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Rheumatoid Arthritis: HELP
Articles from Tunisia
Based on 110 articles published since 2008
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These are the 110 published articles about Arthritis, Rheumatoid that originated from Tunisia during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Review Association between VDR polymorphisms and rheumatoid arthritis disease: Systematic review and updated meta-analysis of case-control studies. 2015

Tizaoui, Kalthoum / Hamzaoui, Kamel. ·Tunis El Manar University, Faculty of Medicine Tunis, Division of Histology and Immunology, Department of Basic Sciences, 15 Rue Djebel Lakdar, 1007 Tunis, Tunisia. Electronic address: kalttizaoui@gmail.com. · Tunis El Manar University, Faculty of Medicine Tunis, Division of Histology and Immunology, Department of Basic Sciences, 15 Rue Djebel Lakdar, 1007 Tunis, Tunisia. ·Immunobiology · Pubmed #25577294.

ABSTRACT: BACKGROUND: Vitamin D receptor (VDR) polymorphisms have been inconsistently investigated in rheumatoid arthritis (RA). However, published studies demonstrated differences concerning design and effect size. A meta-analysis is necessary to determine the magnitude of the association between VDR polymorphisms and RA risk. OBJECTIVE: The aim of the current study was to quantify the magnitude of the association between TaqI, BsmI, and FokI VDR polymorphisms with RA risk. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search and meta-analysis of the literature were conducted. Analyses were performed in the random effects model by using recessive, dominant, codominant, homozygous, and allele contrast models. RESULTS: A total of 1703 cases and 2635 controls in 12 case-control studies were included in the meta-analyses. Results indicated a significant association between TaqI polymorphism and RA disease in homozygous, codominant and allele contrast models (P=0.008, P=0.015, P=0.006 and P=0.002, respectively). Association between BsmI polymorphism and RA risk was marginal in the dominant, codominant and allele contrast models (P=0.057, P=0.071, and P=0.069, respectively). Te association between FokI polymorphism and RA risk was significant in the recessive, dominant and allele contrast models (P=0.045, P=0.027, and P=0.013, respectively). Subgroup analysis showed that publication year, ethnicity, age, latitude, and estimated 25(OH)D levels influenced significantly the association between VDR polymorphisms and RA risk. CONCLUSION: TaqI and FokI VDR polymorphisms contributed significantly to RA risk. Study characteristics influenced the association between VDR polymorphisms and RA disease.

2 Review Association of Toll like receptor Asp299Gly with rheumatoid arthritis risk: a systematic review of case-control studies and meta-analysis. 2015

Tizaoui, Kalthoum / Naouali, Abir / Kaabachi, Wajih / Hamzaoui, Agnès / Hamzaoui, Kamel. ·Department of Histology and Immunology, Faculty of Medicine Tunis, 15 Rue Djebel Lakdhar, 1007 Tunis, Tunisia. Electronic address: kalttizaoui@gmail.com. · Department of Histology and Immunology, Faculty of Medicine Tunis, 15 Rue Djebel Lakdhar, 1007 Tunis, Tunisia. · Department of Histology and Immunology, Faculty of Medicine Tunis, 15 Rue Djebel Lakdhar, 1007 Tunis, Tunisia; Division of Pulmonology, Unit research: 12SP15, "Homeostasis and Cell Immune Dysfunction", A. Mami Hospital, Ariana, Tunisia. ·Pathol Res Pract · Pubmed #25499175.

ABSTRACT: OBJECTIVE: Rheumatoid arthritis (RA) is thought to be triggered by various genetic and environmental factors. Few human epidemiologic studies demonstrated that single nucleotide polymorphisms (SNPs) in Toll-like receptor (TLR) genes are associated with RA. We aimed to evaluate the effects of TLR polymorphisms on the risk of RA pathogenesis by using a meta-analysis approach. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a systematic search and meta-analysis of the literature was conducted. We screened the medical literature based on keywords search in MEDLINE and EMBASE 'Toll-like receptor', 'polymorphism', and rheumatoid arthritis. Meta-analyses were performed under the random-effects model by using: (1) recessive, (2) homozygous, (3) dominant, (4) codominant and allele contrast models. RESULTS: A total of 3086 cases and 3756 controls in nine studies were included in the meta-analysis. Association between TLR4 Asp299Gly and RA risk was marginally significant [OR = 0.856 (95% CI, 0.716-1.022); P = 0.086] in the homozygous model. AA and GG homozygote genotypes tended to be significant protective factors against RA risk. CONCLUSION: Our overall analyses indicated that TLR4 Asp299Gly polymorphism might contribute to RA pathogenesis.

3 Review Role of ultrasound in assessing remission in rheumatoid arthritis. 2015

Ben Abdelghani, K / Miladi, S / Souabni, L / Kassab, S / Chekili, S / Laatar, A / Zakraoui, L. ·Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia. · Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia. Electronic address: saoussenmld@hotmail.com. ·Diagn Interv Imaging · Pubmed #25220573.

ABSTRACT: INTRODUCTION: Remission is the ultimate goal of the treatment of rheumatoid arthritis (RA). However, the diagnosis of remission might still be vague. Musculoskeletal ultrasound (US) seems to effectively assess synovitis, effusion and bone damage. Thus, its role could be relevant for the diagnosis, monitoring or detection of relapse in the follow-up of RA in remission. The goal of this review of the literature was to clarify the added value of ultrasonography during remission. METHODS: A systemic search of the literature was performed on Medline and Scopus. The following key words were used: rheumatoid arthritis, remission, US. Fifty-six papers were collected, then after an in depth analysis, twelve articles were selected for analysis. RESULTS: Twelve papers were identified that assessed remission in RA. Remission criteria varied from one author to another. The number of joints assessed by US varied from six to 44 with the wrist and metacarpo-phalangeal joints of the dominant hand scanned at least. Irrespective of remission criteria, all authors demonstrated that US detected Doppler positive synovitis in patients in clinical remission. Also, power Doppler synovitis predicted structural damage and future flares of RA. CONCLUSION: US seems to be more effective than a clinical exam. True remission in RA must be defined. Moreover, the inclusion of this technique in the new definition of remission is being validated.

4 Review Hypokalemic rhabdomyolysis: an unusual presentation of Sjogren's syndrome. 2013

Cherif, Eya / Ben Hassine, Lamia / Kechaou, Ines / Khalfallah, Narjess. ·Department of Internal Medicine, Charles Nicolles Hospital, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia. ·BMJ Case Rep · Pubmed #24165505.

ABSTRACT: Hypokalaemic rhabdomyolysis represents a medical emergency requiring rapid diagnosis and appropriate aetiological treatment. Renal tubular acidosis is a common cause of hypokalemia which can be idiopathic or secondary to systemic disorders such as Sjogren's syndrome. It can remain asymptomatic or manifest with metabolic abnormalities including hypokalemia paralysis, hypocalcaemia and hyperchloremic metabolic acidosis. Rhabdomyolysis presenting with severe hypokalemia as the first manifestation of Sjogren's syndrome is rare. We report a case of a 59-year-old woman who presented to our department with severe weakness of all limbs. Laboratory examination demonstrated hypokalemic rhabdomyolysis caused by distal renal tubular acidosis. Investigations revealed Sjogren's syndrome as the underlying cause of the metabolic disorders.

5 Review Chronic inflammatory rheumatism associated with Takayasu disease. 2013

Ben Abdelghani, Kaouther / Fazaa, Alia / Ben Abdelghani, Khaoula / Laatar, Ahmed / Khedher, Adel / Zakraoui, Leith. ·Department of Rheumatology, Mongi Slim Hospital, La Marsa-Tunis University, El Manar, Tunis, Tunisia. Kaoutherbenabdelghani@rns.tn ·Ann Vasc Surg · Pubmed #23498318.

ABSTRACT: Takayasu disease is rarely associated with other autoimmune diseases. Therefore, the cases discussued herein are uncommon because we are reporting Takayasu disease associated with rheumatoid polyarthritis and spondylarthropathy. The first case concerns a 40-year-old woman presenting with Takayasu disease 11 years after the diagnosis of erosive and seronegative rheumatoid polyarthritis. The upper limb arteries and 1 lower limb artery were affected. The second 41-year-old case presented with ankylosing spondylitis that had been evolving for 10 years. Human leukocyte antigen-B27 typing was negative. Takayasu disease was revealed by severe high blood pressure. In both cases, radiologic examination revealed a typical aspect of the aorta and its main collaterals. Rarely in the literature have these associations been reported, and the pathology remains unknown.

6 Review Golimumab and immunogenicity? 2010 and beyond. 2011

Zidi, I / Bouaziz, A / Ben Amor, N. ·Laboratory of Biochemistry, Research Unit 02/UR/09-01, Higher Institute of Biotechnology of Monastir, Tunisia. ines.zidi@techemail.com ·Pharmazie · Pubmed #21612149.

ABSTRACT: Immunogenicity is a frequent adverse event observed with biological agents' therapy. Challenges of management in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis treated with golimumab, an anti-TNF-alpha blocker, include limited generation of antibodies like anti-nuclear, anti-golimumab, and anti-double stranded DNA antibodies. We conducted here a meta-analysis study in order to evaluate and compare the newly generated antibody levels after golimumab therapy. The examination of original clinical trials revealed that their levels were neither higher nor significant. Moreover, no evident associations between the induced-antibodies and lupus-like syndromes and/or infusion site reaction were reported. The reduced patients cohort and the absence of systematic newly generated antibodies follow-up might be implicated in the difficulty to evaluate their risk in delaying diseases therapy, and/or predicting for their worse prognosis. Hence, further studies are required to ascertain the real impact of the induced antibodies after golimumab's therapy.

7 Review Dermatologic adverse events: golimumab, friend or foe? 2011

Zidi, I / Bartegi, A / Ben, Amor N. ·Laboratory of Biochemistry, Research Unit 02/UR/09-01, Higher Institute of Biotechnology, BP 74, Avenue Tahar Haddad, Monastir 5000, Tunisia. ines.zidi@techemail.com ·Pharmazie · Pubmed #21391428.

ABSTRACT: Golimumab is a fully human anti-TNF-alpha blocker that has demonstrated its efficacy in the treatment of numerous kinds of diseases. Although it is generally safe and well tolerated, various adverse events have been reported. The present aim is to improve the understanding of dermatologic adverse events associated with golimumab following a search of various scientific databases. This systematic review and meta-analysis shows that golimumab is associated neither with severe injection-site reactions nor with injection-site erythema. We found no significant lupus-like syndromes, and no significant skin squamous cell carcinoma. We further suggest systematic dermatologic monitoring in clinical practice during golimumab therapy. Subsequent research should employ a larger cohort of patients to ensure clear and significant future conclusions.

8 Review Golimumab and malignancies: true or false association? 2011

Zidi, Ines / Bouaziz, Aicha / Mnif, Wissem / Bartegi, Aghleb / Ben Amor, Nidhal. ·Laboratory of Biochemistry, Research Unit 02/UR/09-01, Higher Institute of Biotechnology, BP 74, Monastir, Tunisia. ines.zidi@techemail.com ·Med Oncol · Pubmed #20373059.

ABSTRACT: Malignancy is one of the comorbidities linked to golimumab, a biological TNF-α blocker. In this systematic review and meta-analysis, we searched different databases and analyzed original publications to elucidate the remaining open question about the real association of malignancies with golimumab therapy. The most frequent cancer in patients treated with golimumab, in association or not with methotrexate, is the lung adenocarcinoma. However, lymphoma is not very commonly represented in these patients. We show that there is no major and evident risk of malignancies associated with golimumab in current scientific literature. An increased risk of malignancies may be associated with golimumab, but this warrants further clinical confirmation. Also, this risk mentioned in different studies must be taken with caution because of number of limits and biases.

9 Review Golimumab therapy of rheumatoid arthritis: an overview. 2010

Zidi, I / Bouaziz, A / Mnif, W / Bartegi, A / Al-Hizab, F A / Amor, N B. ·Laboratory of Biochemistry, Research Unit 02/UR/09-01, Higher Institute of Biotechnology, Monastir, Tunisia. ines.zidi@techemail.com ·Scand J Immunol · Pubmed #20618765.

ABSTRACT: Golimumab is a new approved humanized antibody for the treatment of rheumatoid arthritis (RA). This antibody belonging to biologic agents is raised against the pro-inflammatory cytokine tumour necrosis factor-alpha playing an essential role in the initiation of RA. To date, Golimumab administration for patients with RA, as indicated by USA Food and Drug Administration, is subcutaneous combined with methotrexate (MTX). Here, we have reviewed current literature with a focus on characteristics of Golimumab and also have exposed the clinical trials either using MTX or not using MTX. We have also highlighted the incoming clinical trials on Golimumab and have proposed some indications for the future studies based on a setting of clinical data and post-marketing observational studies. These studies will advance rheumatologists' decisions in the beginning of RA therapeutic interventions to insure the best outcomes for patients with RA and to improve their quality of life.

10 Review [The synoviorthesis: a reappraisal]. 2008

Ajlani, Houda / Sahli, Hela / Elleuch, Mohamed / Meddeb, Nihel / Cheour, Elhem / Sellami, Sleheddine. ·Service de Rhumatologie la Rabra, Tunis, Tunisie. ·Tunis Med · Pubmed #19216454.

ABSTRACT: BACKGROUND: The evolution of the rheumatologic practice involved a handing-over in question of the place and methods of application of the synoviorthesis. The last innovations, in particular the appearance of the bio-therapies, allowed a better control of inflammatory rheumatism thus making it possible to better select arthritis likely to profit precociously from a synoviorthesis before the installation of major articular destruction. AIM: Through a general review of the literature, we recall in this work the various means of synoviorthesis, their current indications and their results. METHODS: An extensive electronic search of the relevant literature was carried out using MEDLINE. Key words used for the final search were: synoviorthesis, osmic acid, radiosynoviorthesis, arthritis, treatment. RESULTS: This systematic review allowed us to conclude that fields of application of the synoviorthesis is in addition widens because of the interesting results to see spectacular this technique in some other affections such as the haemophilia. In addition we have compared the efficiency and the tolerance of the different methods of synoviorthesis. CONCLUSION: The synoviorthesis constitutes a tempting therapeutic alternative of share its effectiveness and its good tolerance so much so that it constitutes an undeniable factor of articular protection. Its fields of application widened. Thus on the good knowledge of the indications and the precautions necessary to its realization its success.

11 Article The Clinical Features of Painful Small-Fiber Neuropathy Suggesting an Origin Linked to Primary Sjögren's Syndrome. 2019

Zouari, Hela G / Wahab, Abir / Ng Wing Tin, Sophie / Sène, Damien / Lefaucheur, Jean-Pascal. ·EA 4391, Faculty of Medicine, Paris-Est-Creteil University, Créteil, France. · Physiological Investigations, Habib Bourguiba University Hospital, Sfax, Tunisia. · Neurology Department, Henri Mondor University Hospital, AP-HP, Creteil, France. · Physiological Investigations & Sport Medicine, Avicenne Hospital, AP-HP, Bobign, France. · EA 2363, UFR SMBH, Paris_13 University, Bobigny, France. · Internal Medicine Department, Lariboisiere Hospital, AP-HP, Paris-7 University, Paris, France. · Clinical Neurophysiology, Henri Mondor University Hospital, AP-HP, Créteil, France. ·Pain Pract · Pubmed #30636091.

ABSTRACT: OBJECTIVE: We attempted to determine whether clinical features could differentiate painful small-fiber neuropathy related to primary Sj€ogren's syndrome (pSS-SFN) from idiopathic SFN (idio-SFN). METHODS: Validated clinical questionnaires and neurophysiological investigations specific for pain and SFN assessment were performed in 25 patients with pSS-SFN and 25 patients with idio-SFN. RESULTS: Patients with idio-SFN had more frequent severe burning sensations and higher mean anxiety scores and daily pain intensity compared to patients with pSSSFN. Conversely, patients with pSS-SFN had reduced electrochemical skin conductance measured by Sudoscan_, and almost half of them had the sensation of walking on cotton wool. CONCLUSION: Our results suggest that idio-SFN more specifically involved small sensory fibers than pSS-SFN, in which subtle dysfunction of larger sensory fibers and damage of distal autonomic sudomotor innervation may occur. A practical algorithm is proposed to help to differentiate SFN associated with pSS from idio-SFN, based on information very easy to obtain by clinical interview.

12 Article [Senile rheumatoid arthritis associated with rheumatoid lung: a caricatural observation]. 2018

Kechaou, Ines / Boukhris, Imène. ·Service de Médecine Interne B, Hôpital Charles Nicolle, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisie. ·Pan Afr Med J · Pubmed #30627314.

ABSTRACT: In the elderly, rheumatoid arthritis is defined by an average age of onset over 60 years. Prognosis mainly depends upon functional capacity, evolutionary stage of the disease, onset or no onset of joint malformations. We report the case of a 70-year old female patient with a history of arterial hypertension, hypothyroidism and Sjögren syndrome diagnosed in 2005. The patient was lost to follow-up and hospitalized in our department in 2016 for diffuse polyarthralgies of large joints with biologic inflammatory syndrome. Clinical examination showed cachectic patient (BMI: 17,6Kg/m

13 Article A cross sectional study of bone and cartilage biomarkers: correlation with structural damage in rheumatoid arthritis. 2018

Ben Achour, Wael / Bouaziz, Mouna / Mechri, Meriem / Zouari, Béchir / Bahlous, Afef / Abdelmoula, Leila / Laadhar, Lilia / Sellami, Maryam / Sahli, Hela / Cheour, Elhem. ·a Rheumatology Department La Rabta Hospital, Immunology-Rheumatology Research Laboratory LR05SP01 , University of Tunis-El Manar , Tunis , Tunisia. · b Radiology Department , Orthopedics kassab institute , Tunis , Tunisia. · c Biochemistry Department , Pasteur Institute , Tunis , Tunisia. ·Libyan J Med · Pubmed #30160204.

ABSTRACT: The aim of our study was to assess the relationship between bone and cartilage remodeling biomarkers and joint damage in Rheumatoid Arthritis (RA), and to detect whether they have the capacity to predict the progression of joint disease assessment by computed tomography (CT) erosion score. We analyzed 65 female patients with established RA in our Rheumatology Department. Serum levels of bone and cartilage markers were measured: osteocalcin (OC), N-propeptide of type I collagen (PINP), collagen type I and II, C-telopeptide (CTX I, CTX-II) and cartilage oligomeric matrix protein (COMP). Radiography of both wrist and MCP joints were available. Two expert-readers independently scored articular damage and progression using the High-resolution low dose CT scan in a blinded fashion. 65 female patients with established RA with a median age of 44 years were included. The median disease-duration was two years and the median (Disease activity score) DAS 28 score at 4.46 [2.65-7.36]. The percentage of patient with low disease activity was 13.8%, while 55.4 and 30.8% for those with moderate and high disease activity respectively. The resorption bone markers were high in active versus non-active RA. Wrist and MCP erosion scores were also associated with RA activity. Our study shows that biomarkers of bone and cartilage collagen breakdown were related to specific joint erosion in RA and could predict subsequent radiographic damage in RA. Further larger scale longitudinal studies maybe needed to confirm our data.

14 Article Association of hyperhomocysteinemia with genetic variants in key enzymes of homocysteine metabolism and methotrexate toxicity in rheumatoid arthritis patients. 2018

Chaabane, Souhir / Messedi, Meriam / Akrout, Rim / Ben Hamad, Mariem / Turki, Mouna / Marzouk, Sameh / Keskes, Leila / Bahloul, Zouheir / Rebai, Ahmed / Ayedi, Fatma / Maalej, Abdellatif. ·Laboratory of Human Molecular Genetics, Faculty of Medicine, Avenue Majida Boulila, 3029, Sfax, Tunisia. Chaabane.souhir@yahoo.fr. · UR "Molecular Bases of Human Diseases", Faculty of Medicine, Sfax, Tunisia. · Department of Rheumatology, University Hospital Hedi Chaker, Sfax, Tunisia. · Laboratory of Human Molecular Genetics, Faculty of Medicine, Avenue Majida Boulila, 3029, Sfax, Tunisia. · Department of Internal Medicine, University Hospital Hedi Chaker, Sfax, Tunisia. · Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology, Sfax, Tunisia. ·Inflamm Res · Pubmed #29796841.

ABSTRACT: OBJECTIVES: The study investigated the association between plasma homocysteine, folate and vitamin B12 with 5,10 methylenetetrahydrofolate reductase (MTHFR C677T and A1298C), thymidylate synthase (TYMS 2R → 3R) and methionine synthase (MTR A2756G) polymorphisms and methotrexate (MTX) treatment and toxicity in Tunisian Rheumatoid arthritis (RA) patients. METHODS: A total of 185 patients with RA were included. Homocysteine (Hcy) was assessed by fluorescence polarization immunoassay, and folate and vitamin B12 were measured by chemiluminescence immunoassays. The genetic polymorphisms were analyzed by PCR or PCR-RFLP. Hyperhomocysteinemia (HHC) was considered for Hcy > 15 µmol/L. RESULTS: MTHFR C677T polymorphism was associated with HHC in RA patients (multi-adjusted OR, 95% CI 2.18, [1.07-4.57]; p = 0.031). No association was detected with the remaining polymorphisms. Plasma Hcy, folate, and vitamin B12 did not differ according to each polymorphism, or with MTX treatment or toxicity. However, HHC was more prevalent in patients with than those without MTX toxicity (32.7 vs. 16.7%; p = 0.035). CONCLUSIONS: The MTHFR 677TT genotype is an independent risk factor for HHC in Tunisians RA patients. HHC could be a useful marker of MTX toxicity in RA patients.

15 Article Methylglyoxal: A Relevant Marker of Disease Activity in Patients with Rheumatoid Arthritis. 2018

Knani, Ines / Bouzidi, Hassan / Zrour, Saoussen / Bergaoui, Naceur / Hammami, Mohamed / Kerkeni, Mohsen. ·Laboratory of Biochemistry, LR12ES05, Faculty of Medicine, University of Monastir, Monastir, Tunisia. · Laboratory of Biochemistry, University Hospital Tahar Sfar, Mahdia, Tunisia. · Department of Rheumatology, University Hospital of Fattouma Bourguiba, Monastir, Tunisia. ·Dis Markers · Pubmed #29606988.

ABSTRACT: Background: The contribution of methylglyoxal (MGO) and soluble receptor for advanced glycation end products (sRAGE) in the presence of rheumatoid arthritis (RA) is still unknown. We investigated whether serum MGO and sRAGE were related to the presence of disease activity in RA. Methods: 80 patients with RA and 30 control subjects were included in a cross-sectional study. The severity of RA was assessed using the disease activity score for 28 joints (DAS28). Serum MGO and sRAGE were measured by ELISA. Results: Serum MGO levels were significantly higher in patients with RA versus control subjects ( Conclusion: Serum MGO and sRAGE levels are inversely related to the activity of RA, and MGO is independently associated with a higher disease activity of RA.

16 Article IL-17A, IL-17RC polymorphisms and IL17 plasma levels in Tunisian patients with rheumatoid arthritis. 2018

Dhaouadi, Tarak / Chahbi, Mayssa / Haouami, Youssra / Sfar, Imen / Abdelmoula, Leila / Ben Abdallah, Taieb / Gorgi, Yousr. ·Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis, Tunisia. · Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia. ·PLoS One · Pubmed #29584788.

ABSTRACT: BACKGROUND: Interleukin-17 (IL-17), a cytokine mainly secreted by Th17 cells, seems to play a significant role in the pathogenesis of rheumatoid arthritis (RA). Functional genetic polymorphisms in IL-17 and its receptor genes can influence either qualitatively or quantitatively their functions. Therefore, we aimed to study the impact of IL17-A and IL17RC polymorphisms on plasma level of IL-17 and RA susceptibility and severity. METHODS: In this context, IL-17A*rs2275913 and IL-17RC*rs708567 polymorphisms were investigated together with the quantification of IL17 plasma level in 115 RA patients and 91 healthy control subjects matched in age, sex and ethnic origin. RESULTS: There were no statistically significant associations between IL-17A and IL-17RC studied polymorphisms and RA susceptibility. In contrast, IL-17A plasma levels were significantly higher in patients (55.07 pg/ml) comparatively to controls (4.75 pg/ml), p<10E-12. A ROC curve was used to evaluate the performance of plasma IL-17 in detecting RA. Given 100% specificity, the highest sensitivity of plasma IL-17A was 61.7% at a cut-off value of 18.25 pg/ml; p < 10E-21, CI = [0.849-0.939]. Analytic results showed that the IgM-rheumatoid factor and anti-CCP antibodies were significantly less frequent in patients with the IL-17RC*A/A genotype than those carrying *G/G and *G/A genotypes; p = 0.013 and p = 0.015, respectively. Otherwise, IL-17 plasma levels' analysis showed a significant association with the activity of RA (DAS28≥5.1 = 74.71 pg/ml vs. DAS28<5.1 = 11.96 pg/ml), p<10E-6. CONCLUSION: IL-17A*rs2275913 (G/A) and IL-17RC*rs708567 (G/A) polymorphisms did not seem to influence RA susceptibility in Tunisian population. This result agrees with those reported previously. Plasma IL-17A level seems to be predictive of severe RA occurrence.

17 Article Detection of Shigella spp. nucleic acids in the synovial tissue of Tunisian rheumatoid arthritis patients and other forms of arthritis by quantitative real-time polymerase chain reaction. 2018

Siala, Mariam / Rihl, Markus / Sellami, Hanen / Znazen, Abir / Sassi, Nadia / Laadhar, Lilia / Gdoura, Radhouane / Belghuith, Imen / Mrabet, Dalila / Baklouti, Sofien / Sellami, Slaheddine / Sibilia, Jean / Fourati, Hela / Hammami, Adnene / Cheour, Ilhem. ·Preparatory Institute for Engineering Studies (IPEIS), Université de Sfax-Tunisie, Route Menzel Chaker Km 0,5, 3018, Sfax, Tunisia. mariamsiela@gmail.com. · Laboratoire de recherche Toxicologie Microbiologie Environnementale et Santé (LR17ES06), Faculté des Sciences de Sfax, Université de Sfax-Tunisie, 3000, Sfax, Tunisia. mariamsiela@gmail.com. · Rheumatologische Facharztpraxis, Jahnstr. 36, 83278, Traunstein, Germany. · Laboratoire de recherche Toxicologie Microbiologie Environnementale et Santé (LR17ES06), Faculté des Sciences de Sfax, Université de Sfax-Tunisie, 3000, Sfax, Tunisia. · Laboratory of Treatment and Valorization of Wastewater, Research and Water Technologies Centre (CERTE), Borj Cedria Technopark, Touristic road of Soliman, Nabeul, Tunisia. · Laboratoire de Recherche 'Micro-organismes et Pathologie Humaine', EPS Habib Bourguiba, Université de Sfax-Tunisie, Rue El Ferdaous, 3029, Sfax, Tunisia. · Laboratoire Immunologie rhumatologie, EPS La Rabta, Université Tunis-Elmanar, Tunisie, rue 7051 Centre Urbain Nord, 1082, Tunis, Tunisia. · Laboratoire de LGMH Faculté de Médecine de Sfax, Université de Sfax-Tunisie, Sfax, Tunisia. · Service de Rhumatologie Hôpital Hédi Chaker, Université de Sfax-Tunisie, Avenue Majida Boulila, 3029, Sfax, Tunisia. · Fédération de Médecine Translationnelle, Laboratoire d'Immuno Rhumatologie Moléculaire, Inserm UMR_S1109, Faculté de Médecine, Université de Strasbourg, 4 rue Kirschleger, 67085, Strasbourg Cedex, France. ·Rheumatol Int · Pubmed #29404675.

ABSTRACT: Enterobacterial components in the joints of patients are believed to contribute to a perpetuating inflammation leading to a reactive arthritis (ReA), a condition in which microbial agents cannot be recovered from the joint. At present, it is unclear whether nucleic acids from Shigella spp. are playing a pathogenic role in causing not only ReA but also other forms of arthritis. Quantitative real-time polymerase chain reaction assay (qPCR) is the method of choice for the identification of bacteria within the synovium. The aim of our study was to detect the presence of Shigella spp. nucleic acids in the synovial tissue (ST) of Tunisian arthritis patients. We investigated 57 ST samples from rheumatoid arthritis (RA) n = 38, undifferentiated oligoarthritis (UOA) n = 12, and spondyloarthritis (SpA) n = 7 patients; 5 ST samples from healthy individuals were used as controls. Shigella spp. DNA and mRNA transcripts encoding the virulence gene A (VirA) were examined using an optimized qPCR with newly designed primers and probes. Using qPCR, Shigella spp. DNA was found in 37/57 (65%) ST samples (24/38, i.e., 63.2% of RA, 8/12, i.e., 67% of UOA, and 5/7, i.e., 71.4% of SpA patients). Paired DNA and mRNA were extracted from 39 ST samples, whose VirA cDNA was found in 29/39 (74.4%) patients. qPCR did not yield any nucleic acids in the five healthy control ST samples. The qPCR assay was sensitive and showed a good intra- and inter-run reproducibility. These preliminary findings generated by an optimized, highly sensitive PCR assay underline a potential role of past gastrointestinal infections. In Tunisian patients, a bacterial etiology involving Shigella spp. in the manifestation of arthritic disorders including RA might be more common than expected.

18 Article IRAK2 is associated with susceptibility to rheumatoid arthritis. 2018

Hassine, Hana Ben / Sghiri, Rim / Chabchoub, Elyes / Boumiza, Asma / Slama, Foued / Baccouche, Khadija / Shakoor, Zahid / Almogren, Adel / Mariaselvam, Christina / Tamouza, Ryad / Bouajina, Elyes / Zemni, Ramzi. ·Laboratory of Immunology, Research Unit UR 807, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia. · Laboratory of Immunology, Research Unit UR 807, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia. sghiririm@yahoo.com. · Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. sghiririm@yahoo.com. · Department of Rheumatology, Farhat Hached Hospital, Sousse, Tunisia. · Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. · Mondor Institute of Biomedical Research, U955, team 15, Henri Mondor Hospital, Créteil, France. ·Clin Rheumatol · Pubmed #29129009.

ABSTRACT: This study was performed to investigate the association of the single nucleotide polymorphisms of interleukin-1 receptor-associated kinase 2 (IRAK2) rs3844283 and rs708035 with rheumatoid arthritis (RA). IRAK2 rs3844283 and rs708035genotyping was determined by mutagenically separated PCR with specifically designed primers in a cohort of 222 (30 men, 192 women, mean age 49 years) adult RA patients and 224 matched controls. IRAK2 rs3844283 C allele was detected in 66% of RA patients and 74% of controls. The CC genotype was the most frequent genotype in both RA patients (45.5%) and the controls (56.3%). The G allele was found to be associated with RA susceptibility (OR = 1.47, 95% CI = 1.10-1.96, p = 0.008). The GG genotype was found to be associated with RA in the co-dominant and the dominant models (OR = 2.03, 95% CI = 1.08-3.81, p = 0.042 and OR = 1.54, 95% CI = 1.06-2.23, p = 0.023, respectively). IRAK2 rs708035 was found not to be in the Hardy-Weinberg equilibrium. The hyperfunctional IRAK2 rs708035 A allele was more frequent in RA patients than in controls (69.9 versus 62.2%, respectively, p = 0.015). Moreover, IRAK2 rs708035 and IRAK2 rs3844283 were in linkage disequilibrium and the GA haplotype was significantly more frequent in RA patients than in controls (p = 0.034). This study for the first time ever reports the association of IRAK2 rs3844283, IRAK2 rs708035, and the corresponding haplotypes with RA. Functional studies are recommended to elucidate the risk posed by the GA haplotype for the development of RA.

19 Article Increased serum concentrations of N 2018

Knani, Ines / Bouzidi, Hassan / Zrour, Saoussen / Bergaoui, Naceur / Hammami, Mohamed / Kerkeni, Mohsen. ·1 Laboratory of Biochemistry, LR12ES05, Faculty of Medicine, University of Monastir, Monastir, Tunisia. · 2 Laboratory of Biochemistry, University Hospital-Tahar Sfar, Mahdia, Tunisia. · 3 Department of Rheumatology, University Hospital of Fattouma Bourguiba, Monastir, Tunisia. ·Ann Clin Biochem · Pubmed #28882063.

ABSTRACT: Background There are limited data regarding the contribution of advanced glycation end products in the presence of rheumatoid arthritis. We investigated whether serum N

20 Article Atypical form of Adult-onset Still's Disease with Distal Interphalangeal Joints Involvement. 2018

Belghali, Safaa / El Amri, Nejla / Baccouche, Khadija / Laataoui, Sadok / Bouzaoueche, Monia / Zeglaoui, Hela / Bouajina, Elyes. ·Farhat Hached Hospital, University of Medicine of Sousse Rheumatology, Sousse, Tunisia. ·Curr Rheumatol Rev · Pubmed #28758587.

ABSTRACT: BACKGROUND: A distal interphalangeal (DIP) joint involvement in the adult-onset Still's disease (AOSD) has been described in some publications but is rarely reported to be severe. We report severe DIP joints damages in a young patient with AOSD. CASE REPORT: A 22 years old patient presented to our department complaining of inflammatory joints pain associated with prolonged fever and cutaneous rash. Physical examination identified polyarthritis and hepatosplenomegaly but no lymphadenopathies. After an extensive screening for neoplastic, infectious or hematologic diseases, the patient was finally diagnosed with AOSD. Treatment based on corticosteroids was then initiated with a good response on systemic signs. However, the patient continued to have recurrent arthritis affecting wrists and proximal interphalangeal joints. A Few years later, he developed a severe and disabling DIP arthritis with signs of joint destruction on conventional radiographs and MRI. Despite the initiation of methotrexate with optimal dosage, the patient continued to have polyarticular flares. The combination of methotrexate and sulfasalazine was responsible for drug-induced hepatotoxicity and this treatment was stopped. Anti-TNFα treatment was then indicated as general signs improved but severe joints damage persisted. Unfortunately, and due to healthcare system considerations, the patient was not able to benefit from TNFα inhibitors, and remained on methotrexate treatment only. Conculsion: The distal destructive arthritis during AOSD is rare and controversial. Our patient had a severe form with resistance to conventional therapies.

21 Article Measurement of absolute copy number variation of Glutathione S-Transferase M1 gene by digital droplet PCR and association analysis in Tunisian Rheumatoid Arthritis population. 2018

Achour, Yosser / Ben Kilani, Mohamed Sahbi / Ben Hamad, Mariem / Marzouk, Sameh / Mahfoudh, Nadia / Bahloul, Zouheir / Keskes, Leila / Petit-Teixeira, Elisabeth / Maalej, Abdellatif. ·Laboratory of Human Molecular Genetics, Faculty of Medecine, Sfax, Tunisia. · GenHotel-EA3886, Evry University, Evry, France. · Department of Internal Medecine, University Hospital Hedi Chaker, Sfax, Tunisia. · Laboratory Services, University Hospital Hedi Chaker, Sfax, Tunisia. ·J Clin Lab Anal · Pubmed #28703442.

ABSTRACT: BACKGROUND: The investigation of copy number variations (CNVs) analysis of candidate genes is currently an important research area in modulating human diseases. We aimed to quantify CNVs in glutathione S-transferase M1 (GSTM1) gene and determine its genetic contribution in Tunisian rheumatoid arthritis (RA) and its subsets through an innovative technique for quantification. METHODS: A total of 165 RA cases and 102 healthy controls were included in the study. Using a recently powerful approach of digital droplet PCR (ddPCR), we quantified GSTM1 gene to determine the presence of no, one, or multiple copy number (CN) at high levels of sensitivity and specificity. Odds ratio and Fisher exact test were performed to estimate the association risk for GSTM1CNVs in RA. RESULTS: Copy number identified by ddPCR was 0, 1, and 2 copies per diploid genome. A high frequency of '0' copy was revealed with 54% in RA patients. The deletion ('0' copy) of GSTM1 was found to be a significant risk factor for anti-cyclic citrullinated peptide (anti-CCP) positive RA (OR=4.16, CI CONCLUSION: This study highlights the powerful accuracy of ddPCR for the quantification of CNVs and suggests that the variation in the CN of GSTM1 is associated with anti-CCP positivity in RA. However, it does not indicate a specific role in the susceptibility to the disease in our Tunisian sample.

22 Article Analysis of two susceptibility SNPs in HLA region and evidence of interaction between rs6457617 in HLA-DQB1 and HLA-DRB1*04 locus on Tunisian rheumatoid arthritis. 2017

Achour, Yosser / Ben Hamad, Mariem / Chaabane, Souhir / Rebai, Ahmed / Marzouk, Sameh / Mahfoudh, Nadia / Bahloul, Zouhir / Keskes, Leila / Maalej, Abdellatif. ·Faculty of Medicine, Laboratory of Human Molecular Genetics, Avenue Majida Boulila. 3029, Sfax, Tunisia. achour.yosr@gmail.com. ·J Genet · Pubmed #29321349.

ABSTRACT: Previous genomewide association studies (GWAS) and meta-analyses have enumerated several genes/loci in major histocompatibility complex region, which are consistently associated with rheumatoid arthritis (RA) in different ethnic populations. Given the genetic heterogeneity of the disease, it is necessary to replicate these susceptibility loci in other populations. In this case, we investigate the analysis of two SNPs, rs13192471 and rs6457617, from the human leukocyte antigen (HLA) region with the risk of RA in Tunisian population. These SNPs were previously identified to have a strong RA association signal in several GWAS studies. A case-control sample composed of 142 RA patients and 123 healthy controls was analysed. Genotyping of rs13192471 and rs6457617 was carried out using real-time PCR methods by TaqMan allelic discrimination assay. A trend of significant association was found in rs6457617 TT genotype with susceptibility to RA (P = 0.04, pc = 0.08, OR = 1.73). Moreover, using multivariable analysis, the combination of rs6457617*TT-HLA-DRB1*04+ increased risk of RA (OR = 2.38), which suggest a gene-gene interaction event between rs6457617 located within the HLA-DQB1 and HLA-DRB1. Additionally, haplotypic analysis highlighted a significant association of rs6457617*T-HLA-DRB1*04+ haplotype with susceptibility to RA (P = 0.018, p

23 Article [Primary Sjögren syndrome in a child]. 2017

Majdoub, I / Kallel, S / Hsairi, M / Snoussi, M / Charfi, M / Ben Halima, A / Frikha, A / Weli, M / Safi, F / Gargouri, L / Ben Halima, N / Mahfoudh, A / Ghorbel, A / Bahloul, Z. ·Service de pédiatrie, urgence et réanimation pédiatriques, CHU Hédi Chaker, 3029 Sfax, Tunisie. Electronic address: majdoub.imen@yahoo.fr. · Service d'oto-rhino-larynologie, CHU Habib Bourguiba, route El Ain km 0.5, Sfax, Tunisie. · Service de pédiatrie, urgence et réanimation pédiatriques, CHU Hédi Chaker, 3029 Sfax, Tunisie. · Service de médecine interne, CHU Hédi Chaker, 3029 Sfax, Tunisie. ·Arch Pediatr · Pubmed #29158045.

ABSTRACT: Sjögren syndrome is uncommon in children and occurs most often in association with autoimmune diseases (secondary Sjögren syndrome). We describe the clinical and biological features of a 7-year-old girl with primary Sjögren syndrome revealed by recurrent parotiditis. CASE REPORT: A 7-year-old girl was referred for investigation of multiple episodes of parotid swelling since age 4 years, without systemic symptoms. The examination was unremarkable except for enlarged and painless parotid glands. Laboratory investigations and labial salivary gland biopsy revealed Sjögren syndrome without associated disease. Hydroxychloroquine was prescribed with clinical improvement. CONCLUSION: Recurrent parotiditis in children is an uncommon condition. The onset of parotid swelling at 5 years or over deserves screening for disimmune disorders, sarcoidosis, or Sjögren syndrome. Diagnosis of Sjögren syndrome is based on diagnostic criteria.

24 Article [Role of ultrasonography in rheumatoid arthritis]. 2017

Miladi, Saoussen / Ben Abdelghani, Kaouther / Fazaa, Aliaa / Laatar, Ahmed / Zakraoui, Leith. ·Hôpital Mongi-Slim, service de rhumatologie, la Marsa, Tunisie. Electronic address: saoussenmld@hotmail.com. · Hôpital Mongi-Slim, service de rhumatologie, la Marsa, Tunisie. ·Presse Med · Pubmed #29089217.

ABSTRACT: Ultrasound imaging may have an impact in management patients with rheumatoid arthritis. Through technological improvements, ultrasonography, has become an established imaging technique for the diagnosis and the follow up of this inflammatory chronic disease. In fact, ultrasounds, allow follow up during treatment by evaluating synovitis count and assessment of synovial vascularization by Power Doppler. Besides, erosions are found sooner and more frequently by ultrasonography than with conventional radiography. Rheumatologist training in sonography is essential, this technique has become indispensable in the management of inflammatory rheumatism, to avoid more invasive or more expensive imaging procedures.

25 Article None 2017

Khalifa, Olfa / Balandraud, Nathalie / Lambert, Nathalie / Auger, Isabelle / Roudier, Jean / Sénéchal, Audrey / Geneviève, David / Picard, Christophe / Lefranc, Gérard / Touitou, Isabelle / Mrenda, Bakridine M'Madi / Benedito, Cécilia / Pardoux, Etienne / Gagez, Anne-Laure / Pers, Yves-Marie / Jorgensen, Christian / Mahjoub, Touhami / Apparailly, Florence. ·Inserm, U 1183, Institute for Regenerative Medicine and Biotherapies, CHU Saint Eloi, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France; University of Montpellier, Boulevard Henri IV, 34090 Montpellier, France. · Inserm UMRs 1097, Aix-Marseille University, Marseille, France; Rheumatology Department, APHM, Marseille, France. · Inserm UMRs 1097, Aix-Marseille University, Marseille, France. · Inserm, U1051, University Hospital Saint Eloi, Institute for Neurosciences of Montpellier, Montpellier, France. · Inserm, U 1183, Institute for Regenerative Medicine and Biotherapies, CHU Saint Eloi, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France; University of Montpellier, Boulevard Henri IV, 34090 Montpellier, France; Department of Clinical Genetics, University Hospital of Montpellier, Montpellier, France. · Aix-Marseille University, CNRS, EFS, ADES UMR 7268, 13916 Marseille, France. · University of Montpellier, Boulevard Henri IV, 34090 Montpellier, France; Laboratoire d'Immunogénétique Moléculaire, UPR 1142 CNRS, Institute of Human Genetics, Montpellier, France. · Inserm, U 1183, Institute for Regenerative Medicine and Biotherapies, CHU Saint Eloi, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France; University of Montpellier, Boulevard Henri IV, 34090 Montpellier, France; Department of Molecular Genetics, University Hospital of Montpellier, France. · Aix-Marseille University, CNRS, Centrale Marseille, I2M, UMR 7373, 13453 Marseille, France. · CNRS UMR 5235, Université de Montpellier, Montpellier, France. · Inserm, U 1183, Institute for Regenerative Medicine and Biotherapies, CHU Saint Eloi, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France; University of Montpellier, Boulevard Henri IV, 34090 Montpellier, France; Clinical Department for Osteoarticular Diseases and Biotherapy, University Hospital Lapeyronie, 34295 Montpellier, France. · Laboratory of Human Genome and Multifactorial Diseases, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia. ·J Immunol Res · Pubmed #28271077.

ABSTRACT: Polymorphisms have been identified in the Xq28 locus as risk loci for rheumatoid arthritis (RA). Here, we investigated the association between three polymorphisms in the Xq28 region containing

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