Docteur Irina COMAN

Bibliographie

• Long‐term evaluation of rheumatoid arthritis activity with erythrocyte methotrexate‐polyglutamate 3

  2025

  ArticleFundamental & Clinical Pharmacology

Source : HAL — archive ouverte CCSD/CNRS (couvre articles, chapitres EMC, communications congrès, thèses).

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Top publications · les plus citées

• 1

  N-acetylcysteine reduces disease activity by blocking mammalian target of rapamycin in T cells from systemic lupus erythematosus patients: a randomized, double-blind, placebo-controlled trial

  Arthritis and rheumatism · 2012

  📚 322 citations🎯 RCR 8.83Top 3% NIH🩺 Clinique

  Lire l'abstract Crossref ↓

  Abstract Objective Systemic lupus erythematosus (SLE) patients exhibit T cell dysfunction, which can be regulated through mitochondrial transmembrane potential (Δψm) and mammalian target of rapamycin (mTOR) by glutathione (GSH). This randomized, double‐blind, placebo‐controlled study was undertaken to examine the safety, tolerance, and efficacy of the GSH precursor N ‐acetylcysteine (NAC). Methods A total of 36 SLE patients received either daily placebo or 1.2 gm, 2.4 gm, or 4.8 gm of NAC. Disease activity was evaluated monthly by the British Isles Lupus Assessment Group (BILAG) index, the SLE Disease Activity Index (SLEDAI), and the Fatigue Assessment Scale (FAS) before, during, and after a 3‐month treatment period. Mitochondrial transmembrane potential and mTOR were assessed by flow cytometry. Forty‐two healthy subjects matched to patients for age, sex, and ethnicity were studied as controls. Results NAC up to 2.4 gm/day was tolerated by all patients, while 33% of those receiving 4.8 gm/day had reversible nausea. Placebo or NAC 1.2 gm/day did not influence disease activity. Considered together, 2.4 gm and 4.8 gm NAC reduced the SLEDAI score after 1 month ( P = 0.0007), 2 months ( P = 0.0009), 3 months ( P = 0.0030), and 4 months ( P = 0.0046); the BILAG score after 1 month ( P = 0.029) and 3 months ( P = 0.009); and the FAS score after 2 months ( P = 0.0006) and 3 months ( P = 0.005). NAC increased Δψm ( P = 0.0001) in all T cells, profoundly reduced mTOR activity ( P = 0.0009), enhanced apoptosis ( P = 0.0004), reversed expansion of CD4−CD8− T cells (mean ± SEM 1.35 ± 0.12‐fold change; P = 0.008), stimulated FoxP3 expression in CD4+CD25+ T cells ( P = 0.045), and reduced anti‐DNA production ( P = 0.049). Conclusion This pilot study suggests that NAC safely improves lupus disease activity by blocking mTOR in T lymphocytes.

• 2

  The use of biologic therapies in uveitis

  Romanian journal of ophthalmology · 2018

  📚 10 citations
• 3

  Screening for Pulmonary Hypertension in Systemic Sclerosis-A Primer for Cardio-Rheumatology Clinics

  Diagnostics (Basel, Switzerland) · 2021

  📚 9 citations🔓 Open Access📄 PDF gratuit ↗

  Lire l'abstract Crossref ↓

  Systemic sclerosis (SSc) is a rare disease, with unfavorable clinical course and prognosis, characterized by progressive multisystemic involvement. SSc associated pulmonary hypertension (SSc-PAH) and interstitial lung disease (ILD) are the most important factors for morbi-mortality in these patients, being responsible for more than 60% of total deaths. Though pulmonary arterial hypertension (PAH) is the dominant subtype seen in SSc, PH secondary to ILD, left-heart pathology, and pulmonary veno-occlusive disease (PVOD) are also possible occurrences. Initial evaluation of a SSc case is complex and should be performed with a multidisciplinary approach. Early detection of SSc-PAH is imperative, given the fact that new and effective medications are available and early treatment was shown to improve outcomes. Therefore, screening algorithms must be used adequately and in a cost-effective manner. Sensitivity and negative predictive value (NPV) are the most important performance measures in a screening test. Several algorithms were developed in the last decade (e.g., DETECT and ASIG) and demonstrated higher efficiency when compared to older algorithms. The present manuscript details the risk factors for SSc-PAH and includes a critical description of current detection algorithms, as a primer for clinicians working in the field of cardio-rheumatology.

Publications scientifiques (5) — classées par pathologie

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