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Master Thesis

Stress, immunité et physiologie de la polyarthrite rhumatoïde : étude d’une cohorte de 71 patients

Abstract : A growing body of research indicates that interactions between the nervous and immune system as triggered by stress play a pivotal role in the pathophysiology of rheumatoid arthritis (RA). The aim of our study was to assess the role of stress in the evolution of the disease. Methods: the presence of a stressful life event assigned by patients as trigger of their disease was recorded at the initiation of a multicentric cohort of 71 RA patients. In a prospective design, parameters related to RA clinical and self-reported disease activity as well as levels of stress and anxiety were collected. Biological parameters such as pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) and neurotrophins (Brain-Derived Neurotrophic Factor, Transforming Growth Factor beta, basic Fibroblast Growth Factor) were also assessed. Results: 71 patients were included (mean age 57.3 ± 14.2 years, 66% of females). 38 patients (54%) had attributed the onset of their disease to a stressful life event. After one year of follow-up, those patients had a significantly more severe disease (DAS28-VS score 3.45 ± 1.45 versus 2.28 ± 0.92; p=0.0008). Perceived Stress Scale (PSS-14) was significantly correlated to disease activity (for DAS28-VS: Spearman r=0.4627, p=0.0009; for patient global health assessment: r=0.3406, p=0.0083), as well as the State-Trait Anxiety Inventory Score (STAI-Y-A) (for patient global: Spearman r=0.2630, p=0.0481). No correlations or differences according to the stress level were found with biological parameters. Conclusion: exposure to stress is likely to play a role in the progression of RA, through complex pathophysiological links. This should be used for tailored management of RA patients. Future directions also lie in assessing neuropathic pain in these patients.
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https://dumas.ccsd.cnrs.fr/dumas-02492076
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Pauline Henrot. Stress, immunité et physiologie de la polyarthrite rhumatoïde : étude d’une cohorte de 71 patients. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02492076⟩

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