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Abstract: The results provide new insights into the role of IL-2/IL-2R pathway in DC. We report that stimulation of human monocyte-derived DC with LPS strongly upregulated CD25 (α chain of the IL-2R) expression. In addition, by using a humanized monoclonal antibody against CD25, we demonstrated that the IL-2 signalling in DC upregulated both IL-12 and γIFN production but decreased IL-10 synthesis. Anti-CD25 treatment reduced the ability of LPS-DC to induce allogeneic CD4+ T cell proliferation as compared to LPS-matured DC. In addition, LPS-matured DC treated with IL-2 had a higher allostimulatory capacity compared to LPS-DC. We also found that LPS-matured DC produced IL-2. Thus, IL-2 seems to contribute actively to DC activation through an autocrine pathway. Moreover, IL-2 pathway in DC is involved in T helper priming. These findings might be useful for protocols in cellular therapy and a valuable tool to understand graft rejection versus the acquisition of peripheral tolerance. [Copyright &y& Elsevier]

Metabolic alteration plays a functional role in kidney allograft complications. Metabolomics is a promising high-throughput approach in nephrology but is still limited by the lack of overlap in metabolite coverage. We performed an untargeted fecal metabolomic analysis of forty stable kidney allograft recipients and twenty non-transplant controls. First, we applied the ultra-high performance liquid chromatography (UHPLC) analysis coupled with the Diod Array detector. The potential biomarkers were then collected and identified by gas chromatography-mass spectrometry (GCMS). In order to allow for complete coverage of the fecal polar and non-polar metabolites, the performance of five organic solvents with increasing polarity was investigated successively. UHPLC analysis revealed that the fecal metabolite profiles following the five extractions were significantly different between controls and kidney allografts. GC-MS analysis showed that the best predictors' metabolites belonged mainly to long-chain fatty acids, phenolic compounds, and amino acids. Collectively, our results showed the efficiency of our pioneer method to successfully discriminate stable kidney-transplant recipients from controls. These findings suggest that distinct metabolic profiles mainly affect fatty acid biosynthesis and amino acid metabolism. In such a context, the novel insights into metabolomic investigation may be a valuable tool that could provide useful new relevant biomarkers for preventing kidney transplant complications.

Monitoring graft recipients remains dependent on traditional biomarkers and old technologies lacking specificity, sensitivity, or accuracy. Recently, metabolomics is becoming a promising approach that may offer to kidney transplants a more effective and specific monitoring. Furthermore, emerging evidence suggested a fundamental role of gut microbiota as an important determinant of patients' metabolomes. In the current study, we enrolled forty stable renal allografts recipients compared to twenty healthy individuals. Samples were taken at different time points from patient to patient following transplantation surgery, which varied from 3 months to 22 years post-graft. All patients started the immunosuppression therapy immediately following kidney graft (Day 0). Gas chromatography-mass spectrometry (GC-MS) was employed to perform untargeted analysis of fecal metabolites. Globally, the fecal metabolic signature was significantly different between kidney transplants and the control group. Fecal metabolome was dominated by lipids (sterols and fatty acids) in the stable transplant group compared to the controls ( p < 0.05). Overall, 18 metabolites were significantly altered within kidney transplant recipients. Furthermore, the most notable altered metabolic pathways in kidney transplants include ubiquinone and other terpenoid-quinone biosynthesis, tyrosine metabolism, tryptophan biosynthesis, and primary bile acid biosynthesis. Fecal metabolites could effectively distinguish stable transplant recipients from controls, supporting the potential utility of metabolomics in rapid and non-invasive diagnosis to produce relevant biomarkers and to help clinicians in monitoring kidney transplants. Further investigations are needed to clarify the physiological relevance of fecal metabolome and to assess the impact of microbiota modulation.

The multiple exostosis is a hereditary bone tumour. Generally, its complications are benign and are related to compressing surrounding structures such as nerves and vessels. This is the case of a 52-year-old woman with a family history of multiple exostosis, which was complicated by a pseudoaneurysm of the right superficial femoral artery. The delay in diagnosis was allowed to develop this pseudoaneurysm which caused nervous and deep venous compression., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Infection with hepatitis B virus has a major implication for transplant recipients due to the risk of reactivation under immunosuppression, progression to chronic liver disease, development of liver cirrhosis and hepatocellular carcinoma. We report two cases of renal transplantation patients who were hepatitis B surface antigen positive before transplantation and were treated by Lamivudine.

Aberrant right subclavian artery or arteria lusoria (AL) is the most frequent anomaly of the aortic arch, secondary to abnormal embryogenesis. It is usually asymptomatic and fortuitously discovered. It can compress neighboring structures and cause dysphagia or, more rarely, dyspnea. In symptomatic cases or in the presence of an aneurysm of the AL origin, it should be surgically treated. The case herein reported concerns a child presenting with respiratory symptomatology related to an AL that was surgically treated by right supraclavicular approach., (Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.)

The results provide new insights into the role of IL-2/IL-2R pathway in DC. We report that stimulation of human monocyte-derived DC with LPS strongly upregulated CD25 (α chain of the IL-2R) expression. In addition, by using a humanized monoclonal antibody against CD25, we demonstrated that the IL-2 signalling in DC upregulated both IL-12 and γIFN production but decreased IL-10 synthesis. Anti-CD25 treatment reduced the ability of LPS-DC to induce allogeneic CD4(+) T cell proliferation as compared to LPS-matured DC. In addition, LPS-matured DC treated with IL-2 had a higher allostimulatory capacity compared to LPS-DC. We also found that LPS-matured DC produced IL-2. Thus, IL-2 seems to contribute actively to DC activation through an autocrine pathway. Moreover, IL-2 pathway in DC is involved in T helper priming. These findings might be useful for protocols in cellular therapy and a valuable tool to understand graft rejection versus the acquisition of peripheral tolerance., (Copyright © 2009 Elsevier Masson SAS. All rights reserved.)

Recently, attention has been focused on the role for dendritic cells (DCs) in the promotion of peripheral tolerance. It is currently believed that the maturation/activation state of DCs might be a control point for the induction of graft tolerance through modifications of the activation state of T cells. We have observed IL-2, and IL-2 receptor gene expression by reverse transcriptase-polymerase chain reaction (RT-PCR) in human DC lysates following bacterial stimulation. It has been demonstrated in the present study IL-2R alpha (CD25) expression on human DCs upon LPS activation. DCs differentiated from monocytes were exposed to anti CD25 during maturation, anti CD25 treatment affected the abilities of human DCs to induce CD4+ T cell proliferation in response to alloantigens, maintained endocytic capacity, Anti CD25 treated DCs produce low levels of IL-12 and IFN and high level of IL-10. All these characteristics suggest that DCs may be used in cellular therapy either to induce allograft tolerance (anti CD25 treated DCs) or to restore immunity against tumors (IL-2 treated DCs).

The prevalence of obstructive arterial disease is between 3.5 and 12.1% in 60 aged populations. It's a current disease which has a pernicious influence in quality of life. Management of patients with peripheral arterial occlusive disease has to be planned in the context of natural history, epidemiology, and apparent risk factors that predict deterioration. The purpose of this review is to take stock of the consensus and the controversies about terminology, epidemiology, diagnosis and management of peripheral arterial occlusive disease.

Chronic contained rupture of abdominal aortic aneurysm is a rare event which can cause diagnostic difficulties. It can present as a chronic back pain and the delayed diagnosis and delayed surgical repair may compromise the final results. The outcome of urgent repair of a chronic contained leak is equivalent to that of elective aneurysm repair. We report a case of contained rupture of a small abdominal aortic aneurysm with delayed diagnosis, evaluated by computed tomography showing a beginning erosion of the lumbar vertebral body. The patient was operated on within 24 hours on admission with uneventful surgical outcome.

Objectives: To assess the effet of cryopreservation on the structural and functional properties of venous and arterial human allografts., Materials and Methods: Segments of arteries and veins harvested from multiorgan donors were divided into 3 groups: fresh-control tested for 24 hours after harvesting, frozen directly at -80 degrees C and frozen gradually (progressive freezing technique) and preserved in liquid nitrogen at -196 degrees C degree. The 2 cryopreserved groups of segments were allowed in two different cryoprotectant solutions (M1 and M2) containing both dimethyl sulphoxide (10%), RPMI 1640 for the first and M 199 for the second. Rapid thawing was done at regular intervals over 4 months and the allografts were processed for biomechanical, ultrastructural, morphological and immunohistochemical analysis., Results: Cell damage was less intense in the specimens conserved in M1 solution and by progressive freezing technique especially for smooth muscle cells and endothelial cells which remained preserved until 12 weeks., Conclusion: Cryopreservation in both the solutions employed induce changes in the morphology of arterial wall. Better results were obtained with RPMI 1640 associated with progressive freezing.

Arteritis is a local finding of a general disease: atherosclerosis. To define the risk factors of this disease in Tunisia, 531 patients were collected by a multicenter retrospective study between January 1998 and December 1999. Most of our patients were male with a mean age of 62 years. The most important risk factor was tobacco with an incidence of 90%. Lipids and diabetes were less common. The association of risk factors is particularly dangerous.

There has not been a peripheral vascular surgical procedure subject to as exquisite scruting as carotid endarterectomy. The last decade gave a new attitude after the analysis and conclusions of the North American Symptomatic Carotid Endarterectomy Symptomatic extracranial lesions were best managed with operative intervention rather than antiplatelet treatment alone. Now, in the first decade of the new millenium, we are embarking on yet another test of carotid endarterectmy--a comparison with percutaneous angioplasty and stenting, which is a most rigorous contest because endarterectomy must now withstand comparison with another "active treatment" rather than the more passive observational modality of antiplatelet therapy. The topic of the authors was to provide a panorama of the contemporay treatment of carotid disease at this pivotal point in the life cycle carotid endarterectomy.

Purpose: Results that were obtained from three patients and a literature review allow the authors to better define the place of medical and surgical treatments according to the different locations of arterial aneurysm occurring in the course of Behcet's disease., Methods: Retrospective report of five cases of arterial aneurysm that occurred during Behcet's disease in three patients., Results: Due to the unusual symptoms, diagnosis can be hampered. Though lesions may be observed in various areas, they were mostly aortic (two patients). Surgical revascularization was done in all three patients. It mainly involved prosthetic grafts. Two patients were subsequently treated by postoperative immunosuppressive drugs. The mean follow-up was 22 months. Relapsing aneurysm was observed in one patient, while in another patient aneurysm developed in a new location., Conclusion: These types of arterial lesions respond poorly to medical treatment when a combination of colchicine and intermittent intravenous bolus of cyclophosphamide is used. Surgical indications should be given great yet selected weight, using prosthetic rather than venous autologous grafts (due to the risk of spontaneous venous involvement). Since either complication or recurrence is possible, prolonged monitoring is required.

The authors report three new cases of ectopic pheochromocytoma: latero-aortic, bladder and near the kidney. From the review of the literature, they propose a diagnostic and therapeutic strategy for the management of ectopic localisation of pheochromocytoma.

Chronic post traumatic ischaemia is a specific late complication of vascular injuries. The authors report a four cases series, including three war vascular injuries. They emphasize the surgical management lines and point out the preeminence of vascular restoration on reconstructive bone and joint surgery.

A diabetic woman developed spontaneous gas gangrene of upper limb extending into trunk and due to clostridium septicum. Recovery was obtained after major surgery involving disarticulation of upper limb and excision of soft tissues of left hemithorax, and a difficult intensive care programme (hyperbaric oxygen therapy, assisted ventilation). The presence of this gas gangrene revealed a bipolar colon cancer treated in parallel. The conventional therapeutic hierarchy is discussed: surgery should be carried out as an extreme emergency and should not be delayed to allow transfer to a center equipped with a hyperbaric oxygen therapy apparatus.