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C Cuvelier

Publications and source records attributed to C Cuvelier.

116 records · Page 7Linked to original sources

Idiopathic inflammatory bowel diseases: immunological hypothesis.

Circumstantial evidence indicates that immunological mechanisms are important in the pathogenesis of inflammatory bowel diseases. In Crohn's disease lesions the naive T cells are reduced and memory T cells are increased in number. Colonocytes of normal mucosa do not express MHC class II molecules but aberrant HLA-DR expression is induced in inflammatory conditions. Also in ileal epithelial cells there is increased MHC class II molecules expression suggesting augmented antigen presentation. Once the initiating event (environmental, dietary, infectious or enterobacterial products) has activated inflammatory cells, an auto-amplifying inflammatory immune cascade is induced by numerous agents such as cytokines, transforming growth factors, leukotrienes, prostaglandins and other mediators. Tissue injury may be caused by oxygen free radicals generated by neutrophils and macrophages. The inflammatory process can be perpetuated by a persistent antigenic stimulus or alternatively, by abnormal regulation of immune and inflammatory responses. This can mean exaggerated activation of inflammatory responses to "normal" stimuli or defective feedback mechanisms of down-regulation. The early lesions of inflammatory bowel disease are patchy necrosis of the surface epithelium, focal accumulations of leukocytes adjacent to crypts and an increased number of intraepithelial lymphocytes. In Crohn's disease the earliest lesions are aphthoid ulcers overlying lymphoid follicles in the terminal ileum. In patients with spondylarthropathy and asymptomatic intestinal inflammation we demonstrated lesions in the top of the follicle associated epithelium. The changes consist of increase in number of membranous (M) epithelial cells, ruptures, fissures and perforations of M cells. Aphthoid ulcers that may occur in the entire gastrointestinal tract are typically found at the M cell level.(ABSTRACT TRUNCATED AT 250 WORDS)

Colitis, Ulcerative↗

Fundic gland polyps: three other case reports suggesting a possible association with acid suppressing therapy.

We describe three patients who developed fundic gland polyps after starting a treatment with acid suppressive agents. All three patients were treated for a long time with H2-blockers or proton pump inhibiting agents for reflux oesophagitis. In one patient the fundic gland polyps disappeared after discontinuation of the acid suppressing therapy. A possible causal role of these agents is suggested. A review of the literature about fundic gland polyps and their possible association with acid suppressive therapy and a short review about proton pump inhibiting agents and the appearance of gastric polyps in general is given.

Aged↗

Altered expression of alpha E beta 7 integrin on intra-epithelial and lamina propria lymphocytes in patients with Crohn's disease.

OBJECTIVE: To compare the expression of adhesion molecules on intestinal intra-epithelial (IEL) and lamina propria T cells (LPL) from ileum and colon, in patients with Crohn's disease (CD) versus healthy controls, with special reference for the alpha E beta 7 integrin. METHODS: IEL and LPL were obtained from 18 CD patients and 20 controls by enzymatic extraction, and subsequently characterized by flow cytometry for CD3, CD4, CD8, CD25, LFA-1 alpha (CD11a), CD44, alpha 4 and alpha E beta 7 integrin. RESULTS: In LPL of controls, a decreased CD4/CD8 ratio was noted in ileum compared to colon. This regional difference was accompanied by a higher expression of alpha E beta 7 integrin in ileum versus colon. In LPL from left hemicolon of CD patients, a decreased CD4/CD8 ratio was noted versus controls. alpha E beta 7 expression on T cells of LPL did not discriminate CD from controls. However, an overexpression of this beta 7 integrin member was observed on CD25+ T cell subsets from lamina propria of left hemicolon, in CD versus controls. Moreover, in IEL, profound alterations in alpha E beta 7 integrin were observed in CD, compared to controls. A decreased expression of alpha E beta 7 was noted in IEL of ileum of CD patients. This was also apparent in non-inflamed mucosa. CONCLUSION: The observed changes of alpha E beta 7 integrin expression in CD patients versus controls are of pathogenic relevance, especially the decreased expression of alpha E beta 7 in IEL of non-inflamed CD mucosa. This may be one of the earliest events in the pathogenesis of this disease.

Adolescent↗

Prolactin and colorectal cancer: is there a connection?

UNLABELLED: The purpose of this study was to confirm the reported incidence of hyperprolactinemia in colorectal cancer and to find further evidence for an ectopic prolactin production by the tumor. MATERIAL AND METHOD: Thirty two consecutive patients with an adenocarcinoma of the colon (n = 17) or the rectum (n = 15) were included. Preoperative serum prolactin concentrations were determined and correlated with CEA concentrations and tumor stages. To exclude an ectopic production by the colon cancer, prolactin concentrations were determined during the operation, in the peripheral blood and in the efferent venous drainage area of the tumor. After resection, immunohistochemical staining for prolactin was made in all resected tumors. RESULTS: In all except two patients with a rectal cancer, preoperative plasma prolactin concentrations were normal. Peroperative serum concentrations of prolactin were high in all patients. No significant gradient was found between the peripheral venous concentration and the local venous concentration in the drainage area of the tumor. Immunohistochemical staining for prolactin was positive in only one rectal cancer. Finally, no correlation was found between plasma prolactin concentrations and tumor stages or CEA concentrations. CONCLUSION: Our results do not support the hypothesis of an ectopic prolactin production by colon adenocarcinoma. Only in a subgroup of rectal cancers, an ectopic prolactin production remains probable. At present, prolactin cannot be recommended as a tumor marker in colorectal cancer.

Adenocarcinoma↗