Table 1. Questions that a BU CHIM may answer.
1 | What is the natural history of natural infection? |
2 | What are the systemic and local immunological responses to low dose infection? |
3 | What are the immunological correlates of protection? |
4 | What proportion of people develop antibodies against M. ulcerans-specific antigens? |
5 | What kind of antibodies do people develop against M. ulcerans? |
6 | What is the immunological basis for paradoxical reactions? |
7 | Can paradoxical reactions be predicted based on systemic immunological parameters? |
8 | What are the immunological correlates of spontaneous healing? |
9 | Can M. bovis BCG protect people from low-dose M. ulcerans infection? [45] |
10 | Can candidate vaccines delay or prevent clinical disease? |
11 | Can clinical disease be prevented by using early, short courses of antibiotics prior to the onset of clinical disease? (i.e., chemoprophylaxis) |
12 | Can abbreviated antibiotic courses (e.g., 4 to 6 weeks of rifampicin and clarithromycin) be used to treat early disease? |
13 | Can ultra-short treatment with telacebac [52] successfully treat BU in humans? |
14 | Can M. ulcerans-targeted bacteriophages be used in the management of BU? |
15 | Can non-antibiotic options be useful in the treatment of early (pre-ulcerative or small) lesions? For example, local heat therapy (thermotherapy) [53] |
BU, Buruli ulcer; CHIM, controlled human infection model.