Ceccarelli Giancarlo, Cavallari Eugenio Nelson, Savinelli Stefano, Bianchi Luigi, Pierangeli Alessandra, Vullo Francesco, Ciardi Antonio, D'ettorre Gabriella
Department of Public Health and Infectious Diseases Department of Molecular Medicine, Laboratory of Virology Department of Radiological, Oncological and Pathology Sciences, "Sapienza" University of Rome, Italy.
Medicine (Baltimore). 2018 Apr;97(16):e0329. doi: 10.1097/MD.0000000000010329.
Here we present the case of a 56-year-old human immunodeficiency virus (HIV)-infected man with multiple anal condylomas and positivity for human papilloma virus (HPV) 18 on anal brushing. Biopsies of the anal mucosa led to the diagnosis of Bowen's disease and a subsequent pelvic magnetic resonance imaging (MRI) scan evidenced multiple reactive lymphoadenopathies and large intra-anal condylomas. The patient was treated with a complete excision of Bowen's lesion and with a 4 months course of supplementation with a high concentration multistrain probiotic formulation administered orally and by rectal instillation with the purpose to reduce local inflammation and to enhance local mucosal immunity.
An MRI performed at the end of the supplementation period evidenced the clearance of the anal condylomas previously described and no evidence of residual lymphadenopathies. Trials are therefore required to confirm this therapeutic possibility and for a better understanding of the mechanisms by which this specific probiotic formulation interacts with local epithelium when administered by the anal route.
在此我们介绍一例56岁感染人类免疫缺陷病毒（HIV）的男性病例，该患者有多处肛门尖锐湿疣，肛门刷检显示人乳头瘤病毒（HPV）18呈阳性。肛门黏膜活检诊断为鲍恩病，随后的盆腔磁共振成像（MRI）扫描显示多处反应性淋巴结病和较大的肛门内尖锐湿疣。患者接受了鲍恩病病变的完整切除，并接受了为期4个月的高浓度多菌株益生菌制剂补充治疗，通过口服和直肠滴注给药，目的是减轻局部炎症并增强局部黏膜免疫力。
补充治疗期结束时进行的MRI显示，先前描述的肛门尖锐湿疣已清除，且无残留淋巴结病的迹象。因此，需要进行试验以证实这种治疗可能性，并更好地了解这种特定益生菌制剂经肛门途径给药时与局部上皮相互作用的机制。
