Heiligenberg Marlies, Lutter René, Pajkrt Dasja, Adams Karin, De Vries Henry, Heijman Titia, Schim van der Loeff Maarten F, Geerlings Suzanne
Cluster of Infectious Diseases, Health Service Amsterdam, Amsterdam, the Netherlands.
Clin Vaccine Immunol. 2013 Oct;20(10):1517-23. doi: 10.1128/CVI.00763-12. Epub 2013 Jul 31.
Asymptomatic Chlamydia trachomatis infections are common in HIV-infected men who have sex with men (MSM). Although C. trachomatis combined with HIV would be likely to enhance inflammation, the asymptomatic course suggests otherwise. We assessed local inflammation, mucosal damage, and cytokine concentrations in rectal mucosal fluid samples from patients with HIV (with or without the use of combination antiretroviral therapy [cART]) and with or without the presence of rectal C. trachomatis. Rectal swabs from 79 MSM (with and without C. trachomatis, HIV, and cART use) who reported a history of receptive anal sex were analyzed for neutrophil activation (measured by myeloperoxidase [MPO]), mucosal leakage (measured by albumin and alpha-2-macroglobulin), and proinflammatory and anti-inflammatory cytokines. C. trachomatis infection, HIV infection, and cART use in MSM had no differential effects on rectal neutrophilic inflammation and mucosal damage. Interleukin 8 (IL-8) was found to correlate with MPO, and MPO correlated with markers of mucosal damage. In HIV-negative participants, men with C. trachomatis infection had lower concentrations of monocyte chemotactic protein 1 (MCP-1), IL-1α, and IL-1 receptor antagonist (IL-1RA) than men without rectal C. trachomatis infection (P = 0.005, 0.007, and 0.07, respectively). We found no difference in anal cytokine concentrations in HIV-infected participants in relation to the presence of C. trachomatis infection or cART use. In participants with rectal C. trachomatis infection, those who were HIV negative had lower median concentrations of IL-8 and IL-1α than those with HIV (P = 0.05 and 0.06, respectively). The slope of the regression line between MPO and IL-8 was reduced in participants with rectal C. trachomatis infection. C. trachomatis dampens cytokine concentrations but not in HIV-infected patients. The extent of mucosal damage was comparable in all patient groups. The apparent reduced neutrophil response to IL-8 in HIV-infected patients with C. trachomatis infection is in accordance with its asymptomatic course.
无症状沙眼衣原体感染在男男性行为者（MSM）的HIV感染者中很常见。虽然沙眼衣原体合并HIV可能会加重炎症，但无症状病程却并非如此。我们评估了HIV患者（无论是否使用联合抗逆转录病毒疗法[cART]）且有无直肠沙眼衣原体感染的直肠黏膜液样本中的局部炎症、黏膜损伤和细胞因子浓度。对79名有接受肛交史的MSM（有无沙眼衣原体、HIV以及是否使用cART）的直肠拭子进行分析，检测中性粒细胞活化（通过髓过氧化物酶[MPO]测量）、黏膜渗漏（通过白蛋白和α-2-巨球蛋白测量）以及促炎和抗炎细胞因子。MSM中的沙眼衣原体感染、HIV感染和cART使用对直肠中性粒细胞炎症和黏膜损伤没有差异影响。发现白细胞介素8（IL-8）与MPO相关，且MPO与黏膜损伤标志物相关。在HIV阴性参与者中，感染沙眼衣原体的男性的单核细胞趋化蛋白1（MCP-1）、IL-1α和IL-1受体拮抗剂（IL-1RA）浓度低于无直肠沙眼衣原体感染的男性（P分别为0.005、0.007和0.07）。我们发现，在HIV感染参与者中，有无沙眼衣原体感染或使用cART对肛门细胞因子浓度没有差异。在有直肠沙眼衣原体感染的参与者中，HIV阴性者的IL-8和IL-1α中位浓度低于HIV感染者（P分别为0.05和0.06）。直肠沙眼衣原体感染参与者中MPO与IL-8之间的回归线斜率降低。沙眼衣原体可降低细胞因子浓度，但在HIV感染患者中并非如此。所有患者组的黏膜损伤程度相当。感染沙眼衣原体的HIV感染患者中对IL-8的中性粒细胞反应明显降低与其无症状病程一致。
