Epidermal Growth Factor receptor (EGFR) are a key factor for the tumoral proliferation and its tumoral over expression appears to be a powerful prognosis factor. Currently, 2 types of treatments are targeting EGFR: a monoclonal antibodies anti-EGFR and a specific inhibitors of the EGFR tyrosine kinase. The administration of these compound alone or in combination with chemotherapy gives some promising results. These targets as anti-cancer therapy had emerged to be a new perspective for oncology.

Corticoids are molecules which the organism synthesizes to regulate a large number of immune and metabolic physiological mechanisms. The compounds used as therapeutic agents have at higher doses very useful anti-inflammatory and immunomodulatory properties. Corticoids have most original mechanisms of action which are essentially genomic (transcriptional) and characterized by activation (transactivation) or inhibition (transrepression) of numerous target genes. These molecules act in many cells involved in innate immunity (macrophages, granulocytes, mastocytes) and adaptive immunity (lymphocytes) but also in other cells (fibroblasts, epithelial and endothelial cells). The anti-inflammatory efficacy of corticoids may be explained by their inhibition of the synthesis of numerous cytokines, enzymes and mediators of inflammation or induction of cytokines and anti-inflammatory molecules (lipocortin). Corticoids also regulate cellular activation and survival processes (apoptosis), which explains their cytostatic efficacy in certain malignant hematological disorders.

Pharmacoproteomics may be defined as proteomics applied to the discovery of new therapeutic targets and to the study of drug effects. Proteomics is a powerful technique for analyzing the protein expression profiles in a biological system and its modifications in response to a stimulus or according to the physiological or pathophysiological states. Thus it is a technique of choice for the discovery of new drug targets. It is also an interesting approach for the study of the mode of action of treatments and preclinical drug development. This pharmacoproteomic approach may be particularly useful for the research of new molecular alterations implicated in type 2 diabetes and/or obesity and for the further characterization of existing or new drugs.

Thiazolidinediones (TZDs) form a new class of oral antidiabetic agents. They improve insulin sensitivity and reduce glycemia, lipidemia and insulinemia in patients with type 2 diabetes. Their mechanism is original, since they activate the nuclear receptor Peroxisome Proliferator-Activated Receptor gamma (PPARgamma), altering the expression of genes involved in glucose and lipid homeostasis. Stimulating PPARgamma improves insulin sensitivity via several mechanisms: 1) it raises the expression of GLUT4 glucose transporter; 2) it regulates release of adipocyte-derived signaling factors that affect insulin sensitivity in muscle, and 3) it contributes to a turn-over in adipose tissue, inducing the production of smaller, more insulin sensitive adipocytes. TZDs also affect free fatty acids (FFA) lipotoxicity on islets, improving pancreatic B-cell function. In addition, triglycerides and FFA levels are lowered by TZDs. Two TZDs, rosiglitazone and pioglitazone, have recently obtained the European commercial licence, but their use is restricted to the association with metformin or sulfonylureas. At the moment, they are indicated in type 2 diabetes but could be of interest in a broader array of diseases related to insulin resistance. As for side effects, rosiglitazone and pioglitazone may cause increased plasma volume, edema and dose-related weight gain. TZDs offer an attractive option in the treatment of type 2 diabetes, though it may be too soon to determine if they prevent vascular complications, as do other oral antidiabetic agents. An important issue for the future will be to assess the influence of weight gain in the long time.

The physiological effects of angiotensin II (Ang II) are mediated through specific AT(1) and AT(2) receptors. Tissue distribution and affinity of these receptors have been explored in binding studies, reverse transcriptase-polymerase chain reaction and in situ hybridisation. Sequencing has also demonstrated gene polymorphisms for both AT(1) and AT(2) receptors. Numerous potent nonpeptide antagonists of angiotensin converting enzyme or of AT receptors have been developed, thus providing a precise analysis of the physiology of the renin-angiotensin system. AT(1) receptors are widely expressed throughout adult tissues, while AT(2) receptors are mainly expressed in the fetus. Receptor density on the cell surface is regulated by multiple hormonal, cytokine and metabolic factors, and is thus profoundly affected by various pathological conditions, especially in the myocardium, kidney and blood vessels. To date, the precise molecular basis for these modifications has not been fully explained, although it may rely in part upon AT receptor gene polymorphisms, which could thus constitute increased risk factors for cardiovascular disease. AT(1) and AT(2) receptor expression is therefore influenced by both age and environmental specifications and is likely to be increased by a diet rich in salt or cholesterol, thus justifying the use of Ang II receptor antagonists in morbidity-mortality studies in high-risk patients.

In amphibian embryos the central nervous system derives from the dorsal region of the ectoderm. Molecular studies led to the formulation of the "neural default model" in which neural development is under the inhibitory control of members of the BMP family. These growth factors also act as epidermis inducers. The neural fate is revealed by factors secreted by the Spemann Organizer such as noggin, chordin, follistatin, Xnr3 and cerberus which act by blocking BMP signalling. We propose a new model for neural cell determination in which a signalling pathway controlled by an increase in intracellular calcium suppresses the epidermis fate and activates the neural fate instead. This increase in calcium is due to an influx through calcium channels of the L-type, expressed in ectodermal cells during gastrulation. The possible involvement of a calcium-dependent phosphatase (calcineurin) to inhibit the epidermis fate and a calcium-calmodulin kinase (CaMkinase II) which activates the neural fate is discussed.

A number of tissues such as the brain must be continuously provided with glucose to meet their energy demand. In contrast, carbohydrate absorption during meals is a discontinuous process. Thus, we must store glucose when its is provided, release it or spare it when it is less abundant. Insulin, secreted by the pancreatic beta-cell is a key hormone in the adaptations of metabolic pathways linked to glucose homeostasis. It inhibits hepatic glucose production, promotes glucose storage in the liver and glucose uptake and storage in muscles and adipose tissues. This is achieved through the modifications of the activity of existing proteins (enzymes, transporters) but also through the regulation of gene expression. In the liver, when the diet is rich in carbohydrates, insulin is secreted and stimulates the expression of genes involved in glucose utilization (glucokinase, L-pyruvate kinase, lipogenic enzymes) and inhibits genes involved in glucose production (phosphenolpyruvate carboxykinase). The mechanisms by which insulin controls the expression of these genes were poorly understood. Recently, the transcription factor Sterol Regulatory Element Binding Protein-1c (SREBP-1c) has been proposed as a key mediator of insulin transcriptional effects. Insulin increases the synthesis and nuclear abundance of this factor which when overexpressed in the liver mimics the effects of insulin on insulin-sensitive genes. This suggests that SREBP-1c could be involved in pathologies such as type 2 diabetes, obesity and more generally in insulin resistance syndromes.

Soluble elastin-derived peptides from alkaline or elastase hydrolysis of insoluble elastin, as well as tropoelastin, increase matrix metalloproteinase-2 (MMP-2) production by human skin fibroblasts in culture as determined by gelatin zymography and ELISA. Such an effect is time and concentration dependent; it can be reproduced by synthetic elastin: VGVAPG, PGAIPG, and laminin: LGTIPG, hexapeptides and inhibited by lactose and is therefore elastin receptor-mediated. The steady state levels of MMP-2 mRNAs are invariant following elastin-fibroblasts interaction. Inhibition of phospholipase C (D-609), ADP-ribosylation factor (brefeldin), protein kinase C (RO-318220) and phospholipase D (1-propanol) totally abolished the elastin-mediated increase of MMP-2 production. It suggested that the post-transcriptional mechanism controlling the elastin-mediated overproduction of MMP-2 involved a cascade leading to phospholipase D activation.

Retinal pigmented epithelium (RPE) cells are of central importance in the maintenance of neural retinal function. RPE cell apoptosis is responsible for the development of a variety of retinal degeneration. The role of FGF2 was investigated on RPE cell proliferation and apoptosis in vitro. In the absence of serum, RPE cells died by apoptosis, while the addition of FGF2 greatly reduces apoptosis over a 7-day culture period. This is due to an autocrine loop involving secretion of endogenous FGF1 in the mechanism that govern FGF2-induced resistance to apoptosis. FGF2 induces long-term activation of FGFR1 and ERK1/2, and production of the anti-apoptotic protein BcL-x. Because FGF1 has no classical signal sequence to direct its secretion, we investigated the effects of FGF1 secretion on RPE proliferation and apoptosis in the absence of exogenous FGF2. Forced secretion of endogenous FGF1 by adding a signal peptide to the FGF1 molecule induces FGF1 secretion and cell proliferation in the presence of serum, while in FGF1 stops to be secreted and cell die in the absence of serum. Conversely, in cells cultured in the presence of serum, FGF1 without signal peptide is not secreted, but is secreted and rescue RPE cell from apoptosis when cells are cultured without serum. Thus, the proliferation and survival activities of endogenous FGF1 depend on the secretion of FGF1 which is determined by the cell environment.

In cancer immunotherapy, the use of dendritic cells (DC) loaded with tumor-associated antigens (TAA) emerged as a promising strategy. We initiated 3 pilot clinical trials with immunological endpoints using TAA loaded autologous DC. These trials showed that this approach was safe and associated with the induction of potent TAA specific IFN-gamma responses, which were transient despite the providing a further help through KLH presentation. Subcutaneous (s.c.) IL-2 administration was associated with long-lasting TAA specific IL-5 production. Clinical responses were observed in about 1/3 of the patients. Further improvements will take advantage of the use of a new type of DC cells (IL-3/IFN-beta DC) and of tumor cell-DC hybrids.

The interaction between Fas and its ligand (Fas-L) leads to Fas-positive cell apoptosis. Our objective was to study a new mechanism of tumor escape involving these molecules, the so-called "counterattack".

Fibrates are old hypolipidemic drugs with pleitropic effects on lipid metabolism. Until, recently their intimate molecular mechanisms of action were mysterious. In the late 5 years, we have shown that the pharmacological effects of fibrates depend on their binding to "Peroxisome Proliferator Activated Receptor alpha" (PPAR alpha). The binding of fibrates to PPAR alpha induces the activation or the inhibition of multiple genes involved in lipid metabolism through the binding of the activated PPAR alpha to "Peroxisome Proliferator Response Element" (PPRE) located in the gene promoters. Fibrates reduce plasma triglyceride levels by altering the expression of numerous genes coding for proteins involved in fatty acid metabolism (fatty acid transport protein, acyl-CoA synthetase, etc.) and also by increasing the lipoprotein lipase synthesis and decreasing the apolipoprotein C-III synthesis. Fibrates increase HDL cholesterol levels by increasing apolipoprotein A-I and apolipoprotein A-II synthesis. Furthermore, we recently demonstrated that fibrates are potent anti-inflammatory molecules through an indirect modulation of the nuclear-factor-kappa B activity. Therefore, we suggest that fibrates inhibit atherosclerosis development not only by improving the plasma lipid profile but also by reducing inflammation in the vascular wall.

The discovery of an inducible form of cyclooxygenase (COX-2) requires a refinement of the theory that inhibition of cyclooxygenase activity explains both therapeutic effects and side-effects of non-steroidal anti-inflammatory drugs (NSAIDs). Selective COX-2 inhibitors have demonstrated in clinical trials a significantly better gastrointestinal tolerability than classical NSAIDs, for the same anti-inflammatory activity. Their tolerability in patients with active ulcer or with a recent history of ulcer as well as in patients suffering from cardiovascular or renal diseases has still to be investigated in detail. Their therapeutic potential in several new indications, including pre-term labour, colorectal cancer and Alzheimer's disease, is currently being investigated.

Prescription of opiates to non cancer chronic pain patients is controversial, partly because of the risk of tolerance and dependence development. The two objectives of that review were: a) to identify the factors which may explain the variability of tolerance and dependence in clinical practice; b) to analyse the cellular mechanisms of occurrence of those phenomenons.

The use of antisense oligonucleotides as therapeutic agents has generated considerable enthusiasm in the research and medical community. Oligonucleotides inhibit gene expression by binding to their target nucleic acid with high specificity and selectivity. The field of antisense technology has progressed enormously. Major progress has been accomplished in the synthesis and manufacturing of modified oligonucleotides. Numerous studies have demonstrated the ability of antisense oligonucleotides to modulate gene expression, in such diverse fields as infectious diseases, cancer, and inflammation. More than a dozen of clinical trials using antisense oligonucleotides have been initiated during the last three years or so. The insights gained through these ongoing clinical trials has opened the pathway to the design of more advanced chemistries which have improved safety profile and efficacy.