Mycobacterium avium subsp. paratuberculosis and associated risk factors for inflammatory bowel disea

Interesting, but still does not prove I suspect whether MAP is a bystander or causal.
Old Mike



/www.ncbi.nlm.nih.gov/pubmed/28053669

Abstract
BACKGROUND:
Inflammatory bowel disease (IBD) is described as a relapsing condition with high morbidity and uncertain complex pathogenesis. The association of Mycobacterium avium ssp. paratuberculosis (MAP) with Crohn's disease (CD) in human has been debated for decades, however there is no confirmed data to verify such relations in Iran. The aim of this study was to investigate risk factors and a possible role of MAP in Iranian patients with CD.
METHODS:
Anti-MAP antibodies were detected in serum of IBD patients and subjects without IBD (nIBD) through ELISA; MAP DNA and viable MAP cells were identified in patients' biopsies through nested PCR and direct culture methods, respectively. Principal component analysis (PCA) was used to investigate the risk factors in relation to IBD and MAP infection.
RESULTS:
Positivity for IS900 PCR was detected in 64% (n = 18) of CD, 33% (n = 10) of ulcerative colitis (UC) and 9.7% (n = 6) of nIBD samples. Live MAP cells were isolated from biopsies of 2 CD patients only. Among 28 patients with CD, 46% (n = 13) and 39% (n = 11) were positive for antibodies against MAP3865c133-141 and MAP3865c125-133 peptides, respectively, whereas much lower seroreactivity was detected in UC subjects accounting for 3% (n = 1) for MAP3865c133-141 and 16.7% (n = 5) for MAP3865c125-133. A high immune reactivity to MAP epitopes among CD patients was positively correlated with consumption of fast food meals and IBD familiarity. For both CD and UC, breastfeeding period and consumption of fruit/vegetables presented negative correlation with the presence of anti-MAP antibodies.
CONCLUSIONS:
This study provided evidences that high prevalence of MAP DNA and anti-MAP antibodies in CD patients is significantly associated with the development of CD. Despite the role of several factors contributing to IBD, the presence of MAP DNA and anti-MAP antibodies in Iranian CD patients highlights a possible transmission of MAP from animal-derived products to humans.
KEYWORDS:
Crohn’s disease; ELISA; IS900 nested PCR; Inflammatory bowel disease; Iran; Mycobacterium avium subsp. paratuberculosis
PMID: 28053669 DOI: 10.1186/s13099-016-0151-z
[PubMed - in process]
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I don't get the point, no new information from that study

WorriedUCer said...
I personally don't believe that a proven pathogen that is known to cause a chronic wasting gastrointestinal disease in other animals can be a mere "bystander" in other animals (humans) with an extremely similar chronic gastrointestinal condition. And a mycobacterium no less, there's not many of them that don't cause illness in humans (leprosy, tuberculosis, MAC). I think mycobacterium are involved in a lot of "autoimmune" conditions, and a proportion of patients with IBD, I think others will be infected with another bug we can't detect in the mileui.

I agree but that would go against the philosophy behind Big Pharma selling immunosuppressants.

I completely agree with you, and certainly don't think immunosuppressants have been the answer or are the way forward. Of course big pharma continues to pursue them because look at the costs they can charge. But they haven't been a huge success story in IBD, with remission rates much lower than they can achieve in other diseases such as psoriasis for example. I also think it's funny that a lot of the older drugs that we use in IBD because they were found to work well have been shown to have activity against MAP. I personally had the antibiotics before I had my fecal transplant and they pulled me out of an 8 month flare within a week. I didn't want to continue with them because of the side effects and also because the fecal transplant worked so well from then on but I still found that unexpected/interesting and I have UC (technically indeterminate). I just strongly think it's a bug, that seems to be the simplest and most likely explanation. I think the key is to improving our laboratory diagnostics, if only pharma companies would invest in that !

Thanks pb4, the MAP vaccine will hopefully put an end to the debate! Let's hope they get funding and get the legs to get it up. That being said, my concern is that if the vaccine fails like many do (e.g GSK and the early HSV vaccines), that the naysayers will take that as evidence it's not Map and it will be abandoned. That is the major risk as I see it. I for one would like the debate to be over though, my patience is wearing thin