Phase II study of weekly plitidepsin as second-line therapy for small cell lung cancer.

OBJECTIVE: To evaluate the antitumor activity and safety profile of plitidepsin administered as a 1h weekly intravenous (i.v.) infusion of 3.2mg/m(2) to patients with small cell lung cancer (SCLC) who relapsed or progressed after one line of chemotherapy. PATIENTS AND METHODS: This was a multicenter, open-label, single-arm, exploratory, phase II clinical trial. Treatment lasted until disease progression, unacceptable toxicity, patient refusal or treatment delay for >2 weeks. Objective response rate (primary efficacy endpoint) was evaluated according to response evaluation criteria in solid tumors (RECIST). The rate of stable disease (SD) lasting for at least 6 months and time-to-event variables were secondary endpoints of efficacy. Toxicity was assessed using National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 2.0. RESULTS: Twenty pretreated SCLC patients (median age, 60 years) with extensive (n=13) or limited-stage disease (n=7) received a total of 24 treatment cycles (median, one cycle per patient; range, 1-2). Objective tumor responses were not observed and only one of the 17 evaluable patients had SD. With a median follow-up of 11.8 months, the progression-free survival and the median overall survival were 1.3 months and 4.8 months, respectively. The most troubling or common toxicities were fatigue, muscle weakness, lymphopenia, anemia (no patients showed neutropenia), and asymptomatic, non-cumulative increase of transaminases levels and alkaline phosphatase. CONCLUSION: This clinical trial shows that a cycle of 1h weekly i.v. infusion of plitidepsin (3.2mg/m(2)) was generally well tolerated other than fatigue and muscle weakness in patients with pretreated SCLC. One patient died due to multi-organ failure. The absence of antitumor activity found here precludes further studies of this plitidepsin schedule as second-line single-agent treatment of SCLC.

Outcome of long-axis percutaneous sacroplasty as first-line treatment of sacral insufficiency fractures : P219

Purpose: To assess the clinical outcome of patients who were subjected to long-axis sacroplasty as first line treatment for sacral insufficiency fractures. Methods and materials: Nineteen patients with unilateral (n = 3) or bilateral (n = 16) sacral fractures were involved. Under local anaesthesia, each patient was subjected to CT guided sacroplasty using the long-axis approach through a single entry point. An average of 6 ml of PMMA was delivered along the path of each sacral fracture. For each individual patient, the VAS pain score before sacroplasty and at 1, 4, 24, and 48 weeks after the procedure was obtained. Furthermore, the use of analgesics (narcotic/non-narcotic) along with the evolution of post interventional patient mobility before and after sacroplasty was also recorded. Results: The mean pre-procedure VAS score was 8 ± 1.9. This has rapidly declined in the first week after the procedure (mean 4 ± 1.5) followed by gradual decrease along the rest of follow-up period at 4 weeks (mean 3 ± 1.2), 24 weeks (mean 2 ± 1.3), and 48 weeks (mean 1.3 ± 1.4), respectively. Eleven (58%) patients were under narcotic analgesia before sacroplasty, whereas, 8 (42%) patients were using non-narcotics. Corresponding values after the procedure were 2/19 (10%) (narcotic) and 10/19 53% (non-narcotic). Seven (37%) patients did not address post-procedure analgesic use. The evolution of post interventional mobility was favourable in the study group since they revealed a significant improvement in their mobility point scale. Conclusion: Long-axis percutaneous sacroplasty is a suitable minimally invasive treatment option for patients who present with sacral insufficiency fractures. Future studies with larger patient number are warranted to grasp any potential limitations of this therapeutic approach.

In vitro neuroendocrine effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in the AhR-expressing hypothalamic rat GnV-3 cell line.

The aryl hydrocarbon receptor (AhR) is involved in a wide variety of biological and toxicological responses, including neuroendocrine signaling. Due to the complexity of neuroendocrine pathways in e.g. the hypothalamus and pituitary, there are limited in vitro models available despite the strong demand for such systems to study and predict neuroendocrine effects of chemicals. In this study, the applicability of the AhR-expressing rat hypothalamic GnV-3 cell line was investigated as a novel model to screen for neuroendocrine effects of AhR ligands using 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as reference compound. The qRT-PCR analyses demonstrated the presence of several sets of neurotransmitter receptors in the GnV-3 cells. TCDD (10nM) altered neurotransmitter signaling by up-regulation of glutamate (Grik2), gamma-amino butyric acid (Gabra2) and serotonin (Ht2C) receptor mRNA levels. However, no significant changes in basal and serotonin-evoked intracellular Ca(2+) concentration ([Ca(2+)]i) or serotonin release were observed. On the other hand, TCDD de-regulated period circadian protein homolog 1 (Per1) and gonadotropin releasing hormone (Gnrh) mRNA levels within a 24-h time period. Both Per1 and Gnrh genes displayed a similar mRNA expression pattern in GnV-3 cells. Moreover, the involvement of AhR in TCDD-induced alteration of Neuropeptide Y (Npy) gene expression was found and confirmed by using siRNA targeted against Ahr in GnV-3 cells. Overall, the combined results demonstrate that GnV-3 cells may be a suitable model to predict some mechanisms of action and effects of AhR ligands in the hypothalamus.

Preliminary Experience in Treatment of Papillary and Macular Retinoblastoma: Evaluation of Local Control and Local Complications After Treatment with Linear Accelerator-Based Stereotactic Radiotherapy with Micromultileaf Collimator as Second-Line or Salvage Treatment after chemotherapy.

PURPOSE: To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator. METHODS AND MATERIALS: Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator. RESULTS: The median follow-up was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed. CONCLUSIONS: Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials.

Response evaluation in third- and fourth-line treatment of GIST: the role of PET

Background: Response evaluation in gastrointestinal stromal tumors is difficult. Computed tomography and size-based assessments have been found inadequate to draw prognostic conclusions in patients treated with tyrosine kinase inhibitors (TKI). Density criteria (CHOI) have recently been shown to better define prognostic subsets of patients evaluated with CT. Still, positron emission tomography (PET) might be better at identifying responders with good outcome early, as shown for first and recently second-line treatment in GIST (Prior et al.; J Clin Oncol 2009). We wanted to evaluate the role of PET in third- and fourth-line TKI treatment of GIST. Methods: We retrospectively reviewed patients with GIST who had received third- or fourth-line treatment with TKI and had undergone PET for response evaluation. Patient needed to have a baseline and at least one subsequent PET. Results of the first "early" PET after treatment start have been used throughout this analysis and EORTC PET Study Group criteria applied. Results: Twelve treatment courses were evaluable, seven with Nilotinib in third- and five with Sorafenib in fourth-line treatment, in 8 patients, median age 60 y (range 36−78 y), who had all failed prior Imatinib and Sunitinib treatment due to disease progession. Baseline and follow-up PET were performed within a median of 34 days (range 9−84 days). Median progression-free survival (PFS) was 262 days in patients responding to PET versus 76 days in patients with stable or progressing disease (p = 0.15). Conclusions: This small series suggests that PET retains its value for outcome prediction in third- and fourth-line TKI treatment of GIST. This could be of particular clinical value in these vulnerable patients with large tumour masses. Early PET may help in stopping ineffective, but toxic therapy and help switching to a more effective therapy. PET should be evaluated further in this patient population.

Rabies neutralizing antibody detection by indirect immunperoxidase serum neutralization assay performed on chicken embryo related cell line

The aim of this study was to evaluate the indirect immunoperoxidase virus neutralization (IPVN) and mouse neutralization test (MNT) to detect antibodies against rabies virus from vaccinated dogs and cattle. The IPVN was set up for the ability to measure 0.5 International Units/ml (IU) of antibody required by the World Health Organization and the Office International des Epizooties as the minimum response for proof of rabies immunization. IPVN was developed and standardized in chicken embryo related (CER) cell line when 141 dog and 110 cattle sera were applied by serial five-fold dilutions (1:5, 1:25, 1:125) as well as the positive and negative reference controls, all added in four adjacent wells, of 96-well microplates. A 50 µl amount of CVS32 strain dilution containing 50-200 TCID50/ml was mixed to each serum dilution, and after 90 min 50 µl of 3 x 10(5) cells/mlcell suspension added to each well. After five days of incubation, the monolayers were fixed and the IPVN test performed. The correlation coefficient between the MNT and IPVN performed in CER cells was r = 0.9949 for dog sera (n = 100) and r = 0.9307 for cattle sera (n = 99), as well as good specificity (94.7%), sensitivity (87.5%), and agreement (96.6%) were also obtained. IPVN technique can adequately identify vaccinated and unvaccinated animals, even from low-responding vaccinated animals, with the advantage of low cost and faster then MNT standard test.

Up-regulation of placental leptin by human chorionic gonadotropin.

Leptin, the 16,000 molecular weight protein product of the obese gene, was originally considered as an adipocyte-derived signaling molecule for the central control of metabolism. However, leptin has been suggested to be involved in other functions during pregnancy, particularly in placenta, in which it was found to be expressed. In the present work, we have found that recombinant human chorionic gonadotropin (hCG) added to BeWo choriocarcinoma cell line showed a stimulatory effect on endogenous leptin expression, when analyzed by Western blot. This effect was time and dose dependent. Maximal effect was achieved at hCG 100 IU/ml. Moreover, hCG treatment enhanced leptin promoter activity up to 12.9 times, evaluated by transient transfection with a plasmid construction containing different promoter regions and the reporter gene luciferase. This effect was dose dependent and evidenced with all the promoter regions analyzed, regardless of length. Similar results were obtained with placental explants, thus indicating physiological relevance. Because hCG signal transduction usually involves cAMP signaling, this pathway was analyzed. Contrarily, we found that dibutyryl cAMP counteracted hCG effect on leptin expression. Furthermore, cotransfection with the catalytic subunit of PKA and/or the transcription factor cAMP response element binding protein repressed leptin expression. Thereafter we determined that hCG effect could be partially blocked by pharmacologic inhibition of MAPK pathway with 50 microM PD98059 but not by the inhibition of the phosphatidylinositol 3-kinase pathway with 0.1 microm wortmannin. Moreover, hCG treatment promoted MAPK kinase and ERK1/ERK2 phosphorylation in placental cells. Finally, cotransfection with a dominant-negative mutant of MAPK blocked the hCG-mediated activation of leptin expression. In conclusion, we provide some evidence suggesting that hCG induces leptin expression in trophoblastic cells probably involving the MAPK signal transduction pathway.

The neuroretina is a novel mineralocorticoid target: aldosterone up-regulates ion and water channels in Müller glial cells.

Glucocorticoids reduce diabetic macular edema, but the mechanisms underlying glucocorticoid effects are imperfectly elucidated. Glucocorticoids may bind to glucocorticoid (GR) and mineralocorticoid (MR) receptors. We hypothesize that MR activation may influence retinal hydration. The effect of the MR agonist aldosterone (24 h) on ion/water channel expression (real-time PCR, Western blot, immunofluorescence) was investigated on cultured retinal Müller glial cells (RMGs, which contribute to fluid homeostasis in the retina), in Lewis rat retinal explants, and in retinas from aldosterone-injected eyes. We evidenced cell-specific expression of MR, GR, and 11-beta-hydroxysteroid dehydrogenase type II. Aldosterone significantly enhances expression of sodium and potassium channels ENaC-alpha (6.5-fold) and Kir4.1 (1.9-fold) through MR and GR occupancy, whereas aquaporin 4 (AQP4, 2.9-fold) up-regulation is MR-selective. Aldosterone intravitreous injection induces retinal swelling (24% increase compared to sham-injected eyes) and activation of RMGs. It promotes additional localization of Kir4.1 and AQP4 toward apical microvilli of RMGs. Our results highlight the mineralocorticoid-sensitivity of the neuroretina and show that aldosterone controls hydration of the healthy retina through regulation of ion/water channels expression in RMGs. These results provide a rationale for future investigations of abnormal MR signaling in the pathological retina.

Tumor necrosis-like weak inducer of apoptosis as a proinflammatory cytokine in human adipocyte cells: up-regulation in severe obesity is mediated by inflammation but not hypoxia.

CONTEXT Adipose tissue hypoxia and endoplasmic reticulum (ER) stress may link the presence of chronic inflammation and macrophage infiltration in severely obese subjects. We previously reported the up-regulation of TNF-like weak inducer of apoptosis (TWEAK)/fibroblast growth factor-inducible 14 (Fn14) axis in adipose tissue of severely obese type 2 diabetic subjects. OBJECTIVES The objective of the study was to examine TWEAK and Fn14 adipose tissue expression in obesity, severe obesity, and type 2 diabetes in relation to hypoxia and ER stress. DESIGN In the obesity study, 19 lean, 28 overweight, and 15 obese nondiabetic subjects were studied. In the severe obesity study, 23 severely obese and 35 control subjects were studied. In the type 2 diabetes study, 11 type 2 diabetic and 36 control subjects were studied. The expression levels of the following genes were analyzed in paired samples of sc and visceral adipose tissue: Fn14, TWEAK, VISFATIN, HYOU1, FIAF, HIF-1a, VEGF, GLUT-1, GRP78, and XBP-1. The effect of hypoxia, inflammation, and ER stress on the expression of TWEAK and Fn14 was examined in human adipocyte and macrophage cell lines. RESULTS Up-regulation of TWEAK/Fn14 and hypoxia and ER stress surrogate gene expression was observed in sc and visceral adipose tissue only in our severely obese cohort. Hypoxia modulates TWEAK or Fn14 expression in neither adipocytes nor macrophages. On the contrary, inflammation up-regulated TWEAK in macrophages and Fn14 expression in adipocytes. Moreover, TWEAK had a proinflammatory effect in adipocytes mediated by the nuclear factor-kappaB and ERK but not JNK signaling pathways. CONCLUSIONS Our data suggest that TWEAK acts as a pro-inflammatory cytokine in the adipose tissue and that inflammation, but not hypoxia, may be behind its up-regulation in severe obesity.

Early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up : 2nd ESMO Consensus Conference on Lung Cancer.

To complement the existing treatment guidelines for all tumour types, ESMO organises consensus conferences to focus on specific issues in each type of tumour. The 2nd ESMO Consensus Conference on Lung Cancer was held on 11-12 May 2013 in Lugano. A total of 35 experts met to address several questions on non-small-cell lung cancer (NSCLC) in each of four areas: pathology and molecular biomarkers, first-line/second and further lines in advanced disease, early-stage disease and locally advanced disease. For each question, recommendations were made including reference to the grade of recommendation and level of evidence. This consensus paper focuses on early-stage disease.

Long-term effectiveness of first-line antiretroviral theraphy in a cohort of HIV-1 infected patients.

Eligibility criteria might explain differences in viral response to combined antiretroviral treatment (cART) between clinical trials and routine care setting. Prospective analysis including HIV-1 infected patients starting cART between January 2004 and December 2009, at Hospital Universitari Vall d’Hebron. Effectiveness evaluated as time to treatment failure (TF), defined as virologic failure, loss to follow-up, death or treatment discontinuation whatever the reason other than switching. Effectiveness month 12, 24 and 36 was 82.9%, 78.5% and 76%, respectively. 57 (24.6%) patients presented TF, mainly due to intolerance or toxicity. Higher risk in patients starting before 2006 and those with protease inhibitor based regimen.

Cost-effectiveness analysis of the first-line therapies for nicotine dependence.

BACKGROUND: Nicotine dependence is the major obstacle for smokers who want to quit. Guidelines have identified five effective first-line therapies, four nicotine replacement therapies (NRTs)--gum, patch, nasal spray and inhaler--and bupropion. Studying the extent to which these various treatments are cost-effective requires additional research. OBJECTIVES: To determine cost-effectiveness (CE) ratios of pharmacotherapies for nicotine dependence provided by general practitioners (GPs) during routine visits as an adjunct to cessation counselling. METHODS: We used a Markov model to generate two cohorts of one-pack-a-day smokers: (1) the reference cohort received only cessation counselling from a GP during routine office visits; (2) the second cohort received the same counselling plus an offer to use a pharmacological treatment to help them quit smoking. The effectiveness of adjunctive therapy was expressed in terms of the resultant differential in mortality rate between the two cohorts. Data on the effectiveness of therapies came from meta-analyses, and we used odds ratio for quitting as the measure of effectiveness. The costs of pharmacotherapies were based on the cost of the additional time spent by GPs offering, prescribing and following-up treatment, and on the retail prices of the therapies. We used the third-party-payer perspective. Results are expressed as the incremental cost per life-year saved. RESULTS: The cost per life-year saved for only counselling ranged from Euro 385 to Euro 622 for men and from Euro 468 to Euro 796 for women. The CE ratios for the five pharmacological treatments varied from Euro 1768 to Euro 6879 for men, and from Euro 2146 to Euro 8799 for women. Significant variations in CE ratios among the five treatments were primarily due to differences in retail prices. The most cost-effective treatments were bupropion and the patch, and, then, in descending order, the spray, the inhaler and, lastly, gum. Differences in CE between men and women across treatments were due to the shape of their respective mortality curve. The lowest CE ratio in men was for the 45- to 49-year-old group and for women in the 50- to 54-year-old group. Sensitivity analysis showed that changes in treatment efficacy produced effects only for less-well proven treatments (spray, inhaler, and bupropion) and revealed a strong influence of the discount rate and natural quit rate on the CE of pharmacological treatments. CONCLUSION: The CE of first-line treatments for nicotine dependence varied widely with age and sex and was sensitive to the assumption for the natural quit rate. Bupropion and the nicotine patch were the two most cost-effective treatments.

Desenvolupament d'una aplicació per a la creació de pressupostos on-line

En aquests moments, el mercat no es troba en una bona situació, per aquest motiu les empreses han de buscar noves maneres de créixer, expandir-se i noves formes d’interactuar amb els clients. La idea original d’aquest projecte sorgeix de la necessitat de disposar d’una manera diferent de promocionar-se i oferir nous serveis a través d’internet mitjançant una pàgina web. Degut a la situació actual, el preu és un aspecte molt important i influent a l’hora de realitzar una obra. Per aquest motiu es va pensar que seria molt interessant que el client pogués demanar de forma fàcil i ràpida un pressupost, i a l’instant tingués un preu orientatiu del que li pot costar la obra. D’aquesta manera l’interessat s’estalvia i agilitza molts passos previs abans de començar una obra. Després d’analitzar quina era la millor manera de portar a terme el projecte informàtic, s’ha determinat que la pàgina web es desenvoluparà utilitzant els llenguatges HTML i PHP combinant-lo amb el framework CodeIgniter. El disseny de la web es realitzarà mitjançant fulles d’estil CSS conjuntament amb el framework BootStrap. Per realitzar l’aplicació web que realitza els pressupostos s’utilitzarà AJAX i jQuery perquè d’aquesta manera el procés sigui dinàmic. L’entorn de desenvolupament escollit és el NetBeans i per provar el projecte s’utilitza el XAMPP. Un usuari només necessitarà un navegador i connexió a internet per fer servir totes les funcions de la web. Podrà realitzar pressupostos, concertar visites, contactar i per suposat veure tota la part informativa de la pàgina.

High specificity of line-immunoassay based algorithms for recent HIV-1 infection independent of viral subtype and stage of disease.

ABSTRACT: BACKGROUND: Serologic testing algorithms for recent HIV seroconversion (STARHS) provide important information for HIV surveillance. We have shown that a patient's antibody reaction in a confirmatory line immunoassay (INNO-LIATM HIV I/II Score, Innogenetics) provides information on the duration of infection. Here, we sought to further investigate the diagnostic specificity of various Inno-Lia algorithms and to identify factors affecting it. METHODS: Plasma samples of 714 selected patients of the Swiss HIV Cohort Study infected for longer than 12 months and representing all viral clades and stages of chronic HIV-1 infection were tested blindly by Inno-Lia and classified as either incident (up to 12 m) or older infection by 24 different algorithms. Of the total, 524 patients received HAART, 308 had HIV-1 RNA below 50 copies/mL, and 620 were infected by a HIV-1 non-B clade. Using logistic regression analysis we evaluated factors that might affect the specificity of these algorithms. RESULTS: HIV-1 RNA <50 copies/mL was associated with significantly lower reactivity to all five HIV-1 antigens of the Inno-Lia and impaired specificity of most algorithms. Among 412 patients either untreated or with HIV-1 RNA ≥50 copies/mL despite HAART, the median specificity of the algorithms was 96.5% (range 92.0-100%). The only factor that significantly promoted false-incident results in this group was age, with false-incident results increasing by a few percent per additional year. HIV-1 clade, HIV-1 RNA, CD4 percentage, sex, disease stage, and testing modalities exhibited no significance. Results were similar among 190 untreated patients. CONCLUSIONS: The specificity of most Inno-Lia algorithms was high and not affected by HIV-1 variability, advanced disease and other factors promoting false-recent results in other STARHS. Specificity should be good in any group of untreated HIV-1 patients.

Modelling tree population dynamics at the alpine and boreal tree-line ecotones in response to climate and land-use change

Summary Ecotones are sensitive to change because they contain high numbers of species living at the margin of their environmental tolerance. This is equally true of tree-lines, which are determined by attitudinal or latitudinal temperature gradients. In the current context of climate change, they are expected to undergo modifications in position, tree biomass and possibly species composition. Attitudinal and latitudinal tree-lines differ mainly in the steepness of the underlying temperature gradient: distances are larger at latitudinal tree-lines, which could have an impact on the ability of tree species to migrate in response to climate change. Aside from temperature, tree-lines are also affected on a more local level by pressure from human activities. These are also changing as a consequence of modifications in our societies and may interact with the effects of climate change. Forest dynamics models are often used for climate change simulations because of their mechanistic processes. The spatially-explicit model TreeMig was used as a base to develop a model specifically tuned for the northern European and Alpine tree-line ecotones. For the latter, a module for land-use change processes was also added. The temperature response parameters for the species in the model were first calibrated by means of tree-ring data from various species and sites at both tree-lines. This improved the growth response function in the model, but also lead to the conclusion that regeneration is probably more important than growth for controlling tree-line position and species' distributions. The second step was to implement the module for abandonment of agricultural land in the Alps, based on an existing spatial statistical model. The sensitivity of its most important variables was tested and the model's performance compared to other modelling approaches. The probability that agricultural land would be abandoned was strongly influenced by the distance from the nearest forest and the slope, bath of which are proxies for cultivation costs. When applied to a case study area, the resulting model, named TreeMig-LAb, gave the most realistic results. These were consistent with observed consequences of land-abandonment such as the expansion of the existing forest and closing up of gaps. This new model was then applied in two case study areas, one in the Swiss Alps and one in Finnish Lapland, under a variety of climate change scenarios. These were based on forecasts of temperature change over the next century by the IPCC and the HadCM3 climate model (ΔT: +1.3, +3.5 and +5.6 °C) and included a post-change stabilisation period of 300 years. The results showed radical disruptions at both tree-lines. With the most conservative climate change scenario, species' distributions simply shifted, but it took several centuries reach a new equilibrium. With the more extreme scenarios, some species disappeared from our study areas (e.g. Pinus cembra in the Alps) or dwindled to very low numbers, as they ran out of land into which they could migrate. The most striking result was the lag in the response of most species, independently from the climate change scenario or tree-line type considered. Finally, a statistical model of the effect of reindeer (Rangifer tarandus) browsing on the growth of Pinus sylvestris was developed, as a first step towards implementing human impacts at the boreal tree-line. The expected effect was an indirect one, as reindeer deplete the ground lichen cover, thought to protect the trees against adverse climate conditions. The model showed a small but significant effect of browsing, but as the link with the underlying climate variables was unclear and the model was not spatial, it was not usable as such. Developing the TreeMig-LAb model allowed to: a) establish a method for deriving species' parameters for the growth equation from tree-rings, b) highlight the importance of regeneration in determining tree-line position and species' distributions and c) improve the integration of social sciences into landscape modelling. Applying the model at the Alpine and northern European tree-lines under different climate change scenarios showed that with most forecasted levels of temperature increase, tree-lines would suffer major disruptions, with shifts in distributions and potential extinction of some tree-line species. However, these responses showed strong lags, so these effects would not become apparent before decades and could take centuries to stabilise. Résumé Les écotones son sensibles au changement en raison du nombre élevé d'espèces qui y vivent à la limite de leur tolérance environnementale. Ceci s'applique également aux limites des arbres définies par les gradients de température altitudinaux et latitudinaux. Dans le contexte actuel de changement climatique, on s'attend à ce qu'elles subissent des modifications de leur position, de la biomasse des arbres et éventuellement des essences qui les composent. Les limites altitudinales et latitudinales diffèrent essentiellement au niveau de la pente des gradients de température qui les sous-tendent les distance sont plus grandes pour les limites latitudinales, ce qui pourrait avoir un impact sur la capacité des espèces à migrer en réponse au changement climatique. En sus de la température, la limite des arbres est aussi influencée à un niveau plus local par les pressions dues aux activités humaines. Celles-ci sont aussi en mutation suite aux changements dans nos sociétés et peuvent interagir avec les effets du changement climatique. Les modèles de dynamique forestière sont souvent utilisés pour simuler les effets du changement climatique, car ils sont basés sur la modélisation de processus. Le modèle spatialement explicite TreeMig a été utilisé comme base pour développer un modèle spécialement adapté pour la limite des arbres en Europe du Nord et dans les Alpes. Pour cette dernière, un module servant à simuler des changements d'utilisation du sol a également été ajouté. Tout d'abord, les paramètres de la courbe de réponse à la température pour les espèces inclues dans le modèle ont été calibrées au moyen de données dendrochronologiques pour diverses espèces et divers sites des deux écotones. Ceci a permis d'améliorer la courbe de croissance du modèle, mais a également permis de conclure que la régénération est probablement plus déterminante que la croissance en ce qui concerne la position de la limite des arbres et la distribution des espèces. La seconde étape consistait à implémenter le module d'abandon du terrain agricole dans les Alpes, basé sur un modèle statistique spatial existant. La sensibilité des variables les plus importantes du modèle a été testée et la performance de ce dernier comparée à d'autres approches de modélisation. La probabilité qu'un terrain soit abandonné était fortement influencée par la distance à la forêt la plus proche et par la pente, qui sont tous deux des substituts pour les coûts liés à la mise en culture. Lors de l'application en situation réelle, le nouveau modèle, baptisé TreeMig-LAb, a donné les résultats les plus réalistes. Ceux-ci étaient comparables aux conséquences déjà observées de l'abandon de terrains agricoles, telles que l'expansion des forêts existantes et la fermeture des clairières. Ce nouveau modèle a ensuite été mis en application dans deux zones d'étude, l'une dans les Alpes suisses et l'autre en Laponie finlandaise, avec divers scénarios de changement climatique. Ces derniers étaient basés sur les prévisions de changement de température pour le siècle prochain établies par l'IPCC et le modèle climatique HadCM3 (ΔT: +1.3, +3.5 et +5.6 °C) et comprenaient une période de stabilisation post-changement climatique de 300 ans. Les résultats ont montré des perturbations majeures dans les deux types de limites de arbres. Avec le scénario de changement climatique le moins extrême, les distributions respectives des espèces ont subi un simple glissement, mais il a fallu plusieurs siècles pour qu'elles atteignent un nouvel équilibre. Avec les autres scénarios, certaines espèces ont disparu de la zone d'étude (p. ex. Pinus cembra dans les Alpes) ou ont vu leur population diminuer parce qu'il n'y avait plus assez de terrains disponibles dans lesquels elles puissent migrer. Le résultat le plus frappant a été le temps de latence dans la réponse de la plupart des espèces, indépendamment du scénario de changement climatique utilisé ou du type de limite des arbres. Finalement, un modèle statistique de l'effet de l'abroutissement par les rennes (Rangifer tarandus) sur la croissance de Pinus sylvestris a été développé, comme première étape en vue de l'implémentation des impacts humains sur la limite boréale des arbres. L'effet attendu était indirect, puisque les rennes réduisent la couverture de lichen sur le sol, dont on attend un effet protecteur contre les rigueurs climatiques. Le modèle a mis en évidence un effet modeste mais significatif, mais étant donné que le lien avec les variables climatiques sous jacentes était peu clair et que le modèle n'était pas appliqué dans l'espace, il n'était pas utilisable tel quel. Le développement du modèle TreeMig-LAb a permis : a) d'établir une méthode pour déduire les paramètres spécifiques de l'équation de croissance ä partir de données dendrochronologiques, b) de mettre en évidence l'importance de la régénération dans la position de la limite des arbres et la distribution des espèces et c) d'améliorer l'intégration des sciences sociales dans les modèles de paysage. L'application du modèle aux limites alpines et nord-européennes des arbres sous différents scénarios de changement climatique a montré qu'avec la plupart des niveaux d'augmentation de température prévus, la limite des arbres subirait des perturbations majeures, avec des glissements d'aires de répartition et l'extinction potentielle de certaines espèces. Cependant, ces réponses ont montré des temps de latence importants, si bien que ces effets ne seraient pas visibles avant des décennies et pourraient mettre plusieurs siècles à se stabiliser.