Characteristics of the Immune Response in a Patient with Whipple's Disease

Abstract

A patient with Whipple''s disease was studied to examine the effect of antibiotic therapy on the immune status of the patient, and the specific immune response to a cell wall deficient form of an .alpha.-hemolytic Streptococcus (.alpha.HS) isolated from this patient. T [thymus-derived] lymphocyte numbers were reduced, and cutaneous energy was present. Autoantibodies directed against smooth muscle and mitochondria were detected. These abnormal parameters became normal following antibiotic therapy. The specific immune response to the .alpha.HS was characterized by Ig[immunoglobulin]A antibody and lymphocyte sensitization. The latter was detected as antigen-induced lymphocyte stimulation and antigen-induced leukocyte inhibition factor (LIF) production. Antibiotic therapy was associated with a fall in antibody titer and reduced LIF production. No defect in neutrophil function was found. Immunological abnormalities in Whipple''s disease are probably secondary to infection. The primary abnormality is probably an unusual pathogenic bacterium.