Genetic Susceptibility and Predictors of Paradoxical Reactions in Buruli Ulcer
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Date
2016-04-20
Journal Title
Journal ISSN
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Publisher
PLOS Neglected Tropical Diseases
Abstract
Buruli ulcer is an infectious disease of skin, subcutaneous fat and sometimes bone, mainly
affecting children in West Africa. It is considered as one of the Neglected Tropical Diseases
but the disease occurs also in moderate climates like South East Australia and Japan where
it may also affect adults. Once a patient has started antibiotic treatment, lesions may
increase in size even if the antimicrobial treatment is effective; this is highly confusing for
doctors and patients as they may think that treatment actually fails. The cause of Buruli
ulcer is Mycobacterium ulcerans, related to other mycobacteria that cause disease in man,
like leprosy and tuberculosis. Using data from two different studies in West Africa, we
show that these paradoxical reactions are associated with trunk localization and that they
occur more often in larger lesions. The chance to develop these reactions appeared partly
inherited: carrying the homozygous ins/ins genotype of 3’UTR TGTG 285 polymorphism
in the SLC11A1 gene increased the risk of paradoxical reactions. Vitamin D is important
for the immune defense against infections by mycobacteria. Vitamin D blood concentrations
were not associated with paradoxical reactions; patients generally did well, and we
did not need corticosteroid immune suppression to overcome these reactions.
Description
An article published by PLOS Neglected Tropical Diseases and available at DOI:10.1371/journal.pntd.0004594
Keywords
Citation
PLoS Negl Trop Dis 10(4): e0004594. doi:10.1371/journal.pntd.0004594