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“the biggest disease of our time is not leprosy or tuberculosis, but the feeling of being unwanted ”- Mother Teresa

“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. Meagan Davis. April 6, 2010. Photo from the German Federal Archive, Bild 105-DOA0199. Leprosy = Hansen’s Disease.

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“the biggest disease of our time is not leprosy or tuberculosis, but the feeling of being unwanted ”- Mother Teresa

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  1. “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 Meagan Davis April 6, 2010 Photo from the German Federal Archive, Bild 105-DOA0199

  2. Leprosy = Hansen’s Disease One of the world’soldestinfectious diseases Photos from http://www.bevscountrycottage.com/images/leper.jpg and http://symptomsofleprosy.com/treatment-for-leprosy.php

  3. Hansen’s Disease is a chronic disease affecting -Skin-Peripheral nerves-Eyes -Extremities-Respiratory mucosa

  4. Leprosy is identified by skin lesions and progressive debilitation Photos from http://symptomsofleprosy.com/leprosy.php and http://www.asnom.org/image/421_lepre/IB071_lepre.jpg

  5. Forms of Leprosy • Tuberculoid (75%) • Partial T-cell immunity • Paucibacillary • Lepromatous • Little to no T-cell immunity • Multibacillary Photo from http://pathmicro.med.sc.edu/Infectious%20Disease/MYCOBACTERIAL%20DISEASES.htm

  6. 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

  7. Mycobacterium leprae Identical in appearance to M. tuberculosis http://bioweb.uwlax.edu/bio203/s2008/jaedike_alic/scientificclassification.htm

  8. Mycobacterium leprae April 6, 2010 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471987/figure/f2/:

  9. We can’t grow Mycobacteria leprae in the lab! We need living cells…

  10. The Solution? Armadillos, of course!

  11. Mycobacterium leprae has affinity for • Schwann cells http://www.hhmi.org/biointeractive/disease/leprosy/leprosy1.html 2. Macrophages http://www.mc.vanderbilt.edu/histology/slide.php?image_name=myelin&slide_file=images/histology/nervous_tissue/display/schwann3.jpg&image_id=1058

  12. Interaction with Schwann Cell How does Mycobacterium lepraetarget the peripheral nervous system?

  13. Interaction with Macrophage http://newscenter.lbl.gov/wp-content/uploads/phagocytosis.jpg 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.

  14. Genome • Reductive evolution: pseudogenes • Sequenced in 2001 • Unique proteins • PARK2/PACRG Image from http://www.nature.com/nature/journal/v409/n6823/full/4091007a0.html

  15. How infectious?

  16. Treatment • Completely CURABLE! • MDT (Multi-drug Treatment) • Dapsone • Rifampicin • Clofazimine http://www.searo.who.int/en/Section10/Section20/Section57_9882.htm

  17. History of Leprosy April 6, 2010

  18. Middle Ages Photo from http://www.associatedcontent.com/image/625316/index.html?cat=70

  19. Leper Colonies http://www.historycooperative.org/journals/jah/92.3/images/lechtreck_fig01b.jpg http://irrevocable.wordpress.com/2009/02/

  20. Curse! Hereditary! Sexually Transmitted! a highly misunderstood disease

  21. World Health Organization WHO’s Leprosy Elimination Project

  22. A disease of poverty Why? Photo from http://www.flickr.com/photos/medapt/408552571/

  23. “The biggest disease of our time is not leprosy or tuberculosis, but the feeling of being unwanted” - Mother Teresa Quote from http://quotationsbook.com/quote/11148/ Photo from http://baba.niya.org/index.php?mact=Album,cntnt01,default,0&cntnt01albumid=1&cntnt01pictureid=10&cntnt01returnid=64

  24. Comment in: Am J Clin Pathol. 2008 Dec;130(6):849-52. 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).

  25. 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=519http://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-yields- new-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.htmlhttp://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=mmed&part=A1833

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