INTESTINE Vol.19 No.6(4)

Theme Cytomegalovirus enterocolitis and Clostridium difficile infection
Title Pathophysiology and diagnosis of concomitant CMV infection in patients with inflammatory bowel disease
Publish Date 2015/11
Author Minoru Matsuura Department of Gastroenterology and Hepatology, Kyoto University Hospital
Author Yusuke Honzawa Department of Gastroenterology and Hepatology, Kyoto University Hospital
Author Hiroshi Nakase Department of Endoscopic Medicine, Kyoto University Hospital
[ Summary ] Cytomegalovirus (CMV) is a double-stranded DNA virus and a member of the herpesvirus family. CMV infection persists in a latent state throughout host life after primary infection. CMV reactivation often occurs in patients with inflammatory bowel disease, particularly those with ulcerative colitis (UC), who are frequently treated with strong immunosuppressive agents, including corticosteroids and immunomodulators. CMV reactivation is directly induced by infl ammatory signal such as tumor necrosis factor and influenced by the inhibitory effect of immunosuppressive agents on the host immune surveillance in the prevention of CMV reactivation. For diagnosis of CMV infection, histopathologic examination, CMV antigenemia assay, and real-time polymerase chain reaction assay are usually used in clinical practice. However, CMV infection (reactivation) is difficult to differentiate from CMV disease in patients with UC. Further studies are required to clarify the effect of concomitant CMV infection on the pathophysiological characteristics of patients with UC.
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