Document 0243
 DOCN  M95A0243
 TI    Diarrhoea in HIV-infected patients: no evidence of cytokine-mediated
       inflammation in jejunal mucosa.
 DT    9510
 AU    Snijders F; van Deventer SJ; Bartelsman JF; den Otter P; Jansen J;
       Mevissen ML; van Gool T; Danner SA; Reiss P; Division of Infectious
       Diseases, Tropical Medicine and AIDS,; University of Amsterdam, The
       Netherlands.
 SO    AIDS. 1995 Apr;9(4):367-73. Unique Identifier : AIDSLINE MED/95314792
 AB    OBJECTIVE: To determine whether a mucosal cytokine-mediated inflammatory
       response is involved in cryptosporidial or microsporidial diarrhoea, as
       well as in diarrhoea of unknown origin in HIV-infected patients. DESIGN:
       Prospective study. METHODS: Jejunal biopsies were obtained from
       HIV-infected patients with diarrhoea. Controls were HIV-infected and
       HIV-seronegative patients without diarrhoea. Two biopsies were
       homogenized immediately and two other biopsies were first cultured for
       20 h. Cytokines [tumour necrosis factor (TNF), interleukin (IL)-1 beta,
       IL-6, IL-8, IL-10], soluble TNF receptors (sTNFR) p55 and p75, and
       soluble IL-2 receptor (sIL-2R) were assessed in the homogenates and in
       the supernatants by sandwich enzyme-linked immunosorbent or
       enzyme-linked binding assays. The cytokine receptors were also measured
       in serum. RESULTS: Six HIV-infected patients with cryptosporidiosis, six
       with microsporidiosis, seven with diarrhoea of unknown origin, seven
       without diarrhoea, and seven HIV-seronegative patients were eligible.
       Four patients were excluded because of the presence of other pathogens.
       No cytokines were detected in immediately homogenized jejunal tissue.
       Following culture, IL-6 and IL-8 levels were higher in HIV-infected
       patients with diarrhoea of unknown origin than in HIV-seronegative
       controls without diarrhoea, although this was not statistically
       significant. No differences in serum or post-culture supernatant sTNFR
       p55 and p75 levels existed between the HIV-infected patients with or
       without diarrhoea. sTNFR, IL-1 beta, IL-10 and the sIL-2R were only
       detected in low amounts or not at all, and were equally distributed
       among all patient groups. CONCLUSIONS: This study indicates that mucosal
       cytokine-mediated inflammatory responses do not play an important role
       in the pathogenesis of different types of diarrhoea in HIV-infected
       patients. These results do not support the use of immunomodulatory
       therapy in these patients.
 DE    Adult  Animal  AIDS-Related Opportunistic Infections/ETIOLOGY/PATHOLOGY
       Cryptosporidiosis/COMPLICATIONS/IMMUNOLOGY  Cytokines/*PHYSIOLOGY
       Diarrhea/*COMPLICATIONS/ETIOLOGY  Female  Human  HIV
       Infections/*COMPLICATIONS  *HIV-1  Inflammatory Bowel
       Diseases/COMPLICATIONS/IMMUNOLOGY  Intestinal
       Mucosa/IMMUNOLOGY/PATHOLOGY  Jejunum/IMMUNOLOGY/PATHOLOGY  Male
       Microspora Infections/COMPLICATIONS/ETIOLOGY  Microsporida  Middle Age
       Prospective Studies  Receptors, Cytokine/METABOLISM  Support, Non-U.S.
       Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).