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Drug-resistant tuberculosis treatment ushered in a new breakthrough, the course of treatment or shortened by one-third!

 Last Update: 2021-03-20
 Source: Internet
 Author: User

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Prediction of anti-tuberculosis treatment duration based on a 22-gene transcriptomic model.

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The German identification cohort (DS- and MDR-GIC) recruited 50 drug-sensitive (DS) tuberculosis patients and 30 MDR tuberculosis patients, and the German verification cohort (DS- and MDR-GVC) recruited 28 DS tuberculosis patients and 32 For MDR tuberculosis patients, the Romanian Verification Cohort (MDR-RVC) recruited 52 MDR tuberculosis patients.

Researchers have identified 22 genes whose activities are related to disease progression from thousands of genes.

Christoph Lange, clinical director of the Borstel Research Center and research leader, said: “The individualization of treatment time is an important milestone on the road to tuberculosis precision medicine.

According to data released by the World Health Organization (WHO) in 2019, tuberculosis is one of the top ten causes of death in the world and the disease with the largest number of deaths from a single infectious disease (ranked higher than AIDS since 2007).

The incidence of tuberculosis in 2019 The tuberculosis report of countries and regions with tuberculosis> 100,000 in 2019 2020.

In fact, since World War II, countries have adhered to strict implementation of modern tuberculosis control strategies, and the incidence of tuberculosis has declined.

2017 Lancet display sub-study data published in the Journal, forecast that by 2040, nearly a third of Russia's TB cases (32.

The study predicts that drug-resistant strains will lead to a reduction in drug-resistant tuberculosis cases-from approximately 30% of multidrug-resistant tuberculosis cases in 2000 to 20-25% in 2040, and 80% of XDR-resistant cases The disease increased to 50% in 2040 in 2000.

As far as my country is concerned, despite the remarkable achievements made in tuberculosis prevention and control in recent years, the situation is still not optimistic.

Multi-drug-resistant tuberculosis (MDR-TB) refers to tuberculosis bacteria that are resistant to the two most effective first-line drugs (rifampicin and isoniazid) at the same time.

Although most pulmonary tuberculosis can be cured, the proportion of drug-resistant tuberculosis is still high.

At present, most patients with multidrug-resistant and extensively drug-resistant tuberculosis need to use more than 8 antibiotics in combination, and the course of treatment is more than 18 months, but the success rate of treatment is not high.
The WHO has reported and estimated that the treatment success rate for XDR-TB is about 39%, and the success rate for MDR-TB is about 56%.
The treatment success rate for XDR-TB is approximately 39%, and the success rate for MDR-TB is approximately 56%.

Since the first discovery of an effective anti-tuberculosis antibiotic in the 1940s, progress in the field of tuberculosis has been slow.
However, TB patients are infected with TB strains that are resistant to existing drugs, and treatment options are very limited.

Previously, a new anti-tuberculosis drug chemotherapy regimen was proposed at the Anti-tuberculosis-innovative chemotherapy regimen meeting organized by the TB Alliance, which was composed of bedaquiline, Pretomanid, and linezolid.
"BPaL" program, the efficacy of BPaL has been proven in a key clinical trial called Nix-TB.
The efficacy of BPaL was proven in a key clinical trial called Nix-TB.
Relevant results were published in "New England Medicine" (NEJM).
Treatment of Highly Drug-Resistant Pulmonary Tuberculosis.
N Engl J Med.
2020 Mar 5;382(10):893-902.
doi: 10.
1056/NEJMoa1901814.
The results of this study show that after 6 months of treatment, the BPaL regimen was successfully treated The rate is as high as 90%, and the success rate is as high as 90% , which is significantly higher than the success rate of other treatment methods for drug-resistant tuberculosis patients.
Although there are some drug-related side effects, it can be intervened in time through measures such as drug reduction or dressing.
At present, the US Food and Drug Administration FDA has approved the use of the BPaL program in the United States for the treatment of extensively drug-resistant tuberculosis (XDR-TB) or drug intolerant or non-responsive multidrug-resistant tuberculosis (MDR-TB).
FDA Treatment of Highly Drug-Resistant Pulmonary Tuberculosis.
N Engl J Med.
2020 Mar 5;382(10):893-902.
doi: 10.
1056/NEJMoa1901814

For drug-resistant tuberculosis, the production of new drugs undoubtedly gives people some hope, but under the current circumstances, if the treatment endpoint time can be clarified, the treatment time for drug-resistant tuberculosis patients can be greatly reduced.
In a new study in 2019, the UCLA David Geffen School of Medicine team reported that the treatment of drug-resistant tuberculosis can be greatly reduced by using a method called "artificial intelligence-parabolic response surface" time.
As we all know, the synergy of each drug is more effective than the sum of its respective potency.
This data analysis method is to determine which drug combinations can work together.

For drug-resistant tuberculosis, the production of new drugs undoubtedly gives people some hope, but under the current circumstances, if the treatment endpoint time can be clarified, the treatment time for drug-resistant tuberculosis patients can be greatly reduced.
In a new study in 2019, the UCLA David Geffen School of Medicine team reported that the treatment of drug-resistant tuberculosis can be greatly reduced by using a method called "artificial intelligence-parabolic response surface" time.
The treatment time for drug-resistant tuberculosis can be greatly reduced by using a method called "artificial intelligence-parabolic response surface".
As we all know, the synergy of each drug is more effective than the sum of its respective potency.
This data analysis method is to determine which drug combinations can work together.

Researchers quickly identified three or four drug combinations among billions of possible drug and dose combinations, thereby significantly shortening the duration of TB treatment.
These programs are suitable for both drug-sensitive tuberculosis and most drug-resistant tuberculosis, and are five times faster than current standard treatment.
It is suitable for drug-sensitive tuberculosis, as well as most drug-resistant tuberculosis, and is five times faster than the current standard treatment.
It needs to be pointed out that this method is only used for cell culture and tuberculosis mouse models, and there is no human experiment.
The parabolic response surface platform supported by artificial intelligence can identify ultra-fast and nearly universal tuberculosis drug treatment plans composed of approved drugs.
Artificial intelligence enabled parabolic response surface platform identifies ultra-rapid near-universal TB drug treatment regimens comprising approved drugs.
PLOS ONE, 14(5), e0217670.
doi:10.
1371/journal.
pone.
0217670

The author of the study, Dr.
Marcus Horwitz, professor of medicine and microbiology, immunology , and molecular genetics at the David Geffen School of Medicine , said that if the results of the study are repeated in human studies, patients will heal faster and more The drug treatment may be adhered to, drug toxicity is reduced, and drug-resistant tuberculosis is unlikely to develop.

Because the treatment time for multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis is much longer than that of ordinary (drug sensitive) tuberculosis, and second-line anti-tuberculosis drugs are required.
The latter is more expensive and has more side effects than the first-line drugs used to treat drug-sensitive tuberculosis.
Therefore, for patients with drug-resistant pulmonary tuberculosis, early diagnosis and early treatment are very important, but it is also important to use accurate methods to end treatment in the shortest possible time to maximize the benefits of patients.
It is hoped that in the future, through the exploration and practice of scientific researchers, these new drugs and new technologies will be implemented as soon as possible and reduce the burden on patients.
For patients with drug-resistant pulmonary tuberculosis, early diagnosis and early treatment are very important, but it is also important to use accurate methods to end treatment in the shortest possible time to maximize the benefits of patients.
It is hoped that in the future, through the exploration and practice of scientific researchers, these new drugs and new technologies will be implemented as soon as possible and reduce the burden on patients.
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