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.

 

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Selected publications