[Targeting and role of α4β7 integrin in the pathophysiology of IBD and HIV infection]

Integrins are a large family of heterodimeric cell adhesion molecules that are key regulators in multiple biological functions. They orchestrate cell-cell and cell-extracellular matrix (ECM) adhesive interactions from embryonic development to mature tissue function, and are thus involved in cell migration, proliferation, differentiation, and survival. As such, they are also involved in human diseases, such as thrombotic diseases, inflammation, cancer, fibrosis and infectious diseases. Integrins are exciting pharmacological targets because they are exposed on the cell surface. Indeed, several compounds have been developed that block integrins function, and five have been approved as therapeutic drugs for use in clinic. This review will detail the role of α4β7, an integrin of particular relevance for mucosal diseases such as IBD (inflammatory bowel disease) and also, as reported more recently, HIV infection.

[Interleukin-21: a key cytokine for controlling HIV and other chronic viral infections]

The differentiation, homeostatic proliferation and effector functions of different immune cells are controlled, to a large extent, by cytokines. Viruses often cause immune response dysfunctions by causing defects in the cytokine networks. The defects are often manifested by altered cytokine secretion and/or responsiveness to the cytokine. Among these cytokines, Interleukin-21 (IL-21) is a relatively recently discovered cytokine, which is mainly produced by CD4(+) T cells in the body, and exerts multiple and pleiotropic effects on various immune cells. Recent studies have shown that the cytokine is indispensable for controlling chronic viral infections. This review summarizes current knowledges concerning the biological effects of this cytokine on different components of the immune system. We also discuss how it contributes toward mounting efficient antiviral immunity and controlling chronic viral infections, especially HIV-1. The IL-1 cytokine represents a novel therapeutic agent for virus-infected patients as well as an adjuvant in antiviral vaccination strategies.

[Immunopathogenesis of inflammatory bowel disease]

Inflammatory bowel diseases (IBD) are idiopathic, chronic and relapsing inflammatory conditions of the gastrointestinal tract. New insights into the pathogenesis of IBD have been provided by three lines of research: (1) studying susceptibility genes involved in the detection of bacterial components and in the regulation of the host immune response, (2) highlighting the disruption of tolerance towards the commensal microbiota and (3) unravelling the critical role of environmental factors such as sanitation and hygiene. This review presents current etiological hypothesis of IBD which argue that pathogenic intestinal bacteria and/or infectious agents initiate and perpetuate the inflammation of the gut in an individual with genetic vulnerability leading to impaired epithelial barrier function and abnormal mucosal immune responses.

[Pregnancy: a high risk factor in influenza infection]

During pregnancy both mother and foetus are at increased risk of being infected with either pandemic or seasonal influenza viruses, and it is thus legitimate to implement enhanced surveillance for infection particularly with the A/H1N1v and discuss priority vaccine administration. We will review the alterations in immunologic parameters which lead to some degree of cellular immunodeficiency, but also in anatomic changes and pulmonary restrictions which contribute to this suceptibility of pregnant women to severe complications of an influenza infection. We also provide an update on the epidemiological data available for the A/H1N1v infection in this population, and discuss the benefit/risk ratio of treatment with the antiviral medications.