NIAID Collaboration with South Korea Seeks to Advance TB Care
In 2003, NIAID scientists and clinical researchers at South Korea’s Masan National Tuberculosis Hospital joined forces to develop potential new drug regimens for effective treatment of the disease. The Masan National Tuberculosis Hospital is the national referral center for tuberculosis (TB) treatment failures in South Korea and has one of the largest populations of in-patient multidrug-resistant (MDR) TB cases in the world.
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A researcher at the International Tuberculosis Research Center in Masan, South Korea, processes patient samples in a biological safety cabinet.
Credit: NIAID |
One of the first tasks of the NIAID-South Korean team was to have a new biosafety level 3 (BSL-3) facility constructed where research on MDR TB could be performed safely. The BSL-3 lab—opened at a newly founded institute called the International Tuberculosis Research Center adjacent to the hospital—supports clinical studies to test new drugs for both latent and MDR TB. All funding for the BSL-3 lab’s construction was provided by the South Korean Ministry of Health and Welfare.
The U.S. and South Korean researchers have conducted a variety of clinical research studies and currently have more than 600 patients participating in trials. For example, researchers are collecting information about rates and causes of MDR and extensively drug-resistant (XDR) TB in two groups of patients: those who are having an initial episode of active TB and those who have recurrent TB. Investigators are also studying bacterial and human genomes to further understand the relationship between expression of specific bacterial and human gene variants and acquisition and development of XDR TB infection.
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TB patients must adhere to a complex treatment regimen over a six- to nine-month period. The NIAID-South Korean collaboration aims to reduce the complexity and duration of TB therapy.
Credit: NIAID |
Another clinical trial at the hospital is evaluating the use of metronidazole, an agent that has activity against TB only under low-oxygen conditions, in patients with drug-resistant disease. Patients in this trial are followed both clinically and radiologically using high-resolution CT and PET imaging techniques, which produce three-dimensional images of functional processes in the body to help researchers monitor TB progression. In another trial, patients who have severe TB and who are scheduled to have a diseased portion of lung surgically removed are given a chemical that tags lung tissue so that the researchers can determine if TB bacteria persist in areas of the lung where oxygen levels are low. The ultimate goal of this research is to identify drugs that work well against slowly growing TB bacteria in low-oxygen environments, and thereby shorten the duration of TB therapy and develop treatments for latent disease.
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