isionary 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 pharmaceutical companies that have been working behind the scenes in preparation for the day this theory comes to light. "You'll be amazed at how quickly the pharmaceutical companies will be out with a product to address it. They're calling this another Helicobacter," he says, referring to the oft-cited ulcer analogy. Pharmaceutical companies were caught off guard when the Helicobacter theory proved true, and are making sure that doesn't happen again, says Chiodini. He says he has talked with a number of pharmaceutical companies about what they should be doing to prepare for the possibility that Mp causes Crohn's.
And the evidence continues to mount. On June 1, two teams of researchers -- from Baylor College of Medicine in Houston and the University of Central Florida in Orlando -- announced at an annual meeting of the American Society for Microbiology in Chicago that they had isolated Mp from the tissue of Crohn's patients, but not from control specimens.
"We are not making any claims that all patients with Crohn's have paratuberculosis, because it is my belief that this is a disease of multiple causes," says Dr. Ira Shafran from University of Central Florida, a gastroenterologist originally from Cleveland Heights. "But it is my belief that this microorganism will be proven as a human pathogen and clearly operative in these patients with Crohn's.
"Dr. Chiodini should really have the disease changed to his name," continues Shafran. "This is not Crohn's disease. That is a catch-all name that has been applied to a variety of inflammatory problems, of which paratuberculosis is one. My concern here as a physician and father of two children is that the animal source of this infection is dairy cattle. ...My population [of Crohn's patients] that is being treated with antibiotics, I've warned them of a possible animal source for obtaining the infection, and I don't want them to reinfect themselves. I've told them to look for ultra-pasteurized milk and to cook their meat well."
"Barry Marshall suggested that Helicobacter caused ulce