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Yes, I went! It was great. John Aitken had some amazing pics to show linking MAP to Crohn's disease and I got to sit in on discussions with the docs about different treatment options and the new therapies coming in the next few years. Overall, it's hard to argue that MAP (or a mutation) isn't the trigger for most Crohn's patients after the info presented. I am working on getting the videos of the talks online at TheCrohnsInfection.org and doing a post-symposium blog. Will keep you up to date and will post here! Thanks for your interest and hope you are well.
 
irishgal said:
John Aitken had some amazing pics to show linking MAP to Crohn's disease and I got to sit in on discussions with the docs about different treatment options and the new therapies coming in the next few years. Overall, it's hard to argue that MAP (or a mutation) isn't the trigger for most Crohn's patients after the info presented.
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I am very interested to learn more about what John Aitken presented, please let us know asap! I have seen the images from Prof John Hermon-Taylor's MAP test and they are also very exciting and compelling, however, as with any unpublished work which has not been independently verified there needs to be a degree of caution.
 
John Aitken had some critical info about the organism related to Crohn's, which he is now calling Son of MAP. He had scanning electron microscope pics of it and had identified distinct states, including a persistor state which is often found in long term Crohn's cases. It produces biofilm. He showed a picture of a plate where he grew it in only four days. The medium was completely absorbed by the massive organism growth in a wave like pattern. Apparently, he's easily figured out what this organism likes to eat! I wish I had taken better notes! I'm going to wait until the video comes out before saying any more in case I recall incorrectly.

Dr. Collins' talk was very compelling too, since he linked MAP to Crohn's and described Johne's disease in cattle. He has found viable MAP in a good portion of infant formula, which is scary. Also, he said he once bought what appeared to be a healthy cow because he was convinced it had MAP/Johne's and wanted to test it. Sure enough, even though it looked fine, it was riddled with MAP. Must be hard for farmers to know which cows are sick if they don't show syptoms! I'll defer to the video for the exact stats, but I'm pretty sure he said that 91% of US dairy herds have a MAP infection somewhere. I wasn't aware it was that high.

Amy Hermon-Taylor's talk was also interesting. She not only described their new diagnostic (which is critical) but talked about the vaccine. As I understand it, it will not only help keep people from getting MAP, but also remidiate those who are already infected. A more modern vaccine. About the diagnostic, she described how it would attach to MAP cells in the body and then they would glow green, showing where the MAP is present. I think the pics were mouse intestines, so not sure if it's been done in humans, but if not, that's coming. Again, I will defer to the video replay! As soon as I see it, I will post a link. Amy was such a nice, kind person. She had even just celebrated her 40th birthday the previous week, but made sure she was here to present! There was a huge cake at the Meet and Greet. It was wonderful to meet so many patients who had been successful wih AMAT like I have.

Truly an honor and priviledge to meet all of these docs and researchers who have done so much for Crohn's patients! Crossing my fingers for a video soon, though I think everyone's recouping. I know it took most of the week for me, and I got to sit in the audience! It's a lot of information to absorb over a short period of time.
 
JMC - as always, a degree of caution is critical. I think everyone there would agree on one thing: more research is necessary to put an end to this debate, but they're getting closer each year! Both Amy's and Dr. Chamberlin's projects need to be fully tested in humans, but they show promising preliminary response. It's too bad the govt won't step in and fund it all at once.
 
irishgal said:
John Aitken had some critical info about the organism related to Crohn's, which he is now calling Son of MAP. He had scanning electron microscope pics of it and had identified distinct states, including a persistor state which is often found in long term Crohn's cases. It produces biofilm. He showed a picture of a plate where he grew it in only four days. The medium was completely absorbed by the massive organism growth in a wave like pattern. Apparently, he's easily figured out what this organism likes to eat! I wish I had taken better notes! I'm going to wait until the video comes out before saying any more in case I recall incorrectly.
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One of the difficulties (on many levels) with MAP is that it grows so slowly. If John Aitken has identified another faster growing mycobacterium variant connected with Crohn's it could be a very significant breakthrough.
 
irishgal said:
About the diagnostic, she described how it would attach to MAP cells in the body and then they would glow green, showing where the MAP is present. I think the pics were mouse intestines, so not sure if it's been done in humans, but if not, that's coming.
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It has been used to test on a small number of human samples - I have been tested. The key next step is getting the test completed, at the moment it is still in development, and getting the results published so that other people can test the same technique and verify the results.
 
Very cool JMC! John grew my sample at one point, so I know how it feels to have contributed to such significant science. :) One thing that was evident in Chicago but not clear to me prior, was that the need for an accurate diagnostic is critical. John and Amy are looking at that issue from different angles. Where Amy is using a mechanized, high tech method, John is using tried and true old school lab principles. They may both end up with a viable diagnostic. I wonder if they could use each other's test as verification or somehow work together?

Yes, John's growth of the organism is very significant, since growing it has been the bane of many researchers' work! I know from other published literature that cow MAP is clearly not the same as human MAP since it sheds it's cell wall in humans. So in that regard, it's already a variant. I think John mentioned that what he was growing form Crohn's patients was a variant he called Son of MAP, but not sure he mentioned what made it different. He was clear that he could grow large amounts of this in culture. I wonder if it's more the media that he's perfected rather than a fast growing variant? He hasn't published yet, so hoping that his video replay will include the slideshow, but I can understand if he wants to wait until he publishes.

End of the day, great things coming in the next couple of years for Crohn's patients that will hopefully make some of us well!!! Hope you are all feeling well too. :)
 
Thank you for the updates, irishgal, I'm looking forward to viewing the video.

I am not familiar with John Aitken's work, particularly on the diagnostics front. I think RedHill will likely be first to come out with a clinical test since they are applying it in their current Phase III anti-MAP trials, with Quest Diagnostics, at least in the U.S., being the commercial testing facility. This is based on the technology developed by UCF and other researchers.

I appreciate your cautious tone too in stating that current R&D may yield relief for some of us and not promising cures for all. I don't think this disease is that simple that one mode of treatment will cover all cases.
 
I was referred to John by Dr. Chamberlin as someone who could test me for the organism (MAPish) that he was studying. I don't believe he's been very public about his research until now. I also met the RedHill group. Nice guys with a heart for Crohn's patients. Hoping their study shows clear evidence of improvement after AMAT. I figured they must be testing somehow, but didn't know which test they were using. I believe Patrick McLean said something in his talk that they took all Crohn's patients without narrowing them down to MAP positive people since a standard test isn't available. I think that's been the biggest problem for most researchers. Not to say they aren't testing them (sounds like they are!), but the govt has yet to determine which test is the one to use.

I'm always cautious. :thumright: I've been through too much as a Crohn's patient to get my hopes up that there's a quick fix. For now, AMAT is working brilliantly, so I'll take what I can get!! Hope you are well too.
 
irishgal said:
Yes, John's growth of the organism is very significant, since growing it has been the bane of many researchers' work! I know from other published literature that cow MAP is clearly not the same as human MAP since it sheds it's cell wall in humans. So in that regard, it's already a variant. I think John mentioned that what he was growing form Crohn's patients was a variant he called Son of MAP, but not sure he mentioned what made it different. He was clear that he could grow large amounts of this in culture. I wonder if it's more the media that he's perfected rather than a fast growing variant?
Click to expand...

I think it is very unlikely that it is the media, MAP divides only every 22 hours, which is why it can take up to 6 months to grow a positive culture. If JA is able to grow the bacteria in a matter of hours, it is clearly something different and significant if he can prove it is pathogenic. Also remember, there are thousands of variants of Mycobacteria (just search for "mycobacterium classification") so this could be a new branch of MAP which previously had not been differentiated from "regular" MAP. Exciting stuff.
 
Yes, it's some type of relative, but definitely MAP. Maybe it mutated!? Scary thought. He had a great slide which showed 3-4 reasons why it was like MAP, and one why it was different. I wish I had written it down or could remember why it was different! I was on fumes by then, since I had gotten up very early to catch my flight and was sans coffee. Hopefully the powerpoint slides will be part of the video! Regardless, it was cool from a micro point of view to see the thing I believe is making me sick somehow.
 
irishgal said:
Yes, it's some type of relative, but definitely MAP. Maybe it mutated!? Scary thought. He had a great slide which showed 3-4 reasons why it was like MAP, and one why it was different. I wish I had written it down or could remember why it was different! I was on fumes by then, since I had gotten up very early to catch my flight and was sans coffee. Hopefully the powerpoint slides will be part of the video! Regardless, it was cool from a micro point of view to see the thing I believe is making me sick somehow.
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Were the presentations recorded?
 
PPK, yes. They will be up on TheCrohnsInfection.org as soon as we get them from the videographer. I'll post as soon as they're up here.
 
ppk said:
What a fantastic introduction from Dr. Chamberlin. I look forward to watching the other presentations.
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Thank you for posting this. Fascinating. I'm looking forward to viewing the rest of the speakers' presentations.
 
Second video is up at TheCrohnsInfection.org. It's Dr. Michael Collins' talk about MAP being a zoonosis. The other topics are excellent, especially for Crohn's patients, but this talk has applicability for the entire human population - not just Crohn's patients. It's scary, and a bit controversial. He doesn't mince words. I was so upset when I saw my brand of formula in his Powerpoint. This is a critical issue that the governments are ignoring, but I have a feeling this video may start a firestorm. Watch, and let me know what you think. Maybe I'm overreacting because I'm already infected?

If you want, share this video with your friends and people on social media. It's a topic of critical importance, and I bet a lot of people would be interested to know what Dr. Collins has to say!
 
irishgal said:
Second video is up at TheCrohnsInfection.org. It's Dr. Michael Collins' talk about MAP being a zoonosis. The other topics are excellent, especially for Crohn's patients, but this talk has applicability for the entire human population - not just Crohn's patients. It's scary, and a bit controversial. He doesn't mince words. I was so upset when I saw my brand of formula in his Powerpoint. This is a critical issue that the governments are ignoring, but I have a feeling this video may start a firestorm. Watch, and let me know what you think. Maybe I'm overreacting because I'm already infected?

If you want, share this video with your friends and people on social media. It's a topic of critical importance, and I bet a lot of people would be interested to know what Dr. Collins has to say!
Click to expand...

Rather surprisingly, in my opinion. it has been known for years that milk and infant formula are infected with MAP and it has largely been ignored. I have said to several friends and relatives that when it is finally generally acknowledged that MAP is pathogenic in humans and causes Crohn's disease it will be a health/food crisis which will eclipse even CJD/"mad cow disease" and salmonella in eggs.
 
I absolutely agree JMC. I can't believe the govts are still ignoring this, despite the enormous amount of evidence! Very frustrating. They regulate everything else, so why not this too!! I have a feeling that the answer (at least in the US) lies with the political lobbies and that they have no way to easily clean up the problem now. They need the solution in place before they declare it a pathogen. In the meantime, another generation gets exposed. Sorry for the rant! Like you, it's hard to see something like this and have no power to change it.

Plus, I forget that not everyone has seen the full set of videos like those of us who were there. It's clear that this is causing at least some of the Crohn's cases from the later presentations, especially John Aitken's work.
 
irishgal said:
Second video is up at TheCrohnsInfection.org. It's Dr. Michael Collins' talk about MAP being a zoonosis...
Click to expand...

Thanks IrishGal. I watched the second video.

I've been following the MAP story about 3 years since ds, hoping it's the answer. Some of the papers I read early on brought up a good point that still nags at me. The paradox is that if dairy cattle are the source of MAP in our food chain, you'd expect the incidence of Crohn's in dairy farmer populations to be significantly higher than the general population. But it turns out to be the opposite, it's somewhat rare for the farmers. You'd think they'd be eating and breathing the bacteria at far greater concentrations than the rest of us.

Mind you, I'm not poo-poo'ing anything. It's just something that puzzles me. Of course there's counter-arguments such hygiene hypothesis, perhaps lower exposure to processed foods, etc. But then those factors don't align with distribution of genetic predisposition factors within the overall population that includes farmers.

I don't have the papers at hand to reference here but I will try to find them again.

I'm curious what some of you think about this?
 
xeridea:

"You might expect that occupations resulting in frequent exposure to MAP-infected animals, such as dairy farmers and vets, would be associated with a higher risk of Crohn’s Disease, but in fact, data from the US show that these occupations are associated with a significantly reduced death rate from Inflammatory Bowel Disease1. Children exposed to farm animals, particularly cattle, in early life also subsequently have a lower incidence of CD2, and in many countries Crohn’s Disease is more common in towns and cities than in the countryside.

The explanation of this apparent paradox lies in the fact that Mycobacterium avium
subspecies paratuberculosis (MAP) can exist in (and switch between) two forms:

The ‘extracellular’ form (i.e. adapted to live outside of other cells) has an outer ‘capsule’. It is easy to see under an ordinary light microscope because the capsule soaks up and retains a special red stain called Ziehl-Neelsen (ZN) stain, commonly used in medicine to identify Mycobacteria in particular. This form of MAP, excreted by the trillion by heavily infected animals, is not one to which humans are particularly susceptible and exposure to it is likely to confer some natural immunity against disease. It has been shown that occupational exposure to MAP is associated with raised levels of antibodies against MAP. The urban preponderance of CD is probably not that townsfolk have an increased susceptibility to CD but rather that country folk have some natural protection3.
The ‘intracellular’ form (i.e. adapted to live inside other cells) sheds its capsule and in doing so becomes invisible to ZN staining procedures, since it is the capsule which picks up the stain. This ‘naked’ form, which is still very tough, is more virulent to humans and is the form found in people with Crohn’s disease. MAP adopts this form after being taken up into white blood cells in the animal’s bloodstream and tissues. These white blood cells containing MAP bugs then pass into the milk. After a while, MAP in the environment also gets taken up by single-celled amoeba-like organisms called ‘protists’ which again enhances virulence to humans. Humans are therefore exposed to the virulent intracellular form of MAP both via milk from infected cows and via water supplies from contaminated rivers.
As with almost everything to do with MAP, the truth is more complicated than it first appears and what actually happens turns out to be the opposite of what you would expect."

http://crohnsmapvaccine.com/faq/why-dont-dairy-farmers-and-vets-get-crohns-disease-more-often/
 
Funny that this came up today, as I just completed the Patrick McLean transcript this morning, for his portion of the symposium video. When we get it up, you will see he is clear that Crohn's is just like the H. pylori case, where no one believed that it was a bacteria, and then it was finally proven when Marshall infected himself. The thing with MAP is that it is probably not able to be killed like H. pylori, so infecting someone will likely give them Crohn's symptoms for life. AMAT would help, but it's not curative. Even if someone volunteered, I doubt any research would do it because of the ethical issues.

Also interesting - you know Dr. Borody, one of the pioneers of AMAT, is a collegue of Dr. Marshall and worked on the H. pylori case.
 
ppk said:
Someone should infect themselves with MAP and prove it causes Crohn's like lesions on Peyer's patches and GI distress, much like Dr. Barry Marshall did with H. pylori. This is one way to prove Koch's Postulates. Only problem would be curing the person after they infected themselves...

http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-ulcer-solved-medical-mystery
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There are two problems:
1) Unless you have the genetic fault in your innate immune system you may not develop any disease
2) There isn't currently any guaranteed way to get rid of MAP if you are unfortunate enough to have a deficient immune system, so now you are stuck with it
 
JMC said:
There are two problems:
1) Unless you have the genetic fault in your innate immune system you may not develop any disease
2) There isn't currently any guaranteed way to get rid of MAP if you are unfortunate enough to have a deficient immune system, so now you are stuck with it
Click to expand...

Heh, my thoughts exactly. But still, it would be nice if we could do something like this and get more proof/recognition for the MAP theory of Crohn's. I also think some forms of Crohn's-like disease result from a dysbiosis with high loads of AIEC and also from an inappropriate immune reaction to commensal bacteria.
 
sir.clausin said:
xeridea:
The ‘intracellular’ form (i.e. adapted to live inside other cells) sheds its capsule and in doing so becomes invisible to ZN staining procedures, since it is the capsule which picks up the stain. This ‘naked’ form, which is still very tough, is more virulent to humans and is the form found in people with Crohn’s disease. MAP adopts this form after being taken up into white blood cells in the animal’s bloodstream and tissues."
http://crohnsmapvaccine.com/faq/why-dont-dairy-farmers-and-vets-get-crohns-disease-more-often/
Click to expand...

Thanks for the explanation/reference, Sir Clausin.

I have a follow on question if anyone's willing to entertain it. I guess more about immunology than MAP at this point. If the MAP is cloaked within host cells, what's the signalling for the inflammatory processes? Are the host cells somehow saying I'm infected, kill me, and then the body attacking those white blood or epithelial cells? Or is it when the plasma form somehow escapes the protection of those cells that an immune response happens? Also given white blood cells have about a week's lifetime, what happens to the MAP inside them when the infected white blood cell dies. Do they just get release back into the bloodstream, or do they die with their host? Or is this where the innate system breakdown happens -- phagocytes can't sweep in and clean up the debris?
 
xeridea said:
I have a follow on question if anyone's willing to entertain it. I guess more about immunology than MAP at this point. If the MAP is cloaked within host cells, what's the signalling for the inflammatory processes? Are the host cells somehow saying I'm infected, kill me, and then the body attacking those white blood or epithelial cells? Or is it when the plasma form somehow escapes the protection of those cells that an immune response happens? Also given white blood cells have about a week's lifetime, what happens to the MAP inside them when the infected white blood cell dies. Do they just get release back into the bloodstream, or do they die with their host? Or is this where the innate system breakdown happens -- phagocytes can't sweep in and clean up the debris?
Click to expand...

I put this question to JHT apparently the answer is in this paper:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258034/

Amy H-T has also promised me a simpler answer which should be easier to understand for the layman.
 
JMC said:
I put this question to JHT apparently the answer is in this paper:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258034/

Amy H-T has also promised me a simpler answer which should be easier to understand for the layman.
Click to expand...

Thanks JMC. I perused the paper quickly and it's fascinating. I'm really interested in this topic, so I will go back over it and study it in detail over the next few days.

While I have your attentions, what's your take on the whole genetic susceptibility factor? Do ruminants that come down with JD have the same mutations as human CD patients that are infected with MAP? I wonder if anyone's done GWAS on cattle.

I will post questions about Crohn's Map Vaccine (CMV) here too, since you mention Prof/Dr. Hermon-Taylor. I believe CMV uses the Adenovirus 5 (Ad5) vector. Some humans have built up antibodies against this virus and will neutralize it. Will the CMV trials be structured to take this into account and do titers to measure antibody against Ad5 in recruiting subjects?
 
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xerida - I'm not sure of the exact mechanism, but I believe the organism builds up biofilm, and it's the biofilm that gives people the inflammatory response. I'm sure it's much more complicated than that, but biofilm is very bad stuff and John Aitken mentions in his talk that this organism uses it as a protection mechanism. I need to go back and see what he said exactly. I also know it forms a persistor form, which I have, so i found this article helpful on understanding the role and treatment of persistor states in Crohn's.

http://www.nature.com/emi/journal/v3/n1/full/emi20143a.html

JMC - will read that article, but not at 11:30pm. :) Thanks for sharing and I'd love to hear Amy's take on it!
 
xeridea said:
I believe CMV uses the Adenovirus 5 (Ad5) vector. Some humans have built up antibodies against this virus and will neutralize it. Will the CMV trials be structured to take this into account and do titers to measure antibody against Ad5 in recruiting subjects?
Click to expand...

From Amy: "The antiMAP priming vaccine is manufactured for humans using Oxford's new ChAdOx2 adenovirus vector derived from Chimpanzees which is not affected by antibodies to human adenovirus. "
 
JMC said:
From Amy: "The antiMAP priming vaccine is manufactured for humans using Oxford's new ChAdOx2 adenovirus vector derived from Chimpanzees which is not affected by antibodies to human adenovirus. "
Click to expand...

That's terrific.

Maybe I'm just paying more attention to developments in this area but sure does feel like there's a building momentum on the MAP front. I'm looking forward to more details as research continues and trials play out. I just watched Patrick McLean's video over on thecrohnsinfection site. No new information really, but I do get the feeling that they're onto something, even if it works only with a subset of patients, it will help shift the focus from thinking the immune system willy-nilly is attacking the host or commensal bacteria, to acknowledging that there's an infective agent that has to be dealt with.
 
Yes - Patrick's talk is up!

http://thecrohnsinfection.org/symposium-information/

He's not able to give info on how the RedHill study is going since the info is confidential, but the thing I found most interesting about his talk was the comparison of AMAT used in the Selby study (which was flawed on a number of fronts) and the Accent I trial for Remicade. No one thinks twice about prescribing Remicade, but the data from even a flawed AMAT study shows AMAT works better than Remicade!

They are definitely building momentum. In two years this will be a totally different landscape. Lots of hopeful things going on for Crohn's patients!
 
And what is curious about Redhill trials of RHB-104 is that they're promulgating that perhaps MS is a MAP-induced disease by way of molecular mimicry evoking an autoimmune like response. We will likely see some results from their MS study earlier than their CD trial interim reports.
 
I agree xerida. The MS study with RHB104 is a stage II proof of concept study, so those seem shorter than the phase III full blown, large scale trials. I'm very interested to see if this will work in MS. That would indicate that MAP is responsible for more than one autoimmune disease.
 
Haha JMC - You know, I almost put autoimmune in quotes, but I was too tired when I was writing this and got lazy. In my head, I always say autoimmune with a skeptical emphasis.

Love chatting with all of you on the forum! Finally, people who get it! I just finished transcribing John's symposoum presentation yesterday evening, and there's one part where he refers to the reaction of his collegues when he starts talking about MAP: "Nurse, nurse! He's out of bed again!" That's exactly how I feel when I try to talk to non-MAPers about MAP.
 
GeneThera, a company that provides diagnostic equipment to test for Johne's disease, has this press release regarding the symposium.

No new information really, but does provide a little more exposure to the symposium in mainstream media.
 
Thanks for posting this xeridea! I saw this yesterday and was thrilled that the symposium site was mentioned on CNN. Tony Milici is a very intelligent researcher who has come up with a solution for the Johne's MAP problem, which will hopefully allow for new safety regulations to be easily implemented in the future. These are the type of solutions we need to get this issue fixed.
 
Bonus footage from the Chicago Crohn's MAP symposium! At the last minute, world renown gastroenterologist Dr. David Rubin, from the University of Chicago medical Center, gave a presentation. He talks about MAP, the microbiome, how he got started as a GI and what he sees for the future of IBD. Lots of great info!

http://thecrohnsinfection.org/symposium-information/
 

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