“the biggest disease of our time is not
leprosy or tuberculosis, but the feeling of
being unwanted”- Mother Teresa
Leprosy
A Disease of the Forgotten
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Photo from the German Federal Archive, Bild 105-DOA0199
Meagan Davis
Leprosy = Hansen’s Disease
One of the world’s oldest infectious diseases
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Photos from http://www.bevscountrycottage.com/images/leper.jpg and
http://symptomsofleprosy.com/treatment-for-leprosy.php
Hansen’s Disease is a chronic disease affecting
-Skin
-Peripheral nerves
-Eyes
-Extremities
-Respiratory mucosa
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Leprosy is identified by skin lesions and
progressive debilitation
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Photos from http://symptomsofleprosy.com/leprosy.php and
http://www.asnom.org/image/421_lepre/IB071_lepre.jpg
Forms of Leprosy
• Tuberculoid (75%)
– Partial T-cell immunity
– Paucibacillary
• Lepromatous
– Little to no T-cell immunity
– Multibacillary
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Photo from http://pathmicro.med.sc.edu/Infectious%20Disease/MYCOBACTERIAL%20DISEASES.htm
1873: Dr. Amauer Hansen of Norway
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Microphotograph from CDC, US Government public domain,
1979) Public Health Image Library (PHIL) #2123 and photo from
http://en.wikipedia.org/wiki/File:Gerhard_Armauer_Hansen.jpg
Mycobacterium leprae
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Identical in appearance to M. tuberculosis
http://bioweb.uwlax.edu/bio203/s2008/jaedike_alic/scientificclassification.htm
Mycobacterium
leprae
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471987/figure/f2/:
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We can’t grow Mycobacteria
leprae in the lab! We need
living cells…
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The Solution?
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Armadillos, of course!
Mycobacterium leprae has affinity for
1. Schwann cells
http://www.hhmi.org/biointeractive/disease/leprosy/leprosy1.html
http://www.mc.vanderbilt.edu/histology/slide.php?image_name=myelin&slide_f
ile=images/histology/nervous_tissue/display/schwann3.jpg&image_id=1058
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2. Macrophages
Interaction with
Schwann Cell
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How does Mycobacterium leprae target the peripheral nervous system?
Interaction with Macrophage
http://newscenter.lbl.gov/wp-content/uploads/phagocytosis.jpg
No phagocytosis!
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Janeway, C., Travers, P., Walport, M., Shlomchik M. Immuno
Biology: the immune system in health and disease. 6th Ed. 2005.
New York: Garland Science Publishing.
Genome
• Reductive evolution:
pseudogenes
• Sequenced in 2001
• Unique proteins
• PARK2/PACRG
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Image from http://www.nature.com/nature/journal/v409/n6823/full/4091007a0.html
How infectious?
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Treatment
• Completely CURABLE!
• MDT (Multi-drug Treatment)
– Dapsone
– Rifampicin
– Clofazimine
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http://www.searo.who.int/en/Section10/Section20/Section57_9882.htm
History of Leprosy
http://www.nytimes.com/2009/05/27/science/27leprosy.html?_r=1&pagewanted=print
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Middle Ages
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Photo from http://www.associatedcontent.com/image/625316/index.html?cat=70
Leper Colonies
http://www.historycooperative.org/journal
s/jah/92.3/images/lechtreck_fig01b.jpg
http://irrevocable.wordpress.com/2009/02/
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a highly misunderstood disease
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World Health Organization
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WHO’s Leprosy Elimination Project
A disease of poverty
Why?
Photo from http://www.flickr.com/photos/medapt/408552571/
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“The biggest disease
of our time is not
leprosy or
tuberculosis, but the
feeling of being
unwanted”
- Mother Teresa
Quote
http://quotationsbook.com/quote/11148/
Aprilfrom
6, 2010
Photo from http://baba.niya.org/index.php?mact=Album,cntnt01,default,0&cntnt01albumid=1&cntnt01pictureid=10&cntnt01returnid
Sources
Brophy, Peter J. "Microbiology: Subversion of Schwann Cells and the Leper's Bell." Science 296.5569 (2002): 862-863. Print.
Abulafia, Jorge. “Leprosy: pathogenesis updated.” International Journal of Dermatology 38 (1999): 321-334.
Chacha, JJ. “Peripheral nervous system and grounds for the neural insult in leprosy.” An Bras Dermatol 84.5 (2009):
495-500.
Suzuki, Koichi. “Localization of CORO1A in the Macrophages Containing Mycobacterium leprae.” Acta Histochem
Cytochem 39.4 (2006): 107-112.
Cole, S . T. “Massive gene decay in the leprosy bacillus.” Nature 409 (2001): 1007-1011
Baillie, Rebecca A. “Biblical Leprosy as Compared to Present-Day Leprosy.” Southern Medical Journal 75.7 (1982):
855-857.
Vissa, Varalakshmi D. “The genome of Mycobacterium leprae: a minimal mycobacterial gene set.” Genoma Biology
2:reviews1023.1-1023.8 (2001).
Rambukkana, Anura .“How does Mycobacterium leprae target the peripheral nervous system? “ Trends in Microbiology 8.1
(2000): 23-28.
Han, X. Y. “A new Mycobacterium species causing diffuse lepromatous leprosy.” Am J Clin Pathol. 2008
Dec;130(6):849-52.
Scollard, D. M. “The Continuing Challenges of Leprosy.” Clinical Microbiology Review. 19.2 ( 2006) 338-381.
Miller, Timothy S. “Medieval Leprosy Reconsidered.” International Social Sciene Review, Spring-Summer 2006.
http://findarticles.com/p/articles/mi_m0IMR/is_1-2_81/ai_n16701818/pg_2/?tag=content;col1
Nester, Eugene, W. Microbiology. Mcgraw Hill, 6th edition (2009).
Sources
http://www.phgfoundation.org/news/5107/
http://genomebiology.com/2001/2/8/reviews/1023
http://www.webspawner.com/users/MlepBacillus/
http://www.webspawner.com/users/LEPROMAT/
http://www.webspawner.com/users/immunity/
http://newswire.rockefeller.edu/index.php?page=engine&id=519
http://health.nytimes.com/health/guides/disease/leprosy/overview.html
http://www.medicinenet.com/leprosy/page2.htm
http://spittoon.23andme.com/2009/12/16/snpwatch-genetic-association-study-of-leprosy-yieldsnew-insights-into-an-ancient-disease/
http://www.hhmi.org/biointeractive/disease/leprosy/leprosy1.html
http://www.thaindian.com/newsportal/lifestyle/scientists-measure-mercury-level-in-human
bones-from-medieval-times_10055550.html
http://www3.niaid.nih.gov/topics/leprosy/Understanding/history.htm
http://emedicine.medscape.com/article/1104977-overview
http://www.informaworld.com/smpp/section?content=a777379128&fulltext=713240928
http://www.europaworld.org/week113/50worldleprosyday24103.htm
http://www.who.int/mediacentre/factsheets/fs101/en/
http://www.searo.who.int/EN/Section10/Section20/Section57_8963.htm WHO
http://www.ghananewsagency.org/s_health/r_13273/
http://pathmicro.med.sc.edu/fox/mycobacteria.htm
http://www.mdconsult.com/das/book/body/193191995-2/0/1492/1203.html
http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=mmed&part=A1833
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