Maud Brung-Lefebvre

Centre Hospitalier Universitaire Rouen, Rouen, Upper Normandy, France

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Publications (4)15.91 Total impact

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    ABSTRACT: Our aim was to study the 5-HT3 antagonist, ondansetron, on gastric motility changes induced by duodenal infusion of nutrients. First, the effects of a 2-hr intraduodenal infusion (IDI) of a caloric diet on antral motility were assessed. Second, a crossed-over placebo-controlled study assessed 3-day oral intake of ondansetron (8 mg bid) on gastric motility changes induced by the IDI. During the IDI, antral numbers of waves (NW) as area under curve (AUC) were lower than fasting values. After infusion, antral NW and AUC increased to return to basal values. The antral area increased slightly shortly after the start of the IDI, then remained stable. When subjects received ondansetron, the only significant motor effect was a higher antral NW and AUC during the first 30 min of the IDI (P < 0.05). After the end of the IDI, the AUC and NW increased in both the distal and the proximal antrum. The increase was lower by ondansetron in the proximal antrum. Proximal stomach relaxation induced was not influenced by ondansetron. In conclusion, an IDI of nutrients decreased antral motility, increased the antral area, and promoted fundic relaxation. This inhibitory effect was rapidly reversible. Ondansetron induced only minor motility changes in the antrum and had no effect on fundic relaxation promoted by IDI.
    No preview · Article · Nov 2007 · Digestive Diseases and Sciences
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    ABSTRACT: To investigate the glutathione concentrations in gastric mucosa from patients with acute gastric bleeding related to nonsteroidal anti-inflammatory drugs (NSAIDs), and to test the influence of nutritional status on mucosal glutathione. Glutathione protects the gastrointestinal mucosa against reactive oxygen species, and glutathione content in various tissues may be depleted during malnutrition. Endoscopic biopsies were obtained from 39 patients. Eighteen of these (9 well-nourished, 9 malnourished) presented with gastric bleeding ulcers related to NSAIDs. Twenty-one other patients (12 well-nourished, 9 malnourished) underwent normal routine diagnostic endoscopy and served as controls. Malnutrition was defined as a loss of over 10% of normal body weight and/or plasma albumin levels below 30 g/l. Gastric biopsies were taken from the fundus and antrum (controls) and from the region of the ulcer (patients with acute bleeding) and frozen quickly until glutathione analysis by high-performance liquid chromatography (HPLC) coulometric detection. Results were expressed as nmol/mg wet tissue. Gastric mucosal glutathione levels were significantly (P < 0.05) lower in both the antrum (0.81 +/- 0.34 v. 1.41 +/- 0.88 nmol/mg tissue) and the fundus (1.04 +/- 0.54 v. 1.43 +/- 0.92 nmol/mg tissue, P < 0.05) in malnourished than in well-nourished control patients. Glutathione mucosal concentrations were decreased significantly in patients with NSAID-induced gastric bleeding compared with control patients (0.38 +/- 0.36 v. 1.12 +/- 0.56 nmol/mg tissue, P < 0.001), and the lowest glutathione levels were observed in malnourished patients (0.28 +/- 0.20 v. 0.48 +/- 0.15 nmol/mg tissue in well-nourished patients, not significant). Malnutrition is associated with low levels of gastric glutathione. This may contribute to the severity and the onset of haemorrhage in NSAID-induced gastric ulcers.
    No preview · Article · Nov 2001 · European Journal of Gastroenterology & Hepatology
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    ABSTRACT: OBJECTIVES: The pathophysiology of pouchitis occurring after ileal pouch–anal anastomosis remains controversial. Prostaglandins and nitric oxide synthesized in excess by cyclooxygenase-2 and nitric oxide synthase-2 are thought to be involved in the inflammatory process. Because heme oxygenase-1, by its antioxidant properties, could modulate inflammatory reaction, we analyzed mRNAs of the three enzymes (cyclooxygenase-2, nitric oxide synthase-2, and heme oxygenase-1) in patients with ileal pouch–anal anastomosis.
    Preview · Article · Jun 2001 · The American Journal of Gastroenterology
  • Moïse Coeffier · Maud Brung-Lefebvre · Pierre Déchelotte
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    ABSTRACT: During intestinal insufficiency, improving intestinal functions may limit the needs for prolonged parenteral nutrition. Gut trophicity is supported by the intake of nutrients, polyamines, and nitrogenous pharmaconutrients such as glutamine, arginine and ornithine oxoglurate, but also growth factors acting as hormones or locally. Intestinal cell proliferation is stimulated by growth hormone and glucagonlike peptide-2, as well as by the insulin growth factor, epidermal growth factor, transforming growth factor-alpha, while it is inhibited by transforming growth factor-beta. The evaluation of combined therapies with glutamine, growth hormone and a specialized diet in short bowel patients has yielded conflicting results. The clinical use of GLP-2, alone or in combination, looks promising but need to be evaluated. The knowledge about intestinal growth factors and pharmaconutrients is increasing rapidly and should lead to innovative therapeutic strategies of intestinal insufficiency.
    No preview · Article · Dec 2000 · Nutrition Clinique et Métabolisme