Publications of Jean-Philippe LOLY
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See detailMesenchymal Stem Cell Injection in Crohn's Disease Strictures: a phase I-II clinical study
VIEUJEAN, Sophie ULiege; LOLY, Jean-Philippe ULiege; BOUTAFFALA, Layla ULiege et al

in Journal of Crohn's and Colitis (2021)

Background and aim: Mesenchymal stem cells (MSCs) have anti-inflammatory and anti-fibrotic properties and could be a potential therapy for Crohn's Disease (CD) strictures. In this phase I-II pilot trial ... [more ▼]

Background and aim: Mesenchymal stem cells (MSCs) have anti-inflammatory and anti-fibrotic properties and could be a potential therapy for Crohn's Disease (CD) strictures. In this phase I-II pilot trial, we assessed safety and efficacy of local MSC injection to treat CD strictures. Methods: CD patients with a short (less than 5 cm in length) non-passable stricture accessible by ileocolonoscopy were included. Allogenic bone-marrow derived MSCs were injected in the 4 quadrants of the stricture. Adverse events and clinical scores were evaluated at each followup visit while endoscopy and magnetic resonance enterography were performed at baseline, week (W)12 and W48. The main judgement criterion for efficacy was the complete (defined by the ability to pass the ileocolonoscope) or partial (defined by a diameter increase) resolution of the stricture at W12. Second efficacy criteria included assessment of the stricture at W48 and evolution of clinical scores at W12 and W48. Results: We performed 11 MSC injections in 10 CD patients (3 primary and 7 anastomotic strictures; 1 stricture injected twice). MSC injections were well tolerated but 4 hospitalizations for occlusion were reported. At W12, 5 patients presented a complete or partial resolution of the stricture (2 complete and 3 partial). Seven patients were re-evaluated at W48 (1 dilated, 1 operated, and 1 lost to follow-up) and 4 patients had a complete resolution. The evolution of clinical scores between W0, W12 and W48 was not statistically significant. Conclusion: MSCs injection in CD stricture was well tolerated and may offer a benefit. [less ▲]

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See detailCholangite obstructive chez un patient atteint d’une hydatidose.
Basbous, C; Hayette, Marie-Pierre ULiege; LEONARD, Philippe ULiege et al

in Revue medicale de Liege (2021), 76(7-8), 575-578

The authors report the case of a 41-year-old patient originating from Algeria who developed obstructive cholangitis caused by the membrane of a ruptured hydatid cyst leading to the diagnosis of cystic ... [more ▼]

The authors report the case of a 41-year-old patient originating from Algeria who developed obstructive cholangitis caused by the membrane of a ruptured hydatid cyst leading to the diagnosis of cystic echinococcosis. Cystic echinococcosis can be asymptomatic for several years until a complication occurs, such as in this case an obstruction of the common bile duct, or cholangio-hydatidosis. This cause of jaundice is uncommon in Western Europe whereas it is more frequent in endemic areas. Identification and treatment of ruptured cysts are mandatory because of the mortality rate of these complications if left untreated. In this particular case, the treatment by endoscopic retrograde cholangiopancreatography was successful. [less ▲]

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See detailLocal Mesenchymal Stem Cells injection in Crohn’s disease strictures: a phase I-II, open-label clinical study
VIEUJEAN, Sophie ULiege; LOLY, Jean-Philippe ULiege; BOUTAFFALA, Layla ULiege et al

Poster (2021, July)

Background and aim: Intestinal fibrosis is a common complication of Crohn's disease (CD) leading to progressive bowel stricture formation. Mesenchymal stem cells (MSCs), known for their immunomodulatory ... [more ▼]

Background and aim: Intestinal fibrosis is a common complication of Crohn's disease (CD) leading to progressive bowel stricture formation. Mesenchymal stem cells (MSCs), known for their immunomodulatory, anti-inflammatory and anti-fibrotic properties, could be a potential therapy in this frequently fibro-inflammatory condition. In this phase I–II open-label pilot trial, we aimed to assess safety and efficacy of local MSCs injection in CD strictures. Methods: CD patients with a non-passable stricture, length from 2 to 5 cm, accessible by ileocolonoscopy, but without intestinal obstruction, fistulas, or abscess, could be included. A total of 3X107 allogenic bone-marrow derived MSCs were equally injected in the 4 quadrants of the strictured bowel wall during an ileocolonoscopy. Adverse events and clinical scores (Crohn Disease Activity Index, Short Health Scale and Crohn Disease Obstructive Score) were evaluated at each follow-up visit (at week 4, 12, 24 and 48) while endoscopy was performed at baseline, W12 and W48. The main judgement criteria for efficacy was the complete (defined by the ability to pass the ileocolonoscope) or partial (defined by a diameter increase) resolution of the stricture at 12 weeks. Other efficacy criteria included complete or partial resolution of the stricture at 48 weeks as well as the evolution of clinical scores between weeks 0, 12 and 48. Results: Between 2018 and 2020, we performed 11 local MSCs injections in 10 CD patients (6 female; aged to 38-65 years; median 45 years old; 70% were smoker). The strictures’ (3 primary, 7 anastomotic) location was as follows: 7 at an ileo-colonic or ileo-rectal anastomosis, 1 colonic and 2 of the ileocecal valve. MSCs injections were well tolerated but a total of 5 hospitalizations for occlusion were reported (2 secondary to a different stricture than the injected one) leading to a surgical resection for one patient and an endoscopic dilatation for another one. Neither intestinal perforation nor intra-abdominal fistula or abscess was reported. At 12 weeks, 5 patients (45%) presented a stricture improvement with a complete resolution for 2 and a partial resolution for 3. Of the 11 MSCs injections, 6 strictures were re-evaluated at week 48 (2 patients still undergoing follow-up, 1 operated, 1 dilated, and 1 lost to follow-up), 4 patients had a complete resolution and 1 had a partial resolution. The evolution of clinical scores between weeks 0, 12 and 48 (Figure 1) was not statistically significant. Conclusion: Local MSCs injection in non-passable CD stricture was well tolerated over the short term but several occlusions were reported in the follow-up. Combining the effects of MSCs with the proven effect of endoscopic balloon dilatation could possibly improve the outcome of CD stricture. [less ▲]

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See detailLe piège diagnostic de La pancréatite aiguë sans augmentation des enzymes pancréatiques
DEMNATI, Cyrine; LOLY, Jean-Philippe ULiege; PAQUOT, Nicolas ULiege

in Revue Médicale de Liège (2020), 75(7-8), 521-523

We report the case of a patient admitted in emergency care for abdominal pain and whose biological assessment did not show any increase in pancreatic enzymes. The abdominal CT scan revealed pancreatitis ... [more ▼]

We report the case of a patient admitted in emergency care for abdominal pain and whose biological assessment did not show any increase in pancreatic enzymes. The abdominal CT scan revealed pancreatitis of grade E according to the Balthazar radiological score. A diagnosis of acute necrotic pancreatitis secondary to hypertriglyceridemia was thus made. In cases of acute pancreatitis, the rate of pancreatic enzymes may rarely be normal for unclear reasons. In the case of an evocative clinical presentation, the diagnosis of acute pancreatitis cannot be ruled out on the basis of this normal dosage. A CT scan of the pancreas is then indicated to confirm the diagnosis. [less ▲]

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See detailRisques néoplasiques majorés dans la rectocolite ulcéro-hémorragique associée à la cholangite sclérosante primitive.
Kouam, C.; WARLING, Odile ULiege; VAN KEMSEKE, Catherine ULiege et al

in Revue medicale de Liege (2020), 75(11), 724-730

Ulcerative ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by the presence of continuous, uniform, gapless lesions of healthy mucous membrane extending integrally from the ... [more ▼]

Ulcerative ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by the presence of continuous, uniform, gapless lesions of healthy mucous membrane extending integrally from the anus over a variable portion of the colon. It is a multisystemic pathology for which we will describe one of its hepatic manifestations, primary sclerosing cholangitis (PSC). We present here the story of a patient, a carrier of the Breast Cancer type 1 gene mutation (BRCA1), who initially presented with epigastric and peri-umbilical abdominal pain associated with several episodes of bloody diarrhea. The initial assessment made it possible to diagnose BRCA1 and the fortuitous discovery of biliary tract stenosis of an undetermined nature. Further investigations led to the conclusion that there was a strong presumption of UC associated with PSC or even cholangiocarcinoma (CCA). In the course of treatment, cancer of the gallbladder was also detected. This clinical case makes it possible to review, in the light of recent publications, the pathophysiological link existing between UC and PSC. This article also presents an in-depth analysis of this entity with malignant potential that can affect different sites of the digestive tract, and its own management, which is the subject of new recommendations. [less ▲]

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See detailAlcool et complications pancréatiques
LOLY, Jean-Philippe ULiege; MEURISSE, Nicolas ULiege; GAST, Pierrette ULiege et al

in Revue Médicale de Liège (2019), 74(5-6), 342-348

Alcohol consumption is the main cause of development of chronic pancreatitis and the second etiology of acute pancreatitis. The mortality of acute pancreatitis depends on its necrotic haemorrhagic ... [more ▼]

Alcohol consumption is the main cause of development of chronic pancreatitis and the second etiology of acute pancreatitis. The mortality of acute pancreatitis depends on its necrotic haemorrhagic character and the initial inflammatory response, while pain, malnutrition and diabetes are the main issues in the management of chronic pancreatitis. As medical and endoscopic techniques progress, surgical indications have become increasingly rare but remain indispensable for some patients. The multidisciplinary approach of these patients is the key to the success of care.La consommation d’alcool est la cause principale de développement d’une pancréatite chronique et la seconde étiologie de la pancréatite aiguë. La mortalité de la pancréatite aiguë dépend de son caractère nécrotico-hémorragique et de la réponse inflammatoire initiale tandis que les complications de type douleur, dénutrition et diabète sont les principaux enjeux de la prise en charge de la pancréatite chronique. Au fur et à mesure de l’avancée des techniques médicales et endoscopiques, les indications chirurgicales sont devenues de plus en plus rares, mais restent indispensables pour certains patients. L’approche pluridisciplinaire de ces patients est la clé du succès de la prise en charge. [less ▲]

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See detailProteomics highlights common and distinct pathophysiological processes associated with ileal and colonic ulcers in Crohn's disease.
Pierre, Nicolas ULiege; Salee, Catherine ULiege; MASSOT, Charlotte ULiege et al

in Journal of Crohn's & colitis (2019)

BACKGROUND AND AIMS: Based on genetics and natural history, Crohn's disease can be separated in two entities, an ileal and a colonic disease. Protein based-approaches are needed to elucidate whether such ... [more ▼]

BACKGROUND AND AIMS: Based on genetics and natural history, Crohn's disease can be separated in two entities, an ileal and a colonic disease. Protein based-approaches are needed to elucidate whether such subphenotypes are related to distinct pathophysiological processes. METHODS: The proteome of ulcer edge was compared to the one of paired control tissue (n=32 biopsies) by differential proteomics in the ileum and the colon of Crohn's disease patients (n=16). The results were analysed though a hypothesis-driven (based on literature) and a hypothesis-free approach (pathway enrichment analysis). To confirm one of the key pathway highlighted by proteomics, two proteins were also studied by immunochemistry in tissue biopsies. RESULTS: In the ileum and the colon, 4428 and 5204 proteins, respectively, were identified and quantified. Ileal and colonic ulcer edge differed by a distinct distribution of proteins of epithelial-mesenchymal transition, neutrophil degranulation and ribosome. Ileal and colonic ulcer edge were similarly characterised by an increase of the proteins implicated in the pathway of protein processing in endoplasmic reticulum and a decrease of mitochondrial proteins. Immunochemistry confirmed the presence of endoplasmic reticulum stress in the mucosa of ileal and colonic ulcer edge. CONCLUSION: This study provides protein-based evidences showing partly distinct pathophysiological processes associated to ileal and colonic ulcer edge in Crohn's disease patients. This could constitute a first step toward the development of gut segment-specific diagnostic markers and therapeutics. [less ▲]

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See detailOn-site comparison of an enzymatic detergent and a non-enzymatic detergent-disinfectant for routine manual cleaning of flexible endoscopes.
Gonzalez, Jonathan Alfageme; Vanzieleghem, Thomas; Dumazy, Axelle ULiege et al

in Endoscopy International Open (2019), 7(4), 412-420

Background and study aims Flexible endoscopes are potential vectors of pathogen transmission to patients that are subjected to cleaning and high-level disinfection after each procedure. Efficient manual ... [more ▼]

Background and study aims Flexible endoscopes are potential vectors of pathogen transmission to patients that are subjected to cleaning and high-level disinfection after each procedure. Efficient manual cleaning is a prerequisite for effective high-level disinfection. The goal of this study was to demonstrate the impact of the cleaning chemistry in the outcome of the manual cleaning of endoscopes. Materials and methods Twelve endoscopes were included in this study: four colonoscopes, four gastroscopes, two duodenoscopes and two bronchoscopes. This study was designed with two phases; in each of them, the manual cleaning procedure remained identical, but a different detergent was used: a non-enzymatic detergent-disinfectant (NEDD) and an enzymatic detergent (ED). Biopsy and suction channels of endoscopes were sampled using 10 mL of physiological saline at two points: before and after manual cleaning, and adenosine triphosphate (ATP) was measured on each sample. In total, 208 procedures were analyzed for the NEDD phase and 253 for the ED phase. Results For each endoscope type, cleaning endoscopes with ED resulted in larger median decrease in ATP than with NEDD: respectively 99.43 % and 95.95 % for bronchoscopes ( P = 0.0007), 99.28 % and 96.93 % for colonoscopes ( P < 0.0001) and 98.36 % and 95.36 % for gastroscopes ( P < 0.0001). In addition, acceptability rates of endoscopes based on defined post-manual cleaning ATP thresholds (200, 150, 100 or 50 relative light units) for all endoscope types were significantly higher with ED compared to NEDD. Conclusions With all other parameters of manual cleaning remaining unchanged, the enzymatic chemistry of ED provided more consistent and improved cleaning of endoscopes compared to NEDD. Therefore, choice of the detergent for endoscope cleaning has an impact on the outcome of this process. [less ▲]

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See detailAdenocarcinome obstructif localement avance de la tete du pancreas : importance du drainage biliaire precoce.
Deflandre, Laure-Anne; LOLY, Jean-Philippe ULiege; LECLERCQ, Philippe ULiege et al

in Revue Médicale Suisse (2018), 14(615), 1443-1447

The incidence of pancreatic cancer is increasing, but proportion of resectable cases and survival do not increase. Then, our care strategies have to be optimized. Chemotherapy is the principal treatment ... [more ▼]

The incidence of pancreatic cancer is increasing, but proportion of resectable cases and survival do not increase. Then, our care strategies have to be optimized. Chemotherapy is the principal treatment of locally advanced pancreatic cancer. When the tumour triggers biliary obstruction, chemotherapy-associated morbidity increases, and biliary drainage becomes crucial. Gold-standard is endoscopic retrograde cholangiography, which could be impossible when duodenum or papilla are involved by the tumour. Other options are percutaneous radiologic drainage, surgical double by-pass or EUS-guided drainage. When EUS-guided procedures are available, they are proposed today as the best options. [less ▲]

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See detailEndomicroscopie confocale dans la prise en charge des maladies inflammatoires chroniques de l'intestin.
LOLY, Jean-Philippe ULiege; SOMJA, Joan ULiege; REENAERS, Catherine ULiege et al

in Revue Médicale Suisse (2017), 13(571), 1431-1434

Inflammatory bowel diseases are chronic diseases whose long-term evolution depends on the depth of remission. Their clinical and endoscopic evaluation is imperfect. The development of confocal ... [more ▼]

Inflammatory bowel diseases are chronic diseases whose long-term evolution depends on the depth of remission. Their clinical and endoscopic evaluation is imperfect. The development of confocal endomicroscopy allows microscopic images to be obtained in vivo. These microscopic data are correlated with the activity of the disease. They predict a possible relapse of the disease and also predict the response to treatment with a biological agent, which allows to modify the therapy before the relapse or to make a rational choice between the different biological agents before introducing a new treatment. [less ▲]

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See detailComplications oesogastriques de la thermoablation dans le cadre de la fibrillation auriculaire
GAST, Pierrette ULiege; LOLY, Jean-Philippe ULiege; LECLERCQ, Philippe ULiege et al

in Revue Médicale Suisse (2016), 12(527), 1362-1366

Atrial-esophageal fistula (AOF) after ablation in atrial fibrillation has a fatal outcome. Fully documented in 2004, AOF has never completely disappeared despite technological evolvements. Survival ... [more ▼]

Atrial-esophageal fistula (AOF) after ablation in atrial fibrillation has a fatal outcome. Fully documented in 2004, AOF has never completely disappeared despite technological evolvements. Survival depends on early recognition and treatment. Gastroscopy allows early detection of esophageal lesions. We summarize here AOF mechanisms, evoking symptoms and treatment ; contribution of gastroscopy in early detection ; and finally symptoms from vagal and phrenic nerve injuries. This information is useful for emergency doctors, gastroenterologists / endoscopists, and general practitioners. [less ▲]

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See detailLa maladie de Rendu-Osler: une cause rare d'encéphalopathie ammoniacale.
Dumont, R; LOLY, Jean-Philippe ULiege; DELWAIDE, Jean ULiege et al

in Revue Médicale de Liège (2016), 71(2), 83-89

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See detailRefractory hypercalcemia and ectopic calcitonin secretion in a malignant pancreatic neuroendocrine tumor: hypocalcemic effects on cinacalcet
VALDES SOCIN, Hernan Gonzalo ULiege; rubio almanza, Matilde; LOLY, Jean-Philippe ULiege et al

in Acta Clinica Belgica (2013), 68(6), 42

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic ... [more ▼]

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic neuroendocrine tumor (Ki-67= 2%) is diagnosed in a 52-year-old diabetic man. The tumor is revealed with a splenic and hepatic carcinomatosis. Plasmatic calcium was: 3.54 mmol/L (2.15 - 2.6). Biology showed hypophosphatemia, PTH < 4 ng/ml, high 1-25 OH VitD, calcitonin: 1016 ng/ml (< 12 ng/ml). He had hypercalciuria and hypophosphaturia. He received for two years several cycles of Streptozotocin-ADRIAMYCIN and FOLFOX, with partial control of the tumor mass and calcium levels. In 2012, calcitonin levels are 29 ng/ml whereas calcemia is 3.17 mmol/L. Hypercalcemia is refractory to hyperhydration, diuretics, corticosteroids, and bisphosphonates therapy. Cinacalcet (Mimpara) is prescribed up to 120 mg/day (PO). Calcemia decreases gradually from 3 to 2.87 and then 2.76 mmol/L. PTH and calcitonin-the tumor mass remain unchanged. After two months of Cinacalcet treatment, Sunitinib (Sutent) 37.5 mg per day was added. During the third month, calcium levels dropped to 2.09 mmol/L and PTH raised to 78 pg/ml, requiring discontinuation of Mimpara. Calcitonin normalized, with a further improvement over pancreatic and metastatic lesions. Conclusion: Cinacalcet is a Calcium Sensing Receptor oral agonist. Cinacalcet hypocalcemic effects have not been previously documented in pancreatic paraneoplastic hypercalcemia. In our patient, Cinacalcet has significantly improved cancer prognosis: this drug could be a new alternative in paraneoplastic hypercalcemia. [less ▲]

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See detailHypercalcemia treated by sunitinib
LOLY, Jean-Philippe ULiege; VALDES SOCIN, Hernan Gonzalo ULiege; Daly, Adrian ULiege et al

in 23rd meeting of the Belgian Endocrine Society - Abstract book (2013, October 19)

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See detailHypercalcémie réfractaire et sécrétion ectopique de calcitonine dans un cancer neuroendocrine du pancréas : Effets hypocalcémiants du Cinacalcet
VALDES SOCIN, Hernan Gonzalo ULiege; LOLY, Jean-Philippe ULiege; BETEA, Daniela ULiege et al

in Annales d'Endocrinologie (2013, September), 74(4), 235-462

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic ... [more ▼]

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic neuroendocrine tumor (Ki-67= 2%) is diagnosed in a 52-year-old diabetic man. The tumor is revealed with a splenic and hepatic carcinomatosis. Plasmatic calcium was: 3.54 mmol/L (2.15 - 2.6). Biology showed hypophosphatemia, PTH < 4 ng/ml, high 1-25 OH VitD, calcitonin: 1016 ng/ml (< 12 ng/ml). He had hypercalciuria and hypophosphaturia. He received for two years several cycles of Streptozotocin-ADRIAMYCIN and FOLFOX, with partial control of the tumor mass and calcium levels. In 2012, calcitonin levels are 29 ng/ml whereas calcemia is 3.17 mmol/L. Hypercalcemia is refractory to hyperhydration, diuretics, corticosteroids, and bisphosphonates therapy. Cinacalcet (Mimpara) is prescribed up to 120 mg/day (PO). Calcemia decreases gradually from 3 to 2.87 and then 2.76 mmol/L. PTH and calcitonin-the tumor mass remain unchanged. After two months of Cinacalcet treatment, Sunitinib (Sutent) 37.5 mg per day was added. During the third month, calcium levels dropped to 2.09 mmol/L and PTH raised to 78 pg/ml, requiring discontinuation of Mimpara. Calcitonin normalized, with a further improvement over pancreatic and metastatic lesions. Conclusion: Cinacalcet is a Calcium Sensing Receptor oral agonist. Cinacalcet hypocalcemic effects have not been previously documented in pancreatic paraneoplastic hypercalcemia. In our patient, Cinacalcet has significantly improved cancer prognosis: this drug could be a new alternative in paraneoplastic hypercalcemia. [less ▲]

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See detailGuillain-Barré syndrome following hepatitis E
Loly, Jean-Philippe ULiege; Rikir, Estelle ULiege; Seivert, Maxime ULiege et al

in World Journal of Gastroenterology (2009), 15(13), 1645-1647

Guillain-Barré syndrome (GBS) is often triggered by a preceding bacterial or viral infection. Occasionally, it has been observed in association with acute hepatitis A, B and C, and three cases have been ... [more ▼]

Guillain-Barré syndrome (GBS) is often triggered by a preceding bacterial or viral infection. Occasionally, it has been observed in association with acute hepatitis A, B and C, and three cases have been previously described in India in which GBS was associated with acute hepatitis E. A molecular mimicry mechanism is supposed to be involved in the pathogenesis of GBS triggered by infectious agents, although the nature of the shared epitopes has not been characterized in most instances, including that in the case of hepatotropic viruses. We report a case of GBS following acute hepatitis E in a European individual. The presence of antiganglioside GM2 antibodies in this patient suggested molecular mimicry involving ganglioside GM2 in the pathogenesis of GBS associated with hepatitis E. [less ▲]

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