Tocilizumab-induced psoriatic eruption : a case report and a case-based review.

BACKGROUND: Cases of psoriasis associated with Tocilizumab (TCZ) are scarce. OBJECTIVE: To describe a new case of TCZ-associated psoriasis and to perform a case-based review of similar cases. METHODS: We searched Medline/Pubmed, Embase, Scopus, Web of Science, and Directory of Open Access Journals databases using the terms « Tocilizumab ¼ and « Psoriasis ¼ in the French and English literature. RESULTS: We report a 70-year-old woman with a history of Rheumatoid Arthritis who developed Infliximab-induced plaque psoriatic eruption of the soles and palms, that resolved after Infliximab interruption, then relapsed after TCZ relay, and eventually resolved after TCZ interruption. Including our case, we identified 16 cases of TCZ-induced psoriatic eruption. Three (21%) out of 14 patients had a history of cutaneous psoriasis - data were not available for 2 patients. Eight (50%) patients had previously received TNFα antagonists. TCZ was stopped for 10 patients and continued for 4 patients. For the 2 remaining patients, the interval between two injections of TCZ was shortened. All the patients with available follow-up data had an improvement of the eruption within 4 weeks. CONCLUSION: To conclude, in case of TCZ-induced psoriatic eruption and in light of the published cases, we suggest using topical steroids and reassessing the patient 4 weeks later. If no healing is obtained, we suggest stopping TCZ, and treating the underlying disease with another drug. When no other drug is available, while waiting for more data regarding the value of IL-6 levels, it can be discussed to increase TCZ regimen, as it has been successful for 2 authors. Efficacy assessment of the chosen attitude should not take place before 4 weeks.

Visual feedbacks influence short-term learning of torque versus motion profile with robotic guidance among young adults.

Robotic assistance can improve the learning of complex motor skills. However, the assistance designed and used up to now mainly guides motor commands for trajectory learning, not dynamics learning. The present study explored how a complex motor skill involving the right arm can be learned without suppressing task dynamics, by means of an innovative device with robotic guidance that allows a torque versus motion profile to be learned with admittance control. In addition, we assessed how concurrent visual feedback on this profile can enhance learning without creating dependency, by means of a fading procedure (i.e., feedback reduction across trials). On Day 1, a Control group performed an acquisition session (6 blocks) featuring concurrent visual feedback, while a Fading group performed the session with a gradual reduction in feedback (from 100% to 0% over the 6 blocks). On Day 2, both groups performed a block first without feedback (i.e., Transfer test), then with feedback (i.e., Retention test). Results revealed that on Day 1, movement rehearsal induced a significant improvement in spatiotemporal parameters for the Control group, compared with the Fading group. On Day 2, the opposite was found when this visual feedback was removed, as the Fading group performed significantly better than the Control group on the Transfer test. Vision allows a relationship to be established between the required torque and the motion profile. Its suppression then forces the processing of more intrinsic information, leading to the development of a stable internal representation of the task.

Lysophosphatidylcholine induces endothelial cell injury by nitric oxide production through oxidative stress.

OBJECTIVE: To determine whether lysophosphatidylcholine (LPC) induces endothelial cell injury by altering the production of nitric oxide (NO) and thereby increasing reactive oxygen species (ROS). METHODS: Human umbilical vein endothelial cells (HUVECs) were cultured and exposed to LPC, LPC with N(G)-nitro-l-arginine methyl ester (L-NAME), LPC with antioxidants. LPC-induced cell injury and viability were determined using LDH and Resazurin assays. The Mann-Whitney U test was used for statistical analysis. RESULTS: LPC induced HUVEC injury in a concentration-dependent manner. LPC induced the overproduction of NO and ROS in HUVECs and LPC-induced HUVEC injury is significantly inhibited by the eNOS inhibitor (L-NAME) and the antioxidants (p < 0.05). CONCLUSIONS: These findings suggest that LPC induces the overproduction of NO, which may increase the oxidative stress on endothelial cells and lead to endothelial cell injury.