Health Dictionary
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Whipple's disease historical perspective
Introduction
Overview
Overview
Whipple described the disease for the first time in 1907 as a gastrointestinal disorder and named it as “intestinal lipodystrophy.” Light and electron microscopy on small bowel biopsy were used to detect bacilli inside the intestinal mucosa. In 1952, systemic antibiotics were used to treat the disease which confirmed the infective nature of the disease. It took almost 100 years for investigators to cultivate the bacterium and sequenced the genome.
Historical Perspective
Historical Perspective
- In 1907, George Hoyt Whipple described a case who died after a course of gastrointestinal, malabsorption, pulmonary, neurologic and constitutional symptoms. Pathology showed rod-like bacilli in the lamina propria and fat deposition in intestinal and mesenteric lymph nodes. He named this disease as “intestinal lipodystrophy.”[1]
- In 1947, Oliver-Pascual reported a case of “intestinal lipodystrophy” before the death of a patient.[2]
- In 1949, Black-Schaffer used periodic acid-Schiff for staining the bacilli. Also, “Intestinal lipodystrophy” was renamed to “Whipple’s disease.”[3]
- In 1952, Pauley treated a patient successfully by using systemic antibiotics, prolonged period of chloramphenicol.[4]
- In 1958, Bolt reported the use of the small bowel biopsy to differentiate malabsorption diseases and confirm the Whipple’s disease.[5]
- In 1961, Chears and Ashworth used electron microscopy and cytochemical study to detect the bacilli inside the intestinal macrophages.[6] In that year, another team, Yardley and Hendrix demonstrated the rod-shaped structures in the intestinal mucosa by combined electron and light microscopy.[7]
- In 1991, Wilson was able to partially sequence a 16S rRNA of a new bacterium. They classified this bacterium within the Actinomycetes clade.[8]
- In 1992, Relman confirmed the previous result and extended the 16S rRNA sequence by using PCR. They used the term of “Tropheryma whippleii” for the first time for this bacterium.[9]
- In 2000, Raoult reported isolation and cultivation of the bacterium responsible for the Whipple’s disease. They obtained the tissue from the mitral valve of a patient with a culture negative endocarditis.[10]
- In 2001, La Scola isolated Whipple’s disease bacillus from the cardiac valve of a patient with endocarditis and characterized it phenotypically. They slightly changed the name to “Tropheryma whipplei.”[11]
- In 2003, Bentley and Raoult analyzed and sequenced the genome of two different strains of Tropheryma whipplei.[12][13]
| Year | Investigator | Landmark event |
|---|---|---|
| 1907 | George Hoyt Whipple | Described the Whipple’s disease for the first time and named it as “intestinal lipodystrophy“. |
| 1947 | Oliver-Pascual | Reported a case of “intestinal lipodystrophy” before the death of a patient. |
| 1949 | Black-Schaffer | Strained the bacilli with periodic acid-Schiff stain; renamed to “Whipple’s disease.” |
| 1952 | Pauley | Successfully used systemic antibiotics for treatment of the “Whipple’s disease.” |
| 1958 | Bolt | Used small bowel biopsy to differentiate malabsorption diseases and confirm the Whipple’s disease. |
| 1961 | Chears and Ashworth | Used electron microscopy and cytochemical study to detect the bacilli inside the intestinal macrophages. |
| 1961 | Yardley and Hendrix | Used combined electron and light microscopy to detect the rod-shaped structures in the intestinal mucosa. |
| 1991 | Wilson | Sequenced a 16S rRNA of a new bacterium partially and classified it within the Actinomycetes clade. |
| 1992 | Relman | Confirmed the previous result and extended the 16S rRNA sequence by using PCR; named the bacterium “Tropheryma whippleii” for the first time. |
| 2000 | Raoult | Reported isolation and cultivation of “Tropheryma whippleii” for the first time. |
| 2001 | La Scola | Characterized the bacterium phenotypically; slightly renamed it to “Tropheryma whipplei.” |
| 2003 | Bentley
Raoult |
Analyzed and sequenced the genome of two different strains of Tropheryma whipplei. |
Landmark Events in the Development of Treatment Strategies
Landmark Events in the Development of Treatment Strategies
- In 1952, Pauley treated a Whipple’s disease successfully by using systemic antibiotics, prolonged period of chloramphenicol.[4]
References
References
- ↑ Whipple G H. A hitherto undescribed disease characterized anatomically by deposits of fat and fatty acids in the intestinal and mesenteric lymphatic tissues. Bull Johns Hopkins Hosp. 1907;198:383.
- ↑ OLIVER-PASCUAL E, GALAN J (1947). “[Not Available]”. Rev Esp Enferm Apar Dig Nutr (in Undetermined). 6 (3): 213–26. PMID 20251637.
- ↑ BLACK-SCHAFFER B (1949). “The tinctoral demonstration of a glycoprotein in Whipple’s disease”. Proc. Soc. Exp. Biol. Med. 72 (1): 225–7. PMID 15391722.
- ↑ 4.0 4.1 PAULLEY JW (1952). “A case of Whipple’s disease (intestinal lipodystrophy)”. Gastroenterology. 22 (1): 128–33. PMID 12980233.
- ↑ Bolt, Robert J.; Pollard, H. Marvin; Standaert, Ludovic (1958). “Transoral Small-Bowel Biopsy as an Aid in the Diagnosis of Malabsorption States”. New England Journal of Medicine. 259 (1): 32–34. doi:10.1056/NEJM195807032590107. ISSN 0028-4793.
- ↑ CHEARS WC, ASHWORTH CT (1961). “Electron microscopic study of the intestinal mucosa in Whipple’s disease. Demonstration of encapsulated bacilliform bodies in the lesion”. Gastroenterology. 41: 129–38. PMID 13692693.
- ↑ YARDLEY JH, HENDRIX TR (1961). “Combined electron and light microscopy in Whipple’s disease. Demonstration of “bacillary bodies” in the intestine”. Bull Johns Hopkins Hosp. 109: 80–98. PMID 13787237.
- ↑ Wilson KH, Blitchington R, Frothingham R, Wilson JA (1991). “Phylogeny of the Whipple’s-disease-associated bacterium”. Lancet. 338 (8765): 474–5. PMID 1714530.
- ↑ Relman, David A.; Schmidt, Thomas M.; MacDermott, Richard P.; Falkow, Stanley (1992). “Identification of the Uncultured Bacillus of Whipple’s Disease”. New England Journal of Medicine. 327 (5): 293–301. doi:10.1056/NEJM199207303270501. ISSN 0028-4793.
- ↑ Raoult, Didier; Birg, Marie L.; Scola, Bernard La; Fournier, Pierre E.; Enea, Maryse; Lepidi, Hubert; Roux, Veronique; Piette, Jean-Charles; Vandenesch, François; Vital-Durand, Denis; Marrie, Tom J. (2000). “Cultivation of the Bacillus of Whipple’s Disease”. New England Journal of Medicine. 342 (9): 620–625. doi:10.1056/NEJM200003023420903. ISSN 0028-4793.
- ↑ La Scola, B; Altwegg, M; Mallet, M N; Fournier, P E; Fenollar, F; Raoult, D (2001). “Description of Tropheryma whipplei gen. nov., sp. nov., the Whipple’s disease bacillus”. International Journal of Systematic and Evolutionary Microbiology. 51 (4): 1471–1479. doi:10.1099/00207713-51-4-1471. ISSN 1466-5026.
- ↑ Bentley, Stephen D; Maiwald, Matthias; Murphy, Lee D; Pallen, Mark J; Yeats, Corin A; Dover, Lynn G; Norbertczak, Halina T; Besra, Gurdyal S; Quail, Michael A; Harris, David E; von Herbay, Axel; Goble, Arlette; Rutter, Simon; Squares, Robert; Squares, Stephen; Barrell, Bart G; Parkhill, Julian; Relman, David A (2003). “Sequencing and analysis of the genome of the Whipple’s disease bacterium Tropheryma whipplei”. The Lancet. 361 (9358): 637–644. doi:10.1016/S0140-6736(03)12597-4. ISSN 0140-6736.
- ↑ Raoult D, Ogata H, Audic S, Robert C, Suhre K, Drancourt M, Claverie JM (2003). “Tropheryma whipplei Twist: a human pathogenic Actinobacteria with a reduced genome”. Genome Res. 13 (8): 1800–9. doi:10.1101/gr.1474603. PMC 403771. PMID 12902375.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]