title: Fighting mycobacterial infections by antibiotics, phytochemicals and vaccines.
abstract: Buruli ulcer is a neglected disease caused by Mycobacterium ulcerans and represents the world's third most common mycobacterial infection. It produces the polyketide toxins, mycolactones A, B, C and D, which induce apoptosis and necrosis. Clinical symptoms are subcutaneous nodules, papules, plaques and ulcerating oedemae, which can enlarge and destroy nerves and blood vessels and even invade bones by lymphatic or haematogenous spread (osteomyelitis). Patients usually do not suffer from pain or systematic inflammation. Surgery is the treatment of choice, although recurrence is common and wide surgical excisions including healthy tissues result in significant morbidity. Antibiotic therapy with rifamycins, aminoglycosides, macrolides and quinolones also improves cure rates. Still less exploited treatment options are phytochemicals from medicinal plants used in affected countries. Vaccination against Buruli ulcer is still in its infancy.
authors.affiliation: Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, University of Mainz, Staudinger Weg 5, 55128 Mainz, Germany.
authors.forename: Denise
authors.initials: D
authors.lastname: Bamberger
authors.forename: Nora
authors.initials: N
authors.lastname: Jantzer
authors.forename: Katharina
authors.initials: K
authors.lastname: Leidner
authors.forename: Joachim
authors.initials: J
authors.lastname: Arend
authors.forename: Thomas
authors.initials: T
authors.lastname: Efferth
mesh_terms: D000617:Aminoglycosides / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017209:Apoptosis; D001426:Bacterial Proteins / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000627:therapeutic use; D001428:Bacterial Vaccines / Q000627:therapeutic use*; D054312:Buruli Ulcer / Q000188:drug therapy* / Q000382:microbiology; D018834:Chaperonin 60 / Q000627:therapeutic use; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use; D019911:Mycobacterium ulcerans / Q000254:growth & development / Q000472:pathogenicity; D009336:Necrosis; D058069:Neglected Diseases / Q000188:drug therapy; D008517:Phytotherapy; D015363:Quinolones / Q000627:therapeutic use; D012294:Rifamycins / Q000627:therapeutic use; D014611:Vaccination; D019444:Vaccines, DNA / Q000627:therapeutic use
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D001428:Bacterial Vaccines; D018834:Chaperonin 60; D018942:Macrolides; D015363:Quinolones; D012294:Rifamycins; D019444:Vaccines, DNA; C074119:heat-shock protein 65, Mycobacterium; C117218:mycolactone