The Prenatal Lausanne Trilogue Play: A New Observational Assessment Tool of the Prenatal Co-Parenting Alliance.

The goal of this study is to present a new observational assessment tool, the prenatal Lausanne Trilogue Play situation (LTP). Expectant parents were asked to role play their first meeting with their baby using a doll, and the videotaped interaction was subsequently coded. Scores were correlated with measures of the couples' marital satisfaction as well as the postnatal family alliance 3 months after the baby's birth. Results showed that the prenatal co-parenting alliance was positively linked to both fathers' marital satisfaction as well as to the postnatal family alliance at 3 months. Thus, the prenatal LTP allows for assessment of the prenatal co-parenting alliance at the interactional level. It predicts the place the parents will afford their baby after birth and can contribute to methods of clinical assessment and prevention.

[Which psychological support for couples seeking medical assistance for procreation?]. / Quelle assistance psychologique pour les couples requérant une aide médicale à la procréation?

OBJECTIVES: The objective of our qualitative study was to define modalities of psychological support to be offered to couples seeking medically assisted procreation. MATERIAL AND METHODS: Forty couples participated in a semi-structured videotaped interview, which touched on themes such as personal and family histories, the couple's relationship, etc. We focused on the "narrative mobility", that is the way in which the couples transmit their personal and family history during the interview and the interviewer's impression that he may or may not share this with the couples. RESULTS: Observed differences in narrative mobility led us to distinguish three groups of couples and to propose various types of psychological support. DISCUSSION AND CONCLUSION: This exploratory study, with its interest for the narrative mobility, concerns the couples' capacity to stand back from their own story as responsible interlocutors. We made the hypothesis that this capacity is linked to their capacity to handle their emotional stress, to act as partners to the medical team and to prepare themselves for their future parenthood.

Noverbal communication and alliance in therapy: the body formation coding system.

Body formations of therapist and couple during therapy sessions mainly function to signal their degree of readiness to interact or their degree of engagement in the therapeutic process, which is one contextual display of their affective communication. For this study, we developed the Body Formation Coding System (BFCS), a 4-category instrument to assess engagement at the triadic level. This article presents the BFSC method as well as a first validation on a sample of 14 triads. The results show that (a) triads vary according to their degree of triadic engagement; (b) engagement is related to the degree of therapeutic alliance; and (c) when the alliance is sufficient, a triadic invariant of engagement emerges. This means that partners regulate and coordinate their behaviors to maintain a stable level of engagement, whatever changes in their conversational organization. Finally, it discusses the potential of this method for describing the interactive aspects of the therapeutic alliance.

Efficient purification of plasmid DNA for gene transfer using triple-helix affinity chromatography.

Plasmid DNA used for nonviral therapeutic gene transfer or nucleic acid vaccination has to be highly purified devoid of contaminating components such as bacterial proteins, endotoxins, or bacterial chromosomal DNA. We have developed a new affinity chromatography technique for plasmid DNA purification: triple-helix affinity chromatography (THAC). This technique is based on the sequence-specific interaction of an oligonucleotide forming a triple-helix with plasmid DNA. The oligonucleotide was covalently linked to a chromatographic matrix, thus providing a reusable affinity support. By inserting a suitable homopurine sequence in the plasmid DNA, it is possible to obtain a triple-helix interaction that will only be stable at mild acidic pH and that will dissociate in alkaline conditions. A crude lysate from a recombinant E. coli, or a pre-purified plasmid DNA, is thus applied at acidic pH on to a THAC column. After extensive washing of the column, purified plasmid DNA is eluted using an alkaline buffer. The binding conditions of the plasmid DNA on to the column have been optimized, as well as the hybridization sequence and the linker group between the matrix and the third strand oligonucleotide. The THAC technique makes it possible to purify in one step supercoiled plasmid DNA, and to significantly reduce the level of contaminating RNA, endotoxins and chromosomal DNA. In particular, a 100-fold reduction of chromosomal DNA contamination over that obtained with conventional techniques can be achieved through a single additional THAC step. Further improvements of THAC technology are possible, and we anticipate that this technique can be scaled up for integration into a full commercial-scale DNA production process.

Interaction of pristinamycin IA with P-glycoprotein in human intestinal epithelial cells.

Pristinamycin IA is a cyclo-peptidic macrolactone antibiotic belonging to the streptogramin family. In the present work, the interaction of pristinamycin IA with the multidrug transporter P-glycoprotein was investigated in the differentiated human intestinal epithelial cell line Caco-2. Pristinamycin IA specifically inhibited the efflux of the P-glycoprotein substrate [3H]vinblastine, thus increasing the cellular accumulation of the drug. Pristinamycin IA also reduced by 70% the basolateral to apical secretion of [3H]vinblastine across Caco-2 cell monolayers. The cellular accumulation of [14C]pristinamycin IA was very low and was increased by P-glycoprotein inhibitors (verapamil, chlorpromazine and reserpine). The basolateral to apical transport of [14C]pristinamycin IA was 100-fold higher than apical to basolateral passage. This polarized transport was inhibited by verapamil and by ATP depletion. The results suggest that pristinamycin IA is a substrate for the P-glycoprotein, a finding which may have important consequences for the pharmacokinetics of this drug.

Differentiated intestinal epithelial cell lines as in vitro models for predicting the intestinal absorption of drugs.

The oral absorption of a compound is a critical factor for the future of the compound as a drug. This absorption is mainly controlled by the passage across the intestinal epithelium. Thus, the prediction of the intestinal absorption by means of an in vitro model may represent a powerful tool for the early selection of molecules during the process of drug development. In the present study, the differentiated human intestinal epithelial cell line HT29-18-C1, was grown on permeable filters in dual chambers. These cells formed tight monolayers that were used to measure in vitro the transepithelial permeability coefficient (Pc) of various molecules. The results were compared with in vivo data of oral absorption. A threshold value of in vitro permeability of 2 x 10(-6) cm/s was found. Molecules having a permeability coefficient higher than this value were absorbed orally more than 80%, while drugs with Pc values lower than 2 x 10(-6) cm/s were poorly absorbed. By mathematical simulation, it was found that this Pc value, when extrapolated to the surface area and volume of the small intestine, corresponds to an absorption of 80% for a compound with a transit time through the small intestine of 5 h. This demonstrates the predictive utility of the threshold value of the permeability coefficient derived from the in vitro model of intestinal epithelium.

Polarized transport of docetaxel and vinblastine mediated by P-glycoprotein in human intestinal epithelial cell monolayers.

The expression of the multidrug transporter P-glycoprotein has been studied in two human intestinal epithelial cell lines. No functional expression of P-glycoprotein was found in the differentiated HT29-18-C1 cell line. The expression of P-glycoprotein in the Caco-2 cell line was very high, as judged by immunoblotting and by active efflux of vinblastine. The polarized transport of vinblastine in the basolateral to apical direction was temperature and energy dependent, and was reduced by P-glycoprotein inhibitors such as verapamil, chlorpromazine and reserpine. This adds further evidence that the polarized transport of vinblastine across Caco-2 monolayers is mediated by P-glycoprotein. The anticancer drug docetaxel (Taxotere) was transported in a polarized manner: basolateral to apical permeability was 20-fold higher than in the reverse direction. This polarized transport was inhibited by verapamil, chlorpromazine and reserpine, thus demonstrating that docetaxel is a substrate of P-glycoprotein. The implications of these results for the pharmacokinetics and toxicity of taxoids are discussed.

High lipophilicity decreases drug transport across intestinal epithelial cells.

It is generally admitted in drug research that the passage of molecules across cellular barriers increases with lipophilicity and that the most lipophilic compounds will have the highest intestinal absorption. Using two in vitro models of intestinal epithelium, we presently demonstrate that this concept is not always valid and that highly lipophilic compounds display a low transepithelial permeability. We used epithelial cell lines grown on permeable filters to measure in vitro the transepithelial permeability of various molecules. The octanol/buffer distribution coefficient of the drugs (Do/b) was taken as an index of lipophilicity. When log Do/b values were lower than 3.5, the transepithelial permeability coefficient increased with the lipophilicity. But for log Do/b values ranging from 3.5 to 5.2, the transepithelial permeability coefficient decreased with increasing lipophilicity. Identical results were observed with two differentiated intestinal epithelial cell lines (HT29-18-C1 and Caco-2) and in unstirred or agitated conditions. The results show that an octanol/buffer distribution coefficient value around 3000 corresponds to an optimal transepithelial passage of drugs and that too high a lipophilicity can result in low intestinal epithelial permeability and in low oral absorption.