Abstract
BackgroundThe cause of Crohn's Disease (CD) remains unknown. Recently a decrease in the global lymphocyte population in the peripheral blood of CD patients has been reported. This decrease was more evident in γδ T lymphocytes, especially γδ CD8+T subsets. Furthermore, a decrease of IL-7 was also observed in these patients. We propose the hypothesis that microsporidia, an obligate intracellular opportunistic parasite recently related to fungi, in CD patients can take advantage of the lymphocytes and IL-7 deficits to proliferate and to contribute to the pathophysiology of this disease.Methods and FindingsIn this case-control study, serum samples were collected from 36 CD patients and from 36 healthy individuals (controls), IgE and IgG anti-Encephalitozoon antibodies were determined by ELISA; and forty-four intestinal tissue samples were analyzed through real time Polymerase Chain Reaction (PCR), twenty CD patients, nine with others diseases and 15 healthy subjects.We observed that IgE anti-Encephalitozoon levels were significantly higher in patients with CD: 0.386(±0.256) vs control group, 0.201(±0.147), P<0.001. However, IgG anti-Encephalitozoon values were significantly lower in CD patients: 0.361(±0.256) vs control group, 0.876(±0.380), P<0.001. In the group of CD patients, 6/20 (30%) were positive by real time PCR for microsporidia and, all the patients of the control group were negative by real time PCR.ConclusionsThese results suggest that CD patients are a group at risk for microsporidiasis and, moreover that microsporidia may be involved as a possible etiologic factor of CD.
Highlights
The cause of Crohns disease (CD) remains unknown
These results suggest that Crohn’s Disease (CD) patients are a group at risk for microsporidiasis and, that microsporidia may be involved as a possible etiologic factor of CD
CD3, CD19 for the peripheral blood subpopulations and CD4, CD8, CD56, CD2, CD3, CD19, TCRab y TCRcd for the T cd lymphocytes study. cd T lymphocyte populations were analyzed with Phycoerythrin-Cyanine 5.1 (PC5) conjugated anti-human TCR c-d (Beckman Coulter, Miami, FL). ab T lymphocytes were analyzed with Phycoerythrin-Cyanine 5.1 (PC5) conjugated anti-human TCR a-b (Clone: IP26A) (Beckman Coulter, Miami, FL)
Summary
The cause of Crohns disease (CD) remains unknown. Much of the research on CD pathogenesis has been focused on immunology and especially on the role of lymphocytes in this disease. Cases in HIV-negative people, including travellers and elderly people, are increasing [11], [12] and it has been recently suggested that the incidence of microsporidial infections in healthy population is much higher than previously reported [13,14,15]. These opportunistic pathogens can cause a variety of systemic and non systemic manifestations; chronic diarrhea is the most common one [3]. We propose the hypothesis that microsporidia, an obligate intracellular opportunistic parasite recently related to fungi, in CD patients can take advantage of the lymphocytes and IL-7 deficits to proliferate and to contribute to the pathophysiology of this disease
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