von Herbay A, Ditton H J, Maiwald M
Institute of Pathology, University of Heidelberg, Germany.
Gastroenterology. 1996 Jun;110(6):1735-43. doi: 10.1053/gast.1996.v110.pm8964398.
BACKGROUND & AIMS: The uncultured Whipple's disease bacterium (Tropheryma whippelii) was characterized in 1991-1992 by polymerase chain reaction (PCR) and sequencing of the bacterial 16S ribosomal RNA gene. The aim of this study was to develop a PCR assay for diagnostic purposes.
Modified primers for PCR and a specific probe for hybridization were designed. The specificity of this PCR assay was tested using 37 bacterial control strains and intestinal biopsy samples from 16 patients without Whipple's disease. The sensitivity was tested in 88 intestinal biopsy samples from 35 patients with Whipple's disease.
PCR and hybridization were negative in all 37 bacterial controls and in all 16 patients without Whipple's disease. Before therapy, DNA of T. whippelii was detected in all 30 patients with Whipple's disease from whom formalin-fixed biopsy material was available, whereas Bouin-fixed material was negative. During and after treatment, PCR was negative in 23 of the 24 patients who were followed up. Generally, conversion to negative occurred within 1 year. Despite negative intestinal PCR, symptomatic cerebral Whipple's disease appeared in 3 patients.
This PCR assay is specific and sensitive and is applicable as a diagnostic test. However, PCR from intestinal biopsy samples seems less helpful for monitoring the effect of treatment.
未培养的惠普尔病杆菌（Tropheryma whippelii）于1991 - 1992年通过聚合酶链反应（PCR）及细菌16S核糖体RNA基因测序得以鉴定。本研究旨在开发一种用于诊断目的的PCR检测方法。
设计了用于PCR的改良引物及用于杂交的特异性探针。使用37株细菌对照菌株及16例无惠普尔病患者的肠道活检样本对该PCR检测方法的特异性进行了检测。在35例惠普尔病患者的88份肠道活检样本中检测了其敏感性。
在所有37株细菌对照及所有16例无惠普尔病的患者中，PCR及杂交结果均为阴性。治疗前，在所有30例有福尔马林固定活检材料的惠普尔病患者中均检测到了惠普尔病杆菌的DNA，而波因固定材料为阴性。在治疗期间及治疗后，24例接受随访的患者中有23例PCR结果为阴性。一般来说，在1年内转为阴性。尽管肠道PCR结果为阴性，但仍有3例患者出现了有症状的脑型惠普尔病。
该PCR检测方法具有特异性和敏感性，可作为一种诊断试验应用。然而，肠道活检样本的PCR对于监测治疗效果似乎帮助不大。
