Background Crohn’s disease, a form of inflammatory bowel disease, resembles s ome aspects of tuberculosis, leprosy, and paratuberculosis. The role of Mycobact erium avium subspecies paratuberculosis (MAP) in Crohn’s...Background Crohn’s disease, a form of inflammatory bowel disease, resembles s ome aspects of tuberculosis, leprosy, and paratuberculosis. The role of Mycobact erium avium subspecies paratuberculosis (MAP) in Crohn’s disease is controversi al. Methods We tested for MAP by PCR and culture in buffy coat preparations from 28 individuals with Crohn’s disease, nine with ulcerative colitis, and 15 with out inflammatory bowel disease. Findings MAP DNA in uncultured buffy coats was i dentified by PCR in 13 (46%) individuals with Crohn’s disease, four (45%) wit h ulcerative colitis, and three (20%) without inflammatory bowel disease. Viabl e MAP was cultured from the blood of 14 (50%) patients with Crohn’s disease, t wo (22%) with ulcerative colitis, and none of the individuals without inflammat ory bowel disease. Current use of immunosuppressive medication did not correlate with a positive MAP culture. Sequencing of PCR products from MAP cultures confi rmed the presence of the MAP-specific IS900 fragment. Among 11 MAP isolates ass essed, we identified nine strains that were not identical. Interpretation We det ected viable MAP in peripheral blood in a higher proportion of individuals with Crohn’s disease than in controls. These data contribute to the evidence that MA P might be a cause of Crohn’s disease.展开更多
文摘Background Crohn’s disease, a form of inflammatory bowel disease, resembles s ome aspects of tuberculosis, leprosy, and paratuberculosis. The role of Mycobact erium avium subspecies paratuberculosis (MAP) in Crohn’s disease is controversi al. Methods We tested for MAP by PCR and culture in buffy coat preparations from 28 individuals with Crohn’s disease, nine with ulcerative colitis, and 15 with out inflammatory bowel disease. Findings MAP DNA in uncultured buffy coats was i dentified by PCR in 13 (46%) individuals with Crohn’s disease, four (45%) wit h ulcerative colitis, and three (20%) without inflammatory bowel disease. Viabl e MAP was cultured from the blood of 14 (50%) patients with Crohn’s disease, t wo (22%) with ulcerative colitis, and none of the individuals without inflammat ory bowel disease. Current use of immunosuppressive medication did not correlate with a positive MAP culture. Sequencing of PCR products from MAP cultures confi rmed the presence of the MAP-specific IS900 fragment. Among 11 MAP isolates ass essed, we identified nine strains that were not identical. Interpretation We det ected viable MAP in peripheral blood in a higher proportion of individuals with Crohn’s disease than in controls. These data contribute to the evidence that MA P might be a cause of Crohn’s disease.