Mycolactone-dependent depletion of endothelial cell thrombomodulin is strongly associated with fibrin deposition in buruli ulcer lesions

A well-known histopathological feature of diseased skin in Buruli ulcer (BU) is coagulative necrosis caused by the Mycobacterium ulcerans macrolide exotoxin mycolactone. Since the underlying mechanism is not known, we have investigated the effect of mycolactone on endothelial cells, focussing on the expression of surface anticoagulant molecules involved in the protein C anticoagulant pathway. Congenital deficiencies in this natural anticoagulant pathway are known to induce thrombotic complications such as purpura fulimans and spontaneous necrosis. Mycolactone profoundly decreased thrombomodulin (TM) expression on the surface of human dermal microvascular endothelial cells (HDMVEC) at doses as low as 2ng/ml and as early as 8hrs after exposure. TM activates protein C by altering thrombin’s substrate specificity, and exposure of HDMVEC to mycolactone for 24 hours resulted in an almost complete loss of the cells’ ability to produce activated protein C. Loss of TM was shown to be due to a previously described mechanism involving mycolactone-dependent blockade of Sec61 translocation that results in proteasome-dependent degradation of newly synthesised ER-transiting proteins. Indeed, depletion from cells determined by live-cell imaging of cells stably expressing a recombinant TM-GFP fusion protein occurred at the known turnover rate. In order to determine the relevance of these findings to BU disease, immunohistochemistry of punch biopsies from 40 BU lesions (31 ulcers, nine plaques) was performed. TM abundance was profoundly reduced in the subcutis of 78% of biopsies. Furthermore, it was confirmed that fibrin deposition is a common feature of BU lesions, particularly in the necrotic areas. These findings indicate that there is decreased ability to control thrombin generation in BU skin. Mycolactone’s effects on normal endothelial cell function, including its ability to activate the protein C anticoagulant pathway are strongly associated with this. Fibrin-driven tissue ischemia could contribute to the development of the tissue necrosis seen in BU lesions.

Explaining history to children: Otto and Marie Neurath’s work on the ‘Visual history of mankind’

This essay traces the development of Otto Neurath’s ideas that led to the publication of one of the first series of children’s books produced by the Isotype Institute in the late 1940s, the Visual History of Mankind. Described in its publicity material as ‘new in content’ and ‘new in method’, it embodied much of Otto Neurath’s thinking about visual education, and also coincided with other educational ideas in the UK in the 1930s and 1940s. It exemplified the Isotype Institute’s approach: teamwork, thinking about the needs of younger readers, clear explanation, and accessible content. Further, drawing on correspondence, notes and drawings from the Otto and Marie Neurath Isotype Collection at the University of Reading, the essay presents insights to the making of the books and the people involved, the costs of production and the influence of this on design decisions, and how the books were received by teachers and children.

Dancing in translation: Irina Brook’s mise en scène of 'Danser à Lughnasa', Jean-Marie Besset’s translation of Brian Friel’s 'Dancing at Lughnasa'

This essay contributes to debates about theatre and cross-cultural encounter through an analysis of Irina Brook’s 1999 Swiss / French co-production of Irish playwright Brian Friel’s Dancing at Lughnasa, in a French translation by Jean-Marie Besset. While the translation and Brook’s mise en scène clearly identified the source text and culture as Irish, they avoided cultural stereotypes, and rendered the play accessible to francophone audiences without entirely assimilating it to a specific Swiss or French cultural context. Drawing on discourses of theatre translation, and concepts of cosmopolitanism and conviviality, the essay focuses on the potential of such textual and theatrical translation to acknowledge specific cultural traces but also to estrange the familiar perceptions and boundaries of both the source and target cultures, offering modes of interconnection across diverse cultural affiliations.