23. März 2015 Attack from all sides

Tuberculosis – a disease that knows no boundaries, kills millions of people per year worldwide and is developing resistance to current drug therapies at an alarming rate. In order to develop urgently needed new treatment regimes, it is critical to achieve a complete understanding of how Mycobacterium tuberculosis (Mtb) – the bacterium that causes the disease – infects, survives and develops. But despite decades of considerable global research efforts, the mechanisms by which Mtb infects and survives in the human body are still largely a mystery. For such a widespread and complex problem, a multi-disciplinary research approach seems the way to go. A paper published today in the journal PLoS Pathogens by Matthias Wilmanns and collaborators from Switzerland, Poland, and France, illustrates the power of bringing together specialists in different areas.

A global problem

Twenty years ago the World Health Organisation declared Tuberculosis (TB) a global public health emergency. Since then there has been considerable effort to reduce the number of new cases and associated deaths. Although both are decreasing in most parts of the world, TB still remains a major global health concern: in 2013, an estimated nine million people worldwide developed TB and 1.5 million people died from the disease, making it a major cause of death from an infectious disease, second only to HIV/AIDS. The bacterium, Mtb, usually infects the lungs and is spread through the air, for example via coughing or sneezing. Although about one-third of the world's population has come into contact with it, relatively few people will actually develop the disease. Mtb can remain dormant and almost undetected in the human host for years, even decades, before any symptoms develop. Tuberculosis can be treated effectively with a six-month course of multiple antibiotics. However, in part because of incomplete and foreshortened treatment, cases of 'multidrug-resistant TB' and 'extensively resistant TB' are rising. In such cases, treatment is far less successful, requiring more expensive and toxic drugs over an extended period. In Europe, while the overall number of TB cases is decreasing, since 2005 the incidence of drug resistant strains has risen significantly, from 1% to 11% of all cases. Although it is known that people with a suppressed immune system, such as those with HIV, have a greater risk of developing TB, what exactly triggers the disease to arise from the dormant state is a puzzling and long-standing question. The underlying processes of infection and persistence are still poorly understood despite years of global research effort. The first effective treatment was developed in the 1940s and very few new drugs have been introduced to the market since. As increasing drug resistance bears witness, the need for new, alternative treatments is becoming ever more urgent. Den vollständigen Artikel finden Sie hier.