Diagnostic and therapeutic targets in chronic digestive and brain pathologies

Axis 4

Development of diagnostic imaging methods of UNGE.

My research project in 1 video ...

This line of research is transversal to all three previous axes.

It aims to develop innovative imaging tools, especially endoscopic, to characterize the lesions of UNGE during digestive diseases and the brain. Its goal is to identify new diagnostic biomarkers predictive of disease progression or response to treatment.

In addition, this axis also aims to develop and validate new therapeutic and preventive approaches targeting UNGE disorders in pathologies of interest. These approaches are based on the one hand on the use of neurostimulation methods (stimulation of sacred roots in inflammatory diseases). On the other hand, we are also developing research focused on the use of nutritional compounds (short chain fatty acids, lipid mediators, probiotics) or pharmacological compounds.

This last line is developed in close collaboration with all the clinical services (Gastroenterology-Nutrition-Digestive Surgery) and research (CIC-IMAD, UMR Phan) of IMAD.

E-Mage Study


What is known :

  • graft-versus-host disease (GVHD) is a set of lesions caused by the action of the donor immune system against recipient tissues in patients who have received allogeneic bone marrow transplantation for the treatment of hematologic disease

  • GVH can affect many organs: skin, kidneys, digestive tract, liver ...

  • GVH is severe, frequent and difficult to diagnose

  • Confocal endomicroscopy (CME) is an optical technique for real-time in vivo microscopy imaging by applying a probe to a tissue

Previous group results :

  • EMC performed during rectosigmoidoscopy in a small number of asymptomatic transplant patients shows early lesions


The current project :

  • to create an EMC score to assess intestinal mucosal lesions in early GVHD

  • characterize the involvement of the intestinal epithelial barrier and enteric nervous system in GVH

Project display

Figure : patterns of confocal endomicroscopy observed in patients with gastrointestinal graft-versus-host disease (GVHD) after fluorescein injection. A) normal sigmoid B) abnormal microvessel network with dilatation of a microvessel surrounding a colonic crypt (mild GVHD) C) slight increase in fluorescein intensity in the lamina propria (mild GVHD) D) cryptic distortion (moderate GVHD) ) E and F) Major architectural modifications with proliferation and dilation of microvessels in the lamina propria, major extravasation of fluorescein and destruction of colonic crypt architecture (severe GVHD)



What is known :

  • irritable bowel syndrome (IBS) is a common and multifactorial condition that causes abdominal pain and transit disorders

  • some patients with IBS have an increase in intestinal permeability

  • the microbiota probably plays a role in the pathophysiology of IBS

  • there are multiple methods to measure intestinal permeability: ex vivo measurement in Ussing chamber, in vivo measurement by measurement of urinary excretion of sugars, confocal endomicroscopy


The current project

  • to measure changes in intestinal permeability and enteric glia phenotype of probiotic treatment in patients with diarrhea-type irritable bowel syndrome

Researchers / Clinicians

Arnaud Bourreille


+33 2 40 08 31 52


Emmanuel Coron


+33 2 40 08 30 97


Michel Neunlist


+33 2 40 41 28 44


ITA / Students

Tony Durand


+33 2 40 41 29 50


"Study of the dysfunctions of the intestinal epithelial barrier in micro-inflammatory digestive states"

Lucille Quénehervé


+33 2 40 41 28 85



Charlène Brochard


+33 2 40 41



Quénéhervé L, David G, Bourreille A, Hardouin JB, Rahmi G, Neunlist M, Brégeon J, Coron E. Quantitative assessment of mucosal architecture using computer-based analysis of confocal laser endomicroscopy in inflammatory bowel diseases. Gastrointest Endosc. 2018 Aug 16. pii: S0016-5107(18)32925-0. doi: 10.1016/j.gie.2018.08.006

Etchepare N, Bregeon J, Quénéhervé L, Haddara S, Touchefeu Y, Neunlist M, Coron E. Development of a porcine model for assessment of mucosal repair following endoscopic resection of the lower gastrointestinal tract. Endosc Int Open. 2017 Oct;5(10):E1014-E1019. doi: 10.1055/s-0043-115383. Epub 2017 Oct 10. PubMed PMID: 29159277

Quénéhervé L, Neunlist M, Bruley des Varannes S, Tearney G, Coron E. [Novel endoscopic techniques to image the upper gastrointestinal tract]. Med Sci (Paris). 2015 Aug-Sep;31(8-9):777-83. doi: 10.1051/medsci/20153108017

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