By the Hon. Mr.
D. Guillermo Suárez Fernández
Scientific Session of March 20, 2007
Professor of Veterinary
Universidad Complutense de Madrid
Academician
Royal Academy of Medicine
Armchair No. 3-Veterinary-
SUMMARY
Paratuberculosa enteritis Johne's Disease was first described by Johne and Frothingham in 1895, who saw it as a form of intestinal tuberculosis caused by a bacillus called Mycobacterium today next to tuberculosis, a producer of human tuberculosis. The etiological agent of paratuberculosis is included in the complex of Mycobacterium avium subsp. Paratuberculosi s.
Paratuberculous node histogenesis and anatomical changes. In the natural history of disease, study and detailed description of the injury and its genesis has played a leading role both in the field of comparative pathology and in the differential diagnosis with other diseases, Disease such as Crohn's , ulcerative colitis, intestinal tuberculosis, leprosy, etc..
The initial phases of the process would be similar to lesions caused by other pathogenic mycobacteria to differentiate into the final stages. After an initial phase involving epithelial M cells of Peyer's patches and mesenteric lymph nodes as hosts of the bacterium to macrophage phagosomes whose remain untouched while reaching the incubation period, the histogenesis nodular mucosa in the enteric would. The pathogenesis partuberculosa is because at the point where you set the Mycobacterium avium subsp. Paratuberculosis ( MAP ) starts an intestinal inflammation characterized in part by cell proliferation and, in part, by an exudative process, characteristic of the paratuberculosis. Following a localized proliferation linked to the exudative process forms the tuber, the first microscopic or follicle Köster, developed to cluster around the bacilli epithelioid cells are immature fibroblasts and histiocytes vesicular core, making some multinucleated cells in epiteliodides (giant cells), and then form a dense ring of cells, isolating the cell group formed around the MAP. At the same time penetrates the granuloma exudate formed, in part, coagulates, predominantly exudative character.
In particular, the intestinal mucosa undergoes a marked inflammatory infiltration. Transmural inflammation is spreading widely into the submucosa and the opportunity to appreciate the existence of granulomas, ileitis or colitis-like "pavement" of the mucosa with ulceritas and strong thickening of the mucosa of the small intestine, with the formation of folds resembling gyri brain. The intestinal mucosa has a thickness of 3 to 4 times higher than normal. The inner surface is frequently finely warty. Mesenteric lymph in the affected areas are hypertrophied and infiltrated with serum. The box lesion, symptoms and clinical appearance match point by point in the paratuberculosis and Crohn's disease. The pathological and clinical similarity has been the cause of the suspected etiologic relationship for nearly one hundred years.
Paratuberculosa enteritis was discovered in 1895, and Crohn's disease in 1932, while in 1913 Dalziel described the process with the title "Chronic Intestinal Enteritis" and from the first decades of last century been discussing the etiology of the disease now called Crohn reasons and more and more sophisticated, as the enormous scientific progress for 75 years.
Precisely at this moment we are witnessing a debate between supporters of MAP as an agent of Crohn's disease and those who deny this fact. There are conclusive facts in favor of the involvement of Mycobacterium avium subsp. Paratuberculosis in Crohn's disease, such as finding increasing MAP agent in tissues affected by Crohn both by culture, PCR or hybridization "in situ". The positive serological response in Crohn's disease compared to MAP, or the positive response of patients to macrolide antibiotics effective against Mycobacterium, also support the involvement of MAP.
Negative factors would be the limited human infection in the management personnel affected farming or genotypes paratuberculosis isolated from Crohn's disease and Johne are not identical.
It is certain that Mycobacterium avium subsp. Paratuberculosis involved in the process even at a late stage, complicating and compounding that improves intestinal enteritis with antibiotics.
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