Cows, Crohn's and more: is Mycobacterium paratuberculosis a superantigen?

The plausibility of a causal role of Mycobacterium avium subspecies paratuberculosis (MAP) in Crohn's disease has gone from controversial to compelling. This century old debate is resolving because of unfolding understanding of shared genetic susceptibilities for Crohn's and mycobacterial infection in addition to newer laboratory tests to detect MAP which have linked MAP and Crohn's. Mycobacterial heat shock proteins are associated with a multitude of "autoimmune" diseases, including Type 1 diabetes mellitus (T1DM) and the initiating events of atherosclerosis. These heat shock proteins may come from MAP; this article postulates a causal role for MAP in multiple inflammatory and "autoimmune" diseases.