Incidence of Inflammatory Bowel Disease in the Province of Liege (Belgium). La Societe De Gastroenterologie Liegeoise

in Acta Gastro-Enterologica Belgica (1996), 59(1, Jan-Mar), 3-6

Up to now, as there is no national registry of patients with inflammatory bowel disease (IBD) in Belgium, the study of IBD epidemiology in our country is only possible through institutional or regional ... [more ▼]

Up to now, as there is no national registry of patients with inflammatory bowel disease (IBD) in Belgium, the study of IBD epidemiology in our country is only possible through institutional or regional series. Therefore we conducted a prospective epidemiologic study of IBD in the Province of Liege (1 million inhabitants). METHODS: 29 (out of 47) private and public gastroenterologists completed a standard questionnaire for each patient consulting for the first time with clinical symptoms compatible with IBD between 1/06/1993 and 31/05/1994. RESULTS: During that period 104 cases of IBD were recorded: 56 (54%) Crohn's disease (CD), 36 (35%) ulcerative colitis (UC) including 7 proctitis (19% of UC) and 12 (11%) unclassified colitis. The annual incidence was 5.5 per 100.000 for CD and 3.5 for UC. The sex ratio F/M was 1.7 for CD and 0.7 for UC. The median age at the time of diagnosis was 33.5 yrs for CD and 40 yrs for UC. The highest age specific incidence rate for CD and UC was between 20 and 29 yrs : 13.6 and 6.1, respectively. CONCLUSIONS: This first Belgian prospective study has shown an incidence rate for CD comparable with that seen in north European studies but lower than that seen for UC. These results were similar to those observed in the northern part of France. Belgium appears to be a privileged country to undertake a national register and to study epidemiological aspects of IBD. [less ▲]

Cytokine gene polymorphisms in inflammatory bowel disease.

in Gut (1996), 39(5), 705-10

BACKGROUND: Concordance rates in siblings and twins provide strong evidence that genetic susceptibility is important in the pathogenesis of inflammatory bowel disease. The number and identity of ... [more ▼]

BACKGROUND: Concordance rates in siblings and twins provide strong evidence that genetic susceptibility is important in the pathogenesis of inflammatory bowel disease. The number and identity of susceptibility genes is largely uncertain. Cytokine genes are attractive candidate loci. AIMS: To study allelic frequencies of polymorphisms of the interleukin-1 receptor antagonist (IL-1RA) gene and the tumour necrosis factor alpha gene in patients with inflammatory bowel disease. SUBJECTS: One hundred and twenty nine North European caucasoid patients with ulcerative colitis, 120 patients with Crohn's disease, and 89 healthy controls. METHODS: Genotyping was performed by polymerase chain reaction. A variable number of tandem repeats (VNTR) in the IL-1RA gene and a single base pair polymorphism in the TNF alpha gene promoter region (TNF-308) were analysed. RESULTS: No significant differences in IL-1RA VNTR allelic frequencies were noted between Crohn's disease (allele 1: 72.6%, allele 2: 24.7%, allele 3: 2.6%), ulcerative colitis (72.6%, 24.3%, 3.1%, respectively), and controls (76.9%, 20.8% and 2.3%). Some 42.4% of patients with ulcerative colitis and 43.4% patients with Crohn's disease were carriers of allele 2, compared with 34.8% healthy subjects. The TNF2 allele was modestly reduced in Crohn's disease (13.2%), compared with healthy subjects (21.3%; p = 0.04), and ulcerative colitis (21.6%). CONCLUSIONS: The associations demonstrated are modest: these polymorphisms are unlikely to be important determinants of overall disease susceptibility. [less ▲]

Decrease in systemic tolerance to fed ovalbumin in indomethacin-treated mice.

in International Archives of Allergy & Immunology (1996), 109(1), 21-6

The oral administration of non-steroidal anti-inflammatory drugs (NSAID) to animals induces a quick increase in intestinal permeability and secondary inflammatory lesions of the intestine. The mechanisms ... [more ▼]

The oral administration of non-steroidal anti-inflammatory drugs (NSAID) to animals induces a quick increase in intestinal permeability and secondary inflammatory lesions of the intestine. The mechanisms leading to the inflammatory lesions are hypothetical. The increased intestinal permeability could allow a greater mucosal and systemic penetration of fed antigens and bacterial products leading to an abnormal mucosal and systemic immune and inflammatory response toward these materials. We examined the effect of oral dosing with indomethacin on ovalbumin serum levels and the systemic immune response to ovalbumin in mice fed with ovalbumin. The ovalbumin serum level was higher in indomethacin-treated mice and the increase was proportional to the dose of indomethacin. It was associated with epithelial and subepithelial lesions. Moreover, the systemic humoral and, to a lesser extent, the cellular tolerance were partially abrogated in the treated mice. These findings suggest that the oral administration of indomethacin in mice induces an increased passage of fed antigen through the intestinal epithelium associated with a decrease in systemic tolerance to this antigen. The reason for this decrease remains unclear. Besides a disequilibrium between systemic and mucosal immune responses, a loss of integrity of the intestinal epithelial cells and a direct immunomodulating effect of indomethacin may also be involved. This decrease in systemic tolerance to luminal antigen could be involved in the development of NSAID enteropathy. [less ▲]

Soluble Interleukin-2 Receptor in Crohn's Disease. Assessment of Disease Activity and Prediction of Relapse

in Digestive Diseases & Sciences (1995), 40(8), 1750-6

In Crohn's disease, the activity of the disease is difficult to evaluate and the evolution of the disease is difficult to predict. The soluble interleukin-2 receptor serum level has been reported to ... [more ▼]

In Crohn's disease, the activity of the disease is difficult to evaluate and the evolution of the disease is difficult to predict. The soluble interleukin-2 receptor serum level has been reported to correlate with clinical activity of the disease and with mucosal immune activation. We compared serum soluble interleukin-2 receptor to classical inflammatory markers and other immune parameters in the assessment of clinical disease activity and prediction of relapse in patients with Crohn's disease. Soluble interleukin-2 receptor serum levels correlated well with the Crohn's disease activity index, and multivariate analysis showed that this correlation was independent of the other inflammatory and immune markers. The correlation was not greater, However, than that between some inflammatory markers, such as ESR, and Crohn's disease activity index. Longitudinal follow-up showed that a high soluble interleukin-2 receptor serum level was highly predictive of relapse. Multivariate analysis showed that the soluble interleukin-2 recepteur serum level was complementary to other inflammatory and clinical markers in the prediction of relapse of disease. We conclude that soluble interleukin-2 receptor is of use in monitoring Crohn's disease, particularly in prediction of relapse. [less ▲]

Hydroxychloroquine (Plaquenil) for recurrence prevention of Crohn's disease after curative surgery.

in Gastroentérologie Clinique et Biologique (1995), 19(2), 233-4

Foie et maladies inflammatoires du tube digestif

in Médecine et Hygiène (1995), 53

Anticorps anticytoplasme des polynucléaires neutrophiles (ANCA) dans les maladies inflammatoires du tube digestif

in Acta Gastro-Enterologica Belgica (1994), 57(2, Mar-Apr), 171-6

Antineutrophil cytoplasmic antibodies have recently been demonstrated in sera of patients with inflammatory bowel disease. We are reporting here our experience among 94 patients with Crohn's disease and ... [more ▼]

Antineutrophil cytoplasmic antibodies have recently been demonstrated in sera of patients with inflammatory bowel disease. We are reporting here our experience among 94 patients with Crohn's disease and 25 with ulcerative colitis. The indirect immunofluorescence assay with alcohol fixed neutrophils has been used. The presence of antineutrophil cytoplasmic antibodies was significantly associated to the ulcerative colitis 61% VS 17% (p < 0.001). The fluorescence had a perinuclear pattern among all but one suffering from ulcerative colitis. Among the patients suffering from ulcerative colitis there was no relationship between the presence of antineutrophil cytoplasmic antibodies and the activity or the localisation of the disease. Among the 9 patients operated for their ulcerative colitis, 4 were ANCA positive and remained so after proctocolectomy. The existence of antineutrophil cytoplasmic antibodies is useful for the diagnosis of some unclassifiable colitis. Their presence may be used as an argument in favour of some disturbances of the immunoregulation of the disease. [less ▲]

Experimental Models of Inflammatory Bowel Disease

in Acta Gastro-Enterologica Belgica (1994), 57(5-6, Sep-Dec), 306-9

Etiology of inflammatory bowel disease (IBD) is still unknown. A lot of experimental models of these diseases have been developed during the last years. They can be classified as spontaneous and induced ... [more ▼]

Etiology of inflammatory bowel disease (IBD) is still unknown. A lot of experimental models of these diseases have been developed during the last years. They can be classified as spontaneous and induced models. Spontaneous models are infectious, genetic or of unknown etiology. Induced models are infectious, immune-mediated, chemical or genetic. All these models share some characteristics with IBD. In general, they are characterized by a chronic inflammation of the gut, and often, this inflammation appears secondary to mucosal abnormalities leading to an abnormal immune and inflammatory response toward luminal material. The most interesting models are thus those that share not only clinical and pathological characteristics with IBD, but also early mucosal abnormalities. From that point of view, the nonsteroidal anti-inflammatory drug (NSAID) enteropathy is probably one of the most interesting model for Crohn's disease (CD). In effect, this model shares an early modification with CD, that is increased intestinal permeability. In animals NSAID enteropathy, the increased intestinal permeability appears early after NSAID administration and is followed by inflammatory lesions. These lesions seem to be secondary to the increased permeability and depend on intraluminal materials, such as alimentary antigens or bacterial fragments. A possible link between the increased permeability and the inflammatory lesions could be an abnormal immune and inflammatory response toward the intraluminal materials. If the increased intestinal permeability in CD was confirmed, the same mechanisms could be implicated in its pathophysiology. [less ▲]

Effects of Proglumide and Enprostil on Omeprazole-Induced Fundic Endocrine Cell Hyperplasia in Rats

in Gastroentérologie Clinique et Biologique (1993), 17(11), 792-6

Long-term treatment with omeprazole induces hyperplasia of enterochromaffin-like cells, closely related to hypergastrinemia. We studied whether proglumide, an antagonist of gastrin/CCK receptor, and ... [more ▼]

Long-term treatment with omeprazole induces hyperplasia of enterochromaffin-like cells, closely related to hypergastrinemia. We studied whether proglumide, an antagonist of gastrin/CCK receptor, and enprostil, a synthetic prostaglandin E2 derivative, might inhibit this hyperplasia. Six groups of 8 rats were treated for 10 weeks: a) untreated controls; b) omeprazole 10 mumol/kg; c) proglumide 500 mg/kg; d) enprostil 30 micrograms/kg; e) association of omeprazole and proglumide; f) association of omeprazole and enprostil. Serum gastrin levels were measured at different times during treatment. After sacrifice, fundic argyrophil cells were assessed by Grimelius' staining. Serum gastrin levels and argyrophil cell density were not modified in proglumide- and enprostil-treated groups, as compared with controls. Omeprazole increased significantly these two parameters. When given with omeprazole, proglumide decreased significantly serum gastrin levels and argyrophil cell density, as compared to omeprazole alone, while enprostil did not modify significantly these two parameters. These results indicate that proglumide, but not enprostil, can counteract the omeprazole-induced argyrophil cell hyperplasia in rats. [less ▲]

Apports récents de la génétique dans les maladies inflammatoires intestinales

in Acta Clinica Belgica (1993), 48(6), 383-91

It is clear since many years that the liability to develop inflammatory bowel disease is influenced by genetic factors. Recent progresses in the field of genetic markers and genetic models bring the ... [more ▼]

It is clear since many years that the liability to develop inflammatory bowel disease is influenced by genetic factors. Recent progresses in the field of genetic markers and genetic models bring the concept of genetic heterogeneity. This new concept leads us to try to classify different forms of inflammatory bowel disease and could have in the future an impact on the prevention, the follow up and the treatment of these diseases. [less ▲]