The diagnosis and treatment of Whipple's disease.
Whipple's disease is a rare, chronic, and systemic infectious disease caused by the ubiquitously occurring bacterium Tropheryma whippelii. For two reasons, the disease represents a good example for documenting the input of modern molecular-based techniques into pathogenetic, diagnostic, and therapeutic concepts in clinical medicine. First, the unidentified and uncultivable causative organism has been characterized by novel molecular-genetic techniques. Second, in contrast to other chronic inflammatory disorders, clinical manifestations of T. whippelii infection seem to be based on reduced T-cell helper type 1 (TH1) activity. These findings have led to an improved pathophysiologic understanding of the disease and to new aspects in treatment strategies that are discussed in this paper.
Marth
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Deutsche Klinik für Diagnostik, Aukammallee 33, 65191 Wiesbaden, Germany. marth.gastro2@dkd-wiesbaden.de
D000192:Actinomycetales / Q000235:genetics / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis; D006801:Humans; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D008061:Whipple Disease / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology / Q000628:therapy*
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial