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Biomedical subjects

J Blouin

Publications and source records attributed to J Blouin.

At least 19 recordsLinked to original sources

[Complement factor I deficiency revealed by repeated systemic Streptococcus pneumoniae infection].

Recurrent and serious otitis media, and 2 Streptococcus pneumoniae bacteraemia episodes evoked an immune system deficiency in a 6-year-old girl. Upon investigation of the complement system, CH50 activity was moderately reduced and C4 antigen level was normal contrasting with low C3 antigen level. Factor 1 was undetectable. Factor I deficiency is rare, and its diagnosis has important practical consequences. Thanks to preventive antibiotic therapy with penicillin V and vaccinations against Neisseria meningitidis and S. pneumoniae, life expectancy and quality of this child can be significantly improved.

Anti-Bacterial Agents↗

[Neisseria meningitidis infection. Clinical criteria orienting towards a deficiency in the proteins of the complement].

OBJECTIVE: Complement protein deficiency of the classical pathway or in proteins of the alternate pathway is rare but considerably increase the risk of infection with Neisseria meningitidis. The aim of this study was to determine the clinical criteria of the group at risk. METHODS: Retrospective study of the clinical and biological data of patients exhibiting complement protein deficiency associated with one or several N. meningitidis infections. RESULTS: Forty cases were studied, including 35 classical pathway protein deficiencies, with a predominance of C7 deficiency, 3 properdin deficiencies and 2 acquired C3 deficiencies. More than 60% of the patients exhibited recurrent N. meningitidis infections. Serogroups of rare strains were isolated in 50% of cases. Properdin deficiency was associated with a fulminating form in 2 cases out of 3. The age at onset of the first manifestations varied from 2 months to 32 years. CONCLUSION: A deficiency must be systematically searched for in all patients presenting with a N. meningitidis infection before the age of 6 months or after the age of 5 years. Identification of deficient patients permits the proposal of family screening and appropriate prophylaxis, including preventive vaccination.

Adolescent↗

Accuracy of spatial localization depending on head posture in a perturbed gravitoinertial force field.

Spatial orientation is crucial when subjects have to accurately reach memorized visual targets. In previous studies modified gravitoinertial force fields were used to affect the accuracy of pointing movements in complete darkness without visual feedback of the moving limb. Target mislocalization was put forward as one hypothesis to explain this decrease in accuracy of pointing movements. The aim of this study was to test this hypothesis by determining the accuracy of spatial localization of memorized visual targets in a perturbed gravitoinertial force field. As head orientation is involved in localization tasks and carrying relevant sensory systems (visual, vestibular and neck muscle proprioceptive), we also tested the effect of head posture on the accuracy of localization. Subjects (n=10) were seated off-axis on a rotating platform (120 degrees s(-1)) in complete darkness with the head fixed (head-fixed session) or free to move (head-free session). They were required to report verbally the egocentric spatial localization of visual memorized targets. They gave the perceived target location in direction (i.e. left or right) and in amplitude (in centimeters) relative to the direction they thought to be straight ahead. Results showed that the accuracy of visual localization decreased when subjects were exposed to inertial forces. Moreover, subjects localized the memorized visual targets more to the right than their actual position, that was in the direction of the inertial forces. With further analysis, it appeared that this shift of localization was concomitant with a shift of the visual straight ahead (VSA) in the opposite direction. Thus, the modified gravitoinertial force field led to a modification in the orientation of the egocentric reference frame. Furthermore, this shift of localization increased when the head was free to move while the head was tilted in roll toward the center of rotation of the platform and turned in yaw in the same direction. It is concluded that the orientation of the egocentric reference frame was influenced by the gravitoinertial vector.

Adolescent↗

Restricted genetic defects underlie human complement C6 deficiency.

Complement C6 homozygous deficiency (C6D) has been rarely observed in Caucasians but was reported at higher prevalence among African-Americans. We report on the molecular basis of C6D in seven unrelated black individuals of North or Central Africa descent who live in France. These patients have presented Neisseria meningitidis infection (four cases), focal and segmental glomerulosclerosis with hyalinosis (one case), systemic lupus erythematosus (one case) or Still's disease (one case). All patients exhibited undetectable antigenic C6 by using a sensitive ELISA assay. An additional four cases of complete C6 deficiency with no associated disease have been characterized after family studies. Exons 6, 7 and 12 have been described recently as the location of molecular defects on the C6 gene in randomly chosen black Americans. Genomic DNA from the seven patients were subjected to direct polymerase chain reaction amplification of these three exons. Nucleotide sequencing analysis of the amplified DNA fragments revealed a homozygous single-base deletion (1936delG) in exon 12 in three cases and four compound heterozygous deletions for a single base in exon 7 (1195delC) or in exon 6 (878delA) associated with the same deletion in exon 12 (1936delG). Our observations further establish the restricted pattern of genetic defects associated with homozygous C6 complement deficiency in individuals of African descent.

Adolescent↗

Galvanic vestibular stimulation in humans produces online arm movement deviations when reaching towards memorized visual targets.

Using galvanic vestibular stimulation (GVS), we tested whether a change in vestibular input at the onset of goal-directed arm movements induces deviations in arm trajectory. Eight head-fixed standing subjects were instructed to reach for memorized visual targets in complete darkness. In half of the trials, randomly-selected, a 3 mA bipolar binaural galvanic stimulation of randomly alternating polarity was triggered by the movement onset. Results revealed significant GVS-induced directional shifts of reaching movements towards the anode side. The earliest significant deviations of hand path occurred 240 ms after stimulation onset. The likely goal of these online deviations of arm trajectory was to compensate for a vestibular-evoked apparent change in the spatial relationship between the target and the hand.

Adult↗

Molecular basis of a selective C1s deficiency associated with early onset multiple autoimmune diseases.

We have investigated the molecular basis of selective and complete C1s deficiency in 2-year-old girl with complex autoimmune diseases including lupus-like syndrome, Hashimoto's thyroiditis, and autoimmune hepatitis. This patient's complement profile was characterized by the absence of CH50 activity, C1 functional activity <10%, and undetectable levels of C1s Ag associated with normal levels of C1r and C1q Ags. Exon-specific amplification of genomic DNA by PCR followed by direct sequence analysis revealed a homozygous nonsense mutation in the C1s gene exon XII at codon 534, caused by a nucleotide substitution from C (CGA for arginine) to T (TGA for stop codon). Both parents were heterozygous for this mutation. We used the new restriction site for endonuclease Fok-1 created by the mutation to detect this mutation in the genomic DNA of seven healthy family members. Four additional heterozygotes for the mutation were identified in two generations. Our data characterize for the first time the genetic defect of a selective and complete C1s deficiency in a Caucasian patient.

Age of Onset↗

Visual feedback of the moving arm allows complete adaptation of pointing movements to centrifugal and Coriolis forces in human subjects.

A classical visuo-manual adaptation protocol carried out on a rotating platform was used to test the ability of subjects to adapt to centrifugal and Coriolis forces when visual feedback of the arm is manipulated. Three main results emerge: (a) an early modification of the initial trajectory of the movements takes place even without visual feedback of the arm; (b) despite the change in the initial trajectory, the new external force decreases the accuracy of the pointing movements when vision is precluded; (c) a visual adaptive phase allows complete adaptation of the pointing movements performed in a modified gravitoinertial field. Therefore vision would be essential for subjects to completely adapt to centrifugal and Coriolis forces. However, other sensory signals (i.e. vestibular and proprioceptive) may constitute the basis for early but partial correction of the pointing movements.

Adult↗

The gap effect for eye and hand movements in double-step pointing.

The existence of a temporal gap between the offset of a fixation target and the onset of a peripheral target generally reduces the saccadic and manual reaction time in response to the peripheral target. Using a double-step paradigm, the present experiment investigated whether a temporal gap between the extinction of the first target and the presentation of the second target can help in reducing the time to trigger the corrective eye movements and to correct the arm trajectory towards the final target position. A gap was introduced between the presentation of the initial target and a new unexpected goal-target during the movement. The results replicated the gap effect for the corrective saccade to the second target, but revealed an opposite effect for the correction of the reaching movements as the arm correction occurred later in the Gap than in the No-Gap conditions. These results suggest that the information available for the arm motor system to correct the trajectory in relation to the second target was different in the Gap and No-Gap conditions. In the No-Gap condition, the correction of reaching movements would be based on retinal errors between the first and the second targets whereas, in the Gap condition, the correction would be based on information derived from the corrective saccade-related signals to the second target.

Adult↗

Lack of evidence of a specific role for C4A gene deficiency in determining disease susceptibility among C4-deficient patients with systemic lupus erythematosus (SLE).

The aim of the present study was to investigate the prevalence of C4 and C2 deficiencies and to characterize genomic alterations in C4 genes in a large cohort of 125 unselected patients with SLE. We determined the protein concentration and functional activity of C2 and C4, as well as the C4 phenotype. C4 genotyping included Taq 1 restricted fragment lengh polymorphism (RFLP) analysis and polymerase chain reaction using sequence-specific primers (SSP-PCR). Type I C2 deficiency was diagnosed by PCR. Overall, 79.2% of the patients exhibited abnormalities of the C4 genes including deletion, non-expression, gene conversion and duplication. Among C4-deficient patients (n = 66, 52.8% prevalence), 41.0% of the patients exhibited a C4A deficiency and 59.0% a C4B deficiency. Half of the C4 deficiencies were due to a gene deletion. There was a strong association between C4A and C4B gene deletion and the presence of the DRB1*03 allele. Among the silent C4A genes, only two cases were related to a 2-bp insertion in exon 29 of the C4A gene. A gene conversion was demonstrated in eight patients (6.4%). One patient had a homozygous C4A deficiency. Three (2.4%) patients presented with a heterozygous type I C2 deficiency and none with homozygous deficiency. Our results argue against a specific role for C4A gene deficiency in determining disease susceptibility among patients with SLE that are C4-deficient.

Adolescent↗

No deleterious mutations in the FOXJ1 (alias HFH-4) gene in patients with primary ciliary dyskinesia (PCD).

The transcription factor FOXJ1 (alias HFH-4 or FKHL13) of the winged-helix/forkhead family is expressed in cells with cilia or flagella, and seems to be involved in the regulation of axonemal structural proteins. The knockout mouse Foxj1(-/-) shows abnormalities of organ situs, consistent with random determination of left-right asymmetry, and a complete absence of cilia. The human FOXJ1 gene which maps to chromosome 17q, is thus an excellent candidate gene for Kartagener Syndrome (KS), a subphenotype of Primary Ciliary Dyskinesia (PCD), characterized by bronchiectasis, chronic sinusitis and situs inversus. We have collected samples from 61 PCD families, in 31 of which there are at least two affected individuals. Two families with complete aciliogenesis, and six families, in which the affected members have microsatellite alleles concordant for a locus on distal chromosome 17q, were screened for mutations in the two exons and intron-exon junctions of the FOXJ1 gene. No sequence abnormalities were observed in the DNAs of the affected individuals of the selected families. These results demonstrate that the FOXJ1 gene is not responsible for the PCD/KS phenotype in the families examined.

Alleles↗

Updating visual space during passive and voluntary head-in-space movements.

The accuracy of our spatially oriented behaviors largely depends on the precision of monitoring the change in body position with respect to space during self-motion. We investigated observers' capacity to determine, before and after head rotations about the yaw axis, the position of a memorized earth-fixed visual target positioned 21 degrees laterally. The subjects (n=6) showed small errors (mean=-0.6 degrees) and little variability (mean=0.9 degrees) in determining the position of an extinguished visual-target position when the head (and gaze) remained in a straight-ahead position. This accuracy was preserved when subjects voluntary rotated the head by various magnitudes in the direction of the memorized visual target (head rotations ranged between 5 degrees and 60 degrees). However, when the chair on which the subjects were seated was unexpectedly rotated about the yaw axis in the direction of the target (chair rotations ranged between 6 degrees and 36 degrees ) during the head-on-trunk rotations, the performance was markedly decreased, both in terms of spatial precision (mean error=5.6 degrees ) and variability (mean=5.7 degrees). A control experiment showed that the prior knowledge of chair rotation occurrence had no effect on the perceived target position after head-trunk movements. Updating an earth-fixed target position during head-on-trunk rotations could be achieved through both cervical and vestibular signals processing, but, in the present experiment, the vestibular output was the only signal that had the potentiality to contribute to accurate coding of the target position after simultaneous head and trunk movements. Our results therefore suggest that the vestibular output is a noisy signal for the central nervous signal to update the visual space during head-in-space motion.

Adult↗

Encoding target-trunk relative position: cervical versus vestibular contribution.

The contribution of cervical and vestibular cues in signaling the changes in target-trunk relative positions during self-motion was investigated. Normal subjects (Ss) were shown a LED flashed in the peripheral visual field in a dark room. Ss were then passively rotated about the vertical axis in one of three different conditions: (1) head chair-fixed (vestibular condition); (2) head earth-fixed (relaxed neck condition); and (3) head earth-fixed, but with the Ss actively attempting to turn it (activated neck condition). The Ss were then required to indicate, with their unseen index finger, the position of the previously flashed target. It was found that pointing at the memorized target was similarly accurate in the relaxed neck condition and in the activated neck condition. In the vestibular condition, pointing accuracy dropped significantly. These results suggest that neck proprioceptive signals are more effective than vestibular ones in signaling relative changes in the position of stationary objects with respect to the body during head-trunk motion. The finding that cervically mediated estimates were unchanged during active contraction of the neck muscles may suggests that efference copy signals may help interpret the change in the afferent signals caused by voluntary neck muscle activation.

Adult↗

Human complement factor H deficiency associated with hemolytic uremic syndrome.

This study reports on six cases of deficiency in the human complement regulatory protein Factor H (FH) in the context of an acute renal disease. Five of the cases were observed in children presenting with idiopathic hemolytic uremic syndrome (HUS). Two of the children exhibited a homozygous deficiency characterized by the absence of the 150-kD form of Factor H and the presence, upon immunoblotting, of the 42-kD Factor H-like protein 1 (FHL-1) and other FH-related protein (FHR) bands. Southern blot and PCR analysis of DNA of one patient with homozygous deficiency ruled out the presence of a large deletion of the FH gene as the underlying defect for the deficiency. The other four children presented with heterozygous deficiency and exhibited a normal immunoblotting pattern of proteins of the FH family. Factor H deficiency is the only complement deficiency associated with HUS. These observations suggest a role for FH and/or FH receptors in the pathogenesis of idiopathic HUS.

Acute Disease↗

Role of arm proprioception in calibrating the arm-eye temporal coordination.

When subjects track with the eyes an arm-attached target, eye latency is shorter than when tracking an external target. This improved synchrony could result from either a common command addressed to the two systems or from an influence of the arm command on eye motion initiation. According to the first hypothesis, the eyes should start moving long before the arm, because of the difference in dynamics. We recorded arm and eye motion together with biceps muscle activity in controls and a deafferented subject. Data support the second hypothesis. Moreover, the deafferented subject showed a lesser correlation between arm and eye motions than controls, suggesting a role for arm proprioception in the calibration of the temporal relationship between arm and eye movements.

Adult↗

The role of ocular muscle proprioception during modifications in smooth pursuit output.

The output of the smooth pursuit (SP) system can be increased by adding a portion of the recorded eye motion onto target motion, producing a situation analogous to that occurring with weakened ocular muscles. This change is most likely the result of alterations in the signals that code eye and target motion. We have assessed the contribution of one such signal, that arising from ocular proprioception, to the modification process during monocular SP by preventing the motion of the non-viewing eye with a suction scleral lens. The large increases normally observed for SP velocity following the modification period were substantially reduced under these conditions. Similar alterations were also observed in a manual tracking task. These results demonstrate that ocular proprioceptive signals serve to stabilize the output of the SP system following perturbations, via the recoding of eye and target motion.

Humans↗

Combined heterozygous deficiency of the classical complement pathway proteins C2 and C4.

Genetic deficiencies of components of the classical pathway of complement activation are associated with an increased risk for the development of autoimmune and immune complex-mediated diseases. In the present study we report on the molecular and clinical features associated with combined heterozygous C4 and C2 deficiency in 15 individuals investigated within six families. Approximately 30% of the individuals manifested SLE or another autoimmune condition. Heterozygous C2 deficiency was related to a 28-bp deletion in the C2 gene (C2 deficiency type I), in most cases within the HLA-A25 B18 C2Q0 BfS C4A4B2 DR2 haplotype. Among 13 partial C4-deficient haplotypes transmitted, 8 carried C4A*Q0 alleles and 5 C4B*Q0 alleles. In seven cases the C4A*Q0 alleles were associated with a deletion of the C4A/CYP21P genes within the HLA-B8 C2C BfS C4AQ0B1 DR3 haplotype. In three cases, the C4B*Q0 allele was associated with a deletion of the C4B/CYP21P genes within the HLA-B18 C2C BfF1 C4A3BQ0 DR3 haplotype. In the other cases, C4A*Q0 or C4B*Q0 was dependent on as yet uncharacterized defects in the C4 gene or in C4 gene expression. In view of the relatively high frequency of heterozygous C4 deficiency in the normal Caucasian population, the expected frequency of the combined deficiency should approximate 0.001.

Adult↗