Search

Le dosage des IgG totales sur sérum est un examen courant de biologie médicale. Plus spécialisé, le dosage des sous- classes d'IgG sur sérum trouve sa place en deuxième ligne lors d'un bilan de déficit immunitaire ou pour la maladie associée aux IgG4 (MAG4). Dans le liquide céphalorachidien, leur évaluation permet la distinction entre un transsudat et une synthèse intrathécale. Concernant les sous-classes d'IgG dans le LCR, les laboratoires de biologie médicale commencent à recevoir des demandes, afin de mettre en évidence la présence d'IgG4. Dans le LCR elles seraient liées à la pachyméningite hypertrophique associée à la MAG4 mais, en l'absence d'étude clinique de grande envergure, leur dosage ne semble être pertinent que lorsque la biopsie tissulaire est impossible. La technique de dosage validée sur sérum est quantitative en milieu liquide (néphélémétrie/turbidimétrie). L'utilisation de ces techniques sur LCR doit être validée par chaque laboratoire, en l'absence de validation des kits sur LCR. Cette revue actualisée de la littérature revient sur les différentes indications des dosages d'IgG et des sous-classes d'IgG sur sérum, sur l'intérêt du dosage des sous- classes d'IgG sur le LCR et les techniques associées. Serum total IgG measurement is a common lab act in medical biology. More specialized, serum IgG subclasses measurement plays a key role in IgG4-Re- lated Disease but is also useful for second-line diagnosis in humoral immune deficiencies. In the cerebrospinal fluid (CSF), an index is used as an indicator of the relative amount of CSF IgG compared to serum. Any increase in the index reflects IgG production in the central nervous system. Regarding IgG subclasses in the CSF, medical laboratories are now getting demands, actually to find out if there is any IgG4 subclass. These IgG4 in CSF could be associated with IgG4-related hypertrophic pachymeningitis but without appropriate studies corroborating this, their measurement should be done only when tissue biopsy cannot be performed. Quantitative measurement on serum is validated with nephelometry and turbidimetry assays. Each laboratory has to validate the assays on CSF before giving results. In this mini review, we present the indications of total IgG and IgG subclasses on serum as well as the benefit of IgG subclasses in CSF and the techniques available in a medical laboratory. [ABSTRACT FROM AUTHOR]

La biologie est un outil incontournable dans le diagnostic et la prise en charge des patients allergiques. L'apprentissage à l'interprétation d'un bilan biologique est essentiel pour le praticien. En raison de la diversité des cursus, les jeunes allergologues n'ont pas tous la même formation. À la demande du Conseil Scientifique de la Société française d'allergologie (SFA), le Groupe de Travail Biologie de l'Allergie a réalisé une enquête auprès des jeunes allergologues afin d'évaluer leur niveau de formation en biologie de l'allergie et de connaître leurs attentes en termes de formation continue. Au total, 162 allergologues ont été contactés et 36 ont répondu. Les répondants étaient majoritairement des femmes (78 %), allergologues exclusifs (83 %) et 69 % étaient issus du DES d'Allergologie. La moitié estimait avoir eu une formation suffisante en biologie de l'allergie et 50 % ont effectué un stage dans un laboratoire de biologie médicale. Soixante-trois pour cent se considéraient comme compétents pour l'interprétation des bilans. Pour leur formation continue, ils utilisaient les sites internet des sociétés savantes, les revues scientifiques et des webinaires qu'ils jugeaient satisfaisants. Aucune personne n'avait recours à un système d'évaluation des compétences. Plus de 95 % des répondants sont en faveur d'une mise à disposition de documents synthétiques de référence et tous les consulteraient s'ils étaient accessibles en ligne sur le site de la SFA. En conclusion, la formation des jeunes allergologues sur la biologie de l'allergie a besoin d'être complétée et harmonisée, sur le plan théorique et pratique. Plusieurs outils pédagogiques sont plébiscités pour le maintien des compétences. Blood tests are an essential tool for the diagnosis and management of allergy. Learning how to interpret test results is therefore essential for the physician. Due to the diversity of their education, young allergists do not all have the same training. At the request of the French Society of Allergology (SFA) Scientific Committee, the In vitro Diagnosis Working Group carried out a survey for young allergists in order to evaluate their level of initial training in allergy in vitro diagnosis and to know their expectations in terms of continuing medical education. A total of 162 allergists were consulted and 36 responded. Half of them considered that they had sufficient training in allergy in vitro diagnosis and 50% considered themselves competent in the interpretation of tests. For their continuing medical education, they use the websites of learned societies (SFA, EEACI), scientific journals and webinars and consider them satisfactory or very satisfactory. More than 95% of them are in favour of the online availability of summary sheets or reference documents in in vitro diagnosis, and all of them would consult these tools if they were accessible on the SFA website. In conclusion, the training of young allergists in allergy blood tests needs to be completed and standardised, both theoretically and practically. Several educational tools are available and popular to achieve this and help them to keep valuable skills up to date. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Le réseau AllergoBioNet est constitué de biologistes hospitaliers spécialistes des analyses contribuant au diagnostic et au suivi des maladies allergiques. Initialement constitué d'une dizaine de membres, il comporte actuellement soixante-dix-neuf biologistes français exerçant dans 29 CHU et 15 CH, ainsi qu'un biologiste belge. Parmi ces laboratoires, 10 ont été labellisés « laboratoires de biologie médicale de référence » (LBMR) du fait de leur expertise des explorations biologiques des maladies allergiques, des autres causes d'hypersensibilité, des pathologies mastocytaires et du complément. Les objectifs principaux des biologistes du réseau sont de tester et mettre en oeuvre des techniques robustes et fiables accréditées par le COFRAC, d'être un outil de formation médicale continue pour maintenir et actualiser les connaissances et compétences et de promouvoir des projets de recherche dont les résultats sont présentés dans les congrès nationaux et internationaux et sous forme d'articles publiés dans des revues spécialisées. Cet article est un appel auprès des biologistes hospitaliers à s'impliquer dans le domaine de l'allergologie via le réseau AllergoBioNet, mais aussi auprès des allergologues qui peuvent solliciter la collaboration de ces biologistes spécialisés pour répondre à leurs questions pratiques (conditions pré-analytiques, conservation des échantillons), de discuter des qualités analytiques des méthodes utilisées pour comprendre leurs limites techniques, de savoir où adresser le patient nécessitant une analyse très spécialisée et d'échanger autour de l'interprétation des résultats. Ce partenariat permet d'enrichir mutuellement les savoirs et les pratiques dans le but d'optimiser la prise en charge des patients. AllergoBioNet is a French association of clinical laboratory specialists of allergic and mast-cell-related diseases and their differential diagnoses. Its 79 members are working in clinical laboratories in 29 Universitary Hospitals and 15 General Hospitals in France and another one in Belgium. Ten of these laboratories have recently been certified as « laboratoires de biologie médicale de référence » (Reference Clinical Laboratories, LBMR) to valorize the expertise in hypersensitivity, mast-cell and complement laboratory investigations. The first mission of these laboratory professionals is to ensure that results are accurate and reliable. Thus, they deal with all the process of continuous quality improvement and are able to minimize errors of the sample's workflow (pre-analytic, analytic and post-analytic phases). Since years, they are certified by the French Organization for Quality (COFRAC). Moreover, they evaluate newer diagnostic tests, ensure continuous medical formation to actualize competences and knowledge, participate in research protocols and publish in national and international specialized reviews. The aims of this article are (1) to encourage all medical laboratory specialists working in the field of allergic diseases (diagnosis, monitoring patients and responses to therapy) to join the AllergoBioNet network; (2) to encourage physicians to collaborate with these laboratory professionals, so that they could answer to practical questions (ie: pre-analytical needs and conservation samples), receive updates for state-of-the-art laboratory methods and devices, refer patients needing highly specialized analyses and ensure interdisciplinary interpretation of clinical and laboratory results. This partnership should improve mutual competences and contribute to patient care. [ABSTRACT FROM AUTHOR]

La biologie est un outil incontournable dans le diagnostic et la prise en charge des patients allergiques. Pour compléter l'enquête auprès des jeunes allergologues publiée en 2022, le Groupe de travail biologie de l'Allergie (GTBA) en partenariat avec l'ANAFORCAL a réalisé une nouvelle enquête auprès des allergologues seniors afin d'évaluer leur formation en biologie de l'allergie et de connaître leurs attentes en termes d'information et formation continue. Au total, 1092 allergologues ont été contactés (avec des doublons entre les deux listes) et 219 ont répondu. Les allergologues s'estiment être bien formés. Plus de 70 % estiment avoir de bonnes connaissances sur le sujet et 94 % se forment régulièrement sur le sujet, en congrès tout d'abord, par la lecture d'articles scientifiques puis en réunions de formation locales. Sur cet échantillon, 69,4 % ont lu les recommandations sur la biologie de l'allergie publiées en 2021. Parmi ceux qui l'ont lu, 90 % en sont satisfaits. Cependant sur cet échantillon, 89 % n'ont jamais fait de stage dans un laboratoire d'immunoallergologie pendant leurs études. Cette enquête rapporte que 95 % des répondants veulent plus de formation et information, à propos des nouveaux allergènes moléculaires, puis de l'exploration des angiœdèmes bradykiniques, des puces à allergènes, à propos de la tryptase et enfin pour le suivi de l'immunothérapie allergénique (ITA). Ces thématiques sont souhaitées en formation DPC en ligne, au congrès francophone d'allergologie (CFA), ou sous forme de fiches sur le site de la Société française d'allergologie (SFA). Biology is an essential tool in the diagnosis and management of allergic patients. To complete the survey of young allergists published in 2022, the Allergy Biology Working Group (GTBA) in partnership with ANAFORCAL has carried out a new survey of senior allergists to assess their training in allergy biology and to know their expectations in terms of information and continuing education. A total of 1095 allergists were contacted (with duplicates between the two lists) and 219 responded. Allergists consider themselves to be well trained. More than 70% believe they have a good knowledge of the subject and 94% receive regular training on the subject, first at congresses, by reading scientific articles and then at local training meetings. Of this sample, 69.4% have read the recommendations on the biology of allergy published in 2021. Of those who have read it, 90% are satisfied with it. However, of this sample, 89% had never done an internship in an immuno-allergology laboratory during their studies. This survey reports that 95% of respondents want more training and information, about new Activé par Editorial Manager® and ProduXion Manager® about Aries Systems Corporation molecular allergens, then the exploration of bradykine angioedema, allergen chips, about tryptase and finally for the follow-up of immunotherapy allergen (ITA). These themes are desired in online CPD training, at the French-speaking congress of allergology (CFA), or in the form of sheets on the site of the French Society of Allergology (SFA). [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Telemonitoring (TM) of home non-invasive ventilation (NIV) has been shown to facilitate home/outpatient therapy set-up. However, the impact of long-term TM on therapy dropouts, compliance and leak control has not yet been clearly determined. This study evaluated whether the NIV dropout rate was reduced by TM combined with remote patient support compared with a non-telemonitoring (NTM) pathway.Design Retrospective cohort study.Setting Data were obtained from all agencies of a single home care provider in France.Participants Adults with chronic respiratory failure (n=659) who started nocturnal NIV between January 2017 and December 2019 and had ≥8 days of NIV therapy (51% male; mean age 68.5±13.8 years; 35.5% on long-term oxygen therapy) were included. The TM group included 275 patients who spent ≥80% of the follow-up using TM, and the NTM group included 384 patients who had 0 to ≤10 days of telemonitoring during follow-up.Primary and secondary outcome measures The primary outcome was the rate of NIV dropouts at 1 year (ie, treatment discontinuation, excluding deaths). Secondary outcomes included therapy compliance and leaks.Results 82 patients died during follow-up. Significantly fewer patients in the TM vs NTM group had dropped out of NIV therapy at 1 year (13% vs 34%; p4 hours/day and control of leaks.Conclusions In patients starting home NIV, TM with home care provider first-line support was associated with a lower therapy dropout rate at 1 year, and better compliance and leak control, compared with standard follow-up.

Abstract Background Thrombo-inflammation and neutrophil extracellular traps (NETs) are exacerbated in severe cases of COVID-19, potentially contributing to disease exacerbation. However, the mechanisms underpinning this dysregulation remain elusive. We hypothesised that lower DNase activity may be associated with higher NETosis and clinical worsening in patients with COVID-19. Methods Biological samples were obtained from hospitalized patients (15 severe, 37 critical at sampling) and 93 non-severe ambulatory cases. Our aims were to compare NET biomarkers, functional DNase levels, and explore mechanisms driving any imbalance concerning disease severity. Results Functional DNase levels were diminished in the most severe patients, paralleling an imbalance between NET markers and DNase activity. DNase1 antigen levels were higher in ambulatory cases but lower in severe patients. DNase1L3 antigen levels remained consistent across subgroups, not rising alongside NET markers. DNASE1 polymorphisms correlated with reduced DNase1 antigen levels. Moreover, a quantitative deficiency in plasmacytoid dendritic cells (pDCs), which primarily express DNase1L3, was observed in critical patients. Analysis of public single-cell RNAseq data revealed reduced DNase1L3 expression in pDCs from severe COVID-19 patient. Conclusion Severe and critical COVID-19 cases exhibited an imbalance between NET and DNase functional activity and quantity. Early identification of NETosis imbalance could guide targeted therapies against thrombo-inflammation in COVID-19-related sepsis, such as DNase administration, to avert clinical deterioration. Trial registration: COVERAGE trial (NCT04356495) and COLCOV19-BX study (NCT04332016). Graphical Abstract

Plant-associated microorganisms have been shown to aid plants in coping with drought. However, the underlying mechanisms are poorly understood and there is uncertainty regarding which microbial taxa and functions are mostly involved. We explored these issues in Neotropical rainforests and identified foliar microorganisms that may play a role in drought tolerance of trees. Our objectives were to (i) test the relationship between drought tolerance traits in Neotropical trees and the diversity and composition of their foliar fungal and bacterial communities and (ii) identify leaf microbial taxa positively or negatively associated with drought tolerance traits. Our results showed that the composition of leaf fungal communities but not bacterial communities was related to drought tolerance. We identified 27 fungal amplicon sequence variants whose relative abundance covaried with drought tolerance traits. Most variants were assigned to fungal clades often described as plant pathogens and increased in abundance with drought susceptibility. This greater relative abundance of leaf pathogens in the most drought-susceptible trees might increase their vulnerability to climate change. Moreover, we identified the Strelitziana and Ochroconis fungal genera as potential candidates for future culture-dependent studies aimed at understanding and improving drought tolerance in Neotropical forests. [Graphic: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Phosphoinositides (PIs) are membrane lipids that regulate signal transduction and vesicular trafficking. X-linked centronuclear myopathy (XLCNM), also called myotubular myopathy, results from loss-of-function mutations in the MTM1 gene, which encodes the myotubularin phosphatidylinositol 3-phosphate (PtdIns3P) lipid phosphatase. No therapy for this disease is currently available. Previous studies showed that loss of expression of the class II phosphoinositide 3-kinase (PI3K) PI3KC2β (PI3KC2B) protein improved the phenotypes of an XLCNM mouse model. PI3Ks are well known to have extensive scaffolding functions and the importance of the catalytic activity of this PI3K for rescue remains unclear. Here, using PI3KC2β kinase–dead mice, we show that the selective inactivation of PI3KC2β kinase activity is sufficient to fully prevent muscle atrophy and weakness, histopathology, and sarcomere and triad disorganization in Mtm1-knockout mice. This rescue correlates with normalization of PtdIns3P level and mTORC1 activity, a key regulator of protein synthesis and autophagy. Conversely, lack of PI3KC2β kinase activity did not rescue the histopathology of the BIN1 autosomal CNM mouse model. Overall, these findings support the development of specific PI3KC2β kinase inhibitors to cure myotubular myopathy.

The restoration of hay meadows is one of the major challenges in temperate Europe, to overcome the drastic loss and degradation of these semi-natural habitats. Evaluation of restoration success requires the definition of a relevant reference ecosystem. Historical phytosociological relevés dating from the 1960s–1970s, before large scale agriculture intensification, may be used as the reference framework for such purposes. However, this reference framework may no longer be pertinent in our present-day ecological and socio-economic context. In this study, we assessed the success of three restoration techniques for lowland hay meadows, based on plant species richness and composition and functional traits, by comparing the restoration trajectories to historical and current references. The three restoration techniques, passive restoration mowing, active fresh hay transfer and active sowing of threshing material, were implemented depending on the initial level of degradation and the proximity to well-preserved meadows. The species composition of restored meadows clearly differed from historical references but converged toward current references, for both passive and active restoration techniques. Historical references are characterized by short, stress-tolerant dicotyledonous plant species with small specific leaf area, indicators of nutrient-poor environments. The gap observed between plant communities of historical and current meadows suggests that the historical data are an over-ambitious target for restoration purposes and can hardly be considered relevant to our present-day context. Therefore, creation of a new reference framework of lowland hay meadows is needed for the adequate implementation of restoration projects. Successful outcomes of active and passive techniques must encourage practitioners to adapt the choice of the restoration method depending on the local ecological context, i.e., level of degradation and proximity to well-preserved habitats.