Looking for Tropheryma whipplei Source and Reservoir in Rural Senegal

Keïta, Abdoulaye; Mediannikov, Oleg; Ratmanov, Pavel; Diatta, Georges; Basséne, Hubert; Roucher, Clémentine; Tall, Adama; Sokhna, Cheikh; Trape, Jean‐François; Raoult, Didier; Fénollar, Florence

doi:10.4269/ajtmh.2012.12-0614

Cited by 33 publications

(32 citation statements)

References 27 publications

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“…Humans are thought to be the predominant reservoir of T. whipplei in Senegal. 22 Our data confirm that the bacterium is prevalent in this region. The presence of T. whipplei on the skin may be because of fecal contamination by T. whipplei.…”

Section: Discussionsupporting

confidence: 80%

Molecular Identification of Pathogenic Bacteria in Eschars from Acute Febrile Patients, Senegal

Mediannikov

Socolovschi

Million

et al. 2014

The American Journal of Tropical Medicine and Hygiene

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Abstract. Fever caused by Rickettsia felis was recently shown to play an important role in infectious diseases morbidity in sub-Saharan Africa. We collected 68 cotton swabs from fever-associated eschars in four different regions of Senegal. In 5 of 68 eschar samples (7.4%), we have identified DNA from R. felis. In 49 of 68 eschar samples (72.1%), we have identified DNA from Staphylococcus aureus. In 35 of 68 eschar samples (51.5%), we have identified DNA from Streptococcus pyogenes, and in 4 of 68 eschar samples (5.9%), we have identified DNA from Streptococcus pneumoniae. In 34 cases, S. aureus was found together with S. pyogenes. DNA from R. felis was also found in swabs from the skin of the healthy Senegalese villagers (3 of 60; 5%) but not French urbanites. The presence of S. aureus and S. pyogenes was significantly associated with the presence of eschars in febrile patients compared with the healthy skin from the control group. Finally, we confirmed that Senegal is an endemic region for R. felis, which is found in both eschars and healthy skin swabs.

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Section: Discussionsupporting

confidence: 80%

Molecular Identification of Pathogenic Bacteria in Eschars from Acute Febrile Patients, Senegal

Mediannikov

Socolovschi

Million

et al. 2014

The American Journal of Tropical Medicine and Hygiene

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“…It is noteworthy that classic Whipple's disease is a typical Caucasian illness that is very rare in the native Asian and African populations (33), but carriage is common in these latter two continents (34,35). A recent study in northwestern Italy gives information about the prevalence and estimated it to be 3 of 1,000,000 (95% confidence interval [95% CI], 2.1 to 3.8) (36).…”

Section: Epidemiology Incidence and Prevalence Of Classic Whipple's Dmentioning

confidence: 99%

“…Intestinal biopsy specimens from a small collection of domestic animals (24 pigs, 20 cattle, 19 chickens, 15 sheep, 14 cats, 13 dogs, and 10 horses) were also investigated and showed no positive results after analysis by PCR (37). Furthermore, in Senegal where the bacterium is highly prevalent, only 4 of the 1,002 environmental specimens (including domestic and synanthropic animals) tested positive for T. whipplei (34). Although it is commonly believed that there is no significant nonhuman reservoir, this cannot be definitely excluded without proper studies on this subject.…”

Section: Nonhuman Sources Of T Whippleimentioning

confidence: 99%

Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections

et al. 2017

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SUMMARY Whipple's disease is a rare infectious disease that can be fatal if left untreated. The disease is caused by infection with Tropheryma whipplei, a bacterium that may be more common than was initially assumed. Most patients present with nonspecific symptoms, and as routine cultivation of the bacterium is not feasible, it is difficult to diagnose this infection. On the other hand, due to the generic symptoms, infection with this bacterium is actually quite often in the differential diagnosis. The gold standard for diagnosis used to be periodic acid-Schiff (PAS) staining of duodenal biopsy specimens, but PAS staining has a poor specificity and sensitivity. The development of molecular techniques has resulted in more convenient methods for detecting T. whipplei infections, and this has greatly improved the diagnosis of this often missed infection. In addition, the molecular detection of T. whipplei has resulted in an increase in knowledge about its pathogenicity, and this review gives an overview of the new insights in epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of Tropheryma whipplei infections.

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“…Accumulating evidence suggests that T. whipplei causes acute infections, including bacteremia and gastroenteritis, and local chronic infections without gastrointestinal involvement, such as endocarditis, uveitis, or pneumonia, that do not necessarily lead to full-blown CWD (33,34). Only a small number of predisposed individuals develop CWD upon infection with T. whipplei, when the bacterium is not efficiently eliminated due to immunological host factors related to antigen processing or presentation as, for example, a CWD-associated HLA haplotype and alternative macrophage activation (11,35).…”

Section: Discussionmentioning

confidence: 99%

Peripheral T-Cell Reactivity to Heat Shock Protein 70 and Its Cofactor GrpE from Tropheryma whipplei Is Reduced in Patients with Classical Whipple's Disease

et al. 2017

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Classical Whipple's disease (CWD) is characterized by the lack of specific Th1 response toward Tropheryma whipplei in genetically predisposed individuals. The cofactor GrpE of heat shock protein 70 (Hsp70) from T. whipplei was previously identified as a B-cell antigen. We tested the capacity of Hsp70 and GrpE to elicit specific proinflammatory T-cell responses. Peripheral mononuclear cells from CWD patients and healthy donors were stimulated with T. whipplei lysate or recombinant GrpE or Hsp70 before levels of CD40L, CD69, perforin, granzyme B, CD107a, and gamma interferon (IFN-␥) were determined in T cells by flow cytometry. Upon stimulation with total bacterial lysate or recombinant GrpE or Hsp70 of T. whipplei, the proportions of activated effector CD4 ϩ T cells, determined as CD40L ϩ IFN-␥ ϩ , were significantly lower in patients with CWD than in healthy controls; CD8 ϩ T cells of untreated CWD patients revealed an enhanced activation toward unspecific stimulation and T. whipplei-specific degranulation, although CD69 ϩ IFN-␥ ϩ CD8 ϩ T cells were reduced upon stimulation with T. whipplei lysate and recombinant T. whipplei-derived proteins. Hsp70 and its cofactor GrpE are immunogenic in healthy individuals, eliciting effective responses against T. whipplei to control bacterial spreading. The lack of specific T-cell responses against these T. whipplei-derived proteins may contribute to the pathogenesis of CWD.

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Looking for Tropheryma whipplei Source and Reservoir in Rural Senegal

Cited by 33 publications

References 27 publications

Molecular Identification of Pathogenic Bacteria in Eschars from Acute Febrile Patients, Senegal

Molecular Identification of Pathogenic Bacteria in Eschars from Acute Febrile Patients, Senegal

Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections

Peripheral T-Cell Reactivity to Heat Shock Protein 70 and Its Cofactor GrpE from Tropheryma whipplei Is Reduced in Patients with Classical Whipple's Disease

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