Crohn's & MAP: new official review by a committee of UK government

[Malgrave]

On 26.02.2015 the Advisory Committee on Dangerous Pathogens met to review the issue of MAP in Crohn's disease for the first time since 2005. This review was requested by Jeremy Hunt (Secretary of State for Health). Their report has just been published online and you can read it on our news page here:

http://crohnsmapvaccine.com/review-...ubsp-paratuberculosis-map-and-crohns-disease/

The original source of this document is:
https://www.gov.uk/government/groups/advisory-committee-on-dangerous-pathogens
You will find it under 'Minutes' by clicking on 'Minutes, papers and agendas'

Dr Irene Grant, commissioned to write the report, is a senior lecturer in Microbiology and food safety at Queens University Belfast. Whilst she maintains that 'it is difficult to draw firm conclusions about MAP in CD at present', she does highlight the following statement from Dr Ingrid Olsen (Norwegian MAP expert): 'Together with all the genetic susceptibility data emerging over the last decade, it is very hard to reject the hypothesis of mycobacteria being involved in the development of CD in at least a sub-cohort of patients'. Her report also identifies, specifically in regard to MAP testing, that 'further research is clearly needed'.

 

[JMC]

I have read the article a couple of times and unfortunately, in my opinion at least, it falls short of what I would expect from a professional scientific review. The author notes that the last review was in 2005/06, yet then fails to clearly establish the position at that date and the change in the evidence for or against in the intervening years. Surely, that is the most important question that needs to be answered, is the evidence converging towards MAP being the cause of Crohn's or it the evidence becoming weaker as the laboratory tools and theories advance?

Obviously, having read a huge number of papers, I know my opinion on the direction of travel - the evidence for MAP as the cause has grown, not diminished over the last ten years. However, it would have been nice to read it from a person who states, on their own website, that their primary research interest is MAP, that the evidence continues to grow, rather than the watered down, sitting-on-the-fence paper we got.

 

[rollinstone]

I have read the article a couple of times and unfortunately, in my opinion at least, it falls short of what I would expect from a professional scientific review. The author notes that the last review was in 2005/06, yet then fails to clearly establish the position at that date and the change in the evidence for or against in the intervening years. Surely, that is the most important question that needs to be answered, is the evidence converging towards MAP being the cause of Crohn's or it the evidence becoming weaker as the laboratory tools and theories advance?

Obviously, having read a huge number of papers, I know my opinion on the direction of travel - the evidence for MAP as the cause has grown, not diminished over the last ten years. However, it would have been nice to read it from a person who states, on their own website, that their primary research interest is MAP, that the evidence continues to grow, rather than the watered down, sitting-on-the-fence paper we got.

Hopefully there'll be no fence sitters left after the rhb results are in.

 

[JMC]

I am actually tempted to write to Dr Irene R. Grant and challenge her specifically on the content of that paper as I don't understand why it has not provided a more definitive answer one way or the other. To me, it smells of external pressure...

 

[perfectjelly]

Hopefully there'll be no fence sitters left after the rhb results are in.

Pharmaceutical companies, especially the ones with the big biologic drug patents (Remicade, Humira and the dozens in research, like Morgensen,Entyvio) will, obviously, do everything to obfuscate and discredit every result from these and other studies regarding MAP or any other infectious hypothesis in IBD.

 

[rbvashi80]

I strongly believe in this hypothesis. As there evidence that many patient with CD like illness got treated with anti tuberculosis (anti TB treatment) in developing world like India.

Intestinal Tuberculosis (caused by Mycobacterium Tuberculosis) have similar manifestation as CD. Many times there symptoms overlaps with each other.

 

[Malgrave]

Rbvashi, oh yes! And this case report is very interesting:

http://www.hindawi.com/journals/crim/2010/695461/

 

[JMC]

And this, Crohn's fistulas are hard to distinguish from tuberculosis:

http://www.crohnsforum.com/showpost.php?p=889752&postcount=44