Reporter : Tian Yating / http://news.sciencenet.cn/htmlnews/2020/11/449294.shtm / Translation, editing : Gan Yung Chyan, KUCINTA SETIA / Image : Wear masks to prevent tuberculosis and other respiratory infectious diseases
A covid epidemic has made people realize the power of infectious diseases; it is also this epidemic, but people have ignored other infectious diseases, such as tuberculosis known as the "white plague". In fact, this ancient and terrifying respiratory infectious disease has never been far away from us.
Tuberculosis, which many people think only appears in costume dramas, is actually still one of the top ten causes of death in the world and the leading cause of death from a single infectious disease. Some experts pointed out that according to the current rate of decline in tuberculosis incidence and death, if there are no major breakthroughs in diagnostic technology, drugs, vaccines and protection strategies, it may be difficult to achieve the World Health Organization's 2030 goal of eliminating tuberculosis.
News (1)
China's tuberculosis mortality rate fell for the first time to the bottom of the 30 high-burden countries
A few days ago, the World Health Organization released the 2020 Global Tuberculosis Report. The report shows that in 2019, about 10 million people worldwide developed tuberculosis, and about 1.4 million people died of tuberculosis. Tuberculosis is still the world's number one infectious disease killer. my country is one of the countries with a high burden of tuberculosis in the world. In 2019, there were approximately 833,000 cases of the disease, of which 33,000 died.
It is worth mentioning that the report shows that for the first time, the death rate of tuberculosis in my country has dropped to the bottom of the 30 high-burden countries. Chen Zhongdan, a technical officer for HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis of the World Health Organization China Office, believes that this benefited from the first international tuberculosis strategy implemented by my country in the past 20 years, which has enabled my country to make significant progress in tuberculosis control and prevention. Achieved and exceeded the Millennium Development Goals for tuberculosis five years ahead of schedule, including reducing the infection rate of tuberculosis by half and the mortality rate by 80% between 1990 and 2010. From 2000 to 2019, the incidence rate decreased by 45.7%, of which, from 2015 to 2019, the incidence rate decreased by 10.8%.
At the same time, China has also made progress in the detection and treatment of drug-resistant tuberculosis. According to Chen Zhongdan, among TB patients diagnosed with etiology, the proportion of patients who received rifampicin-resistant tests and the proportion of patients diagnosed with drug-resistant TB who started second-line treatment increased from 45% and 46% in 2017 to 81 in 2019. % And 74%, the upward trend is obvious.
News (2)
Drug-resistant tuberculosis is still a public health crisis, and may lead to poverty due to illness
It is understood that although the death rate of tuberculosis in China fell to the bottom of high-burden countries for the first time, the burden of tuberculosis disease in China is still heavy, especially for drug-resistant tuberculosis.
Why is drug-resistant tuberculosis so concerned? The reasons are not difficult to find. First, the treatment is difficult, and the second is the high disease burden. A considerable proportion of tuberculosis patients face a heavy economic burden, which is an important factor restricting tuberculosis diagnosis, timely treatment, standardized treatment and successful treatment. Chen Zhongdan pointed out that the current global catastrophic expenditure on tuberculosis is 49%, but the situation faced by different tuberculosis patients is very different. 44% of sensitive tuberculosis patients face catastrophic expenditure, while 80% of drug-resistant tuberculosis patients face catastrophic expenditure.
China is the "hardest hit area" of drug-resistant tuberculosis. Compared with ordinary tuberculosis, drug-resistant tuberculosis has a longer treatment cycle and the patient's disease burden is heavier. However, the public's attention to tuberculosis is not high enough.
It is understood that as long as patients with sensitive tuberculosis are treated on time, the cure rate is very high, but there is not only one type of tuberculosis, and the treatment rate and cure rate of drug-resistant tuberculosis patients are not high. According to the World Health Organization report, in 2019, about 500,000 people worldwide developed drug-resistant tuberculosis, of which only 38% of drug-resistant tuberculosis patients were treated, and the cure rate was only 57%. Drug-resistant tuberculosis is still a public health crisis.
"The detection of drug-resistant tuberculosis usually requires pathogenic methods to find bacteria to diagnose tuberculosis patients, and then carry out drug-resistant testing. However, in my country, a major problem with drug-resistant tuberculosis is that the proportion of tuberculosis patients is not high. Chen Zhongdan said that 57% of tuberculosis patients worldwide are diagnosed through etiology, while in high-income European and American countries, 84% of tuberculosis cases are diagnosed through etiology, but in my country, this number is less than 50%. Therefore, there is an urgent need to further strengthen quality control, increase the proportion of tuberculosis diagnosed in the etiology, thereby improving prevention and diagnosis, especially the detection and treatment of patients with drug-resistant tuberculosis.
At the same time, medical expenditure is also an important factor affecting the treatment of drug-resistant tuberculosis patients. According to Chen Zhongdan, in 2019, the World Health Organization analyzed the per capita medical expenditure of MDR-TB patients reported by 89 countries. The current treatment plan in China costs about 60,000 to 70,000 yuan for the entire treatment course. As new drugs are included and treatment plans are updated, the cost will increase significantly, reaching RMB 200,000 to 300,000 or more. At present, tuberculosis diagnosis and treatment are not completely free services, especially the diagnosis and treatment of drug-resistant tuberculosis and treatment monitoring services, which are not completely covered by medical insurance and national tuberculosis programs. Different studies have shown that tuberculosis and multidrug-resistant tuberculosis are one of the main diseases that cause poverty and return to poverty due to illness. Fortunately, in the treatment of drug-resistant tuberculosis, the development and promotion of new tuberculosis drugs is accelerating. Li Liang, deputy director of Beijing Chest Hospital, recently introduced that after the introduction of the two new drugs, Bedaquinoline and Dramani, some drug-resistant patients have begun to use them and have achieved good results. At present, nearly 1,500 patients across the country have used Bedaquiline for free, and the cure rate is as high as 85%. Moreover, Bedaquinoline and Dramani were included in the medical insurance level B list at the end of last year, and patients only need to pay part of it. Li Liang expressed the hope that these new drugs can enter the Class A catalog as soon as possible, so that more patients can afford these new and good drugs. In fact, not only Bedaquinoline and Dramani, the World Health Organization report shows that as of August 2020, 22 drugs, multiple different anti-tuberculosis drug programs and 14 candidate vaccines are undergoing clinical trials. In addition, new testing technologies and products have made tuberculosis testing easier and more accurate.
News (3)
The epidemic disrupted the fight against tuberculosis, and the negative impact was huge
What needs to be emphasized is that the current world tuberculosis prevention and control is facing problems such as high disease burden and insufficient capital investment. Although the prevention and treatment of tuberculosis has saved 60 million lives worldwide since 2000, the progress of prevention and treatment is still slow, and investment and actions are far below the need to end the tuberculosis epidemic. Moreover, the new crown pneumonia epidemic has had a huge negative impact on the prevention and treatment of tuberculosis.
During the epidemic, medical services for some TB patients were interrupted, and it was also more difficult to find TB patients. A study by the China CDC on the impact of SARS-CoV-2 on tuberculosis showed that compared with the previous three years, the number of tuberculosis cases detected in the first quarter of this year has dropped significantly. In addition, the number of follow-ups for confirmed patients has also decreased significantly. According to statistics from the World Health Organization, the number of tuberculosis patients whose tuberculosis medical services were interrupted, detected and treated fell by 25% to 50% in just three months. Affected by this, the number of global tuberculosis deaths in 2020 alone may increase by 200,000 to 400,000. Chen Zhongdan also pointed out that data from several countries with a high burden of tuberculosis showed that the number of reported cases of tuberculosis dropped sharply from January to June 2020.
Experts call for the need to continue to increase investment in tuberculosis, promote tuberculosis research and development and innovation, and achieve the goal of ending tuberculosis.
News (4)
Use telemedicine and Internet medical treatment to improve the tuberculosis prevention and control system
As the Director-General of the World Health Organization Dr. Tan Desai said at the 51st International Tuberculosis Association Global Lung Health Conference, the new crown pneumonia epidemic should not be an excuse for the suspension of tuberculosis diagnosis and treatment services. On the contrary, the new crown pneumonia epidemic should become It is an effective way to promote the development of various public health undertakings including tuberculosis prevention and control, and accomplish various prevention and control goals through innovative and efficient remote digital medical treatment, home isolation treatment and other resources at hand.
Li Liang believes that Internet medical care is very suitable for respiratory infectious diseases such as tuberculosis, and this epidemic also provides an opportunity to improve the existing diagnosis and treatment system, allowing us to adopt new forms of telemedicine and Internet medical treatment to improve prevention. Control system.
In fact, the management model of patients with new coronary pneumonia, which is also an infectious disease of the respiratory system, also provides experience for the prevention and control of tuberculosis. Li Liang said that to control respiratory infectious diseases, the first is to find the source of infection, the second is to cut off the route of transmission, isolate the source of infection, and the third is to protect the susceptible population. The reason why my country's new coronary pneumonia prevention and control has made significant progress lies in early detection, early isolation, and early treatment. In the past, we mainly adopted the management method of "not hospitalized" for the chronic infectious disease of tuberculosis. Although not being hospitalized can prevent infections between patients and patients, patients and medical staff, and avoid occupying medical resources, at the same time, this management method increases the risk of tuberculosis transmission. Li Liang believes that after the new crown pneumonia epidemic, perhaps we should re-examine the measures and policies for non-hospital treatment. "China is very big and the conditions are not the same. It is impossible to make a one-size-fits-all, but I think that if the conditions are ripe, inpatient treatment for infectious tuberculosis patients can be implemented." Li Liang said.
Li Liang also emphasized that at present, the majority of tuberculosis patients found in our country are still “seeing doctors due to symptoms”, that is, patients who have symptoms and are screened out after being examined in the hospital, but in fact, half of tuberculosis patients do not have any clinical symptoms. People are likely to be undetected and cause wider spread. Therefore, major breakthroughs must be made in testing and treatment and technology, such as being able to actively screen key populations.
News (5)
Vigorously promote R & D and innovation to achieve the goal of ending tuberculosis
This year's World Health Organization report also sent a worrying signal. Whether it is the 2020 milestone set by the "End Tuberculosis Strategy" or the global target set by the United Nations High-Level Conference on Tuberculosis, there are challenges to achieving on schedule. Dr. Ren Minghui, Assistant Director-General of Infectious and Non-Communicable Diseases of the World Health Organization, said at the 51st International Tuberculosis Association Global Lung Health Conference that in recent years, the incidence and death of tuberculosis have been declining, but the rate of decline is still Not fast enough, we are still far from completing our goal of eliminating tuberculosis on schedule.
Researchers at Harvard University also believe that it has become very difficult to achieve the goal of eliminating tuberculosis by 2030. To achieve the goal of reducing tuberculosis mortality by 90% and morbidity by 80% on the basis of 2015, I am afraid that it will not be until 2045. . This also means that the world will pay an additional $3 trillion in economic losses for this, and at the same time, the number of patients who will die of tuberculosis will be 5 million more than originally planned.
Take my country as an example. If the World Health Organization's goal of ending tuberculosis is to be achieved, that is, by 2035, the incidence of tuberculosis will be reduced from the current 60/100,000 to below 10/100,000. Li Liang said that in the past 10 years, the decline rate of tuberculosis in my country has been around 2% to 3% per year. Even if calculated according to the highest 3%, it will take a long time to drop below 10/100,000, and it will be far from the 2035 target. There is a great distance. If there are no major breakthroughs in diagnostic technology, drugs, vaccines, and protection strategies, it will be very difficult to achieve this goal.
Chen Zhongdan said that it is necessary to vigorously promote the prevention and treatment of people at high risk of tuberculosis, while relying on scientific and technological progress, strengthening the level of diagnosis and treatment, and strengthening drug research and development, so that patients can obtain faster, accurate, convenient, and affordable diagnosis and treatment and care services.
In addition, in the covid pandemic, people are most concerned about the progress of vaccine research and development. At present, many countries have been conducting clinical research on new crown vaccines. At the 51st International Tuberculosis Association Global Lung Health Conference, many experts also called for attention to the development of tuberculosis vaccines. Although tuberculosis is a traditional infectious disease, its severe global spread requires a sense of urgency to promote various measures to end tuberculosis. "If there is a good vaccine in the future, we won't get TB since we were young, then we are closer to the goal of ending TB," Li Liang said.
■ Extended reading
Why tuberculosis is called the white plague
Tuberculosis patients lose weight in the late stage, and their skin is pale due to malnutrition and anemia. Therefore, tuberculosis is also called the "white plague." In an era of medical scarcity, there is no cure for tuberculosis, almost a terminal illness.
Since the disease is mainly spread through the respiratory tract, and 80% of it occurs in the lungs, in the eyes of many people, tuberculosis is equivalent to tuberculosis, which is commonly known as "tuberculosis". In fact, tuberculosis can occur in any organ except hair and nails, but it mainly affects the lungs. Pulmonary tuberculosis is a tuberculosis lesion that occurs in the lung tissue, trachea, bronchi, and pleura. Strictly speaking, tuberculosis is only one type of tuberculosis, but the infection and disease sites are concentrated in the respiratory system.
News (6)
New progress in tuberculosis research and diagnosis in recent years
The severe shortage of funds hindered progress in ending tuberculosis. Chen Zhongdan pointed out that the pledged funds for tuberculosis diagnosis, treatment and care are insufficient. In 2020, the pledged funds for tuberculosis prevention, diagnosis, treatment and care are US$6.5 billion, which is only half of the US$13 billion goal agreed by leaders of the United Nations in the United Nations Political Declaration on Tuberculosis. In addition, the target also includes an annual R & D investment of 2 billion U.S. dollars, which is 900 million in 2018. It can be seen that the funding gap for tuberculosis prevention and treatment is still relatively large.
Low investment does not mean that it is not important. By comparing the number of deaths and the corresponding funding from 2008 to 2018, it can be found that the number of deaths from tuberculosis far exceeds the number of deaths from AIDS and malaria, but the funding for tuberculosis is this. The least of the three diseases shows that the funding for tuberculosis is not consistent with the disease burden.
Although funding is limited, a lot of progress has been made in tuberculosis research and development and diagnosis in recent years. Chen Zhongdan introduced that as of August 2020, a total of 11 diagnosis and treatment technologies have been approved by the World Health Organization, and 19 are under evaluation. In terms of tuberculosis drugs, a total of 22 drugs are in progress in Phase I, Phase II, and Phase III clinical trials, of which 16 are in Phase III clinical trials, and vaccine development has also made progress.
News (7)
Maintain hygiene to prevent tuberculosis
Because of this new crown pneumonia epidemic, human beings have changed many hygiene and living habits. Maria Van Kerkhove, an infectious disease epidemiologist at the World Health Organization and technical director of COVID-19, said that in the past few months, many people have gradually changed their previous behaviors, maintaining social distance, Wearing a mask and paying attention to hand hygiene are these changes in behavior that have helped many regions gradually recover from the epidemic.
Li Liang pointed out that even if there is no SARS-CoV-2, these habits should be adhered to, because wearing a mask can not only prevent covid, but also prevent tuberculosis and other respiratory infections.
Regarding hand hygiene, Li Liang believes that besides washing hands frequently, there are still many other issues that need attention. For example, the elevator button, it is recommended to use the smallest area to touch the button. You can touch the button with the dorsal joint of the knuckles instead of the skin side joints, which can reduce the spread of bacteria between the hands.
Less gathering is also a high-frequency word this year. Whether it is tuberculosis, covid or other infectious diseases, it is easy to cause transmission in densely populated places, especially when there are more respiratory infectious diseases in autumn and winter. If the public can continue to stick to these good habits and form good hygiene and health habits they can reduce the occurrence of many infectious diseases.
In addition, there are several high-risk factors leading to the onset of tuberculosis, of which the highest risk is malnutrition. According to Chen Zhongdan, of the 10 million new tuberculosis patients in the world in 2019, about 2.2 million are related to malnutrition. Other high-risk factors include alcoholism, smoking, HIV infection, and diabetes. Among the 830,000 newly diagnosed cases in my country last year, about 160,000 were ill due to malnutrition, about 100,000 were smoking, and about 75,000 were drinking. Chen Zhongdan said that these high-risk factors also remind us that we can think about the prevention and control of tuberculosis from a broader perspective, and consider other health development issues, such as poverty alleviation strategies to reduce the number of tuberculosis patients caused by malnutrition. At the same time, tobacco control, alcohol control, and strengthening the management of diabetic patients will help reduce the incidence of tuberculosis.
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News (8)
Chinese researchers have discovered an important mechanism of tuberculosis infection
Reporter : Qiu Yi / Publisher : Xinhua News Agency / http://news.sciencenet.cn/htmlnews/2020/1/434943.shtm / Direct translation
Xinhua News Agency, Shanghai, January 17 (Reporter Qiu Yi) How does the Mycobacterium tuberculosis that cause tuberculosis cause disease? The research team of Professor Ge Baoxue from Tongji University School of Medicine and Shanghai Pulmonary Hospital Affiliated to Tongji University, together with the research team of Academician Rao Zihe of the Institute of Immunochemistry of Shanghai Techological University, has recently discovered that a protein secreted by tuberculosis bacteria is very "smart". It can use the body's protein molecules to attack its own immune function, thereby producing virulence, leading to the occurrence of tuberculosis.
Studies have found that when the human body is infected with tuberculosis bacteria, tuberculosis bacteria can secrete the virulence factor Rv0222, and Rv0222 can effectively resist the attack from the human immune system after using the body's protein modification system to effectively resist the attack from the human immune system. The human immune system successfully escapes and causes disease.
Professor Zhao Guoping, academician of the Chinese Academy of Sciences, and former chairman of the Chinese Medical Association Tuberculosis Branch, Professor Xiao Heping from Shanghai Pulmonary Hospital affiliated to Tongji University, said that this study fully explained the escape mechanism of tuberculosis bacteria using the human ubiquitination system to resist human immune attacks. The discovery of a new mechanism of human protein modification system that helps tuberculosis infection cause disease has broadened the vision of the role of protein modification system in the regulation of infectious diseases.
At the same time, through protein structure analysis and functional exploration, the researchers accurately pointed out that the Rv0222 virulence protein is modified by K-11 ubiquitination on its lysine at position 76 and exerts its virulence, which can be used as a new type of antibody in subsequent studies. The development of tuberculosis drugs provides more precise targets.
This important medical research result was published online in Nature on the 16th under the title of "Mycobacterium tuberculosis protein uses host ubiquitination system to inhibit immunity".
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News (9)
Guangzhou Institute of Biology, Chinese Academy of Sciences discovered a new target for the first-line anti-tuberculosis drug pyrazinamide
http://news.sciencenet.cn/htmlpaper/2017522144573543810.shtm / Direct translation
According to the latest statistics of the World Health Organization, the number of new tuberculosis cases worldwide has increased from 9 million to 14 million each year, and 1.4-1.5 million deaths per year (1.8 million deaths in 2015). Tuberculosis (tuberculosis, TB) is a fatal infectious disease caused by Mycobacterium tuberculosis (Mtb), which is mainly transmitted through breathing. It was formerly known as tuberculosis. Since the end of the 1980s, due to the neglect of tuberculosis prevention and control, the increase in population mobility, the co-infection of Mtb and HIV, the emergence of multidrug-resistant, extensively drug-resistant, and even fully drug-resistant tuberculosis, tuberculosis has become global Resurgence within.
Recently, Zhang Tianyu’s research group from the Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences and the Tuberculosis Laboratory of the State Key Laboratory of Respiratory Diseases discovered that a bifunctional enzyme encoded by Rv2783c may be a new target for PZA. Related research results Pyrazinoic Acid Inhibits a Bifunctional Enzyme in Mycobacterium tuberculosis was published in Antimicrobial Agents and Chemotherapy (DOI: 10.1128/AAC.00070-17) hosted by the American Society for Microbiology on April 24. The first author of the paper is Moses Njire, an international student from Guangzhou Academy of Biology, and the second author is Wang Na.
Pyrazinamide (PZA) is the most unique anti-TB drug. Its own anti-tuberculosis activity is not obvious, but when added to first-line drugs, the course of treatment can be shortened by more than 3 months and the recurrence rate can be significantly reduced. Many therapies containing second-line drugs and new drugs recently marketed can only be used in combination with PZA, and their effects will be obvious. Therefore, PZA is of great significance for the treatment of tuberculosis, especially drug-resistant TB. The mechanism of PZA has always been a mystery. It is clear that PZA is a prodrug and needs to be catalyzed by Mtb's pyrazinoic acid (PZase) to become an active drug pyrazinoic acid (POA), but its target is confusing. It was not until an article published in Science in 2011 that it was discovered that the ribosomal protein RpsA may be the target of PZA, and it was proposed that POA promotes the killing of Mtb by inhibiting trans-translation, especially Mtb in a persistence state. Persistence is a ubiquitous phenomenon of pathogenic bacteria, that is, during the treatment process, the bacteria are phenotypically resistant and difficult to be eliminated, but there is no genetic mutation. After the antibiotics are removed, these bacteria will grow up again and remain sensitive to the same antibiotics.
The research team found that overexpression of the mutant Rv2783c gene can cause Mtb to be resistant to PZA; POA can bind to the Rv2783 protein, but PZA does not bind to it, and POA does not bind to the Rv2783 protein; the Rv2783 protein encoded by the gene Rv2783c is confirmed for the first time It has the function of polynucleotide phosphorylase (PNPase) and the activity of guanosine pentaphosphate synthase (GPS I) (as shown). When studying the function of PNPase, the research team pioneered new analytical methods and achieved success. The results showed that Rv2783 protein has the function of synthesizing ssDNA and RNA independently of the template, and has the function of degrading ssDNA and RNA. GPS I function is mainly responsible for hydrolysis rather than synthesis of (p)ppGpp. POA can interfere with these functions and PZA itself does not interfere with these functions. These functions are important physiological guarantees for the survival of Mtb, especially in adversity. POA interferes with DNA repair, or interferes with the stability of various RNAs, or even synthesizes the wrong RNA to synthesize mutant proteins, which may well explain the "persistence" phenomenon, that is, only a small part of the bacteria in the population produces mutant proteins Thus phenotypic resistance (tolerance to drugs), but their genome has not changed. In addition, Rv2783 may also prevent the tuberculosis bacteria from recovering from adversity by inhibiting the hydrolysis of (p)ppGpp by tuberculosis bacteria and kill the tuberculosis bacteria in a persistent state. The results of the study show that the protein is likely to be a new target for PZA.
The research helps to reveal the formation mechanism of persistence bacteria (especially persistence Mtb), and provides a theoretical basis for the development of new anti-TB drugs and new therapies. At the same time, it may provide new molecular markers for the diagnosis of PZA sensitivity, and may also provide useful inspiration for the development of better PZA sensitivity detection technology. The research was supported by the National Natural Science Foundation of China, the Chinese Academy of Sciences project, the UCAS scholarship, the CAS-TWAS scholarship, the Guangzhou Science and Technology Project and the National Key Laboratory of Respiratory Diseases. (Source: Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences)
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News (10)
Indian study found that combined drug treatment can quickly eliminate tuberculosis bacteria
http://news.sciencenet.cn/htmlnews/2019/12/433452.shtm / Direct translation
According to Indian media reports, an Indian research team has newly discovered the mechanism by which tuberculosis bacteria produce drug resistance and successfully prevented the activation of this drug resistance mechanism through a two-month treatment. It almost completely eliminates the bacteria in the lungs of mice, and can effectively reduce the probability of recurring infection.
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, and its morbidity and mortality are high in India. According to a recent report by the Hindu, a research team led by Amit Singh, the Infectious Disease Research Center of the Indian Institute of Science, found that the combined use of the antimalarial drug chloroquine and the tuberculosis drug isoniazid can achieve basic results within 8 weeks. Eliminate all tuberculosis bacteria in the lungs of mice and guinea pigs, and reduce the probability of recurrence. Related research results were published in the American journal "Science Translational Medicine".
When the body is infected by a pathogen, the first line of defense for immune cells, macrophages, is to lower the pH of the cells and turn them into an acidic environment. However, researchers found that not only did the mildly acidic environment fail to control the tuberculosis bacteria, it promoted a small number of bacteria to continue to multiply and develop resistance. The researchers hypothesized that by adjusting the pH of macrophages, the bacteria might be sensitive to drugs.
The anti-malaria drug chloroquine has been shown to neutralize the pH of macrophages, preventing bacteria from triggering resistance in an acidic environment, so that the anti-tuberculosis drug isoniazid can play a role. In vitro culture studies using cell lines and mouse macrophages have shown that these two combined drug treatments are three to five times more effective than treatment with anti-tuberculosis drugs in reducing tuberculosis burden.
To determine the recurrence after treatment, the research team first used a combination of drugs to completely eliminate tuberculosis bacteria from the lungs of infected mice in animal experiments. After 8 weeks, they used drugs to suppress the immune system of the mice, and then placed them with high bacterial content. It was found that all the five mice treated with isoniazid only relapsed with tuberculosis, while three of the five mice treated with the combination therapy were infected with only a few bacteria.
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