利拉鲁肽对RNAi介导的脂联素基因抑制ApoE基因敲除小鼠糖脂代谢的影响

目的 探讨利拉鲁肽对脂联素基因表达缺陷的ApoE基因敲除(ApoE-/-)小鼠糖脂代谢的影响.方法 采用静脉葡萄糖耐量试验(IVGTT)评价利拉鲁肽的量效关系.利用扩展高胰岛素钳夹技术评价各组小鼠糖脂代谢和胰岛素敏感性变化.结果 在IVGTT中,利拉鲁肽1 mg/kg组,糖负荷后5、15和30 min血糖值均明显低于其它剂量组(均P＜0.01),而血浆胰岛素水平在5、15 min均明显高于其他3组(均P＜0.01).联合注射利拉鲁肽和脂联素RNAi腺病毒组体重、空腹血糖、血浆游离脂肪酸、总胆固醇、甘油三酯、血浆胰岛素和低密度脂蛋白胆固醇(LDL-C)水平显著低于脂联素RNAi腺病毒组(P＜0.05或P＜0.01),而高密度脂蛋白胆固醇(HDL-C)则明显高于脂联素RNAi组(P＜0.05).钳夹稳态时,脂联素RNAi组血浆胰岛素明显高于利拉鲁肽组(P＜0.01),游离脂肪酸、总胆固醇、甘油三酯虽被抑制,但仍明显高于利拉鲁肽组(P＜0.05).利拉鲁肽组葡萄糖输注率(GIR)则明显高于脂联素RNAi组(P＜0.01).钳夹结束时,脂联素RNAi组葡萄糖清除率(GRd)明显低于利拉鲁肽组(P＜0.01),而肝糖输出率则明显高于利拉鲁肽组(P＜0.01).结论 长期的利拉鲁肽干预上调了脂联素基因表达缺陷ApoE-/-小鼠血浆脂联素水平,并改善了其胰岛素抵抗.     

利拉鲁肽对低脂联素血症小鼠胆固醇代谢相关基因的影响

目的 探讨利拉鲁肽(liraglutide)对脂联素基因表达缺陷ApoE基因敲除(ApoE-/-)小鼠胆固醇代谢相关基因的影响.方法 雄性ApoE-/-小鼠36只按随机数字表法随机分为单纯高脂喂养组(HF组,n=10)、空载腺病毒组(GFP组,n=6)、高脂+脂联素RNAi腺病毒组(ADI组,n=10)、利拉鲁肽治疗的高脂+脂联素RNAi腺病毒组(HEA组,n=10).采用扩展胰岛素钳夹术评价其胰岛素敏感性,酶联免疫法测定血浆脂联素水平,实时荧光定量PCR方法 检测肝脏组织胰岛素诱导基因1和2(INSIG1,INSIG2)、固醇调节元件结合蛋白1和2(SREBP-1,SREBP-2)、羟甲基戊二酸单酰辅酶A还原酶(HMGCR)和低密度脂蛋白受体(LDLR)mRNA表达.结果 ADI组血浆总胆固醇、甘油三酯、低密度脂蛋白胆固醇、空腹胰岛素和游离脂肪酸水平较其他3组显著升高(P＜0.01);而高密度脂蛋白胆固醇水平则显著降低(P＜0.05).ADI组血浆脂联素水平显著低于HEA、HF和GF组(P＜0.01).ADI组肝组织INSIG2和LDLR mRNA表达水平较其他3组显著降低(P＜0.01或P＜0.05);HEA组肝组织HMGCR 和SREBP-2 mRNA表达水平较其他3组明显升高(P＜0.01或P＜0.05);ADI、HF和GFP组HMGCR和SREBP-2 mRNA表达水平无明显差异.结论 利拉鲁肽可能通过上调脂联素水平调节胆固醇代谢相关基因的表达,从而改善胆固醇代谢紊乱.

Abstract：

Objective To investigate the effects of liraglutide on gene expression related to cholesterol metabolism in ApoE-/-mice with adiponectin deficiency. Methods Thirty six ApoE-/-mice fed with the high-fat diet were subdivided into four groups. One group was given 100 μl(1×109PFU) of adenoviral pAd-U6-GFP(GFP group, n=6). The second group received 100 μl of adenoviral pAd-U6-Acrp30(ADI group, n=10). The third group was given 100 μl of adenoviral pAd-U6-Acrp30 and liraglutide(HEA group, n=10) and the fourth group was given only 100 μl sterile saline(HF group, n=10). Insulin sensitivity and glucose metabolism were assessed by the hyperinsulinemic-euglycemic clamp technique using 3-[3H] glucose as a tracer. Plasma adiponectin level was evaluated using a commercially available ELISA kit. The mRNA expressions of genes involved in cholesterol metabolism were measured by quantitative realtime PCR. Results Fasting blood glucose(FBG), free fatty acids(FFA), total cholesterol, triglyceride, low density lipoprotein cholesterol, adiponectin, and fasting plasma insulin(FINS) in ADI mice were significantly higher than those in the other groups(P＜0.01), while high density lipoprotein cholesterol was significantly lower(P＜0.05). During the clamp, glucose infusion rate(GIR) in ADI group was significantly lower than the other groups(P＜0.01), and hepatic glucose production(HGP) significantly higher in ADI group(P＜0.01). The mRNA expressions of INSIG2 and LDLR in ADI group were significantly down-regulated in HEA group(P＜0.01 or P＜0.05), while HMGCR and SREBP-2 were significantly up-regulated in HEA group(P＜0.01 or P＜0.05). Conclusions Liraglutide regulates a number of genes involved in cholesterol metabolism and ameliorates hypercholesterolemia by elevating plasma adiponectin level.     

脂联素通过LKB1途径激活腺苷酸活化蛋白激酶

目的 探讨脂联素是否通过LKB1途径激活骨骼肌及肝脏中腺苷酸活化蛋白激酶(AMPK).方法 将28只6周龄雄性Sprague-Dawley大鼠分为普通饮食组(NC组,n=15)和高脂饮食组(HF组,n=13).喂养16 周后,取空腹静脉血测定血清游离脂肪酸(FFA)、甘油三酯(TG)、总胆固醇(TC)、空腹血糖(FPG)、空腹胰岛素(FINS)及脂联素.采用Western印迹法测定各组大鼠骨骼肌及肝脏组织中AMPKα、磷酸化的AMPKcα和LKB1蛋白的表达.将原代培养的骨骼肌细胞及肝细胞分别予以脂联素和根赤壳菌素干预,免疫荧光技术测定各组细胞中AMPKα、磷酸化AMPKα和LKB1蛋白的表达.结果 与NC组比较,HF组大鼠体重、FFA、TG、FPG、FINS均升高(均P＜0.05),脂联素水平降低(P＜0.05).骨骼肌及肝组织巾AMPKα磷酸化和LKB1蛋白表达水平降低(均P＜0.05).原代培养大鼠骨骼肌细胞及肝细胞中脂联素显著增加AMPKα磷酸化及LKB1表达水平(均P＜0.05).加入根赤壳菌素表达明显降低(均P＜0.05).结论 脂联素在大鼠骨骼肌和肝脏组织可能通过LKB1途径激活AMPK.     

血浆脂联素在2型糖尿病诊断中的应用价值

2017年1月-2019年7月T_2DM患者分为轻度组(n=35)和重度组(n=35),行血浆脂联素,总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平。结果重度组TC、TG、LDL-C均高于轻度组,血浆脂联素低于轻度组,(P0.05);经Pearson分析,血浆脂联素与TC、TG、LDL-C含量呈负相关,(r0,P0.05)。结论血浆脂联素可鉴别患者病情严重程度。     

二甲双胍降低大鼠肝脏胆固醇和甘油三酯含量的机制探讨

目的 观察二甲双胍对长期高饱和脂肪酸饲养大鼠肝脏腺苷酸活化蛋白激酶α(AMPKα)和PPARα表达和活性的影响,探讨二甲双胍降低肝脏胆固(TC)和甘油三酯(TG)含量的可能机制.方法 Wistar雄性大鼠30只,随机等分为:对照组(C组)、高脂组(HF组)和高脂加二甲双胍组(Met组,高脂喂养4个月,第5个月加用二甲双胍胃1个月),喂养共5个月,测定血清、肝脏组织中的TC和TG含量;分别应用实时PCR、Western印迹检测肝脏AMPKα 和PPARα 的基因转录、蛋白表达和活性水平;PPARα 转录因子DNA结合活性测定用ELISA法.结果 与C组比较,HF组大鼠肝脏AMPKα2和PPAα mRNA表达水平显著降低(均P＜0.05);AMPKα 蛋白表达及活性显著降低(均P＜0.05),PPARα蛋白表达及DNA结合活性分别降低 48.6%、21.6%(均P＞0.05); 肝脏TC、TG含量(均P＜0.05)和血TC、TG水平(均P＜0.01)均显著增高.与HF组比较,Met组肝脏AMPKα2 mRNA和蛋白表达及活性显著增高(均P＜0.05),PPARα蛋白表达增高56.5%(P＞0.05),其DNA结合活性显著增高(P＜0.05);肝脏TC、TG含量血TC、TG水平均显著降低(均P＜0.05).结论 二甲双胍降低长期高脂饲养所致的大鼠肝脏、血中TC、TG水平的增高,可能与其激活肝细胞AMPKα及PPARα有关.     

沉默信息调节因子1对早期2型糖尿病大鼠脂联素的调节作用

目的检测脂联素水平及沉默信息调节因子1(SIRT1)在早期糖尿病(DM)大鼠肝脏组织中的表达变化,探究SIRT1对脂联素的调控作用。方法 Sprague-Dawley大鼠42只,分为4组:正常对照组(n=10)、DM组(n=10)、DM+白藜芦醇(RES)组(n=11)和DM+尼克酰胺(NIA)组(n=11)。高脂饮食联合链脲佐菌素建立2型DM大鼠模型。进行基础代谢和血清学检测,HE染色法观察肝脏病理结构变化,酶联免疫吸附试验(ELISA)试剂盒检测血清脂联素水平;Western blotting和逆转录-聚合酶链反应法检测肝组织SIRT1和脂联素受体(AdipoR)等表达变化。采用SPSS 19.0软件进行数据处理。组间比较采用方差分析及t检验。结果与DM组相比,空腹血糖(FBG)在DM+RES组显著降低(P0.05);总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)在DM+RES组显著降低(P0.01),在DM+NIA组显著升高(P0.05);甘油三酯(TG)在DM+RES组显著降低(P0.05);高密度脂蛋白胆固醇(HDL-C)在DM+RES组显著升高(P0.01)。与DM组相比较,DM+RES组的脂联素水平略有升高(P0.05),DM+NIA组血清脂联素水平显著降低(P0.05)。显微镜下,DM组大鼠肝脏可见不同程度炎细胞浸润、甚至变性,DM+RES组大鼠肝脏脂肪变性减轻,DM+NIA组大鼠肝脏肝细胞散在小泡性脂滴。与DM组相比较,DM+RES组AdipoR2和SIRT1蛋白表达显著增加(均P0.05),WISP-1蛋白表达显著降低(P0.05),而DM+NIA组AdipoR2和SIRT1蛋白表达显著降低。与DM组比较,AdipoR2和SIRT1 mRNA在DM+RES组表达显著增加(P0.01),WISP-1 mRNA表达显著降低(P0.01);而DM+NIA组AdipoR2表达显著降低(P0.05)。结论在早期DM肝损伤的发生发展过程中,SIRT1信号分子可能通过调节AdipoR的表达来调控脂联素的水平,参与DM内分泌系统的病理生理演变。     

MEK/ERK通路在高脂饮食诱导NAFLD大鼠SREBP-1表达中的作用

目的 探讨MEK/ERK通路在高脂饮食诱导NAFLD大鼠固醇调控元件结合蛋白-1(SREBP-1)表达中的作用. 方法应用高脂饮食复制大鼠非酒精性脂肪性肝病NAFLD模型.32只雄性Wister大鼠随机分成正常对照组(N组)、PD98059 +普通饲料组( P组)、高脂模型组(M组)和PD98059 +高脂组(PM组),每组8只.于分组喂养的第4、6、8周末分别给予P组和PM组大鼠鼠尾静脉注射MEK抑制剂PD98059干预.第10周末结束实验,检测血清丙氨酸转移酶(ALT)、门冬氨酸转移酶(AST)、甘油三酯(TG)、总胆固醇(TC),肝组织TG、TC;光镜观察大鼠肝脏的病理改变,免疫组化法检测肝脏磷酸化细胞外信号调节激酶1/2(p-ERK1/2)和SREBP-1表达. 结果与N 组比较, M组所有大鼠肝细胞脂肪变性范围均超过30%并伴有不同程度的炎性细胞浸润和坏死,p-ERK1/2和SREBP-1表达增强,ALT、AST、TC、TG、肝组织TG、TC显著升高(P＜0.01 或 0.05).与M组比较,PM组p-ERK1/2和SREBP-1表达减少(P＜0.01), ALT、TC 、TG、肝组织TG、TC显著降低(P＜0.01或0.05),同时大鼠的肝脏病理学得到了改善.结论 MEK/ERK通路在高脂饮食诱导NAFLD大鼠固醇调控元件结合蛋白-1(SREBP-1)表达中起重要作用.     

瑞舒伐他汀对高脂饲养大鼠心肌脂联素及其受体表达的影响

目的　探讨瑞舒伐他汀对高脂饲养大鼠心肌脂联素及其受体mRNA和蛋白表达的影响。方法　8周龄Wistar大鼠48只,随机分为对照组、高脂饲养组、高脂饲养＋瑞舒伐他汀组,20周后,全自动生化分析仪测定血清甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDLC）、高密度脂蛋白胆固醇（HDLC）、血糖,ELISA测定血清脂联素,RT-qPCR和　Western　blot测定心肌组织脂联素及其受体　mRNA和蛋白的表达。结果　与对照组相比,高脂饲养组大鼠血清TG、TC、LDLC、血糖、脂联素升高（P＜0.01）,HDLC降低（P＜0.01）。与高脂饲养组相比,高脂饲养＋瑞舒伐他汀组血清TG、TC、LDLC、脂联素降低（P＜0.05）,　HDLC升高（P＜0.01）,血糖无明显差异（P＞0.05）。与对照组相比,高脂饲养组心肌脂联素mRNA和蛋白表达升高（P＜0.01）,心肌脂联素受体mRNA和蛋白表达降低（P＜0.05）。与高脂饲养组相比,高脂饲养＋瑞舒伐他汀组心肌脂联素mRNA和蛋白表达降低（P＜0.05）,心肌脂联素受体1　mRNA和蛋白表达升高（P＜0.05）,心肌脂联素受体2　mRNA和蛋白表达无明显差异（P＞0.05）。结论　高脂饲养大鼠过程中,可出现血清脂联素升高,心肌脂联素mRNA和蛋白表达上调,心肌脂联素受体mRNA和蛋白表达下调,瑞舒伐他汀可以部分逆转这些作用。     

利拉鲁肽对糖尿病肾病大鼠NOD样受体热蛋白结构域相关蛋白3表达的影响

目的 探讨利拉鲁肽是否通过抑制NOD样受体热蛋白结构域相关蛋白3(NLRP3)的活化在糖尿病肾病(DN)中发挥肾脏保护作用。方法 22只4周龄的Wistar品系雄性大鼠随机分为正常对照组(n=6)、利拉鲁肽组(n=8)和生理盐水组(n=8)。利拉鲁肽组予利拉鲁肽200μg/(kg·d)皮下注射,生理盐水组予等体积的生理盐水皮下注射,正常对照组不做任何处理,共治疗4周。治疗结束后检测大鼠体质量、24 h尿总蛋白定量(UTP)、空腹血糖(FBG)、甘油三酯(TG)、胆固醇(TC)、血尿素氮(BUN)、血肌酐(SCr)等生化指标,各组大鼠肾组织进行苏木素-伊红染色(HE),光镜下观察肾组织病理形态学改变,Western blot检测肾组织中NLRP3炎症小体相关蛋白表达,酶联免疫吸附试验(ELISA)检测血清白细胞介素-18(IL-18)及血清白细胞介素-1β(IL-1β)的水平。采用SPSS 26.0统计软件和Graph Prism 9.0软件进行分析及绘图。计量资料多组间比较采用单因素方差分析,组内两两比较采用Tukey检验。结果 利拉鲁肽组大鼠FBG、UTP、BUN、SCr、TC、TG...     

ACEI改善糖尿病大鼠的糖代谢紊乱

目的 利用血管紧张素转换酶抑制剂(ACEI)阻断肾素-血管紧张素系统(RAS),研究阻断RAS改善胰岛素抵抗及糖代谢的作用机制,探讨脂肪组织局部RAS与胰岛素抵抗的关系.方法 30只雄性Wistar大鼠随机分为正常对照组(NC组)、高脂组(HF组)和高脂干预组(AE组),分别以基础饲料喂养、高脂喂养、高脂加培哚普利[4 mg/(kg·d)]干预喂养12周.干预结束后HF组和AE组给予链脲佐菌素(STZ)20 mg/kg小剂量腹腔注射诱导成模,2周后3组大鼠分别行口服葡萄糖耐量试验(OGTY)及计算稳态模型评估.胰岛素抵抗指数(HOMA-IR),评价胰岛素抵抗和糖代谢,处死大鼠,以RT-PCR法检测附睾和肾周脂肪组织脂联素、抵抗素、纤溶酶原激活物抑制剂(PAI)-1 mRNA的表达.结果 与NC组(n=10)比较,HF组(n=7)大鼠OGTY各时点血糖、血糖曲线下面积(AUC)、HOMA-IR显著升高,PAI-1、抵抗素mRNA表达显著增加,分别是NC组的1.50倍、1.47倍,脂联素mRNA的表达下降了40.8%(均P＜0.01);与HF组比较,AE组(n=9)大鼠OGTT各时点血糖有所下降,60、120 min血糖差异有显著性(P＜0.05),AUC、HOMA-IR显著减少,PAI-1、抵抗素mRNA表达较HF组分别下降了28%、38.1%,脂联素mRNA表达升高为HF组的1.62倍(P均＜0.05).结论 ACEI可以改善长期高脂喂养联合STZ诱导大鼠的胰岛素抵抗和糖代谢紊乱,其作用机制可能与改善内脏脂肪组织的脂肪因子表达相关.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.