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Whipple's Disease: a Macrophage Disease

Benoît Desnues, Melanie Ihrig, Didier Raoult, Jean-Louis Mege
Benoît Desnues
1Unité des Rickettsies, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 6020, Institut Fédératif de Recherche 48, Université de la Méditerranée, Faculté de Médecine, Marseille, France
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Melanie Ihrig
2Department of Veterinary Pathology, College of Veterinary Medicine, Texas A&M University, College Station, Texas 77843
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Didier Raoult
1Unité des Rickettsies, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 6020, Institut Fédératif de Recherche 48, Université de la Méditerranée, Faculté de Médecine, Marseille, France
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Jean-Louis Mege
1Unité des Rickettsies, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 6020, Institut Fédératif de Recherche 48, Université de la Méditerranée, Faculté de Médecine, Marseille, France
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  • For correspondence: Jean-Louis.Mege@medecine.univ-mrs.fr
DOI: 10.1128/CVI.13.2.170-178.2006
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    FIG. 1.

    Model illustrating the pathophysiology of Whipple's disease. DC, dendritic cells.

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  • TABLE 1.

    Epidemiology and clinical symptoms of Whipple's diseasea

    EpidemiologyFinding
    Reported cases1,000
    Mean age50 yrs
    Sex ratio (male/female)8
    Familial casesFew
    Major clinical manifestations
        Weight loss90%
        Diarrhea75%
        Arthropathy85%
        Abdominal pain60%
    Other symptoms
        Arthralgias, arthritis70-90%
        Anemia75-90%
        Fever45%
        Night sweats
        Lymphadenopathy40-50%
        Hyperpigmentation40-60%
        Cardiac manifestations35-65%
        Pulmonary manifestations35-60%
        CNS manifestations20-30%
        Ocular manifestations5-15%
        Splenomegaly5-10%
    • ↵ a Data were collected from references 22, 26, and 77. CNS, central nervous system.

  • TABLE 2.

    Phenotypic characterization of intestinal macrophages and monocytesa

    CompoundFunctionIntestinal macrophagesCirculating monocytes
    CD11b (CR3)α Subunit of complement receptor 3++++++
    CD123 (IL-3R)IL-3 receptor α chain−++
    CD13Aminopeptidase N++++++++++
    CD14Receptor for LPS-LBP complex−+++++
    CD16 (FcγRIII)Low-affinity Fc receptor−++
    CD25 (IL-2R)IL-2 receptor α chain−+
    CD25 + LPS−+++
    CD32 (FcγRII)Low-affinity receptor for aggregated Ig−+++++
    CD33bBinds sialoconjugates++++++++++
    CD36Scavenger receptor++++++
    CD44Binds hyaluronic acid++++++++
    CD64 (FcγRI)High-affinity receptor for IgG−+++
    CD68 (macrosialin)Unknown+++++++
    CD89 (FcαR)IgA receptor−+++++
    HLA-DRMHC class II++++++++++
    Acid phosphatase++++++++
    Nonspecific esterase++++++++++
    TLR1-5Toll-like receptor−+++++
    • ↵ a Data were collected from references 1 and 112 to 115. LBP, LPS-binding protein.

    • ↵ b A useful marker of intestinal macrophages by flow cytometry.

  • TABLE 3.

    Bacteria that induce macrophage apoptosis

    Bacterial pathogenReference
    Actinobacillus actinomycetemcomitans 58
    Aeromonas hydrophila 34
    Bacillus anthracis 95
    Bordetella pertussis 62
    Brucella abortus 33
    Burkholderia cepacia 52
    Chlamydia psittaci 91
    Chlamydia trachomatis 41
    Clostridium difficile 71
    Escherichia coli K-12 66
    Francisella tularensis 65
    Helicobacter pylori 37
    Leptospira interrogans 81
    Mycobacterium avium 9
    Mycobacterium tuberculosis 59
    Parachlamydia acanthamoeba 42
    Photobacterium damselae subsp. piscicida 25
    Salmonella enterica serovar Typhimurium 46
    Salmonella enterica serovar Typhi 109
    Shigella dysenteriae 102
    Shigella flexneri 127
    Tropheryma whipplei 19
    Yersinia enterocolitica 83
    Yersinia pestis 90
    Yersinia pseudotuberculosis 84
    Vibrio vulnificans 57
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Whipple's Disease: a Macrophage Disease
Benoît Desnues, Melanie Ihrig, Didier Raoult, Jean-Louis Mege
Clinical and Vaccine Immunology Feb 2006, 13 (2) 170-178; DOI: 10.1128/CVI.13.2.170-178.2006

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Whipple's Disease: a Macrophage Disease
Benoît Desnues, Melanie Ihrig, Didier Raoult, Jean-Louis Mege
Clinical and Vaccine Immunology Feb 2006, 13 (2) 170-178; DOI: 10.1128/CVI.13.2.170-178.2006
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  • Top
  • Article
    • WHIPPLE'S DISEASE
    • INTESTINAL MACROPHAGES
    • MACROPHAGES: PIVOTAL CELLS IN WD PATHOPHYSIOLOGY
    • CONCLUDING REMARKS
    • ACKNOWLEDGMENTS
    • REFERENCES
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  • PDF

KEYWORDS

Macrophages
Whipple Disease

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