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M MARCEL KLEIN

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Auteur de référence en rhumatologie
33 articles scientifiques publiés — un praticien à la pointe de la recherche

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Top publications · les plus citées

Serum calprotectin (S100A8/9): an independent predictor of ultrasound synovitis in patients with rheumatoid arthritis

Arthritis research & therapy · 2015

📚 45 citations🎯 RCR 1.81🔓 Open Access

Disease Manifestation and Inflammatory Activity as Modulators of Th17/Treg Balance and RORC/FoxP3 Methylation in Systemic Sclerosis

International archives of allergy and immunology · 2016

📚 40 citations🎯 RCR 1.45🔓 Open Access📄 PDF gratuit ↗

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Background: There is much evidence that T cells are strongly involved in the pathogenesis of localized and systemic forms of scleroderma (SSc). A dysbalance between FoxP3+ regulatory CD4+ T cells (Tregs) and inflammatory T-helper (Th) 17 cells has been suggested. Methods: The study aimed (1) to investigate the phenotypical and functional characteristics of Th17 and Tregs in SSc patients depending on disease manifestation (limited vs. diffuse cutaneous SSc, dcSSc) and activity, and (2) the transcriptional level and methylation status of Th17- and Treg-specific transcription factors. Results: There was a concurrent accumulation of circulating peripheral IL-17-producing CCR6+ Th cells and FoxP3+ Tregs in patients with dcSSc. At the transcriptional level, Th17- and Treg-associated transcription factors were elevated in SSc. A strong association with high circulating Th17 and Tregs was seen with early, active, and severe disease presentation. However, a diminished suppressive function on autologous lymphocytes was found in SSc-derived Tregs. Significant relative hypermethylation was seen at the gene level for RORC1 and RORC2 in SSc, particularly in patients with high inflammatory activity. Conclusions: Besides the high transcriptional activity of T cells, attributed to Treg or Th17 phenotype, in active SSc disease, Tregs may be insufficient to produce high amounts of IL-10 or to control proliferative activity of effector T cells in SSc. Our results suggest a high plasticity of Tregs strongly associated with the Th17 phenotype. Future directions may focus on enhancing Treg functions and stabilization of the Treg phenotype.

Incidence of End-Stage Renal Disease Among Newly Diagnosed Systemic Lupus Erythematosus Patients: The Georgia Lupus Registry

Arthritis care & research · 2016

📚 37 citations🎯 RCR 1.66🔓 Open Access

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ObjectiveTo estimate and identify factors associated with the incidence of all‐cause end‐stage renal disease (ESRD) among newly diagnosed systemic lupus erythematosus (SLE) patients.MethodsData from a national registry of treated ESRD were linked to data from a lupus registry of SLE patients who were newly diagnosed and living in Atlanta, Georgia, 2002–2004 (median followup 7.8 years). Cumulative incidence and incidence rates (ESRD treatment initiations per 1,000 patient‐years) were calculated, and age‐ and race‐adjusted Poisson models were used to calculate incidence rate ratios (IRRs).ResultsAmong 344 newly diagnosed SLE patients, 29 initiated ESRD treatment over 2,603.8 years of followup. Incidence rates were 13.8 (95% confidence interval [95% CI] 9.4–20.3) among black patients and 3.3 (95% CI 0.8–13.0) among white patients, per 1,000 patient‐years; corresponding 5‐year cumulative incidence was 6.4% and 2.5% among black and white patients, respectively. Lupus nephritis documented prior to 2005, which occurred in 80% of those who progressed to ESRD, was the strongest risk factor for incident ESRD (IRR 6.7 [95% CI 2.7–16.8]; incidence rate 27.6 per 1,000 patient‐years). Results suggested that patients who were black versus white (IRR 3.9 [95% CI 0.9–16.4]) or <18 years old (versus ≥30 years old) at diagnosis (IRR 2.1 [95% CI 0.9–5.3]) may be more likely to progress to ESRD, but incidence did not differ by sex or other characteristics.ConclusionThe incidence of all‐cause ESRD among patients with a recent diagnosis of SLE is high in Georgia. Interventions to decrease ESRD incidence among newly diagnosed SLE patients should target young and black patients, as well as patients with lupus nephritis.

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M MARCEL KLEIN

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Top publications · les plus citées

Publications scientifiques (33) — classées par pathologie

Transversal13

Arthrite juvénile6

Pédiatrie5

Qualité de vie / PROMs5

Épidémiologie & registres3

csDMARDs2

Goutte2

Lupus1

Ostéoporose1

Revue générale1

Vascularites des gros vaisseaux1

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