PMID- 23365082
OWN - NLM
STAT- MEDLINE
DCOM- 20130405
LR  - 20130218
IS  - 1550-6606 (Electronic)
IS  - 0022-1767 (Linking)
VI  - 190
IP  - 5
DP  - 2013 Mar 1
TI  - Immunopathology of immune reconstitution inflammatory syndrome in Whipple's 
      disease.
PG  - 2354-61
LID - 10.4049/jimmunol.1202171 [doi]
AB  - During antimicrobial treatment of classic Whipple's disease (CWD), the chronic 
      systemic infection with Tropheryma whipplei, immune reconstitution inflammatory 
      syndrome (IRIS), is a serious complication. The aim of our study was to 
      characterize the immunological processes underlying IRIS in CWD. Following the 
      definition of IRIS, we describe histological features of IRIS and immunological 
      parameters of 24 CWD IRIS patients, 189 CWD patients without IRIS, and 89 healthy 
      individuals. T cell reconstitution, Th1 reactivity, and the phenotype of T cells 
      were described in the peripheral blood, and infiltration of CD4(+) T cells and 
      regulatory T cells in the duodenal mucosa was determined. During IRIS, tissues 
      were heavily infiltrated by CD3(+), predominantly CD45RO(+)CD4(+) T cells. In the 
      periphery, initial reduction of CD4(+) cell counts and their reconstitution on 
      treatment was more pronounced in CWD patients with IRIS than in those without 
      IRIS. The ratio of activated and regulatory CD4(+) T cells, nonspecific Th1 
      reactivity, and the proportion of naive among CD4(+) T cells was high, whereas 
      serum IL-10 was low during IRIS. T. whipplei-specific Th1 reactivity remained 
      suppressed before and after emergence of IRIS. The findings that IRIS in CWD 
      mainly are mediated by nonspecific activation of CD4(+) T cells and that it is 
      not sufficiently counterbalanced by regulatory T cells indicate that flare-up of 
      pathogen-specific immunoreactivity is not instrumental in the pathogenesis of 
      IRIS in CWD.
FAU - Moos, Verena
AU  - Moos V
AD  - Medizinische Klinik I, Campus Benjamin Franklin, Charite-Universitatsmedizin 
      Berlin, 12203 Berlin, Germany. verena.moos@charite.de
FAU - Feurle, Gerhard E
AU  - Feurle GE
FAU - Schinnerling, Katina
AU  - Schinnerling K
FAU - Geelhaar, Anika
AU  - Geelhaar A
FAU - Friebel, Julian
AU  - Friebel J
FAU - Allers, Kristina
AU  - Allers K
FAU - Moter, Annette
AU  - Moter A
FAU - Kikhney, Judith
AU  - Kikhney J
FAU - Loddenkemper, Christoph
AU  - Loddenkemper C
FAU - Kuhl, Anja A
AU  - Kuhl AA
FAU - Erben, Ulrike
AU  - Erben U
FAU - Fenollar, Florence
AU  - Fenollar F
FAU - Raoult, Didier
AU  - Raoult D
FAU - Schneider, Thomas
AU  - Schneider T
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130130
PL  - United States
TA  - J Immunol
JT  - Journal of immunology (Baltimore, Md. : 1950)
JID - 2985117R
RN  - 0 (Anti-Bacterial Agents)
RN  - 130068-27-8 (Interleukin-10)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Biopsy
MH  - CD4 Lymphocyte Count
MH  - Case-Control Studies
MH  - Female
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/complications/drug 
      therapy/immunology/*pathology
MH  - Interleukin-10/blood/immunology
MH  - Intestinal Mucosa/drug effects/immunology/*pathology
MH  - Lymphocyte Activation/drug effects
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - T-Lymphocytes, Regulatory/drug effects/immunology/*pathology
MH  - Th1 Cells/drug effects/immunology/*pathology
MH  - Tropheryma/drug effects/*immunology
MH  - Whipple Disease/complications/drug therapy/immunology/*pathology
EDAT- 2013/02/01 06:00
MHDA- 2013/04/06 06:00
CRDT- 2013/02/01 06:00
PHST- 2013/02/01 06:00 [entrez]
PHST- 2013/02/01 06:00 [pubmed]
PHST- 2013/04/06 06:00 [medline]
AID - jimmunol.1202171 [pii]
AID - 10.4049/jimmunol.1202171 [doi]
PST - ppublish
SO  - J Immunol. 2013 Mar 1;190(5):2354-61. doi: 10.4049/jimmunol.1202171. Epub 2013 
      Jan 30.