Molecular identification of MAP in oral biopsies of Crohn's disease patients

[kiny]

http://www.gutpathogens.com/content/5/1/18/abstract

Gut Pathogens, July 2013

 

[Kev]

OK, so I'm not the sharpest tool in the shed. Let me see if I got this right? 8 out of 12 people with known CD demonstrated lesions attributable to MAP. And 1 person out of 11, with no known CD (at this time) also demonstrated these same lesions. And, the group behind this study aren't maintaining that this demonstrates proof positive that any causative link exists between MAP and CD; merely that.. if present, these MAP lesions may be useful as a diagnostic, or pre-diagnostic indicator of CD. So, if I've got it right, then (based on the numbers of this study) those with the MAP lesions are 8 times more likely to have CD than not. I may have interpreted it wrong.. or I may be mis-stating the results I've read. But, to my un-educated eye, this appears to be another brick in the case against MAP as the culprit behind CD.. or at least more occurences of same.

 

[kiny]

OK, so I'm not the sharpest tool in the shed. Let me see if I got this right? 8 out of 12 people with known CD demonstrated lesions attributable to MAP. And 1 person out of 11, with no known CD (at this time) also demonstrated these same lesions. And, the group behind this study aren't maintaining that this demonstrates proof positive that any causative link exists between MAP and CD; merely that.. if present, these MAP lesions may be useful as a diagnostic, or pre-diagnostic indicator of CD. So, if I've got it right, then (based on the numbers of this study) those with the MAP lesions are 8 times more likely to have CD than not. I may have interpreted it wrong.. or I may be mis-stating the results I've read. But, to my un-educated eye, this appears to be another brick in the case against MAP as the culprit behind CD.. or at least more occurences of same.

Hmmmm,

IS900 serum PCR has been negative twice for me, two different labs. Blood is likely much more unreliable than tissue. Maybe I have it, maybe I don't. Only a positive result would tell anything.

-Ok so for the intestinal tissue, colonscopy is probably more reliable, but again, the size of a biopsy is the size of a pindrop, it's minuscule.

-So even more reliable would be transmural tissue, but unless the person had surgery, you can't measure the deeper tissue.

-Another place to look would be fistula, but again, unless the person had a fistula you could get to, you can't measure it.

-Another place to look would be the duodenum, hasn't been tested yet afaik in people, but it's been suggested. You can get to the duodenum with an gastro-endoscope through the mouth and you can take a biopsy of it very easily.


NOW, for the mouth ulcers...well why are they there in crohn's disease, it's another event that is hard to explain without having some sort of intracellular infection. So taking a biopsy of them as part of a diagnostic feature might be helpful.

Does this show that MAP is causing the inflammation in those people...I don't know. It's there...it's extremely hard to kill...it's hard to test for...it's unreliable to test for....in some studies it is never found...in some it is found a lot....what's going on here...it needs more research.

Is crohn's disease even one disease? Does the fact they find different pathogens, MAP, AIEC, Campylobacter, mean that crohn's disease could be split in different types.

Crohn's disease is not some sort of autoimmunity where autoantibodies react against some sort of self-antigen, crohn's diseasse is a direct response to a specific antigen from the environment.

So does AIEC btw, AIEC is found a lot, with high consistency in CD people with ileal disease, a lot more than MAP I would say.

 

[Malgrave]

This is not directly about MAP and is an old article, but still interesting about the possible role of bacteria in the formation of epithelioid granulomas and their role in CD:

http://gut.bmj.com/content/54/2/223.full

 

[kiny]

This is not directly about MAP and is an old article, but still interesting about the possible role of bacteria in the formation of epithelioid granulomas and their role in CD:

http://gut.bmj.com/content/54/2/223.full

thank you

"It is plausible that granulomas develop only when specific bacterial components are present"

they look strikingly like intestinal TB granuloma

Hope your kiddo is doing well.