Juste Ramón A, Elguezabal Natalia, Pavón Andrés, Garrido Joseba M, Geijo Mariví, Sevilla Iker, Cabriada José L, Tejada Angel, García-Campos Francisco, Casado Roberto, Ochotorena Itziar, Izeta Ander
Departamento de Producción y Sanidad Animal, Instituto Vasco de Investigación y Desarrollo Agrario (NEIKER), Berreaga, 1, 48160 Derio, Bizkaia, Spain.
Int J Infect Dis. 2009 Mar;13(2):247-54. doi: 10.1016/j.ijid.2008.06.034. Epub 2008 Oct 15.
Similarities between human inflammatory bowel disease (IBD) and ruminant paratuberculosis have fueled a heated discussion on the role of Mycobacterium avium subsp. paratuberculosis (MAP) in the etiology of IBD.
In order to determine microbiological and immunological evidence of an association between MAP and IBD, blood from 222 inflammatory bowel disease patients and 80 healthy donors from the Basque Country (Spain) were subjected to nested PCR for MAP-specific insertion sequence IS900, interferon-gamma (IFN-gamma) release test with PPA-3 MAP antigen (IFNMAP) or phosphate-buffered saline (IFNPBS), and antibody ELISA with PPA-3 MAP antigen (ABMAP).
Highly significant differences in the proportion of PCR-positive IBD patients (17%) and healthy controls (43%) as well as lower IFNMAP and higher ABMAP and IFNPBS responses were observed. Treatment was associated with decreases in IFNMAP and PCR-positive frequency.
These results indicate the existence of immune responses and treatment interactions with MAP that strongly support an etiological role of this agent in IBD.
人类炎症性肠病（IBD）与反刍动物副结核病之间的相似性引发了关于鸟分枝杆菌副结核亚种（MAP）在IBD病因学中作用的激烈讨论。
为了确定MAP与IBD之间关联的微生物学和免疫学证据，对来自西班牙巴斯克地区的222例炎症性肠病患者和80名健康供者的血液进行了针对MAP特异性插入序列IS900的巢式PCR、使用PPA-3 MAP抗原的干扰素-γ（IFN-γ）释放试验（IFNMAP）或磷酸盐缓冲盐水（IFNPBS），以及使用PPA-3 MAP抗原的抗体ELISA（ABMAP）。
观察到PCR阳性的IBD患者比例（17%）与健康对照（43%）之间存在高度显著差异，以及较低的IFNMAP和较高的ABMAP及IFNPBS反应。治疗与IFNMAP和PCR阳性频率的降低有关。
这些结果表明存在与MAP的免疫反应和治疗相互作用这强烈支持了该病原体在IBD中的病因学作用。
