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Master Thesis

Sclérodermie systémique : description de la cohorte bordelaise : corrélation phénotypique avec le dosage de la TSLP

Abstract : Background. Systemic sclerosis (SSc) is characterized by endothelial dysfunction, fibrosis and immunological dysregulation. The pro-fibrotic cytokines Th2 (IL-13 and IL-4) induce excessive production of extracellular matrix but the mechanisms skewing Th2 polarization remain unknown. Recent data converge on TSLP (Thymic Stromal LymphoPoietin), a central cytokine in the Th2 polarization produced by keratinocytes, fibroblasts and endothelial cells. Our objective was to describe the cohort of patients with SSc followed in Bordeaux hospital center and to perform clinical associations with their blood TSLP dosage. Methods. Patients with limited SSc (lcSSc) or diffuse SSc (dcSSc) were included in the VISS (Vasculopathy and Inflammation in SSc) cohort. The serum level of TSLP was correlated with phenotypic data. TSLP was measured in 22 healthy controls. Results. 203 patients (65.5% lcSSc and 34.4% dcSSc) including 151 women (sex ratio 2.9:1) were enrolled between March 2012 and January 2015. We identified 97% of patients with a Raynaud’s phenomenon, 7.9% with pulmonary arterial hypertension, 4.9% with scleroderma renal crisis, 19.8% with pulmonary fibrosis, 49.2% with digital ulcers, 69.4% with gastrointestinal involvement and 59.1% with articular involvement. Immunosuppressive drugs were more frequently prescribed in dcSSc than in lcSSc (65.7% and 13.5% respectively; p <0.001). 50.5% of patients received corticosteroids with a median dose of 12.5mg [7.5-30]. 23.3% SSc sera were positive for TSLP. All controls were negative. The dosage of TSLP was correlated with the presence or a history of digital ulcers (p = 0.03). Conclusion. The analysis of the characteristics and therapeutic strategies in the VISS cohort allow us to have an overview of the management of these patients in the CHU of Bordeaux. Moreover, we demonstrate that TSLP is associated to SSc, probably early in its pathogenesis, and can constitute a new biomarker for the development of the vasculopathy.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01206454
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Submitted on : Tuesday, September 29, 2015 - 10:12:24 AM
Last modification on : Saturday, May 30, 2020 - 9:48:02 PM
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Anne Bertrand. Sclérodermie systémique : description de la cohorte bordelaise : corrélation phénotypique avec le dosage de la TSLP. Médecine humaine et pathologie. 2015. ⟨dumas-01206454⟩

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