B Acad Nat Med Paris
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Patient-derived induced pluripotent stem cells as well as human embryonic stem cells are pluripotent and their derivation has been used for the understanding of numerous diseases. Currently they are also used for the treatment of neurologic disorders such as Parkinson disease or cardiac disorders. Gene therapy has been successful for the treatment of hemophilia A and B, hemoglobinopathies and immunodeficiencies. Hemopoietic stem cell transplantation is a well-accepted therapeutic strategy for Leukemias, whereas CAR-T cells is a new promising approach even for lymphomas and myeloma.
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B Acad Nat Med Paris · Oct 2020
Review[Biosimilar medicines: Regulatory issues and medico-economic impacts].
The concept of biosimilar medicine was launched by 2001 and 2004 European Directives. First European marketing authorizations were delivered in 2006. They are "copies" of biologically manufactured medicines, mostly proteins. ⋯ Introduction of biosimilar medicines of monoclonal antibodies has represented a remarkable event in the domain of rheumatology, gastroenterology and dermatology with infliximab, etanercept and adalimumab biosimilars and in cancerology domains with rituximab, trastuzumab and bevacizumab biosimilars. Biosimilar medicines availability reduces the risk of drug supply rupture of princeps but their main impact is the economic one allowing cost reduction of costly princeps biological medicines. With the acquired clinical experience, the initial fears concerning switch form princeps to a biosimilar for a given patient has progressively disappeared.
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Brain development is a complex phenomenon, stretching from fetal life to adolescence, during which brain maturation proceeds through a series of ordered events including critical periods of plasticity. The brain is particularly sensitive to the environment during these changes. The endocannabinoid system participates directly and indirectly in these plasticity and maturation processes. ⋯ Therefore, exposure to cannabis in utero, in perinatal phase, as well as during the adolescence disrupts the brain maturation and can cause disturbances on the cognitive, psychotic and addictive levels that persist far beyond the period of exposure. Several factors modulate the risk of such complications, but studies performed in animal models as well as in human cohorts have shown that exposure during both the critical perinatal and adolescence phases is a risk factor per se. Current knowledge encourages the dissemination of objective information to young people, to prevent and limit early exposure and its consequences.
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B Acad Nat Med Paris · Jun 2020
Review[Testing for cannabis and synthetic cannabinoids in human specimens].
Among the 60 or so various cannabinoids which are present in cannabis sativa indica, terpenophenols are mainly found, including delta-9-trans tetrahydrocannabinol (Δ9-THC) which is the major psychoactive ingredient. Over the last decade, due to the emergence of e-commerce and the continuous investigations by pharmaceutical groups to identify new active molecules, synthetic cannabinoids have been proposed. These compounds, under the generic name "spices" have chemical structures very different from that of Δ9-THC, but share the same CB1 and CB2 receptors. ⋯ All these drugs are controlled. This means that they have to be tested in human biological specimens to document abuse. The aim of this mini-review is to present what has been described in the scientific literature according to the available specimens (blood, urine, saliva, sweat, hair and exhaled breath), focussing on the current advantages and limitations of each test.
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B Acad Nat Med Paris · Jun 2020
Review[Recreational use of cannabis: from effects to harm Epidemiological data].
As the medical use of so-called "therapeutic cannabis" is in the process of being approved in France, the opening to its recreational use is the next logical step, as it has been always the chronology followed in all countries. Indeed, those who have legalized the drug have previously approved its therapeutic use. This "justifying a project phase" stage seems unavoidable. ⋯ Estimated at 12.7% in 1992, it reached 44.8% in 2017. Moreover, 25% of users in the year aged from 18 to 64 years old were at high risk of problematic use or dependence in 2017. This figure is worrying because it is constantly increasing; it affects 3% of 18-64-year-old, just over a million people.