“the biggest disease of our time is not leprosy or tuberculosis, but the feeling of
being unwanted”- Mother Teresa
April 6, 2010
Photo from the German Federal Archive, Bild 105-DOA0199
Leprosy
A Disease of the Forgotten
April 6, 2010 Meagan Davis
Leprosy = Hansen’s Disease
April 6, 2010
One of the world’s oldest infectious diseasesPhotos from http://www.bevscountrycottage.com/images/leper.jpg and
http://symptomsofleprosy.com/treatment-for-leprosy.php
-Skin-Peripheral nerves-Eyes -Extremities-Respiratory mucosa
April 6, 2010
Hansen’s Disease is a chronic disease affecting
Leprosy is identified by skin lesions and progressive debilitation
April 6, 2010
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
April 6, 2010 Photo from http://pathmicro.med.sc.edu/Infectious%20Disease/MYCOBACTERIAL%20DISEASES.htm
April 6, 2010
1873: Dr. Amauer Hansen of Norway
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
April 6, 2010
http://bioweb.uwlax.edu/bio203/s2008/jaedike_alic/scientificclassification.htm
Identical in appearance to M. tuberculosis
April 6, 2010April 6, 2010
Mycobacterium leprae
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471987/figure/f2/:
We can’t grow Mycobacteria leprae in the lab! We need
living cells…
April 6, 2010
The Solution?
Armadillos, of course!April 6, 2010
Mycobacterium leprae has affinity for
April 6, 2010
1. Schwann cells
2. Macrophageshttp://www.mc.vanderbilt.edu/histology/slide.php?image_name=myelin&slide_file=images/histology/nervous_tissue/display/schwann3.jpg&image_id=1058
http://www.hhmi.org/biointeractive/disease/leprosy/leprosy1.html
April 6, 2010 How does Mycobacterium leprae target the peripheral nervous system?
Interaction with Schwann Cell
April 6, 2010
Interaction with Macrophage
No phagocytosis!
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.
http://newscenter.lbl.gov/wp-content/uploads/phagocytosis.jpg
Genome
• Reductive evolution: pseudogenes
• Sequenced in 2001• Unique proteins• PARK2/PACRG
April 6, 2010
Image from http://www.nature.com/nature/journal/v409/n6823/full/4091007a0.html
How infectious?
April 6, 2010
Treatment• Completely CURABLE!• MDT (Multi-drug Treatment)
– Dapsone– Rifampicin– Clofazimine
April 6, 2010 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
April 6, 2010
Middle Ages
April 6, 2010 Photo from http://www.associatedcontent.com/image/625316/index.html?cat=70
Leper Colonies
April 6, 2010
http://irrevocable.wordpress.com/2009/02/
http://www.historycooperative.org/journals/jah/92.3/images/lechtreck_fig01b.jpg
April 6, 2010
Curse!
Sexually Transmitted!
Hereditary!
a highly misunderstood disease
April 6, 2010 WHO’s Leprosy Elimination ProjectWorld Health Organization
A disease of poverty
April 6, 2010
Why?
Photo from http://www.flickr.com/photos/medapt/408552571/
April 6, 2010
“The biggest disease of our time is not
leprosy or tuberculosis, but the
feeling of being
unwanted”
- Mother TeresaPhoto from http://baba.niya.org/index.php?mact=Album,cntnt01,default,0&cntnt01albumid=1&cntnt01pictureid=10&cntnt01returnid=64
Quote from http://quotationsbook.com/quote/11148/
Sources
Comment in:Am J Clin Pathol. 2008 Dec;130(6):849-52.
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).
April 6, 2010
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