DNA viruses in the pathogenesis of sporadic chronic idiopathic intestinal pseudo-obstruction
DNA viruses in the pathogenesis of sporadic chronic idiopathic intestinal pseudo-obstruction
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DOI：
10.1136/gut.41.1.100
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发表时间：
1997-07-01
期刊：
影响因子：
24.5
通讯作者：
Jeffries, DJ
中科院分区：
文献类型：
--
作者：
Debinski, HS;Kamm, MA;Jeffries, DJ
背景 - 慢性特发性假性肠梗阻 (CIIP) 的遗传形式已得到充分描述，但大多数散发性 CIIP 病例的病因尚不清楚。目的 - 确定疱疹病毒是否可以在胃肠道中持续存在，从而将其与 CIIP 的发病机制联系起来。方法 - 来自 13 名 CIIP 患者的 21 份小肠和大肠标本 通过巢式聚合酶链式反应 (PCR) 和原位 DNA，对 8 名内脏肌病、3 名内脏神经病、2 名未分化患者和 12 名接受结直肠癌手术的患者（对照）进行了疱疹病毒 DNA（巨细胞病毒、EB 病毒 (EBV)、1 型单纯疱疹病毒和水痘测试病毒）的证据检查 杂交 (ISH) 将信号定位到固有肌层或肌间神经丛。结果 - 使用巢式 PCR 进行筛查，三名患者的结果呈阳性。一名患有炎症性内脏神经病的患者通过 PCR 在小肠中检测到 EBV，ISH 证明其定位于肌间神经丛中的神经元。一名内脏肌病患者的小肠和大肠中均检测到 EBV DNA；一名内脏神经病变患者的小肠 CMV DNA 呈阳性（ISH 均为阴性）。对照组织中没有任何病毒呈阳性。结论 - 在个别患者中，似乎有证据表明病毒病因与散发性 CIIP 相关。嗜神经病毒在急性和慢性运动障碍中的作用需要进一步研究。
Background - Hereditary forms of chronic idiopathic intestinal pseudo-obstruction (CIIP) are well described but the aetiology of most cases of sporadic CIIP is unknown.Aim - To determine whether herpes viruses can persist in the gastrointestinal tract, thereby implicating them in the pathogenesis of CIIP.Methods - Twenty one specimens of small and large intestine from 13 patients with CIIP (eight visceral myopathy, three visceral neuropathy, two undifferentiated), and 12 patients operated on for colorectal cancer (controls) were examined for evidence of Herpesvirus DNA (cytomegalovirus, Epstein-Barr virus (EBV), herpes simplex virus type 1, and varicella tester virus) by nested polymerase chain reaction (PCR) and in situ DNA hybridisation (ISH) to localise signal to the muscularis propria or myenteric plexus.Results - Screening with nested PCR produced three patients with positive results. One patient with an inflammatory visceral neuropathy had EBV detected in the small intestine by PCR, and ISH demonstrated localisation to neurones in the myenteric plexus. A patient with a visceral myopathy had EBV DNA in both the small and large intestine; and one patient with a visceral neuropathy had small intestine positive for CMV DNA (both negative by ISH). No control tissue was positive for any virus.Conclusions - In individual patients there appears to be evidence linking a viral aetiology to sporadic CIIP. The role of neurotropic viruses in acute and chronic motility disturbances needs further study.