Serological markers for inflammatory bowel disease in AIDS patients with evidence of microbial translocation.
BACKGROUND
Breakdown of the gut mucosal barrier during chronic HIV infection allows translocation of bacterial products such as lipopolysaccharides (LPS) from the gut into the circulation. Microbial translocation also occurs in inflammatory bowel disease (IBD). IBD serological markers are useful in the diagnosis of IBD and to differentiate between Crohn's disease (CD) and ulcerative colitis (UC). Here, we evaluate detection of IBD serological markers in HIV-infected patients with advanced disease and their relationship to HIV disease markers.


METHODS
IBD serological markers (ASCA, pANCA, anti-OmpC, and anti-CBir1) were measured by ELISA in plasma from AIDS patients (n = 26) with low CD4 counts (<300 cells/µl) and high plasma LPS levels, and results correlated with clinical data. For meta-analysis, relevant data were abstracted from 20 articles.


RESULTS
IBD serological markers were detected in approximately 65% of AIDS patients with evidence of microbial translocation. An antibody pattern consistent with IBD was detected in 46%; of these, 75% had a CD-like pattern. Meta-analysis of data from 20 published studies on IBD serological markers in CD, UC, and non-IBD control subjects indicated that IBD serological markers are detected more frequently in AIDS patients than in non-IBD disease controls and healthy controls, but less frequently than in CD patients. There was no association between IBD serological markers and HIV disease markers (plasma viral load and CD4 counts) in the study cohort.


CONCLUSIONS
IBD serological markers may provide a non-invasive approach to monitor HIV-related inflammatory gut disease. Further studies to investigate their clinical significance in HIV-infected individuals are warranted.
Department of Cancer Immunology and AIDS, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
Anupa
A
Kamat
Petronela
P
Ancuta
Richard S
RS
Blumberg
Dana
D
Gabuzda
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000150:complications / Q000276:immunology; D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D018988:Bacterial Translocation; D015415:Biomarkers / Q000097:blood*; D018791:CD4 Lymphocyte Count; D018925:Chemokines / Q000097:blood; D016207:Cytokines / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique / Q000379:methods; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000150:complications / Q000276:immunology; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D008875:Middle Aged; D018272:Porins / Q000276:immunology; D012441:Saccharomyces cerevisiae / Q000276:immunology
D019268:Antibodies, Antineutrophil Cytoplasmic; D015415:Biomarkers; D018925:Chemokines; D016207:Cytokines; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D008070:Lipopolysaccharides; C113724:OmpC protein; D018272:Porins