MHF TOP PICKS FOR JULY
Every month, we at the Mueller Health Foundation like to showcase interesting news and updates in the field of tuberculosis. Below are our top 3 picks for July:
- SickKids Researchers Discover New Way to Attack Treatment-resistant TB Infections
The current treatment for drug-resistant TB relies on a recently developed drug
called bedaquiline (BDQ), which targets ATP synthase, effectively stopping the
bacteria from producing the energy they need to survive. Despite the success of
BDQ in treating drug-resistant TB, resistant mycobacteria have started to
emerge and BDQ’s side effects can include liver toxicity and heart failure. Given
the adverse side-effect profile, the researchers therefore examined two new
compounds that target ATP synthase, called TBAJ-876 and SQ31f. The study
showed why TBAJ-876, which is derived from BDQ and is currently undergoing
clinical trials, binds to ATP synthase better than BDQ. The team also discovered
that although the current form of SQ31f prevents mycobacteria from growing
but does not kill them, it binds to ATP synthase at a previously unknown site,
which could allow development of an entirely new class of antibiotic that could
work even for BDQ-resistant strains. To learn more, you can access the full
paper at:
https://www.embopress.org/doi/epdf/10.15252/embj.2023113687
- Promising Vaccine Candidate Receives Funding for Phase III Trial
A promising vaccine candidate for tuberculosis is getting a new lease of life after two major funders have decided to pour $550 million USD into its final phase of clinical trials. If successful, it would be the first new tuberculosis vaccine on the market in more than a century. The vaccine candidate, called M72/AS01E, aims to tackle the latent infections. And it showed promise in data published from phase II trials in 2019, demonstrating a 54% efficacy in adults who hosted the bacterium. M72/AS01E consists of a fused protein called M72, which is comprised of two M. tuberculosis antigens, and an adjuvant, AS01E. Researchers chose the antigens on the basis of their high immunogenicity, which is defined as a strong ability to provoke the immune system and which stimulates the crucial T-cell response needed to fight the bacteria as well as to create memory cells for future attacks.
DID YOU KNOW?
People who are incarcerated are at high risk of developing tuberculosis. The first global study that was sponsored by the NIH and published this month, aimed to estimate the annual global, regional, and national incidence of tuberculosis among incarcerated populations from 2000 to 2019 using published and unpublished data as well as annual tuberculosis notifications among incarcerated individuals at the country level. Below is a summary of key findings from the study:
- Using Bayesian meta-regression models integrating multiple sources of incarceration and tuberculosis data, the researchers estimated that approximately 125,105 of the 11 million incarcerated individuals globally developed tuberculosis in 2019.
- The estimated global incidence of tuberculosis among incarcerated individuals is approximately nine times greater than the estimated incidence among all individuals.
- The elevated risk of tuberculosis among incarcerated populations exceeds that of diabetes, alcohol use disorders, smoking , and undernourishment.
- The five countries with the highest number of incident tuberculosis cases among incarcerated individuals in 2019 included Brazil (15,266), Russia (12,993), China (11,347), Philippines (6,357), and Thailand (5,249).
- The researchers found a low case-detection ratio in 2019 both globally and across WHO regions, ranging between 42% and 68%. These case-detection ratios are lower than for the general population and similar to ratios for pediatric tuberculosis, which is particularly difficult to diagnose.
- The large gaps in tuberculosis case detection in incarcerated populations should be addressed with interventions specifically tailored to improve diagnoses and prevent transmission as a part of the broader global tuberculosis control effort.