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La génétique, ça peut sauver la vie (de mon oncle)
Genetics can save lives (in this case, my uncle's life) Dans les cas d’infections graves, un bon microbiome vaut mieux qu’une mauvaise boite de Petri |
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| Me, when i started this blog in 2005 |
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| Me, with my uncle Jacques, Dec. 2007 |
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More than one week later, my "favorite" uncle awoke from his coma (yay). But a pulmonary infection seems to be plaguing him... Two days ago, he was trying to discuss his funerals, but yesterday, he asked for his Kindle, books and his glasses. Yup, that's my "favorite" uncle all right ;-)
So here's what i wrote to my cousins in Paris (French and English version):
Il faut savoir qu'une infection pulmonaire résistante peut tuer en quelques jours, surtout une personne âgée fragile (82 ans) qui se réveille d'un coma de dix jours suite à complications post-opératoire (opération de la hanche, au réveil, on découvre un colon nécrosé), et à qui on a enlevé le colon et une partie de l'intestin grêle, plus deux mini AVC dans un passé récent, qui font qu'il est sous anti-coagulants. Les labos qui font cet examen de microbiome pulmonaire :il y en a à l'institut Pasteur de Paris et Lille :https://hal-pasteur.archives-https://research.pasteur.fr/en/team/synthetic-biology
A resistant lung infection can kill within a few days, especially a frail elderly person (82 yo) waking up from a coma due to postoperative complications (colon and part of the small intestine were removed, suffered two strokes in the recent past, and as a consequence, taking anticoagulant or blood-thinner treatment). Before his coma, he was in a clinic in Paris (hip surgery). Then the complications happened (necrosis of colon)... For lung infection, there is a recent protocol based on genomics which consists in sending samples to a laboratory (Pasteur, Lyon, Rennes, Lille) to analyze the DNA of Bacteria to determine what they are resistant to or sensitive to. Do you know if this was done by the European Hospital Georges Pompidou? (Because they probably do not have the lab to do it). This examination is called: the pulmonary microbiome, which would have revealed which bacteria were present in the lungs, and which genes of resistance, for a better choice of antibiotic. The microbiome test is a DNA (genetic) sequencing test of all the bugs that live in our stomach or in our lungs (or genital tract, skin surface, mouth, ears ... etc). When we identify bacteria in this way, we can then, in a second "bioinformatic" round, look for the antibiotic resistance genes known in these bacteria. Yes there are resistant bacteria, they adapt. And so, choose the right antibiotic accordingly. With this big-data DNA (lots of DNA sequencing data), what can be done? This microbiome test identifies bacteria that are difficult to grow, and that traditional microbiology cannot identify. In cases of resistant (lung) infection, seek help from the microbiome, not from the petri dish!
Ce matin, réponse de mon cousin :  Puis, sur ma demande, explications de mon ami biologiste bordelais : "De ce que je comprends, ils ont du faire un test moléculaire (hybridation moléculaire) pour détecter les bactéries non cultivables.
On utilise des fragments d’ADN complémentaire (sondes) à ceux desdites bactéries pour aller à la pêche.
Pour identifier les bactéries, on recherche souvent à identifier leur ARN16S. Dans ce cas de recherche par hybridation moléculaire, on emploie alors des sondes “ARN”.
Meme si c’est moins complet qu’un microbiome, c’est pas mal, quand on n'a pas accès à du NGS (next generation sequencing = les nouvelles méthodes de séquençage du génome)."
Il ajoute : "Je devrai faire traducteur de jargon moléculaire."
Il en faudra bien un, pour que les gens comprennent que l'ADN, ça sauve aussi la vie, ça ne sert pas seulement à faire des scénarios cata pour la télé ...
So this morning, I got a text from my cousin:
"They performed a DNA/RNA probe (immediate and culture) so this should cover pretty much everything." This sounded cryptic. Then he added: "Jacques is doing better" (less cryptic, got that part all right). So i asked a friend of mine, a geneticist, if he could explain what had been done. His answer:
"From what I understand, they had to do a molecular test (molecular hybridization) to detect non-culturable bacteria.
Complementary DNA fragments (probes) are used with those of said bacteria to go fishing.
To identify bacteria, one often seeks to identify their RNA16S. In this case of research by molecular hybridizations, RNA probes are used.
Even if it's less complete than a microbiome, it's good enough, when you do not have access to NGS (next generation sequencing)."
Special thanks to French biologist Patrick Merel, Portable Genomics, San Diego, for his expertise. Indeed, translating molecular jargon for the broad public seems to be a job in demand! Genomics can also make the difference between life and death, not only fill in the gaps in Hollywood dystopian fictions (though i'm a Gattaca fan)... If we cannot find people to do the job (translate cryptic stuff for patients and people around those patients), i guess the population in general will go on thinking genetics is bad for you (police surveillance, eugenism, selling my genetic data without my consent to insurance companies etc)
June 14th, 2017: Reactive medicine can be pretty creepy. How about preventative medicine?  Thank you Regina Holliday for painting this jacket for me. Health care needs activism  |
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