ArticleMucosal immunology2017
Architectural and functional alterations of the small intestinal mucosa in classical Whipple's disease.
Article in Mucosal immunology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 20 citations in OpenAlex.
- Multidisciplinary management of Whipple's disease complicated with rectal stenosis from multidisciplinary nursing management: A case study.Pakistan journal of medical sciences · 2026Article
- Whipple's endocarditis and biologic response modifiers: a case-based review of an intricate host-pathogen interaction.Infection · 2026Review
- Common factors and nutrients affecting intestinal villus height-A review.Animal bioscience · 2025Article
- Case report: A patient with HHV-6 and HHV-7 combined withFrontiers in medicine · 2024Article
- Villi Inspired Mechanical Interlocking for Intestinal Retentive Devices.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2023Article
- Paracellular permeability and tight junction regulation in gut health and disease.Nature reviews. Gastroenterology & hepatology · 2023Review
- Uptake ofInternational journal of molecular sciences · 2023Article
- Intestinal Barrier Dysfunction and Microbial Translocation in Patients with First-Diagnosed Atrial Fibrillation.Biomedicines · 2023Article
- Current knowledge of the immune reconstitution inflammatory syndrome in Whipple disease: a review.Frontiers in immunology · 2023Review
- Intestinal barrier dysfunction mediates Whipple's disease immune reconstitution inflammatory syndrome (IRIS).Immunity, inflammation and disease · 2022Article
- Immune-Mediated Aggravation of theInternational journal of molecular sciences · 2021Article
- Culture of Intestinal Epithelial Cell Monolayers and Their Use in Multiplex Macromolecular Permeability Assays for In Vitro Analysis of Tight Junction Size Selectivity.Current protocols in immunology · 2020Article
- Whipple's Disease: Diagnostic Value of rpoB Gene PCR from Peripheral Blood Mononuclear Cells.Molecular diagnosis & therapy · 2018Article
- Peripheral T-Cell Reactivity to Heat Shock Protein 70 and Its Cofactor GrpE from Tropheryma whipplei Is Reduced in Patients with Classical Whipple's Disease.Infection and immunity · 2017Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Classical Whipple's disease (CWD) affects the gastrointestinal tract and rather elicits regulatory than inflammatory immune reactions. Mechanisms of malabsorption, diarrhea, and systemic immune activation are unknown. We here analyzed mucosal architecture, barrier function, and immune activation as potential diarrheal trigger in specimens from 52 CWD patients. Our data demonstrate villus atrophy and crypt hyperplasia associated with epithelial apoptosis and reduced alkaline phosphatase expression in the duodenum of CWD patients. Electrophysiological and flux experiments revealed increased duodenal permeability to small solutes and macromolecules. Duodenal architecture and permeability ameliorated upon antibiotic treatment. Structural correlates for these alterations were concordant changes of membranous claudin-1, claudin-2, claudin-3, and tricellulin expression. Tumor necrosis factor-α and interleukin-13 were identified as probable mediators of epithelial apoptosis, and altered tight junction expression. Increased serum markers of microbial translocation and their decline following treatment corroborated the biological significance of the mucosal barrier defect. Hence, mucosal immune responses in CWD elicit barrier dysfunction. Diarrhea is caused by loss of absorptive capacity and leak flux of ions and water. Downregulation of tricellulin causes increased permeability to macromolecules and subsequent microbial translocation contributes to systemic inflammation. Thus, therapeutic strategies to reconstitute the mucosal barrier and control inflammation could assist symptomatic control of CWD.
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