L'un des vaccins contre l'hépatite B pourrait augmenter le risque de sclérose en plaque

LE MONDE | 25.09.08 | 09h36 • Mis à jour le 25.09.08 | 09h42


L'étude de l'équipe de Marc Tardieu concerne le vaccin contre l'hépatite B le plus utilisé en France, l'Engerix B, mais les auteurs précisent que leur étude ne permet pas d'écarter un risque accru avec un autre vaccin, le GenHevacB.


L'un des vaccins contre l'hépatite B, Engerix B, semble associé chez l'enfant à une augmentation du risque de développer, trois ans plus tard, une sclérose en plaques. Ce risque, qui n'est pas retrouvé pour l'ensemble des vaccins contre l'hépatite B, serait multiplié par 1,74 dans le cas de l'Engerix B. Les autorités sanitaires ont lancé une "expertise approfondie", afin de voir s'il y a lieu de modifier la recommandation de vacciner les nourrissons pour prévenir une maladie à laquelle sont liés plus de 2 800 décès par an.

L'étude, dont Le Monde a pris connaissance, a été menée par l'équipe du professeur Marc Tardieu (service de neuropédiatrie, hôpital Bicêtre au Kremlin-Bicêtre) et doit être prochainement publiée. Jusqu'ici, les deux études menées chez des enfants vaccinés contre l'hépatite B n'avaient pas décelé de risque aggravé d'effet secondaire neurologique. Chez l'adulte, une seule étude a trouvé un lien statistique entre cette vaccination et la survenue ultérieure d'une sclérose en plaques (Le Monde du 16 septembre 2004).

COUVERTURE FAIBLE

L'étude de l'équipe de Marc Tardieu concerne le vaccin contre l'hépatite B le plus utilisé en France : 787 754 doses d'Engerix B enfants et nourrissons ont été remboursées par l'assurance-maladie en 2007. Les auteurs précisent que leur étude ne permet pas d'écarter un risque accru avec un autre vaccin, le GenHevacB.

"La couverture vaccinale contre l'hépatite B est faible en France : 29 % des enfants âgés de 2 ans et 32 % des adultes, souligne le directeur général de la santé, le professeur Didier Houssin. Pourtant, notre pays compte 300 000 porteurs chroniques du virus de l'hépatite B et 3 000 nouvelles hépatites B par an."

Le directeur général de la santé indique qu'en raison de cette situation les autorités sanitaires travaillent depuis plusieurs mois pour améliorer l'information du public, la prévention et la prise en charge des personnes touchées par l'hépatite B. "Nous allons mesurer la portée de cette étude. Cependant, son analyse préliminaire ne remet pas en question les recommandations de vaccination. En l'état actuel, le ministère de la santé maintient donc les recommandations vaccinales", précise le directeur général de la santé.

La direction générale de la santé a réuni, mercredi 24 septembre, des épidémiologistes pour analyser l'étude. Le Comité technique des vaccinations, puis le haut conseil de la santé publique seront consultés début octobre. Le ministère de la santé devra aussi gérer les réactions des parents dont les enfants ont été vaccinés avec Engerix B.

Depuis la mise sur le marché des vaccins contre l'hépatite B, 33 millions de personnes ont été vaccinées en France, dont 12 millions d'enfants de moins de 15 ans et 3,4 millions de nourrissons. Près de 1 300 cas de complications neurologiques ont été recensés chez des personnes vaccinées.

Paul Benkimoun

33 Secrets to a Good Night's Sleep

If you are having sleep problems, whether you are not able to fall asleep, wake up too often, don't feel well-rested when you wake up in the morning, or simply want to improve the quality and quantity of your sleep, try as many of the following techniques below as possible:

asleep : endormi

• My current favorite for insomnia is Emotional Freedom Technique (EFT). Most people can learn this gentle tapping technique in several minutes.

  gentle : doux, douce, peu sévère, léger, modéré, faible

  EFT can help balance your body's bioenergy system and resolve some of the emotional stresses that are contributing to the insomnia at a very deep level. The results are typically long lasting and the improvement is remarkably rapid.

• Listen to white noise or relaxation CDs. Some people find the sound of white noise or nature sounds, such as the ocean or forest, to be soothing for sleep. An excellent relaxation/meditation option to listen to before bed is the Insight audio CD.

  soothing : calmant, apaisant, lénitif

• Avoid before-bed snacks, particularly grains and sugars. This will raise blood sugar and inhibit sleep. Later, when blood sugar drops too low (hypoglycemia), you might wake up and not be able to fall back asleep.

  asleep : endormi
  hypoglycemia : hypoglycémie

• Sleep in complete darkness or as close as possible. If there is even the tiniest bit of light in the room it can disrupt your circadian rhythm and your pineal gland's production of melatonin and seratonin. There also should be as little light in the bathroom as possible if you get up in the middle of the night. Please whatever you do, keep the light off when you go to the bathroom at night. As soon as you turn on that light you will for that night immediately cease all production of the important sleep aid melatonin.

  aid : aide, assistance, secours, aider, assister, venir en aide à, venir à l'aide de, soutenir, contribuer à
  seratonin : ntf

• No TV right before bed. Even better, get the TV out of the bedroom or even out of the house, completely. It is too stimulating to the brain and it will take longer to fall asleep. Also disruptive of pineal gland function for the same reason as above.

  asleep : endormi
  disruptive : perturbateur, turbulent

• Wear socks to bed. Due to the fact that they have the poorest circulation, the feet often feel cold before the rest of the body. A study has shown that this reduces night wakings (Click Here).

  socks : sock : chaussette, socquettes, mi-chaussettes, semelle intérieure, gnon, beigne, cocard, flanquer une beigne à

• Read something spiritual or religious. This will help to relax. Don't read anything stimulating, such as a mystery or suspense novel, as this may have the opposite effect. In addition, if you are really enjoying a suspenseful book, you might wind up unintentionally reading for hours, instead of going to sleep.

  suspenseful : passionnant

  The Sun Alarm™ SA-2002 , which I personally use, is a natural way to wake up in the morning. I highly recommended it as an alternative to loud alarm clocks. Read More Now!

• Avoid using loud alarm clocks. It is very stressful on the body to be awoken suddenly. If you are regularly getting enough sleep, they should be unnecessary. I gave up my alarm clock years ago and now use a sun alarm clock. The Sun Alarm™ SA-2002 provides an ideal way to wake up each morning if you can't wake up with the REAL sun. Combining the features of a traditional alarm clock (digital display, AM/FM radio, beeper, snooze button, etc) with a special built-in light that gradually increases in intensity, this amazing clock simulates a natural sunrise. It also includes a sunset feature where the light fades to darkness over time - ideal for anyone who has trouble falling asleep.

  asleep : endormi
  snooze : petit somme, sommeiller, faire un petit somme
  sunrise : lever du soleil
  sunset : coucher du soleil

• Journaling. If you often lay in bed with your mind racing, it might be helpful keep a journal and write down your thoughts before bed. Personally, I have been doing this for 15 years, but prefer to do it in the morning when my brain is functioning at its peak and my coritsol levels are high (CLICK HERE)

  coritsol : ntf

• Melatonin and its precursors. If behavioral changes do not work, it may be possible to improve sleep by supplementing with the hormone melatonin. However, I would exercise extreme caution in using it, and only as a last resort, as it is a powerful hormone. Ideally it is best to increase levels naturally with exposure to bright sunlight in the daytime (along with full spectrum fluorescent bulbs in the winter) and absolute complete darkness at night. One should get blackout drapes so no light is coming in from the outside. One can also use one of melatonin's precursors, L-tryptophan or 5-hydroxytryptophan (5-HTP). L-tryptophan is the safest and my preference, but must be obtained by prescription only. However, don't be afraid or intimidated by its prescription status. It is just a simple amino acid.

  amino : aminés
  behavioral : du comportement
  caution : précaution, prévoyance, prudence, réprimande, commandement préparatoire, avertir, mettre en garde
  drapes : drape : draper, tendre, se draper, drapé, tentures, rideaux
  tryptophan : tryptophane

• Get to bed as early as possible. Our systems, particularly the adrenals, do a majority of their recharging or recovering during the hours of 11 p.m. and 1 a.m. In addition, your gallbladder dumps toxins during this same period. If you are awake, the toxins back up into the liver which then secondarily back up into your entire system and cause further disruption of your health. Prior to the widespread use of electricity, people would go to bed shortly after sundown, as most animals do, and which nature intended for humans as well.

  adrenals : adrenal : surrénal, surrénale
  dumps : cafard, idées noires
  gallbladder : vésicule biliaire
  sundown : coucher du soleil

• Check your bedroom for electro-magnetic fields (EMFs). These can disrupt the pineal gland and the production of melatonin and seratonin, and may have other negative effects as well. To purchase a gauss meter to measure EMFs try Cutcat at 800-497-9516. They have a model for around $40. One doctor even recommends that people pull their circuit breaker before bed to kill all power in the house (Dr. Herbert Ross, author of "Sleep Disorders").

  breaker : casser, dresser, violateur, vague déferlante ou brisante
  seratonin : ntf

• Keep the temperature in the bedroom no higher than 70 degrees F. Many people keep their homes and particularly the upstairs bedrooms too hot.

• Eat a high-protein snack several hours before bed. This can provide the L-tryptophan need to produce melatonin and serotonin.

  tryptophan : tryptophane

• Also eat a small piece of fruit. This can help the tryptophan cross the blood-brain barrier.

  tryptophan : tryptophane

• Reduce or avoid as many drugs as possible. Many medications, both prescription and over-the-counter may have effects on sleep. In most cases, the condition, which caused the drugs to be taken in the first place, can be addressed by following the guidelines elsewhere on this web site.

• Avoid caffeine. A recent study showed that in some people, caffeine is not metabolized efficiently and therefore they can feel the effects long after consuming it. So an afternoon cup of coffee (or even tea) will keep some people from falling asleep. Also, some medications, particularly diet pills contain caffeine.

  asleep : endormi

• Alarm clocks and other electrical devices. If these devices must be used, keep them as far away from the bed as possible, preferably at least 3 feet.

  least : least, moindre, plus petit

• Avoid alcohol. Although alcohol will make people drowsy, the effect is short lived and people will often wake up several hours later, unable to fall back asleep. Alcohol will also keep you from falling into the deeper stages of sleep, where the body does most of its healing.

  asleep : endormi
  drowsy : assoupi, somnolent

• Lose weight. Being overweight can increase the risk of sleep apnea, which will prevent a restful nights sleep. CLICK HERE for my diet recommendations.

  prevent : empêcher, mettre obstacle à, prévenir, détourner, parer à
  restful : reposant, tranquille

• Avoid foods that you may be sensitive to. This is particularly true for dairy and wheat products, as they may have effect on sleep, such as causing apnea, excess congestion, gastrointestinal upset, and gas, among others.

• Don't drink any fluids within 2 hours of going to bed. This will reduce the likelihood of needing to get up and go to the bathroom or at least minimize the frequency.

  least : least, moindre, plus petit
  likelihood : vraisemblance, probabilité, apparence

• Take a hot bath, shower or sauna before bed. When body temperature is raised in the late evening, it will fall at bedtime, facilitating sleep,

• Remove the clock from view. It will only add to your worry when constantly staring at it... 2 a.m. ...3 a.m. ... 4:30 a.m. ...

• Keep your bed for sleeping. If you are used to watching TV or doing work in bed, you may find it harder to relax and to think of the bed as a place to sleep.

• Have your adrenals checked by a good natural medicine clinician. Scientists have found that insomnia may be caused by adrenal stress (Journal of Clinical Endocrinology & Metabolism, August 2001; 86:3787-3794).

  adrenal : surrénal, surrénale
  adrenals : adrenal : surrénal, surrénale

• If you are menopausal or perimenopausal, get checked out by a good natural medicine physician. The hormonal changes at this time may cause problems if not properly addressed.

• Don't change your bedtime. You should go to bed, and wake up, at the same times each day, even on the weekends. This will help your body to get into a sleep rhythm and make it easier to fall asleep and get up in the morning.

  asleep : endormi

• Make certain you are exercising regularly. Exercising for at least 30 minutes everyday can help you fall asleep. However, don't exercise too close to bedtime or it may keep you awake. Studies show exercising in the morning is the best if you can do it.

  asleep : endormi
  least : least, moindre, plus petit

• Establish a bedtime routine. This could include meditation, deep breathing, using aromatherapy or essential oils or indulging in a massage from your partner. The key is to find something that makes you feel relaxed, then repeat it each night to help you release the day's tensions.

  indulging : gâter

• Go to the bathroom right before bed. This will reduce the chances that you'll wake up to go in the middle of the night.

• Wear an eye mask to block out light. As said above, it is very important to sleep in as close to complete darkness as possible. That said, it's not always easy to block out every stream of light using curtains, blinds or drapes, particularly if you live in an urban area (or if your spouse has a different schedule than you do). In these cases, an eye mask can help to block out the remaining light.

  drapes : drape : draper, tendre, se draper, drapé, tentures, rideaux

• Put your work away at least one hour (but preferably two or more) before bed. This will give your mind a chance to unwind so you can go to sleep feeling calm, not hyped up or anxious about tomorrow's deadlines.

  hyped : ntf
  least : least, moindre, plus petit
  unwind : dérouler, dépelotonner

Sclérose en plaques et vitamine D seraient liés

Canoë
25 août 2008

La vitamine D, le principal régulateur de calcium dans l'organisme, pourrait empêcher la production de cellules malignes dans les cancers du sein et de la prostate. Elle pourrait même protéger les cellules contre des maladies auto-immunes y compris la sclérose en plaques (MS). C’est ce qu’indiquent les résultats d’une recherche menée par Sylvia Christakos à la UMDNJ-New Jersey Medical School

Dans cette recherche publiée dans le Journal of Cellular Biochemistry, le docteur Christakos rapporte que l'incidence de la sclérose en plaques diminue à mesure que la quantité de vitamine D mise à la disposition du corps augmente, soit par l'exposition au soleil ou par l'alimentation.

La recherche du docteur Christakos souligne l'importance de maintenir un niveau suffisant de vitamine D dans le corps puisque celle-ci peut aider à combattre la sclérose en plaques.

«La preuve a démontré que le maintien d'un bon niveau de vitamine D pourrait avoir un effet protecteur chez les individus prédisposés à la sclérose en plaques», a déclaré le Christakos. «La vitamine D action pourrait aider à préserver l'équilibre dans les réactions de cellules T et donc éviter l'auto-immunité», a-t-elle indiqué à Newswise.

Malgré les preuves des avantages de la vitamine D par rapport à sclérose en plaques et d'autres maladies auto-immunes, le docteur Christakos prévient toutefois que d'autres études sont nécessaires pour déterminer si la vitamine D seule ou en combinaison avec d'autres traitements est efficace chez les individus ayant de telles maladies.

Gluten et Sclérose en plaques

(article en évolution)

Dans un article, en anglais, (point 9) sur la sclérose en plaque le Dr Delany fait le lien entre la sclérose en plaque et l'allergie au gluten.

Si l'on regarde sur Wikipédia voici ce que l'on trouve à propos de ce sujet :

Ceux qui souffrent de maladie cœliaque et/ou de dermatite herpétiforme doivent éviter toute forme de gluten, bien que leurs problèmes métaboliques soient différents de ceux de l'autisme. Il existe des compte-rendus sporadiques du succès de ce régime pour les patients souffrant de sclérose en plaques, schizophrénie, syndrome de Tourette, syndrome de fatigue chronique ou d'hyperactivité.

En France, un immunologiste s'est beaucoup investi dans l'étude du rôle de la nutrition sur la perturbation du système immunitaire. La version du régime sans caséine ni gluten qu'il propose a obtenu de nombreux succès dans des maladies incurables^{[réf. nécessaire]}. Voir à ce sujet l'article sur la Nutrition Seignalet.

L'aticle Wikipédia : Régime sans caséine ni gluten

Vitamine B12 et fonctions cognitives : une relation vraiment naturelle

C’est connu, la vitamine B12 est essentielle au bon fonctionnement de notre cerveau. Et plus encore semble-t-il, à sa préservation.

Jusqu’à présent cependant, seule une supplémentation massive était censée être efficace. Or pour la première fois, des chercheurs britanniques mettent en avant les bienfaits à long terme de ce nutriment quand il est absorbé naturellement.

« Nous avons découvert que les seniors dont l’alimentation est riche en vitamine B12, ont un risque de troubles de la mémoire divisé par six » affirment-ils dans les colonnes de la revue spécialisée Neurology.

suite sur : http://www.destinationsante.com/fr_depeche.php?id_rubrique=208&id_article=25953&cat=1


D'après Wikipédia les aliments contenants de la vitamine B12 sont :

(en µg pour 100g)

• Viande
  • Foie de bœuf : 110
  • Foie de mouton : 65
  • Foie de veau : 60
  • Rognons de bœuf : 35
  • Rognons de veau : 25
  • Foie de volaille : 20
  • Rognons de porc : 15

• Poisson
  • Hareng : 15
  • Huîtres : 15
  • Maquereau : 12
  • Morue séchée : 10
  • Crabe : 10
  • Sardine : 10
  • Saumon : 7
  • Thon : 4

• Produits laitiers
  • Fromage frais : 8

• Œufs

Dark-hued fruits, veggies are good for the brain (Les fruits de couleurs foncée, les légumes sont bon pour le cerveau)

Neuroscientist James A. Joseph is one of those lucky people who gets to have his cake and eat it, too. At the Human Nutrition Research Center on Aging at Tufts University (Medford, Massachusetts), Joseph revels in his research demonstrating that dark-hued fruits and vegetables, especially blueberries, are just about the best foods you could consume for inoculating brain and body against the ravages of time.

Every morning before heading to his Boston lab, Joseph pours himself a glass of ruby-red pomegranate juice and then chases it with roughly a cup of blueberries. Not just any blueberries but wild ones, flash-frozen to preserve the phytochemicals that research shows are particularly abundant in the tiny fruits that fend for themselves against the short growing season and harsh conditions of northern climates. There they stretch themselves across stony fields so inhospitable they're known as blueberry barrens.

At work, studying the nutritional modulation of cognitive decline, Joseph delineates the bioactive properties of the fruits he calls "brainberries." Yes, blueberries provide traditional nutrients - carbohydrates, fiber, vitamins C and E, manganese. But the deeply pigmented flavonoid phytochemicals known as anthocyanidins found in the fruit are not nutrients in the strict sense of the word. They are, however, biologically active in surprisingly sophisticated ways: intervening at the molecular level along signaling pathways to turn vital genes on or off in brain cells, making brain cells maximally responsive to incoming messages from other cells, even prompting the growth of new nerve cells.

Cumulatively, the berries produce antioxidant effects, neutralizing cellular damage created by free radicals of oxygen and blocking pathways by which oxidative stress damages cells. Perhaps more important, they function as anti-inflammatory agents to preserve cardiovascular as well as brain integrity. "Oxidative stress and inflammation are the evil twins of brain aging," Joseph insists.

Berries make a difference at the behavioral level, too. Aging rats fed the equivalent of a cup of berries a day navigate water mazes like pups, with few mistakes of memory. Plus, as Joseph told a meeting of the Metropolitan (New York) Area Geriatric Society, the animals were powered by leg muscles "that look like those in the legs of young rats."

As good as blueberries are by themselves, Joseph finds, they are more biologically extravagant in combination with certain other foods. Blueberries have a particularly complex relationship with fats - both the good kind and the bad.

Eaten, for example, with oil-rich walnuts or avocados, the berries act synergistically to keep brain cell membranes youthfully flexible - a feat of wide impact since every flicker of thought or intentional movement starts with a transaction across a brain cell membrane. Then, too, blueberries lower the body's burden of cholesterol, minimizing the threat of atherosclerosis in the blood vessels that supply heart and brain.

Walnuts, Joseph finds, contain both polyphenols, like dark berries, and omega-3 fatty acids. They are especially rich in the omega-3 fat known as alpha-linolenic acid. Nerve cell membranes, he explained to the New York conference, are host to a wide array of receptors, such as those for serotonin and other neurotransmitters; receptors are the gateway to nerve cells. But with age, the membranes become rigid and blunt the actions of receptors.

"Together, the polyphenols in berries and walnuts and the fatty acids in the walnuts fluidize the nerve cell membrane," Joseph reported. "They make it more responsive to a wide array of signals," increasing the efficiency of all transactions. The membrane effects are at least as powerful as the antioxidant effects that have already earned blueberries a place at the well-appointed table.

Walnuts may amplify the effects of richly hued berries in still other ways. The equivalent of one ounce of walnuts - the amount recommended for heart health - may help block inflammation at the cellular level, a process now implicated in cardiovascular disease, Alzheimer's disease, and other degenerative processes of aging. "All this is reversible," Joseph insists. "The effects of natural combinations such as walnuts and blueberries - or strawberries or blackberries - are powerful."

In a study led by Joseph's occasional collaborator, Canadian Wilhelmina Kalt, researchers found that a diet moderately rich in blueberries also directly affects cholesterol transport in the body. The net effect is a decrease in total cholesterol and especially of artery-clogging LDL, or low-density lipoprotein, cholesterol.

Kalt's study, published recently in the British Journal of Nutrition, is the first to document lipid-lowering effects of blueberries. The investigators called the results especially notable because they were achieved in pigs - models of human heart disease - with "doses that could reasonably be achieved in the adult human diet," about a cup of berries a day. The anthocyanins had the greatest cholesterol-lowering effect in those animals fed diets rich in other plant foods as well. Kalt, a Nova Scotia-based researcher with Agri-Food

Canada, spends part of every summer meeting with Joseph and his "brainberry group" at the halfway point, in Maine.

"We have fun in here," Joseph says of his research lab, filled with baskets of fruit. "And it's fun to talk about. It's something that people can use right now. Adding walnuts and berries or purple grape juice to the diet could delay the onset of the degenerative diseases of aging."

It's never too late

The right dietary changes have immediate brain payoffs at any age, contends Joseph. They can slow down neural aging. He advises:

- Eat plenty of colorful fruits and vegetables, which are high in antioxidants, along with nuts such as almonds, walnuts, and pecans.

- Spice up your food with circumin, which has neuroprotective effects.

- Consume foods rich in folic acid to preserve memory.

- Maintain zinc levels to help ward off Alzheimer's disease.

Novartis: une étude menace le FTY720 (Fingolimod) contre la sclérose en plaques (BCZ)

Zurich (AWP) - Une étude de chercheurs américains, parue dans la revue "Nature" (édition du 14 août), pourrait bien mettre un terme à la carrière du produit candidat FTY720 (Fingolimod) de Novartis pour le traitement de la sclérose en plaques (MS). L'étude montre que le FTY720 ne freine pas durablement le système immunitaire mais, au contraire, l'active d'une façon non désirée, note Michael Nawrath de la Banque cantonale de Zurich (BCZ) dans un commentaire. Le Fingolimod passe actuellement des tests de phase III dans une indication contre la MS.

La BCZ n'attribue "presque plus aucune chance" au Fingolimod en tant que médicament. La substance pourrait à la rigueur devenir un virostatique, mais cela demanderait de lancer une batterie de tests supplémentaires. Une commercialisation n'interviendrait alors qu'en 2015, "dans le meilleur des cas".

L'étude américaine montre que Fingolimod a un effet antiviral. La substance freine le système immunitaire, puis le réactive, ce qui la rend inapte à combattre la MS et provoque de nombreux effets secondaires, note la BCZ.

Selon M. Nawrath, 2,5 mio de personnes sont atteintes de MS. Le marché devrait croître de 5% par an. Le potentiel de chiffre d'affaires d'un médicament comme le Fingolimod atteint les 2,5 mrd USD en 2014, soit 20% des parts de marché, estime la BCZ. Les quatre interférons et le Tysabri utilisés jusqu'ici ont permis de réaliser un chiffre d'affaires de 7,75 mrd USD en 2007.

Certains analystes attendaient la commercialisation du Fingolimod pour 2010; elle aurait dû compenser de 2010 à 2012 les pertes liées à l'échéance de certains brevets.

La BCZ n'a pas inclus le Fingolimod dans ses prévisions de chiffre d'affaires. Mais tous les analystes ne vont pas forcément procéder ainsi, ce qui risque de conduire à "d'importantes révisions des prévisions de bénéfices" au cas où l'indication de MS devait être abandonnée, lit-on dans le commentaire de la BCZ.

La BCZ attribue "pondérer au marché" au titre Novartis.

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(AWP/18 août 2008 13h36)