Boivin G, Olson C A, Quirk M R, Kringstad B, Hertz M I, Jordan M C
Department of Medicine, University of Minnesota Medical School, Minneapolis, USA.
J Infect Dis. 1996 Jun;173(6):1304-12. doi: 10.1093/infdis/173.6.1304.
Cytomegalovirus (CMV) is often present in bronchoalveolar lavage (BAL) fluid of immunosuppressed patients without CMV pneumonitis. The amount of viral DNA within BAL cells of patients with definite CMV pneumonitis and of viral shedders was quantitated by polymerase chain reaction (PCR) and the extent of CMV gene expression within BAL cells was defined by reverse transcription - PCR. No viral DNA was detected in 6 viral shedders, and 12 had low copy numbers (mean, 72 copies/10(5) BAL cells; median, 20) compared with numbers in pneumonitis patients (267,580 and 57,000, respectively). When CMV intranuclear inclusions were absent within BAL cells of patients with pneumonitis, copy numbers (mean, 9362; median, 7110) were still significantly higher than among shedders. Expression of viral glycoprotein H mRNA was detected in BAL cells of all 11 pneumonitis patients tested but in 0 of 18 viral shedders. Thus, high-grade infection and viral replication within BAL cells are integral features of CMV pneumonitis but not viral shedding.
巨细胞病毒（CMV）常存在于无CMV肺炎的免疫抑制患者的支气管肺泡灌洗（BAL）液中。通过聚合酶链反应（PCR）对确诊为CMV肺炎的患者和病毒排出者的BAL细胞内的病毒DNA量进行定量，并通过逆转录 - PCR确定BAL细胞内CMV基因表达的程度。在6名病毒排出者中未检测到病毒DNA，与肺炎患者相比，12名病毒排出者的病毒DNA拷贝数较低（平均72拷贝/10⁵个BAL细胞；中位数20）（肺炎患者分别为267,580和57,000）。当肺炎患者的BAL细胞内无CMV核内包涵体时，其拷贝数（平均9362；中位数7110）仍显著高于病毒排出者。在所检测的11名肺炎患者的BAL细胞中均检测到病毒糖蛋白H mRNA的表达，但18名病毒排出者中无一例检测到。因此，BAL细胞内的高度感染和病毒复制是CMV肺炎的固有特征，而非病毒排出。
