JMC, what is your opinion on the fact scientists are finding reduced diversity in good bacteria which regulate inflammation and the potential these missing bacteria could be the cause of inflammation in IBD?
Wildbill,
I am not sure my opinion is of any great value, I am just a Crohn's patient,with a scientific background (PhD in Physics) who has read several hundred scientific papers on a subject that caught my interest - the relationship between MAP and Crohn's. From what I have read, MAP is a
very credible candidate for being the cause of Crohn's, but I also accept that more research and better tools (tests and treatments) are needed to finally close the case.
For what it is worth, my opinion would be: what is causing the reduction in diversity of the good bacteria in IBD patients? Without a clear model explaining how and why that happens, the observation is of limited value.
Also, how do you explain the reports we have regarding Fecal Transplants to have induced long remissions in IBD both crohn's?
I am aware of fecal transplants and the work of Prof Thomas Borody. Have you watched
this? My understanding is that it is an effective treatment for ulcerative colitis, rather than Crohn's.
Is it possible that the restoration of good bacteria that are missing and which regulate inflammation could have initiated a remission or a cure?
I can believe you may be able to achieve remission, just as I believe it may be possible through eating a very restrictive diet. I doubt however, it is a cure unless you can explain how your microbiota got into a bad state in the first place and can prevent that from happening again.
How do you think these facts relate to what you know about MAP and the cause of crohn's disease?
Currently, I believe Crohn's is caused by an immune deficiency which makes us susceptible to mycobacterial infections (specifically Mycobacterium avium sub-species Paratuberculosis). Once a MAP infection becomes established you will suffer immune dysregulation in the gut, chronic inflammation and changes in the microbiota. I like this
infographic.
So the important steps:
1) Immune deficiency
2) MAP infection
3) Microbiota changes
I think you need to address the problem at the earliest point in the chain, how is a fecal transplant going to achieve that?
Were you previously aware of these facts i just provided?
Mostly, yes.
Do you believe these scientific findings have any relevance to the treatment of IBD?
Yes, especially if they provide a safer way of achieving remission than the current crop of biologic therapies.
I'm interested in learning more details of MAP in regards to crohn's/IBD but tentatively I suspect that map is not of any causative relationship and is just another pathogen among others like AIEC that will be abolished with a fecal transplant when the missing bacteria in IBD patients are restored.
I believe we have a immune deficiency and replacing the missing good bacteria will only be a temporary fix unless you address the underlying cause.