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Previous Volume 342:620-625 March 2, 2000 Number 9 Next

	Full Text PDF Editorial by Swartz, M. N. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article PubMed Citation

ABSTRACT

Background Whipple's disease is a systemic bacterial infection, but to date no isolate of the bacterium has been established in subculture, and no strain of this bacterium has been available for study.

Methods Using specimens from the mitral valve of a patient with endocarditis due to Whipple's disease, we isolated and propagated a bacterium by inoculation in a human fibroblast cell line (HEL) with the use of a shell-vial assay. We tested serum samples from our patient, other patients with Whipple's disease, and control subjects for the presence of antibodies to this bacterium.

Results The bacterium of Whipple's disease was grown successfully in HEL cells, and we established subcultures of the isolate. Indirect immunofluorescence assays showed that the patient's serum reacted specifically against the bacterium. Seven of 9 serum samples from patients with Whipple's disease had IgM antibody titers of 1:50 or more, as compared with 3 of 40 samples from the control subjects (P<0.001). Polyclonal antibodies against the bacterium were generated by inoculation of the microorganism into mice and were used to detect bacteria in the excised cardiac tissue from our patient on immunohistochemical analysis. The 16S ribosomal RNA gene of the cultured bacterium was identical to the sequence for Tropheryma whippelii identified previously in tissue samples from patients with Whipple's disease. The strain we have grown is available in the French National Collection.

Conclusions We cultivated the bacterium of Whipple's disease, detected specific antibodies in tissue from the source patient, and generated specific antibodies in mice to be used in the immunodetection of the microorganism in tissues. The development of a serologic test for Whipple's disease may now be possible.

Source Information

From the Unité des Rickettsies, Université de la Méditerranée, Faculté de Médecine, Marseilles, France (D.R., M.L.B., B.L., P.E.F., M.E., H.L., V.R.); the Service de Médecine Interne, Groupe Hospitalier Pitié–Salpêtrière, Paris (J.-C.P.); the Laboratoire de Bactériologie, Hôpital Louis Pradel, Lyons, France (F.V.); the Service de Médecine Interne, Centre Hospitalier Lyon Sud, Lyons, France (D.V.-D.); and the Department of Medicine, University of Alberta, Edmonton, Canada (T.J.M.).

Address reprint requests to Dr. Raoult at the Unité des Rickettsies, Université de la Méditerranée, Faculté de Médecine, CNRS UPRESA 6020, 27 Blvd. Jean Moulin, 13385 Marseilles, France, or at didier.raoult{at}medecine.univ-mrs.fr.

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