Host-directed therapies for multidrug resistant tuberculosis

Publication date: Available online 14 November 2016 Source:International Journal of Mycobacteriology Author(s): Alimuddin Zumla, Markus Maeurer Tuberculosis (TB) causes 1.3 million deaths annually. There are 0.5 million cases of multidrug resistant TB (MDR-TB) and the number of cases is rising globally. The current status quo of the lengthy treatment duration and poor treatment outcomes associated with MDR/extensively drug-resistant TB, and those with comorbidity of TB with human immunodeficiency virus and noncommunicable diseases in sub-Saharan Africa is unacceptable. The TB drug pipeline remains sparse. New innovations for shortening the duration of therapy and improving treatment outcomes (cure and long-term functional disability due to lung damage) are urgently required. A wide range of host-directed therapies (HDT) are now available which require evaluation as adjuncts to current TB drug treatment. Examples are: (1) Repurposed drugs: • Analgesics/nonsteroidal anti-inflammatory drugs (cyclooxygenase-2 inhibitors, e.g., ibupofen). • Cholesterol-lowering drugs (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, e.g., simvastatin). • Asthma drugs (leukotriene synthesis inhibitors, e.g., zileuton). • Diabetes drugs (reactive oxygen species removal and increased CD8+ T-cell responses (e.g., metformin). • Anticonvulsants (inhibition of histone deacylation, e.g., valproic acid). (2) Cellular therapy: using the patient’s own bone marrow-derived stro...
Source: International Journal of Mycobacteriology - Category: Infectious Diseases Source Type: research