Department of Cancer Immunology and AIDS, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
PLoS One. 2010 Nov 15;5(11):e15533. doi: 10.1371/journal.pone.0015533.
Breakdown of the gut mucosal barrier during chronic HIV infection allows translocation of bacterial products such as lipopolysaccharides (LPS) from the gut into the circulation. Microbial translocation also occurs in inflammatory bowel disease (IBD). IBD serological markers are useful in the diagnosis of IBD and to differentiate between Crohn's disease (CD) and ulcerative colitis (UC). Here, we evaluate detection of IBD serological markers in HIV-infected patients with advanced disease and their relationship to HIV disease markers.
IBD serological markers (ASCA, pANCA, anti-OmpC, and anti-CBir1) were measured by ELISA in plasma from AIDS patients (n = 26) with low CD4 counts (<300 cells/µl) and high plasma LPS levels, and results correlated with clinical data. For meta-analysis, relevant data were abstracted from 20 articles.
IBD serological markers were detected in approximately 65% of AIDS patients with evidence of microbial translocation. An antibody pattern consistent with IBD was detected in 46%; of these, 75% had a CD-like pattern. Meta-analysis of data from 20 published studies on IBD serological markers in CD, UC, and non-IBD control subjects indicated that IBD serological markers are detected more frequently in AIDS patients than in non-IBD disease controls and healthy controls, but less frequently than in CD patients. There was no association between IBD serological markers and HIV disease markers (plasma viral load and CD4 counts) in the study cohort.
IBD serological markers may provide a non-invasive approach to monitor HIV-related inflammatory gut disease. Further studies to investigate their clinical significance in HIV-infected individuals are warranted.
慢性 HIV 感染期间肠道黏膜屏障的破坏允许细菌产物（如脂多糖 [LPS]）从肠道转移到循环中。微生物易位也发生在炎症性肠病（IBD）中。IBD 血清学标志物可用于 IBD 的诊断，并有助于区分克罗恩病（CD）和溃疡性结肠炎（UC）。在这里，我们评估了在晚期 HIV 感染患者中检测 IBD 血清学标志物的情况及其与 HIV 疾病标志物的关系。
通过 ELISA 法测量 AIDS 患者（n=26）血浆中的 IBD 血清学标志物（ASCA、pANCA、抗-OmpC 和抗-CBir1），这些患者的 CD4 计数低（<300 个/µl）且血浆 LPS 水平高，结果与临床数据相关。对于荟萃分析，从 20 篇相关文章中提取了相关数据。
在有微生物易位证据的 AIDS 患者中，约有 65%检测到 IBD 血清学标志物。在这些患者中，有 46%检测到与 IBD 一致的抗体模式，其中 75%的患者具有 CD 样模式。对来自 20 篇关于 CD、UC 和非 IBD 对照组中 IBD 血清学标志物的已发表研究的数据进行荟萃分析表明，与非 IBD 疾病对照组和健康对照组相比，IBD 血清学标志物在 AIDS 患者中更频繁地被检测到，但比 CD 患者的检测频率低。在研究队列中，IBD 血清学标志物与 HIV 疾病标志物（血浆病毒载量和 CD4 计数）之间没有关联。
IBD 血清学标志物可能为监测 HIV 相关炎症性肠道疾病提供一种非侵入性方法。需要进一步研究以调查它们在 HIV 感染个体中的临床意义。
