Gastroenterology and Nutrition Unit

Saint-Antoine-de-Breuilh, France

Gastroenterology and Nutrition Unit

Saint-Antoine-de-Breuilh, France
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Juste C.,French National Institute for Agricultural Research | Kreil D.P.,University of Vienna | Kreil D.P.,University of Warwick | Beauvallet C.,French National Institute for Agricultural Research | And 25 more authors.
Gut | Year: 2014

Objective: No Crohn's disease (CD) molecular maker has advanced to clinical use, and independent lines of evidence support a central role of the gut microbial community in CD. Here we explore the feasibility of extracting bacterial protein signals relevant to CD, by interrogating myriads of intestinal bacterial proteomes from a small number of patients and healthy controls. Design: We first developed and validated a workflow-including extraction of microbial communities, two-dimensional difference gel electrophoresis (2D-DIGE), and LC-MS/MS-to discover protein signals from CD-associated gut microbial communities. Then we used selected reaction monitoring (SRM) to confirm a set of candidates. In parallel, we used 16S rRNA gene sequencing for an integrated analysis of gut ecosystem structure and functions. Results: Our 2D-DIGE-based discovery approach revealed an imbalance of intestinal bacterial functions in CD. Many proteins, largely derived from Bacteroides species, were over-represented, while under-represented proteins were mostly from Firmicutes and some Prevotella members. Most overabundant proteins could be confirmed using SRM. They correspond to functions allowing opportunistic pathogens to colonise the mucus layers, breach the host barriers and invade the mucosae, which could still be aggravated by decreased host-derived pancreatic zymogen granule membrane protein GP2 in CD patients. Moreover, although the abundance of most protein groups reflected that of related bacterial populations, we found a specific independent regulation of bacteria-derived cell envelope proteins. Conclusions: This study provides the first evidence that quantifiable bacterial protein signals are associated with CD, which can have a profound impact on future molecular diagnosis. © 2014 BMJ Publishing Group Ltd & British Society of Gastroenterology.

Vaquero-Sosa E.,Gastroenterology and Nutrition Unit | Francisco-Gonzalez L.,Gastroenterology and Nutrition Unit | Bodas-Pinedo A.,Gastroenterology and Nutrition Unit | Ruiz-de-Leon-San-Juan A.,Hospital Clinico San Carlos
Revista Espanola de Enfermedades Digestivas | Year: 2015

Oropharyngeal dysphagia is a rather frequent clinical entity in patients with neurological problems that can lead to serious complications such as aspiration pneumonia and other disorders like dehydration or malnutrition due to feeding difficulties. It should be suspected in children with splitting of food intake or prolonged feeding, coughing or choking during feeding, continuous drooling or repeated respiratory symptoms. For the diagnosis, apart from the examination of swallowing, additional tests can be run like the water-swallowing test, the viscosity-volume test (which determines what kind of texture and how much volume the patient is able to tolerate), a fiberoptic endoscopy of swallowing or a videofluoroscopic swallow study, which is the gold standard for the study of swallowing disorders. It requires a multidisciplinary approach to guarantee an adequate intake of fluids and nutrients with minimal risk of aspiration. If these two conditions cannot be met, a gastrostomy feeding may be necessary. © 2015 Arán Ediciones, S. L.

Grogan J.L.,Alder Hey Childrens NHS Foundation Trust | Casson D.H.,Gastroenterology and Nutrition Unit | Terry A.,Alder Hey Childrens NHS Foundation Trust | Burdge G.C.,University of Southampton | And 4 more authors.
Inflammatory Bowel Diseases | Year: 2012

Background: This study compared the efficacy of an elemental formula (EF) to a polymeric formula (PF) in inducing remission for pediatric Crohn's disease (CD). Methods: Newly diagnosed CD children were randomized to EF or PF for 6 weeks. Change in the Pediatric Crohn's Disease Activity Index (PCDAI), fecal calprotectin, and plasma fatty acids were measured at 0 and 6 weeks. Patients were followed up for 2 years. Time and treatment choice for first relapse were documented. Results: Thirty-four children completed the study; EF: 15 (7 M, 8 F), PF: 19 (13 M, 6 F). The mean age was (years) EF: 12.6, PF: 11.7. Ninety-three percent of children (14/15) achieved remission in the EF group and 79% (15/19) in the PF group. One-third of patients maintained remission for 2 years. Mean time to relapse (days); EF: 183 (63-286), PF: 162 (53-301). Most children who relapsed used feed as a treatment for that relapse (EF: 9/10 and PF: 8/13). With PF, an increase of eicosapentanoic acid (EPA) and alpha linolenic acid was found with a reciprocal decrease in arachidonic acid (AA). With EF, AA and EPA levels were reduced with a significant decrease in docosahexaenoic acid. Fecal calprotectin measurements decreased significantly but did not normalize at the end of week 6. Conclusions: There was no significant difference between EF and PF in inducing remission. One-third of children maintained remission. Changes in plasma polyunsaturated fatty acid status were subtle and may be relevant; however, further evaluation is recommended. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

Lerner A.,Gastroenterology and nutrition Unit | Makhoul B.F.,Rambam Health Care Campus | Eliakim R.,Technion - Israel Institute of Technology
European Neurological Journal | Year: 2012

Celiac disease (CD) is a common, life-long, autoimmune condition, affecting the small intestine of genetically susceptible individuals. The classical clinical picture is disappearing as awareness progresses and the extra-intestinal presentation is emerging. Skin, endocrine, hepatic, skeletal, hematological, gynecological, infertility, dental, and behavioral abnormalities are emerging. Among the new growing domains is the extra-intestinal presentation of CD affecting the peripheral and central neurological systems. This review highlights neurological presentations in these patients, focusing on the clinical signs/symptoms in the pediatric and the adult age group, separately.

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