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Crohn's disease uveitis. Parasitization of vitreous leukocytes by mollicute-like organisms
L A Johnson1, E Wirostko, W J Wirostko
1Department of Pathology, Columbia-Presbyterian Medical Center, New York, New York 10032.
Abstract:
Crohn's disease (CD) is an idiopathic chronic inflammatory gut disease with frequent extragut inflammatory manifestations in the eyes, orbit, lungs, joints, and skin. A bacterial cause of CD is suspected, but cultivation of a specific pathogen has not been forthcoming. Mollicute-like organisms (MLOs) were recently reported to cause human chronic ocular inflammatory disease. Inoculation of this MLO into mouse eyelids produced chronic progressive granulomatous ocular and orbital inflammatory disease. In addition, MLOs disseminated to produce similar disease in the gut, heart, and lungs. MLOs are noncultivable cell wall-deficient bacterial pathogens. Because they also pass bacteria-retaining 0.450-micron filters, they can be overlooked or confused with viruses. Because MLOs have a characteristic ultrastructural appearance, they can be identified in diseased cells with the use of a transmission electron microscope. MLOs parasitize and destroy leukocytes. They alter the nucleus, replace the cytoplasm, and destroy organelles. MLO-caused disease is treatable by certain antibiotics. This report describes MLO-parasitized vitreous lymphocytes, monocytes, and polymorphonuclear leukocytes from three patients with CD who had chronic uveitis. The results indicate that MLOs probably caused the uveitis of these patients with CD. The gut as the possible source of the MLO is suggested. Rifampin therapy of Crohn's and MLO-caused disease is discussed.
Insights
Mollicute-like organisms (MLOs), a type of bacteria, may cause Crohn's disease (CD) and associated eye inflammation. These cell wall-deficient bacteria infect immune cells and could be treated with antibiotics like rifampin.
Area of Science:
- Microbiology
- Immunology
- Gastroenterology
Background:
- Crohn's disease (CD) is a chronic inflammatory condition with unknown causes, often affecting the gut and other organs.
- A bacterial etiology for CD is suspected, but no specific pathogen has been identified.
- Mollicute-like organisms (MLOs) are cell wall-deficient bacteria known to cause chronic inflammatory diseases and can be mistaken for viruses.
Purpose of the Study:
- To investigate the potential role of MLOs in Crohn's disease (CD).
- To examine MLOs in patients with CD and chronic uveitis.
- To explore MLOs as a potential cause of both ocular and gut inflammation in CD.
Main Methods:
- Transmission electron microscopy was used to identify MLOs within leukocytes from the vitreous of three CD patients with uveitis.
- MLOs were previously shown to cause granulomatous inflammation in mouse models after inoculation into eyelids, with dissemination to other organs.
- MLOs were characterized as noncultivable, cell wall-deficient bacterial pathogens passing through 0.450-micron filters.
Main Results:
- MLOs were identified within vitreous lymphocytes, monocytes, and polymorphonuclear leukocytes from CD patients with uveitis.
- MLOs were observed to parasitize and destroy leukocytes, altering cellular structures.
- Experimental inoculation of MLOs in mice led to chronic ocular, orbital, gut, heart, and lung inflammation.
Conclusions:
- MLOs are likely the cause of uveitis in these Crohn's disease patients.
- The gastrointestinal tract is suggested as the potential source of MLO infection.
- Antibiotic therapy, specifically rifampin, is a potential treatment for MLO-caused diseases, including Crohn's disease.
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