[Present possibilities and future development of clinical proteomics]. / Présent et futur de la Protéomique clinique.

This review focuses on "clinical proteomics" which represents an emerging discipline in biomedical research. "Clinical proteomics" relies on the analysis of the proteome, i.e. the entire set of peptides and proteins present in a biological sample, to provide relevant data for diagnosis, prognosis or therapeutic strategies of human pathologies. This new type of approach has tremendous potential for the diagnosis of complex pathologies or for the early detection of cancers. This article reports the conclusions of a workgroup of the French Society for Clinical Biology (SFBC) 2004-2006 which evaluated the status, the impact and the future development of proteomics in the clinical field. It provides therefore a broad view going from the methods already present in the clinical laboratories (multiplex technologies...), to the tools for clinical and basis research including bioinformatics.

A multicentric randomised study of alpha 2b interferon (IFN) and hydroxyurea (HU) with or without cytosine-arabinoside (Ara-c) in previously untreated patients with Ph+ chronic myelocytic leukemia (CML): preliminary cytogenetic results.

The CML 88 study was designed to evaluate the efficacy of maintenance therapy in a multicentric randomised protocol using IFN combined with low-dose Ara-C versus IFN alone, following an induction with IFN + HU. Between April 1988 and February 1991, 237 patients from 36 French Hematology Centres were entered in the study. Preliminary cytogenetic results show a slightly higher, although not statistically significant, proportion of major chromosomal responses, including complete cytogenetic remissions, in the IFN + Ara C arm.

High-impact loading training induces bone hyperresorption activity in young elite female gymnasts.

The aim of this study was to investigate the effect of intensive exercise on bone turnover (as reflected by bone resorption) in young elite female gymnasts. Forty-five healthy girls including 24 gymnasts (11.9+/-2 yr) and 21 controls (12.3+/-1.4 yr) were studied. Body weight, height, bone age and body composition were measured. Bone mineral density (BMD) was assessed at the whole body, lumbar vertebrae, hip and radius by means of DXA. Volumetric density (BMAD) was calculated. Bone velocity (SOS) and attenuation (BUA) were measured by QUS at the calcaneus. Urinary androstenedione (delta4), dehydroepiandrosterone sulfate (DHEA-S), and CrossLaps (CTx) were measured. BMD and BMAD were significantly greater in the gymnasts at all sites except whole body. SOS was found significantly higher. Delta4 values were significantly lower in the gymnasts. The distribution of the subjects according to Tanner stages was not different between groups. CTx levels were significantly higher in the gymnasts (989.08+/-154.63 microg/mmol Cr.) vs controls (580.25+/-123.99 microg/mmol Cr., p=0.02). CTx values decreased from Tanner stage 1 to stage 4 in each group, the gymnasts' levels always being higher than those of the controls. In conclusion, gymnastics seems to stimulate bone resorption activity in highly-trained young females. The coexistence of bone hyperresorption and higher BMD in gymnasts suggests increased bone turnover resulting in increased bone density in these subjects.

[Results of hemograms of a series of top-level cyclists: an example of a factor of biological variability]. / Résultats d'hémogrammes d'une série de cyclistes de haut niveau: exemple d'un facteur de variation biologique.

We report data about 50 caucasian top-level cyclists (45 males, 5 women, aged between 16 and 36 years, mean 25 +/- 4.5). Recruitment was by controlling top-level athletes in order to follow their blood cell counts to detect variation in haemoglobin concentration and hematocrit level (prevention of erythropoietin abuse). All samples were drawn in the morning, when the cyclists were at rest, according to a standardized protocol. Erythroblastic serie was abnormal in several cases (4 anaemias, 3 macrocytosis, 6 low haematocrit level, 10 mean cell haemoglobin higher than 32 pg, low reticulocyte count). White blood cells showed a trend toward low counts for neutrophils and lymphocytes. Two cyclists had platelets counts below 150.109/l. Our data indicated that top-level cyclism had some effects on the blood cell counts, which is likely to indicate an effect of intense aerobic training on physiological status.

[Association of autoimmune thrombopenic purpura and leiomyoma. Recovery after excision of the tumor]. / Association d'un purpura thrombopénique auto-immun et d'un léiomyome. Guérison après exérèse de la tumeur.

A case of auto-immune thrombocytopenic purpura in a woman with benign cystic leiomyoma in Retzius' space is reported. The platelet Coombs' test was positive on platelets; the indirect Coombs' test was negative on serum but strongly positive on cyst fluid. Following excision of the leiomyoma thrombocytopenia rapidly subsided and the serological findings became negative, which strongly suggests that the antibody was produced by the tumour.

[Extramembranous glomerulonephritis of acquired syphilis in a patient recently infected by the hepatitis B virus. Demonstration of the treponemal antigen in the kidney by indirect immunofluorescence]. / Glomérulonéphrite extra-membraneuse de la syphilis acquise chez un malade récemment infecté par le virus de l'hépatite B. Mise en évidence au niveau du rein de l'antigène tréponémique par immunofluorescence indirecte.

A 38 years old male homosexual with active secondary syphilis presented with pure nephrotic syndrome while HBs and HBe tests were positive without clinical hepatitis. He had circulating immune complexes, IgG--IgM cryoglobulinemia and high IgA, IgM and IgE levels; the C3 and C4 complement constituents were normal. Examination of renal biopsy sections under light, fluorescent and electronic microscopy showed stage I membranous glomerulonephritis the syphilitic origin of which was confirmed by indirect immunofluorescence and by rapid cure under penicillin treatment. This case calls for the following comments: (1) glomerular deposits are extramembranous rather than subendothelial in syphilitic nephrosis, a disease now classified among circulating immune complexes diseases; (2) in the kidney, the treponema antigen can be demonstrated by indirect immunofluorescence and the anti-treponema antibody, by elution; (3) the outcome of the nephrotic syndrome is always favourable, either spontaneously or after penicillin treatment; (4) syphilis and HBs antigens are frequently associated, particularly in homosexual patients; one should be looked for when the other is discovered.

Comparison of the cytotoxic effects of corticoids on the neoplastic B cells.

Many clinical trials have been engaged to prove the benefits of new drugs in the treatment of hematological tumours. However, no real progress have occurred in diseases such as multiple myeloma, the association of melphalan and prednisone is still the mainstay of the treatment. During all these years, the family of glucocorticoids have not been totally studied. Their efficiency in the cure of lymphoid malignancies has been early recognised, but still to be based on their anti-inflammatory potency for the dosages. Only few works reported the comparison between members of this family. We demonstrate in this work, in vitro, with a cell line of medium sensibility and a B cell of tumoral origin grew up in our laboratory, that exists some differences in the anti-neoplastic potency of the more commonly used corticoids. If the order in which we can class these drugs is not surprising and empirically known, the importance of the differences observed need a special attention. We also found that these drugs might have stimulatory effects, at various degree in function of their concentrations, on the proliferation of the B cell lines. Theses side effects coupled to the efficiency variations of each corticoid present the need of paying more attention to the choice of the molecule implied in the chemotherapy.

[Hemoglobin E: report of the first 2 cases in French subjects]. / Hémoglobinose E: présentation des deux premières observations chez des sujets d'origine française.

Hemoglobin E has been discovered casually in the blood of two French donors: one coming from the Alsace region, the other one coming from the Champagne region. In the two cases, the hemoglobin E is in an heterozygote state and takes the place of 33 per cent of the total haemoglobin in the first and 24 per cent in the second. We investigated in their families and found that other members of these families had hemoglobin E. Each time, it was associated with a microcytosis and polycythaemia without anemy or iron deficiency. The red cells morphology shows many microspherocytes and target-cells. There is no relationship between these two families and the research of an asiatic antecedent proved negative. These two observations give a supplementary proof that the geographic repartition of the hemoglobin E is larger than what we read in the first publications and shows the interest to study the hemoglobin of unexplained polycythaemia with microcytes in the blood of blood donors.