Eck M, Kreipe H, Harmsen D, Müller-Hermelink H K
Institute of Pathology, University of Würzburg, Germany.
Hum Pathol. 1997 Dec;28(12):1424-8. doi: 10.1016/s0046-8177(97)90234-3.
Whipple's disease is a poorly understood systemic disorder associated with the bacillus, Tropheryma whippelii. An early stage of Whipple's disease is studied by using electron microscopy (ELMI) and immunohistochemistry. The diagnosis was confirmed by polymerase chain reaction-amplification and sequencing of the 16S ribosomal-RNA of the bacterium. By using ELMI, Tropheryma whippelii was found in plasma cells and macrophages in the jejunal mucosa. The immunoglobulin (Ig)A-positive plasma cells were focally destructed and their number significantly reduced. However, the bacilli in the plasma cells were morphologically intact. In contrast, the macrophages showed no signs of cell destruction, but contained bacilli in various stages of disintegration. A cytopathic effect of Tropheryma whippelii to IgA plasma cells may be the reason for the commonly found plasma cell reduction in the small intestine mucosa and an important pathogenic mechanism contributing to the evasion of the bacilli from local immune response.
惠普尔病是一种与惠普尔嗜组织菌相关的、了解甚少的全身性疾病。通过电子显微镜检查（ELMI）和免疫组织化学对惠普尔病的早期阶段进行研究。通过聚合酶链反应扩增和该细菌16S核糖体RNA测序确诊。通过ELMI，在空肠黏膜的浆细胞和巨噬细胞中发现了惠普尔嗜组织菌。免疫球蛋白（Ig）A阳性浆细胞受到局灶性破坏，其数量显著减少。然而，浆细胞内的杆菌形态完整。相比之下，巨噬细胞没有细胞破坏的迹象，但含有处于不同解体阶段的杆菌。惠普尔嗜组织菌对IgA浆细胞的细胞病变效应可能是小肠黏膜中常见的浆细胞减少的原因，也是杆菌逃避局部免疫反应的重要致病机制。
