Gene expression profile of human endometrial receptivity: comparison between natural and stimulated cycles for the same patients.

BACKGROUND: The adjunction of exogenous hormones for controlled ovarian stimulation (COS) may alter endometrial receptiveness. In order to identify the genes misregulated under COS, we compared the endometrium gene expression profiles, from the same patients, in a natural cycle and in a subsequent COS cycle. METHODS: For the same normal-responder patients (n = 21), endometrial biopsies (n = 84) were collected during the pre-receptive (LH + 2) and receptive stages (LH + 7) of a natural cycle and, subsequently, on oocyte retrieval day (hCG + 2) and on transfer day (hCG + 5) of a stimulated cycle. Samples were analyzed using DNA microarrays. Gene expression profiles and biological pathways involved in endometrial receptivity were analyzed. RESULTS: Although endometrium transition profiles from pre-receptive to receptive phases are similar between patients, COS regimens alter endometrial receptivity in comparison with natural cycle. Under COS conditions, two endometrial profiles were identified and were associated either with a moderately altered receptivity profile for the majority of the patients or a strongly altered profile for a sub-category of patients. The receptive endometrium transcription profile under COS was defective for biological functions such as TGFbeta signaling, leukocyte transendothelial migration and the cell cycle. CONCLUSIONS: Gonadotrophin treatments in COS cycles led to disruptions of the transcriptional activation of genes involved in normal endometrial receptivity. We propose that when the receptiveness of the endometrium is seriously compromised by the COS protocol, fresh embryo replacement should be cancelled, the embryo frozen and thawed embryo replacement should be performed under natural cycles.

[Human embryonic stem cells: from the human embryo transgressed to the regenerative medicine of tomorrow]. / Les cellules souches embryonnaires humaines: de la transgression de l'embryon humain à la médecine régénératrice de demain.

Human embryonic stem cells (hESC) are derived from the inner cell mass (ICM) of the human blastocyst at day 5 or 6 of the early embryo development. These cells display two cardinal features: they are able to differentiate into cell types from many if not all human tissue (pluripotency) and they proliferate strongly and indefinitely without senescence in vitro. Therefore, hESC are a source of choice for stem cells for regenerative medicine and are a reference model to study the biology of pluripotency. Since 2004, the French law (loi de Bioéthique) authorizes hESC research under certain conditions.

[Biology and potential of human embryonic stem cells]. / Biologie et potentialités des cellules souches embryonnaires humaines.

Human embryonic stem cells (hESC) are obtained from the inner cell mass from the early embryo at blastocyste stage. Derived in cell lines for the first time in 1998, they can be maintained in culture in an undifferentiated state indefinitely under certain conditions. Two essential properties characterize hESC: pluripotency and self-renewal. Pluripotency is convey by the expression of specific transcription factors such as OCT4 and NANOG, and is under the control of growth factors such as IGF2 and FGFb. Markers used to characterize these cells include surface antigens, notably SSEA-3 and SSEA-4, and nuclear markers such as OCT4. HESC can differentiate into different cell types in vitro. They represent a unique and essential model for early human development research and for regenerative medicine. By their self-renewal capacity and their potential to differentiate into several cell types, hESC are an unlimited source of cells enabling to replace or restore lost or damaged cells in numerous diseases. Even if it is not conceivable today to use them in clinical practice for ethic and scientific reasons, it seems essential to explore the numerous potentialities of these cells. This knowledge might be relevant to handle adult stem cells in vitro and will be mandatory for a therapeutic use of hESC in the future.

[Streptococcus pneumoniae neonatal infection]. / Infection néonatale précoce à Streptococcus pneumoniae.

One case of early onset invasive pneumococcal disease in the newborn, acquired from the maternal vagina, is reported. Streptococcus pneumoniae has been estimated to be rarely responsible for neonatal sepsis (1-8%) together with maternal infection. Clinical features are similar to other neonatal infections, but outcome is particularly severe (mortality: 50%, neurological sequelae: 13%). Newborn are most often infected from the maternal vagina that has been colonized with S. pneumoniae, despite the rarity of vaginal carriage of S. pneumoniae (yield in genital swabs from 0.03 to 0.75%). Severe outcome should lead to presumptive treatment (amoxicillin +/- vancomycin) of babies colonized with pneumococcus or born to colonized mother, even if asymptomatic, and, when necessary, of the mother. The rarity of the genital carriage, together with the difficulty to isolate S. pneumoniae from vaginal swabs makes unrealistic to systematically search for this organism. However, given the high ratio infection: colonization, greater significance should be attached to the discovery of vaginal colonization with pneumococcus in the pregnant or in the newborn in order to improve treatment and outcome.

The MLL recombinome of acute leukemias in 2013.

Chromosomal rearrangements of the human MLL (mixed lineage leukemia) gene are associated with high-risk infant, pediatric, adult and therapy-induced acute leukemias. We used long-distance inverse-polymerase chain reaction to characterize the chromosomal rearrangement of individual acute leukemia patients. We present data of the molecular characterization of 1590 MLL-rearranged biopsy samples obtained from acute leukemia patients. The precise localization of genomic breakpoints within the MLL gene and the involved translocation partner genes (TPGs) were determined and novel TPGs identified. All patients were classified according to their gender (852 females and 745 males), age at diagnosis (558 infant, 416 pediatric and 616 adult leukemia patients) and other clinical criteria. Combined data of our study and recently published data revealed a total of 121 different MLL rearrangements, of which 79 TPGs are now characterized at the molecular level. However, only seven rearrangements seem to be predominantly associated with illegitimate recombinations of the MLL gene (≈ 90%): AFF1/AF4, MLLT3/AF9, MLLT1/ENL, MLLT10/AF10, ELL, partial tandem duplications (MLL PTDs) and MLLT4/AF6, respectively. The MLL breakpoint distributions for all clinical relevant subtypes (gender, disease type, age at diagnosis, reciprocal, complex and therapy-induced translocations) are presented. Finally, we present the extending network of reciprocal MLL fusions deriving from complex rearrangements.