Researchers at Baylor Scott & White Research Institute have developed a first-of-its-kind treatment regimen for children infected with tuberculosis (TB), tailored specifically for the way the disease spreads in their bodies. The research is outlined in seven papers published in the October special issue of Clinical Infectious Diseases.
Tuberculosis is one of the world's deadliest infectious diseases, affecting one-third of the population. Children are more likely to get sick with TB disease and to get sick more quickly than adults, according to the Centers for Disease Control and Prevention. The current treatment regimen for children infected with TB is modeled after the regimen for adults, even though the disease acts differently in children. Researchers for this study successfully designed a new treatment regimen that allows for the difference, using data on TB drug levels and response to treatment from children treated in Chennai, South India.
"Treatment for children with any infectious disease is copied and adapted from how we treat adults, but TB in children is very different from TB in adults," said Tawanda Gumbo, MD, investigator at Baylor Scott & White Research Institute and the director of the Center for Infectious Diseases Research and Experimental Therapeutics at Baylor Institute for Immunology Research. Dr. Gumbo is author of the papers published in the special issue of Clinical Infectious Diseases. "In children, TB spreads to the brain and other parts of the body, while in adults it's usually confined to the lungs. Our research takes that difference into consideration. This is a first-of-its-kind in the world of children's health."
In addition to Dr. Gumbo, the Baylor Scott & White Research Institute team involved in the study includes Devyani Deshpande, MD, associate investigator; Jotam Pasipanodya, MD, PhD, assistant investigator; and Shashikant Srivastava, PhD, associate investigator. Dr. Soumya Swaminathan, Director General of the Indian Council of Medical Research, and Dr. Eric Nuermberger of Johns Hopkins University School of Medicine also participated in the initiative.
To develop a TB regimen for children from scratch, researchers conducted experiments with the hollow fiber system model of TB, created by Dr. Gumbo and approved by The European Medicines Agency in 2015 and editorially endorsed by the U.S. Food and Drug Administration. The system is used to select and evaluate possible drugs and treatment regimens before they're tested in clinical trials. Thousands of hollow fibers throughout the unit carry nutrients and antibiotics to multi-drug-resistant mycobacterium tuberculosis, the causative agent of TB, to test which drug concentrations and combinations effectively kill the bacteria.
The series of papers published in Clinical Infectious Diseases outlines the progression of research conducted by Dr. Gumbo and his team, from treatment design to the lab to children. The clinical data and pediatric input came from the team led by Dr. Swaminathan and her colleagues in Chennai, who measured drug levels and treatment response in children being treated for TB with standard regimens. The study, sponsored by the National Institutes of Health, underscores the need for development of more child-specific infectious disease treatments, Dr. Gumbo said.
"There is an immediate need in the world to find a treatment regimen for children with drug-resistant TB," Dr. Gumbo said. "It's so hard to treat and many children die. We're proud to share this important work that will make a difference in the health of millions of people worldwide."
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