Hermon-Taylor J, Moss M, Tizard M, Malik Z, Sanderson J
Baillieres Clin Gastroenterol. 1990 Mar;4(1):23-42. doi: 10.1016/0950-3528(90)90037-h.
A Glasgow surgeon, T.K. Dalziel, published a detailed description of chronic enteritis in humans in 1913. He proposed that the disease was caused by the same organisms as those responsible for chronic enteritis, Johne's disease, in animals described a few years earlier (1895). Dalziel's dilemma was that he could see acid-fast bacilli in the diseased animal tissues but not in the diseased human tissues. Little real progress in the medical understanding of the causes of chronic enteritis in humans occurred over the next half a century or more. From 1978, a decade of research in many laboratories using improved methods for the culture of environmental mycobacteria showed that these could be grown in bacillary form from about one in five cases of Crohn's disease, from the same proportion of cases of ulcerative colitis, and from about one in ten control tissues. Spheroplasts were grown from two in five cases of Crohn's disease, one in five cases of ulcerative colitis, and rarely from control tissues. The nature of these agents was often uncertain. We describe work which began in 1985 and led rapidly to the identification of IS900, a DNA repetitive element in an uncharacterized Crohn's disease mycobacterial isolate. With other isolates, these were then shown by DNA fingerprinting to be indistinguishable from Mycobacterium paratuberculosis, Johne's bacillus. Similar techniques also demonstrated the wood-pigeon strain of M. avium in some Crohn's disease cultures. This bacillus can also cause chronic enteritis in calves. IS900 is the first of a family of unusual DNA insertion sequences which extend widely throughout environmental mycobacteria. Use of assays based on PCR amplification of highly specific DNA sequences from these insertional elements, and recombinant and synthetic peptides from their predicted proteins, will revolutionize the detection and characterization of these agents. These methods, applied to animal, human and environmental samples, will indicate new ways for the prevention and treatment of chronic enteritis, as well as other disorders associated with infections by environmental mycobacteria.
1913年，格拉斯哥的外科医生T.K. 达尔齐尔发表了一篇关于人类慢性肠炎的详细描述。他提出，这种疾病是由与几年前（1895年）所描述的动物慢性肠炎即副结核（约内氏病）相同的病原体引起的。达尔齐尔的困境在于，他在患病动物组织中能看到抗酸杆菌，而在患病人类组织中却看不到。在接下来的半个多世纪里，医学上对人类慢性肠炎病因的理解几乎没有取得实质性进展。从1978年起，许多实验室进行了长达十年的研究，采用了改进的环境分枝杆菌培养方法，结果表明，约五分之一的克罗恩病病例、相同比例的溃疡性结肠炎病例以及约十分之一的对照组织中能够培养出杆菌形态的这类病菌。五分之二的克罗恩病病例、五分之一的溃疡性结肠炎病例中培养出了原生质球，对照组织中很少培养出原生质球。这些病原体的性质往往难以确定。我们描述了始于1985年的一项研究工作，该工作迅速导致了IS900的鉴定，IS900是一种未鉴定的克罗恩病分枝杆菌分离株中的DNA重复元件。通过DNA指纹图谱分析，发现这些分离株与副结核分枝杆菌（约内氏杆菌）无法区分。类似技术还在一些克罗恩病培养物中证实了鸟分枝杆菌的木鸽菌株。这种杆菌也可引起犊牛慢性肠炎。IS900是一类不寻常的DNA插入序列家族中的第一个成员，这类序列广泛存在于环境分枝杆菌中。利用基于PCR扩增这些插入元件高度特异性DNA序列以及其预测蛋白的重组和合成肽的检测方法，将彻底改变对这些病原体的检测和鉴定。将这些方法应用于动物、人类和环境样本，将为慢性肠炎以及与环境分枝杆菌感染相关的其他疾病的预防和治疗指明新方向。
