Development of an alternative to bone grafting for edentate patients

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Decreased jaw bone volume in edentate patients is the main difficulty which arises when fitting dental implants. Bone grafting is currently the most frequent solution for this problem. However, this method has several disadvantages, such as deterioration of the bone graft over time. Between 2010 and 2015, Pierre Layrolle, Inserm researcher, working with Norwegian and German teams as part of the REBORNE European project, tested an innovative technique for bone augmentation in 11 edentate patients, by combining a biomaterial with stem cells. The results, published in the journal Stem Cell Research & Therapy, demonstrate sufficient growth of viable bone in the treated area to allow implants to be fitted, together with the durable preservation of this bone after fitting dental prostheses.

Owing to the lack of mechanical stimulation resulting from mastication among edentate patients, bone wastage affecting the alveolar bone (surrounding and supporting the tooth) can be observed, which represents a third of contraindications for fitting dental implants. This procedure, in fact, requires sufficient bone volume to avoid impinging on the facial nerve, which would result in facial paralysis. Now, without sufficient bone volume in the jawbone to support the soft tissue in the gums, even dentures are proving relatively unsuitable.

While bone augmentation involving biomaterials is successfully used to fill the dental alveoli, bone grafting is currently the most commonly used technique for correcting longstanding multiple tooth loss, with a bone sample taken from the patient’s mandible or skull. In addition to the postoperative risks associated with creating two surgical sites, along with the limited quantity of bone material able to be sourced from a single patient, and postoperative pain, this technique appears relatively unsustainable over time. Transplanted bone tends to resorb very quickly. Owing to the lack of vascularization and continuity with the original underlying bone, it is degraded by immune cells which perceive it as a foreign body.

Pierre Layrolle, Inserm researcher heading up the “Inflammation and cellular communications in bone disorders” team (Unit 1238, Inserm/University of Nantes) worked with Norwegian and German teams as part of the Reborne project from 2010 to 2015, on a long-term solution for alveolar bone augmentation. This European clinical trial followed up 11 edentate (over several years) patients, treated with an innovative mandibular bone augmentation technique based on the “cell therapy” principle.

To replace the bone lamellae (containing the patient’s cells and growth factors) conventionally used in bone augmentation, the research team used a biomaterial, calcium phosphate, to which stem cells taken from patient hip bone marrow samples, cultured for amplification, had been affixed. Although calcium phosphate is unable to regenerate bone, it allows adhesion of stem cells – which have this function. This biomaterial is, moreover, highly resistant to the degrading action of immune cells. The mixture thus obtained was applied to the edentate part of the mandible.

For 5 months, researchers monitored positive bone formation around the graft, then generated a 3D model of the augmented part in order to select the type of implant suited to each patient. The sample taken from the 11 patients when fitting the implants showed that the tissue formed not only generated sufficient quantities of bone enabling dental implants to be fitted, but was also vascularized, unlike conventional bone grafts. The dental implants and prostheses were functional two years after fitting, in the 11 patients.

Further to these positive results, the research team launched the MAXIBONE European project in 2018, once again coordinated by Pierre Layrolle. This clinical trial aims to compare the results of maxillary bone augmentation using cell therapy with conventional bone grafting, on a wider scale on 150 patients, by evaluating the quantity of bone generated by the two types of transplants and their specific cost. This project will also examine the possibility of replacing the patient’s stem cells (autologous cells) with donor stem cells in the context of cell therapy. This could offset the technical difficulties related to the cost and complexity of sampling and storing autologous cells, but also mitigate the variations observed in terms of each individual’s ability to effectively generate bone.

The FP7-Reborne project, a phase 2 clinical trial, received European funding from 2010 to 2015.

The H2020-Maxibone project, a phase 3 clinical trial, has received two European grants and is scheduled to start in early 2019.

Pierre Layrolle is due to attend the Nantes international science fiction festival Les Utopiales from October 31 to November 5, 2018, to demonstrate 3D bioprinting. He will lead the round table “In foreign flesh: accepting a foreign body”, on Wednesday, October 31, at 14:00.

An Unbalanced Maternal Diet Affects the Digestive System of Offspring

©Inserm/Naveilhan, Philippe/U913/IMAD

Inadequate protein intake in a gestating female is linked to lasting digestive abnormalities in her offspring. When studying the link between perinatal malnutrition and digestive system in rats, a team of researchers from Inserm in conjunction with Inra, Université de Nantes and University Hospital Nantes discovered functional digestive abnormalities in young rats and an inappropriate response to stress. Although conducted in animals, this research once again demonstrates the incidence of perinatal stress on health in adulthood and draws our attention to the impacts of restrictive diet-related or involuntary deficiencies during pregnancy. This research has been published in The FASEB Journal.

Gestation is an extremely vulnerable time when it comes to normal fetal development and the maintenance of good health throughout life. Several studies have already revealed effects of maternal malnutrition on the cardiovascular and cognitive development of offspring, with repercussions in adulthood. This time, the focus was on the digestive system of young rats, just before they reached adulthood. This involved halving the protein intake of the mothers throughout the gestation and lactation periods and then reintroducing a normal diet once the offspring were weaned.

The researchers began by studying digestive system functioning in the young rats, particularly intestinal motility and permeability. Motility corresponds to the frequency and speed of stool passage. Permeability represents the capacity of nutrients and other molecules to pass through the intestinal wall into the bloodstream. What they observed was an increase in these two parameters in the animals whose mothers had had an inadequate protein intake. They also detected high levels of stress hormone.

To understand these phenomena, the animals were subjected to a model of psychological stress. In the control rats, the stress situation (mimicked by isolating them on a platform with no way out, placed in the middle of a basin of water) triggered accelerated motility and increased permeability. However, this response was altered in the young rats whose mothers had consumed insufficient protein. Their basic digestive activity was greater but did not increase during the stressful event. “Their stress response appeared inappropriate, as if perinatal stress had desensitized the response to acute stress during future life”, suggests Hélène Boudin, Inserm researcher and co-director of this research.

The researchers then examined whether the digestive nervous system had been modified. They observed that the stress hormone induced an excess of neurons stimulating intestinal motility and permeability. These neurons, in addition to their large number, present the disadvantage of being unable to eliminate waste and toxins naturally. And this is “indicative of a poor capacity to respond to stress” clarifies Boudin.

These various observations enabled the researchers to hypothesize that: perinatal nutritional deficiency leads to an increase in the stress hormone in offspring, itself inducing long-term remodeling of the digestive nervous system. This would be responsible for digestive disorders that can weaken the intestine and impact on wellbeing and quality of life.

This research also reinforces the hypothesis of the prenatal origin of certain digestive diseases and disorders. In addition, the mechanisms brought into play by the perinatal stress studied could be shared with those present in other diseases of malnutrition (overeating and undernourishment) and possibly also in neurodevelopmental diseases including some psychiatric diseases” clarifies Boudin. For her, this research once again shows the incidence of perinatal stress on health in adulthood and draws our attention to the impacts of restrictive diet-related or involuntary deficiencies during pregnancy.

Fewer cases of cancer in organic food consumers?


A 25% reduction in cancer risk has been observed among “regular” organic food consumers, compared to consumers who eat organic less often. These were the findings of an epidemiological study conducted by a team from Inra, Inserm, University of Paris 13, CNAM, following analysis of a sample of 68,946 participants in the NutriNetSanté cohort. Although a link between cause and effect cannot be established based on this study alone, the results suggest that a diet rich in organic foods could limit the incidence of cancer. Additional research is nonetheless necessary in order for appropriate, targeted public health measures to be introduced. This study was published in JAMA Internal Medicine on October 22, 2018.

The organic food market has grown tremendously in recent years. In addition to ethical and environmental aspects, one of the main driving factors for eating organic is that these foods are grown without crop protection products and synthetic inputs, and could therefore be associated with health benefits. However, insufficient epidemiological data are currently available to conclude that an organic diet has a protective effect on health (or that there is an increased risk related to the consumption of conventionally farmed foods). Although contact with chemical inputs, particularly via occupational exposure among farmers, has been associated with an increased risk of disease (notably prostate cancer, lymphoma, and Parkinson’s disease), the risk to the general population via food is unknown.

Researchers from the Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (Inra/ Inserm/University of Paris 13/CNAM) conducted an epidemiological study based on the analysis of a sample of 68,946 participants (78% females, mean age 44 years) in the NutriNet-Santé cohort (see text box below). Data on their conventional or organic food consumption were collected at inclusion, using a questionnaire on the frequency of consumption (never, occasionally, most of the time) for 16 food groups[1]. This analysis also took sociodemographic characteristics, lifestyle and nutritional habits into account.

Over the seven-year follow-up period (2009-2016), 1,340 new cancer cases were recorded and validated based on medical records. A 25% reduction in cancer risk (all types combined ) was observed among “regular” organic food consumers compared to more occasional consumers.

This relationship was particularly pronounced for breast cancer in menopausal women (-34% risk, high versus low organic score) and lymphomas (-76% risk). Taking into account various risk factors potentially affecting this relationship (sociodemographic factors, diet, lifestyle, and family history) had no effect on the results.

Several hypotheses could explain these data: the much more common presence of synthetic pesticide residues at higher doses in conventionally farmed foods, compared to organic foods. Another possible explanation: potentially higher concentrations of certain micronutrients (carotenoid antioxidants, polyphenols, vitamin C, or more beneficial fatty acid profiles) in organic foods.

The conclusions of this study need to be confirmed by other investigations conducted on other study populations, in different contexts. Nevertheless, these results support the recommendations issued by the Haut Conseil de Santé Publique (HCSP) in 2017, for the future dietary indicators of the French National Nutrition and Health Program (Programme National Nutrition Santé – PNNS), aiming to prioritize foods cultivated using methods reducing exposure to pesticides, for fruit, vegetables, pulses, and wholegrain products.

[1] Fruit, vegetables, soy-based products, dairy products, meat/fish/eggs, starchy foods/pulses, bread/cereals, flour, oils/condiments, ready meals, coffee/tea/herbal teas, wine, biscuits/chocolate/sugar/confectionary, other foods, and food supplements.

NutriNet-Santé study and Bionutrinet project

This is a national cohort study conducted on a large population of adult volunteers (known as

“Nutrinauts” after enrollment), initiated in 2009, aiming to study the relationships between

nutrition and health. As part of the NutriNet-Santé study, the BioNutriNet project focuses on

the potential impact of food consumption according to production methods (organic versus conventional farming methods), on nutritional status, toxicological markers, the environment, and individual health.

The recruitment of new volunteers to participate in the NutriNet-Santé study continues. Simply register online ( and complete the questionnaires. These will enable the researchers to deepen their knowledge on the links between nutrition and health and thereby improve the prevention of chronic diseases through our diet.

Find out more:

Identifying a genetic factor causing lung fibrosis complicating rheumatoid arthritis

©Inserm/Cantagrel, Alain, 1993

Teams of rheumatology, respiratory medicine, genetics and the university hospital department FIRE Hospital Bichat Claude Bernard AP-HP, in collaboration with INSERM, Université Paris Diderot, the Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA, have discovered that a rare allele of rs35705950 variant gene  MUC5B  multiply by six the risk of occurrence of pulmonary fibrosis in patients with rheumatoid arthritis (RA). This broad study of genetic association demonstrates the existence of a common genetic basis between pulmonary fibrosis associated with rheumatoid arthritis and idiopathic pulmonary fibrosis (IPF). These results, obtained with the participation of national and international network of pulmonologists and rheumatologists, are published in the journal  The New England Journal of Medicine  October 20, 2018.  They are a first step in understanding the diffuse interstitial lung disease (PID) of rheumatoid arthritis, a serious complication whose therapeutic management is not currently codified.

The teams tested the influence of the major genetic risk factor for idiopathic pulmonary fibrosis (IPF): rs35705950 variant gene MUC5B . 

This genetic association study case-control, coordinated by Professor Philippe Dieudé in collaboration with Prof. Bruno Crestani, compared 620 patients with rheumatoid arthritis with diffuse interstitial lung disease (PID), 614 patients with rheumatoid arthritis and without PID 5448 control individuals, from 7 different countries (France, Greece, Netherlands, Japan, China, Mexico and USA).

The results of this international collaboration show a varying contribution MUC5Brs35705950 in the determination of the PID in rheumatoid arthritis. 

The presence of  the risk allele multiply by 3 the risk of occurrence of interstitial lung disease  diffuse (PID)  and  by 6 that of usual interstitial pneumonia (PIC) (the most severe form of PID). Finally, an exploratory phase exploring 12 more REIT susceptibility markers suggests the existence of a common genetic architecture between IPF and pulmonary fibrosis in rheumatoid arthritis.

This work is the first to show that there are  common pathways between the two diseases – pulmonary fibrosis in rheumatoid arthritis and idiopathic pulmonary fibrosis – and provides a strong argument for promoting therapeutic intervention studies in pulmonary fibrosis associated with rheumatoid arthritis, using anti-fibrotic drugs already validated in the idiopathic pulmonary fibrosis.


To know more

The diffuse interstitial lung disease (PID)  is a common extra-articular manifestation and severe  rheumatoid arthritis (RA) , which affects nearly 30% of RA patients, and gradually progresses to irreversible pulmonary fibrosis in about 40 to 50 % of cases. Thus, a PID occurrence is responsible for about 7 to 10% of deaths in patients with rheumatoid arthritis and median survival varies between 2 and 5 years after the onset of Respiratory symptoms. The risk factors and pathophysiological mechanisms underlying the onset of pulmonary fibrosis in RA remain largely unknown. 

Idiopathic pulmonary fibrosis (IPF)  is a lung disease characterized by progressive fibrosis, in which there is no extra-respiratory disorder for which the genetic origins are known. 

Pulmonary fibrosis in rheumatoid arthritis has similarities with idiopathic pulmonary fibrosis, including a  high prevalence of interstitial pneumonia (PIC) , shared environmental risk factors (such as smoking) and a very poor prognosis.

Outbreak of multidrug-resistant tuberculosis undetected by standard tests

Fluorescence microscopy of BCG vaccine. ©Inserm/Latron, Patrice, 2017

Amid a plan announced by the United Nations to eradicate tuberculosis by 2030, a new study has revealed the emergence of multidrug-resistant strains of the disease which go undetected by WHO-endorsed tests. These findings, from an international research team co-directed by CNRS researcher Philip Supply at the Center of Infection and Immunity of Lille (CNRS/INSERM/Institut Pasteur de Lille/Université de Lille), are published in the 17 October 2018 edition of The Lancet Infectious Diseases. This follows another article, published in the 26 September edition of The New England Journal of Medicine, proposing a new algorithm to detect resistant strains of tuberculosis.

On 26 September, the United Nations announced a plan to raise $13 billion annually for the fight to eradicate tuberculosis by 2030. With 10 million new cases and 1.6 million deaths in 2017, it is the most common infectious disease in the world, ahead of HIV.

In over 450,000 new cases of antibiotic-resistant tuberculosis that likely appeared, only 25% were detected. A study by an international research team1 co-directed by Philip Supply, a CNRS researcher at the Center of Infection and Immunity of Lille (CNRS/INSERM/Institut Pasteur de Lille/Université de Lille), has underlined this serious problem of under-detection, in South Africa in particular.

The findings, published in The Lancet Infectious Diseases, show that certain South African isolates of Mycobacterium tuberculosis (the bacterium which causes the disease) carry a specific combination of mutations which make them resistant to the two primary first-line antibiotics prescribed: rifampicine and isoniazide.

This combined resistance goes undetected by the standard tests endorsed by the World Health Organization: the gene region carrying a particular mutation causing rifampicine resistance is not included in the DNA test, and the resistance to the treatment due to this mutation is not detected in cultures.

This omission leads to unsuccessful first-line treatments in patients, increased mortality and contagion, and the development of additional antibiotic resistances. Researchers especially detected the presence of mutations probably causing decreased sensitivity to bedaquiline, the newest molecule used to treat cases of multidrug-resistant (MDR) tuberculosis. These mutations appeared immediately following its launch in the country from 2013 on.

This was discovered thanks to a new MDR screen test developed by Genoscreen2 together with P. Supply. Unlike standard DNA tests, this one analyses a wide panel of target genes in the bacteria and can identify resistance to over a dozen antibiotics simultaneously. These results are obtained in as little as one to three days, compared to the weeks needed for cultures. The test will help solve the problem of under-detection of MDR tuberculosis. It will benefit from a new algorithm for the detection of resistance mutations, the effectiveness of which has been detailed in an article published in The New England Journal of Medicine by another consortium (CRyPTIC)3 in which Dr Supply and Genoscreen took part. This study was based on an analysis of 10,000 genomes, making it one of the biggest microbial genome sequencing projects conducted to date.  

[1]National Health Laboratory Service, Dr George Mukhari Tertiary Laboratory, Pretoria, Sefako Makgatho Health Sciences University, Pretoria, and Gauteng Department of Health, Hatfield, South Africa; National Reference Laboratory, Ministry of Health, Mbabane, Swaziland; Forschungszentrum Borstel and German Center for Infection Research, Borstel Site, Borstel, Germany; Institute of Tropical Medicine and University of Antwerp, Antwerp, Belgium; Université Catholique de Louvain, Brussels, and Katholieke Universiteit Leuven, Leuven, Belgium

[2]Company specialised in genomics, based at the Institut Pasteur de Lille.


Tools: Sensory Organs in Their Own Right ?

©Photo by Adi Goldstein on Unsplash

What if by holding a tool we could perceive our environment through touch – using the whole tool, and not just the tip? A study by Inserm researchers at the Lyon Neuroscience Research Center (Inserm/Université Jean Monnet Saint-Etienne/Université Claude Bernard Lyon 1/CNRS) has shown just that – the capacity of the human brain to incorporate a tool as an actual sensory organ. This research, published in Nature, raises the question of a new paradigm concerning the sense of touch, its interpretation when developing our use of tools, and in its medical applications – particularly prosthetics.

The sense of touch is essential to the control we have over our hands and, by extension, over the tools we use to perceive our environment through touch.

Inserm researchers at the Lyon Neuroscience Research Center (Inserm/Université Jean Monnet Saint-Etienne/Université Claude Bernard Lyon 1/CNRS) examined the mechanisms which enable the brain to locate touch through tools. To do this, they used three complementary approaches which involved tapping a wooden rod held in the hand.

The first approach involved tapping different locations of a rod held by a volunteer whose vision was obstructed and then asking him or her to locate the impact. Irrespective of where the rod was tapped, the volunteer was able to sense the location of the impact with the same accuracy as when it was his or her own arm which was tapped.

These results demonstrate the human capacity to “incorporate” the entirety of a tool held in the hand as if it was part of the body, with the brain integrating it as a sensory organ in its own right.

The second approach involved recording the vibrations of the rod perceived at the base of the wrist and on the skin of the hand holding it. The researchers observed that the characteristics of the rod’s vibrations transmitted to the hand predictably depended on the location of the impact.

Finally, in the third approach, the characteristics of the vibrations recorded in the second approach were processed by a computerized simulator of skin responses, thereby modeling the responses, to the vibrations, of the mechanoreceptors (sensory neurons of the skin) in contact with the rod. The research team observed that the mechanoreceptors were able to very precisely decode the vibratory motifs of the rod. Since these motifs strictly depend on the location of the impact, the brain is able to interpret their “profile” sent by the mechanoreceptors and, as a result, locate the area of impact.

This study shows that the human brain treats the tools as sensory extensions to the body, a mechanism which the research team suggests calling “sensing with tools“. The phenomenon newly-described here represents a new paradigm which could improve knowledge of tool-incorporation phenomena in humans and the sensory perception of the visually-impaired, as well as the understanding of prosthesis use in amputees.

An Improved Diet Could Protect Against Depression

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Researchers from Inserm and Université de Montpellier have produced a meta-analysis of the links between a simple-to-use score measuring adherence to dietary guidelines and the development of depressive disorders. The researchers were able to show that adopting a Mediterranean diet (high in fruit, vegetables, fish and whole grains) was linked to a 33% reduction in the risk of depression. These results were published in Molecular Psychiatry.

Globally, more than 300 million people suffer from depression, representing a frequency of 7% for women and 4% for men. It is the costliest brain disorder in Europe. Using data from 36,556 adults, researchers from Inserm and Université de Montpellier were able to show that adopting a Mediterranean diet (high in fruit and vegetables, fish and whole grains) was linked to a 33% reduction in the risk of depression.

Their study also shows that a pro-inflammatory diet (high in saturated fatty acids, sugar, and processed foods) was associated with a higher risk of depression. The chronic inflammation potentially induced by this type of diet could be directly implicated in the onset of depression. According to Tasnime Akbaraly, Inserm researcher responsible for the study: “These findings support the hypothesis that avoiding pro-inflammatory foods (in favor of an anti-inflammatory diet) helps prevent depressive symptoms and depression.

Other studies have also shown the importance of diet in the functioning and composition of the gut microbiota, directly impacting the link between the gut and the brain – with this relationship playing a key role in depressive disorders.

For Tasnime Akbaraly: “The results of our study show the importance of our dietary habits in the development of depressive disorders and encourage the widespread provision of dietary advice at medical consultations”.

Additional clinical trials are necessary to evaluate the efficacy of diets such as the Mediterranean diet in reducing the risk, severity and recurrence of depressive episodes.

NONO, “The Red Flag System” That Detects HIV

Illustration du virus HIV ©Adobestock

There is not one but several types of HIV. Although HIV-1, which is the most common, wreaks havoc in infected populations, this is not the case for HIV-2 which less frequently leads to the development of AIDS. But why does the immune system do a better job of fighting this version of the virus? Researchers from Inserm and Institut Curie looked at this question. Researchers from Inserm and Institut Curie identified the NONO protein, a detector which is more sensitive to HIV-2 and responsible for direct recognition of the virus by the immune system. This work, published in the journal Cell, provides a better understanding of the natural control of HIV and paves the way for new progress in the search for a vaccine for this virus.

AIDS develops when the immune system of an HIV-positive individual becomes unable to fight infection and becomes dramatically weak. The majority of people infected and not treated develop fatal AIDS. But in some cases AIDS does not develop in certain untreated HIV-positive individuals. This explains the existence of several forms of HIV.

Although HIV-1, which affects 25 million people, without treatment leads to AIDS in 99% of cases, this is not the case for HIV-2. This particular form of HIV is very close to HIV-1 but differs in terms of genetics. It is found mostly in West Africa and affects 1 million people. HIV-2 leads to the development of AIDS in fewer than 25% of cases, has no impact on the life expectancy of most people infected, and proves to be difficult to transmit to others. Furthermore, HIV-positive individuals with the HIV-2 form of the virus, and who also contract HIV-1, show improved resistance to the latter.

Researchers from Inserm and Institut Curie in Unit 932 Immunity and Cancer (Inserm/Institut Curie/PSL University/Paris Descartes University) studied the reasons for the immune system’s better control of HIV-2.

In 2010, this research team had already shown that dendritic cells – the immune system’s “sentinel” cells – were able to detect HIV-2 much more efficiently than HIV-1. In order for the immune response to be effective, there needs to be good immune recognition.

Based on this observation, the researchers sought to understand the molecular mechanisms involved in the dendritic cells’ recognition of HIV-2, and to find out why this recognition is effective in comparison to that of HIV-1.

They thus discovered that the NONO protein, located in the dendritic cells, acted as a detector able to recognize the internal casing (or capsid) of HIV-2 a lot better than that of HIV-1, and as a result to trigger an immune response to fight the virus.

The capsid – which surrounds the genetic material of viruses – is made up of proteins, and NONO is apparently able to recognize a specific protein pattern of the capsid of HIV-2.

This study provides a better understanding of the natural mechanisms involved in infection control by HIV. According to Nicolas Manel, Inserm researcher in charge of the study: “the next step in this research project is to understand how this detection system works at the molecular level and how this detection triggers the immune response. We are developing innovative vaccine strategies in the lab, and this discovery paves the way for the new studies needed to develop a new generation of vaccines capable of “imitating” the HIV-2 capsid, and as a result triggering an immune response in people infected with the HIV-1 virus.”

Center-based and Other Forms of Childcare: An Impact on the Behavioral and Emotional Development of Children.

Crédits: AdobeStock

Researchers from Inserm, Sorbonne Université and Université de Bordeaux have published a study based on data from 1,428 children showing that access to a center-based form of childcare between the ages of 0 and 3 years is linked to fewer emotional and peer relationship problems in later life compared with other forms of childcare. These findings were published on October 1, 2018 in Journal of Epidemiology and Community Health.

Researchers from Inserm, Sorbonne Université and Université de Bordeaux (Bordeaux Population Health for Unit 1219) studied in France the impact of the form of childcare used during the three first years of life on the behavioral and emotional development of children. This study is based on 1,428 children from the EDEN cohort (study of the pre- and early postnatal determinants of child health and psychomotor development), based in Nancy and Poitiers which followed up mothers during pregnancy as well as their children up to the age of 8 years.

The mothers reported the main childcare method used for their child at the ages of 4 months, 8 months, 1 year, 2 years and 3 years: informal care (mainly the parents themselves or sometimes the grandparents, neighbors, etc.), home daycare (childminder), or center-based childcare (childcare center, daycare center). Then at 3 years, 5.5 years, and 8 years, they completed the “Strengths and Difficulties Questionnaire” which measures behavioral and emotional symptoms using five scales (emotional symptoms, peer relationship problems, hyperactivity/inattention, conduct problems, and prosocial behavior).

Following adjustment for various sociodemographic characteristics, the study shows that compared with children who stay at home before going to preschool, those attending center-based childcare were around three times less likely to experience emotional problems or peer relationship difficulties at a later stage (between the ages of 3 and 8 years).

Their behavior was also more prosocial, i.e. more empathic (for example, sharing, kindness towards younger children).

“Access to a center-based form of childcare between the ages of 0 and 3 years represents an opportunity for the children concerned because it is linked to better psychological and emotional development down the line.” explains Inserm researcher, Maria Melchior. These findings taken from data from two cities must now be confirmed on a larger scale.