@article{PAR00010199,
  title = {{I}mmunopathology of immune reconstitution inflammatory syndrome in {W}hipple's {D}isease},
  author = {{M}oos, {V}. and {F}eurle, {G}. {E}. and {S}chinnerling, {K}. and {G}eelhaar, {A}. and {F}riebel, {J}. and {A}llers, {K}. and {M}oter, {A}. and {K}ikhney, {J}. and {L}oddenkemper, {C}. and {K}uhl, {A}. {A}. and {E}rben, {U}. and {F}enollar, {F}. and {R}aoult, {D}idier and {S}chneider, {T}.},
  editor = {},
  language = {{ENG}},
  abstract = {{D}uring antimicrobial treatment of classic {W}hipple's disease ({CWD}), the chronic systemic infection with {T}ropheryma whipplei, immune reconstitution inflammatory syndrome ({IRIS}), is a serious complication. {T}he aim of our study was to characterize the immunological processes underlying {IRIS} in {CWD}. {F}ollowing 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, {T}h1 reactivity, and the phenotype of {T} cells were described in the peripheral blood, and infiltration of {CD}4(+) {T} cells and regulatory {T} cells in the duodenal mucosa was determined. {D}uring {IRIS}, tissues were heavily infiltrated by {CD}3(+), predominantly {CD}45{RO}(+){CD}4(+) {T} cells. {I}n the periphery, initial reduction of {CD}4(+) cell counts and their reconstitution on treatment was more pronounced in {CWD} patients with {IRIS} than in those without {IRIS}. {T}he ratio of activated and regulatory {CD}4(+) {T} cells, nonspecific {T}h1 reactivity, and the proportion of naive among {CD}4(+) {T} cells was high, whereas serum {IL}-10 was low during {IRIS}. {T}. whipplei-specific {T}h1 reactivity remained suppressed before and after emergence of {IRIS}. {T}he findings that {IRIS} in {CWD} mainly are mediated by nonspecific activation of {CD}4(+) {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}. {T}he {J}ournal of {I}mmunology, 2013, 190: 2354-2361.},
  keywords = {},
  booktitle = {},
  journal = {{J}ournal of {I}mmunology},
  volume = {190},
  numero = {5},
  pages = {2354--2361},
  ISSN = {0022-1767},
  year = {2013},
  DOI = {10.4049/jimmunol.1202171},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00010199},
}