Frontiers in Immunology (Oct 2020)

Perspective for Precision Medicine for Tuberculosis

  • Christoph Lange,
  • Christoph Lange,
  • Christoph Lange,
  • Christoph Lange,
  • Christoph Lange,
  • Rob Aarnoutse,
  • Dumitru Chesov,
  • Dumitru Chesov,
  • Dumitru Chesov,
  • Dumitru Chesov,
  • Reinout van Crevel,
  • Stephen H. Gillespie,
  • Hans-Peter Grobbel,
  • Hans-Peter Grobbel,
  • Hans-Peter Grobbel,
  • Barbara Kalsdorf,
  • Barbara Kalsdorf,
  • Barbara Kalsdorf,
  • Barbara Kalsdorf,
  • Irina Kontsevaya,
  • Irina Kontsevaya,
  • Irina Kontsevaya,
  • Arjan van Laarhoven,
  • Tomoki Nishiguchi,
  • Anna Mandalakas,
  • Matthias Merker,
  • Matthias Merker,
  • Matthias Merker,
  • Stefan Niemann,
  • Stefan Niemann,
  • Stefan Niemann,
  • Niklas Köhler,
  • Niklas Köhler,
  • Niklas Köhler,
  • Jan Heyckendorf,
  • Jan Heyckendorf,
  • Jan Heyckendorf,
  • Maja Reimann,
  • Maja Reimann,
  • Maja Reimann,
  • Morten Ruhwald,
  • Patricia Sanchez-Carballo,
  • Patricia Sanchez-Carballo,
  • Patricia Sanchez-Carballo,
  • Dominik Schwudke,
  • Dominik Schwudke,
  • Dominik Schwudke,
  • Franziska Waldow,
  • Franziska Waldow,
  • Andrew R. DiNardo

DOI
https://doi.org/10.3389/fimmu.2020.566608
Journal volume & issue
Vol. 11

Abstract

Read online

Tuberculosis is a bacterial infectious disease that is mainly transmitted from human to human via infectious aerosols. Currently, tuberculosis is the leading cause of death by an infectious disease world-wide. In the past decade, the number of patients affected by tuberculosis has increased by ~20 percent and the emergence of drug-resistant strains of Mycobacterium tuberculosis challenges the goal of elimination of tuberculosis in the near future. For the last 50 years, management of patients with tuberculosis has followed a standardized management approach. This standardization neglects the variation in human susceptibility to infection, immune response, the pharmacokinetics of drugs, and the individual duration of treatment needed to achieve relapse-free cure. Here we propose a package of precision medicine-guided therapies that has the prospect to drive clinical management decisions, based on both host immunity and M. tuberculosis strains genetics. Recently, important scientific discoveries and technological advances have been achieved that provide a perspective for individualized rather than standardized management of patients with tuberculosis. For the individual selection of best medicines and host-directed therapies, personalized drug dosing, and treatment durations, physicians treating patients with tuberculosis will be able to rely on these advances in systems biology and to apply them at the bedside.

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