The effects of Mansonella perstans infections on concomitant mycobacterial infections and BCG vaccination efficacy in Ghana, Cameroon, and Benin

持久曼氏菌（Mansonella perstans（M. perstans）是撒哈拉以南非洲最流行的寄生虫之一，在流行地区估计有1亿感染者。儿童和青少年早期感染这种线虫。虽然曼森氏菌病本身可能是不太相关的公共卫生问题，因为它的无症状或轻微的临床图片，M。perstans可以调节或阻碍针对伴随感染（合并感染）的免疫。加纳的初步研究表明，混合感染M。布鲁里溃疡病（BUD）儿童的持久性。由于在这些M. perstans分离株，合并感染的个体对抗生素治疗敏感。这些观察结果构成了由加纳、贝宁、喀麦隆和德国（杜塞尔多夫和波恩）的五个合作机构进行的拟议流行病学、临床和免疫学研究的基础。我们解决的问题，是否免疫极化由于合并感染M。perstans影响i）对分枝杆菌疾病（即BUD、结核病（TB））的易感性，ii）BUD/TB的病程和恢复，以及iii）儿童中的BCG疫苗接种功效。强力霉素介导的M.将应用perstans感染的健康青少年来确定合并感染对抗分枝杆菌免疫的影响。最后，我们的目标是通过建立和实施基于PCR和血清学的方法来提高诊断。在这方面，一个关键因素将是建立一个M。perstans动物模型鉴定蠕虫特异性抗原。该项目的预期结果可能对M. perstans流行的国家。将作出重大努力，促进非洲和德国合作伙伴之间的互动，包括技术转让和能力建设。这将改善撒哈拉以南非洲不同文化和语言背景的研究人员之间正在进行的合作，并促进他们未来的合作。

Mansonella perstans (M. perstans) is one of the most prevalent parasites in sub-Saharan Africa with estimated 100 million infected individuals in endemic regions. Children and adolescents are infected early by this nematode species. Although Mansonellosis itself may be less relevant for public health issues because of its asymptomatic or mild clinical picture, M. perstans can modulate or impede immunity against concomitant infections (co-infections). Initial studies from Ghana indicate co-infections of M. perstans in children with Buruli ulcer disease (BUD). Since essential Wolbachia endosymbionts were detected in these M. perstans isolates, co-infected individuals are susceptible to antibiotic treatment. These observations form the basis for the proposed epidemiological, clinical, and immunological studies performed by five partner institutions from Ghana, Benin, Cameroon, and Germany (Düsseldorf and Bonn). We address the questions whether immune polarization due to co-infection with M. perstans affects i) susceptibility to mycobacterial diseases (i.e. BUD, Tuberculosis (TB), ii) disease course and recovery of BUD/TB, and iii) BCG vaccination efficacy in children. Doxycycline-mediated deworming of M. perstans infected healthy adolescents will be applied to determine the influence co-infections on anti-mycobacterial immunity. Finally, we aim to improve diagnosis by establishing and implementing PCR-based and serological methods. In this regard a crucial factor will be establishment of an M. perstans animal model to identify specific antigens of adult worms. The expected results of this project may have crucial implications for public health politics in M. perstans endemic countries. Major efforts will be undertaken to catalyze interactions between African and German partners including technology transfer and capacity building. This will improve ongoing and facilitate future collaborations between researchers with different cultural and linguistic background from sub-Saharan Africa.