13 research outputs found
Management of adult patients with Langerhans cell histiocytosis: recommendations from an expert panel on behalf of Euro-Histio-Net
La présence de molécules MIC solubles sériques au cours de la maladie de Behçet a-t-elle un rÎle physiopathologique?
La maladie de Behçet est une maladie chronique, ayant principalement un tropisme cutanĂ©, oculaire et neurologique. Son Ă©volution se fait par rĂ©pĂ©tition d Ă©pisodes inflammatoires. Sa physiopathologie, encore obscure, associe diffĂ©rents facteurs gĂ©nĂ©tiques (rĂŽle connu de l allĂšle de prĂ©disposition HLA-B51), environnementaux et des dĂ©sordres immunologiques de l immunitĂ© innĂ©e et adaptative.Les molĂ©cules MIC sont des molĂ©cules de classe I non classiques codĂ©es sur le chromosome 6. Elles pourraient intervenir dans la physiopathologie de la maladie Ă plusieurs niveaux : d une part, sur le plan gĂ©nĂ©tique, et d autre part sur le plan fonctionnel, car elles participent Ă l activation des cellules NK et des lymphocytes par le biais du rĂ©cepteur activateur NKG2D, avec lequel elles interagissent. Ces molĂ©cules, lorsqu elles sont exprimĂ©es Ă la surface cellulaire, peuvent ĂȘtre clivĂ©es et relarguĂ©es dans le sĂ©rum sous forme soluble (MICs). Lors de la maladie de Behçet, les molĂ©cules MIC sont surexprimĂ©es. Dans une sĂ©rie de 88 patients, nous avons mesurĂ© le taux de MICs dans le sĂ©rum par test ELISA. MICs est dĂ©tectĂ© chez 31% des patients et aucun tĂ©moin (p= 0,0009). La prĂ©sence de MICs semble ĂȘtre corrĂ©lĂ©e au gĂ©notype MICA 5.1. Aucun lien entre la dĂ©tection de MICs et l existence d une forme clinique particuliĂšre de maladie n a pu ĂȘtre Ă©tablie. La prĂ©sence de MICs ne semble pas non plus moduler le niveau d expression du rĂ©cepteur NKG2D Ă la surface des cellules NK et de lymphocytes T CD8 . Le dosage de MICs n est d aucune utilitĂ© dans le suivi de la maladie de Behçet. Ceci n exclut pas un rĂŽle Ă©ventuel des molĂ©cules MIC dans la physiopathologie de la maladie.PARIS6-Bibl.PitiĂ©-SalpĂȘtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Expansion aberrante de la lymphocytes T CD4+ "NK-LIKE" au cours de la granulomatose de Wegener (rĂŽle de l'IL-15)
Les lymphocytes NK participent Ă la rĂ©ponse immunitaire innĂ©e. Leur activation rĂ©sulte de l'action coordonnĂ©e de rĂ©cepteurs activateurs et inhibiteurs. Quelques rĂ©cepteurs NK (NKR) activateurs sont prĂ©sents Ă la surface des cellules T CD8+, oĂč ils peuvent fournir un signal de costimulation. L'expansion anormale de lymphocytes T CD4+CD28-NKR+ a Ă©tĂ© notĂ©e en pathologie, notamment au cours de la maladie de Wegener (MW). Le but de notre travail a Ă©tĂ© de mieux caractĂ©riser ces cellules au cours de la MW. Nos rĂ©sultats mettent en Ă©vidence une population de lymphocytes T CD4+CD28-NKR+ au cours de la MW, ayant un phĂ©notype et des capacitĂ©s NK-like . Cette population pourrait jouer une rĂŽle dĂ©lĂ©tĂšre, en exerçant sa cytotoxicitĂ© contre les cellules endothĂ©liales et en participant Ă la vascularite. L'activitĂ© cytotoxique de ces cellules pourrait ĂȘtre liĂ©e Ă l'expression anormale de la molĂ©cule adaptatrice DAP12, normalement absente chez les CD4 et semble s'expandre sous le contrĂŽle de l'IL-15.NK cells participate in innate immune response. Their activation depends on coordonate stimulation of activating and inhibitory receptors. Some activating NK receptors (NKR) are also present on CD8+T cells, where they play the role of co stimulatory molecules. Abnormal expression of activating NKR have been described on CD4+CD28- T cells in pathologies such as Wegener's granulomatosis (WG). Our goal in this work was to further characterize those cells. Our results show the aberrant expansion of CD4+CD28-NKR+ T cells in WG patients, with NK-like phenotype and properties. This population could be delerious to vascular endothelial cells and participate to vasculitis. Cytotoxicity could be consecutive to abnormal expression of DAP12, an adaptator molecule that is usually not expressed on CD4+T cells. Those unusual cells develop under abnormal IL-15 signaling.PARIS5-BU MĂ©d.Cochin (751142101) / SudocSudocFranceF
Clinical Spectrum, Quality of Life, BRAF Mutation Status and Treatment of Skin Involvement in Adult Langerhans Cell Histiocytosis
Langerhans cell histiocytosis is a rare histiocytic disorder for which skin involvement and management are poorly described in adults. The aim of this retrospective monocentric study in a national reference centre is to describe the clinical characteristics, quality of life, BRAF mutation status and outcomes of skin involvement in adult patients with Langerhans cell histiocytosis. Twenty-five patients (14 females, mean age 47 years) were included, with a median follow-up of 33 months (range 4â420 months). Patients experienced poor dermatological quality of life despite low body surface involvement. BRAFV600 mutations were detected in 8 of the 18 patients analysed (45%). Eight patients had an associated malignancy. Several treatment options were used and consisted of surgery, topical steroids and carmustine, thalidomide, methotrexate, vinblastine and steroids and cladribine. This study highlights the need to evaluate quality of life and to screen for associated malignancy in adult patients with Langerhans cell histiocytosis
Tissue-Specific Microvascular Endothelial Cells Show Distinct Capacity To Activate NK Cells: Implications for the Pathophysiology of Granulomatosis with Polyangiitis
Psychiatric Symptoms and Cognitive Disorders in Behçetâs Disease: A Single-Center, Cross-Sectional Study
International audienceBackground: Behçetâs disease (BD) is a rare form of vasculitis involving both veins and arteries of all calibers. Psychological symptoms and cognitive impairment appear to be frequent, but few data are available. Methods: All consecutive patients in our center fulfilling the 2013 BD criteria underwent a psychometric evaluation with auto- (SCL-90-R and Modified Fatigue Index) and hetero-questionnaires (MINI). A standardized test battery assessed cognitive dysfunction. Data were correlated with BD activity as well as quality of life (SF-36). Results: We included 20 consecutive patients (16 men, four women) with a median [IQR] age of 38 (30.0â45.5) and a median disease duration of 7 years (1.8â11.0). Five patients had an abnormal brain MRI. The SCL-90-R questionnaire highlighted eight psychopathological profiles (42.1%) that correlated with altered quality of life and more severe fatigue. The most frequent symptoms were anxiety (9/19, 47.4%), somatization (8/19, 42.1%) and phobia (5/19, 26.3%). Psychopathological symptoms appeared to be more severe, but not more frequent, in neuro-Behçetâs patients. Based on standardized cognitive evaluation, nine patients had cognitive impairment defined by three or more altered tests. Notably, 6/9 patients did not have any complaint of memory loss and were thus considered ansognostic. Conclusion: Cognitive involvement was significantly associated with BD activity score (BSAS) but not with brain MRI abnormalities
Interstitial Lung Disease during ANCA-Associated Vasculitis: A Poor-Prognosis Factor
IF 7.873International audienc
Usual interstitial pneumonia in ANCA-associated vasculitis: A poor prognostic factor.
BACKGROUND: Progressive fibrosing interstitial lung disease (ILD) is rarely associated with antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV). This study focused on the outcomes of ILD patients with associated AAV (AAV-ILD). METHODS: AAV-ILD (cases: microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA) with ILD) were compared to AAV patients without ILD (controls). ILD was defined as a usual interstitial pneumonia (UIP) or non-specific interstitial pneumonia (NSIP) pattern. Two controls were matched to each case for age (>or â€65 years), ANCA status (PR3-or MPO-positive) and creatininemia (â„or 65 years (hazard ratio (HR) 4.54; pâŻ<âŻ0.001), alveolar haemorrhage (HR 2.25; pâŻ=âŻ0.019) and UIP (HR 2.73; pâŻ=âŻ0.002), but not immunosuppressant use, as factors independently associated with shorter survival. CONCLUSION: For AAV-ILD patients, only UIP was associated with poorer prognosis. Immunosuppressants did not improve the AAV-ILD prognosis. But in analogy to idiopathic pulmonary fibrosis, anti-fibrosing agents might be useful and should be assessed in AAV-ILD patients with a UIP pattern.status: publishe
Rationale and efficacy of interleukin-1 targeting in Erdheim-Chester disease
International audienc