Mycobacterium paratuberculosis as a cause of Crohn's disease
Adrienne L McNees1, Diane Markesich2, Najah R Zayyani3
1a 1 Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
Abstract:
Crohn's disease is a chronic inflammatory bowel disease of unknown cause, affecting approximately 1.4 million North American people. Due to the similarities between Crohn's disease and Johne's disease, a chronic enteritis in ruminant animals caused by Mycobacterium avium paratuberculosis (MAP) infection, MAP has long been considered to be a potential cause of Crohn's disease. MAP is an obligate intracellular pathogen that cannot replicate outside of animal hosts. MAP is widespread in dairy cattle and because of environmental contamination and resistance to pasteurization and chlorination, humans are frequently exposed through contamination of food and water. MAP can be cultured from the peripheral mononuclear cells from 50-100% of patients with Crohn's disease, and less frequently from healthy individuals. Association does not prove causation. We discuss the current data regarding MAP as a potential cause of Crohn's disease and outline what data will be required to firmly prove or disprove the hypothesis.
Insights
Mycobacterium avium paratuberculosis (MAP) may cause Crohn's disease, a chronic inflammatory bowel disease. Further research is needed to confirm if MAP is the definitive cause of Crohn's disease in humans.
Area of Science:
- Gastroenterology
- Microbiology
- Immunology
Background:
- Crohn's disease is a chronic inflammatory bowel disease affecting 1.4 million North Americans, with unknown etiology.
- Johne's disease, a ruminant enteritis caused by Mycobacterium avium paratuberculosis (MAP), shares similarities with Crohn's disease.
- MAP is a widespread pathogen in cattle, posing a risk of human exposure through contaminated food and water due to environmental persistence and resistance to disinfection.
Purpose of the Study:
- To evaluate the current evidence linking Mycobacterium avium paratuberculosis (MAP) to Crohn's disease.
- To discuss the data required to establish or refute MAP as a causative agent of Crohn's disease.
Main Methods:
- Review of existing scientific literature on MAP and Crohn's disease.
- Analysis of MAP culture data from Crohn's disease patients and healthy individuals.
Main Results:
- MAP has been cultured from a high percentage of Crohn's disease patients' peripheral mononuclear cells (50-100%), with lower detection rates in healthy individuals.
- The presence of MAP in Crohn's disease patients indicates an association, but does not confirm causation.
Conclusions:
- While a strong association exists, current data is insufficient to definitively prove or disprove Mycobacterium avium paratuberculosis (MAP) as the cause of Crohn's disease.
- Further research is necessary to elucidate the etiological role of MAP in Crohn's disease.
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