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Introduction La rachialgie commune (RC) est un probleme de sante publique qui cause un handicap chronique avec un impact social important et un cout de soins eleve. Sa physiopathologie et sa prise en charge restent insuffisamment maitrises. Les cytokines, notamment l’interleukine 8 (IL-8), semblent intervenir dans cette pathologie [1] . Le but de notre travail etait d’identifier la capacite de l’IL-8 a distinguer les patients ayant une rachialgie commune des temoins sains. Patients et methodes Nous avons mene une etude transversale type cas-temoin incluant 30 patients suivis pour rachialgie commune confirmee par une imagerie par resonance magnetique (IRM) et 42 temoins sains de toute symptomatologie articulaire. Pour chaque patient nous avons recueillie les parametres suivants : l’âge, type de rachialgie, presence de radiculalgie, l’Echelle Visuelle Analogique (EVA) de la douleur rachidienne et radiculaire et l’etiologie de la rachialgie a l’IRM. La concentration serique de l’IL-8 a ete dosee par methode de Chimiluminescence. Nous avons realise une courbe ROC et calculer l’aire sous la courbe afin d’evaluer la capacite de l’IL-8 a distinguer les patients ayant une RC des temoins sains. Resultats L’âge moyen etait de 41,33 ± 10,19 ans (43 ± 9,23 vs 40,11 ± 10,76 ans, p = 0,22). Dans le groupe RC, la duree d’evolution de la symptomatologie etait de 4,72 ± 3,03 ans. L’EVA-rachis moyenne et l’EVA-radiculalgie moyennes etaient de 2,48 ± 2,03 et 3,3 ± 2,54, respectivement. Quatre-vingts pour cent des patients avaient une radiculalgie (n = 24). La rachialgie etait d’origine discale dans 22 % des cas (n = 16) et arthrosique dans 20 % des cas (n = 14) a l’IRM. La concentration de l’IL-8 etait significativement plus elevee chez les patients ayant une RC par rapport a celle des temoins sains (24,06 ± 54,53 vs 4,5 ± 1,47 pg/mL, p = 0,05). De plus, une correlation entre la concentration de l’IL-8 et l’EVA-radiculalgie a ete retrouvee (r = 0,377, p = 0,044). L’IL-8 etait capable de distinguer les patients ayant une rachialgie commune du groupe temoin sain avec seuil 5,69 pg/mL. L’aire sous la courbe etait bonne (0,850). La sensibilite et la specificite etaient de 70 % et 100 %, respectivement. Conclusion Notre etude concorde avec celle de Wang et al., la concentration de l’IL-8 etait plus elevee chez les patients ayant une rachialgie commune par rapport aux temoins sains [2] . Nous avons trouve un resultat interessant, l’IL-8 etait capable de distinguer les patients ayant une RC des temoins avec un seuil de 5,69 pg/mL avec une sensibilite de 70 % et une specificite de 100 %. Ce resultat peut ouvrir les perspectives pour des nouvelles therapeutiques dans la prise en charge la rachialgie commune.

BackgroundPhysipathological mechanisms of spondyloarthritis (SA) are very complex. The role of the interleukin (IL)- 8, which is an angiogenic chemokine, has been suggested [1].ObjectivesWe aimed to evaluate the discriminative value of interleukin 8 in SA.MethodsWe conducted a cross-sectional study during two years (2019-2020) including 144 subjects divided into two groups: a group G1 that included 72 patients followed for spondyloarthritis meeting the Assessement of SpondyloArthritis international Society (ASAS) criteria and a group (G2) including 72 healthy controls. The two groups were matched by age and sex.IL-8 was measured for each participant using chemiluminescence.We performed a ROC analysis and computed the air under the curve (AUC) at IL-8 to assess the ability of this chemokine to diagnose SA and to distinguish between SA patients from healthy controls. Statistical analysis was performed using SPSS.ResultsWe included 57 men and 15 females in each group. The mean age was 44.84 ± 13.42 years. In G1, the mean disease duration was 10.25 ±7.7 years. Axial and peripheral involvements were found in 85% of cases (n=65) and 50% of cases, respectively.The mean BASDAI and ASDAS-CRP were 3.21 ± 1.87 and 2.92 ±1.55, respectively.IL-8 was able to distinguish SA patients from healthy controls with a cutoff of 4.5 pg/mL. The AUC was good at 0.855 (pFigure 1.AUC at IL-8 between SA patients and healthy controls 0.855 (pConclusionSeveral studies have found that IL-8 was significantly higher in SA patients comparing to controls [2,3]. Our study showed that IL-8 could distinguish SA patients from controls with a cutoff of 4.5 pg/mL. This suggests that IL-8 could play a role in the pathophysiology of SA.References[1]König A, Krenn V, Gillitzer R, Glöckner J, Janssen E, Gohlke F, et al. Inflammatory infiltrate and interleukin-8 expression in the synovium of psoriatic arthritis--an immunohistochemical and mRNA analysis. Rheumatol Int. 1997;17(4):159‑68.[2]Limón-Camacho L, Vargas-Rojas MI, Vázquez-Mellado J, Casasola-Vargas J, Moctezuma JF, Burgos-Vargas R, et al. In vivo peripheral blood proinflammatory T cells in patients with ankylosing spondylitis. J Rheumatol. avr 2012;39(4):830‑5.[3]Sonel B, Tutkak H, Düzgün N. Serum levels of IL-1beta, TNF-alpha, IL-8, and acute phase proteins in seronegative spondyloarthropathies. Joint Bone Spine. 1 oct 2002;69(5):463‑7.Disclosure of InterestsNone declared

Introduction Les adipocytes interviennent dans la production des cytokines pro-inflammatoires. L’effet de l’obesite sur les cytokines de l’inflammation au cours de la spondyloarthrite (SPA) est peu etudie. L’objectif de notre travail etait d’etudier l’effet de l’obesite sur les interleukines pro-inflammatoires SPA. Patients et methodes Nous avons mene une etude transversale incluant les patients ayant une spondyloarthrite repondant aux criteres ASAS 2009 (Assessement SpondyloArthritis International Society 2009). Pour chaque patient nous avons recueilli les parametres suivants : âge, phenotype de la SPA, tour de taille (TT), indice de masse corporelle (IMC) et l’activite de la maladie en utilisant les scores Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) et l’Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP). Nous avons aussi dose les taux des parametres inflammatoires : la vitesse de sedimentation (VS) et la proteine C-reactive (CRP) ainsi que les interleukines de l’inflammation : interleukine 1 (IL-1), IL-6, IL-8, IL-17, IL-22 et IL-23. L’obesite est definie par un IMC superieur ou egale a 30 kg/m2. L’obesite androide est definie par un tour de taille >94 cm pour les hommes et > 80 cm pour les femmes. Resultats Il s’agissait de 33 hommes 5 cinq femmes. L’âge moyen etait de 45,43 ± 12,47 ans. L’âge moyen au debut de la maladie etait de 35,57 ± 11,64 ans. La duree d’evolution moyenne de la SPA etait de 9,54 ± 8,7 ans. Une spondyloarthrite axiale radiographique a ete note dans 80,6 % des cas (n = 58), une atteinte peripherique a ete associee dans 26,4 % des cas (n = 19) et isolee dans 19,4 % des cas (n = 14). Un psoriasis a ete note dans 36,1 % des cas (n = 26). Le BASDAI et l’ASDAS-CRP moyens etait a 3,76 ± 2,12 et 2,89 ± 1,24, respectivement. L’IMC moyen etait de 25,09 ± 4,9 kg/m2 le TT moyen etait de 87,5 ± 11,51 cm. Une obesite a ete objectivee dans 7 cas et une obesite androide dans 13 cas. La VS et la CRP moyennes etaient 41,03 ± 33,93 mm/h et 29,61 ± 40,34 mg/L, respectivement. Les concentrations seriques moyennes des interleukines 1 et 6 etaient a 11,64 ± 25,08 pg/dL et 25,27 ± 47,98 pg/dL. Le taux moyen de l’IL-8 etait a 15,2 ± 22,2 pg/dL. Les concentrations moyennes des interleukines 17 et 22 etaient a 11,36 ± 85,33 pg/dL et 39,56 ± 29,31 pg/dL, respectivement. Le taux moyen de l’IL-23 etait a 20,36 ± 16,7 pg/dl. Le taux serique de l’IL-8 etait significativement plus eleve chez les patients obeses (18,48 ± 11,6 vs 14,46 ± 24,04 pg/dL, p = 0,019). De meme, les patient ayant une obesite androide avaient un taux d’IL-22 significativement plus eleve (55,65 ± 38,2 vs 31,2 ± 19,54 pg/dL, p = 0,011). Neanmoins, aucune correlation n’a ete retrouvee entre le taux des interleukines et ces parametres suivants : le poids, la taille, l’IMC, le tour de taille et l’activite de la maladie. Conclusion Notre etude concordait avec celle de Kanimaru et al. Qui avaient montre que les taux d’IL-22 etaient associe a l’obesite au cours des spondyloarthrite [1] . Nous avons aussi mis en evidence l’association de l’obesite au taux serique d’IL-8. Nos resultats suggerent que l’obesite contribue dans l’inflammation via les adipocytes au cours de la SPA [2] .

Introduction Les plaquettes contribuent a la regulation de l’inflammation dans certaines maladies inflammatoires. Leur role au cours de la spondyloarthrite (SA) est peu etudie. Le but de notre travail etait de determiner le lien entre les plaquettes et des cytokines pro-inflammatoires au cours de la SA. Patients et methodes Nous avons mene une etude transversale incluant des patients suivis pour spondyloarthrite repondant aux criteres Assessment of SpondyloArthritis international Society (ASAS) 2009. Pour chaque patient nous avons collecte les donnees suivantes : âge, duree d’evolution, l’activite de la maladie en utilisant les scores ASDAS-CRP pour l’atteinte axiale et le DAS44-CRP pour l’atteinte peripherique. Nous avons realise une numeration de la formule sanguine (NFS) et nous avons mesure les concentrations de l’interleukine (IL)-6 et du TNFα par Chimiluminescence et celle de l’IL-17 par la methode enzyme-linked immunosorbent assay (ELISA). Resultats Soixante-douze patients ont ete inclus (57 hommes et 15 femmes). L’âge moyen etait de 44,84 ± 13,42 ans. L’âge moyen de debut de la maladie etait de 35,97 ± 12,88 ans. La duree moyenne d’evolution de la maladie etait de 102,56 ± 92,45 mois. Une atteinte axiale a ete notee dans 85 % des cas (n = 61). Une atteinte peripherique etait associee dans 50 % des cas (n = 36) : articulaire dans 42 % des cas (n = 30) et enthesitique dans 15 % des cas (n = 11). L’ASDAS et le DAS44-CRP moyens etaient de 2,92 ± 1,55 et de 3,51 ± 1,34, respectivement. Le taux moyen des plaquettes etait de 235 000 ± 809 000/mm3. Les concentrations moyennes de l’IL-6 et du TNFα etaient de 15,13 ± 47,14 et de 20,48 ± 38,25 pg/mL, respectivement. La concentration moyenne de l’IL-17 etait de 102,23 ± 103,14 pg/mL. Le taux des plaquettes etait correle aux concentrations des cytokines suivantes : IL-6 (r = 0,398 ; p = 0,001) et TNFα (r = 0,274 ; p = 0,03). De plus, nous avons trouve une correlation du taux des plaquettes avec l’ASDAS-CRP (r = 0,326 ; p = 0,014) et le DAS44-CRP (r = 0,403 ; p = 0,037). Conclusion Nos resultats sont en accord avec ceux de la litterature qui avaient montre une correlation entre l’IL6 et le taux des plaquettes [1] . Ce dernier correlait aussi le TNFα (r = 0,274 ; p = 0,03). Nous avons aussi trouve une correlation entre le taux des plaquettes et l’activite de la maladie. Ces resultats suggerent que les plaquettes interviennent dans la liberation des cytokines pro-inflammatoires et dans la regulation de l’activite des cellules immunitaires [2] .

Introduction Le tabagisme contribue dans la physiopathologie des spondyloarthrites (SPA) et dans le maintien d’une forte activite de la maladie en aggravant l’inflammation. L’effet du tabagisme sur les cytokines pro-inflammatoires et anti-inflammatoires n’est pas bien etudiee. Patients et methodes Il s’agit d’une etude transversale sur une periode de deux ans [2019-2020] incluant 72 patients suivis pour SPA. Pour chaque patient nous avons evaluer l’activite de la maladie en utilisant le BASDAI et l’ASDAS-CRP et le retentissement structural par le BASRI. Nous avons aussi dose la VS, CRP et le taux serique des cytokines pro-inflammatoire : interleukine (IL)-1, IL-6, IL-17, IL-22 et IL23 et une cytokine anti-inflammatoire : IL-10. Resultats Le sex-ratio homme sur femme etait de 57/15. Le tabagisme a ete note dans 47 % des cas (n = 34) avec une moyenne de 19,83 paquets/annee. La CRP etait plus elevee chez les tabagiques (p = 0,046). De meme, le tabagisme etait associe a un BASRI significativement plus eleve (p = 0,001). Les concentrations des interleukines suivantes etaient significativement plus eleves chez les patients tabagiques : IL-1 (p = 0,006) et l’IL-10 (p = 0,015). Conclusion Notre etude suggere que le tabagisme contribue dans l’inflammation au cours de la SPA. De surcroit, les concentrations de l’IL-10 etaient plus elevees chez les tabagiques. En effet, la liberation des cytokines proinflammatoires au cours de la SPA est responsable d’une elevation des concentration de l’IL-10 en reponse a cette inflammation. Notre etude souligne egalement l’effet du tabagisme sur l’atteinte structurale au cours de la SPA.

Introduction Les rhumatismes inflammatoires chroniques augmentent le risque cardiovasculaire d’une facon significative par le biais de l’inflammation, surtout si associes a un autre facteur de risque cardiovasculaire comme la dyslipidemie. Notre etude avait comme objectif de chercher le lien entre la dyslipidemie et le cytokines pro-inflammatoires chez des patients atteints spondyloarthrite dans sa forme axiale et radiographique. Patients et methodes Nous avons realise une etude transversale regroupant 38 patients suivis pour spondyloarthrite axiale et radiographique repondant aux criteres de l’ASAS 2009. Chaque patient a beneficie d’un dosage des parametres de l’inflammation : proteine C reactive (CRP) et vitesse de sedimentation (VS), des interleukines(IL) suivantes : IL1, IL6, IL17, IL23 et Tumor Necrosis factor(TNF) alpha et d’un bilan lipidique complet : Cholesterol total(CT), Triglycerides(TG), Low density lipoprotein cholesterol (LDLc) et le high density lipoprotein cholesterol (HDLc). Nous avons utilise l’ASDAS-CRP et le BASDAI comme scores d’activite de la maladie. L’etude statique a ete realisee par le logitiel IBM SPSS statistics version 25. Resultats L’âge moyen etait de 45,5 ± 12,5 ans. Le sex ratio etait de 6,6 (33 hommes). La moyenne de CRP etait de 29,6 ± 40,34 mg/L, la moyenne de VS etait de 41 + 33,9 mm. Les moyennes de l’ASDAS-CRP et de BASDAI etaient de 2,8 ± 1,24 et 3,7 ± 2,12 respectivement. En utilisant le score ASDAS-CRP, 68 % des patients avaient une maladie active. Les moyennes de l’ IL1, IL6, IL17, IL23 et TNF alpha etaient de 11,6 ±25 pg/ml, 15,4 ± 45,9 pg/ml, 84,6 ± 77,9 pg/ml, 15,3 ± 15,26 pg/ml et 25,3± 47,9 pg/ml respectivement. Les moyennes de CT, HDLc, LDLc et TG etaient de 4,47 ± 0,93 mmol/l, 1,09 ± 0,3 mmol/L, 2,77 ± 0,78 mmol/L et 1,29 ± 0,54 mmol/L respectivement. Nous n’avons pas objective une association entre la dyslipidemie et les parametres de l’inflammation(CRP et VS). Les patients qui avaient une hypoHDLemie, avaient des valeurs de IL6(p = 0,009), IL17(p = 0,0027) et TNF alpha(p = 0,002) significativement plus elevees. Les patients qui avaient une hypercholesterolemie, avaient une valeur d’IL6 significativement plus elevee(p = 0,031). Nous avons constate des valeurs de IL1(p Conclusion Nos resultats suggerent que l’apparition de dyslipidemie au cours des spondyloarthrite est favorisee par la liberation accrue des cytokines pro-inflammatoires. On propose un dosage des cytokines pro-inflammatoires et une realisation d’un bilan lipidique de facon periodique pour ameliorer la prise en charge des patients atteints de spondyloarthrite qui sont a haut risque cardio-vasculaire.

Background:Interleukin 23 (IL-23) is a pivotal pro-inflammatory cytokine in the Th17/IL-23 axis which became the center of attention in researches during these last decades, especially during spondyloarthritis (1).Objectives:We aimed to study the diagnosis value of IL-23 serum in spondyloarthritis.Methods:We conducted a case-control study, including 144 subjects divided into 2 groups:-G1: 72 patients meeting the Assessment of SpondyloArthritis International Society (ASAS) criteria for spondyloarthritis (SA)-G2: 72 healthy controls matched for age and sex.For each SA patient we collected the following parameters: BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), ASDAS (Ankylosing Spondylitis Disease Activity Score), BASFI (Bath Ankylosing Spondylitis Functional Index), and BASRI (Bath Ankylosing Spondylitis Radiology Index).The IL-23 level was measured using Enzyme-linked immunosorbent assay (ELISA).Erythrocyte Sedimentation rate (ESR) and C-reactive protein (CRP) were also measured.We performed a ROC analysis and computed the air under the curve (AUC) at IL-23 to diagnose SA patients.Statistical analysis was performed using “IBM SPSS Statistics” software version 25.Results:The study included 57 men and 15 women. The mean age was 44.84 ± 13.42 years. The mean age at the onset of the disease was 35.97 ± 12.88 years. The disease duration was 8.54 ± 7.7 years.Seventy-nine per cent of our patients had axial radiographic spondyloarthritis (n=57). Peripheral involvement was found in 45.8% (n=33). Eighteen patients had both axial and peripheral involvement concomitantly. Psoriasis was found in 36.1% of the cases (n=26).The mean BASDAI and ASDAS-CRP were 3.21 ± 1.64 and 3.05 ± 1.51, respectively.The mean was BASFI 3.88 ± 2.69. The mean was BASRI 5.26 ± 4.14.The mean ESR and CRP were 36.74 ± 29.38 mm/hr and 20.45 ± 25.19 mg/dL, respectively.IL-23 level was significantly higher in patients compared to healthy controls (23.1 ± 2.72 pg/mL and 5.02 ± 0.59 pg/mL, respectively, pAs shown in Figure 1, the AUC value to distinguish between spondyloarthritis and healthy control was 0.705 (pFigure 1.AUC at IL-23 between SA patients 0.705 (pConclusion:As reported to previous studies, our study showed that IL-23 is significantly higher in SA patients (2).Interestingly, IL-23 was able to distinguish between SA patients and healthy controls with a cut-off of 7.96 pg/mL. This finding suggests that IL-23 may be practical for the diagnosis of SA.References:[1]K V, D E. IL-23 Responsive Innate-Like T Cells in Spondyloarthritis: The Less Frequent They Are, the More Vital They Appear [Internet]. Vol. 17, Current rheumatology reports. Curr Rheumatol Rep; 2015 [cité 13 avr 2020]. Disponible sur: https://pubmed.ncbi.nlm.nih.gov/25874346/[2]Wang X, Lin Z, Wei Q, Jiang Y, Gu J. Expression of IL-23 and IL-17 and effect of IL-23 on IL-17 production in ankylosing spondylitis. Rheumatol Int. sept 2009;29(11):1343-7.Disclosure of Interests:None declared

Background:The cardiovascular burden in inflammatory rheumatic diseases is well recognized. This burden has been reported in spondyloarthritis. Atherogenic indexes are known with their role of predicting cardiovascular risk.Objectives:The aim of our study was to determine the relation between pro-inflammatory cytokines and atherogenic indexes in spondyloarthritis.Methods:We performed a cross sectional study including 38 patients with spondyloarthritis according to ASAS criteria. For each patient we measured interleukin (IL)1, IL6, IL17, IL23 and tumor necrosis factor (TNF) alpha, total Cholesterol (CT), Triglycerides (TG), High density lipoprotein Cholesterol (HDLc) and Low density lipoprotein cholesterol (LDLc). We also calculated the following ratios: CT/HDLc, TG/HDLc, LDLc/HDLc, and LogTG/HDLc.Disease activity was measured using ASDAS (Ankylosing Spondylitis Disease Activity Score) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index).Statistical analysis was performed using IBM SPSS Statistics 25.Results:The mean age were 45.4±12.5 years. There were 33 Male (sex ratio were 6.6).The mean C-reactive protein(CRP) were 29.6 ±40.34mg/L, mean erythrocyte sedimentation rate(ESR) were 41±33.9mm.The mean ASDASCRP, BASDAI were 2.8±1.24, 3.7±2.12, respectively.Active disease were noted in 68 % of patients using ASDASCRP score.The mean IL1, IL6, IL17, IL23, TNF alpha were 11.6 ±25pg/ml, 15.4±45.9pg/ml, 84.6±77.9pg/ml, 15.3±15.26pg/ml, 25.3± 47.9pg/ml respectively.The mean CT,HDLc,LDLc, TG were 4.47±0.93mmol/l, 1.09±0.3mmol/L, 2.77±0.78mmol/L, 1.29±0.54mmol/L respectively.The mean CT/HDLc, TG/HDLc, LDL/HDLc, LogTG/HDLc were 4.28±1.26, 1.22±0.6, 2.7±1.06, 0.03±0.23, respectively.Correlations were found between TG/HDLC ratio and IL1 (pHowever, no correlations were noted between atherogenic indexes and IL7, IL17, IL23, TNFalpha.Conclusion:Our study showed a correlations between atherogenic indexes and both IL1 and IL6.These findings suggests that serum IL-6 and IL1 levels in spondyloarthritis contribute to the development of cardiovascular disease atherosclerosis.References:[1]Lau et al. Role of Adipokines in Cardiovascular Disease. Circ J. 2017; 81(7): 920-8.Disclosure of Interests:None declared

Background:Common low back pain (LBP) is a common health problem affecting 50 to 80% of working age adults. It is one of the common and costly health problems in Tunisia. Actually, the role of the immune response and inflammatory cytokines in the pathogenesis of chronic pain has been of growing interest.Objectives:The aim of this study was to assess whether pro and anti-inflammatory cytokines could be detected in serum in patients with LBP compared with healthy subjects and whether they could be related to pain severity and to clinical findings.Methods:It was a an analytical cross-sectional study including 50 patients with at least three months of LBP, in the department of rheumatology, orthopedics and immunology at the Military Hospital of Tunis between January 1st and March 31, 2020. All patients had a standardized clinical assessment.Levels of serum cytokines IL-6, IL-8, IL-1β and TNF- α, were measured using the chimiluminescence technique. Serum concentration of IL-10 was assayed by the enzyme-linked immunosorbent assay technique (ELISA). The normal levels of cytokines were determined in 50 healthy controls.Results:The mean age of the patients was 41.9 ± 8.4 years and the sex ratio was 4.5. LBP duration was 66.4 months. The mean lumbar visual analog scale (VAS) was 4.5 ± 1.9, and the root VAS was 2.6 ± 2.5. Neuropathic pain was found in 26% of patients. The average BMI was 27 ± 3.7 kg/m2. Only serum level of IL-8 was significantly higher in subjects with LBP compared to healthy controls (p Conclusion:Interleukin-8 is a biomarker of common low back pain and correlate with anxiety and functional disability. These results suggest that IL-8 may be a therapeutic target to reduce chronic back pain and reduce the social and profession impact.Disclosure of Interests:None declared

Background:Interleukin 17 (IL-17) is pro-inflammatory cytokine that plays a crucial role in spondyloarthritis via the Th17/IL-17 axis. (1)Objectives:We aimed to study the diagnosis value of IL-17 serum in spondyloarthritis.Methods:We conducted a case-control study, including 104 subjects divided into 2 groups:-G1: 52 patients meeting the Assessment of SpondyloArthritis International Society (ASAS) criteria for spondyloarthritis (SA)-G2: 52 healthy controls matched for age and sex.The IL-17 level was measured using Enzyme-linked immunosorbent assay (ELISA).We performed a ROC analysis and computed the air under the curve (AUC) at IL-17 to assess the ability of IL-17 to diagnose SA.Statistical analysis was performed using “IBM SPSS Statistics” software version 25.Results:Eighty per cent of the patients were men (n=41). The mean age was 44.96 ± 13.09 years. The mean age at the onset of the disease was 35.07 ± 12.66 years. The disease duration was 9.25 ± 8.09 years. Axial radiographic spondyloarthritis and peripheral involvement were found in 53.8% (n=28) and 44.2% (n=23) of cases, respectively. Psoriasis was noted in 46% of cases (n=24). The mean ASDAS-CRP was 3.21 ± 1.64.IL-17 level was significantly higher in patients compared to healthy controls (92.76 ± 71.85 pg/mL and 2.67 ± 9.01 pg/mL, respectively, pAs shown in Figure 1, the AUC value to distinguish between spondyloarthritis and healthy control was 0.987 (pFigure 1.AUC at IL-17 between SA patients and healthy controls 0.987 (pConclusion:According to previous studies, our study showed that serum IL-17 level is significantly higher in SA patients compared to healthy controls (2).Interestingly, IL-17 was able to distinguish between SA patients and healthy controls with a cut-off of 13.79 pg/mL. This finding suggests that IL-17 may be useful for the diagnosis of SA.References:[1]Ruiz de Morales JMG, Puig L, Daudén E, Cañete JD, Pablos JL, Martín AO, et al. Critical role of interleukin (IL)-17 in inflammatory and immune disorders: An updated review of the evidence focusing in controversies. Autoimmun Rev. janv 2020;19(1):102429.[2]Chen W-S, Chang Y-S, Lin K-C, Lai C-C, Wang S-H, Hsiao K-H, et al. Association of serum interleukin-17 and interleukin-23 levels with disease activity in Chinese patients with ankylosing spondylitis. J Chin Med Assoc. juill 2012;75(7):303-8.Disclosure of Interests:None declared

Rheumatoid arthritis (RA) is an inflammatory disease, which affects synovial joints, and is influenced by environmental and genetic factors, in particular the human leucocyte antigen (HLA) system. In our study, we investigated the association of HLA class II DRB1 and DQB1 alleles and DRB1-DQB1 haplotypes with RA susceptibility in Tunisian subjects. Therefore, HLA class II low-resolution genotyping was done in 110 RA patients and 116 controls, with a HLA-DRB1*04 high-resolution typing. Our results showed a strong association between HLA-DRB1*04/DRB1*04:05 alleles and RA presence, which persisted after correcting for multiple comparisons (Pc < 10-3, Pc = 0.020, respectively), in contrast to the protective effect of HLA-DRB1*04:03 allele (Pc = 15.2 × 10-4). However, increased frequency of DQB1*05 (Pc = 0.020) and decreased frequency of DRB1*04:03 subtype (Pc = 0.032) were seen in RF+ patients than controls. Moreover, when RA patients were compared to controls, DRB1*04-DQB1*03 haplotype was associated with RA susceptibility in Tunisians (Pc = 16.8 × 10-5), independently of RF status. Conversely, DRB1*01 allele and DRB1*01-DQB1*05 haplotype was highly present in RF+ vs RF- groups (Pc < 10-3, Pc = 5.6 × 10-3, respectively) and seems to be linked to seropositivity. Investigation of HLA class II alleles and haplotypes association with RA susceptibility with secondary Sjogren's syndrome (sSS) showed a predisposing effect of DRB1*04 (Pc < 10-3) and DRB1*04-DQB1*03 haplotype when RA with sSS/without sSS groups were compared to healthy controls. Our results confirms the association of HLA-DRB1*04, specifically HLA-DRB1*04:05 subtype, and DRB1*04-DQB1*03 haplotype with RA susceptibility in Tunisians, independently of seropositivity or the sSS presence.

Introduction L’hypoparathyroidie est une maladie rare qui est caracterisee par un deficit en hormone parathyroidienne. Elle peut etre acquise ou congenitale, quelle qu’en soit la cause elle peut se manifester par des signes cliniques d’hypocalcemie mais peut aussi etre asymptomatique de decouverte fortuite. Nous rapportons un cas d’hypoparathyroidie auto-immune revele par une hyperdensite osseuse diffuse. Observation Patient âge de 45 ans avait consulte pour des lombalgies mecaniques chroniques sans notion de facteur declenchant. L’examen avait trouve un syndrome rachidien. Les radiographies avaient objective une osteophytose anterieure et un canal lombaire etroit avec une osteocondensation osseuse diffuse. Une DMO avait revele une hyperdensite avec un Z-score a + 2,5 DS au rachis et + 3,2 DS au site femoral. A la biologie, il avait une hypocalcemie a 1,16 mmol/L, une hyperphosphoremie a 1,87 mmol/L et une parathormone inferieure a 6 ng/L. La magnesemie etait normale a 0,74 mmol/L Les signes de Chvosteck et Trousseau etaient negatifs. En revanche, l’electrocardiogramme avait montre un QT corrige a 480 ms. Le bilan immunologique etait positif pour les anticorps Anti Calcium Sensing Receptor. Une TDM cerebrale avait decele des calcifications bilaterales et symetriques des noyaux gris centraux en rapport avec un syndrome de Fahr. Il avait egalement une cataracte corticale et sous-capsulaire bilaterale. Le diagnostic d’une hypoparathyroidie auto-immune a ete alors retenu. Une supplementation en calcium a la dose de 4 g/j et en alfacalcidiol a la dose de 1 μg/j a ete prescrite. La calcemie de controle etait a 1,57 mmol/L apres 3 mois de recul. Conclusion L’hypoparathyroidie est une cause rare d’osteopathie condensante diffuse. Elle est la consequence d’une diminution du remodelage osseux et une augmentation de la masse osseuse. Cette hyperdensite est liee a la duree de la maladie plutot qu’aux taux seriques de calcium maintenu par les patients [1] .

International audience; OBJECTIVES:Acute myocardial infarction (MI) leads to molecular, structural, geometric and functional changes in the heart during a process known as ventricular remodeling. Myocardial infarction is followed by an inflammatory response in which pro- and anti-inflammatory cytokines play a crucial role, particularly in left ventricular remodeling. This study aimed at evaluating serum concentrations of interleukin-8 (IL8), tumor-necrosis-factor-alpha (TNFα) and interleukin-10 (IL10), pro- and anti-inflammatory cytokines, and at correlating them with left ventricular remodeling as assessed by echocardiographic parameters.METHODS:In a case-control study 30 MI patients were compared with 30 healthy controls. Serum concentrations of IL8, TNFα and IL10 were measured on day 2 and day 30 post-MI by chemiluminescence immunoassay and correlated with echocardiographic parameters.RESULTS:There was an increase of IL8, and TNFα together with a decrease of IL10 at both time points. IL8 was negatively correlated with the left ventricular end-diastolic diameter (LVEDD) and positively with left ventricular systolic volume. IL10 was negatively correlated with LVEDD and left atrial volume 30days post-MI.CONCLUSION:The increase of pro-inflammatory cytokines TNFα and IL8 was accompanied by decreased anti-inflammatory IL10. This imbalance between pro- and anti-inflammatory cytokines might contribute to the progression of left ventricular remodeling and may lead to heart failure.

Rheumatoid arthritis (RA) is an inflammatory disease, which affects synovial joints, and is influenced by environmental and genetic factors, in particular the human leucocyte antigen (HLA) system. In our study, we investigated the association of HLA class II DRB1 and DQB1 alleles and DRB1-DQB1 haplotypes with RA susceptibility in Tunisian subjects. Therefore, HLA class II low-resolution genotyping was done in 110 RA patients and 116 controls, with a HLA-DRB1*04 high-resolution typing. Our results showed a strong association between HLA-DRB1*04/DRB1*04:05 alleles and RA presence, which persisted after correcting for multiple comparisons (Pc10-3, Pc = 0.020, respectively), in contrast to the protective effect of HLA-DRB1*04:03 allele (Pc = 15.2 × 10-4). However, increased frequency of DQB1*05 (Pc = 0.020) and decreased frequency of DRB1*04:03 subtype (Pc = 0.032) were seen in RF+ patients than controls. Moreover, when RA patients were compared to controls, DRB1*04-DQB1*03 haplotype was associated with RA susceptibility in Tunisians (Pc = 16.8 × 10-5), independently of RF status. Conversely, DRB1*01 allele and DRB1*01-DQB1*05 haplotype was highly present in RF+ vs RF- groups (Pc10-3, Pc = 5.6 × 10-3, respectively) and seems to be linked to seropositivity. Investigation of HLA class II alleles and haplotypes association with RA susceptibility with secondary Sjögren's syndrome (sSS) showed a predisposing effect of DRB1*04 (Pc10-3) and DRB1*04-DQB1*03 haplotype when RA with sSS/without sSS groups were compared to healthy controls. Our results confirms the association of HLA-DRB1*04, specifically HLA-DRB1*04:05 subtype, and DRB1*04-DQB1*03 haplotype with RA susceptibility in Tunisians, independently of seropositivity or the sSS presence.

Summary Sickle-cell disease (SCD) is an hemoglobinopathy resulting from a ponctual mutation in the human globin gene. The major related SCD complications are usually unpredictable and reveal the lack of our knowledge of their starting factors. The aim of this study was to evaluate the serologic profile of three adhesion molecules: intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and l -selectin in patients with SCD. Studied adhesion molecules were quantitated by an ELISA sandwich method. In all studied sickle-cell patients, the levels of adhesion molecules were significantly increased. These results outline the important participation of endothelial cells through the overexpression and release of adhesion molecules in case of their activation by the vascular microenvironment.

Resume La transplantation est aujourd’hui couramment pratiquee en clinique et les techniques qui permettent de se procurer et d’implanter sont suffisamment bien au point cependant un pourcentage assez eleve de greffe d’organes n’est pas couronne de succes et ces echecs sont lies en partie a la reponse immunitaire du receveur vis a vis des antigenes HLA du donneur. Notre etude a porte sur six patients de l’UGO de l’HMPIT, quatre greffes cardiaques et deux greffes renaux pour les quels on a procede a un phenotypage lymphocytaire des marqueurs CD3,CD4 et CD8 moyennant l’Immunofluorescence, et un dosage serologique par Elisa de deux interleukines pro-inflammatoires (Il1β, TNFα). Les resultats obtenus ont permis de constater que les transplantes immunodeprimes, soumis a triple therapie pharmaceutique immunosuppressive moyennant Ciclosporine®–Imurel®–Solupred®, montrent des profils lymphocytaires irreguliers presentant des pics suite a une mobilisation cellulaire induite par les interleukines. Ces manifestations immunologiques precedent en general des symptomes cliniques d’un episode de rejet.

Resume Dans la presente etude, on a determine le groupage sanguin ABO sur 63 375 donneurs de sang, au centre militaire de transfusion sanguine, entre janvier 1998 et decembre 2001 et provenant de differentes regions de la Tunisie. On a retrouve les frequences geniques suivantes : O = 0,686, A = 0,196 et B = 0,120. On a observe d’importantes variations entre les differentes regions du pays. La comparaison avec les resultats d’autres pays explique le brassage de la population tunisienne tout au long de son histoire, la Tunisie etant un point strategique dans le bassin mediterraneen.

Summary Thyroiditis in diabetic patients is always diagnosed at the latest stage. In the present study, we report results from 92 diabetic patients without any autoimmune thyroid disease (35 of type 1 diabetes mellitus and 57 of type 2 diabetes mellitus patients). We assayed two anti-thyroid antibodies: anti-thyroid peroxydase antibody (ATPOAb) and anti-thyroglobuline antibody (ATGAb), using an immunometric method with a luminescent marquer. The prevalence of ATPOAb and ATGAb were, respectively, 37 and 11.42% in type 1 diabetes mellitus patients and 22.8 and 3.5% in type 2. The anti-thyroid antbodies must be systymatically assayed in diabetes mellitus patients in order to detect infraclinical autoimmune thyroid disease.

Cardiomyopathies (CMs) are primary disorders of cardiac muscle. They are a major cause of morbidity and mortality for all ages and, like acquired forms of cardiovascular disease, often result in heart failure. Molecular genetic studies have made remarkable progress in defining the pathogenesis of CM. The present study was the first report to evaluate the relationship between class II major histocompatibility complex (MHC) genes (HLA-DRB1 and HLA-DQB1) and the genetic susceptibility to primary dilated cardiomyopathy (DCM) in Tunisian patients. The human leukocyte antigen (HLA)-DRB1 and -DQB1 alleles were analyzed in 76 patients with primary DCM and 111 ethnically matched healthy controls using polymerase chain reaction-sequence specific primers technique. An increased frequencies of HLA-DRB1*0401 (OR = 2.67, P < 0.001), HLA-DQB1*0302 (OR = 3.28, P = 0.001) and HLA-DQB1*0401 (OR = 6.26, P = 0.005) alleles were found in the patients with primary DCM compared with healthy controls. Individuals with HLA-DRB1*1301 (OR = 0.24, P < 0.001) and HLA-DQB1*0201 (OR = 0.49, P = 0.002) alleles have a protective effect against primary DCM. Two haplotypes were associated with increased risk of primary DCM: DRB1*0401/DQB1*0302 (OR = 4.53, P = 0.002) and DRB1*0401/DQB1*0401 (OR = 9.42, P = 0.004). In conclusion, our data suggest that the variation in class II HLA alleles could be a genetic factor involved in the susceptibility to primary DCM in the Tunisian population.

The present survey was carried out in the Military Center of Blood Transfusion from January 1998 to December 2001. 63,375 blood donors were concerned coming from different regions of Tunisia. Gene frequencies were found as follows: O = 0.686, A = 0.196 and B = 0.120. Important variations are observed between different regions of the country. The comparison with other countries' results traces the history of the Tunisian population, Tunisia being a strategic point in the Mediterranean region.

The aim of this in vitro study was to sketch the subtle anticoagulant profile of iopamidol 300 mg l/ml (low osmolality non ionic contrast medium) and meglumine amidotrizoate 370 mg l/ml (high osmolality ionic contrast medium) in situations where variable amounts of clotting factors are observed and to check whether thrombin-generation significantly occurred in non anticoagulated blood-contrast materials mixtures. In the first experiment, mixtures of deficient plasmas with a routine plasma pool provided different ranges with variable amounts of clotting factors II, V, VIII, X, XI and XII. For each clotting factor level studied within these ranges, an activated partial thromboplastin time was determined with either contrast material loaded thromboplastin (5% v/v) or glucose loaded thromboplastin (5% v/v) used as a control. In the second experiment fibrino-peptide A (FpA) or modified antithrombin III (ATM) assays were performed in either (9:1) non anti-coagulated blood contrast materials mixtures or blood-glucose mixtures (control). Differing aPTT prolongation profiles were observed when clotting factors V, VIII, XI and XII were lowered in the plasma. However, neither iopamidol nor amidotrizoate induced an aPTT prolongation with decreasing clotting factor II. In the second experiment no significant thrombin generation was observed as both blood-contrast materials mixtures showed significantly lower FpA and ATM levels (p0.001) than glucose control after 5 minutes and 10 minutes incubation at room temperature. These findings provide evidence that the use of iopamidol in angiographic procedures does not increase risk of clotting or hemorrhage.

Antiphospholipid antibodies were investigated in 37 individuals with sickle cell disease and compared to a control group of 30 healthy subjects. Sickle cell patients included 18 homozygous sickle cell patients, 8 S/beta thalassemic patients and 11 sickle cell trait subjects. In all individuals, antiphospholipid antibodies were explored by lupus anticoagulant (LA) detection and the quantification of IgG and IgM anticardiolipin (aCL) isotypes, total antiphospholipid antibodies (APA) and IgM, IgG and IgA antiphospholipid classes. In homozygous sickle cell patients, mean level of IgG aCL and total APA were significantly increased (17.02 +/- 8.88 GPL/ml, p0.05 and 10.64 +/- 10.58 UPL/ml, p0.05 respectively). The IgG aCL, total APA and LA frequencies were 22.2%, 44.4% and 62.2%, respectively. APA isotypes were mostly IgG or IgG and IgA. In S/beta thalassemic patients, mean levels of APA were significantly increased (10.81 +/- 7.82 UPL/ml, p0.05). Their frequency was 71.4% and they were mostly IgG or IgG and IgA. In patients with sickle cell trait, mean levels of APA were significantly increased (10.84 +/- 5.84 UPL/ml, p0.01). Their frequency was 72.7% and mostly of IgG isotype. Our study showed a close association between high APA levels and sickle cell syndrome, however there was no relationship between high levels of antiphospholipid antibodies and the major complications of sickle cell disease.

The fibrinolytic potential was evaluated in 37 patients with homozygous sickle cell disease and compared to a control group of 30 age- and sex-matched healthy volunteers. In all individuals, the euglobulin clot lysis time and plasma antigen levels of t-PA and PAI-1 were measured before and after venous occlusion (v.o) for 10 min. The global fibrinolytic activity was normal in 4 patients (good responders to v.o), while it was decreased in 33 patients (poor responders to v.o). Among the latter, 22 patients had significantly increased baseline levels of PAI-1 Ag (82.6 ± 27.5 ng/ml, p < 0.001) and a normal release of t-PA Ag after v.o. In contrast, 11 patients had basal values of PAI-1 Ag comparable to those in controls with a defective release of t-PA Ag after v.o (11.4 ± 5.2 ng/ml, p < 0.01). These data provide evidence for reduced fibrinolytic capacity resulting from either increased basal levels of PAI-1 or defective release of t-PA.