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通过精准医学、药物研发和队列研究创新在结核病治疗中搭建科学与政策的桥梁:一项叙述性综述

Bridging science and policy in tuberculosis treatment through innovations in precision medicine, drug development, and cohort research: a narrative review.

作者信息

Min Jinsoo, Andrade Bruno B, Kim Ju Sang, Jeong Yoolwon

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Laboratory of Clinical and Translational Research, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil.

出版信息

Ewha Med J. 2025 Apr;48(2):e22. doi: 10.12771/emj.2025.00115. Epub 2025 Apr 2.

DOI:10.12771/emj.2025.00115
PMID:40703366
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12277494/
Abstract

Recent advancements in tuberculosis treatment research emphasize innovative strategies that enhance treatment efficacy, reduce adverse effects, and adhere to patient-centered care principles. As tuberculosis remains a significant global health challenge, integrating new and repurposed drugs presents promising avenues for more effective management, particularly against drug-resistant strains. Recently, the spectrum concept in tuberculosis infection and disease has emerged, underscoring the need for research aimed at developing treatment plans specific to each stage of the disease. The application of precision medicine to tailor treatments to individual patient profiles is crucial for addressing the diverse and complex nature of tuberculosis infections. Such personalized approaches are essential for optimizing therapeutic outcomes and improving patient adherence-both of which are vital for global tuberculosis eradication efforts. The role of tuberculosis cohort studies is also emphasized, as they provide critical data to support the development of these tailored treatment plans and deepen our understanding of disease progression and treatment response. To advance these innovations, a robust tuberculosis policy framework is required to foster the integration of research findings into practice, ensuring that treatment innovations are effectively translated into improved health outcomes worldwide.

摘要

结核病治疗研究的最新进展强调了创新策略,这些策略可提高治疗效果、减少不良反应并坚持以患者为中心的护理原则。由于结核病仍然是一项重大的全球卫生挑战,整合新的和重新利用的药物为更有效的管理提供了有前景的途径,尤其是针对耐药菌株。最近,结核病感染和疾病中的谱概念已经出现,强调了开展旨在制定针对疾病每个阶段的治疗计划的研究的必要性。应用精准医学根据个体患者情况定制治疗方案对于应对结核病感染的多样性和复杂性至关重要。这种个性化方法对于优化治疗结果和提高患者依从性至关重要,而这两者对于全球结核病消除努力都至关重要。还强调了结核病队列研究的作用,因为它们提供关键数据以支持这些定制治疗计划的制定,并加深我们对疾病进展和治疗反应的理解。为了推进这些创新,需要一个强大的结核病政策框架来促进将研究结果整合到实践中,确保治疗创新有效地转化为全球范围内改善的健康结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/adfb4767ac22/emj-2025-00115f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/e1c61bd43658/emj-2025-00115f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/794141a0b090/emj-2025-00115f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/9861d978a79c/emj-2025-00115f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/adfb4767ac22/emj-2025-00115f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/e1c61bd43658/emj-2025-00115f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/794141a0b090/emj-2025-00115f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/9861d978a79c/emj-2025-00115f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a8/12277494/adfb4767ac22/emj-2025-00115f4.jpg

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本文引用的文献

1
Tuberculosis: An Update for the Clinician.《结核病:临床医生最新指南》
Respirology. 2025 Mar;30(3):196-205. doi: 10.1111/resp.14887. Epub 2025 Jan 31.
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Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis.耐利福平、对氟喹诺酮敏感的结核病的口服治疗方案
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High-Dose Rifampicin for 3 Months after Culture Conversion for Drug-Susceptible Pulmonary Tuberculosis.药敏性肺结核培养转阴后给予3个月高剂量利福平治疗
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Impact of pyrazinamide usage on serious adverse events in elderly tuberculosis patients: A multicenter cohort study.吡嗪酰胺使用对老年肺结核患者严重不良事件的影响:一项多中心队列研究。
PLoS One. 2024 Sep 26;19(9):e0309902. doi: 10.1371/journal.pone.0309902. eCollection 2024.
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Need for high-resolution observational cohort studies to understand the natural history of tuberculosis.需要开展高分辨率观察性队列研究以了解结核病的自然史。
Lancet Microbe. 2024 Oct;5(10):100908. doi: 10.1016/S2666-5247(24)00140-X. Epub 2024 Jul 3.
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Effect of complicated, untreated and uncontrolled diabetes and pre-diabetes on treatment outcome among patients with pulmonary tuberculosis.复杂、未经治疗和控制的糖尿病及糖尿病前期对肺结核患者治疗结局的影响。
Respirology. 2024 Jul;29(7):624-632. doi: 10.1111/resp.14714. Epub 2024 Mar 27.
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Tuberculosis Notification and Incidence: Republic of Korea, 2022.结核病通报与发病率:大韩民国,2022年
Tuberc Respir Dis (Seoul). 2024 Jul;87(3):411-413. doi: 10.4046/trd.2024.0018. Epub 2024 Feb 28.
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Long term management of people with post-tuberculosis lung disease.肺结核病后患者的长期管理。
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Short oral regimens for pulmonary rifampicin-resistant tuberculosis (TB-PRACTECAL): an open-label, randomised, controlled, phase 2B-3, multi-arm, multicentre, non-inferiority trial.简短口服方案治疗肺部利福平耐药结核病(TB-PRACTECAL):一项开放标签、随机、对照、2B-3 期、多臂、多中心、非劣效性试验。
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