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==Overview==
==Overview==
[[George Whipple|Whipple]] described the disease for the first time in 1907 as a [[gastrointestinal]] disorder and named it as "[[intestinal lipodystrophy]]." Light and [[Electron microscope|electron microscopy]] on [[Small intestine|small bowel]] [[biopsy]] were used to detect [[bacilli]] inside the [[intestinal]] [[mucosa]]. In 1952, systemic [[Antibiotic|antibiotics]] were used to treat the disease which confirmed the [[Infection|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 Whipple|George Hoyt Whipple]] described a case who died after a course of gastrointestinal, [[malabsorption]], [[pulmonary]], [[Neurological|neurologic]] and constitutional symptoms. Pathology showed rod-like [[bacilli]] in the [[lamina propria]] and fat deposition in [[intestinal]] and [[mesenteric]] [[Lymph node|lymph nodes]]. He named this disease as “[[Whipple's disease|intestinal lipodystrophy]].”<ref>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. </ref>
*In 1947, Oliver-Pascual reported a case of “[[Whipple's disease|intestinal lipodystrophy]]” before the death of a patient.<ref name="pmid20251637">{{cite journal |vauthors=OLIVER-PASCUAL E, GALAN J |title=[Not Available] |language=Undetermined |journal=Rev Esp Enferm Apar Dig Nutr |volume=6 |issue=3 |pages=213–26 |year=1947 |pmid=20251637 |doi= |url=}}</ref>
*In 1949, Black-Schaffer used [[Periodic acid-Schiff stain|periodic acid-Schiff]] for staining the [[bacilli]]. Also, “[[Whipple's disease|Intestinal lipodystrophy]]” was renamed to “Whipple’s disease."<ref name="pmid15391722">{{cite journal |vauthors=BLACK-SCHAFFER B |title=The tinctoral demonstration of a glycoprotein in Whipple's disease |journal=Proc. Soc. Exp. Biol. Med. |volume=72 |issue=1 |pages=225–7 |year=1949 |pmid=15391722 |doi= |url=}}</ref>


It was first described by [[George Hoyt Whipple]] in 1907,<ref>{{WhoNamedIt|synd|3892}}</ref><ref name=Whipple_1907>{{cite journal | author = Whipple GH | title = A hitherto undescribed disease characterized anatomically by deposits of fat and fatty acid in the intestinal and mesenteric lymphatic tissues | journal = Bull Johns Hopkins Hosp | year = 1907 | volume = 18 | pages = 382&ndash;93 | url= }}</ref> and it is commonly considered a gastrointestinal disorder.
*In 1952, Pauley treated a patient successfully by using systemic [[Antibiotic|antibiotics]], prolonged period of [[chloramphenicol]].<ref name="pmid12980233">{{cite journal |vauthors=PAULLEY JW |title=A case of Whipple's disease (intestinal lipodystrophy) |journal=Gastroenterology |volume=22 |issue=1 |pages=128–33 |year=1952 |pmid=12980233 |doi= |url=}}</ref>


*In 1958, Bolt reported the use of the [[Small intestine|small bowel]] [[biopsy]] to differentiate [[malabsorption]] diseases and confirm the Whipple's disease.<ref name="BoltPollard1958">{{cite journal|last1=Bolt|first1=Robert J.|last2=Pollard|first2=H. Marvin|last3=Standaert|first3=Ludovic|title=Transoral Small-Bowel Biopsy as an Aid in the Diagnosis of Malabsorption States|journal=New England Journal of Medicine|volume=259|issue=1|year=1958|pages=32–34|issn=0028-4793|doi=10.1056/NEJM195807032590107}}</ref>


===Discovery===
*In 1961, Chears and Ashworth used [[Electron microscope|electron microscopy]] and cytochemical study to detect the [[bacilli]] inside the intestinal [[Macrophage|macrophages]].<ref name="pmid13692693">{{cite journal |vauthors=CHEARS WC, ASHWORTH CT |title=Electron microscopic study of the intestinal mucosa in Whipple's disease. Demonstration of encapsulated bacilliform bodies in the lesion |journal=Gastroenterology |volume=41 |issue= |pages=129–38 |year=1961 |pmid=13692693 |doi= |url=}}</ref> In that year, another team, Yardley and Hendrix demonstrated the rod-shaped structures in the intestinal [[Mucous membrane|mucosa]] by combined electron and light [[microscopy]].<ref name="pmid13787237">{{cite journal |vauthors=YARDLEY JH, HENDRIX TR |title=Combined electron and light microscopy in Whipple's disease. Demonstration of "bacillary bodies" in the intestine |journal=Bull Johns Hopkins Hosp |volume=109 |issue= |pages=80–98 |year=1961 |pmid=13787237 |doi= |url=}}</ref>
*[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].


*The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
*In 1991, Wilson was able to partially sequence a 16S [[rRNA]] of a new [[bacterium]]. They classified this [[bacterium]] within the [[Actinobacteria|''Actinomycetes'']] clade.<ref name="pmid1714530">{{cite journal |vauthors=Wilson KH, Blitchington R, Frothingham R, Wilson JA |title=Phylogeny of the Whipple's-disease-associated bacterium |journal=Lancet |volume=338 |issue=8765 |pages=474–5 |year=1991 |pmid=1714530 |doi= |url=}}</ref>
*In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
*In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].


==Outbreaks==
*In 1992, Relman confirmed the previous result and extended the 16S [[Ribosomal RNA|rRNA]] sequence by using [[Polymerase chain reaction|PCR]]. They used the term of “[[Tropheryma whipplei|''Tropheryma whippleii'']]” for the first time for this [[bacterium]].<ref name="RelmanSchmidt1992">{{cite journal|last1=Relman|first1=David A.|last2=Schmidt|first2=Thomas M.|last3=MacDermott|first3=Richard P.|last4=Falkow|first4=Stanley|title=Identification of the Uncultured Bacillus of Whipple's Disease|journal=New England Journal of Medicine|volume=327|issue=5|year=1992|pages=293–301|issn=0028-4793|doi=10.1056/NEJM199207303270501}}</ref>
*There have been several outbreaks of [disease name], which are summarized below:


==Landmark Events in the Development of Treatment Strategies==
*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|culture negative endocarditis]].<ref name="RaoultBirg2000">{{cite journal|last1=Raoult|first1=Didier|last2=Birg|first2=Marie L.|last3=Scola|first3=Bernard La|last4=Fournier|first4=Pierre E.|last5=Enea|first5=Maryse|last6=Lepidi|first6=Hubert|last7=Roux|first7=Veronique|last8=Piette|first8=Jean-Charles|last9=Vandenesch|first9=François|last10=Vital-Durand|first10=Denis|last11=Marrie|first11=Tom J.|title=Cultivation of the Bacillus of Whipple's Disease|journal=New England Journal of Medicine|volume=342|issue=9|year=2000|pages=620–625|issn=0028-4793|doi=10.1056/NEJM200003023420903}}</ref>
*In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].
 
*In 2001, La Scola isolated Whipple’s disease [[bacillus]] from the [[Heart valve|cardiac valve]] of a patient with [[endocarditis]] and characterized it [[phenotypically]]. They slightly changed the name to “[[Tropheryma whipplei|''Tropheryma whipplei'']].”<ref name="La ScolaAltwegg2001">{{cite journal|last1=La Scola|first1=B|last2=Altwegg|first2=M|last3=Mallet|first3=M N|last4=Fournier|first4=P E|last5=Fenollar|first5=F|last6=Raoult|first6=D|title=Description of Tropheryma whipplei gen. nov., sp. nov., the Whipple's disease bacillus.|journal=International Journal of Systematic and Evolutionary Microbiology|volume=51|issue=4|year=2001|pages=1471–1479|issn=1466-5026|doi=10.1099/00207713-51-4-1471}}</ref>


==Impact on Cultural History==
*In 2003, Bentley and Raoult analyzed and sequenced the [[genome]] of two different strains of [[Tropheryma whipplei|''Tropheryma whipplei'']].<ref name="BentleyMaiwald2003">{{cite journal|last1=Bentley|first1=Stephen D|last2=Maiwald|first2=Matthias|last3=Murphy|first3=Lee D|last4=Pallen|first4=Mark J|last5=Yeats|first5=Corin A|last6=Dover|first6=Lynn G|last7=Norbertczak|first7=Halina T|last8=Besra|first8=Gurdyal S|last9=Quail|first9=Michael A|last10=Harris|first10=David E|last11=von Herbay|first11=Axel|last12=Goble|first12=Arlette|last13=Rutter|first13=Simon|last14=Squares|first14=Robert|last15=Squares|first15=Stephen|last16=Barrell|first16=Bart G|last17=Parkhill|first17=Julian|last18=Relman|first18=David A|title=Sequencing and analysis of the genome of the Whipple's disease bacterium Tropheryma whipplei|journal=The Lancet|volume=361|issue=9358|year=2003|pages=637–644|issn=01406736|doi=10.1016/S0140-6736(03)12597-4}}</ref><ref name="pmid12902375">{{cite journal |vauthors=Raoult D, Ogata H, Audic S, Robert C, Suhre K, Drancourt M, Claverie JM |title=Tropheryma whipplei Twist: a human pathogenic Actinobacteria with a reduced genome |journal=Genome Res. |volume=13 |issue=8 |pages=1800–9 |year=2003 |pmid=12902375 |pmc=403771 |doi=10.1101/gr.1474603 |url=}}</ref>
{| class="wikitable"
!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 [[Antibiotic|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 microscope|electron microscopy]] and cytochemical study to detect the [[bacilli]] inside the intestinal [[Macrophage|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 [[Actinobacteria|''Actinomycetes'']] clade.
|-
|1992
|Relman
|Confirmed the previous result and extended the 16S rRNA sequence by using [[Polymerase chain reaction|PCR]]; named the bacterium “[[Tropheryma whipplei|''Tropheryma whippleii'']]” for the first time.
|-
|2000
|Raoult
|Reported isolation and cultivation of “[[Tropheryma whipplei|''Tropheryma whippleii'']]” for the first time.
|-
|2001
|La Scola
|Characterized the [[bacterium]] phenotypically; slightly renamed it to “[[Tropheryma whipplei|''Tropheryma whipplei'']].”
|-
|2003
|Bentley
Raoult
|Analyzed and sequenced the [[genome]] of two different strains of [[Tropheryma whipplei|''Tropheryma whipplei'']].
|}


==Landmark Events in the Development of Treatment Strategies==
*In 1952, Pauley treated a Whipple's disease successfully by using systemic [[Antibiotic|antibiotics]], prolonged period of [[chloramphenicol]].<ref name="pmid12980233">{{cite journal |vauthors=PAULLEY JW |title=A case of Whipple's disease (intestinal lipodystrophy) |journal=Gastroenterology |volume=22 |issue=1 |pages=128–33 |year=1952 |pmid=12980233 |doi= |url=}}</ref>


==Famous Cases==
*The following are a few famous cases of [[disease name]]:
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


{{WH}}
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{{WS}}
 
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Latest revision as of 00:44, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

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

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

References

  1. ↑ 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.
  2. ↑ OLIVER-PASCUAL E, GALAN J (1947). "[Not Available]". Rev Esp Enferm Apar Dig Nutr (in Undetermined). 6 (3): 213–26. PMID 20251637.
  3. ↑ 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. ↑ 4.0 4.1 PAULLEY JW (1952). "A case of Whipple's disease (intestinal lipodystrophy)". Gastroenterology. 22 (1): 128–33. PMID 12980233.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ Wilson KH, Blitchington R, Frothingham R, Wilson JA (1991). "Phylogeny of the Whipple's-disease-associated bacterium". Lancet. 338 (8765): 474–5. PMID 1714530.
  9. ↑ 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.
  10. ↑ 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.
  11. ↑ 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.
  12. ↑ 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.
  13. ↑ 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.

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