La neuromyopathie acquise en réanimation

Guéret, Gildas; Guillouët, Maïté; Vermeersch, Véronique; Guillard, Emilie; Talarmin, Hélène; Nguyen, Ba Vinh; Rannou, Fabrice; Giroux-Metgès, Marie-Agnès; Pennec, Jean-Pierre; Ozier, Yves

doi:10.1016/j.annfar.2013.05.011

Cited by 2 publications

(1 citation statement)

References 182 publications

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“…Les mécanismes à l'origine sont complexes et multifactoriels, avec une atteinte métabolique directe de la chaîne respiratoire mitochondriale et des troubles de l'excitabilité nerveuse et musculaire. 11 Les facteurs favorisants principaux sont le sepsis, le syndrome de réponse inflammatoire systémique et la défaillance multiorganique. Les autres facteurs favorisants sont listés dans le tableau 1.…”

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Neuropathies aiguës sévères induites par l’infection à SARS-CoV-2

Epiney¹,

Bernard‐Valnet²,

Küntzer³

2021

Revue Médicale Suisse

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Différentes complications neuromusculaires ont été décrites suite à l'infection à SARS-CoV-2, notamment le syndrome de Guillain-Barré (SGB) et la neuromyopathie des soins intensifs (NMSI). Deux cas représentatifs sont discutés ici. Il apparaît que le SGB partage la plupart des caractéristiques du SGB postinfectieux classique, mais le SARS-CoV-2 pourrait participer à la majoration de l'incidence de la NMSI. D'autres complications rares ont été décrites, notamment le syndrome de Tapia et le syndrome inflammatoire multisystémique de type Kawasaki. La question de la vaccination et du risque de neuropathie à médiation immunitaire reste ouverte, mais l'absence de réaction rapportée est rassurante dans la mesure où ces complications surviennent habituellement dans les 6 semaines après la vaccination. Acute severe neuropathies in the context of SARS-CoV-2 infection Various neuromuscular complications have been described in SARS-CoV-2 infection, especially Guillain-Barré syndrome (GBS) and Critical Illness neuromyopathy (CI-NM). Two representative cases are discussed below. It appears that GBS shares most of the characteristics of classical post-infectious GBS, but SARS-CoV-2 may contribute tothe increased incidence of CI-NM. Other rare complications have been described, including Tapia Syndrome and Kawasaki-like multiple system inflammatory syndrome. The question of vaccination and the risk of immune-mediated neuropathies remains open, but the lack of reported cases is reassuring as these complications usually occur within 6 weeks after vaccination.

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Section: Commentairesunclassified

Neuropathies aiguës sévères induites par l’infection à SARS-CoV-2

Epiney¹,

Bernard‐Valnet²,

Küntzer³

2021

Revue Médicale Suisse

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TGF-β Pathway Inhibition Protects the Diaphragm From Sepsis-Induced Wasting and Weakness in Rat

Jude

Dubourg

Droguet

et al. 2019

Shock

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Sepsis is a frequent complication in patients in intensive care units (ICU). Diaphragm weakness, one of the most common symptoms observed, can lead to weaning problems during mechanical ventilation. Over the last couple of years, members of the transforming growth factor (TGF) β family, such as myostatin, activin A, and TGF-β1, have been reported to strongly trigger the activation of protein breakdown involved in muscle wasting. The aim of this study was to investigate the effect of TGF-β inhibitor LY364947 on the diaphragm during chronic sepsis. Rats were separated into four groups exposed to different experimental conditions: Control group, Septic group, Septic group with inhibitor from day 0 (LY D0), and Septic group with inhibitor from day 1 (LY D1). Sepsis was induced in rats by cecal ligation and puncture, and carried out for 7 days. Chronic sepsis was responsible for a decrease in body weight, food intake and diaphragm's mass. The inhibitor was able to abolish diaphragm wasting only in the LY D1 group. Similarly, LY364947 had a beneficial effect on the diaphragm contraction only for the LY D1 group. SMAD3 was over-expressed and phosphorylated within rats in the Septic group; however, this effect was reversed by LY364947. Calpain-1 and -2 as well as MAFbx were over-expressed within individuals in the Septic group. Yet, calpain-1 and MAFbx expressions were decreased by LY364947. With this work, we demonstrate for the first time that the inhibition of TGF-β pathway during chronic sepsis protects the diaphragm from wasting and weakness as early as one day post infection. This could lead to more efficient treatment and care for septic patients in ICU.

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La neuromyopathie acquise en réanimation

Cited by 2 publications

References 182 publications

Neuropathies aiguës sévères induites par l’infection à SARS-CoV-2

Neuropathies aiguës sévères induites par l’infection à SARS-CoV-2

TGF-β Pathway Inhibition Protects the Diaphragm From Sepsis-Induced Wasting and Weakness in Rat

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