Biomedical subjects
Marc Thellier
Publications and source records attributed to Marc Thellier.
The genes encoding cAMP-dependent protein kinase catalytic subunit homologues of the microsporidia Encephalitozoon intestinalis and E. cuniculi: molecular characterisation and phylogenetic analysis.
A gene encoding a protein kinase was identified by homology-based PCR amplification in Encephalitozoon intestinalis, a microsporidian parasite pathogenic to humans, and its orthologue has been identified by database mining in the genome of the related species E. cuniculi, whose sequence has been recently published. Phylogenetic analysis revealed that the proteins encoded by these genes are homologues of the cAMP-dependent protein kinase catalytic subunits (PKAc). Southern blot analysis indicated that the EiPKAc gene is present in two copies in the E. intestinalis genome, whereas the E. cuniculi orthologue (EcPKAc) is a single copy gene. RT-PCR data showed that the EiPKAc gene is expressed in at least one of the intracellular stages during infection of the mammalian host cell by E. intestinalis.
Localized cutaneous leishmaniasis imported into Paris: a review of 39 cases.
BACKGROUND: Localized cutaneous leishmaniasis (LCL) is a common cause of dermatosis in travelers returning from the tropics. We describe the epidemiological, clinical, and biological aspects and therapeutic outcome of imported LCL. METHODS: A retrospective study of all cases of LCL observed from 1992 to 2000 in our tropical disease unit. Diagnosis was based on direct examination of skin smear and/or culture with identification of subsequent subspecies. RESULTS: Thirty-nine cases (25 males, 14 females; median age: 38 years) were included: 35 French travelers and four foreign immigrants; 15 cases were acquired in the Old World and 24 cases in the New World. The patients presented to our department with a median of 60 days after return. Thirteen patients had already consulted general practitioners, and the diagnosis was missed in five cases (38%). Five clusters were identified. The median number of skin lesions was two per patient. Diagnosis was established by direct microscopic examination in 36 cases (92%). Thirty-five patients were assessable for first-line treatment with antimonials (intramuscularly in 18, intralesionally in nine), intramuscular pentamidine isethionate or oral ketoconazole (four patients each). Twenty-five patients (71.4%) were cured. The remaining 10 patients were cured after one to three courses of other treatments. Overall adverse events occurred in 60% of the patients treated with antimonials and 37% of those treated with pentamidine. CONCLUSION: Imported LCL is still unrecognized by Western physicians. Clusters may be observed in groups of travelers. The therapeutic outcome is impaired by numerous but minor side-effects.
[Ivermectin, a broad spectrum antiparasitic drug].
ACTIVITY: Ivermectine, derived from beta avermectines, monocyclic lactones produced by Streptomyces avermitilis, is a potent oral microfilaricide used by veterinaries since 1981. The anti-filarial activity is two-fold: both microfilaricide and embryotoxic in female adults; it has no activity on the latter. INDICATIONS: Ivermectine is the treatment of choice in onchocercosis, induced by the nematode Onchocerca volvulus, and was included in the onchocercosis control program (programme de contrôle de l'onchocercose (OCP) in 1987. Ivermectine has also demonstrated efficacy on other filaries (Wuchereria bancrofti, Loa loa), in intestinal nematodes (Ascaris lumbricoïdes, Strongyloides stercoralis) and in parasite nematodes in man (larva migrans ankylosis). ACCORDING TO THE RESULTS OF RECENT STUDIES: Its activity has been recently extended to ectoparasitosis: sarcoptes and pediculosis of the scalp.
Potential value of Plasmodium falciparum-associated antigen and antibody detection for screening of blood donors to prevent transfusion-transmitted malaria.
BACKGROUND: Malaria antibody detection is a valuable tool in the prevention of transfusion-transmitted malaria in countries with a high proportion of donors with travel exposure to malaria. The immunofluorescent antibody test (IFAT) is still the reference method, but it is not suitable for screening of blood donors. ELISA would be an interesting alternative to the IFAT, but it lacks sensitivity. STUDY DESIGN AND METHODS: To evaluate the potential value of a combined screening strategy based on malaria antigen and antibody detection, plasma samples from 203 patients infected with Plasmodium falciparum were tested with an ELISA for the detection of malaria antibodies (Malaria IgG CELISA, Cellabs) and a P. falciparum histidine-rich protein-2 kit (Malaria P.f., ICT Diagnostics) for the detection of malaria antigens. RESULTS: Among patients with positive IFAT results, CELISA had a sensitivity of 71 percent, whereas the combined screening tests (CELISA and Malaria P.f.) had a sensitivity of 88 percent (p < 0.001). Sequential samples from 50 patients were tested. The combined screening tests shortened the detection of seroconversion from 11.4 +/- 1.6 to 5.3 +/- 1.1 days (p < 0.001). CONCLUSION: Combined malaria antigen and antibody detection, with methods compatible with mass screening, may constitute an attractive alternative to the IFAT for blood donor screening.