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"Chardin, Virginie"
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A 1-Year Prospective French Nationwide Study of Emergency Hospital Admissions in Children and Adults with Primary Immunodeficiency
PurposePatients with primary immunodeficiency (PID) are at risk of serious complications. However, data on the incidence and causes of emergency hospital admissions are scarce. The primary objective of the present study was to describe emergency hospital admissions among patients with PID, with a view to identifying “at-risk” patient profiles.MethodsWe performed a prospective observational 12-month multicenter study in France via the CEREDIH network of regional PID reference centers from November 2010 to October 2011. All patients with PIDs requiring emergency hospital admission were included.ResultsA total of 200 admissions concerned 137 patients (73 adults and 64 children, 53% of whom had antibody deficiencies). Thirty admissions were reported for 16 hematopoietic stem cell transplantation recipients. When considering the 170 admissions of non-transplant patients, 149 (85%) were related to acute infections (respiratory tract infections and gastrointestinal tract infections in 72 (36%) and 34 (17%) of cases, respectively). Seventy-seven percent of the admissions occurred during winter or spring (December to May). The in-hospital mortality rate was 8.8% (12 patients); death was related to a severe infection in 11 cases (8%) and Epstein-Barr virus–induced lymphoma in 1 case. Patients with a central venous catheter (n = 19, 13.9%) were significantly more hospitalized for an infection (94.7%) than for a non-infectious reason (5.3%) (p = 0.04).ConclusionOur data showed that the annual incidence of emergency hospital admission among patients with PID is 3.4%. The leading cause of emergency hospital admission was an acute infection, and having a central venous catheter was associated with a significantly greater risk of admission for an infectious episode.
Journal Article
Nitrate activates a MKK3-dependent MAPK module via NLP transcription factors in Arabidopsis
Plant responses to nutrient availability are critical for plant development and yield. Nitrate, the major form of nitrogen in most soils, serves as both a nutrient and signaling molecule. Nitrate itself triggers rapid, major changes in gene expression, especially via NIN-LIKE PROTEIN (NLP) transcription factors, and stimulates protein phosphorylation. Mitogen-activated protein (MAP) kinase genes are among the early nitrate-responsive genes; however, little is known about their roles in nitrate signaling pathways. Here, we show that nitrate resupply to nitrogen-depleted Arabidopsis (Arabidopsis thaliana) plants triggers, within minutes, a MAPK cascade that requires NLP-dependent transcriptional induction of MITOGEN-ACTIVATED PROTEIN KINASE KINASE KINASE 13 (MAP3K13) and MAP3K14. Importantly, nitrate reductase-deficient mutants exhibited nitrate-induced MAPK activities comparable to those observed in wild-type plants, indicating that nitrate itself is the signal that stimulates the cascade. We show that the modified expression of MAP3K13 and MAP3K14 affects nitrate-stimulated gene expression and modulates plant responses to nitrogen availability, such as nitrate uptake and senescence. Our finding that a MAPK cascade involving MAP3K13 and MAP3K14 functions in the complex regulatory network governing responses to nitrate availability will guide future strategies to optimize plant responses to nitrogen fertilization and nitrogen use efficiency.
Nitrate is an essential nutrient that also acts as a signaling molecule to regulate plant metabolism and development. We identified a specific MAPK cascade that is activated by nitrate and regulates several nitrate-dependent responses, such as senescence and nitrate transport.
Paper