BACKGROUND: Crohn's disease, a form of inflammatory bowel disease, resembles some aspects of tuberculosis, leprosy, and paratuberculosis. The role of Mycobacterium avium subspecies paratuberculosis (MAP) in Crohn's disease is controversial.
METHODS: We tested for MAP by PCR and culture in buffy coat preparations from 28 individuals with Crohn's disease, nine with ulcerative colitis, and 15 without inflammatory bowel disease.
FINDINGS: MAP DNA in uncultured buffy coats was identified by PCR in 13 (46%) individuals with Crohn's disease, four (45%) with ulcerative colitis, and three (20%) without inflammatory bowel disease. Viable MAP was cultured from the blood of 14 (50%) patients with Crohn's disease, two (22%) with ulcerative colitis, and none of the individuals without inflammatory bowel disease. Current use of immunosuppressive medication did not correlate with a positive MAP culture. Sequencing of PCR products from MAP cultures confirmed the presence of the MAP-specific IS900 fragment. Among 11 MAP isolates assessed, we identified nine strains that were not identical.
INTERPRETATION: We detected viable MAP in peripheral blood in a higher proportion of individuals with Crohn's disease than in controls. These data contribute to the evidence that MAP might be a cause of Crohn's disease.
}, year = {2004}, journal = {Lancet (London, England)}, volume = {364}, pages = {1039-44}, month = {2004 Sep 18-24}, issn = {1474-547X}, doi = {10.1016/S0140-6736(04)17058-X}, language = {eng}, }