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.

Gehringer M et al. Configurationally stabilized analogs of M. ulcerans exotoxins mycolactones A and B reveal the importance of side chain geometry for mycolactone virulence. Org Lett. 2019;21(15):5853-5857. DOI: 10.1021/acs.orglett.9b01947

Guenin-Macé L, Ruf M.T, Pluschke G, Demangel C. Mycolactone: more than just a cytotoxin. In: Pluschke G,Röltgen K, eds. Buruli ulcer: mycobacterium ulcerans disease, 117-134. Cham: Springer, 2019

Ondari E.M et al. Rapid transcriptional responses to serum exposure are associated with sensitivity and resistance to antibody-mediated complement killing in invasive Salmonella Typhimurium ST313. Wellcome Open Res. 2019;4:74. DOI: 10.12688/wellcomeopenres.15059.1

Ondari E.M. Investigating resistance to antibody-dependent complement-mediated lysis in invasive Salmonella Typhimurium. Basel: University Basel, 2019. PhD, University of Basel, Faculty of Science

Piazena H et al. Thermal field formation during wIRA-hyperthermia: temperature measurements in skin and subcutis of piglets as a basis for thermotherapy of superficial tumors and local skin infections caused by thermosensitive microbial pathogens. Int J Hyperthermia. 2019;36(1):938-952. DOI: 10.1080/02656736.2019.1655594