Differential regulation of IL-22BP in Crohn’s disease versus ulcerative colitis

International audienc

Le retard de croissance intra-utérin induit des altérations de la barrière épithéliale colique et augmente le risque de pathologie colique chez le rat

Le retard de croissance intra-utérin induit des altérations de la barrière épithéliale colique et augmente le risque de pathologie colique chez le rat. Journées Francophones d’Hépato-Gastroentérologie et d’Oncologie Digestiv

Butyrate utilization by the colonic mucosa in inflammatory bowel diseases : A transport deficiency

The short-chain fatty acid butyrate, which is mainly produced in the lumen of the large intestine by the fermentation of dietary fibers, plays a major role in the physiology of the colonic mucosa. It is also the major energy source for the colonocyte. Numerous studies have reported that butyrate metabolism is impaired in intestinal inflamed mucosa of patients with inflammatory bowel disease (IBD). The data of butyrate oxidation in normal and inflamed colonic tissues depend on several factors, such as the methodology or the models used or the intensity of inflammation. The putative mechanisms involved in butyrate oxidation impairment may include a defect in beta oxidation, luminal compounds interfering with butyrate metabolism, changes in luminal butyrate concentrations or pH, and a defect in butyrate transport. Recent data show that butyrate deficiency results from the reduction of butyrate uptake by the inflamed mucosa through downregulation of the monocarboxylate transporter MCT1. The concomitant induction of the glucose transporter GLUT1 suggests that inflammation could induce a metabolic switch from butyrate to glucose oxidation. Butyrate transport deficiency is expected to have clinical consequences. Particularly, the reduction of the intracellular availability of butyrate in colonocytes may decrease its protective effects toward cancer in IBD patients

Intrauterine growth retardation alters the colonic epithelial barrier and increases the risk of colonic deseases in adult rats

Intrauterine growth retardation alters the colonic epithelial barrier and increases the risk of colonic deseases in adult rats. United European Gastroenterology Wee

Efficacy and Safety of Tumor Necrosis Factor Antagonists in Treatment of Internal Fistulizing Crohn's Disease

International audienceBackground & aims - Few data are available on the effects of tumor necrosis factor (TNF) antagonist therapy for patients with internal fistulizing Crohn's disease (CD) and there is debate regarding the risk of abscess. We aimed to assess the long-term efficacy and safety of anti-TNF therapy for patients with internal fistulas. Methods - We performed a retrospective study of data collected from the Groupe d'Etude Thérapeutique des Affections Inflammatoires Digestives trial, from January 1, 2000, through December 31, 2017. Our final analysis included 156 patients who began treatment with an anti-TNF agent for CD with internal fistula (83 men; median disease duration, 4.9 y). The primary end point was the onset of a major abdominal surgery. Secondary analysis included disappearance of the fistula tract during follow-up evaluation and safety. The Kaplan-Meier method was used for statistical analysis. Results - After a median follow-up period of 3.5 years, 68 patients (43.6%) underwent a major abdominal surgery. The cumulative probabilities for being surgery-free were 83%, 64%, and 51% at 1, 3, and 5 years, respectively. A concentration of C-reactive protein >18 mg/L, an albumin concentration <36 g/L, the presence of an abscess at the fistula diagnosis, and the presence of a stricture were associated independently with the need for surgery. The cumulative probabilities of fistula healing, based on imaging analyses, were 15.4%, 32.3%, and 43.9% at 1, 3, and 5 years, respectively. Thirty-two patients (20.5%) developed an intestinal abscess and 4 patients died from malignancies (3 intestinal adenocarcinomas). One patient died from septic shock 3 months after initiation of anti-TNF therapy. Conclusions - In a retrospective analysis of data from a large clinical trial, we found that anti-TNF therapy delays or prevents surgery for almost half of patients with CD and luminal fistulas. However, anti-TNF therapy might increase the risk for sepsis-related death or gastrointestinal malignancies

CAD-CAP: a 25,000-image database serving the development of artificial intelligence for capsule endoscopy

International audienceBackground and study aims : Capsule endoscopy (CE) is the preferred method for small bowel (SB) exploration. With a mean number of 50,000 SB frames per video, SBCE reading is time-consuming and tedious (30 to 60 minutes per video). We describe a large, multicenter database named CAD-CAP (Computer-Assisted Diagnosis for CAPsule Endoscopy, CAD-CAP). This database aims to serve the development of CAD tools for CE reading.Materials and methods Twelve French endoscopy centers were involved. All available third-generation SB-CE videos (Pillcam, Medtronic) were retrospectively selected from these centers and deidentified. Any pathological frame was extracted and included in the database. Manual seg-mentation of findings within these frames was performed by two pre-med students trained and supervised by an expert reader. All frames were then classified by type and clinical relevance by a panel of three expert readers. An automated extraction process was also developed to create a dataset of normal, proofread, control images from normal, complete, SB-CE videos.Results Four-thousand-one-hundred-and-seventy-four SB-CE were included. Of them, 1,480 videos (35 %) containing at least one pathological finding were selected. Findings from 5,184 frames (with their short video sequences) were extracted and delimited: 718 frames with fresh blood, 3,097 frames with vascular lesions, and 1,369 frames with inflammatory and ulcerative lesions. Twenty-thousand normal frames were extracted from 206 SB-CE normal videos. CAD-CAP has already been used for development of automated tools for angiectasia detection and also for two international challenges on medical computerized analysis

Efficacy of adalimumab in patients with Crohn's disease and symptomatic small bowel stricture: a multicentre, prospective, observational cohort study (CREOLE)

International audienc

Les traditions économiques françaises

Les années 1848-1939 correspondent à une époque que l’on a pu caractériser par «l’essor des sciences sociales ». Les économistes français d’alors, et plus généralement les économistes francophones, tiennent dans ce mouvement une place importante. On observe un foisonnement d’idées, d’observations, de théories, tout un riche tissu intellectuel sur des thèmes tels que les crises, la monnaie, les marchés, l’équilibre, l’économie sociale, les questions de méthode, le socialisme ou le libéralisme. Un des intérêts de l’ouvrage est de mieux faire connaître ces travaux, y compris ceux d’auteurs considérés, à tort, comme mineurs. Les économistes français sont imprégnés par les traditions économiques nationales. Traditions en ce qui concerne les théories de la valeur axée sur l’utilité, le rôle donné aux mathématiques sociales, l’importance des sciences de l’ingénieur, l’intérêt pour une économie qui ne soit pas déshumanisée, le débat entre un libéralisme et un socialisme chacun eux-mêmes originaux. L’ouvrage permet de montrer l’importance des relations de l’économie avec d’autres disciplines comme le droit, la psychologie, la sociologie, l’histoire. Il met également l’accent sur les relations entre l’histoire de la pensée et celle des faits, entre les économistes français et ceux du reste du monde