Mycolactone toxin induces an inflammatory response by targeting the IL-1ß pathway: Mechanistic insight into Buruli ulcer pathophysiology.

Mycolactone, a lipid-like toxin, is the major virulence factor of Mycobacterium ulcerans, the etiological agent of Buruli ulcer. Its involvement in lesion development has been widely described in early stages of the disease, through its cytotoxic and immunosuppressive activities, but less is known about later stages. Here, we revisit the role of mycolactone in disease outcome and provide the first demonstration of the pro-inflammatory potential of this toxin. We found that the mycolactone-containing mycobacterial extracellular vesicles produced by M. ulcerans induced the production of IL-1ß, a potent pro-inflammatory cytokine, in a TLR2-dependent manner, targeting NLRP3/1 inflammasomes. We show our data to be relevant in a physiological context. The in vivo injection of these mycolactone-containing vesicles induced a strong local inflammatory response and tissue damage, which were prevented by corticosteroids. Finally, several soluble pro-inflammatory factors, including IL-1ß, were detected in infected tissues from mice and Buruli ulcer patients. Our results revisit Buruli ulcer pathophysiology by providing new insight, thus paving the way for the development of new therapeutic strategies taking the pro-inflammatory potential of mycolactone into account.

The COL5A3 and MMP9 genes interact in eczema susceptibility.

BACKGROUND: Genetic studies of eczema have identified many genes, which explain only 14% of the heritability. Missing heritability may be partly due to ignored gene-gene (G-G) interactions. OBJECTIVE: Our aim was to detect new interacting genes involved in eczema. METHODS: The search for G-G interaction in eczema was conducted using a two-step approach, which included as a first step, a biological selection of genes, which are involved either in the skin or epidermis development or in the collagen metabolism, and as a second step, an interaction analysis of the selected genes. Analyses were carried out at both SNP and gene levels in three asthma-ascertained family samples: the discovery dataset of 388 EGEA (Epidemiological study on the Genetics and Environment of Asthma) families and the two replication datasets of 253 SLSJ (Saguenay-Lac-Saint-Jean) families and 207 MRCA (Medical Research Council) families. RESULTS: One pair of SNPs, rs2287807 in COL5A3 and rs17576 in MMP9, that were detected in EGEA at P ≤ 10-5 showed significant interaction by meta-analysis of EGEA, SLSJ and MRCA samples (P = 1.1 × 10-8 under the significant threshold of 10-7 ). Gene-based analysis confirmed strong interaction between COL5A3 and MMP9 (P = 4 × 10-8 under the significant threshold of 4 × 10-6 ) by meta-analysis of the three datasets. When stratifying the data on asthma, this interaction remained in both groups of asthmatic and non-asthmatic subjects. CONCLUSION: This study identified significant interaction between two new genes, COL5A3 and MMP9, which may be accounted for by a degradation of COL5A3 by MMP9 influencing eczema susceptibility. Further confirmation of this interaction as well as functional studies is needed to better understand the role of these genes in eczema.

Network-assisted analysis of GWAS data identifies a functionally-relevant gene module for childhood-onset asthma.

The number of genetic factors associated with asthma remains limited. To identify new genes with an undetected individual effect but collectively influencing asthma risk, we conducted a network-assisted analysis that integrates outcomes of genome-wide association studies (GWAS) and protein-protein interaction networks. We used two GWAS datasets, each consisting of the results of a meta-analysis of nine childhood-onset asthma GWASs (5,924 and 6,043 subjects, respectively). We developed a novel method to compute gene-level P-values (fastCGP), and proposed a parallel dense-module search and cross-selection strategy to identify an asthma-associated gene module. We identified a module of 91 genes with a significant joint effect on childhood-onset asthma (P < 10-5). This module contained a core subnetwork including genes at known asthma loci and five peripheral subnetworks including relevant candidates. Notably, the core genes were connected to APP (encoding amyloid beta precursor protein), a major player in Alzheimer's disease that is known to have immune and inflammatory components. Functional analysis of the module genes revealed four gene clusters involved in innate and adaptive immunity, chemotaxis, cell-adhesion and transcription regulation, which are biologically meaningful processes that may underlie asthma risk. Our findings provide important clues for future research into asthma aetiology.

Clusterin facilitates apoptotic cell clearance and prevents apoptotic cell-induced autoimmune responses.

Clusterin (Clu), an extracellular chaperone, exhibits characteristics of soluble innate immunity receptors, as assessed by its ability to bind some bacteria strains. In this study, we report that Clu also binds specifically to late apoptotic cells but not to live, early apoptotic, or necrotic cells. Histones, which accumulate on blebs during the apoptotic process, represent privileged Clu-binding motifs at the surface of late apoptotic cells. As a consequence, Clu potentiates, both in vitro and in vivo, the phagocytosis of late apoptotic cells by macrophages. Moreover, the increased phagocytosis of late apoptotic cells induced by Clu favors the presentation and cross-presentation of apoptotic cell-associated antigens. Finally, we observed that, in a model of apoptotic cell-induced autoimmunity, and relative to control mice, Clu(-/-) mice develop symptoms of autoimmunity, including the generation of anti-dsDNA antibodies, deposition of immunoglobulins and complement components within kidneys, and splenomegaly. These results identify Clu as a new molecule partner involved in apoptotic cell efferocytosis and suggest a protective role for Clu in inflammation and autoimmune diseases.

[Genetic and environmental factors of asthma and allergy: Results of the EGEA study]. / Facteurs génétiques et environnementaux de l'asthme et de l'allergie: synthèse des résultats de l'étude EGEA.

INTRODUCTION AND METHODS: The EGEA study (epidemiological study on the genetics and environment of asthma, bronchial hyperresponsiveness and atopy), which combines a case-control and a family-based study of asthma case (n=2120 subjects) with three surveys over 20 years, aims to identify environmental and genetic factors associated with asthma and asthma-related phenotypes. We summarize the results of the phenotypic characterization and the investigation of environmental and genetic factors of asthma and asthma-related phenotypes obtained since 2007 in the EGEA study (42 articles). RESULTS: Both epidemiological and genetic results confirm the heterogeneity of asthma. These results strengthen the role of the age of disease onset, the allergic status and the level of disease activity in the identification of the different phenotypes of asthma. The deleterious role of active smoking, exposure to air pollution, occupational asthmogenic agents and cleaning products on the prevalence and/or activity of asthma has been confirmed. Accounting for gene-environment interactions allowed the identification of new genetic factors underlying asthma and asthma-related traits and better understanding of their mode of action. CONCLUSION: The EGEA study is contributing to the advances in respiratory research at the international level. The new phenotypic, environmental and biological data available in EGEA study will help characterizing the long-term evolution of asthma and the factors associated to this evolution.

Haemophilus influenzae: a forgotten cause of neonatal sepsis?

Due to the introduction of the conjugate vaccine against serotype b, neonatal sepsis caused by Haemophilus influenzae became very rare. There is little data in Belgium concerning the prevalence of H. influenzae early onset neonatal sepsis and articles about neonatal sepsis and H. influenzae published in the last decade are scarce. We report two invasive infections with a non-typeable H. influenzae. These cases show that neonatal sepsis caused by non-typeable H. influenzae may be underestimated and we believe that there is need for a better registration of this kind of infection.

Endogenous PTX3 translocates at the membrane of late apoptotic human neutrophils and is involved in their engulfment by macrophages.

Neutrophils are short-lived innate immune cells that rapidly die by apoptosis. A rapid and efficient clearance of apoptotic cells is crucial to avoid autoimmunity. This process involves cell alterations, endocytic receptors expressed by phagocytic cells and soluble bridging molecules (opsonins) that facilitate internalization of apoptotic cells by phagocytes. Neutrophils constitutively express the prototypic long pentraxin PTX3 that binds to apoptotic cells and modulates their clearance. We thus evaluated whether endogenous PTX3 may interfere with the capture of apoptotic neutrophils. We observed that PTX3 accumulates in blebs at the surface of late apoptotic neutrophils, resulting from its active translocation from granules to the membrane. A neutralizing anti-PTX3 monoclonal Ab (mAb) inhibits the capture of late apoptotic neutrophils by macrophages. This study shows that intracellular PTX3 translocates at the surface of late apoptotic neutrophils and acts as an 'eat-me' molecule for their recognition and capture by macrophages.

[Comparison and relevance of rheumatoid factors, antikeratin antibodies and anti-cyclic citrullinated peptides antibodies in rheumatoid arthritis]. / Comparaison et intérêt des dosages des facteurs rhumatoïdes, des anticorps anti-filaggrine (anti-kératine) et des anticorps anti-peptides cycliques citrullinés dans la polyarthrite rhumatoïde.

OBJECTIVES: to evaluate specificity and sensibility of the rheumatoid factors (RF), the anti-cyclic citrullinated peptide antibodies (CCP) and the anti-keratin antibodies (AKA) according to the rheumatoid arthritis (RA) diagnosis; pathology other than RA with at least one of these marker positive; the significance of the flocculent fluorescence of the antibodies AKA by indirect immunofluorescence (IIF). METHOD: two hundred forty height patients were studied: 121 RA, 89 inflammatory rheumatisms, 23 non inflammatory rheumatisms, and 15 non rheumatic affections. The RF was investigated by nephelometry, the anti-CCP by immunofluorometry and the AKA by IIF on rat oesophagus. RESULTS: specificity and sensibility were respectively in a retrospective manner: 68% and 83% for the RF, 95% and 76% for the anti- CCP, 83% and 40% for the AKA during RA with evolution of less than one year. The rates of agreements were: RF versus CCP: 81%, RF versus AKA: 57%, CCP versus AKA: 73%. Twelve patients with pathologies different from RA have positive anti-CCP or AKA. Thirty three of the patients with anti-CCP level superior to 130 U/mL have flocculent AKA versus only 5% when the anti-CCP are lower than 130 U/mL. CONCLUSION: the RF and the anti-CCP are complementary in RA. Autoimmune and neoplasic pathologies are sometimes responsible for the positivity of the anti-CCP and the AKA. The flocculent aspect of AKA in IIF may be associated with raised concentrations of anti-CCP.

Antineutrophil cytoplasmic autoantibodies: how should the biologist manage them?

Antineutrophil cytoplasmic antibodies (ANCA) are directed against enzymes found in the granules of the polymorphonuclear (PMN) leukocytes. They are detected by indirect immunofluorescence microscopy assays on human ethanol fixed neutrophils. Three different fluorescence patterns can be distinguished: a cytoplasmic pattern (cANCA), a perinuclear pattern (pANCA), and an atypical pattern (aANCA). The use of other fixatives, e.g., formalin and methanol, allows differentiation between the pANCA and the antinuclear antibodies. ANCA specificity is determined by solid phase assays (ELISA, immunodot, and multiplex assay). ANCA with high titres and defined specificities (antiproteinase 3 [PR 3] or antimyeloperoxidase [MPO]) are proven to be good serological markers of active primary systemic vasculitis: c/PR 3-ANCA for Wegener's granulomatosis and p/MPO-ANCA for microscopic polyangiitis. The former have higher sensitivity and specificity for Wegener's granulomatosis than the latter for microscopic polyangiitis. ANCA with low titres and unknown specificity have been detected in a wide range of inflammatory and infectious diseases leading to a critical reappraisal of the diagnostic significance of ANCA testing. Physicians must keep in mind the possible occurrence of infectious diseases like subacute endocarditis that could be dramatically worsened by irrelevant immunosuppressive therapy. ANCA findings in certain manifestations, such as the pulmonary-renal syndrome in which massive pulmonary hemorrhage can quickly be life-threatening, warrant ANCA testing as an emergency test for patient care.

Efficacy of fipronil in the treatment of feline cheyletiellosis.

The purpose of the present study was to confirm the efficacy of 10% (w/v) fipronil spot-on (Frontline spot-on for cats) in the treatment of feline cheyletiellosis under field conditions. A total of 16 cats of different breeds, sexes, 4 months to 14 years of age and weighing 0.5-6 kg were treated with a single topical application of 10% (w/v) fipronil spot-on according to label directions. The animals were naturally infested with Cheyletiella mites and housed in their normal environment throughout the study. Animals were selected based on clinical signs and infestation was confirmed by demonstration of mites. Mite counts and a clinical assessment of mite infestations (i.e. skin lesions and/or scales) were performed on days 0 and approximately days 14 and 28. Individual counts on day 0 ranged from 1 to 40 mites on individual animals. No mites were detected on cats treated with 10% (w/v) fipronil spot-on (Frontline spot-on for cats) at both post-treatment evaluations. Typical skin lesions and/or scales were present in all animals pre-treatment. In 56% of the cats, the lesions resolved within 14 days after treatment. At the final assessment, 75% cats were free of lesions. Two cats that still had clinical signs on day 28 were suspected of having allergic reactions to food or environmental allergens. The lesions on the remaining two cats could not be related to a specific cause. The efficacy of fipronil in elimination of mites was 100% on each occasion when compared to the pre-treatment count. The results of this study demonstrated that fipronil in a topical formulation is highly effective (100%) for the elimination of an existing Cheyletiella mite infestation under field conditions following a single topical application in cats.

Efficacy of fipronil/(S)-methoprene combination spot-on for dogs against shed eggs, emerging and existing adult cat fleas (Ctenocephalides felis, Bouché).

The inhibitory activities of fipronil (10% (w/v) solution), (S)-methoprene (9% (w/v) solution), and fipronil/(S)-methoprene (10 and 9% (w/v) solution, respectively) combination against eggs and emerging adult cat fleas (Ctenocephalides felis) and adulticidal activity were tested on experimentally infested dogs. Thirty-two Beagle dogs were selected for this study and eight replicates of four animals were formed based on body weight within sex. One dog in each replicate was randomly allocated to treatment with: (1) untreated control; (2) fipronil 10% (w/v) solution, (3) (S)-methoprene 9% (w/v) solution, and (4) fipronil 10% (w/v) and (S)-methoprene 9% (w/v) combination solution. Treatments were applied once topically on Day 0 at the rate of 0.067 ml/kg. On Days -12, -1, 21, and weekly to Day 84 each dog was infested with approximately 200 fleas and comb counted approximately 24h later, or 2 days (our 48 h) after in the case of Day -1 infestation. On Days -11, 1, 22, and weekly to Day 85 each dog was again infested with approximately 200 fleas. Flea eggs were collected over approximately 24 h beginning 3 days after infestation. Fleas were combed off of the dogs and counted at the end of the egg collection period (approximately 96 h count). One aliquot of up to about 100 eggs, if available, from each animal at each infestation time was incubated for approximately 72 h to determine larval hatch and the other for 35 days to determine the number of adults that developed. The 10% (w/v) fipronil spot-on provided excellent control (>95%) of adult fleas on dogs for 5 weeks. Similarly, the combination spot-on of 10% (w/v) fipronil and 9% (w/v) (S)-methoprene provided excellent control of adult fleas, i.e., >95% for 5 weeks. From week 6 post-treatment onward, the relatively low inhibition of adult flea emergence substantiated the lack of significant ovicidal/larvicidal activity in the fipronil (10%, w/v) treatment group. However, the combination product provided excellent (>90%) ovicidal activity for 8 weeks and high (91.4%) inhibition of adult flea emergence for 12 weeks. In addition, a synergistic effect of the two compounds in combination was demonstrated with fipronil enhancing the ovicidal and inhibition of adult flea emergence activity of (S)-methoprene against cat flea eggs. When all stages of the life cycle of the cat flea are considered, the combination spot-on product provided a high level of total flea control yielding a curative effect against adult fleas and inhibition of flea development stages with little to no potential reinfestation pressure on the animal or in the environment for 12 weeks.

HLA-DQ relative risks for coeliac disease in European populations: a study of the European Genetics Cluster on Coeliac Disease.

Coeliac disease is an enteropathy due to an intolerance to gluten. The association between HLA-DQ genes and CD is well established. The majority of patients carry the HLA-DQ heterodimer encoded by DQA1*05/DQB1*02, either in cis or in trans. The remaining patients carry either part of the DQ heterodimer or DQA1*03-DQB1*0302. The aim of the study was to estimate the risks associated with different DQ genotypes in European populations. HLA information was available for 470 trio families from four countries: France (117), Italy (128), and Norway and Sweden (225). Five DQA1-DQB1 haplotypes were considered and control haplotype frequencies were estimated from the set of parental haplotypes not transmitted to the affected child. The possible genotypes were grouped into five genotype groups, based on the hierarchy of risk reported in the literature. A north-south gradient in the genotype group frequencies is observed in probands: homogeneity is strongly rejected between all country pairs. For each country, the relative risks associated with each genotype group were computed taking into account the control haplotype frequencies. Homogeneity of relative risks between countries was tested pairwise by maximum likelihood ratio statistics. The hypothesis of homogeneity of relative risks is rejected (P is approximately 10(-6)) for all country pairs. In conclusion, the gradient in the genotype group frequencies in probands is not only due to differences in haplotype frequencies but also due to differences in genotype relative risks in the studied populations; the relative risks associated with each DQ genotype group are different between northern and southern European countries; neither are they ordered in the same way.

Effective treatment and control of biting lice, Felicola subrostratus (Nitzsch in Burmeister, 1838), on cats using fipronil formulations.

The efficacy of 0.25% fipronil spray (Frontline Spray, Merial), 10% fipronil spot-on (Frontline Spot-on for Cats, Merial) and 10% fipronil/12% (S)-methoprene (Frontline Plus for Cats, Merial) against the biting louse Felicola subrostratus on cats was assessed and confirmed under laboratory conditions. A field study evaluated the efficacy of a single topical application of Frontline Spray, and spot-on against the parasite on cats. In the laboratory studies, animals were allocated based on pre-treatment louse counts to the treatment groups: (1) untreated control and (2) 10% fipronil spot-on in the exploratory study or (1) untreated control, (2) 0.25% fipronil spray, at 6 ml/kg; (3) 10% fipronil spot-on as per label and (4) 10% fipronil/12% (S)-methoprene as per label in the confirmation study. Cats in treatment groups 2-4 were treated twice topically on Days 0 and 28. No live F. subrostratus were found on cats treated with fipronil formulations at any post-treatment examination. The difference from controls was significant (P < 0.01) for each product at each examination. Based on whole body counts at Day 42, the efficacy of each product was determined to be 100%. In the field study, cats were allocated in strict order of presentation. Cats were randomly allocated to one of the three treatment groups: (1) propoxur collar (Bolfo, Bayer); (2) 0.25% fipronil spray, at 6 ml/kg and (3) 10% fipronil spot-on as per label. Cats were treated once topically on Day 0. Louse counts of cats treated with fipronil formulations were not different than those of cats receiving the propoxur collar. The efficacy was determined to be > 98% on Day 2 and 100% on Days 28 and 42 in all treatment groups. The results of these studies demonstrate that fipronil in topical formulations is effective for treatment and control of biting lice (F. subrostratus) infestations on cats.

Detection of circulating soluble CD28 in patients with systemic lupus erythematosus, primary Sjögren's syndrome and systemic sclerosis.

The aim of this study was to evaluate the presence and the role of the serum soluble costimulatory molecule CD28 in patients with systemic lupus erythematosus (SLE), primary Sjögren's syndrome (SS), and systemic sclerosis (SSc). Soluble CD28 concentration was determined by ELISA in 45 patients with SLE, 45 patients with primary SS, 30 patients with SSc, and 45 healthy subjects. We also evaluated CD28 mRNA expression by semiquantitative RT-PCR, and the biological activity of recombinant soluble CD28 on T lymphocyte activity. Concentrations of soluble CD28 were significantly higher in patients with SLE, primary SS and SSc than in healthy subjects. Soluble CD28 concentrations were higher in patients with systemic primary SS than in patients with glandular-limited primary SS. PCR analysis suggested that soluble CD28 resulted from the shedding of the membrane form. In vitro assay revealed that soluble CD28 inhibits the anti-CD3 mAb induced T cell proliferation. Soluble CD28, which modulates the proliferation of T lymphocytes, could be associated with disease severity in patients with autoimmune disease, especially primary SS. These results suggest that soluble CD28 could play an important role in the regulation of autoimmune diseases.

Evaluation of fipronil spot-on in the treatment of flea allergic dermatitis in dogs.

The purpose of this study was to evaluate the effectiveness of treatment with 10 per cent fipronil solution for controlling signs of flea allergic dermatitis in dogs under field conditions. Thirty-one client-owned dogs with flea allergic dermatitis were treated with three monthly applications of 10 per cent fipronil solution. Flea counts and pruritus were significantly reduced at all post-treatment visits. At the final visit, on day 90, flea counts were reduced by 98 per cent, and pruritus was reduced or eliminated in 84 per cent of the study dogs. Dermatological lesion scores for erythema, crusts, scales and papules were also significantly improved by the final visit. The overall assessment of efficacy on day 90 was 'excellent' to 'good' for 87 per cent of the study dogs. The results demonstrate that treatment with monthly topical applications of 10 per cent fipronil solution is effective in reducing the prevalence and severity of signs of flea allergic dermatitis in dogs.

Evaluation of the efficacy of fipronil formulations in the treatment and control of biting lice, Trichodectes canis (De Geer, 1778) on dogs.

The efficacy of FRONTLINE SPRAY (0.25% (w/v) fipronil), FRONTLINE SPOT-ON FOR DOGS (10% (w/v) fipronil) and FRONTLINE PLUS FOR DOGS (10% (w/v) fipronil and 9% (S)-methoprene) against the biting louse Trichodectes canis on dogs was confirmed under laboratory conditions. A field study evaluated the efficacy of a single topical application of FRONTLINE SPRAY and FRONTLINE SPOT-ON against the parasite on dogs. A total of 48 dogs of mixed breeds, both sexes, aged 2 months-7 years and weighing 1.8-37.0kg were used. The animals were either experimentally (laboratory study) or naturally (field study) infested with lice. Dogs were housed individually in order to prevent contact between animals. In the laboratory study, animals were allocated based on pre-treatment louse counts from 38 hair coat-partings per animal. Dogs were randomly assigned to the four treatment groups: (1) untreated control; (2) FRONTLINE SPRAY, at 6ml/kg; (3) FRONTLINE SPOT-ON as per label and (4) FRONTLINE PLUS as per label. Dogs in treatment groups 2-4 were treated twice topically on Days 0 and 28. The number of live lice in the 38 hair coat-partings per animal were counted on Days 2, 7 and weekly to Day 63. In addition, a whole body comb count was performed on Day 63. No live T. canis were found on dogs treated with FRONTLINE formulations at any post-treatment examination. The difference from controls was significant (P<0.01) for each product at each examination. Based on the whole body comb count at Day 63, the efficacy of each product was determined to be 100%. In the field study, dogs were allocated in strict order of presentation. Dogs were randomly allocated to one of the three treatment groups: (1) BOLFO collar (propoxur); (2) FRONTLINE SPRAY, at 6ml/kg and (3) FRONTLINE SPOT-ON as per label. Dogs were treated once topically on Day 0. The number of live lice was determined by whole body searches on Days 0 (pre-treatment), 2, 28 and 42. Louse counts of dogs treated with either FRONTLINE SPRAY, or FRONTLINE SPOT-ON were not different than those of dogs receiving the propoxur collar. The efficacy was determined to be >98% on Day 2 and, 100% on Days 28 and 42 in all treatment groups. The results of these studies demonstrate that fipronil in topical formulations is effective for treatment and control of biting lice (T. canis) infestations on dogs.

Histamine polarizes human dendritic cells into Th2 cell-promoting effector dendritic cells.

Allergic disorders are characterized by allergen-specific Th2-biased responses. Signals controlling Th2 cell polarization, especially those acting by polarizing dendritic cells (DC) into Th2-promoting DC (DC2), are not well known. Histamine, a mediator released by allergen-stimulated mast cells from allergic subjects, has been reported to activate human immature DC. We have therefore tested whether histamine affects DC polarization. We report here that histamine inhibits LPS-induced IL-12 production and polarizes uncommitted maturing DC into effector DC2. DC matured in the presence of histamine fail to produce IL-12 upon subsequent stimulation and prime Th2 responses, even in presence of IFN-gamma, a potent DC1-driving factor. All these effects are mediated through both H1 and H2 receptors. These data show that histamine is a potent DC2-polarizing factor and provide evidence for a novel mechanism that explains the initiation and maintenance of a predominant Th2 response in allergic disorders.