Schito Marco, Maeurer Markus, Kim Peter, Hanna Debra, Zumla Alimuddin
Critical Path to TB Drug Regimens, Critical Path Institute, Tucson, Arizona.
Therapeutic Immunology Division, Department of Laboratory Medicine, Karolinska Institutet Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden.
Clin Infect Dis. 2015 Oct 15;61Suppl 3(Suppl 3):S95-101. doi: 10.1093/cid/civ608.
Despite the availability of effective diagnostics and curative treatment regimens for tuberculosis, millions of people die each year of this disease. The steady global increase in the number of tuberculosis cases caused by multidrug-resistant and extensively drug-resistant strains of Mycobacterium tuberculosis are of major concern, especially in light of the thin tuberculosis drug pipeline. New tuberculosis drugs are undergoing clinical evaluation, and renewed hope comes from fresh approaches to improve treatment outcomes using a range of adjunct host-directed cellular and repurposed drug therapies. Current efforts in developing second-generation and new rapid point-of-care diagnostic assays take advantage of recent genetic and molecular advances. Slow progress in the development of prophylactic and therapeutic vaccines requires increased funding for basic as well as translational research. Although major challenges remain, these can be overcome by cementing our resolve, raising advocacy, bolstering global funder investments, and leveraging more effective collaborations through equitable public-private partnerships.
尽管有针对结核病的有效诊断方法和治疗方案,但每年仍有数百万人死于这种疾病。全球范围内,耐多药和广泛耐药结核分枝杆菌菌株导致的结核病病例数持续增加,这是一个主要问题,特别是考虑到结核病药物研发进展缓慢。新型结核病药物正在进行临床评估,一系列辅助宿主导向的细胞疗法和重新利用的药物疗法等新方法为改善治疗效果带来了新希望。目前在开发第二代和新型即时快速诊断检测方面的努力利用了近期的基因和分子进展。预防性和治疗性疫苗的研发进展缓慢,需要增加对基础研究和转化研究的资金投入。尽管仍然存在重大挑战,但通过坚定我们的决心、加强宣传、增加全球资助者的投资以及通过公平的公私伙伴关系建立更有效的合作,可以克服这些挑战。