Crohn's Disease: The Complete Guide to Medical Management

Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Chapter 11: Antibiotic Use in the Treatment of Crohn's Disease (continued)

Manuel Mendizabal, MD; Wojciech Blonski, MD, PhD; David Kotlyar, MD; Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Bacterial pathogens have evolved several strategies to escape phagocytic killing by macrophages, including avoidance of phagocytosis19-21 and escape from autophagic recognition.22 Recently, Mpofu et al23 described mannan-induced inhibition of bacterial killing as an additional mechanism by which phagocytosed bacteria may survive and replicate within macrophages. These represent plausible mechanisms wherein bacteria and lipopolysaccharide (LPS) are translocated to the portal vein with the consequent finding of circulating antibodies against bacterial flagellar antigens.