[Prevention of iatrogenic risk and screening of chronic kidney disease]. / Maladie rénale chronique : prévention des risques de iatrogénies médicamenteuses et dépistage de la maladie.

Ten percent of the world's population is affected by chronic kidney disease that can lead to kidney failure. In France, nearly three million people are concerned, half of whom are undiagnosed, 85,000 people are on dialysis or waiting for a kidney transplant. Each year, 11,000 new diagnoses of severe renal failure are made, one third of which had not been treated before. Kidney failure is constantly increasing due to the aging of the population and the resurgence of chronic diseases, including obesity and cardiovascular diseases such as high blood pressure and diabetes, two conditions that impair renal function. The pharmacist, a local actor, is well placed to help patients adhere to their treatment and manage it to the best of their quality of life. It is up to the pharmacist to check the dosages according to the degree of renal involvement, ideally noted on the prescription or, failing that, by asking the patient the results of his recent biological examinations. The consultation of the pharmaceutical file and, ultimately, the shared medical file, will make it possible, in a concerted management of the patient's care pathway, to also detect possible drug interactions. By dispensing the prescribed drugs, the pharmacist can also warn against those known to be known for their nephrotoxicity, especially nonsteroidal anti-inflammatory drugs. In the case of over-the-counter products, the pharmacist may discourage a person at risk from taking certain drugs containing nonsteroidal anti-inflammatory drugs, including aspirin and ibuprofen. Because of their potential renal toxicity, the pharmacist is competent to alert, especially on certain food supplements, herbal products, and is legitimate to participate in screening campaigns.

Translational research in immune and inflammatory diseases; what are the challenges, expected advances, and innovative therapies?

Despite very different aetiologies and clinical expressions, advancing knowledge in the physiopathology and treatment of immune and inflammatory diseases (IID) prompts us to consider them as a whole. These are chronic, often incapacitating and painful illnesses that progress and destroy organs. Management by discipline too often leads to erroneous diagnoses and sometimes inappropriate treatment. More integrated translational research would further understanding of the complex relationships between cytokines and organ damage, which vary with the conditions and patients, making it possible to develop new biomarkers and personalize treatment. The research in France has very many strengths but its organization is fragmented. Better coordinated research into IID, which could be based on creating a strategic valorization field (domaine de valorisation stratégique, DVS) and thematic multi-organization institute (Institut thématique multi-organismes ITMO), would advance patient management.

[French biomedical competitiveness clusters: opportunities for public-private partnerships]. / Les pôles de compétitivité biomédicaux français: une opportunité pour la recherche partenariale public-privé en santé.

A "competitive cluster" is a partnership between businesses, research units and training centers, working together to generate synergies for innovative projects in a particular geographic area. Since 2005, the first five calls for cluster projects have led to the funding of 645 R&D projects involving 13,000 researchers. Together, the R&D expenditure of these projects has so far totaled nearly Euro 3.6 billion. This included public funding of Euro 1300 million, Euro 840 million of which was provided by central government. In the biomedical field, 80 R&D projects have been funded to the tune of Euro 140 million (Euro 81 million from central government and Euro 59 million from local government). A total of 288 agreements have been signed, 12% with large companies, 36% with SMEs and 49.8% with public research laboratories. Alongside the more classical biomedical research funding sources, such as the National Research Agency and government-sponsored projects (on cancer, Alzheimer's disease, rare diseases, etc.), competitive clusters provide the impetus for profound changes in research culture. They draw on the principle of professional guidance and public-private partnerships to build a bridge between the "academic" and "industrial" research arenas. By facilitating knowledge generation and sharing, competitive clusters create a climate of action-driven mutual respect and trust.