Antimicrobial Susceptibility Testing for Three Malassezia Species

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kiny

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Malassezia was also found in the pediatric study I posted below.

As far as itraconazole, it's a very common medication used to treat fungi infections. It wouldn't be rocket science to try it to treat crohn's disease in a study, so it's odd there haven't been any so far. Many people with crohn's disease on anti-TNF would have been prescribed itraconazole to deal with fungi infections. There has been only one study that suggested the patients that were being treated with itraconazole for secondary fungi infections also had improvement in crohn' disease. I have been on a course of itraconazole but my crohn's is in remission so it's impossible to judge if that treatment had any effect on my crohn's disease.

The debate about the presence of MCT in EN is interesting. While MCT is technically a saturated fat, they have a short carbon chain length and they're soluble in water, which is how they mix easily in EN. It's also why you can absorb MCT easily, relatively speaking. Because of how certain fungi like Malassezia use fatty acids it's an interesting debate.

ASCA tests are sometimes done to differentiate between Crohn's and UC, ASCA test is positive in over half of Crohn's patients and in about 30 percent of people who later develop crohn's disease. ASCA positivity is very rare in UC. ASCA, or IgG against Saccharomyces cerevisiae, baker's yeast, used to brew beer and bread right. The ASCA antibody detects a carbohydrate cell wall of S. cerevisiae, but it's not very specific, which suggest it could be detecting an immune response against other fungi.

At lease one study has shown that IgG tests against S. cerevisiae are associated with intestinal presence of Malassezia, specifically M. restricta, correlating with disease activity in crohn's disease.
 
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It's interesting to look at Paracoccidioidomycosis studies from South America, especially in young adults, an age groups that match crohn's disease unset.

They can develop intestinal manifestation of fungi infections that closely mimic crohn's disease, typical transmural inflammation with pockets of granuloma. They often get treated with itraconazole.

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Not too long ago, IL-17 blockers which are used to treat other inflammatory diseases, were tried to treat to crohn's disease, with rather disastrous consequences, crohn's disease patients became much sicker on IL-17 blockers, even though IL-17 is highly elevated in crohn's disease tissue. It can not be overstated how sick crohn's disease patient became when IL-17 was blocked, trials had to be immediately stopped.

IL-17 is secreted by pro-inflammatory Th17 and CD8 T cells. Th17 also secrete IL-23, IL-23 blockers are sometimes used to treat crohn's disease. Even thought these cells are involved in inflammaton, blocking IL-17 is disastrous in crohn's disease.

What's interesting is that Th17 is very active during fungi infections with Candida albicans, both in the intestine and lungs.
 
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