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Ultrastructural Findings, at Micrometric and nanometric Scales, in Rectal and Muscular Mucosa of Patients with HIV/AIDS and Anorectal Pathology

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International Journal of Clinical Medicine 2018年第5期9卷 481-493页

作者： Annunziato Maria Antonieta Sardiñ as Carlos Finol Hector Carvajal Ana González Roschman De Gouveia Yetsenia García Estefanie Garibaldi Liseth Department of Internal Medicine Medical Attention Center General Checkups Medical Exams and Consultations Wheelchair Center (BANDESIR) Caracas Venezuela Coloproctology Unit Caracas University Hospital (HUC) Caracas Venezuela Center for Electron Microscopy Sciences Faculty Central University of Venezuela Caracas Venezuela Department of Infectious Diseases University Hospital of Caracas (HUC) Caracas Venezuela School of Biology Faculty of Sciences Central University of Venezuela Caracas Venezuela Research Assistant Department of Electronic Microscopy Venezuelan Institute of Scientific Research (IVIC) Altos de Pipe Venezuela

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.

关键词： Anorectal Pathologies HIV/AIDS Transmission Electron Microscopy (TEM) nanometric Scales Rectal Mucosa Caveolae Endothelial Cell nano-drugs

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