B Acad Nat Med Paris
-
Since the 1950s, the therapeutic arsenal against depression has grown considerably. From the discovery of monoamine oxidase inhibitors (MAOI) to the antidepressant effect of ketamine, these pharmacological breakthroughs made the history of psychiatry. They also guided the research about the pathophysiology of depression, one of the most devasting diseases, which affects between 10 and 20 % of general population. ⋯ Ketamine's effects are spectacular both in terms of their very short onset time, and because they are observed even in treatment-resistant depression. Just as MAOIs and tricyclic antidepressants allowed the "monoaminergic hypothesis of depression" to emerge, to unravel the mechanisms of ketamine's antidepressant effects should allow the understanding of the role of glutamatergic system, or that of neuro-inflammation, in the neurobiology of depression. Ketamine might also help to refine our understanding of the cognitive pathophysiology of depression, or even to deeply transform the clinical representations about what depression is.
-
B Acad Nat Med Paris · Dec 2020
Review[Emerging vectorial diseases: West Nile fever, Bluetongue and Schmallenberg].
The increase in international trade over the last thirty years, climate change owing to the industrial revolution, disruption of ecosystems, etc. are some of the factors that may explain the dynamics of disease emergence in regions of the world where they were not present. Thus in 1999, West Nile virus was introduced on the American continent where it spread at high speed. More than 2300 deaths and more than 25,000 neuroinvasive forms were recorded in humans from 1999 to 2019 in the United States of America. ⋯ This virus had never been identified in the world before. These three viruses (WNV, BTV and SBV) are transmitted by arthropod vectors (mosquitoes and Culicoïdes). These emergences are a good illustration of the challenges that our countries will face in the coming years, in public, human and veterinary health.
-
Rabies still causes about 60,000 human deaths per year, mainly in poor populations in Africa and Asia. However, since Louis Pasteur developed the first vaccine 130 years ago, prophylactic measures have been considerably improved and simplified. They now consist of the vaccine combined with purified rabies immunoglobulins of equine or human origin. ⋯ Approaches have been developed to deal with these two issues that offer hope for a paradigm shift for the benefit of exposed populations. Finally, mass rabies vaccination in dogs, which are the most cost-effective measure for preventing rabies in humans, are difficult to implement and sometimes have moderate effectiveness. The identification and analysis of the epidemiological drivers conditioning the circulation of the virus in dog populations allow a better understanding of the key control points that need to be associated with these campaigns for a better efficacy.
-
Blood platelets are anucleated elements of the blood. With a diameter of 2 to 3 μm, they are the smallest elements of blood. While their main role is to stop or prevent bleeding, they are also involved in other functions, such as immunity, inflammation or tumour progression. ⋯ Consequently, this type of product could have its place in meeting a number of transfusion challenges such as alloimmunization or refractory states. However, culture yields remain low and many hurdles still need to be overcome before considering an application in transfusion. This article reviews the rationale for the production of cultured platelets for transfusion and summarizes the main advances in the field while highlighting its limitations.
-
Antipsychotic drugs are one of the oldest drugs that can change the brain activity. These drugs are mainly used in schizophrenia and the first drug that was judged as efficacious in the treatment of psychosis has been chlorpromazine. ⋯ Three main issues could explain this failure: the exact causes of schizophrenia is still unknown, we still used the idea that one drug could improve all the symptoms of schizophrenia and it is clear that the group of schizophrenics disease could be different disease with different causes. We propose to review the different drugs that have been tested and we will discuss why the most recent genetic studies could help us to propose new pharmacological targets to treat schizophrenia.