Le cytomégalovirus et les maladies inflammatoires cryptogénétiques de l’intestin

Pofelski, Joanna; Héluwaert, Frédéric; Roblin, Xavier; Morand, Patrice; Gratacap, B.; Germain, Emmanuel; Brion, Jean‐Paul; Salon, Caroline; Bonaz, Bruno

doi:10.1016/s0399-8320(07)89376-6

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…The small number of subjects enrolled (63 IBD patients) could account for the low positive rate in the Indian study. Another research done in France showed 60% positive rate in IBD patients [18], which was consistent with our research. In developed countries, the anti-CMV IgG positive rate was found to be above 70% [19].…”

Section: Discussionsupporting

confidence: 93%

The prevalence and risk factors of cytomegalovirus infection in inflammatory bowel disease in Wuhan, Central China

Zhao²,

Luckheeram³

et al. 2013

Virol J

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BackgroundThe etiology of inflammatory bowel disease (IBD) is not clear and cytomegalovirus (CMV) infection is often associated with IBD patients. The etiologic link between IBD and CMV infection needs to be studied. The objective of the present study is to investigate the prevalence and risk factors of CMV in a cohort of IBD patients from Central China.MethodsTwo hundred and twenty six IBD patients (189 ulcerative colitis (UC) and 37 patients with Crohn’s disease (CD)), and 290 age and sex matched healthy controls were recruited. CMV DNA was detected by nested PCR, while serum anti-CMV IgG and anti-CMV IgM was determined by ELISAs. Colonoscopy/enteroscopy with biopsy of diseased tissues and subsequent H&E stain were then conducted in IBD patients with positive anti-CMV IgM. Finally, we analyzed the prevalence and clinical risk factors of CMV infection in IBD patients.ResultsThe prevalence of CMV DNA and anti-CMV IgG positive rate in IBD patients were 84.07% and 76.11%, respectively, higher than those in healthy controls (59.66% and 50.69%, respectively, P < 0.05), However, anti-CMV IgM positive rate was no different with healthy controls (1.77% vs 0.34%, P = 0.235). In univariate analysis of risk factors, the recent use of corticosteroid was associated with increase of CMV DNA and IgM positive rate in UC (P = 0.035 and P = 0.015, respectively), aminosalicylic acid drug therapy was correlated with positivity of CMV DNA and IgG in UC and CMV DNA in CD (P = 0.041, P < 0.001 and P = 0.014, respectively), the treatment of immunosuppresent was correlated with CMV IgM (P < 0.001). Furthermore, patients with severe UC were significantly associated with CMV DNA and IgM (P = 0.048 and P = 0.031, respectively). Malnutrition (albumin < 35 G/L) was also found to be related with CMV recent infection (P = 0.031). In multivariate analysis of risk factors in UC, pancolitis was significantly associated with CMV DNA positivity (P = 0.001). Severe UC and pancolitis seemed to be related with IgG positivity. For CD, there was just single factor associated with CMV positive in each group, multivariate analysis was unnecessary.ConclusionsCMV positive rate in IBD patients was significantly higher, than in healthy controls. The use of aminosalicylic acid, corticosteroid, immunosuppressants, pancolitis and severe IBD patients seemed to be more susceptible to CMV infection in univariate analysis of risk factors. However, no risk factor was found to be significantly correlated with CMV infection in multivariate analysis of risk factors.

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Section: Discussionsupporting

confidence: 93%

The prevalence and risk factors of cytomegalovirus infection in inflammatory bowel disease in Wuhan, Central China

Zhao²,

Luckheeram³

et al. 2013

Virol J

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“…Kambham [18] obtained a similar result, using HE and ICH on colonoscopic biopsy specimens, detecting CMV in 4 of 15 steroid-resistant patients (26%). Pofelsky [19] , using PCR, showed a higher prevalence (60%) compared to previous reports, and an overall prevalence of viral DNA in the colon of 38%. However, there was a poor correlation between colonic and peripheral viral load which suggests a role of local inflammation in the colon.…”

Section: Patient Selection Methodscontrasting

confidence: 59%

Cytomegalovirus and inflammatory bowel disease: Is there a link?

Criscuoli¹,

Rizzuto²,

Cottone³

2006

WJG

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The objective of this report is to give an overall view of the epidemiological, clinical, diagnostic and therapeutic features of Cytomegalovirus (CMV) infection in inflammatory bowel disease (IBD). A review of published reports on this topic was carried out, with particular attention paid to the selection of patients included in studies and the diagnostic methods employed. CMV is frequently associated with IBD. In some cases, CMV infection is associated with a poor outcome but it is not clear which patients are more likely to be affected and in which stage of the disease. The use of anti-viral therapy in IBD is controversial and an empirical study with controls is needed. The natural history of CMV infection related to the development and treatment of IBD has not been clarified but it is important to take it in consideration because of the possibility of viral persistence in the immunocompromised host and viral interaction with the immune system. family, which includes Epstein -Barr virus (EBV), Herpes Simplex virus tipes1 and 2 (HSV-1,2), Varicella-Zoster virus, and Human Herpes virus types 6 and 7 (HHV-6,7). Similar to infection with other viruses in the family, primary infection with CMV results in the establishment of a persistent or latent infection, due to the ability of the virus to remain integrated in the DNA of host cells. The sign of a viral infection is a cytopathic effect shown by the presence of large nuclear and cytoplasmic inclusions, represented by aggregates of replicating CMV nucleoprotein cores. To avoid recognition and destruction by CD8+T lymphocytes, the virus develops the ability to evade the immune system by several mechanisms. CMV produces some proteins, such as US2, US3 and US11, that inhibit the presentation of viral antigens to T cells, blocking the class I MHC in the endoplasmic reticulum or in the cytosol. It also produces homologues to class I MHC proteins and may compete for binding and presentation of viral antigens. Once the viral DNA remains undisturbed in the infected cells, subsequent reactivation can occur in response to several stimuli, such as immunosuppressant therapy or chemotherapy [1] . The down-regulation of the cell surface markers acts on interferon-alpha/beta dependent responses by affecting several levels of IFN signal transduction and a transcription activation pathway. CMV infection leads to the activation of Nuclear Factor kappa B (NF-kB) and its translocation to the nucleus, promoting the expression of cytokines, chemokines and cellular adhesion molecules. These mechanisms are also present in inflammatory bowel disease (IBD) where there is activation of several pro-inflammatory cytokines (such as IFN-gamma), the transcription of which is regulated through nuclear transcription factors (such as Nuclear Factor kappa B) and through a signal transducer and activator of transcription (STAT family). CMV aND IBDThe role of CMV in IBD is reviewed considering the following issues: diagnostic methods to detect the virus, prevalence of CMV in IBD according to pa...

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“…Ce patient a initialement eu une colite aiguë. La surinfection à CMV, de loin la plus fréquente au cours des MICI [6] a pu être éliminée chez notre patient devant l'absence d'inclusion virale colique donnant l'aspect caractéristique en « oeil de hibou », une immunohistochimie et une PCR coliques négatives. Souvent, c'est l'évolution dans le temps qui permet de rectifier le diagnostic [4].…”

Section: Discussionunclassified

Une infection herpétique colique dans le tableau initial d’une rectocolite hémorragique : difficultés diagnostiques

et al. 2010

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Le cytomégalovirus et les maladies inflammatoires cryptogénétiques de l’intestin

Cited by 7 publications

References 17 publications

The prevalence and risk factors of cytomegalovirus infection in inflammatory bowel disease in Wuhan, Central China

The prevalence and risk factors of cytomegalovirus infection in inflammatory bowel disease in Wuhan, Central China

Cytomegalovirus and inflammatory bowel disease: Is there a link?

Une infection herpétique colique dans le tableau initial d’une rectocolite hémorragique : difficultés diagnostiques

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