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Dupont M, Carlier C, Gower-Rousseau C, Barbier-Lider P, Botsen D, Brasseur M, Burgevin A, Chourbagi C, D’Almeida R, Hautefeuille V, Hentzien M, Lambert A, Lamuraglia M, Lavau-Denes S, Lopez A, Parent D, Slimano F, Brugel M, Bouché O. Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: a possible association with Lyme disease? BMC Cancer 2022; 22:1219. [PMID: 36434607 PMCID: PMC9701068 DOI: 10.1186/s12885-022-10192-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 10/17/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Previous studies have observed an increased incidence of Cetuximab-induced hypersensitivity infusion reactions (CI-IRs) in the southeastern states of the USA. Tick's bites were suspected of generating cross-reactions between cetuximab and alpha-gal. This study aims was to describe the incidence and associated risk factors of CI-IRs, in the French areas chosen according to their Lyme disease incidence. PATIENTS AND METHODS A retrospective chart review was conducted on patients that received cetuximab infusion from January 2010 to June 2019 in 4 French areas with different Lyme disease incidence rates. RESULTS Of 1392 patients, 117 (8.4%) experienced a CI-IR, including 68 severe (grade 3 or 4) reactions (4.9%). This CI-IR incidence was significantly higher in the Lyme disease high-risk area than in the other areas (13.2% versus 7.1%, 8.1% and 6.4%; P = 0.016). Sex (P = 0.53), premedication (P = 0.91), primary cancer location (P = 0.46) and chemotherapy regimen type (P = 0.78) had no impact on CI-IR incidence in the overall population. In the head and neck squamous cell carcinoma (HNSCC) patient subgroup, CI-IRs were significantly more frequent in the high-risk area (16.4% versus 6.7%, 7.1% and 7.0%; P = 0.0015). CONCLUSION This study suggests that patients treated in the French area with the highest incidence of Lyme disease are at a higher risk of CI-IRs.
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Affiliation(s)
- M Dupont
- Department of Medical Oncology, Godinot Cancer Institute, 1 Rue du Général Koenig, 51100 Reims, France
| | - Claire Carlier
- Department of Medical Oncology, Godinot Cancer Institute, 1 Rue du Général Koenig, 51100 Reims, France ,grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - C Gower-Rousseau
- grid.414215.70000 0004 0639 4792Department of Research and Public Health, CHU Reims, Reims, France
| | - P Barbier-Lider
- grid.410527.50000 0004 1765 1301Department of Pharmacy, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - D Botsen
- Department of Medical Oncology, Godinot Cancer Institute, 1 Rue du Général Koenig, 51100 Reims, France ,grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - M Brasseur
- grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - A Burgevin
- grid.29172.3f0000 0001 2194 6418Department of Gastroenterology and Digestive Oncology, Nancy University Hospital, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - C Chourbagi
- grid.134996.00000 0004 0593 702XDepartment of Pharmacy, Amiens University Hospital, Amiens, France
| | - R D’Almeida
- grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - V Hautefeuille
- grid.11162.350000 0001 0789 1385Department of Gastroenterology and Digestive Oncology, Amiens University Hospital, University of Picardie Jules Verne, Amiens, France
| | - M Hentzien
- grid.11667.370000 0004 1937 0618Department of Infectious Diseases and Internal Medicine, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - A Lambert
- Department of Medical Oncology, Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - M Lamuraglia
- grid.11162.350000 0001 0789 1385Department of Medical Oncology, Amiens University Hospital, University of Picardie Jules-Vernes, Amiens, France
| | - S Lavau-Denes
- grid.411178.a0000 0001 1486 4131Department of Medical Oncology, Limoges University Hospital, Limoges, France
| | - A Lopez
- grid.29172.3f0000 0001 2194 6418Department of Gastroenterology and Digestive Oncology, Nancy University Hospital, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - D Parent
- Department of Pharmacy, Godinot Cancer Institute, Reims, France
| | - F Slimano
- grid.11667.370000 0004 1937 0618Department of Pharmacy, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - M Brugel
- grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - O Bouché
- grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
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Sendid B, Jawhara S, Sarter H, Maboudou P, Thierny C, Gower-Rousseau C, Colombel JF, Poulain D. Uric acid levels are independent of anti-Saccharomyces cerevisiae antibodies (ASCA) in Crohn's disease: A reappraisal of the role of S. cerevisiae in this setting. Virulence 2018; 9:1224-1229. [PMID: 30027793 PMCID: PMC6086291 DOI: 10.1080/21505594.2018.1496779] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- B Sendid
- a Inserm, Univ. Lille, CHU Lille, UMR995-LIRIC- Lille Inflammation Research International Center , Lille , France.,b CHU Lille, Parasitologie-Mycologie , Institut de Microbiologie , Lille , France
| | - S Jawhara
- a Inserm, Univ. Lille, CHU Lille, UMR995-LIRIC- Lille Inflammation Research International Center , Lille , France
| | - H Sarter
- a Inserm, Univ. Lille, CHU Lille, UMR995-LIRIC- Lille Inflammation Research International Center , Lille , France
| | - P Maboudou
- c CHU Lille, laboratoire de Biochimie , Institut de Biochimie et Biologie Moléculaire , Lille , France
| | - C Thierny
- c CHU Lille, laboratoire de Biochimie , Institut de Biochimie et Biologie Moléculaire , Lille , France
| | - C Gower-Rousseau
- a Inserm, Univ. Lille, CHU Lille, UMR995-LIRIC- Lille Inflammation Research International Center , Lille , France
| | - J F Colombel
- d Division of Gastroenterology , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - D Poulain
- a Inserm, Univ. Lille, CHU Lille, UMR995-LIRIC- Lille Inflammation Research International Center , Lille , France.,b CHU Lille, Parasitologie-Mycologie , Institut de Microbiologie , Lille , France
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Savoye G, Fumery M, Gower-Rousseau C. Editorial: post-operative complications in elderly onset inflammatory bowel disease-what is surgery, what is disease, and what is delay of surgery? Authors' reply. Aliment Pharmacol Ther 2018; 48:384-385. [PMID: 29998504 DOI: 10.1111/apt.14854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- G Savoye
- Epimad Registry, Gastroenterology Unit, Rouen University Hospital, Rouen, France
| | - M Fumery
- Epimad Registry, Gastroenterology Unit, Amiens University Hospital, Amiens, France
| | - C Gower-Rousseau
- Epimad Registry, Public Health Unit, Lille University Hospital, Lille, France.,Inserm, UMR 995 LIRIC, Lille University, Lille, France
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Sacleux SC, Sarter H, Fumery M, Charpentier C, Guillon-Dellac N, Coevoet H, Pariente B, Peyrin-Biroulet L, Gower-Rousseau C, Savoye G. Post-operative complications in elderly onset inflammatory bowel disease: a population-based study. Aliment Pharmacol Ther 2018; 47:1652-1660. [PMID: 29737553 DOI: 10.1111/apt.14790] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/06/2017] [Accepted: 04/08/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND IBD diagnosed after the age of 60 is increasing. Data on post-operative complications in elderly onset IBD are scarce. AIM To describe the incidence of and factors associated with post-operative complications in elderly onset IBD, diagnosed after the age of 60. METHODS Using EPIMAD Cohort (1988-2006), among 841 incident IBD patients, 139 (17%) underwent intestinal surgery, including 100 Crohn's disease (CD) and 39 ulcerative colitis (UC). RESULTS After a median post-operative follow-up of 6 years (2-10), 50 (36%) patients experienced at least 1 complication with a total of 69. During the first 30 post-operative days, the mortality rate was 4%. Thirty-two early complications (<30 days) were observed in 23 patients (17%), with 15 infectious, without significant difference between CD and UC. More than half early post-operative complications (n = 19, 59%) were severe (>grade 2) without significant difference between CD and UC (P = 0.28). Thirty-seven long-term adverse effects of surgical therapy (≥30 days) were observed in 33 patients (24%). Multivariate analysis found (1) acute severe colitis (OR = 7.84 [2.15-28.52]) and emergency surgery (OR = 4.46 [1.75-11.36]) were associated with early post-operative complications, and (2) Female gender (HR = 2.10 [1.01-4.37]) and delay before surgery >3 months (HR = 2.09 [1.01-4.31]) with long-term adverse effects of surgical therapy. CONCLUSIONS One-third of elderly IBD patients experienced at least 1 post-operative complication. Half of the early complications were severe, and infectious. Emergency surgery was the key driver for post-operative complication.
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Affiliation(s)
- S-C Sacleux
- Epimad Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France
| | - H Sarter
- Public Health, Epidemiology and Economic Health, Epimad Registry, Maison Régionale de la Recherche Clinique, Lille University and Hospital, Lille, France.,Lille Inflammation Research International Center LIRIC - UMR 995 Inserm Lille 2 University, CHRU de Lille, Lille, France
| | - M Fumery
- Epimad Registry, CHU Amiens Sud, Avenue Laennec-Salouel, Amiens University Hospital, Amiens, France
| | - C Charpentier
- Epimad Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France
| | - N Guillon-Dellac
- Public Health, Epidemiology and Economic Health, Epimad Registry, Maison Régionale de la Recherche Clinique, Lille University and Hospital, Lille, France.,Lille Inflammation Research International Center LIRIC - UMR 995 Inserm Lille 2 University, CHRU de Lille, Lille, France
| | - H Coevoet
- Clinique des Bonnettes, Arras, France
| | - B Pariente
- Hôpital Huriez, Lille University Hospital, Lille, France
| | | | - C Gower-Rousseau
- Public Health, Epidemiology and Economic Health, Epimad Registry, Maison Régionale de la Recherche Clinique, Lille University and Hospital, Lille, France.,Lille Inflammation Research International Center LIRIC - UMR 995 Inserm Lille 2 University, CHRU de Lille, Lille, France
| | - G Savoye
- Epimad Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France
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Shafer LA, Walker JR, Chhibba T, Ivekovic M, Singh H, Targownik LE, Peyrin-Biroulet L, Gower-Rousseau C, Sarter H, Bernstein CN. Independent Validation of a Self-Report Version of the IBD Disability Index (IBDDI) in a Population-Based Cohort of IBD Patients. Inflamm Bowel Dis 2018; 24:766-774. [PMID: 29554260 DOI: 10.1093/ibd/izx063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION A new clinician-administered inflammatory bowel disease (IBD) Disability Index (IBDDI) was recently developed and validated among a population in France. We aimed to validate the IBDDI in a North American setting and adapt for use as a self-report tool. METHODS Persons 18-65 years old from the population-based University of Manitoba IBD Research Registry were mailed a self-administered survey. This survey included the IBDDI and several scales that should correlate with a disability measure- the World Health Organization (WHO) Disability Assessment Scale (WHODAS) 2.0, Work and Social Adjustment Scale (WSAS), the Inflammatory Bowel Disease Questionnaire (IBDQ), and the K6-Kessler Emotional Distress Scale. We used Pearson correlation coefficients to assess construct validity, Cronbach's alpha to assess internal consistency, and Factor analysis to assess which of the IBDDI items likely belonged to a single IBD-related disability factor. RESULTS In response to the survey request,1143 (46% of those contacted) participated (61% female, mean age 51, 52% with Crohn's disease). On an index scale from 0-100, 14% had a score ≥50 (extreme disability, 18% of those with Crohn's disease; 10% of those with ulcerative colitis). There were strong correlations between IBDDI and WSAS (0.76), WHODAS (0.76), K6 (0.73), and an inverse correlation with IBDQ (-0.86). The Cronbach's alpha was high (0.88). All but 2 items (number of liquid stools in the past week and arthritis/arthralgia) of the 14 identified for IBDDI loaded highly onto a single factor (factor loading > 0.40). CONCLUSIONS The findings support the validity of this new self-report version of the IBDDI as a sound measure of disability in IBD.
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Affiliation(s)
- L A Shafer
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - J R Walker
- University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - T Chhibba
- University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - M Ivekovic
- University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - H Singh
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - L E Targownik
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - L Peyrin-Biroulet
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - C Gower-Rousseau
- Gastroenterology Department and Inserm U954, Nancy University Hospital, Université de Lorraine, Nancy, France.,Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm/Université Lille 2/CHRU de Lille; Equipe IBD and environmental factors: epidemiology and functional analyses, Lille University, France
| | - H Sarter
- Gastroenterology Department and Inserm U954, Nancy University Hospital, Université de Lorraine, Nancy, France.,Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm/Université Lille 2/CHRU de Lille; Equipe IBD and environmental factors: epidemiology and functional analyses, Lille University, France
| | - C N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
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6
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Lo B, Prosberg MV, Gluud LL, Chan W, Leong RW, van der List E, van der Have M, Sarter H, Gower-Rousseau C, Peyrin-Biroulet L, Vind I, Burisch J. Systematic review and meta-analysis: assessment of factors affecting disability in inflammatory bowel disease and the reliability of the inflammatory bowel disease disability index. Aliment Pharmacol Ther 2018; 47:6-15. [PMID: 28994131 DOI: 10.1111/apt.14373] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 07/31/2017] [Accepted: 09/20/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The Inflammatory Bowel Disease Disability Index (IBD-DI) has recently been developed for patients with Crohn's disease (CD) and ulcerative colitis (UC). AIM To assess the severity of disability and associated factors using the IBD-DI, and review the validity of the IBD-DI as a tool. METHOD Systematic review of cross-sectional studies. Patients included had UC or CD and were classified as active, in remission, or needing surgery, biological and/or steroid treatment. We included studies assessing disability using the IBD-DI and that were captured by electronic and manual searches (January 2017). The possibility of bias was evaluated with the Newcastle-Ottawa Scale. RESULTS Nine studies were included with 3167 patients. Comparatively, patients with active disease had higher disability rates than those in remission (SMD [CI95] = 1.49[1.11, 1.88], I2 = 94%, P<.01), while patients on biological treatment had lower disability rates than those receiving corticosteroid treatment (SMD [CI95] = -0.22[-0.36, -0.08], I2 = 0%, P<.01). Disease activity and unemployment were found to be associated factors. The IBD-DI scored "good" for internal consistency, "fair" to "excellent" for intra-rater reliability and "excellent" for inter-rater reliability. Construct validity was "moderately strong" to "very strong" and structural validity was found to be mainly unidimensional. The IBD-DI had excellent responsiveness, while its interpretability was only useful on a group level. CONCLUSIONS This systematic review and meta-analysis found a significant association between disease activity, treatment received and disability; although significant heterogeneity was found. The IBD-DI is reliable and valid, but further studies are needed to measure its interpretability.
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Affiliation(s)
- B Lo
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - M V Prosberg
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - L L Gluud
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - W Chan
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.,Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia
| | - R W Leong
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia
| | - E van der List
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia
| | - M van der Have
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands
| | - H Sarter
- Public Health Unit, Epimad Registry, Lille University Hospital, Lille, France
| | - C Gower-Rousseau
- Public Health Unit, Epimad Registry, Lille University Hospital, Lille, France
| | - L Peyrin-Biroulet
- Inserm U954 and Department of Gastroenterology, University Hospital Nancy and Lorraine University, Vandoeuvre-lès-Nancy, France
| | - I Vind
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - J Burisch
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Hochart A, Gower-Rousseau C, Sarter H, Fumery M, Ley D, Spyckerelle C, Peyrin-Biroulet L, Laberenne JE, Vasseur F, Savoye G, Turck D. Ulcerative proctitis is a frequent location of paediatric-onset UC and not a minor disease: a population-based study. Gut 2017; 66:1912-1917. [PMID: 27489240 DOI: 10.1136/gutjnl-2016-311970] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/29/2016] [Accepted: 07/14/2016] [Indexed: 12/08/2022]
Abstract
OBJECTIVE Natural history of paediatric-onset ulcerative proctitis (UP) is poorly described. Our aim was to describe the phenotype and disease course of incident UP in a population-based study of paediatric-onset UC. PATIENTS AND METHODS All patients with UC diagnosed <17 years from 1988 to 2004, and followed during >2 years have been extracted from a population-based registry. UC location was defined according to the Paris classification. Cumulative risks for use of immunosuppressants (IS), anti-tumour necrosis factor alpha (TNF-α) therapy, colonic extension and colectomy were described using Kaplan-Meier method. Risk factors for colonic extension were assessed using Cox proportional hazards models. RESULTS 158 patients with paediatric-onset UC (91 females) with a median age at diagnosis of 14.5 years (Q1: 11.4-Q3: 16.1) have been identified and followed during a median of 11.4 years (8.2-15.8). Among them, 25% had UP (E1) at diagnosis and 49% of them presented a colonic extension at maximal follow-up. In these children, the cumulative risk for colonic extension was 10% at 1 year, 45% at 5 years and 52% at 10 years. No parameter at diagnosis was associated with colonic extension in the UP (E1 group). IS use was significantly lower in patients with UP than in those with E2, E3 or E4 location (p=0.049). For the UP cohort, the cumulative risk for colectomy was 3% at 1 year, 10% at 5 years, 13% at 10 years and 13% at 15 years. Risks for colonic extension, treatment with anti-TNF-α and colectomy did not differ between the E1 group and the E2-E3-E4 group. CONCLUSIONS UP is frequent in paediatric-onset UC and should not be considered as a minor disease. Compared with more extensive UC locations, risks for colonic extension, anti-TNF-α therapy and colectomy were similar in UP, whereas the risk for use of IM was lower.
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Affiliation(s)
- A Hochart
- Gastroenterology, Hepatology and Nutrition Unit, Department of Pediatrics, Lille University and Hospital, France et Univ. Lille CHU Lille, Lille, France
| | - C Gower-Rousseau
- Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France.,Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille, Cedex, France
| | - H Sarter
- Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France.,Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille, Cedex, France
| | - M Fumery
- Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France.,Gastroenterology Unit, Epimad Registry, CHU Amiens Sud, Avenue Laennec-Salouel, Amiens University Hospital, France
| | - D Ley
- Gastroenterology, Hepatology and Nutrition Unit, Department of Pediatrics, Lille University and Hospital, France et Univ. Lille CHU Lille, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France
| | - C Spyckerelle
- Gastroenterology, Hepatology and Nutrition Unit, Department of Pediatrics, Saint Vincent de Paul Hospital and Lille Catholic University, Lille, France
| | - L Peyrin-Biroulet
- Hepato-Gastroenterology Unit, Inserm, U954, Nancy University Hospital, France
| | - J-E Laberenne
- Hepato-Gastroenterology Unit, Epimad Registry, General Hospital, Seclin, France
| | - F Vasseur
- Department of Biostatistics, EA 2694, Lille University Hospital, France
| | - G Savoye
- Gastroenterology Unit, Epimad Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France
| | - D Turck
- Gastroenterology, Hepatology and Nutrition Unit, Department of Pediatrics, Lille University and Hospital, France et Univ. Lille CHU Lille, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France
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8
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Bequet E, Sarter H, Fumery M, Vasseur F, Armengol-Debeir L, Pariente B, Ley D, Spyckerelle C, Coevoet H, Laberenne JE, Peyrin-Biroulet L, Savoye G, Turck D, Gower-Rousseau C. Incidence and Phenotype at Diagnosis of Very-early-onset Compared with Later-onset Paediatric Inflammatory Bowel Disease: A Population-based Study [1988-2011]. J Crohns Colitis 2017; 11:519-526. [PMID: 28453757 DOI: 10.1093/ecco-jcc/jjw194] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/26/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Very-early-onset inflammatory bowel disease [VEO-IBD] is a form of IBD that is distinct from that of children with an older onset. We compared changes over time in the incidence and phenotype at diagnosis between two groups according to age at IBD diagnosis: VEO-IBD diagnosed before the age of 6 years, and early-onset IBD [EO-IBD] diagnosed between 6 and 16 years of age. METHODS Data were obtained from a cohort enrolled in a prospective French population-based registry from 1988 to 2011. RESULTS Among the 1412 paediatric cases [< 17 years], 42 [3%] were VEO-IBD. In the VEO-IBD group, the incidence remained stable over the study period. In contrast, the incidence of EO-IBD increased from 4.4/105 in 1988-1990 to 9.5/105 in 2009-2011 [+116%; p < 10-4]. Crohn's disease [CD] was the most common IBD, regardless of age, but ulcerative colitis [UC] and unclassified IBD were more common in VEO-IBD cases [40% vs 26%; p = 0.04]. VEO-IBD diagnosis was most often performed in hospital [69% vs 43%; p < 10-3]. Rectal bleeding and mucous stools were more common in patients with VEO-IBD, whereas weight loss and abdominal pain were more frequent in those with EO-IBD. Regarding CD, isolated colonic disease was more common in the VEO-IBD group [39% vs 14%; p = 0.003]. CONCLUSIONS In this large population-based cohort, the incidence of VEO-IBD was low and stable from 1988 to 2011, with a specific clinical presentation. These results suggest a probable genetic origin for VEO-IBD, whereas the increase in EO-IBD might be linked to environmental factors.
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Affiliation(s)
- E Bequet
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France
| | - H Sarter
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Maison Régionale de la Recherche Clinique, Lille University and Hospital, Lille, France
- Lille Inflammation Research International Center LIRIC - UMR 995 Inserm Lille 2 University, CHRU de Lille, Lille, France
| | - M Fumery
- Gastroenterology Unit, EPIMAD Registry, CHU Amiens Sud, Amiens University Hospital, Amiens, France
| | - F Vasseur
- Biostatistics Unit, EA 2694, Lille University and Hospital, Lille, France
| | - L Armengol-Debeir
- Gastroenterology Unit, EPIMAD Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France
| | - B Pariente
- Gastroenterology Unit, Hôpital Huriez, Lille University Hospital, Lille, France
| | - D Ley
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France
- Lille Inflammation Research International Center LIRIC - UMR 995 Inserm Lille 2 University, CHRU de Lille, Lille, France
| | - C Spyckerelle
- Paediatric Unit, St Vincent Hospital, Catholic University, Lille, France
| | - H Coevoet
- Gastroenterology Unit, Les Bonnettes Private Hospital, Arras, France
| | - J E Laberenne
- Gastroenterology Unit, General Hospital, Seclin, France
| | - L Peyrin-Biroulet
- Gastroenterology Unit, Inserm U954, Université de Lorraine, Nancy, France
| | - G Savoye
- Gastroenterology Unit, EPIMAD Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France
| | - D Turck
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France
- Lille Inflammation Research International Center LIRIC - UMR 995 Inserm Lille 2 University, CHRU de Lille, Lille, France
| | - C Gower-Rousseau
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Maison Régionale de la Recherche Clinique, Lille University and Hospital, Lille, France
- Lille Inflammation Research International Center LIRIC - UMR 995 Inserm Lille 2 University, CHRU de Lille, Lille, France
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9
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Agossa K, Dendooven A, Dubuquoy L, Gower-Rousseau C, Delcourt-Debruyne E, Capron M. Periodontal manifestations of inflammatory bowel disease: emerging epidemiologic and biologic evidence. J Periodontal Res 2016; 52:313-324. [PMID: 27663744 DOI: 10.1111/jre.12422] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2016] [Indexed: 12/27/2022]
Abstract
Inflammatory bowel disease and periodontitis are both described as a disproportionate mucosal inflammatory response to a microbial environment in susceptible patients. Moreover, these two conditions share major environmental and lifestyle-related risk factors. Despite this intriguing pathogenic parallel, large-scale studies and basic research have only recently considered periodontal outcomes as relevant data. There are mounting and consistent arguments, from recent epidemiologic studies and animal models, that these two conditions might be related. This article is a comprehensive and critical up-to-date review of the current evidence and future prospects in understanding the biologic and epidemiologic relationships between periodontal status and inflammatory bowel disease.
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Affiliation(s)
- K Agossa
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, Lille, France.,Department of Periodontology, School of Dentistry, University of Lille, Lille, France
| | - A Dendooven
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
| | - L Dubuquoy
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
| | - C Gower-Rousseau
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France.,Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France
| | - E Delcourt-Debruyne
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, Lille, France.,Department of Periodontology, School of Dentistry, University of Lille, Lille, France
| | - M Capron
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
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10
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Choteau L, Vasseur F, Lepretre F, Figeac M, Gower-Rousseau C, Dubuquoy L, Poulain D, Colombel JF, Sendid B, Jawhara S. Corrigendum: Polymorphisms in the Mannose-Binding Lectin Gene are Associated with Defective Mannose-Binding Lectin Functional Activity in Crohn's Disease Patients. Sci Rep 2016; 6:33426. [PMID: 27633086 PMCID: PMC5025643 DOI: 10.1038/srep33426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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11
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Choteau L, Vasseur F, Lepretre F, Figeac M, Gower-Rousseau C, Dubuquoy L, Poulain D, Colombel JF, Sendid B, Jawhara S. Polymorphisms in the Mannose-Binding Lectin Gene are Associated with Defective Mannose-Binding Lectin Functional Activity in Crohn's Disease Patients. Sci Rep 2016; 6:29636. [PMID: 27404661 PMCID: PMC4940739 DOI: 10.1038/srep29636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/22/2016] [Indexed: 02/07/2023] Open
Abstract
Mannose-binding lectin, together with mannose-associated serine proteases, activates the lectin pathway of the complement system and subsequent inflammatory mechanisms. An association between mannose-binding lectin deficiency and anti-Saccharomyces cerevisiae antibody levels is observed in Crohn’s disease and this deficiency is frequently associated with a severe Crohn’s disease phenotype. In the present study, we assessed the relationship between serum concentrations of mannose-binding lectin, mannose-binding lectin functional activity, MBL2 and NOD2 polymorphisms, anti-S. cerevisiae antibody levels and clinical Crohn’s disease phenotype in 69 Crohn’s disease patients and 30 age- and sex-matched healthy controls. The results show that the MBL2 variant rs5030737 at codon 52 was associated with a low level of mannose-binding lectin and impaired mannose-binding lectin–mannose-associated serine protease (MBL-MASP) functional activity in Crohn’s disease patients. This MBL2 variant was also associated with a higher level of anti-S. cerevisiae antibodies. In addition, the NOD2 variant rs2066844, which is associated with susceptibility to Crohn’s disease, was significantly correlated with an impairment in MBL-MASP functional activity. These results provide evidence that Crohn’s disease patients have an impairment in MBL-MASP functional activity and that this defect is associated with MBL2 and NOD2 variants.
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Affiliation(s)
- Laura Choteau
- INSERM, U995, F-59000 Lille, France.,University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France.,CHU Lille, Service de Parasitologie Mycologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France
| | - Francis Vasseur
- Université Lille Nord de France, Unité de Biostatistique, EA 2694, F-59000 Lille, France
| | | | | | - Corine Gower-Rousseau
- INSERM, U995, F-59000 Lille, France.,University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France
| | - Laurent Dubuquoy
- INSERM, U995, F-59000 Lille, France.,University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France
| | - Daniel Poulain
- INSERM, U995, F-59000 Lille, France.,University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France.,CHU Lille, Service de Parasitologie Mycologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France
| | - Jean-Frederic Colombel
- Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Boualem Sendid
- INSERM, U995, F-59000 Lille, France.,University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France.,CHU Lille, Service de Parasitologie Mycologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France
| | - Samir Jawhara
- INSERM, U995, F-59000 Lille, France.,University Lille2, U995-LIRIC, Lille Inflammation Research International Centre, F-59000 Lille, France.,CHU Lille, Service de Parasitologie Mycologie, Pôle de Biologie Pathologie Génétique, F-59000 Lille, France
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12
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Carette-Lherbier S, Sarter H, Spyckerelle C, Devouge E, Legrand C, Couttenier F, Coopman S, Michaud L, Guimber D, Gottrand F, Ganga-Zandzou P, Gower-Rousseau C, Turck D. Évaluation du recours aux médecines non conventionnelles par les enfants atteints de maladie inflammatoire chronique de l’intestin. Arch Pediatr 2016. [DOI: 10.1016/j.arcped.2016.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Fumery M, Duricova D, Gower-Rousseau C, Annese V, Peyrin-Biroulet L, Lakatos PL. Review article: the natural history of paediatric-onset ulcerative colitis in population-based studies. Aliment Pharmacol Ther 2016; 43:346-55. [PMID: 26582737 DOI: 10.1111/apt.13478] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/18/2015] [Accepted: 10/27/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND A better knowledge of the natural history of disabling chronic diseases is essential to improve patient management, evaluate the impact of treatment strategies and provide predictors for disabling disease and comprehensive information for patients. AIM To summarise our current knowledge issued from population-based studies of the natural history of ulcerative colitis (UC) in children. METHODS We searched MEDLINE (source PubMed) and international conference abstracts, and included all population-based studies that evaluated long-term outcome of paediatric-onset (<17 years at diagnosis) UC. RESULTS A total of 26 population-based studies were considered in this review from the total of 61 articles or abstracts screened. Most patients presented disease extension and about two-thirds of patients had pancolitis at the end of follow-up. One-half of patients experienced extra-intestinal manifestations and primary sclerosing cholangitis was observed in 5-10% of patients. Overall, patients did not appear to have any significant growth retardation or delayed puberty. About two-thirds of patients required corticosteroid therapy and up to 25% were steroid dependent. An increased use of thiopurines was observed and the most recent data indicate that up to one-half of patients were exposed to thiopurines and 10-30% were exposed to anti-tumour necrosis factor. One-half of patients required hospitalisations and 20% of patients required colectomy after a follow-up of 10 years. CONCLUSIONS Paediatric-onset UC is characterised by a high rate of disease extension. About 20% of patients had been operated at 10-year follow-up. New population-based studies are needed to evaluate the impact of new treatment strategies comprising immunosuppressants and biologics.
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Affiliation(s)
- M Fumery
- Gastroenterology Unit, Epimad Registry, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - D Duricova
- Department of Gastroenterology, Univerzity Karlovy, Prague, Czech Republic.,EPICOM, European Crohn & Colitis Organization, Vienna, Austria
| | - C Gower-Rousseau
- EPICOM, European Crohn & Colitis Organization, Vienna, Austria.,Public Health, Epidemiology and Economic Health, Epimad Registry, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, 59037, Lille Cedex, France.,Lille Inflammation Research International Center LIRIC - UMR 995 Inserm/Université Lille 2/CHRU de Lille, Equipe IBD and Environmental Factors: Epidemiology and Functional Analyses, Lille University, Lille, France
| | - V Annese
- EPICOM, European Crohn & Colitis Organization, Vienna, Austria.,Division of Gastroenterology, AOU Careggi Hospital, Florence, Italy
| | - L Peyrin-Biroulet
- Gastroenterology, Inserm U954, University Hospital of Nancy-Brabois, Université Henri Poincaré, Vandoeuvre-lès-Nancy, France
| | - P L Lakatos
- EPICOM, European Crohn & Colitis Organization, Vienna, Austria.,1st Department of Medicine, Semmelweis University, Budapest, Hungary
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14
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Cheddani H, Dauchet L, Charpentier C, Fumery M, Salleron J, Bouvier AM, Dupas JL, Vasseur F, Lerebours E, Armengol-Debeir L, Laberenne E, Peyrin-Biroulet L, Colombel JF, Savoye G, Gower-Rousseau C. DOP094 Cancer in elderly-onset inflammatory bowel disease: A population-based study. J Crohns Colitis 2014. [DOI: 10.1016/s1873-9946(14)60119-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2023]
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15
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Tavernier N, Fumery M, Peyrin-Biroulet L, Colombel JF, Gower-Rousseau C. Systematic review: fertility in non-surgically treated inflammatory bowel disease. Aliment Pharmacol Ther 2013; 38:847-53. [PMID: 24004045 DOI: 10.1111/apt.12478] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 08/12/2013] [Accepted: 08/17/2013] [Indexed: 12/28/2022]
Abstract
BACKGROUND Inflammatory bowel diseases (IBD) typically affect young patients during the reproductive years, and reproductive issues are of key concern to them. AIM To evaluate the impact of IBD on fertility in both women and men with IBD who had no history of surgical treatment for IBD. METHODS We searched MEDLINE, Cochrane Library, EMBASE and international conference abstracts and included all controlled observational studies that evaluated fertility in Crohn's disease (CD) and/or ulcerative colitis (UC) in women and/or men. RESULTS Eleven studies matching our criteria were included. In women with CD, there was a 17-44% reduction in fertility as compared with controls. Reduction in fertility was linked to voluntary childlessness, while there was no evidence of physiological causes of infertility. Most studies did not find any reduction in fertility in women with UC as compared with controls. In men with CD, there was an 18-50% reduction in fertility as compared with controls with no difference in reproductive capacity. There was no evidence of reduced fertility in men with UC. CONCLUSIONS The infertility observed in both women and men with CD is due to voluntary childlessness as opposed to involuntary infertility. This voluntary childlessness is often based on incorrect beliefs about the impact of the disease on fertility and pregnancy outcomes. Our results reinforce the need to increase awareness among male and female patients that IBD does not itself lead to reduced fertility.
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Affiliation(s)
- N Tavernier
- Department of Hepato-Gastroenterology, University Lille Nord de France, CHRU Lille, Lille, France
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16
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Olivier S, Zephir H, Salleron J, Gower-Rousseau C, Debouverie M, Lebrun C, Lepage E, Papeix C, William C, Benoit V, Cortot A, Colombel JF, Patrick V. Could Inflammatory Bowel Disease Regulate Multiple Sclerosis Course? (P05.108). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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17
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Chouraki V, Savoye G, Dauchet L, Vernier-Massouille G, Dupas JL, Merle V, Laberenne JE, Salomez JL, Lerebours E, Turck D, Cortot A, Gower-Rousseau C, Colombel JF. The changing pattern of Crohn's disease incidence in northern France: a continuing increase in the 10- to 19-year-old age bracket (1988-2007). Aliment Pharmacol Ther 2011; 33:1133-42. [PMID: 21488915 DOI: 10.1111/j.1365-2036.2011.04628.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Crohn's disease incidence rates have stabilised in industrialised countries since the 1980s. Conversely, a continuing increase in childhood-onset Crohn's disease incidence has been reported. AIM To confirm trends in inflammatory bowel disease (IBD) incidence in northern France over an extended time period (1988-2007) with a focus on childhood-onset Crohn's disease. METHODS The IBD patients recorded in the EPIMAD registry between 1988 and 2007 were included. Standardised incidence rates were calculated for Crohn's disease and ulcerative colitis in the entire population, and separately according to age. Evolution of phenotypes at diagnosis was also studied. RESULTS A total of 12 084 incident IBD cases (7428 Crohn's disease and 4656 ulcerative colitis) were recorded. Crohn's disease incidence rates increased from 5.2 cases/100 000 persons in 1988-1990 to 6.7 in 2006-2007 (+29%), stabilising after a peak at 7.1 in 1997-1999. Crohn's disease incidence rates in the 10-19-year age category increased by 71%, from 6.5 (1988-1990) to 11.1 (2006-2007). The frequency of initial ileo-colonic localisation increased from 52.9% in 1988-1990 to 68.6% in 2006-2007 (P<0.0001). Ulcerative colitis incidence rates decreased during the same period. CONCLUSIONS From 1988 to 2007, Crohn's disease incidence increased by 29% in northern France and by 71% in the 10-19-year-old age group. Consequently, studies on Crohn's disease risk factors should focus on the population under 20 years of age.
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Affiliation(s)
- V Chouraki
- Registre des Maladies Inflammatoires Chroniques de l'Intestin du Nord Ouest de la France, Epidemiology Unit, Lille University Hospital, Lille Cedex, France
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18
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Chouraki V, Dauchet L, Merle V, Dupas JL, Lerebours E, Vernier-Massouille G, Marti R, Salomez JL, Cortot A, Gower-Rousseau C, Colombel JF. Incidence de la maladie de Crohn et de la rectocolite hémorragique dans le nord de la France de 1988 à 2005 : résultats du registre EPIMAD. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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19
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Baron S, Turck D, Leplat C, Merle V, Gower-Rousseau C, Marti R, Yzet T, Lerebours E, Dupas JL, Debeugny S, Salomez JL, Cortot A, Colombel JF. Environmental risk factors in paediatric inflammatory bowel diseases: a population based case control study. Gut 2005; 54:357-63. [PMID: 15710983 PMCID: PMC1774426 DOI: 10.1136/gut.2004.054353] [Citation(s) in RCA: 156] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Environmental exposures in early life have been implicated in the aetiology of inflammatory bowel disease. OBJECTIVE To examine environmental risk factors prior to the development of inflammatory bowel disease in a paediatric population based case control study. METHODS A total of 222 incident cases of Crohn's disease and 60 incident cases of ulcerative colitis occurring before 17 years of age between January 1988 and December 1997 were matched with one control subject by sex, age, and geographical location. We recorded 140 study variables in a questionnaire that covered familial history of inflammatory bowel disease, events during the perinatal period, infant and child diet, vaccinations and childhood diseases, household amenities, and the family's socioeconomic status. RESULTS In a multivariate model, familial history of inflammatory bowel disease (odds ratio (OR) 4.3 (95% confidence interval 2.3-8)), breast feeding (OR 2.1 (1.3-3.4)), bacille Calmette-Guerin vaccination (OR 3.6 (1.1-11.9)), and history of eczema (OR 2.1 (1-4.5)) were significant risk factors for Crohn's disease whereas regular drinking of tap water was a protective factor (OR 0.56 (0.3-1)). Familial history of inflammatory bowel disease (OR 12.5 (2.2-71.4)), disease during pregnancy (OR 8.9 (1.5-52)), and bedroom sharing (OR 7.1 (1.9-27.4)) were risk factors for ulcerative colitis whereas appendicectomy was a protective factor (OR 0.06 (0.01-0.36)). CONCLUSIONS While family history and appendicectomy are known risk factors, changes in risk based on domestic promiscuity, certain vaccinations, and dietary factors may provide new aetiological clues.
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Affiliation(s)
- S Baron
- Registre des Maladies Inflammatoires Chroniques de l'Intestin (EPIMAD), Service d'Epidémiologie et de Santé Publique, Hôpital Calmette, Lille, France
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20
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Molinié F, Gower-Rousseau C, Yzet T, Merle V, Grandbastien B, Marti R, Lerebours E, Dupas JL, Colombel JF, Salomez JL, Cortot A. Opposite evolution in incidence of Crohn's disease and ulcerative colitis in Northern France (1988-1999). Gut 2004; 53:843-8. [PMID: 15138211 PMCID: PMC1774088 DOI: 10.1136/gut.2003.025346] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2003] [Indexed: 12/11/2022]
Abstract
BACKGROUND Northern France was characterised by a high incidence of Crohn's disease (CD) and a low incidence of ulcerative colitis (UC) according to the first inquiry undertaken in the late 1980s. AIMS To assess the trends in the incidence of inflammatory bowel disease (IBD) over a 12 year period (1988-1999) in the same area of Northern France. PATIENTS Patients living in Northern France (Nord, Pas-de-Calais, Somme, and Seine Maritime--total of 5,790,526 inhabitants) between 1988 and 1999 were included in the study. Case ascertainment was established according to methodology previously described. METHODS Trends in incidence were studied using a Poisson regression model in four three year periods (1988-90, 1991-93, 1994-96, and 1997-99) adjusted for age at diagnosis and sex. Incidence rates were standardised for age with the European standard population. RESULTS During 1988-99, 7066 cases of IBD were recorded (56.8% CD, 37.7% UC, and 5.5% indeterminate colitis). Mean annual incidence rate of CD increased from 5.2/100,000 inhabitants in 1988-90 to 6.4 in 1997-99 (adjusted p for trend <0.001). In contrast, the incidence of UC decreased from 4.2 to 3.5 (adjusted p for trend <0.001). The ileocolonic subtype of CD increased by 25% even though median age at diagnosis and frequency of digestive investigations were not different. CONCLUSIONS Contrary to what has been reported in other countries in Northern Europe, the incidence of CD increased by 23% in 12 years in Northern France while that of UC decreased by 17% during the same period. This indicates that some factors which influence IBD frequency (in both directions) are still at work in this area of Europe, and that further studies aimed at identifying these should be performed. The rising incidence of CD could enhance the burden of this disease on the public health system in France.
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Affiliation(s)
- F Molinié
- Registre des Maladies Inflammatoires Chroniques de l'Intestin (EPIMAD), Service d'Epidémiologie et de Santé Publique, Hôpital Calmette, CHR&U de Lille, 59037 Lille Cedex, France
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21
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Zouali H, Lesage S, Merlin F, Cézard JP, Colombel JF, Belaiche J, Almer S, Tysk C, O'Morain C, Gassull M, Christensen S, Finkel Y, Modigliani R, Gower-Rousseau C, Macry J, Chamaillard M, Thomas G, Hugot JP. CARD4/NOD1 is not involved in inflammatory bowel disease. Gut 2003; 52:71-4. [PMID: 12477763 PMCID: PMC1773516 DOI: 10.1136/gut.52.1.71] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are complex genetic disorders. CARD15/NOD2, a member of the Ced4 superfamily which includes Apaf-1 and CARD4/NOD1, has recently been associated with genetic predisposition to CD but additional genetic factors remain to be identified. Because CARD4/NOD1 shares many structural and functional similarities with CARD15, we tested its putative role in IBD. PATIENTS AND METHODS The 11 exons of CARD4 were screened for the presence of variants in 63 unrelated IBD patients. The only non-private genetic variation encoding for a substitution in the peptidic chain was genotyped in 381 IBD families (235 CD, 58 UC, 81 mixed, and seven indeterminate colitis families) using a polymerase chain reaction-restriction fragment length polymorphism procedure. Genotyping data were analysed by the transmission disequilibrium test. RESULTS Five of nine sequence variations identified in the coding sequence of the gene encoded for non-conservative changes (E266K, D372N, R705Q, T787M, and T787K). Four were present in only one family. The remaining variant (E266K), which exhibited an allele frequency of 0.28, was not associated with CD, UC, or IBD. Furthermore, IBD patients carrying sequence variations in their CARD4 gene had a similar phenotype to those with a normal sequence. CONCLUSION Our results suggest that CARD4 does not play a major role in genetic susceptibility to IBD.
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Affiliation(s)
- H Zouali
- Fondation Jean Dausset-CEPH, Paris, France
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22
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Zouali H, Chamaillard M, Lesage S, Cézard JP, Colombel JF, Belaiche J, Almer S, Tysk C, Montague S, Gassull M, Christensen S, Finkel Y, Gower-Rousseau C, Modigliani R, Macry J, Selinger-Leneman H, Thomas G, Hugot JP. Genetic refinement and physical mapping of a chromosome 16q candidate region for inflammatory bowel disease. Eur J Hum Genet 2001; 9:731-42. [PMID: 11781683 DOI: 10.1038/sj.ejhg.5200710] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2001] [Revised: 06/29/2001] [Accepted: 07/03/2001] [Indexed: 01/03/2023] Open
Abstract
Crohn's disease (CD) is a complex genetic disorder for which a susceptibility gene, IBD1, has been mapped within the pericentromeric region of chromosome 16. In order to refine the location of IBD1, 77 multiplex CD families were genotyped for 26 microsatellite markers evenly spaced by approximately 1 cM. Nonparametric linkage analyses exhibited a maximum NPL score of 3.49 (P=2.37x10(-4)) in a region centred by markers D16S3136, D16S3117 and D16S770. Simulation studies showed that the probability for IBD1 to be located in a 5 cM region around these markers was 70%. A 2.5 Mb YAC and BAC contig map spanning this genetic region on chromosome band 16q12 was built. TDT analyses demonstrated suggestive association between the 207 bp allele of D16S3136 (P<0.05) and a new biallellic marker hb27g11f-end (P=0.01). These markers were located in the hb27g11 and hb87b10 BAC clones from the contig. Taken together, the present results provide a crucial preliminary step before an exhaustive linkage disequilibrium mapping of putatively transcribed regions to identify IBD1.
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Affiliation(s)
- H Zouali
- Fondation Jean Dausset CEPH, Paris, France
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Hugot JP, Chamaillard M, Zouali H, Lesage S, Cézard JP, Belaiche J, Almer S, Tysk C, O'Morain CA, Gassull M, Binder V, Finkel Y, Cortot A, Modigliani R, Laurent-Puig P, Gower-Rousseau C, Macry J, Colombel JF, Sahbatou M, Thomas G. Association of NOD2 leucine-rich repeat variants with susceptibility to Crohn's disease. Nature 2001; 411:599-603. [PMID: 11385576 DOI: 10.1038/35079107] [Citation(s) in RCA: 3811] [Impact Index Per Article: 165.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Crohn's disease and ulcerative colitis, the two main types of chronic inflammatory bowel disease, are multifactorial conditions of unknown aetiology. A susceptibility locus for Crohn's disease has been mapped to chromosome 16. Here we have used a positional-cloning strategy, based on linkage analysis followed by linkage disequilibrium mapping, to identify three independent associations for Crohn's disease: a frameshift variant and two missense variants of NOD2, encoding a member of the Apaf-1/Ced-4 superfamily of apoptosis regulators that is expressed in monocytes. These NOD2 variants alter the structure of either the leucine-rich repeat domain of the protein or the adjacent region. NOD2 activates nuclear factor NF-kB; this activating function is regulated by the carboxy-terminal leucine-rich repeat domain, which has an inhibitory role and also acts as an intracellular receptor for components of microbial pathogens. These observations suggest that the NOD2 gene product confers susceptibility to Crohn's disease by altering the recognition of these components and/or by over-activating NF-kB in monocytes, thus documenting a molecular model for the pathogenic mechanism of Crohn's disease that can now be further investigated.
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Affiliation(s)
- J P Hugot
- Fondation Jean Dausset CEPH, 27 rue J. Dodu 75010 Paris, France
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24
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Hugot JP, Chamaillard M, Zouali H, Lesage S, Cézard JP, Belaiche J, Almer S, Tysk C, O'Morain CA, Gassull M, Binder V, Finkel Y, Cortot A, Modigliani R, Laurent-Puig P, Gower-Rousseau C, Macry J, Colombel JF, Sahbatou M, Thomas G. Association of NOD2 leucine-rich repeat variants with susceptibility to Crohn's disease. Nature 2001. [DOI: 78495111110.1038/35079107' target='_blank'>'"<>78495111110.1038/35079107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [78495111110.1038/35079107','', 'Corine Gower-Rousseau')">Reference Citation Analysis] [78495111110.1038/35079107', 24)">What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
78495111110.1038/35079107" />
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25
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Laharie D, Debeugny S, Peeters M, Van Gossum A, Gower-Rousseau C, Bélaïche J, Fiasse R, Dupas JL, Lerebours E, Piotte S, Cortot A, Vermeire S, Grandbastien B, Colombel JF. Inflammatory bowel disease in spouses and their offspring. Gastroenterology 2001; 120:816-9. [PMID: 11231934 DOI: 10.1053/gast.2001.22574] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS The rarity of inflammatory bowel disease (IBD) in both husband and wife is often given as an argument against an infectious origin. We registered conjugal instances of IBD in Northern France and in Belgium between 1989 and 2000. METHODS Couples were assigned to group A if both partners had symptoms of IBD before cohabitation, to group B if one spouse had IBD before cohabitation and the other experienced first symptoms afterwards, and to group C if both partners got the disease after cohabitation. Risk of IBD was assessed in their offspring. RESULTS Thirty conjugal instances were registered. Seventeen were concordant for Crohn's disease and 3 for ulcerative colitis; 10 were mixed. Two belonged to group A, 6 to group B, and 22 to group C. In group C, IBD occurred in the first affected spouse an average of 9 years after cohabitation and in the second spouse an average of 8.5 years later. Group C conjugal forms were more frequent than expected by chance (P < 0.02). Fifty-four children were born to 25 couples; among them 9, of whom 4 were siblings, developed Crohn's disease at a median age of 15 years. CONCLUSIONS The frequency of conjugal forms of IBD suggests an etiologic role for environmental factors. Offspring of 2 affected parents have a high risk of developing IBD.
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Affiliation(s)
- D Laharie
- Registre des MICI du Nord-Ouest de la France (EPIMAD), France
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26
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Abstract
BACKGROUND Recent findings that early-in-life virus infections represent a risk factor for Crohn disease, that exacerbations of disease sometimes appear associated with common viral infections, and, in particular, suggestions that Crohn disease may be the result of persistent infection with measles virus prompted serologic studies for antibody to 19 common viruses, Chlamydia psittaci, and Mycoplasma pneumoniae. METHODS Sera from 14 affected members of 2 French families with a high frequency of Crohn disease and from age- and sex-matched controls, taken in 1990 and 1992, and from unaffected family members were tested. Complement fixation, enzyme immunoassay, and indirect immunofluorescent tests were used. RESULTS There were no significant differences between patients and controls or between affected and unaffected family members of family 2, with the exception that affected siblings carried higher antibody titers for mycoplasma one year and for varicella another year. There were no differences in measles IgM and IgG or mumps IgG antibody levels between patients and controls, or between patients and unaffected family members. CONCLUSIONS Serology failed to find evidence of participation by 19 common viruses, C. psittaci, and M. pneumoniae in Crohn disease. The data do not support the hypothesis that persistent measles virus infection causes Crohn disease.
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Affiliation(s)
- H J Van Kruiningen
- Dept. of Pathobiology, University of Connecticut, Storrs 06269-3089, USA
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27
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Rolland N, Grandbastien B, Merle V, Gower-Rousseau C, Yzet T, Marti R, Lerebours E, Dupas JL, Czernichow P, Salomez JL, Lebrun T, Cortot A. [Cost of early management of chronic inflammatory intestinal disease]. Gastroenterol Clin Biol 1999; 23:483-8. [PMID: 10416112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
OBJECTIVES The aim of this study was to assess the cost of the first management of inflammatory bowel disease (IBD) from the onset of first symptoms until 6 weeks after the diagnosis. This cost was calculated in French francs (FF) for all IBD and namely for Crohn's disease (CD), ulcerative colitis (UC), and ulcerative proctitis (UP). MATERIAL AND METHODS Data concerning 258 patients were collected by the mean of a standardized questionnaire from 3 different sources: the patient, his general practitioner, and his gastroenterologist. RESULTS Two hundred and fifty eight patients were included: 144 CD (55.8%), 76 UC (29.5%), 30 UP (11.6%), and 8 chronic unclassifiable colitis (CUC) (3.1%). The mean direct costs of the diagnosis (m +/- SD) were 23,116 +/- 40,820 FF for CD, 10,628 +/- 17,316 FF for UC and 3,451 +/- 2,743 FF for UP. Although unplanned hospitalizations occurred in only 38% of the patients (98/258), they represented the 3/4 of the mean costs: 78.2% for CD and 64% for UC. Indirect costs generated by days off work were 4,719 +/- 6,610 FF for CD, 2,996 +/- 6,897 FF for UC and 1,230 +/- 3,622 FF for UP. CONCLUSION The first management of a patient with CD was twice more expensive than the one with UC and 6.5 times than the one with UP.
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Affiliation(s)
- N Rolland
- CRESGE-Centre de Recherches Economiques Sociologiques et de Gestion, Lille, France
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Touze I, Gower-Rousseau C, Grandbastien B, Paris JC, Quandalle P, Cortot A, Colombel JF. [Diffuse jejuno-ileitis of Crohn's disease: a separate form of the disease?]. Gastroenterol Clin Biol 1999; 23:307-11. [PMID: 10384331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND AIMS Diffuse jejuno-ileitis of Crohn's disease may be a homogeneous clinical subgroup. The aim of this work was to compare the demographic and clinical data at diagnosis and the initial treatments of patients with diffuse jejuno-ileitis of Crohn's disease and to the ones without this localization. PATIENTS AND METHODS For demographic and clinical studies, 48 (32M/16F) incident cases of diffuse jejuno-ileitis of Crohn's disease diagnosed between 1988 and 1994 in the EPIMAD register were compared with 96 (48M/48F) controls diagnosed the same year. As far as for the therapeutic management, the 48 incident cases were compared with 48 controls. RESULTS Diffuse jejuno-ileitis constituted 3.3% of the total incident cases. Median age at diagnosis was significantly lower (20 vs 23 years, P = 0.01) and an upper digestive involvement was more frequent (56% vs 34%, P = 0.03) in patients with diffuse jejuno-ileitis. These patients were more often treated by total parenteral nutrition (43.8% vs 19.6%, P = 0.01) or azathioprine (50% vs 20.8%, P = 0.005). Azathioprine was also introduced earlier (20.7 vs 40.3 months, P = 0.009). Surgery for resection was less often required in diffuse jejuno-ileitis than in controls (65.2% vs 99.8%, P = 0.02) while more stricturoplasties were performed (52.9% vs 10%, P = 0.003); overall surgical rates did not significantly differ in the 2 groups. CONCLUSION Our series suggest that diffuse jejuno-ileitis of Crohn's disease is a subgroup of patients characterized by a young age at diagnosis, with more frequent and earlier requirement for azathioprine.
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Affiliation(s)
- I Touze
- Service de Chirurgie Adultes Ouest, Hôpital Huriez, CHU, Lille
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29
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Grandbastien B, Gower-Rousseau C, Merle V, Dupas JL, Yzet T, Lerebours E, Marti R, Laine I, Cortot A, Salomez JL. [Diagnostic and therapeutic management of patients with chronic inflammatory bowel disease]. Rev Epidemiol Sante Publique 1999; 47:45-53. [PMID: 10214676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND The period of time required for the diagnosis of a chronic illness depends on initial clinical symptoms and their perception by the patient and the physicians. The aim of this study was to describe the procedures of diagnosis of incident cases of Inflammatory Bowel Disease (IBD). METHODS Patients reported by the Registry of inflammatory bowel disease of northern France (EPIMAD) in 1994 were included. Standardized questionnaires describing clinical history, patient behavior, medical consultations and examinations were collected by an interviewer practitioner from three sources: patients, general practitioners (GP) and gastroenterologists (GE). Patients were divided in 2 groups according to the time between symptom onset and diagnosis: more than 9 months or less than 9 months (D > 9 and D < or = 9). RESULTS 258 patients were included: 144 Crohn's disease (CD) (56%), 106 ulcerative colitis (UC) (41%) and 8 chronic unclassifiable colitis (CUC). Median time between symptom onset and diagnosis was 3 months, 196 (76%) patients belonged to the group D < or = 9 and 62 (24%) to the group D > 9. There was no difference between the 2 groups for initial clinical symptoms. The delay between symptom onset and the consultation to the GP and the GE was longer in the group D > 9: respectively 1 month vs 0 and 7.6 vs 2. Thirty-five percent of patients in the group D > 9 had consulted more than one GP vs 14% (p < 0.05). Diagnosis management by the GE was the same in both groups. Patients of group D < or = 9 had more often perceived their symptoms as serious (p < 0.05). CONCLUSIONS Delay to diagnosis in a quarter of patients with IBD was more than 9 months. This later diagnosis was not due to patient management by the GE but rather to a longer delay to consulting the GP and between GP and GE referral. Patient interpretation of the symptoms could also explain the variability of this delay.
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Affiliation(s)
- B Grandbastien
- Registre des Maladies Inflammatoires Chroniques de l'Intestin du Nord-Ouest de la France (EPIMAD), Service d'Epidémiologie, Hôpital Calmette, Lille
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Cortot A, Gower-Rousseau C, Marti R, Colombel JF. [Homogeneous groups of patients in Crohn's disease: reality or imagination?]. Gastroenterol Clin Biol 1998; 22:591-3. [PMID: 9762329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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31
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Grandbastien B, Peeters M, Franchimont D, Gower-Rousseau C, Speckel D, Rutgeerts P, Belaïche J, Cortot A, Vlietinck R, Colombel JF. Anticipation in familial Crohn's disease. Gut 1998; 42:170-4. [PMID: 9536939 PMCID: PMC1726980 DOI: 10.1136/gut.42.2.170] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Offspring with a family history of Crohn's disease have an earlier age of onset than their parents. This might be due to genetic anticipation, characterised by earlier and/or more severe disease in subsequent generations. AIMS To investigate the possibility of genetic anticipation in affected parent-child pairs with Crohn's disease from France and Belgium. PATIENTS AND METHODS In a cohort of 160 multiply affected families with Crohn's disease, 57 parent-first affected child pairs were detected. Clinical characteristics (age at diagnosis, disease extent, and type) of both parents and children were registered and compared. RESULTS Children were younger than their parents at diagnosis in 48/57 (84%) pairs. The median age at diagnosis was 16 years younger in children than in parents (p < 0.0001). However, the difference was related to the age at diagnosis in the parents and was not present in 12 parent-child pairs with an early age at diagnosis for the parents. In most cases, disease extent and type were not considered more severe in children than in parents. Parental sex affected neither age at diagnosis nor extent and type of disease in children. CONCLUSION Patients in the second affected generation acquire their disease at an earlier time in life in some but not all familial cases of Crohn's disease. Several explanations including genetic anticipation and environmental factors might explain this phenomenon.
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Affiliation(s)
- B Grandbastien
- Registre des Maladies Inflammatoires du Tube Digestif du Nord-Ouest de la France (EPIMAD), Service D'Hépato-Gastroentérologie, Hôpital Huriez, CH et U Lille, France
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Gower-Rousseau C, Grandbastien B, Colombel JF, Cortot A. [Incidences of chronic inflammatory bowel diseases in France: the table is growing richer]. Gastroenterol Clin Biol 1997; 21:481-2. [PMID: 9295975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Franchimont D, Belaiche J, Louis E, Simon S, GrandBastien B, Gower-Rousseau C, Fontaine F, Delforge M. Familial Crohn's disease: a study of 18 families. Acta Gastroenterol Belg 1997; 60:134-7. [PMID: 9260324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
UNLABELLED The high frequency of familial Crohn's disease (CD) suggests a genetic predisposition. The most recent data from epidemiology and molecular biology are consistent with a multifactorial, polygenic inheritance with a possible genetic heterogeneity. The aim of our study was, first to compare familial and sporadic CD on the basis of the type and location of the disease, and age at diagnosis, and second, to evaluate among families, the concordance rate for the type and location of the disease. PATIENTS AND METHODS 18 families with 2 (n = 16) and 3 (n = 2) affected first degree relatives were studied. They were compared to a population of 154 sporadic CD coming from the same gastroenterology unit. RESULTS Age at diagnosis was the same in sporadic and familial CD. There was an increased frequency of ileal (p = 0.02), and fibro stenotic (p = 0.005) CD and a decreased frequency of colonic (p = 0.006) and inflammatory (p = 0.02) disease, in familial CD. There was a significant increase in concordance rate for fibrostenotic disease (p < 0.001) and a decrease for inflammatory disease (p < 0.01), among the families. The observed concordance rate for the location of the disease was not significantly different from the expected one. In conclusion, these data suggest that CD may be heterogenous and that different clinical patterns may be determined either by genetic or environmental factors.
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Affiliation(s)
- D Franchimont
- Department of gastroenterology, CHU, ULG, Start Tilman, Liège, Belgium
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Colombel JF, Grandbastien B, Gower-Rousseau C, Plegat S, Evrard JP, Dupas JL, Gendre JP, Modigliani R, Bélaïche J, Hostein J, Hugot JP, van Kruiningen H, Cortot A. Clinical characteristics of Crohn's disease in 72 families. Gastroenterology 1996; 111:604-7. [PMID: 8780563 DOI: 10.1053/gast.1996.v111.pm8780563] [Citation(s) in RCA: 129] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND & AIMS Familial aggregation argues for genetic susceptibility to Crohn's disease. The aim of this study was to compare the age of onset and the clinical features of Crohn's disease between patients with familial disease and those with sporadic disease and investigate the concordance for disease location and type among relatives with Crohn's disease. METHODS Seventy-two families with 2 (n = 55), 3 (n = 8), 4 (n = 6), and 5 or more (n = 3) affected first-degree relatives were selected for the study. A population of 1377 patients with sporadic nonfamilial Crohn's disease was used for comparison. RESULTS Clinical data were obtained from 176 patients with familial Crohn's disease (79 men and 97 women). Median age at onset was younger in familial Crohn's disease than in sporadic cases: 22 vs. 26.5 years (P < 0.01). In familial cases, fewer patients had exclusively colonic involvement and more patients had both small bowel and colonic involvement. Among relatives of families with 2 affected members, 56% were concordant for disease location and 49% for disease type. These percentages reached 83% and 76%, respectively, within families with more than 2 affected members. CONCLUSIONS Patients with familial Crohn's disease are characterized by an early age at onset with more extensive disease and may represent a homogeneous clinical subgroup with a particularly strong genetic influence.
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Affiliation(s)
- J F Colombel
- Registre des Maladies Inflammatoires du Tube Digestif du Nord-Ouest de la France (No. 92/R12), Unit of Epidemiology, Centre Hospitalier Régional et Universitaire, Lille, France
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Hugot JP, Laurent-Puig P, Gower-Rousseau C, Olson JM, Lee JC, Beaugerie L, Naom I, Dupas JL, Van Gossum A, Orholm M, Bonaiti-Pellie C, Weissenbach J, Mathew CG, Lennard-Jones JE, Cortot A, Colombel JF, Thomas G. Mapping of a susceptibility locus for Crohn's disease on chromosome 16. Nature 1996; 379:821-3. [PMID: 8587604 DOI: 10.1038/379821a0] [Citation(s) in RCA: 665] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Crohn's disease (CD) and ulcerative colitis are the major forms of chronic inflammatory bowel diseases in the western world, and occur in young adults with an estimated prevalence of more than one per thousand inhabitants. The causes of inflammatory bowel diseases remain unknown, but genetic epidemiology studies suggest that inherited factors may contribute in part to variation in individual susceptibility to Crohn's disease. A genome-wide search performed on two consecutive and independent panels of families with multiple affected members, using a non-parametric two-point sibling-pair linkage method, identified a putative CD-susceptibility locus on chromosome 16 (P less than 0.01 for each panel). The localization was centered around loci D16S409 and D16S419 by using multipoint sibpair analysis (P less than 1.5x10(-5)). This region of the genome contains candidate genes which may be relevant to the pathogenic mechanism of inflammatory bowel diseases.
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Affiliation(s)
- J P Hugot
- Laboratoire de Génétique des Tumeurs, INSERM U 434, Institut Curie, Paris France
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Gower-Rousseau C, Grandbastien B, Cortot A, Colombel JF. Epidemiology of inflammatory bowel disease: is there a "Belgian-French exception?". Acta Gastroenterol Belg 1996; 59:2. [PMID: 8686413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Neut C, Guillemot F, Gower-Rousseau C, Biron N, Cortot A, Colombel JF. [Treatment of diversion colitis with short-chain fatty acids. Bacteriological study]. Gastroenterol Clin Biol 1995; 19:871-5. [PMID: 8746044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Bacterial imbalance may be involved in the pathogenesis of diversion colitis, via diminished production of short chain fatty acids. The aim of the study was to evaluate the effectiveness of short chain fatty acids on microbial flora of patients with diversion colitis and to compare this flora to the microbial flora of controls. METHODS We prospectively evaluated the effectiveness of short chain fatty acids irrigation on bacterial flora of the excluded colon in 13 patients (8 males, 5 females; mean age: 43.7 years). The causes of diversion were inflammatory bowel disease (n = 4) colonic cancer (n = 2) sigmoid diverticulitis with perforation (n = 3) ischio-rectal abscess (n = 2) and miscellaneous (n = 2). Patients were given, twice a day for 14 days in a double blind manner, a 60 mL enema containing either short chain fatty acids (acetate: 60 mmol/L; propionate: 30 mmol/L; and n-butyrate: 40 mmol/L) (group 1; n = 7) or isotonic NaCl (group 2; n = 6). Bacteriological studies were carried on before starting the trial (D1) and 14 days later (D14). RESULTS Before and after treatment, there was no difference between group 1 and group 2 concerning bacterial counts and species. Bacterial flora of patients with diversion colitis was characterized by: a) an increase of the count of aerobic bacteria; b) an increase of aerobic and aeroanaerobic species; c) the presence of black pigmented Gram negative anaerobic rods such as Prevotella intermedia and Porphyromonas asaccharolytica which were not found in rectal flora of the control group (16 volunteers, mean age: 27 years). CONCLUSIONS These data suggest that: a) enema with short chain fatty acids does not induce significant changes in the composition of the microbial flora in patients with diversion colitis; b) bacterial dysbiosis may be involved in pathogenesis of diversion colitis without involving the action of short chain fatty acids.
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Affiliation(s)
- C Neut
- Laboratoire de Bactériologie, Faculté de Pharmacie, Lille
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Guillemot F, Bouche B, Gower-Rousseau C, Chartier M, Wolschies E, Lamblin MD, Harbonnier E, Cortot A. Biofeedback for the treatment of fecal incontinence. Long-term clinical results. Dis Colon Rectum 1995; 38:393-7. [PMID: 7720447 DOI: 10.1007/bf02054228] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
UNLABELLED Biofeedback therapy has been proposed as a treatment for fecal incontinence with good, short-term results. PURPOSE This study was designed to assess long-term clinical results of biofeedback therapy compared with medical therapy alone and to assess manometric results in patients treated with biofeedback. METHODS Two groups of incontinent patients were studied. Group 1 consisted of 16 patients (3 males and 13 females; mean age, 59.9 years). Etiologies treated by biofeedback included descending perineum syndrome (7), postfistula or hemorroidectomy (4), and miscellaneous (5). Group 2 consisted of eight patients (two males, six females; mean age, 62.2 years). Etiologies treated with medical treatment alone (including enema and antidiarrheal therapy) included descending perineum syndrome (3), postfistula or hemorroidectomy (2), and miscellaneous (3). The incontinence score was initially 17.81 +/- 3.27 (standard deviation) in Group 1 and 17.0 +/- 2.77 in Group 2. Resting pressure of the upper and lower anal sphincter, maximum squeezing pressure, and duration of contraction were not initially different in Groups 1 and 2 but were significantly lower than in the control group of patients without incontinence (n = 12; 8 males, 4 females; mean age, 66.4 years) (P < 0.05). Follow-up duration was 30 months, with intermediate clinical score at 6 months for Group 1. RESULTS After biofeedback therapy, the incontinence score at 30 months was lower in Group 1 (14.43 +/- 6.35 vs. 17.81 +/- 3.27; P < 0.035) and unchanged in Group 2 (18.0 +/- 2.72 vs. 17.0 +/- 2.77). However, in Group 1 the score at 6 months was much lower than at 30 months (6.31 +/- 7.81 vs. 14.43 +/- 6.35; P < 0.001). Only the amplitude of voluntary contraction and upper anal pressure (51.1 (range, 27-90) vs 36.7 (range, 20-80) mmHg) were significantly increased (81.5 (range, 55-120) vs. 62.1 (range, 30-90) mmHg; P < 0.05). CONCLUSION Biofeedback improved continence at 6 months and at 30 months. However, the score at 6 months was much better, suggesting that the initial good results may deteriorate over a long time. These data suggest that it could be useful to reinitiate biofeedback therapy in some patients.
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Gower-Rousseau C, Salomez JL, Dupas JL, Marti R, Nuttens MC, Votte A, Lemahieu M, Lemaire B, Colombel JF, Cortot A. Incidence of inflammatory bowel disease in northern France (1988-1990). Gut 1994; 35:1433-8. [PMID: 7959201 PMCID: PMC1375020 DOI: 10.1136/gut.35.10.1433] [Citation(s) in RCA: 185] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
There were no data concerning the incidence of inflammatory bowel disease (IBD) in France. The aim of this study was to investigate the incidence of Crohn's disease and ulcerative colitis in northern France. This prospective population based study was realised through the gastroenterologists of the region Nord-Pas de Calais and the Somme Department. Each gastroenterologist referred patients consulting for the first time with clinical symptoms compatible with IBD. Data were collected by an interviewer practitioner present at the gastroenterologist's consulting room. Two independent expert gastroenterologists assessed each case in a blind manner and made a final diagnosis of Crohn's disease, ulcerative colitis, ulcerative proctitis, or unclassifiable chronic colitis. From 1988 to 1990, 1291 cases of IBD were recorded: 674 (52%) Crohn's disease, 466 (36%) ulcerative colitis including 162 proctitis (35%), and 151 (12%) unclassifiable chronic colitis. The mean annual incidence was 4.9 per 100,000 for Crohn's disease and 3.2 for ulcerative colitis. The sex ratio F/M was 1.3 for Crohn's disease and 0.8 for ulcerative colitis. The highest age specific incidence rate for Crohn's disease was between 20 and 29 years: 13.1 for women and 9.8 for men. The highest age specific incidence rate for ulcerative colitis was between 20 and 39 years: 5.5 for women and 6.5 for men. This first French prospective study has shown an incidence rate for Crohn's disease comparable with that seen in north European studies but lower than that seen for ulcerative colitis. These results could be related to the different environmental factors or the genetic background of the population studied, or both.
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Affiliation(s)
- C Gower-Rousseau
- Registre des Maladies Inflammatoires du Tube Digestif du Nord-Ouest de la France
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Comes MC, Gower-Rousseau C, Colombel JF, Belaïche J, Van Kruiningen HJ, Nuttens MC, Cortot A. Inflammatory bowel disease in married couples: 10 cases in Nord Pas de Calais region of France and Liège county of Belgium. Gut 1994; 35:1316-8. [PMID: 7959244 PMCID: PMC1375715 DOI: 10.1136/gut.35.9.1316] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Ten pairs of husband-wife couples are reported with inflammatory bowel disease who were seen in the same geographical area in Nord Pas de Calais region of France and in Liège county (Belgium). Among these 10 couples, four were concordant for Crohn's disease, two for ulcerative colitis, and four were discordant. In nine of 10 couples neither spouse had symptoms before marriage but inflammatory bowel disease subsequently developed in both. In one couple, one spouse had Crohn's disease before marriage and the other partner experienced symptoms afterwards. Eighteen children were born to eight of 10 couples. Five of them developed Crohn's disease but four belong to the same family. In all cases the affected children were born to parents who both developed Crohn's disease after they had married and were conceived at a time when parents did not yet have symptoms. It is proposed that this pattern of emergence of inflammatory bowel disease suggests a role for an infectious agent yet to be identified.
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Affiliation(s)
- M C Comes
- Registre des Maladies Inflammatoires du Tube Digestif du Nord Ouest de la France CHRU Lille
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Colombel JF, Gower-Rousseau C, Laurent-Puig P. [Inflammatory bowel diseases: genetic hypothesis]. Acta Gastroenterol Belg 1994; 57:285-91. [PMID: 7709696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- J F Colombel
- MITD du Nord-Ouest de la France, Hôpital Huriez, CHRU Lille
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Hugot JP, Laurent-Puig P, Gower-Rousseau C, Caillat-Zucman S, Beaugerie L, Dupas JL, Van Gossum A, Bonäit-Pellie C, Cortot A, Thomas G. Linkage analyses of chromosome 6 loci, including HLA, in familial aggregations of Crohn disease. G.E.T.A.I.D. Am J Med Genet 1994; 52:207-13. [PMID: 7802010 DOI: 10.1002/ajmg.1320520216] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Segregation analyses of familial aggregations of Crohn disease have provided consistent results pointing to the involvement of a predisposing gene with a recessive mode of inheritance. Although extensively investigated, the role played by human leucocyte antigen (HLA) genes in this inflammatory bowel disease remains elusive and the major histocompatibility complex is a candidate region for the mapping of the Crohn disease susceptibility gene. A total of 25 families with multiple cases of Crohn disease was genotyped for HLA DRB1 and for 16 highly polymorphic loci evenly distributed on chromosome 6. The data were subjected to linkage analysis using the lod score method. Neither individual nor combined lod scores for any family and for any locus tested reached values suggesting linkage or genetic heterogeneity. The Crohn disease predisposing locus was excluded from the whole chromosome 6 with lod scores less than -2. It was excluded from the major histocompatibility complex and from 91% of the chromosome 6 genetic map with lod scores less than -4. The major recessive gene involved in genetic predisposition to Crohn disease does not reside on the major histocompatibility complex nor on any locus mapping to chromosome 6.
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Affiliation(s)
- J P Hugot
- Laboratoire de Génétique des Tumeurs, I.N.S.E.M. CJF 9201, Institut Curie, Paris, France
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Colombel JF, Gower-Rousseau C. [Etiology of Crohn disease. Current data]. Presse Med 1994; 23:558-60. [PMID: 8066056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Both genetic and environmental factors appear to play an aetiologic role in Crohn's disease. The hypothesis of genetic susceptibility is based on the frequency of familial forms (6-33%) and higher relative risk in first degree relatives (x10 to x21). Three genetic segregation analyses have defined a genetic model favouring autosomal recessive transmission and incomplete penetration. The frequency of the deleterious allele would be 0.01 in the general population. One-third of all patients would be homozygous. To date, no genetic marker has been found for Crohn's disease although in one study, molecular biology techniques revealed a significant association between the HLA-DR1, DQW5 genotypes, and the association DR1/DQW5, and Crohn's disease. There are also many arguments in favour of an environmental cause, including: increased incidence since the Second World War, a north-south incidence gradient (established in the US and probable in Europe), predominance in urban areas. In addition, 21 conjugal forms were recently reported in the US, including 14 which appeared after marriage. We have also observed 10 conjugal forms in a limited area in northern France and in Belgium. Smoking has also been shown to have a detrimental effect, perhaps via modifications in the microcirculation of the intestinal wall. Despite contradictory results, oestrogen-progesterone treatment does not appear to increase the risk of Crohn's disease and there is no convincing evidence that any particular food could be incriminated. In contradiction with a widely believed myth, there is no evidence showing that psychiatric factors have an effect on appearance or aggravation of the disease. Perinatal infection has however been recently shown to affect incidence and subjects born during periods of flu epidemics have a higher relative risk. Still other studies have emphasized the dual role of genetic/environmental factors. Based on current knowledge, the sequence leading to the appearance of Crohn's disease would include one or more perinatal event(s) such as viral infection acting on a genetically susceptible subject and leading to modified immune response in a vulnerable system (perinatal period). Later in life an aggression (environment) would lead to inappropriate immune response. Current research is directed towards identifying infectious agents capable of triggering the disease and on markers of genetic susceptibility.
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Gower-Rousseau C, Reumaux D, Bellard M, Delecourt L, Ribet M, Colombel JF. Remission of myasthenia gravis after proctocolectomy in a patient with ulcerative colitis. Am J Gastroenterol 1993; 88:1136-8. [PMID: 8317426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Cortot A, Colombel J, Gower-Rousseau C. Epidémiologie et génétique des maladies inflammatoires cryptogénétiques. Med Sci (Paris) 1993. [DOI: 10.4267/10608/3006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Gower-Rousseau C, Maunoury V, Colombel JF, Coulom P, Piette F, Cortot A, Paris JC. Hidradenitis suppurativa and Crohn's disease in two families: a significant association? Am J Gastroenterol 1992; 87:928. [PMID: 1615957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Gower-Rousseau C, Guillemot F, Chiche A, Pruvost FR, Adenis A, Paris JC, Cortot A. Thromboembolism as the first symptom of Menetrier's disease. Am J Gastroenterol 1992; 87:681-2. [PMID: 1595668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Cortot A, Gower-Rousseau C, Colombel JF. [Epidemiology and genetics of inflammatory bowel diseases]. Rev Prat 1991; 41:393-6. [PMID: 2011685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Inflammatory bowel diseases (IBDs) have been reported throughout the world, but their frequency is highest in Northern Europe and the USA. The mean incidence of ulcerative colitis (UC) is 6/10(5) inhabitants, and that of Crohn's disease (CD) is 4/10(5) inhabitants. IBDs occur in young adults, especially Crohn's disease which reaches a peak of incidence between the ages of 20 and 30 years. Among possible factors influencing their incidence, only tobacco smoking has been shown to facilitate the acute episodes and relapses of CD and to diminish those of UC. The frequency of familial IBDs, which mainly affects first degree relatives, varies from 6.1 to 35.8%. A genetic component is present and probably more important for CD than for UC, although no genetic marker has yet been identified.
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Dupas J, Colombel J, Cortot A, Salomez J, Marti R, Gower-Rousseau C, Votte A, Lemaaire B, Paris J. Incidence des maladies inflammatoires du tube digestif dans la région Nord-Pas-de-Calais et le département de la Somme. Rev Med Interne 1990. [DOI: 10.1016/s0248-8663(05)81731-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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