Mycobacterium avium Subspecies paratuberculosis Infection in Cases of Irritable Bowel Syndrome and Comparison with Crohn's Disease and Johne's Disease: Common Neural and Immune Pathogenicities

Abstract

Mycobacterium avium subsp. paratuberculosis causes Johne's disease, a systemic infection and chronic inflammation of the intestine that affects many species, including primates. Infection is widespread in livestock, and human populations are exposed. Johne's disease is associated with immune dysregulation, with involvement of the enteric nervous system overlapping with features of irritable bowel syndrome in humans. The present study was designed to look for an association between Mycobacterium avium subsp. paratuberculosis infection and irritable bowel syndrome. Mucosal biopsy specimens from the ileum and the ascending and descending colon were obtained from patients with irritable bowel syndrome attending the University of Sassari, Sassari, Sardinia, Italy. Crohn's disease and healthy control groups were also included. Mycobacterium avium subsp. paratuberculosis was detected by IS900 PCR with amplicon sequencing. Data on the potential risk factors for human exposure to these pathogens and on isolates from Sardinian dairy sheep were also obtained. Mycobacterium avium subsp. paratuberculosis was detected in 15 of 20 (75%) patients with irritable bowel syndrome, 3 of 20 (15%) healthy controls, and 20 of 23 (87%) people with Crohn's disease (P ‫؍‬ 0.0003 for irritable bowel syndrome patients versus healthy controls and P ‫؍‬ 0.0000 for Crohn's disease patients versus healthy controls). One subject in each group had a conserved single-nucleotide polymorphism at position 247 of IS900 that was also found in isolates from seven of eight dairy sheep. There was a significant association (P ‫؍‬ 0.0018) between Mycobacterium avium subsp. paratuberculosis infection and the consumption of handmade cheese. Mycobacterium avium subsp. paratuberculosis is a candidate pathogen in the causation of a proportion of cases of irritable bowel syndrome as well as in Crohn's disease.

Commensal Bugs from the Gut-Shaping Human Health and Disease

“…This in turn may cause significant changes in water and electrolyte transport in the colon which result in diarrhea [96,97]. Malabsorption of carbohydrates may cause increase in the level of hydrogen production, which is associated with diarrhea predominant IBS (IBS-D) [98]. On the other hand, excess methane gas production is associated with constipation predominant IBS (IBS-C) [96].…”

Environmental Triggers of Type 1 Diabetes Mellitus – Mycobacterium Avium Subspecies Paratuberculosis

“…However, with newer laboratory techniques, primarily PCR, evidence of MAP is readily found in Crohn's tissues (Chiodini, 1989;McFadden et al, 1987); it can be visualized within the granulomas by in situ hybridization (Sechi, 2001): and, with extreme care and patience, MAP can be grown from the gut and blood of Crohn's patients (Naser et al, 2004(Naser et al, , 2009Sechi et al, 2005). MAP has also been reported as a candidate pathogen in the causation irritable bowel syndrome (Scanu et al, 2007) and some suspect that MAP causes the spectrum of inflammatory bowel disease including Crohn's, ulcerative colitis and irritable bowel syndrome (Pierce, 2010). Irritable bowel syndrome is a widespread abdominal condition that affects about 10 to 15% of people in the industrialized economies of Europe, North America, Australasia, and Japan, with a rising prevalence among the populations in the developing economies of Asia.…”

Risk Factors for the Presence of Mycobacterium avium spp. paratuberculosis in Human Intestinal Biopsies in Brazil

“…paratuberculosis and CD [15]. A study performed by Scanu, et al (2007) in the United Kingdom supplied data on the potential risk factors for human exposure to some pathogens; these authors found that MAP is a candidate pathogen of cases of IBD and CD, and there was a significant association between MAP infection and the consumption of handmade cheese in CD patients [16]. Zamani, et al (2017) also found high immune reactivity to MAP epitopes among CD patients, which was positively correlated with the consumption of fast food meals and a family history of IBD.…”