Ion Channels as Promising Therapeutic Targets for Melanoma

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Diagnostic accuracy of blood B-cell subset profiling and autoimmunity markers in Sjögren's syndrome.

International audienceThe aims of this study were to evaluate the diagnostic accuracy of blood B-cell subset profiling and immune-system activation marker assays in primary Sjögren's syndrome (pSS) and to assess whether adding these tools to the current laboratory item would improve the American-European Consensus Group (AECG) criteria. METHODS: In a single-center cohort of patients with suspected pSS, we tested the diagnostic performance of anti-SSA, antinuclear antibody (ANA), rheumatoid factor (RF), gammaglobulins, IgG titers, and B-cell ratio defined as (Bm2 + Bm2')/(eBm5 + Bm5), determined using flow cytometry. The reference standard was a clinical diagnosis of pSS established by a panel of experts. RESULTS: Of 181 patients included in the study, 77 had pSS. By logistic regression analysis, only ANA ≥1:640 (sensitivity, 70.4%; specificity 83.2%) and B-cell ratio ≥5 (sensitivity, 52.1%; specificity, 83.2%) showed independent associations with pSS of similar strength. In anti-SSA-negative patients, presence of either of these two criteria had 71.0% sensitivity but only 67.3% specificity for pSS; whereas combining both criteria had 96.2% specificity but only 12.9% sensitivity. Adding either of these two criteria to the AECG criteria set increased sensitivity from 83.1% to 90.9% but decreased specificity from 97.1% to 85.6%, whereas adding both criteria in combination did not substantially modify the diagnostic performance of the criteria set. The adjunction of RF + ANA ≥1:320, as proposed in the new American College of Rheumatology (ACR) criteria, did not improve the diagnostic value of anti-SSA. CONCLUSIONS: Blood B-cell subset profiling is a simple test that has good diagnostic properties for pSS. However, adding this test, with or without ANA positivity, does not improve current classification criteria

A new molecular classification to drive precision treatment strategies in primary Sjögren’s syndrome

There is currently no approved treatment for primary Sjögren's syndrome, a disease that primarily affects adult women. The difficulty in developing effective therapies is -in part- because of the heterogeneity in the clinical manifestation and pathophysiology of the disease. Finding common molecular signatures among patient subgroups could improve our understanding of disease etiology, and facilitate the development of targeted therapeutics. Here, we report, in a cross-sectional cohort, a molecular classification scheme for Sjögren's syndrome patients based on the multi-omic profiling of whole blood samples from a European cohort of over 300 patients, and a similar number of age and gender-matched healthy volunteers. Using transcriptomic, genomic, epigenetic, cytokine expression and flow cytometry data, combined with clinical parameters, we identify four groups of patients with distinct patterns of immune dysregulation. The biomarkers we identify can be used by machine learning classifiers to sort future patients into subgroups, allowing the re-evaluation of response to treatments in clinical trials

Integrative epigenomics in Sjögren´s syndrome reveals novel pathways and a strong interaction between the HLA, autoantibodies and the interferon signature

Primary Sjögren's syndrome (SS) is a systemic autoimmune disease characterized by lymphocytic infiltration and damage of exocrine salivary and lacrimal glands. The etiology of SS is complex with environmental triggers and genetic factors involved. By conducting an integrated multi-omics study, we confirmed a vast coordinated hypomethylation and overexpression effects in IFN-related genes, what is known as the IFN signature. Stratified and conditional analyses suggest a strong interaction between SS-associated HLA genetic variation and the presence of Anti-Ro/SSA autoantibodies in driving the IFN epigenetic signature and determining SS. We report a novel epigenetic signature characterized by increased DNA methylation levels in a large number of genes enriched in pathways such as collagen metabolism and extracellular matrix organization. We identified potential new genetic variants associated with SS that might mediate their risk by altering DNA methylation or gene expression patterns, as well as disease-interacting genetic variants that exhibit regulatory function only in the SS population. Our study sheds new light on the interaction between genetics, autoantibody profiles, DNA methylation and gene expression in SS, and contributes to elucidate the genetic architecture of gene regulation in an autoimmune population

Complement component C4 structural variation and quantitative traits contribute to sex-biased vulnerability in systemic sclerosis

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER), "A way of making Europe".Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher C4 CN confers protection to SSc, and deviations from CN parity of C4A and C4B augmented risk. The protection contributed per copy of C4A and C4B differed by sex. Stronger protection was afforded by C4A in men and by C4B in women. C4 CN correlated well with its gene expression and serum protein levels, and less C4 was detected for both in SSc patients. Conditioned analysis suggests that C4 genetics strongly contributes to the SSc association within the major histocompatibility complex locus and highlights classical alleles and amino acid variants of HLA-DRB1 and HLA-DPB1 as C4-independent signals

Serum profiling identifies CCL8, CXCL13, and IL-1RA as markers of active disease in patients with systemic lupus erythematosus

IntroductionSystemic lupus erythematosus (SLE) is a clinically heterogeneous disease that presents a challenge for clinicians. To identify potential biomarkers for diagnosis and disease activity in SLE, we investigated a selected yet broad panel of cytokines and autoantibodies in patients with SLE, healthy controls (HC), and patients with other autoimmune diseases (AIDs).MethodsSerum samples from 422 SLE patients, 546 HC, and 1223 other AIDs were analysed within the frame of the European PRECISESADS project (NTC02890121). Cytokine levels were determined using Luminex panels, and autoantibodies using different immunoassays.ResultsOf the 83 cytokines analysed, 29 differed significantly between patients with SLE and HC. Specifically, CCL8, CXCL13, and IL-1RA levels were elevated in patients with active, but not inactive, SLE versus HC, as well as in patients with SLE versus other AIDs. The levels of these cytokines also correlated with SLE Disease Activity Index 2000 (SLEDAI-2K) scores, among five other cytokines. Overall, the occurrence of autoantibodies was similar across SLEDAI-2K organ domains, and the correlations between autoantibodies and activity in different organ domains were weak.DiscussionOur findings suggest that, upon validation, CCL8, CXCL13, and IL-1RA could serve as promising serum biomarkers of activity in SLE

O31 Integrative analysis reveals a molecular stratification of systemic autoimmune diseases

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Choc Septique : Défaillance Myocardique et Altérations des Relations Force-Fréquence et Relaxation-Fréquence

Septic shock is a major cause of mortality in hospital. It is characterized by vasoplegia, tachycardia and by myocardial dysfunction for many patients. Physiologically, tachycardia raises cardiac output by multiplying cardiac cycles but it also has its own effects that raise ventricle contractility and relaxation. These phenomenons are named force-frequency relationship (FFR) and frequency dependant acceleration of relaxation (FDAR). Septic myocardial dysfunction is characterized by alterations of myocardial contractility and also by modifications of ventricular relaxation. In the first part of this study, we showed that cardiac dysfunction is present in our septic shock model induced by injected endotoxin. It also reveals that caspase (proteases involved in the apoptosis pathway) activation takes part in the development of this dysfunction. Next, we investigated the role of circulating mediators in the onset of this dysfunction. Identity of these mediators is probably cytokinic. TNF-α and IL-1β have already shown their ability to induce such a dysfunction but in our model they were not necessary to induce it, and other cytokines might be involved. At last we showed that septic myocardial dysfunction present alteration of FFR and FDAR and that this phenomenon may be linked to the increase of myocardial phosphatases. Thus, these new knowledge of septic shock mechanisms doesn't allow direct modification of treatment for septic patients, but they point new investigation fields that could tend to improve therapeutic strategies of septic shock.L'état de choc septique est une des principales causes de mortalité hospitalière. Il est caractérisé par une vasoplègie, une tachycardie et s'y associe une défaillance myocardique chez de nombreux patients. Physiologiquement, la tachycardie est non seulement à l'origine d'une augmentation du débit par la multiplication des cycles cardiaques mais elle a de plus des effets propres qui augmentent la contractilité et la relaxation ventriculaire. Ces phénomènes sont appelés relation force-fréquence (FFR) et accélération de la relaxation par la fréquence (FDAR). La défaillance myocardique septique est caractérisée par une altération de la contractilité myocardique mais également par des modifications de la relaxation ventriculaire. Dans un premier temps notre travail a consisté à mettre en évidence la défaillance contractile cardiaque dans un modèle de choc septique par injection d'endotoxine. Il met également en avant l'implication de l'activation des caspases (protéases participant à la voie de l'apoptose) comme étant un des mécanismes de cette défaillance. Ensuite nous avons mis en avant le rôle de médiateurs circulants dans l'apparition de cette dysfonction. L'identité de ces médiateurs est probablement cytokinique. TNF-α et IL-1β ont déjà montré leur capacité à induire cette dysfonction mais dans notre modèle ils n'ont pas été nécessaires à son apparition, d'autres cytokines pourraient être impliquées. Enfin nous avons mis en évidence que cette dysfonction myocardique septique était associée à une altération de FFR et de FDAR et que cette particularité pourrait être liée à une augmentation de l'activité de phosphatases cardiomyocytaires. L'apport de ces connaissances supplémentaires sur les mécanismes impliqués dans le choc septique ne permet pas de modification directe du traitement à proposer aux patients septiques, mais il ouvre de nouvelles voies d'investigation qui pourraient permettre une amélioration des stratégies thérapeutiques du choc septique