Diarrhoea in HIV-infected patients: no evidence of cytokine-mediated inflammation in jejunal mucosa

AIDS. 1995 Apr;9(4):367-73.


Objective: To determine whether a mucosal cytokine-mediated inflammatory response is involved in cryptosporidial or microsporidial diarrhoea, as well as in diarrhoea of unknown origin in HIV-infected patients.

Design: Prospective study.

Methods: Jejunal biopsies were obtained from HIV-infected patients with diarrhoea. Controls were HIV-infected and HIV-seronegative patients without diarrhoea. Two biopsies were homogenized immediately and two other biopsies were first cultured for 20 h. Cytokines [tumour necrosis factor (TNF), interleukin (IL)-1 beta, IL-6, IL-8, IL-10], soluble TNF receptors (sTNFR) p55 and p75, and soluble IL-2 receptor (sIL-2R) were assessed in the homogenates and in the supernatants by sandwich enzyme-linked immunosorbent or enzyme-linked binding assays. The cytokine receptors were also measured in serum.

Results: Six HIV-infected patients with cryptosporidiosis, six with microsporidiosis, seven with diarrhoea of unknown origin, seven without diarrhoea, and seven HIV-seronegative patients were eligible. Four patients were excluded because of the presence of other pathogens. No cytokines were detected in immediately homogenized jejunal tissue. Following culture, IL-6 and IL-8 levels were higher in HIV-infected patients with diarrhoea of unknown origin than in HIV-seronegative controls without diarrhoea, although this was not statistically significant. No differences in serum or post-culture supernatant sTNFR p55 and p75 levels existed between the HIV-infected patients with or without diarrhoea. sTNFR, IL-1 beta, IL-10 and the sIL-2R were only detected in low amounts or not at all, and were equally distributed among all patient groups.

Conclusions: This study indicates that mucosal cytokine-mediated inflammatory responses do not play an important role in the pathogenesis of different types of diarrhoea in HIV-infected patients. These results do not support the use of immunomodulatory therapy in these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / etiology
  • AIDS-Related Opportunistic Infections / pathology
  • Adult
  • Animals
  • Cryptosporidiosis / complications
  • Cryptosporidiosis / immunology
  • Cytokines / physiology*
  • Diarrhea / complications*
  • Diarrhea / etiology
  • Female
  • HIV Infections / complications*
  • HIV-1*
  • Humans
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / immunology
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / pathology
  • Jejunum / immunology
  • Jejunum / pathology
  • Male
  • Microsporida
  • Microsporidiosis / complications
  • Microsporidiosis / etiology
  • Middle Aged
  • Prospective Studies
  • Receptors, Cytokine / metabolism


  • Cytokines
  • Receptors, Cytokine