Studies Suggest New Targets for Tuberculosis TreatmentsMarch 07, 2006With the hope of designing more effective treatments for tuberculosis (TB), scientists from the U.S. Department of Energy's Brookhaven National Laboratory and collaborating institutions have published the first detailed reports on the biochemistry and structure of a protein-cleaving complex that is essential to the TB bacterium's survival. The research is published in two papers in the March 2006 issue of Molecular Microbiology, which features a rendition of the "proteasome" structure on its cover. "Understanding the structure and biochemistry of this proteasome, and how it is different from those found in human cells, could greatly improve prospects for developing specific proteasome-based anti-tuberculosis treatments," said biophysicist Huilin Li, who led Brookhaven's role in the research. Mycobacterium tuberculosis, the bacterium that causes TB, infects one person in three worldwide. In most infected people, who remain symptom-free, the bacterium is kept in check within immune system cells known as macrophages by compounds such as nitric oxide that kill or disable most bacteria. The current hypothesis is that the compounds work by damaging or destroying proteins, and the accumulated damaged proteins kill the cells if not removed.
The current studies reveal that TB bacteria have a sophisticated way to remove the damaged proteins - a protein-cleaving complex known as a proteasome - with wide specificity for degrading protein parts. This protein cleanup mechanism allows Mycobacterium tuberculosis to remain in macrophages, and possibly go on to cause active TB infections. With details revealed, it could also serve as a target for new anti-TB drugs. "If we could find a way to specifically inhibit the activity of this Mycobacterium tuberculosis proteasome, then we might have a new, effective treatment for TB," said Li. "Such a treatment might even eradicate TB microbes from infected individuals who show no signs of infection." One complicating factor is that human cells also contain proteasomes for degrading unneeded proteins. This process is essential for human cell survival. So any drug targeting the TB proteasome would have to be extremely specific. This was one reason for conducting such detailed structural and biochemical studies, to try to identify the unique characteristics that would allow such a targeted drug design. In addition, the scientists conducted studies to see how an analog for a newly approved anti-myeloma drug that targets human proteasomes binds to the TB proteasome. These studies revealed highly specific details of the proteasome active site and mechanism, which will be invaluable to designing TB specific inhibitors. The proteasome structure was revealed by Guiqing Hu and collaborators using cryo electron microscopy in Brookhaven Lab's Biology Department and by x-ray crystallography at the Lab's National Synchrotron Light Source. It is a cylindrical gated structure, which suggests that it requires an activator that has yet to be investigated. The biochemical studies were conducted at Weill Medical College of Cornell University by Gang Lin in a group led by Carl Nathan. Other collaborating institutions included the Max Planck Institute of Biochemistry, Cold Spring Harbor Laboratory, and Millennium Pharmaceuticals. This research was funded by the Office of Biological and Environmental Research within the U.S. Department of Energy's Office of Science, the National Institutes of Health, and Brookhaven's Laboratory Directed Research and Development program. Brookhaven National Laboratory | ||||||||||
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Related Tuberculosis Treatment Current Events and Tuberculosis Treatment News Articles Certain HIV treatment less effective when used with anti-TB therapy Patients receiving rifampicin-based anti-tuberculosis therapy are more likely to experience virological failure when starting nevirapine-based antiretroviral therapy, an HIV treatment that is widely used in developing countries because of lower cost, than when starting efavirenz-based antiretroviral therapy. Patients with tuberculosis should be more involved in decisions about their treatment Tuberculosis (TB) is a major killer, causing up to two million deaths worldwide every year. Treatment takes many months and many patients fail to complete the course of drugs prescribed. Patients with TB should be more involved in decisions about their treatment Tuberculosis (TB) is a major killer, causing up to two million deaths worldwide every year. Treatment takes many months and many patients fail to complete the course of drugs prescribed. TB relapse due to low weight gain after initial treatment Among tuberculosis (TB) patients who were underweight when diagnosed, those who subsequently regained less than five percent of their weight during the first two months of treatment had a significantly increased risk of disease relapse, according to results from a large study. Building On Sucess: Scope For Further Expansion Of Tuberculosis Control In China The results of an initiative to reduce tuberculosis in China-supported by the World Bank and WHO-are reported in this week's issue of THE LANCET. Disease prevalence has been reduced by around 30% in areas where a treatment programme was introduced a decade ago; authors of the study comment that expansion of the programme to all areas of China will further improve national and global tuberculosis control. China has 1"¢4 million new cases of tuberculosis every year-more than any country except India. A tuberculosis control project based on short-course chemotherapy using anti-tuberculosis drugs within the internationally recommended DOTS strategy was introduced in half the country in 1991 Study suggests chest radiography unnecessary to identify tuberculosis among HIV patients in resource-poor settings (pp 1516, 1551) Embargoed 0001 h (London time) 7 November 2003. Authors of a research letter in this week's issue of THE LANCET provide evidence that counters UNAIDS/WHO guidelines with respect to preventive tuberculosis treatment for people with HIV-1 infection. Chest radiography-considered important by UNAIDS/WHO in screening out people with tuberculosis before preventive antibiotic treatment can be initiated-was not found to be necessary. HIV-1 infection is a major risk factor for tuberculosis. Preventive antibiotic programmes are being initiated in some less-developed settings; however this approach can only be effective if patients with active tuberculosis are excluded, to avoid the emergence of antib COST-EFFECTIVENESS ASSESSMENTS IMPORTANT FOR HIV RESPONSE IN AFRICA (p 1635) A systematic review in this week's issue of THE LANCET highlights the importance of cost-effectiveness evaluation to identify realistic intervention programmes to tackle HIV/AIDS in Africa. HIV/AIDS accounts for around 20% of all deaths in Africa. The cost-effectiveness of interventions is important as African governments face difficult choices in striking the right balance between prevention, treatment, and care, all of which are necessary to deal with the HIV/AIDS epidemic. Andrew Creese from WHO, Geneva, Switzerland, and colleagues assessed existing data and their implications for value-for-money strategies to combat HIV/AIDS in Africa. The investigators identified over 60 reports that m TNF-Alpha Blocker Infliximab Highly Effective For Patients With Ankylosing Spondylitis BERLIN, Germany - 6 April 2002 -- For the first time, there is a therapy that can significantly reduce disease activity for the majority of patients with ankylosing spondylitis (AS), a chronic inflammatory rheumatic disease that often leads to stiffening and subsequent fusion of the spine. The study, published in the April 6 issue of "The Lancet," found more than 80 percent of patients treated with infliximab (also known as Remicade?) experienced clinical improvement and more than 50 percent had their disease activity reduced by more than half. "Treatment with infliximab, a biological medication from the new group of tumor necrosis factor alpha (TNF-?) blockers, can be regarded West Meets East - WHO TuberculosisTreatment Results of a tuberculosis trial, published in this week’s issue of The Lancet, suggest that a WHO strategy could make a valuable contribution to tuberculosis control in Russia. There has been a resurgence of tuberculosis in Russia in the past decade, mainly due to the collapse of the health-care infrastructure in the 1980s and early 1990s. Traditional Russian services for treatment of tuberculosis are very different from those in the West. Patients suspected of having the disease are referred to specialist tuberculosis hospitals or sanatoria. Treatment methods combine chemotherapy with a range of additional treatments, some of which predate the chemotherapy era (10% of patients undergo INCREASED RISK OF TUBERCULOSIS RECURRENCE IN PEOPLE WITH HIV-1 INFECTION (pp 1470, 1488) People with HIV-1 infection are at an increased risk of recurrent tuberculosis, and could benefit from preventative treatment after the first episode of the disease, concludes research published in this week's issue of THE LANCET. Patients with HIV-1 infection respond well to treatment for active tuberculosis, but whether such patients are at increased risk of disease recurrence after successful treatment is uncertain. As a result, most experts do not recommend more intensive tuberculosis therapy for HIV-1-infected individuals than for uninfected people, and do not recommend prophylaxis after curative treatment. Jean William Pape and colleagues from New York Hospital-Cornell Medical Centre, More Tuberculosis Treatment Current Events and Tuberculosis Treatment News Articles |
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