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1. Is it necessary to perform a morphological assessment for an esophageal motility disorder? A retrospective descriptive study

Author

Cloé Charpentier, Julien Recton, Fabien Wuestenberghs, Chloé Melchior, Charlotte Desprez, Elise van der Eecken, Sabrina Sidali, Anne Marie Leroi, Olivier Touchais, Guillaume Gourcerol, Sofya Latrache, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Hôpital Charles Nicolle [Rouen], Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, and UCL - (MGD) Service de gastro-entérologie

Subjects
Endoscopic ultrasound, medicine.medical_specialty, Etiology, Manometry, Esophageal motility disorders, Achalasia, Endoscopic ultrasonography, Endosonography, 03 medical and health sciences, 0302 clinical medicine, medicine, Occult malignancy, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Esophageal Motility Disorders, Esophagogastric junction, Tomography, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Retrospective cohort study, Middle Aged, medicine.disease, 3. Good health, Esophageal Achalasia, Esophageal motility disorder, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Esophagogastric Junction, Radiology, business
Abstract

Background Esophageal motility disorders are most often of primary origin but may be secondary to an occult malignancy or another etiology. High-resolution esophageal manometry cannot differentiate between secondary or primary origin. This study aimed at discussing the usefulness of a morphological assessment in the diagnosis of specific esophageal motility disorders, and to establish the predictive factors of a potential secondary origin. Methods In this retrospective study, patients with suspected esophageal motility disorders who underwent an esophageal manometry were included. High-resolution manometry results were interpreted according to the Chicago Classification, 3rd version. The results of endoscopic ultrasound and computed tomography, assessed by a panel of experts, allowed to diagnose a secondary origin. Key Results Out of 2138 patients undergoing manometry, 502 patients had a esophageal motility disorder suspect to be from secondary origin; among them 182 patients underwent tomography or endoscopic ultrasound. According to experts, 16 patients (8.8%) had a secondary esophageal motility disorder: esophagogastric junction outflow obstruction (n = 7), jackhammer disorder (n = 4), achalasia (n = 3) and localized pressurization (n = 2). The etiology was malignant in 8 patients. Predictive factors suggesting potential secondary esophageal motility disorders were smoking, age ≥ 58 years and an Integrated Relaxation Pressure higher than 10 mmHg for water swallows. Conclusion and Inferences Esophageal motility disorders with organic origin are not uncommon. A morphological assessment using endoscopic ultrasonography and/or computed tomography may be of use to diagnose a secondary origin, especially in the elderly and smokers.

Published
2021
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2. Abdominopelvic CT-scan in emergency departments for patients with suspected complications of Crohn’s disease: a single tertiary center experience

Author

Guillaume Savoye, Coralie Benard, Cloé Charpentier, Mikael Verdalle-Cazes, Céline Savoye-Collet, Jean-Nicolas Dacher, Luc-Marie Joly, Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU), Hôpital Charles Nicolle [Rouen], Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Service de Radiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Malbec, Odile

Subjects
Adult, Male, Crohn’s disease, medicine.medical_specialty, Adolescent, Fistula, [SDV]Life Sciences [q-bio], Perforation (oil well), Pelvis, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Crohn Disease, Internal medicine, Abdomen, medicine, Humans, Abscess, Retrospective Studies, Abdominopelvic CT-scan, Crohn's disease, Univariate analysis, RC86-88.9, business.industry, Emergency department, Research, RC952-1245, Medical emergencies. Critical care. Intensive care. First aid, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Bowel obstruction, [SDV] Life Sciences [q-bio], Special situations and conditions, 030220 oncology & carcinogenesis, Emergency Medicine, 030211 gastroenterology & hepatology, Female, Complication, business, Emergency Service, Hospital, Tomography, X-Ray Computed
Abstract

Background Crohn’s disease (CD) is a chronic disorder with frequent complications. The objective of this study was to assess the predictive factors of finding a complication of CD using abdominopelvic CT-scan in patients with a visit to the emergency department. Methods Patients with at least one visit to the gastroenterology department of our University hospital during the year with a CD were retrospectively included. All visits to the emergency department of the hospital during the follow-up of these patients were identified. Results A total of 638 patients were included and 318 (49.8%) had at least one visit to the emergency department since the beginning of their follow-up. Abdominopelvic CT-scan was performed in 141 (23.7%) of the 595 visits for digestive symptoms. Only 4.3% of these CT-scans were considered as normal; there was luminal inflammation without complication in 24.8%, abscess, fistula or perforation in 22.7%, mechanical bowel obstruction in 36.9% and diagnosis unrelated to CD in 11.3%. In univariate analysis, stricturing phenotype (OR, 2.48; 95% CI, 1.16–5.29; p = 0.02) and previous surgery (OR, 2.90; 95% CI, 1.37–6.14; p = 0.005) were predictive factors of finding a complication of CD using abdominopelvic CT-scan, whereas no independent predictive factor was statistically significant in multivariate analysis. Conclusion In CD patients consulting in emergency department, CT-scan examination was performed in 24% of visits for digestive symptoms and complications of CD were found in 60%. Complications were more frequent in patients with stricturing phenotype and previous surgery.

Published
2021
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3. Magnetic resonance imaging assessment of body composition parameters in Crohn's disease

Author

Cloé Charpentier, Jean-Nicolas Dacher, C. Savoye-Collet, Guillaume Savoye, Pauline Roullee, Ghislain Labarthe, M Dolores, Mikael Verdalle-Cazes, Service de Radiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Université Le Havre Normandie (ULH)

Subjects
Adult, Male, [SDV]Life Sciences [q-bio], Computed tomography, Disease, Mri studies, Body composition, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Magnetic resonance imaging, Crohn Disease, Active disease, Humans, Medicine, Muscle, Skeletal, ComputingMilieux_MISCELLANEOUS, Adiposity, Retrospective Studies, Crohn's disease, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Reproducibility of Results, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Sarcopenia, Cohort, Disease Progression, Feasibility Studies, Female, 030211 gastroenterology & hepatology, business, Nuclear medicine
Abstract

Background Body composition, currently evaluated by computed tomography scan, is related to poor evolution and severity of Crohn's disease (CD). Few MRI studies have been performed, yet it is the most commonly used imaging modality for the surveillance of the disease. Aim Evaluate the feasibility of MRI body composition measurement and compare the variation according to the activity of the disease. Methods A cohort of 132 consecutive patients was studied. The visceral adiposity index (VAI), subcutaneous adiposity index (SAI) and skeletal muscle index (SMI) were measured. Patients were divided into 2 groups according to disease activity. Sarcopenic status was defined according to the cut off value (SMI Results MRI measurements of body composition parameters were feasible and reproducible. After adjustment, sarcopenia was more common (2.07 [1.02; 4.27], p = 0.046), and the SMI (−4.90 [−9.36; −0.431], p = 0.032) was lower in active disease. The SAI was lower (−14.7 [−29.8; 0.258], p = 0.054) in active disease. The VAI tended to be higher with active disease (3.91 [−3.50; 11.9], p = 0.34), and the VAI/SAI+VAI ratio was higher (9.40 [4.72; 14.1], p Conclusion Assessment of body composition is feasible and reproducible in routine MR and parameters are related to disease activity.

Published
2020
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4. Natural history of perianal fistulizing lesions in patients with elderly-onset Crohn’s disease: a population-based study

Author

Marie, Danielou, Hélène, Sarter, Benjamin, Pariente, Mathurin, Fumery, Delphine, Ley, Christel, Mamona, Maël, Barthoulot, Cloé, Charpentier, Laurent, Siproudhis, Guillaume, Savoye, Corinne, Gower-Rousseau, C, Ziade, UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Registre EPIMAD, Normandie Université (NU)-Normandie Université (NU)-CHU Amiens-Picardie-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Epidémiologie et de Santé Publique [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Claude Huriez [Lille], CHU Lille, Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], CHU Amiens-Picardie, Service d'hépato-gastro-entérologie [Rennes] = Gastroenterology [Rennes], CHU Pontchaillou [Rennes], Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), This work was based on the EPIMAD registry, which is funded by the Institut National de la Santé et de la Recherche Médicale [INSERM] and the Agence Santé Publique France. The registry has also received logistic support from the Fondation DigestScience charity [Lille, France]. The research was part of a cohort study of elderly-onset IBD [PHRC] funded by the French Health Ministry [PHRC programme] in 2010. The EPIMAD registry also receives support from Amiens, Lille, and Rouen university hospitals., Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Service d'hépato-gastro-entérologie [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]

Subjects
Male, medicine.medical_specialty, Population, elderly-onset Crohn’s disease, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Interquartile range, Internal medicine, Epidemiology, medicine, Prevalence, Humans, Rectal Fistula, Registries, Age of Onset, education, Aged, education.field_of_study, Crohn's disease, treatment, business.industry, Proportional hazards model, Hazard ratio, Gastroenterology, Surgical Stomas, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, General Medicine, medicine.disease, 3. Good health, perianal disease, Natural history, natural history, 030220 oncology & carcinogenesis, Case-Control Studies, 030211 gastroenterology & hepatology, Female, Tumor Necrosis Factor Inhibitors, epidemiology, France, business, Fecal Incontinence, Immunosuppressive Agents, Cohort study
Abstract

Introduction Most studies of elderly-onset Crohn’s disease [CD; diagnosed in patients aged 60 or over] have described a mild course. However, data on the natural history of perianal fistulising CD [pfCD] in this population are scarce. In a population-based cohort study, we described the prevalence, natural history, and treatment of pfCD in patients with elderly-onset CD vs patients with paediatric-onset CD. Method All patients diagnosed with CD at or after the age of 60 between 1988 and 2006, were included [n = 372]. Logistic regression, Cox models, and a nested case-control method were used to identify factors associated with pfCD. Results A total of 34 elderly patients [9% of the 372] had pfCD at diagnosis. After a median follow-up of 6 years (interquartile range [IQR]: 3; 10), 59 patients [16%] had pfCD; the same prevalence [16%] was observed in paediatric-onset patients. At last follow-up, anal incontinence was more frequent in elderly patients with pfCD than in elderly patients without pfCD [22% vs 4%, respectively; p < 10–4]. Rectal CD at diagnosis was associated with pfCD: hazard ratio (95% confidence interval [CI] = 2.8 [1.6–5.0]). Although 37% of the patients received immunosuppressants and 17% received anti-tumour necrosis factor agents, 24% [14 out of 59] had a definitive stoma at last follow-up. Conclusion During the first 6 years of disease, the prevalence of pfCD was similar in elderly and paediatric patients. Rectal involvement was associated with the appearance of pfCD in elderly-onset patients. Around a quarter of patients with elderly-onset CD will have a stoma. Our results suggest that treatment with biologics should be evaluated in these patients.

Published
2019
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5. Deep remission on magnetic resonance imaging impacts outcomes of perianal fistulizing Crohn’s disease

Author

Mikael Verdalle-Cazes, Marion Chambaz, Céline Savoye-Collet, Lucie Thomassin, Guillaume Savoye, Cloé Charpentier, Valérie Bridoux, Charlotte Desprez, Sébastien Grigioni, Laura Armengol-Debeir, CCSD, Accord Elsevier, Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'imagerie médicale [CHU Rouen], Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Service de nutrition [CHU Rouen], Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service de chirurgie digestive [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Université Le Havre Normandie (ULH)

Subjects
Adult, Male, Anal fistula, medicine.medical_specialty, Contrast enhancement, Adolescent, Kaplan-Meier Estimate, Disease, Perineum, Disease-Free Survival, Tertiary Care Centers, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Gastrointestinal Agents, medicine, Humans, Rectal Fistula, In patient, Pathological, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Crohn's disease, Hepatology, medicine.diagnostic_test, Tumor Necrosis Factor-alpha, business.industry, Adalimumab, Gastroenterology, Antibodies, Monoclonal, Magnetic resonance imaging, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Infliximab, Hyperintensity, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Hospitalization, Treatment Outcome, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Radiology, business
Abstract

The long-term management of perianal Crohn's disease for patients on anti-TNF-α therapy remains challenging.To evaluate the long-term course and complications of patients with perianal fistulas treated with anti-TNF-α based on their clinical remission and healing on MRI.Patients were evaluated clinically and by MRI. Deep remission was defined as clinical remission associated with the absence of contrast enhancement and T2 hyperintensity on MRI. Flare-free survival, surgery and hospitalizations were compared based on the presence or not of deep remission.Forty-eight consecutive patients were included with a median follow-up of 62 months after anti-TNF-α first administration. Deep remission was observed in 16 patients (33.4%). For patients in deep remission, the median time to any perianal event was 116 months (95-130) versus 42 months (8-72) in patients with pathological MRI (p 0.001). Sixteen patients (50%) with pathological MRI had perianal surgery versus 2 (12.5%) in the deep remission group (p 0.05). The mean duration of cumulative hospital stays was 0.75 ± 0.52 days in the deep remission group versus 19.7 ± 7.4 in the pathological group (p 0.05).Higher flare-free survival and lower rates of surgery and hospitalization were found in patients achieving deep remission.

Published
2019
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6. Dietary n-3 PUFA May Attenuate Experimental Colitis

Author

Aito Ueno, Charlène Guérin, Khaly Mbodji, E. Salameh, Moïse Coëffier, Guillaume Savoye, Subrata Ghosh, Cloé Charpentier, Rachel Marion-Letellier, Ronald Chan, Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Department of Biological Sciences [Calgary], University of Calgary, Kitasato University, Service de nutrition [CHU Rouen], University of Birmingham [Birmingham], douville, sabine, and Hôpital Charles Nicolle [Rouen]-CHU Rouen

Subjects
Male, 0301 basic medicine, Nitric Oxide Synthase Type II, Occludin, Rats, Sprague-Dawley, 0302 clinical medicine, Claudin-1, 2. Zero hunger, chemistry.chemical_classification, Tight junction, Experimental colitis, Colitis, 3. Good health, 030211 gastroenterology & hepatology, Tumor necrosis factor alpha, medicine.symptom, Research Article, Polyunsaturated fatty acid, lcsh:RB1-214, medicine.medical_specialty, Article Subject, Immunology, Inflammation, Leukotriene B4, digestive system, 03 medical and health sciences, Internal medicine, Fatty Acids, Omega-3, medicine, lcsh:Pathology, Animals, N 3 pufa, Interleukin-6, Tumor Necrosis Factor-alpha, business.industry, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Cell Biology, Inflammatory Bowel Diseases, medicine.disease, digestive system diseases, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Rats, Disease Models, Animal, 030104 developmental biology, Endocrinology, chemistry, Cyclooxygenase 2, business
Abstract

Background. Inflammatory bowel diseases (IBD) occurred in genetically predisposed people exposed to environmental triggers. Diet has long been suspected to contribute to the development of IBD. Supplementation with n-3 polyunsaturated fatty acids (PUFA) protects against intestinal inflammation in rodent models while clinical trials showed no benefits. We hypothesized that intervention timing is crucial and dietary fatty acid pattern may influence intestinal environment to modify inflammation genesis. The aim of this study was to evaluate the dietary effect of PUFA composition on intestinal inflammation.Methods. Animals received diet varying in their PUFA composition for four weeks before TNBS-induced colitis. Colon inflammatory markers and gut barrier function parameters were assessed. Inflammatory pathway PCR arrays were determined.Results. n-3 diet significantly decreased colon iNOS, COX-2 expression, IL-6 production, and LTB4 production but tended to decrease colon TNFαproduction (P=0.0617) compared to control diet. Tight junction protein (claudin-1, occludin) expressions and MUC2 and TFF3 mRNA levels were not different among groups. n-9 diet also decreased colon IL-6 production (P<0.05).Conclusions. Dietary n-3 PUFA influence colitis development by attenuating inflammatory markers. Further research is required to better define dietary advice with a scientific rationale.

Published
2018
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7. Natural history of elderly-onset inflammatory bowel disease: a population-based cohort study

Author

Corinne Gower-Rousseau, Julia Salleron, Jean-Louis Dupas, Guillaume Savoye, Antoine Cortot, Luc Dauchet, Eric Lerebours, Jean-Eric Laberenne, Laurent Peyrin-Biroulet, Mathurin Fumery, Véronique Merle, Jean-Frederic Colombel, Cloé Charpentier, Francis Vasseur, Registre EPIMAD, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Amiens-Picardie-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Service de biostatistiques [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], CHU Amiens-Picardie, Département d'épidémiologie et de promotion de la santé [Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Service d'Hépato-Gastroenterologie [Seclin], Centre Hospitalier de Seclin, Service de Gastroenterologie [CHRU Lille], Service d'Epidémiologie et de Santé Publique [Lille], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Icahn School of Medicine at Mount Sinai [New York] (MSSM)

Subjects
Male, Epidemiology, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Anti-Inflammatory Agents, Kaplan-Meier Estimate, Gastroenterology, Inflammatory bowel disease, 0302 clinical medicine, Elderly, Crohn Disease, Registries, Age of Onset, Child, Colectomy, Aged, 80 and over, education.field_of_study, Crohn's disease, Middle Aged, Ulcerative colitis, Combined Modality Therapy, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Disease Progression, 030211 gastroenterology & hepatology, Female, France, Immunosuppressive Agents, Adult, medicine.medical_specialty, Adolescent, Population, 03 medical and health sciences, Young Adult, Internal medicine, medicine, Humans, education, Proctitis, Aged, Proportional Hazards Models, Retrospective Studies, business.industry, Inflammatory Bowel Disease, medicine.disease, Surgery, Colitis, Ulcerative, business, Follow-Up Studies
Abstract

International audience; Data on the natural history of elderly-onset inflammatory bowel disease (IBD) are scarce.METHODS:In a French population-based cohort we identified 841 IBD patients >60 years of age at diagnosis from 1988 to 2006, including 367 Crohn's disease (CD) and 472 ulcerative colitis (UC).RESULTS:Median age at diagnosis was similar for CD (70 years (IQR: 65-76)) and UC (69 years (64-74)). Median follow-up was 6 years (2-11) for both diseases. At diagnosis, in CD, pure colonic disease (65%) and inflammatory behaviour (78%) were the most frequent phenotype. At maximal follow-up digestive extension and complicated behaviour occurred in 8% and 9%, respectively. In UC, 29% of patients had proctitis, 45% left-sided and 26% extensive colitis without extension during follow-up in 84%. In CD cumulative probabilities of receiving corticosteroids (CSs), immunosuppressants (ISs) and anti tumor necrosis factor therapy were respectively 47%, 27% and 9% at 10 years. In UC cumulative probabilities of receiving CS and IS were 40% and 15%, respectively at 10 years. Cumulative probabilities of surgery at 1 year and 10 years were 18% and 32%, respectively in CD and 4% and 8%, respectively in UC. In CD complicated behaviour at diagnosis (HR: 2.6; 95% CI 1.5 to 4.6) was associated with an increased risk for surgery while CS was associated with a decreased risk (HR: 0.5; 0.3 to 0.8). In UC CS was associated with an increased risk (HR: 2.2; 1.1 to 4.6) for colectomy.CONCLUSIONS:Clinical course is mild in elderly-onset IBD patients. This information would need to be taken into account by physicians when therapeutic strategies are established.

Published
2014
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8. Magnetic resonance colonography in rats with TNBS-induced colitis: a feasibility and validation study

Author

C. Savoye-Collet, Cloé Charpentier, Pierre Vera, Lionel Nicol, Guillaume Savoye, Moutaz Aziz, Rachel Marion-Letellier, Pierre Déchelotte, Paul Mulder, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Nouvelles Cibles Pharmacologiques de la Protection Endothéliale et de l'Insuffisance Cardiaque (EnVI), CHU Rouen, Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Breton, Céline

Subjects
Male, medicine.medical_specialty, Validation study, Blotting, Western, Nitric Oxide Synthase Type II, Gastroenterology, 030218 nuclear medicine & medical imaging, Rats, Sprague-Dawley, 03 medical and health sciences, 0302 clinical medicine, Cytokines metabolism, Internal medicine, medicine, Animals, Immunology and Allergy, Intestinal Mucosa, Chronic colitis, ComputingMilieux_MISCELLANEOUS, Tnbs colitis, medicine.diagnostic_test, business.industry, Reproducibility of Results, Magnetic resonance imaging, Colonoscopy, Colonic wall, Colitis, Magnetic Resonance Imaging, Rats, 3. Good health, Sprague dawley, Disease Models, Animal, Trinitrobenzenesulfonic Acid, Cyclooxygenase 2, Cytokines, Feasibility Studies, 030211 gastroenterology & hepatology, Inflammation Mediators, Signal intensity, business
Abstract

Magnetic resonance colonography (MRC) has been recently developed to assess bowel inflammation in inflammatory bowel disease (IBD) patients. Evaluating animal models of inflammation with MRC may be important in new drug-screening processes. The aim of this study was to assess the feasibility of MRC in colitic rats and confront it with model characteristics.Colitis was induced by rectal injection of trinitrobenzene-sulfonic acid (TNBS) in 13 rats while six rats received the vehicle. MRC was performed at day 2. Colon inflammation and production of inflammatory mediators were evaluated. Image quality was assessed by wall and motion artifacts. MRC criteria were bowel wall thickness, wall signal intensity on T2-weighted (T2w) and T1w images, the appearance of a target sign pattern, and irregular patterns of mucosal surface.MRC quality was good or excellent in 16/21 examinations with no difference between groups. Colitis rats were significantly different from controls in terms of wall thickness (P = 0.004), the appearance of a target sign pattern (P = 0.02), irregular patterns of mucosal surface (P = 0.01), and hyperintensity on T1w images (P = 0.03). All MRC criteria except maximal bowel wall thickness were associated with colon weight:length ratio and inflammatory biomarkers (all P0.05). Minimal bowel wall thickness and wall signal intensity on T2w images were associated with histological score (P0.05).MRC is feasible and reliable in rats with TNBS-induced colitis. MRC criteria including colon wall thickness, wall signal intensity on T2w images, hyperintensity in T1w sequence, and the appearance of a target sign pattern may be potential targets for new IBD drugs.

Published
2012

9. Intérêt de l’analyse de la composition corporelle en tomodensitométrie dans la maladie de Crohn

Author

Thiberge, Claire, UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), and Cloé Charpentier

Subjects
Composition corporelle, Maladie de Crohn, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Tomodensitométrie
Abstract

La maladie de Crohn (MC) est fréquemment associée à la perte de poids et à la dénutrition. De plus, des modifications de la composition corporelle ont été décrits chez les patients atteints de MC. Mais le rôle de la composition corporelle dans l'évolution de la MC reste non élucidé. L'objectif de cette étude était d'évaluer la composition corporelle par tomodensitométrie (TDM) chez les patients atteints de MC, en comparant avec les paramètres anthropométriques et biologiques. Nous avons également étudié l’évolution de ces patients, en fonction des différents paramètres de composition corporelle au moment de la TDM. Méthodes : Les patients atteints de MC ayant réalisé une TDM abdominale pour suspicion de complication, entre janvier 2011 et décembre 2015 ont été inclus rétrospectivement. L’indice de masse corporelle (IMC) et l’albuminémie ont été analysés. La définition de l'évolution défavorable dans les 6 mois suivant la TDM comprenait la chirurgie en lien avec la maladie ou le décès. Les indices de muscle squelettique (SMI), d’adiposité viscérale (VAI) et sous-cutanée (SAI) ont été calculés à partir des surfaces de tissu mesurées au niveau de la troisième vertèbre lombaire en TDM, divisées par la taille au carré. Résultats :Dans notre cohorte, la prévalence de l’insuffisance pondérale était de 26,8% alors que celle de la sarcopénie était de 33,6%. Après ajustement selon le sexe, le SMI tendait à diminuer chez les patients avec chirurgie ou décès dans les 6 mois suivant la TDM, comparativement aux patients sans chirurgie ni décès (p=0,0746). De plus, le SAI et le VAI étaient significativement plus faibles chez les patients opérés ou décédés (p=0,0091 et pConclusion : La TDM semble plus adaptée et plus précise que l’IMC ou l’albuminémie pour évaluer la composition corporelle chez les patients atteints de MC. Le SAI et le VAI étaient inversement corrélés à la chirurgie ou le décès dans les 6 mois suivant la TDM chez les patients atteints de MC. L'altération de la composition corporelle évaluée par TDM chez les patients atteints de MC semble être un marqueur de sévérité de la maladie. Ainsi, chez les patients atteints de MC qui effectuent une TDM abdominale, nous pourrions utiliser la composition corporelle pour détecter les patients à risque d'évolution défavorable.

Published
2017

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