Etiology of Crohn's disease: the role of Mycobacterium avium paratuberculosis

Trends Mol Med. 2001 Jun;7(6):247-52. doi: 10.1016/s1471-4914(01)01983-9.


Crohn's disease is a chronic inflammatory bowel disease characterized by transmural inflammation and granuloma formation. Several theories regarding the etiology of Crohn's disease have been proposed, one of which is infection with Mycobacterium avium subspecies paratuberculosis (M. paratuberculosis), which causes a similar disease in animals, and is present in the human food chain. Considerable evidence supports the presence of M. paratuberculosis in the intestinal tissues of many patients with Crohn's disease including culture, detection of homologous mycobacterial DNA, detection of the mycobacterial insertion sequence IS900 by both PCR and in situ hybridization in tissues, and a serologic immune response to recombinant M. paratuberculosis antigens. Despite this evidence, and our personal belief that M. paratuberculosis is a cause of Crohn's disease, widespread acceptance of this hypothesis will require evidence that specific anti-mycobacterial chemotherapy will cure the disease.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Cell Wall / metabolism
  • Colitis, Ulcerative / microbiology
  • Crohn Disease / etiology*
  • Crohn Disease / microbiology*
  • Crohn Disease / pathology
  • DNA / metabolism
  • DNA Transposable Elements / genetics
  • Granuloma / pathology
  • Humans
  • In Situ Hybridization
  • Mycobacterium avium / metabolism*
  • Nucleic Acid Hybridization
  • Polymerase Chain Reaction
  • Recombinant Proteins / metabolism


  • DNA Transposable Elements
  • Recombinant Proteins
  • DNA