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 tre...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-03-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971219300505 |
| _version_ | 1819112373823209472 |
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| author | Martin Rao Giuseppe Ippolito Sayoki Mfinanga Francine Ntoumi Dorothy Yeboah-Manu Cris Vilaplana Alimuddin Zumla Markus Maeurer |
| author_facet | Martin Rao Giuseppe Ippolito Sayoki Mfinanga Francine Ntoumi Dorothy Yeboah-Manu Cris Vilaplana Alimuddin Zumla Markus Maeurer |
| author_sort | Martin Rao |
| collection | DOAJ |
| description | 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. Keywords: Multidrug-resistant tuberculosis, Clinical studies, Host-directed therapies, Personalised medicine, Immunotherapy, Biomarkers |
| first_indexed | 2024-12-22T04:12:29Z |
| format | Article |
| id | doaj.art-186370c885bb4d6482f44404debd9730 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-22T04:12:29Z |
| publishDate | 2019-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-186370c885bb4d6482f44404debd97302022-12-21T18:39:29ZengElsevierInternational Journal of Infectious Diseases1201-97122019-03-0180S62S67Improving treatment outcomes for MDR-TB — Novel host-directed therapies and personalised medicine of the futureMartin Rao0Giuseppe Ippolito1Sayoki Mfinanga2Francine Ntoumi3Dorothy Yeboah-Manu4Cris Vilaplana5Alimuddin Zumla6Markus Maeurer7ImmunoSurgery Unit, Champalimaud Centre for the Unknown, Lisbon, PortugalNational Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, ItalyNational Institute of Medical Research Muhimbili, Dar es Salaam, TanzaniaUniversity Marien NGouabi and Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Institute for Tropical Medicine, University of Tübingen, GermanyDepartment of Bacteriology, Noguchi Memorial Institute for Medical Research, Accra, GhanaExperimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Catalonia, SpainDivision of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UKImmunoSurgery Unit, Champalimaud Centre for the Unknown, Lisbon, Portugal; Department of Oncology and Haematology, Krankenhaus Nordwest, Frankfurt am Main, Germany; Corresponding author at: Champalimaud Centre for the Unknown, Avenida Brasília, 1400-038 Lisbon, Portugal.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. Keywords: Multidrug-resistant tuberculosis, Clinical studies, Host-directed therapies, Personalised medicine, Immunotherapy, Biomarkershttp://www.sciencedirect.com/science/article/pii/S1201971219300505 |
| spellingShingle | Martin Rao Giuseppe Ippolito Sayoki Mfinanga Francine Ntoumi Dorothy Yeboah-Manu Cris Vilaplana Alimuddin Zumla Markus Maeurer Improving treatment outcomes for MDR-TB — Novel host-directed therapies and personalised medicine of the future International Journal of Infectious Diseases |
| title | Improving treatment outcomes for MDR-TB — Novel host-directed therapies and personalised medicine of the future |
| title_full | Improving treatment outcomes for MDR-TB — Novel host-directed therapies and personalised medicine of the future |
| title_fullStr | Improving treatment outcomes for MDR-TB — Novel host-directed therapies and personalised medicine of the future |
| title_full_unstemmed | Improving treatment outcomes for MDR-TB — Novel host-directed therapies and personalised medicine of the future |
| title_short | Improving treatment outcomes for MDR-TB — Novel host-directed therapies and personalised medicine of the future |
| title_sort | improving treatment outcomes for mdr tb novel host directed therapies and personalised medicine of the future |
| url | http://www.sciencedirect.com/science/article/pii/S1201971219300505 |
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