HIV infection of the gastrointestinal tract

  • T. Schneider
  • V. Zeitz
Part of the Immunology and Medicine Series book series (IMME, volume 31)


There is growing evidence that the gastrointestinal tract is fundamentally involved in the pathogenesis of human immunodeficiency virus (HIV) infection. Even before the aetiology of the acquired immunodeficiency syndrome (AIDS) was known, it was recognized that the gastrointestinal tract is frequently affected by opportunistic infections and malignancies [1]. During the course of HIV infection most of the patients develop gastrointestinal symptoms. In Europe and North America, prior to the introduction of the highly active antiretroviral combination therapy (HAART), about 18-50% of HIV-infected patients suffered from diarrhoea [2-4]. In developing countries like Zaire or Haiti the percentage of AIDS-patients with diarrhoea is even higher at about 90% [5,6]. In Africa, the clinical symptoms of weight loss and diarrhoea are so prominent that AIDS is commonly referred to as “slim disease” [7]. These observations indicate that during the infection with HIV not only the peripheral immune system is disturbed but also the specialized local immune system termed gut associated lymphoid tissue (GALT). Therefore intestinal HIV/SIV-infection may represent a model for a mucosal immune defect.


Human Immunodeficiency Virus Human Immunodeficiency Virus Type Lamina Propria Intestinal Mucosa Acquire Immunodeficiency Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Gottlieb MS, Groopman JE, Weinstein WM, Fahey JL, Detels R. The aquired immunodeficiency syndrome. Ann Intern Med 1983; 99:208–20.PubMedGoogle Scholar
  2. 2.
    Quinn TC, Piot P, McCormick JB, Feinsod FM, Taelman H, Kapita B, Stevens W, Fauci AS. Serologic and immunologic studies in patients with AIDS in North America and Africa. JAMA 1987; 252:2617–21.Google Scholar
  3. 3.
    Heise W, Mostertz P, Skörde J, L’age M. Gastrointestinale Befunde bei der HIV-Infektion. Dtsch Med Wochenschr 1988; 113:1588–93.PubMedGoogle Scholar
  4. 4.
    Renü E, Marche C, Regnier B, Saimot AG, Vilde JL, Perrone C, Michon C, Wolf M, Chevalier T, Vallot T, et al. Intestinal infections in patients with acquired immunodeficiency syndrome. Dig Dis Sci 1989; 34:773–80.Google Scholar
  5. 5.
    Malebranche R, Arnoux E, Guerin JM et al. Acquired immunodeficiency syndrome with severe gastrointestinal manifestations in Haiti. Lancet 1983; 2:873–7.PubMedGoogle Scholar
  6. 6.
    Colebunders R, Lusakumuni K, Nelson AM, Gigase P, Lebughe I, van Marck E, Kapita B, Francis H, Salaun JJ, Quinn TC, et al. Persistent diarrhoea in Zairian AIDS patients: an endoscopic and histological study. Gut 1988; 29:1687–91.PubMedGoogle Scholar
  7. 7.
    Serwadda D, Mugerwa RD, Sewankambo NK et al. Slim disease: a new disease in Uganda and its association with HTLV-III infection. Lancet 1985; 2:849–52.PubMedGoogle Scholar
  8. 8.
    Lim SG, Condez A, Lee CA, Johnson MA, Elia C, Poulter LW. Loss of mucosal CD4 lymphocytes is an early feature of HIV infection. Clin Exp Imunol 1993; 92:448–54.Google Scholar
  9. 9.
    Schneider T, Jahn H-U, Schmidt W, Riecken E-O, Zeitz M, Ullrich R. Loss of CD4 T lymphocytes in patients infected with Human Immunodeficiency Virus Type 1 is more pronounced in the duodenal mucosa than in the peripheral blood. Gut 1995; 37:524–9.PubMedGoogle Scholar
  10. 10.
    Veazey RS, DeMaria M, Chalifoux LV, Shvetz DE, Pauley DR, Knight HL, Rosenzweig M, Johnson RP, Desrosiers RC, Lackner AA. Gastrointestinal tract as a major site of CD4+ T cell depletion and viral replication in SIV infection. Science 1998; 280:427–31.PubMedGoogle Scholar
  11. 11.
    Kewenig S, Schneider T, Hohloch K, Lampe-Dreyer K, Ullrich R, Stolte N, Stahl-Hennig C, Kaup FJ, Stallmach A, Zeitz M. Rapid mucosal CD4+ T cell depletion and enteropathy in Simian Immunodeficiency Virus-infected Rhesus Macaques. Gastroenterology 1999; 116:1115–23.PubMedGoogle Scholar
  12. 12.
    Kotler DP, Reka S, Borcich A, Cronin WJ. Detection, localisation and quantitation of HIV-assosiated antigens in the intestinal biopsies from patients with HIV. Am J Pathol 1991; 139:823–30.PubMedGoogle Scholar
  13. 13.
    Fackler O, Schäfer M, Schmidt W, Zippel T, Heise W, Schneider T, Zeitz M, Riecken E-O, Muller-Lantzsch N, Ullrich R. HIV-1 p24 but not proviral load is increased in the intestinal mucosa compared to the peripheral blood in HIV-infected patients. AIDS 1998; 12:139–46.PubMedGoogle Scholar
  14. 14.
    Schneider T, Zippel T, Schmidt W, Pauli G, Heise W, Wahschaffe U, Riecken E-O, Zeitz M, Ullrich R. Abnormal predominance of IgG in HIV-specific antibodies produced by short-term cultured duodenal biopsies from patients infected with HIV. J Aquir Immunodefic Syndr 1997; 16:333–9.Google Scholar
  15. 15.
    Zippel T, Schneider T, Schmidt W, Köppe S, Riecken E-O, Ullrich R. Identification of CMV-specific immunoglobulin production by intestinal biopsies of AIDS patients with CMV enteritis. Ann N Y Acad Sci 1998; 859:271–5.PubMedGoogle Scholar
  16. 16.
    Carr A, Marriott D, Field A, Vasak E, Cooper DA. Treatment of HIV-1associated microsporidiosis and cryptosporidiosis with combination antiretroviral therapy. Lancet 1998; 351:256–61.PubMedGoogle Scholar
  17. 17.
    Foudraine NA, Weverling GJ, van Gool T, Roos MU, de Wolf F, Koopmans PP, van den Broek PJ, Meenhorst PL, van Leeuwen R, Lange JMA, Reiss P. Improvement of chronic diarrhoea in patients with advanced HIV-1 infection during potent antiretroviral therapy. AIDS 1998; 12:35–41.PubMedGoogle Scholar
  18. 18.
    Kotler DP, Shimada T, Snow G, Winson G, Chen W, Zhao M, Inada Y, Clayton F. Effect of combination antiretroviral therapy upon rectal mucosal HIV RNA burden and mononuclear cell apoptosis. AIDS 1998; 12:597–604.PubMedGoogle Scholar
  19. 19.
    Dagleish AG, Beverly PCL, Clapham PR, Crawford DH, Greaves MF, Weiss RA. The CD4 (T4) antigen is an essential component of the receptor for the AIDS retrovirus. Nature 1984; 312:763–6.Google Scholar
  20. 20.
    Deng H, Liu R, Ellmeier W et al. Identification of a major co-receptor for primary isolates of HIV-1. Nature 1996; 381:661–6.PubMedGoogle Scholar
  21. 21.
    Dragic T, Litwin V, Allaway GP, Martin SR, Huang Y, Nagashima KA, Cayanan C, Maddon PJ, Koup RA, Moore JP, Paxtom WA. HIV-1 entry into CD4+ cells is mediated by the chemokine receptor CC-CKR-5. Nature 1996; 381:667–73.PubMedGoogle Scholar
  22. 22.
    Schnittman SM, Lane HC, Greenhouse J, Justement JS, Baseler M, Fauci AS. Preferential infection of CD4+ memory T cells by human immunodeficiency virus type 1: Evidence for a role in the selective T-cell functional defects observed in infected individuals. Proc Natl Acad Sci USA 1990; 87:6058–62.PubMedGoogle Scholar
  23. 23.
    Schieferdecker HL, Ullrich R, Hirseland H, Zeitz M. T cell differentiation antigens on lymphocytes in the human intestinal lamina propria. J Immunol 1992; 149:2816–22.PubMedGoogle Scholar
  24. 24.
    Lapenta C, Boirivant M, Marini M, Santini SM, Logozzi M, Belardelli F, Fais S. Human intestinal lamina propria lymphocytes are naturally permissive to HIV-1 infection. Eur. J. Immunol. 1999; 29:1202–8.PubMedGoogle Scholar
  25. 25.
    Amerongen HM, Weltzin R, Famet CM, Michetti P, Haseltine WA, Neutra MR. Transepithelial transport of HIV-1 by intestinal M cells: a mechanism for transmission of AIDS. J Acquir Immune Defic Syndr 1991; 4:760–5.PubMedGoogle Scholar
  26. 26.
    Owen RL, Jones AL. Epithelial cell specialization within human Peyer’s patch: An ultrastructural study of intestinal lymphoid follicles. Gastroenterology 1974; 66:189–203PubMedGoogle Scholar
  27. 27.
    Owen RL, Nemanic P. Antigen processing structures of the mammalian intestinal tract: an SEM study of lymphoepithelial organs. Scanning Electron Microsc 1978; 2:367–78.Google Scholar
  28. 28.
    Owen RL, Pierce NF, Apple RT, Gray WC. M cell transport of Vibrio cholerae from the intestinal lumen into Peyer’s patches: A mechanism for antigen sampling and for microbial transepithelial migration. J Infect Dis 1986; 153:1108–18.PubMedGoogle Scholar
  29. 29.
    Hussain LA, G. KC, Hecht E-M, Fellowes R, Jourdan M, Lehner T. The expression of Fc receptors for immunoglobulin G in human rectal epithelium. AIDS 1991; 5:1089–94.PubMedGoogle Scholar
  30. 30.
    Lehner T, Hussain L, Wilson J, Chapman M. Mucosal transmission of HIV. Nature 1991; 353:709.PubMedGoogle Scholar
  31. 31.
    Fantini J, Yahi N, Chermann J-C. Human immunodeficiency virus can infect the apical and basolateral surface of human colonic epithelial cells. Proc Natl Acad Sci USA 1991; 88:9297–301.PubMedGoogle Scholar
  32. 32.
    Yahi N, Baghdiguian S, Moreau H, Fantini J. Galactosyl ceramide (or a closely related molecule) is the receptor for human immunodeficiency virus type 1 on human colon epithelial HT29 cells. J Virol 1992; 66:4848–54.PubMedGoogle Scholar
  33. 33.
    Mathijs JM, Hing M, Grierson J, Dwyer DE, Goldschmidt C, Cooper DA, Cunningham AL. HIV infection of rectal mucosa. Lancet 1988; 1:1111.PubMedGoogle Scholar
  34. 34.
    Nelson JA, Wiley CA, Reynolds-Kohler C, Reese CE, Margaretten W, Levy JA. Human immunodeficiency virus detected in bowel epithelium from patients with gastrointestinal symptoms. Lancet 1988; 1:259–62.PubMedGoogle Scholar
  35. 35.
    Kingsley LA, Deles R, Kaslow R, al. e. Risk factors for seroconversion to human immunodeficiency virus among male homosexuals. Lancet 1987; i:345–48.Google Scholar
  36. 36.
    Fox CH, Kotler D, Tierney A, Wilson CS, Fauci AS. Detection of HIV-1 RNA in the lamina propria of patients with AIDS and gastrointestinal disease. J Infect Dis 1989; 159:467–71.PubMedGoogle Scholar
  37. 37.
    Ullrich R, Zeitz M, Heise W, L’age M, Höffken G, Riecken EO. Small intestinal structure and function in patients infected with human immunodeficiency virus (HIV): Evidence for HIV-induced enteropathy. Ann Intern Med 1989; 111:15–21.PubMedGoogle Scholar
  38. 38.
    Jarry A, Cortez A, René E, Muzeau F, Brousse N. Infected cells and immune cells in the gastrointestinal tract of AIDS patients. An immunohistochemical study of 127 cases. Histopathology 1990; 16:133–40.PubMedGoogle Scholar
  39. 39.
    Clayton F, Reka S, Gronin WJ, Torlakovic E, Sigal SH, Kotler DP. Rectal mucosal pathology varies with human immunodeficiency virus antigen content and disease stage. Gastroenterology 1992; 103:919–33.PubMedGoogle Scholar
  40. 40.
    Ehrenpreis ED, Patterson BK, Brainer JA, Yokoo H, Rademaker AW, Glogowski W, Noskin GA, Craig RM. Histopathologic findings of duodenal biopsy specimens in HIV-infected patients with and without diarrhoea and malabsorption. Am J Clin Pathol 1992; 97:21–8.PubMedGoogle Scholar
  41. 41.
    Smith PD, Fox CH, Masur H, Winter HS, Ailing DW. Quantitative analysis of mononuclear cells expressing human immundeficiency virus type 1 RNA in esophageal mucosa. J Exp Med 1994; 180:1541–6.PubMedGoogle Scholar
  42. 42.
    Racz P. Pathomorphologie des intestinalen Immunsystems. Presented at the. 3rd German AIDS-Congress 1990:November 24–17, Hamburg.Google Scholar
  43. 43.
    Donze HEI, Cummins JE, Schwiebert R, Kantele A, Han Y, Fultz PN, Jackson S, Mestecky J. HIV-1/Simian Immunodeficiency Virus infection of human and nonhuman primate lymphocytes results in the migration of CD2+ T cells into the intestine of engrafted SCID mice. J Immunol 1998; 160:250613.Google Scholar
  44. 44.
    Pantaleo G, Graziosi C, Butini L, Pizzo PA, Schnittman SM, Kotler DP, Fauci AS. Lymphoid organs function as major reservoirs for human immunodeficiency virus. Proc Natl Acad Sci USA 1991; 88:9838–42.PubMedGoogle Scholar
  45. 45.
    Pantaleo G, Graziosi C, Fauci A. The immunopathogenesis of human immunodeficiency virus infection. N Engl J Med 1993; 328:327–35.PubMedGoogle Scholar
  46. 46.
    Pantaleo G, Graziosi C, Demarest JF, Butini L, Montroni M, Fox CH, Orenstein JM, Kotler DP, Fauci AS. HIV infection is active and progressive in lymphoid tissue during the clinically latent stage of disease. Nature 1993; 362:355–8.PubMedGoogle Scholar
  47. 47.
    Embretson J, Zupanic M, Ribas JL, Burke A, Racz P, Tenner-Racz K, Haase AT. Massive covert infection of helper T lymphocytes and macrophages by HIV during the incubation period of AIDS. Nature 1993; 362:359–62.PubMedGoogle Scholar
  48. 48.
    Du Z, Lang SM, Sasseville VG, Lackner AA, Ilyinskii PO, Daniel MD, Jung JU, Desosiers RC. Identification of a nef allele that causes lymphocyte activation and acute disease in Macaque Monkeys. Cell 1995; 82:665–74.PubMedGoogle Scholar
  49. 49.
    Sasseville VG, Du Z, Chalifoux LV, Pauley DR, Young HL, Sehgal PK, Desrosiers RC, Lackner AA. Induction of lymphocyte proliferation and severe gastrointestinal disease in macaques by a nef gene variant of SIVmac239. Am J Pathol 1996; 149:163–76.PubMedGoogle Scholar
  50. 50.
    Schooley RT. Cytomegalovirus in the setting of infection with human immunodeficiency virus. Rev Infect Dis 1990; 12:811–9.Google Scholar
  51. 51.
    Gimble JM, Duh E, Ostrove JM, Gendelman HE, Max EE, Rabson AB. Activation of the human immunodeficiency virus long terminal repeat by Herpes Simplex Type 1 is associated with induction of a nuclear factor that binds to the NF-kB/core enhancer sequence. J. Virol. 1988; 62:4104–12.PubMedGoogle Scholar
  52. 52.
    Schmidt W, Schneider T, Heise W, Epple H-J, Stöffler-Meilicke M, Liesenfeld O, Ignatius R, Zeitz M, Riecken E-O, Ullrich R. Enteric viruses and coinfections in HIV-infected patients. J Acq Immun Def Synd 1996; 13:33–8.Google Scholar
  53. 53.
    Wu L, Rosser DSE, Schmidt MC, Berk A. A TATA box implicated in EIA transcriptional activation of a simple adenovirus 2 promotor. Nature 1987; 326:512–5.PubMedGoogle Scholar
  54. 54.
    Adachi A, Koenig S, Gendelman HE, Daugherty D, Gattoni CS, Fauci AS, Martin MA. Productive, persistent infection of human colorectal cell lines with human immunodeficiency virus. J Virol 1987; 61:209–13.PubMedGoogle Scholar
  55. 55.
    Bourinbaiar AS, Phillips DM. HIV transmission across intact epithelia. In: VIIIth International Congress of Virology. Berlin, 1990.Google Scholar
  56. 56.
    Bourinbaiar AS, Phillips DM. Transmission of human immunodeficiency virus from monocytes to epithelia. J Acquir Immune Defic Syndr 1991; 4:5663.Google Scholar
  57. 57.
    Fantini J, Yahi N, Baghdiguian S, Chermann J-C. Human colon epithelial cells productively infected with human immunodeficiency virus show impaired differentiation and altered secretion. J Virol 1992; 66:580–5.PubMedGoogle Scholar
  58. 58.
    Delezay O, Yahi N, Tamalet C, Baghdiguian S, Boudier J-A, Fantini J. Direct effect of Type 1 Human Immunodeficiency Virus (HIV-1) on intestinal epithelial cell differentiation: Relationship to HIV-1 enteropathy. Virology 1997; 238:231–42.Google Scholar
  59. 59.
    Bomsel M. Transcytosis of infectious human immunodeficiency virus across a tight human epithelial cell line barrier. Nature Medicine 1997; 3:42–7.PubMedGoogle Scholar
  60. 60.
    Rodgers VD, Fassett R, Kagnoff MF. Abnormalities in intestinal mucosal T cells in homosexual populations including those with the lymphadenopathy syndrome and acquired immunodeficiency syndrome. Gastroenterology 1986; 90:552–8.PubMedGoogle Scholar
  61. 61.
    Ellakany S, Whiteside TL, Schade RR, vanThiel DH. Analysis of intestinal lymphocyte subpopulations in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. Am J Clin Pathol 1987; 87:356–64.PubMedGoogle Scholar
  62. 62.
    Budhraja M, Levendoglu H, Kocka F, Mangkomkanok M, Sherer R. Duodenal mucosal T cell subpopulation and bacterial cultures in acquired immune deficiency syndrome. Am J Gastroenterol 1987; 82:427–31.PubMedGoogle Scholar
  63. 63.
    Ullrich R, Zeitz M, Heise W, L’age M, Ziegler K, Bergs C, Riecken EO. Mucosal atrophy is associated with loss of activated T cells in the duodenal mucosa of human immundeficiency virus (HIV)-infected patients. Digestion 1990; 46(Suppl 2):302–7.PubMedGoogle Scholar
  64. 64.
    Lim SG, Condez A, Poulter LW. Mucosal macrophage subset of the gut in HIV: decrease in antigen-presenting cell phenotype. Clin Exp Immunol 1993; 92:442–7.PubMedGoogle Scholar
  65. 65.
    Schneider T, Ullrich R, Bergs C, Schmidt W, Riecken EO, Zeitz M. Abnormalities in subset distribution, activation, and differentiation of T cells isolated from large intestine biopsies in HIV infection. Clin Exp Immunol 1994; 95:430–5.PubMedGoogle Scholar
  66. 66.
    Clayton F, Snow G, Reka S, Kotler DP. Selective depletion of rectal lamina propria rather than lymphoid aggregate CD4 lympocytes in HIV infection. Clin Exp Immunol 1997; 107:288–92.PubMedGoogle Scholar
  67. 67.
    Van Noesel CJ, Gruters RA, Terpstra FG, Schellekens PT, van Lier RA, Miedema F. Functional and phenotypic evidence for a selective loss of memory T cells in asymptomatic human immunodeficiency virus-infected men. J Clin Invest 1990; 86:293–9.PubMedGoogle Scholar
  68. 68.
    Zhang L, He T, Talal A, Wang G, Frankel SS, Ho DD. In vivo distribution of the Human Immunodeficiency Virus/Simian Immunodeficiency Virus co-receptors: CXCR4, CCR3, and CCR5. J Virol 1998; 72:5035–45.PubMedGoogle Scholar
  69. 69.
    Walker BD, Flexner C, Paradis TJ, Fuller TC, Hirsch MS, Schooley RT, Moss B. HIV-1 reverse transcriptase is a target for cytotoxic T lymphocytes in infected individuals. Science 1988; 240:64–6.PubMedGoogle Scholar
  70. 70.
    Culmann B, Gomard E, Kieny M-P, Guy B, Dreyfus F, Saimot A-G, Sereni D, Levy J-P. An antigenic peptide of the HIV-1 nef protein recognized by cytotoxic T lymphocytes of seropositive individuals in association with different HLA-B molecules. Eur J Immunol 1989; 19:2383–6.PubMedGoogle Scholar
  71. 71.
    Nixon DF, McMichael AJ. Cytotoxic T-cell recognition of HIV proteins and peptides. AIDS 1991; 5:1049–59.PubMedGoogle Scholar
  72. 72.
    Kundu SK, Merigan TC. Equivalent recognition of HIV proteins, Env, Gag and Pol by CD4+ and CD8+ cytotoxic T-lymphocytes. AIDS 1992; 6:643–9.PubMedGoogle Scholar
  73. 73.
    Autran B, Mayaud CM, Raphael M, et al. Evidence for a cytotoxic T-lymphocyte alveolitis in human immunodeficiency virus-infected patients. AIDS 1988; 2:179–83.PubMedGoogle Scholar
  74. 74.
    Evans CM, Phillips AD, Walker-Smith JA, MacDonald TT. Activation of lamina propria cells induces crypt epithelial proliferation and goblet cell depletion in cultured human fetal colon. Gut 1992; 33:230–5.PubMedGoogle Scholar
  75. 75.
    Mackewicz CE, Ortega HW, Levy JA. CD8+ cell anti-HIV activity correlates with the clinical state of the infected individual. J Clin Invest 1991; 87:14626.Google Scholar
  76. 76.
    Nilssen DE, Müller F, Oktedalen O, Stig SF, Fausa O, Halstensen TS, Brantzaeg P. Intraepithelial y/S T cells in duodenal mucosa are related to the immune state and survival time in AIDS. J Virol 1996; 70:3545–50.PubMedGoogle Scholar
  77. 77.
    Li L, Meng G, E. GM, Shaw GM, Smith PD. Intestinal macrophages display reduced permissiveness to Human Immunodeficiency Virus 1 and decreased surface CCR5. Gastroenterology 1999; 116:1043–53.PubMedGoogle Scholar
  78. 78.
    Matusyama T, Kobayashi N, Yamamoto N. Cytokines and HIV infection: is AIDS a tumor necrosis factor disease? AIDS 1991; 5:1405–17.Google Scholar
  79. 79.
    Poli G, Fauci AS. The effect of cytokines and pharmacologic agents on chronic HIV infection. AIDS Res Hum Retroviruses 1992; 8:191–7.PubMedGoogle Scholar
  80. 80.
    Fan J, Bass HZ, Fahey JL. Elevated INF-y and decreased IL-2 gene expression are associated with HIV infection. J Immunol 1993; 151:5031–40.Google Scholar
  81. 81.
    Lathey JL, Kanangat S, Rouse BT. Differential expression of tumor necosis factor-a and interleukin-113 compared with interleukin-6 in monocytes from human immunodeficiency virus-positive individuals measured by polymerase chain reaction. J Acquir Immune Defic Syndr 1994; 7:109–15.PubMedGoogle Scholar
  82. 82.
    Navikas V, Link J, Wahren B, Persson CH, Link H. Increased levels of interferon-gamma (INF-y), IL-4 and transforming growth factor-beta (TGFß) mRNA expressing blood mononuclear cells in human HIV infection. Clin Exp. Immunol 1994; 96:59–63.Google Scholar
  83. 83.
    Kotler DP, Reka S, Clayton F. Intestinal mucosal inflammation associated with human immunodeficiency virus infection. Dig Dis Sci 1993; 38:111927.Google Scholar
  84. 84.
    Steffen M, Reinecker HC, Peterson J, Doehn C, Pfluger I, Voss A, Raedler A. Differences in cytokine secretion by intestinal mononuclear cells, peripheral blood monocytes and alveolar macrophages from HIV-infected patients. Clin Exp Immunol 1993; 91:30–6.PubMedGoogle Scholar
  85. 85.
    Reka S, Kotler DP. Detection and localisation of HIV RNA and TNF mRNA in rectal biopsies from patients with AIDS. Cytokine 1993; 5:305–8.PubMedGoogle Scholar
  86. 86.
    McGowan I, Radford-Smith G, Jewell DP. Cytokine gene expression in HIV-infected intestinal mucosa. AIDS 1994; 8:1569–75.PubMedGoogle Scholar
  87. 87.
    Clerici M, Shearer GM. A TH1 to TH2 switch is a critical step in the etiology of HIV infection. Immunol Today 1993; 14:107–11.PubMedGoogle Scholar
  88. 88.
    Maggi E, Mazzetti M, Ravina A, Annunziato F, De Carli M, Piccinni MP, Manetti R, Carbonari M, Pesce AM, Del Prete G, Romagnani S. Ability of HIV to promote a TH1 to THO shift and to replicate preferentially in TH2 and THO cells. Science 1994; 265:244–8.PubMedGoogle Scholar
  89. 89.
    Graziosi C, Pantaleo G, Gantt KR, Fortin J-P, Demarest JF, Cohen OJ, Sekaly RP, Fauci AS. Lack of evidence for the dichotomy of TH1 and TH2 predominance in HIV-infected individuals. Science 1994; 265:248–52.PubMedGoogle Scholar
  90. 90.
    Smit-McBride Z, Mattapallil JJ, M. M, Ferrick D, Dandekar S. Gastrointestinal T lymphocytes retain high potential for cytokine responses but have severe CD4(+) T-cell depletion at all stages of simian immunodeficiency virus infection compared to peripheral lymphocytes. J Virol 1998; 72:6646–56.PubMedGoogle Scholar
  91. 91.
    Baier M, Werner A, Bannert N, Metzner K, Kurth R. HIV suppression by interleukin-16. Nature 1995; 378:563.PubMedGoogle Scholar
  92. 92.
    Cocchi F, DeVico AL, Garzino-Demo A, Arya SK, Gallo RC, Lusso P. Identification of RANTES, MIP-1a, and MIP-1ß as the major HIV-suppressive factors produced by CD8+ T cells. Science 1995; 270:1811–5.PubMedGoogle Scholar
  93. 93.
    Kotler DP, Scholes JV, Tierney AR. Intestinal plasma cell alterations in the acquired immunodeficiency syndrome. Dig Dis Sci 1987; 32:129–38.PubMedGoogle Scholar
  94. 94.
    Kiyono H, Cooper MD, Kearney JF, Mosteller LM, Michalek SM, Koopman WJ, McGhee JR. Isotype specificitiy of helper T cell clones: Peyer’s patch Th cells preferentially collaborate with mature IgA B cells for IgA responses. J Exp Med 1984; 159:798–811.PubMedGoogle Scholar
  95. 95.
    Kunimoto DY, Harriman GR, Strober W. Regulation of IgA differentiation in CH12LX B cells by lymphokines: IL-4 induces membrane IgM-positive CH12LX cells to express membrane IgA and IL-5 induces membrane IgApositive CH12LX cells to secrete IgA. J Immunol 1988; 141:713–20.PubMedGoogle Scholar
  96. 96.
    Jackson S. Secretory and serum IgA are inversely altered in AIDS patients. In: MacDonald TT, Challacombe SJ, Bland PW, Stokes CR, Heatley RV, Mowat AM, eds. Advances in Mucosal Immunology. Proceedings of the Fifth International Congress of Mucosal Immunology. Dordrecht, Boston, London: Kluwer Academic Press, 1990:665–8.Google Scholar
  97. 97.
    Müller F, Froland SS, Hvatum M, Radl J, Brandtzaeg P. Both IgA subclasses are reduced in parotid saliva from patients with AIDS. Clin exp Immunol 1991; 83:203–9.PubMedGoogle Scholar
  98. 98.
    Janoff EN, Jackson S, Wahl SM, Thomas K, Peterman JH, Smith PD. Intestinal mucosa immunoglobulins during Human Immunodeficiency Viruds Type 1 infection. J Infect Dis 1994; 170:299–307.PubMedGoogle Scholar
  99. 99.
    Schneider T, Zippel T, Schmidt W, Pauli G, Wahnschaffe U, Chakravarti S, Heise W, Riecken E-O, Zeitz M, Ullrich R. Increased immunoglobulin G production by short-term cultured duodenal biopsies from HIV-Infected patients. Gut 1998; 42:357–61.PubMedGoogle Scholar
  100. 100.
    Stockmann M, Fromm M, Schmitz H, Schmidt W, Riecken E-O, Schulzke JD. Duodenal biopsies of HIV-infected patients with diarrhoea exhibit epithelial barrier defects but no active secretion. AIDS 1998; 12:43–51.PubMedGoogle Scholar
  101. 101.
    Eriksson K, Kilander A, Hagberg L, Norkrans G, Holmgren J, Czerkinsky C. Virus-specific antibody production and polyclonal B-cell activation in the intestinal mucosa of HIV-infected individuals. AIDS 1995; 9:695–700.PubMedGoogle Scholar
  102. 102.
    Mathewson JJ, Jiang ZD, DuPont HL, Chintu C, Luo N, Zumala A. Intestinal secretory IgA immune response against human immunodeficiency virus among infected patients with acute and chronic diarrhoea. J Infect Dis 1994; 169:614–7.PubMedGoogle Scholar
  103. 103.
    Mohamed OA, Ashley R, Goldstein A, McElrath J, Dalessio J, Corey L. Detection of rectal antibodies to HIV-1 by a sensitive chemiluminescent Western blot immunodetection method. J Acquir Immune Defic Syndr 1994; 7:375–80.PubMedGoogle Scholar
  104. 104.
    Bomsel M, Heyman M, Hocini H, Lagaye S, Belec L, Dupont C, Desgranges C. Intracellular neutralization of HIV transcytosis across tight epithelial barriers by anti-HIV envelope protein dIgA or IgM. Immunity 1998; 9:27787.Google Scholar
  105. 105.
    Benhamou Y, Kapel N, Hoang C, Matta H, Meillet D, Magne D, Raphael M, Gentilini M, Opolon P, Gobert J-G. Inefficiency of intestnal secretory immune response to Cryptosporidium in AIDS. Gastroenterology 1995; 108:627–35.PubMedGoogle Scholar
  106. 106.
    Janoff EN, Smith PD. Perspectives on gastrointestinal infections in AIDS. Gastroenterol Clin North America 1988; 17:451–63.Google Scholar
  107. 107.
    MacDonald TT, Spencer J. Evidence that activated mucosal T cells play a role in the pathogenesis of enteropathy in human small intestine. J Exp Med 1988; 167:1341–49.PubMedGoogle Scholar
  108. 108.
    MacDonald TT, Spencer J. Gut immunology. Bailliere’s Clin Gastroenterol 1990; 4:291–313.Google Scholar
  109. 109.
    Griffiths CE, Barrison IG, Leonard JN, Caun K, Valdimarsson H, Fry L. Preferential activation of CD4 T lymphocytes in the lamina propria of gluten-sensitive enteropathy. Clin Exp Immunol 1988; 72:280–3.PubMedGoogle Scholar
  110. 110.
    Kotler DP, Gaetz HP, Lange M, Klein EB, Holt PR. Enteropathy associated with the acquired immunodeficiency syndrome. Ann Intern Med 1984; 101:421–8.PubMedGoogle Scholar
  111. 111.
    Batman PA, Miller AR, Forster SM, Harris JR, Pinching AJ, Griffin GE. Jejunal enteropathy associated with human immunodeficiency virus infection: quantitative histology. J Clin Pathol 1989; 42:275–81.PubMedGoogle Scholar
  112. 112.
    Cummins AG, LaBrooy JT, Stanley DP, Rowland R, Shearman DJ. Quantitative histological study of enteropathy associated with HIV infection. Gut 1990; 31:317–21.PubMedGoogle Scholar
  113. 113.
    Kotler DP, Francisco A, Clayton F, Scholes JV, Orenstein.1M. Small intestinal injury and parasitic disease in AIDS. Ann Intern Med 1990; 113:444–9.PubMedGoogle Scholar
  114. 114.
    Batman PA, Fleming SC, Sedgwick PM, MacDonald Ti’, Griffin GE. HIV infection of human fetal intestinal explant cultures induces epithelial cell proliferation. AIDS 1994; 8:161–7.PubMedGoogle Scholar
  115. 115.
    MacDonald TT, Ferguson A. Regulation of villus height: the role of luminal factors in determining the villus height gradient of the mouse small intestine. In: Robinson JWL, Dowling RH, Riecken EO, eds. International conference on intestinal adaptation. Lancaster: MTP Press, 1982:47–53.Google Scholar
  116. 116.
    Palella F, Delaney K, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med 1998; 338:853–60.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • T. Schneider
  • V. Zeitz

There are no affiliations available

Personalised recommendations