[iko (OP)]

Dear understudy,

thank you so much for joining us
in this whipply discussion.
I'll reply your multiple questions asap!
For now I suggest not to focus on one single germ
causing many diseases, but on MANY different 'fastidious'
germs causing troubles in few predisposed individuals: this is the
mainframe of this whipple experiment here.
I'm not an expert: sometimes it helps!  []
Cheers,

ikod

[iko (OP)]

OK understudy,

I'll reply your multiple questions as
a no-expert, just your discussant and
a simple 'reader' of intriguing cases
regarding obnoxious fastidious germs.

iko,
First, let me say thank you to you for your insight and thoughts on Tropheryma whipplei bacteria.
A good friend of mine has recently begun treatment consistent with that for Whipple's disease.

After reading a bit on this bacteria and the Whipple's disease, I have come to believe that it is considered to be rare only because it is so difficult to observe.

I think Tropheryma whipplei may be a common germ in our environment, nevertheless it causes troubles in very few people. Even considering a consistent number of undiagnosed cases, it should be a rare pathogen anyway.
I overstressed on purpose intriguing reports from medical literature to open the discussion on how to find a cheap and easy way to avoid these treatable ailments go undetected for months and years, with all the human suffering involved.


Also, I am curious about a few potential issues relating to this bacteria:
- Is this bacteria is able to be passed from one person to another by becoming airborne?

I think it survives happily in the environment (Actinomycetae) with its triple layer membrane, consequently air, dust, water and contacts may be the routes of infection.
As in many other cases, infection is routinely kept under control efficiently by the defence systems: only in rare instances -probably because of some immune defect- whipple bacteria manage to spread around.
See the previously cited reviews for details.

- Has any researcher actually ever seen this bacteria alive, since an electron microscope does not allow for live viewing?

Interesting point: Whipple bacteria had been successfully cultured at the end of the last century.  They are intracellular germs...I think it's quite difficult to see them alive.

- If not, how does this restrict the effort of researchers to understand the nature of this bacteria?

-  Could many, many diseases that are presently known to the medical community be simply manifestations of different stages of this bacteria's existence within its human host and be incorrectly viewed as stand alone diseases?

Good point, and the actual target of this thread, but never forget that this could be just one of several germs playing dirty tricks and hiding behind some 'idiopathic' human diseases.
I decided to start with this peculiar one knowing that it's not alone.

- Are some or all of the bacteria in the family of this bacteria being underestimated in terms of their ability to work together?

- Can evolutionary change to any of the (six?) bacteria in this family  allow a systematic evolution from one to another to another ... and ultimately to the T whipelii?

I'd like to be able to answer these questions!   []

- Is it possible that this bacteria plays a very substantial role in cancer diseases?

We cannot exclude it, if we accept the connection between persistent infection, chronic inflammation and cancerogenesis. Helicobacter pylori causes intestinal lymphomas and gastric cancer.

- Do you think that routine efforts to check for this bacteria and further understand the likelihood of its role in medical conditions listed on the following website as soon as a few of these symptoms are recognized (http://www.mayoclinic.com/health/whipples-disease/DS00757/DSECTION=2) would help to substantially increase advanced detection of this bacteria, prevent more advanced illnesses and deaths, and thus save the medical industry money?

Give me some time to check this out...

-  Do you believe that until this bacteria is dressed up in threads of economics and globally paraded before the medical insurance industry as a profit thief that that industry will continue to underestimate it or overlook it?

Sometimes peculiar issues and rare disorders are ignored just like that: I would not always search for a hidden negative influence by medical insurance industry or others.
I tend to think that we need many more new smart brains most of all, honest enthusiastic researchers.  I've met many, maybe we need more.
Medical research about fastidious persistent germs could be partly supported by our govs and independent foundations.  Major pharmaceutical companies will follow

Thank you again for your insight and for your devotion to this subject.

I look forward to seeing what your responses to these questions are.

Thank you so much for your difficult questions:
I apologize right away for my short replies...
I prefer synthetic and condensed communication.
Regards,

ikod

[iko (OP)]

I overstressed on purpose intriguing reports from medical literature to open the discussion on how to find a cheap and easy way to avoid these treatable ailments going undetected for months and years, with all the human suffering involved.

In a few words, modern PCR technology will eventually allow us -in the near future- to develop special inexpensive microchips to detect by one simple blood test most of the germs that we carry 'on board'.

An infectious disease will be diagnosed in seconds starting from the germ this time, not from patients' medical history, signs and symptoms.

Quite a little revolution in clinical medicine, but today we do already use other 'screening' tests.
Of course we'll need top notch sensitivity and the highest number of bugs searched through a single test, to make it reliable, easy and cheap.
Unfortunately, these days we see some of this magic hightech show used mostly in forensic medicine.

ikodnotes   [^]

 
http://images.the-scientist.com/content/figures/0890-3670-050411-44-1-1.jpg
http://www.five.tv/media/image/11970633.jpg

The Bug
What is it?
Where is it found?
How is it transmitted?
What diseases does it cause?
Who/what is at risk of infection?

click here for free full-text!
http://microbiology.mtsinai.on.ca/bug/TW/tw-bug.shtml 

[understudy]

iko,

Thank you very much for your responses to my questions.

Kindly take notice of some relatively new findings regarding previous studies on the prevalence of Tropheryma whipplei in certain populations.

newbielink:http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1890548 [nonactive]

If this new study is accurate, then how does this affect the widely held belief that for those testing positive for the Tropheryma whipplei bacteria in their saliva that the bacteria itself is less responsible for disease than a defect in one's immune system or individual immunity to Tropheryma whipplei?   <<<<<<<this is the key question here!

Previous estimates have suggested that as many as 40% of the population carry Tropheryma whipplei in their saliva, and that only a small percentage of those testing positive for it have Whipple's disease - or one of the accepted forms of it.

Is it possible that the methods used in the new study could still have overlooked additional false positives, despite greatly reducing the prevalence of Trpheryma whipplei in the general population?

Am I misreading the data or are as much as 80% of the positives reviewed, in this May 2007 study, "false positives?"

Thank you again for your time and effort.

[iko (OP)]

iko,

Thank you very much for your responses to my questions.

Kindly take notice of some relatively new findings regarding previous studies on the prevalence of Tropheryma whipplei in certain populations.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1890548

If this new study is accurate, then how does this affect the widely held belief that for those testing positive for the Tropheryma whipplei bacteria in their saliva that the bacteria itself is less responsible for disease than a defect in one's immune system or individual immunity to Tropheryma whipplei?   <<<<<<<this is the key question here!

Previous estimates have suggested that as many as 40% of the population carry Tropheryma whipplei in their saliva, and that only a small percentage of those testing positive for it have Whipple's disease - or one of the accepted forms of it.

Is it possible that the methods used in the new study could still have overlooked additional false positives, despite greatly reducing the prevalence of Trpheryma whipplei in the general population?

Am I misreading the data or are as much as 80% of the positives reviewed, in this May 2007 study, "false positives?"

Thank you again for your time and effort.

Thanks for your help overstudy!  []

This contribution of yours shows us how fragile is our so called 'evidence' sometime.
Whipple bacteria are not anymore so common in humans as previously stated and we have to wait for properly arranged studies to know the percentage of 'healthy carriers' in our population.
We wanted to play the Helicobacter pylori game with Whipple too: common germ and few affected patients. No, this time is going to be different and maybe more complicated.
Of course, this is Whipple, the great granulomatous masquerader!

ikod  []

http://www.teatrozircone.com/maschere.jpg

Still, impo*, we urgently need a cheap and reliable routine laboratory test for patients.

*) in my personal opinion

[understudy]

iko,

Welcome back.

To celebrate your return, I'll ask a new question.

Do parasites co-exist with "Tropheryma whipplei" in human hosts?

Just asking.

Thank you so much, again.

[iko (OP)]

Hi understudy,

I took a couple of weeks off in fact.
Now I'm back to the Whipplipedia forum!
Thank you for your precious support around here.
Parasites, defined as protozoa (Toxoplasma, Giardia, Amoebas etc.) or multicellular (Nematoda, Cestoda) like pinworms, surely may coexist in any patient affected by any bacterial infection, so supposedly even in Whipple disease.
In certain countries, people don't carry just one, but 2 or 3 different species of parasites per person, due to the precarious hygienic standards.
I don't remember a single case report of whipple disease and any parasitic infestation of sort.
That doesn't certainly mean that there aren't any!
Why are you interested in such a peculiar association?
Do you suspect an immune deficiency in WD patients?

Bacterial infections swich on different immune reactions.
Common bacteria stimulate antibody production and macrophages' appetite.
Intracellular (e.g. TB, WD) bacteria need a macrophage and T-Lymph more complex response.
Parasites and fungi as well require a T-Lymph compartment fully operative.
As you probably read before, years ago a slightly defective T-cell subset has been suspected to contribute to Whipple disease...but these data need confirmation, like those PCR results!  []

ikoD

[understudy]

iko,

Sorry for my delay in responding.

Do most symptoms for a person suffering from parasites mimic those of a person suffering from a classic case of Whipple's disease?

Once antibiotic treatment for classic Whipple's disease is ongoing, should routine blood analysis show histaminase and basophils reacting as though one is being treated for parasites?

Are these just overlapping symptoms and reactions?

Thank you again.

[iko (OP)]

iko,

Sorry for my delay in responding.

Do most symptoms for a person suffering from parasites mimic those of a person suffering from a classic case of Whipple's disease?

There are many different species of parasites and they cause a wide variety of symptoms, so the 'classic' presentation of Whipple's disease, diarrhea-fever-weightloss-anemia and joint pain may overlap a parasite infestation.
Anyway, parasites are carefully searched in any severe case of diarrhea.

Once antibiotic treatment for classic Whipple's disease is ongoing, should routine blood analysis show histaminase and basophils reacting as though one is being treated for parasites?

I cannot answer this question.
WD bacteria duplication time is very long: approx. 18days.
When you start antibiotic therapy bacteria don't die in a short time, and for this reason treatment has to be extended (at least one year).

Are these just overlapping symptoms and reactions?

Thank you again.

If you consider the previously reported cases, you'll find that WD may be misdiagnosed as rheumatoid arthritis or dermatomyositis, as sarcoidosis or even non-Hodgkin lymphoma.
In rare cases WD has been discovered as  the unsuspected cause of reversible dementia.
Whipple's disease has never been reported misdiagnosed as a parasite infestation.
Parasitic diseases are diagnosed by specific tests: it's easy to rule them out.
One exception could be intracellular protozoa like Toxoplasma and Babesia, but this is another story...

This is the aim of this thread: difficult diagnosis and -maybe in rare cases- the 'real' cause of diseases of uncertain(!) etiology.

ikod  [^]

[understudy]

iko,

Let me thank you so much for your compelling response.

Intracellular parasitic infestation never misdiagnosed as a Whipple's disease?

It appears that "another story" is little understood and rapidly changing, even if intracellular parasites and Tropheryma Whipplei are mutually exclusive, which remains to be "seen."

Again, thank you for your fine work.

[iko (OP)]

iko,

Let me thank you so much for your compelling response.

Intracellular parasitic infestation never misdiagnosed as a Whipple's disease?

It appears that "another story" is little understood and rapidly changing, even if intracellular parasites and Tropheryma Whipplei are mutually exclusive, which remains to be "seen."

Again, thank you for your fine work.

Good point understudy,

I assume that a coexistent pathogen should have been spotted easily.
WD bacteria are so tiny that electron microscopy is required to make a sure diagnosis and visualize those peculiar 'three layer' cell walls.
Any protozoa, even the intracellular ones (i.e. Toxoplasma gondii) are so big compared to the invisible Tropheryma whipplei.
In my opinion, for some reason, in most cases one pathogen tend to prevail, and other germs are probably kept under control by the patient's aspecific immune reaction, that is loosing its battle against WD only.
I know that several infectious agents can damage a patient simultaneously when immune defense is jammed (i.e. AIDS), but very exceptionally in the so called 'immunocompetent' host.
We must cosider that when you give a WD patient Bactrim for at least one year, even many other germs may suffer!
I am afraid I am not a qualified expert, able to cover this issue properly.

ikod   

[iko (OP)]

Ola whipple amigos,

Allow me to re-post this intriguing whipple report from Australia:

http://www.biomedcentral.com/content/pdf/1472-6823-6-3.pdf

it's free full-text, instant access online, easy text and nice pictures...
This is a unique report concerning thyroid damage by WD.
Nevertheless no bacteria was found in the thyroid itself!
Enjoy the reading if you missed my previous link in page 1 of this topic.

ikod  [^]

[Karen W.]

WOW i did miss this. Very good Article Long article but very good information.. well How about that IKO! That sounds promising for people with thyroid Goiters with worry so much about all the other stuff on top of it! LOL... Nice article I think I will print it! LOL Or at least the link!

[iko (OP)]

Wait Karen,

this is an extremely rare presentation.
It may serve as a model for the current hypothesis
hidden pathogen - persistent infection - autoimmune disease.
Many other common germs could play the same trick just like our dear Tropheryma w.

ikod   [^]

[Karen W.]

Wait Karen,

this is an extremely rare presentation.
It may serve as a model for the current hypothesis
hidden pathogen - persistent infection - autoimmune disease.
Many other common germs could play the same trick just like our dear Tropheryma w.

ikod   [^]

http://images.the-scientist.com/supplements/20070501/images/37-1.gif

So there may be other germs that could cause this same presentation you mean perhaps not only the T w..  . I remember that Bartonellos(spelling, sorry) and Q fever  .. could be a source also right!

[Karen W.]

What kind of disease is Addisons? Is it an auto immune disease?

[Karen W.]

Would you explain autoimmunity to me a little bit better? I am not sure I get it! Are auto immune diseases ones that break down our immune systems ability to fight off infections and such?

[iko (OP)]

What kind of disease is Addisons? Is it an auto immune disease?

Primary Addison's disease is a severe failure of adrenal glands and following stop of secretion of vital steroid hormones.  Potentially fatal if untreated.
Sometimes it is caused by infection, other times by metastatic cancers or autoimmune reaction.

There is a recent topic right here about this:
http://www.thenakedscientists.com/forum/index.php?topic=10216.0


Definition of autoimmunity:

A situation in which the body produces an immune response against its own organs or tissues.
www.biotech.ca/EN/glossary.html

an immune reaction to the body's own tissues.
www.shortbowel.com/glossary/a.asp

A condition in which the body's immune system fights it's own tissues.
www.spacecoastmedicalassociates.com/terms/

A condition characterized by a specific antibody (antiphospholipid antibody or antibodies to DNA) or cells (such as Natural Killer Cells) which react with molecules or constituents of the body's own tissue and cause disease such as Rheumatoid arthritis and lupus.
repro-med.net/glossary.php

a condition in which an individual’s immune system starts reacting against one’s own tissues, causing disease.
www.oup.com/uk/booksites/content/0199264724/student/glossary.htm

A condition in which the immune system produces antibodies against the body's own proteins or tissues. This may result in an autoimmune disease such as lupus, type 1 diabetes, rheumatoid arthritis, or multiple sclerosis.
www.beyondpsoriasis.com/glossary.jsp

Immune-mediated destruction of the body's own cells and tissues; immunity against self.
www.dental.mu.edu/oralpath/opgloss.html

...plus many others!  

We better start a new topic for such a wide and complex issue.
Actually I do not think I will be able to discuss it properly.

ikod

[iko (OP)]

Better to go back to intriguing presentations of
Whipple's disease in human beings on this Planet.
Here there is a quite recent report from China:

Diffuse cortical lesions with hemorrhage in cerebral Whipple's disease.

Wu L, Wang X, Wei H, Li C, Jia J.
Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, PR China.

A 30-year-old Chinese male with a history of diarrhea and arthralgia presented for evaluation of progressive dementia, epilepsy, and increased intracranial pressure. Imaging of the brain showed progressive cortical and subcortical lesions with hemorrhage involving the bilateral temporal and occipital lobes, the posterior parietal lobes, and the left frontal lobe. "Foamy" periodic acid-Schiff (PAS)-positive macrophages were demonstrated on brain biopsy. The patient showed clinical improvement following treatment with chloromycetin and sulfadiazine for 2 months.
This constitutes the first reported case of cerebral Whipple's disease with diffuse cortical lesions with hemorrhage reported in a Chinese individual. Further, this case points out the significance of early recognition and treatment of cerebral Whipple's disease, especially in those cases with unusual manifestations.

Clin Neurol Neurosurg. 2007 Oct 6;

http://www.stylophilesonline.com/archive/jan03/05omas6.jpg

Whipple's disease.

Panicker JN, Vijayaraghavan L, Madhusudanan S.
Department of Medicine, Medical College, Thiruvananthapuram, Kerala.

A 52 year old lady was admitted for progressive pedal oedema over a six year period and recent onset of hyperpigmentation. Laboratory investigations revealed that she was having a malabsorption syndrome with protein losing enteropathy. In view of associated arthralgia and higher mental function disturbances, a clinical diagnosis of Whipple's disease was postulated. Duodenal biopsy revealed infiltration of the lamina propria with PAS positive macrophages, suggestive of Whipple's disease. This case is being reported to highlight that Whipple's disease can manifest in the most unsuspecting manner and that early treatment can cure the patient.

J Assoc Physicians India. 2001 Aug;49:853-5.

[iko (OP)]

http://www.hamptons.com/gallery/articles/952c.jpg

For a neglected issue like this
over 3000 viewers
3 good reasons to celebrate...

ikod  [^]