Intestinal Mucosal Injury In Patients With HIV Infection

Objective:To compare the difference and correlation of colonoscopy,histopathology and expression of tight junction protein Claudin-1 in intestinal mucosal epithelial cells among patients who were early HIV infected,AIDS infected and healthy.To explore the dynamic changes of intestinal mucosal injury during the course of HIV infection.Methods:Early HIV infected patients,AIDS infected patients and healthy people were divided into group A,group B and group C.The intestinal mucosal injury and pathological changes of the three groups were directly observed by colonoscopy,At the same time,we collected colon mucosal tissues of all the participants to observe and analyze the pathological manifestations of intestinal tissue by light microscope.During the process,Western blotting and immunohistochemistry were applied to assess the expression of tight junction protein Claudin-1.SPSS17.0 software was utilized to analyze the difference and correlation of basic information,histopathological data,expression of tight junction protein Claudin-1 and immunoblotting among the three groups.When P<0.05,the difference is considered to be statistically significant.Results:1.Colonoscopy:among the three groups,the total prevalence rate of colorectal congestion,erosion and ulcer in group B(80%)was higher than that in group A(60%),and that in group A(60%)was higher than that in group C(13.3%).2.Pathology:(1)The number of lymphatic follicles in group A was significantly higher than that in group B(P<0.001)and group C(P=0.03),but there was no significant difference between group B and group C(P=0.233).(2)The ratio of goblet cells in group C was higher than that in group A(P=0.01)and group B(P<0.001),and that in group A was higher than that in group B(P=0.08).3.Expression of tight junction protein Claudin-1 in intestinal mucosal epithelium:(1)Claudin-1 was expressed in colorectal mucosal epithelial cells of normal people,patients with early HIV infection and patients with AIDS disease.(2)Immunohistochemistry:the average optical density of Claudin-1 in group C was higher than that in group A(P<0.001)and group B(P<0.001),and that in group A was higher than that in group B(P<0.001).(3)Western blotting:the gray value of Claudin-1 in group C was higher than that in group A and group B(P<0.001),and that in group A(P<0.001)was higher than that in group B(P<0.001).4.Correlation analysis:(1)the results of immunohistochemistry and Western blotting of Claudin-1 expression were highly consistent(P<0.001).(2)There was a positive correlation between CD4~+T cell count and Claudin-1 expression in immunohistochemistry(P<0.001)and Western blotting(P<0.001).the level of HIV viral load was negatively correlated with the expression of Claudin-1 in both immunohistochemical assay(P=0.008)and Western blotting assay(P=0.003).(3)The ratio of goblet cells was positively correlated with the expression of Claudin-1 in immunohistochemistry(P<0.001)and Western blotting(P<0.001).Conclusion:1.Compared with normal people,HIV-infected people are more likely to develop colorectal congestion,erosion,ulcers and other diseases,and the total prevalence rate increases gradually with the progress of the disease.2.The proportion of goblet cells decreased significantly in the early stage of HIV infection,and gradually decreased with the development of HIV infection,suggesting that goblet cells may be involved in the trigger stage of intestinal mucosal barrier damage caused by HIV.3.Claudin-1 was expressed in colorectal mucosal epithelial cells of normal people,patients with early HIV infection and patients with AIDS disease,while the expression of Claudin-1 decreased significantly in patients with early HIV infection,and gradually decreased with the development of the disease,suggesting that Claudin-1 may play an important role in the initial and process of intestinal mucosal barrier destruction in the progression of HIV.4.In the early stage of intestinal mucosal injury in patients with early HIV infection,our team found that there was no significant difference in intestinal injury markers such as intestinal fatty acid binding protein(I-FABP),D-lactic acid(D-LA)and lipopolysaccharide(LPS)between patients with early HIV infection and healthy controls,but this study showed that the expression of Claudin-1 in patients with early HIV infection showed a decreasing trend.It is suggested that in reflecting intestinal mucosal injury,the direct detection of intestinal tight junction protein may be more sensitive and specific than the measurement of intestinal injury markers.5.Correlation analysis:The expression of Claudin-1 was positively correlated with CD4~+T cell count and goblet cell count,and negatively correlated with HIV viral load.