Faecal tumour necrosis factor-α in individuals with HIV-related diarrhoea
Faecal tumour necrosis factor-α in individuals with HIV-related diarrhoea
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HIV 相关腹泻患者粪便肿瘤坏死因子-α
DOI：
10.1097/00002030-199610090-00009
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发表时间：
1996
期刊：
影响因子：
3.8
通讯作者：
B. Gazzard
中科院分区：
文献类型：
--
作者：
D. Sharpstone;A. Rowbottom;M. Nelson;M. W. Lepper;B. Gazzard
目的：HIV相关胃肠道感染与腹泻、体重减轻、粘膜炎症和肠道通透性增加有关。由于肿瘤坏死因子（TNF）-α可能介导这些特征，因此在患有腹泻的HIV血清阳性个体的粪便中测定了该细胞因子，以评估其在HIV相关胃肠道疾病发病机制中的作用以及与特定肠道病原体的相关性。设计：前瞻性研究。方法：204例HIV血清阳性个体提供粪便样本，使用标准夹心酶联免疫吸附试验分析粪便TNF-α（FTNF-α）。结果：细菌性、巨细胞病毒性和微孢子虫性腹泻患者粪便中FTNF-α水平显著高于病原体阴性腹泻患者（P < 0.05）。FTNF-α在隐孢子虫病、病原体阴性或固体粪便中不升高。在腹泻持续时间超过2周且3份粪便样本肠道病原体阴性的受试者中，FTNF-α> 15 U/ml诊断大肠杆菌相关CMV肠炎的敏感性为88%，特异性为66%。结论：TNF-α的产生可能在HIV血清阳性个体的细菌性、微孢子虫性和CMV相关性腹泻的发病机制中起作用。因此，抗TNF-α药物可能在这些疾病的管理中具有治疗作用。在明显病原体阴性的腹泻中，FTNF-α大于15 U/ml可能提示内镜胃肠道活检诊断CMV肠炎。
Objective:HIV-related gastrointestinal infection is associated with diarrhoea, weight loss, mucosal inflammation and increased intestinal permeability. As tumour necrosis factor (TNF)-α may mediate these features this cytokine was measured in the faeces of HIV-seropositive individuals with diarrhoea to assess its role in the pathogenesis of HIV-related gastrointestinal disease and the association with specific intestinal pathogens. Design:Prospective study. Methods:Two hundred and four HIV-seropositive individuals provided stool samples that were analysed for faecal TNF-α (FTNF-α) using a standard sandwich enzyme-linked immunosorbent assay. Results:Stool from patients with bacterial, cytomegalovirus (CMV) and microsporidial diarrhoea had significantly elevated FTNF-α compared with those who had pathogen-negative diarrhoea (P < 0.05). FTNF-α was not raised in cryptosporidiosis, pathogen-negative or solid stool. In subjects with diarrhoea of more than 2 weeks duration and three stool samples negative for enteric pathogens, FTNF-α greater than 15 U/ml has a sensitivity of 88% and a specificity of 66% for the diagnosis of diarrhoea-related CMV enteritis. Conclusion:TNF-α production may have a role in the pathogenesis of bacterial, microsporidial and CMV-related diarrhoea in HIV-seropositive individuals. Thus, anti-TNF-α agents may have a therapeutic role in the management of these conditions. FTNF-α greater than 15 U/ml in apparently pathogen-negative diarrhoea may suggest endoscopic gastrointestinal biopsy to diagnose CMV enteritis.