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Lehnert T, Gijs MAM. Microfluidic systems for infectious disease diagnostics. LAB ON A CHIP 2024; 24:1441-1493. [PMID: 38372324 DOI: 10.1039/d4lc00117f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Microorganisms, encompassing both uni- and multicellular entities, exhibit remarkable diversity as omnipresent life forms in nature. They play a pivotal role by supplying essential components for sustaining biological processes across diverse ecosystems, including higher host organisms. The complex interactions within the human gut microbiota are crucial for metabolic functions, immune responses, and biochemical signalling, particularly through the gut-brain axis. Viruses also play important roles in biological processes, for example by increasing genetic diversity through horizontal gene transfer when replicating inside living cells. On the other hand, infection of the human body by microbiological agents may lead to severe physiological disorders and diseases. Infectious diseases pose a significant burden on global healthcare systems, characterized by substantial variations in the epidemiological landscape. Fast spreading antibiotic resistance or uncontrolled outbreaks of communicable diseases are major challenges at present. Furthermore, delivering field-proven point-of-care diagnostic tools to the most severely affected populations in low-resource settings is particularly important and challenging. New paradigms and technological approaches enabling rapid and informed disease management need to be implemented. In this respect, infectious disease diagnostics taking advantage of microfluidic systems combined with integrated biosensor-based pathogen detection offers a host of innovative and promising solutions. In this review, we aim to outline recent activities and progress in the development of microfluidic diagnostic tools. Our literature research mainly covers the last 5 years. We will follow a classification scheme based on the human body systems primarily involved at the clinical level or on specific pathogen transmission modes. Important diseases, such as tuberculosis and malaria, will be addressed more extensively.
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Affiliation(s)
- Thomas Lehnert
- Laboratory of Microsystems, École Polytechnique Fédérale de Lausanne, Lausanne, CH-1015, Switzerland.
| | - Martin A M Gijs
- Laboratory of Microsystems, École Polytechnique Fédérale de Lausanne, Lausanne, CH-1015, Switzerland.
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Sahoo P. Complementary supramolecular drug associates in perfecting the multidrug therapy against multidrug resistant bacteria. Front Immunol 2024; 15:1352483. [PMID: 38415251 PMCID: PMC10897028 DOI: 10.3389/fimmu.2024.1352483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/23/2024] [Indexed: 02/29/2024] Open
Abstract
The inappropriate and inconsistent use of antibiotics in combating multidrug-resistant bacteria exacerbates their drug resistance through a few distinct pathways. Firstly, these bacteria can accumulate multiple genes, each conferring resistance to a specific drug, within a single cell. This accumulation usually takes place on resistance plasmids (R). Secondly, multidrug resistance can arise from the heightened expression of genes encoding multidrug efflux pumps, which expel a broad spectrum of drugs from the bacterial cells. Additionally, bacteria can also eliminate or destroy antibiotic molecules by modifying enzymes or cell walls and removing porins. A significant limitation of traditional multidrug therapy lies in its inability to guarantee the simultaneous delivery of various drug molecules to a specific bacterial cell, thereby fostering incremental drug resistance in either of these paths. Consequently, this approach prolongs the treatment duration. Rather than using a biologically unimportant coformer in forming cocrystals, another drug molecule can be selected either for protecting another drug molecule or, can be selected for its complementary activities to kill a bacteria cell synergistically. The development of a multidrug cocrystal not only improves tabletability and plasticity but also enables the simultaneous delivery of multiple drugs to a specific bacterial cell, philosophically perfecting multidrug therapy. By adhering to the fundamental tenets of multidrug therapy, the synergistic effects of these drug molecules can effectively eradicate bacteria, even before they have the chance to develop resistance. This approach has the potential to shorten treatment periods, reduce costs, and mitigate drug resistance. Herein, four hypotheses are presented to create complementary drug cocrystals capable of simultaneously reaching bacterial cells, effectively destroying them before multidrug resistance can develop. The ongoing surge in the development of novel drugs provides another opportunity in the fight against bacteria that are constantly gaining resistance to existing treatments. This endeavour holds the potential to combat a wide array of multidrug-resistant bacteria.
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Affiliation(s)
- Pathik Sahoo
- International Center for Materials and Nanoarchitectronics (MANA), Research Center for Advanced Measurement and Characterization (RCAMC), National Institute for Materials Science, Tsukuba, Japan
- Foundation of Physics Research Center (FoPRC), Celico, Italy
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Khelghati F, Nasirpour Seilakhori F, Goudarzi M, Malekloo S, Shahidi Bonjar AH, Goudarzi H, Nasiri MJ. Multidrug-resistant tuberculosis in Iran: a multicenter study. Monaldi Arch Chest Dis 2024. [PMID: 38214397 DOI: 10.4081/monaldi.2024.2844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/28/2023] [Indexed: 01/13/2024] Open
Abstract
The worldwide incidence of multi-drug-resistant tuberculosis (MDR-TB) is rapidly increasing, and it has emerged as a pressing public health issue in Iran. Nevertheless, there is a scarcity of up-to-date research on the prevalence of MDR-TB in individuals with pulmonary TB in the country. In this cross-sectional study, we gathered a total of 1216 respiratory samples, each corresponding to a unique patient, from five distinct regional TB laboratories in Iran. We identified clinical isolates as Mycobacterium tuberculosis using the IS6110-based PCR assay and Xpert MTB/RIF. Drug susceptibility testing (DST) was conducted using the conventional proportion method. Out of the collected specimens, 448 tested positive for M. tuberculosis. Among these isolates, 445 (99.4%) exhibited susceptibility to the tested drugs, while 3 (0.6%) were found to be MDR. The findings from this recent study indicate that the prevalence of MDR in Iran stands at 0.6%. The absence of recently approved treatment protocols in various regions of Iran, along with inadequately equipped laboratories lacking DST capabilities, could contribute significantly to the rise in TB/MDR-TB prevalence in Iran. Therefore, the implementation of enhanced treatment management strategies and the adoption of innovative technologies are essential steps towards improving the current situation.
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Affiliation(s)
- Fatemeh Khelghati
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran.
| | | | - Mehdi Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran.
| | - Shima Malekloo
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran.
| | | | - Hossein Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran.
| | - Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran.
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Olabiyi OE, Okiki PA, Adarabioyo MI, Adebiyi OE, Adegoke OE, Esan OE, Idris OO, Agunbiade TB. Distribution of multi-drug resistant tuberculosis in Ekiti and Ondo states, Nigeria. New Microbes New Infect 2023; 55:101192. [PMID: 38046896 PMCID: PMC10690628 DOI: 10.1016/j.nmni.2023.101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Background Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is one of the top infectious killer diseases in the world. The emergence of drug-resistant MTB strains has thrown challenges in controlling TB worldwide. This study investigated the prevalence of drug-resistant tuberculosis in the states of Nigeria and the risk factors that can increase the incidence of tuberculosis. Methods The study is a cross-sectional epidemiological research carried out in the six senatorial districts of Ekiti and Ondo states, Nigeria, between February 2019 and January 2020. A structured questionnaire was administered to 1203 respondents for socio-demographic information, and sputum samples were collected from them for TB investigation. GeneXpert technique was used to diagnose TB from the sputum samples, followed by bacterial isolation using Löweinstein-Jensen medium and antibiotic susceptibility testing. Results Prevalence of TB in the two states combined was 15 %; with 13.8 % for Ekiti state and 16.1 % for Ondo State. The distribution of TB in the senatorial districts was such that: Ondo South > Ekiti Central > Ekiti South > Ondo North > Ekiti North > Ondo Central. The risk factors identified for TB prevalence in two states were gender, male > female (OR = 0.548, p = 0.004); overcrowding (OR = 0.733, p = 0.026); room size (OR = 0.580, p = 0.002); smoking (OR = 0.682, p = 0.019) and dry and dusty season (OR = 0.468, p = 0.005). The prevalence of MDR-TB in Ekiti and Ondo States were 1.2 % and 1.3 % respectively. The identified risk factors for MDR were education (OR = 0.739, p = 0.017), age (OR = 0.846, p = 0.048), religion (OR = 1.95, p = 0.0003), family income (OR = 1.76, p = 0.008), previous TB treatment (OR = 3.64, p = 0.004), smoking (OR = 1.33, p = 0.035) and HIV status (OR = 1.85, p = 0.006). Rifampicin monoresistant was reported in 6.7 % of the rifampicin-resistant strains, while 93.3 % were rifampicin polyresistant strains. Two (13.3 %) of the MDR-TB strains were resistant to all the 3 first-line antimycobacterial agents. All the Rifampicin-resistant TB strains were susceptible to the aminoglycosides (Amikacin, Capreomycin and Kanamycin), also with high susceptibility to the fluoroquinilones: Moxifloxacin (100 %) and Levofloxacin (86.7 %). Sixteen (94.1 %) of the 17 Rifampicin-susceptible strains were susceptible to all the eight antibiotics tested, while one (5.9 %) was susceptible to Rifampicin and Isoniazid but resistant to the rest antibiotics. Conclusion: The study showed that there is high prevalence of TB and MDR-TB in Ekiti and Ondo States Nigeria, hence, to meet the SDG Target 3.3 of ending TB epidemic by 2030, culturing and antibiotic susceptibility testing should be carried out on every TB-positive sputum and the patients treated accordingly.
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Affiliation(s)
- Olugbenga Enoch Olabiyi
- Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
- Department of Medical Microbiology and Parasitology, Ekiti State Teaching Hospital, Ado-Ekiti, Nigeria
| | - Pius Abimbola Okiki
- Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
- Institute of One-Health, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Mumuni Idowu Adarabioyo
- Department of Mathematical & Physical Sciences (Statistics Unit), Afe Babalola University, Ado-Ekiti, Nigeria
| | - Oludele Emmanuel Adebiyi
- South-West Zonal Tuberculosis Reference Laboratory, Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria
| | - Olusola Emannuel Adegoke
- South-West Zonal Tuberculosis Reference Laboratory, Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria
| | - Olubunmi Ebenezer Esan
- Department of Medical Microbiology and Parasitology, Ondo State Specialist Hospital, Akure, Nigeria
| | - Olayinka O. Idris
- Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Toluwani Bosede Agunbiade
- Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
- Department of Integrated General Medical Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
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Gilbertson B, Subbarao K. What Have We Learned by Resurrecting the 1918 Influenza Virus? Annu Rev Virol 2023; 10:25-47. [PMID: 37774132 DOI: 10.1146/annurev-virology-111821-104408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
The 1918 Spanish influenza pandemic was one of the deadliest infectious disease events in recorded history, resulting in approximately 50-100 million deaths worldwide. The origins of the 1918 virus and the molecular basis for its exceptional virulence remained a mystery for much of the 20th century because the pandemic predated virologic techniques to isolate, passage, and store influenza viruses. In the late 1990s, overlapping fragments of influenza viral RNA preserved in the tissues of several 1918 victims were amplified and sequenced. The use of influenza reverse genetics then permitted scientists to reconstruct the 1918 virus entirely from cloned complementary DNA, leading to new insights into the origin of the virus and its pathogenicity. Here, we discuss some of the advances made by resurrection of the 1918 virus, including the rise of innovative molecular research, which is a topic in the dual use debate.
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Affiliation(s)
- Brad Gilbertson
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kanta Subbarao
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Victoria, Australia
- WHO Collaborating Centre for Reference and Research on Influenza, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia;
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Xia J, Liu Y, Ma Y, Yang F, Ruan Y, Xu JF, Pi J. Advances of Long Non-Coding RNAs as Potential Biomarkers for Tuberculosis: New Hope for Diagnosis? Pharmaceutics 2023; 15:2096. [PMID: 37631310 PMCID: PMC10458399 DOI: 10.3390/pharmaceutics15082096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Tuberculosis (TB), one of the top ten causes of death globally induced by the infection of Mycobacterium tuberculosis (Mtb), remains a grave public health issue worldwide. With almost one-third of the world's population getting infected by Mtb, between 5% and 10% of these infected individuals are predicted to develop active TB disease, which would not only result in severe tissue damage and necrosis, but also pose serious threats to human life. However, the exact molecular mechanisms underlying the pathogenesis and immunology of TB remain unclear, which significantly restricts the effective control of TB epidemics. Despite significant advances in current detection technologies and treatments for TB, there are still no appropriate solutions that are suitable for simultaneous, early, rapid, and accurate screening of TB. Various cellular events can perturb the development and progression of TB, which are always associated with several specific molecular signaling events controlled by dysregulated gene expression patterns. Long non-coding RNAs (lncRNAs), a kind of non-coding RNA (ncRNA) with a transcript of more than 200 nucleotides in length in eukaryotic cells, have been found to regulate the expression of protein-coding genes that are involved in some critical signaling events, such as inflammatory, pathological, and immunological responses. Increasing evidence has claimed that lncRNAs might directly influence the susceptibility to TB, as well as the development and progression of TB. Therefore, lncRNAs have been widely expected to serve as promising molecular biomarkers and therapeutic targets for TB. In this review, we summarized the functions of lncRNAs and their regulatory roles in the development and progression of TB. More importantly, we widely discussed the potential of lncRNAs to act as TB biomarkers, which would offer new possibilities in novel diagnostic strategy exploration and benefit the control of the TB epidemic.
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Affiliation(s)
- Jiaojiao Xia
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China; (J.X.); (Y.L.); (Y.M.); (F.Y.); (Y.R.)
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Yilin Liu
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China; (J.X.); (Y.L.); (Y.M.); (F.Y.); (Y.R.)
- Institute of Laboratory Medicine, School of Medical Technology, Guangdong Medical University, Dongguan 523808, China
| | - Yuhe Ma
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China; (J.X.); (Y.L.); (Y.M.); (F.Y.); (Y.R.)
- Institute of Laboratory Medicine, School of Medical Technology, Guangdong Medical University, Dongguan 523808, China
| | - Fen Yang
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China; (J.X.); (Y.L.); (Y.M.); (F.Y.); (Y.R.)
- Institute of Laboratory Medicine, School of Medical Technology, Guangdong Medical University, Dongguan 523808, China
| | - Yongdui Ruan
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China; (J.X.); (Y.L.); (Y.M.); (F.Y.); (Y.R.)
| | - Jun-Fa Xu
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China; (J.X.); (Y.L.); (Y.M.); (F.Y.); (Y.R.)
- The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang 524023, China
| | - Jiang Pi
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China; (J.X.); (Y.L.); (Y.M.); (F.Y.); (Y.R.)
- Institute of Laboratory Medicine, School of Medical Technology, Guangdong Medical University, Dongguan 523808, China
- The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang 524023, China
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Wu C, Yi H, Hu Y, Luo D, Tang Z, Wen X, Zhang Y, Tang M, Zhang L, Wu S, Chen M. Effects of second-line anti-tuberculosis drugs on the intestinal microbiota of patients with rifampicin-resistant tuberculosis. Front Cell Infect Microbiol 2023; 13:1127916. [PMID: 37187470 PMCID: PMC10178494 DOI: 10.3389/fcimb.2023.1127916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/13/2023] [Indexed: 05/17/2023] Open
Abstract
Objective To determine the effects of second-line anti-tuberculosis (TB) drugs on the composition and functions of intestinal microbiota in patients with rifampicin-resistant TB (RR-TB). Methods In this cross-sectional study, stool samples and relevant clinical information were collected from patients with RR-TB admitted to the Drug-resistant Specialty Department at Hunan Chest Hospital (Hunan Institute For Tuberculosis Control). The composition and functions of intestinal microbiota were analyzed using metagenomic sequencing and bioinformatics methods. Results Altered structural composition of the intestinal microbiota was found when patients from the control, intensive phase treatment, and continuation phase treatment groups were compared (P<0.05). Second-line anti-TB treatment resulted in a decrease in the relative abundance of species, such as Prevotella copri, compared with control treatment. However, the relative abundance of Escherichia coli, Salmonella enterica, and 11 other conditionally pathogenic species increased significantly in the intensive phase treatment group. Based on differential functional analysis, some metabolism-related functions, such as the biosynthesises of phenylalanine, tyrosine, and tryptophan, were significantly inhibited during second-line anti-TB drug treatment, while other functions, such as phenylalanine metabolism, were significantly promoted during the intensive phase of treatment. Conclusion Second-line anti-TB drug treatment caused changes in the structural composition of the intestinal microbiota in patients with RR-TB. In particular, this treatment induced a significant increase in the relative abundance of 11 conditionally pathogenic species, including Escherichia coli. Functional analysis revealed significantly decreased biosynthesises of phenylalanine, tyrosine, and tryptophan and significantly increased phenylalanine metabolism.
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Affiliation(s)
- Chunli Wu
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Hengzhong Yi
- 6th Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
- *Correspondence: Hengzhong Yi,
| | - Yanmei Hu
- 6th Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
| | - Danlin Luo
- 6th Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
| | - Zhigang Tang
- 6th Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
| | - Xinmin Wen
- 6th Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
| | - Yong Zhang
- 6th Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
| | - Mi Tang
- 6th Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
| | - Lizhi Zhang
- Orthopedics and integration Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
| | - Shu Wu
- 6th Medical Department, Hunan Province Chest Hospital, Changsha, Hunan, China
| | - Mengshi Chen
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
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Zhao J, Gao S, Chen C, Li H, Wang S, Yu Y, Ming L. Screening and identification of differentially expressed long non-coding RNAs in multidrug-resistant tuberculosis. PeerJ 2022; 10:e12776. [PMID: 35111403 PMCID: PMC8772445 DOI: 10.7717/peerj.12776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/21/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Efforts to eradicate tuberculosis are largely threatened by drug-resistant tuberculosis, particularly, multidrug-resistant tuberculosis (MDR-TB). Screening and identification potential biomarkers for MDR-TB is crucial to diagnose early and reduce the incidence of MDR-TB. METHODS To screen the differentially expressed long non-coding RNAs in MDR-TB, the lncRNA and mRNA expression profiles in serum derived from healthy controls (HCs), individuals with MDR-TB and drug-sensitive tuberculosis (DS-TB) were analyzed by microarray assay and 10 lncRNAs were randomly selected for further validation by reverse transcription-quantitative real-time PCR(RT-qPCR). The biological functions of differentially expressed mRNAs as well as relationships between genes and signaling pathways were investigated using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG), respectively. RESULTS A total of 353 differentially expressed lncRNAs (312 upregulated) and 202 mRNAs (99 upregulated) were found in the MDR-TB group compared to HCs. And compared with the DS-TB group, 442 differentially expressed lncRNAs (115 upregulated) and 190 mRNAs (87 upregulated) were found in the MDR-TB group. The expression levels of lncRNA n335659 were found to differ significantly between each group by RT-qPCR. Compared with DS-TB group, the GO analysis showed that the differential mRNAs were mainly enriched in the processes associated with the detection of the chemical stimulus, the regulation of mRNA metabolic process and neutrophil activation in the MDR-TB group; the KEGG analysis indicated that the differential mRNAs between DS-TB and MDR-TB were mainly enriched in proteasome and Notch signaling pathway, which might reveal a fraction of the mechanism of MDR-TB. The discovery of the serum lncRNA n335659 might serve as a potential biomarker for MDR-TB and Notch signaling pathway provided a new clue for the investigation of the pathological mechanism of MDR-TB.
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Affiliation(s)
- Junwei Zhao
- Department of Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - ShuHui Gao
- Department of Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chunguang Chen
- Department of Clinical Laboratory, Henan Provincial Infectious Disease Hospital, Zhengzhou, China
| | - Hui Li
- Tuberculosis Reference Laboratory, Centers for Disease Control and Prevention of Henan Province, Zhengzhou, China
| | - Shaohua Wang
- Tuberculosis Reference Laboratory, Centers for Disease Control and Prevention of Henan Province, Zhengzhou, China
| | - Yongmin Yu
- Department of Clinical Laboratory, Henan Provincial Infectious Disease Hospital, Zhengzhou, China
| | - Liang Ming
- Department of Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Abdelouahab MS, Arama A, Lozi R. Bifurcation analysis of a model of tuberculosis epidemic with treatment of wider population suggesting a possible role in the seasonality of this disease. CHAOS (WOODBURY, N.Y.) 2021; 31:123125. [PMID: 34972319 DOI: 10.1063/5.0057635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
In this paper, a novel epidemiological model describing the evolution of tuberculosis in a human population is proposed. This model is of the form SEIR, where S stands for Susceptible people, E for Exposed (infected but not yet infectious) people, I for Infectious people, and R for Recovered people. The main characteristic of this model inspired from the disease biology and some realistic hypothesis is that the treatment is administered not only to infectious but also to exposed people. Moreover, this model is characterized by an open structure, as it considers the transfer of infected or infectious people to other regions more conducive to their care and accepts treatment for exposed or infectious patients coming from other regions without care facilities. Stability and bifurcation of the solutions of this model are investigated. It is found that saddle-focus bifurcation occurs when the contact parameter β passes through some critical values. The model undergoes a Hopf bifurcation when the quality of treatment r is considered as a bifurcation parameter. It is shown also that the system exhibits saddle-node bifurcation, which is a transcritical bifurcation between equilibrium points. Numerical simulations are done to illustrate these theoretical results. Amazingly, the Hopf bifurcation suggests an unexpected and never suggested explanation of seasonality of such a disease, linked to the quality of treatment.
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Affiliation(s)
- M-S Abdelouahab
- Laboratory of Mathematics and Their Interactions, Abdelhafid Boussouf University Center, Mila 43000, Algeria
| | - A Arama
- School of Mathematics and Statistics, Central South University, Changsha, Hunan 410083, People's Republic of China
| | - R Lozi
- Université Côte d'Azur, CNRS, LJAD, Nice 06108, France
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Lecai J, Mijiti P, Chuangyue H, Mingzhen L, Qian G, Weiguo T, Jihong C. Predictors and Trends of MDR/RR-TB in Shenzhen China: A Retrospective 2012-2020 Period Analysis. Infect Drug Resist 2021; 14:4481-4491. [PMID: 34737588 PMCID: PMC8558316 DOI: 10.2147/idr.s335329] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/07/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose We analyzed the trends and predictors of multidrug-resistant (MDR) or rifampicin-resistant (RR) tuberculosis (TB) in culture-positive cases in Shenzhen during 2012–2020, after the implementation of improved strategies (scale-up molecular drug susceptibility testing [mDST], expansion of DST eligibility, and generous reimbursement of MDR-TB outpatient care costs). Materials and Methods We retrospectively extracted and analyzed data from the TB Information System on drug-resistant pulmonary tuberculosis diagnosed in Shenzhen during the 2012–2020 period. We analyzed trends in RR- and MDR-TB rates in new cases during 2012–2018 and 2018–2020 periods, and among previously-treated cases during 2012–2017 and 2017–2020 periods, using Cochran-Armitage tests. We generated multivariate logistic regression models to analyze demographic predictors of MDR/RR-TB rates. Results We found 21,367 positive mycobacterial cultures in Shenzhen during the 2012–2020 period, and 19,951 (93.4%) were identified as Mycobacterium tuberculosis and had DST results (92.0% of those were mDST-based). Of these patients with DST results, 1630 (8.2%) were RR-TB, and 1142 (5.7%) were MDR-TB. Of the RR-TB, 70% were MDR-TB. The MDR/RR-TB rate in new TB cases increased significantly during the 2012–2018 period (Ptrend < 0.05), but it decreased in the 2018–2020 period (Ptrend > 0.05, with a significant trend for MDR-TB). Among previously treated cases, the temporal MDR/RR-TB rate trends did not differ significantly (Ptrend > 0.05). Our multivariate analysis showed that age younger than 30 years, housework service/unemployment, local residency, and previous TB treatment were all predictors of MDR/RR-TB. The percentage of patients with MDR-TB on treatment increased from 49.4% in 2012 to 70.5% in 2020. The treatment success rate of patients with MDR-TB during the 2012–2018 period was 71%. Conclusion During the study period in Shenzhen, the cases of MDR/RR-TB were detected, and the treatment enrollment increased and the MDR-TB rates decreased gradually after 2017. Decreasing trends may reflect the efficacy of improved strategies; however, their long-term impact on the MDR-TB burden remains to be investigated. The predictors of MDR-TB identified in our study should be considered when developing targeted MDR-TB control strategies.
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Affiliation(s)
- Ji Lecai
- Department of Nephrology, Affiliated Bao'an Hospital of Shenzhen, The Second School of Clinical Medicine, Southern Medical University, Shenzhen, Guangdong, 518101, People's Republic of China.,Department of Tuberculosis, Shenzhen Center for Chronic Disease Control, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Peierdun Mijiti
- The Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, School of Basic Medical Science, Fudan University, Shanghai, 200032, People's Republic of China
| | - Hong Chuangyue
- Department of Tuberculosis, Shenzhen Center for Chronic Disease Control, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Li Mingzhen
- Department of Tuberculosis, Shenzhen Center for Chronic Disease Control, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Gao Qian
- The Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, School of Basic Medical Science, Fudan University, Shanghai, 200032, People's Republic of China
| | - Tan Weiguo
- Department of Tuberculosis, Shenzhen Center for Chronic Disease Control, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Chen Jihong
- Department of Nephrology, Affiliated Bao'an Hospital of Shenzhen, The Second School of Clinical Medicine, Southern Medical University, Shenzhen, Guangdong, 518101, People's Republic of China
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11
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Wotale TW, Terefe AN, Fufa JA. Modeling Time to Death of Patients with Multidrug-Resistant Tuberculosis at Saint Peter's Specialized Hospital. J Res Health Sci 2021; 21:e00513. [PMID: 34465635 PMCID: PMC8957672 DOI: 10.34172/jrhs.2021.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/29/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Currently, the worldwide prevalence and incidence of multidrug-resistant tuberculosis (MDR-TB) is drastically increasing. The main objective of this study was modeling the time-to-death of patients with MDR-TB at St. Peter's Specialized Hospital, Addis Ababa, Ethiopia, by using various parametric shared frailty models. STUDY DESIGN A retrospective study design was used. METHODS The study population was TB patients with MDR at St. Peter's Specialized Hospital from January 2016 through December 2019. Exponential, Weibull, and log-normal were used as baseline hazard functions with the gamma and inverse Gaussian frailty distributions. All the models were compared based on Akaike's Information Criteria. RESULTS The overall median time to death was 11 months and 123 (33.5%) patients died. Patients who lived in rural areas had shorter survival time than those who lived in urban areas with an accelerated factor of 0.135 (P=0.002). Patients with a history of anti-TB drug consumption had a short survival time than those without such a history with an accelerated factor of 0.02 (P=0.001). The variability (heterogeneity) of time to death of patients in the region for the selected model (Weibull-inverse Gaussian shared frailty model) was =0.144 (P=0.027). CONCLUSION The MDR-TB patients with weight gain, khat and alcohol consumption, clinical complication of pneumothorax and pneumonia, extrapulmonary TB, and history of anti-TB drug consumption as well as those who lived in rural areas had a shorter survival time, compared to others. There was a significant heterogeneity effect in the St. Peter's Specialized Hospital. The best model for predicting the time to death of MDR-TB patients was Weibull-inverse Gaussian shared frailty model.
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Affiliation(s)
- Teramaj Wongel Wotale
- Department of Statistics, College of Natural Science, Mettu University, Mettu, Oromia, Ethiopia
| | - Abiyot Negash Terefe
- Department of Statistics, College of Natural Science, Jimma University, Jimma, Oromia, Ethiopia
| | - Jaleta Abdisa Fufa
- Department of Statistics, College of Natural Science, Jimma University, Jimma, Oromia, Ethiopia
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12
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Cutfield T, Mowlem L, Paynter J, Christmas T, Harrison A, Lewis C, Newton S, Nisbet M. Treatment and outcomes of Multidrug-resistant tuberculosis in Auckland 1995-2018. Intern Med J 2021; 52:1381-1386. [PMID: 33961727 DOI: 10.1111/imj.15341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/27/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION New Zealand has a low burden of tuberculosis, however multidrug-resistant tuberculosis (MDR-TB) still represents a challenge for clinicians. This is the first description of clinical aspects of MDR-TB in New Zealand. METHODS Clinical data were obtained for patients treated for MDR-TB at Auckland District Health Board (ADHB). RESULTS There were 60 patients nationally with MDR-TB between 1989 and 2018; 41/60 (69%) received care at ADHB. Pulmonary infection was present in 36/41 (88%) of patients, with 19/41 (46%) with smear-positive sputum (smear 1-2+ in 6/41, 15%; smear 3-4+ in 13/41, 32%). The median duration of treatment was 22 months (range 7.5-26) for 18/41 (44%) patients who completed MDR-TB treatment by August 2018. The median duration of amikacin treatment was 6 months (range 2-12) for the 23/38 (61%) in whom these data were available. All 38 patients who received treatment for MDR-TB experienced adverse effects, most commonly gastrointestinal (66%), neurologic (50%), ototoxicity (47%) and psychiatric (37%). Complications of intravenous access were experienced by 10/37 (27%) patients. Of the 19/41 (46%) patients who completed treatment, 18/19 (95%) achieved cure. There was one case who had recurrence who had inadequate treatment, and one case who had spontaneous resolution without treatment. Seventeen (41%) patients left Auckland prior to completion of treatment, mostly to return to their country of origin (15/17, 88%). CONCLUSION MDR-TB is uncommon in New Zealand. Treatment is frequently associated with adverse events, however rates of cure for people completing treatment in New Zealand are high. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tim Cutfield
- Department of Infectious Disease, Auckland City Hospital, Auckland, New Zealand.,Department of Respiratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Lydia Mowlem
- Department of Respiratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Jennifer Paynter
- Department of Respiratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Timothy Christmas
- Department of Respiratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Adrian Harrison
- Department of Respiratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Christopher Lewis
- Department of Respiratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Sandra Newton
- LabPlus, Auckland City Hospital, Auckland, New Zealand
| | - Mitzi Nisbet
- Department of Infectious Disease, Auckland City Hospital, Auckland, New Zealand.,Department of Respiratory Medicine, Auckland City Hospital, Auckland, New Zealand
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13
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Sharifi-Rad J, Salehi B, Stojanović-Radić ZZ, Fokou PVT, Sharifi-Rad M, Mahady GB, Sharifi-Rad M, Masjedi MR, Lawal TO, Ayatollahi SA, Masjedi J, Sharifi-Rad R, Setzer WN, Sharifi-Rad M, Kobarfard F, Rahman AU, Choudhary MI, Ata A, Iriti M. Medicinal plants used in the treatment of tuberculosis - Ethnobotanical and ethnopharmacological approaches. Biotechnol Adv 2020; 44:107629. [PMID: 32896577 DOI: 10.1016/j.biotechadv.2020.107629] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 06/22/2017] [Accepted: 07/05/2017] [Indexed: 01/02/2023]
Abstract
Tuberculosis is a highly infectious disease declared a global health emergency by the World Health Organization, with approximately one third of the world's population being latently infected with Mycobacterium tuberculosis. Tuberculosis treatment consists in an intensive phase and a continuation phase. Unfortunately, the appearance of multi drug-resistant tuberculosis, mainly due to low adherence to prescribed therapies or inefficient healthcare structures, requires at least 20 months of treatment with second-line, more toxic and less efficient drugs, i.e., capreomycin, kanamycin, amikacin and fluoroquinolones. Therefore, there exists an urgent need for discovery and development of new drugs to reduce the global burden of this disease, including the multi-drug-resistant tuberculosis. To this end, many plant species, as well as marine organisms and fungi have been and continue to be used in various traditional healing systems around the world to treat tuberculosis, thus representing a nearly unlimited source of active ingredients. Besides their antimycobacterial activity, natural products can be useful in adjuvant therapy to improve the efficacy of conventional antimycobacterial therapies, to decrease their adverse effects and to reverse mycobacterial multi-drug resistance due to the genetic plasticity and environmental adaptability of Mycobacterium. However, even if some natural products have still been investigated in preclinical and clinical studies, the validation of their efficacy and safety as antituberculosis agents is far from being reached, and, therefore, according to an evidence-based approach, more high-level randomized clinical trials are urgently needed.
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Affiliation(s)
- Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zorica Z Stojanović-Radić
- Department of Biology and Ecology, Faculty of Science and Mathematics, University of Niš, Višegradska 33, Niš, Serbia
| | - Patrick Valere Tsouh Fokou
- Department of Clinical Pathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra LG 581, Ghana; Antimicrobial Agents Unit, LPMPS, Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé 812, Cameroon
| | - Marzieh Sharifi-Rad
- Department of Chemistry, Faculty of Science, University of Zabol, Zabol, Iran
| | - Gail B Mahady
- Department of Pharmacy Practice, Clinical Pharmacognosy Laboratories, University of Illinois at Chicago, USA
| | - Majid Sharifi-Rad
- Department of Range and Watershed Management, Faculty of Natural Resources, University of Zabol, Zabol, Iran
| | - Mohammad-Reza Masjedi
- Tobacco Control Strategic Research Center, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Temitope O Lawal
- Department of Pharmacy Practice, Clinical Pharmacognosy Laboratories, University of Illinois at Chicago, USA; Department of Pharmaceutical Microbiology, University of Ibadan, Ibadan, Nigeria
| | - Seyed Abdulmajid Ayatollahi
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Javid Masjedi
- Tobacco Control Strategic Research Center, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Razieh Sharifi-Rad
- Department of Biology, Faculty of Science, University of Zabol, Zabol, Iran
| | - William N Setzer
- Department of Chemistry, University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Mehdi Sharifi-Rad
- Department of Medical Parasitology, Zabol University of Medical Sciences, 61663335 Zabol, Iran.
| | - Farzad Kobarfard
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Iran
| | - Atta-Ur Rahman
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Muhammad Iqbal Choudhary
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Athar Ata
- Department of Chemistry, Richardson College for the Environmental Science Complex The University of Winnipeg, Winnipeg, Canada
| | - Marcello Iriti
- Department of Agricultural and Environmental Sciences, Milan State University, via G. Celoria 2, Milan 20133, Italy.
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14
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Yaghubi Kalurazi T, Jafari A. Evaluation of magnesium oxide and zinc oxide nanoparticles against multi-drug-resistance Mycobacterium tuberculosis. Indian J Tuberc 2020; 68:195-200. [PMID: 33845951 DOI: 10.1016/j.ijtb.2020.07.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 07/28/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The current study has evaluated the MICs and MBCs of ZnONPs, MgONPs, and MgONPs-ZnONPs against H37Rv Mtb and MDR-Mtb. METHODS Mixture, magnesium oxide nanoparticles (NPs) and zinc oxide (MgONPs-ZnONPs) were prepared. The microplate alamar blue (MABA) assay and the proportion method were used to evaluate of anti-tubercular activity against MDR-MTB. MTT test was done to MgONPs-ZnONPs against Vero and HepG2 cell lines. RESULTS The MIC of MgONPs and ZnONPs were 0.195 and 0.468 μg mL-1 against 104 of H37Rv Mtb. As well, 0.166 μg mL-1 of MgONPs-ZnONPs was able to inhibit 10-4 H37Rv Mtb. The MIC of MgONPs against 104 concentrations of MDR-Mtb was 12.5 μg mL-1. The MIC of MgONPs/ZnONPs against 104 concentrations of MDR-Mtb reached to 0.664 μg mL-1. The MBC value of ZnONPs increased to 1.875 μg mL-1 against 10-4 concentrations of MDR-Mtb. Testing showed that the MBCs of MgONPs/ZnONPs reached to 1.328 μg mL-1 against 104 concentrations of MDR-Mtb. The IC50 against MDR-TB was 0.779 μg mL-1 for ZnONPs and 0.883 μg mL-1 for MgONPs-ZnONPs. The MgONPs-ZnONPs was not toxic to Vero cell lines however ZnONPs could inhibit the Vero and HepG2 cell lines. CONCLUSION We found that ZnONPs and mixture MgONPs-ZnONPs not only have higher bactericide behavior but might have also synergistic effects against MDR-TB.
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Affiliation(s)
- Tofigh Yaghubi Kalurazi
- Department of Health, Nutrition & Infectious Diseases, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Jafari
- Inflammatory Lung Disease Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
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15
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Tekalegn Y, Woldeyohannes D, Assefa T, Aman R, Sahiledengle B. Predictors of Time to Sputum Culture Conversion Among Drug-Resistant Tuberculosis Patients in Oromia Region Hospitals, Ethiopia. Infect Drug Resist 2020; 13:2547-2556. [PMID: 32821129 PMCID: PMC7419643 DOI: 10.2147/idr.s250878] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 06/17/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose Multi-drug-resistant tuberculosis occurs when the tuberculosis bacteria develop resistance to at least the two most effective first-line anti-tuberculosis drugs, isoniazid and rifampicin. Sputum culture conversion is one of the indicators to monitor patients’ prognosis throughout the treatment. Hence, this study aimed to assess time to culture conversion and its determinants among drug-resistant tuberculosis patients. Patients and Methods A total of 228 drug-resistant tuberculosis patients in selected hospitals in Oromia region, Ethiopia, were included in this study. Descriptive statistics like median time to sputum smear and culture conversion were computed. Bivariate and multivariate Cox proportional hazard models were used to identify the independent predictors of time to culture conversion. The adjusted hazard ratio (AHR) with 95% confidence interval (CI) was used to report the strength of association. Statistical significance was declared at p <0.05. Results The median age of the study participants was 28 years with inter-quartile range of (IQR) of 22–32 years, and 60% of the patients were male. The median time to culture conversion was 61 days (IQR: 34–92 days). The proportion of sputum culture conversion at 2nd, 4th, and 6th months of treatment initiation was 47%, 82.5%, and 89%, respectively. The final adjusted multivariate Cox proportional hazard model revealed that patients with massive effusion on chest radiographic finding had a 60%-decreased culture conversion time (AHR: 0.4, 95% CI: 0.1–0.9). Patients with abnormalities without cavitations (AHR: 0.5, 95% CI: 0.2–0.9) and those with uninterpreted findings (AHR: 0.3 95% CI: 0.1–0.5) had delayed culture conversion time. Conclusion Chest radiographic findings such as massive effusion, abnormalities without cavitations, and uninterpreted findings were found to be predictors of time to sputum culture conversion. Patients with such characteristics have prolonged culture conversion time. Hence, they may need special attention during the treatment.
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Affiliation(s)
- Yohannes Tekalegn
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Demelash Woldeyohannes
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Tesfaye Assefa
- Department of Nursing, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Rameto Aman
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
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16
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Letang E, Ellis J, Naidoo K, Casas EC, Sánchez P, Hassan-Moosa R, Cresswell F, Miró JM, García-Basteiro AL. Tuberculosis-HIV Co-Infection: Progress and Challenges After Two Decades of Global Antiretroviral Treatment Roll-Out. Arch Bronconeumol 2020; 56:446-454. [PMID: 35373756 DOI: 10.1016/j.arbr.2019.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/02/2019] [Indexed: 06/14/2023]
Abstract
Despite wide antiretroviral scale-up during the past two decades resulting in declining new infections and mortality globally, HIV-associated tuberculosis remains as a major public health concern. Tuberculosis is the leading HIV-associated opportunistic infection and the main cause of death globally and, particularly, in resource-limited settings. Several challenges exist regarding diagnosis, global implementation of latent tuberculosis treatment, management of active tuberculosis, delivery of optimal patient-centered TB and HIV prevention and care in high burden countries. In this article we review the advances on pathogenesis, diagnosis, and treatment after nearly two decades of global roll-out of antiretroviral therapy and discuss the current challenges for the global control of tuberculosis-HIV co-infection.
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Affiliation(s)
- Emilio Letang
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Infectious Diseases Department, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain.
| | - Jayne Ellis
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Hospital for Tropical Diseases, University College London, London, UK
| | - Kogieleum Naidoo
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; MRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, South Africa
| | - Esther C Casas
- Southern Africa Medical Unit, Médecins sans Frontières, Cape Town, South Africa
| | - Paquita Sánchez
- Infectious Diseases Department, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain
| | - Razia Hassan-Moosa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; MRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, South Africa
| | - Fiona Cresswell
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK; MRC-UVRI-London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Jose M Miró
- Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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17
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Baral B, Mozafari MR. Strategic Moves of "Superbugs" Against Available Chemical Scaffolds: Signaling, Regulation, and Challenges. ACS Pharmacol Transl Sci 2020; 3:373-400. [PMID: 32566906 PMCID: PMC7296549 DOI: 10.1021/acsptsci.0c00005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Indexed: 12/12/2022]
Abstract
Superbugs' resistivity against available natural products has become an alarming global threat, causing a rapid deterioration in public health and claiming tens of thousands of lives yearly. Although the rapid discovery of small molecules from plant and microbial origin with enhanced bioactivity has provided us with some hope, a rapid hike in the resistivity of superbugs has proven to be the biggest therapeutic hurdle of all times. Moreover, several distinct mechanisms endowed by these notorious superbugs make them immune to these antibiotics subsequently causing our antibiotic wardrobe to be obsolete. In this unfortunate situation, though the time frame for discovering novel "hit molecules" down the line remains largely unknown, our small hope and untiring efforts injected in hunting novel chemical scaffolds with unique molecular targets using high-throughput technologies may safeguard us against these life-threatening challenges to some extent. Amid this crisis, the current comprehensive review highlights the present status of knowledge, our search for bacteria Achilles' heel, distinct molecular signaling that an opportunistic pathogen bestows to trespass the toxicity of antibiotics, and facile strategies and appealing therapeutic targets of novel drugs. Herein, we also discuss multidimensional strategies to combat antimicrobial resistance.
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Affiliation(s)
- Bikash Baral
- Department
of Biochemistry, University of Turku, Tykistökatu 6, Turku, Finland
| | - M. R. Mozafari
- Australasian
Nanoscience and Nanotechnology Initiative, 8054 Monash University LPO, Clayton, Victoria 3168, Australia
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18
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Li BY, Shi WP, Zhou CM, Zhao Q, Diwan VK, Zheng XB, Li Y, Hoffner S, Xu B. Rising challenge of multidrug-resistant tuberculosis in China: a predictive study using Markov modeling. Infect Dis Poverty 2020; 9:65. [PMID: 32513262 PMCID: PMC7281937 DOI: 10.1186/s40249-020-00682-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/28/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Multidrug-resistant tuberculosis (MDR-TB) is on the rise in China. This study used a dynamic Markov model to predict the longitudinal trends of MDR-TB in China by 2050 and to assess the effects of alternative control measures. METHODS Eight states of tuberculosis transmission were set up in the Markov model using a hypothetical cohort of 100 000 people. The prevalence of MDR-TB and bacteriologically confirmed drug-susceptible tuberculosis (DS-TB+) were simulated and MDR-TB was stratified into whether the disease was treated with the recommended regimen or not. RESULTS Without any intervention changes to current conditions, the prevalence of DS-TB+ was projected to decline 67.7% by 2050, decreasing to 20 per 100 000 people, whereas that of MDR-TB was expected to triple to 58/100 000. Furthermore, 86.2% of the MDR-TB cases would be left untreated by the year of 2050. In the case where MDR-TB detection rate reaches 50% or 70% at 5% per year, the decline in prevalence of MDR-TB would be 25.9 and 36.2% respectively. In the case where treatment coverage was improved to 70% or 100% at 5% per year, MDR-TB prevalence in 2050 would decrease by 13.8 and 24.1%, respectively. If both detection rate and treatment coverage reach 70%, the prevalence of MDR-TB by 2050 would be reduced to 28/100 000 by a 51.7% reduction. CONCLUSIONS MDR-TB, especially untreated MDR-TB, would rise rapidly under China's current MDR-TB control strategies. Interventions designed to promote effective detection and treatment of MDR-TB are imperative in the fights against MDR-TB epidemics.
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Affiliation(s)
- Bing-Ying Li
- School of Public Health, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment (Fudan University), National Health Commission, Shanghai, China
| | - Wen-Pei Shi
- School of Public Health, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment (Fudan University), National Health Commission, Shanghai, China
| | - Chang-Ming Zhou
- School of Public Health, Fudan University, Shanghai, China
- Department of Cancer prevention, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qi Zhao
- School of Public Health, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment (Fudan University), National Health Commission, Shanghai, China
| | - Vinod K Diwan
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Xu-Bin Zheng
- School of Public Health, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment (Fudan University), National Health Commission, Shanghai, China
| | - Yang Li
- School of Public Health, Fudan University, Shanghai, China
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Sven Hoffner
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Biao Xu
- School of Public Health, Fudan University, Shanghai, China.
- Key Lab of Health Technology Assessment (Fudan University), National Health Commission, Shanghai, China.
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden.
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19
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Lubanyana H, Arvidsson PI, Govender T, Kruger HG, Naicker T. Improved Synthesis and Isolation of Bedaquiline. ACS OMEGA 2020; 5:3607-3611. [PMID: 32118176 PMCID: PMC7045498 DOI: 10.1021/acsomega.9b04037] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/10/2020] [Indexed: 05/02/2023]
Abstract
Bedaquiline (BDQ) is the most critical pharmaceutical in the world for treating multidrug-resistant Mycobacterium tuberculosis. Despite it being highly effective, BDQ asymmetric synthesis remains a challenge. Herein, the influence of chiral bases, namely, bis(1-phenylethyl)amine, bisoxazoline, and sparteine on the diastereoselective lithiation reaction to obtain BDQ was investigated. The highest diastereoselective ratio (dr) emerged as 90:10 from the (+)-bis[(R)-1-phenylethyl] lithium amide. This is a significant improvement from the 50:50 dr achieved from the commercial synthesis. Thereafter, the desired (90:10 RS, SR) diastereomeric mixture was easily isolated via a gravity column and subjected to chiral supercritical fluid chromatography (SFC) to access the desired enantiomer (1R, 2S)-BDQ. The advantages of this procedure are enhanced diastereoselection as well as a greener, faster way to achieve excellent enantioseparation (up to 1.0 g scale).
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Affiliation(s)
- Hlengekile Lubanyana
- Catalysis
and Peptide Research Unit, University of
KwaZulu-Natal, Durban 4000, South Africa
| | - Per I. Arvidsson
- Catalysis
and Peptide Research Unit, University of
KwaZulu-Natal, Durban 4000, South Africa
- Science
for Life Laboratory, Drug Discovery & Development Platform &
Division of Translational Medicine, and Chemical Biology, Department
of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm 17177, Sweden
| | - Thavendran Govender
- Catalysis
and Peptide Research Unit, University of
KwaZulu-Natal, Durban 4000, South Africa
| | - Hendrik G. Kruger
- Catalysis
and Peptide Research Unit, University of
KwaZulu-Natal, Durban 4000, South Africa
| | - Tricia Naicker
- Catalysis
and Peptide Research Unit, University of
KwaZulu-Natal, Durban 4000, South Africa
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20
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Ivanchenko DA, Hrytsenko LM. In vitro synergy testing of prodigiosin in combination with inhibitors of cell wall synthesis against Mycobacterium smegmatis. REGULATORY MECHANISMS IN BIOSYSTEMS 2020. [DOI: 10.15421/022019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The cell wall is not a target of currently used therapeutics as Mycobacterium are considered naturally resistant to most β-lactam antibiotics. Therefore, combinations of conventional antibiotics with antibiotic activity-enhancing compounds offer a productive treatment strategy and address the widespread emergence of antibiotic-resistant strains. The first area of research was the study of a comparative analysis of disk diffusion testing and the broth dilution method for evaluating the susceptibility of M. smegmatis to antimicrobial agents. A comparative analysis of the susceptibility to antimicrobial agents alone showed that M. smegmatis was the most susceptible to ceftriaxone and kanamycin, and moderately sensitive to vancomycin and prodigiosin. Compared to the susceptibility of the antibacterial combinations, the isolate was not susceptible to antibacterial combinations with prodigiosin in disk diffusion testing. The second area of research was the study of the synergic activity of prodigiosin of S. marcescens and inhibitors of cell wall synthesis manifested by their simultaneous effect on M. smegmatis. The greatest increase in the sensitivity of test-culture of mycobacteria occurred with ampicillin, benzylpenicillin, cephazolin and ceftriaxone in combination with prodigiosin of S. marcescens. The presented combination of antibiotics and prodigiosin reduce the required concentration of the antibiotic and by amplifying the effect of compounds inhibiting cell wall synthesis, thereby giving lower FICI values. These data indicate the possibility of using prodigiosin as a promising candidate for the development of "accompaniment-preparations" for antibiotics for the additional therapy of infectious diseases caused by Mycobacterium spp. and can suspend the likelihood of developing resistance to antibiotics.
The cell wall is not a target of currently used therapeutics as Mycobacterium are considered naturally resistant to most β-lactam antibiotics. Therefore, combinations of conventional antibiotics with antibiotic activity-enhancing compounds offer a productive treatment strategy and address the widespread emergence of antibiotic-resistant strains. The first area of research was the study of a comparative analysis of disk diffusion testing and the broth dilution method for evaluating the susceptibility of M. smegmatis to antimicrobial agents. A comparative analysis of the susceptibility to antimicrobial agents alone showed that M. smegmatis was the most susceptible to ceftriaxone and kanamycin, and moderately sensitive to vancomycin and prodigiosin. Compared to the susceptibility of the antibacterial combinations, the isolate was not susceptible to antibacterial combinations with prodigiosin in disk diffusion testing. The second area of research was the study of the synergic activity of prodigiosin of S. marcescens and inhibitors of cell wall synthesis manifested by their simultaneous effect on M. smegmatis. The greatest increase in the sensitivity of test-culture of mycobacteria occurred with ampicillin, benzylpenicillin, cephazolin and ceftriaxone in combination with prodigiosin of S. marcescens. The presented combination of antibiotics and prodigiosin reduce the required concentration of the antibiotic and by amplifying the effect of compounds inhibiting cell wall synthesis, thereby giving lower FICI values. These data indicate the possibility of using prodigiosin as a promising candidate for the development of "accompaniment-preparations" for antibiotics for the additional therapy of infectious diseases caused by Mycobacterium spp. and can suspend the likelihood of developing resistance to antibiotics.
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Letang E, Ellis J, Naidoo K, Casas EC, Sánchez P, Hassan-Moosa R, Cresswell F, Miró JM, García-Basteiro AL. Tuberculosis-HIV Co-Infection: Progress and Challenges After Two Decades of Global Antiretroviral Treatment Roll-Out. Arch Bronconeumol 2020. [PMID: 31932150 DOI: 10.1016/j.arbres.2019.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Despite wide antiretroviral scale-up during the past two decades resulting in declining new infections and mortality globally, HIV-associated tuberculosis remains as a major public health concern. Tuberculosis is the leading HIV-associated opportunistic infection and the main cause of death globally and, particularly, in resource-limited settings. Several challenges exist regarding diagnosis, global implementation of latent tuberculosis treatment, management of active tuberculosis, delivery of optimal patient-centered TB and HIV prevention and care in high burden countries. In this article we review the advances on pathogenesis, diagnosis, and treatment after nearly two decades of global roll-out of antiretroviral therapy and discuss the current challenges for the global control of tuberculosis-HIV co-infection.
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Affiliation(s)
- Emilio Letang
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Infectious Diseases Department, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain.
| | - Jayne Ellis
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Hospital for Tropical Diseases, University College London, London, UK
| | - Kogieleum Naidoo
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; MRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, South Africa
| | - Esther C Casas
- Southern Africa Medical Unit, Médecins sans Frontières, Cape Town, South Africa
| | - Paquita Sánchez
- Infectious Diseases Department, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain
| | - Razia Hassan-Moosa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; MRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, South Africa
| | - Fiona Cresswell
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK; MRC-UVRI-London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Jose M Miró
- Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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Munawar A, Schirhagl R, Rehman A, Shaheen A, Taj A, Bano K, Bassous NJ, Webster TJ, Khan WS, Bajwa SZ. Facile in situ generation of bismuth tungstate nanosheet-multiwalled carbon nanotube composite as unconventional affinity material for quartz crystal microbalance detection of antibiotics. JOURNAL OF HAZARDOUS MATERIALS 2019; 373:50-59. [PMID: 30903956 DOI: 10.1016/j.jhazmat.2019.03.054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 03/04/2019] [Accepted: 03/12/2019] [Indexed: 06/09/2023]
Abstract
Overuse and thus a constant presence of antibiotics leads to various environmental hazards and health risks. Thus, accurate sensors are required to determine their presence. In this work, we present a mass-sensitive sensor for the detection of rifampicin. We chose this molecule as it is an important antibiotic for tuberculosis, one of the leading causes of deaths worldwide. Herein, we have prepared a carbon nanotube reinforced with bismuth tungstate nanocomposite material in a well-defined nanosheet morphology using a facile in situ synthesis mechanism. Morphological characterization revealed the presence of bismuth tungstate in the form of square nanosheets embedded in the intricate network of carbon nanotubes, resulting in higher surface roughness of the nanocomposite. The synergy of the composite, so formed, manifested a high affinity for rifampicin as compared to the individual components of the composite. The developed sensor possessed a high sensitivity toward rifampicin with a detection limit of 0.16 μM and excellent specificity, as compared to rifabutin and rifapentine. Furthermore, the sensor yielded statistically good recoveries for the monitoring of rifampicin in human urine samples. This work opens up a new horizon for the exploration of unconventional nanomaterials bearing different morphologies for the detection of pharmaceuticals.
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Affiliation(s)
- Anam Munawar
- National Institute for Biotechnology and Genetic Engineering (NIBGE), P.O. Box No.577, Jhang Road, Faisalabad, Pakistan; University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, Antonius Deusinglaan 1, 9712AW Groningen, Netherlands; Pakistan Institute of Engineering and Applied Sciences, Nilore, Islamabad, Pakistan
| | - Romana Schirhagl
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, Antonius Deusinglaan 1, 9712AW Groningen, Netherlands
| | - Abdul Rehman
- Chemistry Department, King Fahd University of Petroleum and Minerals (KFUPM), Dhahran 31261, Saudi Arabia
| | - Ayesha Shaheen
- National Institute for Biotechnology and Genetic Engineering (NIBGE), P.O. Box No.577, Jhang Road, Faisalabad, Pakistan; Pakistan Institute of Engineering and Applied Sciences, Nilore, Islamabad, Pakistan
| | - Ayesha Taj
- National Institute for Biotechnology and Genetic Engineering (NIBGE), P.O. Box No.577, Jhang Road, Faisalabad, Pakistan; Pakistan Institute of Engineering and Applied Sciences, Nilore, Islamabad, Pakistan
| | - Khizra Bano
- National Institute for Biotechnology and Genetic Engineering (NIBGE), P.O. Box No.577, Jhang Road, Faisalabad, Pakistan; Pakistan Institute of Engineering and Applied Sciences, Nilore, Islamabad, Pakistan; Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Nicole J Bassous
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Thomas J Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Waheed S Khan
- National Institute for Biotechnology and Genetic Engineering (NIBGE), P.O. Box No.577, Jhang Road, Faisalabad, Pakistan; Nanobiomaterials Group, Ningbo Institute of Materials Technology and Engineering (NIMTE), Chinese Academy of Sciences (CAS), Ninbgo City, Zhejiang, China.
| | - Sadia Z Bajwa
- National Institute for Biotechnology and Genetic Engineering (NIBGE), P.O. Box No.577, Jhang Road, Faisalabad, Pakistan.
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Kishk SM, McLean KJ, Sood S, Smith D, Evans JW, Helal MA, Gomaa MS, Salama I, Mostafa SM, de Carvalho LPS, Levy CW, Munro AW, Simons C. Design and Synthesis of Imidazole and Triazole Pyrazoles as Mycobacterium Tuberculosis CYP121A1 Inhibitors. ChemistryOpen 2019; 8:995-1011. [PMID: 31367508 PMCID: PMC6646865 DOI: 10.1002/open.201900227] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Indexed: 12/31/2022] Open
Abstract
The emergence of untreatable drug-resistant strains of Mycobacterium tuberculosis is a major public health problem worldwide, and the identification of new efficient treatments is urgently needed. Mycobacterium tuberculosis cytochrome P450 CYP121A1 is a promising drug target for the treatment of tuberculosis owing to its essential role in mycobacterial growth. Using a rational approach, which includes molecular modelling studies, three series of azole pyrazole derivatives were designed through two synthetic pathways. The synthesized compounds were biologically evaluated for their inhibitory activity towards M. tuberculosis and their protein binding affinity (K D). Series 3 biarylpyrazole imidazole derivatives were the most effective with the isobutyl (10 f) and tert-butyl (10 g) compounds displaying optimal activity (MIC 1.562 μg/mL, K D 0.22 μM (10 f) and 4.81 μM (10 g)). The spectroscopic data showed that all the synthesised compounds produced a type II red shift of the heme Soret band indicating either direct binding to heme iron or (where less extensive Soret shifts are observed) putative indirect binding via an interstitial water molecule. Evaluation of biological and physicochemical properties identified the following as requirements for activity: LogP >4, H-bond acceptors/H-bond donors 4/0, number of rotatable bonds 5-6, molecular volume >340 Å3, topological polar surface area <40 Å2.
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Affiliation(s)
- Safaa M. Kishk
- School of Pharmacy & Pharmaceutical SciencesCardiff UniversityKing Edward VII AvenueCardiffCF10 3NBU.K.
- Medicinal Chemistry Department, Faculty of PharmacySuez Canal UniversityIsmailiaEgypt
| | - Kirsty J. McLean
- Manchester Institute of Biotechnology, School of ChemistryUniversity of Manchester131 Princess StreetManchesterM1 7DNU.K.
| | - Sakshi Sood
- Mycobacterial Metabolism and Antibiotic Research LaboratoryThe Francis Crick Institute1 Midland RoadLondonNW1 1ATU.K.
| | - Darren Smith
- School of Pharmacy & Pharmaceutical SciencesCardiff UniversityKing Edward VII AvenueCardiffCF10 3NBU.K.
| | - Jack W.D. Evans
- School of Pharmacy & Pharmaceutical SciencesCardiff UniversityKing Edward VII AvenueCardiffCF10 3NBU.K.
| | - Mohamed A. Helal
- Medicinal Chemistry Department, Faculty of PharmacySuez Canal UniversityIsmailiaEgypt
- Biomedical Sciences ProgramUniversity of Science and Technology Zewail City of Science and TechnologyGiza12588Egypt
| | - Mohamed S. Gomaa
- Medicinal Chemistry Department, Faculty of PharmacySuez Canal UniversityIsmailiaEgypt
- Department of Chemistry College of Clinical PharmacyImam Abdulrahman Bin Faisal UniversityDammamKingdom of Saudi Arabia
| | - Ismail Salama
- Medicinal Chemistry Department, Faculty of PharmacySuez Canal UniversityIsmailiaEgypt
| | - Samia M. Mostafa
- Medicinal Chemistry Department, Faculty of PharmacySuez Canal UniversityIsmailiaEgypt
| | - Luiz Pedro S. de Carvalho
- Mycobacterial Metabolism and Antibiotic Research LaboratoryThe Francis Crick Institute1 Midland RoadLondonNW1 1ATU.K.
| | - Colin W. Levy
- Manchester Institute of Biotechnology, School of ChemistryUniversity of Manchester131 Princess StreetManchesterM1 7DNU.K.
| | - Andrew W. Munro
- Manchester Institute of Biotechnology, School of ChemistryUniversity of Manchester131 Princess StreetManchesterM1 7DNU.K.
| | - Claire Simons
- School of Pharmacy & Pharmaceutical SciencesCardiff UniversityKing Edward VII AvenueCardiffCF10 3NBU.K.
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Discovery of (3-Benzyl-5-hydroxyphenyl)carbamates as New Antitubercular Agents with Potent In Vitro and In Vivo Efficacy. Molecules 2019; 24:molecules24102021. [PMID: 31137832 PMCID: PMC6572244 DOI: 10.3390/molecules24102021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/17/2019] [Accepted: 05/24/2019] [Indexed: 11/24/2022] Open
Abstract
A series of 3-amino-5-benzylphenol derivatives were designed and synthesized. Among them, (3-benzyl-5-hydroxyphenyl)carbamates were found to exert good inhibitory activity against M. tuberculosis H37Ra, H37Rv and clinically isolated multidrug-resistant M. tuberculosis strains (MIC = 0.625–6.25 μg/mL). The privileged compounds 3i and 3l showed moderate cytotoxicity against cell line A549. Compound 3l also exhibited potent in vivo inhibitory activity on a mouse infection model via the oral administration. The results demonstrated 3-hydroxyphenylcarbamates as a class of new antitubercular agents with good potential.
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Yang Z, Zhou C, Ning Z, Lu W, Zhao Q, Hu Y, Diwan VK, Xu B. High-risk screening and detection of multidrug-resistant tuberculosis in two prefectures of China: a drug susceptibility surveillance-based secondary data analysis. Glob Health Action 2019; 11:1500763. [PMID: 30203719 PMCID: PMC6136353 DOI: 10.1080/16549716.2018.1500763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND In China, less than one-fifth of multidrug-resistant tuberculosis (MDR-TB) cases are detected. MDR-TB screening is conducted amongst the following five high-risk groups of TB patients: chronic cases, close contacts of MDR-TB patients, patients with treatment failure, relapsed and returned patients, and smear-positive patients at the end of the third month of initial treatment. OBJECTIVE To estimate the possibility of detecting MDR-TB cases if only the high-risk screening strategy is applied in China. METHODS A secondary analysis was applied to the surveillance-based longitudinal data of all sputum smear-positive TB patients in Prefecture E and Prefecture W of China from 2013 to 2015. The population attributable risk (PAR) was estimated using odds ratios for five risk factors/predictors and exposure proportions amongst all MDR-TB cases. RESULTS A total of 3513 TB patients (2807 from Prefecture E and 706 from Prefecture W) were included. Males accounted for 77.91% (2737/3513) of the patients. The average age was 52.5 ± 20.0 years old. Overall, 40.34% (71/176) of MDR-TB patients were from the five high-risk groups during the three-year study period. The detected proportion of MDR-TB cases using the high-risk screening strategy was significantly higher in Prefecture E than in Prefecture W. The PAR% for all five risk factors/predictors was 43.4% (95% CI: 24.6-61.7%), 49.9% (95% CI: 31.3-67.0%), and 30.3% (95% CI: 12.9-50.1%) in Prefecture E and 36.6% (95% CI: 10.4-64.5%), 13.3% (95% CI: -1.7-39.7%), and -82.5% (95% CI: -117.5--11.2%) in Prefecture W in 2013, 2014, and 2015, respectively. The PAR% for the five specific risk factors/predictors ranged from 0.4% (95% CI: -0.2-4.8%) to 21.0% (95% CI: 13.1-30.0%) in these two prefectures. CONCLUSION In general, a high-risk screening strategy would miss more than half of the MDR-TB patients because they do not belong to the five high-risk groups.
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Affiliation(s)
- Zhiqi Yang
- a Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education) , Fudan University , Shanghai , PR China
| | - Changming Zhou
- b Department of cancer prevention , Fudan University Shanghai Cancer Center , Shanghai , PR China
| | - Zhu Ning
- c Zigong Center for Disease Control and Prevention , Zigong , Sichuan , PR China
| | - Wei Lu
- d Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu , PR China
| | - Qi Zhao
- a Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education) , Fudan University , Shanghai , PR China
| | - Yi Hu
- a Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education) , Fudan University , Shanghai , PR China
| | - Vinod K Diwan
- e Department of Public Health Sciences (Global Health/IHCAR) , Karolinska Institutet , Stockholm , Sweden
| | - Biao Xu
- a Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education) , Fudan University , Shanghai , PR China
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Haufroid M, Wouters J. Targeting the Serine Pathway: A Promising Approach against Tuberculosis? Pharmaceuticals (Basel) 2019; 12:E66. [PMID: 31052291 PMCID: PMC6630544 DOI: 10.3390/ph12020066] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 12/22/2022] Open
Abstract
Tuberculosis is still the leading cause of death by a single infectious agent. Effective chemotherapy has been used and improved since the 1950s, but strains resistant to this therapy and most antibacterial drugs on the market are emerging. Only 10 new drugs are in clinical trials, and two of them have already demonstrated resistance. This paper gives an overview of current treatment options against tuberculosis and points out a promising approach of discovering new effective drugs. The serine production pathway is composed of three enzymes (SerA1, SerC and SerB2), which are considered essential for bacterial growth, and all of them are considered as a therapeutic drug target. Their crystal structure are described and essential regulatory domains pointed out. Sequence alignment with similar enzymes in other host would help to identify key residues to target in order to achieve selective inhibition. Currently, only inhibitors of SerB2 are described in the literature. However, inhibitors of human enzymes are discussed, and could be used as a good starting point for a drug discovery program. The aim of this paper is to give some guidance for the design of new hits for every enzyme in this pathway.
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Affiliation(s)
- Marie Haufroid
- Laboratoire de Chimie Biologique Structurale (CBS), Namur Medicine and Drug Innovation Center (Namedic), Namur Research Institute for Life Sciences (NARILIS), University of Namur (UNamur), B-5000 Namur, Belgium.
| | - Johan Wouters
- Laboratoire de Chimie Biologique Structurale (CBS), Namur Medicine and Drug Innovation Center (Namedic), Namur Research Institute for Life Sciences (NARILIS), University of Namur (UNamur), B-5000 Namur, Belgium.
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Sweeney L, McCloskey AP, Higgins G, Ramsey JM, Cryan SA, MacLoughlin R. Effective nebulization of interferon-γ using a novel vibrating mesh. Respir Res 2019; 20:66. [PMID: 30943978 PMCID: PMC6448243 DOI: 10.1186/s12931-019-1030-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interferon gamma (IFN-γ) is a clinically relevant immunomodulatory cytokine that has demonstrated significant potential in the treatment and management of respiratory diseases such as tuberculosis and pulmonary fibrosis. As with all large biomolecules, clinical translation is dependent on effective delivery to the disease site and delivery of IFN-γ as an aerosol offers a logical means of drug targeting. Effective localization is often hampered by instability and a lack of safe and efficient delivery systems. The present study sought to determine how effectively IFN-γ can be nebulized using two types of vibrating mesh nebulizer, each with differing mesh architectures, and to investigate the comparative efficiency of delivery of therapeutically active IFN-γ to the lungs. METHODS Nebulization of IFN-γ was carried out using two different Aerogen vibrating mesh technologies with differing mesh architectures. These technologies represent both a standard commercially available mesh type (Aerogen Solo®) and a new iteration mesh (Photo-defined aperture plate (PDAP®). Extensive aerosol studies (aerosol output and droplet analysis, non-invasive and invasive aerosol therapy) were conducted in line with regulatory requirements and characterization of the stability and bioactivity of the IFN-γ post-nebulization was confirmed using SDS-PAGE and stimulation of Human C-X-C motif chemokine 10 (CXCL 10) also known as IFN-γ-induced protein 10KDa (IP 10) expression from THP-1 derived macrophages (THP-1 cells). RESULTS Aerosol characterization studies indicated that a significant and reproducible dose of aerosolized IFN-γ can be delivered using both vibrating mesh technologies. Nebulization using both devices resulted in an emitted dose of at least 93% (100% dose minus residual volume) for IFN-γ. Characterization of aerosolized IFN-γ indicated that the PDAP was capable of generating droplets with a significantly lower mass median aerodynamic diameter (MMAD) with values of 2.79 ± 0.29 μm and 4.39 ± 0.25 μm for the PDAP and Solo respectively. The volume median diameters (VMD) of aerosolized IFN-γ corroborated this with VMDs of 2.33 ± 0.02 μm for the PDAP and 4.30 ± 0.02 μm for the Solo. SDS-PAGE gels indicated that IFN-γ remains stable after nebulization by both devices and this was confirmed by bioactivity studies using a THP-1 cell model in which an alveolar macrophage response to IFN-γ was determined. IFN-γ nebulized by the PDAP and Solo devices had no significant effect on the key inflammatory biomarker cytokine IP-10 release from this model in comparison to non-nebulized controls. Here we demonstrate that it is possible to combine IFN-γ with vibrating mesh nebulizer devices and facilitate effective aerosolisation with minimal impact on IFN-γ structure or bioactivity. CONCLUSIONS It is possible to nebulize IFN-γ effectively with vibrating mesh nebulizer devices without compromising its stability. The PDAP allows for generation of IFN-γ aerosols with improved aerodynamic properties thereby increasing its potential efficiency for lower respiratory tract deposition over current technology, whilst maintaining the integrity and bioactivity of IFN-γ. This delivery modality therefore offers a rational means of facilitating the clinical translation of inhaled IFN-γ.
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Affiliation(s)
- Louise Sweeney
- Aerogen, IDA Business Park, Dangan, Galway, Ireland
- School of Pharmacy, RCSI, Dublin, Ireland
| | - Alice P. McCloskey
- School of Pharmacy, RCSI, Dublin, Ireland
- Tissue Engineering Research Group (TERG), RCSI, Dublin, Ireland
- Centre for Research in Medical Devices (CÚRAM) NUIG & RCSI, Dublin, Ireland
| | - Gerard Higgins
- School of Pharmacy, RCSI, Dublin, Ireland
- Tissue Engineering Research Group (TERG), RCSI, Dublin, Ireland
- Centre for Research in Medical Devices (CÚRAM) NUIG & RCSI, Dublin, Ireland
| | - Joanne M. Ramsey
- School of Pharmacy, RCSI, Dublin, Ireland
- Tissue Engineering Research Group (TERG), RCSI, Dublin, Ireland
| | - Sally-Ann Cryan
- School of Pharmacy, RCSI, Dublin, Ireland
- Tissue Engineering Research Group (TERG), RCSI, Dublin, Ireland
- Trinity Centre for Bioengineering (TCBE), TCD, Dublin, Ireland
- Centre for Research in Medical Devices (CÚRAM) NUIG & RCSI, Dublin, Ireland
| | - Ronan MacLoughlin
- Aerogen, IDA Business Park, Dangan, Galway, Ireland
- School of Pharmacy, RCSI, Dublin, Ireland
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
- Centre for Research in Medical Devices (CÚRAM) NUIG & RCSI, Dublin, Ireland
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Peters MJ, Bourke JE. Lung health in a changing world. Med J Aust 2018; 207:426-428. [PMID: 29129172 PMCID: PMC7168401 DOI: 10.5694/mja17.00853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/13/2017] [Indexed: 11/21/2022]
Affiliation(s)
| | - Jane E Bourke
- Biomedicine Discovery Institute, Monash University, Melbourne, VIC
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29
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Siddique AA, Schnitzer ME, Bahamyirou A, Wang G, Holtz TH, Migliori GB, Sotgiu G, Gandhi NR, Vargas MH, Menzies D, Benedetti A. Causal inference with multiple concurrent medications: A comparison of methods and an application in multidrug-resistant tuberculosis. Stat Methods Med Res 2018; 28:3534-3549. [PMID: 30381005 DOI: 10.1177/0962280218808817] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper investigates different approaches for causal estimation under multiple concurrent medications. Our parameter of interest is the marginal mean counterfactual outcome under different combinations of medications. We explore parametric and non-parametric methods to estimate the generalized propensity score. We then apply three causal estimation approaches (inverse probability of treatment weighting, propensity score adjustment, and targeted maximum likelihood estimation) to estimate the causal parameter of interest. Focusing on the estimation of the expected outcome under the most prevalent regimens, we compare the results obtained using these methods in a simulation study with four potentially concurrent medications. We perform a second simulation study in which some combinations of medications may occur rarely or not occur at all in the dataset. Finally, we apply the methods explored to contrast the probability of patient treatment success for the most prevalent regimens of antimicrobial agents for patients with multidrug-resistant pulmonary tuberculosis.
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Affiliation(s)
| | | | - Asma Bahamyirou
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada
| | - Guanbo Wang
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada
| | - Timothy H Holtz
- Division of Global HIV and TB, Centers for Disease Control and Prevention, New Delhi, India
| | - Giovanni B Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Neel R Gandhi
- Rollins School of Public Health and Emory School of Medicine, Emory University, Atlanta, USA
| | - Mario H Vargas
- Departamento de Investigación en Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.,Unidad de Investigación Médica en Enfermedades Respiratorias, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Dick Menzies
- Respiratory Epidemiology and Clinical Research Institute, McGill University Health Centre, Montreal, Canada.,Department of Medicine, McGill University, Montreal, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada.,Respiratory Epidemiology and Clinical Research Institute, McGill University Health Centre, Montreal, Canada.,Department of Medicine, McGill University, Montreal, Canada
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Short KR, Kedzierska K, van de Sandt CE. Back to the Future: Lessons Learned From the 1918 Influenza Pandemic. Front Cell Infect Microbiol 2018; 8:343. [PMID: 30349811 PMCID: PMC6187080 DOI: 10.3389/fcimb.2018.00343] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 01/02/2023] Open
Abstract
2018 marks the 100-year anniversary of the 1918 influenza pandemic, which killed ~50 million people worldwide. The severity of this pandemic resulted from a complex interplay between viral, host, and societal factors. Here, we review the viral, genetic and immune factors that contributed to the severity of the 1918 pandemic and discuss the implications for modern pandemic preparedness. We address unresolved questions of why the 1918 influenza H1N1 virus was more virulent than other influenza pandemics and why some people survived the 1918 pandemic and others succumbed to the infection. While current studies suggest that viral factors such as haemagglutinin and polymerase gene segments most likely contributed to a potent, dysregulated pro-inflammatory cytokine storm in victims of the pandemic, a shift in case-fatality for the 1918 pandemic toward young adults was most likely associated with the host's immune status. Lack of pre-existing virus-specific and/or cross-reactive antibodies and cellular immunity in children and young adults likely contributed to the high attack rate and rapid spread of the 1918 H1N1 virus. In contrast, lower mortality rate in in the older (>30 years) adult population points toward the beneficial effects of pre-existing cross-reactive immunity. In addition to the role of humoral and cellular immunity, there is a growing body of evidence to suggest that individual genetic differences, especially involving single-nucleotide polymorphisms (SNPs), contribute to differences in the severity of influenza virus infections. Co-infections with bacterial pathogens, and possibly measles and malaria, co-morbidities, malnutrition or obesity are also known to affect the severity of influenza disease, and likely influenced 1918 H1N1 disease severity and outcomes. Additionally, we also discuss the new challenges, such as changing population demographics, antibiotic resistance and climate change, which we will face in the context of any future influenza virus pandemic. In the last decade there has been a dramatic increase in the number of severe influenza virus strains entering the human population from animal reservoirs (including highly pathogenic H7N9 and H5N1 viruses). An understanding of past influenza virus pandemics and the lessons that we have learnt from them has therefore never been more pertinent.
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Affiliation(s)
- Kirsty R. Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Katherine Kedzierska
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
| | - Carolien E. van de Sandt
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
- Department of Hematopoiesis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
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Wejse C. Medical treatment for urogenital tuberculosis (UGTB). GMS INFECTIOUS DISEASES 2018; 6:Doc04. [PMID: 30671335 PMCID: PMC6301712 DOI: 10.3205/id000039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Urogenital tuberculosis (UGTB) should in general be treated as pulmonary TB with a four-drug regimen of Isoniazid, Rifampicin, Ethambutol and Pyrazinamide for a total of 6 months, Ethambutol and Pyrazinamide only the first two months. Some patients may need longer treatment (cavitary disease, kidney abscess/malfunction, HIV co-infection). Treatment of multi-drug resistant tuberculosis (MDR-TB) requires use of long-term intravenous treatment with aminoglycosides and other drugs with considerable toxicity for 18–24 months. Complications such as urinary tract obstruction may occur and should be treated with corticosteroids or surgery.
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Affiliation(s)
- Christian Wejse
- Department of Infectious Diseases/Center for Global Health, Dept of Public Health, Aarhus University, Denmark
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32
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Recent therapeutic approaches for the management of tuberculosis: Challenges and opportunities. Biomed Pharmacother 2018; 99:735-745. [DOI: 10.1016/j.biopha.2018.01.115] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 11/19/2022] Open
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Alene KA, Clements ACA, McBryde ES, Jaramillo E, Lonnroth K, Shaweno D, Viney K. Sequelae of multidrug-resistant tuberculosis: protocol for a systematic review and meta-analysis. BMJ Open 2018; 8:e019593. [PMID: 29440162 PMCID: PMC5829942 DOI: 10.1136/bmjopen-2017-019593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The sequelae of multidrug-resistant tuberculosis (MDR-TB) are poorly understood and inconsistently reported. We will aim to assess the existing evidence for the clinical, psychological, social and economic sequelae of MDR-TB and to assess the health-related quality of life in patients with MDR-TB. METHODS AND ANALYSIS We will perform a systematic review and meta-analysis of published studies reporting sequelae of MDR-TB. We will search PubMed, SCOPUS, ProQuest, Web of Science and PsychINFO databases up to 5 September 2017. MDR-TB sequelae will include any clinical, psychological, social and economic effects as well as health-related quality of life that occur after MDR-TB treatment or illness. Two researchers will screen the titles and abstracts of all citations identified in our search, extract data, and assess the scientific quality using standardised formats. Providing there is appropriate comparability in the studies, we will use a random-effects meta-analysis model to produce pooled estimates of MDR-TB sequelae from the included studies. We will stratify the analyses based on treatment regimen, comorbidities (such as HIV status and diabetes mellitus), previous TB treatment history and study setting. ETHICS AND DISSEMINATION As this study will be based on published data, ethical approval is not required. The final report will be disseminated through publication in a peer-reviewed scientific journal and will also be presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42017073182.
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Affiliation(s)
- Kefyalew Addis Alene
- Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Archie C A Clements
- Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
| | | | - Knut Lonnroth
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Debebe Shaweno
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Kerri Viney
- Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Polymer-Based Nanomaterials and Applications for Vaccines and Drugs. Polymers (Basel) 2018; 10:polym10010031. [PMID: 30966075 PMCID: PMC6415012 DOI: 10.3390/polym10010031] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/19/2017] [Accepted: 12/21/2017] [Indexed: 02/07/2023] Open
Abstract
Nanotechnology plays a significant role in drug development. As carriers, polymeric nanoparticles can deliver vaccine antigens, proteins, and drugs to the desired site of action. Polymeric nanoparticles with lower cytotoxicity can protect the delivered antigens or drugs from degradation under unfavorable conditions via a mucosal administration route; further, the uptake of nanoparticles by antigen-presenting cells can increase and induce potent immune responses. Additionally, nanomaterials are widely used in vaccine delivery systems because nanomaterials can make the vaccine antigen long-acting. This review focuses on some biodegradable polymer materials such as natural polymeric nanomaterials, chemically synthesized polymer materials, and biosynthesized polymeric materials, and points out the advantages and the direction of research on degradable polymeric materials. The application and future perspectives of polymeric materials as delivery carriers and vaccine adjuvants in the field of drugs and vaccines are presented. With the increase of knowledge and fundamental understandings of polymer-based nanomaterials, means of integrating some other attractive properties, such as slow release, target delivery, and alternative administration methods and delivery pathways are feasible. Polymer-based nanomaterials have great potential for the development of novel vaccines and drug systems for certain needs, including single-dose and needle-free deliveries of vaccine antigens and drugs in the future.
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Taban IM, Elshihawy HEAE, Torun B, Zucchini B, Williamson CJ, Altuwairigi D, Ngu AST, McLean KJ, Levy CW, Sood S, Marino LB, Munro AW, de Carvalho LPS, Simons C. Novel Aryl Substituted Pyrazoles as Small Molecule Inhibitors of Cytochrome P450 CYP121A1: Synthesis and Antimycobacterial Evaluation. J Med Chem 2017; 60:10257-10267. [PMID: 29185746 PMCID: PMC5748275 DOI: 10.1021/acs.jmedchem.7b01562] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Three series of biarylpyrazole imidazole and triazoles are described, which vary in the linker between the biaryl pyrazole and imidazole/triazole group. The imidazole and triazole series with the short -CH2- linker displayed promising antimycobacterial activity, with the imidazole-CH2- series (7) showing low MIC values (6.25-25 μg/mL), which was also influenced by lipophilicity. Extending the linker to -C(O)NH(CH2)2- resulted in a loss of antimycobacterial activity. The binding affinity of the compounds with CYP121A1 was determined by UV-visible optical titrations with KD values of 2.63, 35.6, and 290 μM, respectively, for the tightest binding compounds 7e, 8b, and 13d from their respective series. Both binding affinity assays and docking studies of the CYP121A1 inhibitors suggest type II indirect binding through interstitial water molecules, with key binding residues Thr77, Val78, Val82, Val83, Met86, Ser237, Gln385, and Arg386, comparable with the binding interactions observed with fluconazole and the natural substrate dicyclotyrosine.
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Affiliation(s)
- Ismail M Taban
- School of Pharmacy & Pharmaceutical Sciences, Cardiff University , King Edward VII Avenue, Cardiff CF10 3NB, U.K
| | - Hosam E A E Elshihawy
- Department of Organic Chemistry, Faculty of Pharmacy, Suez Canal University , Ismalia, Egypt
| | - Beyza Torun
- School of Pharmacy & Pharmaceutical Sciences, Cardiff University , King Edward VII Avenue, Cardiff CF10 3NB, U.K.,Faculty of Pharmacy, Department of Pharmaceutical Chemistry, Ankara University , 06100 Tandogan, Ankara, Turkey
| | - Benedetta Zucchini
- School of Pharmacy & Pharmaceutical Sciences, Cardiff University , King Edward VII Avenue, Cardiff CF10 3NB, U.K.,Department of Pharmaceutical Sciences, University of Perugia , Via del Liceo, 1-06123 Perugia, Italy
| | - Clare J Williamson
- School of Pharmacy & Pharmaceutical Sciences, Cardiff University , King Edward VII Avenue, Cardiff CF10 3NB, U.K
| | - Dania Altuwairigi
- School of Pharmacy & Pharmaceutical Sciences, Cardiff University , King Edward VII Avenue, Cardiff CF10 3NB, U.K
| | - Adeline S T Ngu
- School of Pharmacy & Pharmaceutical Sciences, Cardiff University , King Edward VII Avenue, Cardiff CF10 3NB, U.K
| | - Kirsty J McLean
- Manchester Institute of Biotechnology, School of Chemistry, The University of Manchester , 131 Princess Street, Manchester M1 7DN, U.K
| | - Colin W Levy
- Manchester Institute of Biotechnology, School of Chemistry, The University of Manchester , 131 Princess Street, Manchester M1 7DN, U.K
| | - Sakshi Sood
- Mycobacterial Metabolism and Antibiotic Research Laboratory, The Francis Crick Institute , 1 Midland Road, London NW1 1AT, U.K
| | - Leonardo B Marino
- Faculty of Pharmaceutical Sciences, UNESP-Univ Estadual Paulista , Araraquara, São Paulo14801-902, Brazil
| | - Andrew W Munro
- Manchester Institute of Biotechnology, School of Chemistry, The University of Manchester , 131 Princess Street, Manchester M1 7DN, U.K
| | - Luiz Pedro S de Carvalho
- Mycobacterial Metabolism and Antibiotic Research Laboratory, The Francis Crick Institute , 1 Midland Road, London NW1 1AT, U.K
| | - Claire Simons
- School of Pharmacy & Pharmaceutical Sciences, Cardiff University , King Edward VII Avenue, Cardiff CF10 3NB, U.K
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Lv XT, Lu XW, Shi XY, Zhou L. Prevalence and risk factors of multi-drug resistant tuberculosis in Dalian, China. J Int Med Res 2017; 45:1779-1786. [PMID: 28345426 PMCID: PMC5805195 DOI: 10.1177/0300060516687429] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 12/12/2016] [Indexed: 11/29/2022] Open
Abstract
Objectives To investigate the prevalence and risk factors associated with multi-drug resistant tuberculosis (MDR-TB) in Dalian, China. Methods This was a retrospective review of data from patients attending a TB clinic in Dalian, China between 2012 and 2015. Demographic and drug susceptibility data were retrieved from TB treatment cards. Univariate logistic analysis was used to assess the association between risk factors and MDR-TB. Results Among the 3552 patients who were smear positive for Mycobacterium tuberculosis (MTB), 2918 (82.2%) had positive MTB cultures and 1106 (31.1%) had isolates that showed resistance to at least one drug. The overall prevalence of MDR-TB was 10.1% (359/3552; 131/2261 [5.8%] newly diagnosed and 228/1291 [17.7%] previously treated patients). Importantly, 75 extensively drug-resistant TB isolates were detected from 25 newly treated and 50 previously treated patients. In total, 215 (6.1%) patients were infected with a poly-resistant strain of MTB. Previously treated patients and older patients were more likely to develop MDR-TB. Conclusions The study showed a high prevalence of MDR-TB among the study population. History of previous TB treatment and older age were associated with MDR-TB.
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Affiliation(s)
- Xin-Tong Lv
- School of Public Health, Dalian Medical
University, Dalian, Liaoning Province, China
| | - Xi-Wei Lu
- Dalian Tuberculosis Hospital, Dalian,
Liaoning Province, China
| | - Xiao-Yan Shi
- Dalian Tuberculosis Hospital, Dalian,
Liaoning Province, China
| | - Ling Zhou
- School of Public Health, Dalian Medical
University, Dalian, Liaoning Province, China
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Yao Y, Song W, Wang K, Ma B, Liu H, Zheng W, Tang Y, Zhou Y. Features of 921 Patients With Spinal Tuberculosis: A 16-Year Investigation of a General Hospital in Southwest China. Orthopedics 2017; 40:e1017-e1023. [PMID: 29058758 DOI: 10.3928/01477447-20171012-03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 09/05/2017] [Indexed: 02/03/2023]
Abstract
Southwest China has a high burden of spinal tuberculosis (TB). Few large case studies of spinal TB in southwest China have been conducted. This study investigated the features of 921 patients who were treated for spinal TB at a general hospital in southwest China between 2001 and 2016. Demographic data, clinical data, laboratory data, imaging findings, treatment methods, and outcomes of patients who were admitted to the hospital for spinal TB were reviewed retrospectively. The annual incidence of spinal TB increased throughout the study period. The greatest number of patients were 41 to 50 years old (22.04%). Local pain was the most common symptom (97.8%). A significant difference in the duration of symptoms was observed between rural populations (28.40 months) and urban populations (10.17 months) (P=.041). Of the patients, 32.68% had a normal erythrocyte sedimentation rate and 25.84% had a normal C-reactive protein level. The lumbar spine was the most commonly involved spinal site (44.77%), followed by the thoracic spine (43.60%). All of the patients underwent chemotherapy, and 77.10% of patients underwent surgery. Most of the patients were cured, with the exception of 2.19% of patients who discontinued chemotherapy after early improvement of clinical status. Spinal TB is still a major public health problem in southwest China. Chemotherapy and surgery can yield satisfactory outcomes with timely diagnosis and long-term treatment. It is urgent to increase the attention paid to spinal TB and improve knowledge of this disease among the general public, especially in southwest China. [Orthopedics. 2017; 40(6):e1017-e1023.].
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Liu Z, Pan A, Wu B, Zhou L, He H, Meng Q, Chen S, Pang Y, Wang X. Feasibility of a new model for early detection of patients with multidrug-resistant tuberculosis in a developed setting of eastern China. Trop Med Int Health 2017; 22:1328-1333. [PMID: 28746979 DOI: 10.1111/tmi.12934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The poor detection rate of multidrug-resistant tuberculosis (MDR-TB) highlights the urgent need to explore new case finding model to improve the detection of MDR-TB in China. The aim of this study was to evaluate the feasibility of a new model that combines molecular diagnostics and sputum transportation for early detection of patients with MDR-TB in Zhejiang. METHODS From May 2014 to January 2015, TB suspects were continuously enrolled at six county-level designated TB hospitals in Zhejiang. Each patient gave three sputum samples, which were submitted to laboratory for smear microscopy, solid culture and GeneXpert. The specimens from rifampin (RIF)-resistant cases detected by GeneXpert, and positive cultures were transported from county-level to prefecture-level laboratories for line probe analysis (LPA) and drug susceptibility testing (DST). The performance and interval of MDR-TB detection of the new model were compared with those of conventional model. RESULTS A total of 3151 sputum specimens were collected from TB suspects. The sensitivity of GeneXpert for detecting culture-positive cases was 92.7% (405/437), and its specificity was 91.3% (2428/2659). Of 16 RIF-resistant cases detected by DST, GeneXpert could correctly identify 15 cases, yielding a sensitivity of 93.8% (15/16). The specificity of GeneXpert for detecting RIF susceptibility was 100.0% (383/383). The average interval to diagnosis of the conventional DST model was 56.5 days, ranging from 43 to 71 days, which was significantly longer than that of GeneXpert plus LPA (22.2 days, P < 0.01). CONCLUSION Our data demonstrate that the combination of improved molecular TB tests and sputum transportation could significantly shorten the time required for detection of MDR-TB, which will bring benefits for preventing an epidemic of MDR-TB in this high-prevalence setting.
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Affiliation(s)
- Zhengwei Liu
- The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Aizhen Pan
- The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - BeiBei Wu
- The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lin Zhou
- The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Haibo He
- The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qiong Meng
- The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Songhua Chen
- The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yu Pang
- National Clinical Laboratory on Tuberculosis, Beijing Key laboratory for Drug-resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Xiaomeng Wang
- The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Gil-Olivares F. [Multidrug-resistant tuberculosis: a barrier to achieving the Sustainable Development Goals]. SALUD PUBLICA DE MEXICO 2017; 59:213-214. [PMID: 28902306 DOI: 10.21149/8042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Señor editor: Dentro de los Objetivos de Desarrollo Sostenible para el año 2035 propuestos por la OMS está la eliminación de la tuberculosis a nivel mundial. Esto podría ser factible si tomamos en cuenta que los objetivos propuestos por la OMS para el año 2015 fueron logrados...
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Affiliation(s)
- Fradis Gil-Olivares
- Unidad de Gestión de la Calidad, Hospital de Emergencias Villa El Salvador. Lima, Perú
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40
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Momin MA, Sinha S, Tucker IG, Doyle C, Das SC. Dry powder formulation of kanamycin with enhanced aerosolization efficiency for drug-resistant tuberculosis. Int J Pharm 2017; 528:107-117. [DOI: 10.1016/j.ijpharm.2017.06.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 05/31/2017] [Accepted: 06/01/2017] [Indexed: 01/05/2023]
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Sharifi-Rad J, Salehi B, Stojanović-Radić ZZ, Fokou PVT, Sharifi-Rad M, Mahady GB, Sharifi-Rad M, Masjedi MR, Lawal TO, Ayatollahi SA, Masjedi J, Sharifi-Rad R, Setzer WN, Sharifi-Rad M, Kobarfard F, Rahman AU, Choudhary MI, Ata A, Iriti M. RETRACTED: Medicinal plants used in the treatment of tuberculosis - Ethnobotanical and ethnopharmacological approaches. Biotechnol Adv 2017:S0734-9750(17)30077-0. [PMID: 28694178 DOI: 10.1016/j.biotechadv.2017.07.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 06/22/2017] [Accepted: 07/05/2017] [Indexed: 12/30/2022]
Abstract
Tuberculosis is a highly infectious disease declared a global health emergency by the World Health Organization, with approximately one third of the world's population being latently infected with Mycobacterium tuberculosis. Tuberculosis treatment consists in an intensive phase and a continuation phase. Unfortunately, the appearance of multi drug-resistant tuberculosis, mainly due to low adherence to prescribed therapies or inefficient healthcare structures, requires at least 20months of treatment with second-line, more toxic and less efficient drugs, i.e., capreomycin, kanamycin, amikacin and fluoroquinolones. Therefore, there exists an urgent need for discovery and development of new drugs to reduce the global burden of this disease, including the multi-drug-resistant tuberculosis. To this end, many plant species, as well as marine organisms and fungi have been and continue to be used in various traditional healing systems around the world to treat tuberculosis, thus representing a nearly unlimited source of active ingredients. Besides their antimycobacterial activity, natural products can be useful in adjuvant therapy to improve the efficacy of conventional antimycobacterial therapies, to decrease their adverse effects and to reverse mycobacterial multi-drug resistance due to the genetic plasticity and environmental adaptability of Mycobacterium. However, even if some natural products have still been investigated in preclinical and clinical studies, the validation of their efficacy and safety as antituberculosis agents is far from being reached, and, therefore, according to an evidence-based approach, more high-level randomized clinical trials are urgently needed.
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Affiliation(s)
- Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zorica Z Stojanović-Radić
- Department of Biology and Ecology, Faculty of Science and Mathematics, University of Niš, Višegradska 33, Niš, Serbia
| | - Patrick Valere Tsouh Fokou
- Department of Clinical Pathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra LG 581, Ghana; Antimicrobial Agents Unit, LPMPS, Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé 812, Cameroon
| | - Marzieh Sharifi-Rad
- Department of Chemistry, Faculty of Science, University of Zabol, Zabol, Iran
| | - Gail B Mahady
- Department of Pharmacy Practice, Clinical Pharmacognosy Laboratories, University of Illinois at Chicago, USA
| | - Majid Sharifi-Rad
- Department of Range and Watershed Management, Faculty of Natural Resources, University of Zabol, Zabol, Iran
| | - Mohammad-Reza Masjedi
- Tobacco Control Strategic Research Center, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Temitope O Lawal
- Department of Pharmacy Practice, Clinical Pharmacognosy Laboratories, University of Illinois at Chicago, USA; Department of Pharmaceutical Microbiology, University of Ibadan, Ibadan, Nigeria
| | - Seyed Abdulmajid Ayatollahi
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Javid Masjedi
- Tobacco Control Strategic Research Center, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Razieh Sharifi-Rad
- Department of Biology, Faculty of Science, University of Zabol, Zabol, Iran
| | - William N Setzer
- Department of Chemistry, University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Mehdi Sharifi-Rad
- Department of Medical Parasitology, Zabol University of Medical Sciences, 61663335 Zabol, Iran.
| | - Farzad Kobarfard
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Iran
| | - Atta-Ur Rahman
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Muhammad Iqbal Choudhary
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Athar Ata
- Department of Chemistry, Richardson College for the Environmental Science Complex The University of Winnipeg, Winnipeg, Canada
| | - Marcello Iriti
- Department of Agricultural and Environmental Sciences, Milan State University, via G. Celoria 2, Milan 20133, Italy.
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Moreno R, López R, Tenorio A, Victoria J, Volz A, Cruz O, Moreno E, Quijada C, Hesse-de-Herrera A, Aguirre S, Santos L, Lima N, Tanomaru N, Alarcon A, Del-Granado M. Hospital-based tuberculosis control activities in five cities of Latin America. Rev Panam Salud Publica 2017; 41:e95. [PMID: 31384249 PMCID: PMC6645313 DOI: 10.26633/rpsp.2017.95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 10/16/2016] [Indexed: 11/24/2022] Open
Abstract
Objective. To generate actionable insights for improving TB control in urban areas by describing the tuberculosis (TB) control activities of hospitals in five cities in Latin America.
Methods. A descriptive study of hospital-based TB control activities was conducted in 2013–2015 using a cross-sectional survey designed by the Pan American Health Organization and administered in Guatemala City, Guatemala; Guarulhos, Brazil; Bogotá, Colombia; Lima, Peru; and Asunción, Paraguay. Data were analyzed using Chi-squared, Fisher exact tests, and the Mantel–Haenszel test for Risk Ratios, as necessary (P < 0.05).
Results. While variation among cities existed, most hospitals (91.3%) conducted acid-fast bacilli smears for TB diagnosis and had a quality control process (94.0%), followed national TB guidelines (95%), and reported TB cases to the respective health authorities (96%). Additionally, TB treatment was offered free of charge almost universally (97.1%). However, only 74.2% of hospitals were supervised by the national or local TB programs; 52.8% followed up on the outcome of referrals; and 39.1% offered full ambulatory TB treatment, with 68.7% using Directly-Observed Therapy.
Conclusion. The study underscored strengths and weaknesses in specific areas for TB control activities in hospitals and highlighted the importance and complexity of coordinating efforts among private and public hospitals and the various stakeholders. Local TB programs and health authorities should use these results to enhance the quality of TB-related actions in hospitals in similar settings.
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Affiliation(s)
- Ralfh Moreno
- Pan American Health Organization, Washington, DC, United States of America
| | - Rafael López
- Pan American Health Organization, Washington, DC, United States of America
| | - Alfonso Tenorio
- Pan American Health Organization, Washington, DC, United States of America
| | - Jorge Victoria
- Pan American Health Organization, Washington, DC, United States of America
| | - Anna Volz
- Pan American Health Organization, Washington, DC, United States of America
| | - Oscar Cruz
- Secretary of Health of Bogotá, Bogotá, Colombia
| | - Ernesto Moreno
- Ministry of Health and Social Protection, Bogotá, Colombia
| | - Carlos Quijada
- Ministry of Public Health and Social Welfare, Guatemala City, Guatemala
| | | | - Sarita Aguirre
- Ministry of Public Health and Social Welfare, Asuncion, Paraguay
| | - Laedi Santos
- Center for Epidemiological Surveillance, São Paulo, Brazil
| | - Noemi Lima
- Health Secretary of Guarulhos, Guarulhos, Brazil
| | | | | | - Mirtha Del-Granado
- Pan American Health Organization, Washington, DC, United States of America
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43
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Nasiri MJ, Haeili M, Ghazi M, Goudarzi H, Pormohammad A, Imani Fooladi AA, Feizabadi MM. New Insights in to the Intrinsic and Acquired Drug Resistance Mechanisms in Mycobacteria. Front Microbiol 2017; 8:681. [PMID: 28487675 PMCID: PMC5403904 DOI: 10.3389/fmicb.2017.00681] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 04/04/2017] [Indexed: 01/25/2023] Open
Abstract
Infectious diseases caused by clinically important Mycobacteria continue to be an important public health problem worldwide primarily due to emergence of drug resistance crisis. In recent years, the control of tuberculosis (TB), the disease caused by Mycobacterium tuberculosis (MTB), is hampered by the emergence of multidrug resistance (MDR), defined as resistance to at least isoniazid (INH) and rifampicin (RIF), two key drugs in the treatment of the disease. Despite the availability of curative anti-TB therapy, inappropriate and inadequate treatment has allowed MTB to acquire resistance to the most important anti-TB drugs. Likewise, for most mycobacteria other than MTB, the outcome of drug treatment is poor and is likely related to the high levels of antibiotic resistance. Thus, a better knowledge of the underlying mechanisms of drug resistance in mycobacteria could aid not only to select the best therapeutic options but also to develop novel drugs that can overwhelm the existing resistance mechanisms. In this article, we review the distinctive mechanisms of antibiotic resistance in mycobacteria.
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Affiliation(s)
- Mohammad J. Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical SciencesTehran, Iran
| | - Mehri Haeili
- Department of Biology, Faculty of Natural Sciences, University of TabrizTabriz, Iran
| | - Mona Ghazi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical SciencesTehran, Iran
| | - Hossein Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical SciencesTehran, Iran
| | - Ali Pormohammad
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical SciencesTehran, Iran
| | - Abbas A. Imani Fooladi
- Applied Microbiology Research Center, Baqiyatallah University of Medical SciencesTehran, Iran
| | - Mohammad M. Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical SciencesTehran, Iran
- Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical SciencesTehran, Iran
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44
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Piñeros AR, Campos LW, Fonseca DM, Bertolini TB, Gembre AF, Prado RQ, Alves-Filho JC, Ramos SG, Russo M, Bonato VLD. M2 macrophages or IL-33 treatment attenuate ongoing Mycobacterium tuberculosis infection. Sci Rep 2017; 7:41240. [PMID: 28128217 PMCID: PMC5269597 DOI: 10.1038/srep41240] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 12/19/2016] [Indexed: 11/09/2022] Open
Abstract
The protective effects of mycobacterial infections on lung allergy are well documented. However, the inverse relationship between tuberculosis and type 2 immunity is still elusive. Although type 1 immunity is essential to protection against Mycobacterium tuberculosis it might be also detrimental to the host due to the induction of extensive tissue damage. Here, we determined whether lung type 2 immunity induced by allergen sensitization and challenge could affect the outcome of M. tuberculosis infection. We used two different protocols in which sensitization and allergen challenge were performed before or after M. tuberculosis infection. We found an increased resistance to M. tuberculosis only when allergen exposure was given after, but not before infection. Infected mice exposed to allergen exhibited lower bacterial load and cellular infiltrates in the lungs. Enhanced resistance to infection after allergen challenge was associated with increased gene expression of alternatively activated macrophages (M2 macrophages) and IL-33 levels. Accordingly, either adoptive transfer of M2 macrophages or systemic IL-33 treatment was effective in attenuating M. tuberculosis infection. Notably, the enhanced resistance induced by allergen exposure was dependent on IL-33 receptor ST2. Our work indicates that IL-33 might be an alternative therapeutic treatment for severe tuberculosis.
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Affiliation(s)
- A R Piñeros
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - L W Campos
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - D M Fonseca
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - T B Bertolini
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - A F Gembre
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - R Q Prado
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - J C Alves-Filho
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - S G Ramos
- Department of Pathology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - M Russo
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - V L D Bonato
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Manjelievskaia J, Erck D, Piracha S, Schrager L. Drug-resistant TB: deadly, costly and in need of a vaccine. Trans R Soc Trop Med Hyg 2016; 110:186-91. [PMID: 26884499 PMCID: PMC4755426 DOI: 10.1093/trstmh/trw006] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
TB is an underappreciated public health threat in developed nations. In 2014, an estimated 9.6 million TB cases and 1.5 million deaths occurred worldwide; 3.3% of these cases resulted from multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) strains. These figures underestimate the economic burden associated with MDR-TB and XDR-TB, as the cost of treating disease caused by these strains can be 9–25 times higher than treating drug-susceptible TB. Developing new drugs, improved diagnostics and new TB vaccines are critical components of a strategy to combat TB in general, and drug-resistant TB in particular. Because Mycobacterium tuberculosis (MTB) has demonstrated a capacity to develop resistance to drugs developed to combat it, it is unlikely that drug-resistant MTB would be ‘resistant’ to vaccines capable of preventing disease or established infection with drug-sensitive MTB strains. Accordingly, the development of TB vaccines represents an important long-term investment in preventing the spread of drug-resistant TB and achieving WHO's goal of ending the global TB epidemic by 2035. Our current understanding of the epidemiology of drug-resistant TB and the interventions needed to limit its spread, reviewed in this article, illustrates the need for increased financial support for developing new TB drugs, diagnostics and vaccines to meet the WHO goal of TB elimination by 2035.
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Affiliation(s)
| | - Dara Erck
- External Affairs, Aeras, Rockville, MD 20850 USA
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46
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Identification of lipid metabolism-targeting compounds active against drug-resistant M. tuberculosis. J Glob Antimicrob Resist 2016; 7:26-27. [DOI: 10.1016/j.jgar.2016.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/10/2016] [Indexed: 11/20/2022] Open
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Pulipati L, Yogeeswari P, Sriram D, Kantevari S. Click-based synthesis and antitubercular evaluation of novel dibenzo[ b , d ]thiophene-1,2,3-triazoles with piperidine, piperazine, morpholine and thiomorpholine appendages. Bioorg Med Chem Lett 2016; 26:2649-54. [DOI: 10.1016/j.bmcl.2016.04.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/24/2016] [Accepted: 04/07/2016] [Indexed: 12/14/2022]
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Brown ML, Henderson SJ, Ferguson RW, Jung P. Revisiting tuberculosis risk in Peace Corps Volunteers, 2006-13. J Travel Med 2016; 23:tav005. [PMID: 26684486 DOI: 10.1093/jtm/tav005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 11/13/2022]
Abstract
BACKGROUND Risk of tuberculosis (TB) is generally considered to be low for long-term travellers, though risk varies with travel destination, duration and purpose. Peace Corps Volunteers (PCVs) serve for 27 months as community-level development workers in various countries around the world and may be exposed to TB in the course of their service. This study examines recent trends in TB in PCVs and compares rates with a previous analysis published by Jung and Banks. METHODS Tuberculosis case data submitted to the Peace Corps' Epidemiologic Surveillance System by Peace Corps Medical Officers and gathered from Federal Employees Compensation Act claims for latent TB infection (LTBI) and active TB between 2006 and 2013 were aggregated and analysed for trends and significance. RESULTS Overall, there were 689 cases of LTBI and 13 cases of active TB, for a rate of 0.95 cases of LTBI [95% confidence interval (CI) 0.88-1.02] and 0.02 cases of active TB (95% CI 0.01-0.03) per 1000 Volunteer-months. Both are significantly lower than rates presented in the initial study (P < 0.001). Per-country incidence rates for LTBI ranged from 0.00 to 4.52 cases per 1000 Volunteer-months. Per-country active TB rates ranged from 0.00 to 0.78 cases per 1000 Volunteer-months. Among the 13 cases of active TB, there was one successfully treated case of extensively drug-resistant TB. CONCLUSIONS Overall rates of both active and latent TB in PCVs were significantly lower compared with the previous study period. PCVs continue to have statistically significantly higher rates of active TB compared with the general US population but lower rates compared with other long-term travellers.
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Affiliation(s)
- Megan L Brown
- US Peace Corps, Office of Health Services, Washington, DC, USA
| | | | | | - Paul Jung
- US Peace Corps, Office of Health Services, Washington, DC, USA
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Sweileh WM, AbuTaha AS, Sawalha AF, Al-Khalil S, Al-Jabi SW, Zyoud SH. Bibliometric analysis of worldwide publications on multi-, extensively, and totally drug - resistant tuberculosis (2006-2015). Multidiscip Respir Med 2016; 11:45. [PMID: 28096979 PMCID: PMC5225617 DOI: 10.1186/s40248-016-0081-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 11/25/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The year 2015 marked the end of United Nations Millennium Development Goals which was aimed at halting and reversing worldwide tuberculosis (TB). The emergence of drug resistance is a major challenge for worldwide TB control. The aim of this study was to give a bibliometric overview of publications on multi-, extensively, and totally drug-resistant TB. METHODS Scopus database was used to retrieve articles on multidrug resistant (MDR), extensively drug-resistant (XDR), and totally drug-resistant (TDR) tuberculosis for the study period (2006-2015). The number of publications, top productive countries and institutions, citation analysis, co-authorships, international collaboration, active authors, and active journals were retrieved and analyzed. RESULTS A total of 2260 journal articles were retrieved. The mean ± SD citations per article was 7.04 ± 16.0. The h-index of retrieved data was 76. The number of publications showed a three - fold increase over the study period compared with less than two - fold increase in tuberculosis research during the same study period. Stratified by number of publications, the United States of America ranked first while Switzerland ranked first in productivity per 100 million people, and South Africa ranked first in productivity stratified per one trillion Gross Domestic Product. Three of the High Burden Countries (HBC) MDR-TB (India, China, and South Africa) were present in top productive countries. High percentage of international collaboration was seen among most HBC MDR-TB. Except for Plos One journal, most active journals in publishing articles on MDR, XDR, TDR-TB were in infection - related fields and in general medicine. Top 20 cited articles were published in prestigious journal such as Lancet and New England Journal of Medicine. The themes in top 20 cited articles were diverse, ranging from molecular biology, diagnostic tools, co-infection with HIV, and results of new anti-TB drugs. CONCLUSION Publications on MDR, XDR and TDR - TB are increasing in the past decade. International collaboration was common. Many low resourced African and Asian countries will benefit from research leading to new diagnostic and screening technology of TB. The exchange of expertise, ideas and technology is of paramount importance in this field.
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Affiliation(s)
- Waleed M. Sweileh
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Adham S. AbuTaha
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ansam F. Sawalha
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Suleiman Al-Khalil
- Department of Anatomy, Biochemistry and Genetics, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samah W. Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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50
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Niu NK, Yin JJ, Yang YX, Wang ZL, Zhou ZW, He ZX, Chen XW, Zhang X, Duan W, Yang T, Zhou SF. Novel targeting of PEGylated liposomes for codelivery of TGF-β1 siRNA and four antitubercular drugs to human macrophages for the treatment of mycobacterial infection: a quantitative proteomic study. Drug Des Devel Ther 2015; 9:4441-70. [PMID: 26300629 PMCID: PMC4535548 DOI: 10.2147/dddt.s79369] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Tuberculosis (TB) is still a major public health issue in developing countries, and its chemotherapy is compromised by poor drug compliance and severe side effects. This study aimed to synthesize and characterize new multimodal PEGylated liposomes encapsulated with clinically commonly used anti-TB drugs with linkage to small interfering RNA (siRNA) against transforming growth factor-β1 (TGF-β1). The novel NP-siRNA liposomes could target THP-1-derived human macrophages that were the host cells of mycobacterium infection. The biological effects of the NP-siRNA liposomes were evaluated on cell cycle distribution, apoptosis, autophagy, and the gene silencing efficiency of TGF-β1 siRNA in human macrophages. We also explored the proteomic responses to the newly synthesized NP-siRNA liposomes using the stable isotope labeling with amino acids in cell culture approach. The results showed that the multifunctional PEGylated liposomes were successfully synthesized and chemically characterized with a mean size of 265.1 nm. The novel NP-siRNA liposomes functionalized with the anti-TB drugs and TGF-β1 siRNA were endocytosed efficiently by human macrophages as visualized by transmission electron microscopy and scanning electron microscopy. Furthermore, the liposomes showed a low cytotoxicity toward human macrophages. There was no significant effect on cell cycle distribution and apoptosis in THP-1-derived macrophages after drug exposure at concentrations ranging from 2.5 to 62.5 μg/mL. Notably, there was a 6.4-fold increase in the autophagy of human macrophages when treated with the NP-siRNA liposomes at 62.5 μg/mL. In addition, the TGF-β1 and nuclear factor-κB expression levels were downregulated by the NP-siRNA liposomes in THP-1-derived macrophages. The Ingenuity Pathway Analysis data showed that there were over 40 signaling pathways involved in the proteomic responses to NP-siRNA liposome exposure in human macrophages, with 160 proteins mapped. The top five canonical signaling pathways were eukaryotic initiation factor 2 signaling, actin cytoskeleton signaling, remodeling of epithelial adherens junctions, epithelial adherens junction signaling, and Rho GDP-dissociation inhibitor signaling pathways. Collectively, the novel synthetic targeting liposomes represent a promising delivery system for anti-TB drugs to human macrophages with good selectivity and minimal cytotoxicity.
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Affiliation(s)
- Ning-Kui Niu
- Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin, People’s Republic of China
- Department of Spinal Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Juan-Juan Yin
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Yin-Xue Yang
- Department of Colorectal Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Zi-Li Wang
- Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin, People’s Republic of China
| | - Zhi-Wei Zhou
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Zhi-Xu He
- Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino-US Joint Laboratory for Medical Sciences, Guizhou Medical University, Guiyang, Guizhou, People’s Republic of China
| | - Xiao-Wu Chen
- Department of General Surgery, The First People’s Hospital of Shunde Affiliated to Southern Medical University, Shunde, Foshan, Guangdong, People’s Republic of China
| | - Xueji Zhang
- Research Center for Bioengineering and Sensing Technology, University of Science and Technology Beijing, Beijing, People’s Republic of China
| | - Wei Duan
- School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
| | - Tianxin Yang
- Department of Internal Medicine, University of Utah and Salt Lake Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Shu-Feng Zhou
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA
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