Pathogenesis of skin ulcers: lessons from the Mycobacterium ulcerans and Leishmania spp. pathogens
Résumé
Skin ulcers are most commonly due to circulatory or metabolic disorders and are a major
public health concern. In developed countries, chronic wounds affect more than 1% of the
population and their incidence is expected to follow those observed for diabetes and
obesity. In tropical and subtropical countries, an additional issue is the occurrence of ulcers
of infectious origins with diverse aetiologies. While the severity of cutaneous Leishmaniasis
correlates with protective immune responses, Buruli ulcers caused by Mycobacterium
ulcerans develop in the absence of inflammation. Based on these two examples, this review
aims to demonstrate how studies on microorganism-provoked wounds can provide insight
into the molecular mechanisms controlling skin integrity. We highlight the potential interest
of a mouse model of non-inflammatory skin ulceration caused by intradermal injection of
mycolactone, an unusual lipid toxin with ulcerative and immunosuppressive properties
produced by M. ulcerans.
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