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Mycobacterium avium subspecies Paratuberculosis and Crohn's regional ileitis: how strong is association?
Sarman Singh1, Krishnamoorthy Gopinath
1Department of Laboratory Medicine, Division of Clinical Microbiology, All India Institute of Medical Sciences, New Delhi, India. sarman_singh@yahoo.com
Abstract:
Mycobacterium avium subsp. paratuberculosis (MAP) is a well-established etiological agent of Johne's disease in animals. In humans, similar clinical condition, first described by Crohn as regional ileitis in 1932, now known as Crohn's diseases (CD), has also been associated with this mycobacterial species. However, there are two schools of thoughts, one favoring MAP as its etiological agent while the second considers it as an immune-inflammatory condition triggered by an external factor. Onset of CD requires a series of events including predisposition of certain inherited genetic traits, associated environmental stimuli, and immune-inflammatory response. A combination of these factors probably leads to this disease. Recently, some human genes have also been identified which regulate ability to respond appropriately to the external factors. Added to these factors are concerns about the selection of clinical specimens and poor adherence to laboratory quality controls. The literature is full of contradictory findings, but there a lack of uniformity in the materials and methods used by many of these researchers. In this review, we provide our perspective under above circumstances and give our point of view which may open a platform for debate regarding the MAP as the etiological agent of human CD.
Insights
Mycobacterium avium subsp. paratuberculosis (MAP) is linked to Crohn's disease (CD) in humans. This review explores the evidence for MAP as a cause of CD, considering genetic and environmental factors, and highlights research inconsistencies.
Area of Science:
- Microbiology
- Immunology
- Gastroenterology
Background:
- Mycobacterium avium subsp. paratuberculosis (MAP) is a known cause of Johne's disease in animals.
- MAP has been investigated as a potential etiological agent for Crohn's disease (CD) in humans.
- The role of MAP in CD pathogenesis remains debated, with theories suggesting it as a cause or an immune-inflammatory trigger.
Purpose of the Study:
- To review the current evidence and conflicting findings regarding MAP's role in human Crohn's disease.
- To present a perspective on the etiological debate surrounding MAP and CD.
- To stimulate further discussion and research into the potential link between MAP and CD.
Main Methods:
- Literature review of studies investigating MAP and Crohn's disease.
- Analysis of factors contributing to CD onset, including genetics, environment, and immune response.
- Discussion of methodological variations and quality control issues in relevant research.
Main Results:
- Contradictory findings exist in the literature regarding MAP's association with CD.
- CD onset is multifactorial, involving genetic predisposition, environmental stimuli, and immune responses.
- Inconsistencies in study designs, specimen selection, and laboratory quality control complicate definitive conclusions.
Conclusions:
- The etiological role of MAP in human Crohn's disease is not definitively established.
- A combination of genetic, environmental, and immune factors likely contributes to CD development.
- Further standardized research is needed to resolve the debate on MAP as a causative agent of CD.
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