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| 1 | Long-term results of subtotal colectomy with cecorectal anastomosis for isolated colonic inertia显示文摘AIM: To evaluate the results of sub total colectomy with cecorectal anastomosis (STC-CRA) for isolated colonic inertia (CI). METHODS: Fourteen patients (mean age 57.5 ± 16.5 year) underwent surgery for isolated CI between January 1986 and December 2002. The mean frequency of bowel motions with the aid of laxatives was 1.2 ± 0.6 per week. All subjects underwent colonoscopy, anorectal manometry, cinedefaecography and colonic transit time (CTT). CI was defined as diffuse markers delay on CTT without evidence of pelvic floor dysfunction. All patients underwent STC- CRA. Long-term follow-up was obtained prospectively by clinical visits between October 2005 and February 2006 at a mean of 10.5 ± 3.6 years (range 5-16 years) during which we considered the number of stool emissions, the presence of abdominal pain or digitations, the use of pain killers, laxatives and/or fibers. Patients were also asked if they were satisfied with the surgery. RESULTS: There was no postoperative mortality. Postoperative complications occurred in 21.4% (3/14). At the end of follow-up, bowel frequency was significantly (P < 0.05) increased to a mean of 4.8 ± 7.5 per day (range 1-30). One patient reported disabling diarrhea. Two patients used laxatives less than three times per month without complaining of what they called constipation. Overall, 78.5% of patients would have chosen surgery again if necessary. CONCLUSION: STC-CRA is feasible and safe in patientswith CI achieving 79% of success at a mean follow- up of 10.5 years. A prospective controlled evaluation is warranted to verify the advantages of this surgical approach in patients with CI. | Antonio Iannelli Thierry Piche Raffaella Dainese Pascal Fabiani Albert Tran Jean Mouiel Jean Gugenheim | 2007 | World Journal of Gastroenterology2007，13，18： | 14 |
| 2 | Multispecies probiotic protects gut barrier function in experimental models显示文摘AIM:To investigate the effect of the probiotic combination Lactibiane Tolerance?(LT)on epithelial barrier function in vitro and in vivo.METHODS:The effect of the multispecies probiotic LT was assessed on several models of epithelial barrier function both in vitro(in basal and inflammatory conditions)and in vivo[visceral hypersensitivity induced by chronic stress or by colonic perfusion of a fecal supernatant(FSN)from patients with irritable bowel syndrome(IBS)].In vitro,we measured the permeability of confluent T84 cell monolayers incubated with or without LT by evaluating the paracellular flux of macromolecules,in basal conditions and after stimulation with lipopolysaccharide(LPS)or with conditioned medium of colonic biopsies from IBS patients(IBS-CM).In vivo,male C57/Bl6 mice received orally NaCl or LT for 15 d and were submitted to water avoidance stress(WAS)before evaluating visceral sensitivity by measuring the myoelectrical activity of the abdominal muscle and the paracellular permeability with 51Cr-EDTA.Permeability and sensitivity were also measured after colonic instillation of FSN.Tight-junctions were assessed by immunoblotting and TLR-4 expression was evaluated by immunohistochemistry RESULTS:Incubation of T84 cell monolayers with LT in basal conditions had no significant effect on permeability(P>0.05 vs culture medium).By contrast,addition of LT bacterial bodies(LT)completely prevented the LPS-induced increase in paracellular permeability(P<0.01 vs LPS 10 ng/mL(LPS 10);P<0.01 vs LPS 100ng/mL(LPS 100),P>0.05 vs culture medium).The effect was dose dependent as addition of 109 LT bacterial bodies induced a stronger decrease in absorbance than 106 LT(109 LT+LPS 10:-20.1%±13.4,P<0.01vs LPS 10;106 LT+LPS 10:-11.6%±6.2,P<0.01 vs LPS 10;109 LT+LPS 100:-14.4%±5.5,P<0.01 vs LPS 100;106 LT+LPS 100:-11.6%±7.3,P<0.05 vs LPS 100).Moreover,the increase in paracellular permeability induced by culturing T84 cells with conditioned medium of colonic biopsies from IBS patients(IBS-CM)was completely inhibited in the presence of 109 LT(P<0.01 vs IBS-CM).LT also significantly prevented the epithelial disruption induced by intracolonic infusion of fecal supernatant from IBS patients(P<0.01 vs IBS FSN)or water avoidance stress P<0.01 vs WAS)in C57/Bl6 mice and increased the expression of occludin in vitro and in vivo,as assessed by immnunoblotting.The WAS-induced effect on visceral sensitivity was prevented by LT treatment since values obtained for all steps of colorectal distension were significantly(P<0.01)different from the WAS group.Finally,LT downregulated the response mediated through TLR-4 in vitro(decrease in tumor necrosis factorαsecretion in response to LPS:-65.8%for 109 LT and-52.5%for 106LT,P<0.01 vs LPS)and in vivo(inhibition of WAS induced an increase in TLR-4 expression in the LT treated mice colon,P<0.01 vs WAS).CONCLUSION:The probiotic LT mix prevented the disruption to the epithelial barrier induced by LPS,stress or colonic soluble factors from IBS patients and prevented visceral hypersensitivity. | Mylene Nébot-Vivinus Cherryl Harkat Hanene Bzioueche Christel Cartier Raffaella Plichon-Dainese Lara Moussa Helene Eutamene Dorsa Pishvaie Sophie Holowacz Christian Seyrig Thierry Piche Vassilia Theodorou | 2014 | World Journal of Gastroenterology2014，20，22： | 12 |
| 3 | Dysregulation of innate immunity in ulcerative colitis patients who fail anti-tumor necrosis factor therapy显示文摘AIM To study the innate immune function in ulcerative colitis(UC) patients who fail to respond to anti-tumor necrosis factor(TNF) therapy.METHODS Effects of anti-TNF therapy, inflammation and medications on innate immune function were assessed by measuring peripheral blood mononuclear cell(PBMC) cytokine expression from 18 inflammatory bowel disease patients pre- and 3 mo post-anti-TNF therapy. Toll-like receptor(TLR) expression and cytokine production post TLR stimulation was assessed in UC 'responders'(n = 12) and 'non-responders'(n = 12) and compared to healthy controls(n = 12). Erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels were measured in blood to assess disease severity/activity and inflammation. Pro-inflammatory(TNF, IL-1β, IL-6), immuno-regulatory(IL-10), Th1(IL-12, IFNγ) and Th2(IL-9, IL-13, IL-17A) cytokine expression was measured with enzyme-linked immunosorbent assay while TLR cellular composition and intracellular signalling was assessed with FACS.RESULTS Prior to anti-TNF therapy, responders and nonresponders had similar level of disease severity and activity. PBMC's ability to respond to TLR stimulation was not affected by TNF therapy, patient's severity of the disease and inflammation or their medication use. At baseline, non-responders had elevated innate but not adaptive immune responses compared to responders(P < 0.05). Following TLR stimulation, nonresponders had consistently reduced innate cytokine responses to all TLRs compared to healthy controls(P < 0.01) and diminished TNF(P < 0.001) and IL-1β(P < 0.01) production compared to responders. This innate immune dysfunction was associated with reduced number of circulating plasmacytoid dendritic cells(p DCs)(P < 0.01) but increased number of CD4+ regulatory T cells(Tregs)(P = 0.03) as well as intracellular accumulation of IRAK4 in non-responders following TLR-2,-4 and-7 activation(P < 0.001). CONCLUSION Reduced innate immunity in non-responders may explain reduced efficacy to anti-TNF therapy. These serological markers may prove useful in predicting the outcome of costly anti-TNF therapy. | Angela C Baird Dominic Mallon Graham Radford-Smith Julien Boyer Thierry Piche Susan L Prescott Ian C Lawrance Meri K Tulic | 2016 | World Journal of Gastroenterology2016，22，41： | 10 |
| 4 | Efficacy and safety profile of LCR35 complete freeze-dried culture in irritable bowel syndrome:A randomized,double-blind study显示文摘AIM:To assess the effects and safety of Lactobacillus casei rhamnosus LCR35 complete freeze-dried culture(LCR35) in patients suffering from irritable bowel syndrome(IBS).METHODS:A randomized,double-blind pilot study was performed in 50 patients complaining of IBS symptoms complying with RomeⅢcriteria.Patients were allocated to receive either LCR35(n = 25) at a minimum daily dose of 6 × 108 colony forming units or placebo(n = 25) for 4 wk.At inclusion,after treatment and 2 wk later,patients completed the IBS severity scale.Change from baseline in the IBS severity score at the end of treatment was the primary efficacy criterion.Changes were compared between groups in the whole population and in IBS subtypes(IBS with predominance of constipation,IBS with predominance of diarrhoea,mixed IBS,unsubtyped IBS).The presence of lactobacillus casei rhamnosus in stools was investigated at inclusion and at the end of treatment.The gastrointestinal quality of life questionnaire and the hospital anxiety and depression(HAD) scale were also completed.RESULTS:Both groups were balanced for baseline characteristics.In 85% of patients,stool analyses showed that lactobacillus casei rhamnosus able to survive in the digestive tract.In the whole population,improvements in the IBS severity score did not differ significantly between treatments with a 25% decrease after 4-wk treatment,and a 15% decrease from baseline 2 wk later in both groups.In IBS subgroups,statistical analysis could not be performed due to small sample size,but a clinical response in favour of LCR35 was observed in IBS patients with predominance of diarrhoea:no change in the symptom severity score was seen with the placebo after 4 wk treatment,whereas a clinically relevant decrease occurred with LCR35(-37% vs-3%).Furthermore,in spite of an increase in symptom intensity,the IBS severity score was maintained below the baseline value 2 wk later with LCR35(-19% from baseline),whilst a slight 5% increase from baseline was observed with placebo.In the IBS subgroup with predominance of diarrhoea only,a clinically relevant decrease in abdominal pain severity score(-36%)was observed with LCR35,whereas no change occurred with placebo.In mixed IBS patients,the 20% and 30% decreases in the IBS severity score observed after treatment with LCR35 and placebo,respectively,were maintained 2 wk later in both groups.A clinical response slightly in favour of placebo was observed at the end of the treatment period in IBS patients with predominance of constipation(-41% vs-20%) and unsubtyped IBS patients(-47% vs-17%),with the same value maintained 2 wk later.In both groups,no clinically relevant changes were observed either for the gastrointestinal quality of life index or HAD score.Thus,these results suggest that sub-grouping of IBS patients may be important for optimizing treatment responses by the physician.CONCLUSION:This pilot study suggests that LCR35 could have some efficacy in IBS patients complaining of diarrhoea.These preliminary results need to be conf irmed in larger studies. | Michel Dapoigny Thierry Piche Philippe Ducrotte Bernard Lunaud Jean-Michel Cardot Annick Bernalier-Donadille | 2012 | World Journal of Gastroenterology2012，18，17： | 10 |
| 5 | Laparoscopic sleeve gastrectomy for morbid obesity显示文摘The incidence of obesity is steadily rising, and it has been estimated that 40% of the US population will be obese by the year 2025 if the current trend continues. In recent years there has been renewed interest in the surgical treatment of morbid obesity in concomitance with the epidemic of obesity. Bariatric surgery proved effective in providing weight loss of large magnitude, correction of comorbidities and excellent short-term and long-term outcomes, decreasing overall mortality and providing a marked survival advantage. The Laparoscopic Sleeve Gastrectomy (LSG) has increased in popularity and is currently very 'trendy' among laparoscopic surgeons involved in bariatric surgery. As LSG proved to be effective in achieving considerable weight loss in the short-term, it has been proposed by some as a sole bariatric procedure. This editorial focuses on the particular advantages of LSG in the treatment of morbid obesity. | Antonio Iannelli Raffaella Dainese Thierry Piche Enrico Facchiano Jean Gugenheim | 2008 | World Journal of Gastroenterology2008，14，6： | 5 |
| 6 | Perineal retraining improves conservative treatment for faecal incontinence: A multicentre randomized study显示文摘 | Henri Damon Laurent Siproudhis Jean-Luc Faucheron Thierry Piche Laurent Abramowitz Marianne Eléouet Isabelle Etienney Philippe Godeberge Guy Valancogne Angélique Denis Fran?ois Mion Anne-Marie Schott | 2013 | Digestive and Liver Disease2013，，： | 1 |
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