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结核病治疗监测和结局指标:新的关注点和新策略。

Tuberculosis Treatment Monitoring and Outcome Measures: New Interest and New Strategies.

机构信息

Department of Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany.

Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.

出版信息

Clin Microbiol Rev. 2022 Sep 21;35(3):e0022721. doi: 10.1128/cmr.00227-21. Epub 2022 Mar 21.

Abstract

Despite the advent of new diagnostics, drugs and regimens, tuberculosis (TB) remains a global public health threat. A significant challenge for TB control efforts has been the monitoring of TB therapy and determination of TB treatment success. Current recommendations for TB treatment monitoring rely on sputum and culture conversion, which have low sensitivity and long turnaround times, present biohazard risk, and are prone to contamination, undermining their usefulness as clinical treatment monitoring tools and for drug development. We review the pipeline of molecular technologies and assays that serve as suitable substitutes for current culture-based readouts for treatment response and outcome with the potential to change TB therapy monitoring and accelerate drug development.

摘要

尽管出现了新的诊断方法、药物和治疗方案,但结核病(TB)仍然是全球公共卫生威胁。TB 控制工作的一个重大挑战是监测 TB 治疗和确定 TB 治疗成功。目前 TB 治疗监测的建议依赖于痰和培养物转换,其敏感性低,周转时间长,存在生物危害风险,并且容易受到污染,从而削弱了它们作为临床治疗监测工具和药物开发的用途。我们回顾了作为当前基于培养的治疗反应和结果读出物的合适替代品的分子技术和检测方法的流水线,这些方法有可能改变 TB 治疗监测并加速药物开发。

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