Maladies neuro-musculaires

Le 01/12/2022 de 09:00 à 10:30

Retour Session


Le syndrome post-poliomyélitique n'est pas une maladie dysimmunitaire : une étude cas-controle

Isabelle Laffont (Montpellier, France), claire duflos (Montpellier, France)

Objective : Poliomyelitis is a global disabling disease (12-20 millions of people). Post poliomyelitis syndrome (PPS) may affect up to 80% of polio survivors: increased muscle weakness, pain, fatigue, functional decline. It relies on aging of an impaired neuro-muscular system with ongoing denervation processes. A late involvement of humoral or cellular pro-inflammatory phenomenons is suspected.

Material / Patients and Methods : This monocentric study compared PPS patients and controls on their lymphocyte subpopulations and humoral immune factors (IL-1, IL-6, IL-8, IL-17, IFN-γ, TNF-α, RANTES, MCP1, CCL20, IL-10, TGF-β). Patients were further compared according to their dominant clinical symptoms.

Results : We recruited 74 participants: 47 patients, 27 controls. The two groups were comparable in gender, age and weight. Most patients had lower limb motor sequelae (45, 95.7%), a minority had upper limb motor impairment (16, 34.0%). Forty-five were able to walk (94%), 35/45 with technical aids. The mean of the two-minutes walking test was 97.16 (± 45.86) metres. Eighteen (38%) required help in their daily life. Their quality of life was low (SF36). All described an increase in muscular weakness, 40 (85%) a general fatigue, 39 (83%) muscular or joint pain.

Discussion - Conclusion : Blood count and serum electrolytes were comparable between patients and controls, except for Creatine Phosho Kinase that was significantly higher in PPS patients. T and B lymphocyte subpopulation analysis and cytokine dosages were also similar between the two groups. None of these variables differed between the 20/47 patients whose late main symptoms were pain or fatigue, and other patients.
Our results do not sustain the dysimmune hypothesis of PPS.

Keywords : Post poliomyelitis syndrom; dysimmune profil; motor weakness; pain

Disclosure of interest : aucun