Futuro de la epidemiología molecular en la lepra

La evidencia actual, aunque limitada, indica que la diversidad genética entre las cepas de M. leprae es muy baja, incluso en comparación con M. tuberculosis. Las variaciones en la cantidad de copias de tandems de repetición cortas, desta can como una importante excepción en este modelo y parecen ser los más prometedores a corto plazo para la epidemiología molecular. Resultará difícil identificar loci polimórficos adicionales y se conseguirá de manera más efectiva generando información secuencial parcial del genoma con más cepas de M. leprae (AU)

The impact of "ancient pathogen" studies on the practice of public health.

A new field of "ancient pathogens" is making an impact on our concepts of the evolution of infectious diseases, and it will eventually alter the practice of public health in their control. It has begun to answer important questions regarding past epidemics of influenza and tuberculosis by recovering the genetic sequences of the ancient causative agents. Vaccination strategics will have to study these microbial variants in order to develop tomorrow's vaccines. It may also be possible to examine the role of past and present reservoirs in the dynamics of emerging diseases. In unraveling the evolution of pathogens, insights into the mechanisms of drug and antibiotic resistance are possible. As "genome projects" of more and more pathogens are being completed. Targets for chemotherapy are being revealed which are totally different from the metabolic processes of the mammalian host. Signal molecules are being identified which alter the virulence of the microbe. Focussing on these mechanisms without attempting to kill the pathogen may in some cases drive it into a benign state. These and other aspects of the evolution of pathogens are discussed which may lead to innovative approaches to the control of infectious diseases.