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    ABSTRACT: Human immunodeficiency virus (HIV)-1 has been detected in ocular tissues; however, the mechanism of entry has not been established. It has been hypothesized that the blood-retinal barrier (BRB), a critical guardian against microbial invasion of the eye, may be compromised in the presence of HIV-1 in the eye. In vivo and in vitro model systems have shown that the breach of tight junctions induced by HIV-1-associated factors contributes to the breakdown of the BRB. The present study reviews the mechanism of tight junction disruption, focusing on signaling pathways, the expression of enzymes, including metalloproteinases, and cytokines that affect inflammation. The studied pathways may be potential targets for the prevention of ocular HIV complications.
    Experimental and therapeutic medicine 04/2014; 7(4):768-772. DOI:10.3892/etm.2014.1521 · 0.94 Impact Factor
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    ABSTRACT: To study the prognostic role of cotton-wool spots on HIV infection, a prospective cohort study was set up between September 1990 and November 1992. The 135 HIV-infected patients included in the cohort were those hospitalized in an Infectious Diseases Department and submitted to a systematic retinography, whatever the stage of HIV infection. Clinical examination, CD4+ lymphocyte count, and retinography were systematically performed at inclusion. Patients with active Cytomegalovirus (CMV) or toxoplasmic retinitis were excluded from the study. Overall, 41 subjects were diagnosed with cotton-wool spots (spots+) and 94 without (spots-). At inclusion, the patients spots+ were at a more advanced stage of immunosuppression than the patients spots- : the proportion of AIDS patients was, respectively 78 % vs 60 % (P = 0,04) and their median CD4+ count was 28/mm3 vs 70/mm3 (P = 0,03). The mean follow-up of the cohort was 13 months. Adjustment was made according to delay between HIV infection diagnosis and inclusion, age, clinical stage, antiretroviral therapy and CD4+ at the time of retinography. Cotton-wool spots appeared to be an independent prognostic factor in the onset of CMV retinitis (adjusted relative risk (RR) = 5.1 with a 95 % Confidence Interval [CI] : 1.3–20.4) and of opportunistic cerebral pathology (RR = 2.6 - IC = 1.1–6.4). In conclusion, because of the increased risk of CMV retinitis in patients spots+, a regular ophthalmologic surveillance (fundoscopy, retinography) is mandatory in HIV-infected patients, whatever their immunosuppression level may be. The presence of cotton-wool spots justifies a more frequent retinal examination and should be taken into consideration for inception of primary prophylaxis of CMV retinitis.
    Médecine et Maladies Infectieuses 05/1997; 27(5):586-590. DOI:10.1016/S0399-077X(97)80089-3 · 0.91 Impact Factor
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    ABSTRACT: Objective: To analyze the referral patterns and diag-nosis of uveitis during the past decade in a large tertiary eye center.
    Archives of Ophthalmology 01/1996; 114(1996):593-599. · 4.49 Impact Factor