CO021
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.
Our results do not sustain the dysimmune hypothesis of PPS.
Keywords :
Post poliomyelitis syndrom; dysimmune profil; motor weakness; pain
Disclosure of interest :
aucun