1
|
Phelippeau M, Marion E, Robbe-Saule M, Ganlanon L, Chauty A, Adeye A, Blanchard S, Johnson C, Marsollier L, Dubee V. Changes in Inflammatory Markers in Patients Treated for Buruli Ulcer and Their Ability to Predict Paradoxical Reactions. J Infect Dis 2023; 228:1630-1639. [PMID: 37221015 PMCID: PMC10681857 DOI: 10.1093/infdis/jiad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/11/2023] [Accepted: 05/22/2023] [Indexed: 05/25/2023] Open
Abstract
Mycobacterium ulcerans causes Buruli ulcer, the third most frequent mycobacterial disease after tuberculosis and leprosy. Transient clinical deteriorations, known as paradoxical reactions (PRs), occur in some patients during or after antibiotic treatment. We investigated the clinical and biological features of PRs in a prospective cohort of 41 patients with Buruli ulcer from Benin. Neutrophil counts decreased from baseline to day 90, and interleukin 6 (IL-6), granulocyte colony-stimulating factor, and vascular endothelial growth factor were the cytokines displaying a significant monthly decrease relative to baseline. PRs occurred in 10 (24%) patients. The baseline biological and clinical characteristics of the patients presenting with PRs did not differ significantly from those of the other patients. However, the patients with PRs had significantly higher IL-6 and tumor necrosis factor alpha (TNF-α) concentrations on days 30, 60, and 90 after the start of antibiotic treatment. The absence of a decrease in IL-6 and TNF-α levels during treatment should alert clinicians to the possibility of PR onset.
Collapse
Affiliation(s)
- Michael Phelippeau
- Service des Maladies Infectieuses et Tropicales, University Hospital Angers
| | - Estelle Marion
- Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France
| | - Marie Robbe-Saule
- Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France
| | - Line Ganlanon
- Centre de dépistage et de traitement de la lèpre et de l’ulcère de Buruli, Centre de diagnostic et de traitement de la lèpre et de l’ulcère de Buruli, Pobè, Benin
| | - Annick Chauty
- Centre de dépistage et de traitement de la lèpre et de l’ulcère de Buruli, Centre de diagnostic et de traitement de la lèpre et de l’ulcère de Buruli, Pobè, Benin
| | - Ambroise Adeye
- Centre de dépistage et de traitement de la lèpre et de l’ulcère de Buruli, Centre de diagnostic et de traitement de la lèpre et de l’ulcère de Buruli, Pobè, Benin
| | - Simon Blanchard
- Université Angers, Nantes Université, Inserm, Centre National de la Recherche Scientifique (CNRS), Nantes - Angers Cancer and Immunology Research Center (CRCINA2)
- Laboratoire d’Immunologie et Allergologie, Centre Hopitalier Universitaire (CHU) d’Angers, Angers, France
| | - Christian Johnson
- Center inter facultaire de formation et de recherche en environnement (CIFRED), Université d’Abomey Calavi, Abomey Calavi, Benin
| | - Laurent Marsollier
- Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France
| | - Vincent Dubee
- Service des Maladies Infectieuses et Tropicales, University Hospital Angers
- Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France
| |
Collapse
|
2
|
Huang T, Yao H, Huang J, Wang N, Zhou C, Huang X, Tan X, Li Y, Jie Y, Wang X, Yang Y, Liang Y, Yue S, Mao Y, Lai S, Zheng J, He Y. Effectiveness of acupuncture for pain relief in shoulder-hand syndrome after stroke: a systematic evaluation and Bayesian network meta-analysis. Front Neurol 2023; 14:1268626. [PMID: 38046583 PMCID: PMC10693460 DOI: 10.3389/fneur.2023.1268626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Background Shoulder-hand syndrome (SHS) is a common complication after stroke, and SHS-induced pain significantly hampers patients' overall recovery. As an alternative therapy for pain relief, acupuncture has certain advantages in alleviating pain caused by SHS after stroke. However, choosing the best treatment plan from a variety of acupuncture options is still a serious challenge in clinical practice. Therefore, we conducted this Bayesian network meta-analysis to comprehensively compare the effectiveness of various acupuncture treatment methods. Methods We systematically searched for randomized controlled trials (RCTs) of acupuncture treatment in patients with post-stroke SHS published in PubMed, Embase, Cochrane, and Web of Science until 9 March 2023. We used the Cochrane bias risk assessment tool to assess the bias risk in the included original studies. Results A total of 50 RCTs involving 3,999 subjects were included, comprising 19 types of effective acupuncture interventions. Compared to single rehabilitation training, the top three interventions for VAS improvement were floating needle [VAS = -2.54 (95% CI: -4.37 to -0.69)], rehabilitation + catgut embedding [VAS = -2.51 (95% CI: -4.33 to -0.68)], and other multi-needle acupuncture combinations [VAS = -2.32 (95% CI: -3.68 to -0.94)]. The top three interventions for improving the Fugl-Meyer score were eye acupuncture [Meyer = 15.73 (95% CI: 3.4627.95)], other multi-needle acupuncture combinations [Meyer = 12.22 (95% CI: 5.1919.34)], and traditional western medicine + acupuncture + traditional Chinese medicine [Meyer = 11.96 (95% CI: -0.59 to 24.63)]. Conclusion Multiple acupuncture methods are significantly effective in improving pain and upper limb motor function in post-stroke SHS, with relatively few adverse events; thus, acupuncture can be promoted. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, CRD42023410957.
Collapse
Affiliation(s)
- Ting Huang
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Hongfang Yao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Junneng Huang
- The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Ning Wang
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Chunjun Zhou
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Xuyang Huang
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Xiangyuan Tan
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Yanyan Li
- Department of Traditional Chinese Medicine, Nanning Maternal and Child Health Hospital, Nanning, China
| | - Yuyu Jie
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Xiang Wang
- Sainz College of New Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Yu Yang
- The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Yingye Liang
- The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Siqian Yue
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Yawen Mao
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Songxian Lai
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Jingyiqi Zheng
- The First School of Clinical Medicine, Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Yufeng He
- The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning, China
| |
Collapse
|
3
|
Sur A, Iflazoglu Mutlu S, Tatli Seven P, Seven I, Aslan A, Kizil M, Kulaksiz R, Yaranoglu MH, Esen S. Effects of grape seed proanthocyanidin extract on side effects of high-dose methylprednisolone administration in male rats. Toxicol Res 2023; 39:749-759. [PMID: 37779581 PMCID: PMC10541365 DOI: 10.1007/s43188-023-00196-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/17/2023] [Accepted: 05/30/2023] [Indexed: 10/03/2023] Open
Abstract
In this study, we investigated the effects of grape seed proanthocyanidin extract (GSPE) against the side effects of high-dose administration of methylprednisolone (MP) in male rats. A total of 32 adult Wistar male albino rats were divided into four groups: (1) control (CON), received standard food only; (2) MP, received standard food + intraperitoneal injection of 60 mg/kg MP on day 7; (3) GSPE, received standard food + 200 mg/kg/day GSPE; and (4) MP + GSPE, received standard food + 200 mg/kg/day of GSPE + intraperitoneal injection of 60 mg/kg MP on day 7. All animals in the GSPE and GSPE + MP groups were treated once a day by oral gavage for 14 consecutive days. The feed intake of rats in the MP and MP + GSPE groups decreased significantly by 24.14% and 13.52%, respectively (p < 0.05). Administration of MP resulted in significant increases in serum concentrations of blood urea nitrogen (p < 0.001), glucose (p < 0.01), alkaline phosphatase, and adrenocorticotropic hormone (p < 0.05). High-dose MP administration significantly reduced catalase (p < 0.001) and glutathione peroxidase (p < 0.05) concentrations in the liver and kidney tissues of rats, while glutathione concentrations were only reduced in liver tissue (p < 0.05). The expression levels of Bcl-2 and TNF-α in liver, kidney, and testicular tissue were significantly increased, while the expression levels of caspase-3 were reduced (p < 0.001). Furthermore, sperm concentration was significantly affected by GSPE in rats induced by high-dose MP, and sperm loss was significantly reduced in MP + GSPE (p < 0.05). These findings suggest that GSPE could be useful as a supplement to alleviate MP-induced toxicity in rats.
Collapse
Affiliation(s)
- Aslihan Sur
- Department of Veterinary Medicine, Vocational School of Kepsut, Balikesir University, 10000 Balikesir, Turkey
| | - Seda Iflazoglu Mutlu
- Department of Animal Nutrition and Nutritional Diseases, Faculty of Veterinary Medicine, Firat University, 23119 Elazig, Turkey
| | - Pinar Tatli Seven
- Department of Animal Nutrition and Nutritional Diseases, Faculty of Veterinary Medicine, Firat University, 23119 Elazig, Turkey
| | - Ismail Seven
- Department of Plant and Animal Production, Vocational School of Sivrice, Firat University, 23119 Elazig, Turkey
| | - Abdullah Aslan
- Department of Biology, Faculty of Science, Firat University, 23119 Elazig, Turkey
| | - Meltem Kizil
- Department of Physiology, Faculty of Veterinary Medicine, Firat University, 23119 Elazig, Turkey
| | - Recai Kulaksiz
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Medicine, Balikesir University, 10000 Balikesir, Turkey
| | | | - Selim Esen
- Balikesir Directorate of Provincial Agriculture and Forestry, Republic of Turkey Ministry of Agriculture and Forestry, 10470 Balikesir, Turkey
| |
Collapse
|
4
|
Yun JH, Hsiao MY, Boudier-Revéret M, Chang MC. Cytomegalovirus lumbosacral polyradiculitis in patients with long-term use of an oral corticosteroid: a case report. BMC Neurol 2022; 22:90. [PMID: 35287603 PMCID: PMC8919595 DOI: 10.1186/s12883-022-02623-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background The long-term use of an oral corticosteroid suppresses immunity. Here, we describe a case involving a patient with weakness in the bilateral lower extremities due to cytomegalovirus (CMV) lumbosacral polyradiculitis. Case presentation A 64-year-old man visited a university hospital for symmetric motor weakness in both lower extremities (Medical Research Council grade: 2). Symptoms started 1 month before and gradually aggravated. The patient had been taking oral prednisolone for 10 years in order to control pain in multiple joints due to seronegative rheumatoid arthritis. He also had neuropathic pain on the entire right lower extremity and voiding difficulty. Gadolinium-enhanced magnetic resonance imaging revealed enhancement along the entire lumbosacral nerve roots. In the cerebrospinal fluid analysis (CSF), elevated white blood cell (WBC) count (19 cells/μL) and protein level (142.5 mg/dL) were observed. CMV detection by polymerase chain reaction (PCR) was positive. We diagnosed the patient as having lumbosacral polyradiculitis due to CMV. Ganciclovir (250 mg twice daily) was administered intravenously. Two months after initiating Ganciclovir, in the CSF analysis, CM detection by PCR was negative, and no WBC was found. Conclusion We reported a patient who had symmetric motor weakness in the bilateral lower extremities induced by CMV lumbosacral polyradiculitis. Its occurrence seems to be related to immunosuppresion due to the long-term use of an oral corticosteroid. When a patient who is taking an oral corticosteroid shows motor weakness in the bilateral lower extremities, CMV lumbosacral polyradiculitis is one of the possible disorders to be differentiated. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02623-3.
Collapse
Affiliation(s)
- Jung Hae Yun
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Daegu, 705-717, Republic of Korea
| | - Ming-Yen Hsiao
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Mathieu Boudier-Revéret
- Department of Physical Medicine and Rehabilitation, Centre hospitalier de l'Université de, Montréal, Montreal, Canada
| | - Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Daegu, 705-717, Republic of Korea.
| |
Collapse
|