References of "Louis, Edouard"
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See detailOptimizing treatment with thioguanine derivatives in inflammatory bowel disease.
Louis, Edouard ULg; Belaiche, Jacques ULg

in Bailliere's Best Practice & Research. Clinical Gastroenterology (2003), 17(1), 37-46

Thioguanine derivatives, azathioprine and 6-mercaptopurine, represent major drugs in the treatment of chronic active inflammatory bowel disease. They are effective in two-thirds of the patients and safe ... [more ▼]

Thioguanine derivatives, azathioprine and 6-mercaptopurine, represent major drugs in the treatment of chronic active inflammatory bowel disease. They are effective in two-thirds of the patients and safe over the long term in patients who can tolerate them (80-90%). Recent progress in understanding the metabolism of these drugs and its implication in clinical practice have brought up new tools and strategies that are proposed to optimize treatment. In particular, the measurement and characterization of key enzymes and metabolites may have clinical impact. Thus, thiopurine methyl transferase genotyping and activity measurement, as well as erythrocytes, 6-thioguanine nucleotides and 6-methyl mercaptopurine levels, may help in some situations of intolerance or inefficacy with these drugs. Indications for starting and stopping treatment with thioguanine derivatives are also discussed. [less ▲]

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See detailSubocclusion colique precoce apres traitement d'une maladie de Crohn refractaire active par infliximab.
Belaiche, Jacques ULg; Louis, Edouard ULg

in Gastroentérologie Clinique et Biologique (2003), 27(11), 1045-7

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See detailEpidemiology, clinical presentation and diagnostic strategy of gastro-esophageal reflux
Louis, Edouard ULg

in Acta Endoscopica (2003), 33

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See detailRevue de l'épidémiologie de la maladie de Crohn en Europe
Piront, Patricia ULg; Belaiche, Jacques ULg; Louis, Edouard ULg

in Acta Endoscopica (2003), 33

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See detailNegative association between smoking and anti-saccharomyces cerevisiae antibodies in Crohn's disease
Van Kemseke, Catherine ULg; Belaiche, Jacques ULg; Steeman, C. et al

in Acta Gastro-Enterologica Belgica (2003), 66(1, Jan-Mar), 1-6

Background: Crohn's disease (CD) is a polygenic multifactorial heterogeneous disease. Anti-Saccharomyces Cerevisiae antibodies (ASCA) correlate highly with CD and are present in 50-80% of patients. The ... [more ▼]

Background: Crohn's disease (CD) is a polygenic multifactorial heterogeneous disease. Anti-Saccharomyces Cerevisiae antibodies (ASCA) correlate highly with CD and are present in 50-80% of patients. The reason for ASCA positivity or negativity in CD is unknown. The aim of our work was to analyse clinical, epidemiological and genetic characteristics in ASCA + or ASCA- CD patients. Methods : 113 patients with CD were tested for ASCA (IgA and IgG) by using a commercial kit (Medipan Diagnostica). Age, gender, systemic manifestations, familial form of disease, age at diagnosis, location and behaviour of the disease, smoking habit as well as genotyping for -308 TNF gene polymorphisms were determined. Results : 38.9% CD patients were negative for both IgA and IgG ASCA while 61.1% were ASCA positive (respectively IgA and IgG : 31.9%; IgA only : 9.7%; IgG only : 19.5%). The only significant difference between ASCA+ and ASCA- patients was for smoking habit : there were 29% smokers in ASCA+ versus 50% in ASCA- CD patients (P = 0.03). This low proportion of smokers was more prominent in ASCA IgA+ patients than in isolated ASCA IgG+ patients (25.6% versus 45.5%) and was minimal in patients with high titers of ASCA IgA (0/8). Logistic regression showed smoking habit still borderline for significance (P = 0.057). Conclusions : Our results suggest a negative association between smoking and ASCA positivity in CD. This association was more prominent for ASCA IgA+. It indicates that smoking habit should be taken into account when analysing ASCA status in CD patients and may suggest an influence of smoking on immunization against intestinal material. [less ▲]

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See detailClassification of Crohn's disease - Vienna and Beyond
Louis, Edouard ULg; Belaiche, Jacques ULg

in Inflammatory Bowel Disease Monitor (2003), 5

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See detailSevere lower gastrointestinal bleeding in Crohn's disease: Successful control with infliximab
Berlaiche, J.; Louis, Edouard ULg

in American Journal of Gastroenterology (2002), 97(12), 3210-3211

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See detailCytokine production from sputum cells after allergenic challenge in IgE-mediated asthma
Bettiol, Jeanne; Sele, Jocelyne ULg; Henket, Monique ULg et al

in Allergy (2002), 57(12), 1145-1150

Background: Th2 cytokine production from airway cells is thought to govern the eosinophilic airways in ammation in allergic asthma. Induced sputum has become a widely used technique to assess airways in ... [more ▼]

Background: Th2 cytokine production from airway cells is thought to govern the eosinophilic airways in ammation in allergic asthma. Induced sputum has become a widely used technique to assess airways in ammation. Methods: By applying the technique of induced sputum to collect airways cells, we have assessed the spontaneous production of a set of cytokines, including interleukin-4, 6, 10, interferon-gamma and tumour necrosis factor-alpha 6 h after a bronchial allergenic hallenge with Dermatophagoides pteronyssinus (Dpt) in 12 sensitized asthmatics and compared the results obtained after inhalation of saline as control. A group of eight healthy non-allergic subjects was enrolled to control for any non-specific effect of Dpt. Cytokines were measured by a dynamic immunoassay during a 24-h sputum cell culture. Results: Allergen challenge in sensitized asthmatics caused an acute and a late bronchospasm together with a rise in sputum eosinophil counts. Afterwards allergen sputum cells from allergic asthmatics displayed a rise in their production of IL-4 (P < 0.01), IL-6 (P < 0.05) and IL- 10 (P < 0.05) when compared to saline. By this time sputum generation of IL- 4 in atopic asthmatics was greater than in healthy subjects (P < 0.001). Furthermore, in allergic asthmatics there was a strong correlation between the rise in interleukin-4 production from sputum cells and the rise in sputum eosinophils (r = 0.87, P < 0.001). Conclusions: Sputum cell culture is a useful model to assess cytokine production in allergic asthmatics who show a marked up-regulation of Th2 cytokines following acute allergen exposure. The rise in sputum eosinophil count following allergen challenge strongly correlates with the rise in IL-4 generation from sputum cells. [less ▲]

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See detailDemographic and clinical parameters influencing the short-term outcome of anti-tumor necrosis factor (infliximab) treatment in Crohn's disease
Vermeire, S.; Louis, Edouard ULg; Carbonez, A. et al

in American Journal of Gastroenterology (2002), 97(9), 2357-2363

OBJECTIVE: Infliximab is an effective treatment for refractory or fistulizing Crohn's disease (CD). However, about 30% of patients do not respond to infliximab for unknown reasons. Identifying predictive ... [more ▼]

OBJECTIVE: Infliximab is an effective treatment for refractory or fistulizing Crohn's disease (CD). However, about 30% of patients do not respond to infliximab for unknown reasons. Identifying predictive factors of response is important for optimizing clinical management and for better understanding infliximab's mechanisms of action. The aim of this study was to assess whether demographic or clinical parameters influence short-term response to infliximab. METHODS: The first 240 CD patients of the Belgian Infliximab Expanded Access Program were studied for response to infliximab treatment and assessed at 4 (refractory luminal CD) or 10 wk (fistulizing CD) after the first infusion. Detailed demographic and clinical information on age, sex, type of disease (fistulizing or refractory), Crohn's Disease Activity Index score, C-reactive protein (CRP), smoking habits, disease duration, localization of disease, concomitant medication, and previous surgery were obtained from all patients. Logistic regression and decision tree analysis were performed. RESULTS: There were 73.5% responders and 26.5% nonresponders to treatment. Stepwise logistic regression identified age (OR = 0.971, 95% CI = 0.947-0.995, p = 0.018), isolated ileitis (OR = 0.359, 95% CI 0.177-0.728, p = 0.004), and previous surgery (OR 0.429, 95% CI = 0.233-0.787, p = 0.006) as inversely correlated with response, whereas isolated colitis (OR = 1.905, 95% CI = 1.010-3.597, p = 0.046) and concomitant immunosuppressive treatment (OR = 2.670, 95% CI = 1.430-5.016, p = 0.0022) were positively correlated with response to infliximab. Surprisingly, smoking habits were not retained as predictors for response. Decision tree analysis provided a working algorithm based on age and immunosuppressive treatment that warrants further exploration. CONCLUSIONS: In this large cohort of infliximab-treated CD patients, young age, Crohn's colitis, and concomitant immunosuppressive treatment were identified as independent variables favoring short-term response to infliximab. [less ▲]

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See detailPharma clinics le medicament du mois. L'esomeprazole
Louis, Edouard ULg

in Revue Médicale de Liège (2002), 57(9), 610-2

Esomeprazole is the last PPI registered on the Belgian market. It is the stable s-isomer of omeprazole. It has a better pharmacokinetic profile than omeprazole (racemate), allowing also better clinical ... [more ▼]

Esomeprazole is the last PPI registered on the Belgian market. It is the stable s-isomer of omeprazole. It has a better pharmacokinetic profile than omeprazole (racemate), allowing also better clinical performances. Esomeprazole is the first PPI shown superior to omeprazole in acute and chronic treatment of gastro-esophageal reflux disease. Controlled trials with this drug have also allowed to define new cost-effective strategies, such as on demand treatment for endoscopy-negative gastro-esophageal reflux and one week treatment of Helicobacter pylori positive duodenal ulcer. [less ▲]

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See detailStrictureplasty in Crohn's disease : Short- and long-term follow-up
Laurent, Stanislas; Detry, Olivier ULg; Detroz, Bernard ULg et al

in Acta Chirurgica Belgica (2002), 102(4, JUL-AUG), 253-255

Strictureplasty for obstructive Crohn's disease is still controversial because lesions are left in place and the suture is performed on a diseased bowel. Many surgeons prefer to perform bowel resection ... [more ▼]

Strictureplasty for obstructive Crohn's disease is still controversial because lesions are left in place and the suture is performed on a diseased bowel. Many surgeons prefer to perform bowel resection, hoping for fewer complications and a lower recurrence rate. In this paper, the authors reports their strictureplasty experience. They performed a systematic retrospective review of the patients suffering from Crohn's disease who underwent strictureplasties during a 10-year period in the abdominal surgery department of the University Hospital of Liege Sart Tilman, and studied the short- and long-term clinical results of 68 strictureplasties performed in 18 patients. Median follow-up was 63 months (range 12 to 144). Mortality was 0% and septic morbidity was 11% (one wound abscess and one leakage). Among the 16 patients available for the latest follow-up, symptomatic stenotic recurrence had to be medically treated in hospital for 4 patients (25%) with a recurrence delay range of 19 to 49 months. Stenosis recurrence needed re-intervention in one patient 48 months after surgery: stenosis occurred at a distance from the corrected site. These results confirmed that strictureplasty is a safe and efficient procedure in selected patients undergoing surgery for obstructive Crohn's disease. [less ▲]

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See detailImplications pathologiques du systeme neuroendocrinien digestif
Piette, Caroline ULg; Polus, Marc ULg; Louis, Edouard ULg

in Revue Médicale de Liège (2002), 57(8), 509-18

The neuroendocrine system is made of endocrine cells disseminated in various organs. In this article, we will focus on the implication of the neuroendocrine system in digestive pathology. First of all, we ... [more ▼]

The neuroendocrine system is made of endocrine cells disseminated in various organs. In this article, we will focus on the implication of the neuroendocrine system in digestive pathology. First of all, we will review the neuroendocrine tumors in every location and then describe their classification, epidemiology, symptomatology, diagnosis and treatment. Finally, we will consider the implications of the neuroendocrine system in the inflammatory and functional pathology of the digestive tract. [less ▲]

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See detailOesophage de Barrett: mise au point
Delforge, M.; Plomteux, O.; Delfosse, Valérie ULg et al

in Revue Médicale de Liège (2002), 57(8), 535-45

Barrett's oesophagus (BE) is a segment of columnar lined epithelium in the distal oesophagus, above the gastrooesophageal junction. So it is important to localize this junction endoscopically; the ... [more ▼]

Barrett's oesophagus (BE) is a segment of columnar lined epithelium in the distal oesophagus, above the gastrooesophageal junction. So it is important to localize this junction endoscopically; the proximal margin of the gastric folds is the anatomic landmark. Another important feature of BE is the specialized intestinal metaplasia. In the aetiology of this condition, acid reflux is a primary event but there is evidence that other factors are causal. As BE is a well known premalignant condition, detection of dysplastic epithelium and its severity is the crucial element. Practical guidelines are presented for endoscopic surveillance program. The purpose is the early detection of high grade dysplasia and carcinoma to advise oesophagectomy or endoscopic ablation therapy for patients unfit to undergo surgery. [less ▲]

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See detailNOD2/CARD15 does not influence response to infliximab in Crohn's disease
Vermeire, S.; Louis, Edouard ULg; Rutgeerts, P. et al

in Gastroenterology (2002), 123(1), 106-111

Background

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See detailA positive response to infliximab in Crohn disease: Association with a higher systemic inflammation before treatment but not with-308 TNF gene polymorphism
Louis, Edouard ULg; Vermeire, S.; Rutgeerts, P. et al

in Scandinavian Journal of Gastroenterology (2002), 37(7), 818-824

Background: Two-thirds to three-fourths of patients with either refractory luminal or fistulizing Crohn disease respond to infliximab treatment. The ability or inability to respond seems to persist over ... [more ▼]

Background: Two-thirds to three-fourths of patients with either refractory luminal or fistulizing Crohn disease respond to infliximab treatment. The ability or inability to respond seems to persist over time. Biological characteristics and/or genetic background can influence the response to treatment. The aim was to assess the value of C-reactive protein and TNF-alpha serum levels before treatment as well as the TNF -308 gene polymorphism in the prediction of response to infliximab treatment in Crohn disease. Methods: Two-hundred-and-twenty-six Crohn disease patients treated in the setting of an expanded access programme to infliximab in Belgium were studied. There were 136 refractory luminal diseases and 90 refractory fistulizing diseases. Luminal diseases were treated with one single infusion; fistulizing diseases with three infusions at weeks 0, 2 and 6. A clinical response to treatment was defined as either a Crohn disease activity index <150 (complete) or a drop of 70 points (partial) at week 4, for luminal disease, and as either complete fistula healing (complete) or a decrease of at least 50% of the number of draining fistulas on two consecutive visits between weeks 0 and 18, for fistulizing disease. CRP and serum TNF-α levels were measured at week 0 before treatment and were compared between responders and non- responders. Patients were genotyped for the -308 TNF gene polymorphism, and allelic as well as genotype frequencies were compared between responders and non- responders. Results: There were 73.2% responders (46.4% complete and 26.8% partial) and 26.8% non- responders. Response rates were similar in luminal and fistulizing diseases. CRP level before treatment was significantly higher in responders than in non-responders (16.8 mg/l (5-160) versus 9.6 mg/l (5-143); P = 0.02). Furthermore, response rate was significantly higher in patients with elevated CRP (> 5 mg/l) than in patients with a normal CRP value (< 5 mg/l) before treatment (76% versus 46%; P = 0.004; OR: 0.26 (0.11-0.63)). Allelic and genotype frequencies for -308 TNF gene polymorphis m were not significantly different between responders and non- responders - with the exception of a slightly higher TNF2 frequency in nonresponders in luminal disease (22.1% versus 11.6%; P = 0.04). However, this was not associated with a significant difference in genotype frequencies. Conclusion: A positive clinical response to infliximab was associated with a higher CRP level before treatment in our population of Crohn disease patients, but there was no relevant association with -308 TNF gene polymorphism. We therefore suggest that CRP level may help to identify better candidates for infliximab treatment. [less ▲]

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See detailSerological markers for prediction of response to anti-tumor necrosis factor treatment in Crohn's disease
Esters, N.; Vermeire, S.; Joossens, S. et al

in American Journal of Gastroenterology (2002), 97(6), 1458-1462

OBJECTIVES: The use of monoclonal anti-tumor necrosis factor (TNF) antibodies (infliximab, Remicade) is a new therapeutic approach for severe refractory luminal or fistulizing, Crohn's disease (CD ... [more ▼]

OBJECTIVES: The use of monoclonal anti-tumor necrosis factor (TNF) antibodies (infliximab, Remicade) is a new therapeutic approach for severe refractory luminal or fistulizing, Crohn's disease (CD). However, up to 30% of patients do not respond to this treatment. So far, no parameters predictive of response to anti-TNT have been identified. Our aim was to determine whether serological markers ASCA (anti-Saccharomyces cerevisiae antibodies) or pANCA (perinuclear antineutrophil cytoplasmic antibodies) could identify Crohn's patients likely to benefit from anti-TNF therapy. METHODS: Serum samples of 279 CID patients were analyzed for ASCA and pANCA before anti-TNF therapy. A blinded physician determined clinical response at week 4 (refractory luminal CD) or week 10 (fistulizing CD) after the first infusion of infliximab (5 mg/kg). RESULTS: Overall, there was no relationship between ASCA or pANCA and response to therapy. However, lower response rates were observed for patients with refractory intestinal disease carrying the pANCA+/ASCA- combination, although this lacked significance (p = 0.067). CONCLUSIONS: In this cohort of infliximab-treated patients, neither ASCA nor pANCA could predict response to treatment. However, the combination pANCA+/ASCA- might warrant further investigation for its value in predicting nonresponse in patients with refractory luminal disease. [less ▲]

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See detailHeartburn in Belgium: prevalence, impact on daily life, and utilization of medical resources
Louis, Edouard ULg; DeLooze, D.; Deprez, P. et al

in European Journal of Gastroenterology & Hepatology (2002), 14(3), 279-284

Background Gastro-oesophageal reflux disease (GORD) is a frequently occurring disease that may be considered a public health issue, particularly in developed countries. The specificity of heartburn for ... [more ▼]

Background Gastro-oesophageal reflux disease (GORD) is a frequently occurring disease that may be considered a public health issue, particularly in developed countries. The specificity of heartburn for the diagnosis of GORD is good. Our aim was to define the prevalence of heartburn in Belgium, characterizing both its impact on everyday life and the ensuing use of medical resources. Methods Two thousand people living in Belgium, selected randomly after stratification, were interviewed face to face. The main question in the questionnaire used in this interview concerned the presence over the previous 12 months of a burning sensation in the epigastric and/or retrosternal region. This was followed by 21 secondary questions on the characteristics of the population studied, the impact of heartburn on everyday life, and the medical resources used. Results Twenty-eight per cent of the population interviewed reported heartburn. This symptom was present at least once a week in 42% of sufferers. Heartburn was more frequent in women than men (P < 0.05) and was not distributed uniformly throughout the various regions of the country (P < 0.05). Seventy-seven per cent of the people with heartburn found that it had a significantly negative impact on their daily lives (in 27%, this effect was strong). Heartburn associated with a substantial negative impact on daily life was characterized by a higher frequency of symptoms (P < 0.0001), a longer duration of the problem (P= 0.006), and the presence of pain (P < 0.0001) and anxiety (P < 0.0001). Fifty-six per cent of individuals with heartburn had already sought medical advice, 45% had undergone an upper-gastrointestinal tract endoscopy, and 59% were taking medications. Among patients complaining that heartburn had a substantial negative effect on their everyday lives, 21.6% had not sought medical advice and 22.2% did not take any medication. Conclusion Heartburn is very frequent in Belgium and is associated with a considerable negative impact on everyday life. It also generates a significant use of medical resources. However, among the patients complaining of a substantial negative effect on their daily lives, one-fifth (which would represent 1.5% of the Belgian population) seemed to lack appropriate care. [less ▲]

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See detailEpidemiology of inflammatory bowel diseases in the elderly in the province of Liege - A three-year prospective study
Piront, Patricia ULg; Louis, Edouard ULg; Latour, Pascale ULg et al

in Gastroentérologie Clinique et Biologique (2002), 26(2), 157-161

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See detailPharma-clinics le medicament du mois. Le rabeprazole (Pariet)
Louis, Edouard ULg

in Revue Médicale de Liège (2002), 57(1), 53-6

Proton pomp inhibitors (PPI) have revolutionized the treatment of gastro-oesophageal reflux disease and gastro-duodenal ulcers. Rabeprazole (Pariet) is the last PPI arrived on the Belgian market ... [more ▼]

Proton pomp inhibitors (PPI) have revolutionized the treatment of gastro-oesophageal reflux disease and gastro-duodenal ulcers. Rabeprazole (Pariet) is the last PPI arrived on the Belgian market. Controlled studies have shown an efficacy similar to emeprazole in the treatment of oeso-gastro-duodenal acid diseases. Rabeprazole has a favourable profile with rapid action and good safety. [less ▲]

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