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Moghadam M, Ghaemi EA, Akbari H, Razavi Nikoo H, Zamani S. Mycobacterium avium subsp. paratuberculosis and Hashimoto’s thyroiditis: Is MAP the trigger? Front Cell Infect Microbiol 2022; 12:972929. [PMID: 36204645 PMCID: PMC9530259 DOI: 10.3389/fcimb.2022.972929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/08/2022] [Indexed: 12/01/2022] Open
Abstract
Hashimoto’s thyroiditis (HT) is an autoimmune disorder of the thyroid gland that can cause hypothyroidism. As HT is a multifactorial disorder, activation of immune responses in genetically predisposed individuals exposed to some environmental factors can contribute to it. Microorganisms, as environmental factors, including Mycobacterium avium ssp. paratuberculosis (MAP) by molecular mimicry, can be important in this autoimmune disorder. This study aimed to investigate the association between MAP and HT. This case–control study included 110 participants consisting of 60 HT patients and 50 healthy controls (HCs). Blood samples were collected. Nested PCR of the IS900 gene determined the presence of MAP DNA. The enzyme-linked immunosorbent assay (ELISA) was designed to identify antibodies (Abs) against the MAP3865c epitope, which has a homologous sequence with ZnT8 in the sera. The demographic information of all participants was recorded. Anti-TG, anti-TPO, TSH, anemia, and ruminant exposure were higer in HT patients than in the HCs (p < 0.05). MAP IS900 was detected significantly more in the patients (46.6% consisting of 30, 8.3, and 8.3% in clinical, subclinical, and unknown) than in the HCs (14%). The sera showed a remarkable frequency of reactivity against MAP3865c in the patients (38.3%) in comparison to the HCs (10%) (p = 0.0001). Furthermore, a significantly higher rate of livestock contact and traditional dairy consumption was found in individuals with MAP or anti-MAP3865c Abs positive result (p < 0.05). This study suggests a possible link between MAP and HT. These findings indicated that MAP frequency was not statistically different in the severity of HT and its shift into the clinical and subclinical forms; therefore, it could be assumed that MAPs are the initiators of the process. The results imply on a possible zoonosis transmission route of MAP from livestock products to humans. Further research is needed to confirm these results in larger groups of HT patients.
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Affiliation(s)
- Maedeh Moghadam
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ezzat Allah Ghaemi
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hamideh Akbari
- Department of Endocrinology, Clinical Research Development Unit (CRDU), Sayad Shirazi hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hadi Razavi Nikoo
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Samin Zamani
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- *Correspondence: Samin Zamani,
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Agrawal G, Aitken J, Hamblin H, Collins M, Borody TJ. Putting Crohn's on the MAP: Five Common Questions on the Contribution of Mycobacterium avium subspecies paratuberculosis to the Pathophysiology of Crohn's Disease. Dig Dis Sci 2021; 66:348-358. [PMID: 33089484 PMCID: PMC7577843 DOI: 10.1007/s10620-020-06653-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 02/06/2023]
Abstract
For decades, Mycobacterium avium subspecies paratuberculosis (MAP) has been linked to the pathogenesis of Crohn's disease. Despite many investigations and research efforts, there remains no clear unifying explanation of its pathogenicity to humans. Proponents argue Crohn's disease shares many identical features with a granulomatous infection in ruminants termed Johne's disease and similarities with ileo-cecal tuberculosis. Both are caused by species within the Mycobacterium genus. Sceptics assert that since MAP is found in individuals diagnosed with Crohn's disease as well as in healthy population controls, any association with CD is coincidental. This view is supported by the uncertain response of patients to antimicrobial therapy. This report aims to address the controversial aspects of this proposition with information and knowledge gathered from several disciplines, including microbiology and veterinary medicine. The authors hope that this discussion will stimulate further research aimed at confirming or refuting the contribution of MAP to the pathogenesis of Crohn's disease and ultimately lead to advanced targeted clinical therapies.
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Affiliation(s)
- Gaurav Agrawal
- Gastroenterology and Infectious Diseases, Centre for Digestive Diseases, Sydney, Australia.
- Guy's and St. Thomas' NHS Foundation Trust & King's College, London, UK.
| | - John Aitken
- Microbiology, Otakaro Pathways, Christchurch, New Zealand
| | - Harrison Hamblin
- Gastroenterology and Infectious Diseases, Centre for Digestive Diseases, Sydney, Australia
| | - Michael Collins
- Veterinary Microbiology, Department of Pathobiological Sciences, University of Wisconsin, Madison, USA
| | - Thomas J Borody
- Gastroenterology and Infectious Diseases, Centre for Digestive Diseases, Sydney, Australia
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Presence of Infection by Mycobacterium avium subsp. paratuberculosis in the Blood of Patients with Crohn's Disease and Control Subjects Shown by Multiple Laboratory Culture and Antibody Methods. Microorganisms 2020; 8:microorganisms8122054. [PMID: 33371478 PMCID: PMC7767509 DOI: 10.3390/microorganisms8122054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/08/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023] Open
Abstract
Mycobacterium avium subspecies paratuberculosis (MAP) has long been suspected to be involved in the etiology of Crohn's disease (CD). An obligate intracellular pathogen, MAP persists and influences host macrophages. The primary goals of this study were to test new rapid culture methods for MAP in human subjects and to assess the degree of viable culturable MAP bacteremia in CD patients compared to controls. A secondary goal was to compare the efficacy of three culture methods plus a phage assay and four antibody assays performed in separate laboratories, to detect MAP from the parallel samples. Culture and serological MAP testing was performed blind on whole blood samples obtained from 201 subjects including 61 CD patients (two of the patients with CD had concurrent ulcerative colitis (UC)) and 140 non-CD controls (14 patients in this group had UC only). Viable MAP bacteremia was detected in a significant number of study subjects across all groups. This included Pozzato culture (124/201 or 62% of all subjects, 35/61 or 57% of CD patients), Phage assay (113/201 or 56% of all subjects, 28/61 or 46% of CD patients), TiKa culture (64/201 or 32% of all subjects, 22/61 or 36% of CD patients) and MGIT culture (36/201 or 18% of all subjects, 15/61 or 25% of CD patients). A link between MAP detection and CD was observed with MGIT culture and one of the antibody methods (Hsp65) confirming previous studies. Other detection methods showed no association between any of the groups tested. Nine subjects with a positive Phage assay (4/9) or MAP culture (5/9) were again positive with the Phage assay one year later. This study highlights viable MAP bacteremia is widespread in the study population including CD patients, those with other autoimmune conditions and asymptomatic healthy subjects.
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Honap S, Johnston E, Agrawal G, Al-Hakim B, Hermon-Taylor J, Sanderson J. Anti- Mycobacterium paratuberculosis (MAP) therapy for Crohn's disease: an overview and update. Frontline Gastroenterol 2020; 12:397-403. [PMID: 35401965 PMCID: PMC8989010 DOI: 10.1136/flgastro-2020-101471] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/28/2020] [Accepted: 06/14/2020] [Indexed: 02/06/2023] Open
Abstract
The role of Mycobacterium avium subspecies paratuberculosis (MAP) in the pathogenesis of Crohn's disease (CD) has been strongly debated for many years. MAP is the known aetiological agent of Johne's disease, a chronic enteritis affecting livestock. At present, due to the paucity of high-quality data, anti-MAP therapy (AMT) is not featured in international guidelines as a treatment for CD. Although the much-quoted randomised trial of AMT did not show sustained benefits over placebo, questions have been raised regarding trial design, antibiotic dosing and the formulation used. There are several lines of evidence supporting the CD and MAP association with uncontrolled and controlled trials demonstrating effectiveness, including a retrospective review of cases treated at our own institution. Here, we provide an overview of the evidence supporting and refuting AMT in CD before focussing on updates of the current research in the field, including the ongoing trials with the novel RHB-104 formulation and the MAP vaccine trial. While controversial, gastroenterologists are often asked about long-term combination antibiotic therapy for CD. There has been broadcast and social media coverage surrounding this, particularly with regard to current trials. Although patients should not be deterred from treatments of proven effectiveness, this review aims to help with commonly asked questions and highlights our own approach for the use of anti-MAP in specific circumstances.
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Affiliation(s)
- Sailish Honap
- IBD Centre, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | - Emma Johnston
- Department of Gastroenterology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Gaurav Agrawal
- IBD Centre, Guy's and Saint Thomas' NHS Foundation Trust, London, UK,Department of Nutritional Sciences, King's College London, London, UK
| | - Bahij Al-Hakim
- IBD Centre, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | | | - Jeremy Sanderson
- IBD Centre, Guy's and Saint Thomas' NHS Foundation Trust, London, UK,Department of Nutritional Sciences, King's College London, London, UK
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Paratuberculosis: A Potential Zoonosis and a Neglected Disease in Africa. Microorganisms 2020; 8:microorganisms8071007. [PMID: 32635652 PMCID: PMC7409332 DOI: 10.3390/microorganisms8071007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 01/15/2023] Open
Abstract
The Mycobacterium avium subspecies paratuberculosis (MAP) is the causative agent of paratuberculosis, which is an economically important disease of ruminants. The zoonotic role of MAP in Crohn’s disease and, to a lesser extent, in ulcerative colitis, the two major forms of idiopathic inflammatory bowel disease (IIBD), has been debated for decades and evidence continues to mount in support of that hypothesis. The aim of this paper is to present a review of the current information on paratuberculosis in animals and the two major forms of IIBD in Africa. The occurrence, epidemiology, economic significance and “control of MAP and its involvement IIBD in Africa” are discussed. Although the occurrence of MAP is worldwide and has been documented in several African countries, the epidemiology and socioeconomic impacts remain undetermined and limited research information is available from the continent. At present, there are still significant knowledge gaps in all these areas as far as Africa is concerned. Due to the limited research on paratuberculosis in Africa, in spite of growing global concerns, it may rightfully be considered a neglected tropical disease with a potentially zoonotic role.
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Rees WD, Lorenzo-Leal AC, Steiner TS, Bach H. Mycobacterium avium Subspecies paratuberculosis Infects and Replicates within Human Monocyte-Derived Dendritic Cells. Microorganisms 2020; 8:microorganisms8070994. [PMID: 32635236 PMCID: PMC7409171 DOI: 10.3390/microorganisms8070994] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Mycobacterium avium subspecies paratuberculosis (MAP), a member of the mycobacteriaceae family, causes Johne's disease in ruminants, which resembles Crohn's disease (CD) in humans. MAP was proposed to be one of the causes of human CD, but the evidence remains elusive. Macrophages were reported to be the only cell where MAP proliferates in ruminants and humans and is likely the major producer of TNFα-associated inflammation. However, whether human dendritic cells (DCs), another major antigen-presenting cell (APC), have the ability to harbor MAP and disseminate infection, remains unknown. METHODS Human monocyte-derived dendritic cells (moDCs) were infected with MAP and phagocytosis and intracellular survival were quantified by immunofluorescence (IF) and colony counts, respectively. MoDC cytokine expression was measured via ELISA and their activation state was measured via flow cytometry. RESULTS We showed that MAP can infect and replicate in human moDCs as means to evade the immune system for successful infection, through inhibition of the phago-lysosome fusion via the secretion of protein tyrosine phosphatase PtpA. This mechanism initially led to a state of tolerance in moDCs and then subsequently caused a pro-inflammatory response as infection persisted, characterized by the upregulation of IL-6 and TNFα, and downregulation of IL-10. Moreover, we showed that moDCs have the ability to phagocytose up to 18% of MAP, when exposed at a multiplicity of infection of 1:1. CONCLUSION Infection and subsequent proliferation of MAP within moDCs could provide a unique means for the dissemination of MAP to lymphoid tissue, while altering immune responses to facilitate the persistence of infection of host tissues in CD.
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Affiliation(s)
- William D. Rees
- Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, BC V5Z3J5, Canada; (W.D.R.); (A.C.L.-L.)
- BC Children’s Hospital Research Institute, Vancouver, BC V6H3N1, Canada
| | - Ana C. Lorenzo-Leal
- Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, BC V5Z3J5, Canada; (W.D.R.); (A.C.L.-L.)
- Chemical and Food Engineering Department, Universidad de las Americas Puebla, San Andres Cholula, Puebla 72810, Mexico
| | - Theodore S. Steiner
- Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, BC V5Z3J5, Canada; (W.D.R.); (A.C.L.-L.)
- BC Children’s Hospital Research Institute, Vancouver, BC V6H3N1, Canada
- Correspondence: (T.S.S.); (H.B.)
| | - Horacio Bach
- Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, BC V5Z3J5, Canada; (W.D.R.); (A.C.L.-L.)
- Correspondence: (T.S.S.); (H.B.)
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Dow CT, Sechi LA. Cows Get Crohn's Disease and They're Giving Us Diabetes. Microorganisms 2019; 7:microorganisms7100466. [PMID: 31627347 PMCID: PMC6843388 DOI: 10.3390/microorganisms7100466] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 12/20/2022] Open
Abstract
Increasingly, Johne's disease of ruminants and human Crohn's disease are regarded as the same infectious disease: paratuberculosis. Mycobacterium avium ss. paratuberculosis (MAP) is the cause of Johne's and is the most commonly linked infectious cause of Crohn's disease. Humans are broadly exposed to MAP in dairy products and in the environment. MAP has been found within granulomas such as Crohn's disease and can stimulate autoantibodies in diseases such as type 1 diabetes (T1D) and Hashimoto's thyroiditis. Moreover, beyond Crohn's and T1D, MAP is increasingly associated with a host of autoimmune diseases. This article suggests near equivalency between paucibacillary Johne's disease of ruminant animals and human Crohn's disease and implicates MAP zoonosis beyond Crohn's disease to include T1D.
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Affiliation(s)
- Coad Thomas Dow
- McPherson Eye Research Institute, University of Wisconsin, 9431 WIMR, 1111 Highland Avenue, Madison, WI 53705, USA.
| | - Leonardo A Sechi
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43b, 07100 Sassari, Italy.
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Naser A, Qasem A, Naser SA. Mycobacterial infection influences bone biomarker levels in patients with Crohn's disease. Can J Physiol Pharmacol 2018; 96:662-667. [PMID: 29638140 DOI: 10.1139/cjpp-2017-0700] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Patients with Crohn's disease (CD) have higher risk for osteoporosis following decreased level of osteocalcin. We hypothesize that active inflammation following Mycobacterium avium subsp. paratuberculosis (MAP) infection results in elevation of undercarboxylated osteocalcin (ucOC) and downregulation of active osteocalcin in CD patients and cow-disease model (Johne's disease). In this study, we measured ucOC, active osteocalcin, and calcium levels in sera from 42 cattle (21 infected with MAP and 21 healthy cattle), 18 CD patients, and 20 controls. The level of ucOC in MAP+ bovine samples was higher than that in MAP- controls (318 ± 57.2 nmol/mL vs. 289 ± 95.8 nmol/mL, P > 0.05). Consequently, mean calcium level in bovine MAP+ was significantly higher than that in bovine-MAP- samples (9.98 ± 0.998 mg/dL vs. 7.65 ± 2.12 mg/dL, P < 0.05). Also, the level of ucOC was higher in CD-MAP+ than in CD-MAP- (561 ± 23.7 nmol/mL vs. 285 ± 19.6 nmol/mL, P < 0.05). Interestingly, the mean osteocalcin level in MAP+ bovine was lower than that in MAP- bovine (797 ± 162 pg/mL vs. 1190 ± 43 pg/mL) and it was lower in CD-MAP+ than in CD-MAP- infection (1.89 ± 0.184 ng/mL vs. 2.19 ± 0.763 ng/mL) (P < 0.05). The correlation between MAP infection and elevation of sera ucOC, reduction of active osteocalcin and increased calcium supports MAP infection role in CD and complications with osteoporosis.
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Affiliation(s)
- Amna Naser
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816 USA.,Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816 USA
| | - Ahmad Qasem
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816 USA.,Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816 USA
| | - Saleh A Naser
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816 USA.,Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816 USA
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Sharp RC, Beg SA, Naser SA. Role of PTPN2/22 polymorphisms in pathophysiology of Crohn's disease. World J Gastroenterol 2018; 24:657-670. [PMID: 29456405 PMCID: PMC5807669 DOI: 10.3748/wjg.v24.i6.657] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/03/2018] [Accepted: 01/18/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To establish the relationship of protein tyrosine phosphatase non-receptor type 2 and 22 (PTPN2/22) polymorphisms and mycobacterial infections in Crohn's disease (CD). METHODS All 133 subjects' blood samples were genotyped for nine single nucleotide polymorphisms (SNPs) in PTPN2/22 using TaqMan™ genotyping, while the effect of the SNPs on PTPN2/22 and IFN-γ gene expression was determined using RT-PCR. Detection of Mycobacterium avium subspecies paratuberculosis (MAP) IS900 gene was done by nPCR after DNA extraction from the isolated leukocytes of each subjects' blood samples. T-cells isolated from the patient samples were tested for response to phytohematoagglutonin (PHA) mitogen or mycobacterial antigens by BrdU proliferation assays for T-cell activity. RESULTS Out of the nine SNPs examined, subjects with either heterozygous (TC)/minor (CC) alleles in PTPN2:rs478582 occurred in 83% of CD subjects compared to 61% healthy controls (P-values < 0.05; OR = 3.03). Subjects with either heterozygous (GA)/minor (AA) alleles in PTPN22:rs2476601 occurred in 16% of CD compared to 6% healthy controls (OR = 2.7). Gene expression in PTPN2/22 in CD subjects was significantly decreased by 2 folds compared to healthy controls (P-values < 0.05). IFN-γ expression levels were found to be significantly increased by approxiately 2 folds in subjects when either heterozygous or minor alleles in PTPN2:rs478582 and/or PTPN22:rs2476601 were found (P-values < 0.05). MAP DNA was detected in 61% of CD compared to only 8% of healthy controls (P-values < 0.05, OR = 17.52), where subjects with either heterozygous or minor alleles in PTPN2:rs478582 and/or PTPN22:rs2476601 had more MAPbacteremia presence than subjects without SNPs did. The average T-cell proliferation in CD treated with PHA or mycobacteria antigens was, respectively, 1.3 folds and 1.5 folds higher than healthy controls without any significant SNP. CONCLUSION The data suggests that SNPs in PTPN2/22 affect the negative regulation of the immune response in CD patients, thus leading to an increase in inflammation/apoptosis and susceptibility of mycobacteria.
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Affiliation(s)
- Robert C Sharp
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816, United States
| | - Shazia A Beg
- University of Central College of Medicine, Health Center, Orlando, FL 32816, United States
| | - Saleh A Naser
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816, United States
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Sharp RC, Beg SA, Naser SA. Polymorphisms in Protein Tyrosine Phosphatase Non-receptor Type 2 and 22 (PTPN2/22) Are Linked to Hyper-Proliferative T-Cells and Susceptibility to Mycobacteria in Rheumatoid Arthritis. Front Cell Infect Microbiol 2018; 8:11. [PMID: 29423382 PMCID: PMC5788942 DOI: 10.3389/fcimb.2018.00011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/09/2018] [Indexed: 12/19/2022] Open
Abstract
A shared genetic pre-disposition, chronic inflammation, and treatment with similar biologics between Rheumatoid arthritis (RA) and Crohn's disease (CD) have intrigued us to investigate whether the two disorders share trigger association or possible causation. We hypothesized earlier that Single Nucleotide Polymorphisms (SNPs) in the negative regulators Protein Tyrosine Phosphatase Non-receptor type 2 and 22 (PTPN2/22) lead to a dysregulated immune response, susceptibility to environmental triggers, and continued apoptosis as seen in chronic inflammation in RA and CD. To test the hypothesis, peripheral leukocytes samples from 132 consented subjects were genotyped for 9 SNPs in PTPN2/22 using TaqMan™ genotyping. The effect of the SNPs on PTPN2/22 and IFN-γ expression was determined using real time PCR. T-cell proliferation and response to phytohematoagglutonin (PHA) mitogen and mycobacterial antigens were determined by BrdU proliferation assay. Blood samples were also analyzed for the Mycobacterium avium subspecies paratuberculosis (MAP) IS900 gene by nPCR. Out of 9 SNPs examined, heterozygous (TC) or minor (CC) alleles of PTPN2:rs478582 occurred in 79% RA compared to 60% healthy controls (p-values ≤ 0.05; OR = 2.28). Similarly, heterozygous (GA) or minor (AA) alleles of PTPN22:rs2476601 occurred in 29% RA compared to 6% healthy controls (p-values ≤ 0.05; OR = 5.90). PTPN2/22 expression in RA was decreased by 1.2-fold compared to healthy controls. PTPN2:rs478582 upregulated IFN-γ in RA by 1.5-fold. Combined PTPN2:rs478582 and PTPN22:rs2476601 increased T-cell proliferation by 2.7-fold when treated with PHA. Surprisingly, MAP DNA was detected in 34% of RA samples compared to 8% healthy controls, (p-values ≤ 0.05, OR = 5.74). RA samples with PTPN2:rs478582 and/or PTPN22:rs2476601 were more positive for MAP than samples without polymorphisms. Combined occurrence of PTPN2:rs478582 and PTPN22:rs2476601 in association with the presence of MAP has significantly increased T-cell response and elevated IFN-γ expression in RA samples. The data suggest that genetic polymorphisms may play vital role in T-cell regulation, susceptibility to mycobacteria and ultimately response to treatment. This is the first study to report the detection of MAP DNA in the blood of RA patients; further studies are needed using larger number of samples.
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Affiliation(s)
- Robert C. Sharp
- Burnett School of Biomedical Sciences, University of Central Florida College of Medicine, Orlando, FL, United States
| | - Shazia A. Beg
- Health Center, Universtiy of Central Florida College of Medicine, Orlando, FL, United States
| | - Saleh A. Naser
- Burnett School of Biomedical Sciences, University of Central Florida College of Medicine, Orlando, FL, United States
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Chaubey KK, Singh SV, Gupta S, Singh M, Sohal JS, Kumar N, Singh MK, Bhatia AK, Dhama K. Mycobacterium avium subspecies paratuberculosis - an important food borne pathogen of high public health significance with special reference to India: an update. Vet Q 2018; 37:282-299. [PMID: 29090657 DOI: 10.1080/01652176.2017.1397301] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
This review underlines the public health significance of 'Indian Bison Type' of Mycobacterium avium subspecies paratuberculosis (MAP) and also its potential as 'zoonotic infection'. In the absence of control programs, bio-load of MAP is increasing and if we take total population of animals (500 million plus) and human beings (1.23 billion plus) into account, the number of infected animals and human beings will run into millions in India. Our research on screening of over 26,000 domestic livestock for MAP infection using 4 different diagnostic tests (microscopy, culture, ELISA and PCR), during last 31 years has shown that the average bio-load of MAP in the livestock population of India is very high (cattle 43%, buffaloes 36%, goats 23% and sheep 41%). 'Mass screening' of 28,291 human samples between 2008-2016 revealed also high bio-load of MAP. It has been proved that MAP is not in-activated during pasteurization and therefore live bacilli are continuously reaching human population by consumption of even pasteurized milk and other milk products. Live bacilli have also been recovered from meat products and the environment thus illustrating the potential of MAP as pathogen of public health concern. However, at present, there is inadequate scientific evidence to confirm a conclusive link between MAP infection and Johne's disease in ruminants and some cases of Crohn's disease in human beings.
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Affiliation(s)
- Kundan Kumar Chaubey
- a Animal Health Division, Central Institute for Research on Goats (CIRG) , Mathura , UP , India.,b Department of Microbiology and Immunology , GLA University , Mathura , UP , India
| | - Shoor Vir Singh
- a Animal Health Division, Central Institute for Research on Goats (CIRG) , Mathura , UP , India
| | - Saurabh Gupta
- a Animal Health Division, Central Institute for Research on Goats (CIRG) , Mathura , UP , India.,b Department of Microbiology and Immunology , GLA University , Mathura , UP , India
| | - Manju Singh
- a Animal Health Division, Central Institute for Research on Goats (CIRG) , Mathura , UP , India
| | - Jagdip Singh Sohal
- c Amity Institutes of Microbial Technology, Amity University , Jaipur , India
| | - Naveen Kumar
- d Veterinary Type Culture Collection, NRC On Equines , Indian Council of Agricultural Research , Hisar , India
| | - Manoj Kumar Singh
- a Animal Health Division, Central Institute for Research on Goats (CIRG) , Mathura , UP , India
| | - Ashok Kumar Bhatia
- b Department of Microbiology and Immunology , GLA University , Mathura , UP , India
| | - Kuldeep Dhama
- e Pathology Division , Indian Veterinary Research Institute (IVRI) , Bareilly , UP , India
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Kuenstner JT, Naser S, Chamberlin W, Borody T, Graham DY, McNees A, Hermon-Taylor J, Hermon-Taylor A, Dow CT, Thayer W, Biesecker J, Collins MT, Sechi LA, Singh SV, Zhang P, Shafran I, Weg S, Telega G, Rothstein R, Oken H, Schimpff S, Bach H, Bull T, Grant I, Ellingson J, Dahmen H, Lipton J, Gupta S, Chaubey K, Singh M, Agarwal P, Kumar A, Misri J, Sohal J, Dhama K, Hemati Z, Davis W, Hier M, Aitken J, Pierce E, Parrish N, Goldberg N, Kali M, Bendre S, Agrawal G, Baldassano R, Linn P, Sweeney RW, Fecteau M, Hofstaedter C, Potula R, Timofeeva O, Geier S, John K, Zayanni N, Malaty HM, Kahlenborn C, Kravitz A, Bulfon A, Daskalopoulos G, Mitchell H, Neilan B, Timms V, Cossu D, Mameli G, Angermeier P, Jelic T, Goethe R, Juste RA, Kuenstner L. The Consensus from the Mycobacterium avium ssp. paratuberculosis (MAP) Conference 2017. Front Public Health 2017; 5:208. [PMID: 29021977 PMCID: PMC5623710 DOI: 10.3389/fpubh.2017.00208] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 07/28/2017] [Indexed: 01/29/2023] Open
Abstract
On March 24 and 25, 2017 researchers and clinicians from around the world met at Temple University in Philadelphia to discuss the current knowledge of Mycobacterium avium ssp. paratuberculosis (MAP) and its relationship to human disease. The conference was held because of shared concern that MAP is a zoonotic bacterium that poses a threat not only to animal health but also human health. In order to further study this problem, the conferees discussed ways to improve MAP diagnostic tests and discussed potential future anti-MAP clinical trials. The conference proceedings may be viewed on the www.Humanpara.org website. A summary of the salient work in this field is followed by recommendations from a majority of the conferees.
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Affiliation(s)
- J Todd Kuenstner
- Temple University Health System, Philadelphia, PA, United States
| | - Saleh Naser
- Temple University Health System, Philadelphia, PA, United States
| | | | - Thomas Borody
- Temple University Health System, Philadelphia, PA, United States
| | - David Y Graham
- Temple University Health System, Philadelphia, PA, United States
| | - Adrienne McNees
- Temple University Health System, Philadelphia, PA, United States
| | | | | | - C Thomas Dow
- Temple University Health System, Philadelphia, PA, United States
| | - Walter Thayer
- Temple University Health System, Philadelphia, PA, United States
| | - James Biesecker
- Temple University Health System, Philadelphia, PA, United States
| | | | - Leonardo A Sechi
- Temple University Health System, Philadelphia, PA, United States
| | - Shoor Vir Singh
- Temple University Health System, Philadelphia, PA, United States
| | - Peilin Zhang
- Temple University Health System, Philadelphia, PA, United States
| | - Ira Shafran
- Temple University Health System, Philadelphia, PA, United States
| | - Stuart Weg
- Temple University Health System, Philadelphia, PA, United States
| | - Grzegorz Telega
- Temple University Health System, Philadelphia, PA, United States
| | - Robert Rothstein
- Temple University Health System, Philadelphia, PA, United States
| | - Harry Oken
- Temple University Health System, Philadelphia, PA, United States
| | - Stephen Schimpff
- Temple University Health System, Philadelphia, PA, United States
| | - Horacio Bach
- Temple University Health System, Philadelphia, PA, United States
| | - Tim Bull
- Temple University Health System, Philadelphia, PA, United States
| | - Irene Grant
- Temple University Health System, Philadelphia, PA, United States
| | - Jay Ellingson
- Temple University Health System, Philadelphia, PA, United States
| | - Heinrich Dahmen
- Temple University Health System, Philadelphia, PA, United States
| | - Judith Lipton
- Temple University Health System, Philadelphia, PA, United States
| | - Saurabh Gupta
- Temple University Health System, Philadelphia, PA, United States
| | - Kundan Chaubey
- Temple University Health System, Philadelphia, PA, United States
| | - Manju Singh
- Temple University Health System, Philadelphia, PA, United States
| | - Prabhat Agarwal
- Temple University Health System, Philadelphia, PA, United States
| | - Ashok Kumar
- Temple University Health System, Philadelphia, PA, United States
| | - Jyoti Misri
- Temple University Health System, Philadelphia, PA, United States
| | - Jagdip Sohal
- Temple University Health System, Philadelphia, PA, United States
| | - Kuldeep Dhama
- Temple University Health System, Philadelphia, PA, United States
| | - Zahra Hemati
- Temple University Health System, Philadelphia, PA, United States
| | - William Davis
- Temple University Health System, Philadelphia, PA, United States
| | - Michael Hier
- Temple University Health System, Philadelphia, PA, United States
| | - John Aitken
- Temple University Health System, Philadelphia, PA, United States
| | - Ellen Pierce
- Temple University Health System, Philadelphia, PA, United States
| | - Nicole Parrish
- Temple University Health System, Philadelphia, PA, United States
| | - Neil Goldberg
- Temple University Health System, Philadelphia, PA, United States
| | - Maher Kali
- Temple University Health System, Philadelphia, PA, United States
| | - Sachin Bendre
- Temple University Health System, Philadelphia, PA, United States
| | - Gaurav Agrawal
- Temple University Health System, Philadelphia, PA, United States
| | | | - Preston Linn
- Temple University Health System, Philadelphia, PA, United States
| | | | - Marie Fecteau
- Temple University Health System, Philadelphia, PA, United States
| | | | - Raghava Potula
- Temple University Health System, Philadelphia, PA, United States
| | - Olga Timofeeva
- Temple University Health System, Philadelphia, PA, United States
| | - Steven Geier
- Temple University Health System, Philadelphia, PA, United States
| | - Kuruvilla John
- Temple University Health System, Philadelphia, PA, United States
| | - Najah Zayanni
- Temple University Health System, Philadelphia, PA, United States
| | - Hoda M Malaty
- Temple University Health System, Philadelphia, PA, United States
| | | | - Amanda Kravitz
- Temple University Health System, Philadelphia, PA, United States
| | - Adriano Bulfon
- Temple University Health System, Philadelphia, PA, United States
| | | | - Hazel Mitchell
- Temple University Health System, Philadelphia, PA, United States
| | - Brett Neilan
- Temple University Health System, Philadelphia, PA, United States
| | - Verlaine Timms
- Temple University Health System, Philadelphia, PA, United States
| | - Davide Cossu
- Temple University Health System, Philadelphia, PA, United States
| | - Giuseppe Mameli
- Temple University Health System, Philadelphia, PA, United States
| | - Paul Angermeier
- Temple University Health System, Philadelphia, PA, United States
| | - Tomislav Jelic
- Temple University Health System, Philadelphia, PA, United States
| | - Ralph Goethe
- Temple University Health System, Philadelphia, PA, United States
| | - Ramon A Juste
- Temple University Health System, Philadelphia, PA, United States
| | - Lauren Kuenstner
- Temple University Health System, Philadelphia, PA, United States
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Chaubey KK, Gupta RD, Gupta S, Singh SV, Bhatia AK, Jayaraman S, Kumar N, Goel A, Rathore AS, Sahzad, Sohal JS, Stephen BJ, Singh M, Goyal M, Dhama K, Derakhshandeh A. Trends and advances in the diagnosis and control of paratuberculosis in domestic livestock. Vet Q 2016; 36:203-227. [PMID: 27356470 DOI: 10.1080/01652176.2016.1196508] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Paratuberculosis (pTB) is a chronic granulomatous enteritis caused by Mycobacterium avium subsp. paratuberculosis (MAP) in a wide variety of domestic and wild animals. Control of pTB is difficult due to the lack of sensitive, efficacious and cost-effective diagnostics and marker vaccines. Microscopy, culture, and PCR have been used for the screening of MAP infection in animals for quite a long time. Besides, giving variable sensitivity and specificity, these tests have not been considered ideal for large-scale screening of domestic livestock. Serological tests like ELISA easily detects anti-MAP antibodies. However, it cannot differentiate between the vaccinated and infected animals. Nanotechnology-based diagnostic tests are underway to improve the sensitivity and specificity. Newer generation diagnostic tests based on recombinant MAP secretory proteins would open new paradigm for the differentiation between infected and vaccinated animals and for early detection of the infection. Due to higher seroreactivity of secretory proteins vis-à-vis cellular proteins, the secretory proteins may be used as marker vaccine, which may aid in the control of pTB infection in animals. Secretory proteins can be potentially used to develop future diagnostics, surveillance and monitoring of the disease progression in animals and the marker vaccine for the control and eradication of pTB.
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Affiliation(s)
- Kundan Kumar Chaubey
- a Microbiology Laboratory, Animal Health Division , Central Institute for Research on Goats , Mathura , India.,b Department of Microbiology and Immunology , GLA University , Mathura , India
| | - Rinkoo Devi Gupta
- c Department of Life sciences and Biotechnology , South Asian University , New Delhi , India
| | - Saurabh Gupta
- a Microbiology Laboratory, Animal Health Division , Central Institute for Research on Goats , Mathura , India.,b Department of Microbiology and Immunology , GLA University , Mathura , India
| | - Shoor Vir Singh
- a Microbiology Laboratory, Animal Health Division , Central Institute for Research on Goats , Mathura , India
| | - Ashok Kumar Bhatia
- b Department of Microbiology and Immunology , GLA University , Mathura , India
| | - Sujata Jayaraman
- d Amity Institutes of Microbial Technology , Amity University , Jaipur , India
| | - Naveen Kumar
- a Microbiology Laboratory, Animal Health Division , Central Institute for Research on Goats , Mathura , India
| | - Anjana Goel
- b Department of Microbiology and Immunology , GLA University , Mathura , India
| | - Abhishek Singh Rathore
- c Department of Life sciences and Biotechnology , South Asian University , New Delhi , India
| | - Sahzad
- a Microbiology Laboratory, Animal Health Division , Central Institute for Research on Goats , Mathura , India
| | - Jagdip Singh Sohal
- d Amity Institutes of Microbial Technology , Amity University , Jaipur , India
| | - Bjorn John Stephen
- a Microbiology Laboratory, Animal Health Division , Central Institute for Research on Goats , Mathura , India
| | - Manju Singh
- a Microbiology Laboratory, Animal Health Division , Central Institute for Research on Goats , Mathura , India
| | - Manish Goyal
- e Division of Parasitology , Central Drug Research Institute , Lucknow , India
| | - Kuldeep Dhama
- f Pathology Division , Indian Veterinary Research Institute (IVRI) , Bareilly , India
| | - Abdollah Derakhshandeh
- g Department of Pathobiology, School of Veterinary Medicine , Shiraz University , Shiraz , Iran
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14
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Davis WC. On deaf ears, Mycobacterium avium paratuberculosis in pathogenesis Crohn’s and other diseases. World J Gastroenterol 2015; 21:13411-13417. [PMID: 26730151 PMCID: PMC4690169 DOI: 10.3748/wjg.v21.i48.13411] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/22/2015] [Accepted: 11/19/2015] [Indexed: 02/06/2023] Open
Abstract
The historic suggestion that Mycobacterium avium subsp. paratuberculosis (Map) might be a zoonotic pathogen was based on the apparent similarity of lesions in the intestine of patients with Crohn’s disease (CD) with those present in cattle infected with Map, the etiological agent of Johne’s disease. Reluctance to fully explore this possibility has been attributed to the difficulty in demonstrating the presence of Map in tissues from patients with CD. Advances in technology have resolved this problem and revealed the presence of Map in a significant proportion of patients with CD and other diseases. The seminal finding from recent investigations, however, is the detection of Map in healthy individuals with no clinical signs of disease. The latter observation indicates all humans are susceptible to infection with Map and lends support to the thesis that Map is zoonotic, with a latent stage of infection similar to tuberculosis, where infection leads to the development of an immune response that controls but does not eliminate the pathogen. This clarifies one of the reasons why it has been so difficult to document that Map is zoonotic and associated with the pathogenesis of CD and other diseases. As discussed in the present review, a better understanding of the immune response to Map is needed to determine how infection is usually kept under immune control during the latent stage of infection and elucidate the triggering events that lead to disease progression in the natural host and pathogenesis of CD and immune related diseases in humans.
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Monif GRG. The Hruska postulate of Crohn's disease. Med Hypotheses 2015; 85:878-81. [PMID: 26432629 DOI: 10.1016/j.mehy.2015.09.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/09/2015] [Accepted: 09/20/2015] [Indexed: 02/07/2023]
Abstract
Crohn's disease is due to the loss of immunological tolerance within the gastrointestinal tract to the antigenic array of Mycobacterium avium subspecies paratuberculosis (MAP) and closely related polymorphic variants. The loss of immune tolerance results in an effector cytokine responsive upon re-exposure to MAP. For immune tolerance to MAP to be induced, infection must occur when acquired immunity is markedly underdeveloped.
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Affiliation(s)
- Gilles R G Monif
- Infectious Diseases Incorporated, Bellevue, NE, United States; University of Florida, College of Veterinary Medicine, Gainesville, FL, United States.
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16
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Nazareth N, Magro F, Machado E, Ribeiro TG, Martinho A, Rodrigues P, Alves R, Macedo GN, Gracio D, Coelho R, Abreu C, Appelberg R, Dias C, Macedo G, Bull T, Sarmento A. Prevalence of Mycobacterium avium subsp. paratuberculosis and Escherichia coli in blood samples from patients with inflammatory bowel disease. Med Microbiol Immunol 2015; 204:681-92. [PMID: 25994082 DOI: 10.1007/s00430-015-0420-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/13/2015] [Indexed: 12/31/2022]
Abstract
Mycobacterium avium subsp. paratuberculosis (MAP) and adherent-invasive Escherichia coli (AIEC) have been implicated as primary triggers in Crohn's disease (CD). In this study, we evaluated the prevalence of MAP and E. coli (EC) DNA in peripheral blood from 202 inflammatory bowel disease (IBD) patients at various disease periods and compared against 24 cirrhotic patients with ascites (CIR) (non-IBD controls) and 29 healthy controls (HC). MAP DNA was detected by IS900-specific nested PCR, EC DNA by malB-specific nested PCR and AIEC identity, in selected samples, by sequencing of fimH gene. CD patients with active disease showed the highest MAP DNA prevalence among IBD patients (68 %). Infliximab treatment resulted in decreased MAP detection. CIR patients had high individual and coinfection rates (75 % MAP, 88 % EC and 67 % MAP and EC), whilst HC controls had lower MAP prevalence (38 %) and EC was undetectable in this control group. EC DNA prevalence in IBD patients was highly associated with CD, and 80 % of EC from the selected samples of CD patients analyzed carried the fimH30 allele, with a mutation strongly associated with AIEC. Our results show that coinfection with MAP and AIEC is common and persistent in CD, although the high MAP and EC detection in CIR patients suggested that colonization is, at least, partially dependent on increased gut permeability. Nevertheless, facilitative mechanisms between a susceptible host and these two potential human pathogens may allow their implication in CD pathogenesis.
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Affiliation(s)
- Nair Nazareth
- FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal
| | - Fernando Magro
- Institute of Pharmacology and Therapeutics, Faculdade de Medicina, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
- Gastroenterology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
- MedInUP -Center for Drug Discovery and Innovative Medicines, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Elisabete Machado
- FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal
- REQUIMTE, Laboratory of Microbiology, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Teresa Gonçalves Ribeiro
- FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal
- REQUIMTE, Laboratory of Microbiology, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - António Martinho
- FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal
| | - Pedro Rodrigues
- FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal
- Infection and Immunity Unit, IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal
| | - Rita Alves
- FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal
| | - Gonçalo Nuno Macedo
- FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal
| | - Daniela Gracio
- Institute of Pharmacology and Therapeutics, Faculdade de Medicina, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
- MedInUP -Center for Drug Discovery and Innovative Medicines, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Rosa Coelho
- Gastroenterology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Candida Abreu
- Department of Infectious Diseases, Centro Hospitalar S. João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
- Nephrology Research and Development Unit, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Rui Appelberg
- Infection and Immunity Unit, IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal
| | - Camila Dias
- Department of Biostatistics and Medical Informatics, Faculdade de Medicina, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Tim Bull
- Institute for Infection and Immunity, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Amélia Sarmento
- FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.
- Infection and Immunity Unit, IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal.
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Dow CT. M. paratuberculosis and Parkinson's disease--is this a trigger. Med Hypotheses 2014; 83:709-12. [PMID: 25459140 DOI: 10.1016/j.mehy.2014.09.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 09/04/2014] [Accepted: 09/30/2014] [Indexed: 12/14/2022]
Abstract
Genetic linkage studies and genome wide analysis have provided insights into complex medical diseases. Mycobacterium avium ss. paratuberculosis (MAP) causes Johne's disease, an important enteric inflammatory disease mostly studied in ruminant animals. MAP is also the putative cause of Crohn's disease. Moreover, MAP has been linked to other inflammatory diseases: sarcoidosis, Blau syndrome, autoimmune diabetes, autoimmune thyroiditis and multiple sclerosis. Genetic studies reveal an association between Parkinson's disease (PD), leprosy and Crohn's disease and since discovered, these findings have been considered "surprising". Autophagy and ubiquitin-proteosome systems are cellular systems that both fight intracellular pathogens (xenophagy) and maintain cellular protein quality control. PD is a common neurodegenerative disease that manifests clinically as a profound movement disorder. The recognized genetic defects of PD create disruption of cellular homeostasis that result in protein folding abnormalities of PD called Lewy bodies. Those same genetic defects are associated with susceptibility to intracellular pathogens, including mycobacteria. It is now understood that PD Lewy body pathology starts in the enteric nervous system and "spreads" to the brain in a retrograde fashion via the vagus nerve. This is the same process by which prions affect the brain. Lewy body pathology of the enteric nervous system predates the Lewy body pathology of the central nervous system (CNS) by years or even decades. This article proposes that genetic defects associated with PD also result in a permissive environment for MAP infection--ineffective xenophagy. It postulates that beginning as an enteric infection, MAP--via the vagus nerve--initiates a pathologic process that results in a targeted neuroinvasion of the CNS. The article proposes that MAP infection and resultant PD pathology are due, in the genetically at-risk and age dependant, to the consumptive exhaustion of the protein quality control systems.
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Affiliation(s)
- Coad Thomas Dow
- McPherson Eye Research Institute, University of Wisconsin-Madison, 9431 WIMR, 1111 Highland Avenue, Madison, WI 53705, United States; Chippewa Valley Eye Clinic, 2715 Damon Street, Eau Claire, WI 54701, United States.
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Shoor VS, Naveen K, Jagdip SS, Ajay VS, Pravin KS, Narottam DA, Saurabh G, Kundan KC, Rajib D, Kuldeep D, Krishna DR. First mass screening of the human population to estimate the bio-load of Mycobacterium avium subspecies paratuberculosis in North India. ACTA ACUST UNITED AC 2014. [DOI: 10.5897/jphe2013.0564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Magin WS, Van Kruiningen HJ, Colombel JF. Immunohistochemical search for viral and bacterial antigens in Crohn's disease. J Crohns Colitis 2013; 7:161-6. [PMID: 22537638 DOI: 10.1016/j.crohns.2012.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 03/26/2012] [Accepted: 03/27/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND Recent studies show that diseased intestinal tissues of patients with Crohn's disease (CD) contain obstructed lymphatics, granulomas, and tertiary lymphoid organs, representing responses to persistent antigen. METHODS Forty-seven tissue sections from 28 CD patients and 20 tissue sections from 17 control patients were studied. Tissues were immunostained with antibody directed against adenovirus, Epstein-Barr virus, herpes simplex virus I, parvovirus B19, Listeria monocytogenes, Escherichia coli, Clostridium perfringens, and Mycobacterium avium subspecies paratuberculosis. RESULTS There was no evidence of adenovirus, Epstein-Barr virus, parvovirus B19, or M. avium subsp. paratuberculosis in the tissues. Clostridia were positively stained in the mucus of 18.5% of CD patients versus 35.3% of controls and in the tissue of 11.1% of CD patients but in no controls. Immunoreactivity to listeria antibody occurred in the mucus of 3.7% of CD patients and in 5.9% of controls while it occurred in the tissue of 37.0% of CD patients and 29.4% of controls. E. coli occurred in the mucus of 48.1% CD and 64.7% controls and in the tissue of 18.5% and 5.9% respectively. CONCLUSIONS Of the agents demonstrated in this search, none was located in granulomas or inflamed lymphatics. Finding the common gut microbes, E. coli and clostridia, in the mucus of patients and controls was not unexpected. The minor focal staining of E. coli and clostridia does not suggest a primary role for these pathogens in CD. Positive staining for listeria in patients and controls may very well represent cross reactivity rather than specific identification.
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Affiliation(s)
- William S Magin
- Department of Pathobiology and Veterinary Science, The University of Connecticut, Storrs, CT, United States.
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M. paratuberculosis Heat Shock Protein 65 and Human Diseases: Bridging Infection and Autoimmunity. Autoimmune Dis 2012; 2012:150824. [PMID: 23056923 PMCID: PMC3465878 DOI: 10.1155/2012/150824] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 08/27/2012] [Accepted: 08/29/2012] [Indexed: 01/19/2023] Open
Abstract
Mycobacterium avium subspecies paratuberculosis (MAP) is the known infectious cause of Johne's disease, an enteric inflammatory disease mostly studied in ruminant animals. MAP has also been implicated in the very similar Crohn's disease of humans as well as sarcoidosis. Recently, MAP has been associated with juvenile sarcoidosis (Blau syndrome), autoimmune diabetes, autoimmune thyroiditis, and multiple sclerosis. While it is intuitive to implicate MAP in granulomatous diseases where the microbe participates in the granuloma, it is more difficult to assign a role for MAP in diseases where autoantibodies are a primary feature. MAP may trigger autoimmune antibodies via its heat shock proteins. Mycobacterial heat shock protein 65 (HSP65) is an immunodominant protein that shares sequential and conformational elements with several human host proteins. This molecular mimicry is the proposed etiopathology by which MAP stimulates autoantibodies associated with autoimmune (type 1) diabetes, autoimmune (Hashimoto's) thyroiditis, and multiple sclerosis. This paper proposes that MAP is a source of mycobacterial HSP65 and acts as a trigger of autoimmune disease.
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Chiodini RJ, Chamberlin WM, Sarosiek J, McCallum RW. Crohn's disease and the mycobacterioses: a quarter century later. Causation or simple association? Crit Rev Microbiol 2012; 38:52-93. [PMID: 22242906 DOI: 10.3109/1040841x.2011.638273] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
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.
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Affiliation(s)
- Rodrick J Chiodini
- Divisions of Infectious Diseases, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
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Davis WC, Madsen-Bouterse SA. Crohn's disease and Mycobacterium avium subsp. paratuberculosis: the need for a study is long overdue. Vet Immunol Immunopathol 2012; 145:1-6. [PMID: 22209202 PMCID: PMC3273645 DOI: 10.1016/j.vetimm.2011.12.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 12/04/2011] [Accepted: 12/08/2011] [Indexed: 02/06/2023]
Abstract
The initial suggestion that Mycobacterium avium subsp. paratuberculosis (Map) might be involved in the pathogenesis of Crohn's disease (CD) was based on the apparent similarity of lesions in the intestine of patients with CD with those present in cattle infected with Map, the etiological agent of Johne's disease (JD). Recent investigations have now revealed the presence of Map or Map DNA in blood or lesions from adults and children with CD. Of special interest, Map has also been found in patients with other diseases as well as healthy subjects. The latter observations indicate all humans are susceptible to infection with Map and that, like with other mycobacterial pathogens such as Mycobacterium tuberculosis, infection does not invariably lead to development of clinical disease but rather development of a persistent latent stage of infection where an immune response controls but does not eliminate the pathogen. Limited information has been obtained on the immune response to Map in healthy subjects and patients with CD. Understanding how Map may be involved in the pathogenesis of CD will require a better understanding of the immune response to Map in one of its common hosts as well as healthy humans and patients with CD.
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Affiliation(s)
- William C Davis
- Department of Veterinary Microbiology and Pathology, Washington State University, Pullman, WA 99164, USA.
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Dow CT. Mycobacterium avium subspecies paratuberculosis—An environmental trigger of type 1 diabetes mellitus. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/jdm.2012.21014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Van Kruiningen HJ. Where are the weapons of mass destruction − the Mycobacterium paratuberculosis in Crohn's disease? J Crohns Colitis 2011; 5:638-44. [PMID: 22115388 DOI: 10.1016/j.crohns.2011.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 08/08/2011] [Accepted: 08/11/2011] [Indexed: 02/08/2023]
Affiliation(s)
- Herbert J Van Kruiningen
- Department of Pathobiology and Veterinary Science, 61 North Eagleville Road, U3089, Storrs, Connecticut 06269-3089,United States.
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25
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Dow CT. Mycobacterium paratuberculosis and autism: is this a trigger? Med Hypotheses 2011; 77:977-81. [PMID: 21903338 DOI: 10.1016/j.mehy.2011.08.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 08/14/2011] [Indexed: 12/21/2022]
Abstract
Autism is a heterogeneous group of life-long neurologic problems that begin in childhood. Success in efforts to understand and treat autism has been mostly elusive. The role of autoimmunity in autism has gained recognition both for associated systemic autoimmune disease and the presence of brain autoantibodies in autistic children and their family members. There is an acknowledged genetic susceptibility to autism--most notably allotypes of complement C4. C4 defects are associated with several autoimmune diseases and also confer susceptibility to mycobacterial infections. Mycobacterium avium ss. paratuberculosis (MAP) causes an enteric inflammatory disease in ruminant animals (Johne's disease) and is the putative cause of the very similar Crohn's disease in humans. Humans are widely exposed to MAP in food and water. MAP has been also linked to ulcerative colitis, irritable bowel syndrome, sarcoidosis, Blau syndrome, autoimmune (Type 1) diabetes, Hashimoto's thyroiditis and multiple sclerosis. Environmental agents are thought to trigger autism in the genetically at risk. Molecular mimicry is the proposed mechanism by which MAP is thought to trigger autoantibodies. Autoantibodies to brain myelin basic protein (MBP) is a common feature of autism. This article considers the subset of autoimmunity-related autism patients and postulates that MAP, through molecular mimicry to its heat shock protein HSP65, triggers autism by stimulating antibodies that cross react with myelin basic protein (MBP).
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Affiliation(s)
- Coad Thomas Dow
- UW Eye Research Institute, 445 Henry Mall #307, Madison, WI 53706, United States.
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Allen AJ, Park KT, Barrington GM, Lahmers KK, Abdellrazeq GS, Rihan HM, Sreevatsan S, Davies C, Hamilton MJ, Davis WC. Experimental infection of a bovine model with human isolates of Mycobacterium avium subsp. paratuberculosis. Vet Immunol Immunopathol 2011; 141:258-66. [PMID: 21477870 PMCID: PMC3097062 DOI: 10.1016/j.vetimm.2011.03.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 02/09/2011] [Accepted: 03/08/2011] [Indexed: 02/07/2023]
Abstract
Mycobacterium avium subsp. paratuberculosis (Map), the etiologic agent of Johne's disease (JD) in ruminants, has been implicated in the pathogenesis of Crohn's disease (CD) in humans. We developed a bovine ileal cannulation model to facilitate comparison of the immune response to Map and the mechanisms of pathogenesis in cattle and humans. Initial studies showed a T cannula could be maintained for up to a year in calves without inducing inflammation or adversely affecting intestinal function. Map introduced through the cannula established a persistent low level of infection without inflammation. Infection elicited an immune response to Map antigens detectable by flow cytometry. Further studies now show the cannulation model can be used with cows during the later stage of infection, affording access to the target tissue at all stages of infection. The studies also revealed no difference in infectivity or immunogenicity of isolates of Map obtained from cattle or humans with CD. Comparison of the immune response to Map during the early and late stages of infection using PCR, flow cytometry and QRT-PCR, showed the immune response early in the disease process is dominated by CD4 T cells. A CD8 response is delayed but comparable at later stages of infection. Genes for pro-inflammatory cytokines IFN-γ and the recently identified genes encoding IL-17 and IL-22 are up regulated in infected animals. These findings reveal that both human and bovine isolates of Map can establish infection and induce similar immune responses in a bovine model. They also reveal the cytokine responses elicited in cattle are similar to those implicated in CD pathogenesis.
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Affiliation(s)
- Andrew J. Allen
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA 99164
| | - Kun-Taek Park
- Veterinary Microbiology and Pathology, Washington State University, Pullman, WA 99164
| | - George M. Barrington
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA 99164
| | - Kevin K. Lahmers
- Veterinary Microbiology and Pathology, Washington State University, Pullman, WA 99164
- School for Global Animal Health, Washington State University, Pullman, WA 99164
| | - Gaber S. Abdellrazeq
- Department of Microbiology, Faculty of Veterinary Med, Alexandria University, Egypt
| | - Heba M. Rihan
- Department of Bacteriology, Mycology and Immunology, Faculty of Vet Med, Mansoura University, Egypt
| | - Srinand Sreevatsan
- Veterinary Population Medicine Department University of Minnesota, St. Paul, MN 55108
| | - Christopher Davies
- Department of Animal, Dairy and Veterinary Sciences and Center for Integrated BioSystems, Utah State University, Logan, UT 84322
| | - Mary J. Hamilton
- Veterinary Microbiology and Pathology, Washington State University, Pullman, WA 99164
| | - William C. Davis
- Veterinary Microbiology and Pathology, Washington State University, Pullman, WA 99164
- Center of Reproductive Biology, Washington State University, Pullman, WA 99164
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Salgado M, Collins MT, Salazar F, Kruze J, Bölske G, Söderlund R, Juste R, Sevilla IA, Biet F, Troncoso F, Alfaro M. Fate of Mycobacterium avium subsp. paratuberculosis after application of contaminated dairy cattle manure to agricultural soils. Appl Environ Microbiol 2011; 77:2122-9. [PMID: 21239557 PMCID: PMC3067322 DOI: 10.1128/aem.02103-10] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 01/02/2011] [Indexed: 11/20/2022] Open
Abstract
Details regarding the fate of Mycobacterium avium subsp. paratuberculosis (basonym, Mycobacterium paratuberculosis) after manure application on grassland are unknown. To evaluate this, intact soil columns were collected in plastic pipes (lysimeters) and placed under controlled conditions to test the effect of a loamy or sandy soil composition and the amount of rainfall on the fate of M. paratuberculosis applied to the soil surface with manure slurry. The experiment was organized as a randomized design with two factors and three replicates. M. paratuberculosis-contaminated manure was spread on the top of the 90-cm soil columns. After weekly simulated rainfall applications, water drainage samples (leachates) were collected from the base of each lysimeter and cultured for M. paratuberculosis using Bactec MGIT ParaTB medium and supplements. Grass was harvested, quantified, and tested from each lysimeter soil surface. The identity of all probable M. paratuberculosis isolates was confirmed by PCR for IS900 and F57 genetic elements. There was a lag time of 2 months after each treatment before M. paratuberculosis was found in leachates. The greatest proportions of M. paratuberculosis-positive leachates were from sandy-soil lysimeters in the manure-treated group receiving the equivalent of 1,000 mm annual rainfall. Under the higher rainfall regimen (2,000 mm/year), M. paratuberculosis was detected more often from lysimeters with loamy soil than sandy soil. Among all lysimeters, M. paratuberculosis was detected more often in grass clippings than in lysimeter leachates. At the end of the trial, lysimeters were disassembled and soil cultured at different depths, and we found that M. paratuberculosis was recovered only from the uppermost levels of the soil columns in the treated group. Factors associated with M. paratuberculosis presence in leachates were soil type and soil pH (P < 0.05). For M. paratuberculosis presence in grass clippings, only manure application showed a significant association (P < 0.05). From these findings we conclude that this pathogen tends to move slowly through soils (faster through sandy soil) and tends to remain on grass and in the upper layers of pasture soil, representing a clear infection hazard for grazing livestock and a potential for the contamination of runoff after heavy rains.
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Affiliation(s)
- M Salgado
- Microbiology Department, Faculty of Science, Universidad Austral de Chile, P.O. Box (Casilla) 567, Valdivia, Chile.
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