Electron Microscopic Study of the Intestinal Mucosa in Whipple's Disease

Wc, Chears; Ct, Ashworth

doi:10.1016/s0016-5085(19)35160-1

Cited by 172 publications

(11 citation statements)

References 11 publications

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“…The cell wall is the structure between L2 and the surface membrane, and L1 represents an inner, polysaccharide-containing layer of the wall. The presence of this layer in the wall of the Whipple bacillus has not been recognized in previous studies (Chears & Asworth, 1961 ;Dobbins & Kawanishi, 1981 ;Trier et al, 1965;Watson & Haubrich, 1969). The conclusions regarding the organization of the Whipple bacillus cell wall are based on the results of the phosphotungstic acid stain and of the Thikry procedure.…”

Section: Discussionmentioning

confidence: 76%

“…The presence of bacillary forms in the small intestine and other affected tissues of patients with Whipple's disease, before any antibacterial treatment, has been consistently observed by several authors (Chears & Asworth, 1961 ;Dobbins & Ruffin, 1967;Dobbins & Kawanishi, 1981 ;Watson & Haubrich, 1969), and it is generally accepted that the disease results from bacterial infection (Maize1 et al, 1970;Miksche et al, 1974;Watson & Haubrich, 1969). The Whipple bacillus, the presumed causative agent of the disease, is a peculiar micro-organism: it is not cultivable in bacteriological media and its ultrastructure has been considered as not in accordance with its Gram-positive staining (Dobbins & Kawanishi,198 1).…”

Section: Ultrastructure Of Bacilli and The Bacillary Origin Of The Mamentioning

confidence: 84%

“…One very characteristic feature of the histology of Whipple's disease is the presence inside macrophages of PAS-positive inclusions (Maize1 et al, 1970) that have been assumed to be of bacterial origin (Chears & Asworth, 1961;Bhagavan et al, 1981). Our present results demonstrate such an origin and further show that the inclusions are accumulations of a particular, polysaccharide-containing layer of the Whipple bacillus envelope (Ll).…”

Section: Discussionmentioning

confidence: 99%

“…The PAS-positive material of these inclusions has been assumed to be polysaccharide of bacterial origin (Chears & Asworth, 1961 ;Keren et al, 1976), but this has not been conclusively demonstrated. In the present paper we describe the results of an ultrastructural and cytochemical study of the degeneration of phagocytosed W hipple bacilli inside macrop hages.…”

Section: Ultrastructure Of Bacilli and The Bacillary Origin Of The Mamentioning

confidence: 99%

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Ultrastructure of Bacilli and the Bacillary Origin of the Macrophagic Inclusions in Whipple's Disease

1985

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An electron microscopic and cytochemical study of the Whipple bacillus in jejunal biopsies from three untreated patients was made using fixation procedures developed for the satisfactory preservation of bacterial ultrastructure. The envelopes of the normal-looking bacilli present free in the lamina propria consisted of the following layers. (i) A cytoplasmic membrane with a triple-layered profile and a mean thickness (peak-to-peak distance) of 6.08 nm. (ii) A thick (20 nm) cell wall containing peptidoglycan; the wall had a hitherto undescribed inner layer that contained polysaccharides, possibly teichoic acids. (iii) Surrounding the cell wall, a surface membrane with a symmetric profile and a mean peak-to-peak distance of 4.74 nm. The ultrastructural pattern of the Whipple bacillus wall corresponds to that of Gram-positive bacteria, but with an additional surface membrane. This membrane is different from the outer membrane of Gram-negative bacteria because it has a symmetric profile, is thinner and has no periodic acid-Schiff (PAS)-positive components. Normal-looking bacilli were seen very rarely inside jejunal macrophages, but degenerating bacteria were abundant in these phagocytes. Electron microscopy and ultrastructural cytochemistry of Whipple bacilli inside jejunal macrophages of the three untreated patients showed that the degenerative process is a sequence that leads to the loss of bacillary forms and to the accumulation of bacterial remnants resistant to degradation by the macrophage. These remnants correspond to the innermost, polysaccharide-containing portion of the bacillus wall. The progressive accumulation of these PAS-positive wall remnants is the origin of the intramacrophagic inclusions that are important in the histological diagnosis of Whipple's disease. The reported results indicate that in the three patients studied, the Whipple bacillus multiplies extracellularly, the bacteria that are phagocytosed by macrophages being degraded.

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Section: Discussionmentioning

confidence: 76%

Section: Ultrastructure Of Bacilli and The Bacillary Origin Of The Mamentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Ultrastructure Of Bacilli and The Bacillary Origin Of The Mamentioning

confidence: 99%

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Ultrastructure of Bacilli and the Bacillary Origin of the Macrophagic Inclusions in Whipple's Disease

1985

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“…THE electron-microscope demonstration of bacilli in the intestinal wall (Chears and Ashworth, 1961;Yardley and Hendrix, 1961;Kurtz, Davis and Ruffin, 1962;Kent et al, 1963;Trier et al, 1963Trier et al, , 1965Kok, Dybkaer and Rostgaard, 1964;Rostgaard, 1964) and the favourable response to antibiotic therapy (England, French and Rawson, 1960;Davis et al, 1963;Trier and Phelps, 1963;Trier et al, 1965) in Whipple's disease have stimulated renewed interest in this disorder. Whether the bacilli are secondary invaders or are the primary aetiological agent of the disease remains unsettled (Ashworth et al, 1964;Kojecky et al, 1964).…”

mentioning

confidence: 99%

Bacilli‐lipid associations in Whipple's disease

Phillips

Finlay

1967

J. Pathol.

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The capacity of newly transformed cells of Bacillus subtilis to synthesize deoxyribonucleic acid (DNA), ribonucleic acid (RNA), and protein has been determined by following the kinetics of suicide after their exposure to tritiated precursors of each of these macromolecules. Competent cells, whether transformed or not, are heterogeneous with respect to DNA synthesis. About 40 to 50% are latent in DNA synthesis. This latency may persist for 2.5 to 3 hr since transformants are resistant to thymineless death for this period after DNA addition. The remainder of the transformants synthesize DNA at one-half the rate of the cells of the total population. Synthesis of stable RNA does not occur at an appreciable rate in newly transformed cells. Newly transformed cells, however, do synthesize protein extensively, as demonstrated by the lethality of incorporated tritiated amino acids. Either chloramphenicol or actinomycin D treatment during the time of exposure to the tritiated amino acid prevented the suicide of transformants.

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Whipple's Disease With Associated Splenomegaly and Pancytopenia

Lundberg¹

1963

Arch Intern Med

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Electron Microscopic Study of the Intestinal Mucosa in Whipple's Disease

Cited by 172 publications

References 11 publications

Ultrastructure of Bacilli and the Bacillary Origin of the Macrophagic Inclusions in Whipple's Disease

Ultrastructure of Bacilli and the Bacillary Origin of the Macrophagic Inclusions in Whipple's Disease

Bacilli‐lipid associations in Whipple's disease

Whipple's Disease With Associated Splenomegaly and Pancytopenia

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