title: Mycobacterium avium subspecies paratuberculosis in the etiology of Crohn's disease, cause or epiphenomenon?
abstract: The origin of inflammatory bowel disease is unknown. Attempts have been made to isolate a microorganism that could explain the onset of inflammation, but no pathological agent has ever been identified. Johne's disease is a granulomatous chronic enteritis of cattle and sheep caused by Mycobacterium avium subspecies paratuberculosis (MAP) and shows some analogies with Crohn's disease (CD). Several studies have tried to clarify if MAP has a role in the etiology of CD. The present article provides an overview of the evidence in favor and against the "MAP-hypothesis", analyzing the methods commonly adopted to detect MAP and the role of antimycobacterial therapy in patients with inflammatory bowel disease. Studies were identified through the electronic database, MEDLINE, and were selected based on their relevance to the objective of the review. The presence of MAP was investigated using multiple diagnostic methods for MAP detection and in different tissue samples from patients affected by CD or ulcerative colitis and in healthy controls. On the basis of their studies, several authors support a close relationship between MAP and CD. Although increasing evidence of MAP detection in CD patients is unquestionable, a clear etiological link still needs to be proven.
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Carla Cardamone, Andrea Belluzzi, Gastroenterology Division, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Liverani
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Carla Cardamone, Andrea Belluzzi, Gastroenterology Division, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Scaioli
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Carla Cardamone, Andrea Belluzzi, Gastroenterology Division, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Cardamone
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Carla Cardamone, Andrea Belluzzi, Gastroenterology Division, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Dal Monte
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Carla Cardamone, Andrea Belluzzi, Gastroenterology Division, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi University Hospital, 40138 Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Belluzzi
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007422:Intestines / Q000187:drug effects / Q000382:microbiology*; D016927:Mycobacterium avium subsp. paratuberculosis / Q000187:drug effects / Q000472:pathogenicity*; D010283:Paratuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Crohn’s disease; Inflammatory bowel disease; Johne’s disease; Mycobacterial protein tyrosine phosphatase; Mycobacterium avium paratuberculosis