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Expert Rev Gastroenterol Hepatol. 2015;9(12):1523-34. doi: 10.1586/17474124.2015.1093931. Epub 2015 Oct 16.

Mycobacterium paratuberculosis as a cause of Crohn's disease.

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a 1 Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
b 2 Pulmotect, Inc., Houston, TX, USA.
c 3 Bahrain Gastroenterology and Hepatology Center at Bahrain Specialist Hospital, Manama, Kingdom of Bahrain.
d 4 Department of Medicine, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, TX, USA.


Crohn's disease is a chronic inflammatory bowel disease of unknown cause, affecting approximately 1.4 million North American people. Due to the similarities between Crohn's disease and Johne's disease, a chronic enteritis in ruminant animals caused by Mycobacterium avium paratuberculosis (MAP) infection, MAP has long been considered to be a potential cause of Crohn's disease. MAP is an obligate intracellular pathogen that cannot replicate outside of animal hosts. MAP is widespread in dairy cattle and because of environmental contamination and resistance to pasteurization and chlorination, humans are frequently exposed through contamination of food and water. MAP can be cultured from the peripheral mononuclear cells from 50-100% of patients with Crohn's disease, and less frequently from healthy individuals. Association does not prove causation. We discuss the current data regarding MAP as a potential cause of Crohn's disease and outline what data will be required to firmly prove or disprove the hypothesis.


Crohn’s disease; Helicobacter pylori; Inflammatory bowel disease; Johne’s disease; Mycobacterium avium subspecies paratuberculosis; prevention; treatment trials

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