by John Aitken and Kevin Taylor
The following abstract accompanied an oral presentation at a New Zealand veterinary conference in 2014, and it was a fair summary of our thinking at the time. Most of the problems outlined in the article have since been addressed by us. In addition, the contributing group has expanded considerably.
In the plant world, endophytes exist within plants to perform essential functions in the plant – stimulation of plant immunity, competitive inhibition (making sure there is no room left for an invader) and production of chemicals capable of killing other bacteria (antibiotics). This is a process called “symbiosis.” Symbiosis occurs when two organisms co-exist and one, or both, organisms benefit from the relationship. In plants, endophytes have evolved to be part of the growth mechanisms of the plant. They are found in the roots and in the leaves.
What has this to do with Crohn’s disease?
In the midst of World War 2, Winston Churchill announced the change in fortunes for the British Empire, since the dark days of 1939, and instructed that the Church bells all over Britain be rung for the first time since the outbreak of the War. In his speech to the nation, he used the phrase: “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”
On October 19, 2015 John Aitken and his team presented details about their Mycobacterium avium subspecies paratuberculosis (MAP) research to attendees of the American College of Gastroenterology (ACG) meeting in Hawaii. The poster that Mr. Aitken and his team presented is shared here. It discusses how his team has isolated Son of MAP in the blood of Crohn’s disease patients, a novel idea to many in the GI field.
For some 20 years there have been attempts to use antibiotics in the treatment of Crohn’s disease. Although most trials have delivered mixed results, this direction has been reinforced by the association of Mycobacterium avium ssp paratuberculosis (MAP) with Crohn’s disease.
The main principle of judicious and effective antibiotic usage has been the targeting of the suspected pathogen with a therapy that is both specific and directed. This has been a difficult job, as there has been, up to now, no protocol that will ensure the reliable isolation of the pathogen from the patient. The model that is used for new compounds against MAP-associated organisms is directly related to the proven therapies for tuberculosis, and this has been a wise model to follow.
My memory is not as polished as it was at age 30. I can still recite entire speeches from Shakespeare, but I sometimes forget to pick up the dry cleaning. Though I have a large brain and many neurons to assist my powers of recall, I question how the immune system retains it’s memory. My immune system has been “primed” to recognize threats to my health, and also to keep my body in generally good shape over a lifetime. In order to properly fight infections, the immune system needs to distinguish between the invaders and the beneficial bacteria.
Evolution is a random process, not always directed at benefits to both parties. One thought that has been occupying my mind is: What if a new pathogen was introduced into a well-balanced immune system, which then evolved to mimic a beneficial mycobacteria species, but with a sinister intent? Immune memory would be of no help at all.
I suppose everything is real to the cat. I was watching our cat sleeping the other night, and he suddenly started twitching in his sleep. He appeared to be dreaming. Maybe our cat can distinguish between the reality of waking life and the world of the dream. In all probability, he cannot grapple with abstract concepts. He probably doesn’t wonder at all about where the food on the plate came from prior to being placed in his bowl in the morning. For our cat, reality is very concrete.
For a Crohn’s disease patient, reality is far from concrete. The reason they have become ill is not yet understood by the medical profession, and there are any number of theories that can be presented to the patient to explain the age old question, “Why me?”
Internationally, New Zealand seems to be a desired destination. We have a thriving tourist industry, tempting tourists with a multitude of ways to place their lives in danger. Unfortunately, there is not the same attraction for career scientists, partly because of funding and partly because of remoteness from the centres of international research excellence. The adventurous spirit seems to be implanted in our genes. As a Boy Scout, I had frequent expeditions into the wilderness, usually in a small team of others near my age. I learned the value of working in a team to achieve a goal. Like in Boy Scouts, the most cost-effective way to advance in research is to form teams.
See how John Aitken’s exceptional team has been able to accomplish critical Crohn’s disease research despite encountering many obstacles.