Human Intestinal Spirochaetosis in Two Ulcerative Colitis Patients

The agglutination titers of Brachyspira pilosicoli (B. pilosicoli) and Brachyspira aalborgi (B. aalborgi) were examined in colitis patients with human intestinal spirochetes. Among three cases of colitis patients, the titer of B. pilosicoli was extremely high in two cases while the titer of B. aalborgi was extremely high in one case. These three cases had symptoms of colitis, such as watery diarrhea, and we diagnosed the case as Brachyspira- related colitis. These findings suggest that the agglutination titers of Brachyspira may be useful in cases of Brachyspira- related colitis. Severe symptoms, such as abdominal pain and diarrhea, were observed in cases with high antibody titer of B. aalborgi, as well as B. pilosicoli, indicating that B. aalborgi could also cause symptomatic colitis.

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“…(15) We also have reported cases of HIS infection in ulcerative colitis patients undergoing long-term steroid therapy. (16)…”

Section: Discussionmentioning

confidence: 99%

The comparison of the intensity of human intestinal spirochetes between Brachyspira pilosicoli and Brachyspira aalborgi infections

Iwamoto

Adachi

Honda

et al. 2019

J. Clin. Biochem. Nutr.

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“…Although inflammation did not seem to be associated with HIS, a HIS case was found among the UC cases, representing 12.5 % of UC cases in the present study. Previous studies have reported finding HIS among UC cases, and some HIS cases might mimic the clinical, endoscopic, and pathologic features of UC [13][14][15]. Considering the clinical importance of UC, the possible association between HIS and UC should be a subject for continued scrutiny.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemistry application as step one for diagnosing human intestinal spirochetosis

Ogata¹,

Shimizu²,

Nakanishi³

2018

Dig Sys

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Diagnosing human intestinal spirochetosis (HIS), a colorectal infectious disease caused by Brachyspira species bacteria, in routine practice depends histologically on the presence of the so-called fringes on the mucosal epithelial surface. Cases in which hematoxylin-eosin (HE) sections raise suspicions of HIS may be further examined using immunohistochemistry (IHC). We aimed to elucidate whether an initial IHC application might increase the proportion of cases considered HIS-suspicious. Focusing on the fringes, we compared HIS diagnosed by HE (HIS-HE) and by IHC (HIS-IHC; based on results obtained using a polyclonal anti-Treponema pallidum antibody) in one month's consecutive lower GI endoscopic specimens in the pathology department at a single hospital. Among the 140 individuals examined during the period, 10 HIS-IHC cases (7.1%; M:F=5:5; 34-75 yrs; median 57 yrs) were diagnosed, while HE pathology found eight HIS-HE cases (the fringes were thick and distinct; 5.7%) and two possible cases. All 8 HIS-HE cases matched HIS-IHC cases. However, the two possible HIS-HE cases were denied by IHC, while two of the HIS-IHC cases were overlooked by HE pathology. Among the 10 HIS-IHC cases, 8 cases had conventional adenomas, 1 sessile serrated adenoma/polyp, 2 microvesicular hyperplastic polyps, 3 goblet cell rich hyperplastic polyps, and 1 ulcerative colitis. Cases with goblet cell rich hyperplastic polyps were at a higher rate in HIS than in non-HIS cases (p < 0.01). In conclusion, an initial IHC application might detect more HIS cases in routine practice, and importantly it might help to establish a correct diagnosis of HIS.

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“…Therefore, most cases are found incidentally by histological examination of specimens taken endoscopically during (a) annual check-up in healthy persons, (b) further investigation after positive results for fecal occult blood, or (c) follow-up after polypectomy/surgery for tumorous lesions [2]. However, some HIS cases manifest a signi cant degree of mucosal in ammation [4,5] or exacerbated in ammaton of accompanying ulcerative colitis [6], and thus the pathogenesis of HIS is considered uncertain. Histologically, mucosal in ammation in HIS has been reported to be mild or non-speci c [1], but mucosal eosinophilia was indicated in a recent report [7].…”

Section: Introductionmentioning

confidence: 99%

Mucosal eosinophilic infiltration may be a characteristic of human intestinal spirochetosis

Ogata

Shimizu

Tominaga

et al. 2021

Preprint

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Background: Human intestinal spirochetosis (HIS) is an infectious disease of large intestines caused by Brachyspira species, and most HIS cases are asymptomatic or exhibit mild intestinal symptoms. The host reaction to HIS remains unclear, and we examined HIS-related mucosal inflammatory features histologically. Method: From the archival HIS cases in a single medical center, 24 endoscopically taken specimens from 14 HIS cases (M:F = 10:4; 28-73 yrs) were selected as not containing polypoid or neoplastic lesions. Stromal neutrophils, eosinophils, and mast cells, and intraepithelial neutrophils and eosinophils, (sNeu, sEo, sMast, iNeu, and iEo, respectively) were counted, and the presence or absence of lymphoid follicles/aggregates (LFs) was also examined. Association of the above inflammation parameters and spirochetal infection parameters (such as degrees of characteristic fringe distribution, of spirochetal cryptal invasion, and of spirochetal intraepithelial invasion) were also analysed. Results: iNeu was observed in 29.2%, iEo in 58.3%, and LFs in 50.0% of the specimens. Maximal counts of sNeu, sEo, sMast, iNeu, and iEo averaged 8.4, 21.5, 6.0, 0.5 and 1.5, respectively. Strong correlation between the maximum counts of iNeu and iEo (p < 0.001, r = 0.81), and correlations between those of iEo and sNeu (p = 0.0012, r = 0.62) and between those of iEo and sEo (p = 0.026, r = 0.45) were observed. iNeu was influenced by fringe formation (p < 0.05) and spirochetal crypt involvement (p < 0.05). Conclusions: HIS was accompanied by inflammatory reactions, and among these, mucosal eosinophilic infiltration may be a central indicator and host reaction of HIS.

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Human Intestinal Spirochaetosis in Two Ulcerative Colitis Patients

Cited by 18 publications

References 19 publications

The comparison of the intensity of human intestinal spirochetes between <i>Brachyspira pilosicoli</i> and <i>Brachyspira aalborgi</i> infections

The comparison of the intensity of human intestinal spirochetes between <i>Brachyspira pilosicoli</i> and <i>Brachyspira aalborgi</i> infections

Immunohistochemistry application as step one for diagnosing human intestinal spirochetosis

Mucosal eosinophilic infiltration may be a characteristic of human intestinal spirochetosis

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