Treatment of severe Crohn's disease using antimycobacterial triple therapy — approaching a cure?

Borody, Thomas J.; Leis, Sharyn; Warren, Eloise F.; Surace, Rosa

doi:10.1016/s1590-8658(02)80056-1

Cited by 94 publications

(47 citation statements)

References 49 publications

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“…In this connection, Borody et al [27] treated a series of 12 patients suffering from severe, obstructive, or penetrating CD with a triple Proper sample manipulation and accurate procedures may allow to overcome the difficulties related to possible contamination troubles which may otherwise invalidate the analysis; stool samples have the advantage of being easier to come by than blood and/or biopsies and offer another field where the MAP presence can be researched.…”

Section: Discussionmentioning

confidence: 99%

Fecal Detection of Mycobacterium avium Paratuberculosis Using the IS900 DNA Sequence in Crohn’s Disease and Ulcerative Colitis Patients and Healthy Subjects

et al. 2011

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The possibility to track the MAP presence in human feces represents a new approach to the "MAP hypothesis". Detection of MAP DNA in feces is very common, reaching very high prevalence both in CD and in UC and even in HC. Our findings seem consistent with a high prevalence of MAP asymptomatic infection among the general population and so the possible involvement of MAP in CD pathogenesis could be linked to a specific immune defective response.

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Section: Discussionmentioning

confidence: 99%

Fecal Detection of Mycobacterium avium Paratuberculosis Using the IS900 DNA Sequence in Crohn’s Disease and Ulcerative Colitis Patients and Healthy Subjects

et al. 2011

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“…52 In subjects whose sera tested positive for antigens against MAP, early uncontrolled trials suggested antibiotics against MAP could induce symptomatic improvement. [53][54][55] A large randomized controlled in trial from Australia found an early clinical benefit of antibiotics for MAP in addition to steroids compared to placebo (week 16, 66% v. 50%, p D 0.02). 56 Unfortunately there were no changes in inflammatory parameters, endoscopic endpoints, or maintenance of remission As of this writing, a Phase III trial is underway to further explore the use of antibiotics against MAP in Crohn's disease (NCT01951326).…”

Section: Specific Bacteria Are Associated With Ibdmentioning

confidence: 99%

Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease

2017

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Inflammatory bowel disease (IBD) is a complex set of diseases that lead to chronic inflammation in the gastrointestinal tract. Although the etiology of IBD is not fully understood, it is well-known that the intestinal microbiota is associated with the development and maintenance of IBD. Manipulation of the gut microbiota, therefore, may represent a target for IBD therapy. Fecal microbiota transplantation (FMT), where fecal microbiota from a healthy donor is transplanted into a patient's GI tract, is already a successful therapy for Clostridium difficile infection. FMT is currently being explored as a potential therapy for IBD as well. In this review, the associations between the gut microbiota and IBD and the emerging data on FMT for IBD will be discussed.

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“…32 Additionally, some patients with Crohn's disease respond to antimycobacterial therapy. 14 Mononuclear phagocytes play a pivotal role in the detection and elimination of pathogenic microorganisms and initiation of an adaptive immune response. 8,11,51,87 Despite this, pathogenic mycobacteria have developed mechanisms to survive within mononuclear phagocytes by blocking or modulating macrophage antimicrobial activities.…”

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confidence: 99%

Review Paper: Modulation of Mononuclear Phagocyte Function byMycobacterium aviumsubsp.paratuberculosis

Weiss

Souza

2008

Vet Pathol

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Abstract. Pathogenic mycobacteria are highly adapted for survival within host mononuclear phagocytes. This is largely due to the organism's capacity to prevent macrophage activation, block phagosome acidification and maturation, and attenuate presentation of antigens to the immune system. Mycobacterium avium subsp. paratuberculosis (MAP) is one such organism that modulates the ruminant innate immune response. It is the causative agent in paratuberculosis, a chronic progressive granulomatous enteritis in ruminants. MAP initially interacts with cell membrane receptors on bovine mononuclear phagocytes and initiates cell signaling responses and phagocytosis. Mannosylated liparabinomannan (Man-LAM) is a major component of the MAP cell wall that interacts with the cell membrane of mononuclear phagocytes and may be a major virulence factor. Toll-like receptor 2 (TLR2) has been incriminated as major signaling receptor that binds to MAP and initiates signaling though the mitogen-activated protein kinase (MAPK)-p38 pathway. This pathway induces transcription of interleukin (IL)-10. Early production of IL-10 suppresses proinflammatory cytokines, chemokines, IL-12, and major histocompatability factor class-II expression. Both IL-10 dependent and IL-10 independent mechanisms appear to be involved in attenuation of phagosome acidification and phagolysosome fusion. Many of the suppressive effects of MAP on bovine mononuclear phagocytes can be reproduced by exposure of bovine monocytes to Man-LAM. Therefore, MAP Man-LAM-induced TLR2-MAPK-p38 signaling with resultant excessive IL-10 expression has emerged as one of the mechanisms by which MAP organisms suppress inflammatory, immune, and antimicrobial responses and promote their survival within host mononuclear phagocytes.

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Treatment of severe Crohn's disease using antimycobacterial triple therapy — approaching a cure?

Cited by 94 publications

References 49 publications

Fecal Detection of Mycobacterium avium Paratuberculosis Using the IS900 DNA Sequence in Crohn’s Disease and Ulcerative Colitis Patients and Healthy Subjects

Fecal Detection of Mycobacterium avium Paratuberculosis Using the IS900 DNA Sequence in Crohn’s Disease and Ulcerative Colitis Patients and Healthy Subjects

Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease

Review Paper: Modulation of Mononuclear Phagocyte Function byMycobacterium aviumsubsp.paratuberculosis

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