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Barré T, Carrat F, Ramier C, Fontaine H, Di Beo V, Bureau M, Dorival C, Larrey D, Delarocque-Astagneau E, Mathurin P, Marcellin F, Petrov-Sanchez V, Cagnot C, Carrieri P, Pol S, Protopopescu C, Alric L, Pomes C, Zoulim F, Maynard M, Bai R, Hucault L, Bailly F, Raffi F, Billaud E, Boutoille D, Lefebvre M, André-Garnier E, Cales P, Hubert I, Lannes A, Lunel F, Boursier J, Asselah T, Boyer N, Giuily N, Castelnau C, Scoazec G, Pol S, Fontaine H, Rousseaud E, Vallet-Pichard A, Sogni P, de Ledinghen V, Foucher J, Hiriart JB, M’Bouyou J, Irlès-Depé M, Bourlière M, Ahmed SNS, Oules V, Tran A, Anty R, Gelsi E, Truchi R, Thabut D, Hammeche S, Moussali J, Causse X, De Dieuleveult B, Ouarani B, Labarrière D, Ganne N, Grando-Lemaire V, Nahon P, Brulé S, Ulker B, Guyader D, Jezequel C, Brener A, Laligant A, Rabot A, Renard I, Habersetzer F, Baumert TF, Doffoel M, Mutter C, Simo-Noumbissie P, Razi E, Bronowicki JP, Barraud H, Bensenane M, Nani A, Hassani-Nani S, Bernard MA, Pageaux GP, Larrey D, Meszaros M, Metivier S, Bureau C, Morales T, Peron JM, Robic MA, Decaens T, Faure M, Froissart B, Hilleret MN, Zarski JP, Riachi G, Goria O, Paris F, Montialoux H, Leroy V, Amaddeo G, Varaut A, Simoes M, Amzal R, Chazouillières O, Andreani T, Angoulevant B, Chevance A, Serfaty L, Samuel D, Antonini T, Coilly A, Duclos-Vallée JC, Tateo M, Abergel A, Reymond M, Brigitte C, Benjamin B, Muti L, Geist C, Conroy G, Riffault R, Rosa I, Barrault C, Costes L, Hagège H, Loustaud-Ratti V, Carrier P, Debette-Gratien M, Mathurin P, Lassailly G, Lemaitre E, Canva V, Dharancy S, Louvet A, Minello A, Latournerie M, Bardou M, Mouillot T, D’Alteroche L, Barbereau D, Nicolas C, Elkrief L, Jaillais A, Gournay J, Chevalier C, Archambeaud I, Habes S, Portal I, Gelu-Simeon M, Saillard E, Lafrance MJ, Catherine L, Carrat F, Chau F, Dorival C, Goderel I, Lusivika-Nzinga C, Bellance MA, Bellet J, Monfalet P, Chane-Teng J, Bijaoui S, Pannetier G, Téoulé F, Nicol J, Sebal F, Bekhti R, Cagnot C, Boston A, Nailler L, Le Meut G, Diallo A, Petrov-Sanchez V, Bourlière M, Boursier J, Carrat F, Carrieri P, Delarocque-Astagneau E, De Ledinghen V, Dorival C, Fontaine H, Fourati S, Housset C, Larrey D, Nahon P, Pageaux GP, Petrov-Sanchez V, Pol S, Bruyand M, Wittkop L, Zoulim F, Zucman-Rossi J, L’hennaff M, Sizorn M, Cagnot C. Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: results from the ANRS CO22 Hepather cohort. J Cannabis Res 2022; 4:31. [PMID: 35690798 PMCID: PMC9188079 DOI: 10.1186/s42238-022-00138-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/19/2022] [Indexed: 11/21/2022] Open
Abstract
Background Patients with chronic hepatitis C virus (HCV) infection are at greater risk of developing metabolic disorders. Obesity is a major risk factor for these disorders, and therefore, managing body weight is crucial. Cannabis use, which is common in these patients, has been associated with lower corpulence in various populations. However, this relationship has not yet been studied in persons with chronic HCV infection. Methods Using baseline data from the French ANRS CO22 Hepather cohort, we used binary logistic and multinomial logistic regression models to test for an inverse relationship between cannabis use (former/current) and (i) central obesity (i.e., large waist circumference) and (ii) overweight and obesity (i.e., elevated body mass index (BMI)) in patients from the cohort who had chronic HCV infection. We also tested for relationships between cannabis use and both waist circumference and BMI as continuous variables, using linear regression models. Results Among the 6348 participants in the study population, 55% had central obesity, 13.7% had obesity according to their BMI, and 12.4% were current cannabis users. After multivariable adjustment, current cannabis use was associated with lower risk of central obesity (adjusted odds ratio, aOR [95% confidence interval, CI]: 0.45 [0.37–0.55]), BMI-based obesity (adjusted relative risk ratio (aRRR) [95% CI]: 0.27 [0.19–0.39]), and overweight (aRRR [95% CI]: 0.47 [0.38–0.59]). This was also true for former use, but to a lesser extent. Former and current cannabis use were inversely associated with waist circumference and BMI. Conclusions We found that former and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. Longitudinal studies are needed to confirm these relationships and to assess the effect of cannabis use on corpulence and liver outcomes after HCV cure. Trial registration ClinicalTrials.gov identifier: NCT01953458.
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Brunton E, Brunton A, Hohwieler K, Ogbourne S, Conroy G. Spatial genetic structure and gene flow of the eastern grey kangaroo (Macropus giganteus), in a rapidly urbanising landscape. Glob Ecol Conserv 2022. [DOI: 10.1016/j.gecco.2022.e02273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Carrieri P, Carrat F, Di Beo V, Bourlière M, Barré T, De Ledinghen V, Pageaux GP, Bureau M, Cagnot C, Dorival C, Delarocque-Astagneau E, Marcellin F, Pol S, Fontaine H, Protopopescu C, Laurent Alric, Bonnet D, Payssan-Sicart V, Pomes C, Zoulim F, Maynard M, Bai R, Hucault L, Bailly F, Raffi F, Billaud E, Boutoille D, Lefebvre M, André-Garnier E, Cales P, Hubert I, Lannes A, Lunel F, Boursier J, Asselah T, Boyer N, Giuily N, Castelnau C, Scoazec G, Pol S, Fontaine H, Rousseaud E, Vallet-Pichard A, Sogni P, de Ledinghen V, Foucher J, Hiriart JB, M’Bouyou J, Irlès-Depé M, Bourlière M, Si Ahmed SN, Oules V, Tran A, Anty R, Gelsi E, Truchi R, Thabut D, Hammeche S, Moussali J, Causse X, De Dieuleveult B, Ouarani B, Labarrière D, Ganne N, Grando-Lemaire V, Nahon P, Brulé S, Ulker B, Guyader D, Jezequel C, Brener A, Laligant A, Rabot A, Renard I, Habersetzer F, Baumert TF, Doffoel M, Mutter C, Simo-Noumbissie P, Razi E, Bronowicki JP, Barraud H, Bensenane M, Nani A, Hassani-Nani S, Bernard MA, Pageaux GP, Larrey D, Meszaros M, Metivier S, Bureau C, Morales T, Peron JM, Robic MA, Decaens T, Froissart B, Hilleret MN, Costentin C, Gerster T, Riachi G, Goria O, Paris F, Montialoux H, Leroy V, Amaddeo G, Varaut A, Simoes M, Amzal R, Chazouillières O, Andreani T, Angoulevant B, Chevance A, Serfaty L, Duclos Vallée JC, Samuel D, Antonini T, Coilly A, Tateo M, Abergel A, Reymond M, Brigitte C, Benjamin B, Muti L, Geist C, Conroy G, Riffault R, Rosa I, Barrault C, Costes L, Hagège H, Loustaud-Ratti V, Carrier P, Debette-Gratien M, Mathurin P, Lassailly G, Lemaitre E, Canva V, Dharancy S, Louvet A, Minello A, Latournerie M, Bardou M, Mouillot T, D’Alteroche L, Barbereau D, Nicolas C, Elkrief L, Jaillais A, Gournay J, Chevalier C, Archambeaud I, Habes S, Portal I, Gelu-Simeon M, Saillard E, Lafrance MJ, Catherine L, Carrat F, Chau F, Dorival C, Goderel I, Lusivika-Nzinga C, Bellance MA, Bellet J, Monfalet P, Chane-Teng J, Bijaoui S, Pannetier G, Téoulé F, Nicol J, Bekhti R, Cagnot C, Boston A, Nailler L, Le Meut G, Diallo A, Petrov-Sanchez V, Marc Bourlière, Boursier J, Carrat F, Carrieri P, Delarocque-Astagneau E, De Ledinghen V, Dorival C, Fontaine H, Fourati S, Housset C, Larrey D, Nahon P, Pageaux GP, Petrov-Sanchez V, Pol S, Bruyand M, Wittkop L, Zoulim F, Zucman-Rossi J, L’hennaff M, Sizorn M, Boston A, Diallo A, Cagnot C, Bousselet A, Caralp M. Severe liver fibrosis in the HCV cure era: major effects of social vulnerability, diabetes, and unhealthy behaviors. JHEP Rep 2022; 4:100481. [PMID: 35514789 PMCID: PMC9065909 DOI: 10.1016/j.jhepr.2022.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/08/2022] [Accepted: 02/24/2022] [Indexed: 11/06/2022] Open
Abstract
Background & Aims After HCV cure, not all patients achieve significant liver fibrosis regression. We explored the effects of clinical and socio-behavioral factors on liver fibrosis, before and after HCV cure with direct-acting antivirals. Methods We analyzed data from the ongoing ANRS CO22 HEPATHER cohort, which prospectively collects clinical and socio-behavioral data on HCV-infected patients. Mixed-effects logistic regression models helped identify predictors of longitudinal measures of severe liver fibrosis, defined as a fibrosis-4 index >3.25. We also estimated the adjusted population attributable fractions (PAFs) for modifiable risk factors. Results Among the 9,692 study patients (accounting for 24,687 visits over 4 years of follow-up, 48.5% of which were post-HCV cure), 26% had severe fibrosis at enrolment. After multivariable adjustment, HCV-cured patients had an 87% lower risk of severe fibrosis. An inverse dose-response relationship was found for coffee consumption, with the risk of severe fibrosis diminishing by 58% per additional cup/day (adjusted odds ratio (aOR 0.42; 95% CI 0.38-0.46). Unemployment, low educational level, and diabetes were associated with a higher severe fibrosis risk (aOR 1.69; 95% CI 1.32-2.16, aOR 1.50; 95% CI 1.20-1.86, and aOR 4.27; 95% CI 3.15-5.77, respectively). Severe fibrosis risk was 3.6/4.6-fold higher in individuals with previous/current unhealthy alcohol use than in abstinent patients. All these associations remained valid after HCV cure. The risk factors accounting for the greatest severe fibrosis burden were unemployment, low education level, and diabetes (PAFs: 29%, 21%, and 17%, respectively). Conclusions Monitoring liver fibrosis after HCV cure is crucial for patients with low socioeconomic status, previous/current unhealthy alcohol use, and diabetes. Innovative HCV care models for the most socially vulnerable individuals and interventions for healthier lifestyles are needed to reinforce the positive effects of HCV cure on liver health. Lay summary After hepatitis C virus (HCV) cure, not all patients achieve significant liver fibrosis regression. Herein, we studied the effects of clinical and socio-behavioral factors on the risk of severe liver fibrosis. Coffee consumption was strongly inversely associated with severe fibrosis, while diabetes, previous and current unhealthy alcohol use were associated with a 4.3-, 3.6- and 4.6-fold higher risk of severe fibrosis, respectively. Unemployment and low educational level were also associated with a higher risk of severe fibrosis. All these associations remained valid after HCV cure. These results demonstrate the need to continue liver fibrosis monitoring in at-risk groups, and to facilitate healthier lifestyles after HCV cure as a clinical and public health priority. Liver fibrosis assessment is a key prognostic tool in the hepatitis C cure era. Significant liver fibrosis regression does not always occur after hepatitis C cure. Coffee intake displays protective effects on severe fibrosis even after HCV cure. Social vulnerability, diabetes, and unhealthy alcohol use predict severe fibrosis. Socio-behavioral factors are associated with severe fibrosis even after HCV cure.
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Maida M, Alrubaiy L, Bokun T, Bruns T, Castro V, China L, Conroy G, Trabulo D, Van Steenkiste C, Voermans RP, Burisch J, Ianiro G. Current challenges and future needs of clinical and endoscopic training in gastroenterology: a European survey. Endosc Int Open 2020; 8:E525-E533. [PMID: 32258375 PMCID: PMC7089798 DOI: 10.1055/a-1093-0877] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/04/2019] [Indexed: 12/19/2022] Open
Abstract
Background and study aims A universal European training program in gastroenterology and hepatology is currently not available. The European Board of Gastroenterology and Hepatology (EBGH) has produced guidance regarding expected competencies for European gastroenterology trainees but it is unclear whether these have been incorporated in national curricula. The aim of this study was to provide an in-depth assessment of training and research opportunities, professional activities and of socioeconomic aspects of gastroenterology training across Europe through a web-based 90-point questionnaire. Materials and methods Physicians in their last year or who had recently finished their training, from 16 European countries, were invited to answer the questionnaire. Results A total of 144 physicians answered the survey. A minimum number of procedures is required before completing training in nine of 16 countries (56 %). Overall, European trainees dedicate a median of 12 months (IQR 6-25) of their training period to endoscopy and a median of 3 months (IQR 0-6) to ultrasound. Training in interventional endoscopy was not always exhaustive, as about 50 % of participants performed fewer of several interventional procedures than was recommended by EBGH, most participants did not perform endoscopic hemostasis or endoscopic mucosal resection, and nearly a half of participants had no access to pancreatobiliary endoscopy training. Finally, up to 13 % of residents complete their training without the supervision of a mentor. Conclusion In this large European survey, deep gaps and considerable differences in several gastroenterology training activities were found both among and within 16 European countries. Homogenization of educational programs and training opportunities across Europe is therefore necessary.
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Affiliation(s)
- Marcello Maida
- Department of Gastroenterology, S.Elia - Raimondi Hospital, Caltanissetta, Italy
| | - Laith Alrubaiy
- Department of Gastroenterology, St Mark’s Hospital, London, UK
| | - Tomislav Bokun
- Department of Gastroenterology, Hepatology and clinical nutrition, University Hospital Dubrava, University of Zagreb, Zagreb, Yugoslavia
| | - Tony Bruns
- Department of Medicine III, University Hospital RWTH Aachen, Germany
| | - Valeria Castro
- Department of Internal Medicine, Gastroenterology and Hepatology Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Louise China
- Metabolism and Experimental Therapeutics, Division of Medicine, University College London, London, UK
| | - Guillaume Conroy
- Department of Hepatology and Gastroenterology, Mercy Hospital, Metz, France
| | - Daniel Trabulo
- Gastroenterology department, Hospital de Cascais, Hospital da Luz Setúbal, Portugal
| | | | - Rogier P. Voermans
- Department of Gastroenterology & Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Johan Burisch
- Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark
| | - Gianluca Ianiro
- Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Amiot A, Conroy G, Le Baleur Y, Winkler J, Palazzo M, Treton X. Endoscopic training: A nationwide survey of French fellows in gastroenterology. Clin Res Hepatol Gastroenterol 2018; 42:160-167. [PMID: 28927657 DOI: 10.1016/j.clinre.2017.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 08/07/2017] [Accepted: 08/15/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND During their 4 years of training, French fellows in gastroenterology should acquire theoretical and practical competency in gastrointestinal (GI) endoscopy. AIMS To evaluate the delivery of endoscopy training to French GI fellows and perception of learning. METHODS A nationwide electronic survey was carried out of French GI fellows using an anonymous, 17-item electronic questionnaire. RESULTS A total of 291 out of 484 (60%) GI fellows responded to the survey. Only 40% of subjects had access to theoretical training and/or virtual simulators. Only 49% and 35% of fourth year fellows had reached the threshold numbers of EGD and colonoscopies recommended by the European section and Board of gastroenterology and hepatology. Sixty-two percent and 57% of trainees reported having insufficient knowledge in interpreting gastric and colic lesions. Access to dedicated endoscopy activity for at least 8 weeks during the year was the only independent factor associated with the achievement of the recommended annual threshold number of procedures. CONCLUSION The access of fellows to theoretical training and to preclinical virtual simulators is still insufficient. Personalized support and regular assessment of cognitive and technical acquisition over the 4 years of training seems to be necessary.
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Affiliation(s)
- Aurélien Amiot
- Department of gastroenterology, Henri Mondor hospital, AP-HP, EC2M3-EA 7375, Paris-Est Creteil Val-de-Marne university (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - Guillaume Conroy
- Association française des internes d'hépatogastroentérologie (AFIHGE), Maison de l'hépatogastroentérologie et de l'endoscopie digestive, 79, boulevard du Montparnasse, 75006 Paris, France
| | - Yann Le Baleur
- Department of gastroenterology, Henri Mondor hospital, AP-HP, EC2M3-EA 7375, Paris-Est Creteil Val-de-Marne university (UPEC), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - Jérôme Winkler
- Association française des internes d'hépatogastroentérologie (AFIHGE), Maison de l'hépatogastroentérologie et de l'endoscopie digestive, 79, boulevard du Montparnasse, 75006 Paris, France
| | - Maxime Palazzo
- Department of gastrointestinal endoscopy, Beaujon hospital, AP-HP, university Paris 7 Denis Diderot, 92110 Clichy, France
| | - Xavier Treton
- Department of gastroenterology, IBD and nutrition support, Beaujon hospital, AP-HP, UMR1149, university Paris 7 Denis Diderot, 92110 Clichy, France
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Oussalah A, Rischer S, Bensenane M, Conroy G, Filhine-Tresarrieu P, Debard R, Forest-Tramoy D, Josse T, Reinicke D, Garcia M, Luc A, Baumann C, Ayav A, Laurent V, Hollenbach M, Ripoll C, Guéant-Rodriguez RM, Namour F, Zipprich A, Fleischhacker M, Bronowicki JP, Guéant JL. Plasma mSEPT9: A Novel Circulating Cell-free DNA-Based Epigenetic Biomarker to Diagnose Hepatocellular Carcinoma. EBioMedicine 2018; 30:138-147. [PMID: 29627389 PMCID: PMC5952996 DOI: 10.1016/j.ebiom.2018.03.029] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 03/23/2018] [Indexed: 02/06/2023] Open
Abstract
Background Patients with cirrhosis are at high risk of hepatocellular carcinoma (HCC). The SEPT9 gene is a key regulator of cell division and tumor suppressor whose hypermethylation is associated with liver carcinogenesis. The primary aim of this study was to evaluate the diagnostic accuracy of a PCR-based assay for the analysis of SEPT9 promoter methylation in circulating cell-free DNA (mSEPT9) for diagnosing HCC among cirrhotic patients. Methods We report two phase II biomarker studies that included cirrhotic patients with or without HCC from France (initial study) and Germany (replication study). All patients received clinical and biological evaluations, and liver imaging according to current recommendations. The primary outcome was defined as the presence of HCC according to guidelines from the American Association for the Study of Liver Diseases. The diagnosis of HCC was confirmed by abdominal contrast-enhanced computed tomography scan and systematically discussed in a multidisciplinary consultation meeting. HCC-free cirrhotic patients were recruited if the screening abdominal ultrasound showed no evidence of HCC at the time of blood sampling for the mSEPT9 test and on the next visit six months later. The adjudicating physicians were blinded to patient results associated with the mSEPT9 test. Findings We included 289 patients with cirrhosis (initial: 186; replication: 103), among whom 98 had HCC (initial: 51; replication: 47). The mSEPT9 test exhibited high diagnostic accuracy for HCC diagnosis, with an area under the receiver operating characteristic curve (AUROC) of 0.944 (0.900–0.970, p < 0.0001) in the initial study (replication: 0.930 [0.862–0.971, p < 0.0001]; meta-analysis: AUROC = 0.940 [0.910–0.970, p < 0.0001], no heterogeneity: I2 = 0%, p = 0.67; and no publication bias). In multivariate logistic regression analysis, the number of positive mSEPT9 triplicates was the only independent variable significantly associated with HCC diagnosis (initial: OR = 6.30, for each mSEPT9 positive triplicate [2.92–13.61, p < 0.0001]; replication: OR = 6.07 [3.25–11.35, p < 0.0001]; meta-analysis: OR = 6.15 [2.93–9.38, p < 0.0001], no heterogeneity: I2 = 0%, p = 0.95; no publication bias). AUROC associated with the discrimination of the logistic regression models in initial and validation studies were 0.969 (0.930–0.989) and 0.942 (0.878–0.978), respectively, with a pooled AUROC of 0.962 ([0.937–0.987, p < 0.0001], no heterogeneity: I2 = 0%, p = 0.36; and no publication bias). Interpretation Among patients with cirrhosis, the mSEPT9 test constitutes a promising circulating epigenetic biomarker for HCC diagnosis at the individual patient level. Future prospective studies should assess the mSEPT9 test in the screening algorithm for cirrhotic patients to improve risk prediction and personalized therapeutic management of HCC. Patients with cirrhosis are at high risk of hepatocellular carcinoma (HCC). Accurate tumor biomarkers for the diagnosis and early detection of HCC need to be developed. The circulating, cell-free, epigenetic biomarker mSEPT9 is a promising biomarker for diagnosing HCC in patients with cirrhosis.
Patients with cirrhosis are at high risk of hepatocellular carcinoma (HCC). Several circulating epigenetic markers are under evaluation in HCC, notably those identified through “omics” approaches. However, to date, no circulating epigenetic biomarker has been shown to be useful for HCC diagnosis at the individual patient level. Through initial and replication phase II biomarker studies, we showed that the circulating, cell-free, DNA-based epigenetic biomarker mSEPT9 is a promising biomarker for diagnosing HCC in patients with cirrhosis. Future prospective studies should assess the mSEPT9 test in a screening algorithm for patients with cirrhosis to improve risk prediction and the personalized therapeutic management of HCC.
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Affiliation(s)
- Abderrahim Oussalah
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France; INSERM, U1256, NGERE - Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, Nancy F-54000, France.
| | - Susann Rischer
- First Department of Internal Medicine, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Mouni Bensenane
- Department of Hepatology and Gastroenterology, University Hospital of Nancy, Nancy F-54000, France
| | - Guillaume Conroy
- Department of Hepatology and Gastroenterology, University Hospital of Nancy, Nancy F-54000, France
| | - Pierre Filhine-Tresarrieu
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France; INSERM, U1256, NGERE - Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, Nancy F-54000, France
| | - Renée Debard
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France
| | - Denise Forest-Tramoy
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France
| | - Thomas Josse
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France
| | - Dana Reinicke
- First Department of Internal Medicine, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Matthieu Garcia
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France
| | - Amandine Luc
- ESPRI-BioBase Unit, Methodological and Biostatistical Support Unit, Platform of Clinical Research Support PARC, University Hospital of Nancy, Nancy F-54000, France
| | - Cédric Baumann
- ESPRI-BioBase Unit, Methodological and Biostatistical Support Unit, Platform of Clinical Research Support PARC, University Hospital of Nancy, Nancy F-54000, France
| | - Ahmet Ayav
- Department of Digestive, Hepatobiliary and Endocrine Surgery, University Hospital of Nancy, Nancy, F-54000, France
| | - Valérie Laurent
- Department of Radiology, University Hospital of Nancy, Nancy, F-54000, France
| | - Marcus Hollenbach
- Division of Gastroenterology and Rheumatology, Department of Medicine, Dermatology and Neurology, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany
| | - Cristina Ripoll
- First Department of Internal Medicine, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Rosa-Maria Guéant-Rodriguez
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France; INSERM, U1256, NGERE - Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, Nancy F-54000, France
| | - Fares Namour
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France; INSERM, U1256, NGERE - Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, Nancy F-54000, France
| | - Alexander Zipprich
- First Department of Internal Medicine, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Michael Fleischhacker
- First Department of Internal Medicine, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Jean-Pierre Bronowicki
- INSERM, U1256, NGERE - Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, Nancy F-54000, France; Department of Hepatology and Gastroenterology, University Hospital of Nancy, Nancy F-54000, France
| | - Jean-Louis Guéant
- Department of Molecular Medicine and Personalized Therapeutics, Department of Biochemistry, Molecular Biology, Nutrition, and Metabolism, University Hospital of Nancy, F-54000, France; INSERM, U1256, NGERE - Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, Nancy F-54000, France; Department of Hepatology and Gastroenterology, University Hospital of Nancy, Nancy F-54000, France.
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Conroy G, Salleron J, Belle A, Bensenane M, Nani A, Ayav A, Peiffert D, Lopez A, Baumann C, Barraud H, Bronowicki JP. The prognostic value of inflammation-based scores in advanced hepatocellular carcinoma patients prior to treatment with sorafenib. Oncotarget 2017; 8:95853-95864. [PMID: 29221172 PMCID: PMC5707066 DOI: 10.18632/oncotarget.21401] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 07/25/2017] [Indexed: 12/18/2022] Open
Abstract
Background and Aims The multikinase inhibitor sorafenib is the only currently approved drug for the indication of advanced hepatocellular carcinoma (HCC). It provides a limited gain in survival time but is frequently associated with adverse events. We currently lack simple prognostic factors in sorafenib-treated HCC patients. Various inflammation-based scores (IBSs) have been evaluated as predictors of tumor recurrence and survival in various malignancies (including HCC). The objective of the present study was to determine the prognostic value of IBSs for overall survival (OS) in advanced HCC patients prior to the initiation of sorafenib therapy. Methods Patients with Barcelona Clinic Liver Cancer stage C HCC were enrolled retrospectively between October 2007 and September 2015. To identify prognostic factors for OS, bivariate and multivariate analysis were performed using a Cox proportional hazards regression model. Results 161 patients (87.0% males; median age: 67; median OS: 9.1 months) were enrolled. A multivariate analysis identified a body mass index <25kg/m2 (hazard ratio (HR)=1.55, p<0.017), macroscopic vascular invasion (HR=1.63, p< 0.001), an AST level >38 U/L (HR=2.65, p<0.001), Child Pugh B stage (HR=2.59, p<0.001) and a systemic immune-inflammation index (SII) ≥600 × 109 (HR 1.72, p=0.002) as independent risk factors for OS in advanced HCC. Conclusion IBSs (such as the SII) are novel, simple, low-cost prognostic indices in patients with advanced HCC. They may be of value in determining whether these patients may benefit from sorafenib therapy.
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Affiliation(s)
- Guillaume Conroy
- INSERM U954, Department of Hepato-gastroenterology, Lorraine University, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Julia Salleron
- Department of Biostatistics, Lorraine Comprehensive Cancer Center, Vandœuvre-lès-Nancy, France
| | - Arthur Belle
- INSERM U954, Department of Hepato-gastroenterology, Lorraine University, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Mouni Bensenane
- INSERM U954, Department of Hepato-gastroenterology, Lorraine University, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Abdelbasset Nani
- INSERM U954, Department of Hepato-gastroenterology, Lorraine University, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Ahmet Ayav
- Department of Digestive, Hepatobiliary and Endocrine Surgery, Lorraine University, Nancy University Hospital, Nancy, France
| | - Didier Peiffert
- Department of Radiotherapy, Lorraine University, Lorraine Comprehensive Cancer Center, Vandœuvre-lès-Nancy, France
| | - Anthony Lopez
- INSERM U954, Department of Hepato-gastroenterology, Lorraine University, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Cédric Baumann
- ESPRI-BioBase Unit, Platform of PARC, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Hélène Barraud
- INSERM U954, Department of Hepato-gastroenterology, Lorraine University, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Jean-Pierre Bronowicki
- INSERM U954, Department of Hepato-gastroenterology, Lorraine University, Nancy University Hospital, Vandœuvre-lès-Nancy, France
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Mallet AL, Bouguen G, Conroy G, Roblin X, Delobel JB, Bretagne JF, Siproudhis L, Peyrin-Biroulet L. Azathioprine for refractory ulcerative proctitis: A retrospective multicenter study. Dig Liver Dis 2017; 49:280-285. [PMID: 28089625 DOI: 10.1016/j.dld.2016.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/30/2016] [Accepted: 12/05/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Efficacy of azathioprine (AZA) in refractory ulcerative proctitis (UP) is unknown. METHODS All patients treated with AZA for refractory UP in three referral centers between 2002 and 2012 were included. "Treatment success" in the long-term was defined as the absence of colectomy during follow-up, no need for anti-TNF during follow-up, no ongoing systemic steroids use, no adverse event leading to AZA withdrawal, and clinically quiescent disease at last follow-up. RESULTS Of the 1279 adult patients with ulcerative colitis, 25 patients were treated with AZA for refractory UP (median disease duration 4.9 years). Of these, 4 had no short-term clinical assessment. Of the remaining 21, 4 were primary non responders to AZA, 7 discontinued AZA for adverse events and 10 showed clinical improvement. At the long-term assessment at last follow up after a median of 46 months, 5 patients had treatment success and were still on AZA treatment, the remaining 20 were treatment failures. Of these, 5 discontinued AZA for adverse events and 15 were treated with infliximab (clinical response in 11 patients, primary non-response in one patient, and 3 underwent colectomy). CONCLUSION AZA may be efficacious in maintaining clinical response in one-fifth of patients with refractory UP in a real-life setting.
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Affiliation(s)
- Anne-Laure Mallet
- Department of Hepato-Gastroenterology, University Hospital of Pontchaillou, Rennes, France
| | - Guillaume Bouguen
- Department of Hepato-Gastroenterology, University Hospital of Pontchaillou, Rennes, France; Inserm 991, University of Rennes 1, France; CIC1414, Université de Rennes 1, France.
| | - Guillaume Conroy
- Department of Gastroenterology, Inserm U954, Nancy University Hospital, Lorraine University, France
| | - Xavier Roblin
- Department of Hepato-Gastroenterology, University Hospital of Saint-Etienne, Saint-Etienne, France; Inserm U954 and Department of Hepato-Gastroenterology, Nancy, France
| | - Jean-Bernard Delobel
- Department of Hepato-Gastroenterology, University Hospital of Pontchaillou, Rennes, France
| | - Jean-François Bretagne
- Department of Hepato-Gastroenterology, University Hospital of Pontchaillou, Rennes, France
| | - Laurent Siproudhis
- Department of Hepato-Gastroenterology, University Hospital of Pontchaillou, Rennes, France; Inserm 991, University of Rennes 1, France; CIC1414, Université de Rennes 1, France
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology, Inserm U954, Nancy University Hospital, Lorraine University, France
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9
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Bison A, Marchal-Bressenot A, Li Z, Elamouri I, Feigerlova E, Peng L, Houlgatte R, Beck B, Pourié G, Alberto JM, Umoret R, Conroy G, Bronowicki JP, Guéant JL, Guéant-Rodriguez RM. Foetal programming by methyl donor deficiency produces steato-hepatitis in rats exposed to high fat diet. Sci Rep 2016; 6:37207. [PMID: 27853271 PMCID: PMC5112564 DOI: 10.1038/srep37207] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 10/13/2016] [Indexed: 01/04/2023] Open
Abstract
Non-alcoholic steatohepatitis (NASH) is a manifestation of metabolic syndrome, which emerges as a major public health problem. Deficiency in methyl donors (folate and vitamin B12) during gestation and lactation is frequent in humans and produces foetal programming effects of metabolic syndrome, with small birth weight and liver steatosis at day 21 (d21), in rat pups. We investigated the effects of fetal programming on liver of rats born from deficient mothers (iMDD) and subsequently subjected to normal diet after d21 and high fat diet (HF) after d50. We observed increased abdominal fat, ASAT/ALAT ratio and angiotensin blood level, but no histological liver abnormality in d50 iMDD rats. In contrast, d185 iMDD/HF animals had hallmarks of steato-hepatitis, with increased markers of inflammation and fibrosis (caspase1, cleaved IL-1β, α1(I) and α2(I) collagens and α-SMA), insulin resistance (HOMA-IR and Glut 2) and expression of genes involved in stellate cell stimulation and remodelling and key genes triggering NASH pathomechanisms (transforming growth factor beta super family, angiotensin and angiotensin receptor type 1). Our data showed a foetal programming effect of MDD on liver inflammation and fibrosis, which suggests investigating whether MDD during pregnancy is a risk factor of NASH in populations subsequently exposed to HF diet.
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Affiliation(s)
- Anaïs Bison
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Aude Marchal-Bressenot
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Zhen Li
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Ilef Elamouri
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Eva Feigerlova
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Lu Peng
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Remi Houlgatte
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Bernard Beck
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Gregory Pourié
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Jean-Marc Alberto
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Remy Umoret
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Guillaume Conroy
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Jean-Pierre Bronowicki
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Jean-Louis Guéant
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
| | - Rosa-Maria Guéant-Rodriguez
- Inserm U954, Nutrition-Genetics-Environmental Risk Exposure (N-GERE), University of Lorraine, BP 184, 54511, Vandœuvre-lès-Nancy, France
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Belle A, Gizard E, Conroy G, Lopez A, Bouvier-Alias M, Rouanet S, Peyrin-Biroulet L, Pawlotsky JM, Bronowicki JP. 25-OH vitamin D level has no impact on the efficacy of antiviral therapy in naïve genotype 1 HCV-infected patients. United European Gastroenterol J 2016; 5:69-75. [PMID: 28405324 DOI: 10.1177/2050640616640157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 02/24/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIM The impact of 25-OH vitamin D on sustained viral response (SVR) to antiviral therapy and on fibrosis progression in hepatitis C is debated. We assessed the impact of 25-OH vitamin D concentration on the efficacy of antiviral therapy in naïve genotype 1 hepatitis C virus (HCV)-infected patients. METHODS The study population consisted of treatment-naïve genotype 1 patients enrolled in a randomised controlled trial. A total of 516 patients received peginterferon α-2a 180 µg/week plus ribavirin 800 mg/day for 24 weeks. There were 349 patients with undetectable HCV RNA (<50 IU/ml) at week 24 (W24) who were randomised to continue dual therapy (n = 173) or to continue peginterferon alone (n = 176) until week 48. 25-OH vitamin D concentration was measured at baseline in frozen serum. RESULTS A total of 461 patients could be analysed for virologic response at W24, and 285 (119 non-responders at W24 + 166 responders who continued dual therapy until W48) for the impact of SVR. There were 487 patients who could be analysed for fibrosis progression. Metavir fibrosis scores (centralised analysis) were: F1 30%, F2 34%, F3 27% and F4 9%. Median 25-OH vitamin D concentrations were similar in virologic responders (13.5 ng/ml) and in non-responders at W24 (12.6 ng/ml), as well as in patients with SVR (12.8 ng/ml) and without SVR (12.8 ng/ml, 3.99) at W72. Median 25-OH vitamin D concentrations were: F1: 14.30 ng/ml, F2: 13.50 ng/ml, F3: 13.30 ng/ml and F4: 12.80 ng/ml. CONCLUSION In this study, 25-OH vitamin D level has no impact on the efficacy of antiviral therapy in naïve genotype 1 HCV-infected patients.
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Affiliation(s)
- Arthur Belle
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy Brabois, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Emmanuel Gizard
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy Brabois, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Guillaume Conroy
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy Brabois, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Anthony Lopez
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy Brabois, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Magali Bouvier-Alias
- National Reference Center for Viral Hepatitis B, C and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France; INSERM U955, Créteil, France
| | | | - Laurent Peyrin-Biroulet
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy Brabois, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Jean-Michel Pawlotsky
- National Reference Center for Viral Hepatitis B, C and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France; INSERM U955, Créteil, France
| | - Jean-Pierre Bronowicki
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy Brabois, Université de Lorraine, Vandoeuvre-les-Nancy, France
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Tréchot F, Angioi K, Latarche C, Conroy G, Beaujeux P, Andrianjafy C, Portier M, Batta B, Conart JB, Cloché V, Peyrin-Biroulet L. Keratoconus in Inflammatory Bowel Disease Patients: A Cross-sectional Study. J Crohns Colitis 2015; 9:1108-12. [PMID: 26351387 DOI: 10.1093/ecco-jcc/jjv151] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/21/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Increasing evidence suggests that keratoconus may have an inflammatory component. The possible association of keratoconus with inflammatory bowel disease (IBD) has yet to be determined. The aim of this study was to determine the prevalence of keratoconus and suspect keratoconus in patients with IBD. METHODS All consecutive adult IBD patients seen in the Department of Gastroenterology, Nancy, University Hospital, France, between March 2014 and June 2014 were included. Pregnant women, rigid lens wearers, patients with a family history of keratoconus and patients with a history of refractive surgery were excluded. A control group of healthy subjects was included. All included patients underwent a corneal topography (OPD-Scan III, Nidek) to detect keratoconus or suspect keratoconus. Rabinowitz videokeratographic indices were the basis of corneal topography interpretation. RESULTS Two hundred and one IBD patients were included, 150 with Crohn's disease and 51 with ulcerative colitis. Mean age was 38.7 years and 121 were women. Mean disease duration was 10.8 years. Two IBD patients were diagnosed with keratoconus (1%) and 38 with suspect keratoconus (18.9%). Overall prevalence of keratoconus and suspect keratoconus was 19.9% (95% confidence interval [CI] 17.5-22.0). None of the 100 healthy subjects had keratoconus, while three were diagnosed with suspect keratoconus (p = 0.0002 versus IBD patients). Only smoking was identified as a risk factor (p = 0.029), especially in Crohn's disease. CONCLUSION Inflammatory bowel disease patients may carry an increased risk of keratoconus and suspect keratoconus, smoking further increasing this risk. This supports the hypothesis of an inflammatory origin of keratoconus.
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Affiliation(s)
- Fanny Tréchot
- Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France
| | - Karine Angioi
- Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France
| | - Clothilde Latarche
- Inserm CIC-EC and Department of Epidemiology and Clinical Evaluation, Nancy, University Hospital, University of Lorraine, France
| | - Guillaume Conroy
- Inserm U 954 and Department of Gastroenterology, Nancy, University Hospital, University of Lorraine, France
| | - Pauline Beaujeux
- Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France
| | - Charlotte Andrianjafy
- Inserm U 954 and Department of Gastroenterology, Nancy, University Hospital, University of Lorraine, France
| | - Mathilde Portier
- Inserm U 954 and Department of Gastroenterology, Nancy, University Hospital, University of Lorraine, France
| | - Benjamine Batta
- Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France
| | - Jean-Baptiste Conart
- Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France
| | - Véronique Cloché
- Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France
| | - Laurent Peyrin-Biroulet
- Inserm U 954 and Department of Gastroenterology, Nancy, University Hospital, University of Lorraine, France
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Abstract
There was a spontaneous outbreak of mycobacteriosis in fancy veiltail guppies, Lebistes reticulatus, raised on an ornamental fish farm in Venezuela. The clinical signs included listlessness, emaciation, spinal curvature, sunken eyes and loss of colour. Numerous acid-fast bacteria, identified as Mycobacterium species, were detected in smears from the kidneys, liver, mesentery and spleen of the fish, from fresh faecal material, and from the unborn embryos of infected gravid females. The bacteria were eradicated by the addition of kanamycin sulphate to the water at a concentration of 50 ppm, the dose being repeated on four occasions with 48 hours between each dose. Fifteen days after the treatment, none of the clinical signs described were detected in any of the treated fish. The offspring born to treated females were healthy and normal, and did not harbour acid-fast bacteria.
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Affiliation(s)
- G Conroy
- Unidad de Diagnóstico y Asesoría Técnica en Patobiología Acuática (UDAPTA), Pharma-Fish SRL, Estado Aragua, Venezuela
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Kelley P, Conroy G. A promotive health plan preventing alcohol and drug abuse in the schools. Ariz Med 1972; 29:54-6. [PMID: 5007931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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