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Ishwarlall TZ, Adeleke VT, Maharaj L, Okpeku M, Adeniyi AA, Adeleke MA. Multi-epitope vaccine candidates based on mycobacterial membrane protein large (MmpL) proteins against Mycobacterium ulcerans. Open Biol 2023; 13:230330. [PMID: 37935359 PMCID: PMC10645115 DOI: 10.1098/rsob.230330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 11/09/2023] Open
Abstract
Buruli ulcer (BU) is a neglected tropical disease. It is caused by the bacterium Mycobacterium ulcerans and is characterized by skin lesions. Several studies were performed testing the Bacillus Calmette-Guérin (BCG) vaccine in human and animal models and M. ulcerans-specific vaccines in animal models. However, there are currently no clinically accepted vaccines to prevent M. ulcerans infection. The aim of this study was to identify T-cell and B-cell epitopes from the mycobacterial membrane protein large (MmpL) proteins of M. ulcerans. These epitopes were analysed for properties including antigenicity, immunogenicity, non-allergenicity, non-toxicity, population coverage and the potential to induce cytokines. The final 8 CD8+, 12 CD4+ T-cell and 5 B-cell epitopes were antigenic, non-allergenic and non-toxic. The estimated global population coverage of the CD8+ and CD4+ epitopes was 97.71%. These epitopes were used to construct five multi-epitope vaccine constructs with different adjuvants and linker combinations. The constructs underwent further structural analyses and refinement. The constructs were then docked with Toll-like receptors. Three of the successfully docked complexes were structurally analysed. Two of the docked complexes successfully underwent molecular dynamics simulations (MDS) and post-MDS analysis. The complexes generated were found to be stable. However, experimental validation of the complexes is required.
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Affiliation(s)
- Tamara Z. Ishwarlall
- Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Victoria T. Adeleke
- Department of Chemical Engineering, Mangosuthu University of Technology, Umlazi, Durban, South Africa
| | - Leah Maharaj
- Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Moses Okpeku
- Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Adebayo A. Adeniyi
- Department of Chemistry, Faculty of Natural and Agricultural Sciences, University of the Free State, Bloemfontein, South Africa
- Department of Industrial Chemistry, Federal University Oye Ekiti, Ekiti State, Nigeria
| | - Matthew A. Adeleke
- Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
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Fevereiro J, Fraga AG, Pedrosa J. Genetics in the Host-Mycobacterium ulcerans interaction. Immunol Rev 2021; 301:222-241. [PMID: 33682158 DOI: 10.1111/imr.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
Buruli ulcer is an emerging infectious disease associated with high morbidity and unpredictable outbreaks. It is caused by Mycobacterium ulcerans, a slow-growing pathogen evolutionarily shaped by the acquisition of a plasmid involved in the production of a potent macrolide-like cytotoxin and by genome rearrangements and downsizing. These events culminated in an uncommon infection pattern, whereby M. ulcerans is both able to induce the initiation of the inflammatory cascade and the cell death of its proponents, as well as to survive within the phagosome and in the extracellular milieu. In such extreme conditions, the host is sentenced to rely on a highly orchestrated genetic landscape to be able to control the infection. We here revisit the dynamics of M. ulcerans infection, drawing parallels from other mycobacterioses and integrating the most recent knowledge on its evolution and pathogenicity in its interaction with the host immune response.
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Affiliation(s)
- João Fevereiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Alexandra G Fraga
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Jorge Pedrosa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Avumegah MS, Waidyatillake NT, Michalski WP, O’Brien DP, Nelson TM, Athan E. Cell-mediated and serology-based tests for Mycobacterium ulcerans disease: A systematic review and meta-analysis. PLoS Negl Trop Dis 2020; 14:e0008172. [PMID: 32251470 PMCID: PMC7162525 DOI: 10.1371/journal.pntd.0008172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 04/16/2020] [Accepted: 02/26/2020] [Indexed: 11/24/2022] Open
Abstract
Buruli ulcer (BU) is a subcutaneous necrotic infection of the skin caused by Mycobacterium ulcerans. It is the third most common human mycobacterial disease after tuberculosis (TB) and leprosy. The available methods for detection of the bacilli in lesions are microscopic detection, isolation and cultivation of the bacterium, histopathology, and polymerase chain reaction (PCR). These methods, although approved by the World Health Organization (WHO), have infrastructural and resource challenges in medical centres and cell-mediated immunity (CMI) and/or serology-based tests have been suggested as easier and more appropriate for accurate assessment of the disease, especially in remote or underdeveloped areas. This study systematically reviewed and conducted a meta-analysis for all research aimed at developing cell-mediated immunity (CMI) and/or serology-based tests for M. ulcerans disease. Information for this review was searched through PubMed and Web of Science databases and identified up to June 2019. References from relevant articles and reports from the WHO Annual Meeting of the Global Buruli Ulcer Initiative were also used. Twelve studies beginning in 1952, that attempted to develop CMI and/or serology-based tests for the disease were identified. These studies addressed issues of specificity and sensitivity in context of antigen composition as well as study heterogeneity and bias. The two main types of antigenic preparations considered were pathogen-derived and recombinant protein preparations. There was slight difference in test performance when M. ulcerans recombinant proteins [positivity: 67.5%; 32.5%] or pathogen-derived [positivity: 76.0%; 24.0%] preparations were used as test antigens among BU patients. However, pathogen-derived preparations were better at differentiating between patients and control groups [odds ratio (OR) of 27.92, 95%CI: 5.05-154.28]. This was followed by tests with the recombinant proteins [OR = 1.23, 95%CI: 0.27-5.62]. Overall, study heterogeneity index, I2 was 92.4% (p = 0.000). It is apparent from this review that standardisation is needed in any future CMI and/or serology-based tests used for M. ulcerans disease.
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Affiliation(s)
- Michael S. Avumegah
- The University of Queensland, School of Chemistry and Molecular Bioscience, Brisbane, Australia
- Deakin University, School of Medicine, Geelong Australia
- Geelong Centre for Emerging Infectious Diseases (GCEID), Geelong, Australia
| | - Nilakshi T. Waidyatillake
- Department of Infectious Diseases, Barwon Health, Geelong, Australia
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Wojtek P. Michalski
- Commonwealth Scientific and Industrial Research Organisation, Australian Animal Health Laboratory (CSIRO AAHL), Geelong, Australia
| | - Daniel P. O’Brien
- Department of Infectious Diseases, Barwon Health, Geelong, Australia
- Department of Medicine and Infectious Diseases, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Tiffanie M. Nelson
- Deakin University, School of Medicine, Geelong Australia
- Geelong Centre for Emerging Infectious Diseases (GCEID), Geelong, Australia
| | - Eugene Athan
- Deakin University, School of Medicine, Geelong Australia
- Geelong Centre for Emerging Infectious Diseases (GCEID), Geelong, Australia
- Department of Infectious Diseases, Barwon Health, Geelong, Australia
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Gehringer M, Altmann KH. The chemistry and biology of mycolactones. Beilstein J Org Chem 2017; 13:1596-1660. [PMID: 28904608 PMCID: PMC5564285 DOI: 10.3762/bjoc.13.159] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 07/21/2017] [Indexed: 12/21/2022] Open
Abstract
Mycolactones are a group of macrolides excreted by the human pathogen Mycobacterium ulcerans, which exhibit cytotoxic, immunosuppressive and analgesic properties. As the virulence factor of M. ulcerans, mycolactones are central to the pathogenesis of the neglected disease Buruli ulcer, a chronic and debilitating medical condition characterized by necrotic skin ulcers. Due to their complex structure and fascinating biology, mycolactones have inspired various total synthesis endeavors and structure-activity relationship studies. Although this review intends to cover all synthesis efforts in the field, special emphasis is given to the comparison of conceptually different approaches and to the discussion of more recent contributions. Furthermore, a detailed discussion of molecular targets and structure-activity relationships is provided.
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Affiliation(s)
- Matthias Gehringer
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zürich, Vladimir-Prelog-Weg 4, 8093 Zürich, Switzerland
| | - Karl-Heinz Altmann
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zürich, Vladimir-Prelog-Weg 4, 8093 Zürich, Switzerland
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Ruf MT, Chauty A, Adeye A, Ardant MF, Koussemou H, Johnson RC, Pluschke G. Secondary Buruli ulcer skin lesions emerging several months after completion of chemotherapy: paradoxical reaction or evidence for immune protection? PLoS Negl Trop Dis 2011; 5:e1252. [PMID: 21829740 PMCID: PMC3149035 DOI: 10.1371/journal.pntd.0001252] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 06/08/2011] [Indexed: 11/28/2022] Open
Abstract
Background The neglected tropical disease Buruli ulcer (BU) caused by Mycobacterium ulcerans is an infection of the subcutaneous tissue leading to chronic ulcerative skin lesions. Histopathological features are progressive tissue necrosis, extracellular clusters of acid fast bacilli (AFB) and poor inflammatory responses at the site of infection. After the recommended eight weeks standard treatment with rifampicin and streptomycin, a reversal of the local immunosuppression caused by the macrolide toxin mycolactone of M. ulcerans is observed. Methodology/Principal Findings We have conducted a detailed histopathological and immunohistochemical analysis of tissue specimens from two patients developing multiple new skin lesions 12 to 409 days after completion of antibiotic treatment. Lesions exhibited characteristic histopathological hallmarks of Buruli ulcer and AFB with degenerated appearance were found in several of them. However, other than in active disease, lesions contained massive leukocyte infiltrates including large B-cell clusters, as typically found in cured lesions. Conclusion/Significance Our histopathological findings demonstrate that the skin lesions emerging several months after completion of antibiotic treatment were associated with M. ulcerans infection. During antibiotic therapy of Buruli ulcer development of new skin lesions may be caused by immune response-mediated paradoxical reactions. These seem to be triggered by mycobacterial antigens and immunostimulators released from clinically unrecognized bacterial foci. However, in particular the lesions that appeared more than one year after completion of antibiotic treatment may have been associated with new infection foci resolved by immune responses primed by the successful treatment of the initial lesion. Buruli ulcer (BU) is a chronic necrotizing skin disease presenting with extensive tissue destruction and local immunosuppression. Standard treatment recommended by the WHO includes 8 weeks of rifampicin/streptomycin and, if necessary, wound debridement and skin grafting. In some patients satellite lesions develop close to the primary lesion or occasionally also at distant sites during effective antibiotic treatment of the primary lesion. We performed a detailed analysis of tissue specimens from lesions that emerged in two BU patients from Benin 12 to 409 days after completion of chemotherapy. Histopathology revealed features of tissue destruction typically seen in BU and degenerated acid-fast bacilli. In addition, lesions contained organized immune infiltrates typically found in successfully treated BU lesions. Secondary lesions emerging many months after completion of chemotherapy may have been caused by immune response-mediated paradoxical reactions. However, the late onset may also indicate that they were associated with new infection foci spontaneously resolved by adaptive immune responses primed by antibiotic treatment of the primary lesions.
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Affiliation(s)
- Marie-Thérèse Ruf
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Annick Chauty
- Centre de Diagnostic et de Traitement de l'Ulcère de Buruli, Pobè, Benin
- Fondation Raoul Follereau, Cotonou, Benin
| | - Ambroise Adeye
- Centre de Diagnostic et de Traitement de l'Ulcère de Buruli, Pobè, Benin
- Fondation Raoul Follereau, Cotonou, Benin
| | - Marie-Françoise Ardant
- Centre de Diagnostic et de Traitement de l'Ulcère de Buruli, Pobè, Benin
- Fondation Raoul Follereau, Cotonou, Benin
| | - Hugues Koussemou
- Centre de Diagnostic et de Traitement de l'Ulcère de Buruli, Pobè, Benin
- Fondation Raoul Follereau, Cotonou, Benin
| | | | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Pidot SJ, Porter JL, Marsollier L, Chauty A, Migot-Nabias F, Badaut C, Bénard A, Ruf MT, Seemann T, Johnson PDR, Davies JK, Jenkin GA, Pluschke G, Stinear TP. Serological evaluation of Mycobacterium ulcerans antigens identified by comparative genomics. PLoS Negl Trop Dis 2010; 4:e872. [PMID: 21072233 PMCID: PMC2970529 DOI: 10.1371/journal.pntd.0000872] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 10/06/2010] [Indexed: 01/17/2023] Open
Abstract
A specific and sensitive serodiagnostic test for Mycobacterium ulcerans infection would greatly assist the diagnosis of Buruli ulcer and would also facilitate seroepidemiological surveys. By comparative genomics, we identified 45 potential M. ulcerans specific proteins, of which we were able to express and purify 33 in E. coli. Sera from 30 confirmed Buruli ulcer patients, 24 healthy controls from the same endemic region and 30 healthy controls from a non-endemic region in Benin were screened for antibody responses to these specific proteins by ELISA. Serum IgG responses of Buruli ulcer patients were highly variable, however, seven proteins (MUP045, MUP057, MUL_0513, Hsp65, and the polyketide synthase domains ER, AT propionate, and KR A) showed a significant difference between patient and non-endemic control antibody responses. However, when sera from the healthy control subjects living in the same Buruli ulcer endemic area as the patients were examined, none of the proteins were able to discriminate between these two groups. Nevertheless, six of the seven proteins showed an ability to distinguish people living in an endemic area from those in a non-endemic area with an average sensitivity of 69% and specificity of 88%, suggesting exposure to M. ulcerans. Further validation of these six proteins is now underway to assess their suitability for use in Buruli ulcer seroepidemiological studies. Such studies are urgently needed to assist efforts to uncover environmental reservoirs and understand transmission pathways of the M. ulcerans. Buruli ulcer is a slowly progressive but potentially devastating disease of skin and subcutaneous tissue caused by the bacterium Mycobacterium ulcerans. The disease is widespread throughout West and Central Africa, and some countries in the region have established Buruli ulcer control programs. Buruli ulcer is difficult to distinguish from other chronic skin conditions that require different treatments, and there is an urgent need for an accurate point-of-care diagnostic test. In this study, we have used genomic techniques to identify 45 potential M. ulcerans–specific antigens, 33 of which we have been able to produce and purify. We tested these proteins against sera from patients, healthy people living in the same region as the patients and from individuals living in a region with no cases of Buruli ulcer. We found that seven proteins were able to elicit antibody responses that were significantly different between patients and the control subjects from the non-endemic region but not from the healthy individuals in the same Buruli ulcer endemic region. Further analysis showed that six of these M. ulcerans proteins might be useful as markers of exposure to M. ulcerans and could be developed into tools to uncover environmental reservoirs and understand transmission pathways of the bacterium.
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Affiliation(s)
- Sacha J. Pidot
- Department of Microbiology, Monash University, Clayton, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia
| | - Jessica L. Porter
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia
| | - Laurent Marsollier
- Groupe d'Étude des Interactions Hôte-Pathogène, Université d'Angers, Angers, France
| | - Annick Chauty
- Centre de Dépistage et de Traitement de l'ulcère de Buruli, Pobè, Benin
| | - Florence Migot-Nabias
- Institut de Recherche pour le Développement UMR216, Mère et enfant face aux infections tropicales, Paris, France
- Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - Cyril Badaut
- Institut de Recherche pour le Développement UMR216, Mère et enfant face aux infections tropicales, Paris, France
- Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - Angèle Bénard
- Swiss Tropical Public Health Institute, Basel, Switzerland
| | | | - Torsten Seemann
- Victorian Bioinformatics Consortium, Monash University, Clayton, Victoria, Australia
| | - Paul D. R. Johnson
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - John K. Davies
- Department of Microbiology, Monash University, Clayton, Victoria, Australia
| | - Grant A. Jenkin
- Department of Microbiology, Monash University, Clayton, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia
| | - Gerd Pluschke
- Swiss Tropical Public Health Institute, Basel, Switzerland
| | - Timothy P. Stinear
- Department of Microbiology, Monash University, Clayton, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia
- * E-mail:
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Sopoh GE, Barogui YT, Johnson RC, Dossou AD, Makoutodé M, Anagonou SY, Kestens L, Portaels F. Family relationship, water contact and occurrence of Buruli ulcer in Benin. PLoS Negl Trop Dis 2010; 4:e746. [PMID: 20644620 PMCID: PMC2903473 DOI: 10.1371/journal.pntd.0000746] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 05/28/2010] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Mycobacterium ulcerans disease (Buruli ulcer) is the most widespread mycobacterial disease in the world after leprosy and tuberculosis. How M. ulcerans is introduced into the skin of humans remains unclear, but it appears that individuals living in the same environment may have different susceptibilities. OBJECTIVES This study aims to determine whether frequent contacts with natural water sources, family relationship or the practice of consanguineous marriages are associated with the occurrence of Buruli ulcer (BU). DESIGN Case control study. SETTING Department of Atlantique, Benin. SUBJECTS BU-confirmed cases that were diagnosed and followed up at the BU detection and treatment center (CDTUB) of Allada (Department of the Atlantique, Benin) during the period from January 1st, 2006, to June 30th, 2008, with three matched controls (persons who had no signs or symptoms of active or inactive BU) for age, gender and village of residence per case. MAIN OUTCOMES MEASURED Contact with natural water sources, BU history in the family and the practice of consanguineous marriages. RESULTS A total of 416 participants were included in this study, including 104 cases and 312 controls. BU history in the family (p<0.001), adjusted by daily contact with a natural water source (p = 0.007), was significantly associated with higher odds of having BU (OR; 95% CI = 5.5; 3.0-10.0). The practice of consanguineous marriage was not associated with the occurrence of BU (p = 0.40). Mendelian disorders could explain this finding, which may influence individual susceptibility by impairing immunity. CONCLUSION This study suggests that a combination of genetic factors and behavioral risk factors may increase the susceptibility for developing BU.
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Affiliation(s)
| | - Yves Thierry Barogui
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli (CDTUB) de Lalo, Lalo, Bénin
| | - Roch Christian Johnson
- Programme National de Lutte contre la Lèpre et l'Ulcère de Buruli (PNLLUB), Cotonou, Bénin
| | - Ange Dodji Dossou
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli (CDTUB) d'Allada, Allada, Bénin
| | | | | | - Luc Kestens
- Immunology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Françoise Portaels
- Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerpen, Belgium
- * E-mail:
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Silva MT, Portaels F, Pedrosa J. Pathogenetic mechanisms of the intracellular parasite Mycobacterium ulcerans leading to Buruli ulcer. THE LANCET. INFECTIOUS DISEASES 2009; 9:699-710. [PMID: 19850228 DOI: 10.1016/s1473-3099(09)70234-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The necrotising skin infection Buruli ulcer is at present the third most common human mycobacteriosis worldwide, after tuberculosis and leprosy. Buruli ulcer is an emergent disease that is predominantly found in humid tropical regions. There is no vaccine against Buruli ulcer and its treatment is difficult. In addition to the huge social effect, Buruli ulcer is of great scientific interest because of the unique characteristics of its causative organism, Mycobacterium ulcerans. This pathogen is genetically very close to the typical intracellular parasites Mycobacterium marinum and Mycobacterium tuberculosis. We review data supporting the interpretation that M ulcerans has the essential hallmarks of an intracellular parasite, producing infections associated with immunologically relevant inflammatory responses, cell-mediated immunity, and delayed-type hypersensitivity. This interpretation judges that whereas M ulcerans behaves like the other pathogenic mycobacteria, it represents an extreme in the biodiversity of this family of pathogens because of its higher cytotoxicity due to the secretion of the exotoxin mycolactone. The acceptance of the interpretation that Buruli ulcer is caused by an intracellular parasite has relevant prophylactic and therapeutic implications, rather than representing the mere attribution of a label with academic interest, because it prompts the development of vaccines that boost cell-mediated immunity and the use of chemotherapeutic protocols that include intracellularly active antibiotics.
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Affiliation(s)
- Manuel T Silva
- IBMC-Instituto de Biologia Molecular e Celular, Universidade do Porto, Rua do Campo Alegre 823, Porto 4150-180, Portugal
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Huygen K, Adjei O, Affolabi D, Bretzel G, Demangel C, Fleischer B, Johnson RC, Pedrosa J, Phanzu DM, Phillips RO, Pluschke G, Siegmund V, Singh M, van der Werf TS, Wansbrough-Jones M, Portaels F. Buruli ulcer disease: prospects for a vaccine. Med Microbiol Immunol 2009; 198:69-77. [DOI: 10.1007/s00430-009-0109-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Indexed: 10/21/2022]
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10
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Schütte D, Pluschke G. Immunosuppression and treatment-associated inflammatory response in patients withMycobacterium ulceransinfection (Buruli ulcer). Expert Opin Biol Ther 2008; 9:187-200. [DOI: 10.1517/14712590802631854] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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11
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Tanghe A, Dangy JP, Pluschke G, Huygen K. Improved protective efficacy of a species-specific DNA vaccine encoding mycolyl-transferase Ag85A from Mycobacterium ulcerans by homologous protein boosting. PLoS Negl Trop Dis 2008; 2:e199. [PMID: 18350112 PMCID: PMC2265439 DOI: 10.1371/journal.pntd.0000199] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Accepted: 01/22/2008] [Indexed: 11/25/2022] Open
Abstract
Vaccination with plasmid DNA encoding Ag85A from M. bovis BCG can partially protect C57BL/6 mice against a subsequent footpad challenge with M. ulcerans. Unfortunately, this cross-reactive protection is insufficient to completely control the infection. Although genes encoding Ag85A from M. bovis BCG (identical to genes from M. tuberculosis) and from M. ulcerans are highly conserved, minor sequence differences exist, and use of the specific gene of M. ulcerans could possibly result in a more potent vaccine. Here we report on a comparison of immunogenicity and protective efficacy in C57BL/6 mice of Ag85A from M. tuberculosis and M. ulcerans, administered as a plasmid DNA vaccine, as a recombinant protein vaccine in adjuvant or as a combined DNA prime-protein boost vaccine. All three vaccination formulations induced cross-reactive humoral and cell-mediated immune responses, although species-specific Th1 type T cell epitopes could be identified in both the NH2-terminal region and the COOH-terminal region of the antigens. This partial species-specificity was reflected in a higher—albeit not sustained—protective efficacy of the M. ulcerans than of the M. tuberculosis vaccine, particularly when administered using the DNA prime-protein boost protocol. Buruli ulcer (BU) is an infectious disease characterized by deep, ulcerating skin lesions, particularly on arms and legs, that are provoked by a toxin. BU is caused by a microbe belonging to the same family that also causes tuberculosis and leprosy. The disease is emerging as a serious health problem, especially in West Africa. Vaccines are considered to be the most cost-effective strategy to control and eventually eradicate an infectious disease. For the moment, however, there is no good vaccine against BU, and it is still not fully understood which immune defence mechanisms are needed to control the infection. The identification of microbial components that are involved in the immune control is an essential step in the development of an effective vaccine. In this paper, we describe the identification of one of these microbial components, i.e., antigen 85A, a protein involved in the integrity of the cell wall of the microbe. Our findings obtained in a mouse model now need to be extended to other experimental animals and later to humans. Combination with a vaccine targeting the toxin may be a way to strengthen the effectiveness of the vaccine.
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MESH Headings
- Acyltransferases/genetics
- Acyltransferases/immunology
- Acyltransferases/metabolism
- Animals
- Antigens, Bacterial/genetics
- Antigens, Bacterial/immunology
- Antigens, Bacterial/metabolism
- Bacterial Proteins/genetics
- Bacterial Proteins/immunology
- Bacterial Proteins/metabolism
- Cell Line
- Cells, Cultured
- Enzyme-Linked Immunosorbent Assay
- Female
- Foot/microbiology
- Immunity, Cellular/immunology
- Immunity, Humoral/immunology
- Immunoglobulin G/immunology
- Interferon-gamma/metabolism
- Interleukin-2/metabolism
- Male
- Mice
- Mice, Inbred C57BL
- Mycobacterium ulcerans/genetics
- Mycobacterium ulcerans/immunology
- Recombinant Proteins/genetics
- Recombinant Proteins/immunology
- Recombinant Proteins/metabolism
- Vaccines, DNA/genetics
- Vaccines, DNA/immunology
- Vaccines, DNA/metabolism
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Affiliation(s)
- Audrey Tanghe
- Mycobacterial Immunology, IPH-Pasteur Institute Brussels, Brussels, Belgium
| | - Jean-Pierre Dangy
- Department of Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
| | - Gerd Pluschke
- Department of Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
| | - Kris Huygen
- Mycobacterial Immunology, IPH-Pasteur Institute Brussels, Brussels, Belgium
- * E-mail:
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12
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Schipper HS, Rutgers B, Huitema MG, Etuaful SN, Westenbrink BD, Limburg PC, Timens W, van der Werf TS. Systemic and local interferon-gamma production following Mycobacterium ulcerans infection. Clin Exp Immunol 2007; 150:451-9. [PMID: 17900302 PMCID: PMC2219368 DOI: 10.1111/j.1365-2249.2007.03506.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Buruli ulcer disease (BUD) is an emerging predominantly tropical disease caused by Mycobacterium ulcerans. The initial pre-ulcerative skin lesion often breaks down into an ulcer with undermined edges. Healing is common but may require considerable time, and scarring often results in functional limitations. Considerable evidence has now emerged that patients with early BUD cannot mount a sufficient protective T helper 1 (Th1) cell response to M. ulcerans, but uncertainty remains as to whether immune protection is restored over time. This study investigates the Th1 cell response of patients with various stages of BUD on mycobacterial antigens. We measured interferon (IFN)-gamma levels after ex vivo whole blood stimulation with tuberculin purified protein derivative (PPD), and compared the Th1 cell response of individuals with pre-ulcerative, ulcerative and healed BUD as well as healthy controls. Moreover, the systemic Th1 cell response was related to histopathological features in the various stages of surgically resected BUD lesions. We show that patients with ulcerative and healed BUD produce significantly higher IFN-gamma levels after mycobacterial ex vivo whole blood stimulation than healthy controls, and that patients with a granulomatous tissue response produce higher IFN-gamma levels than individuals without. We therefore suggest that the mounted Th1 cell response in ulcerative BUD patients might be related to their histopathological tissue response.
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Affiliation(s)
- H S Schipper
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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13
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Stienstra Y, van der Werf TS, Oosterom E, Nolte IM, van der Graaf WTA, Etuaful S, Raghunathan PL, Whitney EAS, Ampadu EO, Asamoa K, Klutse EY, te Meerman GJ, Tappero JW, Ashford DA, van der Steege G. Susceptibility to Buruli ulcer is associated with the SLC11A1 (NRAMP1) D543N polymorphism. Genes Immun 2007; 7:185-9. [PMID: 16395392 DOI: 10.1038/sj.gene.6364281] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Similar to other mycobacterial diseases, susceptibility to Buruli ulcer (Mycobacterium ulcerans infection) may be determined by host genetic factors. We investigated the role of SLC11A1 (NRAMP1) in Buruli ulcer because of its associations with both tuberculosis and leprosy. We enrolled 182 Buruli ulcer patients (102 with positive laboratory confirmation) and 191 healthy neighbourhood-matched controls in Ghana, and studied three polymorphisms in the SLC11A1 gene: 3' UTR TGTG ins/del, D543N G/A, and INT4 G/C. Finger prick blood samples from study subjects were dried on filter papers (FTA) and processed. D543N was significantly associated with Buruli ulcer: the odds ratio (adjusted for gender, age, and region of the participant) of the GA genotype versus the GG genotype was 2.89 (95% confidence intervals (CI): 1.41-5.91). We conclude that a genetic polymorphism in the SLC11A1 gene plays a role in susceptibility to develop Buruli ulcer, with an estimated 13% population attributable risk.
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Affiliation(s)
- Y Stienstra
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands.
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14
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Affiliation(s)
- Thomas A Kwyer
- Department of Surgery, St. Charles Hospital, Oregon, OH, USA
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15
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Diaz D, Döbeli H, Yeboah-Manu D, Mensah-Quainoo E, Friedlein A, Soder N, Rondini S, Bodmer T, Pluschke G. Use of the immunodominant 18-kiloDalton small heat shock protein as a serological marker for exposure to Mycobacterium ulcerans. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2006; 13:1314-21. [PMID: 17021247 PMCID: PMC1694454 DOI: 10.1128/cvi.00254-06] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
While it is well established that proximity to wetlands is a risk factor for contracting Buruli ulcer, it is not clear what proportion of a population living in an area where the etiologic agent, Mycobacterium ulcerans, is endemic is actually exposed to this disease. Immunological cross-reactivity among mycobacterial species complicates the development of a specific serological test. Among immunodominant proteins recognized by a panel of anti-M. ulcerans monoclonal antibodies, the M. ulcerans homologue of the M. leprae 18-kDa small heat shock protein (shsp) was identified. Since this shsp has no homologues in M. bovis and M. tuberculosis, we evaluated its use as a target antigen for a serological test. Anti-18-kDa shsp antibodies were frequently found in the sera of Buruli ulcer patients and of healthy household contacts but rarely found in controls from regions where the infection is not endemic. The results indicate that only a small proportion of M. ulcerans-infected individuals contract the clinical disease.
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Affiliation(s)
- Diana Diaz
- Molecular Immunology, Swiss Tropical Institute, CH 4002 Basel, Switzerland
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16
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Sizaire V, Nackers F, Comte E, Portaels F. Mycobacterium ulcerans infection: control, diagnosis, and treatment. THE LANCET. INFECTIOUS DISEASES 2006; 6:288-96. [PMID: 16631549 DOI: 10.1016/s1473-3099(06)70464-9] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The skin disease Buruli ulcer, caused by Mycobacterium ulcerans, is the third most common mycobacterial disease after tuberculosis and leprosy and mainly affects remote rural African communities. Although the disease is known to be linked to contaminated water, the mode of transmission is not yet understood, which makes it difficult to propose control interventions. The disease is usually detected in its later stages, when it has caused substantial damage and disability. Surgery remains the treatment of choice. Although easy and effective in the early stages of the disease, treatment requires extended excisions and long hospitalisation for the advanced forms of the disease. Currently, no antibiotic treatment has proven effective for all forms of M ulcerans infection and research into a new vaccine is urgently needed. While the scientific community works on developing non-invasive and rapid diagnostic tools, the governments of endemic countries should implement active case finding and health education strategies in their affected communities to detect the disease in its early stages. We review the diagnosis, treatment, and control of Buruli ulcer and list priorities for research and development.
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