01657nas a2200253   4500000000100000008004100001260001200042653001700054653001400071653001900085653002000104653001200124653003700136653001900173100001500192700001500207700001400222700001400236700001300250245006600263856006700329520099300396022001401389       2020                            d  c02/202010aBuruli ulcer10adiagnosis10aImmune evasion10aImmunopathology10aleprosy10aPolarization of immune responses10aVaccine design1 aRöltgen K1 aPluschke G1 aSpencer J1 aBrennan P1 aAvanzi C00aThe immunology of other mycobacteria: M. ulcerans, M. leprae.  uhttps://link.springer.com/article/10.1007%2Fs00281-020-00790-43 a<p>Mycobacterial pathogens can be categorized into three broad groups: Mycobacterium tuberculosis complex causing tuberculosis, M. leprae and M. lepromatosis causing leprosy, and atypical mycobacteria, or non-tuberculous mycobacteria (NTM), responsible for a wide range of diseases. Among the NTMs, M. ulcerans is responsible for the neglected tropical skin disease Buruli ulcer (BU). Most pathogenic mycobacteria, including M. leprae, evade effector mechanisms of the humoral immune system by hiding and replicating inside host cells and are furthermore excellent modulators of host immune responses. In contrast, M. ulcerans replicates predominantly extracellularly, sheltered from host immune responses through the cytotoxic and immunosuppressive effects of mycolactone, a macrolide produced by the bacteria. In the year 2018, 208,613 new cases of leprosy and 2713 new cases of BU were reported to WHO, figures which are notoriously skewed by vast underreporting of these diseases.</p>  a1863-2300