Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13005, Marseille, France.
Department of Internal Medicine, Hôpital Estaing, Centre, Hospitaliser Universitaire, Clermont-Ferrand, France.
Infection. 2019 Apr;47(2):317-321. doi: 10.1007/s15010-018-1243-0. Epub 2018 Oct 27.
Immunohistochemistry and Periodic acid-Schiff (PAS) staining have been routinely used for the diagnosis of Whipple's disease (WD). However, these methods present limitations. As a result, the last years, Fluorescence in situ hybridization (FISH) has been increasingly used as a complementary tool for the diagnosis of WD from various tissue samples.
In this study, we visualized, by FISH, Tropheryma whipplei within macrophages of a lymph node from a patient with WD. Moreover, we report in this study a patient with a pulmonary biopsy compatible with WD by PAS, immunostaining and FISH, although the specific molecular assays for T. whipplei were negative. Sequencing analysis of the 16S rDNA revealed a T. whipplei-related species with unknown classification.
FISH can be a valuable method for the detection of Tropheryma species in formalin-fixed paraffin-embedded tissues. FISH cannot replace the other already approved diagnostic techniques for WD, it can be used as a complementary tool and can provide supplementary information in a relatively short time.
免疫组织化学和过碘酸雪夫(PAS)染色已被常规用于 Whipple 病(WD)的诊断。然而,这些方法存在局限性。因此,近年来,荧光原位杂交(FISH)已被越来越多地用作从各种组织样本诊断 WD 的辅助工具。
在本研究中,我们通过 FISH 在 WD 患者淋巴结中的巨噬细胞中可视化了 Tropheryma whipplei。此外,我们在本研究中报告了一例经 PAS、免疫染色和 FISH 检查与 WD 相符的肺活检患者,尽管针对 T. whipplei 的特定分子检测呈阴性。16S rDNA 测序分析显示出一种与未知分类相关的 Tropheryma 种。
FISH 可以成为检测福尔马林固定石蜡包埋组织中 Tropheryma 种的有价值的方法。FISH 不能替代其他已批准的 WD 诊断技术,它可以作为一种辅助工具,并且可以在相对较短的时间内提供补充信息。