Mycobacterium avium subspecies paratuberculosis (MAP) and Crohn's disease: the debate continues.

Autor:	Mintz MJ; Division of Gastroenterology and Hepatology, New York Presbyterian Hospital-Weill, Cornell Medicine, New York, NY, USA., Lukin DJ; Division of Gastroenterology and Hepatology, New York Presbyterian Hospital-Weill, Cornell Medicine, New York, NY, USA.; Jill Roberts Center for Inflammatory Bowel Disease, New York Presbyterian Hospital-Weill, Cornell Medicine, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Translational gastroenterology and hepatology [Transl Gastroenterol Hepatol] 2023 Jul 25; Vol. 8, pp. 28. Date of Electronic Publication: 2023 Jul 25 (Print Publication: 2023).
DOI:	10.21037/tgh-23-16
Abstrakt:	Crohn's disease (CD) in humans and Johne's disease (JD) in ruminants share numerous clinical and pathologic similarities. As Mycobacteria avium subspecies paratuberculosis (MAP) is known to fulfill Koch's postulates as the cause of JD, there has been considerable debate over the past century about whether MAP also plays a role in CD. With recent advances in MAP identification techniques, we can now demonstrate a higher presence of MAP in CD patients compared to the general population. However, it remains unclear if MAP is playing a bystander role or is directly pathogenic in these patients. Studies have shown that there may be an immune response targeting MAP in these patients, which may underlie a pathologic role in CD. Clinical studies have yielded conflicting results as to whether anti-MAP therapy improves clinical outcomes in CD, leading to the lack of its inclusion within evidence-based clinical guidelines. Additionally, many of these studies have been small case series, with only a few randomized controlled trials published to date. In this article, we will discuss the historical context of MAP in CD, review clinical and laboratory data surrounding detection of MAP and possible pathogenesis in human disease, and suggest future directions which may finally provide some clarity to this debate. Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-23-16/coif). The series “Controversies and Updates in Inflammatory Bowel Disease” was commissioned by the editorial office without any funding or sponsorship. DJL receives educational grants for fellowship support and research grants for investigator-initiated research, receives speaker’s bureaus Non-branded disease state awareness. DJL is also in the consulting or advisory boards of companies listed below: Abbvie, Abgenomics, Boehringer Ingelheim, BMS, Eli Lilly, Fresenius Kabi, Janssen, Magellan, Palatin Technologies, Pfizer, Prometheus Labs, Takeda, and sits on DSMB for one clinical trial. No funds were utilized in the writing of this manuscript. The authors have no other conflicts of interest to declare. (2023 Translational Gastroenterology and Hepatology. All rights reserved.)
Databáze:	MEDLINE
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