Pathogenic Yersinia DNA Is Detected in Bowel and Mesenteric Lymph Nodes From Patients With Crohn's Disease

Abstract

Previously, we detected pathogenic (invasive) DNA in the appendices of two patients who later developed Crohn's disease (CD). This subsequent investigation is the first to evaluate a series of specimens from CD patients for the presence of pathogenic DNA. A total of 54 intestinal resection specimens from 52 patients with confirmed CD were evaluated. Lesional tissue was tested by polymerase chain reaction analysis for the presence of genes occurring only in pathogenic Primer pairs are specific for each species, with no known cross reactions with other bacteria. Forty normal bowel specimens, 30 cases of acute appendicitis, and 50 cases of various active colitides served as disease controls. Medical records were reviewed following polymerase chain reaction and histologic evaluation. A total of 17 of 54 resections (31%) contained DNA by polymerase chain reaction. Mesenteric lymph nodes were also positive in eight of these cases. All controls were negative. -positive patients had carried the diagnosis of CD for a median of 10 years before resection (range 1 month to 40 years). We report the first documentation of DNA in a series of CD cases. Further studies are needed, including serial study, over time, of -positive CD patients, as well as prospective studies of newly diagnosed CD patients for evidence of infection. Like previous studies associating infectious organisms with CD, much work remains to elucidate whether the presence of DNA is an epiphenomenon or actually a factor in the pathogenesis of CD.

Strong Decrease in Invasive Ability and Outer Membrane Vesicle Release in Crohn's Disease-Associated Adherent-Invasive Escherichia coli Strain LF82 with the yfgL Gene Deleted

“…CD exhibits features that might be the result of a microbial process in the gut. Various studies have addressed the hypothesis that pathogenic bacteria contribute to the pathogenesis of inflammatory bowel disease (9,28,31,37,38). Of the bacteria that could play a role in the pathogenesis of CD, pathogenic Escherichia coli strains have been incriminated.…”

Yersinia pseudotuberculosis induces transcytosis of nanoparticles across human intestinal villus epithelium via invasin-dependent macropinocytosis

“…21 Other enteric bacteria that have been implicated in CD pathogenesis include Yersinia spp. Two independent groups have shown increased frequency of DNA of Y. enterocolitica and Y. pseudotuberculosis in intestinal samples of CD patients, 22,23 and several case reports have linked Yersinia-induced ileitis and lymphadenitis to the early phases of clinical CD. 24,25 Yersinia pseudotuberculosis expresses two different virulenceassociated adhesion proteins anchored to the outer membrane, ie, invasin and YadA.…”

HtrA Stress Protein Is Involved in Intramacrophagic Replication of Adherent and Invasive Escherichia coli Strain LF82 Isolated from a Patient with Crohn's Disease

“…Some characteristic pathological elements of CD, including aphthous ulcers of the mucosa, mural abscesses, and macrophage and epithelioid cell granulomas, also occur in well-recognized infectious diseases, such as shigellosis, salmonellosis, and Yersinia enterocolitis, in which invasiveness is an essential virulence factor of the bacteria involved (49). Various studies have addressed the hypothesis that virulent bacteria contribute to the pathogenesis of CD (6,24,29,37,38). The ileal mucosa of a subset of patients with CD is abnormally colonized by pathogenic Escherichia coli strains called adherent and invasive E. coli (AIEC), which are able to adhere to and to invade intestinal epithelial cells (4,11,12).…”