Buruli ulcer |
Mycobacterium ulcerans infection (Buruli ulcer): towards improving control, diagnosis and therapy
After tuberculosis and leprosy, Buruli ulcer (BU), caused by M. ulcerans, is the third most common mycobacterial disease, and Western Africa is the world region most affected by this chronic necrotising disease of the skin and the subcutaneous tissue. M. ulcerans is unique among mycobacterial pathogens in that it is mainly extracellular and produces a plasmid-encoded toxin with a polyketide-derived macrolide structure, named mycolactone. Mycolactone is believed to play a central role in determining the extracellular localization of the bacteria and modulation of immunological responses to M. ulcerans. Clinical lesions usually start as painless nodules and if left untreated lead to massive destruction of skin and sometimes bone. While surgery has traditionally been the only recommended treatment for BU, in 2004 WHO published provisional guidelines recommending treatment with a combination of rifampicin and streptomycin for 8 weeks. The goals of our research are to
- improve understanding of the pathogenesis, immunology and transmission of Buruli ulcer,
- develop methods for early diagnosis, and
- investigate prospects for improving therapy and vaccine development.
Selected publications
- Genomic diversity and evolution of Mycobacterium ulcerans revealed by next-generation sequencing. Qi W, Käser M, Röltgen K, Yeboah-Manu D, Pluschke G. PLoS Pathog. 2009 Sep;5(9):e1000580. Epub 2009 Sep 11.
- Development of highly organized lymphoid structures in buruli ulcer lesions after treatment with rifampicin and streptomycin. Schütte D, Um-Boock A, Mensah-Quainoo E, Itin P, Schmid P, Pluschke G. PLoS Negl Trop Dis. 2007 Oct 31;1(1):e2.
- Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial. Junghanss T, Um Boock A, Vogel M, Schuette D, Weinlaeder H, Pluschke G. PLoS Negl Trop Dis. 2009;3(2):e380. Epub 2009 Feb 17.
- Evolution of two distinct phylogenetic lineages of the emerging human pathogen Mycobacterium ulcerans. Käser M, Rondini S, Naegeli M, Stinear T, Portaels F, Certa U, Pluschke G. BMC Evol Biol. 2007 Sep 27;7:177.
- Contiguous spread of Mycobacterium ulcerans in Buruli ulcer lesions analysed by histopathology and real-time PCR quantification of mycobacterial DNA. Rondini S, Horsfield C, Mensah-Quainoo E, Junghanss T, Lucas S, Pluschke G. J Pathol. 2006 Jan;208(1):119-28.