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Crohn’s disease, one of the major types of inflammatory bowel disease, is an inflammatory condition that can affect any area of the gastrointestinal tract. Pathogenic micro-organism(s) or dysbiosis of the intestinal microflora have been suggested to be initiators of the disease (Man et al., 2011). Over recent years, our group has investigated the possible role of pathogenic Campylobacter concisus strains as initiators of inflammatory bowel disease (Kaakoush & Mitchell, 2012). Based on findings related to the pathogenesis of C. concisus (Burgos-Portugal et al., 2014; Kaakoush et al., 2010, 2011b; Man et al., 2010; Nielsen et al., 2011), we hypothesized that C. concisus strains can be subdivided into two pathotypes, adherent and invasive C. concisus (AICC) and adherent and toxigenic C. concisus (AToCC), which are distinct from nonpathogenic strains (Kaakoush et al., 2014b). Briefly, AICC strains possess greater ability to survive intracellularly within intestinal epithelial cells, whilst AToCC strains produce a zonula occludens toxin (ZOT) (Kaakoush et al., 2014b). ZOT is used by virulent pathogens such as Vibrio cholerae and Neisseria meningitidis to increase tissue permeability by targeting tight junctions (Fasano et al., 1995).

Faecal levels of zonula occludens toxin in paediatric patients with Crohn’s disease and their association with the intestinal microbiota