RT Journal Article
SR Electronic
T1 HIV enteropathy: HAART reduces HIV-induced stem cell hyperproliferation and crypt hypertrophy to normal in jejunal mucosa
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 14
OP 18
DO 10.1136/jclinpath-2012-201289
VO 67
IS 1
A1 Philip A Batman
A1 Moses S Kapembwa
A1 Liliana Belmonte
A1 Gregory Tudor
A1 Donald P Kotler
A1 Christopher S Potten
A1 Catherine Booth
A1 Pedro Cahn
A1 George E Griffin
YR 2014
UL http://jcp.bmj.com/content/67/1/14.abstract
AB Objective To analyse the structural and kinetic response of small intestinal crypt epithelial cells including stem cells to highly active antiretroviral therapy (HAART). Design 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.