title: High mucosal levels of tumor necrosis factor alpha messenger RNA in AIDS-associated cytomegalovirus-induced esophagitis.
abstract: OBJECTIVE
  To evaluate the role of tumor necrosis factor alpha (TNF-alpha), a key inflammatory cytokine, in cytomegalovirus-associated gastrointestinal disease, we quantitated the level of TNF-alpha messenger RNA (mRNA) in esophageal mucosa from patients with cytomegalovirus-associated esophagitis and acquired immunodeficiency syndrome.
  
  
  METHODS
  Four patients underwent endoscopic biopsy of their cytomegalovirus-associated esophageal ulcers before and after ganciclovir therapy. The level of TNF-alpha mRNA in coded esophageal specimens was assessed by in situ hybridization, reverse-transcription polymerase chain reaction, and quantitative polymerase chain reaction.
  
  
  RESULTS
  Esophageal mucosa from 3 patients whose ulcers healed or markedly improved contained before therapy numerous macrophages expressing TNF-alpha mRNA and high tissue levels of TNF-alpha mRNA that decreased substantially or were not detectable after therapy. In contrast, esophageal specimens from the single patient whose ulcer worsened after therapy contained many mucosal macrophages expressing TNF-alpha mRNA before as well as after therapy, and the high number of molecules of TNF-alpha mRNA present in the tissue before therapy increased further after treatment.
  
  
  CONCLUSIONS
  Increased macrophage production and high tissue levels of TNF-alpha mRNA are associated with cytomegalovirus-associated esophageal ulcers and probably contribute to the inflammatory response associated with cytomegalovirus-induced gastrointestinal disease.
authors.affiliation: Department of Medicine, University of Alabama School of Medicine, Birmingham, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Wilcox
authors.forename: P R
authors.initials: PR
authors.lastname: Harris
authors.forename: T K
authors.initials: TK
authors.lastname: Redman
authors.forename: S
authors.initials: S
authors.lastname: Kawabata
authors.forename: T
authors.initials: T
authors.lastname: Hiroi
authors.forename: H
authors.initials: H
authors.lastname: Kiyono
authors.forename: P D
authors.initials: PD
authors.lastname: Smith
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000378:metabolism*; D003586:Cytomegalovirus Infections / Q000378:metabolism*; D004941:Esophagitis / Q000378:metabolism* / Q000821:virology; D006801:Humans; D009092:Mucous Membrane / Q000378:metabolism / Q000821:virology; D012333:RNA, Messenger / Q000096:biosynthesis; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*
chemical_list: D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha