Perspective for precision medicine for tuberculosis
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Tuberculosis is a bacterial infectious disease that is mainly transmitted from human to human via infectious aerosols. Currently, tuberculosis is the leading cause of death by an infectious disease world-wide. In the past decade, the number of patients affected by tuberculosis has increased by ~20 percent and the emergence of drug-resistant strains of Mycobacterium tuberculosis challenges the goal of elimination of tuberculosis in the near future. For the last 50 years, management of patients with tuberculosis has followed a standardized management approach. This standardization neglects the variation in human susceptibility to infection, immune response, the pharmacokinetics of drugs, and the individual duration of treatment needed to achieve relapse-free cure. Here we propose a package of precision medicine-guided therapies that has the prospect to drive clinical management decisions, based on both host immunity and M. tuberculosis strains genetics. Recently, important scientific discoveries and technological advances have been achieved that provide a perspective for individualized rather than standardized management of patients with tuberculosis. For the individual selection of best medicines and host-directed therapies, personalized drug dosing, and treatment durations, physicians treating patients with tuberculosis will be able to rely on these advances in systems biology and to apply them at the bedside.
Lange , C , Aarnoutse , R , Chesov , D , van Crevel , R , Gillespie , S H , Grobbel , H-P , Kalsdorf , B , Kontsevaya , I , van Laarhoven , A , Nishiguchi , T , Mandalakas , A , Merker , M , Niemann , S , Köhler , N , Heyckendorf , J , Reimann , M , Ruhwald , M , Sanchez-Carballo , P , Schwudke , D , Waldow , F & DiNardo , A R 2020 , ' Perspective for precision medicine for tuberculosis ' , Frontiers in Immunology , vol. 11 , 566608 . https://doi.org/10.3389/fimmu.2020.566608
Frontiers in Immunology
Copyright © 2020 Lange, Aarnoutse, Chesov, van Crevel, Gillespie, Grobbel, Kalsdorf, Kontsevaya, van Laarhoven, Nishiguchi, Mandalakas, Merker, Niemann, Köhler, Heyckendorf, Reimann, Ruhwald, Sanchez-Carballo, Schwudke, Waldow and DiNardo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
DescriptionFunding: German Center for Infection Research (DZIF) Clinical TB TTU-TB 02.704. The publication of this article was supported by the Open Access Publication Fund of the Leibniz Association.
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