Diagnostic Testing for Human Mycobacterium avium spp paratuberculosis (hMAP)
Before starting Atypical Mycobacteria Antibiotic Therapy (AMAT or Anti-MAP), it may be prudent to obtain a test for human paratuberculosis (commonly referred to as a cell-wall deficient form of Mycobacterium aviumsubspecies paratuberculosis or hMAP.)
As a species, Mycobacterium are notoriously difficult to culture (grow in a lab). The cell wall version of MAP, which is found in animals, has been successfully cultured and veterinarians have multiple tests they use to identify MAP. However, there are very few labs in the world where the human version of MAP can be accurately cultured, making it difficult and frustrating for patients seeking AMAT.
One lab that has developed an innovative diagnostic test for human MAP is John Aitken’s lab in New Zealand. In conjunction with Otakaro Pathways, Mr. Aitken’s lab has provided hundreds of patients with detailed results of their unique human paratuberculosis (MAP) cultures. These results can be taken to a local physician, infectious disease specialist or gastroenterologist and utilized to develop an individual treatment pathway. The current cost for this test is $250 USD and requires two vials of blood be sent to the laboratory. Please see the Otakaro Pathway site for more information on how to obtain a human paratuberculosis (MAP) culture through Mr. Aitken’s lab.
PZM Diagnostics has developed a test for MAP by using culture, antibody detection and polymerase chain reaction (PCR) testing to identify specific MAP DNA sequences. Led by Dr. Peilin Zhang in West Virginia, this test is still in development, and may produce false negative results. The current cost of this test is $450 USD and requires two vials of blood be sent to the laboratory. Please see the PZM Diagnostics site for more information on how to obtain their test.
Prof. John Hermon-Taylor
Prof. John Hermon-Taylor of the Crohn’s MAP Vaccine group in England is developing a diagnostic test for MAP, although this test is not yet available to the public. The MAP Vaccine began Stage I trials in January 2017. To learn more about Prof. Hermon-Taylor’s MAP test and follow the progress of the MAP vaccine, see Dr. Amy Hermon-Taylor’s symposium video or the CMV website.
PCR Testing of MAP
Many researchers identify MAP in humans by using PCR DNA identification since culture has proven difficult. One well known researcher who has developed a nested PCR assay to detect the presence of MAP in clinical samples is Dr. Saleh A. Naser. The most well known DNA target for MAP is IS900. F57 is another MAP specific DNA target. For more information on Dr. Naser’s work, see the University of Central Florida site.