Serum Neurotrophin Profile in Systemic Sclerosis

International audienceBACKGROUND: Neurotrophins (NTs) are able to activate lymphocytes and fibroblasts; they can modulate angiogenesis and sympathic vascular function. Thus, they can be implicated in the three pathogenic processes of systemic sclerosis (SSc). The aims of this study are to determine blood levels of Nerve Growth Factor (NGF), Brain-Derived Neurotrophic Factor (BDNF) and Neurotrophin-3 (NT-3) in SSc and to correlate them with clinical and biological data.METHODS: Serum samples were obtained from 55 SSc patients and 32 control subjects to measure NTs levels by ELISA and to determine their relationships with SSc profiles. FINDINGS: Serum NGF levels were higher in SSc patients (288.26 ± 170.34 pg/mL) than in control subjects (170.34 ± 50.8 pg/mL, p<0.001) and correlated with gammaglobulins levels and the presence of both anti-cardiolipin and anti-Scl-70 antibodies (p<0.05). In contrast, BDNF levels were lower in SSc patients than in controls (1121.9 ± 158.1 vs 1372.9 ± 190.9 pg/mL, p<0.0001), especially in pulmonary arterial hypertension and diffuse SSc as compared to limited forms (all p<0.05). NT-3 levels were similar in SSc and in the control group (2657.2 ± 2296 vs 2959.3 ± 2555 pg/mL, NS). BDNF levels correlated negatively with increased NGF levels in the SSc group (and not in controls). CONCLUSION: Low BDNF serum levels were not previously documented in SSc, particularly in the diffuse SSc subset and in patients with pulmonary hypertension or anti-Scl-70 antibodies. The negative correlation between NGF and BDNF levels observed in SSc and not in healthy controls could be implicated in sympathic vascular dysfunction in SSc

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Facteurs associés au recours tardif à la consultation prénatale chez les gestantes au Bénin

International audienceContexteLe recours tardif à la consultation prénatale (après 16 semaines d'aménorrhées) influence le bon déroulement de la grossesse et de l'accouchement. Il est un facteur de risque de morbi-mortalité maternelle et péri-natale en Afrique subsaharienne. L'objectif de cette étude était d’étudier les facteurs associés au recours tardif à la CPN chez les gestantes au Bénin en 2021.MéthodesIl s'agissait d'une étude transversale, réalisée dans 30 maternités du Bénin d'avril 2020 à novembre 2021. Toutes les femmes enceintes reçues en consultation âgées d'au moins 15 ans étaient incluses. Les données ont été collectées par une entrevue structurée en mode face à face et par le dépouillement des dossiers médicaux et des cartes maternelles. Les données ont été analysées avec le logiciel R 4.1.2. Une régression logistique binaire pas à pas descendante a été réalisée. Le seuil de significativité était p&lt;0,05.RésultatsL’échantillon comportait 3528 gestantes ; 1469 (41,64 %) gestantes avaient réalisé leur première CPN après la 16ème SA. Les facteurs associés retrouvés étaient le niveau d'instruction secondaire (OR=0,6 ; 95% CI (0,4-0,9)), le fait de vivre en concubinage (OR=1,6 ; 95% CI (1,3- 2,0)), la profession d'agricultrice (OR=3,0 ; 95% CI (1,6-5,8)), les antécédents de macrosomie (OR=1,5 ; 95% CI (1,1-2,0)), de diabète familial (OR=1,5 ; 95% CI (1,0-2,1)) et de prééclampsie (OR=2,0 ; 95% CI (1,5-2,6)).ConclusionCes résultats démontrent la fréquence élevée du recours tardif à la consultation prénatale dans cette population. Les facteurs associés retrouvés appellent sur la nécessité de la mise en place des politiques de sensibilisation des femmes en général au recours précoce aux consultations. Ils interpellent en particulier à la sensibilisation des gestantes avec des antécédents de complications maternelles sur les grossesses antérieures

Prévalence des désordres tensionnels et facteurs associés chez les femmes enceintes au Bénin

PRIX DU MEILLEUR POSTERInternational audienc

Prévalence des désordres tensionnels et facteurs associés chez les femmes enceintes au Bénin

PRIX DU MEILLEUR POSTERInternational audienc

Systemic brain-derived neurotrophic factor and nerve growth factor balance in systemic sclerosis

International audienc

[Small fibre neuropathy in primary Sjögren syndrome].

International audiencePURPOSE: About forty percent of the patients with primary Sjögren's syndrome (pSS) experience chronic neuropathic pain with normal electrodiagnostic studies. Two previous studies suggest that chronic neuropathic pain in pSS is due to small fiber neuropathy (SFN). Quantification of epidermal nerve fiber density after skin biopsy has been validated to diagnose small fiber neuropathy. METHODS: Skin biopsy was performed in 14 consecutive pSS patients (satisfying the american-european classification criteria) with chronic neuropathic pain and normal electrodiagnostic studies suggesting SFN. RéSULTS: Fourteen female pSS patients exhibited chronic neuropathic pain [burning sensation (n=14), prickling (n=4), dysesthesia (n=8)] with paroxystic exacerbations (n=10) and allodynia (n=13), for a mean period of 18.4±12.4 months. Neuropathic pain involved mostly hands and feet (n=13), with a distal (n=9) and leg (n=4) predominant distribution. Neurological examination disclosed normal deep tendon responses and absence of motor weakness (n=14). Small fiber neuropathy was confirmed by skin biopsy in 13 cases. Epidermal nerve fiber density was decreased in distal [(n=12), mean 3.5±1.7 fibers/mm (N>6.9)] and proximal site of biopsy [(n=9), mean 7.04±2.63 fibers/mm (N>9.3)]. CONCLUSION: Small fiber neuropathy is commonly responsible of chronic neuropathic pain in pSS. Prevalence, physiopathology and neurological evolution of such neuropathies still remain unknown

Supplementary Material for: Use of complementary and alternative medicine by patients treated for systemic lupus erythematosus, primary Sjögren's syndrome or systemic sclerosis in a french rural region

Background: Complementary and alternative medicine (CAM) is composed of a wide range of interventions and frequently used in parallel with conventional medicine. The aim of this study was to assess the prevalence, modalities, and association factors of CAM utilization in patients treated for systemic lupus erythematosus, primary Sjögren's syndrome or systemic sclerosis. Patients and Methods: This was a prospective single-center observational study conducted in a french university hospital center. Inclusion criteria were patients followed for systemic lupus erythematosus, primary Sjögren's syndrome or systemic sclerosis. Data were collected with a survey which assessed socio-demographic, disease characteristics, CAM use details, life quality and anxiety score. Results: A total of 121 patients were included, mostly women (87%), with an average age of 56 years. Proportion of patients seeking CAM was 55%. A total of 186 CAM interventions were recorded: most common was osteopathy, homeopathy and acupuncture. Patients were looking for well-being (22%), reducing their fatigue (18%) and pain (33%). Concerning physical and mental feeling after CAM use, a subjective improvement was reported in 89% of cases. In multivariate analysis, CAM use by patient was associated with these 3 variables : coming from a Western culture, being professionally active, having a poor quality of life and anxiety scores. Conclusion and Outlook: This is the first study to focus on CAM use in patients followed for three AID in a french rural region. The current challenge is to enrich conventional medicine with CAM that are effective and safe through supervised programs to move towards an integrative medicine