Transmissible agents in inflammatory bowel disease: 1980

Detection of immunoreactive antigen, with a monoclonal antibody to measles virus, in tissue from a patient with Crohn's disease

Using immunofluorescence (IF), we investigated reactive antigens present in Crohn's disease patients with monoclonal antibodies derived from cells infected with measles virus, but not with the subacute sclerosing panencephalitis virus. During immunoblotting, one monoclonal antibody (mAb 86) reacted with a polypeptide with a molecular weight of 36,000 dalton (M; matrix protein) in measles virus-infected cells. This monoclonal antibody displayed a positive reaction only with tissues from patients with Crohn's disease by the IF test. It did not react with samples from patients with other chronic inflammatory bowel diseases, such as ulcerative colitis. Other monoclonal antibodies to the measles virus protein, and monoclonal antibodies to Herpes simplex virus type 1 did not react with the same tissue samples. The role of measles virus infection and/or a viral antigen (possibly the M protein) as a causative agent in Crohn's disease poses a challenging avenue for further research.

Investigation of mycobacteria in Crohn's disease tissue by Southern blotting and DNA hybridisation with cloned mycobacterial genomic DNA probes from a Crohn's disease isolated mycobacteria

A mycobacterial aetiology for Crohn's disease (CD) has been suggested. Slow growing mycobacteria indistinguishable from M paratuberculosis, the causative agent of enteritis in ruminants (Johne's disease) have been isolated from CD tissues. We have used cloned genomic DNA probes derived from a CD isolated mycobacteria strain Ben, to investigate the presence of mycobacterial DNA sequences in CD tissues. DNA was extracted from total tissue from 17 CD and four control gut specimens. DNA was digested with restriction endonucleases, electrophoresed and transferred to nylon membranes by Southern blotting and hybridised to radiolabelled DNA probes. No mycobacterial DNA was detected in any tissue sample studied. Reconstitution experiments with known numbers of in vitro cultured mycobacteria showed sensitive detection of mycobacterial DNA. DNA extracted from mouse liver, infected with M lepraemurium revealed a strong hybridisation signal and showed the applicability of the experimental approach to the detection of mycobacterial DNA in naturally infected tissues. The results do not provide evidence for the involvement of mycobacteria in the pathogenesis of CD but do not exclude the possibility of low levels of infection in subsets of intestinal cells with spheroplast or cell wall deficient forms of mycobacteria.

Investigation of association of mycobacteria with inflammatory bowel disease by nucleic acid hybridization

We used DNA-DNA hybridization to characterize a mycobacterial isolate, strain Linda, that was obtained from a patient with Crohn's disease and that has been reported to cause ileitis in experimental animals. We also investigated the association of this mycobacterium with Crohn's disease. Our results identified Mycobacterium strain Linda as a strain of Mycobacterium paratuberculosis, the etiologic agent of Johne's disease, a disease of ruminants that has some superficial resemblance to Crohn's disease. Sequences that hybridized with strain Linda DNA probes were detected in DNA extracted from human intestinal tissues from patients with Crohn's disease, ulcerative colitis, and noninflammatory bowel disease. These hybridizing DNA sequences were more prevalent in the muscle layers than in the intestinal mucosa, making it unlikely that they represented DNA from bacterial contaminants in the intestinal lumen. Measurement of the melting temperatures of the DNA-DNA hybrids formed between strain Linda probes and tissue DNAs indicated that the related sequences detected were of mycobacterial origin but were not identical to each other or to strain Linda DNA. These results do not support the proposed specific relationship between Mycobacterium strain Linda and Crohn's disease. The possible etiologic role of mycobacteria in Crohn's disease is discussed.

Isolation and characterization of Crohn's disease tissue-specific glycoproteins

Two Crohn's disease tissue-specific proteins are identified and purified several thousand-fold from crude tissue extracts by different chromatographic procedures. The two proteins migrate in sodium dodecyl sulfate-polyacrylamide gel electrophoresis as 200-210-kilodalton and 150-160-kilodalton species. They are glycoproteins, as evidenced by their binding to concanavalin A-Sepharose 4B and positive staining with Schiff's reagent. Specific immunoreactivity of the two glycoproteins against Crohn's disease sera was demonstrated by immunotransblot analysis. All but one of the operative specimens of colon or small intestine (or both) from 13 patients with Crohn's disease contained either or both of the proteins; they were not detected in specimens of colon from 5 patients with ulcerative colitis, 1 patient with diverticulitis, 1 patient with ischemic colitis, from the normal bowel segments resected from 3 patients with colon cancer, and from two normal ileal tissue specimens. The two glycoproteins did not react with antihuman IgG, IgM, and IgA, suggesting that they are not immunoglobulins. The purified glycoproteins may provide important leads toward the understanding of the pathogenesis of Crohn's disease.

New developments in infectious diarrhea

The past decade has produced exciting advances in our knowledge of infectious diarrhea. The list of potential enteric pathogens continues to grow with both the identification of new organisms, e.g., E. coli serotype O157:H7, and the recognition that previously characterized microorganisms, e.g., M. avium-intracellulare, can also cause gastrointestinal disease in immunosuppressed patients. Multiple investigations have led to a greater understanding of the epidemiology and clinical features of these illnesses. Application of modern biological techniques has yielded a number of diagnostic assays that are just now becoming clinically relevant. New drugs and treatment modalities for enteric infections have been developed and are now being evaluated in clinical trials. Despite these advancements, however, many questions still remain unanswered. For example, the etiology of the debilitating diarrhea in AIDS patients in whom no known intestinal pathogen can be identified remains unknown. The mechanism of diarrhea due to Cryptosporidium, Isospora, and Giardia remains elusive. And last, will new intestinal vaccines be effective in preventing diarrheal disease? Certainly, the next decade of research in enteric diseases should prove to be even more interesting than the last.

Search for evidence of a viral aetiology for inflammatory bowel disease

The aetiology of the inflammatory bowel diseases. Crohn's disease, and ulcerative colitis, is still obscure. A viral aetiology has been proposed, based in part on reports that filtrates prepared from tissues of patients with inflammatory bowel disease induce cytopathic effects in tissue culture cells. Our attempts to culture viruses in many cell lines from filtrates prepared from the tissue of 95 patients have been negative, except for one case in which cytomegalovirus was isolated from the tissue of a Crohn's disease patient. Our studies confirm previous reports that intestinal tissue filtrates induce cytopathic effects in inoculated cell cultures, but the effect we observed is non-specific; cytopathic effects were induced in most cell lines tested and with similar frequency irrespective of whether the intestinal filtrates were prepared from Crohn's disease patients, ulcerative colitis patients, or non-inflammatory bowel disease controls. Electron microscopy studies of tissue culture cells exhibiting cytopathic effects have not revealed virus particles. Characterisation of the cytopathic effect inducing factor showed that it was incapable of serial passage in tissue culture, too small to be a conventional virus, resistant to inactivation by ultraviolet light, and heat stable. Our results suggest that the observed cytopathic effect was caused by a non-replicating cytotoxic factor, or factors, released from intestinal tissues of both inflammatory bowel disease and non-inflammatory bowel disease patients.

Microbial colonization of rat colonic mucosa following intestinal perturbation

An allochthonous population of spiral-shaped bacteria was found colonizing the surfaces of the colonic mucosa of rats after they had been given magnesium sulphate (MgSO4)-induced diarrhea. These organisms were rarely seen in normal control rats and were not displaced when the treatment was ceased, remaining associated with the tissue for periods of up to 180 days. Similar bacteria were also found when specific pathogen-free rats, lacking mucosa-associated populations, were inoculated with homogenized rat intestine from conventional animals. Light and electron microscopic observations showed that the organisms were attached to the surface of the colon, orientated at right angles to the tissue, with one end inserted into the microvillus border. This is the first report of long-term colonization, following perturbation of the gut ecosystem, of a site on the gastrointestinal mucosa not normally associated with bacteria. The ultrastructure and mode of attachment of these organisms were very similar to that of spiral-shaped bacteria known to associate with the colonic mucosa in monkeys and man.