Relman D A, Schmidt T M, MacDermott R P, Falkow S
Department of Medicine, Stanford University, Calif.
N Engl J Med. 1992 Jul 30;327(5):293-301. doi: 10.1056/NEJM199207303270501.
Whipple's disease is a systemic disorder known for 85 years to be associated with an uncultured, and therefore unidentified, bacillus.
We used a molecular genetic approach to identify this organism. The bacterial 16S ribosomal RNA (rRNA) sequence was amplified directly from tissues of five unrelated patients with Whipple's disease by means of the polymerase chain reaction, first with broad-range primers and then with specific primers. We determined and analyzed the nucleotide sequence of the amplification products.
A unique 1321-base bacterial 16S rRNA sequence was amplified from duodenal tissue of one patient. This sequence indicated the presence of a previously uncharacterized organism. We then detected this sequence in tissues from all 5 patients with Whipple's disease, but in none of those from 10 patients without the disorder. According to phylogenetic analysis, this bacterium is a gram-positive actinomycete that is not closely related to any known genus.
We have identified the uncultured bacillus associated with Whipple's disease. The phylogenetic relations of this bacterium, its distinct morphologic characteristics, and the unusual features of the disease are sufficient grounds for naming this bacillus Tropheryma whippelii gen. nov. sp. nov. Our findings also provide a basis for a specific diagnostic test for this organism.
惠普尔病是一种全身性疾病，85年来一直被认为与一种无法培养因而身份不明的杆菌有关。
我们采用分子遗传学方法来鉴定这种微生物。通过聚合酶链反应直接从5名无亲缘关系的惠普尔病患者的组织中扩增细菌16S核糖体RNA（rRNA）序列，先用通用引物，然后用特异性引物。我们测定并分析了扩增产物的核苷酸序列。
从一名患者的十二指肠组织中扩增出一个独特的1321个碱基的细菌16S rRNA序列。该序列表明存在一种以前未被鉴定的微生物。然后我们在所有5名惠普尔病患者的组织中检测到了这个序列，但在10名无该病患者的组织中均未检测到。根据系统发育分析，这种细菌是一种革兰氏阳性放线菌，与任何已知属均无密切关系。
我们已经鉴定出与惠普尔病相关的未培养杆菌。这种细菌的系统发育关系、其独特的形态特征以及该疾病的异常特征足以将这种杆菌命名为惠普尔嗜组织菌新属新种。我们的发现也为针对这种微生物的特异性诊断试验提供了依据。
