Separation of the CaV 1.2-CaV 1.3 calcium channel duo prevents type 2 allergic airway inflammation

BACKGROUND

Voltage-gated calcium (Ca_v 1) channels contribute to T-lymphocyte activation. Ca_v 1.2 and Ca_v 1.3 channels are expressed in Th2 cells but their respective roles are unknown, which is investigated herein.

METHODS

We generated mice deleted for Ca_v 1.2 in T cells or Ca_v 1.3 and analyzed TCR-driven signaling. In this line, we developed original fast calcium imaging to measure early elementary calcium events (ECE). We also tested the impact of Ca_v 1.2 or Ca_v 1.3 deletion in models of type 2 airway inflammation. Finally, we checked whether the expression of both Ca_v 1.2 and Ca_v 1.3 in T cells from asthmatic children correlates with Th2-cytokine expression.

RESULTS

We demonstrated non-redundant and synergistic functions of Ca_v 1.2 and Ca_v 1.3 in Th2 cells. Indeed, the deficiency of only one channel in Th2 cells triggers TCR-driven hyporesponsiveness with weakened tyrosine phosphorylation profile, a strong decrease in initial ECE and subsequent reduction in the global calcium response. Moreover, Ca_v 1.3 has a particular role in calcium homeostasis. In accordance with the singular roles of Ca_v 1.2 and Ca_v 1.3 in Th2 cells, deficiency in either one of these channels was sufficient to inhibit cardinal features of type 2 airway inflammation. Furthermore, Ca_v 1.2 and Ca_v 1.3 must be co-expressed within the same CD4⁺ T cell to trigger allergic airway inflammation. Accordingly with the concerted roles of Ca_v 1.2 and Ca_v 1.3, the expression of both channels by activated CD4⁺ T cells from asthmatic children was associated with increased Th2-cytokine transcription.

CONCLUSIONS

Thus, Ca_v 1.2 and Ca_v 1.3 act as a duo, and targeting only one of these channels would be efficient in allergy treatment.

Outcomes at 7 and 21 years after surgical treatment of Dupuytren's disease by fasciectomy and open-palm technique

The goal of this study was to assess the recurrence of Dupuytren's disease and the stability of the functional result after fasciectomy combined with the McCash open-palm technique. From 1989 to 1999, 56 consecutive patients were surgically treated for Dupuytren's disease. In 2003, 40 of these operated patients were reviewed by an independent evaluator; 12 patients were Tubiana stage 1, 16 stage 2, 9 stage 3 and 3 stage 4. Twenty-one of them were reviewed again in 2016 by a second evaluator who was unaware of the clinical results in 2003. The mean follow-up was 7.32 years (range, 4.26 to 12.5 years) at the first review. Recurrence occurred in 7 patients (17.5%) and extension of the disease in 15 (37.5%). Three patients had developed complex regional pain syndrome (CRPS). Mean residual contracture was 19.3°. Average improvement in finger extension was 53°. At the second review, 21 patients were assessed with a mean follow-up of 21.5 years (range, 18.7 to 26.3 years). None of them were re-operated and no extension of the disease was observed. There was no recurrence in patients who had no recurrence in 2003. However, the contracture had worsened in five patients (23.8%), three of whom had a recurrence of the disease in 2003. Mean residual contracture was 31.8°. Recurrence occurs most often in the first few years after surgery. The functional result is stable over time. CRPS and the number of rays operated are the main factors negatively affecting overall improvement of mobility.

Résultats à plus de cinq ans d'une série consécutive de 44 trapézectomies avec ligamentoplastie et interposition

BACKGROUND

Surgical management of trapeziometacarpal joint osteoarthritis remains controversial. There have been few long term studies of trapeziectomy combined with ligamentoplasty and interposition arthroplasty (TLIA). Our results are based on a five year minimum follow-up study.

METHODS

We carried out a study of 44 TLIA in 39 consecutive patients. A physical and radiological assessment was undertaken after on average of 6.9 years by a independent observer.

RESULTS

A durable physical improvement was obtained in 18 cases in less than six months and in five cases after more than one year. Thereafter there was no secondary deterioration. A standard pain measurement gave an average result of 1.4 on a ten point scale. Pain was independent of displacement of the first metacarpal bone but had a tendency to be greater where associated with scaphotrapezoidal joint osteoarthritis. Strength was improved in 36 cases. The patients were satisfied and considered their grip to be normal in 41 cases. These variables did not change over time.

DISCUSSION

TLIA give an excellent result in more than 90% of cases. This remains unchanged seven years after surgery. As opposed to prostheses, there is no secondary deterioration once healing is achieved. Algodystrophy is the main drawback.

CONCLUSION

In our opinion, TLIA remains the best available surgical treatment of trapeziometacarpal joint osteoarthristis.

[Increase of anaerobic infections. Prevalence of Bacteroides. Apropos of 17 cases in abdominal surgery]

Seventeen cases of anaerobic infections in abdominal surgery are reported. Predominance of bacteroides is evident (9/17), especially bacteroides fragilis. The clinical manifestations of bacteroides infections are severe: 7 septicemias and 2 parietal infections, being the cause of the death in four patients. Bacteroides infection develops preferently in an old patient, with severe disease, in colic surgery especially in emergency. Bacteroides are characterized by their polyresistance to antibiotics: beta-lactamins, except carbenicillin, and aminosids. Metronidazole is a powerful bactericidal agent with a very low toxicity, particularly active in the treatment of these affections, as well as clindamycin. If oral route is impossible, chloramphenicol, I.V. tetracyclin, and above all carbenicillin are able to be used with success.