Vaccination efforts for Buruli ulcer

ABSTRACT

Background

Buruli ulcer is one of the most common mycobacterial diseases usually affecting poorer populations in tropical and subtropical environments. This disease, caused by M. ulcerans infection, has devastating effects for patients, with significant health and economic burden. Antibiotics are often used to treat affected individuals, but in most cases, surgery is necessary.

Area covered

We present progress on Buruli ulcer vaccines and identify knowledge gaps in this neglected tropical disease.

Expert opinion

The lack of appropriate infrastructure in endemic areas, as well as the severity of symptoms and lack of noninvasive treatment options, highlights the need for an effective vaccine to combat this disease. In terms of humoral immunity, it is vital to consider its significance and the magnitude to which it inhibits or slows down the progression of the disease. Only by answering these key questions will it be possible to tailor more appropriate vaccination and preventative provisions.

KEYWORDS:

• Buruli ulcer
• Mycobacterium
• Mycobacterium ulcerans
• toxin
• necrotizing skin infection

Article highlights

• Buruli ulcer is a necrotizing skin infection which is one of the 20 neglected tropical diseases recognized by the World Health Organization

• Mycobacterium ulcerans produces mycolactone polyketide toxin

• Treatment: Antibiotics are used and surgery may be required

• BCG vaccines have shown some efficacy in pre-clinical and clinical trials but do not show full protection against Mycobacterium ulcerans and effects are short term

• Identification of novel genes/proteins on Mycobacterium ulcerans such as Ag85A are being evaluated for potential translation to human clinical trials

Acknowledgments

V.P.C. wants to dedicate this work to L M College of pharmacy as a part of the 75th year celebration of the college. V.A. would like to thank the support from the Immunology and Translational Research Group, for helpful discussions. V.A. was supported by Victoria University Research, VIC Australia.

Author contributions

All authors contributed to the design of the article. M.H-S., V.P.C., R.B. and V.A. wrote the article. M.H-S., V.P.C, R.B. and V.A. edited the article and contributed to the interpretation of the included papers. All authors have read, reviewed, and approved the final paper.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or mending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.