Tropheryma whipplei colonization in HIV-infected individuals is not associated with lung function or inflammation

Qin, Shulin; Clausen, Emily; Nouraie, Mehdi; Kingsley, Lawrence; McMahon, Deborah; Kleerup, Eric C.; Huang, Laurence; Ghedin, Elodie; Greenblatt, Ruth M.; Morris, Alison

doi:10.1371/journal.pone.0205065

Cited by 15 publications

(10 citation statements)

References 30 publications

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“…In addition to this, markers of immune activation were found to be decreased in T. whipplei carriers in our cohort. This finding is in agreement with a study on T. whipplei colonization of the lung in PLHIV, where T. whipplei positivity was not associated with increased systemic or local inflammation [ 14 ]. Indeed, Moos and Schneider related an absence of an inflammatory response against T. whipplei to the establishment of a chronic infection, which might in part explain the higher prevalence in individuals receiving anti-inflammatory antiretroviral therapy [ 29 ].…”

Section: Discussionsupporting

confidence: 93%

“…In agreement with a study on PLHIV in Europe, there was no accumulation of acute or chronic symptoms in subjects carrying T. whipplei in our cohort from Sub-Saharan Africa [ 15 ]. Likewise, Qin et al reported no impairment of pulmonary function in PLHIV with T. whipplei positive bronchoalveolar lavage samples [ 14 ]. Our findings are also in line with a recent work from Ghana in which T. whipplei was found equally in symptomatic pediatric cases and controls [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies from Europe and the US reported higher prevalence and abundance rates of T. whipplei in people living with HIV (PLHIV) than in HIV negative subjects [ 14 , 15 , 16 ]. Further, Lozupone et al observed a decline of this microbe in respiratory samples after initiation of antiretroviral therapy (ART), whereas a longitudinal study in healthy subjects without any antibiotic or antiviral treatment demonstrated a persistence of T. whipplei over time [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Intestinal Colonization with Tropheryma whipplei—Clinical and Immunological Implications for HIV Positive Adults in Ghana

et al. 2021

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Background: Recent studies demonstrated higher prevalence rates of Tropheryma whipplei (T. whipplei) in HIV positive than in HIV negative subjects. However, associations with the immune status in HIV positive participants were conflicting. Methods: For this cross-sectional study, stool samples of 906 HIV positive and 98 HIV negative individuals in Ghana were tested for T. whipplei. Additionally, sociodemographic parameters, clinical symptoms, medical drug intake, and laboratory parameters were assessed. Results: The prevalence of T. whipplei was 5.85% in HIV positive and 2.04% in HIV negative participants. Within the group of HIV positive participants, the prevalence reached 7.18% in patients without co-trimoxazole prophylaxis, 10.26% in subjects with ART intake, and 12.31% in obese participants. Frequencies of clinical symptoms were not found to be higher in HIV positive T. whipplei carriers compared to T. whipplei negative participants. Markers of immune activation were lower in patients colonized with T. whipplei. Multivariate regression models demonstrated an independent relationship of a high CD4+ T cell count, a low HIV-1 viral load, and an obese body weight with the presence of T. whipplei. Conclusions: Among HIV positive individuals, T. whipplei colonization was associated with a better immune status but not with clinical consequences. Our data suggest that the withdrawal of co-trimoxazole chemoprophylaxis among people living with HIV on stable cART regimen may inadvertently increase the propensity towards colonization with T. whipplei.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intestinal Colonization with Tropheryma whipplei—Clinical and Immunological Implications for HIV Positive Adults in Ghana

et al. 2021

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“…BAL and mouths of 82 HIV-positive and 77 HIV-negative subjects qPCR Higher prevalence and relative abundance of TW in BAL in HIV-positive individuals [13] BAL and induced sputum samples in 76 HIV-infected participants PCR and sequencing Frequency of TW in either BAL or IS was 43.4% [22] bronchial biopsy specimens of a man with a history of intermittent fever and arthritis…”

Section: Methods Comments Referencesmentioning

confidence: 99%

Severe pneumonia in adults caused by Tropheryma whipplei and Candida sp. infection: a 2019 case series

Zhang

et al. 2021

BMC Pulm Med

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Background Whipple’s disease is a chronic infectious disease caused by the Gram-positive bacterium Tropheryma whipplei (TW), which not only affects the gastrointestinal tract and causes malabsorption of nutrients, but several other systems, such as the cardiovascular system, central nervous system, the joints, and the vascular system, can also be simultaneously involved. The aim of this report was to be able to alert the clinician to severe pneumonia caused by TW combined with Candida sp. Case presentation The case study was conducted on patients in September and November 2019. After routine examination and treatment, the results were not satisfactory. A bronchoalveolar lavage (BAL) using metagenomics next-generation sequencing was conducted on two adults who presented with fever, cough, and progressive dyspnea and who had no history of gastrointestinal symptoms, immunodeficiency diseases, or use of immunosuppressive agents. TW and Candida sp. were detected in in BAL. Conclusions This is a report of life-threatening pneumonia caused by TW combined with Candida sp. in a Chinese population.

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“…It has been associated with smoking and its prevalence decreases with initiation of ART. Despite its presence in the lung, it has not been associated with pulmonary inflammation or lung function (21). The discordance between its high abundance in raw samples and relatively lower abundance in IgG-bound samples could suggest that the absence of an inflammatory response to Tropheryma in the lungs may be due to a lack of active host recognition and response (20,21).…”

Section: Discussionmentioning

confidence: 99%

Magnetic activated cell-sorting identifies a unique lung microbiome community associated with disease states

Dunlap

Yang

Qin

et al. 2021

Preprint

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Rationale: The advent of culture-independent, next-generation DNA sequencing has led to discovery of distinct lung bacterial communities. Studies of lung microbiome taxonomy often reveal only subtle differences between health and disease, but microbial host response may distinguish members of similar communities in different populations. Objectives: Magnetic-activated cell sorting (MACS) has been applied to the gut microbiome to identify numbers and types of bacteria eliciting a humoral response. We adapted this technique to examine populations of immunoglobulin-bound bacteria and investigate the lung microbiota in HIV as a representative disease. Methods: 42 people living with HIV (PLWH) and 22 HIV-uninfected individuals underwent bronchoalveolar lavage (BAL). We separated immunoglobulin G-bound bacteria using MACS and sequenced the 16S rRNA gene on the Illumina MiSeq platform. We analyzed sequences and quantified BAL cytokines and bacterial rRNA copy numbers. Results: Immunoglobulin G-bound bacteria were detectable in the healthy lung microbiota. Comparison of raw BAL by HIV status showed no significant taxonomic differences, but the immunoglobulin-bound lung microbiota differed by HIV status with greater abundance of Pseudomonas in PLWH. BAL cytokine levels were also higher in PLWH, which correlated with increased quantity of immunoglobulin G-bound bacteria. Conclusions: We report a novel application of magnetic-activated cell sorting to identify immunoglobulin G-bound bacteria in the lung. This technique identified distinct bacterial communities which differed in composition from raw BAL, revealing differences in health and disease not detected by traditional analyses. Cytokine response was also associated with differential immunoglobulin binding of lung bacteria, suggesting functional importance of these communities.

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Tropheryma whipplei colonization in HIV-infected individuals is not associated with lung function or inflammation

Cited by 15 publications

References 30 publications

Intestinal Colonization with Tropheryma whipplei—Clinical and Immunological Implications for HIV Positive Adults in Ghana

Intestinal Colonization with Tropheryma whipplei—Clinical and Immunological Implications for HIV Positive Adults in Ghana

Severe pneumonia in adults caused by Tropheryma whipplei and Candida sp. infection: a 2019 case series

Magnetic activated cell-sorting identifies a unique lung microbiome community associated with disease states

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