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TUBERCULOSIS
Coordinator
Dr. Vicente Ausina
New research and innovation on tuberculosis: basic research,
prevention, drug regimens and diagnosis.
Tuberculosis (TB) is a major global health problem . Each year, there are around nine million new cases of TB, and close to two million deaths . All countries are affected, but 85% of cases occur in Africa (30%) and Asia (55%), while India and China alone represent 35% . TB is closely connected with HIV . People living with HIV, represent over 10% of annual TB cases, and are up to 37 times more likely to develop TB than people
who are HIV-negative .
Yet TB is, in most instances, a curable disease . More than 90% of people with drug-susceptible TB can be cured in six months using combinations of first-line drugs . Treatment of multidrug-resistant TB (MDR-TB) is more challenging, requiring the use of second-line drugs that are more costly, cause more severe side- effects, and must be taken for up two years . Cure rates for MDR-TB are lower, typically ranging from 50% to 70% .
In 2006, the Stop TB Partnership launched the “Global Plan to Stop TB 2006-2015”, a roadmap for scaling up prevention and treatment, for research and development, and for financing . By 2015, it is expected that we will have: point-of-care tests than can be used in health centres for diagnosing active TB, diagnosing latent TB infection and predicting the risk of progression to TB disease, and detecting drug resistance; a new, four-month TB treatment regimen for patients with drug-susceptible TB; at least one new drug on the marked for treatment of drug-resistant TB; a safer, higher-efficacy regimen for the treatment of latent TB infection; four new TB vaccine candidates in Phase III clinical trials for safety and efficacy . If no improvements in TB control are made, about 10 million people will die from TB by 2015 .
This research programme is the result of evolution from previous versions of Corporate Research Programme on Tuberculosis since CIBERES consortium was established in 2006 . Some topics on the programme coincide with those listed in the “The Global Plan to Stop TB 2011-15”.
Aims and objectives
1 . Basic research. New approaches to the nature of latent tuberculosis infection (LTBI) and its treatment in experimental models.
LTBI affects one third of humanity, with the lack of clinical symptoms, in which case it may go unnoticed . However, approximately 10% of these cases develop into active disease . The main problem is lack of understanding of the underlying mechanisms of the infection and the evolution of the active disease . In spite of the classic theory to explain the origin and progression of LTBI, the data obtained in recent years have generated scientific doubts . On the other hand, to date, and despite the existence of very useful animal models to evaluate the different characteristics of the new therapeutic candidates, the presence of a model that is able to faithfully imitate the infection and disease in humans has not been established . An exception is, perhaps, the model in pigs, established by Cardona et al . Thus, research based on the development of animal experimental models plays an ever more essential role in terms of its importance for translation .
In CIBERES researchers have been working in the field of basic research of latent tuberculosis infection since 1997 . This work is essentially based on in an effort to determine its underlying mechanisms and novel animal experimental models have been developed that can better imitate the infection and its progression into active disease with the idea of being able
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CIBERES » Annual report 2014