title: High rates of apoptosis in human Mycobacterium ulcerans culture-positive buruli ulcer skin lesions.
abstract: Buruli ulcer, a disease caused by Mycobacterium ulcerans, causes ulcerative skin disease likely generated by a toxin that mediates apoptosis. We analyzed paraffin-embedded sections of surgically excised Buruli ulcer lesions (two ulcers and one edematous plaque) and adjacent non-lesional skin samples (n = 9) for apoptosis by an indirect immunofluorescent terminal deoxynucleotide transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) assay. All samples were stained for acid-fast bacilli (AFB) and cultured for mycobacteria, and most were analyzed with an M. ulcerans-specific diagnostic polymerase chain reaction (PCR). TUNEL (+) bodies were numerous in both ulcers and the plaque, and sparse or absent in adjacent non-lesional skin. The AFB tissue stains and cultures for M. ulcerans were positive only in the three lesions. The result of the PCR for M. ulcerans was positive in all three lesions and in four of six non-lesional tissue samples; three contained sparse TUNEL (+) bodies. An abundance of TUNEL (+) bodies in the three AFB stain (+), culture (+), and PCR (+) Buruli ulcer lesional samples, but not in nearby AFB stain (-), culture (-), and PCR (+) non-lesional skin samples, strengthen the evidence that apoptosis is an important tissue destruction mechanism in human lesions closely associated with viable M. ulcerans.
authors.affiliation: Dermatology Service, Eisenhower Army Medical Center, Fort Gordon, Georgia 30905, USA. douglas.walsh@se.amedd.army.mil
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Walsh
authors.forename: Wayne M
authors.initials: WM
authors.lastname: Meyers
authors.forename: Francoise
authors.initials: F
authors.lastname: Portaels
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Lane
authors.forename: Duangrat
authors.initials: D
authors.lastname: Mongkolsirichaikul
authors.forename: Kittinun
authors.initials: K
authors.lastname: Hussem
authors.forename: Panita
authors.initials: P
authors.lastname: Gosi
authors.forename: Khin Saw Aye
authors.initials: KS
authors.lastname: Myint
mesh_terms: D000293:Adolescent; D000328:Adult; D017209:Apoptosis; D002648:Child; D003470:Culture Media; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000382:microbiology / Q000473:pathology; D019911:Mycobacterium ulcerans / Q000302:isolation & purification / Q000472:pathogenicity*; D016133:Polymerase Chain Reaction; D017192:Skin Diseases, Bacterial / Q000382:microbiology / Q000473:pathology*; D012883:Skin Ulcer / Q000382:microbiology / Q000473:pathology*
chemical_list: D003470:Culture Media