title: HIV enteropathy: HAART reduces HIV-induced stem cell hyperproliferation and crypt hypertrophy to normal in jejunal mucosa.
abstract: OBJECTIVE
  To analyse the structural and kinetic response of small intestinal crypt epithelial cells including stem cells to highly active antiretroviral therapy (HAART).
  
  
  METHODS
  Crypt size and proliferative activity of transit and stem cells in jejunal mucosa were quantified using morphometric techniques.
  
  
  METHODS
  Crypt length was measured by counting the number of enterocytes along one side of a number of crypts in each biopsy specimen and the mean crypt length was calculated. Proliferating crypt cells were identified with MIB-1 monoclonal antibody, and the percentage of crypt cells in proliferation was calculated at each cell position along the length of the crypt (proliferation index). Data were obtained from 9 HIV-positive test patients co-infected with microsporidia, 34 HIV-positive patients receiving HAART and 13 control cases.
  
  
  RESULTS
  Crypt length was significantly greater in test patients than in controls, but crypt length in patients receiving HAART was normal. The proliferation index was greater in test subjects than in controls in stem and transit cell compartments, and was decreased in patients treated with HAART only in the stem cell region of the crypt.
  
  
  CONCLUSIONS
  Villous atrophy in HIV enteropathy is attributed to crypt hypertrophy and encroachment of crypt cells onto villi. HAART restores normal crypt structure by inhibition of HIV-driven stem cell hyperproliferation at the crypt bases.
authors.affiliation: Department of Life Sciences, University of Bradford, , Bradford, UK.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Batman
authors.forename: Moses S
authors.initials: MS
authors.lastname: Kapembwa
authors.forename: Liliana
authors.initials: L
authors.lastname: Belmonte
authors.forename: Gregory
authors.initials: G
authors.lastname: Tudor
authors.forename: Donald P
authors.initials: DP
authors.lastname: Kotler
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Potten
authors.forename: Catherine
authors.initials: C
authors.lastname: Booth
authors.forename: Pedro
authors.initials: P
authors.lastname: Cahn
authors.forename: George E
authors.initials: GE
authors.lastname: Griffin
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D049109:Cell Proliferation / Q000187:drug effects*; D019053:HIV Enteropathy / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D006984:Hypertrophy / Q000473:pathology; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology*; D007583:Jejunum / Q000187:drug effects / Q000473:pathology; D008940:Mitotic Index; D013234:Stem Cells / Q000187:drug effects* / Q000473:pathology
keywords: AIDS; Cell Counting; HIV Pathogenesis; Proliferation; Small Intestine