MAP & Crohn's

Well I am Nanners and I did not lock the post. The forum administrator locked it down due to it getting too political and controversial. Many have different opinions on this subject, myself included. Personally I feel there are just too many variables for MAP to be the only cause of Crohns. JMHO

So as long as the post remains civil and polite to all opinions it will be allowed to stay. But should it become contentious again, it will once again be locked. Thank you for your understanding.

I have been in contact with Professor Hermon-Taylor and am going to visit him come the summer months.  I think it is important that more Crohn's patients read about his work and watch the videos.  I am no salesman, but prof JHT has done more work on MAP than anyone else in the world and I totally believe in his work and that of other Professors such as Tom Borody. 

$rules, how did u manage to meet Prof JHT, did u meet him at Kings College London?

 

$rules, I do think it's an interesting line of research and an intriguing possibility that there could be some truth to what Hermon-Taylor is saying.  I would not be so quick to jump for joy based on what he is saying/finding though.  One of the main concerns I have is that Professor Hermon-Taylor owns a patent for the vaccine he is trying to produce.  Of course, then, he wants to pursuade everybody that his research is extremely important and he has all of the answers.  I'm not saying that he is lying or fabricating data (he wouldn't have patented his idea and devoted so much time if he did not believe in it) but right now he is in need of funding and a great way to get funding is to convince people that there is a clear-cut answer in sight.

Others haven't been able to find MAP infection in Crohn's patients or reproduce his findings and suspect either sample contamination or analysis of isolated individuals with an outside predisposition to MAP infection.  Still others argue that MAP is found in patients with Crohn's as a secondary infection (due to immune suppression and/or compromising of the gut).  Crohn's does not respond to treatment for tuberculosis.  The arguement that Johne's and Crohn's are "pretty much identical in symptoms" is not really relevant.  It's hard enough for doctors to diagnose Crohn's disease (vs other GI ailments) so saying the symptoms are identical to those of other animals is a stretch.

Again, I'm not trying to launch an assault on his research because I think we will benefit from as much research as possible - whether it results in a cure or the elmination of a suspected cause - but scientists' observations can be skewed by their own particular theories and when there is a the added interest of profit from discovery this only enhanced.  I would be (pleasantly) surprised if a broadly effective vaccine results from this research, but I certainly praise and support his efforts in trying to find answers for us all.

But thank you $rules for giving me an interesting thing to investigate/research at work today and bringing this possible link between Crohn's and MAP to my attention.  I'm reservedly excited to see how things turn out with his research.

 

I think that at this point MAP is most likely the cause of Crohn's disease, at least in a substantial subset of patients. Koch's postulates have been fulfilled supposedly. It's the simplest explanation for what's going on (a more complicated one would be less likely). MAP has been proven without a doubt to CAUSE Johne's disease, which is at least grossly very similar to Crohn's though the pathology is not identical. Before Crohn's was a common diagnosis, it was often misdiagnosed as tuberculous enteritis from mycobacterium tuberculosis (not identical to MAP but in same species).

It's true you have to be very wary about theories, especially when the cause of this disease has evaded researches for decades. I acknowledge that part of me wishes this is the causes. It is something tangible that I can blame for what has happened to me. We definitely need more research to prove/disprove this once and for all, but we must acknowledge that MAP is beyond a reasonable doubt the cause of Crohn's.

I am inclined to think that MAP isthe cause, or a cause of Crohn's Disease - or a proportion of the cases diagnosed as Crohn's Disease - BUT I would take issue (politely I hope ! ) with a couple of the points made here. Consider me playing Devil's Advocate, in order to keep myself honest !
Koch's Postulates have not been met - nor are they ever likely to be. This is because Koch's Postulates demand, amongst other things which I forget - that the proposed pathogen must be isolated from the host, cultured in the laboratory in vitro, then used to infect a healthy host which will show the symptoms of disease, before finally being eradicated which then causes the host to return to good health.
As ethics committees quite rightly frown upon the idea of infecting healthy people with diseases that currently have no cure, if MAP is ever proven to be the cause of Crohn's Disease using Koch's Postulates it will be once the matter is academic - ie, once an effective treatment has been found. In actual fact, it is unlikely that even after a treatment is found, an ethics committee would allow infection of a healthy person with what they believe to be a pathogen - something might go wrong.
I'd agree very much with dodger's second paragraph, insofar as I can see that these scenarios are plausible possibilities, and diagnosis of intestinal disorders is murky enough that going cross-species is bound to be iffy.
Furthermore - and I say this with all respect to Dr Hermon-Taylor, whose conclusions I do after all tend to agree with - it is a known effect, that those who are more committed financially or emotionally to a medical or research project, will find that their attitudes are skewed by this. They may still be correct - but the relative weightings they give to various variables and premises will be affected by the emotions they feel, regardless of how flawless the logic of their reasoning is otherwise. This is why at least one British medical journal, having discovered this effect in large measure amongst supposedly objective doctors contributing influential articles on treatments and drugshtey were involved with, now has a strict policy of not accepting such papers. Quite simply, the bias was there and could not be eliminated even by absolute paragons of objectivity who were trying to do so - so they decided that the only way to ensure objectivity was to ensure no links.
Personally, I think I am fairly objective - but only as long as I doubt what my conclusions, and the effectiveness of even that I doubt...if you see what I mean.
The quote that Escelador gives is one that I can quite see being true. It would explain a lot, and it is a situation that I think has been repeated in medical history time and time again, down through the ages. (Early Hellenic work on diagnosis of menstrual problems, and Medieval thinking on scrofula and leprosy are good examples.) The key to ending the confusion in all cases ? A clearer understanding of the processes at work. (I'm not holding my breath. )
Taking off the Advocate's cap, I would say one thing in favour of the MAP theory. It may not be pertinent in this case, but I am firmly convinced that the most common mistake in the world, made by everyone daily, day since time immemorial, in all cultures and classes, irrespective of education and wit, is to concentrate on details as soon as confusion begins, instead of taking a large mental step backwards and looking at the context. Context decides everything; see the similarities and differences between a situation and its fellows, and you are far past halfway to recognising the truth. Although at the end of the day experiments must be done to prove or disprove assumptions and findings, perspective is rarely if ever the poorer for including more information, even if it does seem irrelevant initially. Time and again, breakthroughs in intractable questions in biology or medicine have been made by looking at a wider picture than usual and thus seeing mistakes that have been made, and errors of judgement or belief that have resulted. (I'm thinking here of Helicobacter pylori, and the theory that no bacteria could live in the acid of the stomach.) The problem with in-depth expertise is that it deprives one of breadth of comparisons.
Context is what epidemiology provides us with for Crohn's, when the immunology and microbiology looks fuzzy. Granted, neither will prevail alone, but it is William of Ockham's famed Razor, fully sharpened. I would dearly love to know what an old-school TB specialist would say about Crohn's...