Biomarkers of tuberculosis
TB is a contagious bacterial lung infection, affecting millions of people worldwide. Although treatment has been available via antibiotics, resistant strains of the TB bacterium now make such treatment ineffective. The EU-funded TB PROGNOSIS (A progress of tuberculosis and HIV/tuberculosis treatment assessed by fingerprinting of small molecule-biomarkers in patients from eastern Europe) project investigated the management of drug-resistant TB in Ukraine. Hence, the team established international collaboration among countries affected by TB in various ways. Researchers explored metabolites able to serve as biomarkers for monitoring TB treatment. The team analysed a broad range of blood metabolites (small organic molecules) using metabolomics. The technique combines chromatography and mass spectrometry with multivariate statistical analyses in order to assess patients’ blood samples. A second aspect of research involved the identification of TB strains in Ukraine and their drug resistance profiles. Researchers used a new generation of gene sequencing techniques to compare strains and identify mutation for drug resistance. The genomic results were combined with conventional methods for tracking drug resistance. The project arranged for the exchange of more than 10 young and 10 experienced researchers among Spain, Sweden and Ukraine. Participants were trained in relevant diagnostic methods and in genomics research. Data collected from Ukraine involving 65 TB patients and 15 healthy subjects showed that the TB patients’ metabolomes differed from those of the healthy volunteers. The metabolomes also differed between patients responding well or poorly to treatment. Such findings open up the possibility of developing a laboratory test for the monitoring of treatment progress. DNA sequencing of 186 Ukrainian strains of the TB bacterium showed that one highly drug-resistant strain accounts for most transmission within the Ukrainian population. The discovery challenges the standard treatment regimen in Ukraine, and opens up the possibility of alternative treatment strategies. Researchers also showed that only HIV-positive subjects receive TB screening. Hence, the team identified a need for improved screening programmes. The project’s work helped to reform screening and treatment of TB in Ukraine, thereby improving outcomes for patients.
Keywords
Biomarkers, tuberculosis, resistant strain, TB PROGNOSIS, HIV, drug resistance