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1.
Clin Exp Immunol ; 150(3): 451-9, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17900302

RESUMO

Buruli ulcer disease (BUD) is an emerging predominantly tropical disease caused by Mycobacterium ulcerans. The initial pre-ulcerative skin lesion often breaks down into an ulcer with undermined edges. Healing is common but may require considerable time, and scarring often results in functional limitations. Considerable evidence has now emerged that patients with early BUD cannot mount a sufficient protective T helper 1 (Th1) cell response to M. ulcerans, but uncertainty remains as to whether immune protection is restored over time. This study investigates the Th1 cell response of patients with various stages of BUD on mycobacterial antigens. We measured interferon (IFN)-gamma levels after ex vivo whole blood stimulation with tuberculin purified protein derivative (PPD), and compared the Th1 cell response of individuals with pre-ulcerative, ulcerative and healed BUD as well as healthy controls. Moreover, the systemic Th1 cell response was related to histopathological features in the various stages of surgically resected BUD lesions. We show that patients with ulcerative and healed BUD produce significantly higher IFN-gamma levels after mycobacterial ex vivo whole blood stimulation than healthy controls, and that patients with a granulomatous tissue response produce higher IFN-gamma levels than individuals without. We therefore suggest that the mounted Th1 cell response in ulcerative BUD patients might be related to their histopathological tissue response.


Assuntos
Úlcera de Buruli/imunologia , Interferon gama/biossíntese , Adolescente , Adulto , Antígenos de Bactérias/imunologia , Úlcera de Buruli/patologia , Células Cultivadas , Criança , Progressão da Doença , Feminino , Granuloma/imunologia , Granuloma/patologia , Humanos , Interleucina-10/biossíntese , Masculino , Fito-Hemaglutininas/imunologia , Células Th1/imunologia , Tuberculina/imunologia , Cicatrização/imunologia
2.
Trans R Soc Trop Med Hyg ; 97(2): 159-60, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14584368

RESUMO

Mycobacterium ulcerans disease starts as a painless, subcutaneous nodule, excision of which prevents the development of large Buruli ulcers. An outreach programme was set up in Ghana to promote nodule recognition and excision. The programme was cost-effective and shifted the pattern of disease presentation. This could from a model for other countries.


Assuntos
Educação em Saúde/organização & administração , Infecções por Mycobacterium não Tuberculosas/prevenção & controle , Mycobacterium ulcerans , Dermatopatias Bacterianas/prevenção & controle , Análise Custo-Benefício , Gana , Educação em Saúde/economia , Humanos , Infecções por Mycobacterium não Tuberculosas/economia , Infecções por Mycobacterium não Tuberculosas/cirurgia , Dermatopatias Bacterianas/economia , Dermatopatias Bacterianas/cirurgia
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