Sipponen Taina, Turunen Ulla, Lautenschlager Irmeli, Nieminen Urpo, Arola Johanna, Halme Leena
Department of Medicine, Division of Gastroenterology, Helsinki University Central Hospital, Helsinki, Finland.
Scand J Gastroenterol. 2011 Nov;46(11):1324-33. doi: 10.3109/00365521.2011.605466. Epub 2011 Aug 31.
Reactivation of a latent cytomegalovirus (CMV) may occur in inflammatory bowel disease (IBD). Data of human herpesvirus 6 (HHV-6)--a close relative to CMV--in active IBD are scarce. The aim of this study was to detect HHV-6 and CMV antigens in the mucosa of active and inactive IBD.
79 IBD patients (47 ulcerative colitis (UC) and 32 Crohn's disease (CD)) were recruited and endoscopic and histological disease activity was scored. Control group consisted of 15 non-IBD patients with normal colonoscopy. Immunohistochemical stainings for HHV-6B and CMV antigens were performed on biopsy specimens from the ileum and colorectum. The intensity of HHV-6B and CMV expression was graded as negative, mild, moderate, or intense.
HHV-6B antigen was positive in 35 (44%) and CMV in 64 (81%). Of controls, 6 (40%) were mildly positive for HHV-6 and 6 (40%) for CMV. In IBD, both CMV and HHV-6B intensity correlated with endoscopic disease severity (CMV p = 0.010 and HHV-6 p = 0.048). Simultaneous HHV-6B and CMV antigen expression occurred in 29 (37%) and associated with endoscopic activity (p = 0.006) and to a number of immunosuppressives (p = 0.033). A significant difference in HHV-6B positivity was found between endoscopically active and inactive UC (p = 0.040). Both CMV and HHV-6B intensity correlated with histological severity in the rectal biopsy specimens (for CMV p = 0.040 and for HHV-6B p = 0.027).
Both viruses occurred ubiquitously in the IBD mucosa. Coexistence of viruses was common and associated with disease activity and use of immunosuppressives. HHV-6B intensity correlated with endoscopic severity in UC.
潜伏性巨细胞病毒（CMV）再激活可能发生在炎症性肠病（IBD）中。人类疱疹病毒6型（HHV - 6）是CMV的近亲，关于其在活动期IBD中的数据较少。本研究旨在检测活动期和非活动期IBD黏膜中的HHV - 6和CMV抗原。
招募79例IBD患者（47例溃疡性结肠炎（UC）和32例克罗恩病（CD）），并对内镜和组织学疾病活动度进行评分。对照组由15例结肠镜检查正常的非IBD患者组成。对来自回肠和结直肠的活检标本进行HHV - 6B和CMV抗原的免疫组织化学染色。HHV - 6B和CMV表达强度分为阴性、轻度、中度或重度。
HHV - 6B抗原阳性35例（44%），CMV阳性64例（81%）。对照组中，6例（40%）HHV - 6轻度阳性，6例（40%）CMV轻度阳性。在IBD中，CMV和HHV - 6B强度均与内镜疾病严重程度相关（CMV p = 0.010，HHV - 6 p = 0.048）。HHV - 6B和CMV抗原同时表达29例（37%），并与内镜活动度相关（p = 0.006）以及多种免疫抑制剂相关（p = 0.033）。内镜活动期和非活动期UC之间HHV - 6B阳性率存在显著差异（p = 0.040）。CMV和HHV - 6B强度均与直肠活检标本中的组织学严重程度相关（CMV p = 0.040，HHV - 6B p = 0.027）。
两种病毒在IBD黏膜中普遍存在。病毒共存常见，且与疾病活动度和免疫抑制剂的使用相关。HHV - 6B强度与UC的内镜严重程度相关。
