Back
 IJCM  Vol.9 No.5 , May 2018
Ultrastructural Findings, at Micrometric and Nanometric Scales, in Rectal and Muscular Mucosa of Patients with HIV/AIDS and Anorectal Pathology
Abstract: Objective: To determine the ultrastructural findings on Rectal Mucosa (RM) of patients with HIV/AIDS and anorectal pathologies (ARP), at micrometric and nanometric scales. Materials and methods: 5 patients were evaluated, 18 - 55 years old, with ARP (HIV co-infection with HPV, n = 4, and HIV-negative patient with HPV infection) (control n = 1), who were referred to the Coloproctology Unit of the HUC, and subjected to rectoscopy and biopsy. RM samples were identified, placed in a sterile plastic bottle with 1 mL of 2% glutaraldehyde and immediately transported for routine processing of fine cut (60 - 90 nm) to be evaluated via Transmission Electron Microscopy (TEM). They were fixed with Karnovsky solution with Millonig phosphate buffer (pH 7.4 and 320 mOsm) and post-fixed with OsO4 under the same conditions of pH and osmolarity. Results: Ultrastructural findings, at 10−6 scale: 1) Intestinal mucosa: vacuoles of mucus of different sizes that seem to be fused. 2) Smooth muscle cells: loss of definition of contractile myofilaments mass. 3) Unmyelinated axons and terminals of Schwann cells (SC): Edema and loss of their plasma membranes in some areas of association with axon terminals as well as abundant collagen fibers associated with SC. Ultrastructural findings, at 10−9 scale: 1) Smooth muscle cells: folded wrapper cores and edema of mitochondria and rough endoplasmic reticulum cisterns (RER). 2) Myelinated axon terminals: Loss of synaptic vesicles. 3) Fibroblasts: One observes mitochondria and cisterns of RER with alterations. All these alterations can generate intestinal and anorectal dysfunction in these patients. Conclusions: The HIV causes changes in rectal and muscular mucosa despite HAART treatment with undetectable viral load.
Cite this paper: Antonieta, A. , Carlos, S. , Hector, F. , Ana, C. , Roschman, G. , Yetsenia, D. , Estefanie, G. and Liseth, G. (2018) Ultrastructural Findings, at Micrometric and Nanometric Scales, in Rectal and Muscular Mucosa of Patients with HIV/AIDS and Anorectal Pathology. International Journal of Clinical Medicine, 9, 481-493. doi: 10.4236/ijcm.2018.95041.
References

[1]   Annunziato, M.A. (1997) Clinical, Mycotic, and Anorectal Immunohistochemically Findings in Patients with AIDS. University Hospital. Dr. Angel Larralde, University of Carabobo, Valencia, Venezuela. Department of Internal Medicine. Special Research to Qualify for the Title of Internal Medicine Specialist.

[2]   Smith, P.D., et al. (1992) Gastrointestinal Infections in AIDS. Annals of Internal Medicine, 116, 63-77.
https://doi.org/10.7326/0003-4819-116-1-63

[3]   Gold, J.W., Telzak, E.E. and White, D.A. (1996) Management of the HIV-Infected Patient, Part I. The Medical Clinics of North America, 80, 1223-1238, 1395-1414.

[4]   Carvajal, A. (1997) Acquired Immunodeficiency Syndrome. In: Núñez, M.J. and Gómez, M.J., Eds., Medical Microbiology, 2 Edition, Vice-Rectorate Academic U.C.V, Venezuela, 885-913.

[5]   Brar, H.S., et al. (1998) Anorectal Pathology in AIDS. Gastrointestinal Endoscopy Clinics of North America, 8, 913-931.

[6]   Kent, C., Samuel, M. and Winskelstein, W.J.R. (1987) The Role of Anal/Genital Warts in HIV Infection. JAMA, 258, 3385-3386.
https://doi.org/10.1001/jama.1987.03400230045017

[7]   Annunziato, M.A. (2000) Anorectal Findings in Patients Infected with HIV. University Hospital of Caracas, Central University of Venezuela, Caracas, Venezuela. Special Research to Qualify for the Title of Specialist on Infectious Diseases.

[8]   Orkin, B.A. and Smith, L.E. (1992) Perianal Manifestations of HIV Infection. Diseases of the Colon & Rectum, 35, 310-314.
https://doi.org/10.1007/BF02048106

[9]   Guadalupe, et al. (2003) Severe CD4+ t-Cell Depletion in Gut Lymphoid Tissue during Primary Human Immunodeficiency Virus Type 1 Infection and Substantial Delay in Restoration Following Highly Active Antiretroviral Therapy. Journal of Virology, 80, 11708-11717.
https://doi.org/10.1128/JVI.77.21.11708-11717.2003

[10]   Belmonte, L., et al. (2007) The Intestinal Mucosa as a Reservoir of HIV-1 after Successful HAART. AIDS, 21, 2106-2108.
https://doi.org/10.1097/QAD.0b013e3282efb74b

[11]   Mariangela, C., et al. (2013) R5 HIV-1 Envelope Attracts Dendritic Cells to Cross the Human Intestinal Epithelium and Sample Luminal Virions via Engagement of the CCR5. EMBO Molecular Medicine, 5, 776-794.
https://doi.org/10.1002/emmm.201202232

[12]   Veazey, R.S. and Lackner, A.A. (1998) The Gastrointestinal Tract and the Pathogenesis of AIDS. AIDS, 12, S35-S42.

[13]   Scheider, T., Ullrich, R. and Zeitz, M. (1997) Immunopathology of Human Immunodeficiency Virus Infection in the Gatrointestinal Tract. Seminars in Immunopathology, 18, 515-533.
https://doi.org/10.1007/BF00824056

[14]   Guadalupe, et al. (2006) Viral Suppression and Immune Restoration in the Gastrointestinal Mucosa of Human Immunodeficiency Virus Type 1-Infected Patients Initiating Therapy during Primary or Chronic Infection. Journal of Virology, 80, 8236-8247.
https://doi.org/10.1128/JVI.00120-06

[15]   Sanjay, S., et al. (2004) P Glycoprotein in Human Immunodeficiency Virus Type 1 Infection and Therapy. Antimicrobial Agents and Chemotherapy, 48, 1073-1108.
https://doi.org/10.1128/AAC.48.4.1073-1081.2004

[16]   Kotler, D.P. (1989) Intestinal and Hepatic Manifestations of AIDS. Advances in Internal Medicine, 34, 43-72.

[17]   Greenson, J.K., Belitsos, P.C., Yardley, J.H., et al. (1991) AIDS Entheropathy: Occult Enteric Infections and Duodenal Mucosal Alterations in Chronic Diarrhea. Annals of Internal Medicine, 114, 366-372.
https://doi.org/10.7326/0003-4819-114-5-366

[18]   Kottler, D.P., Reka, S. and Clayton, F. (1993) Intestinal Mucosal Inflamation Associated with Human Immunodeficiency Virus Infection. Digestive Diseases Sciences, 38, 1119-1127.
https://doi.org/10.1007/BF01295730

[19]   Paiardini, M., et al. (2008) Mucosal Immune Dysfunction in AIDS Pathogenesis. AIDS Reviews, 10, 36-46.

[20]   Fox, A., et al. (2005) The Value of Anal Cytology and Human Papillomavirus Typing in the Detection of Anal Intraepithelial Neoplasia: A Review of Cases from an Anoscopy Clinic. Sexually Transmitted Infections, 81, 142-146.
https://doi.org/10.1136/sti.2003.008318

[21]   Piketty, C., et al. (2008) Marked Increase in the Incidence of Invasive anal Cancer among HIV-Infected Patients Despite Treatment with Combination Antiretroviral Therapy. AIDS, 19, 1203-1211.

[22]   Palefky, J.M. (1999) Anal Squamos Intraepitelial: Relation to HIV and Human Papillomavirus Infection. Journal of AIDS, 21, S42-S48.

[23]   Barbaro, G. and Barbarini, G. (2007) HIV Infection and Cancer in the Era of Highly Active Antiretroviral Therapy (Review). Oncology Reports, 17, 1121-1126.
https://www.ncbi.nlm.nih.gov/pubmed/17390054

[24]   Pérez-Matute, P., et al. (2013) Role of Mitochondria in HIV Infection and Associated Metabolic Disorders: Focus on Nonalcoholic Fatty Liver Disease and Lipodystrophy Syndrome. Oxidative Medicine and Cellular Longevity, 2013, Article ID: 493413.
https://www.hindawi.com/journals/omcl/2013/493413/

[25]   Mergia, A. (2017) The Role of Caveolin 1 in HIV Infection and Pathogenesis. Viruses, 9, 129.
http://www.mdpi.com/1999-4915/9/6/129
https://doi.org/10.3390/v9060129


[26]   Benson, E.J., et al. (2014) Development of HIV Reservoir Targeted Long Acting Nanoformulated Antiretroviral Therapies. Current Medicinal Chemistry, 21, 4186-4198.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281174/
https://doi.org/10.2174/0929867321666140826114135


[27]   Corsi, F., et al. (2016) Antiretroviral Therapy through Barriers: A Prominent Role for Nanotechnology in HIV-1 Eradication from Sanctuaries. Journal of Pharmacy and Pharmacology, 4, 328-339.
https://air.unimi.it/retrieve/handle/2434/526744/911463/7-JPP2016021701.pdf

[28]   Wang, Z., et al. (2011) Targeting of Nanoparticle-Complexed Drugs across the Vascular Endothelial Barrier via Caveolae. IUBMB Life, 63, 659-667.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142311/
https://doi.org/10.1002/iub.485


[29]   Beloqui, A., et al. (2013) Mechanism of Transport of Saquinavir-Loaded Nanostructured Lipid Carriers across the Intestinal Barrier. Journal of Controlled Release, 166, 115-123.
https://doi.org/10.1016/j.jconrel.2012.12.021
https://cdn.uclouvain.be/public/Exports%20reddot/ir-ldri/images/Beloqui2013.pdf

 
 
Top