TMSS Medical College Journal

Introduction: The human gut contains 10'* microorganisms of more than 500-1000 different species, forming intestinal microbiota. And its an emerging hypothesis of involvement of pathogenesis of inflammatory bowel disease (IBD) with the alteration of this gut microbiota. We are going to find the missing string of this hypothesis here. Objective: Objective of this study was to assess the association of Mycobacterium avium sub species paratuberculosis (MAP) in patient with Crohn's disease (CD). Materials and Methods: This case-control study was carried out in the department of Gastroenterology, BSMMU, Bangladesh. Period of study was from January 2016 to September 20017. Thirty-four diagnosed case of Crohn’s disease was included in this study. Thirty-four controls were; patients undergoing Colonoscopy for screening purpose of any abnormal bowel symptoms and found to have normal findings; included in the study. Biopsy for PCR to detect Mycobacterium avium sub species paratuberculosis (MAP) and NTM was collected from ulcer in CD patients and left side of the colon in controls. IS 900 primer was used to detect MAP and ITS primer was used to detect NTM. Results: NTM was detected in 28 biopsy of CD patient (82.4%) and only 8 healthy control (23.5%) with Odds ratio 15.17 (95 % CI 4.07-60.75) and P value was significant (0.001). Conclusion: It appears that NTM other than MAP may have association with Crohn's disease in Bangladesh but further study is needed to find out which organism.

The human gut contains 10" microorganisms of more than 500-1000 different species, forming intestinal microbiota’. This microbiota can initiate immune responses either by functioning as adjuvants or antigens. The most common hypothesis regarding the pathogenesis of Crohn’s disease ( CD) is, overactive acquired T cell activity to a subset of microbiota; develop in genetically susceptible hosts, and environmental factors causes onset or reactivation of the disease. This theory involves four components that must intersect in multiple ways for the disease process to affect the patient’. But it is almost universally accepted that a host genetic predisposition is critical for development of CD’. Among bacteria Mycobacterium avium subsp paratuberculosis (MAP) a member of the group of NTM has shown high prevalence* although not uniformly®. This large variation may be due to differences in DNA extraction techniques or to geographical variations in the prevalence and modes of transmission of MAP®. This prospective study aimed to see the association of Mycobacterium avium sub species paratuberculosis (MAP) with Crohns disease.