Despite the fact that immune responses are extremely complex and vary from one person to another, medical practices and public health policies are based on a single model of patient care and drug development. The Milieu Intérieur project was created specifically to address this paradox. This Laboratoire d’Excellence project involves more than thirty scientists from the top French research centers. At the Institut Pasteur the project is coordinated by Professor Matthew Albert (Inserm research director) and Dr. Lluis Quintana-Murci (CNRS research director). Its primary objective is to define and increase understanding of the notion of a “healthy” donor, in order to give the research world an unprecedented opportunity to study the relationship between genetics, immunity and environment.
The scientists have just published the recruitment criteria for a cohort of healthy donors, comprising 500 French men and 500 French women aged between 20 and 69 and all in good health. The project has already led to the constitution of a biobank of different samples, including blood, nasal and stool samples as well as skin biopsies. The scientists have also collected medical, nutritional and sociodemographic data, as well as information about donors’ lifestyles.
The statistical approach initially adopted by the scientists enabled them to pinpoint the known correlation between certain biological profiles and the age and sex of donors. It confirmed in particular that LDL cholesterol levels increase with age and that creatinine – which measures renal function – is higher in men than in women. These initial results highlighted the integrity and significance of the data collected, and validated the Milieu Intérieur cohort as a benchmark group for the French population.
With the help of biological and epidemiological data, the scientists were also able to observe the impact of environmental and lifestyle factors on the immune system. For example they observed an increase in white cells circulating in the blood stream and a reduction in certain classes of antibodies (IgG.) that could identify smokers amongst the donors of the cohort. This work highlights a more general impact of tobacco on health, which goes beyond pulmonary toxicity. This and other environmental and lifestyle factors will be placed in the wider context once all additional phenotypic data have been analyzed.
In the long term, the Milieu Intérieur project aims to provide a new reference framework and data control system for patient studies. By providing a better understanding of the variability of immune responses between individuals, it should also constitute a first step towards personalized medicine, tailoring treatment to the individual and developing drugs and diagnostic tests that match the genetic and immune profile of each patient.
 Institut Pasteur, Institut Curie, Paris-Diderot University, Paris-13 University, INSERM and CNRS
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