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Autoimmune Dis. 2012; 2012: 150824.
Published online Sep 29, 2012. doi:  10.1155/2012/150824
PMCID: PMC3465878
M. paratuberculosis Heat Shock Protein 65 and Human Diseases: Bridging Infection and Autoimmunity
Coad Thomas Dow*
Chippewa Valley Eye Clinic, Wisconsin and Eye Research Institute, University of Wisconsin-Madison, 2715 Damon Street, Eau Claire, WI 54701, USA
*Coad Thomas Dow: ctdow/at/
Academic Editor: Kamal D. Moudgil
Received June 13, 2012; Revised August 27, 2012; Accepted August 29, 2012.
Mycobacterium avium subspecies paratuberculosis (MAP) is the known infectious cause of Johne's disease, an enteric inflammatory disease mostly studied in ruminant animals. MAP has also been implicated in the very similar Crohn's disease of humans as well as sarcoidosis. Recently, MAP has been associated with juvenile sarcoidosis (Blau syndrome), autoimmune diabetes, autoimmune thyroiditis, and multiple sclerosis. While it is intuitive to implicate MAP in granulomatous diseases where the microbe participates in the granuloma, it is more difficult to assign a role for MAP in diseases where autoantibodies are a primary feature. MAP may trigger autoimmune antibodies via its heat shock proteins. Mycobacterial heat shock protein 65 (HSP65) is an immunodominant protein that shares sequential and conformational elements with several human host proteins. This molecular mimicry is the proposed etiopathology by which MAP stimulates autoantibodies associated with autoimmune (type 1) diabetes, autoimmune (Hashimoto's) thyroiditis, and multiple sclerosis. This paper proposes that MAP is a source of mycobacterial HSP65 and acts as a trigger of autoimmune disease.
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