Tuberculosis, Lung cancer & other lung ailments

[waltky]

Who knew that the answer to TB could be right under our feet?...


A Bacterium Found in Soil Could Fight Tuberculosis
March 06, 2017 - Scientists are developing an antibiotic from a microorganism found in soil to fight the tuberculosis bacterium. As TB becomes increasingly resistant to existing antibiotics, soil could hold the key to new drugs against this global killer.

Tuberculosis is treatable with antibiotics, but in thousands of cases, antibiotic misuse has caused the disease to become non-responsive to the drugs. According to the World Health Organization, there are 10.4 million new cases of tuberculosis every year, killing 1.8 million people. In 2015, it was estimated that 480,000 infections were not responsive to two major drugs commonly used to treat TB. A quarter-million patients died reportedly of drug-resistant infections. An international team of researchers has been hunting for new sources of antibiotics in nature to treat deadly illnesses like TB. Investigators have hit upon a species of bacteria in a large family called Streptomyces found in soil.


Making synthetic compounds


In the laboratory, they’ve extracted compounds from Streptomyces that target a specific enzyme called MraY in mycobacterium, the pathogen that causes TB. The compounds effectively kill mycobacterium. Using synthetic chemistry, the researchers were able to recreate these compounds, turning them into more potent versions of the originals. Structural biology professor David Roper of England's University of Warwick is part of the team that includes scientists in the United States and Australia sleuthing for novel agents to treat disease.

A doctor points to an X-ray showing a pair of lungs infected with tuberculosis on board a mobile X-ray unit screening for TB in London

In the case of the Streptomyces microorganism, Roper said researchers have extracted compounds that target how mycobacterium makes its cell walls. He likens them to bones in the human body. “If you knock out our skeletons, you’re not going to be a very competent human being, are you? And the same is true for the biosynthesis of the bacterial cell wall. It’s exactly the same principle that penicillin inhibits, although that’s a different enzyme and other antibiotics like vancomycin for example. So, the biosynthesis of the bacterial cell wall is a good target for antibiotics,” said Roper.


Finding the right tools


The work was published in the journal Nature Communications. In the soil, Roper said the bacteria use the compounds to kill other microorganisms near them, giving them a survival advantage. “One of the reasons for looking at natural product compounds in general is that these things have been derived from nature, therefore they’ve gone through many millennia years of evolution in the first place, and they’ve been retained by nature so they must have, as it were, long-standing efficacy.” The challenge has been growing soil bacteria like Streptomyces in the lab with available tools so they can be made into drugs. The team is looking for ways to do that and they are beginning to find the right tools.


There is no timetable for turning soil bacteria into drugs against diseases like TB, just that it will take time. As new drugs from soil bacteria become available, Roper doesn’t rule out the possibility that TB eventually may become resistant to them too. Researchers, however, have learned from experience with tuberculosis that antibiotics must be used with great care to preserve their effectiveness.


http://www.voanews.com/a/a-bacterium...b/3751855.html

[waltky]

Superbug TB threatening to derail decades of progress against the disease...


Rise of Superbug Tuberculosis Hampers Global Control Efforts
March 22, 2017 — Rising rates of superbug tuberculosis (TB) are threatening to derail decades of progress against the contagious disease, experts said Thursday, and new drugs powerful enough to treat them are few and far between.

TB kills more people each year than any other infectious disease, including HIV and AIDS. In 2015 alone, it is estimated to have killed 1.8 million people, according to the World Health Organization (WHO). While some new antibiotics with the potential to treat some drug-resistant strains are becoming available for the first time, experts who conducted a global study said that without accurate diagnostics, better case tracking and clear treatment guidelines, their effectiveness could rapidly be lost. "Resistance to anti-tuberculosis drugs is a global problem that threatens to derail efforts to eradicate the disease," said Keertan Dheda, a University of Cape Town professor who co-led research published in the Lancet Respiratory Medicine journal. "Cure rates for drug-resistant TB are poor and people can remain infectious."

A physician examines an X-ray picture of a tuberculosis patient.

TB is a bacterial infection normally treated with a combination of antibiotics. But extensive overuse of antibiotics worldwide has led to a rise in drug-resistant "superbug" strains. Bacteria can acquire many drug-resistance traits over time, making several types of antibiotics ineffective. Some 1 in 5 cases of TB are now resistant to at least one major anti-TB drug, the researchers found. Around 1 in 20 are classed as multidrug-resistant (MDR) — meaning they are resistant to two essential first-line TB drugs, isoniazid and rifampicin — or extensively drug-resistant — meaning they are also resistant to fluoroquinolones and second-line injectable drugs. Approximately half of global cases of MDR-TB are in India, China, and Russia, but migration and international travel have allowed these highly drug-resistant strains to emerge in almost every part of the world.


In a commentary on TB in the same journal, David W. Dowdy, a specialist at Johns Hopkins Bloomberg School of Public Health in the United States, warned that over the next decade, "it is quite possible that we will see a drug-resistant tuberculosis epidemic of unprecedented global scale." He added, however, that it might also be possible for the global health community to bring about "an unprecedented reversal" of the drug-resistant TB problem. "The difference between these two outcomes lies less with the pathogen and more with ... whether we have the political will to prioritize," he said. "Drug-resistant TB is not standing still; neither can we."


http://www.voanews.com/a/rise-superb...s/3778290.html

[waltky]

Doctors Warn Of New Drug-Resistant TB...


On World Tuberculosis Day, Doctors Warn Of New Drug-Resistant Bacteria
March 24, 2017 — Friday marks the United Nations’ World Tuberculosis Day, aimed at raising awareness of a disease that kills an estimated 1.8 million people every year. Six countries account for nearly two-thirds of the cases: India, Indonesia, China, Nigeria, Pakistan and South Africa.

The date commemorates the day in 1882 when German scientist Dr. Robert Koch announced that he had discovered the cause of the disease, the TB bacillus. It remains the most deadly infectious disease in the world. “Every single day 5,000 people lose their lives because of tuberculosis. TB hits particularly those vulnerable populations that include migrants, refugees, prisoners, people who are marginalized in their societies,” said Mario Raviglione, the World Health Organization’s Global Tuberculosis Program Director.


Drug-resistant strains


In recent years drug-resistant strains of TB have taken hold around the world, posing an increasingly urgent public health threat. These strains often go undetected and are spread across populations. “In South Africa, for example, TB is the commonest cause of death and the disease is out of control in Africa,” said Dr. Keertan Dheda, head of the Division of Pulmonology at the University of Cape Town.

A doctor examines a tuberculosis patient in a government TB hospital in Allahabad, India, March 24, 2014. An estimated 1.8 million people die every year of the disease.

But there is new hope as a small number of new drugs have become available. “For the first time after about four to five decades, we have two drugs. One is called bedaquiline,” Dheda said. “That has now been registered in South Africa and is available to treat many patients with drug-resistant TB. And there’s another new drug called delamanid, that’s not yet licensed in South Africa but is available in other countries.”


New drugs must be used carefully


In a report published in the Lancet medical journal, Dheda and his co-authors warn that the effectiveness of these new drugs could be rapidly lost if they aren’t used correctly. “There are several case reports globally of patients that have already become resistant to both delamanid and bedaquiline. We need to change our strategy,” Dheda said. “We need to go out into the community and find these cases. We have to address the major drivers of TB, which are poverty and overcrowding, nutritional deprivation, alcohol abuse, cigarette smoking and biomass fuel exposure,” Dheda added in a VOA interview Thursday. The report warns the new drugs must be prescribed as individually targeted treatments with clear dosing guidelines, to prevent further resistant TB strains from emerging.


http://www.voanews.com/a/world-tuber...a/3779980.html

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Protecting Rights of TB Patients Critical in Ending Global Epidemic
March 23, 2017 — In advance of World TB day (March 24), the World Health Organization is warning the battle to wipe out the global tuberculosis epidemic will not be won unless stigma, discrimination and marginalization of TB patients is brought to an end. VOA was in Geneva at the launch of new WHO ethics guidance for the treatment of people with tuberculosis.

Progress is being made toward achieving the U.N. Sustainable Development Goal of ending the global TB epidemic by 2030. The World Health Organization reports 49 million lives have been saved since 2000. But, much remains to be done. Data from 2015 show more than 10.4 million people fell ill and 1.8 million died of tuberculosis, with most cases and fatalities occurring in developing countries. The World Health Organization says stigma and discrimination against TB patients hamper efforts to wipe out this deadly disease.


WHO Global TB Program medical officer Ernesto Jaramillo says vulnerable people, such as migrants, prisoners, ethnic minorities, marginalized women and children are most likely to suffer abuse, neglect and rejection. He says this prevents them from seeking treatment for tuberculosis. “Having new tools for diagnosis, and treatment of TB is not sufficient if there are not clear standards to ensure that vulnerable people can have access in a matter of priority to these tools in a way that the end TB strategy can really serve the interest not only of individuals, but also the interests of public health in general ," said Jaramillo.


WHO Global TB program director Mario Raviglione tells VOA no country, rich or poor, is immune from getting tuberculosis. He warns marginalizing patients with TB is dangerous. “You cannot eliminate a disease like TB thinking that you build walls or you isolate your country," said Raviglione. "TB is an airborne disease. It travels by air. So, you have a Boeing 747 that leaves Malawi tonight and it comes to Switzerland tomorrow morning and there you go. So, it has to be faced from a global perspective.”


New WHO ethical guidance includes actions to overcome barriers of stigma, discrimination and marginalization of people with tuberculosis. The agency says protecting the human rights of all those affected will save many lives and will make it possible to end this global scourge.


http://www.voanews.com/a/protecting-...c/3778947.html

[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.

http://www.voanews.com/a/scientists-...n/3877684.html

[NapRover]

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.

Great news! American exceptionalism on display with another profound contribution to mankind!

[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.


https://www.voanews.com/a/vitamin-a-...s/3901971.html

[waltky]

possum thinks dat's a mean lookin' moo-cow...

WHO Urges Action to Stop Animal TB, Its Spread to Humans
October 12, 2017 — The World Health Organization (WHO) is urging action to stop the spread of tuberculosis from animals to humans. The health agency warns zoonotic TB, as it is called, infects about 150,000 people and kills more than 12,000 every year.

The WHO says TB in animals has been neglected for too long and it is time to put an end to that. So, for the first time, the organization is issuing a road map to combat animal tuberculosis and its transmission to humans. Anna Dean, technical officer for Zoonotic and Drug Resistant Tuberculosis at the WHO, told VOA zoonotic TB is a global problem, with the disease thriving mainly in Africa and to a lesser extent in the Asia region. “It is mainly transmitted to people through food; dairy products and milk that have not been heat-treated is the most common route. Less commonly, it can also be transmitted through the consumption of improperly prepared meat from diseased animals,” Dean said.

Cows graze in a field in Vlezenbeek near Brussels, Belgium, Aug. 7, 2015. Veterinary authorities in Western countries routinely cull cattle infected with bovine tuberculosis whereas similar protocols are less prevalent in developing countries.

Besides posing a major risk to food safety and human health, the WHO notes bovine TB threatens people’s livelihoods and results in major economic and trade barriers.


Dean said the best way to eliminate bovine TB is to slaughter diseased animals. She says that is generally not a hardship for wealthy countries such as the United States, where cattle herders tend to be compensated for their lost animals. Dean pointed out that in other parts of the world, doing so poses a challenge. “It is not the case obviously in African countries. To implement these animal health interventions requires a lot of economic - a lot of financial investment. So, I think to stop, to prevent TB in people, you need to first of all control the disease in animals,” she said. Dean added that improving food safety, which can be easily done, is also essential. For example, she says, boiling untreated milk is enough to kill TB and other important bacteria that can cause illness in people.


https://www.voanews.com/a/world-heal...s/4067411.html

[waltky]

Giant Rats Could Help Fight Tuberculosis in Major Cities...

Could Giant Rats Help Fight Tuberculosis in Major Cities?
November 15, 2017 — Giant rats are probably not the first thing that come to mind to tackle tuberculosis but scientists hope their sniffing skills will speed up efforts to detect the deadly disease in major cities across the world.

Tuberculosis, which is curable and preventable, is one of the world's deadliest infectious diseases, according to the World Health Organization (WHO), killing 1.7 million people in 2016 and infecting 10.4 million others. African Giant Pouched Rats, trained by Belgian charity APOPO, are known for sniffing out landmines in countries from Angola to Cambodia and for detecting TB cases in East Africa. Over the next few years, APOPO plans to fight tuberculosis at the source by launching TB-detection rat facilities in major cities of 30 high-risk countries including Vietnam, India and Nigeria. "One of the best ways to fight TB at source is in major cities that draw a lot of people from the rural areas," James Pursey, APOPO spokesman, told the Thomson Reuters Foundation. "It is a vicious circle. You can be reinfected. To fight TB, you have to hit it hard," he said by phone from Zimbabwe.

Dr. Simon Angelo (L) examines Iman Steven suffering from tuberculosis, held by her mother (R) at the hospital of Doctors Without Borders (MSF), June 15, 2016, at the Protection of Civilians (PoC) site in Malakal, South Sudan.

Many people get infected in big, densely populated cities and spread the disease to rural areas, according to Pursey. The rats learn to recognize the presence of TB in samples of mucus that is coughed up from the patient's lower airways. In Tanzania, people in communities where TB is most common, including in prisons, often fail to show up for screening because of a lack of money or awareness, placing a huge burden on health authorities, health experts said. "TB is a disease of poverty," said Pursey. "If nothing changes it can only get worse."

The APOPO has seen the TB detection rate increase by 40 percent in clinics it has worked with in Tanzania and Mozambique, according to Pursey, who said that using rats to screen did not negate the need for proper diagnostic testing. While a technician may take four days to detect a case of TB, a trained rat can screen 100 samples in 20 minutes, and a rat screening costs as little as 20 US cents, APOPO said.

https://www.voanews.com/a/could-gian...-/4117604.html

[waltky]

Adding Chemo to Cancer Immunotherapy...

Roche Win Boosts Case for Adding Chemo to Cancer Immunotherapy
November 20, 2017 — Cancer doctors struggling to work out the best way to use modern immunotherapy drugs now have further evidence of the benefits of adding them to chemotherapy, despite earlier skepticism.

News that Roche's immune system-boosting drug Tecentriq delayed lung cancer progression when given alongside chemo and its older drug Avastin validates the approach for the first time in a large Phase III clinical trial. It is a significant milestone for physicians, patients and investors, who are trying to assess the competitive landscape as drugmakers race to develop better ways to fight tumors in previously untreated lung cancer. Lung cancer is by far the biggest oncology market and first-line treatment provides access to the most patients, opening up potential annual sales forecast by some analysts at $20 billion. Roche and Merck & Co have led the way in pioneering so-called "chemo-combo" treatment, while AstraZeneca and Bristol-Myers are betting primarily on mixing two immunotherapies. AstraZeneca notably failed to show a similar
benefit in a high-profile clinical trial in July.

Stefan Zimmermann, an oncologist at Lausanne University Hospital in Switzerland, said the Roche data would help scotch concerns that chemo might hamper the new class of immuno-oncology medicines. "Many experts in the field will be relieved because there has been uncertainty ... I think this will really encourage many of us to use this combination upfront," he told Reuters. "For now, the only positive data that we have is for chemo combination." Merck, in fact, already has U.S. approval to add chemo to its immunotherapy drug Keytruda - but this was based on a small trial and the company withdrew a similar European application last month, knocking confidence in its strategy.

Swiss drugmaker Roche's logo is seen at their headquarters in Basel, Switzerland.

Since Keytruda, Bristol's Opdivo, Roche's Tecentriq and AstraZeneca's Imfinzi are all rival inhibitors of biological switches known as PD-1 or PD-L1, the market is "largely a zero-sum game," according to Bernstein analyst Tim Anderson. "Roche's good fortune means there is less to go around for other companies," he said. In the case of Merck, the U.S. drugmaker now faces a rival with a different and perhaps superior drug combination. Roche believes adding Avastin in addition to chemo can further help restore anti-cancer immunity. For AstraZeneca and Bristol, the bar has just been raised for two other key clinical trials sponsored by the drugmakers that are expected to report results in 2018.

Roche itself will present full results on the ability of its new combination to delay the worsening of lung cancer at a European Society for Medical Oncology meeting in Geneva on December 7. Data on whether it also helps patients live longer is expected in the first half of next year. Overall survival is the gold standard in cancer care but proving a treatment extends the time before disease progresses is an important marker on the way. "If there is positive progression-free survival then I think it is very, very likely this will also translate into an overall survival benefit over time," said Zimmermann.

https://www.voanews.com/a/roche-wins...y/4126543.html

[waltky]

A charity who trains giant rats to sniff out TB...

Giant Rats Expand Tuberculosis Fight in Tanzania
December 14, 2017 — The use of giant rats to sniff out the potentially deadly disease tuberculosis (TB) in Tanzania is set to nearly double by the end of the year thanks to successful detection rates, a charity who trains them said Thursday.

African giant pouched rats, which are taught to detect TB using their olfactory abilities, have been so successful at the task that they will now service nearly 60 clinics countrywide, up from 29. The rats, which can measure up to 3 feet (0.9 m) and can spot TB in samples of human mucus, were introduced in Tanzania in 2007 by Belgian charity APOPO as an alternative to more costly and slower traditional chemical testing. “APOPO is very encouraged about the support and trust in our diagnostic service,” Lena Fiebig, the nonprofit’s head of TB, said in a statement.

Tanzania a TB hotspot

Tuberculosis, which is curable and preventable, is one of the world’s deadliest infectious diseases, according to the World Health Organization (WHO), killing 1.7 million people in 2016. In Tanzania, some 287 in 100,000 people are thought to be TB-infected, putting the country among 30 nations that the WHO views as TB hotspots because of the disease’s high incidence. Yet, lack of money or awareness often means people in the east African nation fail to get screened.

Rats quick, accurate

Under the rat program’s growing footprint, mucus samples are dispatched by motorbike from across the country to laboratories, including one in the capital Dar es Salaam that employs 10 rats. Seventeen more clinics will be located in Dar es Salaam. APOPO said trained rats take 20 minutes to screen 100 samples, compared with four days for a lab technician, with almost 100 percent accuracy although the rodents cannot distinguish between normal and drug-resistant strains.

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The rats, nicknamed HeroRATs, undergo a training process that begins when they are 4 weeks old and involves receiving banana rewards for good behavior. APOPO’s rats are also at work fighting tuberculosis in Mozambique and Ethiopia with APOPO one of various organizations fighting to meeting the global plan to end TB by 2030. The rats are also deployed to detect explosives in minefields from Cambodia to Colombia.

https://www.voanews.com/a/giant-rats...a/4164908.html