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Rusty, mycobacteria can be very hard to kill. For example, tuberculosis treatment takes many months of treatment with several antibiotics, if you're lucky enough to have a sensitive strain. More important, though, is that even if this bacterium proves to be a causative factor (and the paper was misleading for treating that as an essentially proven idea), it could easily be something more complicated than a simple infection. For example, imagine (hypothetically) that some protein in the mycobacterium resembles a intestinal protein, but is different enough to trigger an immune response. That immune response could become a lifelong sensitivity to ones own intestines, even if the bacterium disappears completely. A vaccine generally is designed to increase an immune response, but in the scenario I described you'd want to reduce the immune response (induce "tolerance"), more like allergy shots than vaccines.

Scott F
Last edited by Scott F

Exactly. "Killing" the bacteria is not what it is about. The idea is that those who are IBD susceptible might have inflammation triggered by MAP. The vaccine is for altering your immune system so that it can respond to MAP appropriately. The reason that this vaccine is more for Crohn's and not so much for UC is because the theory is that MAP is the root cause of Crohn's, but UC is thought to be more of an autoimmune disease with an infectious trigger. While a single causation would be a wonderful finding, I think it is unlikely.

We'll just have to see how the human trials work out.

Jan

Jan Dollar

Rusty, allergy shots have none of the risks of broad immune suppression, because they are specific to the particular substances causing the immune response. My point is that you'd want to induce tolerance to a specific substance if and when the immune response to that substance is causing harm.

Immunosuppressants aren't specific at all. They carry risks and side effects, though they are often better than a disease out of control.

Scott F

Sure, a vaccine would be preferable to immune modulators or biologics, because they are targeted, except for Entyvio, a biologic which targets the gut. That said, we don't have it yet, so it it a moot point. 

Whether or not it seems too dangerous to be on immune modulators and biologics depends on the benefit vs. risk ratio. For me, my quality of life is vastly improved by them, so the benefit outweighs the risk. I've been on biologics for over a decade with only improved health.

Jan

Jan Dollar

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