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Crohn's Disease

Crohn’s disease (CD) is a lifelong debilitating condition principally characterized by a chronic inflammation of the gastro-intestinal tract. It can start at any age but usually appears for the first time between the age of 10 and 40.

It affects at least 115,000 people in the UK and more than 3 million worldwide. It began in the early part of the 20th century as mainly a disease of western countries but the incidence is rising rapidly both in western countries and in other regions.

CD has been thought be an autoimmune disease and drug therapy involving anti-inflammatories such as steroids, immunomodulators and anti-TNF preparations has centred on treating the inflammatory process. At best, these therapies delay the progression of the disease and do not provide a cure. Surgery to remove the damaged section(s) of the gut can provide a long lasting remission in some cases but most patients will require further treatment including surgery as the disease moves to other areas of the gut.

It is now accepted that, while a number of things such as diet, stress, smoking and well defined genetic susceptibilities can contribute to the onset of CD, a major disease mechanism involves an abnormal reaction of the immune system to gut bacteria.

While many bacteria, such as E coli, have been implicated our belief is that the agent most likely to be causing the changes that result in CD is MAP. This is due to the ability of MAP to cause similar diseases to CD in many types of animals including primates, the epidemiology, the zoonotic connection between animals and man, the high percentage of CD patients shown to be infected with MAP (more than 90%, using current technologies), and the strong genetic association between CD and mycobacterial infection (Nature 2012).  Furthermore, although MAP is highly resistant to most antibiotics, treating patients with a cocktail of anti-mycobacterial drugs with greater activity against MAP over long periods can result in disease remission with MAP tests changing from positive to negative.