Carrillo P, Petit AC, Gaillard R
… +1 more, Vinckier F
Bull Acad Natl Med
· 2020 Dec · PMID 36879561
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Since the 1950s, the therapeutic arsenal against depression has grown considerably. From the discovery of mono-amine oxidase inhibitors (MAOIs) to the antidepressant effect of ketamine, several pharmacological breakthrou...Since the 1950s, the therapeutic arsenal against depression has grown considerably. From the discovery of mono-amine oxidase inhibitors (MAOIs) to the antidepressant effect of ketamine, several pharmacological breakthroughs made the history of psychiatry. These discoveries oriented the research about the pathophysiology of depression, which is one of the most disabling diseases worldwide affecting 10 to 20% of general population. In this article, we offer a short historical review of the various therapeutic options developed over the past century and the consequences of these innovations. We then review the discovery of the antidepressant effects of ketamine (and its S-enantiomer, esketamine), the lastest development in depression treatment. Ketamine's effects are spectacular both in terms of their very short onset time, and because they are observed even in treatment-resistant depression. Just as MAOIs and tricyclic antidepressants allowed the "monoaminergic hypothesis of depression" to emerge, unravelling the mechanisms of ketamine's antidepressant effects should highlight the role of glutamatergic system and neuro-inflammation in the neurobiology of depression. Ketamine might also help to refine our understanding of the cognitive pathophysiology of depression and to deeply transform the clinical representations of depressive disorder.
Bull Acad Natl Med
· 2021 Jan · PMID 33199926
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The mechanisms of inflammatory diseases involve the key inflammatory cytokines IL-1, TNF, IL-6, and IL-17 which are now therapeutic targets with biotherapies. They contribute to the local manifestations of clinically dif...The mechanisms of inflammatory diseases involve the key inflammatory cytokines IL-1, TNF, IL-6, and IL-17 which are now therapeutic targets with biotherapies. They contribute to the local manifestations of clinically different diseases. In addition to these local aspects, these cytokines have systemic effects from their action on the liver, muscle, adipose tissue and the cardiovascular system. All these diseases have in common an increase in cardiovascular risk. In the general population, the same concepts are applicable, as shown by the link between an even modest rise in CRP and cardiovascular risk. More recently, the cytokine storm of severe forms of COVID-19 has shown that synergistic interactions between cytokines first described in vitro are further amplified in the clinical picture with multiple and severe impairment of key organs. In these chronic and acute contexts, control of inflammation by targeting cytokines is a new vascular treatment option, with already important results for IL-1.
Bull Acad Natl Med
· 2020 Dec · PMID 33100345
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Seafood could be a solution to meet global food demand that will double by 2050. Seafood includes a wide variety of edible marine organisms, except fish and mammals. These are molluscs, crustaceans, echinoderms and algae...Seafood could be a solution to meet global food demand that will double by 2050. Seafood includes a wide variety of edible marine organisms, except fish and mammals. These are molluscs, crustaceans, echinoderms and algae. Like any food, seafood can involve hazards transmitted to humans through food, which affect the health of the consumer. These hazards are both biological (viruses, bacteria, parasites) and chemical (toxins, allergens, chemicals, microplastics). The exposure of populations to these hazards through seafood consumption can be notably explained by their mode of production and the dietary habits. Firstly, the sanitary quality of products reflects the quality of the aquatic environment from which they are taken, which can be contaminated by various types of pollution (faecal or chemical, chronic or accidental). The products are then handled, often treated without using additives or chemical preservatives, and finally distributed without any other means of preservation than refrigeration or freezing. Finally, the dietary habits of seafood favour exposure to certain hazards. Seafood safety must be integrated throughout the food chain, under the responsibility shared by all stakeholders. Seafood safety appears to be an emerging public health issue of global scope, because the sea does not stop at borders.
Bull Acad Natl Med
· 2020 Dec · PMID 33078027
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Blood platelets are anucleated elements of the blood. With a diameter of 2 to 3 μm, they are the smallest elements of blood. While their main role is to stop or prevent bleeding, they are also involved in other functions...Blood platelets are anucleated elements of the blood. With a diameter of 2 to 3 μm, they are the smallest elements of blood. While their main role is to stop or prevent bleeding, they are also involved in other functions, such as immunity, inflammation or tumour progression. The development of biotechnology and the knowledge acquired about the mechanisms regulating the biogenesis of platelets makes the production of cultured platelets a viable option today. Consequently, this type of product could have its place in meeting a number of transfusion challenges such as alloimmunization or refractory states. However, culture yields remain low and many hurdles still need to be overcome before considering an application in transfusion. This article reviews the rationale for the production of cultured platelets for transfusion and summarizes the main advances in the field while highlighting its limitations.
Bouet G, Mookerjee S, Foster H
… +2 more, Waller A, Ghevaert C
Bull Acad Natl Med
· 2020 Dec · PMID 33078026
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Platelet transfusions, which are currently totally dependent on altruistic donations, are absolutely necessary to the treatment of patients with thrombocytopenia following trauma, surgery or other pathologies (especially...Platelet transfusions, which are currently totally dependent on altruistic donations, are absolutely necessary to the treatment of patients with thrombocytopenia following trauma, surgery or other pathologies (especially malignancies). Producing platelets in vitro represent a major technological and scientific breathrough that would address logistical issues (supply chain, stock holding…) and medical concerns (compatibility and biosafety). The translation of this innovation will need to be accompanied by rigorous quality control, harmonised between laboratory when it comes to functionality and biosafety for use in the clinic.
Bull Acad Natl Med
· 2020 Dec · PMID 33078025
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INTRODUCTION: In the past decades, the massive explosion of "Japanese" restaurants serving raw fish popularised new culinary habits in France. At the same time, consumers have made a habit of preparing raw or pickled fis...INTRODUCTION: In the past decades, the massive explosion of "Japanese" restaurants serving raw fish popularised new culinary habits in France. At the same time, consumers have made a habit of preparing raw or pickled fish dishes themselves at home. As a result, the identification of live parasitic worm larvae in raw fish flesh is common and a source of concern for professionals or amateur cooks. Sometimes, these worms are spit out or removed after fibroscopy in patients developing severe epigastric pain quickly after eating raw fish. This paper is aiming at having a quick review of the main parasites transmitted to humans by eating raw fish in France. METHODS: This article is based on the personal experience of the authors, on references preferentially from the French literature and on the results of the Fish Parasites (ANR) research program. RESULTS: From 2011 to 2014, Fish-Parasites (ANR) assessed the prevalence of parasitism in sea and freshwater fish belonging to 29 species. About 57% of sea fish were parasitised by Anisakidae. Larvae of Dibothriocephalus latus were found in pike, perch, and burbot in Lake Geneva but in none of the fish examined from Annecy or Le Bourget lakes. Concerning human anisakidosis, a retrospective survey was carried out in the years 2010 to 2014 among all medical parasitology laboratories from university hospitals in France. Thirty-seven cases of anisakidosis have been reported, including 18 cases of allergic anisakidosis. Six additional cases of severe Anisakidae allergy were reported to the National Allergovigilance Network over the same period. CONCLUSIONS: Despite the increase in consumption of raw fish, and compared to previous studies, cases of anisakidosis are decreasing, but their allergenic potential is increasing. The incidence of dibothriocephalosis, after some trend of emergence on the shores of Lake Geneva some 20 years ago, is currently decreasing, but sporadic cases of importation are still reported. Actions with professionals (investigation, providing of information) and research programs on management of parasitic risk control are being pursued and have resulted in an update of the technical instruction of the French General Directorate for Food on the control of parasitic risk in fish.
Bull Acad Natl Med
· 2020 Dec · PMID 33071288
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Antipsychotic drugs are one of the oldest drugs that can change the brain activity. These drugs are mainly used in schizophrenia and the first drug that was judged as efficacious in the treatment of psychosis has been ch...Antipsychotic drugs are one of the oldest drugs that can change the brain activity. These drugs are mainly used in schizophrenia and the first drug that was judged as efficacious in the treatment of psychosis has been chlorpromazine. This is a decade later that it has been shown that these drugs were antagonists at the dopamine transmission by blocking the dopamine D2/D3 receptors. Several other pharmacological targets have been tested during the last decades as glutamatergic, serotoninergic, cholinergic and neuropeptidergic agents but none has been shown to improve symptoms of schizophrenia. Three main issues could explain this failure: the exact causes of schizophrenia is still unknown, we still used the idea that one drug could improve all the symptoms of schizophrenia and it is clear that the group of schizophrenics disease could be different disease with different causes. We propose to review the different drugs that have been tested and we will discuss why the most recent genetic studies could help us to propose new pharmacological targets to treat schizophrenia.