title: Genotyping reveals a wide heterogeneity of Tropheryma whipplei.
abstract: Tropheryma whipplei, the causative agent of Whipple's disease, is associated with various clinical manifestations as well as an asymptomatic carrier status, and it exhibits genetic heterogeneity. However, relationships that may exist between environmental and clinical strains are unknown. Herein, we developed an efficient genotyping system based on four highly variable genomic sequences (HVGSs) selected on the basis of genome comparison. We analysed 39 samples from 39 patients with Whipple's disease and 10 samples from 10 asymptomatic carriers. Twenty-six classic gastrointestinal Whipple's disease associated with additional manifestations, six relapses of classic Whipple's disease (three gastrointestinal and three neurological relapses), and seven isolated infections due to T. whipplei without digestive involvement (five endocarditis, one spondylodiscitis and one neurological infection) were included in the study. We identified 24 HVGS genotypes among 39 T. whipplei DNA samples from the patients and 10 T. whipplei DNA samples from the asymptomatic carriers. No significant correlation between HVGS genotypes and clinical manifestations of Whipple's disease, or asymptomatic carriers, was found for the 49 samples tested. Our observations revealed a high genetic diversity of T. whipplei strains that is apparently independent of geographical distribution and unrelated to bacterial pathogenicity. Genotyping in Whipple's disease may, however, be useful in epidemiological studies.
authors.affiliation: Unité des Rickettsies, IFR 48, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Li
authors.affiliation: Unité des Rickettsies, IFR 48, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Fenollar
authors.affiliation: Unité des Rickettsies, IFR 48, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
authors.affiliation: Unité des Rickettsies, IFR 48, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Fournier
authors.affiliation: DRK Krankenhaus Neuwied, Germany.
authors.forename: Gerhard E
authors.initials: GE
authors.lastname: Feurle
authors.affiliation: Universitätsklinik für Innere Medizin IV, Klinische Abteilung Gastroenterologie und Hepatologie, Medizinische Universität, Wien, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.affiliation: DRK Krankenhaus Neuwied, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Moos
authors.affiliation: Department of Internal Medicine, St Josef Hospital, Zel, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Marth
authors.affiliation: Bio-Analytica AG, Maihofstrasse 95a, 6000 Luzern 6, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Altwegg
authors.affiliation: Department of Medical Microbiology, University of Zurich, Zurich, Switzerland.
authors.forename: Romana C
authors.initials: RC
authors.lastname: Calligaris-Maibach
authors.affiliation: Department of Infectious Diseases, Charité, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schneider
authors.affiliation: Gastroenterology Unit, Fondazione IRCCS, Policlinico San Matteo, University of Pavia, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Biagi
authors.affiliation: Unité des Rickettsies, IFR 48, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: La Scola
authors.affiliation: Unité des Rickettsies, IFR 48, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D004269:DNA, Bacterial / Q000145:classification / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000235:genetics; D005838:Genotype; D006801:Humans; D008969:Molecular Sequence Data; D010802:Phylogeny; D016133:Polymerase Chain Reaction / Q000379:methods; D011110:Polymorphism, Genetic; D012329:RNA, Bacterial / Q000235:genetics; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D017421:Sequence Analysis; D054851:Tropheryma / Q000145:classification* / Q000235:genetics*; D008061:Whipple Disease / Q000382:microbiology*
chemical_list: D004269:DNA, Bacterial; D021903:DNA, Ribosomal Spacer; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S; D012338:RNA, Ribosomal, 23S