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O objetivo do trabalho é demonstrar o papel do fonoaudiólogo na amamentação do prematuro. Justifica-se esta pesquisa, pois o prematuro pode vir a apresentar interferências no seu desenvolvimento, inclusive em decorrência da sua permanência nas unidades hospitalares, entre elas, alterações no padrão alimentar. Trata-se de uma pesquisa de revisão bibliográfica e de natureza qualitativa, utilizando as bases Scopus, Google acadêmico e Scielo, bem como livros relacionados ao assunto. O prematuro apresenta uma alteração no subdesenvolvimento do sistema nervoso decorrente de sua imaturidade neurológica, e em consequência disso, alterações nas coordenação sucção-deglutição-respiração. Funções essas, essenciais para que ocorra a amamentação, sendo, portanto, necessárias que estejam em condições favoráveis. A pesquisa traz como conclusão a importância da presença do fonoaudiólogo na intervenção da amamentação do bebê prematuro, viabilizando o ato de alimentar e colaborando para a construção do vínculo mãe e filho.

La vaccination est l’un des progrès majeurs de la médecine moderne. Mais afin d’améliorer l’efficacité des vaccins existants et d’en élaborer de nouveaux, nous devons mieux connaître les mécanismes d’action à l’origine de l’immunité protectrice et les stratégies vaccinales permettant d’induire une défense durable. La voie cutanée est une stratégie de vaccination importante, en raison de la richesse qu’elle présente en cellules de l’immunité innée qui ont un rôle clé dans la qualité, l’intensité et la persistance des réponses adaptatives qu’elles induisent. L’intégration des données biologiques obtenues au cours d’un essai clinique de vaccination antigrippale nous donne un aperçu de l’impact de la voie d’immunisation et de la signature innée sur la qualité des réponses immunitaires.

Background: The identification of new biomarkers is essential to making it possible to predict the degree of protection following vaccination. Very few human studies have focused on baseline characteristics including microbiota and gene expression to underlie vaccine immune responsiveness. We investigated the host whole-blood transcriptome and microbiome before vaccination, to assess the likelihood of their involvement in an effective MVA-neutralizing antibody response (MVA-Nab) two months later. Results: We based our analyses on data obtained ­from a randomized clinical study in which participants (n=10) were vaccinated with the MVA-HIV clade B vaccine (MVA-B). Samples were collected at 2-time points prior vaccination (week-2, w0) to study blood transcriptome. Skin wrap (site of vaccination) and stool microbiota were analysed for diversity and abundance (16S rRNAseq). MVA-neutralizing antibody responses were measured at week 8. The levels of MVA-Nab responses were positively correlated with an abundance of Eubacterium in stool and Prevotella in skin. The simultaneous investigation of blood transcriptome and host microbiota before vaccination showed that genus diversity and bacterial abundance at that time correlated significantly with the expression of genes involved in B cell development stages. The combination of gene expression and microbiota makes it possible to forecast strong responders to MVA-B vaccination.Conclusion: To our knowledge, this is the first study integrating host blood gene expression and microbiota before vaccination to predict the intensity of humoral response months later. The genes identified are involved in B cell differentiation might open an avenue of research in this field to optimize vaccination strategies.

BACKGROUND. Systems vaccinology allows cutting-edge analysis of innate biomarkers of vaccine efficacy. We explored a strategy to shape the adaptive immune response by targeting innate immune cells through novel immunization routes. METHODS. This randomized phase I/II clinical study (n = 60 healthy subjects aged 18–45 years old) used transcriptomic analysis to discover early biomarkers of immune response quality after transcutaneous (t.c.), intradermal (i.d.), and intramuscular (i.m.) administration of a trivalent influenza vaccine (TIV, season 2012–2013, 1:1:1 ratio). Safety and immunogenicity (hemagglutinin inhibition [HI], microneutralization [MN] antibodies, and CD4+ and CD8+ effector T cells) were measured at baseline day 0 (d0) and at d21. Blood transcriptome was analyzed at d0 and d1. RESULTS. TIV-specific CD8+ granzyme B+ (GRZ) T cells appeared in more individuals immunized by the t.c. and i.d. routes, whereas immunization by the i.d. and i.m. routes prompted high levels of HI antibody titers and MN against A/H1N1 and A/H3N2 influenza viral strains. The early innate gene signature anticipated immunological outcome by discriminating 2 clusters of individuals with either distinct humoral or CD8 cytotoxic responses. Several pathways explained this dichotomy and confirmed that 9 genes and the serum level of CXCL10 were correlated with either TIV-specific cytotoxic CD8+GRZ+ T cell or antibody responses. A logistic regression analysis demonstrated that these 9 genes and the serum levels of CXCL10 at d1/d0 best predicted TIV-specific CD8+GRZ+ T cell and antibody responses at d21. CONCLUSION. This study provides new insight into the impact of immunization routes and innate signature in the quality of adaptive immune responses. TRIAL REGISTRATION. This study has been registered at ClinicalTrials.gov (NCT01707602). FUNDING. This work was supported by grants from the French Ministry of Health PHRCN 2012 – RCT 12061, INSERM-DGOS, the Fondation pour la Recherche Médicale, and the Société Française de Dermatologie (to AS). These funding sources had no direct role in any aspect of the research or article.

Loyher et al. demonstrate that lung tumors are densely colonized by macrophages of various ontogenies. These distinct developmental origins dictate tumor-associated macrophages relative anatomical distributions, functions and responses to anti-cancer therapies., Tissue-resident macrophages can self-maintain without contribution of adult hematopoiesis. Herein we show that tissue-resident interstitial macrophages (Res-TAMs) in mouse lungs contribute to the pool of tumor-associated macrophages (TAMs) together with CCR2-dependent recruited macrophages (MoD-TAMs). Res-TAMs largely correlated with tumor cell growth in vivo, while MoD-TAMs accumulation was associated with enhanced tumor spreading. Both cell subsets were depleted after chemotherapy, but MoD-TAMs rapidly recovered and performed phagocytosis-mediated tumor clearance. Interestingly, anti-VEGF treatment combined with chemotherapy inhibited both Res and Mod-TAM reconstitution without affecting monocyte infiltration and improved its efficacy. Our results reveal that the developmental origin of TAMs dictates their relative distribution, function, and response to cancer therapies in lung tumors., Graphical Abstract