Yaws

=__**Disease/Drug of interest** : __ Yaws is a disease that occurs commonly among children and mainly attacks the immune system in order to harm the skin organ and cause lesions. There is an existing drug that counteracts yaws which is penicillin, but resistance to antibiotics is increasing and causing a concern for when they no longer work. Diseases that grow in underdeveloped countries have no other way to receive help unless it is from other people who are able to give this help. Furthermore, we can explore and study the effects of these antibiotics, how long it takes for bacteria to gain an immunization in a population and also factors that contribute to this immunization so that we are able to prevent future outbreaks and reduce the fear of running out of drugs to counteract new strains of bacteria. =

==**Motivation and Background** : Yaws is mainly found in poor communities with warm, humid climates such as the ones found in areas of Africa, Asia, Latin America, and the Pacific where the people do not have access to healthcare and basic necessities. Yaws mainly affects children between the ages of two and five, affecting the skin, bone, and cartilage. ==



Fig 1. Yaws, caused by //Treponema pertinue// bacteria, causes skin lesions and disfiguration more commonly in children than in any other age group.


 * References: **
 * 1) World Health Organization. Yaws.
 * 2) Giacani, L; Lukehart, S. A., The Endemic Treponematoses. Clinical Microbiology Reviews2016, 27 (1), 89-115
 * 3) Janeway, C.A. Jr.; Travers, P.; Walport M., Immunobiology: The Immune System in Health and Disease, 5th ed.; Garland Science: New York, 2001.
 * 4) Thornburg, R. W.; Baseman, J. B., Comparison of Major Protein Antigens and Protein Profiles of Treponema pallidum and Treponema pertenue. American Society for Microbiology1983, 42 (2), 623-627.
 * 5) Mitjà, O.; Asiedu, K.; Mabey, D., Yaws. The Lancet2013, 381 (9868), 763-773.
 * 6) Zervosen, A.; Sauvage, E.; Charlier, P.; Luxen, A., Development of New Drugs for an Old Target - The Penicillin Binding Proteins. Molecules2012, 17 (11), 12478-12505.
 * 7) Drugs.com. Penicillin v potassium Side Effects.
 * 8) American Chemical Society International Historic Chemical Landmarks. Discovery and Development of Penicillin.
 * 9) Fletcher, C., First clinical use of penicillin. British Medical Journal Clinical Topics1984, 289 (72), 1721-1723.
 * 10) ClinicalTrials.gov. Study of 5 and 10 Days Treatment With Penicillin Against Sore Throat Caused by Streptococci.
 * 11) National Institutes of Health. How Did They Make Penicillin?.
 * 12) MedicineNet.com. Yaws.

**External links:**
http://www.who.int/mediacentre/factsheets/fs316/en/

=__**Target Information** : __ Yaws mainly attacks the immune system, specifically b-cells, in order to harm the skin organ. Yaws attempts to inhabit cells so that b-cells will be unable to produce antibodies and unable to protect the cell, as well as make the immune system unable to work. =

** Location ** : Antibodies are produced by the immune system as a response to a foreign substance being detected. They travel through the bloodstream and are also found in bodily fluids.
===** Function in a normal cell ** : When antibodies come into contact with an antigen, or a detected foreign substance, then they bind to the target. The binding either prevents the bacteria from causing damage or the antibody releases chemical signals to attract phagocytic cells to destroy the foreign substance. ===

=__**Drug Information**** : **__ Penicillin was found to counteract yaws. This drug aids antibodies by binding to sites where pathogens bind to body cells and signaling for phagocytes to eliminate what they have surrounded. Penicillin acts as a suicide substrate since it is also engulfed by the phagocyte while they engulf the pathogen. During the 1950s and 1960s, a major campaign to eradicate yaws was launched where they treated people with injectable penicillin and were able to reduce the number of cases by ninety-five percent worldwide, but yaws has reappeared in recent years in Africa, Asia, and the western Pacific. It was discovered in 2012 that one oral dose of azithromycin was shown to be as effective as intramuscular penicillin in the treatment of the disease. Relapse is very rare, so it is highly effective for mass use. The dose for adults is 1.2 million units and for children, it is 600,000 units. However, just as yaws reappeared after the 1950s and 1960s, it may reappear once more as bacteria grows immune to these other versions of penicillin. =


 * Schematic figure of drug ** :



Fig. 2 Penicillin core structure where “R” is the variable group.

C 31 H 43 N 3 O 8.
 * Formula ** : Multiple versions of penicillin exist to attack various bacteria forms. The common type of penicillin used has the following formula:


 * Molecular weight ** : The common type of penicillin has the following molecular weight: 585.69 g/mol.


 * CAS Number ** : The CAS registry number given by SciFinder is 1406-05-9 for the above molecular formula and weight.


 * Delivery method ** : Penicillin can be injected but giving it orally is as effective and more efficient, so it is preferred.
 * Side effects ** : The most common side effects are mild diarrhea, headache, sore mouth or tongue, vaginal itching and discharge, and/or white patches in the mouth and/or on the tongue.


 * Other names ** : Other names for penicillin ar e Mykoin BF 510, and other penicillins.


 * Maker or company ** : None specifically cited.
 * Is it patented ** ? Alexander Fleming, the one who discovered penicillin, never patented penicillin, but since the study of the drug increased, the different strands of penicillin discovered have been patented.


 * Clinical Trials Info ** : The first trials of penicillin were carried out during war times. Since there were no ethical committees to be consulted, teams searched sickly people willing to try it. Since then, various trials have been performed with new versions and strains discovered.

__** Origin ** : __ Penicillin is naturally produced from //penicillium// mold.


 * Alternatives to this drug ** : For those who are allergic to penicillin, tetracycline, erythromycin, and doxycycline could be used.

Fig. 3: After being treated with medication, the ulcers are gone and the skin returns to normal.


 * Miscellaneous ** : The WHO made it its goal to eradicate yaws by 2020.


 * Other uses ** : Penicillin is an antibiotic used to treat a variety of infections caused by bacteria such as pneumonia, scarlet fever, and ear, skin, and throat infections although they will not work for colds, flu, or other viral infections.