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Baratte C, Willemetz A, Trystram L, Kapel N, Bado A, Poghosyan T, Le Gall M. La sleeve gastrectomie avec bipartition du transit est plus efficace que le bypass Roux-en-Y sur la perte de poids et l’amélioration de la sécrétion d’insuline chez le rat obèse. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.042] [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: 10/18/2022]
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Mauras A, Ould-Beziou I, Zehani M, Ribeiro-Parenti L, Mayeur C, Willemetz A, Le Gall M, Bado A, Kapel N, Thomas M, Joly F, Le Beyec J. Mise en place d’une dysbiose associée à une adaptation jéjunale et colique dans un modèle de grêle court chez le rat. NUTR CLIN METAB 2020. [DOI: 10.1016/j.nupar.2020.02.199] [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: 10/24/2022]
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Lambe C, Talbotec C, Kapel N, Goulet O. OR54: The Reve Study, Preliminary Results. A Monocentric Single-Arm Study to Characterize the Long-Term Safety and Efficacy of GLP-2 Analog (Teduglutide) in the Management of Short Bowel Syndrome in Pediatric Patients on Home-Parenteral Nutrition. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32526-9] [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: 11/28/2022]
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Huttner B, Galperine T, Kapel N, Harbarth S. ‘A five-day course of oral antibiotics followed by faecal transplantation to eradicate carriage of multidrug-resistant Enterobacteriaceae’ – Author's reply. Clin Microbiol Infect 2019; 25:914-915. [DOI: 10.1016/j.cmi.2019.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/02/2019] [Indexed: 11/28/2022]
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Cheminet G, Kapel N, Bleibtreu A, Sadou-Yaye H, Bellanger A, Duval X, Joly F, Fantin B, De Lastours V. Transplantation de microbiote fécal par gélules congelées lors des récurrences d’infection à Clostridium difficile : suivi d’une cohorte pilote de 15 patients en France. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.342] [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]
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Cohen L, Mayeur C, Reygner J, Kapel N, Thomas M, Joly F. Validation d’une méthode de conservation des selles dans le syndrome de grêle court. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.133] [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: 10/27/2022]
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Cheminet G, Kapel N, Sadou-Yaye H, Bellanger A, Fantin B, de Lastours V. Transplantation de microbiote fécale par gélules dans les récidives d’infections à Clostridium difficile : suivi d’une cohorte pilote de 9 patients. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.036] [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: 10/14/2022]
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Marthey L, Mateus C, Mussini C, Nachury M, Nancey S, Grange F, Zallot C, Peyrin-Biroulet L, Rahier JF, Bourdier de Beauregard M, Mortier L, Coutzac C, Soularue E, Lanoy E, Kapel N, Planchard D, Chaput N, Robert C, Carbonnel F. Cancer Immunotherapy with Anti-CTLA-4 Monoclonal Antibodies Induces an Inflammatory Bowel Disease. J Crohns Colitis 2016; 10:395-401. [PMID: 26783344 PMCID: PMC4946758 DOI: 10.1093/ecco-jcc/jjv227] [Citation(s) in RCA: 239] [Impact Index Per Article: 29.9] [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: 09/08/2015] [Accepted: 12/08/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Therapeutic monoclonal anti-cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) antibodies are associated with immune-mediated enterocolitis. The aim of this study was to provide a detailed description of this entity. METHODS We included patients with endoscopic signs of inflammation after anti-CTLA-4 infusions for cancer treatment. Other causes of enterocolitis were excluded. Clinical, biological and endoscopic data were recorded. A single pathologist reviewed endoscopic biopsies and colectomy specimens from 27 patients. Patients with and without enterocolitis after ipilimumab-treated melanoma were compared, to identify clinical factors associated with enterocolitis. RESULTS Thirty-nine patients with anti-CTLA-4 enterocolitis were included (ipilimumab n = 37; tremelimumab n = 2). The most frequent symptom was diarrhoea. Ten patients had extra-intestinal manifestations. Most colonoscopies showed ulcerations involving the rectum and sigmoid, 66% of patients had extensive colitis, 55% had patchy distribution and 20% had ileal inflammation. Endoscopic colonic biopsies showed acute colitis in most patients, while half of the patients had chronic duodenitis. Thirty-five patients received steroids that led to complete clinical remission in 13 patients (37%). Twelve patients required infliximab, of whom 10 (83%) responded. Six patients underwent colectomy (perforation n = 5; toxic megacolon n = 1); one of them died postoperatively. Four patients had a persistent enterocolitis at follow-up colonoscopy. Patients with enterocolitis were more frequently prescribed NSAIDs compared with patients without enterocolitis (31 vs 5%, p = 0.003). CONCLUSIONS Ipilimumab and tremelimumab may induce a severe and extensive form of inflammatory bowel disease. Rapid escalation to infliximab should be advocated in patients who do not respond to steroids. Patients treated with anti-CTLA-4 should be advised to avoid NSAIDs.
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Affiliation(s)
- L. Marthey
- Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Le Kremlin Bicêtre, France,Department of Gastroenterology, Antoine Béclère Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Clamart, France
| | - C. Mateus
- Dermatology Unit, Department of Medical Oncology, Gustave Roussy, Paris Sud University, Villejuif, F-94805, France
| | - C. Mussini
- Department of Pathology, Kremlin Bicêtre Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Le Kremlin Bicêtre, France
| | - M. Nachury
- Department of Gastroenterology, Claude Huriez Hospital, Lille, France
| | - S. Nancey
- Department of Gastroenterology, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Benite, France
| | - F. Grange
- Department of Dermatology, Robert Debré Hospital, Reims, France
| | - C. Zallot
- Department of Gastroenterology, Nancy Hospital, Inserm U954, Lorraine University, Vandoeuvre Les Nancy, France
| | - L. Peyrin-Biroulet
- Department of Gastroenterology, Nancy Hospital, Inserm U954, Lorraine University, Vandoeuvre Les Nancy, France
| | - J. F. Rahier
- Department of Hepato-Gastroenterology, CHU Dinant Godinne UCL Namur, Yvoir, Belgium
| | | | - L. Mortier
- Department of Dermatology, Claude Huriez Hospital, Lille, France
| | - C. Coutzac
- Laboratoire d’Immunomonitoring en Oncologie, Gustave Roussy, Villejuif, F-94805, France
| | - E. Soularue
- Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Le Kremlin Bicêtre, France
| | - E. Lanoy
- Biostatistics and Epidemiology Unit, Gustave-Roussy, Villejuif, France,Inserm Unit U1018, CESP, Paris Sud University, Paris-Saclay University, Villejuif, France
| | - N. Kapel
- Department of Functional Coprology, Pitié Salpêtrière Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - D. Planchard
- Pneumology Unit, Department of Medical Oncology, Gustave Roussy, Villejuif, F-94805, France
| | - N. Chaput
- Laboratoire d’Immunomonitoring en Oncologie, Gustave Roussy, Villejuif, F-94805, France,CNRS, UMS 3655, Villejuif, F-94805, France,INSERM, US23, Villejuif, F-94805, France
| | - C. Robert
- Dermatology Unit, Department of Medical Oncology, Gustave Roussy, Paris Sud University, Villejuif, F-94805, France
| | - F. Carbonnel
- Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Le Kremlin Bicêtre, France
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Batista R, Kapel N, Megerlin F, Chaumeil JC, Barbut F, Bourlioux P, Chast F. Le transfert de microbiote fécal lors d’infections récidivantes à Clostridium difficile. Cadre et aspects pharmacotechniques. Annales Pharmaceutiques Françaises 2015; 73:323-31. [DOI: 10.1016/j.pharma.2015.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 02/14/2015] [Accepted: 02/24/2015] [Indexed: 12/15/2022]
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Abstract
Clostridium difficile infection is a leading cause of antibiotic-related and healthcare-related diarrhoea. In the past decade, faecal microbiota transplantation or transfer has attracted increasing interest as an effective treatment strategy for severe recurrent C. difficile infection, with a global success rate of >80%. However, experience with this procedure is limited by a lack of randomized trials supporting its efficacy and the lack of standardization of the procedure. This review will address the practical aspects of the protocol.
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Affiliation(s)
- N Kapel
- Laboratoire de Coprologie Fonctionnelle, APHP, GH Pitié-Salpêtrière Charles Foix, Université Paris Descartes, Paris, France
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Cavin JB, Tavernier A, Ducroc R, Denis R, Cluzeaud F, Guilmeau S, Barbot L, Kapel N, Buyse M, Le Beyec J, Joly F, Luquet S, Le Gall M, Bado A. O33 L’invalidation spécifique du récepteur intestinal LEPR-B modifie l’activité des transporteurs entérocytaires et confère aux souris une moindre susceptibilité à l’obésité nutritionnelle. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70305-4] [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: 12/01/2022]
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Mayeur C, Joly F, Ghandour F, Kapel N, Larroque B, Thomas M. P120 Étude de la composition et de l’activité du microbiote chez des patients atteints de syndrome de grêle court : dosage fécal de D-lactate outil prédictif d’acidose métabolique ? NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70187-x] [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: 11/29/2022]
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Waligora-Dupriet A, Campeotto F, Romero K, Mangin I, Rouzaud G, Ménard O, Suau A, Soulaines P, Nicolis I, Kapel N, Dupont C, Butel M. Diversity of gut Bifidobacterium species is not altered between allergic and non-allergic French infants. Anaerobe 2011; 17:91-6. [DOI: 10.1016/j.anaerobe.2011.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 04/14/2011] [Indexed: 12/11/2022]
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Campeotto F, Baldassarre M, Laforgia N, Viallon V, Kalach N, Amati L, Butel MJ, Dupont C, Kapel N. Fecal expression of human β-defensin-2 following birth. Neonatology 2010; 98:365-9. [PMID: 20980773 DOI: 10.1159/000315872] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Accepted: 05/20/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Newborns display high intestinal permeability and a naive adaptive immune system, but infections are rare, indicating strong innate defense mechanisms. OBJECTIVE To measure the kinetics of fecal β-defensin-2 (HBD2), an inducible endogenous antimicrobial peptide produced by intestinal epithelial cells, in full-term and preterm infants. METHODS As a first step of this bicentric study, we enrolled 30 healthy full-term infants and 20 healthy preterm infants, with fecal samples collected at days 3, 7, 12 and 30 in full-term infants and at days 15, 30 and 60 in preterm infants. As a second step, we enrolled 10 preterm infants with intestinal distress, either necrotizing enterocolitis (NEC) Bell's stage III (n = 3) or isolated rectal bleeding (n = 7) and 20 controls, cross-matched for gestational age and age at sampling. RESULTS HBD2 decreased significantly from day 3 to day 7 (227 ng/g; 14-440 vs. 117 ng/g; 30-470, p = 0.01) then moderately until day 30 (84 ng/g; 10-500) in healthy full-term infants. Healthy preterm infants showed similar high levels between days 15 and 60 (82 ng/g; 30-154 and 85 ng/g; 26-390, respectively). No significant variation of fecal HBD2 levels was observed between infants with clinical features of intestinal distress (77 ng/g, 2-1,271) and cross-matched controls (56 ng/g, 31-164). However, 2/3 infants with NEC and 1/7 infants with isolated rectal bleeding had HBD2 levels above the maximal level observed in controls. CONCLUSIONS The kinetics of fecal HBD2 in the neonatal period indicate that this inducible defensin can be detected at high level in the feces of full-term and preterm infants, independently of gestational age or mode of feeding. The potential role of fecal HBD2 in detecting NEC is suggested.
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Affiliation(s)
- F Campeotto
- Néonatologie et Gastro-Entérologie Pédiatrique, APHP, Hôpital Saint Vincent de Paul, Université Paris Descartes, Paris, France. florence.campeotto @ svp.aphp.fr
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Campeotto F, Nganzali F, Butel M, Viallon V, Moreno M, Soulaines P, Kalach N, Lapillonne A, Moriette G, Dupont C, Kapel N. SFP-38 – Néonatalogie – Calprotectine fécale, marqueur prédictif non invasif de souffrance digestive chez le prématuré ? Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72105-5] [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: 11/30/2022]
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Hubert D, Durieu I, Moreau J, Posselt H, Kapel N, Dorfman P. 55 Exploratory Phase II study of recombinant canine gastric lipase (r-GL, Merispase®) in association with pancreatic extracts (PE) for the treatment of steatorrhea in CF patients inadequately controlled with high doses of PE. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80051-2] [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: 11/29/2022]
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Kapel N, Roman C, Caldari D, Sieprath F, Canioni D, Khalfoun Y, Goulet O, Ruemmele FM. Fecal tumor necrosis factor-alpha and calprotectin as differential diagnostic markers for severe diarrhea of small infants. J Pediatr Gastroenterol Nutr 2005; 41:396-400. [PMID: 16205505 DOI: 10.1097/01.mpg.0000178437.87546.06] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE The etiology of early-onset diarrhea of neonates and small infants that persists despite bowel rest is heterogeneous. Two different categories of disorders presenting with diarrhea in the first weeks of life can be distinguished: constitutive intestinal epithelial disorders (microvillus atrophy [MVA] or epithelial dysplasia [ED]) and immune-inflammatory disorders, (autoimmune enteropathy [AIE] or inflammatory colitis [IC]). We aimed to evaluate in a prospective manner the use of fecal inflammatory markers in the differential diagnosis of severe persistent diarrhea. MATERIAL AND PATIENTS Twenty-five patients (17 males) were enrolled in this study (median age 8 months). Fourteen children had a constitutive enterocyte disorder (group 1: MVA = 8, ED = 6), and 11 patients had an immuno-inflammatory disease (group 2: AIE = 5, IC = 6). Stool samples were collected at the time of diagnosis and stored at -80 degrees until tumor necrosis factor (TNF)-alpha and calprotectin were measured by enzyme-linked immunoadsorbent assay. RESULTS No significant differences in age at onset of diarrhea or in stool volumes were observed between both groups. In group 1, fecal TNF-alpha was undetectable/normal in 14 of 14 children, whereas group 2 showed dramatically elevated TNF-alpha levels (mean 3,104, range 237-18,078 pg/g) in 8 of 11 patients. Similarly, calprotectin levels were undetectable/normal in 14 of 14 patients in group 1 and highly raised in 11 of 11 patients in group 2 (median 1,145, range 375-3,095 mug/g), P < 0.01. Under therapy, these inflammatory parameters normalized. CONCLUSIONS Determination of fecal inflammatory markers is a simple method helping to distinguish constitutive from immuno-inflammatory etiologies of severe persistent diarrhea. These data also suggest that constitutive enterocyte disorders are not accompanied by an inflammatory mucosal reaction.
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Affiliation(s)
- N Kapel
- Laboratory of Functional Coprology, Pitié-Salpétrière Hospital, Paris, France
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Abstract
Quality control in medical laboratories was defined in guidelines for good execution of laboratory analyses issued by the French health authorities in 1994. Application of these guidelines is difficult in coprology because the sample is a complex heterogeneous matrix which varies with disease, surgery, food intake, and treatment. In addition, commercial quality control kits are not available for stool biochemical analyses and a national quality control program has not been established. We thus developed our own fecal quality control technique using pooling lyophylized stool samples. Manual or partially automated methods are used in coprology, leading to a long pre-analysis phase which is not always taken into account in quality control. This implies the need for complementary tools to insure the quality of coprology analyses. For example, semi-quantitative microscopic lipid analysis can be used as an internal standard for a given specimen. Quality assurance also involves a post-analytical phase where results obtained for a given specimen are compared with other available data and interpreted in light of the patient's clinical and therapeutic status. This quality assurance strategy enables accurate reliable results useful for long-term patient management.
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Affiliation(s)
- L Barbot
- Laboratoire de coprologie fonctionnelle, GH Pitié-Salpêtrière, Bâtiment La Force - Division Vincent de Paul, 47-83, boulevard de l'Hôpital, F75652 Paris Cedex 13, France.
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Gobert JG, Barbot L, Kapel N. Élément de physiopathologie digestive et coprologie fonctionnelle. Annales Pharmaceutiques Françaises 2004; 62:367-70. [PMID: 15550892 DOI: 10.1016/s0003-4509(04)94329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Fecal analysis includes qualitative and quantitative studies which allows quantification and labelling of numerous pathophysiologic phenomenona. Malabsorption and over-absorption of water and electrolytes give rise to six types of watery diarrheas, and two types of constipations; malabsorption of nutriments and maldigestion of food, give rise to two types of fatty and nitrogenous diarrheas with metabolic consequences. Fecal analysis often discriminates organic from non-organic diseases and brings informations on increase or decrease of caloric losses, to the nutritionist. Microscopic observations which requires a high degree of competence and experience, allows the recognition of malabsorption/maldigestion phenomenona, of fortuitous presence of parasites and a good interpretation of a fecal file.
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Affiliation(s)
- J G Gobert
- Service de biologie animale et parasitaire, Faculté de Pharmacie, 4, avenue de l'Observatoire F75006 Paris, France
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Kapel N, Barbot L, Gobert JG. Les nouveaux marqueurs disponibles en coprologie fonctionnelle et perspectives. Annales Pharmaceutiques Françaises 2004; 62:371-5. [PMID: 15550893 DOI: 10.1016/s0003-4509(04)94330-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fecal occult blood testing is the most widely prescribed screening test for colorectal cancer. Recent development of immunological tests has increased specificity. Fecal DNA analysis opens up a new field for early detection of this widespread neoplasia. Inflammatory bowel disease is another important area where the development of fecal markers provides an interesting alternative to the gold standard but costly and invasive endoscopic investigations with histological analysis of biopsy specimens. Fecal TNFalpha and calprotectin can now be proposed to distinguish organic from non-organic intestinal disease, so select candidates for further investigations, and to assess disease activity. Measurement of fecal elastase provides real progress in screening for exocrine pancreatic insufficiency in patients with malabsorption syndrome. The development of non-invasive fecal markers is thus of increasing interest, providing data about the entire gastrointestinal tract useful for screening and individual patient management.
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Affiliation(s)
- N Kapel
- Laboratoire de coprologie fonctionnelle, GH Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, F75652 Paris Cedex 13, France.
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Campeotto F, Butel MJ, Kalach N, Derrieux S, Aubert-Jacquin C, Barbot L, Francoual C, Dupont C, Kapel N. High faecal calprotectin concentrations in newborn infants. Arch Dis Child Fetal Neonatal Ed 2004; 89:F353-5. [PMID: 15210674 PMCID: PMC1721713 DOI: 10.1136/adc.2002.022368] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Calprotectin, a major component of soluble cytosolic proteins in human neutrophil granulocytes, is excreted in excess in stools during inflammatory bowel disease in adults and children. Faecal calprotectin concentrations are also higher during the first year of life than in adults. OBJECTIVES To measure faecal calprotectin concentrations in the neonatal period and define reference values according to the mode of feeding: standard infant formula, prebiotic infant formula (Calisma, Blédina SA, France), or breast feeding. PATIENTS AND METHODS A prospective study was carried out over three months in 69 full term, healthy newborns with a median gestational age of 39.8 weeks (range 37-41.5) and a birth weight of 3300 g (range 2600-4460). Three groups were formed depending on the mode of feeding: group 1 (n = 18) received a standard infant formula, group 2 (n = 19) the prebiotic infant formula, and group 3 (n = 32) was breast fed. One stool sample was taken from each newborn on day 4 (3-7), and faecal calprotectin analysed using a commercial enzyme linked immunoassay (Calprest, Eurospital, Italy). RESULTS Faecal calprotectin concentrations (median 167 micro g/g) were higher than reference values in healthy adults. The concentration was below the upper reference limit for adults (50 micro g/g) for three infants only, one fed the standard formula and two fed the prebiotic formula. Concentrations did not differ significantly according to method of feeding. CONCLUSIONS Compared with healthy adults, newborns have high calprotectin concentrations in the first days of life. There is no obvious influence of the mode of feeding.
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Affiliation(s)
- F Campeotto
- Hopital Cochin-Saint Vincent de Paul, 82, Avenue Denfert-Rochereau, 75674 Paris Cedex 14, France.
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Kapel N. Marqueurs inflammatoires fécaux en nutrition et pathologies digestives chez l'enfant. Arch Pediatr 2004; 11:403-5. [PMID: 15135420 DOI: 10.1016/j.arcped.2004.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2004] [Accepted: 02/18/2004] [Indexed: 11/24/2022]
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Bardot L, Gobert JG, Kapel N. [Faecal occult blood testing: comparison of a latex agglutination test (Hemolex) and an immunoturbidimetric test (QuikRead FOB)]. Ann Biol Clin (Paris) 2004; 62:339-43. [PMID: 15217769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
UNLABELLED Occult blood detection is the most prescribed faecal examination. AIM To compare results obtained with the latex agglutination test Hémolex LA (Orion diagnostica, Finlande) with those given by an immuno-turbidimetric test which allows an automatic reading (QuikRead FOB, Orion diagnostica, Finlande). MATERIAL AND METHODS this prospective study was carried out in 140 patients. The reference method was the latex agglutination test, Hemolex LA performed on stool extract obtained through weighting samples. On the base of the results, samples were separated into 2 groups: positive (n = 45) and negative (n = 95). As the QuikRead FOB test indicated a stool extract obtained through a sampling set, such an extraction was performed before Hemolex LA et QuikRead FOB testing. RESULTS all the 95 samples from the negative group gave similar results with the 3 methods. In contrast, 12/45 of the positive samples gave conflicting results, 11 results were negative with the 2 tests performed on stool extract obtained via sampling set, 1 result was negative with the QuikRead FOB method only. DISCUSSION analytical performance were similar with the 2 methods and discrepancies observed wi-thin the positive group were mainly related to the extraction method.
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Affiliation(s)
- L Bardot
- Laboratoire de coprologie fonctionnelle, GH Pitié-Salpêtrière, Paris
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Topouchian A, Huneau JF, Barbot L, Rome S, Gobert JG, Tomé D, Kapel N. Evidence for the absence of an intestinal adaptive mechanism to compensate for C. parvum-induced amino acid malabsorption in suckling rats. Parasitol Res 2003; 91:197-203. [PMID: 12923633 DOI: 10.1007/s00436-003-0956-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2003] [Accepted: 06/03/2003] [Indexed: 10/26/2022]
Abstract
In order to assess the impact of Cryptosporidium parvum on host intestinal physiology, we investigated absorption of the two principal amino acids in dam's milk (leucine, glutamate), using Ussing chambers and RT-PCR analyses. Experiments were performed in both heavily (ileum) and mildly (duodenum) infected segments of the small intestine at the peak of infection [day 8 post-infection (PI)] and after spontaneous clearance of the parasite (day 17 PI). At day 8 PI, amino acid fluxes across the mucosa were decreased throughout the small intestine (P<0.01) and EAAT3 mRNA expression was reduced ( from -49% to -28%). At day 17 PI, leucine and glutamate fluxes were normalized but the decrease in EAAT3 mRNA levels persisted (from -31% to -46%). Our results demonstrate that cryptosporidiosis induces major amino acid malabsorption involving the entire small intestine which is not counterbalanced by any up-regulation, even after spontaneous clearance of the parasite.
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Affiliation(s)
- A Topouchian
- Laboratoire de Biologie Animale et Parasitaire, Faculté des Sciences Pharmaceutiques et Biologiques, Université René Descartes, 75006 Paris, France
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Aubé C, Lebigot J, Pessaux P, Tuech JJ, Kapel N, Burtin P, Arnaud JP, Caron C. Evaluation of the permeability of pancreaticogastric anastomoses (PGA) with dynamic magnetic resonance pancreatography after secretin stimulation (secretin MRCP). Abdom Radiol (NY) 2003; 28:563-70. [PMID: 14580101 DOI: 10.1007/s00261-002-0065-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Because some investigators have reported the systematic occurrence of exocrine pancreatic insufficiency after pancreaticoduodenectomy with pancreaticogastric anastomosis (PGA), we assessed PGA patency after pancreaticoduodenectomy. METHODS Nineteen patients underwent pancreaticoduodenectomy, and their PGAs were studied prospectively with secretin magnetic resonance cholangiopancreatography (MRCP). After administration of negative bowel contrast agent, single-shot fast spin-echo T2-weighted dynamic MR pancreatograms were obtained before and every minute for 12 min after secretin injection. Morphologic features of the pancreatic parenchymal and pancreatic duct were monitored (diameter and winding aspect of the pancreatic duct, pancreatic thickness, direct visualization of the anastomotic site). PGA permeability was classified into four grades, from 0 (obstruction) to 3 (good permeability). Pancreatic function was assessed by fecal-1 elastase concentration, fasting blood glucose, and fasting serum insulin level. RESULTS MRCP grades were 0 in two patients, 1 in four, 2 in five, and 3 in eight. The anastomotic site was visualized in 10 patients. Pancreatic parenchymal atrophy was discovered in four patients. There were statistically significant relations between secretin MRCP permeability grade and fecal-1 elastase concentration (p < 0.03) and between secretin MRCP permeability grade and pancreatic atrophy (p < 0.005). In contrast, fecal-1 elastase concentration was lower than the normal value in all but one case. There was no statistically significant relation between fecal-1 elastase concentration and other morphologic data. CONCLUSION Secretin MRCP may indicate PGA stenosis or dysfunction, but it is not the only factor suggesting exocrine pancreatic insufficiency. Thus the major role of PGA may be the preservation of long-term endocrine function.
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Affiliation(s)
- C Aubé
- Service de radiologie B, CHU Angers, 49033 Angers Cedex 01, France
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Barbot L, Windsor E, Rome S, Tricottet V, Reynès M, Topouchian A, Huneau JF, Gobert JG, Tomé D, Kapel N. Intestinal peptide transporter PepT1 is over-expressed during acute cryptosporidiosis in suckling rats as a result of both malnutrition and experimental parasite infection. Parasitol Res 2003; 89:364-70. [PMID: 12632148 DOI: 10.1007/s00436-002-0776-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2002] [Accepted: 10/07/2002] [Indexed: 11/25/2022]
Abstract
Cryptosporidium parvuminfection induces amino acid malnutrition leading to growth retardation in children. Owing to the nutritional efficiency of peptides compared to free amino acids and the resistance of the di-tripeptide transporter PepT1 to mucosal injury, we analyzed the intestinal expression of PepT1 during experimental acute cryptosporidiosis in suckling rats from day 4 to day 50. PepT1 mRNA levels were increased at the peak of infection (day 10) all along the small intestine and normalized after spontaneous clearance of the parasite (day 21). Immunolocalization of PepT1 showed that its expression was maintained in the brush border membrane of enterocytes in infected rats from day 4 to day 50 all along the small intestine. Our results suggest a transcriptional up-regulation during acute cryptosporidiosis in response to both C. parvum-induced malnutrition and parasite implantation. As no treatment is available, a semi-elemental diet should be considered part of the treatment of cryptosporidiosis.
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Affiliation(s)
- L Barbot
- Laboratoire de Biologie Animale et Parasitaire, Faculté des Sciences Pharmaceutiques et Biologiques, Université René Descartes, 75006 Paris, France.
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Campeotto F, Kapel N, Kalach N, Razafimahefa H, Castela F, Barbot L, Soulaines P, Dehan M, Gobert JG, Dupont C. Low levels of pancreatic elastase 1 in stools of preterm infants. Arch Dis Child Fetal Neonatal Ed 2002; 86:F198-9. [PMID: 11978753 PMCID: PMC1721396 DOI: 10.1136/fn.86.3.f198] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The amount of faecal pancreatic enzyme elastase 1 was significantly lower in 42 preterm newborns than in 12 full term babies at day 2 (89 (3-539) v 354 (52-600) microg/g, p<0.0007) and day 5 (164 (3-600) v 600 (158-600) microg/g, p<0.05) and correlated positively with total nutrient intake during the first week of life in preterm infants. This should probably be taken into account during early feeding.
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Affiliation(s)
- F Campeotto
- Service de Néonatologie, Hôf.pital Cochin-Saint Vincent de Paul, 82 Avenue Denfert Rochereau, 75674 Paris Cedex 14, France.
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Topouchian A, Kapel N, Huneau JF, Barbot L, Magne D, Tomé D, Gobert JG. Impairment of amino-acid absorption in suckling rats infected with Cryptosporidium parvum. Parasitol Res 2001; 87:891-6. [PMID: 11728011 DOI: 10.1007/s004360100441] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the present study. we explored the nutritional consequences of cryptosporidiosis. In order to ascertain the direct responsibility of C. parvum for impairment of staturoponderal development observed during the infection in neonatal animals, we investigated the absorption of two major components of the total amino acids in dam's milk (leucine and glutamate) across the ileal mucosa. The infection resulted in significant (47% and 34%, respectively) reductions in leucine and glutamate fluxes (P<0.01). Moreover, the leucine aminopeptidase and alkaline phosphatase activities were reduced in the infected ileal mucosa. Interestingly, the reduction in weight gain, which began at day 6 post-infection (PI), persisted until day 20 PI, although no cryptosporidia were detected in the ileal mucosa after day 12 PI. We thus provide evidence that the malabsorption of amino acids during cryptosporidiosis contributes to impairing the development of neonatal animals, with consequences that persist beyond eradication of the parasite.
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Affiliation(s)
- A Topouchian
- Laboratoire de Biologie Animale et Parasitaire, Faculté des Sciences Pharmaceutiques et Biologiques, Université Rene Descartes, Paris, France.
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Barbot L, Topouchian A, Capet C, Magne D, Huneau JF, Kapel N, Gobert JG. [Cryptosporidium parvum: functional study of the intestinal malabsorption syndrome]. Ann Pharm Fr 2001; 59:305-11. [PMID: 11787423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Cryptosporidiosis is an important cause of diarrhea associated with growth retardation in children and severe malnutrition in immunocompromised patients. The pathophysiology is poorly understood. In the suckling rat model, we show that C. parvum infection impairs net electrogenic transport across the ileal mucosa without involvement of prostaglandins, as well as trans- and paracellular permeability and leucine and glutamate absorption. These results provide evidence for the development of an intestinal malabsorptive syndrome during cryptosporidiosis. Unspecific process such as villous atrophy and inflammatory cytokines secretion should be regarded as possible mediators of this syndrome. However, specific mechanisms have to be considered since C. parvum induces a rearrangement of the host enterocyte cytoskeleton which might impaired intracellular trafficking thus reducing the membrane expression of nutrient transporters. Infection and malnutrition are known to be tightly associated, making each other worse. As no specific efficient therapy exists, cryptosporidiosis-induced malnutrition must be taken into account when establishing therapeutic scheme.
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Affiliation(s)
- L Barbot
- Laboratoire de Biologie Animale et Parasitaire, Faculté des Sciences Pharmaceutiques et Biologiques, Université René Descartes, Service de Coprologie Fonctionnelle, Groupe-Hospitalier Pitié-Salpêtrière, 47, boulevard de l'Hôpital-F75651 Paris
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Campeotto F, Kapel N, Kalach N, Francoual C, Gobert JG, Dupont C. [Evaluation of exocrine pancreatic function in term and premature infants during the first week of life by fecal elastase 1 assay]. Arch Pediatr 2001; 8:445-6. [PMID: 11339139 DOI: 10.1016/s0929-693x(00)00220-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Capet C, Kapel N, Huneau JF, Magne D, Laikuen R, Tricottet V, Benhamou Y, Tomé D, Gobert JG. Cryptosporidium parvum infection in suckling rats: impairment of mucosal permeability and Na(+)-glucose cotransport. Exp Parasitol 1999; 91:119-25. [PMID: 9990339 DOI: 10.1006/expr.1998.4358] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Na(+)-glucose transport and transepithelial permeability were investigated during symptomatic acute cryptosporidiosis in newborn rats. The infection resulted in a significant (P < 0.01) decrease in the ileal short-circuit current and a nonsignificant fall in the transepithelial potential difference and conductance. In glucose-stimulated conditions, the rise in ileal short-circuit current and transepithelial permeability were significantly lower in Cryptosporidium parvum-infected rats than in controls (delta Isc = 3.24 +/- 1.21 microA.cm-2 vs delta Isc = 5.09 +/- 2.23 microA.cm-2 in infected and control animals, respectively; P < 0.001; delta PD = -0.35 +/- 0.13 mV vs delta PD = -0.44 +/- 0.14 mV for infected and control animals, respectively; P < 0.01). Electrical parameters were not affected by addition of the cyclooxygenase inhibitor indomethacin in either Cryptosporidium-infected newborn rats or controls. Horseradish peroxidase and mannitol flux studies demonstrated a significant decrease (P < 0.05) in transepithelial molecular permeability in infected enterocyte rats, HRP flux = 380, range 68-5570 ng.cm-2, and mannitol flux = 1.06, range, 0.34-1.44%.cm-2.min-1, compared with controls rats, HRP flux = 4446 range, 1121-124,363 ng.cm-2, and mannitol flux = 1.99, range, 0.57-5.09%.cm-2.min-1; P < 0.05. These effects could originate from C. parvum-induced alteration of intracellular trafficking of pinocytosis vesicles and therefore account for the decrease in permeability to solute and macromolecules, together with impaired transcellular nutrient transport, in suckling rats.
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Affiliation(s)
- C Capet
- Laboratoire de Biologie Animale et Parasitaire, UFR des Sciences Pharmaceutiques et Biologiques, Paris, France
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Kapel N, Matarazzo P, Haouchine D, Abiola N, Guérin S, Magne D, Gobert JG, Dupont C. Fecal tumor necrosis factor alpha, eosinophil cationic protein and IgE levels in infants with cow's milk allergy and gastrointestinal manifestations. Clin Chem Lab Med 1999; 37:29-32. [PMID: 10094375 DOI: 10.1515/cclm.1999.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Infants with atopic eczema exhibit a specific fecal protein pattern after oral challenge with cow's milk, characterized by an increase in both eosinophil cationic protein (ECP) and tumor necrosis factor (TNF)alpha. The aim of our study was to determine the pattern of these proteins in allergic infants with intestinal manifestations. TNFalpha, ECP and immunoglobulin E (IgE) were measured in stools from 13 infants with intestinal symptoms and 10 healthy infants. The allergic infants underwent two stool collections, one before a cow's milk challenge and the other after the challenge, either at the onset of clinical manifestations (n=6) or 15 days after the challenge if no clinical manifestations occurred (n=7). Baseline TNFalpha, ECP and IgE levels were low in all infants. The concentration of TNFalpha increased after the challenge in infants positive to challenge (p<0.05) but not in those negative to challenge. ECP and IgE levels remained low after the challenge in all the allergic infants. These data confirm that fecal TNFalpha and ECP levels indicate various reaction types of food allergy and that different immunologic disturbances lead to atopic eczema or intestinal symptoms during food allergy. Fecal protein pattern can thus be a useful tool in diagnosing food allergy in infants with intestinal manifestations.
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Affiliation(s)
- N Kapel
- Laboratoire de Coprologie Fonctionnelle, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Université René Descartes, Paris, France.
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33
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Jaïs P, Kapel N, Chosidow D, Rupaire N, Rougier P, Lasser P, Mignon M, Lewin MJ, Gobert JG. [Detection of protein p53 in the stool of patients with colorectal cancer]. Gastroenterol Clin Biol 1998; 21:754-9. [PMID: 9587516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Mutations of TP53, a tumor suppressor gene, are found in 60% to 70% of colorectal cancers. These mutations usually induce an overexpression caused by modification of the p53 protein conformation. The aim of this study was to investigate whether stool specimens of patients with colorectal cancer contain increased amounts of p53 protein. METHODS p53 protein was measured using a sandwich enzyme immunoassay in the stool specimens of 52 patients: 25 with colorectal cancer, 4 with colorectal adenomas and 23 apparently free of gastrointestinal disease. Results were expressed as pg/mg of total protein. The presence of fecal occult-blood was searched using Hemoccult II and Hemolex (an immunochemical assay for human hemoglobin). RESULTS Median concentrations of stool p53 protein were 16.6 pg/mg (range: 0-591 pg/mg) in patients with colorectal cancers, 39.1 pg/mg (range: 5-72 pg/mg) in patients with adenomas and 5.9 pg/mg (range: 0-65 pg/mg) in control subjects. Resection of colorectal cancers caused a marked decrease of stool p53 protein concentrations. When the cut-off value for stool p53 protein was set at 60 pg/mg of fecal protein (concentrations over the 95th percentile), the positivity of the assay was independent of tumor size and Astler-Coller stage, but weakly associated with rectal location of cancer. The sensitivity of stool p53 protein for colorectal cancer was 44%, and the specificity was 96%. In contrast, the sensitivity of Hemoccult II and Hemolex tests was 48% and 44%, whereas their specificity was 91% and 96%, respectively. CONCLUSION The detection of p53 protein is achievable in stool, but this assay is not more efficient than fecal occult blood tests for detection of colorectal cancer.
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Affiliation(s)
- P Jaïs
- INSERM Unité 10, Hôpital Bichat, Paris
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34
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Brasseur P, Lecoublet S, Kapel N, Favennec L, Ballet JJ. In vitro evaluation of drug susceptibilities of Babesia divergens isolates. Antimicrob Agents Chemother 1998; 42:818-20. [PMID: 9559789 PMCID: PMC105548 DOI: 10.1128/aac.42.4.818] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/1997] [Accepted: 01/27/1998] [Indexed: 02/07/2023] Open
Abstract
The susceptibilities of three bovine and two human Babesia divergens isolates to antimicrobial agents were evaluated in vitro by a tritiated hypoxanthine incorporation assay. The MICs at which 50% of isolates are inhibited (MIC50s) for mefloquine (chlorhydrate), chloroquine (sulfate), quinine (chlorhydrate), clindamycin (phosphate), pentamidine (isethionate), phenamidine (isethionate) plus oxomemazine (chlorhydrate), lincomycin (chlorhydrate monohydrate), and imidocarb (dipropionate) were determined. Except for imidocarb, the MIC50s observed for the different isolates were close. Imidocarb and the combination of phenamidine plus oxomemazine exhibited the highest in vitro activity, while antimalarial agents such as mefloquine, choroquine, and quinine were inactive. Other drugs had intermediate activities. The data support further in vitro evaluation of antimicrobial agents active against B. divergens for the improvement of therapeutic strategies.
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Affiliation(s)
- P Brasseur
- Laboratoire de Parasitologie, Centre Hospitalier Universitaire, Hôpital Charles Nicolle, Rouen, France.
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35
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Matarazzo P, Kapel N, Guérin S, De Boissieu D, Georges P, Gobert JG, Dupont C. Le TNF α, marqueur fécal des manifestations digestives de l'allergie alimentaire. Arch Pediatr 1998. [DOI: 10.1016/s0929-693x(97)86867-4] [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: 11/29/2022]
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36
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Kapel N, Huneau JF, Magne D, Tomé D, Gobert JG. Cryptosporidiosis-induced impairment of ion transport and Na+-glucose absorption in adult immunocompromised mice. J Infect Dis 1997; 176:834-7. [PMID: 9291348 DOI: 10.1086/517316] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Electrolyte transport was investigated during chronic cryptosporidiosis in adult anti-interferon-gamma-treated SCID mice by means of Ussing chamber techniques. In basal conditions, infection of immunocompromised mice with Cryptosporidium parvum resulted in a 30% reduction (P < .05) in the ileal short-circuit (Isc) current related to a 28% reduction (P < .05) in tissue conductance compared with controls. The rises in Isc and transepithelial potential difference induced by glucose (10 mM) were significantly reduced by Cryptosporidium infection (P < .01) compared with controls. In contrast, responses to mucosal glutamine were marginally affected. Electrical parameters of the ileum were not affected by the addition of indomethacin or furosemide, in either control or Cryptosporidium-infected mice. Thus, long-term cryptosporidiosis in immunocompromised animals leads to a reduction in net ion exchanges, decreased paracellular shunting, and impaired Na+-glucose cotransport in the ileum, without prostanoid- or enterotoxin-mediated electrogenic Cl- secretion.
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Affiliation(s)
- N Kapel
- Laboratoire de Biologie Animale et Parasitaire, UFR des Sciences Pharmaceutiques et Biologiques, Université René Descartes, Paris, France
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Brasseur P, Lecoublet S, Kapel N, Favennec L, Ballet JJ. Quinine in the treatment of Babesia divergens infections in humans. Eur J Clin Microbiol Infect Dis 1996; 15:840-1. [PMID: 8950568 DOI: 10.1007/bf01701533] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Kapel N, Benhamou Y, Buraud M, Magne D, Opolon P, Gobert JG. Kinetics of mucosal ileal gamma-interferon response during cryptosporidiosis in immunocompetent neonatal mice. Parasitol Res 1996; 82:664-7. [PMID: 8897498 DOI: 10.1007/s004360050182] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The kinetics of serum and ileal interferon-gamma (IFN-gamma) content were determined during recovery from cryptosporidiosis in NMRI suckling mice. A total of 60 mice aged 4 days were inoculated by intragastric gavage with 10(4) cryptosporidia (n = 30) or phosphate-buffered saline (n = 30). Six animals per group were killed on days 0, 3, 6, 9 and 13 postinoculation. Blood samples and ileum were collected. Experimental infection was followed by a rise in parasite load in the ileum starting on day 3 postinfection, which peaked at day 6 postinoculation. Ileal IFN-gamma levels increased rapidly in parasitized mice from day 3 to day 6, then fell rapidly. These levels were significantly higher than the control values (day 3 P < 0.05, days 6 and 9 P < 0.001). IFN-gamma secretion began before parasite excretion, but the curves of these two parameters correlated positively. Recovery from cryptosporidiosis in immunocompetent neonatal mice is thus associated with an early and marked increase in ileal IFN-gamma content.
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Affiliation(s)
- N Kapel
- Laboratoire de Parasitologie à orientation Coprologique, Groupe Hospitalier Bichat-Claude Bernard, Paris, France
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Claise C, Johanet C, Bouhnik Y, Kapel N, Homberg JC, Poupon R. Antineutrophil cytoplasmic autoantibodies in autoimmune liver and inflammatory bowel diseases. Liver 1996; 16:28-34. [PMID: 8868075 DOI: 10.1111/j.1600-0676.1996.tb00700.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Perinuclear antineutrophil cytoplasmic autoantibodies have been described in inflammatory bowel diseases and in primary sclerosing cholangitis. Because the data concerning their occurrence are conflicting, we have used indirect immunofluorescence on ethanol-fixed neutrophils to test the sera from a large population of 382 patients with various liver and digestive diseases: in particular, from 27 patients with primary sclerosing cholangitis, 105 patients with autoimmune chronic active hepatitis, 30 patients with primary biliary cirrhosis and 124 patients with inflammatory bowel disease. The prevalence of the perinuclear antineutrophil cytoplasmic autoantibodies was 37% in ulcerative colitis and 15% in Crohn's disease. They would not be helpful in the differential diagnosis between these two inflammatory bowel diseases. Within the group of autoimmune liver diseases, perinuclear antineutrophil cytoplasmic autoantibodies were detected in 44% of sera from patients with primary sclerosing cholangitis and in 36% of sera from patients with type I autoimmune active hepatitis, but not in primary biliary cirrhosis. When primary sclerosing cholangitis was associated with an inflammatory bowel disease, the prevalence of these autoantibodies was 60%. They were 88% specific for primary sclerosing cholangitis and 86% specific for type I autoimmune active hepatitis. Despite their moderate sensitivity and specificity in primary sclerosing cholangitis, they remain the only serologic marker of this autoimmune liver disease. Moreover, they turned out to be a more sensitive marker for inflammatory bowel disease with associated primary sclerosing cholangitis.
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Affiliation(s)
- C Claise
- Laboratoire d'Immunologie, CHU Saint-Antoine, Paris, France
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Abstract
Outbred suckling mice (NMRI strain) were used as hosts. They were initially inoculated with oocysts of human origin, and subsequently with parasites recovered from the mouse ileal mucosa. Cryptosporidia were counted in an aliquot of whole-ileum homogenate. Parasite load was expressed as cryptosporidia per centimeter of ileum. Serial passage of C. parvum in NMRI mouse litters led to a gradual amplification of parasite burden relative to animals initially inoculated with the human isolate.
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Affiliation(s)
- M Buraud
- Service de Biologie Animale et Parasitaire, UFR des Sciences Pharmaceutiques et Biologiques, Université René Descartes, Paris
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Benhamou Y, Kapel N, Hoang C, Matta H, Meillet D, Magne D, Raphael M, Gentilini M, Opolon P, Gobert JG. Inefficacy of intestinal secretory immune response to Cryptosporidium in acquired immunodeficiency syndrome. Gastroenterology 1995; 108:627-35. [PMID: 7875465 DOI: 10.1016/0016-5085(95)90433-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND/AIMS An alteration of the secretory immune response has been forwarded to explain frequent and chronic mucosal infections in patients with acquired immunodeficiency syndrome (AIDS). The aim of this study was to explore the intestinal immunoglobulin (Ig) secretions in patients with AIDS and their relationships to cryptosporidiosis. METHODS Patients with AIDS and enteric cryptosporidiosis (n = 12), other enteric infections (n = 10), and no identifiable enteric pathogen (n = 10) and human immunodeficiency virus-seronegative controls (n = 18) were studied. The number of intestinal IgA and IgM plasma cells of the duodenal lamina propria mucosa and total and anti-Cryptosporidium IgA, IgM, and IgG were measured in serum and feces. RESULTS Although not significantly increased, the number of IgA and IgM plasma cells was greater in patients with AIDS (n = 20) than in controls (n = 5). In feces, total IgA outputs and specific anti-Cryptosporidium IgA levels were significantly higher in patients with AIDS and cryptosporidiosis than in the two other groups of patients with AIDS (P < 0.05 and P < 0.01, respectively) and controls (P < 0.001 and P < 0.01, respectively). Total fecal IgM output and specific anti-Cryptosporidium IgM coproantibodies were increased only in the Cryptosporidium-infected patients relative to the controls (P < 0.05). CONCLUSIONS Despite the development of pathogen-specific mucosal antibody responses, patients with AIDS and cryptosporidiosis fail to clear the parasite.
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Affiliation(s)
- Y Benhamou
- Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Comby E, Favennec L, Kapel N, Brasseur P, Gobert JG, Ballet JJ. In vitro detection of anti-Cryptosporidium parvum antibody secreting cells by polyclonal activation of human tonsil mononuclear cells. J Eukaryot Microbiol 1994; 41:29S-30S. [PMID: 7804231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- E Comby
- Lab. Immunol. and Immunopathol., CHU Clémenceau, Caen, France
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Magne D, Chochillon C, Favennec L, Kapel N, Savel J, Gobert JG. Intestinal lipid metabolism in suckling rats infected with Giardia duodenalis. Parasitol Res 1994; 80:528-30. [PMID: 7809005 DOI: 10.1007/bf00932702] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We carried out a quantitative and qualitative analysis of intestinal digestion of neutral lipids in suckling rats infected with Giardia duodenalis. Total lipids were measured after extraction from the contents of the stomach, proximal and distal small bowel, caecum and colon. Amounts gradually fell from the stomach to the colon and were identical in infected animals and controls, although high values were occasionally found in the caecum of infected rats. Relative glyceride quantities were determined by means of high-performance thin-layer chromatography. Triglycerides were absent from the distal small bowel, and only free fatty acids and cholesterol were present in the caecum, reflecting normal digestion of neutral lipids in infected suckling rats. Our results suggest that G. duodenalis does not impair intestinal fat digestion in suckling rats.
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Affiliation(s)
- D Magne
- Laboratoire de Biologie Animale et Parasitaire, Université René Descartes, Paris, France
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Kapel N, Meillet D, Buraud M, Favennec L, Magne D, Gobert JG. Determination of anti-Cryptosporidium coproantibodies by time-resolved immunofluorometric assay. Trans R Soc Trop Med Hyg 1993; 87:330-2. [PMID: 8236410 DOI: 10.1016/0035-9203(93)90152-g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The role of the mucosal immune response against Cryptosporidium has been suggested by studies on the therapeutic effects of hyperimmune colostrum. In order to study the intestinal response to this infection, we have developed a sandwich-type time-resolved immunofluorometric assay for the determination of anti-Cryptosporidium coproantibodies. This assay has the inherent sensitivity of an immunoassay without the problems due to background responses from other biological compounds, and is thus suitable for faecal samples. The intra-assay coefficients of variation (5.1%, 4.6%, and 5.8% for immunoglobulins (Ig) A, M and G respectively), inter-assay coefficients of variation (9.4%; 10.5% and 12.2% for IgA, IgM and IgG, respectively) and specificity (100% for all 3 isotypes) were all satisfactory. Using this assay to study 12 patients with the acquired immune deficiency syndrome (AIDS) who were infected with cryptosporidiosis, we found a marked elevation of anti-Cryptosporidium IgA and IgM coproantibody titres relative to 18 healthy control values, but no correlation with the gravity of the infection in terms of oocyst shedding. These results suggest that a non-protective mucosal immune response develops to Cryptosporidium in AIDS patients.
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Affiliation(s)
- N Kapel
- Parasitaire, Faculté de Pharmacie, Université René Descartes, Paris, France
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Haas L, Meillet D, Kapel N, Rostoker G, Gobert JG. Increased concentrations of fecal anti-gliadin IgA antibodies in untreated celiac disease. Clin Chem 1993; 39:696-7. [PMID: 8472373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Haas L, Meillet D, Kapel N, Rostoker G, Gobert JG. Increased concentrations of fecal anti-gliadin IgA antibodies in untreated celiac disease. Clin Chem 1993. [DOI: 10.1093/clinchem/39.4.696] [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: 11/14/2022]
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Meillet D, Kapel N, Favennec L, Raichvarg D, Savel J, Gobert JG. Correction factors for single radial immunodiffusion and electroimmunodiffusion assays of IgA in secretory fluids. Clin Chim Acta 1993; 214:235-41. [PMID: 8472389 DOI: 10.1016/0009-8981(93)90115-k] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- D Meillet
- Laboratoire de Biologie Animale et Parasitaire, UER René Descartes, Paris, France
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Meillet D, Hoang PL, Unanue F, Kapel N, Diemert MC, Rousselie F, Galli A, Galli J. Filtration and local synthesis of lacrimal proteins in acquired immunodeficiency syndrome. Eur J Clin Chem Clin Biochem 1992; 30:319-23. [PMID: 1324743 DOI: 10.1515/cclm.1992.30.6.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In AIDS the onset of the ocular dry syndrome, characterized by lacrimal hyposecretion and deterioration of the corneal and conjunctival epithelium, generally accompanies the clinical aggravation of immunodepression. The study of serum and lacrimal proteins contributes to our knowledge of the pathophysiology of this syndrome. The lacrimal clearance of albumin indicates changes in the permeability of the haemato-lacrimal and conjunctival barrier. Lacrimal monomeric IgA and IgG are mainly of plasmatic origin, while polymeric IgA and IgM are synthesized in situ. The concentrations of these analytes thus reflect ocular humoral immune status. They show a strong humoral protein response in patients with cytomegalovirus retinitis. Lacrimal concentrations of lactoferrin and lysozyme were found to be significantly decreased in AIDS patients with ocular dryness, reflecting a decrease in the secretory activity of the lacrimal gland. Moreover, ocular lympho-plasmocyte infiltration was observed in several patients, with an increase in lacrimal beta 2-microglobulin concentrations. These various lacrimal proteins could be good markers of the ocular dry syndrome in AIDS.
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Affiliation(s)
- D Meillet
- Laboratoire de Biochimie, Hôpital de la Salpêtrière, Paris, France
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Kapel N, Meillet D, Favennec L, Magne D, Raichvarg D, Gobert JG. Evaluation of intestinal clearance and faecal excretion of alpha 1-antiproteinase and immunoglobulins during Crohn's disease and ulcerative colitis. Eur J Clin Chem Clin Biochem 1992; 30:197-202. [PMID: 1525248 DOI: 10.1515/cclm.1992.30.4.197] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The intestinal clearance of alpha 1-antiproteinase, monomeric IgA and IgG, and the daily fecal output of polymeric IgA and IgM were investigated in patients with inflammatory bowel diseases (inactive and active Crohn's disease, ulcerative colitis) and in a control group. The intestinal clearance of alpha 1-antiproteinase was significantly increased in all patients with inflammatory bowel diseases (p less than 0.01), irrespective of the grade of the disease. In contrast, increases in intestinal clearances of monomeric IgA and IgG were more closely related to the severity of the intestinal lesions. The associate determination of these three quantities should therefore be of interest for monitoring the degree of intestinal bowel inflammation. Faecal output of polymeric IgA was significantly increased in active intestinal disease (p less than 0.01), whereas faecal IgM levels were not. The determination of the faecal output of polymeric IgA should contribute to the assessment of the activity of inflammatory bowel diseases, and may provide insight into the activation of the mucosal immune system.
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Affiliation(s)
- N Kapel
- Laboratoire de Coprologie, Groupe hospitalier Bichat-Claude Bernard, Paris
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Magne D, Favennec L, Chochillon C, Gorenflot A, Meillet D, Kapel N, Raichvarg D, Savel J, Gobert JG. Role of cytoskeleton and surface lectins in Giardia duodenalis attachment to Caco2 cells. Parasitol Res 1991; 77:659-62. [PMID: 1805208 DOI: 10.1007/bf00928679] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
An in vitro model of Giardia duodenalis and the Caco2 cell line enable the study of parameters that could play a part in trophozoite attachment. We explored the role of membranous lectins of G. duodenalis in attachment-inhibition studies using carbohydrates in solution. Attachment rates were reduced by 14% and 23% in the presence of 100 mmol/l mannose-6-phosphate and glucose, respectively, as compared with control values. No significant modification was observed after trophozoite trypsinization at room temperature or at 37 degrees C. The inhibitory effects of colchicine (35%) and nocodazole (70%) suggest a primordial role of the cytoskeleton; microtubules appear to be the principal effectors of trophozoite fixation. Scanning electron microscopy revealed circular imprints on the Caco2 brush border after trophozoite detachment. The mechanisms of attachment of G. duodenalis to intestinal enterocyte-like cells in culture are thus essentially of the mechanical or hydrodynamic type; surface lectins would appear to intervene in the specificity for duodenal cells.
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Affiliation(s)
- D Magne
- Laboratoire de Biologie Animale et Parasitaire, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, France
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