Natural CD4 + CD25 + regulatory T cells (nTreg) have been shown to control graft‐versus‐host disease after hematopoietic stem cell transplantation (HSCT). Herein, we considered the possibility that the beneficial action of nTreg upon immune reconstitution in lymphopenic hosts involves dampening of the inflammatory response induced by bacterial products. We first observed that transfer of syngeneic CD4 + CD25 – T cells in RAG‐deficient mice dramatically enhanced release of inflammatory cytokines and associated pathology upon endotoxin injection. Interferon (IFN)‐γ produced by T cells undergoing homeostatic proliferation was shown to be involved in the endotoxin hyperresponsiveness induced by CD4 + T cell reconstitution. Co‐transfer of CD4 + CD25 + nTreg with CD4 + CD25 – T cells inhibited the expansion of IFN‐γ‐producing T cells and reduced endotoxin responses in RAG –/– mice. We conclude that (1) CD4 + T cell reconstitution sensitizes lymphopenic hosts to endotoxin‐induced pathology and (2) nTreg prevent this process by limiting the emergence of IFN‐γ‐producing cells.

The TEAM trial investigated the efficacy and safety of adjuvant endocrine therapy consisting of either exemestane or the sequence of tamoxifen followed by exemestane in postmenopausal hormone-sensitive breast cancer. The present analyses explored the association between locoregional therapy and recurrence (LRR) in this population.Between 2001 and 2006, 9779 patients were randomized. Local treatment was breast conserving surgery plus radiotherapy (BCS + RT), mastectomy without radiotherapy (MST-only), or mastectomy plus radiotherapy (MST + RT). Patients with unknown data on surgery, radiotherapy, tumor or nodal stage (n = 199), and patients treated by lumpectomy without radiotherapy (n = 349) were excluded.After a median follow-up of 5.2 years, 270 LRRs occurred (2.9%) among 9231 patients. The 5-years actuarial incidence of LRR was 4.2% (95% CI 3.3–4.9%) for MST-only, 3.4% (95% CI 2.4–4.2%) for MST + RT and 1.9% (95% CI 1.5–2.3%) for BCS + RT. After adjustment for prognostic factors, the hazard ratio (HR, reference BCS + RT) for LRR remained significantly higher for MST-only (HR 1.53; 95% CI 1.10–2.11), not for MST + RT (HR 0.78; 95% CI 0.50–1.22).This explorative analysis showed a higher LRR risk after MST-only than after BCS + RT, even after adjustment for prognostic factors. As this effect was not seen for MST + RT versus BCS + RT, it might be explained by the beneficial effects of radiation treatment.

Introduction Le plus souvent, les caracteristiques biologiques d'une tumeur sont evaluees sur des tissus chirurgicaux. De nouvelles approches therapeutiques du cancer bronchique non a petites cellules (CBNPC) consistent a administrer une chimiotherapie neoadjuvante ou des medicaments dirigees contre EGF-R (recepteur au facteur de croissance epidermique). Methodes Nous avons compare l'expression immunohistochimique d'EGF-R sur les biopsies et tissus chirurgicaux correspondents de 27 patients. Resultats Le pourcentage moyen de cellules neoplasiques positives pour EGF-R etait de 11 % dans les tissus chirurgicaux et de 28 % dans les biopsies (p = 0,02). Nonobstant cette difference nous avons retrouve une bonne correlation (R = 0,67 ; p = 0,0001) entre les biopsies et les pieces chirurgicales. De plus, le taux de positivite (seuil > 1 % des cellules) n'etait pas different entre les biopsies (55 %) et les tumeurs primitives (48 %) (p = 0,63). La concordance, en terme de positivite, etait de 85 % entre le tissu tumoral biopsique et chirurgical et les taux de faux negatifs et positifs respectivement de 4 % et 11 % sur les biopsies par rapport aux places chirurgicales. Les valeurs predictives positives et negatives etaient respectivement de 80 % et 92 %. Conclusions Bien que non parfaite, l'evaluation immunohistochimique d'EGF-R sur biopsie semble un bon reflet de la piece chirurgicale.

The process of angiogenesis is an important factor in tumour development. One of the principal factors implicated in this process is vascular endothelial growth factor (VEGF) which induces, among other things, an increase in vascular permeability. We have undertaken a systematic review of the English and French literature in order to clarify its effect on the survival of patients with small cell (SCLC) and non-small cell (NSCLC) lung cancer. To be eligible studies had to deal with the the evaluation of VEGF or its receptors in lung cancer and describe the relationship of their expression to survival. The survival figures were subject to meta-analysis after a methodological evaluation by means of a specific numerical scale evaluating the design of the study, the methodology (including laboratory techniques), and the analysis of results. Among the 20 studies selected 15 identified VEGF expression, using univariate analysis, as a statistically significant indicator of poor prognosis. 17 reported sufficient data to allow aggregation of the survival figures, of which 15 were devoted to NSCLC (1,549 patients). The median overall methodological score was 48.3% (range 21.8-72.4%), without significant difference (p=0.63) between studies eligible or non-eligible for meta-analysis. The meta-analysis, using the authors' threshold of positivity for VEGF, showed that VEGF is an unfavourable prognostic factor in NSCLC (HR=1.48; 95% confidence interval 1.27-1.72). The data were insufficient to determine the prognostic value of VEGF in SCLC and that of its two receptors Flt-1 and KDR, with 1, 2 and 1 published studies respectively. In conclusion the expression of VEGF in MSCLC is a factor indicating a poor prognosis.

Une patiente de 42 ans atteinte d'un cancer bronchique non a petites cellules, se presentant initialement sous la forme d'une masse mediastinale, est hospitalisee pour fievre, cephalees et nausees. La mise au point met en evidence une meningite aseptique. La patiente decede malgre l'administration d'antibiotiques a large spectre et d'antituberculeux. Les diagnostics differentiels sont evoques.