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New Drug To Stop Tuberculosis Epidemic
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Researchers at The University of Manchester are developing a new drug against tuberculosis (TB), one of the oldest human infectious diseases, which is now threatening to reach epidemic proportions once more.
TB poses a serious threat to all nations with its incidence and mortality continuing to grow worldwide, triggered by new viral infections like HIV. It has coexisted with the human population since the Iron Age and currently infects one third of the population. About 90% of infected people carry a latent infection for a lifetime span; the remainder develop the active disease triggered by age, poor health and poverty, as well as by co-infections. Despite the decline of the disease thanks to the introduction of vaccines in the last century, the emergence of new viral infections like HIV/AIDS has resulted in resurgence of TB. Today, more people die of TB than of any other curable infectious disease. TB has turned into a health threat of serious proportions with a major social and economic impact all around the world.
In addition the disease's long history and the problematic use of previous treatments have resulted in the multi-drug resistant strains.
Dr Lydia Tabernero and her team, together with Dr Jen Cavet at the Faculty of Life Sciences, have been awarded £700,000 Medical Research Council (MRC) funding to develop a drug against the disease that will be simpler to use, quicker in its action and, being new, able to combat even drug resistant strains. This research will be developed in collaboration with Professor Franzblau and Dr Abad-Zapatero at the University of Illinois in Chicago.
Dr Tabernero explains: "Antibiotic resistance is the most serious obstacle in the cure and eradication of TB. This is, in part, due to lack of compliance from patients during the complex and long treatment. Multi-drug resistant TB now affects more than 50 million people, with an increasing percentage of cases evolving into extensively drug resistant TB that is extremely hard to treat.
"Existing treatments are more than 40 years old. Clearly, to tackle drug resistance and prevent future epidemics, we need new approaches and novel anti-TB drugs. Several promising compounds are now under development with a few in clinical trials, while alternative potential targets are also being characterised.
"New approaches and therapeutical treatments are urgently needed to tackle the increasing spread of the infection, by reducing drug resistance, time of treatment and to be compatible with anti-retroviral therapies. We propose to fulfil these unmet therapeutical needs by targeting a unique virulence factor (MptpB) from the causing agent of TB, M. Tuberculosis."
Dr Tabernero added: "We are very pleased to have received this funding as it will allow us to develop a drug that will combat a dangerous but somewhat overlooked disease.
"A main bottleneck in the development of inhibitory compounds is that generally resources and expertise are concentrated in the private sector. Companies are highly reluctant to allocate serious investments in 'poor people's diseases' that would compromise their return benefits.
"We have characterised the activity profile of a protein known to be a virulence factor for TB causing bacteria and propose to develop a new drug against this target to treat TB. We have already identified compounds, which are potent inhibitors of this protein. To take our ambitions further, we must now develop some of the leads we have identified and be able to test them. This will only be possible in a non-profit academic environment at this stage."
Dr Tabernero hopes to develop the new drug within three to four years and to start clinical trials in the near future.
For more information or to arrange an interview with Dr Lydia Tabernero contact media relations officer Mikaela Sitford on 0161 275 2111 or Mikaela.Sitford@manchester.Ac.Uk.
Editor's Note:
The University of Manchester's Faculty of Life Sciences (FLS), with more than 1000 people involved in research, 1700 undergraduate students and an annual total budget of £65 million, is one of the largest and most successful unified research and teaching organisations of its kind in Europe. See http://www.Ls.Manchester.Ac.Uk/
The Medical Research Council supports the best scientific research to improve human health. Its work ranges from molecular level science to public health medicine and has led to pioneering discoveries in our understanding of the human body and the diseases which affect us all.
TB Epidemic Alert
by BEEZY MARSH, Daily Mail
Britain may be facing an epidemic of tuberculosis, experts warned yesterday.
Parts of London already have a higher rate of the potentially-fatal disease than many Third World countries.
There are fears that one in six new immigrants are infected, and concerns at a shortage of specialist doctors and nurses able to spot TB.
The alarm was sounded at a Parliamentary briefing by the Stop TB Partnership, an alliance of the World Health Organisation and leading lung doctors.
Paul Sommerfeld, director of the charity TB Alert, said poverty, travel and migration could all be playing a part in the increasing number of cases in London and other urban areas.
The number of cases in the capital has doubled from 1,500 in 1987 to 3,000 last year. Mr Sommerfeld said that despite Government and NHS efforts 'this disease still seems to be leaping ahead of the investment'.
The rate of TB in the London borough of Brent is now higher than in China and twice as high as in Brazil.
The number of cases identified across the UK this year is expected to at least equal last year's total of 7,300, a figure which brought Britain back to levels of the 1970s.
More than 70 per cent have their origins abroad.
Dr Chris Dye, of the World Health Organisation, said London could face an epidemic like the one which swept New York in the 1980s, killing hundreds of people.
He added: 'The overall trend for TB cases in most European countries is downwards, but in the UK it is going up and that is very worrying. Parts of London now have rates as high as the highest found in the world.'
Drug-resistant forms of the disease are also on the increase.
One in 20 TB patients has a form which is resistant to the most commonly-used antibiotics. And one in 100 faces an even more deadly threat from a multi-drug resistant form which kills around half of all those it infects.
The meeting heard that early findings of research into 1,000 TB sufferers by the Public Health Laboratory Service suggest that 17 per cent of new immigrants - one in six - has the disease.
Gini Williams, public health lecturer at City University in London, warned that about 13 per cent of all TB patients come through hospital accident and emergency wards, which often means they are not seeking treatment until they are very ill.
One victim of the disease, Pensions Minister Ian McCartney, told the meeting how he spent nine months of agony, being told he had everything from work stress to ME, before he was finally diagnosed with TB.
Drug treatment to clear the disease worked. But it was only this year, ten years later, that he received full treatment for a range of serious and painful complications related to TB.
Mr McCartney called for more awareness about TB and more staff to provide proper follow-up care. He said: 'It should not have taken ten years of arguing, complaining and bouts of serious illness to get an after-care strategy. If this was the case for me, what is it like for people who don't have a voice?'
The minister believes he contracted TB while working with high-risk groups including the homeless and alcohol abusers.
Professor Peter Ormerod, spokesman for the British Thoracic Society, said more resources are needed to tackle the disease at grassroots level, and some estimates are that £10million would make major improvements.
Studies had shown that of 43 districts in the UK with above average levels of TB, only five have sufficient TB nurses. Lung specialists are also thin on the ground, with between 150 and 300 more needed in the next five years to keep pace with demand.
The briefing came as it was revealed that checks on two London hospitals had found up
to half the TB patients who came to casualty wards were not correctly diagnosed, despite showing typical symptoms including coughing up blood, fever and night sweats.
The audit, carried out by doctors at the Newham Chest Clinic in East London and at Middlesex Hospital, said language problems may hamper diagnosis but staff need to be more aware of the possibility of TB.
Shadow Health Secretary Dr Liam Fox called last night for all immigrants to be screened at ports of entry, as happens in the U.S. And Australia. He said Government failure to act on the crisis is a public health crime.
The Department of Health said an action plan on tackling TB will be published next year.
It also emerged that fresh supplies of the BCG vaccine needed to inoculate high-risk groups and children have arrived in the UK from Denmark. The BCG programme was suspended in August due to fears over the potency of jabs supplied by Labour donor Dr Paul Drayson's Powderject firm.
{"status":"error","code":"499","payload":"Asset id not found: readcomments comments with assetId=150250, assetTypeId=1"}TB's Surprising Results
Did you know? The settlement of cities such as Los Angeles and Denver occurred, in part, due to tuberculosis patients - or consumptives - who moved there seeking better health in the curative climate of the American West. The tuberculosis epidemic also led to the country's very first public health campaign.
By the early 1900s, more scientists began to accept that highly contagious bacteria - and not heredity - spread tuberculosis. The acceptance of tuberculosis as a contagion had a huge impact on American society, not only in medicine and public health policy, but also in recreation, city planning, and even popular fashion.
Waffle ConeA "penny lick" was a tiny portion of ice cream in a small glass container that vendors sold for only one penny. The glass, which created the illusion of a larger portion, often contained merely just one lick's worth of ice cream. Customers licked the glasses clean and returned them; the vendor would then reuse the container for the next customer. Once word spread about the highly contagious nature of tuberculosis and several other diseases, vendors needed to find a different way of serving their ice cream to customers.
An ice cream vendor in New York City named Italo Marchiony developed a pastry cup to hold ice cream, which he patented in 1903. In 1904, at the St. Louis World's Fair, another ice cream vendor, Ernest A. Hamwi, independently developed his own ice cream cone made from a crisp waffle-like pastry. With the decline of the unsanitary glass penny lick containers (London banned them in 1899), Marchiony and Hamwi's edible cones became widely used by vendors across America, with cone production reaching a whopping 245 million by 1924.
Shorter HemlinesAround the turn of the century, most American women wore long dresses and skirts that reached the ground. But those skirts could be major carriers of germs found on one's floors and out in the streets. Once it became widely known that the tubercle bacilli from someone's saliva could survive for an entire day, women abandoned their long dresses, skirts, bodices, and bustles in favor of shorter hemlines that would not drag along potentially germ-ridden sidewalks.
ShavingMost men at the turn of the century featured stylish beards or mustaches, but showing off a smooth face became a new trend once public health officials maintained that men could transmit dangerous infectious particles through the scruff of their facial hair. An editorial in a 1903 Harper's Weekly stated, "Now that consumption is no longer consumption, but tuberculosis, and is not hereditary but infectious…the theory of science is that the beard is infected with the germs of tuberculosis." Ultimately, the clean-shaven look became a symbol of the new middle-class man during the period that Harper's Weekly labeled the "the revolt against the whisker."
No SpittingUp until the late 19th century, spitting in public was considered acceptable social behavior in America, whether it was merely spitting saliva or discarding one's chewing tobacco. With the increased knowledge into the contagious nature of tuberculosis and other diseases at the turn of the century, flyers and newspapers warned Americans against "the filthy habit" of spitting in public. Dr. Edward Otis, President of the Boston Tuberculosis Association advised, "If you have a cough, and must spit, use a paper napkin or a piece of newspaper, and put it in the stove." Many communities banned spitting in shops, theaters, taverns and required public gathering places to provide spittoons.
Children's HygieneIn an effort to prevent the spread of tuberculosis through good hygiene practices, public health officials encouraged school-aged children to join the "Modern Health Crusade." School children were given daily "chores" to ensure healthy habits such as washing their hands before every meal, brushing their teeth twice a day, and sleeping 10 or more hours with their bedroom window open. By completing these tasks, children could rise through the ranks within the Crusade - levels like page, squire or knight -- with badges, pins and banners presented to signify their success and status. Organizers claimed these incentives made healthy "chores" less boring, and instead "things to be accomplished with enthusiasm."
Reclining ChairsSanatoriums -- establishments for people convalescing from chronic illnesses such as tuberculosis -- often used various forms of reclining chairs or "cure chairs" to help treat patients. Placed outside on porches, the chair backs could be adjusted to tilt at varying degrees, making it possible for patients to get fresh air while resting in comfortable semi-reclined positions. In the early 20th century, wealthier individuals began purchasing stylish versions of these reclining chairs so they could take advantage of the health benefits of sunbathing outside their private homes. By the 1950s, tuberculosis was on the decline in America due to medical advancements like the discovery of effective antibiotics; however, by that time, the cure chairs had come to represent fashionable modernist furniture. Americans still use contemporary versions of the original reclining cure chairs in their living rooms today.
Playgrounds and Recreation CentersAround the 1920s, public health reformers argued that the health of the nation should not be dependent on sanatoria or hospitals, but should instead rely on recreation in the readily available outdoors. In an effort to encourage more active lifestyles, and thus help to stave off disease, cities launched initiatives to beautify parks with trees and lively vegetation and to build public recreation areas in order to create more pleasant environments. Additionally, the encouragement of larger recreational spaces played a role in creating more space between buildings and thus reducing overcrowding.
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