John Libbey Eurotext

Virologie

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Cytomégalovirus et maladies inflammatoires cryptogénétiques de l’intestin (MICI) avec un focus spécial sur son rôle dans la rectocolite hémorragique Volume 21, numéro 6, Novembre-Décembre 2017

Illustrations

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Tableaux

Auteurs
1 EA3064, Groupe immunité des muqueuses et agents pathogènes (Gimap), Campus Santé Innovations, Faculté de médecine,
10 rue de la Marandière, BP 80019,
42270 Saint-Priest-en-Jarez
2 Laboratoire des agents infectieux et hygiène, CHU de Saint-Étienne, France
3 Laboratoire d’Immunologie,
CHU de Saint-Étienne, France
4 Service de Gastro-entérologie,
CHU de Saint-Étienne, France
* Tirés à part
  • Mots-clés : colite à CMV, réponse cytokinique Th2, inflammation, corticorésistance, ganciclovir
  • DOI : 10.1684/vir.2017.0713
  • Page(s) : 287-302
  • Année de parution : 2017

Cytomegalovirus (CMV) infects approximately 50 % of adults in France and persists lifelong as a latent agent in different organs, including the gut. A close relationship is observed between inflammation that favors viral expression, and viral replication that modulates inflammation. In this context, CMV colitis may impact the prognosis of patients suffering from inflammatory bowel diseases (IBD), and notably those with ulcerative colitis (UC). In UC, the mucosal inflammation in link with Th2 cytokines, together with immunomodulatory drugs used for controlling flares-up, favors viral reactivation within the gut, which increases mucosal inflammation ; it results in an important risk of impairing corticoid and immunosuppressor efficacy (the probability of steroid resistance is multiplied by more than 20 in case of CMV colitis), precipitating the need for colectomy. This review emphasizes the virological tools that are recommended for exploring CMV colitis during IBD and underlines the interest of using ganciclovir for treating flares-up associated to CMV colitis in UC patients.