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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.
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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
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Hammoudi N, Verdot R, Delorme J, Bouam A, Drancourt M. Screening anti-infectious molecules against Mycobacterium ulcerans: A step towards decontaminating environmental specimens. PLoS One 2020; 15:e0231685. [PMID: 32760069 PMCID: PMC7410233 DOI: 10.1371/journal.pone.0231685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 06/28/2020] [Indexed: 11/18/2022] Open
Abstract
Mycobacterium ulcerans, a non-tuberculous mycobacterium responsible for Buruli ulcer, resides in poorly defined environmental niches in the vicinity of stagnant water. Very few isolates have been confirmed. With a view to culturing M. ulcerans from such contaminated environmental specimens, we tested the in vitro susceptibility of the M. ulcerans CU001 strain co-cultivated with XTC cells to anti-infectious molecules registered in the French pharmacopoeia. We used a standardised concentration to identify molecules that were inactive against M. ulcerans and which could be incorporated into a decontaminating solution. Of 116 tested molecules, 64 (55.1%) molecules were ineffective against M. ulcerans CU001. These included 34 (29.3%) antibiotics, 14 (12%) antivirals, eight (6.8%) antiparasitics, and eight (6.8%) antifungals. This left 52 molecules which were active against M. ulcerans CU001. Three of the inactive antimicrobial molecules (oxytetracycline, polymyxin E and voriconazole) were then selected to prepare a decontamination solution which was shown to respect M. ulcerans CU001 viability. These three antimicrobials could be incorporated into a decontamination solution to potentially isolate and culture M. ulcerans from environmental samples.
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Affiliation(s)
- Nassim Hammoudi
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille University, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | | | - Jean Delorme
- Assistance Publique – Hôpitaux de Marseille, Pharmacie Centrale, Marseille, France
| | - Amar Bouam
- Aix-Marseille University, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Michel Drancourt
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille University, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
- * E-mail:
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Fraga AG, Trigo G, Murthy RK, Akhtar S, Hebbur M, Pacheco AR, Dominguez J, Silva-Gomes R, Gonçalves CM, Oliveira H, Castro AG, Sharma U, Azeredo J, Pedrosa J. Antimicrobial activity of Mycobacteriophage D29 Lysin B during Mycobacterium ulcerans infection. PLoS Negl Trop Dis 2019; 13:e0007113. [PMID: 31425525 PMCID: PMC6730932 DOI: 10.1371/journal.pntd.0007113] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 09/06/2019] [Accepted: 06/10/2019] [Indexed: 11/29/2022] Open
Abstract
Buruli Ulcer (BU) is a cutaneous disease caused by Mycobacterium ulcerans. The pathogenesis of this disease is closely related to the secretion of the toxin mycolactone that induces extensive destruction of the skin and soft tissues. Currently, there are no effective measures to prevent the disease and, despite availability of antibiotherapy and surgical treatments, these therapeutic options are often associated with severe side effects. Therefore, it is important to develop alternative strategies for the treatment of BU. Endolysins (lysins) are phage encoded enzymes that degrade peptidoglycan of bacterial cell walls. Over the past years, lysins have been emerging as alternative antimicrobial agents against bacterial infections. However, mycobacteria have an unusual outer membrane composed of mycolylarabinogalactan-peptidoglycan. To overcome this complex barrier, some mycobacteriophages encode a lipolytic enzyme, Lysin B (LysB). In this study, we demonstrate for the first time that recombinant LysB displays lytic activity against M. ulcerans isolates. Moreover, using a mouse model of M. ulcerans footpad infection, we show that subcutaneous treatment with LysB prevented further bacterial proliferation, associated with IFN-γ and TNF production in the draining lymph node. These findings highlight the potential use of lysins as a novel therapeutic approach against this neglected tropical disease. Buruli Ulcer (BU) is a necrotizing skin disease caused by Mycobacterium ulcerans. Although the current antibiotic treatment for BU is effective, daily administrations for a prolonged period of time, combined with potential risk of severe side effects, negatively impact on patient adherence. In that sense, we tested the efficacy of an alternative strategy based on Lysin B (LysB), a phage encoded lipolytic enzyme that degrades the mycolylarabinogalactan-peptidoglycan complex present in the mycobacterial cell wall. In this study, we show that LysB not only displays lytic activity against M. ulcerans isolates in vitro, but also leads to a decrease of M. ulcerans proliferation in infected mouse footpads. These findings highlight the potential use of lysins as a novel therapeutic approach against this neglected tropical disease.
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Affiliation(s)
- Alexandra G. Fraga
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Gabriela Trigo
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Centre of Biological Engineering, University of Minho, Braga, Portugal
| | | | | | | | - Ana Rita Pacheco
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Juan Dominguez
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rita Silva-Gomes
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Carine M. Gonçalves
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Hugo Oliveira
- Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - António G. Castro
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | | | - Joana Azeredo
- Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Jorge Pedrosa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
- * E-mail:
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Meher-Homji Z, Johnson PDR. An Overview of the Treatment of Mycobacterium ulcerans Infection (Buruli Ulcer). CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2018. [DOI: 10.1007/s40506-018-0174-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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