Strengths of ecosystem services concept for radiation protection.

The successful ecosystem services concept, defined as the benefits people obtain from ecosystems is still not really reflected in the current approaches for protecting public and environment against radiation promoted by the International Commission on Radiological Protection or other similar approaches. Yet some recent thoughts from international organizations lead us to believe that an eco-based approach could be more promoted in the coming years in environmental radiation protection field. The French Institute for Radiation Protection and Nuclear Safety has identified different fields of application of this concept into radiation protection, in line with its integrated approach of radiological risks management. As the ecosystem services approach makes it possible to highlight biophysical and socio-economic approaches of the impacts of ionizing radiation on ecosystems, it represents a subject of primary importance for future works conducted by IRSN. However, the operationality of the ecosystem services concept is the subject of many debates. In many situations, scientists have not yet fully understood how radioactive contamination could affect ecosystem services, and how to articulate with certainty cause and effect relationships between state of an ecosystem and provision of services. In addition, the concept is also accompanied by contradictory perceptions of the status of humans in ecosystems. To solve these knowledge gaps and uncertainties, it is necessary to acquire robust data on the impacts of radiation on ecosystems both under experimental and realistic conditions, and to integrate all potential consequences (direct and indirect, ecotoxicological but also economic and cultural).

Anti-inflammatory effect of different PRGF formulations on cutaneous surface.

Cutaneous autoimmune and inflammatory diseases are a major burden of global disease and many lack effective treatments that can derive in different dermatoses like atopic dermatitis. Despite the increase prevalence and the high health-care costs worldwide, the heterogeniety and multifactoriality of these diseases mean that effective treatment options are scarce. Plasma rich in growth factors (PRGF) technology could be an alternative approach that may help in the management of this cutaneous condition. The aim of this study was to assess the effect of two different PRGF formulations (just activated and autologous topical serum (ATS)) for the management of skin inflammation. Additionally, ATS was assessed over two patients suffering from radiotherapy induced dermatitis. Human organotypic skin explant cultures (hOSECs) were used as human skin models. To induce atopic dermatitis-like conditions, skin explants were treated with both interleukin-4 (IL-4) and interleukin-13 (IL-13). PRGF and ATS were intradermally and topically applied, respectively. Metabolic activity, reactive oxigen species (ROS), necrosis and inflammatory cytokine production were determined. Both PRGF formulations increased tissue viability and significantly reduced the excessive free radical accumulation and the cutaneous cytokine production such as TNF-α and IL-1ß. Case reports showed a positive response after ATS treatment in terms of skin quality improvement, local erythema decrease and burning and itching amelioration. The oedema, swelling and desquamation caused by radiation induced dermatitis was also reduced and the patients referred ceased pruritus and pain. This preliminary study suggests that PRGF might aid in the management of inflammatory skin conditions.

A Novel Autologous Topical Serum Based on Plasma Rich in Growth Factors Technology Counteracts Ultraviolet Light-Derived Photo-Oxidative Stress.

INTRODUCTION: Skin as the major barrier between the internal and external environments protects our body from external injuries. Ultraviolet B (UVB) radiation is majorly responsible for photoaging and is closely associated with oxidative stress, inflammation, and DNA damage. The progression in the field of biological therapies has led to the emergence of new autologous therapies based on growth factors. An autologous topical serum (ATS) based on the plasma rich in growth factors (PRGF) technology has also been developed with regenerative properties. OBJECTIVE: The aim of this study was to evaluate this new topical formulation in protecting skin against UVB-induced photodamage using dermal fibroblast cultures and 3D skin models. METHODS: ATS was assessed over the main mechanisms underlying photodamage including oxidative stress, cell viability, DNA damage, cell death, and biosynthetic activity. Three different irradiation protocols were tested. RESULTS: ATS application showed to significantly reduce free radical production and cell death caused by ultraviolet radiation. It also increased cell viability and promoted the proliferative activity and fibronectin biosynthesis of dermal fibroblasts. DNA double-strand cleavage that occurs after photo-oxidative stress was reduced. Photoexposed 3D explants showed higher levels of metabolic activity and collagen synthesis. Histomorphometric analysis also revealed a reduction in UV-derived edema, hyperkeratosis, and apoptosis and an increase in collagen and cell bioactivity. CONCLUSION: This preliminary study suggests that this novel ATS might counteract the harmful effects of UV radiation.

Efectos indirectos de la infección por citomegalovirus / Indirect effects of cytomegalovirus infection

A pesar de la mejora en las estrategias de prevención, el citomegalovirus (CMV) continúa siendo el principal causante de infección en los pacientes trasplantados de órgano sólido. En estos pacientes, además de efectos directos, como el síndrome viral o la enfermedad invasiva de órgano, el CMV puede ocasionar efectos indirectos que resultan de la interacción del virus con el sistema inmune del huésped. Esta interacción puede desembocar en un mayor grado de inmunosupresión, con el consiguiente aumento de infecciones oportunistas, en un mayor riesgo de malignidad (enfermedad linfoproliferativa postrasplante asociada al virus de Epstein-Barr) y en un mayor riesgo de disfunción del injerto. Aunque en la actualidad no puede establecerse una relación directa de causalidad entre el CMV y la mayoría de los efectos indirectos descritos, numerosos estudios experimentales y clínicos han evidenciado una asociación entre la aparición de estos efectos y el CMV. Además, se ha evidenciado la disminución del riesgo de alguno de estos efectos, como la aparición de infecciones oportunistas, con la instauración de pautas de profilaxis frente al virus (AU)

Despite improvements in prevention strategies, cytomegalovirus (CMV) continues to be the main cause of infection in solid organ transplant recipients. In these patients, in addition to direct effects, such as viral syndrome or invasive organ disease, CMV can cause indirect effects resulting from the interaction of the virus with the host’s immune system. This interaction may increase immunosuppression, with a consequent rise in opportunistic infections and the risk of malignancies (Epstein-Barr virus-associated post- transplantation lymphoproliferative disease) and graft dysfunction. Currently, a direct causal relation between CMV and most of the indirect effects described cannot be established. However, numerous experimental and clinical studies have found an association between the development of these effects and CMV. Moreover, some of these effects, such as the development of opportunistic infections, have been reduced by CMV prophylaxis (AU)

[Indirect effects of cytomegalovirus infection]. / Efectos indirectos de la infección por citomegalovirus.

Despite improvements in prevention strategies, cytomegalovirus (CMV) continues to be the main cause of infection in solid organ transplant recipients. In these patients, in addition to direct effects, such as viral syndrome or invasive organ disease, CMV can cause indirect effects resulting from the interaction of the virus with the host's immune system. This interaction may increase immunosuppression, with a consequent rise in opportunistic infections and the risk of malignancies (Epstein-Barr virus-associated posttransplantation lymphoproliferative disease) and graft dysfunction. Currently, a direct causal relation between CMV and most of the indirect effects described cannot be established. However, numerous experimental and clinical studies have found an association between the development of these effects and CMV. Moreover, some of these effects, such as the development of opportunistic infections, have been reduced by CMV prophylaxis.

Single lung transplantation and fatal fat embolism acquired from the donor: management and literature review.

Fat embolism (FE) is a consequence of skeletal trauma that occurs in more than 90% of cases of severe trauma. However, most of these emboli are clinically insignificant. We report the case of a 59-yr-old man with massive progressive fibrosis who died from widespread FE after a single-lung transplantation (SLT). The lung donor was a 22-yr-old woman who died from traumatic cerebral injury. She had sustained a closed fracture of the tibia, fibula and pelvis. The PaO(2)/FiO(2) before procurement was 452 mmHg. A left SLT using cardiopulmonary bypass was performed. In the immediate postoperative period, profound pulmonary edema in the transplanted lung developed, with overinflation of the native lung and systemic hypotension. Severe Primary Graft Dysfunction (PGD) was suspected and nitric oxide (NO) and independent lung ventilation (ILV) initiated. Over the next 24 h the patient's condition deteriorated and extracorporeal membrane oxygenation (ECMO) was initiated. The patient died 45 h after transplantation as cardiovascular and respiratory function continued to decline and massive thoracic bleeding secondary to coagulopathy appeared. Post-mortem examination revealed both massive FE in the non-transplanted donor lung and in the allograft lung. Only two previous cases of donor-acquired FE and PGD after lung transplantation (LT) have been reported. Occult pulmonary FE in a traumatized donor should be considered a cause of PGD.

Recurrence of bronchioloalveolar carcinoma in donor lung after lung transplantation: microsatellite analysis demonstrates a recipient origin.

Bronchioloalveolar carcinoma is a distinctive subtype of pulmonary adenocarcinoma, without effective therapy, although there have recently been some attempts to use lung transplantation. However, a high post-transplantation local recurrence rate is described with some controversy regarding the possible involved mechanisms, the main possibilities being the lymphatic spread and aerosolization. Presented herein is a case of a bilateral lung transplantation for a bilateral and pneumonic form of non-mucinous bronchioloalveolar carcinoma in a 43-year-old woman. The histological analysis of mediastinal lymph nodes during surgery did not show neoplastic cells. Thirty-five months after transplantation several nodular opacities in donor lungs were detected. Three pulmonary wedge resections were performed showing a non-mucinous bronchioloalveolar carcinoma with the same histological characteristics as the primary. Again, the mediastinal lymph nodes were tumor free. A complete microsatellites molecular analysis was performed to compare the primary and recurrent carcinoma using capillary electrophoresis, showing that the recurrent tumor was generated in a recipient cellular clone. The absence of lymph node metastasis and the molecular evidence of the recipient origin of the neoplasm supports the contamination of the new lungs at the time of implantation as being the reason for the high incidence of recurrence after lung transplantation in this kind of disease.