title: Specific and nonspecific B-cell function in the small intestines of patients with Whipple's disease.
abstract: Whipple's disease is a chronic multisystemic infection caused by Tropheryma whipplei that is characterized by arthritis, weight loss, and diarrhea. The immunological defects in the duodenal mucosa, the site of major replication of the agent underlying the pathogenesis of Whipple's disease, are poorly understood. Mucosal immunoglobulins are essential for the defense against intestinal pathogens; therefore, we analyzed the B-cell response in duodenal specimens and sera of Whipple's disease patients. Whereas systemic immunoglobulin production was affected only marginally, duodenal biopsy specimens of Whipple's disease patients contained reduced numbers of immunoglobulin-positive plasma cells and secreted less immunoglobulin compared to healthy controls but showed a weak secretory IgA response toward T. whipplei. This T. whipplei-specific intestinal immune response was not observed in controls. Thus, we were able to demonstrate that general mucosal immunoglobulin production in Whipple's disease patients is impaired. However, this deficiency does not completely abolish T. whipplei-specific secretory IgA production that nonetheless does not protect from chronic infection.
authors.affiliation: Medizinische Klinik I, Charité-Universitätsmedizin Berlin, CBF, Berlin, Germany.
authors.forename: Anika
authors.initials: A
authors.lastname: Geelhaar
authors.forename: Verena
authors.initials: V
authors.lastname: Moos
authors.forename: Katina
authors.initials: K
authors.lastname: Schinnerling
authors.forename: Kristina
authors.initials: K
authors.lastname: Allers
authors.forename: Christoph
authors.initials: C
authors.lastname: Loddenkemper
authors.forename: Florence
authors.initials: F
authors.lastname: Fenollar
authors.forename: Bernard
authors.initials: B
authors.lastname: LaScola
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
authors.forename: Thomas
authors.initials: T
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000032:analysis / Q000097:blood*; D001402:B-Lymphocytes / Q000276:immunology* / Q000473:pathology; D001706:Biopsy; D004386:Duodenum / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D018928:Immunity, Mucosal; D007071:Immunoglobulin A, Secretory / Q000032:analysis / Q000096:biosynthesis; D007136:Immunoglobulins / Q000032:analysis / Q000097:blood; D007413:Intestinal Mucosa / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D007421:Intestine, Small / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009924:Organ Culture Techniques; D054851:Tropheryma / Q000276:immunology* / Q000472:pathogenicity; D008061:Whipple Disease / Q000276:immunology* / Q000382:microbiology / Q000473:pathology
chemical_list: D000907:Antibodies, Bacterial; D007071:Immunoglobulin A, Secretory; D007136:Immunoglobulins