Dimitroulia Evangelia, Spanakis Nicholas, Konstantinidou Anastasia E, Legakis Nicholas J, Tsakris Athanassios
Unit of Virology, Department of Microbiology, Medical School, University of Athens, Athens, Greece.
Inflamm Bowel Dis. 2006 Sep;12(9):879-84. doi: 10.1097/01.mib.0000231576.11678.57.
Although a growing number of reports have described inflammatory bowel disease (IBD) complicated with cytomegalovirus (CMV) infection, there are limited molecular studies that investigate CMV genome in intestinal sections of patients with IBD.
A cross-sectional prospective study was conducted between September 2000 and June 2003 in a cohort of 85 patients diagnosed with IBD (58 with ulcerative colitis and 27 with Crohn's disease) in two adult gastrointestinal referral centers in Athens, Greece. Prevalence of CMV infection was estimated by pathologic studies in intestinal sections and by molecular assays in blood and intestinal tissue samples and compared with a control group of 42 individuals with noninflammatory disease.
Immunohistochemical staining showed CMV antigen in 10 IBD patients (7 with ulcerative colitis; 9 with severe disease), whereas CMV antigen was not detected in any of the controls. CMV genome in both the intestinal tissue and blood was found by polymerase chain reaction in 23 (27.1%) of the total IBD patients, in 18 (31.0%) of those with ulcerative colitis, and in 5 (18.5%) of those with Crohn's disease. In addition, five (5.9%) IBD patients (2 with ulcerative colitis and 3 with Crohn's disease) had detectable CMV genome in their intestinal samples but not in their blood. In the control group, five (11.9%) individuals had detectable CMV genome in their blood, but only one (2.2%) in his intestine.
Patients with ulcerative colitis had more often detectable CMV genome in their blood as well as in their intestinal tissue samples as compared with controls (P = 0.022 and P < 0.0001, respectively). However, patients with Crohn's disease had more often detectable CMV genome only in their intestinal tissue samples as compared with controls (P = 0.001). Detection of CMV genome in blood or intestinal tissue was significantly associated with short duration of IBD (P = 0.0088 and 0.04, respectively) but not with age, sex, severity of the disease, activity at colonoscopy, pancolitis, administration of a specific treatment, and surgery. In this cross-sectional prospective study, detection of CMV genome or antigen in the intestine was commonly associated with IBD.
尽管越来越多的报告描述了炎症性肠病（IBD）合并巨细胞病毒（CMV）感染，但对IBD患者肠道切片中CMV基因组进行研究的分子学研究有限。
2000年9月至2003年6月，在希腊雅典的两个成人胃肠病转诊中心对85例诊断为IBD的患者（58例溃疡性结肠炎患者和27例克罗恩病患者）进行了一项横断面前瞻性研究。通过肠道切片的病理研究以及血液和肠道组织样本的分子检测来估计CMV感染的患病率，并与42例非炎症性疾病患者的对照组进行比较。
免疫组织化学染色显示10例IBD患者（7例溃疡性结肠炎患者；9例重症患者）中有CMV抗原，而对照组中未检测到CMV抗原。通过聚合酶链反应在23例（27.1%）IBD患者、18例（31.0%）溃疡性结肠炎患者和5例（18.5%）克罗恩病患者的肠道组织和血液中均发现了CMV基因组。此外，5例（5.9%）IBD患者（2例溃疡性结肠炎患者和3例克罗恩病患者）在其肠道样本中检测到CMV基因组，但血液中未检测到。在对照组中，5例（11.9%）个体血液中检测到CMV基因组，但只有1例（2.2%）在其肠道中检测到。
与对照组相比，溃疡性结肠炎患者血液和肠道组织样本中更常检测到CMV基因组（分别为P = 0.022和P < 0.0001）。然而，与对照组相比，克罗恩病患者仅在肠道组织样本中更常检测到CMV基因组（P = 0.001）。血液或肠道组织中CMV基因组的检测与IBD病程短显著相关（分别为P = 0.0088和0.04），但与年龄、性别、疾病严重程度、结肠镜检查时的活动度、全结肠炎、特定治疗的使用及手术无关。在这项横断面前瞻性研究中，肠道中CMV基因组或抗原的检测通常与IBD相关。
