Gastroenterologie Clinique Et Biologique最新文献

{"title":"The place of endoscopic ultrasound in bilio-pancreatic pathology","authors":"M. Giovannini","doi":"10.1016/j.gcb.2010.05.004","DOIUrl":"10.1016/j.gcb.2010.05.004","url":null,"abstract":"<div><p>The place of endoscopic ultrasound (EUS) in malignant pathology of the pancreas is two-fold: (1) EUS is the best examination for the diagnosis of small tumours (&lt;3<!--> <!-->cm in diameter). Its sensitivity is greater than that of CT scan, percutaneous ultrasound or magnetic resonance imaging (MRI) and is equal to that of endoscopic retrograde cholangiopancreatography (ERCP) without sharing its invasive character; (2) EUS is also indicated in the assessment of locoregional extension of tumours judged resectable by tomodensitometric (TDM) (scanner) data. The performance of EUS seems to be greater than other imaging techniques for the diagnosis of vascular and lymph node invasion although recent studies report less good results than those of studies in 1992 to 1994, particularly for vascular involvement. Nevertheless, EUS cannot affirm the malignant or benign character of these pancreatic masses. The development over the last 20 years of linear sector-based EUS has enabled us to perform guided biopsies of such lesions. EUS-guided biopsy is today the best technique for obtaining the histology of a pancreatic mass, with a sensitivity of 85 to 87%. Furthermore, it also has a non-negligible impact on the deciding the treatment particularly in the case of adenocarcinomas (ADKP) not visible to TDM (scanners). This is currently of importance because trials are being developed of preoperative radio-chemotherapy for resectable lesions. probably in the next future, contrast-enhanced EUS (CE-EUS) and elastography will improve the results of EUS and will be necessary for a precise local staging before treatment.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 8","pages":"Pages 436-445"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29082044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrite collagène et iléocolite collagène survenant dans un contexte dysimmunitaire : à propos d’un cas et revue de la littérature","authors":"Gilles Macaigne ,&nbsp;Jean-François Boivin ,&nbsp;Florence Harnois ,&nbsp;Claude Chayette ,&nbsp;Dorian Dikov ,&nbsp;Sadek Cheaib ,&nbsp;Marie-Luce Auriault","doi":"10.1016/j.gcb.2009.06.020","DOIUrl":"10.1016/j.gcb.2009.06.020","url":null,"abstract":"<div><p>La colite collagène est une colite microscopique dont le mécanisme physiopathologique exact est inconnu, différentes hypothèses étiopathogéniques auto-immunes, infectieuses, alimentaires et médicamenteuses ayant été évoquées, cette dernière étant probablement la plus fréquente. La gastrite collagène est une entité rare dont l’association avec une colite collagène a été exceptionnellement rapportée, seuls six cas ayant jusque là été publiés. Nous rapportons une observation de gastrite collagène associée à une iléite et une colite collagène chez une femme de 73 ans présentant une diarrhée chronique et une perte de poids massive évoluant depuis quatre mois. Cet épaississement collagène diffus du tube digestif est apparu dans un contexte auto-immun associant un antécédent de thyroïdite d’Hashimoto et une gastrite atrophique de Biermer probable. L’évolution clinique et histologique a été favorable sous traitement par budésonide.</p></div><div><p>Collagenous colitis belongs to the group of microscopic colitis. The aetiology and pathogenesis are unknown but different pathogenic hypothesis, autoimmune, infectious, alimentary and medicinal being are advanced, the last one being the most frequent aetiology. The collagenous gastritis is a rare entity and its association with collagenous colitis was exceptionally reported, only six cases being published. We report the seventh case of collagenous gastritis, ileitis and colitis in a 75-year-old woman with chronic diarrhea and important weight loss. This thickened subepithelial collagen band was appeared in an autoimmune injury context with antecedent of Hashimoto's thyroiditis and probably chronic atrophic Biermer's gastritis. The clinical and histological evolution was favourable with budesonide.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 8","pages":"Pages e1-e6"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2009.06.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29129219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in Saccharomyces boulardii research","authors":"E. Im,&nbsp;C. Pothoulakis","doi":"10.1016/S0399-8320(10)70023-3","DOIUrl":"10.1016/S0399-8320(10)70023-3","url":null,"abstract":"<div><p>This review summarizes the probiotic mechanisms of action of <em>Saccharomyces boulardii</em> (<em>S. boulardii</em>) against inflammatory and non-inflammatory diarrheal conditions. <em>S. boulardii</em> is distributed in lyophilized form in many countries and used for the prevention of diarrhea in children and adults, including <em>Clostridium difficile</em> (<em>C. difficile</em>) associated infection. The main mechanisms of action of <em>S. boulardii</em> include inhibition of activities of bacterial pathogenic products, trophic effects on the intestinal mucosa, as well as modification of host signaling pathways involved in inflammatory and non-inflammatory intestinal diseases. <em>S. boulardii</em> inhibits production of pro-inflammatory cytokines by inhibiting main regulators of inflammation, including nuclear factor κB (NF-κB), and mitogen-activated protein kinases (MAP kinases), ERK1/2 and p38, but stimulates production of anti-inflammatory molecules such a speroxisome proliferator-activated receptor-gamma (PPAR-γ). Moreover, <em>S. boulardii</em> suppresses bacterial infection by inhibiting adhesion and/or overgrowth of bacteria, produces a serine protease that cleaves <em>C. difficile</em> toxin A, and stimulates antibody production against this toxin. Furthermore, <em>S. boulardii</em> may interfere with pathogenesis of Inflammatory Bowel Disease (IBD) by acting on T cells and acts in diarrheal conditions by improving the fecal biostructure in patients with diarrhea. These diverse mechanisms exerted by <em>S. boulardii</em> provide molecular clues for its effectiveness in diarrheal diseases and intestinal inflammatory conditions with an inflammatory component.</p></div><div><p>La présente revue résume les mécanismes d’action probiotiques de Saccharomyces boulardii (S. boulardii) vis-à-vis des situations inflammatoires ou non inflammatoires associées à une diarrhée. S. boulardii est distribué sous forme lyophilisée dans de nombreux pays et utilisé chez l’adulte et chez l’enfant pour la prévention de la diarrhée, y compris l’infection associée à Clostridium difficile (C. difficile). Les principaux mécanismes d’action de S. boulardii comprennent l’inhibition de l’activité de produits bactériens pathogènes, des effets trophiques sur la muqueuse intestinale, ainsi que la modification des voies de signalisation de l’hôte impliquées dans les maladies intestinales, inflammatoires ou non. <em>S. boulardii</em> inhibe la production de cytokines pro-inflammatoires en inhibant des régulateurs majeurs de l’inflammation, notamment le facteur nucléaire κB (NF κB) et les protéines- kinases activées par les mitogènes (MAP-kinases) ERK1/2 et p38, tout en stimulant la production de molécules anti-inflammatoires, comme le peroxisome proliferator-activated receptor-gamma (PPAR-γ). De plus, <em>S. boulardii</em> prévient l’infection bactérienne en inhibant l’adhésion et/ou la prolifération excessive des bactéries, produit une sérine protéase qui cliv","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 ","pages":"Pages S62-S70"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0399-8320(10)70023-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29319733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saccharomyces boulardii modulates dendritic cell properties and intestinal microbiota disruption after antibiotic treatment","authors":"A. Collignon ,&nbsp;C. Sandré ,&nbsp;M.-C. Barc","doi":"10.1016/S0399-8320(10)70024-5","DOIUrl":"10.1016/S0399-8320(10)70024-5","url":null,"abstract":"<div><p><em>Saccharomyces boulardii</em> is a non-pathogenic yeast with biotherapeutic properties that has been used successfully to prevent and to treat various infectious and antibiotic-associated diarrheas. The intestinal microbiota is responsible for colonization resistance and immune response to pathogens but can be disrupted by antibiotics and lose its barrier effect. Dendritic cells (DCs) are professional antigen-presenting cells of the immune system with the ability to initiate a primary immune response or immune tolerance. In a human microbiota-associated mouse model, we evaluated the influence of <em>S. boulardii</em> on the composition of the microbiota and on the properties of dendritic cells in normal homeostatic conditions and after antibiotic-induced stress. The DCs were derived from splenic precursors. Membrane antigen expression and phagocytosis of FITC-latex beads by DCs were evaluated by flow cytometry. The molecular analysis of the microbiota was performed with fluorescence in situ hybridization (FISH) combined with flow cytometry or confocal microscopy using group specific 16S rRNA targeted probes. This evaluation was conducted during and after a 7-day oral treatment with amoxicillin-clavulanic acid alone and in combination with the administration of the yeast. The antibiotic treatment increased the phagocytic activity of DCs. Their antigen presenting function (MHC class II antigen and CD 86 costimulatory molecule membrane expression) was up-regulated. This reflects a functional activation of DCs. In the presence of <em>S. boulardii</em>, the modification of membrane antigen expression was down regulated. To correlate these modifications to the microbiota disruption, we analyzed in parallel the composition of the intestinal microbiota. As previously shown, the amoxicillin-clavulanic acid treatment, both alone and with <em>S. boulardii,</em> did not quantitatively alter the total microbiota. In contrast, after one day of the antibiotic treatment the <em>Clostridium coccoides</em> group decreased dramatically in the two groups of mice treated with the antibiotic. The level then increased regularly, and at days 17, 22 and 24 it increased faster (<em>P</em> &lt; 0.05) in the AB+ Sb group than in the AB group, reaching the initial level at day 29. The <em>Bacteroides</em> group in the two groups of mice increased during the antibiotic treatment and decreased after the antibiotic was stopped, reaching the initial level. The rate of decrease was faster for the AB+ Sb group than for the AB group, with a significant difference (<em>P</em> &lt; 0.05) at days 17 and 22. During antibiotic treatment, the <em>Enterobacteriaceae</em> group became detectable and its level increased in both groups of mice. After discontinuation of the antibiotic, its level decreased to become undetectable at day 29, without significant difference between the two groups. These results showed that <em>S. boulardii</em> treatment tends to restore the balance of ","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 ","pages":"Pages S71-S78"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0399-8320(10)70024-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29319735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transanal endoscopic microsurgery (TEM) for rectal tumor: The first French single-center experience","authors":"M. Seman ,&nbsp;F. Bretagnol ,&nbsp;N. Guedj ,&nbsp;L. Maggiori ,&nbsp;M. Ferron ,&nbsp;Y. Panis","doi":"10.1016/j.gcb.2009.07.040","DOIUrl":"10.1016/j.gcb.2009.07.040","url":null,"abstract":"<div><h3>Objective</h3><p>Transanal endoscopic microsurgery (TEM) allows complete local excision of rectal tumor, especially in the middle and upper part of the rectum, and provides an alternative to conventional surgery. This is a report of the first French single-center experience to assess the feasibility and postoperative results for rectal tumor excised by TEM.</p></div><div><h3>Methods</h3><p>From October 2007 to December 2008, 27 patients underwent TEM for excision of either rectal adenoma (<em>n</em> <!-->=<!--> <!-->19) or carcinoma (<em>n</em> <!-->=<!--> <!-->8). The median distance from the anal verge was 60<!--> <!-->mm (range: 10–140).</p></div><div><h3>Results</h3><p>TEM excision was performed in 26/27 patients. Intraoperative technical difficulties were recorded in two patients (peritoneal perforation and gas leakage, respectively). The morbidity rate was 22% (<em>n</em> <!-->=<!--> <!-->6), including two patients (7%) with major complications (delayed rectal bleeding) requiring readmission to hospital for both, and surgical hemostasis for one. R0 resection rates for adenoma and carcinoma were 84% and 75%, respectively. Immediate salvage surgery was performed in one patient because of a T2R1 carcinoma. At the time of the median follow-up at nine months (range: 2.5–17.5), no patient had experienced a recurrence.</p></div><div><h3>Conclusion</h3><p>TEM is a safe and effective procedure with low morbidity for local rectal tumor resection. It allows local excision of benign tumors, especially those that are inaccessible to conventional local surgery resection, thereby avoiding radical surgery. In cases of carcinoma, its role in local surgery remains controversial and is yet to be defined.</p></div><div><h3>But</h3><p>L’exérèse transanale par microchirurgie endoscopique (TEM) est une technique très peu développée en France qui associe les avantages d’une chirurgie locale à la possibilité de traitement de tumeurs du moyen et haut rectum inaccessibles par voie transanale classique. Nous rapportons la première expérience unicentrique française.</p></div><div><h3>Méthodes</h3><p>D’octobre 2007 à octobre 2008, 27 patients ont eu une exérèse par TEM pour une lésion bénigne (<em>n</em> <!-->=<!--> <!-->19) ou maligne (<em>n</em> <!-->=<!--> <!-->8). La distance tumorale médiane par rapport à la marge de l’anus était de 60<!--> <!-->mm (extr : 10-140).</p></div><div><h3>Résultats</h3><p>La TEM a pu être réalisée chez 26/27 patients. Deux incidents peropératoires ont été notés (une perforation péritonéale et un défaut d’insufflation). Le taux de morbidité était de 22 % (<em>n</em> <!-->=<!--> <!-->6) incluant une complication grave chez deux patients : rectorragies abondantes nécessitant une réhospitalisation (<em>n</em> <!-->=<!--> <!-->2) dont une réintervention pour hémostase (<em>n</em> <!-->=<!--> <!-->1). L’examen histologique montrait une exérèse complète (R0) dans 84 % des lésions bénignes et dans 75 % des cancers. Une proctectomie comp","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 8","pages":"Pages 488-493"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2009.07.040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29116250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new era in gut research concerning interactions between microbiota and human health","authors":"G. Corthier,&nbsp;J. Doré","doi":"10.1016/S0399-8320(10)70014-2","DOIUrl":"10.1016/S0399-8320(10)70014-2","url":null,"abstract":"<div><p>The scope of this introduction is to make a small review of the texts presented here and to emphasize some points that are not developed but that concern human microbiota functions.</p></div><div><p>Le but de cette courte introduction est de faire une courte revue des textes présentés ici et de mettre l’accent sur certains points qui n’ont pu être développés et qui concernent les fonctions du microbiote humain.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 ","pages":"Pages S1-S6"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0399-8320(10)70014-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29326521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activités métaboliques du microbiote intestinal humain","authors":"A. Bernalier-Donadille","doi":"10.1016/S0399-8320(10)70003-8","DOIUrl":"10.1016/S0399-8320(10)70003-8","url":null,"abstract":"<div><p>Le côlon humain héberge une communauté microbienne extrêmement dense, composée essentiellement d’espèces anaérobies strictes. Ce microbiote intestinal exerce de nombreuses fonctions physiologiques ayant des répercussions importantes sur la nutrition et la santé de l’hôte. Parmi ces fonctions, la fermentation des substrats joue un rôle majeur par la diversité des métabolites produits. Ces processus fermentaires sont fortement corrélés à la nature des substrats disponibles. Ceux-ci sont de deux origines : exogène (alimentaire/polyosides d’origine végétale) et endogène (produits par l’hôte, source importante d’azote). La plupart des métabolites fermentaires synthétisés par le microbiote intestinal sont absorbés puis utilisés par l’hôte. La majorité de ces métabolites sont potentiellement bénéfiques pour l’hôte, toutefois certains peuvent avoir des effets délétères pour la santé. Les interactions entre l’aliment, le microbiote intestinal et l’hôte ont donc un rôle essentiel dans le maintien de l’homéostasie de l’écosystème. Toute rupture de l’équilibre entre ces éléments est susceptible de modifier le fonctionnement de l’écosystème et de conduire à un état pathologique, en particulier au niveau digestif.</p></div><div><p>The human large intestine is colonized by a complex community, largely composed of strictly anaerobic bacteria that exert numerous physiological functions impacting host nutrition and health. Among these functions, the fermentation of substrates is of main importance for host health through production of a large variety of metabolites. The metabolic capacities of the human gut microbiota are correlated with the nature of the substrates available for fermentation in the colon. These substrates are from exogenous (dietary fibres that are mainly plant polysaccharides) and endogenous origins (produced by the host and represent important source of nitrogen). The metabolites produced from the microbial fermentative process in the gut are mainly absorbed and used by the host. Most of them are beneficial for health effects but some could also have deleterious effects. The gut microbiota should thus be considered in its environment including dietary food and the host. The interactions between food, intestinal microbiota and the host are fundamental to maintain homeostasis of the ecosystem. Any disruption of this equilibrium could modify the functionality of the gut microbiota and leads to pathological situation.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 4","pages":"Pages 17-23"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0399-8320(10)70003-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121757201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’importance clinique du microbiote intestinal","authors":"P. Marteau","doi":"10.1016/S0399-8320(10)70013-0","DOIUrl":"10.1016/S0399-8320(10)70013-0","url":null,"abstract":"<div><p>Le clinicien a depuis longtemps appris à connaître des micro-organismes pathogènes responsables d’infections intestinales et qu’il identifie par méthodes de culture dans des prélèvements fécaux, muqueux ou sanguins. Cependant de nombreux progrès ont été réalisés, en bonne partie grâce à la biologie moléculaire, qui ont permis de découvrir des pathogènes non (encore) cultivables mais aussi le rôle protecteur de certains micro-organismes au sein du microbiote. Les perturbations écologiques et cliniques liées à l’antibiothérapie ont été décisives pour mettre en évidence des effets bénéfiques du microbiote endogène et établir les effets bénéfiques d’agents biothérapeutiques - probiotiques. Rares sont les domaines de la gastroentérologie (maladies inflammatoires cryptogénétiques de l’intestin, syndrome de l’intestin irritable, lymphomes, etc.) mais aussi de la médecine dans son ensemble (obésité par exemple) qui échappent à cette nouvelle approche et progrès très significatifs. Cet article résume les étapes historiques de ces découvertes et fait le point sur ce qu’un clinicien « moderne » doit connaître dans ce domaine très dynamique en recherche et conséquences pratiques.</p></div><div><p>Clinicians have long learned of the pathogenic microorganisms that cause intestinal infections and that can be identified by culture methods from fecal, mucosa and blood samples. Nevertheless, much progress has been made due, in large part, to molecular biology which has enabled the discovery of pathogens that are not (yet) able to be cultured, but also to the protective role of some microorganisms within the microbiota. Ecological and clinical disturbances related to antibiotic therapy were decisive for demonstrating the beneficial effects of the endogenous microbiota and establishing the beneficial effects of biotherapeutic agents, known as probiotics. Most areas of gastroenterology (cryptogenic inflammatory bowel disease, irritable bowel syndrome, lymphomas, etc.), but also those in medicine overall (obesity for example), are affected by this new approach and are showing very significant progress. This article summarizes the historical steps of these discoveries and reviews what the “modern” clinician should know in this very dynamic area in regard to research and practical consequences.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 4","pages":"Pages 99-103"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0399-8320(10)70013-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129792699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progrès récents dans la recherche sur Saccharomyces boulardii","authors":"E. Im,&nbsp;C. Pothoulakis","doi":"10.1016/S0399-8320(10)70010-5","DOIUrl":"10.1016/S0399-8320(10)70010-5","url":null,"abstract":"<div><p>La présente revue résume les mécanismes d’action probiotiques de <em>Saccharomyces boulardii</em> (<em>S. boulardii</em>) vis-à-vis des situations inflammatoires ou non inflammatoires associées à une diarrhée. <em>S. boulardii</em> est distribué sous forme lyophilisée dans de nombreux pays et utilisé chez l’adulte et chez l’enfant pour la prévention de la diarrhée, y compris l’infection associée à <em>Clostridium difficile</em> (<em>C. difficile</em>). Les principaux mécanismes d’action de <em>S. boulardii</em> comprennent l’inhibition de l’activité de produits bactériens pathogènes, des effets trophiques sur la muqueuse intestinale, ainsi que la modification des voies de signalisation de l’hôte impliquées dans les maladies intestinales, inflammatoires ou non. <em>S. boulardii</em> inhibe la production de cytokines pro-inflammatoires en inhibant des régulateurs majeurs de l’inflammation, notamment le facteur nucléaire κB (NF κB) et les protéines-kinases activées par les mitogènes (MAP-kinases) ERK1/2 et p38, tout en stimulant la production de molécules anti-inflammatoires, comme le peroxisome proliferator-activated receptor-gamma (PPAR-γ). De plus, <em>S. boulardii</em> prévient l’infection bactérienne en inhibant l’adhésion et/ou la prolifération excessive des bactéries, produit une sérine protéase qui clive la toxine A de <em>C. difficile</em> et stimule production d’anticorps dirigés contre cette toxine. <em>S. boulardii</em> est en outre susceptible d’interférer dans la pathogénie des maladies inflammatoires chroniques de l’intestin (MICI) en exerçant des effets sur les cellules T ; au cours des affections diarrhéiques, il agit en améliorant la biostructure fécale. Ces différents mécanismes d’action de <em>S. boulardii</em> représentent autant d’indices moléculaires pour rendre compte de son efficacité dans les maladies diarrhéiques et dans les affections intestinales inflammatoires ou à composante inflammatoire.</p></div><div><p>This review summarizes the probiotic mechanisms of action of <em>Saccharomyces boulardii</em> (<em>S. boulardii</em>) against inflammatory and non-inflammatory diarrheal conditions. <em>S. boulardii</em> is distributed in lyophilized form in many countries and used for the prevention of diarrhea in children and adults, including <em>Clostridium difficile</em> (<em>C. difficile</em>) associated infection. The main mechanisms of action of <em>S. boulardii</em> include inhibition of activities of bacterial pathogenic products, trophic effects on the intestinal mucosa, as well as modification of host signaling pathways involved in inflammatory and noninflammatory intestinal diseases. <em>S. boulardii</em> inhibits production of pro-inflammatory cytokines by inhibiting main regulators of inflammation, including nuclear factor κB, and mitogen-activated protein kinases (ERK1/2 and p38), but stimulates production of anti- inflammatory molecules such a speroxisome proliferator-activated receptor-gamma (PPAR-γ). Moreov","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 4","pages":"Pages 67-75"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0399-8320(10)70010-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125179324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biostructure fonctionnelle du microbiote colique (zone de fermentation centrale, zone de réserve germinale et couche de mucus séparatrice) chez les sujets sains et chez les patients atteints de diarrhée traités par Saccharomyces boulardii","authors":"A. Swidsinski ,&nbsp;V. Loening-Baucke ,&nbsp;S. Kirsch ,&nbsp;Y. Doerffel","doi":"10.1016/S0399-8320(10)70012-9","DOIUrl":"10.1016/S0399-8320(10)70012-9","url":null,"abstract":"<div><p>Le contenu du côlon peut être comparé à un bioréacteur à haut rendement doté d’une structure spatiale comportant trois régions fonctionnellement différentes : une couche de mucus séparatrice, une zone germinale de réserve et une zone centrale de fermentation. Les selles reflètent cette structure et peuvent être utilisées comme un outil diagnostique chez le sujet sain ou malade. Dans la première partie, nous introduisons une méthode innovante fondée sur l’étude par hybridation <em>in situ</em> (HIS) de coupes de selles prélevées par carottage, ce qui permet une évaluation quantitative du microbiote dans le mucus, dans la zone de réserve germinale et dans la zone centrale de fermentation. Dans la seconde partie, nous démontrons la mise en œuvre pratique de cette méthode en décrivant la biostructure du microbiote fécal chez des sujets sains et chez des patients atteints de diarrhée chronique idiopathique traités par <em>Saccharomyces boulardii</em>. Des carottes de selles de 20 patients souffrant de diarrhée chronique idiopathique et de 20 témoins sains ont été étudiées par la méthode d’HIS. Soixante-treize groupes bactériens ont été évalués. Les fluctuations dans l’organisation de 11 groupes bactériens constitutifs ont été mesurées chaque semaine pendant trois semaines avant, trois semaines pendant et trois semaines après une supplémentation orale par <em>Saccharomyces boulardii</em>. Les constatations typiques chez les sujets sains étaient une couche de mucus séparatrice de 5-60 μm, une distribution et une fluorescence homogènes, de fortes concentrations (&gt;10 × 10¹⁰ bactéries/ml) des trois groupes bactériens habituels – <em>Bacteroides, Roseburia</em> et <em>Faecalibacterium prausnitzii –</em> et de faibles concentrations des groupes bactériens occasionnels. Au cours de la diarrhée était constatée une augmentation d’épaisseur de la couche protectrice de mucus, son incorporation aux selles, une réduction des concentrations des groupes bactériens habituels, une inhibition du métabolisme bactérien dans la zone centrale de fermentation (extinction d’hybridation), une stratification de la structure des selles par des substances aqueuses et une augmentation compensatoire des concentrations des groupes bactériens occasionnels. Les symptômes microbiens et cliniques de la diarrhée ont été réversibles avec le traitement par <em>Saccharomyces boulardii</em>. L’analyse du rapport structure/fonction du microbiote fécal permet de caractériser et de surveiller sur des critères quantitatifs la dysfonction colique et sa réponse au traitement. <em>Saccharomyces boulardii</em> améliore significativement la biostructure des fèces au cours de la diarrhée chronique idiopathique et n’a pas d’effets sur le microbiote fécal des sujets sains.</p></div><div><p>The colonic content can be compared to a spatially structured high output bioreactor composed of three functionally different regions : a separating mucus layer, a germinal stock area, and a cent","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 4","pages":"Pages 84-98"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0399-8320(10)70012-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122230740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}