A Multiplex Polymerase Chain Reaction Assay for the Detection of Mycobacterium paratuberculosis DNA in Crohn's Disease Tissue

Al-Shamali, Mohammed A.; Khan, Imteyaz Ahmad; Al‐Nakib, Basil; Al-Hassan, F; Mustafa, Abu Salim

doi:10.3109/00365529708996540

Cited by 33 publications

(14 citation statements)

References 18 publications

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“…Many studies probing for the IS900 gene sequence of M. avium in intestinal tissue have been conducted to date. The results of most of these studies have been negative (1,6,7,10,15,30,32; S. W. P. Wu, C. C. Pao, J. Chan, and T. S. B. Yen, Letter, Lancet 337:174-175, 1991) or similarly positive for cases and controls (36).…”

Section: Discussionmentioning

confidence: 99%

Study of Animal-Borne Infections in the Mucosas of Patients with Inflammatory Bowel Disease and Population-Based Controls

et al. 2003

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Crohn's disease may be triggered by an infection, and it is plausible to consider that such an infection may be animal borne and ingested with our food. There has been considerable interest in the past in determining whether Mycobacterium avium subsp. paratuberculosis (M. avium) might be the etiologic agent in Crohn's disease since it causes a disease in cattle that is similar to Crohn's disease in humans. We aimed to determine if there was an association between Crohn's disease and infection with M. avium or other zoonotic agents and compared the findings with those for patients with ulcerative colitis, unaffected siblings of Crohn's disease patients, or population-based controls without inflammatory bowel disease. Patients under age 50 years with Crohn's disease or ulcerative colitis, unaffected siblings of patients, or healthy controls drawn from a population-based age-and gender-matched registry were enrolled in a study in which subjects submitted to a questionnaire survey and venipuncture. A nested cohort underwent colonoscopy plus biopsy. Samples were batched and submitted to PCR for the detection of M. avium and other zoonotic agents known to cause predominately intestinal disease in cattle, sheep, or swine. Only one patient with ulcerative colitis, no patients with Crohn's disease, and none of the sibling controls were positive for M. avium, whereas 6 of 19 healthy controls were positive for M. avium. Since the control subjects were significantly older than the case patients, we studied another 11 patients with inflammatory bowel disease who were older than age 50 years, and another single subject with ulcerative colitis was positive for M. avium. One other subject older than age 50 years with ulcerative colitis was positive for circovirus, a swine-borne agent of infection. In conclusion, by performing PCR with mucosal samples from patients with Crohn's disease and controls, no association between Crohn's disease and infection with M. avium or any of the other six zoonotic agents studied could be found.

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Section: Discussionmentioning

confidence: 99%

Study of Animal-Borne Infections in the Mucosas of Patients with Inflammatory Bowel Disease and Population-Based Controls

et al. 2003

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“…Case series 1–4 , 13 , 14 and case‐control 5–12 , 15–19 studies have reported conflicting results regarding the possibility that Crohn’s disease is caused by a mycobacterial infection. If an infection is the cause of disease, effective antimicrobial treatment may be associated with clinical improvement and a change in the natural history of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…Humoral immune response to mycobacterial antigens was also used to support a relationship between Crohn’s disease and mycobacterial infection 9 , . 10 However, other studies relying on culture, 11 , 12 polymerase chain reaction 11–16 and measurement of specific immune responses 17–19 have not supported an aetiologic relationship between mycobacteria and Crohn’s disease.…”

Section: Introductionmentioning

confidence: 99%

Randomized controlled trial of clarithromycin and ethambutol in the treatment of Crohn’s disease

Goodgame

Kimball

Akram

et al. 2001

Aliment Pharmacol Ther

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Background: A mycobacterial infection may be the cause of Crohn’s disease in some patients. Measurement of intestinal permeability may identify Crohn’s disease patients with a high likelihood of relapse and may quantify the severity of intestinal injury. Aim: To assess the effect of 3 months of clarithromycin and ethambutol on the disease activity and intestinal permeability in patients with Crohn’s disease at high risk of relapse. Methods: Patients with Crohn’s disease, with a lactulose–mannitol permeability test above 0.03, were randomly assigned to receive either clarithromycin, 500 mg twice daily, and ethambutol, 15 mg/kg daily, or identically appearing placebo for 3 months in addition to their regular therapy. The Harvey–Bradshaw index and the lactulose–mannitol test were assessed in a blind fashion every 3 months for 12 months. Results: Thirty‐one patients were randomized to receive either drugs (n=15) or placebo (n=16). The groups were similar in age, sex, duration of disease, location of disease, past complications and disease severity. Specifically, there was no difference between the drug or placebo groups in the mean Harvey–Bradshaw index (4.8 vs. 4.4), number with active disease (33% vs. 44%) and mean lactulose–mannitol test (0.06 vs. 0.10). During the 12‐month follow‐up period, there were no consistent, statistically significant differences in the mean Harvey–Bradshaw index or lactulose–mannitol test between treatment and placebo groups. Individual patients showed either improvement or worsening of these indices, but these were not related to study medication. Specifically, no ‘cures’ were noted with anti‐mycobacterial treatment. Conclusions: Three months of treatment with clarithromycin and ethambutol does not benefit Crohn’s disease patients who are receiving standard medical therapy.

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“…4,6,7,9,15,16,19 Other authors have found a variable number of cases, up to 100%, to harbor the organism. 1,3,5,8,[10][11][12][13][14]18 Several reasons may be responsible for the variability in these results.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] However, if MAP and Crohn's disease are etiologically related, then intuitively the granulomas that are characteristic of the latter should harbor the organism. Indeed, some authors have associated the ability to identify MAP DNA with the presence of granulomas, 1,2 while others have not.…”

mentioning

confidence: 99%

Absence of Mycobacterium avium subsp. paratuberculosis in the microdissected granulomas of Crohn's disease

et al. 2004

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A Multiplex Polymerase Chain Reaction Assay for the Detection of Mycobacterium paratuberculosis DNA in Crohn's Disease Tissue

Abstract: The present MPCR method is highly specific and can detect M. paratuberculosis DNA more reliably. These findings do not support an aetiologic role of M. paratuberculosis in Crohn's disease.

Cited by 33 publications

References 18 publications

Study of Animal-Borne Infections in the Mucosas of Patients with Inflammatory Bowel Disease and Population-Based Controls

Study of Animal-Borne Infections in the Mucosas of Patients with Inflammatory Bowel Disease and Population-Based Controls

Randomized controlled trial of clarithromycin and ethambutol in the treatment of Crohn’s disease

Absence of Mycobacterium avium subsp. paratuberculosis in the microdissected granulomas of Crohn's disease

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