Lepromatous leprosy patients produce antibodies that recognise non-bilayer lipid arrangements containing mycolic acids

Non-bilayer phospholipid arrangements are three-dimensional structures that form when anionic phospholipids with an intermediate structure of the tubular hexagonal phase II are present in a bilayer of lipids. Antibodies that recognise these arrangements have been described in patients with antiphospholipid syndrome and/or systemic lupus erythematosus and in those with preeclampsia; these antibodies have also been documented in an experimental murine model of lupus, in which they are associated with immunopathology. Here, we demonstrate the presence of antibodies against non-bilayer phospholipid arrangements containing mycolic acids in the sera of lepromatous leprosy (LL) patients, but not those of healthy volunteers. The presence of antibodies that recognise these non-bilayer lipid arrangements may contribute to the hypergammaglobulinaemia observed in LL patients. We also found IgM and IgG anti-cardiolipin antibodies in 77% of the patients. This positive correlation between the anti-mycolic-non-bilayer arrangements and anti-cardiolipin antibodies suggests that both types of antibodies are produced by a common mechanism, as was demonstrated in the experimental murine model of lupus, in which there was a correlation between the anti-non-bilayer phospholipid arrangements and anti-cardiolipin antibodies. Antibodies to non-bilayer lipid arrangements may represent a previously unrecognised pathogenic mechanism in LL and the detection of these antibodies may be a tool for the early diagnosis of LL patients

Culpability for Violence in the Congo: Lessons from the Crisis of 1960–1965

During Congo’s emergence from colonization in the mid-twentieth century, coups, political assassinations, and ethnic massacres took place that exacerbated inequality and insecurity in the region then and ever since. Some Western literature has essentialized these events, implying that they were a product of African people’s innate disorganization, divisiveness, leftism, and violence. Many of the writings keep to surface appearances rather than probing behind-the-scenes causalities. Evidence from archives, images, memoirs, and interviews, however, reveals a counterintuitive complexity in both the representation and perpetration of the direct and structural violence of the Congo crisis. Very different cultures, financing, technology, and interactions were characteristic of the western state agents who sponsored, organized, took part in, and often wrote about the coups and killings in Congo as opposed to the African functionaries with whom and against whom they worked. This chapter illustrates some of the evidence for these complex and contrasting patterns, offers alternative explanations, and outlines some lessons to be learned from the crisis