01 February 2006
Integrating theories of the etiology of Crohn's Disease On the etiology ofCrohn's Disease: Questioning the Hypotheses.
William M. Chamberlin, Saleh A. NaserMed Sci Monit 2006; 12(2): RA27-33 :: ID: 445257
Abstract
The most prominent theory describes the Crohn's Syndrome as a dysregulated,inappropriate immune response to otherwise innocuous bowel flora in a genetically susceptible host. Theautoimmune theory assumes that a specific infectious agent does not exist. Data from mouse models, impairmentof the mucosal epithelial barrier and the influence of gut flora are used to support the autoimmune theory.Critics claim that the dysregulated immune responses are not the primary disorder but secondary to anunderlying infection. Two other theories are also consistent with the same data. The immunodeficiencytheory hypothesizes that defects in innate immunity leading to compensatory immune processes underliethe Crohn's phenotype and suggests that therapy should stimulate immunity rather than suppress it. Themycobacterial theory proposes that Mycobacterium avium subspecies paratuberculosis is one of the causesof the Crohn's Disease syndrome. Mycobacterial molecules dysregulate immune signaling pathways as partof the organisms'evolved survival strategy. If MAP were to initiate the dysregulated immune responsethen the necessity to hypothesize that commensal gut flora provide the antigenic stimulus would be moot.Commensal bacteria would be relegated to a secondary role of modifying the immune response rather thanoccupying the central role of providing the initiating antigens. Critics claim that MAP is merely a secondaryinvader. The three theories differ primarily by emphasizing different aspects of the same overall process.
Keywords: Autoimmunity, Crohn Disease - microbiology, Immune Tolerance, Immunity, Innate, Intracellular Signaling Peptides and Proteins - genetics, Models, Biological, Models, Immunological, Mutation, Mycobacterium avium subsp. paratuberculosis - pathogenicity, Nod2 Signaling Adaptor Protein
Editorial
01 April 2024 : Editorial
Editorial: Forty Years of Waiting for Prevention and Cure of HIV Infection – Ongoing Challenges and Hopes for Vaccine Development and Overcoming Antiretroviral Drug ResistanceDOI: 10.12659/MSM.944600
Med Sci Monit 2024; 30:e944600
In Press
05 Mar 2024 : Clinical Research
Role of Critical Shoulder Angle in Degenerative Type Rotator Cuff Tears: A Turkish Cohort StudyMed Sci Monit In Press; DOI: 10.12659/MSM.943703
06 Mar 2024 : Clinical Research
Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A ...Med Sci Monit In Press; DOI: 10.12659/MSM.943797
21 Mar 2024 : Meta-Analysis
Economic Evaluation of COVID-19 Screening Tests and Surveillance Strategies in Low-Income, Middle-Income, a...Med Sci Monit In Press; DOI: 10.12659/MSM.943863
10 Apr 2024 : Clinical Research
Predicting Acute Cardiovascular Complications in COVID-19: Insights from a Specialized Cardiac Referral Dep...Med Sci Monit In Press; DOI: 10.12659/MSM.942612
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952