Here are some similarities between measles infection and Crohn's disease. Both have shown to:
Vitamin A helps in the formation and maintenance of healthy teeth, skeletal and soft tissue, mucous membranes, and skin. (1) The prevalence of hypovitaminosis A (defined as serum vitamin A < 20 micrograms/dl) or hypovitaminosis E (defined as serum vitamin E < 5 mg/l) was 16% in the pediatric IBD population studied. Low vitamin A levels were more common than low vitamin E levels. Serum retinol levels correlated significantly with alpha-tocopherol levels. Hypovitaminosis was significantly more prevalent in the Crohn's disease patients who had active disease. (2) Although clinically apparent vitamin A deficiency is rare in this population, the children hospitalized for complicated measles infection had serum retinol levels markedly depressed (mean:+/- SEM:, 0.405 +/- 0.021 mumols per liter:11.6 +/- 0.6 micrograms per deciliter:), and 92% of them had hyporetinemia (serum retinol level less than 0.7 mumols per liter:20 micrograms per deciliter). As compared with the placebo group, the children who received vitamin A( total dose, 400,000 IU of retinyl palmitate, given orally ) recovered more rapidly from pneumonia (mean, 6.3 vs. 12.4 days) and diarrhea (mean, 5.6 vs. 8.5 days). Of the 12 children who died, 10 were among those given placebo.
(3) With previous parental consent, 120 eutrophic infants received vaccination with attenuated measles virus or a combination of measles, mumps and rubella viruses as a model of mild viral infection. A significant hemoglobin drop was seen on days 9 and 14 post-vaccination. This descent was > 10 g/L in 8.2% of the cases, and > or = 6 g/L in 19.6%. Serum iron and transferrin saturation decreased significantly, whereas mean corpuscular volume, free erythrocyte protoporphyrin and serum ferritin were significantly increased. (4) A retrospective study was carried out to determine the effect of common childhood infectious diseases on the hemoglobin level. Episodes of chickenpox, measles, pertussis, and lower respiratory infections were reviewed. Between 38 and 50% of infants between 6 and 23 months of age had hemoglobin levels below 11.0 g/dl. The mean hemoglobin level of infants 6-11 and 12-17 months of age decreased with increasing number of total infectious episodes occurring within the 3 months before hemoglobin measurement.
(5) Primary measles virus (MV) infections led in both cell
lines to the induction of interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6),
interferon-beta (IFN-beta), and tumor necrosis factor-alpha (TNF-alpha). In the
central nervous system (CNS) of subacute sclerosing panencephalitis (SSPE) patients, a
percentage of persistently infected astrocytes may continually synthesize IL-6 and
IFN-beta, and in the presence of additional external stimuli, as possibly provided by
activated lymphocytes, might overexpress the inflammatory cytokines IL-1 beta and
TNF-alpha. This may be of pathogenetic significance in CNS diseases associated with persistent
MV infections.
References:
1. VITAMINS A AND E SERUM LEVELS IN CHILDREN AND YOUNG ADULTS WITH INFLAMMATORY BOWEL DISEASE: EFFECT OF DISEASE ACTIVITY. Bousvaros A, Zurakowski D, Duggan C, Law T, Rifai N, Goldberg NE, Leichtner AM; Combined Program in Gastroenterology and Nutrition, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
2. A RANDOMIZED, CONTROLLED TRIAL OF VITAMIN A IN CHILDREN
WITH SEVERE MEASLES:
Hussey GD; Klein M; N Engl J Med: 323:3:160-4 (1990)
3. CHANGES IN THE HEMOGRAM AND IN THE LABORATORY PARAMETERS INDICATIVE OF IRON METABOLISM IN MILD VIRAL INFECTIONS Olivares M; Walter T; Llaguno S; Osorio M; Chadud P; Velozo L; Unidad de Hematología, Universidad de Chile, Santiago. Sangre (Barc), 1993 Jun, 38:3, 211-6
4. ASSOCIATIONS OF EARLY CHILDHOOD INFECTIONS AND REDUCED HEMOGLOBIN LEVELS IN A HISTORIC COHORT OF ALASKA NATIVE INFANTS. Cruz A; Parkinson AJ; Hall D; Bulkow L; Heyward W; Arctic Investigations Program, Center for Infectious Diseases, Centers for Disease Control, Anchorage, Alaska. Arctic Med Res, 1990 Oct, 49:4, 175-9
5. DIFFERENTIAL INDUCTION OF CYTOKINES BY PRIMARY
AND PERSISTENT MEASLES VIRUS INFECTIONS IN HUMAN GLIAL CELLS.
Schneider-Schaulies J; Schneider-Schaulies S; Ter Meulen V; Institut für Virologie und
Immunbiologie, Universität Würzburg, Germany. Virology, 1993 Jul, 195:1, 219-28
Here is the research that has found involvement of measles in Crohn's:
DETECTION AND COMPARATIVE ANALYSIS OF PERSISTENT MEASLES VIRUS INFECTION IN CROHN'S DISEASE BY IMMUNOGOLD ELECTRON MICROSCOPY.
Daszak P; Purcell M; Lewin J; Dhillon AP; Pounder RE; Wakefield AJ; Inflammatory Bowel Disease Study Group, School of Life Sciences, Kingston University, Kingston-on-Thames, Surrey, United Kingdom. J Clin Pathol, 1997 Apr, 50:4, 299-304
AIMS: To determine the specificity of persistent measles
virus infection in intestinal samples from Crohn’s disease patients using
quantitative immunogold electron microscopy. To compare the results with samples from
ulcerative colitis, a granulomatous inflammatory control (tuberculous lymphadenitis), and
a positive control. METHODS: Formalin fixed, paraffin embedded intestinal tissue
from patients with Crohn’s disease was reprocessed and stained with antimeasles
nucleocaspid protein primary antibody followed by 10 nm gold conjugated secondary
antibody. Tissue samples were taken from granulomatous and non-granulomatous areas of the
intestine. Intestinal samples from patients with ulcerative colitis, tuberculous
lymphadenitis, or acute mesenteric ischaemia were similarly processed. Brain tissue from a
patient with subacute sclerosing panencephalitis (SSPE) was used as the positive control.
Duplicate sections of all tissues were processed without the primary antibody. Stained
specimens were examined by electron microscopy. RESULTS: In Crohn’s disease
patients, 8/9 foci of granulomatous inflammation and 0/4 foci of non-specific inflammation
were positive for measles virus. Of controls, 0/5 non-inflamed intestinal tissues, 1/8
tuberculous tissues, 1/5 ulcerative colitis tissues, and 1/1 SSPE tissues were
positive. Gold grain counts per nuclear field-of-view in both Crohn’s
disease granulomas (43.29) and SSPE (36.94) were significantly higher than in tissues from
patients with ulcerative colitis (13.52) or tuberculous lymphadenitis (15.875), and
nongranulomatous areas of Crohn’s disease (4.89) (p < 0.001, p < 0.001, p =
0.0006, respectively), with no significant difference between Crohn’s disease and
SSPE (p > 0.1). In both SSPE and Crohn’s disease staining was confined to a small
population of cells exhibiting characteristic cytopathology. CONCLUSION: These data
support a role for measles virus in the aetiology of Crohn’s disease.
IGM ANTIBODY AGAINST MEASLES VIRUS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A MARKER OF VIRUS-RELATED DISEASE?
Balzola FA; Castellino F; Colombatto P; Manzini P; Astegiano M; Verme G; Brunetto MR; Pera A; Bonino F; Department of Gastroenterology, Molinette Hospital, Torino, Italy. Eur J Gastroenterol Hepatol, 1997 Jul, 9:7, 661-3
OBJECTIVE: Viral infections of the mesenteric
microvascular endothelium have been hypothesized as pathogenetic factors in inflammatory
bowel diseases. The aim of this study was to determine whether immunoglobulin M (IgM)
antibody against measles virus is associated with disease. PATIENTS AND METHODS: The IgM
antibody was detected by indirect antibody test in 36 patients with evidence of Crohn’s
disease (23 males and 13 females, median age 40 years, range 20-66), 22 patients with
ulcerative colitis (14 males and 8 females, median age 42 years; range 19-65), 59 patients
with a chronic active hepatitis (35 males and 24 females, median age 56 years, range
38-77) and 30 blood donors (20 males and 10 females, median age 45 years, range
29-62). RESULTS: Twenty-eight of 36 patients (78%) with Crohn’s disease and
13 of 22 patients (59%) with ulcerative colitis tested positive as compared to only 3 of
89 (3.3%) controls (P < or = 0.001). CONCLUSION: The detection of IgM anti-measles
virus in the majority of patients with Crohn’s disease and in about half of
ulcerative colitis patients as compared to a very low prevalence in patients with other
chronic inflammatory disease is consistent with the hypothesis that the measles virus has
pathogenetic implications in inflammatory bowel diseases.
DETECTION OF IMMUNOREACTIVE ANTIGEN, WITH A MONOCLONAL ANTIBODY TO MEASLES VIRUS, IN TISSUE FROM A PATIENT WITH CROHN'S DISEASE.
Miyamoto H, Tanaka T, Kitamoto N, Fukuda Y, Shimoyama T; Department of Microbiology, Wakayama Medical College, Japan. J Gastroenterol 1995 Feb;30(1):28-33
Using immunofluorescence (IF), we investigated reactive
antigens present in Crohn’s disease patients with monoclonal antibodies derived from
cells infected with measles virus, but not with the subacute sclerosing panencephalitis
virus. During immunoblotting, one monoclonal antibody (mAb 86) reacted with a polypeptide
with a molecular weight of 36,000 dalton (M; matrix protein) in measles virus-infected
cells. This monoclonal antibody displayed a positive reaction only with tissues from
patients with Crohn’s disease by the IF test. It did not react with samples from
patients with other chronic inflammatory bowel diseases, such as ulcerative colitis. Other
monoclonal antibodies to the measles virus protein, and monoclonal antibodies to Herpes
simplex virus type 1 did not react with the same tissue samples. The role of measles virus
infection and/or a viral antigen (possibly the M protein) as a causative agent in Crohn’s
disease poses a challenging avenue for further research.
MEASLES VIRUS AND CROHN'S DISEASE: RESEARCH FROM THE ROYAL FREE HOSPITAL IN LONDON.
Pounder RE; Inflammatory Bowel Disease Study Group, Royal
Free Hospital, London, England.
J Gastroenterol, 1995 Nov, 30 Suppl 8:, 48-51
This paper provides a summary of a 6-year program of research by the Inflammatory Bowel
Disease Study Group at the Royal Free Hospital and School of Medicine, London. Research
has demonstrated: 1. That Crohn’s disease is associated with profound damage to the
mesenteric vascular blood supply, even in areas where tissue or bowel appear
macroscopically normal; 2. That Crohn’s disease is a granulomatous vasculitis;
3. That aphthous ulceration is due to damage to underlying blood vessels; 4. That
Crohn’s disease is associated with a hypercoagulable state, and that
patients with hemophilia rarely develop Crohn’s disease; 5. That measles virus genome
is localized to foci of granulomatous vasculitis and lymphoid follicles in the bowel of
patients with Crohn’s disease. In conclusion, we have not proved that measles virus
is the cause of Crohn’s disease. Proof may be difficult until there is a specific
anti-viral drug that is able to eradicate this RNA virus.
CROHN'S DISEASE AFTER IN-UTERO MEASLES VIRUS EXPOSURE
Ekbom A; Daszak P; Kraaz W; Wakefield AJ; Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden. Lancet, 1996 Aug, 348:9026, 515-7
BACKGROUND: An epidemiological association between Crohn’s
disease and measles virus exposure in early life has been suggested in case-control
studies. METHODS: To determine absolute risk estimates for in-utero measles virus exposure
and Crohn’s disease, maternity charts for all 25000 deliveries at University
Hospital, Uppsala, between 1940-49 were reviewed: four cases of measles infection in the
mother during pregnancy were identified. The children and two of their mothers were
interviewed and case records reviewed. Three offspring had undergone multiple intestinal
resections; tissue from these cases were examined by routine histology, and for
measles-virus nucleoprotein antigen by immunohistochemistry and immunogold
electronmicroscopy. FINDINGS: Three of the four children had Crohn’s
disease. In each the disease was preceded by recurrent, antibiotic-resistant
pneumonia. They had extensive ileal and colonic disease; two patients required intravenous
feeding. The only offspring to have had measles as a child did not develop Crohn’s
disease. Measles virus antigen was detected in foci of granulomatous and lymphocytic
inflammation in all children with Crohn’s disease. INTERPRETATION: The data
indicate that exposure of mothers to measles virus in utero is a risk factor for Crohn’s
disease in their children. (and what of MMR in mother before pregnancy, or after and their
resultant kids with autism and inflammatory bowel disease>) Exposure at this time may
lead to persistent infection, or modify the response to infection in later life,
leading to persistence of measles virus.
IS MEASLES VACCINATION A RISK FACTOR FOR INFLAMMATORY
BOWEL DISEASE?
Thompson NP; Montgomery SM; Pounder RE; Wakefield AJ; Inflammatory Bowel Disease
Study Group, Royal Free Hospital School of Medicine, London, UK. Lancet, 1995 Apr,
345:8957, 1071-4
Measles virus may persist in intestinal tissue,
particularly that affected by Crohn’s disease, and early exposure to measles may be a
risk factor for the development of Crohn’s disease. Crohn’s disease and
ulcerative colitis occur in the same families and may share a common
aetiology. In view of the rising incidence of inflammatory bowel disease (Crohn’s
disease and ulcerative colitis), we examined the impact of measles vaccination upon these
conditions. Prevalences of Crohn’s disease, ulcerative colitis, coeliac disease, and
peptic ulceration were determined in 3545 people who had received live measles vaccine in
1964 as part of a measles vaccine trial. A longitudinal birth cohort of 11,407 subjects
was one unvaccinated comparison cohort, and 2541 partners of those vaccinated was another.
Compared with the birth cohort, the relative risk of developing Crohn’s disease in
the vaccinated group was 3.01 (95% CI 1.45-6.23) and of developing ulcerative colitis
was 2.53 (1.15-5.58). There was no significant difference between these two groups in
coeliac disease prevalence. Increased prevalence of inflammatory bowel disease, but not
coeliac disease or peptic ulceration, was found in the vaccinated cohort compared
with their partners. These findings suggest that measles virus may play a part in the
development not only of Crohn’s disease but also of ulcerative colitis.
Finally, it is important to note a possible future direction of this research: it has been shown that treatment with ribavirin is effective in other persistent measles indications - subacute measles encephalitis and measles pneumonitis. Ribavirin has less side effects than steroids, and other than quick relief, it might prove to be a cure for Crohn's( or at least for a subgroup of patients ).