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Sansonetti PJ. [mRNA vaccination, a model of transition from basic biology to medicine]. C R Biol 2024; 346:69-74. [PMID: 38231390 DOI: 10.5802/crbiol.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/11/2023] [Indexed: 01/18/2024]
Abstract
Sixty years elapsed between the discovery of messenger RNA (mRNA) and the use of this molecule in an unprecedented global vaccination campaign that brought the Covid-19 pandemic under control. Sixty years of doubts for some and certainties for others about the possibility of using mRNA-an example of synthetic biology-in therapeutic medicine and vaccinology. Years of "translational" research and development have culminated in the success of anti-Covid-19 mRNA vaccines and the promise of more to come against emerging pathogens. A new paradigm in vaccinology, enabling pandemics to be tackled as they emerge. A lesson to be learned: medical progress is less a question of time than of the critical nature of the biological discovery that underpins it. Before leaving us, François Gros, who played a key role in the discovery of mRNA, was able to appreciate the relevance of this obvious fact.
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Rochoy M, Billy E, Calafiore M. [What is the purpose of the ex officio licence, if it is not used during a pandemic?]. Therapie 2021; 76:377-379. [PMID: 34024641 PMCID: PMC8139181 DOI: 10.1016/j.therap.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Michaël Rochoy
- Collectif Du Côté de la Science, France; University Lille, CHU Lille, ULR 2694 - METRICS, CERIM, Département de médecine générale, 59000 Lille, France.
| | | | - Matthieu Calafiore
- Collectif Du Côté de la Science, France; University Lille, CHU Lille, ULR 2694 - METRICS, CERIM, Département de médecine générale, 59000 Lille, France
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Berrada S, Caroff N, Navas D, Moret L, Huon JF. [How to improve vaccination coverage in France? Qualitative study among health care workers]. Ann Pharm Fr 2021; 79:77-85. [PMID: 33049251 DOI: 10.1016/j.pharma.2020.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 09/09/2020] [Accepted: 09/18/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The risk benefit ratio has been clearly proven for a long time to be in favor of vaccination. However, the vaccine distrust is still increasing in the French population and vaccination coverage could be improved. There is a real need to increase confidence in vaccination. In this study, we interviewed heath care workers to collect their opinion concerning vaccination hesitancy amongst their patients. METHODS A qualitative study, using semi structured interviews, was performed. All the Pharmacists and doctors were interviewed by the same person using an interview guide prepared by a multidisciplinary team. Interviews were recorded and transcribed verbatim, then used as a basis for analysis and synthesis of the areas where improvement seems possible for the health care workers interviewed. RESULTS Data saturation was obtained after 10 interviews. Analysis of the verbatim allowed the classification of the leads proposed by health care workers in three main themes: improvement of transparency and restoration of the trust for vaccine policy, improved initial and further training of health care workers, and a better communication towards the population. CONCLUSION Results provide helpful insights into practical avenues to improve the vaccination confidence. If some of them need an in-depth reflection, others could be easily implemented in order to increase the adhesion of the population to vaccination, and consequently the vaccination coverage.
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Boyer O, Baudouin V, Bérard É, Biebuyck-Gougé N, Dossier C, Guigonis V, Audard V, Klifa R, Leroy V, Ranchin B, Roussey G, Samaille C, Tellier S, Vrillon I. [Vaccine recommendations for children with idiopathic nephrotic syndrome]. Nephrol Ther 2020; 16:177-183. [PMID: 32278737 DOI: 10.1016/j.nephro.2019.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/17/2019] [Indexed: 11/16/2022]
Abstract
The specific treatment of idiopathic nephrotic syndrome is based on corticosteroid therapy and/or steroid-sparing immunosuppressive agents in children who are steroid-dependant or frequent relapsers (60-70 %). Patients have an increased infectious risk not only related to the disease during relapses (hypogammaglobulinemia and urinary leakage of opsonins) but also to treatments (corticosteroids or immunosuppressive agents) in period of remission. Vaccination is therefore particularly recommended in these patients. Potential vaccine risks are ineffectiveness, induction of vaccine disease and relapse of idiopathic nephrotic syndrome. Only live vaccines expose to the risk of vaccine disease: they are in general contra-indicated under immunosuppressive treatment. The immunogenicity of inactivated vaccines is reduced but persists. The immunogenic stimulus of vaccination may in theory trigger a relapse of the nephrotic syndrome. Nevertheless, this risk is low in the literature, and even absent in some studies. The benefit-risk ratio is therefore in favor of vaccination with respect to the vaccination schedule for inactivated vaccines, with wide vaccination against pneumococcus and influenza annually. Depending on the context and after expert advice, immunization with live vaccines could be discussed if residual doses/levels of immunosuppressive treatments are moderate and immunity preserved.
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Affiliation(s)
- Olivia Boyer
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France.
| | - Véronique Baudouin
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Robert-Debré, institut Imagine, université de Paris, 48, boulevard Sérurier, 75935 Paris cedex 19, France
| | - Étienne Bérard
- Service de néphrologie pédiatrique, CHU de Nice, Archet 2, 151, route Saint-Antoine de Ginestière, CS 23079, 06202 Nice cedex 3, France
| | - Nathalie Biebuyck-Gougé
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France
| | - Claire Dossier
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Robert-Debré, institut Imagine, université de Paris, 48, boulevard Sérurier, 75935 Paris cedex 19, France
| | - Vincent Guigonis
- Département de pédiatrie, hôpital Mère-Enfant, 8, avenue Dominique-Larrey, 87042 Limoges cedex, France
| | - Vincent Audard
- Inserm U955, service de néphrologie et transplantation, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, université Paris-Est Créteil, CHU Henri Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - Roman Klifa
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France
| | - Valérie Leroy
- Service de néphrologie pédiatrique, CHU La Réunion, Site Félix Guyon, allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion
| | - Bruno Ranchin
- Service de néphrologie pédiatrique, centre de référence néphrogone, CHU de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - Gwenaëlle Roussey
- Clinique médicale pédiatrique, CHU de Nantes, 5, allée de l'Île Gloriette, 44093 Nantes, France
| | - Charlotte Samaille
- Service de néphrologie pédiatrique, hôpital Jeanne de Flandre, centre hospitalo-universitaire de Lille, avenue Eugène-Avinée, 59000 Lille, France
| | - Stéphanie Tellier
- Service de néphrologie-rhumatologie-médecine interne pédiatrique, centre de référence des Maladies rénales rares du Sud-Ouest (SORARE), hôpital des enfants, 330, avenue de Grande-Bretagne, 31300 Toulouse, France
| | - Isabelle Vrillon
- Service de médecine infantile, secteur de néphrologie pédiatrique, hôpital d'Enfants de Brabois, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
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Charron J, Gautier A, Jestin C. Influence of information sources on vaccine hesitancy and practices. Med Mal Infect 2020; 50:727-33. [PMID: 32067795 DOI: 10.1016/j.medmal.2020.01.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 08/30/2019] [Accepted: 01/28/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Many factors influence vaccination practices and attitudes. This study aimed to identify vaccine information sources used by parents of children aged 1-15 years to get a better understanding of the relation between vaccine information sources, practices for two vaccines (MMR, HBV), vaccine acceptance, and vaccine hesitancy. METHODS A total of 3938 parents, drawn by random sampling, were interviewed by telephone as part of the "2016 health barometer" survey. Vaccine information sources were described and analyzed according to socio-demographic variables. Multivariate logistic regression models were then built to explain vaccine information sources usage, vaccination practices and attitudes. RESULTS Healthcare professionals (HCP), the Internet, and relatives were the three main vaccine information sources. Vaccination practices and acceptance were better when parents were getting information from HCPs compared with parents getting information from the Internet or relatives. Besides, getting information from the three different types of sources was associated with the highest rate of vaccine hesitancy: 70.9% (OR=4.6; P<0.0001) versus 34.6% among parents getting information from HCPs only. CONCLUSION Those results suggest an interest in providing quality information about vaccination on the Internet. The primary role of HCPs in vaccination decision is once again demonstrated.
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Vié le Sage F, Cohen R. [Preventing cancer: The role of Papillomavirus vaccination in the general population]. Bull Cancer 2020; 107:10-20. [PMID: 31982092 DOI: 10.1016/j.bulcan.2019.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022]
Abstract
Papillomavirus (HPV), the first sexually transmitted disease in the world, is the main infectious agent responsible for cancer (6300 per year, in France). The cycle of HPV infection - >precancerous lesions - >cancer is well documented with regard to the cervix (cf. Nobel Prize in 2008). While this area is the most frequent (3000), it is far from being the only one. Other cancers include the anus, oropharyngeal sphere, glans and vulva. The sum of these other induced HPV cancers is greater than the total number of cervical cancers and also concerns boys. Screening is essential but insufficient and only concerns the cervix. Only vaccination can provide primary and general prevention. Since 2007, there have been many studies demonstrating its excellent efficacy and tolerance. However, France lags behind other countries with a vaccination coverage (<30 %) that does not allow for an epidemiological impact.
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Affiliation(s)
- François Vié le Sage
- (AFPA) Association Française de Pédiatrie Ambulatoire, cabinet de pédiatrie, 67, rue Alexandre-Dumas, 73100 Aix-les-Bains, France.
| | - Robert Cohen
- Infovac, CHI de Créteil, 40, avenue de Verdun, 94000 Créteil, France
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Autran B. [Alterations in responses to vaccines in older people]. Rev Mal Respir 2019; 36:1047-1056. [PMID: 31522947 DOI: 10.1016/j.rmr.2019.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/08/2019] [Indexed: 11/28/2022]
Abstract
The aging population raises a number of public health issues including a need to address the severity and frequency of infections observed in older people. Vaccines play an important role in prevention. However, immunosenescence alters the intensity and quality of vaccine responses, thus limiting the impact of recommendations directed after 65 years for vaccination against flu, pneumococci, pertussis, tetanus and zoster. Immunosenescence, aggravated by co-morbidities, varies with age, becoming apparent after 60-65 years and more profound after 85 years. All stages of vaccine responses are affected by immunosenescence, from the innate immunity required to activate these responses to the induction of protective antibody responses and immune memory. Nevertheless, the capacity to develop new responses to primary vaccination is more affected than the ability to respond to recalls, although this is also impaired. Responses to vaccines are differentially altered depending on vaccine and age. Influenza vaccines are modestly immunogenic and several meta-analyses agree an estimate for efficacy of about 50% against virologically-proven flu and 40% against flu-related deaths. The anti-pneumococcal 23-valent non-conjugated vaccine does not induce memory while the 13-valent conjugated one does, but their efficacy are likely to be similar between 70 to 52% before 75 years. A sequential vaccination program with the 13-valent primo-vaccination followed by the 23-valent, recommended in immune-suppressed patients, is currently being studied in France. The waning of immunity to pertussis makes recalls necessary in the elderly who develop good antibody responses. Several research avenues are currently being pursued to try improve the degree of protection conferred by these vaccines in elderly.
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Affiliation(s)
- B Autran
- Sorbonne-université, 75005 Paris, France; UMR-S Inserm/UPMC 1135), CIMI-Paris (centre de recherches immunité maladies infectieuses), 83, boulevard de l'Hôpital, 75013 Paris, France.
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8
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Leduc C, Quoix E. [Vaccines for the treatment of non-small cell lung cancer]. Rev Mal Respir 2019; 36:415-425. [PMID: 30902445 DOI: 10.1016/j.rmr.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 05/31/2018] [Indexed: 11/26/2022]
Abstract
Antigen-specific immunotherapy also known as cancer vaccination offers a novel approach for the treatment of non-small cell lung cancer patients. It relies on specific priming of the immune system in order to provoke or increase adaptive antitumor immune response against the vaccine component. Several molecules have been developed in lung cancer, based on whole-tumor cells, dendritic cells, peptides, recombinant proteins, or viral vectors. The aim of this review is to describe the mechanism of action of these vaccines and the results of the main clinical studies.
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Affiliation(s)
- C Leduc
- Service de pneumologie, CHRU de Strasbourg, Strasbourg, France
| | - E Quoix
- Service de pneumologie, CHRU de Strasbourg, Strasbourg, France.
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Aba YT, Gagneux-Brunon A, Andrillat C, Fouilloux P, Daoud F, Defontaine C, Lucht F, Botelho-Nevers E. Travel medicine consultation: An opportunity to improve coverage for routine vaccinations. Med Mal Infect 2018; 49:257-263. [PMID: 30583868 DOI: 10.1016/j.medmal.2018.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 03/05/2018] [Accepted: 11/20/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Travelers may be responsible for the spread of vaccine-preventable diseases upon return. Travel physicians and family physicians may play a role in checking and updating vaccinations before traveling. Our aim was to evaluate the vaccine coverage for mandatory and recommended vaccination in travelers attending a travel medicine clinic (TMC). METHODS Vaccine coverage was measured using the current French immunization schedule as reference for correct immunization, in travelers providing a vaccination certificate during the TMC visit (university hospital of Saint-Étienne), between August 1, 2013 and July 31, 2014. RESULTS In total, 2336 travelers came to the TMC during the study period. Among the 2019 study participants, only 1216 (60.3%) provided a vaccination certificate. Travelers who provided a vaccination certificate were significantly younger than travelers who did not (mean age: 34.8±17.8 vs. 46±18.4 years, P<0.005) and were less likely to be Hajj pilgrims. Vaccine coverage against Tetanus, Diphtheria, and Poliomyelitis (Td/IPV vaccine) was 91.8%, 78.6% against Measles, Mumps, and Rubella (MMR), and 59.4% against Viral Hepatitis B (HBV). BCG vaccine coverage was 71.9%. Older travelers were less likely to be correctly vaccinated, except against HBV as vaccinated travelers were significantly older than unvaccinated travelers. CONCLUSION Obtaining information about immunization in travelers is difficult. Coverage for routine vaccines should be improved in this population. Travel medicine consultations could be the opportunity to vaccinate against MMR, HBV, and Td/IPV.
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Affiliation(s)
- Y T Aba
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Service de santé publique et de maladies infectieuses, université Alassane Ouattara, Bouaké, Côte d'Ivoire; Groupe immunité des muqueuses et agents Pathogènes - GIMAP EA 3064, université de Saint-Étienne, Université de Lyon, 42270 Saint-Priest-en-Jarez, France
| | - A Gagneux-Brunon
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Inserm, CIC 1408, 42055 Saint-Étienne, France; Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75679 Paris, France; Groupe immunité des muqueuses et agents Pathogènes - GIMAP EA 3064, université de Saint-Étienne, Université de Lyon, 42270 Saint-Priest-en-Jarez, France.
| | - C Andrillat
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - P Fouilloux
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Inserm, CIC 1408, 42055 Saint-Étienne, France; Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75679 Paris, France
| | - F Daoud
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - C Defontaine
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - F Lucht
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Inserm, CIC 1408, 42055 Saint-Étienne, France; Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75679 Paris, France; Groupe immunité des muqueuses et agents Pathogènes - GIMAP EA 3064, université de Saint-Étienne, Université de Lyon, 42270 Saint-Priest-en-Jarez, France
| | - E Botelho-Nevers
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Inserm, CIC 1408, 42055 Saint-Étienne, France; Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75679 Paris, France; Groupe immunité des muqueuses et agents Pathogènes - GIMAP EA 3064, université de Saint-Étienne, Université de Lyon, 42270 Saint-Priest-en-Jarez, France
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Cohen R, Rybak A, Tauzin M, Levy C. [Pneumococcal conjugate vaccine in children]. Rev Prat 2017; 67:1056-1058. [PMID: 30512598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Robert Cohen
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
- Association française de pédiatrie ambulatoire, Saint-Germainen- Laye, France
- Service de pédiatrie générale et aval des urgences, hôpital Armand- Trousseau, Paris, France
- Groupe de pathologie infectieuse pédiatrique, Paris, France
- Université Paris-Est, IMRB-GRC GEMINI, Créteil, France
- Unité court séjour, petits nourrissons, service de néonatologie, centre hospitalier intercommunal de Créteil, Créteil, France
- Centre de recherche clinique, centre hospitalier intercommunal de Créteil, Créteil, France
| | - Alexis Rybak
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
- Association française de pédiatrie ambulatoire, Saint-Germainen- Laye, France
| | - Manon Tauzin
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
| | - Corinne Levy
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
- Association française de pédiatrie ambulatoire, Saint-Germainen- Laye, France
- Groupe de pathologie infectieuse pédiatrique, Paris, France
- Université Paris-Est, IMRB-GRC GEMINI, Créteil, France
- Centre de recherche clinique, centre hospitalier intercommunal de Créteil, Créteil, France
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Abstract
IMMUNOTHERAPY IN URO-ONCOLOGY Immunotherapy is moving forward in prostate cancer. The autologous vaccine, Sipuleucel-T has been the first vaccine to be approved by FDA. First results with GVAX, tasquinimob or anti-PD-1 have been disappointing. Ipilimumab seen to be more active at an earlier stage of prostate disease. Identifying predictive factor or surrogate markers of activity of immunotherapy and which agents are clinically effective alone or in combination with others therapies such as hormonal or bone targeted therapies are warranted.
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Affiliation(s)
- Stéphane Oudard
- Service de cancérologie médicale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris-Descartes, Sorbonne-Paris-Cité, France; INSERM U970 PARCC université Paris-Descarte, Paris France.
| | - Constance Thibault
- Service de cancérologie médicale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Antoine Angelergues
- Service de cancérologie médicale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Eric Tartour
- INSERM U970 PARCC université Paris-Descarte, Paris France
| | - Marc Olivier Timsit
- Service d'urologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Arnaud Mejean
- Service d'urologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Constance Michel
- Service de cancérologie médicale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Yann Vano
- Service de cancérologie médicale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; CRC UMRS1138 EQ13, 15, rue de l'École-de-Médecine, 75006 Paris, France
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Gherardi RK, Aouizerate J, Cadusseau J, Yara S, Authier FJ. Aluminum adjuvants of vaccines injected into the muscle: Normal fate, pathology and associated disease. Morphologie 2016; 100:85-94. [PMID: 26948677 DOI: 10.1016/j.morpho.2016.01.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 01/12/2016] [Accepted: 01/16/2016] [Indexed: 02/08/2023]
Abstract
Aluminum oxyhydroxide (Alhydrogel(®)) is a nano-crystalline compound forming aggregates that has been introduced in vaccine for its immunologic adjuvant effect in 1926. It is the most commonly used adjuvant in human and veterinary vaccines but mechanisms by which it stimulates immune responses remain ill-defined. Although generally well tolerated on the short term, it has been suspected to occasionally cause delayed neurologic problems in susceptible individuals. In particular, the long-term persistence of aluminic granuloma also termed macrophagic myofasciitis is associated with chronic arthromyalgias and fatigue and cognitive dysfunction. Safety concerns largely depend on the long biopersistence time inherent to this adjuvant, which may be related to its quick withdrawal from the interstitial fluid by avid cellular uptake; and the capacity of adjuvant particles to migrate and slowly accumulate in lymphoid organs and the brain, a phenomenon documented in animal models and resulting from MCP1/CCL2-dependant translocation of adjuvant-loaded monocyte-lineage cells (Trojan horse phenomenon). These novel insights strongly suggest that serious re-evaluation of long-term aluminum adjuvant phamacokinetics and safety should be carried out.
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Affiliation(s)
- R K Gherardi
- Garches-Necker-Mondor-Hendaye Reference Centre for Neuromuscular Diseases, 94000 Créteil, France; Expert Centre for Neuromuscular Pathology, Henri-Mondor Hospital, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France; Inserm U955-Team 10 "Biology of Neuromuscular System" Paris Est-Créteil University, Créteil, France
| | - J Aouizerate
- Garches-Necker-Mondor-Hendaye Reference Centre for Neuromuscular Diseases, 94000 Créteil, France; Expert Centre for Neuromuscular Pathology, Henri-Mondor Hospital, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France; Inserm U955-Team 10 "Biology of Neuromuscular System" Paris Est-Créteil University, Créteil, France
| | - J Cadusseau
- Garches-Necker-Mondor-Hendaye Reference Centre for Neuromuscular Diseases, 94000 Créteil, France; Inserm U955-Team 10 "Biology of Neuromuscular System" Paris Est-Créteil University, Créteil, France
| | - S Yara
- Garches-Necker-Mondor-Hendaye Reference Centre for Neuromuscular Diseases, 94000 Créteil, France; Inserm U955-Team 10 "Biology of Neuromuscular System" Paris Est-Créteil University, Créteil, France
| | - F J Authier
- Garches-Necker-Mondor-Hendaye Reference Centre for Neuromuscular Diseases, 94000 Créteil, France; Expert Centre for Neuromuscular Pathology, Henri-Mondor Hospital, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France; Inserm U955-Team 10 "Biology of Neuromuscular System" Paris Est-Créteil University, Créteil, France.
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13
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Schernberg A, Marabelle A, Massard C, Armand JP, Dumont S, Deutsch E, Dhermain F. [What's next in glioblastoma treatment: Tumor-targeted or immune-targeted therapies?]. Bull Cancer 2016; 103:484-98. [PMID: 27032303 DOI: 10.1016/j.bulcan.2016.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 02/28/2016] [Accepted: 02/29/2016] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Glioblastoma (GBM) is associated with a poor prognosis. This review will discuss different directions of treatment, mostly regarding immunotherapies and combinatorial approaches. DEVELOPMENT Standard treatment for newly diagnosed GBM is maximal and safe surgical resection followed by concurrent radiochemotherapy (RCT) based on temozolomide, allowing 14.6 months median survival. Nowadays, no combination with molecular-targeted therapy had significantly improved prognosis. Phases I and II data are emerging, highlighting the potential efficacy of associations with other therapies. Studies have suggested the potential of targeting tumor stem cells, at less partially responsible for resistance to RCT. There is now some evidence that immunotherapy is also relevant for brain tumors. Treatment strategies have mainly explored vaccines strategies, such as the dendritic cell, heat shock protein or EGFRvIII vaccines. Of the work initiated in melanoma, immune checkpoints inhibitors have exhibited stimulating results. Others trials have demonstrated potential of autologous stimulated lymphocytes. Moreover, strong data indicates that radiation therapy has the potential to promote immunogenicity and create a sort of in situ personalized vaccine. CONCLUSION These data provide strong evidence to support the potential of associating combinatorial targeted and/or immunotherapeutic regimens in patients with GBM that may change patient outcome.
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Affiliation(s)
- Antoine Schernberg
- Institut Gustave-Roussy, département de radiothérapie, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
| | - Aurélien Marabelle
- Institut Gustave-Roussy, département d'oncologie médicale, 94800 Villejuif, France
| | - Christophe Massard
- Institut Gustave-Roussy, département d'oncologie médicale, 94800 Villejuif, France
| | - Jean-Pierre Armand
- Institut Gustave-Roussy, département d'oncologie médicale, 94800 Villejuif, France
| | - Sarah Dumont
- Institut Gustave-Roussy, département d'oncologie médicale, 94800 Villejuif, France
| | - Eric Deutsch
- Institut Gustave-Roussy, département de radiothérapie, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - Frédéric Dhermain
- Institut Gustave-Roussy, département de radiothérapie, 114, rue Édouard-Vaillant, 94805 Villejuif, France
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14
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Abstract
In 1986 the Ottawa Charter underlined the importance of advocacy in health. This article analyzes the role of advocacy in Public Health making the case of immunization, whose coverage rates are decreasing in many countries. An effective advocacy action could counteract the growing phenomenon of the vaccine hesitancy within both the general population and an increasing share of healthcare providers as well as contrast antivax movements' action. We identify who are the advocates focusing on Italy and on the crucial role of scientific societies which share the responsibility of making the latest scientific evidence and most effective infectious diseases' control strategies available to health policy makers. The Italian Society of Hygiene (SItI) has been actively engaged for several years in a number of initiatives of advocacy communication and vaccines including research, training, media exposure and a dedicated website portal (vaccinarSì).
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Affiliation(s)
- C Signorelli
- Department of Biomedical, Biotechnological & Translational Sciences (S.Bi.Bi.T), University of Parma, Italy - President, Italian Society of Hygiene, Preventive medicine and Public Health (SItI)
| | - A Odone
- Department of Biomedical, Biotechnological & Translational Sciences (S.Bi.Bi.T), University of Parma, Italy
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15
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Luans C, Cardiet I, Rogé P, Baslé B, Le Corre P, Revest M, Michelet C, Tattevin P. Causes and consequences of anti-infective drug stock-outs. Med Mal Infect 2014; 44:470-7. [PMID: 25282606 DOI: 10.1016/j.medmal.2014.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 06/19/2014] [Accepted: 07/22/2014] [Indexed: 11/28/2022]
Abstract
Anti-infective drugs stock-outs are increasingly frequent, and this is unlikely to change. There are numerous causes for this, mostly related to parameters difficult to control: i) 60 to 80% of raw material or components are produced outside of Europe (compared to 20% 30 years ago), with subsequent loss of independence for their procurement; ii) the economic crisis drives the pharmaceutical companies to stop producing drugs of limited profitability (even among important drugs); iii) the enforcement of regulatory requirements and quality control procedures result in an increasing number of drugs being blocked during production. The therapeutic class most affected by drug stock-outs is that of anti-infective drugs, especially injectable ones, and many therapeutic dead ends have recently occurred. We provide an update on this issue, and suggest 2 major actions for improvement: i) to implement a group dedicated to anticipating drug stock-outs within the anti-infective committee in each health care center, with the objectives of organizing and coordinating the response whenever a drug stock-out is deemed at risk (i.e., contingency plans, substitution, communication to prescribers); ii) a national reflection lead by scientific societies, in collaboration with government agencies, upstream of the most problematic drug stock-outs, to elaborate and disseminate consensus guidelines for the management of these stock-outs.
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Affiliation(s)
- C Luans
- Service de Pharmacie, CHU Pontchaillou, 35033 Rennes Cedex, France
| | - I Cardiet
- COMEDIMS, CHU Pontchaillou, 35033 Rennes Cedex, France
| | - P Rogé
- Service de Pharmacie, CHU Pontchaillou, 35033 Rennes Cedex, France
| | - B Baslé
- Service de Pharmacie, CHU Pontchaillou, 35033 Rennes Cedex, France
| | - P Le Corre
- Service de Pharmacie, CHU Pontchaillou, 35033 Rennes Cedex, France
| | - M Revest
- Service des Maladies Infectieuses et Réanimation Médicale, CHU Pontchaillou, 35033 Rennes Cedex, France; CIC-Inserm 0203, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France; Inserm U835, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France
| | - C Michelet
- Service des Maladies Infectieuses et Réanimation Médicale, CHU Pontchaillou, 35033 Rennes Cedex, France; CIC-Inserm 0203, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France
| | - P Tattevin
- Service des Maladies Infectieuses et Réanimation Médicale, CHU Pontchaillou, 35033 Rennes Cedex, France; CIC-Inserm 0203, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France; Inserm U835, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France.
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