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. 1990 Mar;31(3):317–321. doi: 10.1136/gut.31.3.317

Quantitative histological study of enteropathy associated with HIV infection.

A G Cummins 1, J T LaBrooy 1, D P Stanley 1, R Rowland 1, D J Shearman 1
PMCID: PMC1378274  PMID: 2323596

Abstract

A quantitative histological study was performed on small intestinal biopsies from eight ambulatory patients with HIV infection (AIDS/AIDS-related complex, ARC) and compared with those from 16 normal subjects. Enteropathy was assessed by measurement of villus area, crypt length and mitotic count, as well as duodenal counts of intraepithelial lymphocytes, mucosal mast cells and goblet cells. Enteropathy in subjects with AIDS/ARC was shown by reduced mean villus area of 0.363 (SD 0.081) compared with 0.500 (SD 0.064) mm2 in control subjects (p less than 0.0001), while intestinal crypts were of similar length with 239 (SD 36) compared with 225 (SD 28 microns, but mitotic count was increased to 3.8 (SD 1.2) compared with 2.4 (SD 0.8) (p = 0.01) in the same control subjects. These results indicate villous atrophy with impaired crypt hyperplasia. Duodenal cell counts showed similar numbers of mucosal mast cells, intraepithelial lymphocytes and goblet cells in AIDS/ARC patients and fifteen control subjects.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Antony M. A., Brandt L. J., Klein R. S., Bernstein L. H. Infectious diarrhea in patients with AIDS. Dig Dis Sci. 1988 Sep;33(9):1141–1146. doi: 10.1007/BF01535791. [DOI] [PubMed] [Google Scholar]
  2. Batman P. A., Miller A. R., Forster S. M., Harris J. R., Pinching A. J., Griffin G. E. Jejunal enteropathy associated with human immunodeficiency virus infection: quantitative histology. J Clin Pathol. 1989 Mar;42(3):275–281. doi: 10.1136/jcp.42.3.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bramble M. G., Zucoloto S., Wright N. A., Record C. O. Acute gluten challenge in treated adult coeliac disease: a morphometric and enzymatic study. Gut. 1985 Feb;26(2):169–174. doi: 10.1136/gut.26.2.169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chandler F. W., White E. H., Callaway C. S., Spira T. J., Ewing E. P., Jr Unidentified virus-like particles in the intestine of patients with the acquired immunodeficiency syndrome. Ann Intern Med. 1984 Jun;100(6):851–853. doi: 10.7326/0003-4819-100-6-851. [DOI] [PubMed] [Google Scholar]
  5. Colebunders R., Lusakumuni K., Nelson A. M., Gigase P., Lebughe I., van Marck E., Kapita B., Francis H., Salaun J. J., Quinn T. C. Persistent diarrhoea in Zairian AIDS patients: an endoscopic and histological study. Gut. 1988 Dec;29(12):1687–1691. doi: 10.1136/gut.29.12.1687. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cummins A. G., Kenny A. L., Duncombe V. M., Bolin T. D., Davis A. E. The effect of protein deficiency on systemic release of rat mucosal mast cell protease II during Nippostrongylus brasiliensis infection and following systemic anaphylaxis. Immunol Cell Biol. 1987 Aug;65(Pt 4):357–363. doi: 10.1038/icb.1987.40. [DOI] [PubMed] [Google Scholar]
  7. Cummins A. G., Munro G. H., Huntley J. F., Miller H. R., Ferguson A. Separate effects of irradiation and of graft-versus-host reaction on rat mucosal mast cells. Gut. 1989 Mar;30(3):355–360. doi: 10.1136/gut.30.3.355. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cummins A. G., Munro G. H., Miller H. R., Ferguson A. Effect of cyclosporin A treatment on the enteropathy of graft-versus-host reaction in the rat: a quantitative study of intestinal morphology, epithelial cell kinetics and mucosal immune activity. Immunol Cell Biol. 1989 Jun;67(Pt 3):153–160. doi: 10.1038/icb.1989.25. [DOI] [PubMed] [Google Scholar]
  9. Cummins A. G., Steele T. W., LaBrooy J. T., Shearman D. J. Maturation of the rat small intestine at weaning: changes in epithelial cell kinetics, bacterial flora, and mucosal immune activity. Gut. 1988 Dec;29(12):1672–1679. doi: 10.1136/gut.29.12.1672. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Ferguson A., Jarrett E. E. Hypersensitivity reactions in small intestine. I Thymus dependence of experimental 'partial villous atrophy'. Gut. 1975 Feb;16(2):114–117. doi: 10.1136/gut.16.2.114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Ferguson A., Sutherland A., MacDonald T. T., Allan F. Technique for microdissection and measurement in biopsies of human small intestine. J Clin Pathol. 1977 Nov;30(11):1068–1073. doi: 10.1136/jcp.30.11.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Gillin J. S., Shike M., Alcock N., Urmacher C., Krown S., Kurtz R. C., Lightdale C. J., Winawer S. J. Malabsorption and mucosal abnormalities of the small intestine in the acquired immunodeficiency syndrome. Ann Intern Med. 1985 May;102(5):619–622. doi: 10.7326/0003-4819-102-5-619. [DOI] [PubMed] [Google Scholar]
  13. Goodman T., Lefrançois L. Expression of the gamma-delta T-cell receptor on intestinal CD8+ intraepithelial lymphocytes. Nature. 1988 Jun 30;333(6176):855–858. doi: 10.1038/333855a0. [DOI] [PubMed] [Google Scholar]
  14. Guix M., Skinner J. M., Whitehead R. Measuring intraepithelial lymphocytes, surface area, and volume of lamina propria in the jejunal mucosa of coeliac patients. Gut. 1979 Apr;20(4):275–278. doi: 10.1136/gut.20.4.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Harper J. F. Peritz' F test: basic program of a robust multiple comparison test for statistical analysis of all differences among group means. Comput Biol Med. 1984;14(4):437–445. doi: 10.1016/0010-4825(84)90044-1. [DOI] [PubMed] [Google Scholar]
  16. Irani A. M., Craig S. S., DeBlois G., Elson C. O., Schechter N. M., Schwartz L. B. Deficiency of the tryptase-positive, chymase-negative mast cell type in gastrointestinal mucosa of patients with defective T lymphocyte function. J Immunol. 1987 Jun 15;138(12):4381–4386. [PubMed] [Google Scholar]
  17. Karlsson G., Hansson H. A., Petruson B., Björkander J., Hanson L. A. Goblet cell number in the nasal mucosa relates to cell-mediated immunity in patients with antibody deficiency syndromes. Int Arch Allergy Appl Immunol. 1985;78(1):86–91. doi: 10.1159/000233868. [DOI] [PubMed] [Google Scholar]
  18. Kotler D. P., Gaetz H. P., Lange M., Klein E. B., Holt P. R. Enteropathy associated with the acquired immunodeficiency syndrome. Ann Intern Med. 1984 Oct;101(4):421–428. doi: 10.7326/0003-4819-101-4-421. [DOI] [PubMed] [Google Scholar]
  19. Kotler D. P., Weaver S. C., Terzakis J. A. Ultrastructural features of epithelial cell degeneration in rectal crypts of patients with AIDS. Am J Surg Pathol. 1986 Aug;10(8):531–538. doi: 10.1097/00000478-198608000-00002. [DOI] [PubMed] [Google Scholar]
  20. Lorenz-Meyer H., Köhn R., Riecken E. O. Vergleich verschiedener morphometrischer Methoden zur Erfassung der Schleimhautoberfläche des Rattendünndarms und deren Beziehung zur Funktion. Histochemistry. 1976 Oct 22;49(2):123–129. doi: 10.1007/BF00495676. [DOI] [PubMed] [Google Scholar]
  21. MacDonald T. T., Ferguson A. Hypersensitivity reactions in the small intestine. III. The effects of allograft rejection and of graft-versus-host disease on epithelial cell kinetics. Cell Tissue Kinet. 1977 Jul;10(4):301–312. [PubMed] [Google Scholar]
  22. MacDonald T. T., Spencer J. Evidence that activated mucosal T cells play a role in the pathogenesis of enteropathy in human small intestine. J Exp Med. 1988 Apr 1;167(4):1341–1349. doi: 10.1084/jem.167.4.1341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Malebranche R., Arnoux E., Guérin J. M., Pierre G. D., Laroche A. C., Péan-Guichard C., Elie R., Morisset P. H., Spira T., Mandeville R. Acquired immunodeficiency syndrome with severe gastrointestinal manifestations in Haiti. Lancet. 1983 Oct 15;2(8355):873–878. doi: 10.1016/s0140-6736(83)90868-1. [DOI] [PubMed] [Google Scholar]
  24. Marsh M. N. Studies of intestinal lymphoid tissue. XI--The immunopathology of cell-mediated reactions in gluten sensitivity and other enteropathies. Scanning Microsc. 1988 Sep;2(3):1663–1684. [PubMed] [Google Scholar]
  25. Mayrhofer G., Bazin H. Nature of the thymus dependency of mucosal mast cells. III. Mucosal mast cells in nude mice and nude rats, in B rats and in a child with the Di George syndrome. Int Arch Allergy Appl Immunol. 1981;64(3):320–331. doi: 10.1159/000232710. [DOI] [PubMed] [Google Scholar]
  26. Menge H., Germer C. T., Stössel R., Simes G., Hahn H., Riecken E. O. Pathogenesis of the mucosal hyperplasia in self-filling blind loops of rat jejunum: a morphometric study in germ free animals. Gut. 1987;28 (Suppl):175–180. doi: 10.1136/gut.28.suppl.175. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Miller H. R., Nawa Y. Nippostrongylus brasiliensis: intestinal goblet-cell response in adoptively immunized rats. Exp Parasitol. 1979 Feb;47(1):81–90. doi: 10.1016/0014-4894(79)90010-9. [DOI] [PubMed] [Google Scholar]
  28. Mowat A. M., Ferguson A. Intraepithelial lymphocyte count and crypt hyperplasia measure the mucosal component of the graft-versus-host reaction in mouse small intestine. Gastroenterology. 1982 Aug;83(2):417–423. [PubMed] [Google Scholar]
  29. Nawa Y., Miller H. R. Adoptive transfer of the intestinal mast cell response in rats infected with Nippostrongylus brasiliensis. Cell Immunol. 1979 Feb;42(2):225–239. doi: 10.1016/0008-8749(79)90188-6. [DOI] [PubMed] [Google Scholar]
  30. Rodgers V. D., Fassett R., Kagnoff M. F. Abnormalities in intestinal mucosal T cells in homosexual populations including those with the lymphadenopathy syndrome and acquired immunodeficiency syndrome. Gastroenterology. 1986 Mar;90(3):552–558. doi: 10.1016/0016-5085(86)91108-x. [DOI] [PubMed] [Google Scholar]
  31. Wenzel S., Irani A. M., Sanders J. M., Bradford T. R., Schwartz L. B. Immunoassay of tryptase from human mast cells. J Immunol Methods. 1986 Jan 22;86(1):139–142. doi: 10.1016/0022-1759(86)90277-2. [DOI] [PubMed] [Google Scholar]

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