Jejunal enteropathy associated with human immunodeficiency virus infection: quantitative histology.

Batman, P A; Miller, A. R. O.; Forster, Sm; Harris, J. R. W.; Pinching, Anthony J.; Griffin, George E.

doi:10.1136/jcp.42.3.275

Cited by 155 publications

(52 citation statements)

References 24 publications

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“…A pulmonary lymphocytic infiltration has been demonstrated to varying degrees in lung mucosa [32,40]. In the gut no clear pattern has emerged and intraepithelial lymphocyte counts have been reported as increased [41], decreased [37] or unchanged [42] in the presence of HIV infection. However, the elevated numbers of CD81/CD51 cells seen in the ectocervix of HIV1 women (80% compared to 50% in low risks) demonstrates the active recruitment of nonresident CD8 1 lymphocytes rather than an expansion of the resident intraepithelial population.…”

Section: Discussionmentioning

confidence: 99%

Immunity in the Female Lower Genital Tract and the Impact of HIV Infection

Ahmed¹,

Al-Doujaily²,

Johnson

et al. 2001

Scand J Immunol

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This study investigates the distribution of immunocompetent cells in the ectocervix, and cytokine and immunoglobulin (Ig) levels in cervicovaginal secretions to determine whether they are altered in asymptomatic human immunodeficiency virus (HIV) infection. Ectocervical biopsies from 10 HIV1 and 10 presumed HIV-ve women were studied by immunocytochemistry. Levels of Igs in cervicovaginal secretions were quantified by radial immunodiffusion (RID) and cytokine levels by ELISA. HIV1 women had significantly increased numbers of CD8 1 lymphocytes resulting in reversal of the CD4:CD8 ratio. There was a significant increase in the proportion of activated CD81 HLA-DR1 and CD4 1 HLA-DR 1 lymphocytes, but not in CD81 TIA-11 cells. The epithelium of the cervix from HIV1 subjects showed a significant increase in both numbers of macrophages (CD681) and proportions of activated macrophages (CD681 HLA-DR1) compared to normal. The stroma contained increased proportions of inductive (D11) and suppressive (D11 D71) macrophages but a decrease in effector phagocyte (D71) proportions and Langerhans' cells. Significantly lower tumour necrosis factor (TNF)-a levels were observed in cervicovaginal secretions from HIV1 subjects. IgG levels were 4 times higher and IgM levels twice higher in cervicovaginal secretions from HIV1 women, compared to results from normal subjects. These results suggest a response within the CD8 1 cells in HIV1 women, yet these cells may have a low cytolytic capacity. The raised proportions of HLA-DR1 and D11 CD4 1 macrophages could act as antigen-presenting cells (APC) for CD4 1 CD45RO1 lymphocytes, and represent a local acquired response. However, the close juxtaposition of these cells offers the potential for them to act as a local reservoir of virus and promote its proliferation. The increase of IgG over sIgA in secretions of HIV1 subjects provides evidence suggesting a dysregulation of local humoral immunity.

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Section: Discussionmentioning

confidence: 99%

Immunity in the Female Lower Genital Tract and the Impact of HIV Infection

Ahmed¹,

Al-Doujaily²,

Johnson

et al. 2001

Scand J Immunol

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“…37 To our knowledge, eight published studies have reported morphometric (N = 6) and/or permeability (N = 4) data in both early and late HIV infection. 9,34,35,[37][38][39][40][41] Of the morphometric studies, four 9,34,37,39 found no evidence of villous changes in early HIV infection but two 38,40 did. Crypt changes were observed in early infection in two 9,34 but not in others [37][38][39][40] ; generally it was the larger studies that found the difference.…”

Section: Enteropathy Is a Feature Of Hiv Infectionmentioning

confidence: 99%

Enteropathies in the Developing World: Neglected Effects on Global Health

Prendergast¹,

Kelly²

2012

The American Society of Tropical Medicine and Hygiene

237

243

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“…[4][5][6] Histologically, the enteropathy involves inflammatory infiltrates of lymphocytes and damage to the GI epithelial layer, including villous atrophy, crypt hyperlasia, and villous blunting. [7][8][9] Importantly, these pathologic changes occur in the absence of the detectable bacterial, viral, or fungal enteropathogens that are often associated with enteropathy. 7 Hence there are substantial data demonstrating structural abnormalities within the GI tract of HIV-infected individuals.…”

mentioning

confidence: 99%

“…[7][8][9] Importantly, these pathologic changes occur in the absence of the detectable bacterial, viral, or fungal enteropathogens that are often associated with enteropathy. 7 Hence there are substantial data demonstrating structural abnormalities within the GI tract of HIV-infected individuals. Although the mechanisms underlying these abnormalities remain poorly understood, several explanations have been put forward.…”

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confidence: 99%

HIV infection and the gastrointestinal immune system

2008

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There has recently been a resurgence of interest in the gastrointestinal pathology observed in patients infected with HIV. The gastrointestinal tract is a major site of HIV replication, which results in massive depletion of lamina propria CD4 T cells during acute infection. Highly active antiretroviral therapy leads to incomplete suppression of viral replication and substantially delayed and only partial restoration of gastrointestinal CD4 T cells. The gastrointestinal pathology associated with HIV infection comprises significant enteropathy with increased levels of inflammation and decreased levels of mucosal repair and regeneration. Assessment of gut mucosal immune system has provided novel directions for therapeutic interventions that modify the consequences of acute HIV infection.The mucosal surface of the gastrointestinal (GI) tract forms a unique anatomical and physiological niche, serving as a predominant structural and immunological barrier against the microorganisms of the outside world. In addition, the tightly apposed enterocytes that form the single cell layer of the mucosal epithelium also absorb water and nutrients during the digestive process, which is critical to host survival. Hence, loss of the integrity of the mucosal surface results in multiple deleterious sequelae.

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Jejunal enteropathy associated with human immunodeficiency virus infection: quantitative histology.

Cited by 155 publications

References 24 publications

Immunity in the Female Lower Genital Tract and the Impact of HIV Infection

Immunity in the Female Lower Genital Tract and the Impact of HIV Infection

Enteropathies in the Developing World: Neglected Effects on Global Health

HIV infection and the gastrointestinal immune system

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