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Bürkin BM, Czabanowska K, Babich S, Casamitjana N, Vicente-Crespo M, De Souza LE, Ehrenberg JP, Hoffmann A, Kamath R, Matthiä A, Okumu F, Rutebemberwa E, Waser M, Kuenzli N, Bohlius J. Competencies for Transformational Leadership in Public Health-An International Delphi Consensus Study. Int J Public Health 2024; 69:1606267. [PMID: 38481704 PMCID: PMC10935731 DOI: 10.3389/ijph.2024.1606267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/19/2024] [Indexed: 03/17/2024] Open
Abstract
Objectives: This Delphi study intended to develop competencies for transformational leadership in public health, including behavioral descriptions (descriptors) tailored to individuals and their contexts. Methods: The study involved five rounds, including online "e-Delphi" consultations and real-time online workshops with experts from diverse sectors. Relevant competencies were identified through a literature review, and experts rated, ranked, rephrased, and proposed descriptors. The study followed the Guidance on Conducting and REporting DElphi Studies (CREDES) and the COmpeteNcy FramEwoRk Development in Health Professions (CONFERD-HP) reporting guidelines. Results: Our framework comprises ten competencies for transformational public health leadership (each with its descriptors) within four categories, and also describes a four-stage model for developing relevant competencies tailored to different contexts. Conclusion: Educators responsible for curriculum design, particularly those aiming to align curricula with local goals, making leadership education context-specific and -sensitive, may benefit from the proposed framework. Additionally, it can help strengthen links between education and workforce sectors, address competency gaps, and potentially reduce the out-migration of graduates in the health professions.
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Affiliation(s)
- Barbara Maria Bürkin
- Department Education and Training, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Katarzyna Czabanowska
- Department of International Health, Institute of Care and Public Health Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
- Department of Health Policy Management, Institute of Public Health, Medical College, Jagiellonian University, Krakow, Poland
| | - Suzanne Babich
- Department of International Health, Institute of Care and Public Health Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
- Department of Community and Global Health, Richard M. Fairbanks School of Public Health, Indiana University at Indianapolis, Indianapolis, United States
| | - Núria Casamitjana
- ISGlobal, Hospital Clinic—Universitat de Barcelona, Barcelona, Spain
| | - Marta Vicente-Crespo
- Research and Related Capacity Strengthening Division, African Population and Health Research Center, Nairobi, Kenya
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - John P. Ehrenberg
- Arboretum Frutales Mayas Non-Governmental Organization Cholul, Mérida, Colima, Mexico
| | - Axel Hoffmann
- Department Education and Training, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rajesh Kamath
- Department of Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Anja Matthiä
- Department Education and Training, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Fredros Okumu
- Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
| | - Elizeus Rutebemberwa
- African Field Epidemiology Network (AFENET), Kampala, Uganda
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Marco Waser
- Department Education and Training, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nino Kuenzli
- Department Education and Training, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Julia Bohlius
- Department Education and Training, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Ehrenberg N, Ehrenberg JP, Fontes G, Gyapong M, Rocha EMM, Steinmann P, Utzinger J, Zhou XN, de Savigny D. Neglected tropical diseases as a barometer for progress in health systems in times of COVID-19. BMJ Glob Health 2021; 6:bmjgh-2020-004709. [PMID: 33849898 PMCID: PMC8050874 DOI: 10.1136/bmjgh-2020-004709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
| | | | - Gilberto Fontes
- Laboratory of Parasitology, Central-West Campus, Federal University of São João del Rei, Divinopolis, Brazil
| | - Margaret Gyapong
- Centre for Health Policy and Implementation Research, University of Health and Allied Sciences, Ho, Ghana
| | - Eliana M M Rocha
- Laboratory of Parasitology, Central-West Campus, Federal University of São João del Rei, Divinopolis, Brazil
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention, Shanghai, China.,School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Don de Savigny
- Swiss Tropical and Public Health Institute, Basel, Switzerland .,University of Basel, Basel, Switzerland
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Ehrenberg JP, Utzinger J, Fontes G, da Rocha EMM, Ehrenberg N, Zhou XN, Steinmann P. Efforts to mitigate the economic impact of the COVID-19 pandemic: potential entry points for neglected tropical diseases. Infect Dis Poverty 2021; 10:2. [PMID: 33397510 PMCID: PMC7780077 DOI: 10.1186/s40249-020-00790-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/21/2020] [Indexed: 02/08/2023] Open
Abstract
Background The damage inflicted by the coronavirus diseases 2019 (COVID-19) pandemic upon humanity is and will continue to be considerable. Unprecedented progress made in global health over the past 20 years has reverted and economic growth has already evaporated, giving rise to a global recession, the likes of which we may not have experienced since the Second World War. Our aim is to draw the attention of the neglected tropical disease (NTD) community towards some of the major emerging economic opportunities which are quickly appearing on the horizon as a result of COVID-19. Main text This scoping review relied on a literature search comprised of a sample of articles, statements, and press releases on initiatives aimed at mitigating the impact of COVID-19, while supporting economic recovery. Of note, the donor scenario and economic development agendas are highly dynamic and expected to change rapidly as the COVID-19 pandemic unfolds, as are donor and lender priorities. Conclusions The NTD community, particularly in low- and middle-income countries (LMICs), will need to work quickly, diligently, and in close collaboration with decision-makers and key stakeholders, across sectors at national and international level to secure its position. Doing so might enhance the odds of grasping potential opportunities to access some of the massive resources that are now available in the form of contributions from corporate foundations, trust funds, loans, debt relieve schemes, and other financial mechanisms, as part of the ongoing and future economic development agendas and public health priorities driven by the COVID-19 pandemic. This paper should serve as a starting point for the NTD community to seek much needed financial support in order to sustain and revitalize control and elimination efforts pertaining to NTDs in LMICs.![]()
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Affiliation(s)
- John P Ehrenberg
- , Avenida Cedro 9, # 303, Cholul, Merida, Yucatan, Mexico. .,Retired from World Health Organization, Regional Office for the Western Pacific, Manila, The Philippines.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Gilberto Fontes
- Federal University of São João del Rei, Central-West Campus, Divinopolis, Minas Gerais, Brazil
| | | | | | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention & Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China.,School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Ehrenberg JP, Zhou XN, Fontes G, Rocha EMM, Tanner M, Utzinger J. Strategies supporting the prevention and control of neglected tropical diseases during and beyond the COVID-19 pandemic. Infect Dis Poverty 2020; 9:86. [PMID: 32646512 PMCID: PMC7347419 DOI: 10.1186/s40249-020-00701-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/15/2020] [Indexed: 02/14/2023] Open
Abstract
Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern. They include a large group of neglected tropical diseases (NTDs), many of which are of zoonotic nature. Coronavirus disease 2019 (COVID-19), another emerging zoonotic disease, has just increased the stakes exponentially. Most NTDs are subject to the impact of some of the very same human-related activities triggering other emerging and re-emerging diseases, including COVID-19, severe acute respiratory syndrome (SARS), bird flu and swine flu. It is conceivable that COVID-19 will exacerbate the NTDs, as it will divert much needed financial and human resources. There is considerable concern that recent progress achieved with control and elimination efforts will be reverted. Future potential strategies will need to reconsider the determinants of health in NTDs in order to galvanize efforts and come up with a comprehensive, well defined programme that will set the stage for an effective multi-sectorial approach. In this Commentary, we propose areas of potential synergies between the COVID-19 pandemic control efforts, other health and non-health sector initiatives and NTD control and elimination programmes.
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Affiliation(s)
- John P Ehrenberg
- Avenida Cedro 9, # 303, Cholul, Merida, Yucatan, Mexico. .,Formerly World Health Organization, Regional Office for the Western Pacific, Manila, The Philippines.
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention & Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China.,School of Global Health, Chinese Center for Tropical Diseases Research - Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Gilberto Fontes
- Laboratory of Parasitology, Central-West Campus, Federal University of São João del Rei, Divinopolis, Minas Gerais, Brazil
| | - Eliana M M Rocha
- Laboratory of Parasitology, Central-West Campus, Federal University of São João del Rei, Divinopolis, Minas Gerais, Brazil
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Nakagawa J, Ehrenberg JP, Nealon J, Fürst T, Aratchige P, Gonzales G, Chanthavisouk C, Hernandez LM, Fengthong T, Utzinger J, Steinmann P. Towards effective prevention and control of helminth neglected tropical diseases in the Western Pacific Region through multi-disease and multi-sectoral interventions. Acta Trop 2015; 141:407-18. [PMID: 23792012 DOI: 10.1016/j.actatropica.2013.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 04/22/2013] [Accepted: 05/21/2013] [Indexed: 12/13/2022]
Abstract
Neglected tropical diseases (NTDs) cause serious health, social and economic burdens in the countries of the World Health Organization Western Pacific Region. Among the NTDs, helminth infections are particularly prominent with regard to the number of infected individuals and health impact. Co-endemicity is common among impoverished and marginalized populations. To achieve effective and sustainable control of helminth NTDs, a deeper understanding of the social-ecological systems governing their endemicity and strategies beyond preventive chemotherapy are required to tackle the multiple causes of infection and re-infection. We discuss the feasibility of implementing multi-disease, multi-sectoral intervention packages for helminth NTDs in the Western Pacific Region. After reviewing the main determinants for helminth NTD endemicity and current control strategies, key control activities that involve or concern other programmes within and beyond the health sector are discussed. A considerable number of activities that have an impact on more than one helminth NTD are identified in a variety of sectors, suggesting an untapped potential for synergies. We also highlight the challenges of multi-sectoral collaboration, particularly of involving non-health sectors. We conclude that multi-sectoral collaboration for helminth NTD control is feasible if the target diseases and sectors are carefully selected. To do so, an incentive analysis covering key stakeholders in the sectors is crucial, and the disease-control strategies need to be well understood. The benefits of multi-disease, multi-sectoral approaches could go beyond immediate health impacts by contributing to sustainable development, raising educational attainment, increasing productivity and reducing health inequities.
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Affiliation(s)
- Jun Nakagawa
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - John P Ehrenberg
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Joshua Nealon
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Thomas Fürst
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Padmasiri Aratchige
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Glenda Gonzales
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Chitsavang Chanthavisouk
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Leda M Hernandez
- Infectious Disease Office, National Centre for Disease Prevention and Control, Department of Health, Sta. Cruz, 1000 Manila, Philippines
| | - Tayphasavanh Fengthong
- Department of Hygiene and Health Promotion, Ministry of Health, P.O. Box 1232, Vientiane, Lao People's Democratic Republic
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Peter Steinmann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland.
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6
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Schratz A, Pineda MF, Reforma LG, Fox NM, Le Anh T, Tommaso Cavalli-Sforza L, Henderson MK, Mendoza R, Utzinger J, Ehrenberg JP, Tee AS. Neglected Diseases and Ethnic Minorities in the Western Pacific Region. ADVANCES IN PARASITOLOGY 2010; 72:79-107. [DOI: 10.1016/s0065-308x(10)72004-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hotez PJ, Ehrenberg JP. Escalating the Global Fight Against Neglected Tropical Diseases Through Interventions in the Asia Pacific Region. ADVANCES IN PARASITOLOGY 2010; 72:31-53. [DOI: 10.1016/s0065-308x(10)72002-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Failure to establish a contingency plan prior to a public health emergency can have catastrophic consequences. The threat of a new influenza pandemic has prompted countries to draft national strategic preparedness plans to prevent, mitigate, and recover from a potential influenza pandemic. This paper examines these preparations in Latin America and the Caribbean and describes potential scenarios of pandemic impact on the burden of mortality and on health services in the Region. In particular, the paper reports on the progress made by Member States in developing national influenza pandemic preparedness plans and implementation mechanisms at both the national and local levels. These achievements were facilitated through a series of planning workshops and self-assessment exercises conducted by PAHO for intersectoral country teams and guided by the WHO global influenza preparedness plan. Although significant progress has been made in plan completeness, intercountry preparedness planning and local level implementation remain key challenges. Multisectoral partnerships are clearly paramount to securing the commitment and resources needed to reach and sustain effective pandemic preparedness in the Americas.
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Affiliation(s)
- Oscar J Mujica
- Equipo de Influenza Pandémica, Unidad de Enfermedades Transmisibles, Organización Panamericana de la Salud, 525 23rd Street NW, Washington, D.C. 20037, USA.
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Ehrenberg JP, Ault SK. Neglected diseases of neglected populations: thinking to reshape the determinants of health in Latin America and the Caribbean. BMC Public Health 2005; 5:119. [PMID: 16283932 PMCID: PMC1318484 DOI: 10.1186/1471-2458-5-119] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2004] [Accepted: 11/11/2005] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND People living in poverty throughout the developing world are heavily burdened with neglected communicable diseases and often marginalized by the health sector. These diseases are currently referred to as Neglected Diseases of Neglected Populations. The neglected diseases create social and financial burdens to the individual, the family, the community, and the nation. DISCUSSION Numerous studies of successful individual interventions to manage communicable disease determinants in various types of communities have been published, but few have applied multiple interventions in an integrated, coordinated manner. We have identified a series of successful interventions and developed three hypothetical scenarios where such interventions could be applied in an integrated, multi-disease, inter-programmatic, and/or inter-sectoral approach for prevention and control of neglected diseases in three different populations: a slum, an indigenous community, and a city with a mix of populations. SUMMARY The objective of this paper is to identify new opportunities to address neglected diseases, improve community health and promote sustainable development in neglected populations by highlighting examples of key risk and protective factors for neglected diseases which can be managed and implemented through multi-disease-based, integrated, inter-programmatic, and/or inter-sectoral approaches. Based on a literature review, analysis and development of scenarios we visualize how multiple interventions could manage multiple disease problems and propose these as possible strategies to be tested. We seek to stimulate intra- and inter-sectoral dialogue which will help in the construction of new strategies for neglected diseases (particularly for the parasitic diseases) which could benefit the poor and marginalized based on the principle of sustainability and understanding of key determinants of health, and lead to the establishment of pilot projects and activities which can contribute to the achievement of the Millennium Development Goals.
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Affiliation(s)
- John P Ehrenberg
- Chief, Communicable Diseases Unit, Area of Disease Prevention and Control, Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23rd Street NW, Washington, DC 20037, USA
| | - Steven K Ault
- Regional Advisor, Communicable Diseases Unit, Area of Disease Prevention and Control, Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23rd Street NW, Washington, DC 20037, USA
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Savioli L, Neira M, Albonico M, Beach MJ, Chwaya HM, Crompton DW, Dunne J, Ehrenberg JP, Gyorkos T, Kvalsvig J, Taylor MG, Urbani C, Zheng F. Treatment for intestinal helminth infection. Review needed to take account of all relevant evidence, not only effects on growth and cognitive performance. BMJ 2000; 321:1226-7. [PMID: 11185587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Ottenhoff TH, Converse PJ, Gebre N, Wondimu A, Ehrenberg JP, Kiessling R. T cell responses to fractionated Mycobacterium leprae antigens in leprosy. The lepromatous nonresponder defect can be overcome in vitro by stimulation with fractionated M. leprae components. Eur J Immunol 1989; 19:707-13. [PMID: 2659369 DOI: 10.1002/eji.1830190421] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Protective immunity against Mycobacterium leprae is dependent on M. leprae-reactive T lymphocytes. M. lepare-directed T cell reactivity is high in the localized tuberculoid form of leprosy but specifically absent in the disseminated lepromatous type of the disease. Two important questions that are relevant for the understanding of the immune response in leprosy as well as for the design of rational immunoprophylaxis and -therapy strategies are: (a) what are the antigens that trigger T cell responses in tuberculoid patients and thus protect these individuals from developing lepromatous leprosy and (b) is it possible to restore T cell responsiveness to M. leprae in lepromatous patients by rechallenging the immune system with selected antigens that will trigger help but not suppression? We have addressed these question by directly probing the peripheral T cell repertoire of 10 tuberculoid and 18 lepromatous patients with large numbers of different M. leprae and BCG antigenic components that had been separated on the basis of their relative molecular mass (Mr) by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and electroblotted onto nitrocellulose. This technique allows the identification of T cell-stimulating antigens independent of the expression of B cell epitopes by these antigens. So far T cell epitopes have only been mapped on M. leprae proteins that had previously been defined by antibodies. Our results show that: (a) tuberculoid patients' T cells responded preferentially to M. leprae and BCG antigens in the lower (i.e. less than 70 kDa) Mr range with a peak in the 10-25 kDa range; (b) 6 out of 18 lepromatous patients that did not respond to whole M. leprae responded strongly to isolated M. leprae components; antigens in the lower Mr. range were recognized by five out of these six patients and thus commonly seen by both tuberculoid and lepromatous patients' T cells; however, antigens in the higher Mr range, in particular greater than 150 kDa, were only recognized by lepromatous patients' T lymphocytes; (c) furthermore, the T and B cell repertoires in leprosy patients are skewed towards different antigenic fractions.
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Affiliation(s)
- T H Ottenhoff
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Converse PJ, Ottenhoff TH, Gebre N, Ehrenberg JP, Kiessling R. Cellular, humoral, and gamma interferon responses to Mycobacterium leprae and BCG antigens in healthy individuals exposed to leprosy. Scand J Immunol 1988; 27:515-25. [PMID: 3131867 DOI: 10.1111/j.1365-3083.1988.tb02378.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Protective immunity against mycobacteria is dependent on antigen-specific T cells. The antibodies induced upon immunization with mycobacteria have no apparent role in host protection. Serological techniques have detected some antigens that are also recognized by human T cells but may fail to recognize others. Potentially, there may be differences in the epitopes seen by the T and B cell anti-mycobacterial antigen repertoires. We have screened the different components of sonicated BCG or Mycobacterium leprae that were separated according to their molecular weight (MW) by SDS-PAGE and then electroblotted on nitrocellulose paper. The blots were cut into squares and tested directly in a T cell proliferation assay. Our results indicate that peripheral T cells of healthy leprosy patient contacts respond preferentially to the lower MW (less than 70,000) and not the higher MW fractions of M. leprae and BCG, in contrast to the humoral response of these same individuals. The most important fractions in inducing a lymphoproliferative response were in the regions of 11-16 kDa of BCG and M. leprae and to the 22-26 kDa region of M. leprae. These fractions appeared to represent molecular weight regions that were in some instances clearly distinct from previously defined antigens. It was further shown that lymphoproliferation in response to mycobacterial fractions correlated with the production of gamma interferon, a lymphokine required for macrophage activation and elimination of mycobacteria. These studies allow the direct assessment of antigens involved in protective T cell-mediated immunity, and should be helpful in selecting relevant antigens for skin testing and immunization.
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Affiliation(s)
- P J Converse
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
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Abstract
Thirty-two mycobacterial components were detected by antibodies contained in leprosy patients' sera across the clinical spectrum and rabbit anti-M. leprae hyperimmune sera by western blot analysis of armadillo-derived M. leprae antigen preparations. Sera of borderline tuberculoid patients were found to contain antibodies recognizing 18 M. leprae components. While the reactivity of the sera on the lepromatous pole seemed to be distributed over the entire molecular weight range, most of the reactivity in the borderline tuberculoid patients was directed at higher molecular weight components (greater than 70,000). Identification of a series of previously unrecognized M. leprae components offers new possibilities in regard to the potential use of these antigens as targets for immunodiagnosis. Antibodies contained in the rabbit anti-M. leprae sera reacted with 19 M. leprae components. Antigens migrating at 64,000, 38,000, and 22,000 were detected by the rabbit sera only. Evidence of extensive cross-reactivity between M. leprae and BCG organisms emphasizes the need to use well-characterized antibody probes to determine the specificity of select mycobacterial antigens. The potential usefulness of rabbit monospecific hyperimmune sera to select M. leprae fractions in immunodiagnosis, in immune regulation studies, or as a tool to screen for mycobacterial products in lambda gt11 phage lysates of E. coli is discussed. Select M. leprae components were partially purified and their recovery assessed through SDS-PAGE analysis of Coomassie blue-stained gels.
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Affiliation(s)
- J P Ehrenberg
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
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Abstract
A method for the identification of circulating parasite antigens in filarial nematode infections was developed using canine infections with Dirofilaria immitis as a model. Filarial antigens ranging in molecular weight from 211 to 13 kDa were extracted from the sera of microfilaremic dogs by a solid phase immunobinding procedure and identified by immunostaining of Western blots. A major antigen of 104 kDa was selected for further characterization. The 104 kDa circulating antigen showed antigenic and biochemical identity with 104 kDa peptides found in extracts of adult male and microfilarial stages of the parasite. The 104 kDa peptide was antigenically stable under a variety of storage conditions. Its potential as a diagnostic target is discussed.
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Abstract
Various methods of radioiodination were employed to identify peptides on the surface of Dirofilaria immitis microfilariae. Optimum surface radiolabelling occurred with the lactoperoxidase-catalyzed reaction. Two major peptides of 16 and 14 kDa were labelled by this method. These peptides were soluble in Nonidet P-40, were not glycosylated, and showed no signs of disulfide linkages. These peptides were immunoprecipitated by sera from D. immitis-infected dogs, but not by sera from uninfected dogs or sera from dogs with potentially cross-reactive nematode infections. Analysis of the 14 and 16 kDa peptides by two-dimensional gel electrophoresis revealed that the 16 kDa peptide was a single unit with a pI of 5.25 whereas the 14 kDa band was composed of three individual peptides with pI values ranging from 5.6 to 6.1. Iodination by chloramine T resulted in the same panel of labelled peptides but suffered from poor efficiency of 125I incorporation. The viability of microfilariae labelled by the standard Bolton-Hunter method decreased by 50% following the reaction which resulted in the labelling of a variety of internal components.
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