Whipple's Disease: a Macrophage Disease

Desnues, Benoît; Ihrig, Melanie; Raoult, Didier; Mège, Jean‐Louis

doi:10.1128/cvi.13.2.170-178.2006

Cited by 75 publications

(50 citation statements)

References 122 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Macrophages seem to be of central importance in the development of the disease (36). Recently, it has been shown that intestinal macrophages of Whipple's disease patients display in vivo the phenotype of M2/alternatively activated macrophages (17) that favor the development of Th2 responses and inhibit protective Th1 polarization (37).…”

Section: Discussionmentioning

confidence: 99%

“…We studied CD4 ϩ T cell reactivity in 32 patients with different stages of Whipple's disease (13) (Table I, [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]; II, 27 elderly subjects, age-matched to Whipple's disease patients (16 M, 11 F, mean age, 54.9; range, 41-88); and III, 11 active triathletes, agematched to young subjects (11 M, mean age, 32.7; range, [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. Triathletes practice swimming in the river Neckar in Heidelberg where T. whipplei was detected in sewage plants (5) and thus are supposed to have enhanced contact to environmental T. whipplei.…”

Section: Patients and Control Subjectsmentioning

confidence: 99%

See 1 more Smart Citation

Reduced Peripheral and MucosalTropheryma whipplei-Specific Th1 Response in Patients with Whipple’s Disease

Moos

Kunkel

Marth

et al. 2006

The Journal of Immunology

View full text Add to dashboard Cite

Whipple’s disease is a rare infectious disorder caused by Tropheryma whipplei. Major symptoms are arthropathy, weight loss, and diarrhea, but the CNS and other organs may be affected, too. The incidence of Whipple’s disease is very low despite the ubiquitous presence of T. whipplei in the environment. Therefore, it has been suggested that host factors indicated by immune deficiencies are responsible for the development of Whipple’s disease. However, T. whipplei-specific T cell responses could not be studied until now, because cultivation of the bacteria was established only recently. Thus, the availability of T. whipplei Twist-MarseilleT has enabled the first analysis of T. whipplei-specific reactivity of CD4+ T cells. A robust T. whipplei-specific CD4+ Th1 reactivity and activation (expression of CD154) was detected in peripheral and duodenal lymphocytes of all healthy (16 young, 27 age-matched, 11 triathletes) and disease controls (17 patients with tuberculosis) tested. However, 32 Whipple’s disease patients showed reduced or absent T. whipplei-specific Th1 responses, whereas their capacity to react to other common Ags like tetanus toxoid, tuberculin, actinomycetes, Giardia lamblia, or CMV was not reduced compared with controls. Hence, we conclude that an insufficient T. whipplei-specific Th1 response may be responsible for an impaired immunological clearance of T. whipplei in Whipple’s disease patients and may contribute to the fatal natural course of the disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Patients and Control Subjectsmentioning

confidence: 99%

Reduced Peripheral and MucosalTropheryma whipplei-Specific Th1 Response in Patients with Whipple’s Disease

Moos

Kunkel

Marth

et al. 2006

The Journal of Immunology

View full text Add to dashboard Cite

show abstract

“…One describes a reduced or even absent specific Th1-cell response along with a deficit of the macrophageal function disturbing the degradation of the bacterial antigens. That is why it is assumed that the underlying immune deficiency of the organism is responsible for WD development (3,(5)(6)(7)14). The combination of three comparatively rare diseases in the same female patient of ours, such as gluten enteropathy, WD and Crohn's disease is an interesting fact that confirms the conception of the role of the immunological factors in their pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Whipple`s disease - clinical spectrum and diagnostic approach (with a contribution of eight cases)

Gancheva

Stamboliyska

Atanasova

et al. 2014

SSM

View full text Add to dashboard Cite

“…Few epidemiologic studies showed its annual incidence is less than 1 per 1,000,000 per annum [1]. It is has a specific predilection for middle aged white males, about 86% with male-to-female ratio: approximately 8-9:1 [2].…”

Section: Epidemiologymentioning

confidence: 99%

Whipple’s Disease: A Case Report and Review of Literature

Elkholy¹,

Khaled²,

Aziz³

et al. 2017

MOJCR

View full text Add to dashboard Cite

Whipple's disease is a rare systemic disease. It is caused by a gram-positive infectious bacillus called Tropheryma whipplei (T. whipplei). The common presenting feature is malabsorption, but it can also affect multiple organs as heart, central nervous system (CNS), joints, skin, lungs and vascular system. Presentation can be highly variable but mainly the patients are complaining of weight loss, diarrhea, joint pain and arthritis, about 15% of patients do not develop these classic symptoms. Endoscopic picture usually shows pale yellow shaggy mucosa with erythematous eroded patches in the duodenum extending up to the jejunum. Definitive diagnosis is made mainly by endoscopic duodenal biopsies that show characteristic foamy macrophages in the lamina propria containing non-acid fast gram positive bacilli that stain red with Periodic acid-Schiff (PAS) stain. Immunohistochemical staining for antibodies against T. whipplei had been used to detect the organism in a variety of tissues. Polymerase chain reaction (PCR) of T. whipplei is considered a confirmatory test. We present a case of classic Whipple's disease with review of literature for better understanding of the presentation, methods of diagnosis and treatment of the disease.

show abstract

Whipple's Disease: a Macrophage Disease

Cited by 75 publications

References 122 publications

Reduced Peripheral and MucosalTropheryma whipplei-Specific Th1 Response in Patients with Whipple’s Disease

Reduced Peripheral and MucosalTropheryma whipplei-Specific Th1 Response in Patients with Whipple’s Disease

Whipple`s disease - clinical spectrum and diagnostic approach (with a contribution of eight cases)

Whipple’s Disease: A Case Report and Review of Literature

Contact Info

Product

Resources

About