Small bowel epithelial gaps and intestinal permeability in Crohnʼs disease
Notice bibliographique
Résumé
Crohn's disease is a chronic relapsing condition characterized by patchy inflammation anywhere along the alimentary tract from mouth to anus. It affects the mucosal barrier in genetically susceptible individuals with a defect in the innate immune response resulting in chronic activation of the adaptive immunity in the intestine. Loss of epithelial cells can be induced by pro-inflammatory cytokines or may be a primary defect and has been shown to precede inflammatory reactions in the intestinal wall. Therefore, epithelial cell shedding may promote chronic intestinal inflammation and epithelial ulceration under certain conditions. We hypothesize that epithelial cell shedding is increased in patients with Crohn's disease, and contribute to abnormal intestinal permeability. In this study, we quantified the epithelial gaps and epithelial cells seen on confocal endomicroscopy (CEM) imaging of patients with Crohn's disease compared to controls. Intestinal permeability was also measured in these patients. The study cohort of Crohn's disease patients undergoing routine colonoscopy were on maintenance therapy with immunosuppressives or oral 5-ASA compounds. The controls were patients undergoing screening colonoscopy for colon cancer without any gastrointestinal (GI) symptoms or history of chronic GI disorders. Both cohorts had small intestinal permeability determined with a lactulose/mannitol test. CEM was performed using the Cellvizio confocal Gastroflex miniprobes immediately after the intestinal permeability assay. Subjects were imaged with CEM by a single, blinded endoscopist following a standardized method. After intravenous administration of fluorescein to enhance imaging, serial confocal images of the terminal ileum were recorded in all patients at the same location;10 cm proximal to the ileocecal valve. An anti-spasmotic agent (glucagon) was used whenever necessary to reduce movement artifacts. The experimental cohort consisted of 6 controls (2 M; mean age = 58 ± 14 yrs) and 8 active and inactive Crohn's patients (5 M; mean age = 44 ± 15 yrs). Adequately imaged villi, defined as villi with 75% surface area visualized in the CEM images, were used for analysis. Gaps were ascertained in at least three different sequential images. Ten villi from each patient were manually counted for the number of epithelial cells and gaps. The gap density was defined as the number of gaps divided by the number of cells counted in the 10 adequately imaged villi (gap density = gaps/cells). The gap density (mean ± standard error) was 17.70 ± 5.64 gaps/1000 cells for controls and 117.30 ± 32.90 gaps/1000 cells for Crohn's disease patients (p= 0.001). Adherent bacteria were not observed in the epithelial gaps of controls, whereas they were seen in the gaps of 2 Crohn's disease patients. The lactulose/mannitol ratio was 0.014 ± 0.0027 for controls and 0.020 ± 0.0027 for Crohn's patients (p= 0.15). The epithelial gap density is significantly higher for patients with Crohn's disease compared to healthy non-IBD controls. This is associated with slightly increased permeability in these patients, however, increased patient numbers are needed to evaluate the strength of this relationship.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».