Coordinator: Dr. José Antonio Ainsa
Tuberculosis (TB) still is a major global health problem, as around nine million new cases and close to two million deaths are caused per year. Even if all countries are affected, about the 85% of the cases are in Africa (30%) and Asia (55%), and India and China alone represent 35%. Co-infection with HIV represents the 10% of the annual TB cases, and these patients are in high risk to develop TB .
In most cases, TB can be considered a curable disease. Up to 90% of people infected with drug-susceptible M .tuberculosis can be cured in six months using a combination of first-line drugs. However, multidrug-resistant TB (MDR-TB) emerged and represents a challenging problem at health-services, as it requires up-to 2 year-treatment with second-line drugs, which are more expensive and have more side effects. Moreover, the cure rates for MDR-TB are still lower, 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, research and development, and financing. The goals for 2015 were to obtain diagnostic tests for active TB and latent TB infection; to predict the risk of progression to active disease and to detect 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 and four new TB vaccine candidates in Phase III clinical trials for safety and efficacy.
The CIBERES consortium was also established in 2006, and also was the TB line at CIBERES. The present research project is the evolution from previous versions, and its topics are on line with the “The Global Plan to Stop TB 2011-15”.
The current TB line project at CIBERES is structured to develop new tools in fundamental research, prevention, diagnosis and treatment of tuberculosis (TB) with the following objectives:
Prevention: Design and evaluation of new vaccine candidates against TB including: clinical development of MTBVAC, construction of a multivalent live attenuated vaccine based in the three modern M. tuberculosis families, and design or a hiper-attenuated vaccine for immunocompromised individuals; development and evaluation of new prophylactic strategies to avoid TB infection and active disease; and development a novel strategy to control high-risk TB transmission events integrating whole genome sequencing (WGS) and tailored strain-specific PCRs.
Diagnosis: Study of TB lesions obtained in surgical procedures in search of best biomarkers correlating with TB pathology, clinical features, multidrug resistant (MDR) cases and prognostic; Development and evaluation of new immunological and molecular tests for diagnosis of latent TB infection (LTBI) and disease; Development of new techniques point-of-care for the rapid diagnosis of TB, especially addressed to low income countries with high TB incidences; and Development and evaluation of new tools in molecular epidemiology of TB.
Treatment: Anti-tuberculosis drug pipeline: basic research translated into drug development; Evaluation of new therapeutic strategies (host-directed therapies) against TB; and Development of new approach to study host-pathogen interaction with new anti-drug formulations.