Abstract
BackgroundInflammatory bowel disease (IBD) is described as a relapsing condition with high morbidity and uncertain complex pathogenesis. The association of Mycobacterium avium ssp. paratuberculosis (MAP) with Crohn’s disease (CD) in human has been debated for decades, however there is no confirmed data to verify such relations in Iran. The aim of this study was to investigate risk factors and a possible role of MAP in Iranian patients with CD.MethodsAnti-MAP antibodies were detected in serum of IBD patients and subjects without IBD (nIBD) through ELISA; MAP DNA and viable MAP cells were identified in patients’ biopsies through nested PCR and direct culture methods, respectively. Principal component analysis (PCA) was used to investigate the risk factors in relation to IBD and MAP infection.ResultsPositivity for IS900 PCR was detected in 64% (n = 18) of CD, 33% (n = 10) of ulcerative colitis (UC) and 9.7% (n = 6) of nIBD samples. Live MAP cells were isolated from biopsies of 2 CD patients only. Among 28 patients with CD, 46% (n = 13) and 39% (n = 11) were positive for antibodies against MAP3865c133–141 and MAP3865c125–133 peptides, respectively, whereas much lower seroreactivity was detected in UC subjects accounting for 3% (n = 1) for MAP3865c133–141 and 16.7% (n = 5) for MAP3865c125–133. A high immune reactivity to MAP epitopes among CD patients was positively correlated with consumption of fast food meals and IBD familiarity. For both CD and UC, breastfeeding period and consumption of fruit/vegetables presented negative correlation with the presence of anti-MAP antibodies.ConclusionsThis study provided evidences that high prevalence of MAP DNA and anti-MAP antibodies in CD patients is significantly associated with the development of CD. Despite the role of several factors contributing to IBD, the presence of MAP DNA and anti-MAP antibodies in Iranian CD patients highlights a possible transmission of MAP from animal-derived products to humans.
Highlights
Inflammatory bowel disease (IBD) is described as a relapsing condition with high morbidity and uncertain complex pathogenesis
Mycobacterium avium ssp. paratuberculosis (MAP) was cultured in Herrold’s egg medium plus mycobactin J from biopsies of two Crohn’s disease (CD) patients, both of them were positive in enzyme-linked immunosorbent assay (ELISA) and PCR tests
MAP specific IS900 gene was detected by nested PCR in 64% of CD (n = 18), 33% of ulcerative colitis (UC) (n = 10) and 9.7% of nIBD (n = 6) samples; the IS900 positivity was not reflected by the presence of anti-MAP Abs in 11 cases among patients only, 6 of them showed high Abs titers (Table 1)
Summary
Inflammatory bowel disease (IBD) is described as a relapsing condition with high morbidity and uncertain complex pathogenesis. Crohn’s disease (CD) and ulcerative colitis (UC) are the main types of inflammatory bowel disease (IBD) described as a relapsing condition with high morbidity and uncertain pathogenesis. In line with the high incidence of IBD in American and European countries, most information regarding epidemiology, symptoms, risk factors and etiology of IBD are described based on the local populations [7, 8]. The etiology of IBD is largely complex and unknown, it is thought to be caused by a combination of genetic and environmental factors that affect the immune responses. Paratuberculosis (MAP)—a causative agent of Johne’s disease (JD) in domestic and wild ruminants, seems to be important in the pathogenesis of IBD, despite conflicting reports on its possible role in the disease. Some studies showed the involvement of MAP in CD in genetically susceptible individuals [9,10,11], whereas other reports could not confirm such findings [12,13,14]
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