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See detailExploring the effect of a second closely-timed PRP infiltration for tendinopathy
Kaux, Jean-François ULiege; Croisier, Jean-Louis ULiege; Forthomme, Bénédicte ULiege et al

in British Journal of Sports Medicine (in press)

Introduction: Some clinical series have previously evaluated the effect of PRP in the treatment of proximal patellar tendinopathies. Although it is possible that a single infiltrative administration may ... [more ▼]

Introduction: Some clinical series have previously evaluated the effect of PRP in the treatment of proximal patellar tendinopathies. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of successive infiltrations which is arguably likely to increase the risks of complications. Methods: Our study is a single blinded, randomized controlled clinical trial on 20 leisure sportsmen (2 groups, respectively 1 or 2 infiltrations of pure PRP) with chronic proximal patellar tendinopathies, rebel to classical management. PRP was obtained using an aphaeresis machine. The one-year follow-up evaluation consisted of VAS, IKDC and VISA-P scores, while algometer, isokinetic and ultrasounds evaluations were carried out up to 3 months. Results: The concentration of the PRP used was similar in both groups. The VAS significantly decreased with time over the 3-month follow-up period (p=0.002), with no difference observed between the two groups (p=0.2). Values obtained with the pressure algometer increased with time across both groups over the 3-month follow-up period (p<0.0001), and values were significantly higher for Group 1 (p=0.001). The IKDC score increased with time in both groups over the follow-up period (p=0.034), with values again significantly higher for Group 1 (p=0.0026). The VISA-P score increased with time in both groups over the follow-up period (p=0.0023), with no difference observed between the groups (p=0.41). No improvements in isokinetic physical performance were observed in either group. However, pain during E30 significantly decreased over the 3-month follow-up period (p=0.027) for patients in both groups. No improvement in either jumping performances or in pain was observed in either group during opto-jump evaluation. No improvements in US findings were observed. After one year, 90% patients of group 1 did not report anymore pain during daily activities, in comparison with only 20% in group 2. Conclusions: A second closely-timed infiltration of PRP to treat proximal patellar tendinopathies is not necessary to improve the efficacy of this treatment. [less ▲]

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See detailSunscreens block cutaneous vitamin D production with only a minimal effect on circulating 25-hydroxyvitamin D
Libon, Florence ULiege; Courtois, Justine; LE GOFF, Caroline ULiege et al

in Archives of Osteoporosis (2017)

Summary A 50+ SPF sunscreen decreased significantly cutaneous vitamin D production following a single narrow-band (nb)UVB exposure, independently from the body surface area exposed. In contrast, the ... [more ▼]

Summary A 50+ SPF sunscreen decreased significantly cutaneous vitamin D production following a single narrow-band (nb)UVB exposure, independently from the body surface area exposed. In contrast, the circulating 25(OH)D3 levels were only minimally affected. It is probable that another endogenous source of precursors is selected when skin-originated precursors are lacking. Purpose Sunscreen use, highly advocated for preventing cutaneous carcinogenesis, is potentially leading to an aggravation of vitamin D deficiency with its consequences on bone health. The effect of sunscreens on circulating vitamin D levels remains debated. This study investigated the effect of sunscreen on cutaneous vitamin D production and circulating 25(OH)D3 levels, according to different body surface areas (BSA). Methods Vitamin D and 25(OH)D3 levels were measured in four groups exposed to a single nbUVB exposure on 9% (group I: head and hands), 23% (group II: head, hands and arms), 50% (group III: head, hands, arms and legs) and 96% (group IV: total body) of the body surface without and with a 50+ sun protection factor sunscreen. Results Sunscreen use decreased by 83, 88.3, 75.7 and 92.5% the cutaneous vitamin D production in groups I to IV, respectively, but only by 13.2, 10.5, 7.7 and 10.4% the values of circulating 25(OH)D3, correspondingly. Conclusions Although a 50+ sunscreen decreases significantly cutaneous vitamin D production following a single nbUVB exposure, and independently from the BSA, the circulating 25(OH)D3 levels were only minimally affected. This could be explained by a switch to another endogenous source of precursors. Short-term sunscreen use probably does not affect circulating vitamin D levels and hence does not increase the risk for osteoporosis. The effect of long-term sunscreen use remains however to be determined. [less ▲]

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See detailLe Stress Oxydant: arnaque ou biologie d'avenir?
LE GOFF, Caroline ULiege

Conference (2017, September 28)

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See detailComparison of cardiac biomarkers fluctuation in runners of marathons, semi-marathons and untrained runners
Le Goff, Caroline ULiege; VRANKEN, Laura ULiege; Kaux, Jean-François ULiege et al

in European Journal of Sports Medicine (2017, September), 5(Supplement 1), 16

BACKGROUND: Regular exercise like running is one important part of the prevention program of cardiovascular disease. There are several studies on biomarker changes during marathons especially cardiac ... [more ▼]

BACKGROUND: Regular exercise like running is one important part of the prevention program of cardiovascular disease. There are several studies on biomarker changes during marathons especially cardiac biomarkers have been studied and mild to moderate elevations have been described as a results of a running exercise Exact underlying mechanism for these biomarker elevations reflecting physiological or even pathobiological changes is unknown and less trained athletes might exhibit a higher risk compared to well trained The aim of our study was to compare three cardiac biomarkers for ischemic condition (Troponin), cardiac stretch (natriuretic peptides) and fibrotic processes (Galectin3) were tested in different type of runners, trained marathon and semimarathon runners and untrained runners before, directly after and 3 hours after the running exercise. METHODS: 23 (mean age 41± 8.8 yo) marathon runners, 15 semimarathon runners(44.1±8.4yo) and 17 healthy sedentary subjects (37± 4.4 yo) (race of 10 km, <2h of sport/week). Blood samples were taken just before (T0), just after (T1) and 3 hours (T3) after the race, centrifuged, aliquoted and stored frozen at 80C before further analysis. The study was approved by the Ethical Committee of our University Hospital. The analyses were performed on the Abbott ARCHITECT i2000SR (Abbott Laboratories, Germany) for the hs cTnI, BNP and Gal3 and on the C8000 (Roche Diagnostics, Switzerland) for hscTnT and NTproBNP according to the manufacturer’s instructions for use. RESULTS: In all 3 running groups there is an increase of cardiac biomarkers Troponin I, BNP, Galectin3 and NTProBNP after completion of the physical exercise. Biomarkers increase is depending on the intensity and duration of the exercise and is higher in long distance marathon and semimarathon runners compared to the control group with a 1 hour run. Cardiac biomarker levels between trained marathon and semimarathon runners were not statistically different in the preexercise baseline samples for BNP, NTProBNP and Galectin3. Compared to untrained runners only Troponin I levels were higher in baseline sample of marathon runners (hscTnI, p<0.03) when compared to controls, cardiac Troponin T (hscTnT, p<0.29) was less significant. CONCLUSIONS: Our study demonstrates that exercises of different intensity can be associated with biochemical abnormalities that may reflect adverse consequences on cardiac structure as fibrosis and biology. With exeption of Troponin I there was no difference in the preexercise baselines samples. [less ▲]

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See detailExploring the effect of a second closely-timed PRP infiltration for tendinopathy
Kaux, Jean-François ULiege; Forthomme, Bénédicte ULiege; Le Goff, Caroline ULiege et al

in European Journal of Sports Medicine (2017, September), 5(Supplement 1), 20-21

INTRODUCTION: Although PRP is very popular in sport, especially since it was removed from the doping list, it remains controversed in literature (3). Up to now, there exists no general agreement on the ... [more ▼]

INTRODUCTION: Although PRP is very popular in sport, especially since it was removed from the doping list, it remains controversed in literature (3). Up to now, there exists no general agreement on the preparation and the use of PRP. Some clinical series have previously evaluated the effect of PRP in the treatment of proximal patellar tendinopathies. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of two or three successive infiltrations. The multiplication of infiltrations is arguably likely to increase the risks of complications, and this treatment can be expensive. PURPOSE: We aimed to evaluate whether two infiltrations of PRP prove more effective than a single treatment. METHODS: Our study is a single blinded, randomized controlled clinical trial on leisure sportsmen with chronic proximal patellar tendinopathies, rebel to classical management, including physiotherapy, shock wave therapy… Twenty patients suffering from proximal patellar tendinopathies for over than 3 months were enrolled into the study. PRP was obtained using an aphaeresis machine (1). The subjects were split into two randomized groups and beneficed of 1 or 2 infiltrations of pure PRP, respectively. The one-year followup evaluation consisted of VAS, IKDC and VISAP scores, while algometer, isokinetic and ultrasounds evaluations were carried out up to 3 months. RESULTS: The concentration of the PRP used for each infiltration was similar in both groups (913.20 ± 65.60 × 103/ L for group 1 and 917.90 ± 63.08for group 2, with virtually no red (<0.001 × 106/ L) nor white cells (<0.001 × 103/ L) in either group). The VAS significantly decreased with time over the 3 month followup period (p = 0002), with no difference observed between the two groups (p = 0.2). Values obtained with the pressure algometer increased with time across both groups over the 3 month followup period (p < 0.0001), and values were significantly higher for Group 1 (p = 0.001). The IKDC score increased with time in both groups over the followup period (p = 0.034), with values again significantly higher for Group 1 (p = 0.0026). The VISAP score increased with time in both groups over the followup period (p = 0.0023), with no difference observed between the groups (p = 0.41). No improvements in isokinetic physical performance were observed in either group. However, pain during E30 significantly decreased over the 3 month followup period (p = 0.027) for patients in both groups. No improvement in either jumping performances or in pain was observed in either group during optojump evaluation. No improvements in US findings were observed. However, an increase of the sagittal hypoechoic area was observed in Group1 (p = 0.0038). After one year, 90% patients of group 1 did not report anymore pain during daily activities, in comparison with only 20% in group 2. In group 1, 20% of subjects still described pain during work activities and 40% during practicing sports versus 40% and 70%, respectively, in group 2. One patient in each group did not return to sport; both subjects still experienced pain through daily and occupational work activities. Six subjects among the group 1 (67%) and 7 among the group 2 (78%) returned to their former sport, and 55% of both groups to the former level than before the tendinopathy. However, 44% of the group 1 and 78% of the group 2 still experienced pain during sports activities. The practiced sports were football, handball, cycling, running, fitness.On the other hand, patients with only few months of symptoms did not evolved more favorably than those with symptoms for longer. CONCLUSIONS: The comparison between 1 or 2 infiltrations of PRP did not reveal any difference between the 2 groups after a followup period of 3 months. A second closely timed infiltration of PRP to treat proximal patellar tendinopathies is not necessary to improve the efficacy of this treatment in the short term (2). However, there remains a need to evaluate the longer term results. REFERENCES: Kaux JF, Croisier JL, Bruyere O, Rodriguez De La Cruz C, Forthomme B, Brabant G, Lapraille S, Lonneux V, Noel D, Le Goff C, Gothot A, Collette J, Crielaard JM. One injection of plateletrich plasma associated to a submaximal eccentric protocol to treat chronic jumper's knee. J Sports Med Phys Fitness. 2015 Sep;55(9):95361 Kaux JF, Croisier JL, Forthomme B, Le Goff C, Buhler F, Savanier B, Delcour S, Gothot A, Crielaard JM. Using plateletrich plasma to treat jumper's knees: Exploring the effect of a second closelytimed infiltration. J Sci Med Sport. 2016 Mar;19(3):2004. Kaux JF, Drion P, Croisier JL, Crielaard JM. Tendinopathies and plateletrich plasma (PRP): from preclinical experiments to therapeutic use. J Stem Cells Regen Med. 2015 May 30;11(1):717. A10 [less ▲]

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See detailImpact of a mountain ultra-marathon (UTMB) on cardiac biomarkers
Le Goff, Caroline ULiege; Gergelé, Laurent; Kaux, Jean-François ULiege et al

in European Journal of Sports Medicine (2017, September), 5(Supplement 1), 15-16

OBJECTIVES: While moderate exercise has beneficial effects on the cardiovascular system, consequences of a supraphysiological effort are not clear yet. In particular, the physiological consequences of ... [more ▼]

OBJECTIVES: While moderate exercise has beneficial effects on the cardiovascular system, consequences of a supraphysiological effort are not clear yet. In particular, the physiological consequences of ultramarathons need to be further documented. The aim of the study was to assess the changes of various cardiac biomarkers after a mountain ultramarathon. MATERIAL AND METHODS: Blood and urine samples were collected on 28 runners (17 men) participating to the UltraTrail du Mont Blanc (105 km, total positive elevation: 5600 m) at 3 different times: before the race (Pre), within 1 h after the finish (Post) and 7 days after the finish (D+7). Several biomarkers involved in heart disease (coronary syndrome, heart failure and fibrosis) and in inflammation were assayed on different analyzers such a COBAS® (for CKMB,TnThs, NTproBNP, HFABP and CRPs) and KRYPTOR® (for Copeptin). ST2 was measured manually with the Presage kit from CRITICAL DIAGNOSTIC®. RESULTS: Plasma levels of cardiac markers (CKMB, TnThs, NTproBNP, copeptin, HFABP, ST2) and inflammation (CRPs) increased significantly at Post. Means values increased from Pre to Post as follows: 2.3 to 91.9 UI/L for CKMB (p<0.0001); 7.6 to 31.7 ng/L for TnThs (p<0.0001); 41.7 to 1190.5 ng/L for NTproBNP, 4.2 to 22.9 pmol/L for copeptin (p=0.001); 3.6 to 107.8 ng/mL for HFABP (p<0.0001), 29.7 to 126.2 ng/mL for ST2 (p<0.0001); 0.5 to 29.1 mg/L for CRPs (p<0.0001). With the exception of a few (HFABP, ST2, CRPs) biomarkers in some subjects, all values were back to Pre values at D+7. DISCUSSION/CONCLUSION: Prolonged strenuous running exercise caused an elevation in cardiac biomarkers. Elevation in CKMB levels lacks specificity for cardiac damage as runners have increased CKMB from skeletal muscles as well. Previous studies suggested that exercise induced TnThs elevation is a benign reversible physiologic phenomenon but this parameter, as well as HFABP, could be a sign of ischemia. Different phenomena occurred such as stretch of myocytes causing an increase in pressure or volume and neurohormonal activation which can explain the Copeptine and NTproBNP increase, while ST2 is a biomarker of cardiac remodeling and fibrosis. CRP is an acute phase compound that tends to increase following a strenuous and prolonged bout of exercise and/or muscular injury. As the values tended to return within the normal reference range values within 7 days after the race, our study suggests that there is no permanent structural damage at the myocardium level. [less ▲]

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See detailA fast and simple method for simultaneous measurements of 25(OH)D, 24,25(OH)2D and the Vitamin D Metabolite Ratio (VMR) in serum samples by LC-MS/MS (powerpoint)
Fabregat Cabello, Neus ULiege; Farre Segura, Jordi ULiege; Huyghebaert, Loreen ULiege et al

Scientific conference (2017, September)

We present here a rapid, easy, reliable and cost-effective method for the quantification of 25-hydryxoyvitamin D2 and D3, epi-25-hydroxyyvitamin D3 and 24,25-dihydroxyvitamin D3 by LC-MS/MS in serum ... [more ▼]

We present here a rapid, easy, reliable and cost-effective method for the quantification of 25-hydryxoyvitamin D2 and D3, epi-25-hydroxyyvitamin D3 and 24,25-dihydroxyvitamin D3 by LC-MS/MS in serum samples. The proposed methodology has been strongly validated with both NIST and Labquality materials, obtaining mean intra-assay and inter-assay imprecision lower than 6 and 6.4% and mean recoveries within 95-104%. Besides we have compared satisfactorily samples from Vitamin D Standardization Program (n=80) with reference values and patient samples (n=281) with our reference LC-MS/MS method. The proposed methodology is prepared to be used in routine testing and permits the calculation of the Vitamin D Metabolite Ratio (VMR). [less ▲]

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See detailA fast and simple method for simultaneous measurements of 25(OH)D, 24,25(OH)2D and the Vitamin D Metabolite Ratio (VMR) in serum samples by LC-MS/MS
Fabregat Cabello, Neus ULiege; Farre Segura, Jordi ULiege; Huyghebaert, Loreen ULiege et al

in Clinica Chimica Acta (2017)

BACKGROUND: Rapid, easy and reliable measurement of the major vitamin D metabolites is required in order to fulfill the needs of a clinical routine laboratory. To overcome these challenges, we have ... [more ▼]

BACKGROUND: Rapid, easy and reliable measurement of the major vitamin D metabolites is required in order to fulfill the needs of a clinical routine laboratory. To overcome these challenges, we have developed and validated a LC-MS/MS method for the quantification of 25-hydroxyvitamin D2 and D3, epi-25-hydroxyvitamin D3 and 24,25-dihydroxyvitamin D3. METHODS: Sample preparation was based on precipitation and centrifugation of 100 µL of patient serum, followed by injection into the LC-MS/MS system. Samples from Vitamin D Standardization Program (n=80) and patient samples (n=281) have been compared with a reference LC-MS/MS method. For the analytical validation NIST and Labquality quality control materials were used. RESULTS: Mean intra-assay and inter-assay imprecision were less than 6.0 and 6.4% and mean recoveries were within 95-104%. LOQ’s were 0.5 µg/L for 24,25(OH)2D3, 1.1 µg/L for 25(OH)D3 and epi-25(OH)D3 and 1.7 µg/L for 25(OH)D2. A 3% bias obtained between the proposed and the reference method satisfies Vitamin D Standardization Program recommendations. CONCLUSIONS: We present a rapid, easy, reliable and cost-effective method completely adequate for routine testing, which permits the measurement of the ratio of 24,25-dihydroxyvitamin D to 25-hydroxyvitamin D, Vitamin D Metabolite Ratio (VMR), in serum samples. [less ▲]

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See detailReference interval determination for serum and urine aldosterone for healthy Belgian population
LE GOFF, Caroline ULiege; Fabregat Cabello, Neus ULiege; Huyghebaert, Loreen ULiege et al

in Clinical Chemistry & Laboratory Medicine (2017, June)

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See detailEstablishment of reference values for 6 six steroids in serum
LE GOFF, Caroline ULiege; Fabregat Cabello, Neus ULiege; Huyghebaert, Loreen ULiege et al

in Clinical Chemistry and Laboratory Medicine (2017, June)

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See detailComparison of cardiac biomarker fluctuation in runners of marathons, semi-marathons and untrained runners
LE GOFF, Caroline ULiege; VRANKEN, Laura ULiege; van Nueten, Jan et al

in Clinical Chemistry & Laboratory Medicine (2017, June)

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See detailQuantification of serum androstanediol glucuronide
LE GOFF, Caroline ULiege

in Clinical Chemistry and Laboratory Medicine (2017, June)

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See detailImpact of an ultra-trail of 330 km on plasma levels
LE GOFF, Caroline ULiege; Kaux, Jean-François ULiege; Gergelé, Laurent et al

in Clinical Chemistry and laboratory medicine (2017, June)

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See detailEccentric training for tendon healing after lesion: a rat model
Kaux, Jean-François ULiege; Libertiaux, Vincent ULiege; Leprince, Pierre ULiege et al

in American Journal of Sports Medicine (2017), 45(6), 1440-1446

BACKGROUND:The tendon is a dynamic entity that remodels permanently. Platelet-rich plasma (PRP) injection has been shown to have a beneficial effect on tendon healing after lesion in rats. Furthermore ... [more ▼]

BACKGROUND:The tendon is a dynamic entity that remodels permanently. Platelet-rich plasma (PRP) injection has been shown to have a beneficial effect on tendon healing after lesion in rats. Furthermore, eccentric exercise seems to improve the mechanical quality of the tendon. HYPOTHESIS:A combination of PRP injection and eccentric training might be more effective than either treatment alone. STUDY DESIGN:Controlled laboratory study. METHODS:Adult male rats were anesthetized, an incision was performed in the middle of their left patellar tendon and an injection of physiological fluid (PF) or homologous PRP was randomly made at the lesion level. The rats were then divided into 2 groups: the eccentric group, undergoing eccentric training 3 times a week, and the untrained group, without any training. Thus, 4 groups were compared. After 5 weeks, the tendons were removed and their ultimate tensile strength and energy were measured. Tendons were frozen for proteomic analyses when all biomechanical tests were completed. Statistical analysis was performed with linear mixed effect models. RESULTS:No significant difference was found between the treatments using PF injection or PRP injection alone. However, the value of the ultimate tensile force at rupture was increased by 4.5 N (108% of control, P = .006) when eccentric training was performed. An intragroup analysis revealed that eccentric training significantly improved the ultimate force values for the PRP group. Proteomic analysis revealed that eccentric training led to an increase in abundance of several cytoskeletal proteins in the PF group, while a decrease in abundance of enzymes of the glycolytic pathway occurred in the PRP treated groups, indicating that this treatment might redirect the exercise-driven metabolic plasticity of the tendon. CONCLUSION: Eccentric training altered the metabolic plasticity of tendon and led to an improvement of injured tendon resistance regardless of the treatment injected (PF or PRP). CLINICAL RELEVANCE:This study demonstrates the necessity of eccentric rehabilitation and training in cases of tendon lesion regardless of the treatment carried out. [less ▲]

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