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Briand M, Boccarossa A, Rieux A, Jacques MA, Ganlanon L, Johnson C, Eveillard M, Marsollier L, Marion E. Emergence and spread of Mycobacterium ulcerans at different geographic scales. Microbiol Spectr 2024; 12:e0382723. [PMID: 38441471 PMCID: PMC10986537 DOI: 10.1128/spectrum.03827-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/10/2024] [Indexed: 04/06/2024] Open
Abstract
The classical lineage of Mycobacterium ulcerans is the most prevalent clonal group associated with Buruli ulcer in humans. Its reservoir is strongly associated with the environment. We analyzed together 1,045 isolates collected from 13 countries on two continents to define the evolutionary history and population dynamics of this lineage. We confirm that this lineage spread over 7,000 years from Australia to Africa with the emergence of outbreaks in distinct waves in the 18th and 19th centuries. In sharp contrast with its global spread over the last century, transmission chains are now mostly local, with little or no dissemination between endemic areas. This study provides new insights into the phylogeography and population dynamics of M. ulcerans, highlighting the importance of comparative genomic analyses to improve our understanding of pathogen transmission. IMPORTANCE Mycobacterium ulcerans is an environmental mycobacterial pathogen that can cause Buruli ulcer, a severe cutaneous infection, mostly spread in Africa and Australia. We conducted a large genomic study of M. ulcerans, combining genomic and evolutionary approaches to decipher its evolutionary history and pattern of spread at different geographic scales. At the scale of villages in an endemic area of Benin, the circulating genotypes have been introduced in recent decades and are not randomly distributed along the river. On a global scale, M. ulcerans has been spreading for much longer, resulting in distinct and compartmentalized endemic foci across Africa and Australia.
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Affiliation(s)
- Martial Briand
- Univ Angers, Institut Agro, INRAE, IRHS, SFR QUASAV, Angers, France
| | | | - Adrien Rieux
- CIRAD, UMR PVBMT, Saint Pierre, La Réunion, France
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Phelippeau M, Marion E, Robbe-Saule M, Ganlanon L, Chauty A, Adeye A, Blanchard S, Johnson C, Marsollier L, Dubee V. Changes in Inflammatory Markers in Patients Treated for Buruli Ulcer and Their Ability to Predict Paradoxical Reactions. J Infect Dis 2023; 228:1630-1639. [PMID: 37221015 PMCID: PMC10681857 DOI: 10.1093/infdis/jiad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/11/2023] [Accepted: 05/22/2023] [Indexed: 05/25/2023] Open
Abstract
Mycobacterium ulcerans causes Buruli ulcer, the third most frequent mycobacterial disease after tuberculosis and leprosy. Transient clinical deteriorations, known as paradoxical reactions (PRs), occur in some patients during or after antibiotic treatment. We investigated the clinical and biological features of PRs in a prospective cohort of 41 patients with Buruli ulcer from Benin. Neutrophil counts decreased from baseline to day 90, and interleukin 6 (IL-6), granulocyte colony-stimulating factor, and vascular endothelial growth factor were the cytokines displaying a significant monthly decrease relative to baseline. PRs occurred in 10 (24%) patients. The baseline biological and clinical characteristics of the patients presenting with PRs did not differ significantly from those of the other patients. However, the patients with PRs had significantly higher IL-6 and tumor necrosis factor alpha (TNF-α) concentrations on days 30, 60, and 90 after the start of antibiotic treatment. The absence of a decrease in IL-6 and TNF-α levels during treatment should alert clinicians to the possibility of PR onset.
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Affiliation(s)
- Michael Phelippeau
- Service des Maladies Infectieuses et Tropicales, University Hospital Angers
| | - Estelle Marion
- Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France
| | - Marie Robbe-Saule
- Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France
| | - Line Ganlanon
- Centre de dépistage et de traitement de la lèpre et de l’ulcère de Buruli, Centre de diagnostic et de traitement de la lèpre et de l’ulcère de Buruli, Pobè, Benin
| | - Annick Chauty
- Centre de dépistage et de traitement de la lèpre et de l’ulcère de Buruli, Centre de diagnostic et de traitement de la lèpre et de l’ulcère de Buruli, Pobè, Benin
| | - Ambroise Adeye
- Centre de dépistage et de traitement de la lèpre et de l’ulcère de Buruli, Centre de diagnostic et de traitement de la lèpre et de l’ulcère de Buruli, Pobè, Benin
| | - Simon Blanchard
- Université Angers, Nantes Université, Inserm, Centre National de la Recherche Scientifique (CNRS), Nantes - Angers Cancer and Immunology Research Center (CRCINA2)
- Laboratoire d’Immunologie et Allergologie, Centre Hopitalier Universitaire (CHU) d’Angers, Angers, France
| | - Christian Johnson
- Center inter facultaire de formation et de recherche en environnement (CIFRED), Université d’Abomey Calavi, Abomey Calavi, Benin
| | - Laurent Marsollier
- Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France
| | - Vincent Dubee
- Service des Maladies Infectieuses et Tropicales, University Hospital Angers
- Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France
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Khalifa E, Chapusot C, Tournier B, Sentis J, Marion E, Remond A, Aubry M, Pioche C, Bergeron A, Primois C, Blanchard L, Millière A, Boucheix M, Léger Y, Bairrao M, Brouste V, Martin L, Soubeyran I. Idylla EGFR assay on extracted DNA: advantages, limits and place in molecular screening according to the latest guidelines for non-small-cell lung cancer (NSCLC) patients. J Clin Pathol 2023; 76:698-704. [PMID: 35820776 DOI: 10.1136/jcp-2022-208325] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/28/2022] [Indexed: 11/04/2022]
Abstract
AIMS Idylla epidermal growth factor receptor (EGFR) is a fast and fully automated mutation assay that is easy to implement. However, under the Biocartis-recommended technical conditions, tissue sections are directly introduced into the cartridge, at the risk of exhausting the tumour sample. In this study, we evaluate the performance of Idylla EGFR on extracted DNA and discuss its place within the global non-small-cell lung cancer (NSCLC) screening strategy. METHODS 577 comparative tests between Idylla EGFR on extracted DNA and next-generation sequencing (NGS) were performed across two centres. RESULTS Preanalytical thresholds were established (20% tumour cell content, 50 ng DNA input) and challenged prospectively in routine practice. 16.8% of samples referred for screening were considered non eligible for Idylla EGFR testing. Due to discordant by design cases, Idylla EGFR sensitivity was 86.9% for currently actionable EGFR mutations. Idylla EGFR specificity was 100% in first-line screening. NGS was always feasible on the same DNA. CONCLUSION Idylla EGFR on extracted DNA is feasible and enables tumour material to be saved compared with tissue section use. It is not necessary to replace the analytical thresholds of the Biocartis algorithm. Due to both the limits of the mutational repertoire and the high increase of targetable genes in NSCLC, the use of Idylla EGFR should be restricted to clinical emergency situations accompanied by NGS.
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Affiliation(s)
| | - Caroline Chapusot
- Platform of Somatic Oncology of Burgundy, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Benjamin Tournier
- Platform of Somatic Oncology of Burgundy, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Julie Sentis
- Biopathology, Institut Bergonié, Bordeaux, France
| | | | - Alicia Remond
- Platform of Somatic Oncology of Burgundy, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Manon Aubry
- Platform of Somatic Oncology of Burgundy, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Célia Pioche
- Platform of Somatic Oncology of Burgundy, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Anthony Bergeron
- Department of Pathology, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | | | | | - Alice Millière
- Department of Pathology, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | | | | | | | - Véronique Brouste
- Research and Clinical Epidemiology Unit - Biostatistics, Institut Bergonié, Bordeaux, France
| | - Laurent Martin
- Platform of Somatic Oncology of Burgundy, Centre Hospitalier Universitaire de Dijon, Dijon, France
- Department of Pathology, Centre Hospitalier Universitaire de Dijon, Dijon, France
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Bernard Q, Goumeidane M, Chaumond E, Robbe-Saule M, Boucaud Y, Esnault L, Croué A, Jullien J, Marsollier L, Marion E. Type-I interferons promote innate immune tolerance in macrophages exposed to Mycobacterium ulcerans vesicles. PLoS Pathog 2023; 19:e1011479. [PMID: 37428812 PMCID: PMC10358927 DOI: 10.1371/journal.ppat.1011479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/13/2023] [Indexed: 07/12/2023] Open
Abstract
Buruli ulcer is a chronic infectious disease caused by Mycobacterium ulcerans. The pathogen persistence in host skin is associated with the development of ulcerative and necrotic lesions leading to permanent disabilities in most patients. However, few of diagnosed cases are thought to resolve through an unknown self-healing process. Using in vitro and in vivo mouse models and M. ulcerans purified vesicles and mycolactone, we showed that the development of an innate immune tolerance was only specific to macrophages from mice able to heal spontaneously. This tolerance mechanism depends on a type I interferon response and can be induced by interferon beta. A type I interferon signature was further detected during in vivo infection in mice as well as in skin samples from patients under antibiotics regiment. Our results indicate that type I interferon-related genes expressed in macrophages may promote tolerance and healing during infection with skin damaging pathogen.
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Affiliation(s)
- Quentin Bernard
- Univ Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Angers, France
| | | | - Emmanuel Chaumond
- Univ Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Angers, France
| | - Marie Robbe-Saule
- Univ Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Angers, France
| | - Yan Boucaud
- Univ Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Angers, France
| | - Lucille Esnault
- Univ Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Angers, France
| | - Anne Croué
- Laboratoire d'anatomo-pathologie, CHU Angers, Angers, France
| | | | - Laurent Marsollier
- Univ Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Angers, France
| | - Estelle Marion
- Univ Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Angers, France
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Fajloun F, Ganlonon L, Gnimavo RS, Sodjinou E, Habib A, Claco E, Agoundoté I, Adeye A, Catraye P, Al-Bayssari C, Moussa EH, Robbe-Saule M, Houezo JG, Kpoton GG, Ayélo AG, Gomez B, Johnson RC, Marsollier L, Marion E, Kempf M. An Overview of 10 Years of Activity of a Molecular Laboratory for Buruli Ulcer Diagnosis at a Field Hospital in Benin. J Clin Microbiol 2023:e0027423. [PMID: 37212702 DOI: 10.1128/jcm.00274-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023] Open
Abstract
Buruli ulcer (BU) is a neglected tropical disease caused by Mycobacterium ulcerans. Early diagnosis is crucial to prevent morbidity. In November 2012, a field laboratory fully equipped for the rapid on-site quantitative PCR (qPCR) diagnosis of M. ulcerans was established at the Buruli ulcer treatment center (CDTLUB) center in Pobè Benin, a region where BU is endemic. We describe its first 10 years of activity and its gradual evolution into an expert laboratory for BU diagnosis. From 2012 to 2022, the laboratory analyzed 3,018 samples from patients attending consultations for suspected BU at the CDTLUB in Pobè. Ziehl-Neelsen staining and qPCR targeting the IS2404 sequence were performed. Since 2019, the laboratory has also received and analyzed 570 samples from other centers. The laboratory confirmed the diagnosis of BU by qPCR for 39.7% samples: M. ulcerans DNA was detected in 34.7% of swabs, 47.2% of all fine needle aspiration samples (FNA) and 44.6% of all skin biopsy specimens. Positive Ziehl-Neelsen staining results were obtained for 19.0% samples. Bacterial load, estimated by qPCR, was significantly greater for the Ziehl-Neelsen-positive samples than for Ziehl-Neelsen-negative samples, and detection rates were highest for FNA samples. Overall, 26.3% of the samples received from other centers were positive for BU. Most of these samples were sent by the CDTLUBs of Lalo, Allada, and Zagnanado, Benin. The establishment of the laboratory in the CDTLUB of Pobè has been a huge success. Optimal patient care depends on the close proximity of a molecular biology structure to BU treatment centers. Finally, FNA should be promoted among caregivers. IMPORTANCE Here, we describe the first 10 years of activity at a field laboratory established at the Buruli ulcer treatment center (CDTLUB) in Pobè, Benin, a country in which Mycobacterium ulcerans is endemic. Between 2012 and 2022, the laboratory analyzed 3,018 samples from patients consulting the CDTLUB of Pobè with a suspected clinical BU. Ziehl-Neelsen staining and qPCR targeting the IS2404 sequence were performed. In total, 39.7% of samples tested positive by qPCR and 19.0% tested positive by Ziehl-Neelsen staining. Detection rates were highest for FNA samples, and the bacterial loads estimated by qPCR were significantly higher for Ziehl-Neelsen-positive samples than for Ziehl-Neelsen-negative samples. Since 2019, the laboratory has also analyzed 570 samples received from outside the CDTLUB of Pobè, 26.3% of which were positive for BU. Most of these samples were sent by the CDTLUBs of Lalo, Allada, and Zagnanado in Benin. The establishment of the laboratory in the CDTLUB of Pobè has been a huge success, with major benefits for both the medical staff and patients. Our findings illustrate that the usefulness and feasibility of having a diagnostic center in rural Africa, where the disease is endemic, is a key part of optimal patient care, and that FNA should be promoted to increase detection rates.
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Affiliation(s)
- Faraj Fajloun
- Universitaire Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
- Ecole Doctorale en Sciences et Technologie, Université Libanaise, Hadath, Lebanon
- Laboratoire d'Innovation Thérapeutique, Faculté de Sciences 2, Fanar, Lebanon
| | - Line Ganlonon
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Ronald Sètondji Gnimavo
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
- Institut Régional de Santé Publique - Comlan Alfred Quenum, Université d'Abomey Calavi, Ouidah, Bénin
| | - Espoir Sodjinou
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Akimath Habib
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Eric Claco
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Irvine Agoundoté
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Ambroise Adeye
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Perrin Catraye
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Charbel Al-Bayssari
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Balamand, Tripoli, Lebanon
| | - Elie Hajj Moussa
- Laboratoire d'Innovation Thérapeutique, Faculté de Sciences 2, Fanar, Lebanon
| | - Marie Robbe-Saule
- Universitaire Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
| | - Jean Gabin Houezo
- Programme National de Lutte contre L'Ulcère de Buruli et la Lèpre, Cotonou, Benin
| | - Godwin Gérard Kpoton
- Programme National de Lutte contre L'Ulcère de Buruli et la Lèpre, Cotonou, Benin
| | | | | | | | - Laurent Marsollier
- Universitaire Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
| | - Estelle Marion
- Universitaire Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
| | - Marie Kempf
- Universitaire Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
- Département de Biologie des Agents Infectieux, Laboratoire de Bactériologie, Centre Hospitalier Universitaire Angers, Angers, France
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Gnimavo RS, Fajloun F, Al-Bayssari C, Sodjinou E, Habib A, Ganlonon L, Claco E, Agoundoté I, Houngbo OA, Anagonou EG, Biaou CAO, Ayélo AG, Houezo JG, Boccarossa A, Moussa EH, Gomez B, Gine A, Sopoh GE, Marion E, Johnson RC, Kempf M. Importance of consultations using mobile teams in the screening and treatment of neglected tropical skin diseases in Benin. PLoS Negl Trop Dis 2023; 17:e0011314. [PMID: 37172044 DOI: 10.1371/journal.pntd.0011314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/24/2023] [Accepted: 04/15/2023] [Indexed: 05/14/2023] Open
Abstract
CONTEXT Since 2013, the World Health Organization has recommended integrated control strategies for neglected tropical diseases (NTDs) with skin manifestations. We evaluated the implementation of an integrated approach to the early detection and rapid treatment of skin NTDs based on mobile clinics in the Ouémé and Plateau areas of Benin. METHODS This descriptive cross-sectional study was performed in Ouémé and Plateau in Benin from 2018 to 2020. Consultations using mobile teams were performed at various sites selected by reasoned choice based on the epidemiological data of the National Program for the Control of Leprosy and Buruli Ulcer. All individuals presenting with a dermatological lesion who voluntarily approached the multidisciplinary management team on the day of consultation were included. The information collected was kept strictly anonymous and was entered into an Excel 2013 spreadsheet and analyzed with Stata 11 software. RESULTS In total, 5,267 patients with various skin conditions consulted the medical team. The median age of these patients was 14 years (IQR: 7-34 years). We saw 646 (12.3%) patients presenting NTDs with skin manifestations, principally scabies, in 88.4% (571/646), followed by 37 cases of Buruli ulcer (5.8%), 22 cases of leprosy (3.4%), 15 cases of lymphatic filariasis (2.3%) and one case of mycetoma (0.2%). We detected no cases of yaws. CONCLUSION This sustainable approach could help to decrease the burden of skin NTDs in resource-limited countries.
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Affiliation(s)
- Ronald Sètondji Gnimavo
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
- Institut Régional de Santé Publique- Comlan Alfred Quenum, Université d'Abomey Calavi, Ouidah, Bénin
| | - Faraj Fajloun
- University of Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
- Ecole Doctorale en Sciences et Technologie, Université Libanaise, Campus Rafic Hariri, Hadath, Liban
- Laboratoire d'Innovation Thérapeutique, Faculté de Sciences 2, Campus Pierre Gemayel, Fanar, Liban
| | - Charbel Al-Bayssari
- Departement of Medical Laboratory Sciences, Faculty of Health Sciences, University of Balamand, Tripoli, Lebanon
| | - Espoir Sodjinou
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Akimath Habib
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Line Ganlonon
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Eric Claco
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Irvine Agoundoté
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Odile Adjouavi Houngbo
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Esaï Gimatal Anagonou
- Programme National de Lutte contre la Lèpre et l'Ulcère de Buruli, Ministère de la Santé, Cotonou, Bénin
| | | | - Adjimon Gilbert Ayélo
- Programme National de Lutte contre la Lèpre et l'Ulcère de Buruli, Ministère de la Santé, Cotonou, Bénin
| | - Jean Gabin Houezo
- Programme National de Lutte contre la Lèpre et l'Ulcère de Buruli, Ministère de la Santé, Cotonou, Bénin
| | - Alexandra Boccarossa
- University of Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
| | - Elie Hajj Moussa
- Laboratoire d'Innovation Thérapeutique, Faculté de Sciences 2, Campus Pierre Gemayel, Fanar, Liban
| | | | - Anna Gine
- Fondation Anesvad, Henao, Bilbao, Spain
| | - Ghislain Emmanuel Sopoh
- Institut Régional de Santé Publique- Comlan Alfred Quenum, Université d'Abomey Calavi, Ouidah, Bénin
| | - Estelle Marion
- University of Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
| | | | - Marie Kempf
- University of Angers, Nantes Université, CHU Angers, Inserm, INCIT, Angers, France
- Département de Biologie des Agents Infectieux, UF de Bactériologie, Centre Hospitalier Universitaire Angers, Angers, France
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Marion E, Marsollier L. Mycobacterium ulcerans. Trends Microbiol 2022; 30:1116-1117. [PMID: 36163220 DOI: 10.1016/j.tim.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Estelle Marion
- Université d'Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR, 1302, Angers, France.
| | - Laurent Marsollier
- Université d'Angers, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR, 1302, Angers, France
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Handley BL, Tchatchouang S, Grout L, Johnson RC, Tabah EN, Boua B, Boock AU, Koffi AP, Phanzu DM, Kotey NK, Rogers E, Dofitas B, Jung Y, Maweke T, Beiras CG, Maman I, Basing LA, Ngazoa SK, Houezo JG, Togbey K, Telan EF, Sarmento N, Marion E, Addo KK, Mitjà O, Asiedu K, Harding-Esch E, Marks M. Evaluating the yaws diagnostic gap: A survey to determine the capacity of and barriers to improving diagnostics in all yaws-endemic countries. Front Trop Dis 2022. [DOI: 10.3389/fitd.2022.969219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundYaws, caused by Treponema pallidum subsp. pertenue, is a skin neglected tropical disease. It is targeted for eradication by 2030, primarily using mass drug administration (MDA) with azithromycin. Traditionally, diagnosis of yaws has relied on clinical examination and serological testing. However, these approaches have poor diagnostic performance. To achieve eradication, more accurate diagnostics are required to determine whether MDA should be initiated or continued as well as for post-elimination surveillance. Molecular tools will be crucial for detecting antimicrobial resistant cases, which have the potential to derail eradication efforts. In order to determine the feasibility of introducing novel, more accurate, diagnostics for yaws surveillance purposes, it is necessary to understand current in-country diagnostic capacity. This study therefore aimed to understand the current capacity of, and challenges to, improving diagnostics for yaws in all yaws-endemic countries worldwide.Methodology/principal findingsAn online survey was sent to all 15 yaws-endemic countries in July 2021. The survey asked about past prevalence estimates, the availability of different diagnostic tools, and perceived barriers to enhancing capacity. Fourteen countries responded to the survey, four of which did not have a current National Policy for yaws eradication in place. Over 95% of reported that yaws cases from the past five years had not been confirmed with serological or molecular tools, largely due to the limited supply of rapid serological tests. Only four countries reported having operational laboratories for molecular yaws diagnosis, with only one of these having a validated assay to detect azithromycin resistance.Conclusions and significanceThis study highlights the diagnostic capacity constraints across all respondent countries. Countries are in need of access to a sustainable supply of serological tests, and development of molecular testing facilities. Sufficient sustainable funding should be made available to ensure that appropriate diagnostic tools are available and utilised.
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Timothy JWS, Rogers E, Halliday KE, Mulbah T, Marks M, Zaizay Z, Giddings R, Kempf M, Marion E, Walker SL, Kollie KK, Pullan RL. Quantifying Population Burden and Effectiveness of Decentralized Surveillance Strategies for Skin-Presenting Neglected Tropical Diseases, Liberia. Emerg Infect Dis 2022; 28:1755-1764. [PMID: 35997318 PMCID: PMC9423900 DOI: 10.3201/eid2809.212126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We evaluated programmatic approaches for skin neglected tropical disease (NTD) surveillance and completed a robust estimation of the burden of skin NTDs endemic to West Africa (Buruli ulcer, leprosy, lymphatic filariasis morbidity, and yaws). In Maryland, Liberia, exhaustive case finding by community health workers of 56,285 persons across 92 clusters identified 3,241 suspected cases. A total of 236 skin NTDs (34.0 [95% CI 29.1–38.9]/10,000 persons) were confirmed by midlevel healthcare workers trained using a tailored program. Cases showed a focal and spatially heterogeneous distribution. This community health worker‒led approach showed a higher skin NTD burden than prevailing surveillance mechanisms, but also showed high (95.1%) and equitable population coverage. Specialized training and task-shifting of diagnoses to midlevel health workers led to reliable identification of skin NTDs, but reliability of individual diagnoses varied. This multifaceted evaluation of skin NTD surveillance strategies quantifies benefits and limitations of key approaches promoted by the 2030 NTD roadmap of the World Health Organization.
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Boccarossa A, Degnonvi H, Brou TY, Robbe-Saule M, Esnault L, Boucaud Y, Eveillard M, Gnimavo R, Hounsou S, Djenontin A, Johnson CR, Fleuret S, Marion E. A combined field study of Buruli ulcer disease in southeast Benin proposing preventive strategies based on epidemiological, geographic, behavioural and environmental analyses. PLOS Glob Public Health 2022; 2:e0000095. [PMID: 36962132 PMCID: PMC10021984 DOI: 10.1371/journal.pgph.0000095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/08/2021] [Indexed: 06/18/2023]
Abstract
Buruli ulcer is a neglected tropical disease caused by M. ulcerans, an environmental mycobacterium. This cutaneous infectious disease affects populations with poor access to sanitation, safe water and healthcare living in rural areas of West and Central Africa. Stagnant open bodies of surface water and slow-running streams are the only risk factor identified in Africa, and there is no human-to-human transmission. Appropriate and effective prevention strategies are required for populations living in endemic areas. Based on a multidisciplinary approach in an area in which Buruli ulcer is endemic in South Benin, we investigated the link between all human-environment interactions relating to unprotected water and behaviors associated with Buruli ulcer risk likely to affect incidence rates. We characterised the sources of water as well as water bodies and streams used by communities, by conducting a prospective case-control study directly coupled with geographic field observations, spatial analysis, and the detection of M. ulcerans in the environment. A full list of the free surface waters used for domestic activities was generated for a set of 34 villages, and several types of human behaviour associated with a higher risk of transmission were identified: (i) prolonged walking in water to reach cultivated fields, (ii) collecting water, (iii) and swimming. Combining the results of the different analyses identified the risk factor most strongly associated with Buruli ulcer was the frequency of contact with unprotected and natural water, particularly in regularly flooded or irrigated lowlands. We confirm that the use of clean water from drilled wells confers protection against Buruli ulcer. These specific and refined results provide a broader scope for the design of an appropriate preventive strategy including certain practices or infrastructures observed during our field investigations. This strategy could be improved by the addition of knowledge about irrigation practices and agricultural work in low-lying areas.
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Affiliation(s)
- Alexandra Boccarossa
- Univ Angers, Inserm, CRCINA, Angers, France
- Univ Angers, CNRS, ESO, Angers, France
| | - Horace Degnonvi
- Univ Angers, Inserm, CRCINA, Angers, France
- University Abomey Calavi, Cifred, Benin
| | | | | | | | | | | | | | - Saturnin Hounsou
- University Abomey Calavi, Cifred, Benin
- Faculté des Sciences et Techniques, University of Abomey-Calavi, Abomey Calavi, Benin
| | - Armel Djenontin
- Faculté des Sciences et Techniques, University of Abomey-Calavi, Abomey Calavi, Benin
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11
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Gnimavo R, Besnard A, Degnonvi H, Pipoli Da Fonseca J, Kempf M, Johnson CR, Boccarossa A, Brou YT, Marsollier L, Marion E. Molecular and epidemiological characterization of recurrent Mycobacterium ulcerans infections in Benin. PLoS Negl Trop Dis 2021; 15:e0010053. [PMID: 34962930 PMCID: PMC8746791 DOI: 10.1371/journal.pntd.0010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/10/2022] [Accepted: 12/04/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans, an environmental mycobacterium. Although transmission of M. ulcerans remains poorly understood, the main identified risk factor for acquiring Buruli ulcer is living in proximity of potentially contaminated water sources. Knowledge about the clinical features of Buruli ulcer and its physiopathology is increasing, but little is known about recurrence due to reinfection. METHODOLOGY/PRINCIPAL FINDINGS We describe two patients with Buruli ulcer recurrence due to reinfection with M. ulcerans, as demonstrated by comparisons of DNA from the strains isolated at the time of the first diagnosis and at recurrence. Based on the spatial distribution of M. ulcerans genotypes in this region and a detailed study of the behavior of these two patients with respect to sources of water as well as water bodies and streams, we formulated hypotheses concerning the sites at which they may have been contaminated. CONCLUSIONS/SIGNIFICANCE Second episodes of Buruli ulcer may occur through reinfection, relapse or a paradoxical reaction. We formally demonstrated that the recurrence in these two patients was due to reinfection. Based on the sites at which the patients reported engaging in activities relating to water, we were able to identify possible sites of contamination. Our findings indicate that the non-random distribution of M. ulcerans genotypes in this region may provide useful information about activities at risk.
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Affiliation(s)
- Ronald Gnimavo
- Centre de Diagnostic et de Traitement de l’ulcère de Buruli, Fondation Raoul Follereau, Pobè, Bénin
| | | | - Horace Degnonvi
- Univ Angers, Inserm, INCIT, Angers, France
- Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d’Abomey Calavi (UAC), Cotonou, Benin
| | | | - Marie Kempf
- Univ Angers, Inserm, CHU Angers, INCIT, Angers, France
| | - Christian Roch Johnson
- Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable (CIFRED), Université d’Abomey Calavi (UAC), Cotonou, Benin
| | - Alexandra Boccarossa
- Univ Angers, Inserm, INCIT, Angers, France
- CNRS, UMR ESO, Université d’Angers, Angers, France
| | - Yao Télesphore Brou
- UMR 228 ESPACE-DEV (IRD, UAG, UM, UR), Station SEAS-OI, Saint Pierre, Ile de la Réunion, France
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12
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Nalefski EA, Patel N, Leung PJY, Islam Z, Kooistra RM, Parikh I, Marion E, Knott GJ, Doudna JA, Le Ny ALM, Madan D. Kinetic analysis of Cas12a and Cas13a RNA-Guided nucleases for development of improved CRISPR-Based diagnostics. iScience 2021; 24:102996. [PMID: 34505008 PMCID: PMC8411246 DOI: 10.1016/j.isci.2021.102996] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 07/14/2021] [Accepted: 08/13/2021] [Indexed: 12/26/2022] Open
Abstract
Bacterial CRISPR systems provide acquired immunity against invading nucleic acids by activating RNA-programmable RNases and DNases. Cas13a and Cas12a enzymes bound to CRISPR RNA (crRNA) recognize specific nucleic acid targets, initiating cleavage of the targets as well as non-target (trans) nucleic acids. Here, we examine the kinetics of single-turnover target and multi-turnover trans-nuclease activities of both enzymes. High-turnover, non-specific Cas13a trans-RNase activity is coupled to rapid binding of target RNA. By contrast, low-turnover Cas12a trans-nuclease activity is coupled to relatively slow cleavage of target DNA, selective for DNA over RNA, indifferent to base identity, and preferential for single-stranded substrates. Combining multiple crRNA increases detection sensitivity of targets, an approach we use to quantify pathogen DNA in samples from patients suspected of Buruli ulcer disease. Results reveal that these enzymes are kinetically adapted to play distinct roles in bacterial adaptive immunity and show how kinetic analysis can be applied to CRISPR-based diagnostics. Cas13a HEPN trans-RNase activation is directly coupled to rapid target RNA binding Cas12a RuvC trans-nuclease activity is coupled to slow target DNA cleavage Individual crRNA generate widely varying levels of targeted trans-cleavage Pooling multiple crRNA allows pathogen quantification without target amplification
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Affiliation(s)
- Eric A Nalefski
- Global Health Labs, Bellevue, WA 98007, USA.,Center for In Vitro Diagnostics, Intellectual Ventures Global Good Fund, Bellevue, WA 98007, USA
| | | | - Philip J Y Leung
- Global Health Labs, Bellevue, WA 98007, USA.,Center for In Vitro Diagnostics, Intellectual Ventures Global Good Fund, Bellevue, WA 98007, USA
| | - Zeba Islam
- Global Health Labs, Bellevue, WA 98007, USA
| | - Remy M Kooistra
- Global Health Labs, Bellevue, WA 98007, USA.,Center for In Vitro Diagnostics, Intellectual Ventures Global Good Fund, Bellevue, WA 98007, USA
| | | | | | - Gavin J Knott
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94704, USA.,Monash Biomedicine Discovery Institute, Department of Chemistry & Molecular Biology, Monash University, Melbourne, VIC 3800, Australia.,Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jennifer A Doudna
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94704, USA.,Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA.,MBIB Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.,Department of Chemistry, University of California, Berkeley, Berkeley, CA 94704, USA.,Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94704, USA.,Gladstone Institute of Data Science and Biotechnology, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Anne-Laure M Le Ny
- Global Health Labs, Bellevue, WA 98007, USA.,Center for In Vitro Diagnostics, Intellectual Ventures Global Good Fund, Bellevue, WA 98007, USA
| | - Damian Madan
- Global Health Labs, Bellevue, WA 98007, USA.,Center for In Vitro Diagnostics, Intellectual Ventures Global Good Fund, Bellevue, WA 98007, USA
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13
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Noel L, Marion E, Boufercha R, Martin F, Zandotti C, Charrel R, Bouhadfane M, Lehucher-Michel M, Villa A. Dépistage du personnel de santé exposé au SARS-CoV-2 dans un hôpital universitaire. Infect Dis Now 2021. [PMCID: PMC8327642 DOI: 10.1016/j.idnow.2021.06.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction Dans le cadre de la pandémie mondiale au SARS-CoV-2, les personnels de santé (PS) sont professionnellement exposés à ce virus. Dans ce contexte, cette étude présente les données de surveillance de 5704 travailleurs exposés au SARS-CoV-2 d’un centre hospitalier du 17 mars au 20 avril 2020. Matériels et méthodes Les PS symptomatiques, les cas contacts et ceux présentant une forte anxiété ont été testés. Le diagnostic de COVID-19 a été réalisé par RT-PCR après prélèvement nasopharyngé. Résultats Au cours de cette période, 30,4 % (1735/5704) des PS ont bénéficié de 3057 écouvillons nasaux. Parmi ceux-ci, 8,0 % (138/1735) étaient infectés par le SRAS-CoV-2. Parmi les PS positifs au SARS-CoV-2, 21,7 % étaient asymptomatiques. Dans les unités COVID et les unités non COVID, le nombre de personnes infectées par le SARS-CoV-2 était respectivement de 5,8 % (13/223) et 8,2 % (125/1512) (p = 0,2). Parmi les PS travaillant hors des unités COVID, 6,4 % (12/188) des agents des unités pédiatriques et 8,1 % (126/1547) des agents des unités adultes ou des laboratoires étaient positifs au SARS-CoV-2 (p = 0,4). Parmi les PS des unités adultes, 6,4 % (8/125) provenaient de la médecine interne, 5,6 % (7/125) de la neurologie, 5,6 % (7/125) de la pharmacie et 5,6 % (7/125) du service médical d’urgence. Parmi les personnes atteintes du SARS-CoV2, les infirmières, les internes/médecins et les aides-soignants étaient les catégories professionnelles les plus touchées avec respectivement 30,0 % (40/138), 21,0 % (29/138) et 10,9 % (15/138). Parmi les médecins, la majorité étaient des internes (70,0 % ; 20/29). Les travailleurs de plus de 50 ans étaient moins susceptibles d’être positifs au SARS-CoV-2 (3,8 % ; 14/373) que les autres travailleurs plus jeunes (9,1 % ; 124/1362) (p < 0,001). Aucun cas grave de COVID-19 n’a été signalé dans notre population au cours de cette période. Conclusion Parmi les PS positifs détectés, 21,7 % (25/115) étaient asymptomatiques. Ces données soulignent l’importance du dépistage systématique des cas contacts même asymptomatiques et de l’utilisation d’équipements de protection individuelle (EPI) pour éviter la transmission. Le pourcentage des cas positifs diminuait à mesure que l’âge augmentait, en particulier après l’âge de 45 ans. Les personnels de plus de 45 ans, étant plus expérimentées et se sentant plus à risque, ont pu être mieux protégées ou affectées à des services moins à risque ou confinés à domicile. Les PS travaillant dans des unités COVID-19 n’étaient pas plus souvent infectés que ceux travaillant dans des unités non COVID-19, probablement parce qu’ils étaient plus conscients des dangers et des risques associés au SARS-CoV-2, qu’ils disposaient de plus d’équipements de protection individuelle, qu’ils les portaient de manière plus stricte et qu’ils étaient mieux informés et formés.
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14
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Robbe-Saule M, Foulon M, Poncin I, Esnault L, Varet H, Legendre R, Besnard A, Grzegorzewicz AE, Jackson M, Canaan S, Marsollier L, Marion E. Transcriptional adaptation of Mycobacterium ulcerans in an original mouse model: New insights into the regulation of mycolactone. Virulence 2021; 12:1438-1451. [PMID: 34107844 PMCID: PMC8204960 DOI: 10.1080/21505594.2021.1929749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mycobacterium ulcerans is the causal agent of Buruli ulcer, a chronic infectious disease and the third most common mycobacterial disease worldwide. Without early treatment, M. ulcerans provokes massive skin ulcers, caused by the mycolactone toxin, its main virulence factor. However, spontaneous healing may occur in Buruli ulcer patients several months or years after the disease onset. We have shown, in an original mouse model, that bacterial load remains high and viable in spontaneously healed tissues, with a switch of M. ulcerans to low levels of mycolactone production, adapting its strategy to survive in such a hostile environment. This original model offers the possibility to investigate the regulation of mycolactone production, by using an RNA-seq strategy to study bacterial adaptation during mouse infection. Pathway analysis and characterization of the tissue environment showed that the bacillus adapted to its new environment by modifying its metabolic activity and switching nutrient sources. Thus, M. ulcerans ensures its survival in healing tissues by reducing its secondary metabolism, leading to an inhibition of mycolactone synthesis. These findings shed new light on mycolactone regulation and pave the way for new therapeutic strategies.
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Affiliation(s)
| | | | | | | | - Hugo Varet
- Plate-forme Transcriptome Et Epigenome, Biomics, Centre De Ressources Et Recherches Technologiques (C2RT), Institut Pasteur, Paris, France.,Hub De Bioinformatique Et Biostatistique - Département Biologie Computationnelle, Institut Pasteur, Paris, France
| | - Rachel Legendre
- Plate-forme Transcriptome Et Epigenome, Biomics, Centre De Ressources Et Recherches Technologiques (C2RT), Institut Pasteur, Paris, France.,Hub De Bioinformatique Et Biostatistique - Département Biologie Computationnelle, Institut Pasteur, Paris, France
| | | | - Anna E Grzegorzewicz
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States
| | - Mary Jackson
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States
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15
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Foulon M, Robbe-Saule M, Esnault L, Malloci M, Mery A, Saint-André JP, Kempf M, Homedan C, Marion E, Marsollier L. Ketogenic diet impairs Mycobacterium ulcerans growth and toxin production, enhancing hosts' response to the infection in an experimental mouse model. J Infect Dis 2021; 224:1973-1983. [PMID: 33944942 DOI: 10.1093/infdis/jiab236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/29/2021] [Indexed: 11/13/2022] Open
Abstract
Ketogenic diets have been used to treat diverse conditions, and there is growing evidence of their benefits for tissue repair and in inflammatory disease treatment. However, their role in infectious diseases has been little studied. Buruli ulcer (Mycobacterium ulcerans infection) is a chronic infectious disease characterized by large skin ulcerations caused by mycolactone, the major virulence factor of the bacillus. Here, we investigated the impact of ketogenic diet on this cutaneous disease in an experimental mouse model. This diet prevented ulceration, by modulating bacterial growth and host inflammatory response. β-hydroxybutyrate, the major ketone body produced during ketogenic diet and diffusing in tissues, impeded M. ulcerans growth and mycolactone production in vitro underlying its potential key role in infection. These results pave the way for the development of new patient management strategies involving shorter courses of treatment and improving wound healing, in line with the major objectives of the World Health Organization.
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Affiliation(s)
- Mélanie Foulon
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d'Angers, Angers, France
| | - Marie Robbe-Saule
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d'Angers, Angers, France
| | - Lucille Esnault
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d'Angers, Angers, France
| | - Marine Malloci
- MicroPICell Imaging Core Facility, SFR Santé F. Bonamy UMS016, INSERM, CNRS, Université de Nantes, Nantes, France
| | - Anthony Mery
- Département de biochimie et génétique, CHU Angers, France
| | | | - Marie Kempf
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d'Angers, Angers, France.,Laboratoire de bactériologie, CHU, Angers, France
| | - Chadi Homedan
- Département de biochimie et génétique, CHU Angers, France
| | - Estelle Marion
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d'Angers, Angers, France
| | - Laurent Marsollier
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d'Angers, Angers, France
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16
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Coudereau C, Besnard A, Robbe-Saule M, Bris C, Kempf M, Johnson RC, Brou TY, Gnimavo R, Eyangoh S, Khater F, Marion E. Stable and Local Reservoirs of Mycobacterium ulcerans Inferred from the Nonrandom Distribution of Bacterial Genotypes, Benin. Emerg Infect Dis 2021; 26:491-503. [PMID: 32091371 PMCID: PMC7045821 DOI: 10.3201/eid2603.190573] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical disease found in rural areas of West and Central Africa. Despite the ongoing efforts to tackle Buruli ulcer epidemics, the environmental reservoir of its pathogen remains elusive, underscoring the need for new approaches to improving disease prevention and management. In our study, we implemented a local-scale spatial clustering model and deciphered the genetic diversity of the bacteria in a small area of Benin where Buruli ulcer is endemic. Using 179 strain samples from West Africa, we conducted a phylogeographic analysis combining whole-genome sequencing with spatial scan statistics. The 8 distinct genotypes we identified were by no means randomly spread over the studied area. Instead, they were divided into 3 different geographic clusters, associated with landscape characteristics. Our results highlight the ability of M. ulcerans to evolve independently and differentially depending on location in a specific ecologic reservoir.
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17
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Chenouard R, Mahieu R, Luque Paz D, Marion E, Eveillard M, Dubée V. Impact of ceftriaxone and temocillin on fecal abundance of extended-spectrum β-lactamase producing Escherichia coli in a mouse model. PLoS One 2021; 16:e0248177. [PMID: 33690674 PMCID: PMC7946171 DOI: 10.1371/journal.pone.0248177] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Gut colonization by ESBL-producing Enterobacteriaceae (ESBL-PE) is widespread and is promoted by antibiotic exposure. Higher fecal abundance of ESBL-PE promotes the dissemination of the bacteria in the environment and is associated with increased risk of infection. Ceftriaxone and temocillin are commonly used antibiotics with a different activity on gut flora. Their impact on fecal abundance of ESBL-producing Enterobacteriaceae has not been studied. The objective of this study was to compare the propensity of ceftriaxone and temocillin to modify the abundance of ESBL-producing Escherichia coli in feces of colonized mice. METHODS Mice received broad-spectrum antibiotics in order to disrupt their normal gut flora. A CTX-M-type ESBL-producing E. coli clinical isolate was then administered orally, leading to durable colonization. Thirty days later, mice received either temocillin or ceftriaxone with drinking water at a concentration simulating human intestinal exposure. Third-generation-cephalosporin resistant (3GCR) E. coli were enumerated in feces on selective medium before, 2 days and 10 days after the end of antibiotic exposure. The experiment was performed with two E. coli isolates with different temocillin minimum inhibitory concentrations. RESULTS Exposure to ceftriaxone induced an increase in the fecal abundance of 3GCR E. coli. In contrast, temocillin had no effect or transiently decreased the number of 3GCR E. coli. Results obtained with the two strains were similar. CONCLUSION Contrary to ceftriaxone, temocillin does not promote expansion of ESBL-producing E. coli in feces of colonized mice. Thus temocillin may be a therapeutic of choice when a temocillin-susceptible strain infection is suspected or proven to prevent the expansion of ESBL-PE in a previously colonized patient.
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Affiliation(s)
- Rachel Chenouard
- Microbiology Laboratory, Angers University Hospital, Angers, France
- Center for Research in Cancerology and Immunology Nantes-Angers, UMRS1232, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d’Angers, Angers, France
| | - Rafael Mahieu
- Center for Research in Cancerology and Immunology Nantes-Angers, UMRS1232, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d’Angers, Angers, France
- Infectious Diseases Department, Angers University Hospital, Angers, France
| | - David Luque Paz
- Center for Research in Cancerology and Immunology Nantes-Angers, UMRS1232, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d’Angers, Angers, France
| | - Estelle Marion
- Center for Research in Cancerology and Immunology Nantes-Angers, UMRS1232, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d’Angers, Angers, France
| | - Matthieu Eveillard
- Microbiology Laboratory, Angers University Hospital, Angers, France
- Center for Research in Cancerology and Immunology Nantes-Angers, UMRS1232, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d’Angers, Angers, France
| | - Vincent Dubée
- Center for Research in Cancerology and Immunology Nantes-Angers, UMRS1232, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d’Angers, Angers, France
- Infectious Diseases Department, Angers University Hospital, Angers, France
- * E-mail:
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18
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Foulon M, Robbe-Saule M, Manry J, Esnault L, Boucaud Y, Alcaïs A, Malloci M, Fanton d’Andon M, Beauvais T, Labarriere N, Jeannin P, Abel L, Saint-André JP, Croué A, Delneste Y, Boneca IG, Marsollier L, Marion E. Mycolactone toxin induces an inflammatory response by targeting the IL-1β pathway: Mechanistic insight into Buruli ulcer pathophysiology. PLoS Pathog 2020; 16:e1009107. [PMID: 33338061 PMCID: PMC7748131 DOI: 10.1371/journal.ppat.1009107] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/29/2020] [Indexed: 12/12/2022] Open
Abstract
Mycolactone, a lipid-like toxin, is the major virulence factor of Mycobacterium ulcerans, the etiological agent of Buruli ulcer. Its involvement in lesion development has been widely described in early stages of the disease, through its cytotoxic and immunosuppressive activities, but less is known about later stages. Here, we revisit the role of mycolactone in disease outcome and provide the first demonstration of the pro-inflammatory potential of this toxin. We found that the mycolactone-containing mycobacterial extracellular vesicles produced by M. ulcerans induced the production of IL-1β, a potent pro-inflammatory cytokine, in a TLR2-dependent manner, targeting NLRP3/1 inflammasomes. We show our data to be relevant in a physiological context. The in vivo injection of these mycolactone-containing vesicles induced a strong local inflammatory response and tissue damage, which were prevented by corticosteroids. Finally, several soluble pro-inflammatory factors, including IL-1β, were detected in infected tissues from mice and Buruli ulcer patients. Our results revisit Buruli ulcer pathophysiology by providing new insight, thus paving the way for the development of new therapeutic strategies taking the pro-inflammatory potential of mycolactone into account. Buruli ulcer is a neglected tropical disease occurring mainly in poor rural areas of West and Central Africa. This cutaneous disease is caused by Mycobacterium ulcerans, a bacterium belonging to the same family as M. tuberculosis and M. leprae. The skin lesions are caused by a cytotoxic toxin named mycolactone, also known to act as an immunosuppressor and an anti-inflammatory molecule. However, Buruli ulcer lesions are characterized by a chronic cutaneous inflammation with a recruitment of cellular immune cells trying to counteract M. ulcerans. Our work allows for a reconcilitation of previous observations. We found by in vitro experiment on macrophages that the mycolactone-containing mycobacterial extracellular vesicles produced by M. ulcerans induced the production of IL-1β, a potent pro-inflammatory molecule, while other pro-inflammatory soluble factors are inhibited. We also detected IL-1β protein in a mouse model of M. ulcerans infection as well as in biopsies of Buruli ulcer patients. The pro-inflammatory potential of mycolacone has to be taken into account to understand the full pathophysiology of Buruli ulcer.
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Affiliation(s)
- M. Foulon
- Université d’Angers, INSERM, CRCINA, Angers, France
| | | | - J. Manry
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Paris, France
- Université de Paris, Imagine Institute, France
| | - L. Esnault
- Université d’Angers, INSERM, CRCINA, Angers, France
| | - Y. Boucaud
- Université d’Angers, INSERM, CRCINA, Angers, France
| | - A. Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Paris, France
- Université de Paris, Imagine Institute, France
| | - M. Malloci
- Plateforme MicroPiCell, SFR santé François Bonamy, Nantes, France
| | - M. Fanton d’Andon
- Institut Pasteur, Unité Biologie et Génétique de la Paroi Bactérienne, Paris, France; CNRS, INSERM, Équipe Avenir, Paris, France
| | - T. Beauvais
- Université de Nantes, INSERM, CRCINA, Nantes
| | | | - P. Jeannin
- Université d’Angers, INSERM, CRCINA, Angers, France
- Laboratoire d’Immunologie et Allergologie, CHU Angers, Angers, France
| | - L. Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Paris, France
- Université de Paris, Imagine Institute, France
| | - J. P. Saint-André
- Département de Pathologie Cellulaire et Tissulaire, CHU Angers, Angers, France
| | - A. Croué
- Département de Pathologie Cellulaire et Tissulaire, CHU Angers, Angers, France
| | - Y. Delneste
- Université d’Angers, INSERM, CRCINA, Angers, France
- Laboratoire d’Immunologie et Allergologie, CHU Angers, Angers, France
| | - I. G. Boneca
- Institut Pasteur, Unité Biologie et Génétique de la Paroi Bactérienne, Paris, France; CNRS, INSERM, Équipe Avenir, Paris, France
| | | | - E. Marion
- Université d’Angers, INSERM, CRCINA, Angers, France
- * E-mail:
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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: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Manry J, Vincent QB, Johnson C, Chrabieh M, Lorenzo L, Theodorou I, Ardant MF, Marion E, Chauty A, Marsollier L, Abel L, Alcaïs A. Genome-wide association study of Buruli ulcer in rural Benin highlights role of two LncRNAs and the autophagy pathway. Commun Biol 2020; 3:177. [PMID: 32313116 PMCID: PMC7171125 DOI: 10.1038/s42003-020-0920-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/24/2020] [Indexed: 02/07/2023] Open
Abstract
Buruli ulcer, caused by Mycobacterium ulcerans and characterized by devastating necrotizing skin lesions, is the third mycobacterial disease worldwide. The role of host genetics in susceptibility to Buruli ulcer has long been suggested. We conduct the first genome-wide association study of Buruli ulcer on a sample of 1524 well characterized patients and controls from rural Benin. Two-stage analyses identify two variants located within LncRNA genes: rs9814705 in ENSG00000240095.1 (P = 2.85 × 10−7; odds ratio = 1.80 [1.43–2.27]), and rs76647377 in LINC01622 (P = 9.85 × 10−8; hazard ratio = 0.41 [0.28–0.60]). Furthermore, we replicate the protective effect of allele G of a missense variant located in ATG16L1, previously shown to decrease bacterial autophagy (rs2241880, P = 0.003; odds ratio = 0.31 [0.14–0.68]). Our results suggest LncRNAs and the autophagy pathway as critical factors in the development of Buruli ulcer. Jeremy Manry, Quentin Vincent et al. report a genome-wide association study for susceptibility to Buruli ulcer in a rural population from the West African country of Benin. They identify two independently associated variants within LncRNA genes and confirm the protective effect of a missense variant in the bacterial autophagy gene ATG16L1.
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Affiliation(s)
- Jeremy Manry
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France. .,Université de Paris, Imagine Institute, Paris, France.
| | - Quentin B Vincent
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France.,Université de Paris, Imagine Institute, Paris, France
| | - Christian Johnson
- Fondation Raoul Follereau, Paris, France.,Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable. Université d'Abomey, Calavi, Benin
| | - Maya Chrabieh
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France.,Université de Paris, Imagine Institute, Paris, France
| | - Lazaro Lorenzo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France.,Université de Paris, Imagine Institute, Paris, France
| | - Ioannis Theodorou
- Center for Immunology and Infectious Diseases, INSERM UMR S 1135, Pierre and Marie Curie University, and AP-HP Laboratoire d'Immunologie et Histocompatibilité Hôpital Saint-Louis, Paris, France
| | - Marie-Françoise Ardant
- Fondation Raoul Follereau, Paris, France.,Centre de Dépistage et de Traitement de la Lèpre et de l'Ulcère de Buruli (CDTLUB), Pobè, Benin
| | - Estelle Marion
- INSERM UMR-U892 and CNRS U6299, team 7, Angers University, Angers University Hospital, Angers, France
| | - Annick Chauty
- Fondation Raoul Follereau, Paris, France.,Centre de Dépistage et de Traitement de la Lèpre et de l'Ulcère de Buruli (CDTLUB), Pobè, Benin
| | - Laurent Marsollier
- INSERM UMR-U892 and CNRS U6299, team 7, Angers University, Angers University Hospital, Angers, France
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France.,Université de Paris, Imagine Institute, Paris, France.,St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Alexandre Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France. .,Université de Paris, Imagine Institute, Paris, France.
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21
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Phillips RO, Robert J, Abass KM, Thompson W, Sarfo FS, Wilson T, Sarpong G, Gateau T, Chauty A, Omollo R, Ochieng Otieno M, Egondi TW, Ampadu EO, Agossadou D, Marion E, Ganlonon L, Wansbrough-Jones M, Grosset J, Macdonald JM, Treadwell T, Saunderson P, Paintsil A, Lehman L, Frimpong M, Sarpong NF, Saizonou R, Tiendrebeogo A, Ohene SA, Stienstra Y, Asiedu KB, van der Werf TS. Rifampicin and clarithromycin (extended release) versus rifampicin and streptomycin for limited Buruli ulcer lesions: a randomised, open-label, non-inferiority phase 3 trial. Lancet 2020; 395:1259-1267. [PMID: 32171422 PMCID: PMC7181188 DOI: 10.1016/s0140-6736(20)30047-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/23/2019] [Accepted: 01/07/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans infection that damages the skin and subcutis. It is most prevalent in western and central Africa and Australia. Standard antimicrobial treatment with oral rifampicin 10 mg/kg plus intramuscular streptomycin 15 mg/kg once daily for 8 weeks (RS8) is highly effective, but streptomycin injections are painful and potentially harmful. We aimed to compare the efficacy and tolerability of fully oral rifampicin 10 mg/kg plus clarithromycin 15 mg/kg extended release once daily for 8 weeks (RC8) with that of RS8 for treatment of early Buruli ulcer lesions. METHODS We did an open-label, non-inferiority, randomised (1:1 with blocks of six), multicentre, phase 3 clinical trial comparing fully oral RC8 with RS8 in patients with early, limited Buruli ulcer lesions. There were four trial sites in hospitals in Ghana (Agogo, Tepa, Nkawie, Dunkwa) and one in Benin (Pobè). Participants were included if they were aged 5 years or older and had typical Buruli ulcer with no more than one lesion (caterories I and II) no larger than 10 cm in diameter. The trial was open label, and neither the investigators who took measurements of the lesions nor the attending doctors were masked to treatment assignment. The primary clinical endpoint was lesion healing (ie, full epithelialisation or stable scar) without recurrence at 52 weeks after start of antimicrobial therapy. The primary endpoint and safety were assessed in the intention-to-treat population. A sample size of 332 participants was calculated to detect inferiority of RC8 by a margin of 12%. This study was registered with ClinicalTrials.gov, NCT01659437. FINDINGS Between Jan 1, 2013, and Dec 31, 2017, participants were recruited to the trial. We stopped recruitment after 310 participants. Median age of participants was 14 years (IQR 10-29) and 153 (52%) were female. 297 patients had PCR-confirmed Buruli ulcer; 151 (51%) were assigned to RS8 treatment, and 146 (49%) received oral RC8 treatment. In the RS8 group, lesions healed in 144 (95%, 95% CI 91 to 98) of 151 patients, whereas lesions healed in 140 (96%, 91 to 99) of 146 patients in the RC8 group. The difference in proportion, -0·5% (-5·2 to 4·2), was not significantly greater than zero (p=0·59), showing that RC8 treatment is non-inferior to RS8 treatment for lesion healing at 52 weeks. Treatment-related adverse events were recorded in 20 (13%) patients receiving RS8 and in nine (7%) patients receiving RC8. Most adverse events were grade 1-2, but one (1%) patient receiving RS8 developed serious ototoxicity and ended treatment after 6 weeks. No patients needed surgical resection. Four patients (two in each study group) had skin grafts. INTERPRETATION Fully oral RC8 regimen was non-inferior to RS8 for treatment of early, limited Buruli ulcer and was associated with fewer adverse events. Therefore, we propose that fully oral RC8 should be the preferred therapy for early, limited lesions of Buruli ulcer. FUNDING WHO with additional support from MAP International, American Leprosy Missions, Fondation Raoul Follereau France, Buruli ulcer Groningen Foundation, Sanofi-Pasteur, and BuruliVac.
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Affiliation(s)
- Richard O Phillips
- Kwame Nkrumah University of Science and Technology, Kumasi Centre for Collaborative Research in Tropical Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Jérôme Robert
- Centre d'immunologie et des maladies infectieuses, Inserm, Sorbonne Université, Bactériologie site Pitié, AP-HP Sorbonne Université, Centre National de Référence des Mycobactéries, Paris, France
| | | | | | - Fred Stephen Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi Centre for Collaborative Research in Tropical Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | | | - Thierry Gateau
- Centre de diagnostic et de traitement de la lèpre et de l'Ulcère de Buruli Madeleine et Raoul Follereau, Ouémé-Plateau, Pobè, Bénin
| | - Annick Chauty
- Centre de diagnostic et de traitement de la lèpre et de l'Ulcère de Buruli Madeleine et Raoul Follereau, Ouémé-Plateau, Pobè, Bénin
| | - Raymond Omollo
- Drugs for Neglected Diseases initiative, Africa Regional Office, Nairobi, Kenya
| | | | - Thaddaeus W Egondi
- Drugs for Neglected Diseases initiative, Africa Regional Office, Nairobi, Kenya
| | - Edwin O Ampadu
- National Buruli ulcer Control Programme, Ghana Health Service, Accra, Ghana
| | - Didier Agossadou
- Programme National de Lutte contre la lèpre et l'Ulcère de Buruli, Cotonou, Benin
| | - Estelle Marion
- Centre de recherche en cancérologie et immunologie Nantes-Angers, French National Institute of Health and Medical Research, Université d'Angers, Angers, France
| | - Line Ganlonon
- Centre de diagnostic et de traitement de la lèpre et de l'Ulcère de Buruli Madeleine et Raoul Follereau, Ouémé-Plateau, Pobè, Bénin
| | | | - Jacques Grosset
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - John M Macdonald
- Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA; Hospital Bernard Meys Project Medishare, Port-au-Prince, Haiti
| | | | | | - Albert Paintsil
- Reconstructive and Plastic Surgery Unit, Korle-BU Teaching Hospital, Accra, Ghana
| | | | - Michael Frimpong
- Kwame Nkrumah University of Science and Technology, Kumasi Centre for Collaborative Research in Tropical Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Nanaa Francisca Sarpong
- Kwame Nkrumah University of Science and Technology, Kumasi Centre for Collaborative Research in Tropical Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | | | | | - Ymkje Stienstra
- Department of Medicine/Infectious Diseases, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | | | - Tjip S van der Werf
- Department of Medicine/Infectious Diseases, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.
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Coudereau C, Besnard A, Robbe-Saule M, Bris C, Kempf M, Johnson RC, Brou TY, Gnimavo R, Eyangoh S, Khater F, Marion E. Stable and Local Reservoirs of Mycobacterium ulcerans Inferred from the Nonrandom Distribution of Bacterial Genotypes, Benin. Emerg Infect Dis 2020. [DOI: 10.3201/eid2503.190573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Foulon M, Pouchin A, Manry J, Khater F, Robbe-Saule M, Durand A, Esnault L, Delneste Y, Jeannin P, Saint-André JP, Croué A, Altare F, Abel L, Alcaïs A, Marion E. Skin-specific antibodies neutralizing mycolactone toxin during the spontaneous healing of Mycobacterium ulcerans infection. Sci Adv 2020; 6:eaax7781. [PMID: 32133396 PMCID: PMC7043917 DOI: 10.1126/sciadv.aax7781] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
Buruli ulcer, a neglected tropical infectious disease, is caused by Mycobacterium ulcerans. Without treatment, its lesions can progress to chronic skin ulcers, but spontaneous healing is observed in 5% of cases, suggesting the possible establishment of a host strategy counteracting the effects of M. ulcerans. We reveal here a skin-specific local humoral signature of the spontaneous healing process, associated with a rise in antibody-producing cells and specific recognition of mycolactone by the mouse IgG2a immunoglobulin subclass. We demonstrate the production of skin-specific antibodies neutralizing the immunomodulatory activity of the mycolactone toxin, and confirm the role of human host machinery in triggering effective local immune responses by the detection of anti-mycolactone antibodies in patients with Buruli ulcer. Our findings pave the way for substantial advances in both the diagnosis and treatment of Buruli ulcer in accordance with the most recent challenges issued by the World Health Organization.
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Affiliation(s)
- Mélanie Foulon
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
| | - Amélie Pouchin
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
| | - Jérémy Manry
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France
- Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Fida Khater
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
| | - Marie Robbe-Saule
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
| | - Amandine Durand
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
| | - Lucille Esnault
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
| | - Yves Delneste
- Equipe 07, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
- CHU Angers, Département d'Immunologie et Allergologie, Angers, France
| | - Pascale Jeannin
- Equipe 07, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
- CHU Angers, Département d'Immunologie et Allergologie, Angers, France
| | | | - Anne Croué
- Pathology Department, University Hospital of Angers, 49933 Angers, France
| | - Frederic Altare
- Equipe 05, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université d’Angers, Université de Nantes, Nantes, France
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France
- Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Alexandre Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France
- Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Estelle Marion
- Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d’Angers, Angers, France
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Sigg N, Marion E, Gnimavo R, Johnson R, Martin L, Habib A. Intérêt de la PCR quantitative pour le diagnostic de la lèpre. Étude en milieu rural au Bénin. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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.
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Degnonvi H, Fleuret S, Coudereau C, Gnimavo R, Giffon S, Yeramian E, Johnson RC, Marion E. Effect of well drilling on Buruli ulcer incidence in Benin: a case-control, quantitative survey. Lancet Planet Health 2019; 3:e349-e356. [PMID: 31439316 DOI: 10.1016/s2542-5196(19)30110-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/04/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Buruli ulcer is the third most common mycobacterial disease worldwide. The public health burden of this neglected tropical disease is large, particularly in poor areas of west and central Africa. The development of appropriate preventive strategies is hampered by an incomplete understanding of the epidemiology and transmission of the disease. We investigated the effect of the drilling of wells on Buruli ulcer incidence. METHODS In this case-control, quantitative survey, we obtained field data for Buruli ulcer incidence over a 10-year period from a specialised centre that collected data for the Ouémé and Plateau departments in Benin, and data for well drilling from the Ministry of Energy, Water and Mines in Benin. The coordinates of the wells drilled were obtained during site visits. A case-control study was then done to investigate the role of well water use in protecting against Buruli ulcer. FINDINGS We found a strong inverse correlation between the incidence of Buruli ulcer and the number of new wells drilled in the Bonou municipality (r2=0·8818). A case-control study (106 cases and 212 controls) showed that regular use of the water from the wells for washing, bathing, drinking, or cooking was protective against Buruli ulcer (adjusted odds ratio 0·1, 95% CI 0·04-0·44; p=0·0012). INTERPRETATION This study opens up new possibilities for developing an effective yet affordable policy to fight the disease on a substantial geographical scale. Our study shows that providing access to protected water is an efficient and feasable way to reduce the incidence of Buruli ulcer. FUNDING Fondation Francaise Raoul Follereau, French National Institute of Health and Medical Research, and Région Pays de Loire.
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Affiliation(s)
- Horace Degnonvi
- Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable, Université d'Abomey Calavi, Cotonou, Benin; Centre de recherche en cancérologie et immunologie Nantes-Angers, French National Institute of Health and Medical Research, Université de Nantes, Université d'Angers, Angers, France
| | - Sebastien Fleuret
- Centre national de la recherche scientifique, UMR Espaces et SOciétés, Université d'Angers, Angers, France
| | - Clement Coudereau
- Centre de recherche en cancérologie et immunologie Nantes-Angers, French National Institute of Health and Medical Research, Université de Nantes, Université d'Angers, Angers, France
| | - Ronald Gnimavo
- Centre de Diagnostic et de Traitement de la lèpre et de l'ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Sigrid Giffon
- Centre national de la recherche scientifique, UMR Espaces et SOciétés, Université d'Angers, Angers, France
| | - Edouard Yeramian
- Unité de microbiologie structurale, Institut Pasteur, Centre National de Recherche Scientifique, Université de Paris, Paris, France
| | - Roch Christian Johnson
- Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable, Université d'Abomey Calavi, Cotonou, Benin
| | - Estelle Marion
- Centre de recherche en cancérologie et immunologie Nantes-Angers, French National Institute of Health and Medical Research, Université de Nantes, Université d'Angers, Angers, France.
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Babonneau J, Bréard D, Reynaert ML, Marion E, Guilet D, Saint André JP, Croué A, Brodin P, Richomme P, Marsollier L. Mycolactone as Analgesic: Subcutaneous Bioavailability Parameters. Front Pharmacol 2019; 10:378. [PMID: 31031626 PMCID: PMC6473063 DOI: 10.3389/fphar.2019.00378] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 03/26/2019] [Indexed: 01/09/2023] Open
Abstract
Mycobacterium ulcerans is the bacillus responsible for Buruli ulcer, an infectious disease and the third most important mycobacterial disease worldwide, after tuberculosis and leprosy. M. ulcerans infection is a type of panniculitis beginning mostly with a nodule or an oedema, which can progress to large ulcerative lesions. The lesions are caused by mycolactone, the polyketide toxin of M. ulcerans. Mycolactone plays a central role for host colonization as it has immunomodulatory and analgesic effects. On one hand, mycolactone induces analgesia by targeting type-2 angiotensin II receptors (AT2R), causing cellular hyperpolarization and neuron desensitization. Indeed, a single subcutaneous injection of mycolactone into the mouse footpad induces a long-lasting hypoesthesia up to 48 h. It was suggested that the long-lasting hypoesthesia may result from the persistence of a significant amount of mycolactone locally following its injection, which could be probably due to its slow elimination from tissues. To verify this hypothesis, we investigated the correlation between hypoesthesia and mycolactone bioavailability directly at the tissue level. Various quantities of mycolactone were then injected in mouse tissue and hypoesthesia was recorded with nociception assays over a period of 48 h. The hypoesthesia was maximal 6 h after the injection of 4 μg mycolactone. The basal state was reached 48 h after injection, which demonstrated the absence of nerve damage. Surprisingly, mycolactone levels decreased strongly during the first hours with a reduction of 70 and 90% after 4 and 10 h, respectively. Also, mycolactone did not diffuse in neighboring skin tissue and only poorly into the bloodstream upon direct injection. Nevertheless, the remaining amount was sufficient to induce hypoesthesia during 24 h. Our results thus demonstrate that intact mycolactone is rapidly eliminated and that very small amounts of mycolactone are sufficient to induce hypoesthesia. Taken together, our study points out that mycolactone ought to be considered as a promising analgesic.
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Affiliation(s)
- Jérémie Babonneau
- Equipe ATIP AVENIR, CRCINA, INSERM, University of Nantes, University of Angers, Angers, France
| | - Dimitri Bréard
- EA921 SONAS, SFR4207 QUASAV, University of Angers, Université Bretagne-Loire, Angers, France
| | - Marie-Line Reynaert
- CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR8204 - CIIL - Center for Infection and Immunity of Lille, University of Lille, Lille, France
| | - Estelle Marion
- Equipe ATIP AVENIR, CRCINA, INSERM, University of Nantes, University of Angers, Angers, France
| | - David Guilet
- EA921 SONAS, SFR4207 QUASAV, University of Angers, Université Bretagne-Loire, Angers, France
| | | | - Anne Croué
- Laboratoire d'Anatomie Pathologique, Angers, France
| | - Priscille Brodin
- CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR8204 - CIIL - Center for Infection and Immunity of Lille, University of Lille, Lille, France
| | - Pascal Richomme
- EA921 SONAS, SFR4207 QUASAV, University of Angers, Université Bretagne-Loire, Angers, France
| | - Laurent Marsollier
- Equipe ATIP AVENIR, CRCINA, INSERM, University of Nantes, University of Angers, Angers, France
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Vincent QB, Belkadi A, Fayard C, Marion E, Adeye A, Ardant MF, Johnson CR, Agossadou D, Lorenzo L, Guergnon J, Bole-Feysot C, Manry J, Nitschké P, Theodorou I, Casanova JL, Marsollier L, Chauty A, Abel L, Alcaïs A. Microdeletion on chromosome 8p23.1 in a familial form of severe Buruli ulcer. PLoS Negl Trop Dis 2018; 12:e0006429. [PMID: 29708969 PMCID: PMC5945055 DOI: 10.1371/journal.pntd.0006429] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 05/10/2018] [Accepted: 04/04/2018] [Indexed: 12/18/2022] Open
Abstract
Buruli ulcer (BU), the third most frequent mycobacteriosis worldwide, is a neglected tropical disease caused by Mycobacterium ulcerans. We report the clinical description and extensive genetic analysis of a consanguineous family from Benin comprising two cases of unusually severe non-ulcerative BU. The index case was the most severe of over 2,000 BU cases treated at the Centre de Dépistage et de Traitement de la Lèpre et de l’Ulcère de Buruli, Pobe, Benin, since its opening in 2003. The infection spread to all limbs with PCR-confirmed skin, bone and joint infections. Genome-wide linkage analysis of seven family members was performed and whole-exome sequencing of both patients was obtained. A 37 kilobases homozygous deletion confirmed by targeted resequencing and located within a linkage region on chromosome 8 was identified in both patients but was absent from unaffected siblings. We further assessed the presence of this deletion on genotyping data from 803 independent local individuals (402 BU cases and 401 BU-free controls). Two BU cases were predicted to be homozygous carriers while none was identified in the control group. The deleted region is located close to a cluster of beta-defensin coding genes and contains a long non-coding (linc) RNA gene previously shown to display highest expression values in the skin. This first report of a microdeletion co-segregating with severe BU in a large family supports the view of a key role of human genetics in the natural history of the disease. Buruli ulcer (BU) is a tropical infectious disease caused by Mycobacterium ulcerans. Although being the third most common mycobacterial disease in the world after tuberculosis and leprosy, BU remains a neglected tropical disease and an emerging health emergency in several developing countries. It causes profound skin ulcerations and eventually bone infections. Life-long functional sequelae are observed in more than 20% of patients, most of whom are children. Several observations, in particular the large variability in the clinical severity of the disease after infection, suggested the role of human genetic factors in the development of BU. We report the case of a 5-year old girl from Benin, born of consanguineous parents, who suffered from extensive dissemination of the mycobacterium in the skin, bones and joints. One of her siblings was also affected. The deep genetic exploration of this family led to the identification of a small deletion on chromosome 8 in both patients but absent from unaffected siblings. Interestingly, the deletion is located within a region containing genes encoding for beta-defensins, a family of antimicrobial peptides involved in both innate immunity and healing process of skin wounds. This first report of a microdeletion associated with severe BU in a large family supports the view of a key role of human genetics in the natural history of the disease.
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Affiliation(s)
- Quentin B Vincent
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France.,Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Aziz Belkadi
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France.,Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Cindy Fayard
- Department of Radiology, Kremlin-Bicêtre Hospital, Paris, France
| | - Estelle Marion
- Center for Research in Cancerology & Immunology Nantes-Angers (CRCNA), INSERM, Nantes University, Angers University, Angers, France.,Centre de Dépistage et de Traitement de la Lèpre et de l'Ulcère de Buruli (CDTLUB), Fondation Raoul Follereau, Pobe, Benin
| | - Ambroise Adeye
- Centre de Dépistage et de Traitement de la Lèpre et de l'Ulcère de Buruli (CDTLUB), Fondation Raoul Follereau, Pobe, Benin.,Fondation Raoul Follereau, Paris, France
| | - Marie-Françoise Ardant
- Centre de Dépistage et de Traitement de la Lèpre et de l'Ulcère de Buruli (CDTLUB), Fondation Raoul Follereau, Pobe, Benin.,Fondation Raoul Follereau, Paris, France
| | - Christian R Johnson
- Fondation Raoul Follereau, Paris, France.,Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable, Université d'Abomey-Calavi, Cotonou, Benin
| | - Didier Agossadou
- Leprosy and Buruli Ulcer national control program, Beninese Ministry of Health, Cotonou, Benin
| | - Lazaro Lorenzo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France.,Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Julien Guergnon
- INSERM UMR S 945, Pierre et Marie Curie University, Paris, France
| | - Christine Bole-Feysot
- Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France.,Genomic Core Facility, Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, INSERM UMR-1163, Paris, France
| | - Jeremy Manry
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France.,Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - Patrick Nitschké
- Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France.,Bioinformatics Core Facility, Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, INSERM UMR-1163, Paris, France
| | - Ioannis Theodorou
- Center for Immunology and Infectious Diseases, INSERM UMR S 1135, Pierre et Marie Curie University, Paris, France.,Department of Immunology, Pitié-Salpêtrière Hospital, Paris, France
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France.,Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, United States of America.,Howard Hughes Medical Institute, New York, United States of America.,Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France
| | - Laurent Marsollier
- Center for Research in Cancerology & Immunology Nantes-Angers (CRCNA), INSERM, Nantes University, Angers University, Angers, France
| | - Annick Chauty
- Centre de Dépistage et de Traitement de la Lèpre et de l'Ulcère de Buruli (CDTLUB), Fondation Raoul Follereau, Pobe, Benin.,Fondation Raoul Follereau, Paris, France
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France.,Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, United States of America
| | - Alexandre Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Paris, France.,Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Paris, France
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Nitenberg M, Bénarouche A, Maniti O, Marion E, Marsollier L, Géan J, Dufourc EJ, Cavalier JF, Canaan S, Girard-Egrot AP. The potent effect of mycolactone on lipid membranes. PLoS Pathog 2018; 14:e1006814. [PMID: 29320578 PMCID: PMC5779694 DOI: 10.1371/journal.ppat.1006814] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/23/2018] [Accepted: 12/14/2017] [Indexed: 12/15/2022] Open
Abstract
Mycolactone is a lipid-like endotoxin synthesized by an environmental human pathogen, Mycobacterium ulcerans, the causal agent of Buruli ulcer disease. Mycolactone has pleiotropic effects on fundamental cellular processes (cell adhesion, cell death and inflammation). Various cellular targets of mycolactone have been identified and a literature survey revealed that most of these targets are membrane receptors residing in ordered plasma membrane nanodomains, within which their functionalities can be modulated. We investigated the capacity of mycolactone to interact with membranes, to evaluate its effects on membrane lipid organization following its diffusion across the cell membrane. We used Langmuir monolayers as a cell membrane model. Experiments were carried out with a lipid composition chosen to be as similar as possible to that of the plasma membrane. Mycolactone, which has surfactant properties, with an apparent saturation concentration of 1 μM, interacted with the membrane at very low concentrations (60 nM). The interaction of mycolactone with the membrane was mediated by the presence of cholesterol and, like detergents, mycolactone reshaped the membrane. In its monomeric form, this toxin modifies lipid segregation in the monolayer, strongly affecting the formation of ordered microdomains. These findings suggest that mycolactone disturbs lipid organization in the biological membranes it crosses, with potential effects on cell functions and signaling pathways. Microdomain remodeling may therefore underlie molecular events, accounting for the ability of mycolactone to attack multiple targets and providing new insight into a single unifying mechanism underlying the pleiotropic effects of this molecule. This membrane remodeling may act in synergy with the other known effects of mycolactone on its intracellular targets, potentiating these effects.
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Affiliation(s)
- Milène Nitenberg
- Univ. Lyon, Université Lyon 1, CNRS, Institut de Chimie et Biochimie Moléculaires et Supramoléculaires, ICBMS—UMR 5246, GEMBAS team, Lyon, France
| | | | - Ofelia Maniti
- Univ. Lyon, Université Lyon 1, CNRS, Institut de Chimie et Biochimie Moléculaires et Supramoléculaires, ICBMS—UMR 5246, GEMBAS team, Lyon, France
| | - Estelle Marion
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Laurent Marsollier
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Julie Géan
- Univ. Bordeaux, CNRS, Bordeaux INP, Chemistry and Biology of Membranes and Nano-objects, CBMN UMR 5248, Pessac, France
| | - Erick J. Dufourc
- Univ. Bordeaux, CNRS, Bordeaux INP, Chemistry and Biology of Membranes and Nano-objects, CBMN UMR 5248, Pessac, France
| | - Jean-François Cavalier
- Aix-Marseille Univ, CNRS, EIPL, Marseille, France
- Aix-Marseille Univ, CNRS, LISM, Marseille, France
| | - Stéphane Canaan
- Aix-Marseille Univ, CNRS, EIPL, Marseille, France
- Aix-Marseille Univ, CNRS, LISM, Marseille, France
| | - Agnès P. Girard-Egrot
- Univ. Lyon, Université Lyon 1, CNRS, Institut de Chimie et Biochimie Moléculaires et Supramoléculaires, ICBMS—UMR 5246, GEMBAS team, Lyon, France
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Vandelannoote K, Meehan CJ, Eddyani M, Affolabi D, Phanzu DM, Eyangoh S, Jordaens K, Portaels F, Mangas K, Seemann T, Marsollier L, Marion E, Chauty A, Landier J, Fontanet A, Leirs H, Stinear TP, de Jong BC. Multiple Introductions and Recent Spread of the Emerging Human Pathogen Mycobacterium ulcerans across Africa. Genome Biol Evol 2017; 9:414-426. [PMID: 28137745 PMCID: PMC5381664 DOI: 10.1093/gbe/evx003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 12/21/2022] Open
Abstract
Buruli ulcer (BU) is an insidious neglected tropical disease. Cases are reported around the world but the rural regions of West and Central Africa are most affected. How BU is transmitted and spreads has remained a mystery, even though the causative agent, Mycobacterium ulcerans, has been known for more than 70 years. Here, using the tools of population genomics, we reconstruct the evolutionary history of M. ulcerans by comparing 165 isolates spanning 48 years and representing 11 endemic countries across Africa. The genetic diversity of African M. ulcerans was found to be restricted due to the bacterium's slow substitution rate coupled with its relatively recent origin. We identified two specific M. ulcerans lineages within the African continent, and inferred that M. ulcerans lineage Mu_A1 existed in Africa for several hundreds of years, unlike lineage Mu_A2, which was introduced much more recently, approximately during the 19th century. Additionally, we observed that specific M. ulcerans epidemic Mu_A1 clones were introduced during the same time period in the three hydrological basins that were well covered in our panel. The estimated time span of the introduction events coincides with the Neo-imperialism period, during which time the European colonial powers divided the African continent among themselves. Using this temporal association, and in the absence of a known BU reservoir or-vector on the continent, we postulate that the so-called "Scramble for Africa" played a significant role in the spread of the disease across the continent.
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Affiliation(s)
- Koen Vandelannoote
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Evolutionary Ecology Group University of Antwerp, Antwerp, Belgium
| | - Conor J Meehan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Miriam Eddyani
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Sara Eyangoh
- Service de Mycobactériologie, Centre Pasteur du Cameroun, Yaoundé, Cameroun
| | - Kurt Jordaens
- Evolutionary Ecology Group University of Antwerp, Antwerp, Belgium.,Invertebrates Section, Royal Museum for Central Africa, Tervuren, Belgium
| | - Françoise Portaels
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kirstie Mangas
- Department of Microbiology and Immunology, University of Melbourne, Victoria, Australia
| | - Torsten Seemann
- Victorian Life Sciences Computation Initiative University of Melbourne, Victoria, Australia
| | | | - Estelle Marion
- CRCNA Inserm U892 CNRS 6299, CHU & Université d'Angers, Angers, France
| | | | - Jordi Landier
- Service de Mycobactériologie, Centre Pasteur du Cameroun, Yaoundé, Cameroun.,Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - Herwig Leirs
- Evolutionary Ecology Group University of Antwerp, Antwerp, Belgium
| | - Timothy P Stinear
- Department of Microbiology and Immunology, University of Melbourne, Victoria, Australia
| | - Bouke C de Jong
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Coron N, Pavlickova S, Godefroy A, Pailhoriès H, Kempf M, Cassisa V, Marsollier L, Marion E, Joly-Guillou ML, Eveillard M. Mouse model of colonization of the digestive tract with Acinetobacter baumannii and subsequent pneumonia. Future Microbiol 2017; 12:707-719. [PMID: 28540732 DOI: 10.2217/fmb-2016-0203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Implementing a mouse model of Acinetobacter baumannii (AB) digestive colonization and studying the propensity of an intestinal reservoir of AB to be at the origin of pneumonia. MATERIALS & METHODS After a disruption of the digestive flora by piperacillin-tazobactam, two multidrug-resistant AB strains were intranasally inoculated to two cohorts of ten mice daily. For each strain, five mice were rendered transiently neutropenic. RESULTS & CONCLUSION One strain persisted several weeks in the digestive tract, even after stopping piperacillin-tazobactam injections, leading to the hypothesis that some AB strains can authentically colonize the gut. Most of the immunocompromised mice experienced clinical signs and positive lung cultures, which were associated with positive spleen cultures, an argument in favor of bacterial translocation.
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Affiliation(s)
- Noémie Coron
- Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'Angers, Angers, France.,Equipe Atip-Avenir, Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'Angers, Angers, France
| | - Silvie Pavlickova
- Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'Angers, Angers, France.,Equipe Atip-Avenir, Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'Angers, Angers, France
| | - Angélique Godefroy
- Laboratoire de bactériologie, IRIS, CHU, 4 rue Larrey, 49933 Angers cedex, France
| | - Hélène Pailhoriès
- Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'Angers, Angers, France.,Equipe Atip-Avenir, Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'Angers, Angers, France.,Laboratoire de bactériologie, IRIS, CHU, 4 rue Larrey, 49933 Angers cedex, France
| | - Marie Kempf
- Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'Angers, Angers, France.,Equipe Atip-Avenir, Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'Angers, Angers, France.,Laboratoire de bactériologie, IRIS, CHU, 4 rue Larrey, 49933 Angers cedex, France
| | - Viviane Cassisa
- Laboratoire de bactériologie, IRIS, CHU, 4 rue Larrey, 49933 Angers cedex, France
| | - Laurent Marsollier
- Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'Angers, Angers, France.,Equipe Atip-Avenir, Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'Angers, Angers, France
| | - Estelle Marion
- Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'Angers, Angers, France.,Equipe Atip-Avenir, Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'Angers, Angers, France
| | - Marie-Laure Joly-Guillou
- Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'Angers, Angers, France.,Equipe Atip-Avenir, Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'Angers, Angers, France.,Laboratoire de bactériologie, IRIS, CHU, 4 rue Larrey, 49933 Angers cedex, France
| | - Matthieu Eveillard
- Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'Angers, Angers, France.,Equipe Atip-Avenir, Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'Angers, Angers, France.,Laboratoire de bactériologie, IRIS, CHU, 4 rue Larrey, 49933 Angers cedex, France
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Robbe-Saule M, Babonneau J, Sismeiro O, Marsollier L, Marion E. An Optimized Method for Extracting Bacterial RNA from Mouse Skin Tissue Colonized by Mycobacterium ulcerans. Front Microbiol 2017; 8:512. [PMID: 28392785 PMCID: PMC5364165 DOI: 10.3389/fmicb.2017.00512] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/13/2017] [Indexed: 11/13/2022] Open
Abstract
Bacterial transcriptome analyses during host colonization are essential to decipher the complexity of the relationship between the bacterium and its host. RNA sequencing (RNA-seq) is a promising approach providing valuable information about bacterial adaptation, the host response and, in some cases, mutual tolerance underlying crosstalk, as recently observed in the context of Mycobacterium ulcerans infection. Buruli ulcer is caused by M. ulcerans. This neglected disease is the third most common mycobacterial disease worldwide. Without treatment, M. ulcerans provokes massive skin ulcers. A healing process may be observed in 5% of Buruli ulcer patients several months after the initiation of disease. This spontaneous healing process suggests that some hosts can counteract the development of the lesions caused by M. ulcerans. Deciphering the mechanisms involved in this process should open up new treatment possibilities. To this end, we recently developed the first mouse model for studies of the spontaneous healing process. We have shown that the healing process is based on mutual tolerance between the bacterium and its host. In this context, RNA-seq seems to be the most appropriate method for deciphering bacterial adaptation. However, due to the low bacterial load in host tissues, the isolation of mycobacterial RNA from skin tissue for RNA-seq analysis remains challenging. We developed a method for extracting and purifying mycobacterial RNA whilst minimizing the amount of host RNA in the sample. This approach was based on the extraction of bacterial RNA by a differential lysis method. The challenge in the development of this method was the choice of a lysis system favoring the removal of host RNA without damage to the bacterial cells. We made use of the thick, resistant cell wall of M. ulcerans to achieve this end.
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Affiliation(s)
- Marie Robbe-Saule
- Center for Research in Cancerology and Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'AngersAngers, France; Equipe Atip-Avenir, Center for Research in Cancerology and Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'AngersAngers, France
| | - Jérémie Babonneau
- Center for Research in Cancerology and Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'AngersAngers, France; Equipe Atip-Avenir, Center for Research in Cancerology and Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'AngersAngers, France
| | - Odile Sismeiro
- Transcriptome and Epigenome Platform, Biomics, Center for Innovation and Technological Research, Institut Pasteur Paris, France
| | - Laurent Marsollier
- Center for Research in Cancerology and Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'AngersAngers, France; Equipe Atip-Avenir, Center for Research in Cancerology and Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'AngersAngers, France
| | - Estelle Marion
- Center for Research in Cancerology and Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d'AngersAngers, France; Equipe Atip-Avenir, Center for Research in Cancerology and Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire et Université d'AngersAngers, France
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Mols P, Schmidt R, Marion E, Luyckx M. [Genesis of specific multisite Medical Intervention Plans in the Brussels Capital Region]. Rev Med Brux 2017; 38:70-72. [PMID: 28525246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
After the november 19th 2015 Paris terrorist attacks, there was a clear need to update the Medical Intervention Plans (MIP) for Mass Casualty Events (MCE) in the Brussels Capital Region (BCR), because they only offered a response to single-site MCE in a peace-time context. We compared the organisation and the resources of the BCR and cities like Paris and Lille, we discussed with our french colleagues and formed a Multisite Attack Task-force that produced a specific multisite MIP, which had to be put to use only a few days after its creation.
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Affiliation(s)
- P Mols
- Vice-Président de la Commission de l'Aide médicale urgente (CoAMU) Bruxelles-Capitale, C.H.U. Saint-Pierre, ULB
| | - R Schmidt
- Coordinateur du Service de Secours et Ambulance de Bruxelles-Capitale à la Croix-Rouge de Belgique
| | - E Marion
- Directeur médical 112, Bruxelles-Capitale, Hôpital Saint-Luc, UCL
| | - M Luyckx
- Présidente de la CoAMU Bruxelles-Capitale, Inspectrice d'Hygiène fédérale pour la Région Bruxelles-Capitale et pour le Brabant wallon
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Pirson Y, Castronoyo V, Martin J, Plaen JD, Marion E. Book Reviews. Acta Clin Belg 2016. [DOI: 10.1080/17843286.1994.11718365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sanhueza D, Chevillon C, Colwell R, Babonneau J, Marion E, Marsollier L, Guégan JF. Chitin promotes Mycobacterium ulcerans growth. FEMS Microbiol Ecol 2016; 92:fiw067. [PMID: 27020062 DOI: 10.1093/femsec/fiw067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2016] [Indexed: 11/13/2022] Open
Abstract
Mycobacterium ulcerans(MU) is the causative agent of Buruli ulcer, an emerging human infectious disease. However, both the ecology and life cycle of MU are poorly understood. The occurrence of MU has been linked to the aquatic environment, notably water bodies affected by human activities. It has been hypothesized that one or a combination of environmental factor(s) connected to human activities could favour growth of MU in aquatic systems. Here, we testedin vitrothe growth effect of two ubiquitous polysaccharides and five chemical components on MU at concentration ranges shown to occur in endemic regions. Real-time PCR showed that chitin increased MU growth significantly providing a nutrient source or environmental support for thebacillus, thereby, providing a focus on the association between MU and aquatic arthropods. Aquatic environments with elevated population of arthropods provide increased chitin availability and, thereby, enhanced multiplication of MU. If calcium very slightly enhanced MU growth, iron, zinc, sulphate and phosphate did not stimulate MU growth, and at the concentration ranges of this study would limit MU population in natural ecosystems.
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Affiliation(s)
- Daniel Sanhueza
- UMR MIVEGEC IRD-CNRS-Université de Montpellier, Centre IRD de Montpellier, B.P. 64501, 34000 Montpellier, France Equipe Inserm Avenir ATOMycA, CRCNA INSERM U892 and CNRS U6299, Université et CHU d'Angers, 49933 Angers, France
| | - Christine Chevillon
- UMR MIVEGEC IRD-CNRS-Université de Montpellier, Centre IRD de Montpellier, B.P. 64501, 34000 Montpellier, France
| | - Rita Colwell
- Center for Bioinformatics and Computational Biology, University of Maryland, Institute for Advanced Computational Systems (UMIACS), College Park, MD 20742, USA and Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Jérémie Babonneau
- Equipe Inserm Avenir ATOMycA, CRCNA INSERM U892 and CNRS U6299, Université et CHU d'Angers, 49933 Angers, France
| | - Estelle Marion
- Equipe Inserm Avenir ATOMycA, CRCNA INSERM U892 and CNRS U6299, Université et CHU d'Angers, 49933 Angers, France
| | - Laurent Marsollier
- Equipe Inserm Avenir ATOMycA, CRCNA INSERM U892 and CNRS U6299, Université et CHU d'Angers, 49933 Angers, France
| | - Jean-François Guégan
- UMR MIVEGEC IRD-CNRS-Université de Montpellier, Centre IRD de Montpellier, B.P. 64501, 34000 Montpellier, France
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Song OR, Marion E, Comoglio Y, Babonneau J, Guerineau N, Sandoz G, Yeramian E, Brodin P, Marsollier L. [Mycolactone: the amazing analgesic mycobacterial toxin]. Med Sci (Paris) 2016; 32:156-8. [PMID: 26936171 DOI: 10.1051/medsci/20163202007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ok-Ryul Song
- Inserm U1019, CNRS UMR8204, université de Lille, Institut Pasteur de Lille, France - Inserm Avenir, Institut Pasteur Korea, Seoul, Korea
| | - Estelle Marion
- Inserm Avenir, Institut Pasteur Korea, Seoul, Korea - Inserm Avenir ATOMycA, Inserm U892, CNRS U6299, CRCNA, université et CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9, France
| | - Yannick Comoglio
- Inserm Avenir, Laboratories of Excellence, Ion Channel Science and Therapeutics Nice, Institut de Biologie Valrose, iBV, Inserm U1091, CNRS UMR7277, université Nice Sophia Antipolis, Nice, France
| | - Jérémie Babonneau
- Inserm Avenir ATOMycA, Inserm U892, CNRS U6299, CRCNA, université et CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9, France
| | | | - Guillaume Sandoz
- Inserm Avenir, Laboratories of Excellence, Ion Channel Science and Therapeutics Nice, Institut de Biologie Valrose, iBV, Inserm U1091, CNRS UMR7277, université Nice Sophia Antipolis, Nice, France
| | - Edouard Yeramian
- CNRS UMR 3528, unité de microbiologie structurale, Institut Pasteur, Paris, France
| | - Priscille Brodin
- Inserm Avenir, Institut Pasteur Korea, Seoul, Korea - Inserm Avenir ATOMycA, Inserm U892, CNRS U6299, CRCNA, université et CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9, France
| | - Laurent Marsollier
- Inserm Avenir, Institut Pasteur Korea, Seoul, Korea - Inserm Avenir ATOMycA, Inserm U892, CNRS U6299, CRCNA, université et CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9, France
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Marion E, Chauty A, Kempf M, Le Corre Y, Delneste Y, Croue A, Marsollier L. Clinical Features of Spontaneous Partial Healing During Mycobacterium ulcerans Infection. Open Forum Infect Dis 2016; 3:ofw013. [PMID: 26925431 PMCID: PMC4767261 DOI: 10.1093/ofid/ofw013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 01/22/2016] [Indexed: 11/12/2022] Open
Abstract
Background. Buruli ulcer, caused by Mycobacterium ulcerans, is a necrotizing skin disease leading to extensive cutaneous and subcutaneous destruction and functional limitations. Spontaneous healing in the absence of medical treatment occurs in rare cases, but this has not been well described in the literature. Methods. In a retrospective case study in an area of Benin where this disease is highly endemic, we selected 26 Buruli ulcer patients presenting features of spontaneous healing from a cohort of 545 Buruli ulcer patients treated between 2010 and 2013. Results. The 26 patients studied had a median age of 13.5 years and were predominantly male (1.4:1). Three groups of patients were defined on the basis of their spontaneous healing characteristics. The first group (12 patients) consisted of patients with an ulcer of more than 1 year's duration showing signs of healing. The second (13 patients) group contained patients with an active Buruli ulcer lesion some distance away from a first lesion that had healed spontaneously. Finally, the third group contained a single patient displaying complete healing of lesions from a nodule, without treatment and with no relapse. Conclusions. We defined several features of spontaneous healing in Buruli ulcer patients and highlighted the difficulties associated with diagnosis and medical management. Delays in consultation contributed to the high proportion of patients with permanent sequelae and a risk of squamous cell carcinoma. Early detection and antibiotic treatment are the best ways to reduce impairments.
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Affiliation(s)
- Estelle Marion
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Bénin; Atip/Avenir Team, Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Université et Centre Hospitalier Universitaire (CHU) d'Angers
| | - Annick Chauty
- Centre de Dépistage et de Traitement de l'Ulcère de Buruli de Pobè , Fondation Raoul Follereau , Bénin
| | - Marie Kempf
- Laboratoire de Bactériologie et d'Hygiène Hospitalière
| | | | - Yves Delneste
- Team "Innate Immunity" , Université d'Angers, Labex IGO , France
| | - Anne Croue
- Laboratoire d'Anatomie Pathologique , CHU d'Angers
| | - Laurent Marsollier
- Atip/Avenir Team, Centre de Recherche en Cancérologie Nantes-Angers (CRCNA) , Université et Centre Hospitalier Universitaire (CHU) d'Angers
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Marion E, Jarry U, Cano C, Savary C, Beauvillain C, Robbe-Saule M, Preisser L, Altare F, Delneste Y, Jeannin P, Marsollier L. FVB/N Mice Spontaneously Heal Ulcerative Lesions Induced by Mycobacterium ulcerans and Switch M. ulcerans into a Low Mycolactone Producer. J I 2016; 196:2690-8. [DOI: 10.4049/jimmunol.1502194] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/15/2016] [Indexed: 12/29/2022]
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Wadagni A, Frimpong M, Phanzu DM, Ablordey A, Kacou E, Gbedevi M, Marion E, Xing Y, Babu VS, Phillips RO, Wansbrough-Jones M, Kishi Y, Asiedu K. Simple, Rapid Mycobacterium ulcerans Disease Diagnosis from Clinical Samples by Fluorescence of Mycolactone on Thin Layer Chromatography. PLoS Negl Trop Dis 2015; 9:e0004247. [PMID: 26583925 PMCID: PMC4652903 DOI: 10.1371/journal.pntd.0004247] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/28/2015] [Indexed: 11/25/2022] Open
Abstract
Introduction Mycobacterium ulcerans infection, known as Buruli ulcer, is a disease of the skin and subcutaneous tissues which is an important but neglected tropical disease with its major impact in rural parts of West and Central Africa where facilities for diagnosis and management are poorly developed. We evaluated fluorescent thin layer chromatography (f-TLC) for detection of mycolactone in the laboratory using samples from patients with Buruli ulcer and patients with similar lesions that gave a negative result on PCR for the IS2404 repeat sequence of M. ulcerans Methodology/Principal findings Mycolactone and DNA extracts from fine needle aspiration (FNA), swabs and biopsy specimen were used to determine the sensitivity and specificity of f-TLC when compared with PCR for the IS2404. For 71 IS2404 PCR positive and 28 PCR negative samples the sensitivity was 73.2% and specificity of 85.7% for f-TLC. The sensitivity was similar for swabs (73%), FNAs (75%) and biopsies (70%). Conclusions We have shown that mycolactone can be detected from M. ulcerans infected skin tissue by f-TLC technique. The technique is simple, easy to perform and read with minimal costs. In this study it was undertaken by a member of the group from each endemic country. It is a potentially implementable tool at the district level after evaluation in larger field studies. Mycobacterium ulcerans infection, known as Buruli ulcer, is a disease that affects the skin and underlying tissues. The organism responsible for the infection produces a potent toxin called mycolactone that causes extensive skin damage. Easy to perform and cheaper techniques are needed for diagnostic confirmation. We have evaluated fluorescent thin layer chromatography (fTLC) for detection of mycolactone in skin samples from patients with Buruli ulcer comparing them with samples from similar non-Buruli ulcer lesions that gave a negative result in the standard polymerase chain reaction (PCR) test for M. ulcerans. Fluorescent TLC had sensitivity of 73.2% and specificity of 85.7% when compared with PCR whether the skin sample was a swab, a biopsy or a fine needle aspirate. This study shows that mycolactone can be detected reliably from M. ulcerans infected skin tissue by the simple, low cost technique of fluorescent thin layer chromatography that could be developed for point of care use. It requires further evaluation in countries where Buruli ulcer disease is endemic.
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Affiliation(s)
- Anita Wadagni
- Centre de Dépistage et de Traitement de l’Ulcère de Buruli d’Allada, Allada, Bénin
| | - Michael Frimpong
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | | | - Anthony Ablordey
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Mirabelle Gbedevi
- Centre de Dépistage et de Traitement de l’Ulcère de Buruli d’Allada, Allada, Bénin
| | - Estelle Marion
- Centre de Diagnostic et de Traitement de l'Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Yalan Xing
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Vaddela Sudheer Babu
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- * E-mail:
| | | | - Yoshito Kishi
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Kingsley Asiedu
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Zogo B, Djenontin A, Carolan K, Babonneau J, Guegan JF, Eyangoh S, Marion E. A Field Study in Benin to Investigate the Role of Mosquitoes and Other Flying Insects in the Ecology of Mycobacterium ulcerans. PLoS Negl Trop Dis 2015. [PMID: 26196901 PMCID: PMC4510061 DOI: 10.1371/journal.pntd.0003941] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Buruli ulcer, the third mycobacterial disease after tuberculosis and leprosy, is caused by the environmental mycobacterium M. ulcerans. There is at present no clear understanding of the exact mode(s) of transmission of M. ulcerans. Populations affected by Buruli ulcer are those living close to humid and swampy zones. The disease is associated with the creation or the extension of swampy areas, such as construction of dams or lakes for the development of agriculture. Currently, it is supposed that insects (water bugs and mosquitoes) are host and vector of M. ulcerans. The role of water bugs was clearly demonstrated by several experimental and environmental studies. However, no definitive conclusion can yet be drawn concerning the precise importance of this route of transmission. Concerning the mosquitoes, DNA was detected only in mosquitoes collected in Australia, and their role as host/vector was never studied by experimental approaches. Surprisingly, no specific study was conducted in Africa. In this context, the objective of this study was to investigate the role of mosquitoes (larvae and adults) and other flying insects in ecology of M. ulcerans. This study was conducted in a highly endemic area of Benin. Methodology/Principal Findings Mosquitoes (adults and larvae) were collected over one year, in Buruli ulcer endemic in Benin. In parallel, to monitor the presence of M. ulcerans in environment, aquatic insects were sampled. QPCR was used to detected M. ulcerans DNA. DNA of M. ulcerans was detected in around 8.7% of aquatic insects but never in mosquitoes (larvae or adults) or in other flying insects. Conclusion/Significance This study suggested that the mosquitoes don't play a pivotal role in the ecology and transmission of M. ulcerans in the studied endemic areas. However, the role of mosquitoes cannot be excluded and, we can reasonably suppose that several routes of transmission of M. ulcerans are possible through the world. Buruli ulcer is a neglected tropical disease due to M. ulcerans, an environmental mycobacteria. Modes of transmission to human remain unclear and water bugs and mosquitoes had been incriminated with more or less experimental laboratory evidences and filed studies. In this context, we have investigated the presence of M. ulcerans DNA in mosquitoes and other flying insect in a highly endemic area of Buruli ulcer in Benin. No trace of the bacteria was found in mosquitoes and other flying insects, while 8,7% of aquatic insects, including water bugs, caught in the same area and in the same period were found positive to M. ulcerans DNA. Our results support the hypothesis that mosquitoes don’t play a major role in ecology of M. ulcerans in our research area and is in favor of a transmission from the aquatic environment.
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Affiliation(s)
- Barnabas Zogo
- IRD-CREC Cotonou, Bénin, and University of Abomey-Calavi, Cotonou, Bénin
| | - Armel Djenontin
- IRD-CREC Cotonou, Bénin, and University of Abomey-Calavi, Cotonou, Bénin
| | - Kevin Carolan
- UMR MIVEGEC, CNRS, IRD, Universities of Montpellier I and II, Montpellier, France
| | - Jeremy Babonneau
- ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University and CHU of Angers, Angers, France
| | - Jean-François Guegan
- UMR MIVEGEC, CNRS, IRD, Universities of Montpellier I and II, Montpellier, France
| | - Sara Eyangoh
- Laboratoire de Mycobactériologie, Centre Pasteur du Cameroun, Yaoundé, Cameroun
| | - Estelle Marion
- ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University and CHU of Angers, Angers, France
- Centre de Diagnostic et de Traitement de l’ulcère de Buruli, Fondation Raoul Follereau, Pobè, Bénin
- * E-mail:
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Babonneau J, Bernard C, Marion E, Chauty A, Kempf M, Robert R, Marsollier L. Development of a dry-reagent-based qPCR to facilitate the diagnosis of Mycobacterium ulcerans infection in endemic countries. PLoS Negl Trop Dis 2015; 9:e0003606. [PMID: 25830546 PMCID: PMC4382021 DOI: 10.1371/journal.pntd.0003606] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/07/2015] [Indexed: 11/18/2022] Open
Abstract
Background Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans. This skin disease is the third most common mycobacterial disease and its rapid diagnosis and treatment are necessary. Polymerase chain reaction (PCR) is considered to be the most sensitive method for the laboratory confirmation of Buruli ulcer. However, PCR remains expensive and involves reagents unsuitable for use in tropical countries with poor storage conditions, hindering the development of reliable quantitative PCR (qPCR) diagnosis. We aimed to overcome this problem by developing a ready-to-use dry qPCR mix for the diagnosis of M. ulcerans infection. Methodology/Principal Findings We compared the efficiency of three different dry qPCR mixes, lyophilized with various concentrations of cryoprotectants, with that of a freshly prepared mixture, for the detection of a standard range of M. ulcerans DNA concentrations. We evaluated the heat resistance of the dry mixes, comparing them with the fresh mix after heating. We also evaluated one of the dry mixes in field conditions, by analyzing 93 specimens from patients with suspected Buruli ulcers. The dry mix was (i) highly resistant to heat; (ii) of similar sensitivity and efficiency to the fresh mix and (iii) easier to use than the fresh mix. Conclusions Dry qPCR mixes are suitable for use in the diagnosis of M. ulcerans infection in endemic countries. The user-friendly format of this mix makes it possible for untrained staff to perform diagnostic tests with a limited risk of contamination. The possibility of using this mix in either vial or strip form provides considerable flexibility for the management of small or large amounts of sample. Thus, dry-mix qPCR could be used as a reliable tool for the diagnosis of Buruli ulcer in the field. Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans that may result in severe skin ulceration if left untreated. Quantitative PCR (qPCR) is the most sensitive method for diagnosing Buruli ulcer, but is difficult to perform in endemic areas. We overcame these problems by developing an easy-to-use, heat-resistant dry-reagent qPCR device.
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Affiliation(s)
- Jérémie Babonneau
- ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS and LUNAM, CHU and Université d'Angers, Angers, France
- * E-mail:
| | | | - Estelle Marion
- Centre de diagnostic et de traitement de l'ulcère de Buruli, Pobè, Bénin
| | - Annick Chauty
- Centre de diagnostic et de traitement de l'ulcère de Buruli, Pobè, Bénin
| | - Marie Kempf
- Laboratoire de Bactériologie, Institut de Biologie en Santé—PBH, CHU d’Angers, Angers, France
| | | | - Laurent Marsollier
- ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS and LUNAM, CHU and Université d'Angers, Angers, France
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Marion E, Carolan K, Adeye A, Kempf M, Chauty A, Marsollier L. Buruli ulcer in South Western Nigeria: a retrospective cohort study of patients treated in Benin. PLoS Negl Trop Dis 2015; 9:e3443. [PMID: 25569775 PMCID: PMC4287556 DOI: 10.1371/journal.pntd.0003443] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/24/2014] [Indexed: 11/18/2022] Open
Abstract
Nigeria is known to be endemic to Buruli ulcer, but epidemiological data are remarkably rare. Here, we present a large cohort of 127 PCR-confirmed M. ulcerans infection patients coming from Nigeria and treated in a neighbouring country, Benin. Severe lesions and delay of consultation are factors that should encourage establishment of a treatment centre in South Western Nigeria. Buruli ulcer is known to be endemic to Nigeria since at least 1967, however epidemiological data are rare and incomplete. In total, only 51 Buruli ulcer patients were described in 45 years, all found in Southern Nigeria. This is likely a result of the lack of adequate public health structures dedicated to the diagnosis and treatment of Buruli ulcer in the region. Here, we report a large cohort of 127 PCR-confirmed Nigerian patients treated in neighbouring Benin. Nigerian patients presented mainly severe lesions of Buruli ulcer, and this is linked by the fact that period prior consultation is delayed (24% of the patients waited more than one year between the beginning of the lesion and the consultation in the Buruli ulcer treatment centre in Pobè). We identify South Western Nigeria as an important endemic area for Buruli ulcer, and believe our results will be of importance to Nigerian health authorities, the World Health Organisation and NGO's involved in management of Buruli ulcer.
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Affiliation(s)
- Estelle Marion
- Centre de Diagnostic et de Traitement de l'Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
- ATOMycA, Inserm Atip-Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University and Centre Hospitalier Universitaire d'Angers, Angers, France
- * E-mail:
| | - Kevin Carolan
- UMR Mivegec, IRD-CNRS-Universities of Montpellier I and II, Montpellier, Centre IRD de Montpellier, Montpellier, France
| | - Ambroise Adeye
- Centre de Diagnostic et de Traitement de l'Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Marie Kempf
- Laboratoire de bactériologie et d'hygiène hospitalière, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Annick Chauty
- Centre de Diagnostic et de Traitement de l'Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin
| | - Laurent Marsollier
- ATOMycA, Inserm Atip-Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University and Centre Hospitalier Universitaire d'Angers, Angers, France
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Pommelet V, Vincent QB, Ardant MF, Adeye A, Tanase A, Tondeur L, Rega A, Landier J, Marion E, Alcaïs A, Marsollier L, Fontanet A, Chauty A. Findings in patients from Benin with osteomyelitis and polymerase chain reaction-confirmed Mycobacterium ulcerans infection. Clin Infect Dis 2014; 59:1256-64. [PMID: 25048846 DOI: 10.1093/cid/ciu584] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Mycobacterium ulcerans is known to cause Buruli ulcer (BU), a necrotizing skin disease leading to extensive cutaneous and subcutaneous destruction and functional limitations. However, M. ulcerans infections are not limited to skin, and osteomyelitis, still poorly described in the literature, occurs in numerous young patients in Africa. METHODS In a retrospective matched case-control study conducted in a highly endemic area in Benin, we analyzed demographic, clinical, biological, and radiological features in all patients with M. ulcerans infections with bone involvement, identified from a cohort of 1257 patients with polymerase chain reaction-proved M. ulcerans infections. RESULTS The 81 patients studied had a median age of 11 years (interquartile range, 7-16 years) and were predominantly male (male-female ratio, 2:1). Osteomyelitis was observed beneath active BU lesions (60.5%) or at a distance from active or apparently healed BU lesions (14.8%) but also in patients without a history of BU skin lesions (24.7%). These lesions had an insidious course, with nonspecific clinical findings leading to delayed diagnosis. A comparison with findings in 243 age- and sex-matched patients with BU without osteomyelitis showed that case patients were less likely to have received BCG immunization than controls (33.3% vs 52.7%; P = .01). They were also at higher risk of longer hospital stay (118 vs 69 days; P = .001), surgery (92.6% vs 63.0%; P = .001), and long-term crippling sequelae (55.6% vs 15.2%; P < .001). CONCLUSIONS This study highlighted the difficulties associated with diagnosis of M. ulcerans osteomyelitis, with one-fourth of patients having no apparent history of BU skin lesions, including during the current course of illness. Delays in treatment contributed to the high proportion (55.6%) of patients with crippling sequelae.
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Affiliation(s)
| | - Quentin B Vincent
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Recherche Médicale U980 (INSERM) Université Paris Descartes, Sorbonne Paris Cité, Imagine Institute
| | - Marie-Françoise Ardant
- Centre de Diagnostic et de Traitement de la Lèpre et de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Bénin
| | - Ambroise Adeye
- Centre de Diagnostic et de Traitement de la Lèpre et de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Bénin
| | - Anca Tanase
- Department of Pediatric Radiology, Robert Debré Children University Hospital, Assistance Publique-Hôpitaux de Paris
| | - Laura Tondeur
- Emerging Diseases Epidemiology Unit, Institut Pasteur
| | - Adelaide Rega
- Department of Pediatric Radiology, Robert Debré Children University Hospital, Assistance Publique-Hôpitaux de Paris
| | - Jordi Landier
- Emerging Diseases Epidemiology Unit, Institut Pasteur
| | - Estelle Marion
- Centre de Diagnostic et de Traitement de la Lèpre et de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Bénin ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS, Université et CHU LUNAM, Université d'Angers, France
| | - Alexandre Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Recherche Médicale U980 (INSERM) Université Paris Descartes, Sorbonne Paris Cité, Imagine Institute CIC-0109 Cochin-Necker Inserm, Unité de Recherche Clinique, Paris Centre Descartes Necker Cochin, Assistance Publique-Hôpitaux de Paris et EA 3620, Université Paris Descartes Conservatoire National des Arts et Métiers, Paris
| | - Laurent Marsollier
- ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS, Université et CHU LUNAM, Université d'Angers, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur Conservatoire National des Arts et Métiers, Paris
| | - Annick Chauty
- Centre de Diagnostic et de Traitement de la Lèpre et de l'Ulcère de Buruli, Fondation Raoul Follereau, Pobè, Bénin
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Van Ende C, Haufroid V, Marion E, Morelle J, Hantson P. P32: Symptomatic methemoglobinemia in a home hemodialysis patient and tolerance of methylene blue. Toxicologie Analytique et Clinique 2014. [DOI: 10.1016/s2352-0078(14)70093-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Marion E, Chauty A, Yeramian E, Babonneau J, Kempf M, Marsollier L. A case of guilt by association: Water bug bite incriminated in M. ulcerans infection. Int J Mycobacteriol 2014; 3:158-61. [PMID: 26786340 DOI: 10.1016/j.ijmyco.2014.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/17/2014] [Accepted: 01/18/2014] [Indexed: 10/25/2022] Open
Abstract
Buruli ulcer is a cutaneous mycobacterial disease caused by Mycobacterium ulcerans, whose incidence is increasing steadily, especially in West Africa. This study reports a first documented case of M. ulcerans infection which can be attributed to a water bug bite at the site of the primary lesion.
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Affiliation(s)
- Estelle Marion
- Centre de Diagnostic et de Traitement de l'ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin; ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS, Université et CHU, Angers, France; LUNAM, Université d'Angers, Angers, France.
| | - Annick Chauty
- Centre de Diagnostic et de Traitement de l'ulcère de Buruli, Fondation Raoul Follereau, Pobè, Benin
| | - Edouard Yeramian
- Unité de bioinformatique structurale, Institut Pasteur, Paris, France
| | - Jérèmie Babonneau
- ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS, Université et CHU, Angers, France; LUNAM, Université d'Angers, Angers, France; Laboratoire de bactériologie et d'hygiène hospitalière, CHU, France
| | - Marie Kempf
- Laboratoire de bactériologie et d'hygiène hospitalière, CHU, France
| | - Laurent Marsollier
- ATOMycA, Inserm Avenir Team, CRCNA, Inserm U892, 6299 CNRS, Université et CHU, Angers, France; LUNAM, Université d'Angers, Angers, France
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Morris A, Gozlan R, Marion E, Marsollier L, Andreou D, Sanhueza D, Ruffine R, Couppié P, Guégan JF. First detection of Mycobacterium ulcerans DNA in environmental samples from South America. PLoS Negl Trop Dis 2014; 8:e2660. [PMID: 24498449 PMCID: PMC3907311 DOI: 10.1371/journal.pntd.0002660] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 12/09/2013] [Indexed: 11/24/2022] Open
Abstract
The occurrences of many environmentally-persistent and zoonotic infections are driven by ecosystem changes, which in turn are underpinned by land-use modifications that alter the governance of pathogen, biodiversity and human interactions. Our current understanding of these ecological changes on disease emergence however remains limited. Buruli ulcer is an emerging human skin disease caused by the mycobacterium, Mycobacterium ulcerans, for which the exact route of infection remains unclear. It can have a devastating impact on its human host, causing extensive necrosis of the skin and underlying tissue, often leading to permanent disability. The mycobacterium is associated with tropical aquatic environments and incidences of the disease are significantly higher on floodplains and where there is an increase of human aquatic activities. Although the disease has been previously diagnosed in South America, until now the presence of M. ulcerans DNA in the wild has only been identified in Australia where there have been significant outbreaks and in western and central regions of Africa where the disease is persistent. Here for the first time, we have identified the presence of the aetiological agent's DNA in environmental samples from South America. The DNA was positively identified using Real-time Polymerase Chain Reaction (PCR) on 163 environmental samples, taken from 23 freshwater bodies in French Guiana (Southern America), using primers for both IS2404 and for the ketoreductase-B domain of the M. ulcerans mycolactone polyketide synthase genes (KR). Five samples out of 163 were positive for both primers from three different water bodies. A further nine sites had low levels of IS2404 close to a standard CT of 35 and could potentially harbour M. ulcerans. The majority of our positive samples (8/14) came from filtered water. These results also reveal the Sinnamary River as a potential source of infection to humans. This study provides the first ever recorded extraction of Mycobacterium ulcerans DNA from the environment in South America, specifically from French Guiana an ultra-peripheral French territory. M. ulcerans is the causative agent responsible for the devastating necrotic skin infection Buruli ulcer, which is prevalent in many tropical countries, notably in western and central Africa, and continues to present outbreaks in the developing world. Despite this, our understanding of the disease remains limited, routes of infection, environmental sources and ubiquity within the environment are still uncertain and only within the past decade have we begun to understand more about this emerging disease.
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Affiliation(s)
- Aaron Morris
- University of Bournemouth, School of Applied Sciences, Dorset, United Kingdom
- UMR MIVEGEC IRD-CNRS-Universités de Montpellier 1 et 2, Centre IRD de Montpellier, Montpellier, France
- * E-mail:
| | - Rodolphe Gozlan
- UMR MIVEGEC IRD-CNRS-Universités de Montpellier 1 et 2, Centre IRD de Montpellier, Montpellier, France
- UMR BOREA IRD-MNHN-Université Pierre et Marie Curie, Muséum National d'Histoire Naturelle, Paris, France
| | - Estelle Marion
- Equipe Inserm Avenir ATOMycA, CRCNA INSERM U892 and CNRS U6299, Université et CHU d'Angers, Angers, France
| | - Laurent Marsollier
- Equipe Inserm Avenir ATOMycA, CRCNA INSERM U892 and CNRS U6299, Université et CHU d'Angers, Angers, France
| | - Demetra Andreou
- University of Bournemouth, School of Applied Sciences, Dorset, United Kingdom
| | - Daniel Sanhueza
- UMR MIVEGEC IRD-CNRS-Universités de Montpellier 1 et 2, Centre IRD de Montpellier, Montpellier, France
- Equipe Inserm Avenir ATOMycA, CRCNA INSERM U892 and CNRS U6299, Université et CHU d'Angers, Angers, France
| | - Rolland Ruffine
- UMR MIVEGEC IRD-CNRS-Universités de Montpellier 1 et 2, Centre IRD de Montpellier, Montpellier, France
| | - Pierre Couppié
- Institut Guyanais de Dermatologie Tropicale, EA 2188, Centre Hospitalier André Rosemon, Cayenne, French Guiana
| | - Jean-François Guégan
- UMR MIVEGEC IRD-CNRS-Universités de Montpellier 1 et 2, Centre IRD de Montpellier, Montpellier, France
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Marion E, Landier J, Eyangoh S, Marsollier L. [Buruli ulcer: a dynamic transversal research model performed through the international network of Pasteur Institutes]. Med Sci (Paris) 2013; 29:912-7. [PMID: 24148132 DOI: 10.1051/medsci/20132910021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Buruli ulcer is an endemic severe human skin disease caused by Mycobacterium ulcerans, which prevails in western Africa in swampy areas and primarily hits children. Its gravity comes from the extent of tissue destruction, created by the toxin mycolactone. We describe here how the Centre Pasteur of Cameroon, with the help of the ministry of Health, gathered a network of multidisciplinary partners to fight against Buruli ulcer starting in the years 2000. The Centre Pasteur develops three missions : patient care, training of health care workers and research on the insect vector. Ten years of efforts resulted in significant medical advances such as the design of an early diagnostic test using PCR, or the observation that bed net use significantly decreased the risk of Buruli ulcer, offering useful prevention ; on the research side, entomological studies on aquatic bugs, coupled with epidemiological data, point to the role of these insects in the transmission of the disease. This study examplifies how an efficient network can contribute to the prevention and treatment of debilitating infectious diseases.
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Affiliation(s)
- Estelle Marion
- Service de mycobactériologie, centre Pasteur du Cameroun - Réseau international des Instituts Pasteur, BP 1274, Yaoundé, Cameroun - Centre de diagnostic et de traitement de l'ulcère de Buruli Raoul et Madeleine Follereau, BP 191, Pobè, République du Bénin
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Hide M, Marion E, Pomares C, Fisa R, Marty P, Bañuls AL. Parasitic genotypes appear to differ in leishmaniasis patients compared with asymptomatic related carriers. Int J Parasitol 2013; 43:389-97. [PMID: 23380201 DOI: 10.1016/j.ijpara.2012.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 12/18/2012] [Accepted: 12/22/2012] [Indexed: 10/27/2022]
Abstract
For numerous infectious diseases affecting humans, clinical manifestations range from asymptomatic forms to severe pathologies. The originality of this study was its focus on asymptomatic carriers of Leishmania infantum in southern France. The fundamental interest in these asymptomatic carriers is that they can be a reservoir of potentially pathogenic microorganisms. It remains to be established whether the parasitic genomes from asymptomatic carriers differ from those of patients. Multilocus microsatellite typing was used to investigate the genetic variation among 36 French strains of L. infantum. Nine Leishmania strains isolated from blood donors (asymptomatic carriers) were compared with 27 strains of L. infantum belonging to zymodemes, MON-1, -33 and -183. These strains were isolated from HIV positive or negative patients with visceral leishmaniasis, cutaneous leishmaniasis, from canine leishmaniasis or from phlebotomine sandflies. Multilocus microsatellite typing data generated using 33 loci were analyzed by a Bayesian model-based clustering algorithm and construction of a phylogenetic tree based on genetic distances. Both analyses structured the MON-1 sample into two main clusters. Furthermore, genetic analysis demonstrated that these nine asymptomatic carrier strains are divided into two clusters grouped with the MON-1 strains. One cluster with seven strains is related to, but different from, human symptomatic strains from the Alpes-Maritimes region whereas the other cluster has the two remaining strains together with canine leishmaniasis strains as well as one strain from a visceral leishmaniasis patient. Genetic diversity among asymptomatic carrier was very weak since the nine Leishmania strains belong to only two genotypes. Genetic differentiations were evidenced between asymptomatic carrier strains and non-asymptomatic carrier strains and especially between asymptomatic carrier and HIV+ populations, although these findings require confirmation with a larger sample size. We believe that our data explore for the first time, the genetic diversity among L. infantum from asymptomatic human carriers and reveal a weak polymorphism compared with Leishmania parasites isolated from human patients.
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Affiliation(s)
- M Hide
- Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle, MIVEGEC IRD/CNRS/UM1/UM2 (UMR 224/5290), France.
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Marion E, Prado S, Cano C, Babonneau J, Ghamrawi S, Marsollier L. Photodegradation of the Mycobacterium ulcerans toxin, mycolactones: considerations for handling and storage. PLoS One 2012; 7:e33600. [PMID: 22514607 PMCID: PMC3326021 DOI: 10.1371/journal.pone.0033600] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 02/13/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mycolactones are toxins secreted by M. ulcerans, the etiological agent of Buruli ulcer. These toxins, which are the main virulence factors of the bacilli, are responsible for skin lesions. Considering their specificity for M. ulcerans and their presence in skin lesions even at early stages, mycolactones are promising candidates for the development of a diagnostic tool for M. ulcerans infection. Stability of purified mycolactones towards light and heat has not yet been investigated, despite the importance of such parameters in the selection of strategies for a diagnosis tool development. In this context, the effects of UV, light and temperature on mycolactone stability and biological activity were studied. METHODOLOGY/PRINCIPAL FINDINGS To investigate the effect of these physical parameters, mycolactones were exposed to different wavelengths in several solvents and temperatures. Structural changes and biological activity were monitored. Whilst high temperature had no effect on mycolactones, UV irradiation (UV-A, UV-B and UV-C) and sunlight exposure caused a considerable degradation, as revealed by LC-MS and NMR analysis, correlated with a loss of biological activity. Moreover, effect of UVs on mycolactone caused a photodegradation rather than a phototransformation due to the identification of degradation product. CONCLUSION/SIGNIFICANCE This study demonstrates the high sensitivity of mycolactones to UVs as such it defines instructions for storage and handling.
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Affiliation(s)
- Estelle Marion
- Unité Inserm U892, Équipe 15, Nantes-Angers, France
- Groupe d'Etude des Interactions Hôte Pathogène, Université et CHU d'Angers, Angers, France
- * E-mail: (LM); (EM)
| | - Soizic Prado
- Museum National d'Histoire Naturelle de Paris, Paris, France
| | - Camille Cano
- Unité Inserm U892, Équipe 15, Nantes-Angers, France
| | | | - Sarah Ghamrawi
- Groupe d'Etude des Interactions Hôte Pathogène, Université et CHU d'Angers, Angers, France
| | - Laurent Marsollier
- Unité Inserm U892, Équipe 15, Nantes-Angers, France
- Groupe d'Etude des Interactions Hôte Pathogène, Université et CHU d'Angers, Angers, France
- * E-mail: (LM); (EM)
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