Rectal mucosal pathology varies with human immunodeficiency virus antigen content and disease stage

Frederic Clayton, Safak Reka, William J. Cronin, Emina Torlakovic, Samuel H. Sigal, Donald P. Kotler

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Rectal mucosal biopsy specimens from 75 human immunodeficiency virus (HIV)-seropositive and 16 HIV-seronegative subjects were examined. The histopathologic changes were correlated with immunoperoxidase staining for UCHL-1 and HIV core protein p24, quantitative p24 enzyme-linked immunosorbent assay (ELISA) assay in homogenized rectal tissue and serum, and a modified Walter Reed clinical stage. Four phases were seen in the HIV-infected subjects: (1) early phase, in Walter Reed stage 1-2 subjects, with nearly normal histology and low p24; (2) inflammatory phase, typically in Walter Reed stage 3-4 subjects, with a superficial lamina propria infiltrate of lymphocytes, plasma cells, and eosinophils with degranulation, abundant UCHL-1 staining, and maximal p24 by both immunoperoxidase staining and ELISA; (3) transitional phase, in many Walter Reed 5 and some Walter Reed 6 subjects, with normal lymphocyte population density but with subtle inflammatory changes; and (4) lymphoid depletion phase, mainly in Walter Reed stage 6 subjects, with decreased lymphocytes but often with endothelial cell activation and apoptosis. These phases presumably result from effective HIV suppression by a relatively intact immune system, followed by maximal HIV infection and lymphocyte activation, then progressive lymphocyte depletion. The inflammation correlated with the presence and amount of HIV in rectal tissue determined by immunohistochemistry and ELISA and was maximal before overt immunodeficiency developed. Intestinal mucosa could be a preferred site of HIV proliferation and T-cell destruction.

Original languageEnglish (US)
Pages (from-to)919-933
Number of pages15
JournalGastroenterology
Volume103
Issue number3
StatePublished - 1992
Externally publishedYes

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HIV
Pathology
Antigens
Enzyme-Linked Immunosorbent Assay
Lymphocytes
Staining and Labeling
Lymphocyte Depletion
Virus Activation
Virus Diseases
Intestinal Mucosa
Lymphocyte Activation
Population Density
Plasma Cells
Eosinophils
Immune System
Histology
Mucous Membrane
Endothelial Cells
Immunohistochemistry
Apoptosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Clayton, F., Reka, S., Cronin, W. J., Torlakovic, E., Sigal, S. H., & Kotler, D. P. (1992). Rectal mucosal pathology varies with human immunodeficiency virus antigen content and disease stage. Gastroenterology, 103(3), 919-933.

Rectal mucosal pathology varies with human immunodeficiency virus antigen content and disease stage. / Clayton, Frederic; Reka, Safak; Cronin, William J.; Torlakovic, Emina; Sigal, Samuel H.; Kotler, Donald P.

In: Gastroenterology, Vol. 103, No. 3, 1992, p. 919-933.

Research output: Contribution to journalArticle

Clayton, F, Reka, S, Cronin, WJ, Torlakovic, E, Sigal, SH & Kotler, DP 1992, 'Rectal mucosal pathology varies with human immunodeficiency virus antigen content and disease stage', Gastroenterology, vol. 103, no. 3, pp. 919-933.
Clayton, Frederic ; Reka, Safak ; Cronin, William J. ; Torlakovic, Emina ; Sigal, Samuel H. ; Kotler, Donald P. / Rectal mucosal pathology varies with human immunodeficiency virus antigen content and disease stage. In: Gastroenterology. 1992 ; Vol. 103, No. 3. pp. 919-933.
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