基因重组HBV联合表达反义RNA和显性阴性突变体抗HBV作用及HBV包装细胞系的构建

目的探讨HBV作为基因治疗载体的可能性并检验其联合表达反义RNA和显性阴性突变体抗HBV的作用.方法在表达完整HBV颗粒的质粒上,经基因修饰后联合表达S区反义RNA和核心-p蛋白的融合蛋白,整合于具有HBV复制的2.2.15细胞,形成细胞克隆,ELISA法检测细胞培养上清液中HBsAg和HBeAg,斑点杂交法检测细胞内HBV核壳中HBV DNA,PCR检测上清液中重组HBV颗粒.HBV全基因经删除包装信号ε区后,插入到G418抗性pCI-neo载体,转染HepG2细胞系,用G418筛选形成细胞克隆,检测表达HBsAg及HBcAg较多者作为HBV包装细胞系,进一步转染表达复制缺损型HBV的质粒,经两种抗生素同时筛选,PCR方法观察上清液中的病毒.结果2.2.15-pMEP4组、2.2.15-CP组、2.2.15-SAS组和2.2.15-CPAS组,对HBsAg平均抑制率分别为2.74%±3.83%、40.08%±2.05%(t=35.5,P＜0.01)、66.54%±4.45%(t=42.3,P＜0.01)和73.68%±5.07%(t=51.9,P＜0.01);对HBeAg平均抑制率分别为4.46%±4.25%、52.86%±1.32%(t=36.2,P＜0.01)、26.36%±1.69%(t=22.3,P＜0.01)和59.28%±2.10%(t=39.0,P＜0.01);对HBV复制的抑制率分别为0、82.0%、59.9%和96.6%.在各治疗组培养上清液中均能检测出重组HBV颗粒.证明包装细胞系具有HBsAg和HBcAg表达,pMEP-CPAS质粒转染G418抗性包装细胞系,在细胞培养上清液中检出重组HBV,未检出野生型HBV.结论在同一载体上联合表达S区反义RNA及核心蛋白与部分P蛋白的融合蛋白,具有较单一机制更强的抗HBV作用;经修饰后的HBV基因组在野生型HBV辅助下,仍能包装并分泌完整的HBV样颗粒.包装细胞系能为复制缺损型HBV提供包装,但效率较低.     

长片段RNA抑制HepG2.2.15细胞中HBV基因的表达和复制

目的 评估长的反义RNA干扰片段在培养细胞株中对HBV复制的抑制效应.方法将HBV基因组S区的全部核苷酸序列插入至pTARGETTM载体中,并将重组载体转染入HepG2.2.15细胞中.用酶联免疫吸附法检测HBsAg与HBeAg水平,用荧光定量PCR法检测HBVDNA水平.对数据采用多个独立样本Kruskal-Wallis检验与两两比较的Mann-Whitney U检验.结果 经过处理后,HepG2.2.15细胞上清液中HBsAg表达量(A值)在HBS2组(携带长片段反义RNA)为0.621±0.027,在HBS4组(携带正义RNA)为3.399±0.018,对照组为2.232±0.187;HBeAg表达量(A值)在HBS2组、HBS4组和对照组分别为0.749±0.019、1.548±0.025和1.570±0.044; HBV DNA水平(×104拷贝/ml)在HBS2组、HBS4组、对照组分别为1.597±0.082、3.381±0.297和3.610±0.063.与对照组相比,HBS2组HBsAg、HBeAg和HBV DNA表达量均降低,统计量Z值均为-2.309,P值均＜0.05; HBS4组HBsAg表达量增高(Z=-2.309,P＜0.05),而HBeAg和HBV DNA表达量无明显差异,统计量Z值分别为-0.866、-1.155,P值均＞0.05.结论 长片段反义RNA能抑制HBV基因的表达和病毒复制.

Abstract：

Objective To evaluate the inhibitory effects of long antisense RNA on HBV replication in HepG2.2.15 cells. Methods The coding region of HBV S gene was cloned into pTARGET vector in sense and antisense orientations and the recombinant plasmids were transfected into HepG2.2.15 cells which were divided into HBS2 (antisense RNA) group, HBS4 (sense RNA) group and control group. HBsAg and HBeAg in the culture supernant were detected by ELISA. The HBV DNA in the supernant was quantified by real-time PCR. Results After treatment, the levels of HBsAg in HepG2.2.15 cell supernatants of three groups were 0.621 ± 0.027, 3.399 ± 0.018 and 2.232 ± 0.187 respectively; the levels of HBeAg were 0.749 ± 0.019,1.548 ± 0.025 and 1.570 ± 0.044 respectively and the levels of HBV DNA were 1.597 ± 0.082, 3.381 ± 0.297 and 3.610 ± 0.063 respectively. The expressions of HBsAg and HBeAg and the HBV DNA level in HBS2 group were remarkably reduced as compared to the control (Z = -2.309, P ＜ 0.05); whereas the sense plasmid transfection (HBS4) did not affect HBeAg (Z= -0.866) and HBV DNA (Z = -1.155) levels in the culture supernant but slightly increased the HBsAg level (Z = -2.309). Conclusion Antisense RNA might be a useful tool to repress HBV replication.     

白花香莲解毒颗粒对HBV全基因组1.3倍体细胞模型病毒复制与表达的影响

目的:观察白花香莲解毒颗粒对HBV全基因组1. 3倍体Hep G2细胞模型(HBV 1. 3P)病毒复制与表达的影响。方法:按照白花香莲解毒颗粒最优提取工艺制备稠膏,并使用无菌纯水配制为0. 1g稠膏/ml母液,滤纸及0. 45μM、0. 22μM孔径PVDF超滤膜依次过滤后,应用MEM完全培养基稀释为8个浓度梯度的细胞干预液。CCK-8法测定细胞干预液对HBV 1. 3P增殖的抑制率; q PCR法检测干预24h、48h后细胞上清液中HBV DNA水平;化学发光法检测细胞上清液中HBs Ag、HBeAg表达量;免疫荧光法测定细胞内HBs Ag表达强度。结果:(1)白花香莲解毒颗粒的去乙酰车叶草酸甲酯含量为1. 23mg/g。(2)CCK-8法的最佳检测时间是加入试剂后2h,适宜细胞数范围是2×103～1. 2×104个。在0. 04～0. 625mg/ml范围内白花香莲解毒颗粒对HBV 1. 3P增殖无明显抑制作用;在1. 25～5mg/ml范围内则会显著抑制HBV 1. 3P增殖。(3)0. 625mg/ml是白花香莲解毒颗粒的最佳药物浓度,其干预48h HBV DNA的抑制率达(41. 86±5. 35)%,并能显著降低细胞上清液及细胞内HBs Ag、HBeAg的表达。结论:白花香莲解毒颗粒体外具能较强地抑制HBV复制及HBs Ag、HBeAg表达的生物活性。     

HBV S基因的反义锁核酸对乙型肝炎转基因小鼠HBV复制和表达的影响

目的: 探讨乙型肝炎病毒(hepatitis B virus,HBV)S基因的反义锁核酸(LNA)对乙型肝炎转基因小鼠HBV复制和表达的影响.方法: 将30只HBV转基因小鼠随机分为5组,每组6只. 第1组为5% GLU液对照组, 第2组为空脂质体对照组, 第3组为单LNA组, 第4组为S-ASODN脂质体组, 第5组LNA脂质体组. 反义LNA经尾静脉注入小鼠体内, 采用ELISA法检测血清HBsAg;PCR定量检测血清HBV DNA含量;免疫组织化学法检测肝细胞HBsAg的表达;自动生化分析仪检测ALB、ALT、BUN、CR、ApoA1、ApoB等指标;小鼠肝脏、肾脏做常规病理切片HE染色, 观察反义LNA对小鼠脏器的影响.结果: 注射反义LNA 1 d、3 d、7 d、14 d后,LNA-脂质体组对血清HBsAg的表达抑制率分别为41.7%、52.8%、57.8%及30.5%. 对HBV DNA的抑制率分别为18.5%、36.1%、52.9%和32.7%, 与对照组比较均有显著性差异(P <0.05);全自动生化分析仪检测血清中ALB、ALT、BUN、CR、ApoA1、ApoB等指标, 各组结果与对照组比较均无显著性差异(P >0.05);小鼠肝细胞HBsAg的表达显著低于对照组. HE染色显示小鼠肝肾功能及组织学未见异常.结论: HBV S基因反义LNA对乙型肝炎病毒转基因鼠HBV复制和表达有显著抑制作用.     

逆转录病毒介导双靶区反义RNA在转基因小鼠肝细胞中的表达及对HBV DNA复制的影响

目的:探讨逆转录病毒介导的乙型肝炎病毒(HBV)X,P单、双靶区的反义RNA在乙型肝炎转基因小鼠肝细胞中HBV复制的影响．方法:构建表达HBV X,P双靶区正、反义RNA的重组载体质粒,与脂质体混合,注入小鼠体内,第8周时取小鼠肝脏,提取肝组织总RNA,进行逆转录,将逆转录后的cDNA用PCR扩增,琼脂凝胶电泳和DNA测序定性,荧光聚合酶链反应定量:提取肝组织基因组DNA,利用荧光聚合酶链反应定量测定HBV DNA含量.结果:经过PCR扩增,琼脂凝胶电泳和DNA测序定性,荧光聚合酶链反应定量等方法检测到小鼠肝脏内反义RNA得到高效表达;8 wk后,对HBV DNA(×105 copies／g)的作用:与对照组相比(7．24±1．62),空质粒组(9．49±3．34)及正义RNA组(6．52±1．53)之间无明显差异,单(2．60±1．13,2．83±1．67)、双靶区反义RNA组(3．24±0．45)与对照组之间有明显差异(P<0．05),但单、双靶区反义RNA组间无明显差异(P>0．05)．结论:将脂质体包裹逆转录病毒载体(质粒)介导的单、双靶区乙肝病毒反义RNA经iv导入转基因小鼠细胞的方法可行;反义RNA对乙型肝炎病毒转基因小鼠有显著抗HBV复制作用;对转基因小鼠肝脏中HBV DNA的复制有明显的抑制作用,但单、双靶区反义RNA组间无明显差异．     

乙型肝炎病毒C区反义RNA靶向肝细胞抗病毒的研究

目的探讨靶向肝细胞的反义RNA抗HBV作用。方法以糖化多聚赖氨酸为载体,将能转录HBVC区反义RNA的真核质粒pREP4-aC定向导入2.2.15细胞,潮霉素筛选阳性克隆。研究过程中用ELISA和斑点杂交方法检测多个时期培养上清液中HBsAg、HBeAg和HBVDNA,同时观察对细胞的毒性作用。结果导向后24h出现对HBsAg、HBeAg和HBVDNA的抑制,6d左右抑制率达最高水平。未发现对2.2.15细胞的毒性作用。结论糖化多聚赖氨酸导向肝细胞的C区反义RNA,能有效抑制HBV抗原表达和DNA复制。     

低密度cDNA Macroarray对干扰素α抗病毒蛋白的筛选

目的 基于低密度cDNA Macoarray技术筛选出差异表达的干扰素(IFN)α抗病毒基因,以探讨IFN α抗病毒蛋白的表达与HBV复制的关系. 方法 以一定浓度的IFN α处理肝胚瘤细胞株HepG2和HepG2.2.15细胞6h,用cDNA Macroarray分析比较两细胞株IFN α抗病毒基因表达谱,并筛选出差异表达的IFNα抗病毒基因.将表达HBV核心蛋白(HBc)的质粒pHBc-EGFP转染HepG2细胞,RT-PCR法分析HBc对IFN α抗病毒基因表达的影响.将表达抗黏病毒A蛋白(MxA)的表达质粒pcDNA3.1-Flag-MxA转染HepG2.2.15,以酶联免疫吸附试验、Dot blot、Southern blot等方法分别检测HepG2.2.15细胞表达释放的HBsAg与HBeAg、细胞外HBV DNA和细胞内HBV DNA复制中间体(松弛环状DNA、双股线性DNA),以判断HBV复制情况.两组间数据比较采用t检验,组间不同时间点数据比较采用单因素方差分析.结果 cDNA Macroarray分析显示HepG2和HepG2.2.15细胞的抗病毒基因表达谱具有差异性:IFNa抗病毒基因中干扰素诱导跨膜蛋白(IFITM)1、IFITM2、IFITM3、RING4等在HepG2.2.15细胞的表达被部分抑制,而重要的抗病毒蛋白MxA表达被完全抑制.HBc转染组细胞中MxA mRNA表达的相对水平为0.31±0.05,低于空白对照组的0.74±0.04,差异有统计学意义,P＜0.05.MxA蛋白转染HepG2.2.15细胞48、72 h后,MxA转染组细胞上清液中HBsAg的S/CO值分别为1.42+0.21和1.58±0.18,HBeAg的S/CO值为1.44±0.14和2.28±0.24,而空白对照组细胞上清液中HBsAg的S/CO值为1.92±0.19和2.79±0.25,HBeAg的S/CO值为2.31±0.46和3.37±0.29,两组细胞上清液中HBV抗原的S/CO值差异均有统计学意义,P值均＜0.05.细胞外HBV DNA、胞内HBV复制中间体DNA均无明显变化.结论 HBV及其抗原成分的复制和表达影响着IFNα抗病毒蛋白的表达;HBV通过抑制IFN α抗病毒蛋白的表达而发挥拮抗IFNα的抗病毒活性.     

反义锁核酸与拉米夫定在HepG2.2.15细胞中抗HBV作用的比较

目的:应用反义锁核酸与拉米夫定作用HepG2.2.15细胞,对他们抗乙型肝炎病毒(hepatitis B virus,HBV)效果进行比较.方法:设计针对HBV翻译起始区S基因mRNA的反义寡核苷酸,并进行锁核酸修饰,以阳离子脂质体介导反义锁核酸转染HepG2.2.15细胞;拉米夫定组直接作用HepG2.2.15细胞;分别于用药后第2、4、6、8、10天收集细胞培养上清液.用ELISA法和FQ-PCR法检测收集上清液HBsAg、HBeAg和HBVDNA的含量.MTT法分别检测反义锁核酸与拉米夫定对细胞存活率的影响.结果:拉米夫定对HBVDNA具有明显抑制作用,最高可达46.52%,但对HBsAg、HBeAg影响较小;反义锁核酸对HBsAg、HBeAg及HBVDNA均有较强抑制作用,对HBsAg、HBeAg和HBVDNA的最高抑制率分别达67.69%、59.71%和62.96%(P<0.05),且抑制随时间呈增高趋势.反义锁核酸与拉米夫定对细胞代谢均无明显影响.结论:反义锁核酸抗HBV作用机制与拉米夫定不同,反义锁核酸抗HBV作用明显优于拉米夫定.     

HBV preS2反义锁核酸在HepG22.2.15细胞内的抗病毒效果

目的:探讨针对HBV preS2基因mRNA翻译起始区的反义锁核酸(LNA)片段在2.2.15细胞内抗HBV复制和表达的作用.方法:分别合成三段互补于HBV preS2基因mRNA翻译起始区同一靶位的反义锁核酸、全硫代反义寡核苷酸、未修饰寡核苷酸及无关对照序列,以阳离子脂质体作为载药体系,作用于HepG22.2.15细胞,采用时间分辨免疫荧光技术(TRFIA)和荧光定量聚合酶链技术(FQ-PCR)动态检测细胞上清液中HBsAg和HBV DNA的含量,并比较其抑制HBV DNA复制与表达的作用;以四甲基偶氮唑蓝(MTT)法检测LNA对细胞的毒性.结果:加入LNA后第1天,即出现对HBsAg表达和HBV DNA复制的抑制作用,第7天,未修饰反义寡核苷酸组、全硫代修饰反义寡核苷酸组、反义锁核酸组对HBsAg表达的抑制率分别达45.79%、52.92%和67.21%;对HBVDNA复制的抑制率分别达35.15%、40.69%和52.16%.其中LNA抑制病毒活性最强且对细胞代谢无影响.各组与对照组比较均有显著性差异(均P<0.01),且反义LNA组与其他ASODN组比较也有显著性差异(均P<0.05).结论:针对preS2基因的反义锁核酸体外能有效抑制HBV的复制与表达,故preS2基因可作为乙型肝炎基因治疗的有效靶位.     

钠-氢交换蛋白1反义表达载体对人肺腺癌细胞钠-氢交换蛋白1基因表达的影响及其意义

目的　探讨Na /H 交换蛋白 1(NHE 1)反义表达载体 (pNHE 1)对人肺癌细胞NHE 1基因的抑制作用及生物学效应。方法　实验细胞分为 3组 ,A5 4 9 pNHE 1组 (反义组 )、A5 4 9空载体组(空载体组 )、A5 4 9对照组 (A5 4 9组 )。采用阳离子脂质体使pNHE 1转染人肺腺癌A5 4 9细胞株。采用半定量逆转录 聚合酶链式反应 (RT PCR)法测定 3组细胞的NHE 1mRNA表达水平 ;用荧光法测定 3组细胞内pH(pHi)值 ;了解转染细胞增殖生长状况 ;用细胞凋亡原位检测法检测 3组细胞凋亡率。结果　在转染细胞基因组DNA中扩增出外源真核表达载体的DNA片段 ,证明转染成功。半定量RT PCR法证实反义组细胞的NHE 1mRNA表达水平 (0 4 2± 0 0 6 )显著低于A5 4 9组 (0 71± 0 0 8,P <0 0 1)和空载体组 (0 6 9± 0 16 ,P <0 0 1)。A5 4 9组细胞在培养 12、2 4和 4 8h后pHi值分别为 7 15 0±0 0 0 4、7 14 0± 0 0 0 7和 7 12 0± 0 0 0 8,反义组pHi值分别为 6 990± 0 0 0 5、6 84 0± 0 0 0 5和 6 75 0±0 0 0 5 ,两组差异均有极显著性 (P <0 0 1)。A5 4 9组、空载体组和反义组的细胞倍增时间分别为 3 2 0、3 2 8和 4 97d ,反义组细胞的增殖、生长明显慢于A5 4 9组及空载体组 (P <0 0 1)。反义组细胞凋亡率为 (2 4     

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.     

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.     

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.     

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.