• Exploring Mycobacterium avium subsp. paratuberculosis: Antibiotic Resistance and Its Implications for Chronic Diseases
  • Mahlagha Cheraghi,1,*
    1. Department of Biology, Central Tehran Branch, Islamic Azad University, Tehran, Iran


  • Introduction: Mycobacterium avium subsp. paratuberculosis (MAP) is a pathogenic bacterium primarily known for causing Johne's disease in ruminants, particularly cattle. This chronic enteric disease leads to significant economic losses in the livestock industry. It raises concerns regarding its potential zoonotic implications, particularly its association with chronic inflammatory diseases in humans, such as Crohn's disease. The increasing prevalence of antibiotic resistance among MAP strains complicates treatment strategies and highlights the need for comprehensive research into its pathogenic mechanisms and public health implications.
  • Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed using databases such as PubMed, Scopus, and Web of Science to identify relevant studies published up to October 2023. The search terms included "Mycobacterium avium subsp. paratuberculosis," "antibiotic resistance," "chronic disease," and "zoonosis." Inclusion criteria comprised peer-reviewed articles discussing MAP's antibiotic resistance, its role in chronic diseases, and any associated epidemiological studies. Data extraction focused on study design, sample size, findings related to antibiotic resistance patterns, and associations with chronic diseases.
  • Results: Antibiotic Resistance Patterns A total of 128 studies were included in this review. The findings indicated that MAP exhibits significant antibiotic resistance, particularly against commonly used antibiotics such as tetracycline and sulfonamides. Resistance mechanisms involve efflux pumps and biofilm formation, which enhance survival in hostile environments. A meta-analysis revealed that approximately 60% of MAP isolates from cattle were resistant to at least one antibiotic, with multi-drug resistance observed in about 30% of cases. Association with Chronic Diseases The review also highlighted a potential link between MAP infection and several chronic diseases in humans. Crohn's Disease: Epidemiological studies consistently indicate a significant association between MAP presence and Crohn's disease, with odds ratios ranging from 4.26 to 8.44. Type 1 Diabetes: A notable association was found between MAP exposure and Type 1 diabetes (odds ratio range: 2.91–9.95). Multiple Sclerosis: Similar associations were observed for multiple sclerosis (odds ratio range: 6.5–7.99). The evidence suggests that MAP may induce autoimmune responses through mechanisms such as molecular mimicry, where the bacterium's antigens resemble host tissues, leading to immune dysregulation. Knowledge Gaps Despite these findings, substantial knowledge gaps remain regarding the precise mechanisms by which MAP contributes to chronic diseases. Variability in diagnostic methodologies (e.g., PCR primers) and study populations complicates the interpretation of results.
  • Conclusion: Conclusion Mycobacterium avium subsp. paratuberculosis is a significant pathogen with implications for both animal health and human chronic diseases. The documented antibiotic resistance poses challenges for effective treatment and control measures. While there is growing evidence linking MAP to conditions like Crohn's disease and other autoimmune disorders, further research is essential to clarify these associations and understand the underlying pathogenic mechanisms. Comprehensive surveillance of MAP in both livestock and human populations is crucial to mitigate its impact on public health and develop effective prevention strategies.
  • Keywords: Mycobacterium avium paratuberculosis (MAP), Antibiotic resistance, Chronic diseases, Zoonotic infect