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Early Impairment of Gut Function and Gut Flora Supporting a Role for Alteration of Gastrointestinal Mucosa in Human Immunodeficiency Virus Pathogenesis

Division of Infectious Diseases, Department of Internal Medicine, San Gerardo Hospital, University of Milano-Bicocca, Via Solferino 16-20052, Milan, Italy.
Journal of clinical microbiology (Impact Factor: 4.23). 03/2008; 46(2):757-8. DOI: 10.1128/JCM.01729-07
Source: PubMed

ABSTRACT Our results show that impairment of the gastrointestinal tracts in human immunodeficiency virus (HIV)-positive patients is present in the early phases of HIV disease. This impairment is associated with alterations in gut microbiota and intestinal inflammatory parameters. These findings support the hypothesis that alterations at the gastrointestinal-tract level are a key factor in HIV pathogenesis.

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    • "This is based on findings associating the resident bacteria with immune activation. As such, studies have been ascribed to certain bacterial species, roles in maintaining epithelial mucosal integrity [40], and the early maturation of the adaptive immune system [7] [21], and these are being exploited in progut formulations [41]. HIV subjects are known to have a compromised gut barrier function and the observation that Bifidobacterium and Lactobacillus species are depleted among the gut bacteria populations in such patients [23] is consistent with earlier studies attributing improved gut barrier and immune function to these species [42]. "
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    • "This loss of Th17 cells leads to even more microbial translocation, and the cycle continues (Favre et al., 2010). HIV disease disrupts the normal microbiota of the gut (dysbiosis ) (Ellis et al., 2011; Gori et al., 2008; Vujkovic-Cvijin et al., 2013). This process is associated with an enrichment of bacterial species that can catabolize tryptophan through the kynurenine pathway, which may contribute to the loss of Th17 cells (Vujkovic-Cvijin et al., 2013), as noted above. "
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    • "It will be important to determine whether Sarcina and Staphylococci, which also bloomed in the other SIVcpz-positive chimpanzees (who have remained asymptomatic as of this writing), might be an early predictor of subsequent immune deterioration. By tracking the microbiota of individual chimpanzees that became naturally infected by SIVcpz during the course of natural history studies, we identified effects of SIVcpz infection on the gut microbiome that have previously gone unrecognized by comparisons of HIV-1-infected and uninfected humans (Ellis et al., 2011; Gori et al., 2008) or of SIV-infected and uninfected monkeys (Handley et al., 2012; McKenna et al., 2008). However, we were not able to explicitly correlate immune decline in SIVcpz-infected chimpanzees with gut microbiota composition, and as such, we cannot rule out the possibility that the changes in the gut microbiota we observed were mediated by other unmeasured factors. "
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