Despite a sunny environment, vitamin D insufficiency is frequent in healthy Algerian children.

Despite an increasingly sophisticated understanding of pain mechanisms, acute and chronic pain remain undertreated throughout the world. This situation reflects the large gap that exists between evidence and practice in pain management and is typified by inappropriate use of nonsteroidal anti-inflammatory drugs (NSAIDs). The scientific evidence around these drugs continues to expand at a high rate, yet physicians are often unaware of best practice. To address this gap among physicians in Africa and the Middle East, an Expert Panel meeting was convened with representatives from the region. The principal objective of the meeting was to review the latest guidelines on the management of acute and chronic pain and to review the efficacy, safety, and cost-effectiveness of cyclooxygenase-2 (COX-2) inhibitors in these settings. The main outcome of this review process was a number of consensus statements concerning the definitions of acute and chronic pain, and the efficacy, safety and cost-effectiveness of traditional nonselective NSAIDs (nsNSAIDs) and selective COX-2 inhibitors (coxibs). The panel agreed that nsNSAIDs and coxibs are effective analgesics with similar efficacy for acute pain; for chronic musculoskeletal pain, NSAIDs are significantly more effective than either placebo or paracetamol. Coxibs offer important safety advantages over nsNSAIDs, including gastrointestinal safety and preservation of platelet function; notably, the cardiovascular safety of coxibs has been the subject of much recent debate. Furthermore, the panel agreed there is substantial evidence to indicate that cost savings can be achieved by using celecoxib in patients at moderate to high risk of gastrointestinal adverse events, even in countries with moderate healthcare expenditures.

Les connaissances sur la vitamine D ont beaucoup progressé ces dernières années. La vitamine D ne peut plus être considérée comme uniquement nécessaire à la prévention du rachitisme/ostéomalacie. L’évaluation du statut vitaminique D peut être aisément réalisée par le dosage de la 25OHD sérique. Toutefois, la plupart des revues récentes sur le sujet suggèrent que les valeurs de référence de la 25OHD obtenues dans des populations apparemment en bonne santé sont beaucoup trop basses et que la concentration de 25OHD au-dessous de laquelle il existe une insuffisance en vitamine D se situe entre 50 et 100 nmol/L (20 et 40 ng/mL) avec une franche tendance à cibler des valeurs >75 nmol/L (30 ng/mL). Les supplémentations habituellement recommandées sont insuffisantes pour atteindre ces concentrations.

BackgroundThe development of Systemic Lupus Erythematosus (SLE) depends inter alia on genetic factors including genes involved in oxidative stress and angiogenesis as NOS2 and VEGF. The aim of our study is to evaluate the Single Nucleotide Polymorphisms (SNPs) influence of NOS2 gene (rs2779248, rs2779251 and rs8078340) and VEGF gene (rs1570360 and rs2010963) on SLE development in Algerian patients.MethodsThis is a case-control study of 157 SLE patients (age: 37±2 years, sex ratio: 1: 10, disease duration: 7.6±4.3 years, SLEDAI: 7.3±6.1) and 173 healthy controls (age: 28±9 years, sex ratio: 1: 7). We performed NOS2 and VEGF genes SNPs genotyping TaqMAN technology and we respected the Hardy-Weinberg equilibrium.ResultsFirst, we analyzed the allele frequency of NOS2 and VEGF genes SNPs and we obtained for:NOS2 gene that rs2779248 T allele is associated to SLE’s development (OR 1.92) as well as rs2779251 T (OR 2.01) and rs8078340 A alleles (OR 5.00) unlike rs2779248 C, rs2779251 G and rs8078340 G alleles that are protective against SLE development (OR 0.52, 0.50 and 0.20).VEGF gene that rs2010963 C allele is associated SLE’s development (OR 1.86) unlike rs2010963 G allele that is protective (OR 0.54).Thereafter, we analyzed the genotype frequency and we got for:NOS2 gene that rs2779248 CT genotype is associated to SLE’s development (OR 2.01) as well as rs2779251 GG (OR 1.62) and rs8078340 AA genotypes (OR 3.41) inversely to rs2779248 CC, rs2779251 TT and rs8078340 GG genotypes that are protective (OR 0.35, 0.24 and 0.20).VEGF gene that rs1570360 GG genotype is associated to SLE’s development (OR 1.73) as well as rs2010963 CC genotype (OR 2.91) unlike rs1570360 AG and rs2010963 GG genotypes that are protective (OR 0.51 and 0.58).Furthermore, we observed that the VEGF rs1570360 G allele was assiociated to lupus nephritis development (OR 3.51) as well as GG genotype (OR 3.82). Regarding the haplotype analysis, it showed for the NOS2 gene that AGG haplotype is associated to SLE’s development (OR 2.12) and that CGG is protective (OR 0.50). Finally, as a whole, our results are consistent with the literature data.ConclusionsAt the end of our study, we have demonstrated the role the NOS2 and VEGF genes SNPs in the genetic susceptibility to develop SLE in Algerian patients.Funding Source(s):Pasteur Institute of Algeria

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