Divisions of Infectious Diseases, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
Crit Rev Microbiol. 2012 Feb;38(1):52-93. doi: 10.3109/1040841X.2011.638273.
It has been more than 25 years since Mycobacterium paratuberculosis was first proposed as an etiologic agent in Crohn's disease based on the isolation of this organism from several patients. Since that time, a great deal of information has been accumulated that clearly establishes an association between M. paratuberculosis and Crohn's disease. However, data are conflicting and difficult to interpret and the field has become divided into committed advocates and confirmed skeptics. This review is an attempt to provide a thorough and objective summary of current knowledge from both basic and clinical research from the views and interpretations of both the antagonists and proponents. The reader is left to draw his or her own conclusions related to the validity of the issues and claims made by the opposing views and data interpretations. Whether M. paratuberculosis is a causative agent in some cases or simply represents an incidental association remains a controversial topic, but current evidence suggests that the notion should not be so readily dismissed. Remaining questions that need to be addressed in defining the role of M. paratuberculosis in Crohn's disease and future implications are discussed.
自从首次提出分枝杆菌（Mycobacterium paratuberculosis）可能是克罗恩病（Crohn's disease）的病因以来，已经超过 25 年了。该理论基于从几位患者中分离出这种病原体。从那时起，已经积累了大量的信息，明确地确立了分枝杆菌与克罗恩病之间的关联。然而，数据存在冲突且难以解释，该领域已分为坚定的支持者和明确的怀疑论者。本综述试图从基础和临床研究两个方面，从反对者和支持者的角度和解释，对当前的知识进行全面和客观的总结。读者可以根据对立观点和数据解释提出的问题和主张的有效性，得出自己的结论。分枝杆菌是否是某些病例的致病因素，或者只是偶然的关联，仍然是一个有争议的话题，但目前的证据表明，不应轻易否定这一观点。讨论了在确定分枝杆菌在克罗恩病中的作用以及未来影响方面需要解决的剩余问题。
