Improving treatment outcomes for MDR-TB — novel host-directed therapies and personalised medicine of the future
- Multidrug-resistant TB (MDR-TB) is a major threat to global health security. In 2017, only 50% of patients with MDR-TB who received WHO-recommended treatment were cured. Most MDR-TB patients who recover continue to suffer from functional disability due to long-term lung damage. Whilst new MDR-TB treatment regimens are becoming available, conventional drug therapies need to be complemented with host-directed therapies (HDTs) to reduce tissue damage and improve functional treatment outcomes. This viewpoint highlights recent data on biomarkers, immune cells, circulating effector molecules and genetics which could be utilised for developing personalised HDTs. Novel technologies currently used for cancer therapy which could facilitate in-depth understanding of host genetics and the microbiome in patients with MDR-TB are discussed. Against this background, personalised cell-based HDTs for adjunct MDR-TB treatment to improve clinical outcomes are proposed as a possibility for complementing standard therapy and other HDT agents. Insights into the molecular biology of the mechanisms of action of cellular HDTs may also aid to devise non-cell-based therapies targeting defined inflammatory pathway(s) in Mtb-driven immunopathology.
Author: | Martin Rao, Giuseppe Ippolito, Sayoki Mfinanga, Francine Ntoumi, Dorothy Yeboah-Manu, Cris Vilaplana, Alimuddin Zumla, Markus Maeurer |
---|---|
URN: | urn:nbn:de:hebis:30:3-501203 |
DOI: | https://doi.org/10.1016/j.ijid.2019.01.039 |
ISSN: | 1201-9712 |
ISSN: | 1878-3511 |
Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/30685590 |
Parent Title (English): | International journal of infectious diseases |
Publisher: | Elsevier |
Place of publication: | Amsterdam [u. a.] |
Contributor(s): | Eskild Petersen |
Document Type: | Article |
Language: | English |
Year of Completion: | 2019 |
Date of first Publication: | 2019/01/24 |
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Release Date: | 2019/04/29 |
Tag: | Biomarkers; Clinical studies; Host-directed therapies; Immunotherapy; Multidrug-resistant tuberculosis; Personalised medicine |
Volume: | 80 |
Issue: | Supplement |
Page Number: | 6 |
First Page: | S62 |
Last Page: | S67 |
Note: | © 2019 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
HeBIS-PPN: | 450770362 |
Institutes: | Medizin / Medizin |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Licence (German): | Creative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0 |