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.

Symptoms and Treatment

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.

Our research

We developed a brad research portfolio comprising clinical, field and laboratory studies.

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.

Areesanan A. Studies on recombinant Strongyloides ratti prolyl oligopetidase and Plasmodial cystein-rich protective antigens. Basel: Swiss Tropical and Public Health Insitute, 2020. MSc Thesis

Borel N et al. wIRA: hyperthermia as a treatment option for intracellular bacteria, with special focus on Chlamydiae and Mycobacteria. Int J Hyperthermia. 2020;37:373-383. DOI: 10.1080/02656736.2020.1751312

Keller D et al. Performance of a real-time PCR approach for diagnosing Schistosoma haematobium infections of different intensity in urine samples from Zanzibar. Infect Dis Poverty. 2020;9:128. DOI: 10.1186/s40249-020-00726-y

Röltgen K, Pluschke G, Spencer J.S, Brennan P.J, Avanzi C. The immunology of other mycobacteria: M. ulcerans, M. leprae. Semin Immunopathol. 2020;42(3):333-353. DOI: 10.1007/s00281-020-00790-4

Röltgen K, Pluschke G. Buruli ulcer: the efficacy of innate immune defense may be a key determinant for the outcome of infection with Mycobacterium ulcerans. Front Microbiol. 2020;11:1018. DOI: 10.3389/fmicb.2020.01018