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Leaky gut -- A source of non-AIDS complications in HIV-positive patients
Date:9/3/2014

face) cells are compacted against each other, but a miniscule opening (the intercellular space) allows ultra fine molecules to pass through. The tight junction complex forms tiny strands to seal that intercellular space.

Levine and colleagues demonstrated in their investigation that patients whose HIV was well controlled with antiretroviral medications still had weakened intestinal tight junctions. They came to this conclusion by comparing biopsies from 31 virally suppressed HIV-positive patients and from 35 healthy patients who had no HIV infection. (Virally suppressed means the level of circulating virus in the bloodstream is extremely low or undetectable.) The biopsies were obtained from patients at University Hospitals Case Medical Center during routine colonoscopies, a procedure to inspect visually the health of the colon. During the procedure, biopsies were collected from three places in patients' intestines: the end of the small intestine (terminal ileum), the beginning and middle portions of the colon (ascending and transverse) and toward the end of the colon (descending).

"Not only did we find evidence of less tight junctions in the virally suppressed HIV-positive patients, we found that the reduction in tight junctions increased the farther down we went into the colon," Levine said. "So essentially, these patients had the weakest tight junctions where the most bacteria are located. Additionally, we correlated the reduced tight junctions with increased inflammation."

Investigators examined the biopsy tissue that sealed the spaces between epithelial cells and formed a barrier against luminal bacteria. They found that the number of cells and their density (or packing) was unchanged, meaning the leaks are not caused by cell death or pronounced changes in tissue structure or epithelial surface. However, the RNA and proteins that contribute to the organization of the tight junctions in the colon were decreased.

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Contact: Jeannette Spalding
jeannette.spalding@case.edu
216-368-3004
Case Western Reserve University
Source:Eurekalert

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