18+ cells: 'T regulatory-1' cells), in the recurrence of HCV after liver transplantation, using transcriptomic analysis, ELISA assays on serum samples and immunohistochemistry on liver biopsies from liver recipients 1 and 5 years after transplantation. Three groups of patients were included: stable HCV-negative recipients and those with mild and severe hepatitis C recurrence. At 5 years, Treg markers were overexpressed in all HCV+ recipients. By contrast, Tr1 markers were only overexpressed in patients with severe recurrence. At 1 year, a trend toward the overexpression of Tr1 was noted in patients evolving toward severe recurrence. IL-10 production, a characteristic of the Tr1 subset, was enhanced in severe recurrence at both 1 and 5 years. These results suggest that Tr1 are enhanced during severe HCV recurrence after liver transplantation and could be predictive of HCV recurrence. High levels of IL-10 at 1 year could be predictive of severe recurrence, and high IL-10 producers might warrant more intensive management.

Increased expression of regulatory Tr1 cells in recurrent hepatitis C after liver transplantation

Immune response failure during HCV infection has been associated with the activity of regulatory T cells. Hepatitis C-related cirrhosis is the main reason for liver transplantation. However, 80% of transplanted patients present an accelerated recurrence of the disease. This study assessed the involvement of regulatory T-cell subsets (CD4+CD25+ cells: 'Treg' and CD49b+CD18+ cells: 'T regulatory-1' cells), in the recurrence of HCV after liver transplantation, using transcriptomic analysis, ELISA assays on serum samples and immunohistochemistry on liver biopsies from liver recipients 1 and 5 years after transplantation. Three groups of patients were included: stable HCV-negative recipients and those with mild and severe hepatitis C recurrence. At 5 years, Treg markers were overexpressed in all HCV+ recipients. By contrast, Tr1 markers were only overexpressed in patients with severe recurrence. At 1 year, a trend toward the overexpression of Tr1 was noted in patients evolving toward severe recurrence. IL-10 production, a characteristic of the Tr1 subset, was enhanced in severe recurrence at both 1 and 5 years. These results suggest that Tr1 are enhanced during severe HCV recurrence after liver transplantation and could be predictive of HCV recurrence. High levels of IL-10 at 1 year could be predictive of severe recurrence, and high IL-10 producers might warrant more intensive management.

Effects of commercial fishing and predation by cormorants on the Anguilla anguilla stock of a shallow eutrophic lake

Mortality of eels Anguilla anguilla in a large shallow lake in France due to predation by the cormorant Phalacrocorax carbo was found to be moderate when compared to fishery catches over a 9 year period. The results show that, contrary to previous extrapolations made at the pan-European scale, P. carbo predation in shallow lakes is not invariably a major contributor to A. anguilla mortality, even in the presence of large colonies.

Phase II trial of intracerebral administration of CpG oligonucleotide for patients with recurrent glioblastoma

2043

Background: CpG-ODN are immunostimulating oligodeoxynucleotides containing CpG motifs. When injected locally, they can induce tumor rejection in animal models. In a phase I clinical trial, intra-tumoral infusions of CpG-ODN in glioblastoma patients were well tolerated at doses up to 20 mg. This multicenter phase II trial was designed to study the efficacy and tolerance of a local treatment by CpG-ODN in patients with recurrent glioblastoma. Methods: Patients with recurrent GBM occurring at least three months after radiotherapy and previously treated with one at least regimen of chemotherapy received 20mg CpG- ODN (CpG-28) by convection-enhanced delivery. The percentage of patients without tumour progression at 6 months after inclusion was the primary endpoint. Secondary endpoints were tolerance, survival, and radiological response. Results: Thirty-four patients were enrolled in two centers and thirty-one patients received the treatment. The 6-months progression free survival (PFS) was 19%. One partial response and 3 minor responses were observed. Eight patients (24%) were alive after 1 year, and 5 patients (15%) were alive 2 years after inclusion. The median overall survival was 28 weeks.Treatment was usually well tolerated. Among 6 patients studied, the pharmacokinetic profile of CpG-28 in the blood was heterogeneous. CpG-28 reached up to 79 ng/mL at the end of infusion in one patient. Return to baseline concentration occurred at around 70 hours after the start of infusion. Half-life estimates were variable ranging from 3 to 24 hours. The mean area under the plasma concentration-time curve (AUC) ranged from 0.07 to 0.65 μg x hr/ml. Conclusions: CpG-28 induced a few cases of radiological reponses, but the impact on the 6-months PFS was minimal in this population. However, the presence of long-term survivors suggest that this treatment might have been beneficial in some patients, whose molecular or clinical characteristics remain to be defined.

[Table: see text]

[The adolescent to adulthood transition of persons with traumatic-brain injury: the physical-medicine point of view]

Traumatic-brain injury (TBI) is relatively frequent and can involve children and adolescents; it causes not only physical but also important neuropsychological and behavioral problems that can impair familial, social, and professional reintegration. The affected person requires long-term follow-up of medical, psychological, and social problems. The transition from childhood to adulthood, which can cause problems related to the lack of organization and training of specialized TBI medicosocial teams and structures in adult care for both the family, which is reluctant to change, and the patient, who often shows anosognosia, therefore requires organized coordination between pediatric and adult-care teams. This transition must be prepared early and in collaboration with the patient and his family. It first concerns physicians, both pediatric and adult specialists, who need to develop closer collaboration and cooperation. However, the patient should remain the main actor, because the objective is to transfer diversified healthcare, which depends on the TBI patient's individual problems. This relates to medical treatments and, more generally, the life project, which should not be disturbed by divergent practices. The main measures enabling harmonious transfer are training, establishment of specific procedures, and, most particularly, networking.