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Laurens Westerman

Tuesday 10 December 2013

Human Intestinal Spirochaetosis

Promotor: Prof. dr. J. Wagenaar
Defence: 10 December 2013

Human intestinal spirochaetosis is a condition of the colon characterized by the presence of spirochaetes attached to the mucosal cells of the colon. These spirochaetes belong to the family Brachyspiraceae and two species are known to occur in humans: Brachyspira aalborgi and Brachyspira pilosicoli. The condition has been known since the 1960ís, however, due to the fact that these bacteria are very difficult to culture and that histopathology do not allow for species differentiation, the clinical relevance has never been established. Conversely, in veterinary science, infections with these bacteria are feared since they cause large economic losses in both the pig and poultry industry. While it is known that the veterinary pathogen Brachyspira pilosicoli also colonizes humans, there was no convincing data on its pathogenic potential in humans.

This thesis described diagnostic tools to allow for easy and fast species differentiation between the two human Brachyspira species. Moreover, it provides clear evidence for a pathogenic potential of Brachyspira pilosicoli for humans. Since almost one in five Dutch human intestinal spirochaetosis cases is caused by Brachyspira pilosicoli, it is important to differentiate between the non-pathogenic Brachyspira aalborgi and the pathogenic Brachyspira pilosicoli. Additionally this thesis provides evidence for a zoonotic potential of Brachyspira pilosicoli.