Publications (4)9.29 Total impact
-
Article: Why are genetics important for nutrition? Lessons from epigenetic research.
[show abstract] [hide abstract]
ABSTRACT: Marked advances were made over the last decade in deciphering the molecular mechanisms on how external, nutritional factors can impact on the regulation of genes and ultimately their function without modification of the genetic code. This field of nutrigenomic research is literally exploding. With the understanding of epigenetic control mechanisms, such as DNA methylation, histone acetylation, methylation or phosphorylation, as well as the posttranscriptional regulation of gene expression via non-coding microRNA, many different experimental and analytic approaches were possible to elucidate how varying nutritional support might impact on specific functions, with short- and potently long-term effects. This review highlights the major principles of epigenetic control mechanisms and their link to particular nutritional influences. Epidemiological data, such as the Dutch famine studies, suggest that targeted nutritional intervention might be causative for long-term effects on health, such as the increased risk of cardiovascular diseases and metabolic syndrome in this cohort. However, to date most of the knowledge comes from experimental and animal data, which cannot be easily transferred to human situations. It is anticipated that within the next few years, major advances will be made to translate this knowledge of nutritional intervention on gene regulation and expression into health preventive programs.Annals of Nutrition and Metabolism 01/2012; 60 Suppl 3:38-43. · 2.26 Impact Factor -
Article: Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study.
[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to evaluate if the use of antitransglutaminase (tTG) and antiendomysium (EM) antibodies has modified the profile of coeliac disease (CD) in children. Retrospective cohort study. Monocentric study, in one major tertiary centre in Paris. Two cohorts of patients were compared; the first included patients before the use of antibodies, and the second included patients after the use of antibodies. All patients from the same physician diagnosed with a CD between 1976 and 1992 (historical cohort), and between 1994 and 2007, were included in the study. 56 patients were included in the historical cohort, 59 in the recent cohort. PRIMARY AND SECONDARY OUTCOME MEASURES: Clinical, biological and histological profiles at diagnosis have been studied. The recent cohort diagnosis of CD was based in 27% on a systematic screening (type I diabetes, n=10; CD in siblings, n=6). On comparison of CD patients in the historical to the recent cohort, the following significant differences were observed: Median age at diagnosis increased from 1 year to 2.7 years (p<0.0001). Patients in the historical cohort had more gastrointestinal symptoms (93% vs 63%, p=0.0001) and failure to thrive (98% vs 80%, p=0.0025). Nutritional deficiencies and morphological lesions were more severe in the historical cohort (90% subtotal or total villous atrophy vs 51%, p<0.0001). Differences observed between the two cohorts were mainly due to the presence of screened patients. A new type of patients, with a paucisymptomatic or asymptomatic CD, has been identified using serological tests. Silent disease has been diagnosed by screening in a target population. In the other patients of the recent cohort, symptoms were similar but less severe than those observed before. Long-term risks of untreated silent CD are not well determined as yet, and have to be evaluated in prospective studies.BMJ open. 01/2012; 2(6). -
Article: Tolerance and efficacy of azathioprine in pediatric Crohn's disease.
[show abstract] [hide abstract]
ABSTRACT: Thiopurines are considered first-line immunomodulators for the prevention of relapse in moderate to severe pediatric Crohn's disease (CD). Early introduction of thiopurines was shown in a pediatric trial to maintain steroid-free remission in 90% of patients for 18 months. In the present study we analyzed the tolerance and efficacy of azathioprine (AZA) to maintain remission in a homogenous single-center observational cohort of children with CD. In all, 105 pediatric CD patients (male/female 68/37) were retrospectively evaluated for the efficacy of AZA (doses 1.4-4 mg/kg) to maintain remission at 6, 12, 18, and 24 months of follow-up. Overall, 93 children were included with active disease (pediatric Crohn's disease activity index [PCDAI] >30), steroid/enteral-nutrition dependency, or postileocecal resection. Remission was defined as PCDAI ≤10 without steroids. Patients requiring antitumor necrosis factor (TNF) medication, other immunomodulators, or surgery were considered to experience a relapse. Based on PCDAI, steroid-free remission was achieved in 56/93 (60.2%), 37/93 (39.8%), 31/93 (33.3%), and 29/93 (31.2%) at visits month (M)6, M12, M18, and M24, respectively. Within the first 4 weeks, AZA was stopped in 10/93 patients due to adverse reactions (pancreatitis, nausea, vomiting, skin reactions, general weakness), or not introduced due to low thiopurine methyl transferase (TPMT) activity (n = 3). No neutropenia occurred in patients with normal TPMT activity. Three infectious episodes were documented requiring temporary AZA suspension. AZA is efficacious in maintaining remission in pediatric CD patients, but to a lesser extent than previously suggested. The majority of patients who are in steroid-free remission at 12 months remained in prolonged remission. Overall tolerance of AZA was excellent.Inflammatory Bowel Diseases 10/2011; 17(10):2138-43. · 4.86 Impact Factor -
Article: Monitoring of anti-transglutaminase autoantibodies in pediatric celiac disease using a sensitive radiobinding assay.
[show abstract] [hide abstract]
ABSTRACT: The diagnosis of celiac disease (CD) is based on the histological identification of gluten-sensitive enteropathy and detection of anti-tissue transglutaminase antibodies (tTGA) and/or endomysial antibodies. Serial measurements of tTGA are now recommended as a follow-up strategy to monitor compliance with a gluten-free diet (GFD). We evaluated the performances of a quantitative radiobinding assay (RBA) of tTGA immunoglobulin A at diagnosis and during monitoring of GFD in pediatric CD. Eighty children with confirmed CD were selected. Levels of serum tTGA measured by RBA and a commercial enzyme-linked immunosorbent assay (ELISA) were compared at diagnosis. The relation between RBA-tTGA levels and histological damage was analyzed, as well as the time course of tTGA clearance during GFD. Both RBA and ELISA showed high sensitivity and specificity for tTGA detection at diagnosis. There was no relation between RBA-tTGA levels at diagnosis and severity of mucosal damage. Upon initiation of GFD, the rate of RBA-tTGA positivity declined slower than that of endomysial antibodies positivity, with >50% of the children still tTGA positive at year 5; however, tTGA levels decreased rapidly during the first year of GFD and more slowly thereafter. Children who seroreverted had lower tTGA levels at diagnosis (2080±1554 cpm) than those who remained tTGA positive throughout follow-up (3688±1435 cpm). The high sensitivity of RBA is likely responsible for higher tTGA positivity rates during GFD than previously reported with ELISA. A decreasing trend for tTGA levels may represent a better surrogate marker of compliance with GFD than absolute normal tTGA levels.Journal of pediatric gastroenterology and nutrition 09/2011; 54(3):392-6. · 2.18 Impact Factor
Top Journals
Institutions
-
2012
-
Université Paris Descartes
Paris, Ile-de-France, France
-