Medical scientists reveal the "micro-change" process of tuberculosis, and multi-drug combination is essential
May 05, 2017 Source: Xinhua News Agency
Window._bd_share_config={ "common":{ "bdSnsKey":{ },"bdText":"","bdMini":"2","bdMiniList":false,"bdPic":"","bdStyle":" 0","bdSize":"16"},"share":{ }};with(document)0[(getElementsByTagName('head')[0]||body).appendChild(createElement('script')) .src='http://bdimg.share.baidu.com/static/api/js/share.js?v=89860593.js?cdnversion='+~(-new Date()/36e5)];Funded by the Ministry of Science and Technology and the National Natural Science Foundation of China, Professor Gao Qian and Dr. Liu Qingyun from the Basic Medical College of Fudan University, after four years of research, cooperated with the National Institutes of Health in the United States to reveal the "tuberculosis" in patients with multi-drug combination. The process of micro-change is of great significance in reducing the resistance rate of TB patients and improving the cure rate.
The rise in resistance rates is a huge challenge for tuberculosis prevention and control. In order to improve the cure rate of tuberculosis patients, the World Health Organization recommends that at least four kinds of “effective drugs†should be included in the treatment plan for tuberculosis. The traditional drug resistance test takes 1 to 2 months. Most of the tuberculosis patients in the clinic are not resistant. Drug testing, mainly relying on empiric therapy, has a large blindness. If the patient is infected with a drug-resistant strain, it is easy to cause less than 4 effective drugs in the treatment plan; in this case, what happens to the genome of the tuberculosis in the patient? Will it lead to further accumulation of drug resistance? These issues have yet to be clarified.
Gao Qian’s research team applied ultra-deep genome-wide sequencing technology to select 12 representative patients from 52 TB patients. A total of 53 samples at different time points before and after treatment were deeply sequenced to observe and detect tuberculosis population. The proportion of mutations in the lower, and tracking and in-depth study of the dynamic changes of these mutations. The study found that there are a large number of relatively low mutations in the tuberculosis population in patients. Under the treatment scheme with more than 4 effective drugs, the low frequency mutations in the tuberculosis population were strongly eliminated, and the tuberculosis population was genetically stable, and no accumulation of drug resistance mutations was found. However, under the treatment regimen with less than 4 effective drugs, the changes in tuberculosis are quite different: the proportion of tuberculosis bacteria carrying drug-resistant mutations in the population is increasing, and the tuberculosis bacteria are changed from sensitive to resistant, and appear to be low. Concentration resistance changes to high concentration of drug resistance.
Studies have shown that the number of effective drugs in multi-drug combination therapy is the key to determining whether drug-resistant accumulation of tuberculosis occurs. If a tuberculosis patient is infected with a drug-resistant strain and is already resistant to certain drugs, further use of these drugs will only further increase the risk of drug resistance accumulation, thus affecting the treatment effect.
Experts believe that empirical treatment in the clinic can easily lead to a small number of effective drugs in the treatment program, and tuberculosis further accumulates new drug-resistant mutations during the treatment process, affecting the cure rate. Timely and accurate grasp of drug resistance test results is particularly important for the development and adjustment of treatment options. The promotion and application of new rapid drug resistance diagnostic technology is imminent.
Tuberculosis is still one of the most important infectious disease threats facing the world. The research results have been published online in the latest issue of the internationally renowned biogenetics journal "Genomics Biology", which has attracted academic attention. (Chou Yi, Sun Guogen)
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