RESUMO
Data about the impact of Belimumab on corticosteroid sparing in real life are scarce. To assess the corticosteroid-sparing effect among patients with systemic lupus erythematosus (SLE) treated with Belimumab in real-life settings. Multicentric observational retrospective study including patients with SLE and having received Belimumab for at least 6 months between 2011 and 2020, in eight French hospitals. "Low dose" referred to patients receiving up to 7.5 mg of prednisone a day and "Very low dose" to those receiving strictly ≤ 5 mg prednisone a day The primary endpoint was the reduction of daily prednisone dose after six months of Belimumab. The secondary endpoint was a change in the proportion of patients with low or very low dose of prednisone as well as those without prednisone during the Belimumab course. Censoring occurred for patients who stopped Belimumab. Bivariate analyses were performed using the Wilcoxon signed-rank test. The threshold for statistical significance was set at p < 0.05. Thirty patients were included. All were female with a median age of 38 years. A significant reduction in prednisone dose was observed at month 6 (10 [7-20] vs 6.75 [2-9] mg, p < 0.0001), continued until month 12 (10 [7-20] mg vs 5 [0-7.12] mg, p < 0.001) and was sustained until month 24. The proportion of patients with very low dose of prednisone and those without prednisone progressively increased during the Belimumab course. Introducing Belimumab in patients with SLE, in real-life conditions, is associated with early and sustained corticosteroid-sparing effect.
RESUMO
Expression and distribution of a constitutive member of the 90 kDa heat-shock protein family, named HSC90, was investigated during amphibian embryonic development. By Northern blot analysis, two hsp90 transcripts (2.5 and 3 kb) which displayed differing developmental regulation were detected during embryogenesis. Expression of the larger transcript (3 kb), which encodes an HSC90-related protein, decreased until the gastrula stage. However, zygotic transcription for this hsc90 gene was found to start from the neurula stage, and the corresponding zygotic hsc90 transcript was specifically located by whole mount in situ hybridization in the anterior neural tube of a late neurula embryo. Later, in a tailbud embryo, hsc90 transcripts were detected in the cephalic region, neural tube, eye vesicles, branchial and mandibular arches and somites. Distribution of the HSC90-related protein was also analysed by immunohistochemistry throughout embryogenesis. As expected, the protein was strongly expressed in the cytoplasm, mainly in the periplasmic area of embryonic tissue cells. Interestingly, HSC90 was also transiently detected in the nuclear area, with this nuclear transfer depending on the chromatin condensation state, up to the blastula stage. During the process of gastrulation, nuclear translocation of HSC90 was also observed at the level of the blastopore dorsal lip, exclusively in cells undergoing invagination.
