Tuberculosis research & treatment updates

[anotherlife]

Whilst we don't want tuberculosis in children, tuberculosis used to be the old fashioned population control. How long does it take for tuberculosis to kill an adult? And how long for a child? Lots of famous 19th century artists lived with tuberculosis, most famously the musician Chopin, who lived with tuberculosis for39 years. Hardly a killer desease.

My dad caught TB in WW2 Germany during his American occupation of that country.

He had to spend a year in an Army hospital stateside to get over it.

My mom told me it was a very hard disease to get over.

He was in the prime of his life at the time -- late 20's.

I can only imagine how deadly it would be for children or the elderly.

the progress of TB is HIGHLY variable. In fact-----it can remit spontaneously

Yup and all his life that is what everyone in the family was afraid of.

oh-----well---since world war II----there have been MANY new antibiotics used
to fight TB-------sheeeeeesh-----sorry your people were so wrecked------the damned
little microbe mutates and adapts ----right now --there are new developing resistant
strains

In the 19th century, there were no antibiotics, how did people survive it? You seem to be a doctor. How long would a person survive with untreated tuberculosis?

 

[yiostheoy]

Whilst we don't want tuberculosis in children, tuberculosis used to be the old fashioned population control. How long does it take for tuberculosis to kill an adult? And how long for a child? Lots of famous 19th century artists lived with tuberculosis, most famously the musician Chopin, who lived with tuberculosis for39 years. Hardly a killer desease.

Right now the main population control is warfare on a smaller scale like in Iraq and Iran and the Balkans, and accidents like cars and trains and planes, and influenza in the elderly, and cancer from smoking, and inherited cancer, and heart disease from laziness and gluttony (two of the 7 deadly sins), and starvation in Africa and Latin America.

We have not had a really big war like WW1 or WW2 in a long time.

We have not had a really deadly flu outbreak since 1918.

TB is still very deadly for immigrants and the poor.

 

[irosie91]

Whilst we don't want tuberculosis in children, tuberculosis used to be the old fashioned population control. How long does it take for tuberculosis to kill an adult? And how long for a child? Lots of famous 19th century artists lived with tuberculosis, most famously the musician Chopin, who lived with tuberculosis for39 years. Hardly a killer desease.

My dad caught TB in WW2 Germany during his American occupation of that country.

He had to spend a year in an Army hospital stateside to get over it.

My mom told me it was a very hard disease to get over.

He was in the prime of his life at the time -- late 20's.

I can only imagine how deadly it would be for children or the elderly.

the progress of TB is HIGHLY variable. In fact-----it can remit spontaneously

Yup and all his life that is what everyone in the family was afraid of.

oh-----well---since world war II----there have been MANY new antibiotics used
to fight TB-------sheeeeeesh-----sorry your people were so wrecked------the damned
little microbe mutates and adapts ----right now --there are new developing resistant
strains

In the 19th century, there were no antibiotics, how did people survive it? You seem to be a doctor. How long would a person survive with untreated tuberculosis?

SOMETIMES----rarely---the sickness remits by itself. -----other than that its course is VERY VARIABLE --------can kill quickly or go on and on for decades. The "treatment" in the past was isolation in chilly airy places and
good diet. Exposure to OPENED air did not really kill the mycobacterium----
it just lowered the chance of the infected person -----infecting someone else.
The mycobacterium infects "others" by inspiration of droplets suspended
in the air----which the infected person COUGHS up from his lungs <<< this
was the approach to TB before the AGE OF ANTIBIOTICS--------remember the word QUARANTINE? The good news is that GENERALLY----once a person is
ON MEDICATION------he is not likely to pass the infection on. Of course those
mutated strains manage to OVERCOME. -------it is a really nasty bug

 

[waltky]

Tweaking vancomycin to make it more powerful to fight infection...

Scientists ‘Supercharge’ Powerful Antibiotic
May 30, 2017 - Scientists have tweaked a powerful antibiotic, called vancomycin, so it is once more powerful against life-threatening bacterial infections. Researchers say the more powerful compound could eliminate the threat of antibiotic resistance for many years to come.

Antibiotic resistance, in which microbes no longer respond to drugs, is quickly becoming a global health emergency. Of particular concern are so-called “superbugs,” a handful of pathogens that patients acquire in hospitals and other health care settings. Patients recovering from surgery are particularly vulnerable to the resistant, hospital-borne infections, which put them at high risk of death.

A microbiologist works with tubes of bacteria samples at the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia​

Researchers at The Scripps Research Institute in La Jolla, California, modified vancomycin, invented 60 years ago and considered a last resort treatment against many of these infections. They made a key change to its molecular structure, interfering with how the bacterium, enterococcus, makes protective cells walls. In a new study published in the journal Proceedings of the National Academy of Sciences, investigators describe how the change made vancomycin 1,000 times more effective against both drug-resistant enterococci and the original forms of the microorganism.

‘Total cures’

The modification is in addition to two previous changes made by the Scripps team that improved the drug’s potency, so less of it is needed to treat an infection. Lead researcher Dale Boger, who co-chairs the institution’s Department of Chemistry, said it is difficult for enterococcus to find a way around three independent mechanisms of action. “Even if they found a solution to one of those,” said Boger, “the organisms would still be killed by the other two.” The challenge now for researchers is to reduce the number of steps it takes in the lab to boost vancomycin’s effectiveness. Having redesigned the antibiotic’s molecular structure, Boger called streamlining its production the “easy part.”

Even if researchers are unable to simplify the way the improvements are made, Boger said efforts to supercharge vancomycin are worth it for the antibiotic’s lifesaving powers, calling the drugs “total cures” against bacterial infection. Given the growing failure of antibiotics to treat common infections, Boger said making the super-charged vancomycin molecule is important, even if it’s labor-intensive.

Scientists ‘Supercharge’ Powerful Antibiotic

 

[irosie91]

good news

 

[badger2]

Vancomycin Resistance on the North-South Axis
Effect of meteorological factors and geographic location on methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci coloni... - PubMed - NCBI

 

[waltky]

Vitamin A a day could keep TB away...

Vitamin A Supplement May Thwart Tuberculosis Infection
June 15, 2017 — Family members who live with someone with tuberculosis may be shielded against the highly infectious disease by taking vitamin A. A new study finds that many of those who develop TB are deficient in the nutrient.

In a study of 6,000 people in Lima, Peru, researchers found that those whose diets were lacking in vitamin A had a 10-fold increased risk of developing TB from an infected family member. Young people, between the ages of 10 and 19, were found to have 20 times the risk of developing tuberculosis through close exposure to an infected loved one. Researchers at Harvard Medical School found that having a vitamin A deficiency, common among some 30 percent of the world’s population in mostly developing nations, was a potent predictor of TB disease risk.

A girl is given vitamin A drops during a house-to-house vaccination campaign in Sana'a, Yemen Feb. 20, 2017. A new study found that many of those who develop TB are deficient in the nutrient.​

They said supplementing peoples’ diets with vitamin A may be a powerful tool for preventing TB. Megan Murray of Harvard's Department of Global Health and Social Medicine said investigators followed the participants who lived with someone with TB for one year. All agreed to have their blood drawn at the start of the study. Over the course of the investigation, Murray said 192 people of the 6,000 became sick. Their blood samples, taken at the beginning of the study, were compared to those of other close family members who did not have TB.

‘Really surprised’ by result

“And, in those blood samples, people who had gotten TB were much more likely to have been vitamin A deficient or to be in the lower two quartiles of vitamin A level, so not even technically vitamin A deficient, but just lower than ... people who didn’t get TB. ... And we were really surprised by that result because it wasn’t something we were expecting or looking for,” said Murray. Murray said there’s scientific research that has shown the immune systems of people with vitamin A deficiency maybe negatively impacted, possibly making make them more susceptible to developing TB. The fact that more young people were at risk for tuberculosis infection, said researchers, suggested vitamin A may play an even greater role in the development of their immune systems. But Murray was careful to stress her study did not establish a cause-and-effect relationship between vitamin A deficiency and development of tuberculosis.

Murray was asked whether it might be possible to shield close family members from tuberculosis by giving them vitamin A supplements if they are found to be deficient. “The effect was so strong – as I say, it was so unexpected – that it does raise that question,” she replied. Murray said the next step is to study whether adding vitamin A to antibiotics, given to family members of a loved one with TB, would offer additional protection against the disease. Vitamin A deficiency is defined as less than 200 micrograms per liter of blood. The findings were published in the journal Clinical Infectious Diseases. The U.S. National Institute of Allergy and Infectious Diseases funded the work.

Vitamin A Supplement May Thwart Tuberculosis Infection

 

[badger2]

'For over one hundred years, cod-liver oil, a rich source of vitamins A and D, was used for treatment of tuberculosis.'
(Semba RD, Vitamin A and Infectious Diseases, in Vitamin A and Retinoids: An Update of Biological Aspects and Clinical Applications)

We can see that one problem for vitamin A is that its metabolism can be rerouted into more polar metabolites, so designs for blocking agent pharmacophores are on the cutting edge. It is especially noteworthy that anti-fungal compounds are linked in this study to retinoic acid, such as ketoconazole:

RA / CYP26A1
Antidiabetic Activity of Extract and Compounds from an Endophytic Fungus Nigrospora oryzae. - PubMed - NCBI
'....val331 and Pro439 & Val331....Arg51 is the gatekeeper of the binding pocket....RA (retinoic acid) cannot pass through these narrow gaps on its way to the active site....three hydrophobic amino acid residues (Pro74. Val77, and Leu182, and the methyl group of RA occupies the pocket.....retinoic acid, ketoconazole, fluconazole, econazole, voriconazole....The imidazole groups or triazole group has an important role in achieving the high affinity to block the metabolism of retinoic acid....All-trans retinoic acid (ATRA) is very easy to be metabolized into 4-hydroxy RA in vivo by CYP26A1 and eventually into more polar metabolites.'

 

[waltky]

Scientists accidentally discover Vitamin C Might Shorten Tuberculosis Treatment Time...

Vitamin C Might Shorten Tuberculosis Treatment Time, Study Indicates
January 04, 2018 - A new study has found that anti-tuberculosis drugs killed more bacteria in laboratory mice given a vitamin C supplement than those given drugs alone.

If the findings hold up in human studies, the authors say, the result could be that there's a cheap, safe way to reduce the months-long treatment time for one of the world's leading killers. Also, the vitamin supplement could offer a way to cut down on the development of drug-resistant TB, a serious health threat. Tuberculosis is one of the leading causes of death worldwide. According to the World Health Organization, 1.7 million people died of the disease last year. Of more than 10 million new infections, about 600,000 were resistant to the leading drug. Front-line drugs attack TB cells as they multiply, but a small proportion of the bacteria survive by going dormant. If therapy stops too soon, these "persisters" start multiplying and the patient relapses, often with strains that are resistant to the drugs. Current TB treatment takes six months, largely to outlast the persisters. But it's hard for patients to stay on treatment for so long.

Accidental discovery

Albert Einstein College of Medicine microbiologist William Jacobs and colleagues previously discovered by accident that antioxidants like vitamin C stopped TB bacteria in a test tube from becoming persisters. "When we first discovered it, it was like, 'Wow! There's just so much we don't know yet. And wouldn't that be really cool if it really works,' " Jacobs said. The study in the journal Antimicrobial Agents and Chemotherapy said Jacobs and colleagues found that TB-infected mice treated with two standard drugs plus a high dose of vitamin C had roughly tenfold fewer bacteria in their lungs after several weeks than mice treated with drugs alone. "It's not sterilization yet," he added, "but it's heading in that direction."

Multi-drug-resistant tuberculosis bacteria.​

But will it work in people? "The bottom line is that we don't know the answer," Jacobs acknowledged. "But I think what this study suggests is we should really go and [find out]." Other experts not connected to the study agreed. Even though there has been very little research on vitamin C and tuberculosis, the nutrient is "a safe compound, it's widely available, it's inexpensive," noted David Alland, associate dean of clinical research at Rutgers New Jersey Medical School. "I think that when we have those kinds of options to look at, we should look at them without having to spend decades trying to figure out exactly how they work." And if it does work, he added, "you'd get a big bang for your buck."

Vitamin C Might Shorten Tuberculosis Treatment Time, Study Indicates

See also:

WHO: Yemen Children Dying from Rapid Spread of Diphtheria
January 05, 2018 — The World Health Organization warns that children in Yemen are dying as diphtheria, a preventable disease, spreads rapidly throughout the country.

Forty-six of the more than 470 people with clinically diagnosed diphtheria in Yemen — or nearly 10 percent — have died in less than four months, according to WHO. "Diphtheria is a highly infectious but vaccine-preventable disease," WHO spokesman Tarik Jasarevic said. "It can be treated with antitoxins and antibiotics, both of which are in short supply in Yemen. The diphtheria vaccine is normally administered as a part of routine immunization programs for children around the world. "The rapid spread of diphtheria in Yemen highlights major gaps in routine vaccination and also means the health system is under severe strain."

Sixty-eight percent of suspected diphtheria cases are children under 15 years old, Jasarevic said. WHO has deployed Rapid Response Teams throughout affected parts of the country to ensure proper case detection, contact tracing and follow up, as well as health education.

Nahla Arishi, a pediatrician, checks a boy infected with diphtheria at the al-Sadaqa teaching hospital in the southern port city of Aden, Yemen​

WHO has delivered $200,000 worth of antibiotics and 1,000 vials of diphtheria antitoxins, Jasarevic said. The medication can help stop the spread of the bacterium to vital organs in patients already infected with diphtheria.

However, prevention remains the best way to contain the spread of the disease. In preparation for a nationwide immunization campaign, the U.N. children's fund imported 5.5 million doses of anti-diphtheria vaccines into the country December 20. The final decision on when the campaign will kick off rests with Yemeni health authorities, who have not yet given the go-ahead.

WHO: Yemen Children Dying from Rapid Spread of Diphtheria

 

[irosie91]

thanks for the Vit. C. update-------but, actually----it is empirically logical.