Duodenal intraepithelial and lamina propria T lymphocytes in human immunodeficiency virus-infected patients with and without diarrhoea.
BACKGROUND
Diarrhoea is an important problem in human immunodeficiency virus (HIV)-infected patients. Intestinal pathologic conditions may arise from changes in local immunocyte populations. The aims of our study were to establish the histologic features of the duodenal mucosa of HIV-infected patients and to determine a) the phenotype of small-intestinal-intraepithelial (IELs) and lamina propria (LPLs)-lymphocytes; b) their degree of activation and differentiation within the lamina propria; and c) their relation to the presence of diarrhoea.


METHODS
Distal duodenal biopsy specimens were obtained prospectively from 29 HIV-infected patients-11 patients with diarrhoea (group 1) and 18 patients without diarrhoea (group 2)- and from 42 patients who had neither any risk factor for HIV nor diarrhoea (group 3). Histopathologic and immunohistochemical studies were combined with flow cytometric analysis, after separation of the mucosal intraepithelial compartment from the lamina propria.


RESULTS
The median number of IELs and the percentage of gamma delta IELs were both unchanged in HIV-infected patients as compared with controls. In HIV-infected patients LP CD4 cells were decreased, and LP CD8 cells increased. No significant difference was found in the expression of CD25 or CD27 within the LP CD8 populations of HIV-infected patients in groups 1 and 2.


CONCLUSIONS
These findings suggest that the occurrence of diarrhoea in HIV-infected patients is unrelated to IEL and LPL phenotype.
Snijders
F
F
Division of Infectious Diseases, Tropical Medicine, and AIDS, University of Amsterdam, The Netherlands.
Meenan
J
J
van den Blink
B
B
van Deventer
S J
SJ
ten Kate
F J
FJ
D000328:Adult; D000368:Aged; D001706:Biopsy; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes; D016009:Chi-Square Distribution; D003967:Diarrhea / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D004386:Duodenum; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies