Rockwood Neesha, du Bruyn Elsa, Morris Thomas, Wilkinson Robert J
a Department of Medicine , Imperial College London , London , UK.
b Clinical Infectious Diseases Research Initiative, Institute of Infectious Diseases and Molecular Medicine and Department of Medicine , University of Cape Town , Observatory , South Africa.
Expert Rev Respir Med. 2016 Jun;10(6):643-54. doi: 10.1586/17476348.2016.1166960. Epub 2016 Mar 31.
Antibiotic treatment of tuberculosis has a duration of several months. There is significant variability of the host immune response and the pharmacokinetic-pharmacodynamic properties of Mycobacterium tuberculosis sub-populations at the site of disease. A limitation of sputum-based measures of treatment response may be sub-optimal detection and monitoring of Mycobacterium tuberculosis sub-populations. Potential biomarkers and surrogate endpoints should be benchmarked against hard clinical outcomes (failure/relapse/death) and may need tailoring to specific patient populations. Here, we assess the evidence supporting currently utilized and future potential host and pathogen-based models and biomarkers for monitoring treatment response in active and latent tuberculosis. Biomarkers for monitoring treatment response in extrapulmonary, pediatric and drug resistant tuberculosis are research priorities.
结核病的抗生素治疗疗程长达数月。宿主免疫反应以及疾病部位结核分枝杆菌亚群的药代动力学-药效学特性存在显著差异。基于痰液的治疗反应测量方法的一个局限性可能是对结核分枝杆菌亚群的检测和监测不够理想。潜在的生物标志物和替代终点应以确切的临床结局(治疗失败/复发/死亡)为基准,可能需要针对特定患者群体进行调整。在此,我们评估支持目前使用的以及未来基于宿主和病原体的潜在模型和生物标志物用于监测活动性和潜伏性结核病治疗反应的证据。用于监测肺外、儿童和耐药结核病治疗反应的生物标志物是研究重点。