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A new study by researchers from Leicester and Nottingham has shown the potential of a new blood test not only to diagnose human tuberculosis, but also to identify those most at risk of developing the disease, according to findings published in a medical journal. Clinical Infectious Diseases.
Despite recent cuts, England still has one of the highest tuberculosis rates in Western Europe. While tuberculosis cases have generally decreased in the United Kingdom, the TB rate in some of the most disadvantaged areas remains more than seven times higher than in the least disadvantaged. Tuberculosis is a serious bacterial infection, which can be life threatening if it is not properly treated with antibiotics. Pulmonary tuberculosis of the lungs or throat is contagious, although tuberculosis can affect any part of the body.
The research, conducted at the Leicester Biomedical Research Center (BRID) of the National Institute of Health Research (NIHR) and the School of Biosciences at the University of Nottingham, used a new blood test called Actiphage to research the presence of the bacterium responsible for tuberculosis (Mycobacterium tuberculosis, MTB). The study included 66 participants divided into four groups: those with active pulmonary tuberculosis, those with latent tuberculosis, a control group of patients referred for suspected tuberculosis but whose disease was not proven, and a control group of healthy individuals.
The new blood test was used to test all patients twice, 12 months apart. Actiphage was tested positive in 73% of people for whom we subsequently diagnosed tuberculosis. For an experimental study, this rate was much higher than expected. None of the control group participants were tested positive with Actiphage and none of the patients with latent TB who tested negative with Actiphage developed active TB.
Curiously, two of the three participants with latent TB infection and positive for Actiphage developed the disease more than six months later, suggesting that the test could play a predictive role in identifying infected individuals who may develop disease.
Dr. Pranabashis Haldar, keynote speaker at the University of Leicester and respiratory medicine consultant in Leicester Hospitals, is the main author of the article:
"Tuberculosis is the leading cause of death from infectious disease, most commonly affecting the lungs, and is transmitted to others by coughing and sneezing." Due to lack of diagnostic tools for people who can not expectorate, the diagnosis is delayed, which increases the chances of spreading the disease. "
About a quarter of the world's population is infected. In the vast majority of cases, it is latent tuberculosis, which does not affect their health, but presents a risk of progression to the active form of tuberculosis in about 10% of infected persons. The mechanism for this is poorly understood.
Dr. Haldar added, "Our observations provide new information on how human TB is developing and corroborate recent evidence of the existence of a transient state of TB infection called incipient TB." that does not produce symptoms but carries a high risk of progression to active TB.Actiphage could be developed, both as a traditional blood test for the diagnosis of tuberculosis and as a test used in programs screening to help us identify and treat people with latent infections.
"As a blood test, it is especially suited to patients unable to produce sputum, including children, and can help support diagnosis in underserved groups struggling to access freely available health care resources."
The new Actiphage test was developed by the University of Nottingham in collaboration with the Royal Veterinary College of the United Kingdom and marketed by PBD Biotech to treat major livestock diseases, mainly in the form of a blood or milk test. screening for bovine tuberculosis and Johne's disease. This is the first time that the blood test is tested in humans.
Unlike many common bacterial infections, the detection of the bacterium at the origin of TB is limited by the fact that Mycobacterium tuberculosis (MTB) is growing very slowly, making traditional culture methods ineffective. The faster molecular tests for detecting MTB DNA are limited because of the strength of its cell wall that makes DNA extraction difficult. The new test uses a specific bacteriophage that infects living MTB and opens the cells to release DNA. The entire test process can be completed in just 6 hours.
Dr. Catherine Rees, co-author of the study, badociate professor of microbiology at the University of Nottingham and Senior Science Officer at PBD Biotech, said:
"Actiphage is a new blood test to detect mycobacteria that has been developed to identify mycobacterial infections in livestock, to help farmers control these difficult diseases.
"The data from our initial human study suggest that after infection, MTB circulates in the blood to levels previously undetectable and that the immune system may not be able to effectively contain the bacteria in the lungs.
"While we are cautious about generalizing from a small sample, we are optimistic that these early results indicate that Actiphage can be used as a tool to help us better understand the dynamics of infection in humans.
"The new Actiphage blood test offers the opportunity to target patients at risk of TB and allow for rapid treatment.The development of this test is very exciting and requires further study."
The paper, "A new high-sensitivity test of bacteriophages identified a low M. tuberculosis bacteremia in immunocompetent patients with active and debilitating tuberculosis," can be viewed at the following address: Clinical Infectious Diseases academy.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciz548/5522421?
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Notes for editors
Contacts for media inquiries:
For the NIHR Leicester Biomedical Research Center: [email protected] 0116 2584971/07950891193
For the University of Nottingham: [email protected] or [email protected]
For Biotech PBD test developers: [email protected] 01952 202789
About the NIHR Leicester Biomedical Research Center
The Leicester Biomedical Research Center (BRN) of the National Institute of Health Research (NIHR) is a partnership between the NHS Trust of the University of Leicester Hospitals, the University of Leicester and Loughborough University. It is funded by the National Institute of Health Research (NHRI).
NIHR's Leicester BRC at Leicester is undertaking translational clinical research in priority areas of high disease burden and clinical need. These include cardiovascular diseases, respiratory diseases and lifestyle, obesity and physical activity. There is also a cross-cutting theme for precision medicine. BRC harnesses the power of experimental science to explore and develop ways to prevent and treat chronic diseases. It brings together 70 highly qualified researchers, including 30 at the forefront of clinical service delivery. By having scientists work closely with clinicians, the CRB can conduct relevant research for patients and the professionals who treat them.
The National Institute for Health Research (NSRI) is the largest funder of health and care research in the country. The NIHR:
- Funding, support and high-quality research relevant to the NHS, public health and social care
- Involve and involve patients, caregivers and the public to improve the reach, quality and impact of research
- Attracts, trains and supports the best researchers to face the complex challenges of the future in health and care
- Invests in world-clbad infrastructure and qualified delivery personnel to translate discoveries into better treatments and services
- Collaborate with other public funders, charities and the sector to maximize the value of research for patients and the economy
NIHR was created in 2006 to improve the health and wealth of the country through research. It is funded by the Ministry of Health and Social Affairs. In addition to its national role, the NHRI supports applied health research in the direct and vital interest of people in low- and middle-income countries, with the help of the UK government in the United Kingdom.
This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. NIHR recognizes and values the role of patient data, which is securely accessed and stored, both to support and improve research and care. http: // www.
About Nottingham University
The University of Nottingham is a research-intensive university with a proud heritage, consistently ranked among the top 100 universities in the world. Studying at the University of Nottingham is a life changing experience and we are proud to unleash the potential of our 44,000 students – Nottingham was Named both Sports and International University of the Year in the 2019 Times guide and Sunday Times Good University, he won gold at TEF 2017 and is in the top 20 of the top three British rankings. We have a pioneering spirit, expressed in the vision of our founder, Sir Jesse Boot, who has shown us the way by establishing campuses in China and Malaysia – part of a global network of education, research and technology. industrial commitment. In the UK, we rank eighth for UK research power, in line with REF 2014. We have six brands of research excellence that help transform lives and change the world. We are also an employer and a major industrial partner, locally and globally.
About the University of Leicester
The University of Leicester is led by Discovery and Innovation – an international center of excellence recognized for research, teaching and expanding access to higher education. It is one of the top 25 Times Higher Education Times Research Education REF universities with 75% of the world's highest quality research, which has many impacts on society, health, culture and culture. # 39; environment. The university has just over 20,000 students and about 3,000 staff members.
Our centenary
On November 11, 2018 (Armistice Day), the University of Leicester celebrated the centenary of the end of the First World War. This date also marks the beginning of the history of the creation of a university in Leicester, intended to pay tribute to those who made sacrifices during the Great War. This is reflected in the motto of the university, Ut vitamin habeant – "so that they can have life". The university was founded in 1921 under the names of Leicester, Leicestershire and Rutland University College. This short film tells the story of our foundation.
Out of this world looking
Researchers at the University of Leicester have a long and distinguished experience in space science discovery. Every year since 1967, an instrument built by Leicester operates in space. We have occupied and held critical roles in many space missions for space agencies, including the recent Mercury BepiColombo mission. The University is a partner of Space Park Leicester, a new center for the badysis and commercialization of data development and space missions.
About PBD Biotech
PBD Biotech Limited specializes in the use of a new technology based on bacteriophages. The company has developed a patented technology that can be used to detect the presence of mycobacteria such as Mycobacterium bovis (bovine tuberculosis) and Mycobacterium avium subsp.paratuberculosis (MAP, Johne's disease), which are important causes of morbidity and loss of life. productivity in the agricultural industry. In addition, this technology is applicable as a screening tool for human tuberculosis.
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