Title

Review article: Mycobacterium avium subsp paratuberculosis as one cause of Crohn's disease

Authors

Authors

W. Chamberlin; D. Y. Graham; K. Hulten; H. M. T. El-Zimaity; M. R. Schwartz; S. Naser; I. Shafran;F. A. K. El-Zaatari

Comments

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

Abbreviated Journal Title

Aliment. Pharmacol. Ther.

Keywords

INFLAMMATORY BOWEL-DISEASE; POLYMERASE CHAIN-REACTION; SERUM ANTIBODIES; CONTROL TISSUES; IDENTIFICATION; ANTIGEN; DNA; SEROREACTIVITIES; PATHOGENESIS; ETIOLOGY; Gastroenterology & Hepatology; Pharmacology & Pharmacy

Abstract

A number of theories regarding the aetiology of Crohn's disease have been proposed. Diet, infections, other unidentified environmental factors and immune disregulation, all working under the influence of a genetic predisposition, have been viewed with suspicion. Many now believe that Crohn's disease is a syndrome caused by several aetiologies. The two leading theories are the infectious and autoimmune theories. The leading infectious candidate is Mycobacterium avium subspecies paratuberculosis (Mycobacterium paratuberculosis), the causative agent of Johne's disease, an inflammatory bowel disease in a variety of mammals including cattle, sheep, deer, bison, monkeys and chimpanzees. The evidence to support M. paratuberculosis infection as a cause of Crohn's disease is mounting rapidly. Technical advances have allowed the identification and/or isolation of M. paratuberculosis from a significantly higher proportion of Crohn's disease tissues than from controls. These methodologies include: (i) improved culture techniques; (ii) development of M. paratuberculosis-specific polymerase chain reaction assays; (iii) development of a novel in situ hybridization method; (iv) efficacy of macrolide and anti-mycobacterial drug therapies; and (v) discovery of Crohn's disease-specific seroreactivity against two specific M. paratuberculosis recombinant antigens. The causal role for M. paratuberculosis in Crohn's disease and correlation of infection with specific stratification(s) of the disorder need to be investigated. The data implicating Crohn's as an autoimmune disorder may be viewed in a manner that supports the mycobacterial theory. The mycobacterial theory and the autoimmune theory are complementary; the first deals with the aetiology of the disorder, the second deals with its pathogenesis. Combined therapies directed against a mycobacterial aetiology and inflammation may be the optimal treatment of the disease.

Journal Title

Alimentary Pharmacology & Therapeutics

Volume

15

Issue/Number

3

Publication Date

1-1-2001

Document Type

Review

Language

English

First Page

337

Last Page

346

WOS Identifier

WOS:000167004400006

ISSN

0269-2813

Share

COinS