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Related Experiment Videos

Molecular techniques in Whipple's disease.

F Fenollar1, D Raoult

  • 1Unité des Rickettsies, CNRS UMR 6020, Faculté de médecine, Université de la Méditerranée, 27, Boulevard Jean Moulin, 13385 Marseille, France.

Expert Review of Molecular Diagnostics
|March 21, 2002
PubMed
Summary

Whipple's disease, a bacterial infection, presents diverse symptoms. Newer diagnostic methods like PCR show promise but face specificity challenges, while culture and immunohistology are emerging as reliable techniques.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Gastroenterology

Background:

  • Whipple's disease is a rare systemic bacterial infection caused by Tropheryma whipplei.
  • It exhibits varied clinical symptoms including fever, weight loss, diarrhea, polyarthritis, and skin hyperpigmentation.
  • Historically, diagnosis relied on characteristic histologic findings in tissue biopsies.

Purpose of the Study:

  • To review the diagnostic approaches for Whipple's disease.
  • To discuss the evolution of diagnostic techniques from histology to molecular and immunologic methods.
  • To highlight the challenges and advancements in identifying Tropheryma whipplei.

Main Methods:

  • Histologic examination of tissues (e.g., duodenal biopsies) with Periodic Acid-Schiff (PAS) staining.

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  • Polymerase Chain Reaction (PCR) for detecting Tropheryma whipplei DNA in various biological samples.
  • Bacterial culture and immunohistology using rabbit polyclonal antibodies.

    • Main Results:

    • Traditional diagnosis depended on PAS-positive, diastase-resistant staining in biopsies.
    • PCR offers a molecular diagnostic tool, but T. whipplei DNA detection in healthy individuals raises specificity concerns.
    • Stable bacterial culture was achieved in 2000, and immunohistology is now available.

    Conclusions:

    • While PCR is a developing diagnostic method for Whipple's disease, its specificity requires further validation.
    • Bacterial culture and immunohistology represent significant advancements, though not yet widely implemented.
    • Further research into Tropheryma whipplei propagation will enhance understanding of the disease's epidemiology and pathogenicity, improving diagnostic accuracy.