The number of deaths related to tuberculosis continues to rise each year. This might be because of the reemergence of the disease related to immunosuppressive illnesses, such as HIV. Or it may be related to the paucity of new tools which doctors have in order to combat the disease. It was 1891 since the last effective diagnostic tool for latent tuberculosis was developed. It was 1921 since the last vaccine for tuberculosis and 1967 since the last new first-line drug class for treatment of tuberculosis was developed.
The expanding epidemic of HIV and AIDS, as well as the overcrowding of cities, poor nutrition and hygiene and emergence of multi-drugs resistant bacteria, all contrive to increase the number of deaths from the disease that has been documented since 2400 B.C.
Doctors and scientists all over the world are conducting research into the bacteria which causes tuberculosis, mycobacteria tuberculosis. Research studies are being designed to answer important questions about both diagnosis and treatment and to find new approaches which are both safe and effective.
Some new research has already led to advances but researchers continue to search for more effective methods to deal with the bacteria. Some of the current new research is looking at potential new testing that can speed the diagnosis from four weeks to two days. Researchers are also looking at tests to tell the difference between people who have tuberculosis and those who are merely reacting to a previous BCG vaccination. And, finally, researchers are also attempting to identify people were infected with the tuberculosis bacteria and are the highest risk of developing active tuberculosis, and not just carriers, latent tuberculosis.
Researchers who are studying treatment modalities are currently in clinical trials for new medications. Some clinical trials are also evaluating shorter treatment regimens to make it more efficient for people to remain compliant with their drug therapy. Lack of compliance with drug therapy has led to multi-drug-resistant bacteria which is rampant among the homeless and non-industrialized countries. Researchers are also evaluating antibiotics which are already on the market that may be effective in the treatment of the bacteria, making therapy more potent and easier to tolerate.
On the third front researchers are evaluating the efficacy of three new tuberculosis vaccines which are now in clinical trials. There are several more being analyzed in animal studies at this time.
Research into the potential benefits of tuberculosis vaccines and treatments as well as diagnostic testing require volunteers. Patients who joined research studies have the first chance to benefit from treatments that are shown promise in earlier animal research or clinical trials. Although tuberculosis research clinical trials can pose some risks, researchers take very careful steps to protect their patients.
For instance, a discovery in 2007 by researchers from the Netherlands Cancer Institute found that tuberculosis and the leprosy bacteria follow a different path into a host cell than scientists had believed for the past 40 years. Using high-resolution electron microscopes, researchers were able to map the cells and internal organization. This discovery will have significant consequences in the development of new medications and vaccines. For instance, based on the new information, the current BCG vaccine provides very little protection against active tuberculosis. Follow-up research is planned to fix the current BCG vaccine so that it acts like the TB bacteria. In this way, they believe it will make the vaccine more powerful and, hopefully less expensive.
Research into tuberculosis falls on three fronts: diagnosis, treatment and prevention. As researchers gather more and more information about the Mycobacterium tuberculosis they are able to develop better diagnostic tests, more effective treatments and more cost-effective vaccines. All of these efforts will help in the fight against the disease which currently holds seventh place in the number of individuals it kills each year.
RESOURCES
National Institute for Allergy and Infectious Diseases: New Challenge for TB Research
Johns Hopkins Medicine: Center for New TB Research Laboratory
Center for Disease Control and Prevention: TB Research
Tuberculosis Research and Treatment
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