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1.
Lancet Infect Dis ; 3(8): 507-14, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12901893

RESUMO

Although Crohn's disease is considered to be autoimmune in origin, there is increasing evidence that it may have an infectious cause. The most plausible candidate is Mycobacterium avium subspecies paratuberculosis (MAP). Intriguingly, Koch's postulates may have been fulfilled for MAP and Crohn's disease, even though they still have not been met for Mycobacterium leprae and leprosy. In animals MAP causes Johne's disease, a chronic wasting intestinal diarrhoeal disease evocative of Crohn's disease. Johne's disease occurs in wild and domesticated animals, including dairy herds. Viable MAP is found in human and cow milk, and is not reliably killed by standard pasteurisation. MAP is ubiquitous in the environment including in potable water. Since cell-wall-deficient MAP usually cannot be identified by Ziehl-Neelsen staining, identification of MAP in human beings requires culture or detection of MAP DNA or RNA. If infectious in origin, Crohn's disease should be curable with appropriate antibiotics. Many studies that argue against a causative role for MAP in Crohn's disease have used antibiotics that are inactive against MAP. However, trials that include macrolide antibiotics indicate that a cure for Crohn's disease is possible. The necessary length of therapy remains to be determined. Mycobacterial diseases have protean clinical manifestations, as does Crohn's disease. The necessity of stratifying Crohn's disease into two clinical manifestations (perforating and non-perforating) when interpreting the results of antibiotic therapy is discussed. Rational studies to evaluate appropriate therapies to cure Crohn's disease are proposed.


Assuntos
Antibacterianos/uso terapêutico , Doença de Crohn , Hanseníase/microbiologia , Mycobacterium avium subsp. paratuberculosis , Paratuberculose , Tuberculose , Animais , Antibacterianos/efeitos adversos , Bovinos , Doença de Crohn/tratamento farmacológico , Doença de Crohn/microbiologia , Doença de Crohn/fisiopatologia , Humanos , Hanseníase/fisiopatologia , Mycobacterium avium subsp. paratuberculosis/genética , Mycobacterium avium subsp. paratuberculosis/isolamento & purificação , Mycobacterium avium subsp. paratuberculosis/patogenicidade , Paratuberculose/tratamento farmacológico , Paratuberculose/microbiologia , Paratuberculose/fisiopatologia , Tuberculose/tratamento farmacológico , Tuberculose/microbiologia , Tuberculose/fisiopatologia
2.
Mol Med Today ; 1(7): 343-8, 1995 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9415175

RESUMO

Crohn's disease is an idiopathic chronic panenteric intestinal inflammatory disease. Data concerning the pathogenesis of, and the immune responses occurring in, Crohn's disease are often conflicting. Current therapy is empirical and either non-specifically immunosuppressive or surgically ablative in nature. Although controversial, Crohn's disease may be thought of as having two different presentations, an aggressive fistulizing form and an indolent obstructive form. This is analogous to the tuberculoid and lepromatous manifestations of leprosy. If correct, this subclassification may provide key insights into the pathogenesis and differing host immune responses in Crohn's disease and also allow the development of more rational therapies.


Assuntos
Doença de Crohn/classificação , Anexinas/análise , Colite Ulcerativa/classificação , Colite Ulcerativa/fisiopatologia , Colo/patologia , Doença de Crohn/genética , Doença de Crohn/fisiopatologia , Doença de Crohn/terapia , Citocinas/genética , Citocinas/fisiologia , Humanos , Hanseníase/classificação
3.
In. World Health Organization. The armadillo as an experimental model in biomedical research. Washington, Pan American Health Organization, 1978. p.79-80. (Scientific Publication, 366).
Monografia em Inglês | Sec. Est. Saúde SP, HANSEN, Hanseníase, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1243769
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