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Improving treatment outcomes for MDR-TB - novel host-directed therapies and personalised medicine of the future

Rao, M; Ippolito, G; Mfinanga, S; Ntoumi, F; Yeboah-Manu, D; Vilaplana, C; Zumla, A; (2019) Improving treatment outcomes for MDR-TB - novel host-directed therapies and personalised medicine of the future. International Journal of Infectious Diseases 10.1016/j.ijid.2019.01.039. (In press). Green open access

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Abstract

Multidrug-resistant TB (MDR-TB) is a major threat to global health. In 2017, only 50% of patients with MDR-TB who received WHO-recommended treatment were cured. Most MDR-TB patients who recover continue to suffer from functional disability due to lung damage. Whilst new MDR-TB treatment regimens are becoming available, conventional drug therapies need to be complemented with host-directed therapies (HDTs) to reduce tissue damage and improve functional treatment outcomes. This viewpoint highlights recent data on biomarkers, immune cells, circulating effector molecules and genetics which could be utilised for developing personalised HDTs. Novel technologies currently used for cancer therapy which could facilitate in-depth understanding of host genetics and the microbiome in patients with MDR-TB are discussed. Against this background, personalised cell-based HDTs for adjunct MDR-TB treatment to improve clinical outcomes are proposed as a possibility for complementing standard therapy and other HDT agents. Insights into the molecular biology of the mechanisms of action of cellular HDTs may also aid to devise non-cell-based therapies targeting defined inflammatory pathway(s) in Mtb-driven immunopathology.

Type: Article
Title: Improving treatment outcomes for MDR-TB - novel host-directed therapies and personalised medicine of the future
Location: Canada
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ijid.2019.01.039
Publisher version: http://doi.org/10.1016/j.ijid.2019.01.039
Language: English
Additional information: Copyright © 2019 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: biomarkers, clinical studies, host-directed therapies, immunotherapy, multidrug-resistant tuberculosis, personalised medicine
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/10068458
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