Immunology taught by lung dendritic cells.

Dendritic cells (DCs) are leukocytes specialised in the uptake, processing, and presentation of antigen and fundamental in regulating both innate and adaptive immune functions. They are mainly localised at the interface between body surfaces and the environment, continuously scrutinising incoming antigen for the potential threat it may represent to the organism. In the respiratory tract, DCs constitute a tightly enmeshed network, with the most prominent populations localised in the epithelium of the conducting airways and lung parenchyma. Their unique localisation enables them to continuously assess inhaled antigen, either inducing tolerance to inoffensive substances, or initiating immunity against a potentially harmful pathogen. This immunological homeostasis requires stringent control mechanisms to protect the vital and fragile gaseous exchange barrier from unrestrained and damaging inflammation, or an exaggerated immune response to an innocuous allergen, such as in allergic asthma. During DC activation, there is upregulation of co-stimulatory molecules and maturation markers, enabling DC to activate naïve T cells. This activation is accompanied by chemokine and cytokine release that not only serves to amplify innate immune response, but also determines the type of effector T cell population generated. An increasing body of recent literature provides evidence that different DC subpopulations, such as myeloid DC (mDC) and plasmacytoid DC (pDC) in the lungs occupy a key position at the crossroads between tolerance and immunity. This review aims to provide the clinician and researcher with a summary of the latest insights into DC-mediated pulmonary immune regulation and its relevance for developing novel therapeutic strategies for various disease conditions such as infection, asthma, COPD, and fibrotic lung disease.

Plasmacytoid Dendritic Cells Are Productively Infected and Activated through TLR-7 Early after Arenavirus Infection.

The antiviral response is largely mediated by dendritic cells (DCs), including conventional (c) DCs that function as antigen-presenting cells, and plasmacytoid (p) DCs that produce type I interferons, making them an attractive target for viruses. We find that the Old World arenaviruses lymphocytic choriomeningitis virus clone 13 (LCMV Cl13) and Lassa virus bind pDCs to a greater extent than cDCs. Consistently, LCMV Cl13 targets pDCs early after in vivo infection of its natural murine host and establishes a productive and robust replication cycle. pDCs coproduce type I interferons and proinflammatory cytokines, with the former being induced in both infected and uninfected pDCs, demonstrating a dissociation from intrinsic virus replication. TLR7 globally mediates pDC responses, limits pDC viral load, and promotes rapid innate and adaptive immune cell activation. These early events likely help dictate the outcome of infections with arenaviruses and other DC-replicating viruses and shed light on potential therapeutic targets.

TLR3 and Rig-like receptor on myeloid dendritic cells and Rig-like receptor on human NK cells are both mandatory for production of IFN-gamma in response to double-stranded RNA.

Cross-talk between NK cells and dendritic cells (DCs) is critical for the potent therapeutic response to dsRNA, but the receptors involved remained controversial. We show in this paper that two dsRNAs, polyadenylic-polyuridylic acid and polyinosinic-polycytidylic acid [poly(I:C)], similarly engaged human TLR3, whereas only poly(I:C) triggered human RIG-I and MDA5. Both dsRNA enhanced NK cell activation within PBMCs but only poly(I:C) induced IFN-gamma. Although myeloid DCs (mDCs) were required for NK cell activation, induction of cytolytic potential and IFN-gamma production did not require contact with mDCs but was dependent on type I IFN and IL-12, respectively. Poly(I:C) but not polyadenylic-polyuridylic acid synergized with mDC-derived IL-12 for IFN-gamma production by acting directly on NK cells. Finally, the requirement of both TLR3 and Rig-like receptor (RLR) on mDCs and RLRs but not TLR3 on NK cells for IFN-gamma production was demonstrated using TLR3- and Cardif-deficient mice and human RIG-I-specific activator. Thus, we report the requirement of cotriggering TLR3 and RLR on mDCs and RLRs on NK cells for a pathogen product to induce potent innate cell activation.

Potential approaches for more successful dendritic cell-based immunotherapy.

INTRODUCTION: Dendritic cells (DCs) are the most important antigen-presenting cell population for activating antitumor T-cell responses; therefore, they offer a unique opportunity for specific targeting of tumors. AREAS COVERED: We will discuss the critical factors for the enhancement of DC vaccine efficacy: different DC subsets, types of in vitro DC manufacturing protocol, types of tumor antigen to be loaded and finally different adjuvants for activating them. We will cover potential combinatorial strategies with immunomodulatory therapies: depleting T-regulatory (Treg) cells, blocking VEGF and blocking inhibitory signals. Furthermore, recommendations to incorporate these criteria into DC-based tumor immunotherapy will be suggested. EXPERT OPINION: Monocyte-derived DCs are the most widely used DC subset in the clinic, whereas Langerhans cells and plasmacytoid DCs are two emerging DC subsets that are highly effective in eliciting cytotoxic T lymphocyte responses. Depending on the type of tumor antigens selected for loading DCs, it is important to optimize a protocol that will generate highly potent DCs. The future aim of DC-based immunotherapy is to combine it with one or more immunomodulatory therapies, for example, Treg cell depletion, VEGF blockage and T-cell checkpoint blockage, to elicit the most optimal antitumor immunity to induce long-term remission or even cure cancer patients.

Évaluation d'une structure gériatrique entre l'ambulatoire et l'hospitalier [Geriatric institutions, between ambulatory and hospital care: patients' description and performance assessment].

Introduction : Décrire les patients d'une structure gériatrique offrant des hospitalisations de courte durée, dans un contexte ambulatoire, pour des situations gériatriques courantes dans le canton de Genève (Suisse). Mesurer les performances de cette structure en termes de qualité des soins et de coûts. Méthodes : Des données relatives au profil des 100 premiers patients ont été collectées (huit mois), ainsi qu'aux prestations, aux ressources et aux effets (réadmissions, décès, satisfaction, complications) de manière à mesurer différents indicateurs de qualité et de coûts. Les valeurs observées ont été systématiquement comparées aux valeurs attendues, calculées à partir du profil des patients. Résultats : Des critères d'admission ont été fixés pour exclure les situations dans lesquelles d'autres structures offrent des soins mieux adaptés. La spécificité de cette structure intermédiaire a été d'assurer une continuité des soins et d'organiser d'emblée le retour à domicile par des prestations de liaison ambulatoire. La faible occurrence des réadmissions potentiellement évitables, une bonne satisfaction des patients, l'absence de décès prématurés et le faible nombre de complications suggèrent que les soins médicaux et infirmiers ont été délivrés avec une bonne qualité. Le coût s'est révélé nettement plus économique que des séjours hospitaliers après ajustement pour la lourdeur des cas. Conclusion : L'expérience-pilote a démontré la faisabilité et l'utilité d'une unité d'hébergement et d'hospitalisation de court séjour en toute sécurité. Le suivi du patient par le médecin traitant assure une continuité des soins et évite la perte d'information lors des transitions ainsi que les examens non pertinents. INTRODUCTION: To describe patients admitted to a geriatric institution, providing short-term hospitalizations in the context of ambulatory care in the canton of Geneva. To measure the performances of this structure in terms of quality ofcare and costs. METHOD: Data related to the clinical,functioning and participation profiles of the first 100 patients were collected. Data related to effects (readmission, deaths, satisfaction, complications), services and resources were also documented over an 8-month period to measure various quality and costindicators. Observed values were systematically compared to expected values, adjusted for case mix. RESULTS: Explicit criteria were proposed to focus on the suitable patients, excluding situations in which other structures were considered to be more appropriate. The specificity of this intermediate structure was to immediately organize, upon discharge, outpatient services at home. The low rate of potentially avoidable readmissions, the high patient satisfaction scores, the absence of premature death and the low number of iatrogenic complications suggest that medical and nursing care delivered reflect a good quality of services. The cost was significantly lower than expected, after adjusting for case mix. CONCLUSION: The pilot experience showed that a short-stay hospitalization unit was feasible with acceptable security conditions. The attending physician's knowledge of the patients allowed this system tofocus on essential issues without proposing inappropriate services.

T Cell Priming by Activated Nlrc5-Deficient Dendritic Cells Is Unaffected despite Partially Reduced MHC Class I Levels.

NLRC5, a member of the NOD-like receptor (NLR) protein family, has recently been characterized as the master transcriptional regulator of MHCI molecules in lymphocytes, in which it is highly expressed. However, its role in activated dendritic cells (DCs), which are instrumental to initiate T cell responses, remained elusive. We show in this study that, following stimulation of DCs with inflammatory stimuli, not only did NLRC5 level increase, but also its importance in directing MHCI transcription. Despite markedly reduced mRNA and intracellular H2-K levels, we unexpectedly observed nearly normal H2-K surface display in Nlrc5(-/-) DCs. Importantly, this discrepancy between a strong intracellular and a mild surface defect in H2-K levels was observed also in DCs with H2-K transcription defects independent of Nlrc5. Hence, alongside with demonstrating the importance of NLRC5 in MHCI transcription in activated DCs, we uncover a general mechanism counteracting low MHCI surface expression. In agreement with the decreased amount of neosynthesized MHCI, Nlrc5(-/-) DCs exhibited a defective capacity to display endogenous Ags. However, neither T cell priming by endogenous Ags nor cross-priming ability was substantially affected in activated Nlrc5(-/-) DCs. Altogether, these data show that Nlrc5 deficiency, despite significantly affecting MHCI transcription and Ag display, is not sufficient to hinder T cell activation, underlining the robustness of the T cell priming process by activated DCs.

De vitio proprietatis religiosorum.

F. 1-8 De vitio proprietatis religiosorum. « Jhesus, Maria, Franciscus. Sequitur... vicio proprietatis religiosorum » (titre effacé, lisible en partie à la lumière ultra-violette). « Manifestum videtur esse quod persone religiose viri et femine ordinem approbatum professe pro proprietatis vicio alligate nullo modo possint salvari... — ... nec continue. Vide Johannem Andree in regulam Non est obligatorium in novella super librum sextum et sic est finis ». F. 9-279 [BARTHOLOMAEUS DE RINONICO PISANUS] Liber de conformitatibus. « Incipit liber de conformitatibus beati Francisci quamvis plurimum breviatus tres partiales libros complectens... » (éd. dans Analecta franciscana sive chronica, IV-V, Quaracchi, 1906-1912). L. I, Conformitatum I-XII secundae partes : « Prima conformitas. Franciscus declaratur, expositio sequitur. Declarata prima parte primi fructus conformitatis que fuit de Christo (que [sic] ego pro nunc scribere non intendo sed solum que spectant ad beatum Franciscum etc.) manifestat nunc consequenter secundam partem ipsius enodare... — ... lucem Christum perveniamus. Amen. Sic ergo prelibatis apparet declarata secunda pars istius 12mi [sic] conformitatis videlicet Franciscus reserator... tam in isto duodecimo quam in precedentibus et subsequentibus conformitatibus sit laus Deo. Amen » (éd. cit., IV, 33-60, 69-82, 95-100, 108-113, 116-124, 138-149, 156-164, 175-364, 369-457, 464-485, 493-564, 580-632) (9-177v) ; — L. II, Conformitates I-XII, incomplet : « Incipit secundus liber et sequitur secunda pars prime conformitatis secundi libri videlicet Franciscus divulgatur. Expositio. Magister summus et verax... — ... patet ad fratres » (177v-224v), avec variantes et lacunes : Conformitas I, pars 2, incomplète de la fin par lacune matérielle (ibid., V, 10-13) (177v-178v) ; II et III, manquent par lacune matérielle ; IV, pars 2 (ibid., 100-123) (179-189) ; pars 1, fragm. (ibid., 97-100) (189-190v) ; V, texte abrégé (ibid., 123-144) (190v-199v) ; VI, pars 2, texte abrégé (ibid., 159-182) (199v-206) ; VII, pars 2, texte abrégé (ibid., 189-198) (206-208v) ; VIII, pars 2, texte abrégé (ibid., 208-211) (208v-209v) ; IX, texte abrégé (ibid., 211-226) (209v-213) ; X, pars 2 (ibid., 232-233) (213-214) ; XI, texte abrégé (ibid., 233-259) (214-224) ; XII, pars 2, texte abrégé (ibid., 275-277) (224-224v) ; — L. III, Conformitates I-IX, incomplet de la fin : « Incipit liber tercius de conformitate vite beati Francisci ad vitam Jhesu Christi. Fructus primus et conformitas et 2us in ordine Jhesus cum suis comedens, Franciscus emulatur. Expositio prime partis... Virtus illa et sapientia divina qua omnia a Deo fiunt... — ... ad orandum. Lc. XI in quo fuit captus... » (ibid., 333-459) (225-279). Ce texte a été aussi publié sous le nom de BARTHOLOMAEUS ALBISIUS PISANUS ; cf. Sbaralea, Supplementum, I, 114-117. Au contreplat supérieur, cote : « 87 » de l'inventaire après décès de Claude Hardy ; cf. ms. Latin 9363, f. 139. Acheté par Baluze pour la bibliothèque de Colbert ; cf. ibid., f. 145v et add. du ms. Latin 3114A.

[4 lettres de Benjamin Godard à Jules Massenet, 1879-[1895]]

f.1 : adressé à Madame Massenet, f. 5 à 6 : lettre sur papier de deuil écrite par Madeleine, la soeur de Benjamin Godard, celui-ci étant malade, et datée d'après : le contexte des f.3-4 et l'année de décès de Benjamin Godard

[7 lettres d'Augusta Holmès à Jules Massenet, [entre 1892 et 1903]]

f.1-5, 7-8 : lettres, f.6 : carte ; f.1 daté d'après le contenu de la lettre, f.7-8 datés d'après l'année de décès d'Augusta Holmès

[10 lettres d'Henri Meilhac à Jules Massenet, 1881-[1897]]

f.1-2, 5-10 : lettres, f.3-4 : cartes ; f.4 à 10 : datés d'après le contenu des lettres et son année de décès

[2 lettres de Franz Servais à Jules Massenet, 1895-[1901]]

f.3-4 : datés d'après l'année de décès de Franz Servais

[20 lettres d'Armand Silvestre à Jules Massenet, [1868-1901]]

f.1-5, 12-16, 18-26 : lettres, f.6-11 : cartes-lettres, f.17,28-31 : lettres sur papier de deuil ; enveloppe jointe au f.13 ; f.1-2, 12, 15-22 : datés d'après le contenu ; f.23-31 : datés d'après l'année de décès de l'auteur

[13 lettres adressées à Louise Massenet, 1912-[1937]]

f.1-2 : lettre d'Adrien Bernheim, f.3 : lettre d'Henri Büsser, f.4-5 : lettre de François Flameng, f.6 : carte sur papier de deuil d'Albert Girard, f.7 : lettre de Louis Schneider datée d'après l'année de décès de Louis Schneider, f.8 : lettre d'Hélène Seguin, f.9-10 : lettre de Charles Silver, f.12 : lettre de Francis Wey, f.13-18 : lettres de Charles-Marie Widor ; f.11 : lettre sur papier de deuil d'un correspondant non identifié