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Biomedical subjects

P Loiseau

Publications and source records attributed to P Loiseau.

At least 127 records · Page 7Linked to original sources
PubMed1990

Effects of polytherapy with phenytoin, carbamazepine, and stiripentol on formation of 4-ene-valproate, a hepatotoxic metabolite of valproic acid.

The incidence of valproic acid hepatotoxicity has been reported to increase in patients who are receiving polytherapy. A minor valproic acid metabolite, 2-propyl-4-pentenoic acid (4-ene-VPA), formed by a cytochrome P450-mediated reaction, has been shown to be a potent inducer of microvesicular steatosis in rats. This study tested the hypothesis that formation of 4-ene-VPA would be increased in patients taking valproic acid with carbamazepine or with phenytoin but decreased with coadministration of an inhibitor of cytochrome P450 (the antiepileptic drug stiripentol in 300 to 1200 mg daily doses) in healthy subjects. Blood and urine samples in the studies were collected during a dosing interval at steady state. Valproic acid was assayed in plasma by capillary gas chromatography; valproic acid and 15 metabolites were measured in urine by gas chromatography/mass spectrometry. The formation clearance (CLf) of 4-ene-VPA was increased twofold in the valproic acid-carbamazepine and valproic acid-phenytoin groups. In the valproic acid/stiripentol studies, the CLf of 4-ene-VPA decreased by 32% in the 1200 mg/day stiripentol study. Similar findings were obtained at 600 and 300 mg/day stiripentol. These findings provide evidence supporting a role for cytochrome P450 in the formation of the hepatotoxic metabolite, 4-ene-VPA, in humans. The increased formation of 4-ene-VPA associated with carbamazepine and phenytoin is striking in relation to the epidemiologic finding of increased incidence of valproic acid-related hepatotoxicity during polytherapy with P450 inducers.

Adult↗
PubMed1990

HLA-DR, DQ, and/or DP genotypic mismatches between recipient-donor pairs in unrelated bone marrow transplantation and transplant clinical outcome.

Sixteen recipient-donor pairs who underwent unrelated BMT were analyzed for their HLA-class II identity by DNA-RFLP, in order to evaluate the importance of the genotypic HLA-DR, DQ, DP identity in the clinical outcome of unrelated bone marrow transplantation. From our study, a clear correlation between the HLA-DR, DQ, and DP genetic identity and acute GVHD (aGVHD) is not obvious since the number of studied cases is still limited. Nevertheless, it seems that the genetic identity influence the clinical outcome and patient survival. Six patients out of the ten who experienced severe aGVHD (greater than grade II) differed from their respective donors by HLA-DP mismatch in the GVH direction. Two patients rejected their grafts, and both presented HLA-DP incompatibilities in both GVH and HVG directions. Hence, HLA-DP may function as a transplantation antigen like the other HLA-class II molecules (DR, DQ) in unrelated BMT. Accordingly, we propose considering it in the pretransplantation histocompatibility testing. Nevertheless, further studies with larger numbers of cases should be done in order to confirm the role of HLA-DP. No correlation was observed between the mixed lymphocyte reaction (MLR) reactivity and the incidence of aGVHD. Accordingly, MLR response seems to be an incomplete indicator of GVHD, and a functional test is still to be found.

Bone Marrow Transplantation↗
PubMed1990

A simple method for correcting single breath total lung capacity for underestimation.

The single breath method underestimates total lung capacity by comparison with the multiple breath method (TLCmb) because of inhomogeneity of ventilation distribution. This study proposes a simple correction for the single breath TLC (TLCsb), using inert gas phase III slope to account for the effects of uneven ventilation distribution. A model of a non-uniform lung ventilation was designed, composed of a serial dead space and two alveolar compartments arranged in parallel, whose relative ventilations were determined from the phase III plateau. Before correction TLCsb was 104-44% of TLCmb in 64 subjects (17 with diffuse interstitial disease, 42 with chronic obstructive pulmonary disease, and five healthy subjects). The limit of acceptability for the correction (TLCcorr) was determined from the 95% confidence interval of TLCsb/TLCmb in the healthy subjects. The correction resulted in a significant increase in TLCsb (p less than 0.004). TLCcorr remained under the limit of acceptability for only 12 patients with emphysema, and all 12 showed a large improvement in the TLC estimate. The presence of poorly ventilated zones during a single breath in these patients may explain this partial correction.

Adult↗
PubMed1990

HLA-DP genotyping in HLA-A,B, and DR identical intrafamilial bone marrow transplantation.

In a study carried out for patients receiving intrafamilial HLA-A,B,DR identical, MLC negative bone marrow transplants, RFLP profiles of HLA-class II for 27 donor recipient pairs were analyzed. Twenty-four pairs were found HLA-class II identical while three pairs were HLA-DP incompatible. The patients of these three pairs did not reveal any acute GVHD greater than or equal to grade II. The seven cases of acute GVHD greater than or equal to grade II found in our panel were HLA-DR, DQ, and DP compatible. Thus, in practical terms pretransplantation HLA-DP typing does not seem necessary for intrafamilial HLA-identical, MLC negative BMT. On the other hand, this work confirmed that it is possible to type for HLA-DP using molecular biological techniques, and this in itself may have some important implications for unrelated BMT.

Adolescent↗
PubMed1990

Shape change of the occlusion-pressure wave during exercise.

In conscious subjects, the occlusion pressure measured in the initial part of the inspiration (up to 200 ms) appears to be a valid index of output of the respiratory centres. To interpret any relative change in occlusion pressure, the shape of the occlusion-pressure wave must remain absolutely constant. The purpose of this study was to test the hypothesis that the shape of occlusion-pressure wave does not change during exercise. However, we found that the shape changed significantly during cycle incremental-load exercise in five healthy subjects and in 12 of 17 patients with chronic obstructive pulmonary disease. The major change appeared during the second half of the exercise and mainly during the last workloads. This study shows that it is necessary to take into consideration this form change to interpret any relative change in mechanical transforms of the inspiratory neural output such as pressure at 0.1 s (P0.1) and mean inspiratory flow (VT/TI) or their ratio. This finding confirms, in direct fashion, the expected form change from previous data in which P0.1 is thought to measure the rate of change in chest wall muscle pressure (Pmus) over a segment somewhat removed from the onset of neural inspiration.

Adult↗
PubMed1990

[Juvenile myoclonic epilepsy].

Juvenile myoclonic epilepsy is an age-related form of idiopathic generalized epilepsy (mean age of onset: 12-14 years). The diagnosis is based on a cluster of clinical features: types of seizures, namely myoclonic jerks associated with generalized tonic-clonic or clonic-tonic-clonic seizures in 90% of the cases, absence seizures in one third of the cases; triggering factors and circadian rhythm of seizures on awakening or after sleep deprivation; a characteristic EEG pattern, i.e. bilateral symmetrical polyspike-waves. The clinical pattern is so suggestive that in clinical practice EEG is not necessary. Seventy percent of the patients are seizure-free with one-drug therapy. Treatment must be life-long, as relapse occurs in most cases after drug withdrawal, whatever the duration of control.

Adolescent↗
PubMed1990

T cell receptor delta gene rearrangements occur predominantly in immature myeloid leukemias exhibiting lineage promiscuity.

T cell receptor delta (TCR) genes have been recently identified as rearranging during the early stages of T cell differentiation. We have analyzed the configuration of these genes in 47 unselected acute nonlymphoid leukemias. Morphology, phenotype, immunoglobulin heavy chain, and T cell receptor beta and gamma chain gene configuration were also studied. We have documented TCR delta gene rearrangements or deletions in eight cases using a genomic J delta 1 probe. The comparison of morphological, phenotypical, and molecular findings from these cases with those from control acute myeloid leukemias whose TCR delta genes were in germline configuration show that TCR delta rearrangements occur predominantly in immature leukemia exhibiting extensive lineage infidelity. The most striking feature was the frequent expression of the CD10 antigen. These data show that inappropriate gene rearrangements occur nonrandomly in myeloid leukemias and suggest that common mechanisms may be involved in the regulation of gene rearrangements and in the expression of some differentiation antigens.

Adolescent↗
PubMed1990

[Stopping antiepileptic treatment].

Antiepileptic drug withdrawal must be considered in seizure-free patients. It is theoretically possible. A seizure relapse is frequent. Numerous factors predictive of relapse are known, but they are of limited value. A favorable outcome depends mainly on the patient's epileptic syndrome. Drug reduction must be carried out stepwise, with a slow dose-tapering. A partial withdrawal: reduction of polytherapy to monotherapy, or reduction in daily doses, can also be wise.

Anticonvulsants↗
PubMed1989

Analysis of junctional diversity in the preferential V delta 1-J delta 1 rearrangement of fresh T-acute lymphoblastic leukemia cells by in vitro gene amplification and direct sequencing.

To define the junctional diversity of T-cell antigen receptor delta gene rearrangements in fresh T-acute lymphoblastic cells and to correlate cell phenotype with the coding potential of rearrangements, we determined the junctional nucleotide sequences of 13 T-cell antigen receptor delta gene rearrangements involving the preferentially rearranged V (V delta 1) and J (J delta 1) segments using in vitro gene amplification and direct sequencing. We showed that, as in gamma delta+ cell lines, extensive junctional diversity exists in these clones and that this diversity is due both to random nucleotide deletions/additions and to the use of at least two D delta segments. We also showed that a high percentage of these rearrangements are potentially translatable (7:13) and that such functional rearrangements occur in both surface CD3+ and CD3- cells. Comparison of alpha beta versus gamma delta surface expression demonstrates that all CD3+ T acute lymphoblastic leukemias with a functional V delta 1-J delta 1 rearrangement express a surface gamma delta receptor and are recognized by the anti-delta monoclonal antibody delta TCS1, whereas a control CD3+ gamma delta+ leukemic case that had not undergone V delta 1 rearrangement was delta TCS1-. In addition, expression of this monoclonal antibody is not restricted by V gamma or C gamma usage or by the covalent or noncovalent link between gamma and delta chains.

Amino Acid Sequence↗
PubMed1989

Rearrangements of the T cell receptor delta gene in T acute lymphoblastic leukemia cells are distinct from those occurring in B lineage acute lymphoblastic leukemia and preferentially involve one V delta gene segment.

Rearrangement of the TCR-delta gene was studied using J delta, C delta, and V delta probes in 61 cases of acute lymphoblastic leukemia (ALL) and several cases of chronic lymphoid neoplasms to define the specificity and the diversity of rearrangements occurring at the delta locus. TCR-delta rearrangements or deletions were found in all T (33 cases) and B lineage (28 cases) ALL but not in any case of B cell chronic proliferations (13 cases). The restriction patterns of rearrangement were clearly distinct between T and B ALL and use of one V delta probe showed that rearrangement of the V delta IDP2 gene segment which is also productively rearranged in the Peer cell line, occurred frequently in T-ALL but never in B lineage ALL. Studies of WT31 and delta TCS1 antibody reactivity showed that at least 4 of 13 CD3+ T-ALL cases expressed the delta protein. CD4 and/or CD8 Ag expression were observed in some of the gamma delta expressing T-ALL. These data show that particular TCR-delta gene rearrangements occur in neoplastic early B cells and that the combinatorial diversity of TCR-delta rearrangements in T cells is higher than initially expected. In addition this study shows that an important proportion of CD3 positive T-ALL cases express the gamma delta heterodimer.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1989

Rearranging sequence located in the intron of the human T cell receptor gamma chain gene constant region.

Human T cell rearranging gamma genes encode membrane proteins which are expressed by a minor subset of T cells. Extensive studies have shown that TcR gamma gene rearrangements result from V gamma-J gamma recombinations. Here we analyze an unusual rearrangement involving a non-translatable sequence flanked by heptamer and nonamer signals in a Ti alpha/beta-positive T cell clone (JF1). This sequence, designated here as I gamma RS, is distinct from V, D or J elements. It is located in the first intron of the first constant region (C gamma 1) and homologous sequences are conserved in C gamma 2 introns. In JF1 cells the I gamma RS is juxtaposed to the J gamma 2 segment downstream to a V gamma 10-J gamma 1 rearrangement. The use of a cryptic splicing site induced JF1 cells to produce an aberrant large-sized transcript containing the I gamma RS 3' to the first exon of C gamma 1. Such a rearrangement occurring downstream to an inframe V gamma-J gamma junction may induce premature arrest of translation and lack of the C-terminal part of C gamma involved in gamma-protein assembly.

Base Sequence↗
PubMed1989

Inhibition of human liver microsomal epoxide hydrolase by valproate and valpromide: in vitro/in vivo correlation.

On the basis of drug interactions with carbamazepine epoxide, it has been hypothesized that valproic acid and valpromide are inhibitors of epoxide hydrolase, but the role of epoxide hydrolase in these interactions has not been clearly established. In this study, therapeutic concentrations of valproic acid (less than 1 mmol/L) and valpromide (less than 10 mumol/L) inhibited hydrolysis of carbamazepine epoxide and styrene oxide in human liver microsomes and in preparations of purified human liver microsomal epoxide hydrolase. Valpromide (KI = 5 mumol/L) was 100 times more potent than valproic acid (KI = 550 mumol/L) as an inhibitor of carbamazepine epoxide hydrolysis in microsomes. After administration of carbamazepine epoxide to volunteers, the transdihydrodiol formation clearance was decreased 20% by valproic acid (blood concentration approximately 113 mumol/L) and 67% by valpromide (blood concentration less than 10 mumol/L). For both valproic acid and valpromide, a striking similarity exists between in vitro and in vivo inhibitory potencies. Valproic acid and valpromide are the first drugs known to inhibit microsomal epoxide hydrolase, an important detoxification enzyme, at therapeutic concentrations.

Anticonvulsants↗
PubMed1989

In-vitro evaluation of filaricidal activity of GABA and 1,3-dipalmitoyl-2-(4-aminobutyryl)glycerol HCl: a diglyceride prodrug.

A diglyceride ester of gamma-aminobutyric acid (GABA) has been synthesized and its filaricidal activity compared with GABA, and progabide in-vitro, on infective larvae and microfilariae of Molinema dessetae, a rodent filaria. GABA induced paralysis in infective larvae but was inactive on microfilariae. There were interactions between the culture medium and GABA. The ester drug at 0.1 mmol L-1 (1,3-dipalmitoyl-2-(4-aminobutyryl)glycerol HCl) was as active as progabide on infective larvae and hundredfold more potent than GABA. Its microfilaricidal activity at 1 mmol L-1 was lower than that progabide at 0.1 mmol L-1 but a delayed effect was observed. The data confirm filariae sensitivity to GABA derivatives.

Animals↗
PubMed1989

HLA-DR and DQ antigens in chronic lymphocytic leukemia: dissociation of expression revealed by cell surface, protein, and mRNA studies.

We studied peripheral blood lymphocytes (PBL) of eight B chronic lymphocytic leukemia (CLL) patients for the expression of the human leucocyte antigens, HLA-DR and HLA-DQ. Cell surface expression of HLA class II epitopes was analyzed by fluorescent activated cell sorter (FACS) using three monomorphic anti-HLA class II monoclonal antibodies (mAb) specific for DR (D1.12) and DQ (TU22, L2) and a polymorphic anti-DQ (G2A5). The DR and DQ molecules were characterized by two-dimensional gel electrophoresis (2D-PAGE) of the specific immunoprecipitates from biosynthetically labeled cells. DR, DQ specific probes were used to characterize the class II transcripts of the corresponding genes. The data obtained with immunofluorescence disclosed two distinct patterns of HLA class II expression leading to two cell surface phenotypes: (DR+DQ+) and (DR+DQ-). In all cases the cells expressed normal amounts of HLA-DR gene products in terms of mRNA. DR cell surface determinants were present in more than 80% of cells in every sample. By 2-D gel analysis DR proteins disclosed the normal classical pattern associating the alpha, beta, and invariant chain gamma with normal level of biosynthesis for alpha and gamma but decreased biosynthesis for one of the beta gene products. Moreover, the three chains demonstrated defect in glycosylation process. In half of the cases studied the cells lacked DQ molecules at the cell surface. DQ alpha and DQ beta transcripts were detected in all cases, although the amount was extremely low in one case. DQ proteins were variable in the DQ+ phenotype and absent in the DQ- one. Interestingly, TPA and rIFN gamma treatment could restore normal glycosylation process of the DR isotype and increase biosynthesis of DQ alpha and beta chains. Those combined results support the view that transcriptional, post-transcriptional, and posttranslational mechanisms underlie the heterogeneity of class II expression observed in CLL. Moreover, 2-D gel analysis may be an invaluable tool for the analysis of the biosynthetic process of class II molecules.

Antigens, Surface↗
PubMed1989

[Synthesis of 2-aryl benzothiazoles and research on its antiparasitic activity].

Several 2-aryl benzothiazoles (with phenyl, naphthyl, thienyl and some oxygenated heterocycles) were synthesized. The anti-parasitic properties of these compounds were evaluated, in vitro and in vivo, against one Nematode Nippostrongylus brasiliensis and, in vitro against two Protozoaires Entamoeba histolytica and Trichomonas vaginalis. Only two compounds exhibited, in vitro a low nematicidal activity.

Animals↗