title: Prevalence of Mycobacterium avium subsp. paratuberculosis and Escherichia coli in blood samples from patients with inflammatory bowel disease.
abstract: Mycobacterium avium subsp. paratuberculosis (MAP) and adherent-invasive Escherichia coli (AIEC) have been implicated as primary triggers in Crohn's disease (CD). In this study, we evaluated the prevalence of MAP and E. coli (EC) DNA in peripheral blood from 202 inflammatory bowel disease (IBD) patients at various disease periods and compared against 24 cirrhotic patients with ascites (CIR) (non-IBD controls) and 29 healthy controls (HC). MAP DNA was detected by IS900-specific nested PCR, EC DNA by malB-specific nested PCR and AIEC identity, in selected samples, by sequencing of fimH gene. CD patients with active disease showed the highest MAP DNA prevalence among IBD patients (68 %). Infliximab treatment resulted in decreased MAP detection. CIR patients had high individual and coinfection rates (75 % MAP, 88 % EC and 67 % MAP and EC), whilst HC controls had lower MAP prevalence (38 %) and EC was undetectable in this control group. EC DNA prevalence in IBD patients was highly associated with CD, and 80 % of EC from the selected samples of CD patients analyzed carried the fimH30 allele, with a mutation strongly associated with AIEC. Our results show that coinfection with MAP and AIEC is common and persistent in CD, although the high MAP and EC detection in CIR patients suggested that colonization is, at least, partially dependent on increased gut permeability. Nevertheless, facilitative mechanisms between a susceptible host and these two potential human pathogens may allow their implication in CD pathogenesis.
authors.affiliation: FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.
authors.forename: Nair
authors.initials: N
authors.lastname: Nazareth
authors.affiliation: Institute of Pharmacology and Therapeutics, Faculdade de Medicina, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.|Gastroenterology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.|MedInUP -Center for Drug Discovery and Innovative Medicines, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Magro
authors.affiliation: FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.|REQUIMTE, Laboratory of Microbiology, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Machado
authors.affiliation: FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.|REQUIMTE, Laboratory of Microbiology, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.
authors.forename: Teresa Gonçalves
authors.initials: TG
authors.lastname: Ribeiro
authors.affiliation: FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Martinho
authors.affiliation: FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.|Infection and Immunity Unit, IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Rodrigues
authors.affiliation: FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Alves
authors.affiliation: FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.
authors.forename: Gonçalo Nuno
authors.initials: GN
authors.lastname: Macedo
authors.affiliation: Institute of Pharmacology and Therapeutics, Faculdade de Medicina, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.|MedInUP -Center for Drug Discovery and Innovative Medicines, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Daniela
authors.initials: D
authors.lastname: Gracio
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Rosa
authors.initials: R
authors.lastname: Coelho
authors.affiliation: Department of Infectious Diseases, Centro Hospitalar S. João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.|Nephrology Research and Development Unit, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Candida
authors.initials: C
authors.lastname: Abreu
authors.affiliation: Infection and Immunity Unit, IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Appelberg
authors.affiliation: Department of Biostatistics and Medical Informatics, Faculdade de Medicina, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Camila
authors.initials: C
authors.lastname: Dias
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Macedo
authors.affiliation: Institute for Infection and Immunity, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Bull
authors.affiliation: FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal. assuncao@ufp.edu.pt.|Infection and Immunity Unit, IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal. assuncao@ufp.edu.pt.
authors.forename: Amélia
authors.initials: A
authors.lastname: Sarmento
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia; D060085:Coinfection; D004269:DNA, Bacterial; D004926:Escherichia coli / Q000235:genetics; D004927:Escherichia coli Infections / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016927:Mycobacterium avium subsp. paratuberculosis / Q000235:genetics; D010283:Paratuberculosis / Q000150:complications* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial
keywords: Adherent-invasive Escherichia coli (AIEC); IS900, fimH gene; Inflammatory bowel disease; Mycobacterium avium subsp. paratuberculosis (MAP)