In Vivo
Evaluation of Anti-Tuberculosis Drugs For Treatment of Crohn’s Disease
Patients
I.Shafran,
D.Campbell, C.Romero, D.Schwartz and S.Naser
Department
of Molecular Biology and Microbiology/ Center for Discovery of Drugs and
Diagnosis
University
of Central Florida, Orlando
In a previous abstract, we reported that a regimen
consisting of Rifampicin:Clarithromycin at concentrations of 0.5:1.2 ug/ml or
1.0:0.75 ug/ml resulted in significant eradication of M.avium ss paratuberculosis
(M para) in vitro where MIC99.9%
was achieved. M para is the causative
agent of Johne’s Disease in ruminants and has been implicated in the
pathogenisis of Crohn’s disease (CD), a chronic inflammatory bwel disease in
humans. A 65 year old patient diagnosed with CD who was found to be PCR positive
for M para (using IS900 specific
primers) with humoral immune response against recombinant antigens of
M para, has demonstrated significant healing (>80%) of an ulcer seen in
the ileum shown by endoscopy. This healing was observed afyer the patient
underwent a combination of Clarithromycin 250mg. Twice a day and rifabutin 150
mg. Daily. He was endoscoped through his stoma and found to have a 4.0 cm
aphthous ulcer. The remaining ileum was unremarkable to a depth of 120 cm.
Histology showed typical features of CD. He
became asymptomatic in 2 weeks and a follow-up endoscopy was done after
completing 1 month of treatment. The 4 cm ulcer, noted 1 month before, had
decreased to 1 cm with excellent reepithelialization from the edge of the ulcer
inward. The remaining ileum to 120 cm was normal. The patient has remained
symptom free and continues to be on antibiotics. The endoscopic observations
reported further substantiate the possible role of M
para in CD.
All content copyright ©1999 Dr. Ira Shafran, M.D.