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Biomedical subjects

M Moutschen

Publications and source records attributed to M Moutschen.

47 records · Page 3Linked to original sources
PubMed1994

Pathogenic tracks in fatigue syndromes.

This review analyses the recent literature devoted to two related fatigue syndromes: chronic fatigue syndrome (CFS) and acute onset postviral fatigue syndrome (PVFS). The articles are grouped into five pathogenic tracks: infectious agents, immune system, skeletic muscle, hypothalamo-pituitary-adrenal (HPA) axis and psychiatric factors. Although a particular infectious agent is unlikely to be responsible for all CFS cases, evidence is shown that host-parasite relationships are modified in a large proportion of patients with chronic fatigue. Antibody titres against infectious agents are often elevated and replication of several viruses could be increased. Chronic activation of the immune system is also observed and could be due to the reactivation of persistent or latent infectious agents such as herpes viruses (i.e. HHV-6) or enteroviruses. It could also be favorised by an impaired negative feedback of the HPA axis on the immune system. A model is proposed where the abnormalities of the HPA axis are primary events and are mainly responsible for a chronic activation of the immune system which in turn induces an increased replication of several viruses under the control of cellular transcription factors. These replicating viruses together with cytokines such as TNF-alpha would secondarily induce functional disorders of muscle and several aspects of asthenia itself.

Enterovirus↗
PubMed1994

Thymus involvement in murine acquired immunodeficiency (MAIDS).

Due to self-renewal of the peripheral pool of T-cells, adult thymectomy has normally little influence on immunocompetence. However, thymus might play a more important role in the setting of viral-induced cytopathic effects on T-cells in the periphery. Therefore, thymus weight, cell numbers, and subset distribution were sequentially analysed after infection with RadLV-Rs, a viral mixture known to induce murine retrovirus induced immunodeficiency (MAIDS). Infection induced thymic atrophy (concerning organ weight as well as total cell number) which culminated seven weeks after inoculation. The atrophic process mostly reflected the depletion of double positive CD4+ CD8+ cells since their proportion sharply decreased around week 6. Single positive T-cells were less affected by the process. The proportion of B-cells progressively increased. Surprisingly, there was a strong correlation between the extent of atrophy and the frequency of B-cells in the thymus. Finally, an abnormal CD4+ T-cell subset lacking Thy-1 and previously described in the periphery also appeared in the thymus and its frequency was strongly correlated with the expansion of B-cells in this organ.

Animals↗
PubMedDate not supplied

HIV resistance to antiretroviral drugs: mechanisms, genotypic and phenotypic resistance testing in clinical practice.

HIV resistance to antiretroviral agents is a major contributory cause of treatment failure. The dynamics of HIV replication, together with patient-, physician-, and drug-related factors, lead to emergence of HIV resistant strains in most of the patients. Phenotypic assays look for an increase in the antiretroviral drug (ARV) concentration that inhibits 50% of the growth of the tested HIV strain (IC50), comparatively with a reference strain cultivated in parallel. Genotypic tests detect resistance mutations in the reverse transcriptase and protease genes by comparing the gene sequences of a resistant virus to those of a wild-type strain that has previously been described. The efficacy of each ARV class and each individual ARV is threatened by specific mutations and resistance mechanisms. In retrospective studies of genotypic or phenotypic resistance testing, baseline resistance tests results were correlated with virological outcomes. There is some evidence from prospective studies that resistance testing may have some benefits when used to choose salvage regimens. However, problems in the areas of test interpretation, patient compliance, availability of active drugs, and technical test performance limit the usefulness of resistance testing in clinical practice. This article reviews the mechanisms underlying HIV resistance, the principles of phenotypic and genotypic tests, and the use of these tests in clinical practice.

Anti-HIV Agents↗
PubMedDate not supplied

[Alterations in natural immunity and risk of infection in patients with diabetes mellitus].

This review addresses the recent litterature devoted to the risk of severe infections in patients with diabetes and to the potential influence of diabetes on the function of natural immunity. Although much controversy still exists regarding the incidence of infections in diabetic patients, several studies confirm that diabetes mellitus is associated with an increased severity and mortality in community acquired pneumonia. Furthermore, the risk of severe bacteremia (especially associated with Streptococcus pneumoniae) is higher in diabetic patients. Polynuclear neutrophils are clearly influenced by the diabetic state. On the one hand, their antimicrobial function is inhibited by hyperglycaemia, due to inhibition of G6PD or diversion of NADPH in the polyol pathway; on the other hand, the AGE/RAGE/NF-kappaB pathway involved in the pathogenesis of chronic complications of diabetes could also amplify inflammatory systemic manifestations associated with infections and play a role in the higher mortality rate observed in diabetic subjects with severe infections. These observations argue for the systematic vaccination of all diabetic patients against influenza and Streptococcus pneumoniae, for the reappraisal of diabetes as a significant pejorative risk factor in community acquired pneumonia and for intensive insulin therapy in all diabetic patients with severe infection.

Diabetes Complications↗
PubMedDate not supplied

[A review about nephropathia epidemica].

We propose a review of history, aetiology, physiopathology, clinical features, treatment and prevention of nephropathia epidemica (NE) which represents the only form of Hantavirus infection in Belgium.

Hemorrhagic Fever with Renal Syndrome↗
PubMedDate not supplied

[Should the BCG vaccine still be recommended?].

The BCG vaccine has demonstrated its efficacy to protect young children from severe extrapulmonary forms of tuberculosis. Nevertheless, the immunity induced by the vaccine disappears in adults and cannot be boosted by readministration of BCG. Adverse effects of BCG are rare, but potentially dangerous (i.e. disseminated vaccinal infections) and they justify the fact that BCG should not be administered anymore in Western European countries where the incidence of pediatric tuberculous meningitis is very low. The vaccine is still recommanded for children living in countries with high tuberculosis prevalence and for resident children leaving Belgium for these countries.

Adult↗