Gastroenterology: The Pathogenic Potential of Mycobacterium paratuberculosis and Emerging Treatment Targets to Address Increasing Resistance

Dear Colleagues,

Mycobacterium avium ssp. paratuberculosis (MAP) has been implicated in the development of Crohn’s disease for over a century. Despite recent insights pointing to a multi-modal model of disease pathogenesis, how it causes disease has so far eluded scientists. In part, this is due to the fact that the organism is difficult to culture, and detection and animal studies are rare. This Special Issue focuses on how MAP promotes IBD development with increasing evidence of its carriage/invasive potential and hinderances to potential therapeutic targets, with the aim of progressing existing knowledge of the mechanism of inflammation and the ongoing challenges in therapy. Indeed, therapy could be currently said to be treating the effects of the disease (an overactive immune system) but not the cause, due to a lack of consistent resolution and knowlege. The number of patients suffering from Crohn’s is increasing worldwide without a clear reason as to why. Recent insights into the important role of cell-wall-deficient mycobacteria (CWDM) in the life cycle of Mycobacterium species have not contributed to existing treatment options. Mycobacteria are known to adopt different forms in different stages of growth, such as CWDM. Biofilms are a virulence factor in mycobacterial infections, and the involvement of the microbiome in IBD raises the possibility of the availability of nutrients and complex interactions between mycobacterial growth-promoting factors. The complex nature of the path from infection to disease in IBD patients suggests a multi-step pathology if the mycobacterial infection is the root cause. Moreover, each step is susceptibile to disease development and so provides opportunities for a combination of therapies. An improved understanding of MAP and its detection, especially regarding how it affects the gut epithelium in humans as it does in Johne’s Disease, is crucial.

Dr. Gaurav Agrawal
Prof. Dr. Roger Pickup
Guest Editors

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