Maladie respiratoire

Résumé

vignette|Prévalence des maladies respiratoires dans le monde (selon DALY/OMS 2004) Une maladie respiratoire est une maladie qui touche l'appareil respiratoire ou qui provoque des troubles de la respiration. L'étude des maladies respiratoires est connue sous le nom de pneumologie. Histoire épidémiologique Les maladies respiratoires ont sans doute toujours existé, mais elles ont évolué. Jusqu'à la révolution industrielle, la médecine traitait des maladies phtisiologiques et essentiellement la tuberculose, la grippe et quelques autres infections respiratoires endémiques de nombreuses régions habitées par l'homme. Une source supplémentaire de risques était l'exposition à la fumée de foyers intérieurs brûlant du bois et/ou du charbon (qui existe encore dans les pays dits « en développement » ou « pauvres ». Mais alors qu'aux la tuberculose régressait spectaculairement grâce à la vaccination, aux antibiotiques et aux progrès de l'hygiène, les médecins ont vu apparaître

Source officielle

https://fr.wikipedia.org/wiki/Maladie_respiratoire

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Endemic human coronaviruses (hCoVs) 229E and OC43 cause respiratory disease with recurrent infections, while severe acute respiratory syndrome (SARS)-CoV-2 spreads across the world with impact on health and societies. Here, we report an image-based multicycle infection procedure with α-coronavirus hCoV-229E-eGFP in an arrayed chemical library screen of 5440 clinical and preclinical compounds. Toxicity counter selection and challenge with the β-coronaviruses OC43 and SARS-CoV-2 in tissue culture and human airway epithelial explant cultures (HAEEC) identified four FDA-approved compounds with oral availability. Methylene blue (MB, used for the treatment of methemoglobinemia), Mycophenolic acid (MPA, used in organ transplantation) and the anti-fungal agent Posaconazole (POS) had the broadest anti-CoV spectrum. They inhibited the shedding of SARS-CoV-2 and variants-of-concern (alpha, beta, gamma, delta) from HAEEC in either pre- or post exposure regimens at clinically relevant concentrations. Co-treatment of cultured cells with MB and the FDA-approved SARS-CoV-2 RNA-polymerase inhibitor Remdesivir reduced the effective anti-viral concentrations of MB by 2-fold, and Remdesivir by 4 to 10-fold, indicated by BLISS independence synergy modelling. Neither MB, nor MPA, nor POS affected the cell delivery of SARS-CoV-2 or OC43 (+)sense RNA, but blocked subsequent viral RNA accumulation in cells. Unlike Remdesivir, MB, MPA or POS did not reduce the release of viral RNA in post exposure regimen, thus indicating infection inhibition at a post-replicating step as well. In summary, the data emphasize the power of unbiased, full cycle compound screens to identify and repurpose broadly acting drugs against coronaviruses.

2022

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Human tuberculosis (TB) is a frequently fatal lung disease mostly caused by Mycobacterium tuberculosis (M. tb), a slow-growing intracellular pathogen. M. tb utilizes the ESX-1 secretion system, classified as type VII, to export the virulence factors needed for host infection and pathogenesis. A functional ESX-1 pathway largely involves the proteins encoded by two gene clusters, esx-1 and espACD. These proteins are diverse in functions, such as cytolysis, immunogenicity, pore forming, stabilization and energization. Although many of the ESX-1 associated proteins were characterized individually, the overall mechanism of ESX-1 secretion is still far from clear. The main objective of my thesis is to better understand the structure and function of the ESX-1 secretion system in M. tb. To achieve this, an integrated approach which combines biochemistry, biophysics and genetics was applied. The experimental results are organized into three parts, in which I investigated EspC, EccCb1 and the effect of calcium on ESX-1 secretion. Firstly, the focus of this thesis is EspC, a secreted protein encoded in the espACD operon which is not linked to the esx-1 locus, but mediates ESX-1-associated virulence. Based on what I observed from a series of experiments, we propose a novel working model of the ESX-1 apparatus, in which EspC interacts with EspA in the cytosol and then translocates across the membrane to assemble into a channel in the outer membrane and spans the capsular layer of M. tb. This model could explain the mechanism by which the major virulence factors EsxA and EsxB (also named ESAT-6 and CFP-10) rely on EspC for secretion. Moreover, EspC is a potential outer membrane pore protein which has not been previously identified in M. tb. Secondly, the putative ATPase EccCb1 is another protein that was studied. EccCb1 is predicted as an ATPase that targets the EsxA/EsxB heterodimer during translocation. EccCb1 was overexpressed and purified in the form of a NusA- EccCb1 fusion protein due to its low stability. The protein was characterized as a hexamer with an ATPase activity. This result confirms that EccCb1 belongs to the FtsK/SpoIIIE ATPase family. Thirdly, we observed that ESX-1 secretion can be inhibited by a high concentration of calcium (~500 ÎŒM) in the culture medium. Moreover, bacterial persistence, rather than growth rate, decreased with the elevated calcium. RNA- seq was performed to evaluate the changes of global gene expression of M. tb in the presence of high calcium levels. Surprisingly, calcium dramatically repressed hypoxia response genes in the DevRS regulon, leading to reduced persistence. I also include a section that describes the additional work I was involved with, in which we investigated the activation of cGAS-dependent host response by ESX-1. Taken together, these findings provide new insights into the structural and functional aspects of ESX-1 secretion system, and will contribute to discovery of ESX-1 inhibitors with potential applications in TB therapy.

EPFL2016

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On the interplay effect for moving targets treated with the CyberKnife static tracking system

François Bochud, Yihan Jia

Purpose: To assess the interplay effect amplitude between different planned MU distributions and respiratory patterns in the CyberKnife system when treating moving targets with static tracking technique. Methods: Small-and Large-Respiratory Motions (SRM and LRM) differing in amplitude and frequency were simulated in a semi-anthropomorphic dynamic thorax phantom. The interplay effect was evaluated for both respiration motions in terms of GTV coverage and conformity for three plans designed with an increasing range of MU per beam (small, medium and large). Each plan was delivered three times changing the initial beam-on phase to assess the inter-fraction variation. Dose distributions were measured using radiochromic films placed in the GTV axial and sagittal planes. Results: Generally, SRM plans gave higher GTV coverage and were less dependent on beam-on phases than LRM plans. For SRM (LRM) plans, the GTV coverage ranged from 95.2% to 99.7% (85.9% to 99.8%). Maximum GTV coverage was found for large MU plans in SRM and for small MU plans in LRM. Minimum GTV coverage was found for medium MU plans for both SRM and LRM. For SRM plans, dose conformity decreased with increasing MU range while the variation was reduced for LRM plans. Large MU plans reduced the inter-fraction variation for SRM and LRM. Conclusions: We confirmed the interplay effect between target motion and beam irradiation time for CyberKnife static tracking. Plans with large MU per beam improved the GTV coverage for small motion amplitude and the inter-fraction dose variation for large motion amplitude.

2021

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EPFL2016