Service de Gastro Enterologie

Rabat, Morocco

Service de Gastro Enterologie

Rabat, Morocco
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Tejpar S.,University Hospital Gasthiusberg | Piessevaux H.,Service de Gastro enterologie
Asia-Pacific Journal of Clinical Oncology | Year: 2014

Treatment options for colorectal cancer have increased substantially in the past decade, with the introduction of novel biological therapies targeting cancer-specific molecules leading to significantly improved outcomes. Despite access to these treatments, we are not yet in an era where we can fully personalize treatment choices for patients with colorectal cancer. A number of prognostic and predictive markers have been identified that appear to be directly related to sensitivity to targeted therapies, such as those against epidermal growth factor receptor. However, the sensitivities of individual tumors toward different biological agents appear to be more complex. It seems that a more complete molecular signature of the tumor must be taken into account when making individual treatment choices. In the absence of having fully elucidated the influence of these prognostic or predictive markers, other surrogate markers of early treatment success may be useful in determining whether to continue treatment with a particular agent. In this review, we discuss the role of molecular markers in choosing appropriate treatment for the individual patient, along with the use of measuring the depth of response to a particular agent to assist decisions on whether to continue therapy in colorectal cancer. © 2014 Wiley Publishing Asia Pty Ltd.

Jacobson I.M.,Cornell University | Davis G.L.,Baylor Regional Transplant Institute | El-Serag H.,Baylor College of Medicine | Negro F.,University of Geneva | Trepo C.,Service de Gastro enterologie
Clinical Gastroenterology and Hepatology | Year: 2010

Hepatitis C virus (HCV) infections pose a growing challenge to health care systems. Although chronic HCV infection begins as an asymptomatic condition with few short-term effects, it can progress to cirrhosis, hepatic decompensation, hepatocellular carcinoma (HCC), and death. The rate of new HCV infections is decreasing, yet the number of infected people with complications of the disease is increasing. In the United States, people born between 1945 and 1964 (baby boomers) are developing more complications of infection. Men and African Americans have a higher prevalence of HCV infection. Progression of fibrosis can be accelerated by factors such as older age, duration of HCV infection, sex, and alcohol intake. Furthermore, insulin resistance can cause hepatic steatosis and is associated with fibrosis progression and inflammation. If more effective therapies are not adopted for HCV, more than 1 million patients could develop HCV-related cirrhosis, hepatic decompensation, or HCC by 2020, which will impact the US health care system. It is important to recognize the impact of HCV on liver disease progression and apply new therapeutic strategies. © 2010 AGA Institute.

Louis R.,Service de Pneumologie | Schleich F.,Service de Pneumologie | Corhay J.-L.,Service de Pneumologie | Louis E.,Service de Gastro enterologie
Revue Medicale de Liege | Year: 2012

Asthma is a complex disease highly dependent of environmental exposure and genetic background. Through linkage analysis, positional cloning and genome wide association studies, novel asthma genes have come out such as ADAM-33 or ORMLD3. Important environmental factors include allergenic exposure, pollutants and especially particulate matters, tobacco, aerosol exposure, viral infections and level of exposure to endotoxin. The effects of environmental factors are modulated by the genetic sequence and numerous single nucleotide polymorphisms (SNPs). Recently, it has also become clear that environmental factors may alter gene expression by DNA methylation or histone methylation/acetylation without changing the gene sequence and thereby changing asthmatic phenotype.

Chaillon A.,Service de Bacteriologie Virologie | Chaillon A.,University of Tours | Sirinelli A.,Service de Chirurgie Cardiaque | De Muret A.,Laboratoire dAnatomie et Cytologie Pathologiques | And 4 more authors.
Journal of Heart and Lung Transplantation | Year: 2011

Hepatitis E virus (HEV) is an emerging problem amongst transplant recipients. We report a patient with chronic HEV hepatitis after a heart transplant. The patient received a 3-month course of oral ribavirin (17 mg/kg/day). HEV RNA became undetectable in the serum after 1 month of treatment and remained undetectable in serum and stool samples until the last follow-up, 2 months after completion of ribavirin therapy. The values of liver function indicators returned to normal reference ranges. The main ribavirin-induced side effect was a significant but well-tolerated anemia. We confirmed that ribavirin may induce a sustained virologic response (4 months after ribavirin cessation) in heart transplant patients with chronic HEV infection. Liver cytolysis is rather common in patients after heart transplantation. Rapid evolution to liver fibrosis lesions and available anti-viral therapy highlight the need to look for HEV infection in heart transplant recipients with unexplained hepatitis. © 2011 International Society for Heart and Lung Transplantation. All rights reserved.

Hamoudi R.A.,University of Cambridge | Appert A.,University of Cambridge | Ye H.,University of Cambridge | Ruskone-Fourmestraux A.,Service de Gastro enterologie | And 11 more authors.
Leukemia | Year: 2010

Mucosa-associated lymphoid tissue (MALT) lymphoma is characterized by t(11;18)(q21;q21)/API2-MALT1, t(1;14)(p22;q32)/BCL10-IGH and t(14;18)(q32;q21)/IGH-MALT1, which commonly activate the nuclear factor (NF)-B pathway. Gastric MALT lymphomas harboring such translocations usually do not respond to Helicobacter pylori eradication, while most of those without translocation can be cured by antibiotics. To understand the molecular mechanism of these different MALT lymphoma subgroups, we performed gene expression profiling analysis of 21 MALT lymphomas (13 translocation-positive, 8 translocation-negative). Gene set enrichment analysis (GSEA) of the NF-B target genes and 4394 additional gene sets covering various cellular pathways, biological processes and molecular functions have shown that translocation-positive MALT lymphomas are characterized by an enhanced expression of NF-B target genes, particularly toll like receptor (TLR)6, chemokine, CC motif, receptor (CCR)2, cluster of differentiation (CD)69 and B-cell CLL/lymphoma (BCL)2, while translocation-negative cases were featured by active inflammatory and immune responses, such as interleukin-8, CD86, CD28 and inducible T-cell costimulator (ICOS). Separate analyses of the genes differentially expressed between translocation-positive and-negative cases and measurement of gene ontology term in these differentially expressed genes by hypergeometric test reinforced the above findings by GSEA. Finally, expression of TLR6, in the presence of TLR2, enhanced both API2-MALT1 and BCL10-mediated NF-B activation in vitro. Our findings provide novel insights into the molecular mechanism of MALT lymphomas with and without translocation, potentially explaining their different clinical behaviors. © 2010 Macmillan Publishers Limited All rights reserved.

Uzzan B.,Laboratoire Of Pharmacologie | Benamouzig R.,Service de Gastro enterologie
Current Colorectal Cancer Reports | Year: 2016

Curcumin is the main component of the Indian spice curcuma (Indian saffron), originating from its rhizome. Curcumin is consumed as food, anywhere in the world and almost daily in India. It has also been used as a drug in Ayurvedic medicine for centuries. This polyphenol substance has pleiotropic effects, interfering with many signaling molecules: pro-inflammatory molecules, transcription factors, enzymes, protein kinases, transport proteins, proteins involved in cell survival, adhesion molecules, growth factors, receptors, proteins regulating cell cycle, chemokines, nucleic acids…. Oral bioavailability of traditional forms of curcumin is low, making it particularly suitable for therapy of diseases of the intestinal tract. Curcumin has anti-inflammatory, anti-oxidant, anti-proliferative, and pro-apoptotic properties, making it an excellent candidate as a chemopreventive agent in colorectal cancer. Contrasting with many in vitro studies devoted to curcumin and a lot of in vivo studies on animal models, curcumin has rarely been assessed in clinical studies dealing with digestive oncology. However, several clinical trials are in progress in this domain. Until now, curcumin has no official medical indication. © 2016 Springer Science+Business Media New York

Gast P.,Service de Gastro Enterologie
Revue Medicale de Liege | Year: 2014

Treatment of acute cholangitis requires antibiotics and biliary drainage. Some patients develop a life threatening form requiring intensive care and urgent drainage. It is important to identify those patients as soon as possible.

Inflammatory bowel diseases, are dysimmune pathologieswhich cannot be definitely cured. The therapeutic arsenal tends to inhibit the excessive immune response, responsible for intestinal lesions. Infliximab, adalimumab and certolizumab pegol are the three anti-TNF-α biotherapies that are used in Crohn disease and ulcerative colitis. They are very efficient to induce or maintain remission. Numerous specific situations, such as severe colitis or perianal lesions can also be treated by biotherapies. Their efficiency seems better in children than in adult population. Moreover, biotherapies reduce the corticosteroid use and favour the height growth. Conversely, these treatments are responsible for frequent adverse effects, such as infections in particular. Severe complications as cancers were reported, what needs a rigorous and careful use of these relatively new drugs.

Gast P.,Service de Gastro Enterologie
Revue Medicale de Liege | Year: 2014

Acute cholangitis develops as the result of infection by enteric organisms and obstruction of the biliary tract, mainly by stones. Diagnosis is highly probable if patient complains of biliary pain, fever and jaundice. Almost 10% of patients will develop a life-threatening disease. Clinical, biological and radiological features relevant for the diagnosis and management will be discussed.

Nyst J.-F.,Service de Gastro Enterologie
Revue Medicale de Bruxelles | Year: 2015

The hemorrhoidal thrombosis is an acute complication with no gravity but an emergency because of the severe pain. Oral or local medical treatments are rarely effective ; they poorly relieve the pain. The realization of an incision with removal of the blood clot or of an excision is an easy procedure to perform in the consultation room. She brings an almost immediate pain relief. It only takes a few minutes and requires minimal equipment.

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