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Clinical Review
Detection of Mycobacterium avium subspecies paratuberculosis from patients with Crohn's disease using nucleic acid-based techniques: A systematic review and meta-analysis
Article first published online: 20 SEP 2007
DOI: 10.1002/ibd.20276
Copyright © 2007 Crohn's & Colitis Foundation of America, Inc.
Additional Information
How to Cite
Abubakar, I., Myhill, D., Aliyu, S.H. and Hunter, P.R. (2008), Detection of Mycobacterium avium subspecies paratuberculosis from patients with Crohn's disease using nucleic acid-based techniques: A systematic review and meta-analysis. Inflamm Bowel Dis, 14: 401–410. doi: 10.1002/ibd.20276
Publication History
- Issue published online: 7 FEB 2008
- Article first published online: 20 SEP 2007
- Manuscript Accepted: 6 AUG 2007
- Manuscript Received: 1 MAY 2007
- Abstract
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Keywords:
- Mycobacterium avium subspecies paratuberculosis;
- etiology;
- Crohn's disease
Abstract
This study is a systematic review and meta-analysis of studies using nucleic acid-based techniques to detect Mycobacterium avium paratuberculosis (MAP) in patients with Crohn's disease (CD) compared with controls. Database searches were conducted and risk difference estimates were calculated using meta-analysis. Fifty-eight studies were reviewed, 47 of which were included in the analysis. The pooled estimate of risk difference from all studies was 0.23 (95% confidence interval [CI], 0.14–0.32) using a random effects model. Similarly, MAP was detected more frequently from patients with CD compared with those with ulcerative colitis (risk difference 0.19, 95% CI, 0.10–0.28). Year of study, assay type, and inclusion of children explained some but not all of the observed heterogeneity. The data confirms the observation that MAP is detected more frequently among CD patients compared with controls. However, the pathogenic role of this bacterium in the gut remains uncertain. Our analysis demonstrates that there is an association between MAP and CD, across many sites, by many investigators, and controlling for a number of factors; however, this association remains controversial and inconclusive. Future studies should determine whether there is a pathogenic role.
(Inflamm Bowel Dis 2007)