Couple of further points to add to kiny's excellent responses.
This study found 92% of CD sufferers infected with MAP (link).
This study demonstrated that MAP-infected macrophages produce excess amounts of of TNF (link).
Another bug linked to CD is AIEC. Again, AIEC-infected macrophages also produce excess TNF (link).
We have two bugs linked to CD and both invade immune cells and the invaded immune-cells produce excess amounts of TNF. Could this excess TNF cause the inflammation and ulcers in CD?
In one way or another, CD drugs reduce/inhibit TNF in the gut.
- Corticosteroids can improve Crohn’s and corticosteroids inhibit TNF (link).
- Naltrexone can improve Crohn’s and Naltrexone inhibits TNF (link).
- Mesalamine can improve Crohn’s and Mesalamine inhibits TNF (link).
- Enbrel, Remicade and Humira can all improve Crohn’s and all are anti-TNF drugs.
- Ect.
So, how would the excess TNF cause the inflammation/ulcers in CD - what's the elusive disease-causing mechanism
?
This article (link) discusses the miss-labelling of Crohn's as an autoimmune disease, when really it's a chronic inflammatory disorder of unknown cause; in others words, drop the autoimmune-disease label because it's not so! Even Wiki (lol) is saying CD is not an autoimmune disease: "Crohn's disease has wrongly been described as an autoimmune disease in the past; recent investigators have described it as an immune deficiency state"
Again, could the excess TNF from infected immune cells cause CD?
Excess TNF affects the functioning of immune cells (link)... and immune cells protect the gut-lining from damage by normal gut bacteria.
Additionally, there's an aspect of Crohn's missed by everyone... why doesn't the damn inflammation/ulcers/fistulas heal? (Keep in mind that CD is NOT an autoimmune disease)
Excess TNF is linked to non-healing wounds (and obviously non-healing inflammation). Excess TNF up-regulates MMIF (Macrophage migration inhibitory factor). MMIF plays a central role in wound healing. EMPHASIS:
MMIF plays a central role in wound healing!
So, could the excess TNF play a dual role in CD?
1. Indirectly cause the gut damage by preventing immune cells from clearing bacteria from the gut-lining.
2. Prevent/delay the gut damage (inflammation/ulcers) from healing.
Food for thought...
(Can't include links 'cause I've got less than 10 posts).