World Tuberculosis Day 2023: Yes! We can end TB!
According to the World Health Organisation (WHO), approximately 1.5 million people die each year from tuberculosis (TB), a disease of the lungs caused by Mycobacterium tuberculosis. People with a weakened immune system, such as those infected with HIV, are also particularly affected. Combatting the disease and stemming its global spread pose a number of challenges for tuberculosis research: There is a lack of effective vaccines and drugs against TB; resistant and multidrug-resistant germs are becoming increasingly common, against which only a few antibiotics are still effective; biomarkers that can reliably predict or monitor the success of individual treatment are also urgently needed.
World Tuberculosis Day is observed each year on March 24 to mark the day in the year 1882 when the bacterium that causes tuberculosis was discovered. Below are examples from tuberculosis research at DZIF in which our scientists have been instrumental in identifying and overcoming these challenges.
BCG tuberculosis vaccine only effective in early childhood
The tuberculosis vaccine named Bacillus Calmette-Guérin (BCG) after its discoverers effectively protects children under three years of age against pulmonary tuberculosis and children under five years of age against all forms of tuberculosis. In contrast, however, vaccine protection was no longer sufficient in adolescents and adults, as a large-scale systematic study involving the DZIF showed.
More about the large-scale study can be found here: https://www.dzif.de/en/bcg-tuberculosis-vaccine-only-effective-early-childhood
Contact:
Prof. Dr. Dr. h.c. Christoph Lange
Research Center Borstel Leibniz Lung Center
clange@fz-borstel.de
New drug substance BTZ-043 for tuberculosis
The WHO has high hopes for the development of drugs based on new active substances. BTZ-043, developed by researchers in the DZIF and the UNITE4TB consortium, is one such new agent that is already undergoing clinical testing.
Details about the project can be found here: https://www.dzif.de/en/new-drug-substance-btz-043-tuberculosis
Contact:
Prof. Dr. Michael Hoelscher
LMU University Hospital Munich
hoelscher@lrz.uni-muenchen.de
Long-term outcomes of multidrug-resistant tuberculosis better than expected
In some countries of Eastern Europe, e.g., Moldova, Belarus, Ukraine or Russia, more than one third of all tuberculosis patients are infected with multidrug-resistant bacteria, for which the best drugs of standard therapy are no longer effective. A long-term study was able to show that the success of therapy in patients with multidrug-resistant tuberculosis is actually much higher than previously assumed by the WHO.
More about the study can be found here: https://www.dzif.de/en/long-term-outcomes-multidrug-resistant-tuberculosis-better-expected
Contact:
Prof. Dr. Dr. h.c. Christoph Lange
Research Center Borstel Leibniz Lung Center
clange@fz-borstel.de
Antibiotics resistance: Tuberculosis therapy at the limit?
The development of antibiotic resistance is increasingly complicating the treatment of tuberculosis. Patients suffering from multidrug-resistant tuberculosis (MDR-TB) are particularly hard hit. In a particularly complicated case, physicians at the Borstel Medical Clinic, Leibniz Lung Center, treated a patient, who was resistant to virtually all tuberculosis drugs, for the first time with exceptionally high doses.
The particularly complicated case of antibiotic-resistant tuberculosis is presented here: https://www.dzif.de/en/antibiotics-resistance-tuberculosis-therapy-limit
Contact:
Prof. Dr. Dr. h.c. Christoph Lange
Research Center Borstel Leibniz Lung Center
clange@fz-borstel.de
Tuberculosis: Molecular prediction of antimicrobial resistance for tailored therapy
Although more effective therapies would be available for almost all patients, antibiotic-resistant pathogens are not recognised in most cases. In a consensus document, an international panel of experts has defined how to interpret changes in the genome of tuberculosis bacteria in order to devise tailored therapies for patients with multidrug-resistant tuberculosis.
More about the consensus document can be found here: https://www.dzif.de/en/tuberculosis-molecular-prediction-antimicrobial-resistance-tailored-therapy
Contact:
Prof. Dr. Dr. h.c. Christoph Lange
Research Center Borstel Leibniz Lung Center
clange@fz-borstel.de
Personalised antibiotic treatment strategies for tuberculosis patients
Mutations in the genome of M. tuberculosis bacteria that are associated with antibiotic resistance occur in various combinations in multidrug-resistant tuberculosis patients. Identification of certain mutations in the bacterial genome therefore potentially allows prediction of which antibiotics are still effective in a patient, or whether the dose should be increased.
Details of the study can be found here: https://www.dzif.de/en/personalised-antibiotic-treatment-strategies-tuberculosis-patients
Contact:
PD Dr. Claudia Denkinger
Heidelberg University Hospital
Claudia.Denkinger@Uni-Heidelberg.de
Multicentre study on extrapulmonary tuberculosis
Almost 30 percent of tuberculosis cases in Germany affect extrapulmonary organs such as lymph nodes, bones or the brain. This form of tuberculosis is difficult to treat and has been scientifically neglected until now. The aim of a multicentre and prospective DZIF study was to identify biomarkers for extrapulmonary tuberculosis in order to identify risk factors for its development and to enable biomarker-based treatment of patients.
Details of the study can be found here: https://www.dzif.de/en/multicentre-study-extrapulmonary-tuberculosis
Contact:
Dr. Jan Rybniker
University Hospital Cologne
jan.rybniker@uk-koeln.de
Diagnostic biomarker for early detection of active tuberculosis in HIV-infected individuals
Specific biomarkers in the blood can indicate the onset of tuberculosis (TB) in HIV-infected individuals six to twelve months earlier than TB diagnosis by sputum. Early diagnosis via blood-based biomarkers followed by medical treatment could thus prevent progression and transmission of the disease.
More about the longitudinal study can be found here: https://www.dzif.de/en/diagnostic-biomarker-early-detection-active-tuberculosis-hiv-infected-individuals
Contact:
Dr. Christof Geldmacher
LMU University Hospital Munich
geldmacher@lrz.uni-muenchen.de
Tuberculosis: Different types of immunity determine the course of the disease
While the immune system of some tuberculosis patients responds very strongly to the infection and causes irreversible tissue and organ damage through excessive inflammation, the immune response of others is apparently too weak to overcome the infection and kill the bacteria. An international research team has succeeded in characterising different immune responses of tuberculosis patients and identifying groups of patients who either showed a very low or a very strong immune response to the bacterial pathogen. This classification could significantly improve personalised treatment options in the future.
Details of the study can be found here: https://www.dzif.de/en/tuberculosis-different-types-of-immunity-determine-course-of-disease
Contact:
Prof. Dr. Jan Heyckendorf
Research Center Borstel Leibniz Lung Center
jheyckendorf@fz-borstel.de
Weitere Informationen:
https://www.dzif.de/en/world-tuberculosis-day-2023-yes-we-can-end-tb DZIF press release
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