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Démêler Le Vrai Du Faux ➜ Vier Physique Et Avoir Une À La Une U 2015 FÉVRIER - JANVIER l N°23 Biobanques Anne Dejean-Assémat Ebola Comment les financer ? Grand Prix Inserm 2014 Un premier bilan COMPLÉMENTS ALIMENTAIRES Démêler le vrai du faux Le magazine de l’Institut national la santé et recherche médicale 2015 FÉVRIER - JANVIER l N°23 Manger déséquilibré, Biobanques Comment les financer ? Anne Dejean-Assémat Grand Prix Inserm 2014 Ebola Un premier bilan COMPLÉMEN SOMMAIRE TS ALIMENTAIRES ne pas pratiquer d’activité Démêler le vrai du faux ➜ VIER physique et avoir une À LA UNE U Le magazine de l’Institut national de la santé et de la recherche médicale O 4 Biobanques E T « mauvaise » hygiène de LD Gérer les coûts, HI T A coordonner les collections M vie, mais prendre une © pilule miracle de vitamines, ➜ DÉCOUVERTES minéraux ou plantes qui contrebalancerait 6 Alzheimer Mimer la caféine pour traiter la maladie tous les effets néfastes de ces 10 Thérapie cellulaire De la nitroglycérine pour « rebooster » le foie comportements... L’idée est séduisante 12 Explorer le cerveau À un, à deux, à trois niveaux auprès de plus en plus de consommateurs en France et dans les pays occidentaux. ➜ TÊTES CHERCHEUSES 14 Grand Prix Inserm 2014 : Anne Dejean-Assémat Idée attrayante également, celle de pouvoir Percer les mystères moléculaires des cancers mincir, lutter contre la fatigue, voire ➜ REGARDS SUR LE MONDE prévenir les maladies grâce à des gélules, 17 Diabète ampoules ou sirops accessibles à tout un Des cellules β fonctionnelles à la demande chacun en pharmacie, en grande surface ➜ CLINIQUEMENT VÔTRE ou sur Internet. Ce sont les promesses 18 Thérapie génique qu’affichent les compléments alimentaires. Encore plus d’espoir pour les « bébés bulles » 20 Maladie de Crohn Mais qu’en est-il en réalité ? Qui sont les Quand le courant électrique court-circuite consommateurs de ces produits ? les symptômes Quelles sont les supplémentations réellement utiles pour la santé ? ➜ GRAND ANGLE Quels sont les effets à long terme 22 Compléments alimentaires de ces substances sur le risque de Démêler le vrai du faux maladies chroniques (cancers, maladies cardiovasculaires, etc.) ? Et surtout, ➜ MÉDECINE GÉNÉRALE 34 Allaitement Par quelles mères ? les consommer est-il toujours sans danger ? À l’heure où le marché des ➜ ENTREPRENDRE 38 AAVLife Au cœur de la thérapie génique compléments alimentaires ne cesse de se développer, avec des milliers de spécialités ➜ OPINIONS 40 Étiquetage des aliments disponibles en vente libre, ce dossier fait Est-ce une bonne idée ? le point sur toutes ces questions. Depuis les aspects réglementaires jusqu’aux ➜ STRATÉGIES 42 Jean-François Delfraissy recommandations officielles en la matière, « Monsieur Ebola fait un premier bilan » en passant par les derniers résultats ➜ BLOC-NOTES de recherche disponibles. Tentons 46 « Choc Santé » d’y voir plus clair sur ce phénomène. Des livres pour faire le tour des questions de santé Mathilde Touvier 48 médecine/sciences Unité 1153 Inserm/Inra/Cnam/Université Paris 13/Université Paris 7- Denis Diderot/Université Paris-Descartes – Centre de recherche 30 ans au service de la recherche biomédicale en Épidémiologie et statistique Sorbonne Paris Cité JANVIER-FÉVRIER 2015 ● N° 23 ● ● 3 ➜À LA UNE • Découvertes • têtes chercheuses • regarDs sur le monDe • cliniquement vôtre • granD angle • méDecine générale • entreprenDre • opinions • stratégies • Bloc-notes BIOBANQUES Gérer les coûts, coordonner les collections Pour leurs projets de recherche, les scientifiques bénéficient aujourd’hui d’échantillons biologiques humains prélevés, classés et conservés dans des centres dédiés et dans des conditions très encadrées. Des collections précieuses mais coûteuses. Comment alors les financer ? Et comment les organiser ? Échantillons fin de mieux comprendre les mécanismes Pour bien comprendre comment Lbiologiques physiologiques et physiopathologiques humains, les fonctionnent ces biobanques, Obtenus par prélèvement, A chercheurs doivent, pour travailler, pouvoir disposer la Myobank, à Paris, est un bon tissus ou cellules issus d’échantillons biologiques : tumeurs, ti ssus mu sculaires, exemple, précurseur en la matière. du corps humain et leurs cerveaux, cellules, gènes, micro-or ganismes… En 2000, à Fondée en 1996, en même temps dérivés, organes, sang l’initiative du ministère de la Recherche et de l’Inserm, la que l’Institut de myologie par l’Association française ou ses composants, etc. France a été parmi les pr emiers pays européens à reg rouper contre les myopathies, elle abrite une collection de tissus Ressources ses collections dans des centres dédiés : les biobanques. neuro musculaires. « Avant l’existence de telles banques de Lbiomoléculaires On en compte aujourd’hui 82, associées au sein du bien ressources biologiques, la recherche clinique était limitée aux Molécules qui participent nommé rés eau Biobanques, une infrastructure nationale hôpitaux, là où étaient présents les patients. On pouvait bien au processus métabolique dédiée à la recherche médicale, qui utilise les échantillons évidemment mener ailleurs des travaux sur des muscles de d’un organisme vivant, biologiques (L) et les ressources biomoléculaires (L). souris, mais on s’est rapidement rendu compte que tout ne comme les glucides, les lipides, l’eau, les acides Problème : il faut en assurer leur pérennité. Et comme pouvait pas être modélisé chez les petits mammifères et nucléiques (ADN), etc. partout, l’argent est le nerf de la guerre. Il est donc qu’il fallait donner aux équipes un moyen d’accéder à des indispensable de trouver des financements. « Certains échantillons biologiques », explique Thomas Voit *, souhaitent que ces centres s’autofinancent, permettant ainsi directeur de Myobank. Fort de cette ambition, elle a été LMyoblastes de couvrir leurs frais de fonctionnement. Mais le coût réel mise en place et, avec le consentement des patients, se sont Cellules souches à d’un échantillon est très élevé, à titre d’exemple autour de organisés la collecte de tissus lors d’opérations prévues et l’origine des cellules musculaires squelettiques 1 500 € pour une tumeur. Un auto-financement fondé sur le les prélèvements post-mortem. Au moment des greffes, coût réel de l’échantillon constituera indéniablement un frein des cœurs entiers malades peuvent même être prélevés Dystrophie aux projets de recherche », explique Georges Dagher *, et conservés. Des lignées immortelles de myoblastes (L) Lde Duchenne directeur de l’Infrastructure nationale des biobanques. sont également créées par les scientifiques du centre. Maladie génétique Bruno Clément, Georges Dagher et leurs collègues se Chaque année, plus de 1 000 échantillons sont ajoutés à provoquant sont donc penchés sur le sujet et, dans une récente publi- leur collection et environ 500 utilisés. Sous forme de tissus une dégénérescence cation, ils défendent plutôt une adaptation des coûts d’accès ou de cellules, plus de cent maladies sont ainsi représentées, progressive de (L) l’ensemble des muscles selon le type de collaboration engagée entre la biobanque comme la dystrophie de Duchenne , des myopathies de l’organisme et la structure dema ndant les ressources. « S’il s’agit d’une congénitales (L) ou des cardiomyopathies (L). simple “ cession ” des échantillons, alors le coût réel serait Myopathies payé. Mais si l’accès aux échantillons s’accompagne d’une L'essor des biobanques Lcongénitales collaboration au niveau des résultats, ou encore le partage de Autres centres de ressources biologiques, autres Maladies neuro- la propriété intellectuelle, alors les coûts d’accès seraient amé- collections. Au CHU d’Angers, plusieurs sont musculaires présentes nagés et représenteraient 10 à 20 % du coût réel », envisage précieu sement préservées, comme, par exemple, des dès la naissance le scientifique. Et, afin de rendre les montants des transac- échantillons de liquide céphalo-rachidien prélevés à Cardiomyopathie tions totalement transparents, les chercheurs proposent l’occasion du diagnostic de maladie d’Alzheimer. « Ces L une véritable « grille » d’évaluation des coûts, testée dans ressources peuvent faire l’objet d’une cession [transfert de Détérioration du muscle cardiaque, qui conduit 16 biobanques de six pays européens pour 46 types de la propriété de l’échantillon, ndlr] dans le cadre de projets généralement à la crise prestations. Affaire à suivre donc : la proposition a été de recherche clinique menés par des sociétés développant cardiaque. soumise aux ent ités de tutelle concernées. de nouveaux kits de diagnostic de la maladie », explique 4 ● ● N° 23 ● JANVIER - FÉVRIER 2015 ➜À LA UNE Un réseau européen BBMRI-ERIC regroupe les infrastructures nationales de 12 pays membres de l’Union européenne, parmi lesquels la France, l’Allemagne, l’Italie, l’Autriche, les Pays-Bas. Une organisation reconnue comme entité légale par les pays de l’UE. Sa coordination est installée à Graz, en Autriche, depuis décembre 2013. qualité (norme AFNOR), LGénomique 20 autres le seront en 2015. Étude à l’échelle « L’objectif de cette norma- du génome du lisation est avant tout de fonctionnement de standardiser et contrôler l’organisme, d’un organe, IERRE d’une pathologie, etc. P A les procédures opératoires L afin de garantir la qualité K DE C RI Polymorphisme T des échantillons, explique L / PA Georges Dagher. Des Propriétés des gènes M qui se présentent sous ER S études ont montré que 45 % N I plusieurs formes, © des chercheurs doutent des appelées allèles. résultats de leurs travaux du Dans ce laboratoire Annick Barthelaix, à fait d’une qualité inappropriée de leurs échantillons.
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