The many faces of Crohn’s Disease: Latest concepts in etiology

Abstract

The notion that Crohn's Disease (CD) occurs as a result of an aberrant reaction to the commensal microbiota in genetically susceptible hosts is widely regarded by physicians and scientists as fact. Yet although it is undisputed that Crohn's Disease is immune-mediated, an aberrant reaction to one's own native flora is far from proven. The aim of the current review is to present a summary of the known infectious causes of Crohn's Disease, whilst highlighting the limitations of using outdated methods to attempt to classify the disease as a single entity. We propose a re-classification of Crohn's Disease, and suggest that the disease is best conceptualized as a syndrome, an "umbrella-like" term comprising a group of diseases with varying infective etiologies, which clinically, endoscopically and histologically are indistinguishable from CD.

‘Global Warming’ to Mycobacterium Avium Subspecies Paratuberculosis

“…CD was described by the Scottish surgeon, TK Dalziel in 1913 [1], though it was probably described even earlier by a Polish surgeon Antoni Leśniowski in 1904 [1]. Subsequently CD was labeled as 'regional ileitis' by an American gastroenterologist, Burril Crohn [1] and so it became known as CD.…”

“…Subsequently CD was labeled as 'regional ileitis' by an American gastroenterologist, Burril Crohn [1] and so it became known as CD. Dr Burril Crohn commented initially upon its similarities to known mycobacterial infections of the gut, such as Mycobacterium tuberculosis, particularly in that it was of a 'granulomatous enteritis' nature.…”

Mycobacterium avium ss paratuberculosis-associated Diseases

“…Although it is plausible that several pathogens cause CD-like pathology, 11 Prantera 2 suggested "variable disease locations and severity" disprove a single pathogen etiology. Yet a number of pathogens cause "variable disease locations and severity."…”

Antibiotic Therapy for Active Crohn’s Disease Targeting Pathogens: An Overview and Update

“…Several independent studies, using different methods, reported an increased presence (from 25% to 55%) of mucosa-associated AIEC in CD patients [21][22][23]. AIEC was also recovered from 65% of chronic lesions and nearly 100% of biopsies from early lesions of CD patients [16].…”