INTRODUCTION:Crohn's disease is an inflammatory bowel disease that has been debated to be associated with bacterial triggers such as Mycobacterium avium subspecies paratuberculosis (MAP). Standard treatment of Crohn's disease (CD) patients includes a family of immunomodulators and biologics such as Anti-Tumor Necrosis Factor alpha (Anti-TNFα). This cytokine in particular has been known to play vital roles in fighting microbial infections through formation and maintenance of granulomas. Areas covered: This perspective is focused on elucidating the negative effects of using Anti-TNFα therapeutic agents as a treatment option in CD patients who are more likely suspected to have MAP infection, and the role of other immunomodulators in MAP infection. Expert commentary: While treatment with Anti-TNFα is beneficial to reduce inflammation and to provide short term relief to the patients, it also compromises the immune system causing susceptibility to microbial infection. More than 50% of CD patients have shown no response to Anti-TNFα treatment which indicates a demand for introducing novel CD treatment in combination with antibiotics as a future CD treatment plan.

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简介: 克罗恩氏病是一种炎症性肠病,已被争论与细菌触发因素有关,例如鸟分枝杆菌亚种副结核杆菌 (MAP)。克罗恩病 (CD) 患者的标准治疗包括一系列免疫调节剂和生物制剂,例如抗肿瘤坏死因子 α (Anti-tnf α)。尤其是这种细胞因子在通过肉芽肿的形成和维持来对抗微生物感染中起着至关重要的作用。涵盖的领域: 该观点着重于阐明使用抗tnf α 治疗剂作为CD患者的治疗选择的负面影响,这些患者更可能怀疑患有MAP感染,以及其他免疫调节剂在MAP感染中的作用。专家评论: 虽然抗tnf α 治疗有利于减轻炎症并为患者提供短期缓解,但它也会损害免疫系统,导致对微生物感染的敏感性。超过50% 的CD患者对抗tnf α 治疗没有反应,这表明需要将新型CD治疗与抗生素结合作为未来的CD治疗计划。

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