d a human intestine with Crohn's.
"But in the meantime, an awful lot of evidence has come by, and I would be no damn good as an investigator if I didn't accept that evidence from lab after lab after lab. I made a decision a few years ago that I wasn't going to spend the rest of my life chasing Mycobacterium paratuberculosis when all of this evidence is out there that this isn't the correct organism."
Kruiningen -- although at the same time admitting that Crohn's research has been woefully underfunded -- cites examples of researchers' failed attempts, including his own, to establish a connection between Mp and Crohn's.
"When you have low-budget research, you get low-budget results," says Chiodini. "Most scientists appreciate that negative results are easy to achieve. It is the positive results that take effort."
"It's very hard to prove causation," says Collins. "Critics are fair to say it's still just an association. It's a very complicated disease, and it's a very complicated organism to deal with."
Kruiningen, undeterred in his opposition to the theory, wrote to Dr. Dennis Lang, who helped to organize the NIH workshop, shortly afterwards. "I came away [from the Crohn's disease workshop] with the impression that the M. paratuberculosis proponents had carried the day. It appeared that most of the people there were enamored with the interesting hypothesis, to the point that data to the contrary were secondary."
Despite Kruiningen's objection to the theory, the NIH workshop produced a document concluding that research into the possible connection was not only warranted, but necessary. Lang says that a wide net will be cast in looking for a cause of Crohn's, but most of the research recommendations that were made in the NIH document involve various aspects of Mp and its potential to cause Crohn's disease in humans.
Interestingly, every single NIH research recommendation had been made by Chiodini in the form of grant proposals between 1984 and 1994. Yet despite Chiodini's work -- recognized by those in the field as visionary and well-known to the organizers of the workshop -- NIH neglected to invite him to Bethesda. He attended anyway at the behest of the founders of PARA, who paid for his travel expenses.
The politics of medicine
"What you have to realize is that there is a lot of politics in medicine," says Chiodini, who is still unemployed. "It's not whether you have the proof of something, but whether or not the medical community wants to accept it. Any time you don't follow standard thought, you get into trouble."
Chiodini says he conducted a study as early as 1984 to see if Mp survived the pasteurization process and found that it did. He was unable to get these results published for 10 years. He also says that the National Dairy Promotion and Research Board -- the marketing group that promotes dairy consumption with "Got Milk?" ads, which are funded by an assessment on dairy farmers as well as subsidies from the USDA -- has known for some time that there is a possible connection between Mp and Crohn's. He says shortly after his pasteurization study was published in the Journal of Veterinary Diagnostic Investigations, he was called to a Dairy Board roundtable discussion in Chicago on July 8, 1994, on this very topic.
"There were at least a dozen people there to discuss this issue and to see whether or not the dairy industry should be concerned and what they should do," says Chiodini, who provided a memorandum outlining the meeting's agenda. "The panel stated that they should be concerned and gave recommendations on what should be done. To my knowledge, they never did anything."
The Canadian government has also known about a possible connection between Mp and Crohn's since at least 1994. The Food Production and Inspection Branch of Canada's Agriculture Department produced a Food Safety Risk Assessment paper on "Mycobacterium paratuberculosis and Crohn's disease," which concluded that it was indeed a cause for concern. The document was stamped "Protected -- Not for Distribution."
Chiodini also says he knows of pharmaceuti