1
|
Ackam N, Opoku-Boadi A, Agbavor B, Adjei JK, Agbanyo A, Oppong MN, Wiafe-Akenten C, Sylverken A, Obiri-Danso K, Wansbrough-Jones M, Amoako YA, Phillips RO. Bacterial diversity in Buruli ulcer lesions in Ghana. J Clin Tuberc Other Mycobact Dis 2024; 36:100468. [PMID: 39171276 PMCID: PMC11338157 DOI: 10.1016/j.jctube.2024.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024] Open
Abstract
Background Previous studies have demonstrated secondary microbial infection of Buruli ulcer (BUD) lesions before, during and after treatment. However, there is limited data on the bacterial diversity across treatment and their influence on clinical outcome. The present study aimed to investigate the relationship between bacterial diversity within BUD lesions and clinical outcome in affected individuals. Methods We investigated the bacterial diversity within lesions of individuals with PCR confirmed BUD from 5 endemic districts within central Ghana. Samples were collected longitudinally from lesions over treatment period. Microbiological analyses including isolation of bacteria, and species identification were performed using the VITEK 2 compact. Results Out of 36 participants included, 80.5 % presented with ulcers on the lower limbs. Higher bacterial diversity was observed in ulcers compared to other clinical forms of BUD. There was a significant association between bacterial diversity and clinical outcome (p = 0.002). ESBL producing bacteria and MRSA were isolated in slow healing BUD lesions. Conclusion Higher diversity of secondary organisms colonizing BUD lesions may have an impact on clinical outcome in affected individuals. There is the need for the development of treatment guidelines for simultaneous management of M. ulcerans and other potential pathogens within lesions to improve clinical outcome.
Collapse
Affiliation(s)
- Nancy Ackam
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Abigail Opoku-Boadi
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernadette Agbavor
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jonathan Kofi Adjei
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Abigail Agbanyo
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Ntiamoah Oppong
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charity Wiafe-Akenten
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Augustina Sylverken
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwasi Obiri-Danso
- Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mark Wansbrough-Jones
- Institute of Infection and Immunity, St George’s University of London, United Kingdom
| | - Yaw Ampem Amoako
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| |
Collapse
|
2
|
Bohelay G, Guyot A, Billard-Pomares T, Marsollier L, Caux F, Carbonnelle E. Extensive buruli ulcer in a patient returning from Mali and Senegal. Travel Med Infect Dis 2024; 60:102725. [PMID: 38754530 DOI: 10.1016/j.tmaid.2024.102725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
no abstract requested for correspondance items.
Collapse
Affiliation(s)
- Gérôme Bohelay
- Department of Dermatology, Groupe Hospitalier Paris-Seine-Saint-Denis, AP-HP, Bobigny, France; INSERM UMR 1125, Université Sorbonne Paris Nord, Bobigny, France.
| | - Alexis Guyot
- Department of Immuno-Dermatology, Groupe Hospitalier Paris-Saclay, AP-HP, Boulogne-Billancourt, France
| | - Typhaine Billard-Pomares
- Université de Paris, IAME, UMR 1137, INSERM, Paris, France; Clinical Microbiology Laboratory, Groupe Hospitalier Paris-Seine-Saint-Denis, AP-HP, Bobigny, France
| | - Laurent Marsollier
- Université d'Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, Immunology (INCIT), Angers, France
| | - Frédéric Caux
- Department of Dermatology, Groupe Hospitalier Paris-Seine-Saint-Denis, AP-HP, Bobigny, France; INSERM UMR 1125, Université Sorbonne Paris Nord, Bobigny, France
| | - Etienne Carbonnelle
- Université de Paris, IAME, UMR 1137, INSERM, Paris, France; Clinical Microbiology Laboratory, Groupe Hospitalier Paris-Seine-Saint-Denis, AP-HP, Bobigny, France
| |
Collapse
|
3
|
Sebti M, Schweitzer-Chaput A, Cisternino S, Hinterlang M, Ancedy D, Lam S, Auvity S, Cotteret C, Lortholary O, Schlatter J. Formulation and Stability of a 1% Clarithromycin-Based Topical Skin Cream: A New Option to Treat Buruli Ulcers? Pharmaceuticals (Basel) 2024; 17:691. [PMID: 38931358 PMCID: PMC11206874 DOI: 10.3390/ph17060691] [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: 04/23/2024] [Revised: 05/14/2024] [Accepted: 05/19/2024] [Indexed: 06/28/2024] Open
Abstract
There are more than 170 known species of non-tuberculous mycobacteria, and some are responsible for serious diseases in people infected with them. One of these is Buruli ulcers, a neglected tropical disease endemic in more than 33 countries and caused by Mycobacterium ulcerans, which infects skin tissue. Treatment consists of a long-term regimen combining the use of oral rifampin with another anti-tuberculosis drug (e.g., clarithromycin). Patients in these countries face difficulties in accessing and adhering to this therapy. This study investigates the feasibility of formulating stable, optimized clarithromycin as a topical cutaneous cream. The cream was formulated, and its stability was evaluated under different storage temperature conditions and using a stability indicator method. The results showed that the clarithromycin cream was stable for at least 60 days, even at extreme temperatures (40 °C). In conclusion, the data presented here demonstrate the stability of a new form of topical cutaneous clarithromycin, which may offer a new approach to the treatment of Buruli ulcers and clarithromycin-sensitive infections.
Collapse
Affiliation(s)
- Maria Sebti
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
| | - Arnaud Schweitzer-Chaput
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
| | - Salvatore Cisternino
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
- Faculté de Pharmacie, Université Paris Cité, Inserm UMRS 1144, 4, Avenue de l’Observatoire, F-75006 Paris, France
| | - Mélanie Hinterlang
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
| | - Dimitri Ancedy
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
| | - Sandrine Lam
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
| | - Sylvain Auvity
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
- Faculté de Pharmacie, Université Paris Cité, Inserm UMRS 1144, 4, Avenue de l’Observatoire, F-75006 Paris, France
| | - Camille Cotteret
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
| | - Olivier Lortholary
- Service des Maladies Infectieuses et Tropicales, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), F-75015 Paris, France;
- Institut Pasteur, Molecular Mycology Unit, National Reference Centre for Invasive Mycoses and Antifungals, CNRS UMR 2000, F-75015 Paris, France
- Institut Imagine, Hôpital Universitaire Necker—Enfants Malades, F-75105 Paris, France
| | - Joël Schlatter
- Service Pharmacie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris (APHP), 149 Rue de Sèvres, F-75015 Paris, France; (M.S.); (A.S.-C.); (M.H.); (D.A.); (S.L.); (S.A.); (C.C.); (J.S.)
- Service Pharmacie, Hôpital Paul Doumer, Assistance Publique des Hôpitaux de Paris (APHP), 1 Rue de l’Hôpital, F-60140 Labruyère, France
| |
Collapse
|
4
|
Wada T, Yoshida S, Yamamoto T, Nonaka L, Fukushima Y, Nakajima C, Suzuki Y, Imajoh M. Application of Genomic Epidemiology of Pathogens to Farmed Yellowtail Fish Mycobacteriosis in Kyushu, Japan. Microbes Environ 2024; 39:ME24011. [PMID: 38897967 PMCID: PMC11220446 DOI: 10.1264/jsme2.me24011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
To investigate mycobacterial cases of farmed yellowtail fish in coastal areas of western Japan (Kagoshima, Kyushu), where aquaculture fisheries are active, Mycobacterium pseudoshottsii, the causative agent, was isolated from six neighboring fishing ports in 2012 and 2013. A phylogenetic ana-lysis revealed that the strains isolated from one fishing port were closely related to those isolated from other regions of Japan, suggesting the nationwide spread of a single strain. However, strains from Japan were phylogenetically distinct from those from the Mediterranean and the United States; therefore, worldwide transmission was not observed based on the limited data obtained on the strains exami-ned in this study. The present results demonstrate that a bacterial genomic ana-lysis of infected cases, a mole-cular epidemiology strategy for public health, provides useful data for estimating the prevalence and transmission pathways of M. pseudoshottsii in farmed fish. A bacterial genome ana-lysis of strains, such as that performed herein, may play an important role in monitoring the prevalence of this pathogen in fish farms and possible epidemics in the future as a result of international traffic, logistics, and trade in fisheries.
Collapse
Affiliation(s)
- Takayuki Wada
- Department of Microbiology, Graduate School of Human Life and Ecology, Osaka Metropolitan University, Osaka, Japan
- Osaka International Research Center for Infectious Diseases, Osaka Metropolitan University, Osaka, Japan
| | - Shiomi Yoshida
- Clinical Research Center, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Osaka, Japan
| | - Takeshi Yamamoto
- Azuma-cho Fisheries Cooperative Association, Izumi, Kagoshima, Japan
| | - Lisa Nonaka
- Faculty of Human Life Sciences, Shokei University, Kumamoto, Kumamoto, Japan
| | - Yukari Fukushima
- Division of Bioresources, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Chie Nakajima
- Division of Bioresources, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan
- Division of Research Support, Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yasuhiko Suzuki
- Division of Bioresources, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan
- Division of Research Support, Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Masayuki Imajoh
- Laboratory of Fish Disease, Aquaculture Course, Department of Marine Resource Science, Faculty of Agriculture and Marine Science, Kochi University, Nankoku, Kochi, Japan
| |
Collapse
|
5
|
Osei-Owusu J, Aidoo OF, Eshun F, Gaikpa DS, Dofuor AK, Vigbedor BY, Turkson BK, Ochar K, Opata J, Opoku MJ, Ninsin KD, Borgemeister C. Buruli ulcer in Africa: Geographical distribution, ecology, risk factors, diagnosis, and indigenous plant treatment options - A comprehensive review. Heliyon 2023; 9:e22018. [PMID: 38034712 PMCID: PMC10686891 DOI: 10.1016/j.heliyon.2023.e22018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
Buruli ulcer (BU), a neglected tropical disease (NTD), is an infection of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. The disease has been documented in many South American, Asian, and Western Pacific countries and is widespread throughout much of Africa, especially in West and Central Africa. In rural areas with scarce medical care, BU is a devastating disease that can leave patients permanently disabled and socially stigmatized. Mycobacterium ulcerans is thought to produce a mycolactone toxin, which results in necrosis of the afflicted tissue and may be involved in the etiology of BU. Initially, patients may notice a painless nodule or plaque on their skin; as the disease progresses, however, it may spread to other parts of the body, including the muscles and bones. Clinical signs, microbial culture, and histological analysis of afflicted tissue all contribute to a diagnosis of BU. Though antibiotic treatment and surgical removal of infected tissue are necessary for BU management, plant-derived medicine could be an alternative in areas with limited access to conventional medicine. Herein we reviewed the geographical distribution, socioeconomic, risk factors, diagnosis, biology and ecology of the pathogen. Complex environmental, socioeconomic, and genetic factors that influence BU are discussed. Further, our review highlights future research areas needed to develop strategies to manage the disease through the use of indigenous African plants.
Collapse
Affiliation(s)
- Jonathan Osei-Owusu
- Department of Physical and Mathematical Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Owusu Fordjour Aidoo
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Fatima Eshun
- Department of Geography and Earth Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - David Sewordor Gaikpa
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Aboagye Kwarteng Dofuor
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Bright Yaw Vigbedor
- Department of Basic Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Bernard Kofi Turkson
- Department of Herbal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kingsley Ochar
- Council for Scientific and Industrial Research, Plant Genetic Resources Research Institute, Bunso, Ghana
| | - John Opata
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Maxwell Jnr. Opoku
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Kodwo Dadzie Ninsin
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Christian Borgemeister
- Centre for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113 Bonn, Germany
| |
Collapse
|
6
|
Popa GL, Muntean AA, Popa MI. Recent Advances in the Management Strategies for Buruli Ulcers. Pathogens 2023; 12:1088. [PMID: 37764896 PMCID: PMC10538148 DOI: 10.3390/pathogens12091088] [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: 06/28/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Buruli ulcer (BU) is a bacterial skin infection that is caused by Mycobacterium ulcerans and mainly affects people who reside in the rural areas of Africa and in suburban and beach resort communities in Australia. The infection typically begins as a painless papule or nodule that gradually develops into a large ulcer that can cause substantial impairment, damaging soft tissues and even bones. Early detection and immediate treatment are crucial to preventing further tissue damage and any potential complications, although it is worth noting that access to proper therapeutic resources can be limited in certain areas. The most commonly used antibiotics for treating BU are rifampicin, streptomycin, and clarithromycin; efforts have recently been made to introduce new treatments that increase the effectiveness and adherence to therapy. This article presents the latest research and management strategies regarding BU, providing an updated and intriguing perspective on this topic.
Collapse
Affiliation(s)
- Gabriela Loredana Popa
- Department of Microbiology, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Alexandru Andrei Muntean
- Department of Microbiology II, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.M.); (M.I.P.)
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| | - Mircea Ioan Popa
- Department of Microbiology II, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.M.); (M.I.P.)
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| |
Collapse
|
7
|
Roy T, Boateng ST, Uddin MB, Banang-Mbeumi S, Yadav RK, Bock CR, Folahan JT, Siwe-Noundou X, Walker AL, King JA, Buerger C, Huang S, Chamcheu JC. The PI3K-Akt-mTOR and Associated Signaling Pathways as Molecular Drivers of Immune-Mediated Inflammatory Skin Diseases: Update on Therapeutic Strategy Using Natural and Synthetic Compounds. Cells 2023; 12:1671. [PMID: 37371141 PMCID: PMC10297376 DOI: 10.3390/cells12121671] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The dysregulated phosphatidylinositol-3-kinase (PI3K)-Akt-mammalian target of rapamycin (mTOR) signaling pathway has been implicated in various immune-mediated inflammatory and hyperproliferative dermatoses such as acne, atopic dermatitis, alopecia, psoriasis, wounds, and vitiligo, and is associated with poor treatment outcomes. Improved comprehension of the consequences of the dysregulated PI3K/Akt/mTOR pathway in patients with inflammatory dermatoses has resulted in the development of novel therapeutic approaches. Nonetheless, more studies are necessary to validate the regulatory role of this pathway and to create more effective preventive and treatment methods for a wide range of inflammatory skin diseases. Several studies have revealed that certain natural products and synthetic compounds can obstruct the expression/activity of PI3K/Akt/mTOR, underscoring their potential in managing common and persistent skin inflammatory disorders. This review summarizes recent advances in understanding the role of the activated PI3K/Akt/mTOR pathway and associated components in immune-mediated inflammatory dermatoses and discusses the potential of bioactive natural products, synthetic scaffolds, and biologic agents in their prevention and treatment. However, further research is necessary to validate the regulatory role of this pathway and develop more effective therapies for inflammatory skin disorders.
Collapse
Affiliation(s)
- Tithi Roy
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Samuel T. Boateng
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Mohammad B. Uddin
- Department of Toxicology and Cancer Biology, Center for Research on Environmental Diseases, College of Medicine, University of Kentucky, Lexington, KY 40536, USA;
| | - Sergette Banang-Mbeumi
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
- Division for Research and Innovation, POHOFI Inc., Madison, WI 53744, USA
- School of Nursing and Allied Health Sciences, Louisiana Delta Community College, Monroe, LA 71203, USA
| | - Rajesh K. Yadav
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Chelsea R. Bock
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Joy T. Folahan
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Xavier Siwe-Noundou
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, P.O. Box 218, Pretoria 0208, South Africa;
| | - Anthony L. Walker
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Judy A. King
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA;
- College of Medicine, Belmont University, 900 Belmont Boulevard, Nashville, TN 37212, USA
| | - Claudia Buerger
- Department of Dermatology, Venerology and Allergology, Clinic of the Goethe University, 60590 Frankfurt am Main, Germany;
| | - Shile Huang
- Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA;
- Department of Hematology and Oncology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA
- Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| | - Jean Christopher Chamcheu
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA;
| |
Collapse
|
8
|
Mahony M, Hung TY, Cox V, Sufyan W, Wallis P, Nizzero D, Francis J, Yan J. Complicated Mycobacterium ulcerans infection in a child in the Northern Territory. J Paediatr Child Health 2023; 59:392-394. [PMID: 36422163 DOI: 10.1111/jpc.16288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Michelle Mahony
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Te-Yu Hung
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Victoria Cox
- Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Global Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Wajiha Sufyan
- Anatomical Pathology, Territory Pathology, Darwin, Northern Territory, Australia
| | - Peter Wallis
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Danielle Nizzero
- Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Joshua Francis
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Global Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Jennifer Yan
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Global Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| |
Collapse
|
9
|
Johnson RC, Sáez-López E, Anagonou ES, Kpoton GG, Ayelo AG, Gnimavo RS, Mignanwande FZ, Houezo JG, Sopoh GE, Addo J, Orford L, Vlasakakis G, Biswas N, Calderon F, Della Pasqua O, Gine-March A, Herrador Z, Mendoza-Losana A, Díez G, Cruz I, Ramón-García S. Comparison of 8 weeks standard treatment (rifampicin plus clarithromycin) vs. 4 weeks standard plus amoxicillin/clavulanate treatment [RC8 vs. RCA4] to shorten Buruli ulcer disease therapy (the BLMs4BU trial): study protocol for a randomized controlled multi-centre trial in Benin. Trials 2022; 23:559. [PMID: 35804454 PMCID: PMC9270751 DOI: 10.1186/s13063-022-06473-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/09/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Buruli ulcer (BU) is a neglected tropical disease caused by Mycobacterium ulcerans that affects skin, soft tissues, and bones, causing long-term morbidity, stigma, and disability. The recommended treatment for BU requires 8 weeks of daily rifampicin and clarithromycin together with wound care, physiotherapy, and sometimes tissue grafting and surgery. Recovery can take up to 1 year, and it may pose an unbearable financial burden to the household. Recent in vitro studies demonstrated that beta-lactams combined with rifampicin and clarithromycin are synergistic against M. ulcerans. Consequently, inclusion of amoxicillin/clavulanate in a triple oral therapy may potentially improve and shorten the healing process. The BLMs4BU trial aims to assess whether co-administration of amoxicillin/clavulanate with rifampicin and clarithromycin could reduce BU treatment from 8 to 4 weeks. METHODS We propose a randomized, controlled, open-label, parallel-group, non-inferiority phase II, multi-centre trial in Benin with participants stratified according to BU category lesions and randomized to two oral regimens: (i) Standard: rifampicin plus clarithromycin therapy for 8 weeks; and (ii) Investigational: standard plus amoxicillin/clavulanate for 4 weeks. The primary efficacy outcome will be lesion healing without recurrence and without excision surgery 12 months after start of treatment (i.e. cure rate). Seventy clinically diagnosed BU patients will be recruited per arm. Patients will be followed up over 12 months and managed according to standard clinical care procedures. Decision for excision surgery will be delayed to 14 weeks after start of treatment. Two sub-studies will also be performed: a pharmacokinetic and a microbiology study. DISCUSSION If successful, this study will create a new paradigm for BU treatment, which could inform World Health Organization policy and practice. A shortened, highly effective, all-oral regimen will improve care of BU patients and will lead to a decrease in hospitalization-related expenses and indirect and social costs and improve treatment adherence. This trial may also provide information on treatment shortening strategies for other mycobacterial infections (tuberculosis, leprosy, or non-tuberculous mycobacteria infections). TRIAL REGISTRATION ClinicalTrials.gov NCT05169554 . Registered on 27 December 2021.
Collapse
Affiliation(s)
- Roch Christian Johnson
- Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d'Abomey-Calavi, Abomey-Calavi, Benin
- Fondation Raoul Follereau, Paris, France
| | - Emma Sáez-López
- Department of Microbiology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Esaï Sèdjro Anagonou
- Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d'Abomey-Calavi, Abomey-Calavi, Benin
| | - Godwin Gérard Kpoton
- Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d'Abomey-Calavi, Abomey-Calavi, Benin
| | - Adjimon Gilbert Ayelo
- Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d'Abomey-Calavi, Abomey-Calavi, Benin
| | - Ronald Sètondji Gnimavo
- Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d'Abomey-Calavi, Abomey-Calavi, Benin
| | - Franck Zinsou Mignanwande
- Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d'Abomey-Calavi, Abomey-Calavi, Benin
| | - Jean-Gabin Houezo
- Programme National de Lutte Contre l'Ulcère de Buruli, Cotonou, Bénin
| | | | - Juliet Addo
- Global Health Catalyst, GlaxoSmithKline, Brentford, London, UK
| | - Lindsay Orford
- Global Health Catalyst, GlaxoSmithKline, Brentford, London, UK
| | | | - Nandita Biswas
- Global Health Catalyst, GlaxoSmithKline, Brentford, London, UK
| | - Felix Calderon
- Global Health Catalyst, GlaxoSmithKline, Brentford, London, UK
| | - Oscar Della Pasqua
- Clinical Pharmacology & Therapeutics Group, University College London, London, UK
- Consiglio Nazionale Delle Ricerche, Istituto Per Le Applicazioni del Calcolo, Rome, Italy
| | | | - Zaida Herrador
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Alfonso Mendoza-Losana
- Global Health Catalyst, GlaxoSmithKline, Brentford, London, UK
- Department of Bioengineering and Aeroespace Engineering, Carlos III University of Madrid, Madrid, Spain
| | | | - Israel Cruz
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Santiago Ramón-García
- Department of Microbiology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain.
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
- Research & Development Agency of Aragon (ARAID) Foundation, Zaragoza, Spain.
| |
Collapse
|
10
|
Meyer A, Stadie V. [Artificial ulcer with perforating bone defect on the scalp due to repeated - scratching attacks in dementia syndrome]. Dtsch Med Wochenschr 2022; 147:720-723. [PMID: 35636425 DOI: 10.1055/a-1828-6505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HISTORY We report on a 72-year-old demented patient with a palm-sized skin defect on the scalp, who has been manipulating her head several times a day with her fingers but also with sharp objects for many months. CLINICAL FINDINGS A 4 × 6 cm circular, cleanly granulated ulcer was visible on the high parietal surface. On general examination, the patient was little affected: no fever, no signs of inflammation around the ulcer, no evidence of meningitis. EXAMINATIONS There was no histological evidence of the presence of a malignant or benign tumor. A CT of the skull showed a bony defect measuring 2.6 × 3.3 cm without involvement of the dura. The whole body CT without pathological findings. THERAPY AND COURSE First, a protective helmet was made for the patient. Subsequently, a titanium plate was surgically inserted as a bone substitute and the defect was closed by means of transpositionoplasty. In the two-year follow-up, no tumor disease was detected. CONCLUSION Due to the lack of evidence of tumorigenesis in a follow-up period of two years, we evaluate the lesion as an artificial ulcer with perforating bone defect caused by repeated scratching attacks in the context of dementia syndrome.
Collapse
Affiliation(s)
- Alexandra Meyer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Halle/Saale
| | - Volker Stadie
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Halle/Saale
| |
Collapse
|
11
|
A Comprehensive Review and Update on Epidemiology, Symptomatology and Management of Nontuberculous Mycobacteria (NTM). JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.2.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Nontuberculous mycobacteria (NTM) are free-living organisms ubiquitously present in the environment. In recent times, NTM gained much importance due to the increase in incidence globally. They are potential agents in causing both pulmonary and extrapulmonary infections in both immunocompromised and immunocompetent individuals. The problem arises when the possible NTM cases are misdiagnosed as drug-resistant tuberculosis (DR-TB). Hence, it is essential to correctly identify the NTMs causing disease due to two major reasons. One is to prevent clinicians from starting anti-tuberculous drugs and the other is that treatment regimen differs for certain NTM from tuberculosis. Apart from conventional methods like smear microscopy, culture, in the current era newer diagnostic modalities like matrix-assisted laser desorption of ionization-time of flight mass spectrometry (MALDI TOF MS), line probe assay, genomic sequencing, are used in referral laboratories which allows identification and speciation of the organism. A thorough literature search was done in PubMed, Google Scholar, Cochrane Library, Embase, Scopus on nontuberculous mycobacteria. The search keywords include nontuberculous mycobacteria, atypical mycobacteria, case reports, and original articles on NTM. In this review, we have summarised the current knowledge on epidemiology, pathogenesis, clinical features, and treatment of NTM.
Collapse
|
12
|
Ishwarlall TZ, Okpeku M, Adeniyi AA, Adeleke MA. The search for a Buruli Ulcer vaccine and the effectiveness of the Bacillus Calmette-Guérin vaccine. Acta Trop 2022; 228:106323. [PMID: 35065013 DOI: 10.1016/j.actatropica.2022.106323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 11/01/2022]
Abstract
Buruli Ulcer is a neglected tropical disease that is caused by Mycobacterium ulcerans. It is not fatal; however, it manifests a range of devastating symptoms on the hosts' bodies. Various drugs and treatments are available for the disease; however, they are often costly and have adverse effects. There is still much uncertainty regarding the mode of transmission, vectors, and reservoir. At present, there are no official vector control methods, prevention methods, or a vaccine licensed to prevent infection. The Bacillus Calmette-Guérin vaccine developed against tuberculosis has some effectiveness against M. ulcerans. However, it is unable to induce long-lasting protection. Various types of vaccines have been developed based specifically against M. ulcerans; however, to date, none has entered clinical trials or has been released for public use. Additional awareness and funding are needed for research in this field and the development of more treatments, diagnostic tools, and vaccines.
Collapse
|
13
|
Receveur JP, Bauer A, Pechal JL, Picq S, Dogbe M, Jordan HR, Rakestraw AW, Fast K, Sandel M, Chevillon C, Guégan JF, Wallace JR, Benbow ME. A need for null models in understanding disease transmission: the example of Mycobacterium ulcerans (Buruli ulcer disease). FEMS Microbiol Rev 2022; 46:fuab045. [PMID: 34468735 PMCID: PMC8767449 DOI: 10.1093/femsre/fuab045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/12/2021] [Indexed: 01/19/2023] Open
Abstract
Understanding the interactions of ecosystems, humans and pathogens is important for disease risk estimation. This is particularly true for neglected and newly emerging diseases where modes and efficiencies of transmission leading to epidemics are not well understood. Using a model for other emerging diseases, the neglected tropical skin disease Buruli ulcer (BU), we systematically review the literature on transmission of the etiologic agent, Mycobacterium ulcerans (MU), within a One Health/EcoHealth framework and against Hill's nine criteria and Koch's postulates for making strong inference in disease systems. Using this strong inference approach, we advocate a null hypothesis for MU transmission and other understudied disease systems. The null should be tested against alternative vector or host roles in pathogen transmission to better inform disease management. We propose a re-evaluation of what is necessary to identify and confirm hosts, reservoirs and vectors associated with environmental pathogen replication, dispersal and transmission; critically review alternative environmental sources of MU that may be important for transmission, including invertebrate and vertebrate species, plants and biofilms on aquatic substrates; and conclude with placing BU within the context of other neglected and emerging infectious diseases with intricate ecological relationships that lead to disease in humans, wildlife and domestic animals.
Collapse
Affiliation(s)
- Joseph P Receveur
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - Alexandra Bauer
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - Jennifer L Pechal
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - Sophie Picq
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - Magdalene Dogbe
- Department of Biological Sciences, Mississippi State University, Starkville, MS, USA
| | - Heather R Jordan
- Department of Biological Sciences, Mississippi State University, Starkville, MS, USA
| | - Alex W Rakestraw
- Department of Biological and Environmental Sciences, The University of West Alabama, Livingston, AL, USA
| | - Kayla Fast
- Department of Biological and Environmental Sciences, The University of West Alabama, Livingston, AL, USA
| | - Michael Sandel
- Department of Biological and Environmental Sciences, The University of West Alabama, Livingston, AL, USA
| | - Christine Chevillon
- Maladies Infectieuses et Vecteurs : Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Université de Montpellier (UM), Centre National de la Recherche Scientifique (CNRS), Institut pour la Recherche et le Développement, Montpellier, France
| | - Jean-François Guégan
- Maladies Infectieuses et Vecteurs : Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Université de Montpellier (UM), Centre National de la Recherche Scientifique (CNRS), Institut pour la Recherche et le Développement, Montpellier, France
- UMR Animal, santé, territoires, risques et écosystèmes, Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE), Centre de coopération internationale en recherche agronomique pour le développement (Cirad), Université de Montpellier (UM), Montpellier, France
| | - John R Wallace
- Department of Biology, Millersville University, Millersville, PA, USA
| | - M Eric Benbow
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
- Ecology, Evolution and Behavior Program, Michigan State University, East Lansing, MI, USA
- AgBioResearch, Michigan State University, East Lansing, MI, USA
- Department of Osteopathic Medical Specialties, Michigan State University, East Lansing, MI, USA
| |
Collapse
|
14
|
Prasad S, Bassett IV, Freeman EE. Dermatology on the global stage: The role of dermatologists in international health advocacy and COVID-19 research. Int J Womens Dermatol 2021; 7:653-659. [PMID: 34722850 PMCID: PMC8539819 DOI: 10.1016/j.ijwd.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Over the last decade, there has been a surge in interest and funding for global health dermatology. Skin conditions are now recognized as the fourth leading cause of nonfatal disease burden worldwide in disability-adjusted life years. Dermatologists are uniquely positioned within global health because skin conditions are often the presenting sign of severe illnesses, such as neglected tropical diseases and COVID-19. METHODS We review four major areas of work by dermatologists within global health: i) characterization of global burden of skin disease, ii) advocacy for dermatologic therapies on the World Health Organization's Model List of Essential Medicines, iii) advancements in global programming for skin-related tropical diseases, and iv) the role of dermatologists during the COVID-19 pandemic. For each area of work, the significance and impact on the health of women and girls is briefly highlighted. RESULTS Dermatologists have led the efforts to quantify and evaluate the global burden of skin disease, the burden of which is disproportionately shared by women. The dermatology community has also championed global efforts to eliminate skin-related neglected tropical diseases, such as scabies. Through national and international policy advocacy, dermatologists have pushed for more dermatologic therapies in the World Health Organization's Model List of Essential Medicines, helping to secure better care for patients with skin disease throughout the world. Since 2020, the dermatology community has worked collaboratively in the fight against COVID-19, establishing a worldwide registry for cutaneous manifestations of SARS-CoV-2 and pursuing research that has allowed colleagues in the house of medicine to better understand this landmark disease. CONCLUSION Through the study and promotion of global health, dermatologists have an important role in the house of medicine.
Collapse
Affiliation(s)
- Sonya Prasad
- Icahn School of Medicine, The Mount Sinai Hospital, New York, New York
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Ingrid V. Bassett
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
| | - Esther E. Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
| |
Collapse
|
15
|
Joshi G, Quadir SS, Yadav KS. Road map to the treatment of neglected tropical diseases: Nanocarriers interventions. J Control Release 2021; 339:51-74. [PMID: 34555491 DOI: 10.1016/j.jconrel.2021.09.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 12/11/2022]
Abstract
Neglected tropical disease (NTD) is a set of 20 deadliest endemic diseases which shows its presence in most of the developing countries worldwide. Nearly 1 billion of the population are affected by it and suffered from poverty yearly. These diseases offer their own unique challenges and limitations towards effective prevention and treatment methods. Neglected tropical diseases are severe infections they may not kill the patient but debilitate the patient by causing severe skin deformities, disfigurement and horrible risks for several infections. Existing therapies for neglected diseases suffer from the loopholes like high degree of toxicity, side effects, low bioavailability, improper targeting and problematic application for affected populations. Progress in the field of nanotechnology in last decades suggested the intervention of nanocarriers to take over and drive the research and development to the next level by incorporating established drugs into the nanocarriers rather than discovering the newer drugs which is an expensive affair. These nanocarriers are believed to be a sure shot technique to fight infections at root level by virtue of its nanosize and ability to reach at cellular level. This article highlights the recent advances, rationale, targets and the challenges that are being faced to fight against NTDs and how the novel therapy tactics are able to contribute to its importance in prevention and treatment of NTDs.
Collapse
Affiliation(s)
- Garima Joshi
- Department of Pharmaceutical Sciences, Mohanlal Sukhadia University, Udaipur, Rajasthan 313001, India
| | - Sheikh Shahnawaz Quadir
- Department of Pharmaceutical Sciences, Mohanlal Sukhadia University, Udaipur, Rajasthan 313001, India
| | - Khushwant S Yadav
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS (Deemed to be University), Mumbai 400056, India.
| |
Collapse
|
16
|
Llibre A, Dedicoat M, Burel JG, Demangel C, O’Shea MK, Mauro C. Host Immune-Metabolic Adaptations Upon Mycobacterial Infections and Associated Co-Morbidities. Front Immunol 2021; 12:747387. [PMID: 34630426 PMCID: PMC8495197 DOI: 10.3389/fimmu.2021.747387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/08/2021] [Indexed: 12/14/2022] Open
Abstract
Mycobacterial diseases are a major public health challenge. Their causative agents include, in order of impact, members of the Mycobacterium tuberculosis complex (causing tuberculosis), Mycobacterium leprae (causing leprosy), and non-tuberculous mycobacterial pathogens including Mycobacterium ulcerans. Macrophages are mycobacterial targets and they play an essential role in the host immune response to mycobacteria. This review aims to provide a comprehensive understanding of the immune-metabolic adaptations of the macrophage to mycobacterial infections. This metabolic rewiring involves changes in glycolysis and oxidative metabolism, as well as in the use of fatty acids and that of metals such as iron, zinc and copper. The macrophage metabolic adaptations result in changes in intracellular metabolites, which can post-translationally modify proteins including histones, with potential for shaping the epigenetic landscape. This review will also cover how critical tuberculosis co-morbidities such as smoking, diabetes and HIV infection shape host metabolic responses and impact disease outcome. Finally, we will explore how the immune-metabolic knowledge gained in the last decades can be harnessed towards the design of novel diagnostic and therapeutic tools, as well as vaccines.
Collapse
Affiliation(s)
- Alba Llibre
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Martin Dedicoat
- Department of Infectious Diseases, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Julie G. Burel
- Division of Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Caroline Demangel
- Immunobiology of Infection Unit, Institut Pasteur, INSERM U1224, Paris, France
| | - Matthew K. O’Shea
- Department of Infectious Diseases, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Claudio Mauro
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
17
|
Demangel C. Immunity against Mycobacterium ulcerans: The subversive role of mycolactone. Immunol Rev 2021; 301:209-221. [PMID: 33607704 DOI: 10.1111/imr.12956] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/11/2022]
Abstract
Mycobacterium ulcerans causes Buruli ulcer, a neglected tropical skin disease manifesting as chronic wounds that can leave victims with major, life-long deformity and disability. Differently from other mycobacterial pathogens, M ulcerans produces mycolactone, a diffusible lipid factor with unique cytotoxic and immunomodulatory properties. Both traits result from mycolactone targeting Sec61, the entry point of the secretory pathway in eukaryotic cells. By inhibiting Sec61, mycolactone prevents the host cell's production of secreted proteins, and most of its transmembrane proteins. This molecular blockade dramatically alters the functions of immune cells, thereby the generation of protective immunity. Moreover, sustained inhibition of Sec61 triggers proteotoxic stress responses leading to apoptotic cell death, which can stimulate vigorous immune responses. The dynamics of bacterial production of mycolactone and elimination by infected hosts thus critically determine the balance between its immunostimulatory and immunosuppressive effects. Following an introduction summarizing the essential information on Buruli ulcer disease, this review focuses on the current state of knowledge regarding mycolactone's regulation and biodistribution. We then detail the consequences of mycolactone-mediated Sec61 blockade on initiation and maintenance of innate and adaptive immune responses. Finally, we discuss the key questions to address in order to improve immunity to M ulcerans, and how increased knowledge of mycolactone biology may pave the way to innovative therapeutics.
Collapse
Affiliation(s)
- Caroline Demangel
- Immunobiology of Infection Unit, INSERM U1221, Institut Pasteur, Paris, France
| |
Collapse
|
18
|
Abdul-Karim A, Schroeder LF. Inadequate Capacity to Diagnose Cutaneous Infections in Ghana: Extensive Skin Ulceration in a 28-Year-Old Man in the Northern Region. J Appl Lab Med 2020; 6:298-303. [PMID: 33347587 DOI: 10.1093/jalm/jfaa216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/27/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Abass Abdul-Karim
- Ghana Health Services, Zonal Public Health Laboratory, Tamale, Ghana
| | - Lee F Schroeder
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
19
|
Singer TG, Bray MA, Chan A, Ikeda S, Walters B, Fuller MY, Falco C. Chronic Ulcers and Malnutrition in an African Patient. Pediatrics 2020; 146:e20201717. [PMID: 33115794 PMCID: PMC8061712 DOI: 10.1542/peds.2020-1717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 11/24/2022] Open
Abstract
An 11-year-old girl with a congenitally malformed left hand, sickle cell trait, asthma, and history of appendicitis was transferred from Zambia for evaluation and treatment of widespread suppurative and ulcerative skin lesions that typically appeared after trauma to her skin. The ulcers first presented 3 years earlier but had markedly worsened in the 9 months before transfer, spreading circumferentially on her extremities and abdomen at the site of an appendectomy. They were painful and did not resolve with multiple courses of intravenous antibiotics and close management by a pediatric infectious disease specialist working for a nongovernmental organization (NGO) in her home country. Per NGO records, she had previously been average weight-for-age. On presentation after international transfer, she was severely malnourished, with lesions covering ∼35% of her body. In initial workup, leukocytosis of 21 × 103 cells per μL (79% neutrophils), hemoglobin of 6.1 g/dL, and mean corpuscular volume of 66 fL were found. Iron studies revealed an iron level of 18 μg/dL, ferritin level of 55 ng/mL, total iron binding capacity of 222 μg/dL, and transferrin saturation of 8%. Inflammatory markers were elevated, C-reactive protein was 20.1 mg/dL, and the erythrocyte sedimentation rate was 131 mm/h. A chest computed tomography scan revealed bilateral pulmonary nodules, the largest in her left upper lobe measuring 2.4 × 2.0 × 1.9 cm. Our panel of experts reviews the evaluation and treatment of this patient with extensive suppurative and ulcerative skin lesions and the factors considered in offering charity care to international patients.
Collapse
Affiliation(s)
| | | | | | | | - Brittany Walters
- International and Destination Medicine, Texas Children's Hospital, Houston, Texas
| | - Maren Y Fuller
- Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; and
| | | |
Collapse
|
20
|
Mangas KM, Tobias NJ, Marion E, Babonneau J, Marsollier L, Porter JL, Pidot SJ, Wong CY, Jackson DC, Chua BY, Stinear TP. High antibody titres induced by protein subunit vaccines using Mycobacterium ulcerans antigens Hsp18 and MUL_3720 with a TLR-2 agonist fail to protect against Buruli ulcer in mice. PeerJ 2020; 8:e9659. [PMID: 32844063 PMCID: PMC7416718 DOI: 10.7717/peerj.9659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/14/2020] [Indexed: 12/26/2022] Open
Abstract
Background Mycobacterium ulcerans is the causative agent of a debilitating skin and soft tissue infection known as Buruli ulcer (BU). There is no vaccine against BU. The purpose of this study was to investigate the vaccine potential of two previously described immunogenic M. ulcerans proteins, MUL_3720 and Hsp18, using a mouse tail infection model of BU. Methods Recombinant versions of the two proteins were each electrostatically coupled with a previously described lipopeptide adjuvant. Seven C57BL/6 and seven BALB/c mice were vaccinated and boosted with each of the formulations. Vaccinated mice were then challenged with M. ulcerans via subcutaneous tail inoculation. Vaccine performance was assessed by time-to-ulceration compared to unvaccinated mice. Results The MUL_3720 and Hsp18 vaccines induced high titres of antigen-specific antibodies that were predominately subtype IgG1. However, all mice developed ulcers by day-40 post-M. ulcerans challenge. No significant difference was observed in the time-to-onset of ulceration between the experimental vaccine groups and unvaccinated animals. Conclusions These data align with previous vaccine experiments using Hsp18 and MUL_3720 that indicated these proteins may not be appropriate vaccine antigens. This work highlights the need to explore alternative vaccine targets and different approaches to understand the role antibodies might play in controlling BU.
Collapse
Affiliation(s)
- Kirstie M Mangas
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Nicholas J Tobias
- Johann Wolfgang Goethe Universität Frankfurt am Main, Frankfurt, Germany.,LOEWE Centre for Translational Biodiversity in Genomics (TBG), Frankfurt, Germany
| | - Estelle Marion
- Université de Nantes, Nantes, France.,Université de Nantes, Nantes, France.,Université d'Angers, Angers, France
| | - Jérémie Babonneau
- Université de Nantes, Nantes, France.,Université d'Angers, Angers, France
| | - Laurent Marsollier
- Université de Nantes, Nantes, France.,Université d'Angers, Angers, France
| | - Jessica L Porter
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Sacha J Pidot
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Chinn Yi Wong
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - David C Jackson
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Brendon Y Chua
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Timothy P Stinear
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
21
|
Ademe M, Girma F. Candida auris: From Multidrug Resistance to Pan-Resistant Strains. Infect Drug Resist 2020; 13:1287-1294. [PMID: 32440165 PMCID: PMC7211321 DOI: 10.2147/idr.s249864] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/19/2020] [Indexed: 11/23/2022] Open
Abstract
Candida auris is an emerging multidrug-resistant fungus that is rapidly spreading worldwide. Currently, C. auris cases have been reported globally from >30 countries. Most reported infections involve critically ill patients in hospitals, mainly in intensive care unit settings. Infection with C. auris is associated with high mortality rates, and it is often resistant to multiple classes of antifungal drugs. Despite the rapid global spread, it is difficult to predict the actual burden of the infection as the standard laboratory methods fail to correctly identify the fungi. Longer stays in healthcare facilities, use of tracheostomies and percutaneous endoscopic gastrostomy tubes, ventilators in clinical care units and mobile equipment in healthcare settings are shown as major risk factors of C. auris infection. Due to its propensity to cause outbreaks and its antifungal resistance, C. auris poses a risk for patients in healthcare facilities. The emergence of pan-resistant C. auris strains in some areas is an alarming signal for the disease with limited treatment options, high mortality rates, and the ability of the pathogen to spread easily in healthcare settings. In this regard, susceptibility testing on clinical isolates, mainly for patients treated with echinocandins, is needed. Increasing awareness about C. auris infection and advancing the diagnostic methods are also essential for early detection and control of the deadly fungal infection.
Collapse
Affiliation(s)
- Muluneh Ademe
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Friehiwot Girma
- Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
22
|
Nail AMA, Tonga RA, Salih HM, Abuzeid N, Ahmed MH. The co-infection of Buruli ulcer and cutaneous leishmaniasis in Sudanese patient: An association by choice or by chance? J Infect Public Health 2020; 13:1184-1186. [PMID: 32359927 DOI: 10.1016/j.jiph.2020.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 11/17/2022] Open
Abstract
Buruli ulcer and cutaneous leishmaniasis both have the similar cutaneous clinical presentation. Therefore, relying on clinical diagnosis can be challenging. We present a case of 45 years old woman diagnosed with cutaneous leishmaniasis, confirmed by skin biopsy. She received different modalities of anti-leishmanial treatment (fluconazole 450mg daily for 4 weeks, sodium stibogluconate (SSG) followed by thermal therapy, SSG/IV 20mg/kg for 30 days combined with paromomycin 15mg/kg IM for 17 days). These treatments were associated with partial improvement of the ulcer and failure of healing. A second biopsy demonstrated the presence of Mycobacterium ulcerans and hence the diagnosis of Buruli ulcer as a cause of the delayed healing of the ulcer. M. ulcerans releases a toxin known as mycolactone, which decreases immune system function and results in tissue death. M. ulcerans, is regarded as the third most prevalent Mycobacterium after M. tuberculosis and M. leprae. Treatment with streptomycin intramuscular injections 1g daily and rifampicin 600mg daily for 8 weeks was associated with complete healing of the ulcer. To our knowledge, this is the first report that describes the co-infection of Buruli ulcer and cutaneous leishmaniasis in Sudan.
Collapse
Affiliation(s)
- Abdelsalam M A Nail
- Department of Internal Medicine, Faculty of Medicine Omdurman Islamic University & Tropical Diseases Teaching Hospital, Khartoum, Sudan.
| | - Rayan Ali Tonga
- Registrar of Internal medicine Tropical Diseases Teaching Hospital, Sudan
| | - Huda M Salih
- Department of Pathology, AlNeelain University, Khartoum, Sudan
| | - Nadir Abuzeid
- Department of Medical Microbiology Faculty of Medical Laboratory Science, Omdurman Islamic University, Khartoum, Sudan
| | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire, UK
| |
Collapse
|
23
|
Dupechez L, Carvalho P, Hebert V, Marsollier L, Eveillard M, Marion E, Kempf M. Senegal, a new potential endemic country for Buruli ulcer? Int J Infect Dis 2019; 89:128-130. [PMID: 31585214 DOI: 10.1016/j.ijid.2019.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022] Open
Abstract
Mycobacterium ulcerans is the causal agent of Buruli ulcer, a neglected tropical disease with cutaneous tropism. We report a case of Buruli ulcer in a patient who travelled in Senegal, a country not identified by the World Health Organization as being endemic for this disease. This case is the third case of Buruli ulcer reported as having been contracted in Senegal, showing the urgent need to develop data collection in this country by having an active community-based surveillance-response system.
Collapse
Affiliation(s)
- Lucie Dupechez
- Département de Dermatologie, Inserm U519, CHU Rouen, Rouen, France
| | | | - Vivien Hebert
- Département de Dermatologie, Inserm U519, CHU Rouen, Rouen, France
| | - Laurent Marsollier
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Matthieu Eveillard
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France; Laboratoire de Bactériologie-Hygiène, Institut de Biologie en Santé - PBH, CHU Angers, Angers, France
| | - Estelle Marion
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Marie Kempf
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France; Laboratoire de Bactériologie-Hygiène, Institut de Biologie en Santé - PBH, CHU Angers, Angers, France.
| |
Collapse
|
24
|
Aydin F, Sun R, Swanson JMJ. Mycolactone Toxin Membrane Permeation: Atomistic versus Coarse-Grained MARTINI Simulations. Biophys J 2019; 117:87-98. [PMID: 31174850 PMCID: PMC6626831 DOI: 10.1016/j.bpj.2019.05.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 02/06/2023] Open
Abstract
Mycolactone, a cytotoxic and immunosuppressive macrolide produced by Mycobacterium ulcerans, is the central virulent factor in the skin disease Buruli ulcer. This multifunctional cytotoxin affects fundamental cellular processes such as cell adhesion, immune response, and cell death by targeting various cellular structures. Developing effective diagnostics that target mycolactone has been challenging, potentially because of suspected interactions with lipophilic architectures, including membranes. To better understand the pathogenesis of Buruli ulcer disease, aid in the development of diagnostics, and learn how amphiphiles in general use lipid trafficking to navigate the host environment, we seek to understand the nature of mycolactone-membrane interactions. Herein, we characterize how the two dominant isomers of mycolactone (A and B) interact with and permeate DPPC membranes with all-atom molecular dynamics simulations employing transition-tempered metadynamics and compare these results to those obtained by MARTINI coarse-grained simulations. Our all-atom simulations reveal that both isomers have a strong preference to associate with the membrane, although their mechanisms and energetics of membrane permeation differ slightly. Water molecules are found to play an important role in the permeation process. Although the MARTINI coarse-grained simulations give the correct free energy of membrane association, they fail to capture the mechanism of permeation and role of water during permeation as seen in all-atom simulations.
Collapse
Affiliation(s)
- Fikret Aydin
- Department of Chemistry and Institute for Biophysical Dynamics, University of Chicago, Chicago, Illinois
| | - Rui Sun
- Department of Chemistry and Institute for Biophysical Dynamics, University of Chicago, Chicago, Illinois
| | - Jessica M J Swanson
- Department of Chemistry and Institute for Biophysical Dynamics, University of Chicago, Chicago, Illinois.
| |
Collapse
|
25
|
Ibrahim YL, Masouyé I, Tschanz E, Atangana P, Etard JF, Serafini M, Mueller YK, Toutous Trellu L. Diagnostic Value of Histological Analysis of Punch Biopsies in Suspected Cutaneous Buruli Ulcer: A Study on 32 Cases of Confirmed Buruli Ulcer in Cameroon. Dermatopathology (Basel) 2019; 6:28-36. [PMID: 31192197 PMCID: PMC6547264 DOI: 10.1159/000498969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/15/2019] [Indexed: 11/17/2022] Open
Abstract
Background Buruli ulcer (BU) is a cutaneous infectious disease caused by Mycobacterium ulcerans. In this prospective study, we aim to clarify the main histopathological features of cutaneous BU based on 4-mm skin punch biopsies and to evaluate the diagnostic value of this method. Methods Between 2011 and 2013, a prospective study was conducted in Cameroon. Dry swabs from ulcerative lesions and fine-needle aspirates of nonulcerative lesions were examined for Ziehl-Neelsen (ZN) staining, followed by PCR targeting IS2404 and culture. Two 4-mm punch biopsies were performed in the center and in the periphery of each lesion. Results The 364 patients included in the study had 422 lesions (381 were ulcerative and 357 lesions were biopsied). Among the 99 ulcerated lesions with a final diagnosis of BU, histological features for BU were fulfilled in 32 lesions. 32/32 showed subcutaneous necrosis with a neutrophilic inflammatory infiltrate. 26/32 presented alcohol-resistant bacilli confirmed by ZN stain on histology. Conclusion Punch biopsies help in establishing the correct diagnosis of BU and also in the differential diagnosis of chronic ulcers. The main histological feature for BU is diffuse coagulative necrosis of subcutaneous tissue, with acid-fast bacilli detected by ZN stain.
Collapse
Affiliation(s)
| | - Isabelle Masouyé
- Division of Dermatology, Geneva University Hospitals, Geneva, Switzerland
| | | | | | - Jean-François Etard
- Epicentre, Paris, France & Institut de Recherche pour le Développement (IRD) UMI 233-INSERM U 1175, Montpellier University, Montpellier, France
| | | | - Yolanda K Mueller
- Institut Universitaire de Médecine de Famille (IUMF), Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | | |
Collapse
|
26
|
Turner GA, Seck A, Dieng A, Diadie S, Ndiaye B, van Imeerzeel TD, Diallo M, Kempf M, Bercion R, Boye CSB. Confirmed Case of Buruli Ulcer, Senegal, 2018. Emerg Infect Dis 2019; 25:600-601. [PMID: 30789331 PMCID: PMC6390742 DOI: 10.3201/eid2503.180707] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Buruli ulcer is a necrotizing skin disease caused by Mycobacterium ulcerans and is usually associated with tropical climates and exposure to slow-moving or stagnant water. We report a case of Buruli ulcer that may have originated in an urban semiarid area of Senegal.
Collapse
|
27
|
Arenaz-Callao MP, González del Río R, Lucía Quintana A, Thompson CJ, Mendoza-Losana A, Ramón-García S. Triple oral beta-lactam containing therapy for Buruli ulcer treatment shortening. PLoS Negl Trop Dis 2019; 13:e0007126. [PMID: 30689630 PMCID: PMC6366712 DOI: 10.1371/journal.pntd.0007126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/07/2019] [Accepted: 01/04/2019] [Indexed: 12/04/2022] Open
Abstract
The potential use of clinically approved beta-lactams for Buruli ulcer (BU) treatment was investigated with representative classes analyzed in vitro for activity against Mycobacterium ulcerans. Beta-lactams tested were effective alone and displayed a strong synergistic profile in combination with antibiotics currently used to treat BU, i.e. rifampicin and clarithromycin; this activity was further potentiated in the presence of the beta-lactamase inhibitor clavulanate. In addition, quadruple combinations of rifampicin, clarithromycin, clavulanate and beta-lactams resulted in multiplicative reductions in their minimal inhibitory concentration (MIC) values. The MIC of amoxicillin against a panel of clinical isolates decreased more than 200-fold within this quadruple combination. Amoxicillin/clavulanate formulations are readily available with clinical pedigree, low toxicity, and orally and pediatric available; thus, supporting its potential inclusion as a new anti-BU drug in current combination therapies. Buruli ulcer (BU) is a chronic debilitating disease of the skin and soft tissue, mainly affecting children and young adults in tropical regions. Before 2004, the only treatment option was surgery; a major breakthrough was the discovery that BU could be cured in most cases with a standard treatment that involved 8 weeks of combination therapy with rifampicin and streptomycin. However, the use of streptomycin is often associated with severe side effects such as ototoxicity, or nephrotoxicity. More recently, a clinical trial demonstrated equipotency of replacing the injectable streptomycin by the clarithromycin, which is orally available and associated with fewer side effects. BU treatment is now moving toward a full orally available treatment of clarithromycin-rifampicin. Although effective and mostly well tolerated, this new treatment is still associated with side effects and only moxifloxacin is additionally recommended by WHO for BU therapy. New drugs are thus needed to increase the number of available treatments, reduce side effects, and improve efficacy with treatments shorter than 8 weeks. In this work, we describe for the first time the potential inclusion of beta-lactams in BU therapy. More specifically, we propose the use of amoxicillin/clavulanate since it is oral, suitable for the treatment of children, and readily available with a long track record of clinical pedigree. Its inclusion in a triple oral therapy complementing current combinatorial rifampicin-clarithromycin treatment has the potential to counteract resistance development and to reduce length of treatment and time to cure.
Collapse
Affiliation(s)
- María Pilar Arenaz-Callao
- Research & Development Agency of Aragon (ARAID) Foundation, Zaragoza, Spain
- Global Health R&D, GlaxoSmithKline, Tres Cantos, Madrid, Spain
| | | | - Ainhoa Lucía Quintana
- Mycobacterial Genetics Group. Department of Microbiology, Preventive Medicine and Public Health. Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Charles J. Thompson
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, B.C. Canada
| | | | - Santiago Ramón-García
- Research & Development Agency of Aragon (ARAID) Foundation, Zaragoza, Spain
- Global Health R&D, GlaxoSmithKline, Tres Cantos, Madrid, Spain
- Mycobacterial Genetics Group. Department of Microbiology, Preventive Medicine and Public Health. Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, B.C. Canada
- * E-mail: (AML); (SRG)
| |
Collapse
|
28
|
Seth-Smith HMB, Imkamp F, Tagini F, Cuénod A, Hömke R, Jahn K, Tschacher A, Grendelmeier P, Bättig V, Erb S, Reinhard M, Rütimann G, Borrell S, Gagneux S, Casanova C, Droz S, Osthoff M, Tamm M, Nübel U, Greub G, Keller PM, Egli A. Discovery and Characterization of Mycobacterium basiliense sp. nov., a Nontuberculous Mycobacterium Isolated From Human Lungs. Front Microbiol 2019; 9:3184. [PMID: 30671031 PMCID: PMC6331445 DOI: 10.3389/fmicb.2018.03184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/10/2018] [Indexed: 12/22/2022] Open
Abstract
Bacteria belonging to the genus Mycobacterium are predominantly responsible for pulmonary diseases; most notably Mycobacterium tuberculosis causes granulomatous pulmonary infections. Here we describe a novel slow growing mycobacterial species isolated from respiratory samples from five patients, four with underlying pulmonary disease. The isolates were characterized by biochemical and molecular techniques, including whole genome sequencing. Biochemical characteristics generally match those of M. marinum and M. ulcerans; however, the most striking difference of the new species is its ability to grow at 37°C. The new species was found to grow in human macrophages, but not amoebae, suggesting a pathogenic rather than an environmental lifestyle. Phylogenetic analysis reveals a deep-rooting relationship to M. marinum and M. ulcerans. A complete genome sequence was obtained through combining short and long-read sequencing, providing a genome of 5.6 Mb. The genome appears to be highly intact, syntenic with that of M. marinum, with very few insertion sequences. A vast array of virulence factors includes 283 PE/PPE surface-associated proteins, making up 10% of the coding capacity, and 22 non-ribosomal peptide synthase clusters. A comparison of six clinical isolates from the five patients shows that they differ by up to two single nucleotide polymorphisms, suggesting a common source of infection. Our findings are in accordance with the recognition of a new taxonomic entity. We propose the name M. basiliense, as all isolates were found in patients from the Basel area of Switzerland.
Collapse
Affiliation(s)
- Helena M. B. Seth-Smith
- Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Frank Imkamp
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Florian Tagini
- Institute of Microbiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Aline Cuénod
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Rico Hömke
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
- National Center for Mycobacteria, Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Kathleen Jahn
- Division of Pneumology, University Hospital Basel, Basel, Switzerland
| | - Anne Tschacher
- Division of Pneumology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Peter Grendelmeier
- Division of Pneumology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Veronika Bättig
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Stefan Erb
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Miriam Reinhard
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Carlo Casanova
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Sara Droz
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Michael Osthoff
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Michael Tamm
- Division of Pneumology, University Hospital Basel, Basel, Switzerland
| | - Ulrich Nübel
- Leibniz Institute DSMZ, German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
- German Center for Infection Research (DZIF), Braunschweig, Germany
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Peter M. Keller
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
- National Center for Mycobacteria, Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Adrian Egli
- Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| |
Collapse
|
29
|
Bretzel G, Beissner M. PCR detection of Mycobacterium ulcerans-significance for clinical practice and epidemiology. Expert Rev Mol Diagn 2018; 18:1063-1074. [PMID: 30381977 DOI: 10.1080/14737159.2018.1543592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Buruli ulcer (BU) is a neglected disease which has been reported from mostly impoverished, remote rural areas from 35 countries worldwide. BU affects skin, subcutaneous tissue, and bones, and may cause massive tissue destruction and life-long disabilities if not diagnosed and treated early. Without laboratory confirmation diagnostic and treatment errors may occur. This review describes the application of IS2404 PCR, the preferred diagnostic test, in the area of individual patient management and clinico-epidemiological studies. Areas covered: A Medline search included publications on clinical sample collection, DNA extraction, and PCR detection formats of the past and present, potential and limitations of clinical application, as well as clinico-epidemiological studies. Expert commentary: A global network of reference laboratories basically provides the possibility for PCR confirmation of 70% of all BU cases worldwide as requested by the WHO. Keeping laboratory confirmation on a constant level requires continuous outreach activities. Among the potential measures to maintain sustainability of laboratory confirmation and outreach activities are decentralized or mobile diagnostics available at point of care, such as IS2404-based LAMP, which complement the standard IS2404-based diagnostic tools available at central level.
Collapse
Affiliation(s)
- Gisela Bretzel
- a Division of Infectious Diseases and Tropical Medicine , University Hospital, Ludwigs-Maximilians-University , Munich , Germany
| | - Marcus Beissner
- a Division of Infectious Diseases and Tropical Medicine , University Hospital, Ludwigs-Maximilians-University , Munich , Germany
| |
Collapse
|
30
|
Yotsu RR, Suzuki K, Simmonds RE, Bedimo R, Ablordey A, Yeboah-Manu D, Phillips R, Asiedu K. Buruli Ulcer: a Review of the Current Knowledge. CURRENT TROPICAL MEDICINE REPORTS 2018; 5:247-256. [PMID: 30460172 PMCID: PMC6223704 DOI: 10.1007/s40475-018-0166-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF THE REVIEW Buruli ulcer (BU) is a necrotizing and disabling cutaneous disease caused by Mycobacterium ulcerans, one of the skin-related neglected tropical diseases (skin NTDs). This article aims to review the current knowledge of this disease and challenges ahead. RECENT FINDINGS Around 60,000 cases of BU have been reported from over 33 countries between 2002 and 2017. Encouraging findings for development of point-of-care tests for BU are being made, and its treatment is currently in the transition period from rifampicin plus streptomycin (injection) to all-oral regimen. A major recent advance in our understanding of its pathogenesis has been agreement on the mechanism of action of the major virulence toxin mycolactone in host cells, targeting the Sec61 translocon during a major step in protein biogenesis. SUMMARY BU is distributed mainly in West Africa, but cases are also found in other parts of the world. We may be underestimating its true disease burden, due to the limited awareness of this disease. More awareness and more understanding of BU will surely contribute in enhancing our fight against this skin NTD.
Collapse
Affiliation(s)
- Rie R. Yotsu
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Dermatology, National Suruga Sanatorium, Shizuoka, Japan
| | - Koichi Suzuki
- Department of Clinical Laboratory Science, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Rachel E. Simmonds
- Department of Microbial Sciences, School of Bioscience and Medicine, University of Surrey, Surrey, UK
| | - Roger Bedimo
- Department of Medicine, VA North Texas Healthcare System, Dallas, TX USA
- Division of Infectious Diseases, University of Texas Dallas Southwestern, Dallas, TX USA
| | - Anthony Ablordey
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Dorothy Yeboah-Manu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Richard Phillips
- Kumansi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kingsley Asiedu
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|