Persisting positron emission tomography lesion activity and Mycobacterium tuberculosis mRNA after tuberculosis cure
| Autor: | Stephanus T, Malherbe, Shubhada, Shenai, Katharina, Ronacher, Andre G, Loxton, Gregory, Dolganov, Magdalena, Kriel, Tran, Van, Ray Y, Chen, James, Warwick, Laura E, Via, Taeksun, Song, Myungsun, Lee, Gary, Schoolnik, Gerard, Tromp, David, Alland, Clifton E, Barry, Jill, Winter, Gerhard, Walzl, Lance, Lucas, Gian van der, Spuy, Kim, Stanley, Lani, Thiart, Bronwyn, Smith, Nelita, Du Plessis, Caroline G G, Beltran, Elizna, Maasdorp, Annare, Ellmann, Hongjo, Choi, Joonsung, Joh, Lori E, Dodd, Brian, Allwood, Coenie, Koegelenberg, Morné, Vorster, Stephanie, Griffith-Richards |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Adult Male Pathology medicine.medical_specialty Tuberculosis Adolescent Antitubercular Agents General Biochemistry Genetics and Molecular Biology Article Lesion Mycobacterium tuberculosis 03 medical and health sciences South Africa Young Adult Positron Emission Tomography Computed Tomography Medicine Humans Positron emission RNA Messenger Lung Tuberculosis Pulmonary Aged medicine.diagnostic_test biology business.industry Sputum General Medicine Lung scan Middle Aged medicine.disease biology.organism_classification 030104 developmental biology medicine.anatomical_structure Positron emission tomography Female medicine.symptom business Bronchoalveolar Lavage Fluid |
| Zdroj: | Nature medicine. 22(10) |
| ISSN: | 1546-170X |
| Popis: | The absence of a gold standard to determine when antibiotics induce a sterilizing cure has confounded the development of new approaches to treat pulmonary tuberculosis (PTB). We detected positron emission tomography and computerized tomography (PET-CT) imaging response patterns consistent with active disease, along with the presence of Mycobacterium tuberculosis (MTB) mRNA in sputum and bronchoalveolar lavage samples, in a substantial proportion of adult, HIV-negative patients with PTB after a standard 6-month treatment plus 1 year follow-up, including patients with a durable cure and others who later developed recurrent disease. The presence of MTB mRNA in the context of nonresolving and intensifying lesions on PET-CT images might indicate ongoing transcription, suggesting that even apparently curative treatment for PTB may not eradicate all of the MTB bacteria in most patients. This suggests an important complementary role for the immune response in maintaining a disease-free state. Sterilizing drugs or host-directed therapies, and better treatment response markers, are probably needed for the successful development of improved and shortened PTB-treatment strategies. |
| Databáze: | OpenAIRE |
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