瑞舒伐他汀对大鼠肥厚心肌组织PPARγ和NF-kB蛋白表达的影响

目的 探讨瑞舒伐他汀对异丙肾上腺素(isoproterenol,Iso)诱导心肌肥厚大鼠心肌组织PPARγ和NF-kB表达的影响及其抑制心肌肥厚,改善心功能的机制.方法 40只雄性SD大鼠随机分为4组:正常对照组、模型组、瑞舒伐他汀组和卡托普利组,每组10只.除正常对照组外,各组背部皮下注射Iso建立心肌肥厚模型.模型制备成功后,瑞舒伐他汀组灌胃给予瑞舒伐他汀4mg· kg-1·d-1,卡托普利组灌胃给予卡托普利50mg· kg-1 ·d-1,其余两组灌胃给予等体积生理盐水.4w末,分别测定各组大鼠左室收缩压(LVSP)、左室舒张末压(LVEDP)、左室压力上升及下降最大速率(±dp/dt max);测定大鼠体重(BW)、心脏重量(HW)及左心室重量(LVW),计算心脏重量指数(HWI)及左心室重量指数(LVWI);应用病理学方法观察心肌组织形态学改变;Western印迹法测定心肌组织PPARγ和NF-kB亚基p65蛋白表达.结果 模型组大鼠LVEDP、HWI、LVWI 明显高于正常对照组(P＜0.01),LVSP和±dp/dt max明显降低(P＜0.01);模型组PPARγ表达明显低于正常对照组(P＜0.01),p65表达明显升高(P＜0.01);瑞舒伐他汀组和卡托普利组PPARγ表达明显高于模型组(P＜0.01),p65表达明显降低(P＜0.01);瑞舒伐他汀组和卡托普利组比较,上述指标差异均无统计学意义(P＞0.05).结论 瑞舒伐他汀抑制心肌肥厚,改善心功能,其机制与增加PPARγ表达,降低p65表达有关.     

瑞舒伐他汀对大鼠肥厚心肌组织PPARγ和NF-κB蛋白表达的影响

目的探讨瑞舒伐他汀对异丙肾上腺素(isoproterenol,Iso)诱导心肌肥厚大鼠心肌组织PPARγ和NF-κB表达的影响及其抑制心肌肥厚,改善心功能的机制。方法 40只雄性SD大鼠随机分为4组:正常对照组、模型组、瑞舒伐他汀组和卡托普利组,每组10只。除正常对照组外,各组背部皮下注射Iso建立心肌肥厚模型。模型制备成功后,瑞舒伐他汀组灌胃给予瑞舒伐他汀4 mg.kg-1.d-1,卡托普利组灌胃给予卡托普利50 mg.kg-1.d-1,其余两组灌胃给予等体积生理盐水。4 w末,分别测定各组大鼠左室收缩压(LVSP)、左室舒张末压(LVEDP)、左室压力上升及下降最大速率(±dp/dt max);测定大鼠体重(BW)、心脏重量(HW)及左心室重量(LVW),计算心脏重量指数(HWI)及左心室重量指数(LVWI);应用病理学方法观察心肌组织形态学改变;Western印迹法测定心肌组织PPARγ和NF-κB亚基p65蛋白表达。结果模型组大鼠LVEDP、HWI、LVWI明显高于正常对照组(P<0.01),LVSP和±dp/dt max明显降低(P<0.01);模型组PPARγ表达明显低于正常对照组(P<0.01),p65表达明显升高(P<0.01);瑞舒伐他汀组和卡托普利组PPARγ表达明显高于模型组(P<0.01),p65表达明显降低(P<0.01);瑞舒伐他汀组和卡托普利组比较,上述指标差异均无统计学意义(P>0.05)。结论瑞舒伐他汀抑制心肌肥厚,改善心功能,其机制与增加PPARγ表达,降低p65表达有关。     

辛伐他汀与福辛普利对慢性心力衰竭大鼠心肌结缔组织生长因子的影响

目的探讨辛伐他汀和福辛普利单用及联合应用对慢性心力衰竭大鼠左心室心肌结缔组织生长因子(connectivetissue growth factor,CTGF)的影响。方法利用肾上腹主动脉缩窄法制作慢性心力衰竭模型,雄性Wistar大鼠50只随机分为假手术组、模型组、辛伐他汀组、福辛普利组、联合用药组(辛伐他汀+福辛普利),每组10只。观察各组大鼠左心室重量指数(LVMI)、左心室舒张末压(LVEDP)、左心室压力最大上升及下降速率(±dp/dt_(max));SP法检测各组大鼠左心室心肌CTGF表达,Western blot检测各组大鼠左心室心肌CTGF蛋白表达水平,RT-PCR测定各组大鼠左心室心肌CTGF mRNA水平。结果与假手术组比较,模型组LVEDP、LVMI明显升高,±dp/dt_(max)明显下降,左心室心肌CTGF蛋白及mRNA表达明显升高(P<0.01);与模型组比较,辛伐他汀组、福辛普利组和联合用药组±dp/dt_(max)明显升高,LVMI、LVEDP明显下降,左心室心肌CTGF蛋白及mRNA表达明显下降,其中联合用药组表达水平最低(P<0.01)。结论辛伐他汀与福辛普利单用及联合应用均可有效改善心功能、消退心肌肥厚,联合用药对心肌纤维化抑制作用优于单独用药。     

替米沙坦对大鼠心肌缺血再灌注诱导的心肌炎症反应的影响

目的探讨替米沙坦对大鼠心肌缺血再灌注诱导的心肌炎症反应的影响。方法将24只SD大鼠随机分成假手术组、模型组、替米沙坦组,每组8只。通过大鼠在体结扎和松开冠状动脉左前降支的方法建立心肌缺血再灌注损伤模型。建模结束后,检测比较三组大鼠的心功能,通过HE染色观察比较三组大鼠的心肌损伤情况,采用Western blot检测比较三组大鼠心肌组织中NF-κB、TNF-α、IL-1β、IL-6蛋白水平。结果三组大鼠的左心室舒张末期压力(LVEDP)表现为模型组替米沙坦组假手术组;左心室收缩压力(LVSP)、左心室压力上升的最大变化率(+dp/dt_(max))和左心室压力下降的最大变化率(-dp/dt_(max))表现为模型组替米沙坦组假手术组,差异有统计学意义(P0.05)。HE染色光镜下观察发现,三组大鼠心肌损伤的严重程度表现为模型组替米沙坦组假手术组,三组大鼠的心肌损伤评分分别为(2.343±0.378)分、(1.502±0.228)分和(0.317±0.130)分,模型组替米沙坦组假手术组,差异有统计学意义(P0.05)。三组大鼠心肌NF-κB、TNF-α、IL-1β、IL-6蛋白表达水平表现为模型组替米沙坦组假手术组,差异有统计学意义(P0.05)。结论替米沙坦能减轻大鼠心肌缺血再灌注诱导的心肌炎症反应,改善心功能,可能与下调炎症相关基因的表达水平密切相关。     

microRNA-497在麝香保心丸调控急性心肌梗死心室重构中作用机制的实验研究

目的探讨microRNA-497(miRNA-497)在麝香保心丸调控急性心肌梗死心室重构中的作用机制。方法将75只SD大鼠随机分为A组、B组、C组、D组、E组,每组15只。A组为空白对照组,B组、C组、D组、E组采用结扎左冠状动脉前降支法建立急性心肌梗死模型。C组给予miRNA-497激动剂和麝香保心丸干预,D组给予miRNA-497抑制剂和麝香保心丸干预,E组给予麝香保心丸干预,B组给予等量生理盐水。6周后,比较各组大鼠一般情况、心功能指标[左室收缩末压(LVESP)、左室内压最大上升速率(LV+dp/dt_(max))、左室舒张末压(LVEDP)、左室内压最大下降速率(LV-dp/dt_(max))]、急性心肌梗死面积、心肌细胞凋亡率、心肌组织形态学变化、miRNA-497表达量。结果与B组比较,C组大鼠一般情况及心肌组织病理学改变无明显改善,D组、E组大鼠一般情况及心肌组织病理学改变有改善,且D组较E组改善更明显。D组、E组大鼠LVEDP、急性心肌梗死面积、心肌细胞凋亡率明显低于B组、C组(P0.05),且D组大鼠LVEDP、急性心肌梗死面积、心肌细胞凋亡率明显低于E组(P0.05);D组、E组大鼠LV+dp/dt_(max)、LVESP、LV-dp/dt_(max)明显高于B组、C组(P0.05),且D组大鼠LV+dp/dt_(max)、LVESP、LV-dp/dt_(max)明显高于E组(P0.05);C组大鼠LVEDP、LV+dp/dt_(max)、LVESP、LV-dp/dt_(max)、急性心肌梗死面积、心肌细胞凋亡率与B组比较,差异均无统计学意义(P0.05)。B组、C组、D组、E组大鼠心肌组织中miRNA-497表达量明显高于A组(P0.05);C组大鼠心肌组织中miRNA-497表达量明显高于B组(P0.05);D组、E组大鼠心肌组织中miRNA-497表达量明显低于B组、C组(P0.05),D组大鼠心肌组织中miRNA-497表达量低于E组(P0.05)。结论 miRNA-497是麝香保心丸改善急性心肌梗死后心室重构中的关键分子,这为急性心肌梗死后心室重构提供了新的研究方向。     

miR-30a对缺血再灌注损伤大鼠心肌组织的保护作用及机制

目的:研究miR-30a对缺血再灌注损伤大鼠的保护作用及其机制。方法:SD大鼠, 32只随机分为假手术组、模型组、Ad-control组、Ad-miR-30a组,每组各8只。除假手术组外,各组大鼠均通过结扎左冠状动脉45 min后恢复血流的方法制备心肌缺血再灌注模型,其中Ad-control组和Ad-miR-30a组分别转染Ad-control腺病毒空白载体和Ad-miR-30a腺病毒。采用qRT-PCR法检测各组大鼠心肌组织中miR-30a的相对表达量。UCG法检测左心室舒张末压(LVEDP)左心室内压峰值(LVSP),左心室压力上升和下降最大变化速率(±dp/dt_(max))等指标,评价miR-30a对大鼠心功能的影响。通过原位细胞凋亡(TUNEL)法检测各组大鼠心肌细胞的凋亡情况。蛋白免疫印迹法检测大鼠心肌组织中Cleaved caspase-3、Caspase-3、 Bax、Bcl-2等蛋白的表达变化。结果:与假手术组相比较,模型组和Ad-control组大鼠miR-30a的相对表达量明显降低(P0.05),Ad-miR-30a组miR-30a的相对表达量显著提高(P0.01)。miR-30a的过表达能显著上调因为缺血再灌注损伤而下降的LVSP,±dp/dt_(max)值(P0.05),同时明显下调LVDEP值(P0.05),显著降低心肌细胞凋亡率(P0.05),显著降低心肌组织中的Cleaved caspase-3/Caspase-3、 Bax/Bcl-2的蛋白表达水平的比值(P0.01)。结论:miR-30a通过抑制心肌细胞凋亡显著改善缺血再灌注损伤,有可能成为缺血性心血管疾病的新治疗靶点。     

螺内酯对心肌肥厚大鼠左心室可溶性ST2及核转录因子_κB的影响

目的探讨螺内酯对心肌肥厚大鼠可溶性ST2(sST2)及核转录因子_κB(NF-_κB)的影响。方法选取健康雄性SD大鼠30只,随机分为对照组(n=10)、模型组(n=10)、药物干预组(n=10)。对照组大鼠皮下注射生理盐水;模型组皮下注射异丙肾上腺素(ISO);药物干预组皮下注射ISO,同时给予螺内酯20mg/(kg·d)灌胃。14d后处死大鼠,计算心脏质量/体质量、左心室质量/体质量,观察心肌细胞直径;免疫组化及逆转录聚合酶链反应(RT-PCR)法检测心肌组织中sST2及NF-_κB的表达;Masson染色观察心肌纤维化程度。结果与对照组比,模型组心脏质量/体质量、左心室质量/体质量、心肌细胞直径升高[(3.39±0.11)比(2.47±0.07)mg/g,(2.34±0.11)比(1.78±0.07)mg/g,(26.30±0.95)比(14.53±0.47)μm;均P0.05];sST2与NF-_κB mRNA和蛋白表达升高(均P0.05)。与模型组比较,药物干预组心脏质量/体质量、左心室质量/体质量、心肌细胞直径降低[(2.79±0.07)比(3.39±0.11)mg/g,(1.92±0.10)比(2.34±0.11)mg/g,(20.96±0.65)比(26.30±0.95)μm;均P0.05],sST2与NF-_κB mRNA和蛋白表达降低(均P0.05)。心肌纤维化程度:模型组大于对照组,干预组小于模型组。结论螺内酯可能通过调节sST2的表达,抑制下游NF-_κB的表达,对抗ISO诱导的大鼠心肌肥厚。     

淫羊藿次苷Ⅱ通过沉默信息调控子1-叉头蛋白O1通路减轻心肌缺血再灌注损伤

目的探究淫羊藿次苷Ⅱ(ICSⅡ)预处理对心肌缺血再灌注损伤大鼠的保护作用,初步探究可能的作用机制。方法将大鼠分为假手术组、模型组、淫羊藿次苷Ⅱ(ICSⅡ)组、沉默信息调控子1(SIRT1)抑制剂(Selisistat)组、ICSⅡ+Selisistat组;各组大鼠预处理后采用左冠状动脉前降支结扎法建立心肌缺血再灌注损伤模型大鼠。超声检测大鼠心室功能变化;HE染色观察大鼠心肌组织病理学变化情况;酶联免疫吸附法检测血清白细胞介素1β(IL-1β)、心肌肌钙蛋白I(cTnI)和肿瘤坏死因子α(TNF-α)水平;Tunel染色法检测心肌组织凋亡;免疫印迹法检测心肌组织中SIRT1、乙酰化叉头蛋白O1(Ac-FOXO1)、Bcl-2相关X蛋白(Bax)、天冬氨酸特异性半胱氨酸蛋白酶3(Caspase-3)、Cleaved-Caspase-3、B淋巴细胞瘤2(Bcl-2)蛋白表达情况。结果与假手术组相比,模型组左心室舒张末压(LVEDP)升高,平均动脉压(MAP)、左心室收缩压(LVSP)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)降低,cTnI、TNF-α、IL-1β水平升高,细胞凋亡率升高,SIRT1表达降低,Ac-FOXO1表达升高,心肌组织Bax、Cleaved-Caspase-3蛋白表达升高,Bcl-2蛋白表达降低(均P0.05)。与模型组相比,ICSⅡ组LVEDP降低,MAP、LVSP、LVEF、LVFS升高,cTnI、TNF-α、IL-1β水平降低,细胞凋亡率降低,SIRT1表达升高,Ac-FOXO1表达降低,心肌组织Bax、Cleaved-Caspase-3蛋白表达降低,Bcl-2蛋白表达升高(均P0.05);Selisistat组LVEDP升高,MAP、LVSP、LVEF降低,cTnI、TNF-α、IL-1β水平升高,细胞凋亡率升高,SIRT1表达降低,Ac-FOXO1表达升高,心肌组织Bax、Cleaved-Caspase-3蛋白表达升高,Bcl-2蛋白表达降低(均P0.05)。ICSⅡ+Selisistat组LVEDP、cTnI、TNF-α、IL-1β、细胞凋亡率、Ac-FOXO1表达、心肌组织Bax、Cleaved-Caspase-3蛋白表达低于Selisistat组,MAP、LVSP、LVEF、LVFS水平和SIRT1、Bcl-2蛋白表达高于Selisistat组(均P0.05)。结论心肌缺血再灌注损伤大鼠ICSⅡ预处理后,可缓解心肌组织炎症损伤,改善心室功能,其机制可能与激活SIRT1/FOXO1通路有关。     

Rho激酶信号通路与大鼠心肌细胞凋亡的关系

目的探讨Rho激酶信号通路在心肌梗死模型大鼠心肌细胞凋亡组织中的表达变化及对心肌细胞凋亡的影响作用。方法选取健康雄性Wistar大鼠,通过结扎左前降支建立大鼠心肌梗死模型,将24 h后仍然存活的大鼠选取30只,随机分为模型组和治疗组(法舒地尔5 mg/kg,2次/d)各15只,并另外选取健康雄性大鼠15只作为假手术组,假手术组和模型组给予等量生理盐水处理,比较4 w后3组心肌梗死面积及Rho激酶mRNA、蛋白等指标的表达差异。结果 3组左心室收缩压(LVSP)、左室舒张压(LVEDP)、左室内压最大上升速率(+dp/dtmax)、左室内压最大下降速率(-dp/dtmax)差异均有统计学意义(P0.05),模型组LVSP、+dp/dtmax、-dp/dtmax显著低于治疗组和假手术组(P0.05),LVEDP显著高于治疗组和假手术组(P0.05),治疗组LVSP、+dp/dtmax、-dp/dtmax显著低于假手术组(P0.05),LVEDP显著高于假手术组(P0.05)。治疗组心肌缺血面积低于模型组但差异不显著(P0.05);治疗组心梗面积显著低于模型组(P0.05)。3组Rho激酶mRNA、Bax蛋白、Bcl-2蛋白表达差异有统计学意义(P0.05);组间差异均有统计学意义(P0.05)。结论心肌梗死大鼠心肌组织中的Rho激酶mRNA、Bax蛋白达显著增加,同时Bcl-2蛋白表达降低,法舒地尔能够降低Rho激酶mRNA表达,减少心肌细胞凋亡,减轻心肌梗死面积。     

非诺贝特治疗大鼠左心室肥厚

目的研究非诺贝特逆转腹主动脉缩窄(AAC)大鼠左心室肥厚的作用,并初步探讨其对 Akt/GSK3β信号通路的影响。方法采用 AAC 法建立心肌肥厚模型。术前1周和术后4周灌胃给予非诺贝特[80 mg/(kg·d)],观察了其对血流动力学参数、超声参数、左室质量(LVM)/体质量(BM)、心肌超微结构的影响。同时检测了心肌组织中 Akt 和 GSK3β蛋白磷酸化的表达变化。结果 1)与假手术组相比,大鼠腹主动脉缩窄4周后,主动脉收缩压(AoSP)、主动脉舒张压(AoDP)、左室内压(LVESP、LVEDP)明显升高(P<0.05);室内压最大上升速率(+dp/dt_(max))和室内压最大下降速率(-dp/dt_(min))明显减少(P<0.05),而非诺贝特治疗后,+dp/dt_(max)、-dp/dt_(min)明显上升(P<0.05);AoSP、AoDP、LVESP 无明显变化(P>0.05)而 LVEDP 稍降(P<0.05)。2)手术后4周 AAC 大鼠呈现出明显的向心性肥厚,室间隔(IVSd 和 IVSs)及左室后壁厚度(PWTd 和 PWTs)(P<0.05)、LVM/BM[LVM:(2.94±0...     

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.     

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.     

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.