Naser Saleh A, Ghobrial George, Romero Claudia, Valentine John F
Department of Molecular Biology and Microbiology and Biomolecular Science Center, Burnett College of Biomedical Sciences, University of Central Florida, Orlando, FL 32816, USA.
Lancet. 2004;364(9439):1039-44. doi: 10.1016/S0140-6736(04)17058-X.
Crohn's disease, a form of inflammatory bowel disease, resembles some aspects of tuberculosis, leprosy, and paratuberculosis. The role of Mycobacterium avium subspecies paratuberculosis (MAP) in Crohn's disease is controversial.
We tested for MAP by PCR and culture in buffy coat preparations from 28 individuals with Crohn's disease, nine with ulcerative colitis, and 15 without inflammatory bowel disease.
MAP DNA in uncultured buffy coats was identified by PCR in 13 (46%) individuals with Crohn's disease, four (45%) with ulcerative colitis, and three (20%) without inflammatory bowel disease. Viable MAP was cultured from the blood of 14 (50%) patients with Crohn's disease, two (22%) with ulcerative colitis, and none of the individuals without inflammatory bowel disease. Current use of immunosuppressive medication did not correlate with a positive MAP culture. Sequencing of PCR products from MAP cultures confirmed the presence of the MAP-specific IS900 fragment. Among 11 MAP isolates assessed, we identified nine strains that were not identical.
We detected viable MAP in peripheral blood in a higher proportion of individuals with Crohn's disease than in controls. These data contribute to the evidence that MAP might be a cause of Crohn's disease.
克罗恩病是炎症性肠病的一种形式，在某些方面类似于结核病、麻风病和副结核病。副结核分枝杆菌（MAP）在克罗恩病中的作用存在争议。
我们通过聚合酶链反应（PCR）和培养法，对28例克罗恩病患者、9例溃疡性结肠炎患者以及15例无炎症性肠病患者的血沉棕黄层样本进行了MAP检测。
通过PCR检测发现，未培养的血沉棕黄层样本中，13例（46%）克罗恩病患者、4例（45%）溃疡性结肠炎患者以及3例（20%）无炎症性肠病患者存在MAP DNA。从14例（50%）克罗恩病患者的血液中培养出了活的MAP，2例（22%）溃疡性结肠炎患者培养出了活的MAP，无炎症性肠病患者的血液中均未培养出。目前使用免疫抑制药物与MAP培养阳性无相关性。对MAP培养物的PCR产物进行测序，证实存在MAP特异性IS900片段。在评估的11株MAP分离株中，我们鉴定出9株不同的菌株。
我们检测到，克罗恩病患者外周血中活的MAP比例高于对照组。这些数据为MAP可能是克罗恩病病因的证据提供了支持。
