Title

Integrating theories of the etiology of Crohn's disease - On the etiology of Crohn's disease: Questioning the Hypotheses

Authors

Authors

W. M. Chamberlin;S. A. Naser

Comments

Authors: contact us about adding a copy of your work at STARS@ucf.edu

Abbreviated Journal Title

Med. Sci. Monitor

Keywords

Crohn's Disease; etiology; mycobacteria; AVIUM SUBSP PARATUBERCULOSIS; POLYMERASE CHAIN-REACTION; LASER CAPTURE; MICRODISSECTION; MYCOBACTERIUM-PARATUBERCULOSIS; BIOPSY SPECIMENS; NOD2; TUBERCULOSIS; CULTURE; TISSUES; DNA; Medicine, Research & Experimental

Abstract

The most prominent theory describes the Crohn's Syndrome as a dysregulated, inappropriate immune response to otherwise innocuous bowel flora in a genetically Susceptible host. The autoimmune theory assumes that a specific infections agent does not exist. Data from mouse models, impairment of the mucosal epithelial barrier and the influence of gut flora are used to support the autoimmune theory. Critics claim that the dysregulated immune responses are not the primary disorder but secondary to all underlying infection. Two Other theories are also consistent with the same data. The immunodeficiency theory hypothesizes that defects in innate immunity leading to compensatory immune processes underlie the Crohn's phenotype and suggests that therapy should stimulate immunity rather than suppress it. The mycobacterial theory proposes that Mycobacterium avium subspecies paratuberculosis is One Of the causes of the Crohn's Disease syndrome. Mycobacterial molecules dysregulate immune signaling pathways as part of the organisms' evolved survival strategy. If MAP were to initiate the dysregulated immune response then the necessity to hypothesize that commensal gut flora provide the antigenic stimulus would be moot. Commensal bacteria would be relegated to a secondary role of modifying the immune response rather than occupying the central role of providing the initiating antigens. Critics claim that MAP is merely a secondary invader. The three theories differ primarily by emphasizing different aspects of the same overall process.

Journal Title

Medical Science Monitor

Volume

12

Issue/Number

2

Publication Date

1-1-2006

Document Type

Review

Language

English

First Page

RA27

Last Page

RA33

WOS Identifier

WOS:000235441900022

ISSN

1234-1010

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